Objective To construct a predictive model for the survival of transplant kidneys after kidney transplantation. Methods The clinical data of 366 kidney transplant recipients and donors were retrospectively analyzed, and the recipients were divided into low-risk group (n=101), medium-risk group (n=189), and high-risk group (n=76) based on the kidney donor profile index (KDPI). Each group was further divided into Remuzzi score ≤3 group and Remuzzi score >3 group based on time-zero biopsy Remuzzi scores. Kaplan-Meier method was used to analyze the survival of transplant kidneys. Univariate and multivariate Cox regression analyses were performed to identify risk factors affecting long-term survival after kidney transplantation. A predictive model for transplant kidney survival was established and a nomogram was drawn. The predictive performance of the model was evaluated using the receiver operating characteristic (ROC) curve and the area under the curve (AUC). Results The median KDPI was 65%, and the median Remuzzi score was 3. The 5-year survival rate of transplant kidneys was 83.5%. Kaplan-Meier survival curves showed that in the KDPI medium-risk and KDPI high-risk groups, the subgroup with lower Remuzzi score had a higher survival rates of transplant kidneys than the subgroup with higher Remuzzi score. Univariate and multivariate Cox regression analyses showed that KDPI, Remuzzi score, and donor’s age were independent risk factors for transplant kidney loss (all P<0.05). The ROC curve showed that the AUC of the nomogram prediction model established based on independent risk factors for the 1, 3 and 5-year survival rates of transplant kidneys were 0.91, 0.93 and 0.94 for the training set, and 0.89, 0.85 and 0.88 for the validation set. Calibration curves shows good consistency between the training and validation sets of the model. Conclusions The nomogram predictive model based on KDPI, time-zero biopsy Remuzzi score and donor’s age has good predictive value for transplant kidney survival.

Objective To analyze the influencing factors of hepatic encephalopathy(HE)after transjugular intrahepatic portosystemic shunt(TIPS)and construct a nomogram prediction model based on these factors.Methods A total of 290 patients with cirrhotic portal hypertensive variceal gastrointestinal bleeding in the Yuncheng Central Hospital Affiliated to Shanxi Medical University from January 2019 to December 2023 were selected and randomly divided into training set of 145 cases and validation set of 145 cases.All patients underwent TIPS treatment,and the incidence of HE within 3 months after TIPS was recorded.In the training set,patients were divided into HE group(n=42)and non-HE group(n=103)based on the occurrence of HE.Clinical materials were compared between the two groups,and Lasso-Logistic regression analysis was applied to explore the influencing factors of HE after TIPS.A nomogram prediction model was constructed based on the influencing factors and validated in both the training set and the validation set for its clinical value in predicting HE after TIPS.Results The overall incidence of HE was 29.31％,with incidence rates of 28.97％and 29.66％respectively in the training set and the validation set.In the training set,the HE group had significantly higher age,C grading of preoperative Child-Pugh ratio,diabetes mellitus ratio,total bilirubin(TBIL),prothrombin time(PT),serum sodium,serum creatinine,interleukin-6(IL-6),interleukin-18(IL-18),blood ammonia,monocyte chemotactic protein-1(MCP-1),postoperative portal venous pressure,and intestinal flora disturbance ratio when compared to the non-HE group,while the preoperative glial fibrillary acidic protein(GFAP)level was significantly lower in the HE group(P＜0.05).Lasso-Logistic regression analysis showed that preoperative C grading of Child-Pugh grading,diabetes mellitus,TBIL,PT,IL-6,IL-18,blood ammonia,GFAP,MCP-1 level,and postoperative intestinal flora disturbance were influencing factors for HE after TIPS(P＜0.05).A nomogram prediction model was constructed based on ten influencing factors selected by Lasso-Logistic regression analysis.The area under the curve(AUC)of this model for predicting HE after TIPS was 0.933(95％CI,0.889 to 0.976)in the training set and 0.944(95％CI,0.893 to 0.995)in the valida-tion set,with good consistency between the model's prediction and actual observation.Conclusion The nomogram prediction model for HE after TIPS,constructed based on the influencing factors selected by Lasso-Logistic regression analysis,has high predictive efficacy and accuracy.

Recent advances in vital pulp therapy(VPT)research,coupled with the widespread use of biomaterials,have led to an in-crease in the application of VPT.The indications for VPT are continually expanding,particularly for fully developed permanent teeth.Currently,one-way membrane decompression is being investigated as a possible treatment to preserve vital pulp in cases of irreversible pulpitis.This technology involves creating an access point in the pulp cavity and using the one-way membrane to prevent microorganisms from invading the pulp tissue.Additionally,it helps alleviate the high pressure in the pulp cavity caused by inflammation,thereby en-hancing blood circulation within the pulp.This improvement is crucial for establishing a foundation for future vital pulp preservation treatments.A case of irreversible pulpitis caused by caries was reported,in which the dental pulp was preserved using the one-way membrane decompression.The results of a ten-month clinical follow-up indicate a positive outcome.

Recent advances in vital pulp therapy(VPT)research,coupled with the widespread use of biomaterials,have led to an in-crease in the application of VPT.The indications for VPT are continually expanding,particularly for fully developed permanent teeth.Currently,one-way membrane decompression is being investigated as a possible treatment to preserve vital pulp in cases of irreversible pulpitis.This technology involves creating an access point in the pulp cavity and using the one-way membrane to prevent microorganisms from invading the pulp tissue.Additionally,it helps alleviate the high pressure in the pulp cavity caused by inflammation,thereby en-hancing blood circulation within the pulp.This improvement is crucial for establishing a foundation for future vital pulp preservation treatments.A case of irreversible pulpitis caused by caries was reported,in which the dental pulp was preserved using the one-way membrane decompression.The results of a ten-month clinical follow-up indicate a positive outcome.

Objective:To explore the clinical characteristics and outcomes of SARS-CoV-2 infection in kidney transplant recipients(KTRs)and examine the risk factors for severe/critical infection.Methods:A retrospective analysis was conducted for 208 adult KTRs diagnosed with SARS-CoV-2 infection between December 15, 2022, and March 15, 2023.They were assigned into two groups of mild/ordinary(n=168)and severe/critical(n=40)according to the severity of SARS-CoV-2 infection.Two groups were compared with regards to general profiles, status of baseline vaccination against COVID-19, transplant history, immunosuppressive regimens, comorbidities and treatment outcomes.For continuous variables, t or Mann-Whitney U test was utilized for comparing the inter-group differences.For categorical variables, chi-square or Fisher's exact test was employed.Bonferroni correction was applied for multiple comparisons when p value was ≤0.05.Logistic regression analysis of univariates and multivariates was conducted for identifying the risk factors for severe/critical infections.Results:The rates of hospitalization, severe illness, ICU admission, mechanical ventilation and mortality among 208 KTRs with COVID-19 were 27.4%(57/208), 19.2%(40/208), 3.4%(7/208), 5.3%(11/208)and 1.9%(4/208)respectively.Among 57 COVID-19 infected individuals, 43.9%(25/57)experienced bone marrow suppression with an incidence of anemia 36.8%(21/57)and thrombocytopenia 22.8%(13/57). The lowest counts of whole blood lymphocyte, CD4 + T lymphocyte and CD8 + T lymphocyte were 390.0(245.0, 615.0), 138.0(78.0, 293.5)and 180.0(94.7, 575.2)cells/μL respectively.The incidence of bacterial, cytomegaloviral, Pneumocystis jirovecii and other fungal infections after COVID-19 infection was 17.8%(37/208), 3.8%(8/208), 2.9%(6/208)and 2.9%(6/208)respectively.The severe/critical group had a higher incidence of other pathogen infections as compared to mild/ordinary group, including bacterial infections[62.5%(25/40)vs 7.1%(12/168), 95% CI: 47.5%~63.3%, P<0.001], cytomegaloviral infections[15.0%(6/40)vs 1.2%(2/168), 95% CI: 8.1%~19.5%, P=0.001], P.jirovecii infections[15%(6/40)vs 0(0/168), 95% CI: 9.4%~20.6%, P<0.001]and other fungal infections of Candida, Cryptococcus, Malassezia and Aspergillus fumigatus[15.0%(6/40)vs 0(0/168), 95% CI: 9.4%~20.6%, P<0.001]. The incidence of acute kidney injury(AKI)after COVID-19 infection was 13.5%(28/208)and severe/critical group had a higher incidence of AKI than mild/ordinary group[52.5%(21/40)vs 4.2%(7/168), 95% CI: 40.3% to 56.3%, P<0.001]. Univariate analysis showed that age( P=0.003), male gender( P=0.002), smoking history( P=0.012), coronary heart disease( P=0.011), diabetes mellitus( P=0.002), chronic renal insufficiency( P=0.001)and pulmonary disease history( P=0.001)were significantly different between severe/critical and mild/ordinary groups.Multivariate regression analysis revealed that comorbid chronic kidney disease( OR=3.34, 95% CI: 1.46-7.64, P=0.004)and a history of lung disease( OR=3.42, 95% CI: 1.49-7.87, P=0.004)were independent risk factors for severe/critical illness.Baseline vaccination rate against COVID-19 was 17.8%(37/208). Completion of baseline vaccination was associated with a lower risk of severe/critical COVID-19 infection( OR=0.28, 95% CI: 0.08-0.98, P=0.047). Conclusions:KTRs with severe/critical COVID-19 infections are more prone to multiple pathogen co-infections and the incidence of kidney function impairment after infection has remained relatively high.Histories of pulmonary and chronic kidney diseases are independent risk factors for severe/critical infections.Completion of baseline vaccination provides protection against severe/critical infections.

Type 2 diabetes mellitus (T2DM) and nonalcoholic fatty liver disease (NAFLD) are the most problematic metabolic diseases in the world. NAFLD encompasses a spectrum of severity, ranging from simple steatosis to non-alcoholic steatohepatitis (NASH) and fibrosis, increasing the risk of cirrhosis and hepatocellular carcinoma. Importantly, NAFLD is closely linked to obesity and tightly interrelated with insulin resistance and T2DM. T2DM and NAFLD (T2DM-NAFLD) are called as the Xike Rixijing Disease and Tonglaga Indigestion Disease respectively, in Mongolian medicine. Xike Rixijing Disease maybe develop into Tonglaga Indigestion Disease. Forturnately many Mongolian medicines show efficient treatment of T2DM-NAFLD, such as Agriophyllum squarrosum, Haliyasu (dried powder of camel placenta), Digeda-4 (herbs of Lomatogonium carinthiacum, rhizomata of Coptis chinensis, ripe fruits of Gardenia jasminoides, herbs of Dianthus superbus), Guangmingyan Siwei Decoction Powder (Halite, ripe fruits of Terminalia chebula, rhizomata of Zingiber officinale, fruit clusters of Piper longum), Tonglaga-5 (ripe fruits of Punica granatum, barks of Cinnamomum cassia, ripe fruits of Amomum kravanh, fruit clusters of Piper longum, flowers of Carthamus tinctorius), Tegexidegeqi (rhizomata of Inula helenium, ripe fruits of Gardenia jasminoides, rhizomata of Platycodon grandiflorum, rhizomata of Coptis chinensis, heartwood of Caesalpinia sappan), Ligan Shiliu Bawei San (ripe fruits of Punica granatum, barks of Cinnamomum cassia, ripe fruits of Amomum kravanh, fruit clusters of Piper longum, flowers of Carthamus tinctorius, ripe fruits of Amomum tsao-ko, rhizomata of Zingiber officinale), etc. Principles of Mongolian medicine in treating diseases: by balancing “three essences or roots” and “seven elements”, strengthening liver and kidney function, transporting nutrients to enhance physical strength and disease resistance, and combined with drugs for comprehensive conditioning treatment. However, their molecular mechanisms remain unclear. In this review, we prospect that Mongolian medicines might be a promising treatment for T2DM-NAFLD by activating P2X7R/NLRP3/NF-κB inflammatory pathway via lipid-sensitive nuclear receptors (i.e., FXR and LXR).

Objective To evaluate the effect of cardiopulmonary bypass (CPB) on the expression of hypothalamic nerve growth factor precursor (proNGF) and the influence of hypothalamic proNGF on the sympathetic output of paraventrucular nucleus. Methods Forty-two male SD rats, aged 3-4 months, weighing 350-500 g, were divided into control group, CPB group and ischemia reperfusion (IR) group. At the end of CPB for 110 min, hypothalamus and dorsal root ganglion (DRG) were taken to measure the levels of proNGF mRNA and hypothalamic proNGF protein. Mini pipe was put into bilateral paraventrucular nucleus (PVN) and human recombination proNGF protein was injected into PVN for 7 d before the local field potentials (LFP) of RVLM was recoreded. Human recombination proNGF protein was administrated into lateral ventricle, the prior-administration-LFP of PVN and post-administration-LFP were recorded and compared. At the end of the experiment, hypothalamus was taken to measure the levels of glutamate and gammer amino butyric acid (GABA). Results Hypothalamic proNGF protein in CPB group and IR group was higher than that in the control group (P ＜ 0.05); NGF mRNA of hypothalamus and DRG in CPB and IR group were higher than those of control group (P ＜ 0.05). In PVN and RVLM, after the administration of proNGF protein, the power of delta band significantly decreased and other bands increased (P ＜ 0.05). The hypothalamic GABA level decreased (P ＜ 0.05) with no change of hypothalamic glutamate after proNGF was injected into lateral ventricle. Conclusion CPB increases the expression of proNGF in the hypothalamus contributing to the changes of hypothalamic sympathetic output.

Viral myocarditis (VM) refers to human infections thermophilic myocardium virus that causes the circumscribed or diffuse myocardium-inflammatory lesion.Myocarditis can be caused by a variety of microbial infections,and VM is the most common one.In order to make the medical staff in clinical work have a more in-depth understanding of VM,this paper describes the common rviruses related,VM and its pathogenesis,process.At present,there is no effective drug and treatment method for VM.It is particularly important to further study the pathogenesis of VM on the role of the virus in,and inhibit its role in the further exploration of clinical therapeutic targets,to improve the quality of life of patients with VM and prolong the survival time is of great significance.Studying in-depth virus in the pathogenesis of VM and restraining its function are particularly important for the further exploration of clinical therapeutic targets.It is significant to improve the life quality and prolong the survival time for VM patients.

Objective To construct a chimeric infectious clone of the fatal virulent strain SDLY 107, containing the gene fragments encoding 2A and 3B proteins of the mild virulent strain SDLY 1, and to establish a reverse genetic system platform for further investigation on virulence of enterovirus 71 strains. Methods The overlap PCR analysis was performed to obtain the gene fragments encoding 2A and 3B pro-teins of the mild virulent strain SDLY 1.The obtained gene fragments were digested and then cloned into a plasmid pMD19-T containing the full-length gene of SDLY 107 strain by using gene replacement strategy. The recombinant RNA was transfected into Vero cells for the preparation of recombinant virus particles.Sev-eral assays including the PCR, indirect immunofluorescence ( IFA) , Western blot and sequencing were per-formed for virus identification.Virus titers were measured by 50%cell culture infective dose ( CCID50 ) and plaque assay.Results The infectious clones of SDLY 107-2A-1 and SDLY 107-3B-1 chimeric virus strains were constructed successfully.Typical cytopathic effect was observed in Vero cells after viral transfection. Identification of the rescued viruses by PCR, IFA, Western blot and sequencing further confirmed the suc-cessful construction of infectious virus strains.The virus titers of SDLY 107-2A-1 and SDLY 107-3B-1 strains detected by CCID50 and plaque assay were 1.25 ×105 PFU/ml and 0.7 ×105 PFU/ml, respectively. Conclusion The chimeric viruses SDLY 107-2A-1 and SDLY 107-3B-1 were rescued successfully, causing cytopathic effects similar to those by using the parental virus strain SDLY 107.This study might pave the way for further investigation on in vitro and in vivo virulence of enterovirus 71 strains.

Objective To develop and evaluate an up-converting phosphor technology-based lateral flow assay ( UPT-LF) for detection of aflatoxin M1(AFM1) in milk powder and milk.Methods AFM1-UPT-LF was established with up-converting phosphor ( UCP) nano-particles as the bio-label of competitive mode based LF assay .Sensitivity, quantitative ability and precision were evaluated using simulated AFM 1-postive samples with serial standard concentrations .The qualita-tive and quantitative detection performance of AFM 1-UPT-LF was evaluated with reference to liquid chromatography-mass spectrography ( LC-MS) to detect samples of milk powder and milk simultaneously .Results AFM1-UPT-LF could conduct qualitative and quantitative detection without sample pretreatment within 20 min.The detection limit of AFM1-UPT-LF reached 0.1 μg/kg in milk powder and 0.3 μg/L in milk.There was good linearity ranging from 0.1 to 0.7 μg/kg and 0.3 to 0.7 μg/L for milk powder and milk, respectively.The sensitivity, specificity and receiver operating characteristic ( ROC) area under the curve ( AUC) of AFM1-UPT-LF for qualitative result could meet the need of national standards for AFM1 limit in dairy products.After statistical analysis, there was no significant difference (milk powder: t=0.66, P>0.05;milk:t=1.01, P>0.05) between AFM1-UPT-LF and LC-MS for quantitative detection .Conclusion The good qualitative and quantitative detection performance of AFM 1-UPT-LF for milk powder and milk makes possible on-site rapid detection of AFM1 in dairy products quantitatively .