Objective:To explore the intervention mechanism of Clostridium butyricum on asthma from the perspective of im-mune inflammation and pulmonary flora,and to provide a new scheme for the prevention and treatment of asthma.Methods:Mice were randomly divided into Clostridium butyricum(CM)group,asthma model group(Model)and normal control group(Control),with 16 mice in each group.The model group and CM group were sensitized by ovalbumin(OVA)and stimulated by continuous atomi-zation of 1%OVA solution to establish asthma mouse model,and the control group was replaced by normal saline.Mice in CM group were administrated with CM solution at 1×109 CFU/d.The total number of white blood cells in bronchoalveolar lavage fluid(BALF)was counted.Eosinophil number(EOS)was counted by Wright-Giemsa staining.The pathological changes of lung tissue were ob-served by HE staining and PAS staining.Serum levels of IL-4,IgE and IFN-γ were determined by ELISA.Mouse lung microflora was analyzed by 16S rRNA.Results:Compared with Model group,white blood cells and EOS inflammatory cells in CM group were signifi-cantly decreased(P<0.05),lung inflammatory cell infiltration and goblet cell proliferation were significantly reduced,serum IL-4 and IgE levels were significantly decreased(P<0.05),IFN-γ levels were significantly increased(P<0.05),and Th1/Th2 balance was maintained.The abundance of Proteobacteria and Escherichia-Shigella in the lung of mice were significantly decreased,and correlation analysis showed that the decrease of IL-4 and IgE levels were positively correlated with the increase of Escherichia-Shigella abundance(P<0.05,r>0.9).Conclusion:Clostridium butyricum intervention can change the composition of lung flora,regulate immune cells and cytokines,maintain Th1/Th2 balance,so as to reduce the OVA-induced pulmonary inflammation of allergic asthma.

Objective:To investigate protective mechanism of resveratrol(RES)on brain injury after ischemic stroke(IS)and its regulatory mechanism on nico-tinamide adenine dinucleotide phosphate oxidase 2(NOX2)mediated polarization of microglia.Methods:Low and high doses of RES were used for intervention.Tetrabromocinnamic acid(TBCA),a specific agonist of NOX2,was used to save function.PC12 and LMAI Bio cell models with oxygen-glucose deprivation/reoxygenation(OGD/R)were constructed.TUNEL was used to detect apoptosis of PC12 cells.Immunofluorescence was used to detect polarization of LMAI Bio cells.Western blot was used to detect expressions of NOX2,NF-κB,TNF-α,IL-1β,IL-10 and TGF-β in PC12 and LMAI Bio cells.Results:RES could significantly inhibit apoptosis of PC12 cells induced by OGD/R,and regulate LMAI Bio cells polarization to M2 type.Western blot showed that RES could significantly down-regulate NOX2,NF-κB,TNF-α and IL-1β expressions in OGD/R cells,up-regulate IL-10 and TGF-β expressions,while TBCA could partially reverse protective effect of RES on neurons.Conclusion:RES can inhibit neuronal apoptosis after IS,which may be related to its regulation of NOX2-mediated polarization of microglia.

Objective:To explore the risk factors and prediction model of lateral lymph node metastasis(LLNM)in Hashimo-to's thyroiditis(HT)combined with papillary thyroid carcinoma(PTC).By investigating its risk factors in a multi-dimensional and sys-tematic manner,a precise prediction model with clinical application value will be constructed to provide a basis for clinical diagnosis and treatment,prognosis assessment,and surgical practice decision evaluation.Methods:A retrospective analysis was conducted on the clinical data of 201 patients with HT combined with PTC who were admitted to the Thyroid Surgery Department of the First Affiliated Hospital of Jinzhou Medical University from April 2022 to June 2024.According to whether the patients had LLNM,they were divided into a metastasis group(n=82)and a non-metastasis group(n=119).The relevant clinical indicators of the two groups of patients were compared.Univariate and multivariate analyses were used to identify the independent risk factors affecting the occurrence of LLNM in patients.A logistic regression was employed to establish a prediction model and evaluate its predictive value.Results:The results of univariate analysis showed that there were statistically significant differences between the two groups in terms of TSH value,nodule lo-cation,nodule echo,shape,boundary,aspect ratio,tumor diameter,multifocality,microcalcification,rich blood supply of nodules,ELN,CLNM,capsule invasion,and ETE(P<0.05).The results of multivariate logistic regression analysis indicated that tumor diam-eter,CLNM,rich blood supply of nodules,multifocality,and TSH were all independent risk factors for LLNM(P<0.05).The receiv-er operating characteristic(ROC)curve analysis demonstrated that the areas under the curve(AUC)of tumor diameter,multifocality,CLNM,rich blood supply of nodules,and TSH were 0.613(95%CI:0.533～0.693),0.656(95%CI:0.578～0.733),0.694(95%CI:0.619～0.768),0.622(95%CI:0.543～0.701)and 0.588(95%CI:0.510～0.667),respectively.The sensitivities were 72.20%,69.60%,65.80%,60.80%and 41.80%,respectively and the specificities were 45.90%,62.30%,73.80%,60.70%and 83.60%,respectively.Conclusion:Tumor diameter,multifocality,CLNM,rich blood supply of nodules and TSH are significantly associated with the occur-rence of LLNM in patients with HT combined with PTC.Among them,tumor diameter and multifocality had relatively high sensitivities in predicting LLNM and has a certain predictive value for the occurrence of LLNM in patients with HT combined with PTC.

Objective:To investigate the characteristics of vitamin D levels in children in Gansu Province,and to analyze the correlation between vitamin D levels and immune disorders in children with recurrent respiratory tract infections(RRTIs).Methods:From January 2020 to December 2021,9 790 cases of children aged 0～6 years who received vitamin D detection in pediatric depart-ment of maternal and Child health care hospitals and tertiary general hospitals in 6 cities and prefectures of Gansu Province were retro-spectively selected,characteristics of vitamin D in 5 000 children were analyzed.Ninty children with RRTIs in 5 000 children were taken as study group,and 80 healthy children were taken as control group.Correlation between vitamin D levels and immune function indexes(IgA,IgG,IgM,complement C3 and complement C4)between the two groups was compared to analyze the diagnostic value of vitamin D for children RRTIs.Results:After analyzing vitamin D data of 5 000 children in Gansu Province,it was found that vita-min D deficiency rate,deficiency rate and adequate rate were 11.58%,41.38%and 47.04%respectively,and no vitamin D overdose or poisoning were found.Vitamin D level of children was affected by age and season.Vitamin D deficiency of children aged 3 to 4 years was more serious,and vitamin D level of children in winter was the lowest,and vitamin D level was related to the growth and develop-ment of children and disease.25(OH)D level and immune function indexes in study group were lower than those in control group(P<0.05).Level of 25(OH)D was related to the age,allergic history,passive tobacco exposure and susceptible season of RRTIs(P<0.05).Immune function indexes of children with adequate vitamin D were higher than children with insufficient and deficient vitamin D(P<0.05).Level of vitamin D in children with RRTIs was positively correlated with their immune function(P<0.05).Low birth weight,premature delivery,preference for food,daily amount of fruits and vegetables,outdoor activity time,calcium,iron,zinc,25(OH)D,IgA,IgG,IgM,complement C3 and C4 were all independent risk factors for RRTIs in children(P<0.05).Vitamin D had a high diagnostic value for RRTIs in children(P<0.05).Conclusion:Vitamin D level of children in Gansu Province is related to age and season.Lower vitamin D level in children's RRTIs is related to the immune disorders of children,which can be used for the diag-nosis of this disease.

Objective:To explore clinical characteristics of multiple sclerosis(MS)patients in Suzhou,and to analyze main factors affecting their prognosis.Methods:General data,clinical symptoms,cerebrospinal fluid and imaging examinations of 51 MS patients admitted to Department of Neurology of the Second Hospital of Soochow University from July 31,2009 to July 31,2021 were retrospectively analyzed,and main factors affecting their prognosis were discussed.Results:Average age of onset of 51 MS patients was(43.3±15.6)years old,female accounted for 56.9%,male/female=1/1.3.Adult onset MS(AOMS)accounted for 62.8%,male/female=1/1.7;late onset MS(LOMS)accounted for 37.2%,male/female=1/0.9.Relapsing remitting MS(RRMS)accounted for 76.5%,and chronic onset accounted for 60.8%.Average annual recurrence rate was 8.8%.The first symptoms were numbness and weakness of limbs.Dizziness and numbness were more common in patients without recurrence after diagnosis of MS,and limb weak-ness and numbness were more common in patients with recurrence.Among lesions of MRI,62.7%(32/51)of periventricular involve-ment,52.9%(27/51)of spinal cord involvement,51.0%(26/51)of infratentorial involvement.Proportion of subtentorial and spinal cord(cervical,thoracic)involved were significantly higher in patients with recurrent MS than without recurrence.Values of albumin,IgG,IgA and IgM in cerebrospinal fluid increased with increase of recurrence times.EDSS score of male was higher than female,and LOMS score was higher than AOMS.MS patients without relapse had a low EDSS score,and median EDSS score at current follow-up was 0(0,1.00)score.MS score with relapse was relatively high,and median EDSS score at current follow-up was 2.75(0.25,7.25)score.Conclusion:MS patients with chronic onset are more common,with a high proportion of LOMS,and proportion of males increases with increasing age of onset.High EDSS score at first onset,cervical,thoracic and subtentorial lesions,increased values of cerebrospinal fluid albumin,IgG,IgA,IgM,age at first onset(50+years old),male associate with poor MS prognosis.

Objective:To explore effects of early endoscopic enteral nutrition support on immunoglobulin and T lymphocyte subsets in patients with severe intracerebral hemorrhage.Methods:A total of 120 patients with severe intracerebral hemorrhage admit-ted to The First People's Hospital of Chenzhou were enrolled between August 2019 and June 2022,who were divided into gastric tube group and intestinal tube group according to random number table method,with 60 cases in each group.Gastric tube group was given nasogastric tube 12～24 h after admission,while intestinal tube group was given gastroscope-assisted nasojejunal tube for early nutri-tion support.NIHSS and GCS scores,nutritional indexes[albumin(Alb),prealbumin(PAB),hemoglobin(Hb)],IgG,IgA,IgM and T lymphocyte subsets(CD3+,CD4+,CD4+/CD8+)levels on the following day and 14 d after admission,and complications were compared between two groups.Results:At 14 d after admission,NIHSS score in intestinal tube group were significantly lower than gastric tube group,while GCS score,peripheral blood Alb,PAB,Hb,IgG,IgA,IgM,CD3+T,CD4+T and CD4+T/CD8+T levels were signifi-cantly higher than gastric tube group(P<0.05).After treatment,incidences of gastrointestinal bleeding,reflux esophagitis,gastric retention and vomiting in intestinal tube group were lower than gastric tube group(P<0.05).Conclusion:Early endoscopic enteral nutrition support can effectively improve nutritional status and enhance immune function in patients with severe intracerebral hemorrhage,which is beneficial to improve prognosis.

In the new era with the rapid development of internet techonology,the online-and-offline blended teaching mode will be a new trend in the future.BOPPPS teaching model includes six modules:Bridge-in,objective,pre-assessment,participatory learning,post-assessment and summary.The concept of BOPPPS was integrated into the online and offline blended teaching process of Medical Immunology,and the teaching was divided into three stages:Online in pre-class,offline class and online in after-class.Based on the Super Star APP,the first three modules of BOPPPS,including bridge-in,objective,pre-assessment,were carried out online before class.The last three modules of participatory learning,post-assessment and summary were integrated in the offline class and on-line after class.In the teaching process,we pay attention to student-centered,teacher-student interaction in the whole process,which greatly improves the teaching quality.The purpose of this article is to provide reference for the blended teaching in medical colleges and universities in the post-epidemic era.

The immune system is the cornerstone of the human body to resist danger and maintain homeostasis.The dysfunc-tion of the immune system leads to autoimmune diseases,tumors and other immune-related diseases.The mechanisms of the activation and regulation of the immune system is the frontier research field of life science and medicine.Circadian rhythms control individual ac-tivities and behaviors at various levels such as cells,tissues,organs,and play a key regulatory role in the immune system.Innate im-munity and adaptive immunity are strictly regulated by the biological clock,and the clock control genes in immune cells have diversi-fied effects on cell migration,development,functional differentiation and activation.This article summarizes the circadian regulation of innate and adaptive immunity,and discusses the association and potential intervention value of the biological clock with immune-re-lated diseases as a representative of autoimmune diseases.

S100a8 and S100a9 protein are important members of the S100 protein family.It can induce inflammation by acti-vating intracellular signal cascade,and its strong calcium binding ability makes it play an important role in regulating cell contraction.It has been reported that S100a8 and S100a9 could not only regulate asthmatic airway inflammation,but also have a protective effect on asthmatic airway hyperresponsiveness.This article intends to review the role of S100a8 and S100a9 proteins in airway inflammation and airway hyperresponsiveness in asthma,so as to provide new ideas for the research and prevention of asthma.

Objective:To investigate the mechanism of improving liver injury by enhancing the abundance of Akkermansia mu-ciniphila(AKK bacteria)with hepatocyte-specific Yap1 knockout during PD-1 monoclonal antibody treatment.Methods:Hepatocyte-specific Yap1 knockout mice(genotype Yap1Flox/Flox;albumin-Cre,labeled as Yap1LKO)and control mice(genotype Yap1Flox/Flox,labeled Yap1Flox),aristolocholic acidⅠ(AAⅠ)and CCl4 were used to induce liver injury,Yap1LKO mice and Yap1Flox mice were randomly di-vided into control group and PD-1 monoclonal antibody group.After the intervention,real-time PCR detected changes in the abun-dance of AKK bacteria in the fecal microbial DNA of mice,16S rRNA gene sequencing further analyzes intestinal flora changes,the livers of mice were made into wax blocks for HE staining to observe the histopathological changes of the liver.Results:Yap1Flox mice exhibited balloon-like edema degeneration of hepatocytes and infiltration of inflammatory factors in the manifold area,compared with Yap1Flox mice,Yap1LKO mice had reduced the abundance of AKK bacteria in the intestine,fibrosis of the liver,and the degree of dam-age was more serious;PD-1 monoclonal antibody treatment alone did not increase the abundance of AKK bacteria in the intestines of mice,and fibrosis appeared in the liver;however,the abundance of intestinal AKK bacteria in Yap1LKO mice treated with PD-1 mono-clonal antibody increased,the ratio(F/B value)of Firmicutes to Bacteroides at the phylum level decreased,and the morphology of he-patocytes returned to normal and the degree of liver damage decreased.Conclusion:In AAⅠ and CCl4 induced liver injury mice,he-patocyte-specific Yap1 knockout reduced the abundance of AKK bacteria in the intestine,and the degree of liver injury was more se-vere than that in Yap1Flox mice.When treated with PD-1 monoclonal antibody,hepatocyte-specific Yap1 knockout could increase the abundance of AKK bacteria in the intestine,change the composition of intestinal flora,maintain intestinal homeostasis and ameliorate liver injury.