Objective To explore the key active ingredients and action characteristics of Wenxing Jingjintong Gel Patch in the treatment of rheumatoid arthritis(RA)based on the systematic pharmacology and LC-MS/MS technology.Methods The information of active ingredient from Wenxing Jingjintong Gel Patch was established through LC-MS/MS analysis and literature retrieval.The targets of the active ingredients were predicted using Swiss Target Prediction platform and then mapped with the RA-related targets obtained from GeneCards,DrugBank,and OMIM databases to identify the intersecting targets.The"active ingredients-effective targets"network was constructed through the Cytoscape software.The shared targets were imported into STRING database to construct a protein-protein interaction network.GO function and KEGG pathway enrichment analysis were performed using the Metascape database.Molecular docking studies were conducted using AutoDock software to investigate the interactions between key ingredients and target proteins.Results A total of 142 active ingredients were identified in Wenxing Jingjintong Gel Patch by wsing LC-MS/MS,which were further supplemented to 174 through literature retrieval.There were 175 shared targets between the active ingredients and RA.It was anticipated that Wenxing Jingjintong Gel Patch exerted immune regulation and anti-inflammatory and analgesic effects through the interaction between key active ingredients such as berberine,neobavaisoflavone,and palmatine chloride with key targets,including TNF,IL6,and AKT1 to regulate PI3K/Akt1,JAK/STAT,and MAPK signaling pathways.In 1 152 molecular docking validation,94%of them had binding energies less than-5.0 kcal·mol-1,while 51%of them had binding energies less than-7.0 kcal·mol-1.It was indicated that there was a good binding affinity between the potential active ingredients and core targets.Conclusion This study predicted the active ingredients and action characteristics of Wenxing Jingjintong Gel Patch in the treatment of RA,which provided a theoretical basis for further clinical application and quality control.

ObjectiveTo understand the correlation between air quality and pollutants in three underground subway stations in Shanghai and their influencing factors， in order to provide a reference for improving the ambient air quality of rail transit and enhancing control measures. MethodsAir quality was monitored in summer， autumn， and winter of 2021 at the halls， platforms， carriages and fresh air wells of three underground stations of Shanghai metro line 9， with indicators including temperature， relative humidity， wind speed， CO₂， PM₁， PM_2.5， PM₁₀， total airborne bacteria， total airborne fungi， and passenger flow. Correlation analysis and multiple regression analysis were used to explore the association between pollutant indicators and environmental indicators. ResultsThe relative humidity of air at three stations did not meet the national health standards （GB 37488‒2019）， with an exceedance rate of 66.7%； the PM₁₀ detection index at individual stations in autumn and winter did not meet the national health standards （GB 37488‒2019）， with an exceedance rate of 20.6%， while the rest of the indexes basically met the requirements of the standards. Spatially， the CO₂ and wind speed in the carriage were higher than in other areas of the station； the concentration of particulate matter in the fresh air well and the total number of airborne fungi were higher than in other areas. Seasonally， the concentration of particulate matter was higher in winter than in summer and autumn， while the microbial indexes were higher in summer than in autumn and winter. The correlation and regression analysis showed that the passenger flow was significantly and positively correlated with the CO₂ concentration； the temperature and humidity were significantly and negatively correlated with the particulate matter concentration and positively correlated with the microbial index. The correlation and multiple regression analysis showed that the subway station health indicators were significantly affected by the ambient temperature， humidity， seasonal and monitoring regional factors， while the influence of sampling time had no significant effect on the differences in the health indicators. ConclusionThe air quality of the three stations in this survey generally meets the requirements of health standards. The changes of air pollutants in subway stations show obvious spatial and temporal characteristics. The passenger flow and temperature and humidity， as well as sample sites are important factors affecting the concentration of particulate matter and the level of air microorganisms， which need to be considered when formulating the corresponding protection strategies.

Background The use of heating and ventilation air conditioning (HVAC) in public places is conducive to improving indoor air quality and increasing the users comfort level. However, HVAC may also become potential carriers of indoor airborne microbial contamination. Objective To understand the characteristics of microbial pollution and distribution of related pathogenic microorganisms in HVAC of star-rated hotels, and to provide a basis for effective control of such pollution. Methods According to the requirements of the Hygienic specification of central air conditioning ventilation system in public buildings (WS 394-2012), two sets of HVAC in two star-rated hotels (A and B, inaugurated in 2002 and 1998, respectively) in the central area of Shanghai were randomly selected on September 9, 2020 for the hygienic evaluation of microorganisms in the air supply and respirable particulate matter (PM₁₀) in the air supply, dust accumulation and microorganisms on the inner surface of the ducts, as well as Legionella pneumophila in cooling water and condensate water. At the same time, 3 samples from the inner surface of ducts, 1 sample from the surface of the filter, 1 sample from the condensate, and 1 sample from the cooling water were collected from each set of HVAC, a total of 12 sample from 2 sets of HVAC, for Illumina HiSeq metagenomic sequencing，and the samples are divided into 3 groups according to their types: duct group, filter group, and water sample group. The α-diversity indices (Shannon index, Simpson index, Chao1 index, ACE index, and goods_coverage index) were calculated to reflect the microbial community composition; and the β-diversity of the three groups were studied by principal component analysis to determine the similarity of the microbial communities. Results The maximum total number of bacteria and fungi in the air supply of the HVAC were 1158 CFU·m⁻³ and 344 CFU·m⁻³ for Hotel A respectively; and 2000 CFU·m⁻³ and 532 CFU·m⁻³ for Botel B respectively. β-hemolytic streptococci were negative in all samples; the respirable particulate matter, microorganisms and dust accumulation on the inner surface of air ducts, Legionella pneumophila IN cooling water and condensate samples all met the standards. The results of Illumina HiSeq sequencing showed that a total of 17322 microorganisms were reported in the 12 samples, with bacterial microbiota accounting for 97.31% of the classified genes and the remaining 2.69% were from fungi, viruses, and parasites. At the species level, Staphylococcus epidermidis, Pseudomonas, Alternaria, and Malassezia were the dominant microbial taxa measured in this survey. The results of α-diversity analysis showed that the values of Shannon index, Simpson index, and Chao1 index for the three groups of samples were duct > filter > water sample. The goods coverage indices of all sample groups s were close to 1. The principal component analysis showed that the contributions of two principal components were 19.27% and 14.25%, respectively, in which the samples of the filter and duct groups were better clustered into one category. Conclusion The overall hygiene conditions of the two hotels are good, except for the serious microbial contamination in the air supply of HVAC. Metagenomic sequencing reveals complex microbial communities of HVAC, including bacteria, fungi, viruses, and parasites. The species composition vary by sample groups, particularly the species compositions of the samples from filters and ducts are close and dominated by pathogenic microorganisms of human origin, suggesting that the potential biosafety hazards of HVAC should not be ignored.

Objective:Comparison of conventional chemotherapy and immunotargeted therapy efficacy in patients with relapsed/refractory (R/R) acute B cell leukemia (B-ALL) .Methods:The clinical data of 212 patients with R/R B-ALL in the Affiliaed Cancer Hospital of Zhengzhou University from January 2008 to July 2020 were analyzed retrospectively to compare the response rate and survival time difference between conventional chemotherapy and immunotargeted therapies (antiCD19 CAR-T and CD3CD19 bi-specific antibody blinatumomab) , and to explore the related factors affecting prognosis.Results:The CR rate of patients with R/R B-ALL treated with anti-CD19 CAR-T cells was 80.4% , patients treated with blinatumomab was 62.5% , and patients treated with chemotherapy was 38.6% . There was significant difference in the CR rate among the three therapies ( P<0.001) . CAR-T cells 1-year OS rate was 41.5% , which was significantly higher than that of the chemotherapy group (10.3% ) ( P<0.001) . The 1-year PFS rate of CAR-T cells (30.1% ) was also significantly higher than that of the chemotherapy group (9.7% ) ( P<0.001) . The median OS of patients with bridging allo-HSCT after CR treatment by CAR-T cells was 18.5 months, which was higher than that of patients without allo-HSCT (8 months) ( P=0.027) . The median PFS of patients with allo-HSCT was 17 months, which was higher than that of patients without allo-HSCT (4 months) ( P=0.001) . The 1-year OS rate of patients treated with blinatumomab was 14.3% , which was higher than that of the chemotherapy group (10.3% ) ( P=0.018) . The 1-year PFS rate (14.6% ) was also higher than that of the chemotherapy group (9.7% ) ( P=0.046) . The median OS and median PFS of patients with bridging allo-HSCT were 13 and 11 months, respectively, which was higher than that of patients without allo-HSCT (9.5 and 6 months) . The cytokine release syndrome (CRS) incidence in patients with R/R B-ALL treated with anti-CAR-T cells was 89.8% . Grades 3-4, grade 2, and grade 1 CRS were experienced by 30.2% , 11.3% and 58.5% patients, respectively. Only three patients (37.5% ) with blinatumomab developed CRS, all of which were grade 1. Conclusion:The response rate and survival rate of patients with R/R B-ALL treated with CD19 CAR-T cells and blinatumomab were significantly better than those treated with conventional chemotherapy.

Objective:To study the real-world outcome of China FDA-approved Sofosbuvir (SOF)/Velpatasvir (VEL) in Northwest China.Methods:In this multicenter, prospective, real-world cohort study, we recruited patients from 10 sites from Northwest China, who were chronically infected with HCV GTs 1-6 from 06/2018 to 09/2019. Patients received SOF (400mg)/VEL (100mg) for 12 weeks, and with ribavirin 900-1200 mg for GT3 cirrhosis and for any genotype decompensated cirrhosis. The primary endpoint was sustained virological response at 12-weeks post-treatment (SVR12) and safety. The secondary endpoint was the change of liver function after the achievement of SVR12.Results:Totally, 143 patients were enrolled in the study, four patients were lost to follow-up and one died during the follow-up, 138 patients were included in per-protocol analysis. Of the 138 patients, the mean age 53 years, 53.6% male, 94.2% Han nationality, 53.6% liver cirrhosis, 10.1% HBsAg +, 6.5% renal dysfunction, 5.1% treatment-experienced, and 16.7% patients received ribavirin treatment. The genotype distribution was as follows: 35.5% GT1, 42.8% GT2, 15.9% GT3, and 5.8% un-typed. The SVR12 rate was 96.5% (138/143, 95% CI: 93.5%-99.6%) for intention-to-treat analysis, and in per-protocol analysis, all 138 patients obtained SVR12 (100%). Compared with baseline, the serum total bilirubin, ALT and AFP levels decreased (all P < 0.05), as well as increased ALB and platelet count (all P < 0.001) at post-treatment 12-weeks. Overall adverse events (AEs) rate is 29.0%, and the most common AEs were anemia (14.5%) and fatigue (8.0%). Severe side effects (edema and fatigue) occurred in 2 patients, one of whom needed a short-term interruption of treatment due to fatigue. Conclusion:In this real-world cohort study, 12-week SOF/VEL regimen with or without ribavirin achieved high SVR12 rates (96.5%-100% overall) with excellent safety profile among patients with HCV GT1/2/3 infection including patients with GT3 and cirrhosis, and led to improvement of liver function.

Objective To investigate the effects of G-CSF-mobilized autologous stem cells in the prevention of radiation pulmonary injury.Methods Mice were divided into control group,irradiation group and treatment group.Mouse model of pulmonary fibrosis was established by exposing chest to a single dose of 14 Gy.Animals in the treatment group received recombinant human G-CSF (250 μg/kg daily for 5 d) before the irradiation in order to mobilize autologous stem cells in vivo.The general condition and mortality were documented after radiation injury.The pathological study with histological scoring,Masson staining and Sirius red staining with polarized light analysis were used to identify lung injury and the potential benefit of stem cell mobilization.Results Local chest irradiation of a single dose of 14 Gy was a suitable dose to create radiation-induced pulmonary fibrosis in mice.The death rate was 37.5％,which mainly happened around 11 weeks after injury.In contrast,all of the animals in G-CSF treated group survived.The ratio of lung to body mass was significantly increased in both irradiation group and treatment group (F =23.20,P＜0.05) around 3 months after the injury,with a higher ratio in irradiation group than that in treatment group (P＜0.05).Histological scoring for alveolar inflammation at 3 months after injury revealed statistically significant difference in irradiation group and treatment group compared with control group (F=11.93,P＜ 0.05).At this time point,the pathological observation showed lung tissue degeneration and necrosis with alveolitis and interstitial inflammation,as well as fibroblasts proliferation and focal collagen deposition in alveolar septa.At 4 month after the injury,the inflammation ininterstitial tissue was receded,but fibrosis and collagen deposition were significantly increased.In addition,at 3 and 4 months afterinjury,the pulmonary fibrosis was aggravated in irradiation group (F=28.73,16.85,P＜0.05),and significantly alleviated in the treatment group (P＜0.05).The similar results were confirmed in collagen content analysis (IOD) by Sirius red staining and image analysis (F =17.70,17.79,P＜ 0.05).Conclusions Autologous mobilization of stem cells could prevent the death of radiation-injured animals possibly by alleviating early lung injury and interstitial inflammation as well as the late pulmonary fibrosis,suggesting a therapeutic potential of autologous stem cell mobilization in radiation pulmonary fibrosis.

Objective: To describe the MICM (morphology, immunology, cytogenetics and molecular biology) characteristics of a case of acute myelomonocytic leukemia M 4C . Methods: The medical history data of the case of M 4C admitted to our hospital was reviewed. The results of bone marrow cell morphology, cytochemical stains, bone marrow biopsy, immunophenotype, cytogenetics, molecular test and NGS (next-generation sequencing) of the case were analyzed. Results: The bone marrow smear showed markedly active proliferation of bone marrow cells in which the myelomonocytic cells accounted for 85.6%. Cytochemical stains showed peroxidase (POX) stain partially and weakly positive; specific esterase AS-DCE partially positive; non-specific esterase α-NBE partially positive and smothered by sodium fluoride; non-specific esterase AS-DAE partially positive and smothered by sodium fluoride. Bone marrow biopsy showed hyperproliferative cells and diffused hyperplasia of blasts. Immunophenotype analysis showed that the abnormal cell population was positive for CD11B, CD64, CD56, cMPO, CD33, CD41, CD61, CD38 and CD58, but negative for CD13, CD34, CD117, CD7, CD123, HLA-DR, CD10, CD19, CD20, CD2, CD14, CD235, CD15, CD303, CD304, CD25, cCD79a, cCD3, cCD22, CD1a and TDT. Cytogenetic analysis showed 47, XY, t(9;11) (p22;q23),+mar. The molecular test for leukemia showed MLLT3/KMT2A gene rearrangement. NGS showed NRAS and TET2 mutation. The case was finally diagnosed as AML (acute myelomonocytic leukemia) M 4C with t(9;11)(p22;q23), MLLT3-KMT2A. Conclusion Leukemia M 4C may show the characteristics of both granulocytes and monocytes with complex morphological features. The combined examination of MICM should be necessary for the diagnosis of M 4C with great significance.

Combined radiation-trauma injury is mainly observed in radiation treatment of cancer and radiation injury with traumatic patients. The prominent problem of combined radiation-trauma injury is delayed or prolonged wound healing. The mechanism of the impaired wound healing is complicated, and the current effective treatment method are limited. This paper reviews the mechanism and treatment of this impaired wound healing, including the cellular depletion, stromal cell dysfunction, aberrant collagen deposition, microvascular damage, as well as the targeted therapies for the impaired wound healing such as stem cell repletion, antioxidant therapy, transforming growth factor beta-1 ( TGF-β1 ) modulation, and implantable biomaterials. This paper is designed to provide a reference for further deep research on the mechanism and treatment of radiation-trauma injury.

Objective To test the value of miRNA-30c(miR-30c)in early diagnosis of gastric cancer. Methods Serum miR-30c expression levels were detected by using quantitative real-time polymerase chain reaction in 80 patients with advanced gastric cancer, 35 patients with early stage gastric cancer and 35 healthy controls in the Affiliated People's Hospital of Inner Mongolia Medical University from August 2014 to August 2017. The receiver operating characteristic (ROC) curves and the area under the curve (AUC) were analyzed to test the efficacy of the miR-30c in distinguishing advanced gastric cancer, early stage gastric cancer and healthy controls. Results The expression level of serum miR-30c in advanced gastric cancer (0.45±0.11) was lower than that in early stage gastric cancer (0.54±0.15) (t = 5.2, P < 0.05). Compared with the healthy controls (0.61±0.12), miR-30c was down-expressed in the serum of early stage gastric cancer patients(t=6.7,P<0.05).Compared with the traditional tumor markers,the AUC of miR-30c was the biggest (0.92±0.03) in early stage and advanced gastric cancer groups, and the sensitivity and specificity in the diagnosis of gastric cancer were 90 % and 84 %, respectively. The AUC of miR-30c was 0.87±0.04 in early stage gastric cancer and healthy controls, and the sensitivity and specificity in the diagnosis of gastric cancer were 70 % and 86 %, respectively. Conclusion miR-30c might be used as a potential serum biomarker for the early diagnosis of gastric cancer.

Objective To perform a Meta-analysis on hepatitis B surface antigen (HBsAg)-positive rates among general Chinese population aged 1-59 years.Methods We systemically reviewed the related data (January 2007 to August 2016) published from Chinese National Knowledge Infrastructure (CNKI),VIP,and PubMed.We also assessed the HBsAg-positive rates among general Chinese populations aged 1-59 years,using a random effects regression model with the comprehensive Meta-analysis software 2.2.Results A total of 46 papers were finally included,with a total sample size of 625 053 individuals.Results from the Meta-analysis showed that the overall combined HBsAg-positive rate was 5.7％ (95％CI:4.8％-6.6％) among general Chinese populations aged 1-59 years.When comparing the HBsAg-positive rates in different regions,data showed that the HBsAg-positive rate of was higher in the mid-western areas (6.3％,95％CI:4.9％-8.0％)than in the eastern areas (5.5％,95％CI:4.4％-6.8％).Results showed that HBsAg-positive rates was higher in males (6.1％,95％CI:5.3％-7.0％) than in females (4.8％,95％CI:4.2％-5.5％).As for the HBsAg-positive rates in different time periods,data showed positive rate of 6.3％ (95％CI:5.5％-7.2％)in 2007-2009,5.9％ (95％CI:4.4％-8.0％) in 2010-2012 and 3.5％ (95％CI:2.0％-6.1％) in 2013-2016,respectively.Conclusion The prevalence of hepatitis B virus infection was decreasing between 2007 and 2016 in China,making the country an intermediate endemic area on HBV.