The fundamental pathogenic mechanisms of inflammatory bowel disease(IBD),a chronic inflammatory illness affecting the gastrointestinal tract,are still not fully understood.Dipeptidyl peptidase Ⅳ(DPP-4)is a glycoprotein found on the cell surface that has signaling and enzymatic properties.In addition,there is growing evidence from animal models and clinical trials that DPP-4 inhibitors have potential impacts beyond only lowering blood sugar levels,such as immunomodulatory and anti-inflammatory capabilities.This article reviews the biological properties of DPP-4 and its research progress in the diagnosis and treatment of IBD.It also discusses the mechanism of DPP-4 in IBD,aiming to provide a more in-depth understanding of the role of DPP-4 in IBD.

Body is equipped with organic cation transporters (OCTs). These OCTs mediate drug transport and are also involved in some disease process. We aimed to investigate whether liver failure alters intestinal, hepatic and renal Oct expressions using bile duct ligation (BDL) rats. Pharmacokinetic analysis demonstrates that BDL decreases plasma metformin exposure, associated with decreased intestinal absorption and increased urinary excretion. Western blot shows that BDL significantly downregulates intestinal Oct2 and hepatic Oct1 but upregulates renal and hepatic Oct2. In vitro cell experiments show that chenodeoxycholic acid (CDCA), bilirubin and farnesoid X receptor (FXR) agonist GW4064 increase OCT2/Oct2 but decrease OCT1/Oct1, which are remarkably attenuated by glycine-β-muricholic acid and silencing FXR. Significantly lowered intestinal CDCA and increased plasma bilirubin levels contribute to different Octs regulation by BDL, which are confirmed using CDCA-treated and bilirubin-treated rats. A disease-based physiologically based pharmacokinetic model characterizing intestinal, hepatic and renal Octs was successfully developed to predict metformin pharmacokinetics in rats. In conclusion, BDL remarkably downregulates expressions of intestinal Oct2 and hepatic Oct1 protein while upregulates expressions of renal and hepatic Oct2 protein in rats, finally, decreasing plasma exposure and impairing hypoglycemic effects of metformin. BDL differently regulates Oct expressions via Fxr activation by CDCA and bilirubin.

Objective:To explore the effect of the treatment of tendinous mallet finger deformity by the minimally invasive percutaneous quantitative suture technique eight times.Methods:A retrospective analysis was performed on patients with fresh tendinous mallet fingers who underwent surgery in the Department of Hand and Foot Microsurgery of Nanjing Jiangbei Hospital from April 2021 to April 2022. During the procedure, the extensor digitalis tendon in the zone Ⅰ was sutured percutaneous with 3-0 thread monofilament sutures in the "quantitative 8-stitch method" according to the pre-marked number sequence of 1 to 8, and fixed at the base of the distal phalanx via a constructed bone tunnel. Removal of the Kirschner wire 8 weeks, the brace was used to fix the affected finger in the dorsal extension. The flexion and extension of the affected finger were gradually strengthened. The function of the affected finger was evaluated according to the Crawford standard after operation and follow-up: the active flexion and extension range of motion of each joint of the affected finger and the contralateral healthy finger was measured, and the total active ranges of motion of the finger were recorded. Finger function was evaluated according to the total active range of motion (TAM) system of the American Association of Hand Surgeons.Results:A total of 10 patients (10 digits) were enrolled, including 7 males and 3 females, and the age ranged from 20 to 52 years old, with an average age of 36.5 years old. The distance of tendon break was ≤10 mm. The operation time of the patients was 20-30 min, with an average of 24.5 min. The intraoperative blood loss was minimal. All 10 cases were followed up and the follow-up period was 6 to 12 months, with an average of 7 months. Mallet finger deformities were all corrected postoperatively, dorsal skin of fingers without a scar, there were no knot exposure, skin necrosis and other complications. At the last follow-up, the mean active range of motion of the distal interphalangeal joint was 84.4° and the mean TAM of the injured finger was 265.6°. According to TAM system assessment criteria: 8 cases were excellent, and 2 cases were good.Conclusions:Satisfactory therapeutic outcome for the treatment of tendinous mallet finger deformity can be achieved by the minimally invasive percutaneous quantitative suture technique eight times. It is a simple, safe, and effective method with minimal invasion.

Objective:To explore the effect of the treatment of tendinous mallet finger deformity by the minimally invasive percutaneous quantitative suture technique eight times.Methods:A retrospective analysis was performed on patients with fresh tendinous mallet fingers who underwent surgery in the Department of Hand and Foot Microsurgery of Nanjing Jiangbei Hospital from April 2021 to April 2022. During the procedure, the extensor digitalis tendon in the zone Ⅰ was sutured percutaneous with 3-0 thread monofilament sutures in the "quantitative 8-stitch method" according to the pre-marked number sequence of 1 to 8, and fixed at the base of the distal phalanx via a constructed bone tunnel. Removal of the Kirschner wire 8 weeks, the brace was used to fix the affected finger in the dorsal extension. The flexion and extension of the affected finger were gradually strengthened. The function of the affected finger was evaluated according to the Crawford standard after operation and follow-up: the active flexion and extension range of motion of each joint of the affected finger and the contralateral healthy finger was measured, and the total active ranges of motion of the finger were recorded. Finger function was evaluated according to the total active range of motion (TAM) system of the American Association of Hand Surgeons.Results:A total of 10 patients (10 digits) were enrolled, including 7 males and 3 females, and the age ranged from 20 to 52 years old, with an average age of 36.5 years old. The distance of tendon break was ≤10 mm. The operation time of the patients was 20-30 min, with an average of 24.5 min. The intraoperative blood loss was minimal. All 10 cases were followed up and the follow-up period was 6 to 12 months, with an average of 7 months. Mallet finger deformities were all corrected postoperatively, dorsal skin of fingers without a scar, there were no knot exposure, skin necrosis and other complications. At the last follow-up, the mean active range of motion of the distal interphalangeal joint was 84.4° and the mean TAM of the injured finger was 265.6°. According to TAM system assessment criteria: 8 cases were excellent, and 2 cases were good.Conclusions:Satisfactory therapeutic outcome for the treatment of tendinous mallet finger deformity can be achieved by the minimally invasive percutaneous quantitative suture technique eight times. It is a simple, safe, and effective method with minimal invasion.

OBJECTIVE: To investigate the association of fetal cardiac structural abnormalities with chromosomal aneuploidies and copy number variations (CNVs) in amniocytes. METHODS: 328 pregnant women were subjected to fetal ultrasonography and chromosomal microarray analysis (CMA). Based on the fetal heart structure, the subjects were divided into normal (n=273) and abnormal groups (n=55). The detection rates of chromosomal aneuploidies and CNVs were compared between the two groups. Spearman method was used to assess the association between the results and fetal cardiac structural abnormalities. RESULTS: The detection rates for chromosomal aneuploidies and CNVs in the abnormal group were significantly higher than that in the normal group (P< 0.05), and the incidence of fetal cardiac structural abnormalities was strongly associated with chromosomal aneuploidies and CNVs (P< 0.05). CONCLUSION Fetal chromosomal aneuploidies and CNVs are strongly associated with cardiac structural abnormalities.
Aneuploidy ; Chromosome Aberrations ; DNA Copy Number Variations ; Female ; Fetus ; Humans ; Microarray Analysis ; Pregnancy ; Prenatal Diagnosis ; Ultrasonography, Prenatal

Objective:To investigate the efficacy and safety of different dosage regimens of levosimendan in elderly patients with severe heart failure.Methods:Thirty-two patients 75 years or older were randomly divided into a loading dose group (16 cases) in which levosimendan was maintained at 0.1 μg·kg -1·min -1 for 24 h after loaded with 6 μg/kg, and a maintenance dose group (16 cases) with same schedule without loading dose. The amino-terminal brain natriuretic peptide (NT-proBNP) before and after treatment was detected. Left ventricular ejection fraction (LVEF), stroke volume (SV), stroke volume index (SVI) by echocardiograph were monitored. Adverse events, the length of stay in ICU and 28-day mortality were recorded. Results:The NT-proBNP level in loading group after treatment was 1 950 (922,6 481)ng/L, which was improved than that before treatment [4 018(2 716,9 637)ng/L, P<0.05]. The result was similar in maintenance group [1 390 (599,3 297)ng/L vs. 4 576 (2 681,10 682)ng/L, P<0.05]. LVEF in loading group before and after treatment was (39.4±8.8) % vs. (48.9±9.2) % respectively, while in maintenance group it was (40.4±8.8) % vs. (48.7±12.0) % (both P<0.05). SV were also improved after treatment in both groups compared with baseline levels ( P<0.05). NT-proBNP started to decline on day 3 in the loading group, while on day 7 in the maintenance group. SVI recovered on day 14 in the loading group [ (29.4±6.5) ml/m 2 vs. (27.3±6.7) ml/m 2, P<0.05], while it did not change much in the maintenance group. There was no significant differences as to the length of stay in ICU [ (11.1±4.4) d in loading group vs. (9.6±3.5) d in maintenance group] and 28-day mortality rates were comparable (2/16 in loading group vs. 1/16 in maintenance group) . The adverse events were 7 vs. 2 cases in loading group and maintenance group respectively, which were mild and all alleviated. Conclusion:The application of levosimendan only with maintenance dose improves cardiac function in very elderly patients with severe heart failure. Adverse events are mild and manageable.

To analyze the correlation between transcutaneous oxygen pressure (PtcO2) and blood lactate in patients with septic shock. Fifty-sixpatients with septic shock were prospectively investigated. PtcO2 was monitored continuously for 6 hours, and arterial blood gas was measured at baseline (T0) and 6 hours (T6). Records of PtcO2, were analyzed for the correlation with lactate level and lactate clearance rate. PtcO2 valuesin the high lactate clearance group and the low one were compared.The lowest value of PtcO2 at T6 and duration of PtcO2<40 mmHg (1 mmHg=0.133 kPa) were both correlated with lactate level and lactate clearance rateat T6. The low predictive value of PtcO2 was 29 mmHg of lactate clearance under 20％with a sensitivity 85.2％and a specificity 65.5％. The low predictive value of PtcO2 in high lactate clearance group was significantly higher than that in low lactate clearance group, while the duration of PtcO2<40 mmHg was shorter than the latter. During 6 h continuous monitoring, patients with a significant low PtcO2 or prolonged duration of low PtcO2 have relatively high lactate or low lactate clearance after resuscitation.

The aim of this study is to establish a multiplex polymerase chain raction (PCR) to identify of four kinds of laboratory animal pathogens: Pasteurella multocida, Bordetella bronchiseptica, Mycoplasma pneumoniae and Klebsiella pneumoniae.Methods Specific primers were designed based on GenBank data.The multiplex PCR system was established through optimization of multiple PCR and detection of its specificity and sensitivity.This technique was used to test artificially infected samples and tracheal secretions of experimental animals (rat, mouse, guinea pig, rabbit, hamster), and comparing the detection results by this method and traditional detection test.Results Target bands of Pasteurella multocida (356 bp), Bordetella bronchiseptica (237 bp), Mycoplasma pneumoniae (266 bp), and Klebsiella pneumoniae (142 bp) were obtained, with a detection sensitivity of Klebsiella pneumoniae of 10 pg, and that of Pasteurella multocida, Bordetella bronchiseptica and Mycoplasma pneumoniae of 1 pg by this newly developed multiplex PCR assay.No target bands were observed from the non-specific pathogens of artificially infected samples.The tracheal secretions taken from 45 experimental animals (mice and rabbits) were tested with this new PCR assay, among which 15 cases of Klebsiella pneumonia and 9 cases of Pasteurella multocida were detected as positive, while all the results of traditional method and serological test were negative.Conclusions A simple, rapid, specific and highly sensitive multiplex PCR system has been successfully established.It is valuable for detection of Pasteurella multocida, Bordetella bronchiseptica, Mycoplasma pneumoniae, and Klebsiella pneumoniae in laboratory animals.

Background:Acute-on-chronic liver failure( ACLF)is a commonly seen liver failure in China,and lacking an animal model that can effectively simulate the dynamic change of immune status of ACLF. Aims:To establish an animal model that can simulate dynamic change of immune status of ACLF by repeated administration of concanavalin A(ConA). Methods:Mice were randomly divided into normal control group and ConA repeated administration group. Mice in ConA repeated administration group were injected with ConA 15 mg/ kg through retrobulbar angular vein every 48 hours for 5 times,and mice in control group were injected with same volume of 0. 9% NaCl solution. Serum levels of IL-6,IL-10,IL- 12,TNF-α,IFN-γ,MCP-1 in peripheral blood were assessed by CBA assay,and the ratio of IL-10/ TNF-α was calculated. The expression of HLA-DR,number and proportion of CD4+ T cells and the expression of PD-1 of monocytes in peripheral blood were detected by flow cytometry. Results:Peripheral blood cytokines changed from predominated proinflammatory cytokines into predominated anti-inflammatory cytokines with the increasing in time of administration in ConA repeated administration group. Compared with control group,HLA-DR expression of monocytes in peripheral blood was significantly decreased(P <0. 05),number and proportion of CD4+ T cells were significantly decreased(P <0. 05), and PD-1 expression was significantly increased( P < 0. 05)in ConA repeated administration group. Conclusions:An animal model of ACLF immune status from systemic inflammatory response syndrome( SIRS) to compensatory antiinflammatory response syndrome(CARS)induced by repeated ConA stimulation is successfully established.

Background:For patients with liver cirrhosis and acute decompensation(AD),it is of great clinical importance to predict short-term mortality at admission. It has been reported that CLIF-C OF,MELD and MELD-Na score can accurately predict the short-term mortality,but all these scoring systems are complicated and have limits in their application. Aims:To define a simple and objective scoring system -- simplified MELD score for short-term mortality prediction in HBV-related cirrhotic patients with AD. Methods:A total of 890 consecutive HBV-related cirrhotic patients with AD hospitalized during Jan. 2005 to Dec. 2010 at Shanghai Ren Ji Hospital were enrolled retrospectively. Clinical data and patients’outcome were collected,and simplified MELD score was calculated by using total bilirubin,international normalized ratio and creatinine values at admission. Patients were classified into different prognostic groups according to their 28-day mortalities and simplified MELD score. Kaplan-Meier survival curve was used to analyze the 1-year accumulate survival rate,and ROC curve was used to evaluate the performance of different scoring systems in predicting 28-day mortality. Results:Simplified MELD score at admission could classify HBV-related cirrhotic patients with AD into low,moderate and high 28-day mortality groups and different long-term prognostic groups;the score of low,moderate and high 28-day mortality group was 0-2,3 and 4-6,respectively,and the corresponding mortality was 5. 5% ,19. 8% and 48. 6% ,respectively. Simplified MELD score had the same good performance as compared with the CLIF-C OF,MELD and MELD-Na scores in predicting 28-day mortality,the area under ROC curve was 0. 828,0. 831,0. 828 and 0. 830,respectively. Conclusions:Simplified MELD score can accurately classify HBV-related cirrhotic patients with AD into low,moderate and high 28-day mortality groups at admission. It is convenient for using in clinical practice.