Objective: To characterize perioperative dynamic changes in immune-cell phenotypes and inflammatory cytokines in patients undergoing CPB (cardiopulmonary bypass) cardiac surgery, and to explore their associations with postoperative outcomes. Methods: In this prospective cohort study, 120 adult patients who underwent elective cardiac surgery under CPB at West China Hospital from May 2022 to March 2023 were enrolled. Perioperative immune-cell phenotypes and concentrations of 40 inflammation-related cytokines were measured. The primary outcomes were the sequential organ failure assessment (SOFA) score at 24 h after surgery and ΔSOFA (the peak SOFA score within 48 h after surgery minus the preoperative SOFA score). Secondary outcomes included major adverse cardiovascular events (MACE), acute kidney injury (AKI), respiratory failure, severe liver injury, and infection. Results: The mean age of enrolled patients was 57±10 years. Of these, 52% (62/120) were male and 90% (108/120) underwent valve surgery. During the rewarming to the end of CPB, neutrophil counts rapidly increased (7.39×10 /L vs preoperative 3.07×10 /L, P<0.001), with significant upregulation of CD11b (7.30×10 /L vs preoperative 3.05×10 /L, P<0.001) and CD54 (7.15×10 /L vs preoperative 2.99×10 /L, P<0.001). Lymphocyte counts increased at the end of CPB (1.75×10 /L vs preoperative 1.12×10 /L, P<0.001) but decreased significantly at 24 h after surgery (0.59×10 /L vs preoperative 1.12×10 /L, P<0.001). Plasma analysis showed that multiple pro-inflammatory cytokines increased during CPB and remained elevated up to 24 h after surgery; five chemokines and the anti-inflammatory cytokine IL-10 peaked at the end of CPB. The SOFA score increased from 1 (1, 2) preoperatively to 7 (5, 10) at 24 h after surgery, with a ΔSOFA of 6 (4, 8). Within 30 days after surgery, 48 patients (40.0%) developed AKI, 17 (14.2%) developed infection, 4 (3.3%) developed severe liver injury, 3 (2.5%) developed respiratory failure, and 3 (2.5%) experienced MACE. During the 2-year follow-up, 8 patients (6.7%) experienced MACE and 5 (4.2%) died. Conclusion: Multi-organ dysfunction is common after cardiac surgery under CPB (median ΔSOFA, 6), accompanied by perioperative activation of multiple immune-cell subsets and upregulation of pro-inflammatory, anti-inflammatory, and chemotactic mediators. This study provides data-driven evidence and research clues for further investigation of the associations between CPB-related immune perturbations and postoperative organ dysfunction and clinical outcomes.

Objective To investigate the resistance levels of adult Culex quinquefasciatus mosquitoes to three commonly used pyrethroid insecticides in Xingyi City, Guizhou Province, as well as to examine the changes in metabolic detoxification enzyme activities and mutations in the knockdown resistance (kdr) gene thereby providing a scientific foundation for the prevention and control of Culex quinquefasciatus in the region. Methods In 2024, the larvae of Culex quinquefasciatus were collected from different locations in Xingyi and reared to adult mosquitoes in the laboratory, and their resistance to pyrethroid insecticides was determined using the adult mosquito contact tube method. Surviving samples (resistant population) from the resistance tests were examined for the activities of mixed function oxidase (MFO), glutathione-S-transferase (GST), and non-specific esterase (NSE) using a microplate reader. The genomic DNA of individual adult Culex quinquefasciatus mosquitoes was extracted, and the voltage-gated sodium channel (VGSC) gene fragment was amplified via PCR and sequenced to analyze the mutations in the kdr gene. Results The 24-h mortality rates of adult Culex quinquefasciatus exposed to 0.25% permethrin, 0.025% deltamethrin, and 0.025% beta-cypermethrin were 1.00%, 0%, and 0.88%, respectively, indicating all populations of Culex quinquefasciatus exhibited resistance to the three pyrethroid insecticides. The activity of MFO in permethrin-resistant population followed a normal distribution, while deltamethrin-resistant and cypermethrin populations exhibited skewed distributions. The resistance ratios (RRs) for the three populations were 1.17, 1.03, and 1.07 times, respectively, with no statistically significant differences in MFO activity between field populations and susceptible strains (all P>0.05). However, the GST activities of permethrin-resistant and beta-cypermethrin-resistant field populations were 1.06 and 1.45 times higher than those of sensitive strains (P<0.05). Sequencing of the VGSC gene fragments of adult Culex quinquefasciatus resistant to pyrethroid insecticides revealed that mutations occurred solely at 1014 locus, presenting two alleles: wild type TTA(L) (1.26%) and mutant TTT(F) (98.74%). Two genotypes were identified: wild/mutant heterozygotes L/F (2.52%) and mutant homozygotes F/F (97.48%). No statistically significant differences were observed in the frequency of resistance gene mutations among populations resistant to the three pyrethroid insecticides (P>0.05). Conclusion The adult mosquitoes of Culex quinquefasciatus in Xingyi have developed resistance to three commonly used pyrethroid insecticides, with changes observed in metabolic detoxification enzyme activities and mutations in the kdr gene. The resistance of Culex quinquefasciatus in Xingyi is the result of multiple mechanisms. Understanding the resistance level and mechanism can provide a reliable basis for mosquito control and resistance management. It is recommended to enhance the monitoring of mosquitoes' resistance to insecticides, prioritize environmental management focused on eradicating breeding sites, reduce the use of pyrethroid insecticides, and rotate with other classes of insecticides to delay the onset of resistance.

OBJECTIVE: To explore the neuroprotective effect and underlying mechanism of Xingnao Kaiqiao acupuncture (acupuncture for regaining consciousness and opening orifices) in the rat models of cerebral ischemia-reperfusion injury (CIRI) based on the p53 protein (p53)/solute carrier family 7 member 11 (SLC7A11)/glutathione peroxidase 4 (GPX4) signaling pathway. METHODS: Of 102 male Wistar rats, 20 rats were randomly collected as a sham-operation group. Using a modified external carotid artery filament insertion method, CIRI models were prepared by occluding the middle cerebral artery in the rest rats. After modeling and excluding 1 non-successfully modeled rat and 1 dead one, the other modeled rats were randomized into a model group, an agonist group, an acupuncture group, and an acupuncture + agonist group, 20 rats in each one. Xingnao Kaiqiao acupuncture therapy was delivered in the rats of the acupuncture group and the acupuncture + agonist group. The acupoints included "Shuigou" (GV26), bilateral "Neiguan" (PC6), and "Sanyinjiao" (SP6) on the affected side. Electroacupuncture was attached to "Neiguan" (PC6) and "Sanyinjiao" (SP6) on the affected side, with dense-disperse wave, a frequency of 2 Hz/15 Hz and intensity of 1 mA. The intervention was delivered twice daily, 20 min each time and for 7 consecutive days. In the agonist group and acupuncture+agonist group, p53 agonist, COTI-2 was intraperitoneally injected (15 mg/kg), once daily for 7 consecutive days. Neurological deficit was evaluated using Zausinger's six-point scale. Cerebral infarction volume was quantified by triphenyl tetrazolium chloride (TTC) staining. Histopathological changes were observed using hematoxylin-eosin (HE) staining. Iron deposition was assessed by Prussian blue staining. Mitochondrial ultrastructure in the ischemic cortex was examined under transmission electron microscopy (TEM). Serum iron (Fe²⁺) was measured with chromometry. Malondialdehyde (MDA) and glutathione (GSH) levels in the ischemic hippocampus were determined using thiobarbituric acid and microplate assays, respectively. The mean fluorescence intensity of reactive oxygen species (ROS) in the ischemic cortex was analyzed by flow cytometry. The mRNA and protein expression of GPX4, SLC7A11, and p53 in the ischemic hippocampus were evaluated using quantitative real-time PCR (qRT-PCR) and Western blotting, respectively. RESULTS: Compared with the sham-operated group, the model group exhibited the decrease in neurological deficit score (P<0.01), and the increase in cerebral infarction volume percentage (P<0.01). The changes of brain tissue were presented in extensive cellular necrosis, pyknotic and deeply-stained nuclei, and vacuolar degeneration. The iron deposition was elevated in cortex and hippocampus (P<0.01), mitochondrial membrane density increased, the cristae was broken or reduced, and the outer membrane ruptured. The levels of Fe²⁺ and MDA, as well as the mean flourscence intensity of ROS were elevated (P<0.01) and the level of GSH was reduced (P<0.01). The mRNA and protein expression of GPX4 and SLC7A11 was reduced (P<0.01), while that of p53 rose (P<0.01). When compared with the model group, in the agonist group, the neurological deficit score was reduced (P<0.05), the percentage of infarction volume was higher (P<0.01), the histopathological damage was further exacerbated, and the percentage of iron deposition increased in the cortex and hippocampus (P<0.01). The mitochondrial quantity decreased, the membrane density increased, the mitochondrial cristae were broken or reduced, and the outer membrane was ruptured. The levels of Fe²⁺ and MDA, as well as the mean flourscence intensity of ROS were higher (P<0.01, P<0.05) and the level of GSH was reduced (P<0.05). The mRNA and protein expression of GPX4 and SLC7A11 decreased (P<0.01, P<0.05), while that of p53 was elevated (P<0.01). Besides, in comparison with the model group, the neurological deficit score was higher in the acupuncture group and the acupuncture + agonist group (P<0.01, P<0.05), the percentage of cerebral infarction volume was lower in the acupuncture group (P<0.01), the pathological damage of brain tissue was alleviated in the acupuncture group and the acupuncture + agonist group, and the percentage of iron depositiondecreased in the cortex and hippocampus (P<0.01). The mitochondrial structure was relatively clear, the mitochondrial cristae were fractured or reduced mildly in the acupuncture group and the acupuncture + agonist group. The levels of Fe²⁺ and MDA, as well as the mean flourscence intensity of ROS were lower (P<0.01) and the level of GSH was higher (P<0.01) in the acupuncture group. The mean fluorescence intensity of ROS were dropped (P<0.01) in the acupuncture + agonist group. The mRNA expression of GPX4 and SLC7A11 was elevated (P<0.01) and that of p53 was reduced (P<0.01, P<0.05) in either the acupuncture group or the acupuncture + agonist group; the protein expression of GPX4 and SLC7A11 rose (P<0.05, P<0.01) and that of p53 was dropped (P<0.01) in the acupuncture group; and the protein expression of p53 was also lower in the acupuncture + agonist group (P<0.05). When compared with the agonist group, in the acupuncture + agonist group, neurological deficit score increased (P<0.01), the percentage of cerebral infarction volume decreased (P<0.01), the pathological brain tissue damage was reduced, the percentage of iron deposition in cortex and hippocampus decreased (P<0.01), the mitochondrial structure was relatively clear and the cristae broken or reduced slightly; the levels of Fe²⁺ and MDA, as well as the mean fluorescence intensity of ROS were dropped (P<0.01), while the level of GSH increased (P<0.05); the mRNA and protein expression of GPX4 and SLC7411 was elevated (P<0.01, P<0.05), and that of p53 reduced (P<0.01). In comparison with the acupuncture + agonist group, in the acupuncture group, the neurological deficit score increased (P<0.05), the percentage of cerebral infarction volume decreased (P<0.05), the pathological brain tissue damage was alleviated, the percentage of iron deposition in cortex and hippocampus decreased (P<0.01), the mitochondrial structure was normal in tendency; the levels of Fe²⁺ and MDA, as well as the mean fluorescence intensity of ROS were reduced (P<0.05), while the level of GSH rose (P<0.01); the mRNA and protein expression of GPX4 and SLC7411 was elevated (P<0.01, P<0.05), and that of p53 reduced (P<0.01, P<0.05). CONCLUSION Xingnao Kaiqiao acupuncture can alleviate neurological damage in CIRI rats, which is obtained probably by inhibiting ferroptosis through p53/SLC7A11/GPX4 pathway.
Animals ; Reperfusion Injury/metabolism* ; Male ; Acupuncture Therapy ; Rats ; Tumor Suppressor Protein p53/genetics* ; Brain Ischemia/metabolism* ; Rats, Wistar ; Signal Transduction ; Humans ; Phospholipid Hydroperoxide Glutathione Peroxidase/genetics* ; Disease Models, Animal ; Acupuncture Points ; Amino Acid Transport System y+/genetics*

OBJECTIVE: To analyze the MYH9 gene sequence of a patient with hereditary thrombocytopenia and diffuse large B-cell lymphoma and his family members, and to explore the relationship between MYH9 gene and tumors. METHODS: Peripheral blood samples were collected from the patients and their family members for complete blood count analysis. The platelet morphology was observed under microscope. The MYH9 gene sequence was analyzed by Whole Exon Sequencing and Sanger Sequencing. RESULTS: The mutation site c.279C>A:p.(Asn93Lys) in exon 2 of the MYH9 gene were found in patient and his family members, both presenting as thrombocytopenia. The platelet count was significantly increased after the administration of Avatrombopag. CONCLUSION A novel mutation of MYH9 was found in this study, and the case was sensitive to Avatrombopag, by exploring the relationship between the MYH9 gene and tumors, suggesting that the MYH9 gene may be associated with the development of diffuse large B-cell lymphoma.
Humans ; Myosin Heavy Chains/genetics* ; Thrombocytopenia/genetics* ; Mutation ; Male ; Lymphoma, Non-Hodgkin/genetics* ; Lymphoma, Large B-Cell, Diffuse/genetics* ; Molecular Motor Proteins/genetics* ; Pedigree

Somatostatin receptor 1 (SSTR1) is a crucial therapeutic target for various neuroendocrine and oncological disorders. Current SSTR1-targeted treatments, including the first-generation somatostatin analog lanreotide (Lan) and the second-generation analog pasireotide (Pas), show promise but encounter challenges related to selectivity and efficacy. This study presents high-resolution cryo-electron microscopy structures of SSTR1 complexed with Lan or Pas, revealing the distinct mechanisms of ligand-binding and activation. These structures illustrate unique conformational changes in the SSTR1 orthosteric pocket induced by each ligand, which are critical for receptor activation and ligand selectivity. Combined with the biochemical assays and molecular dynamics simulations, our results provide a comparative analysis of binding characteristics within the SSTR family, highlighting subtle differences in SSTR1 activation by Lan and Pas. These insights pave the way for designing next-generation therapies with enhanced efficacy and reduced side effects through improved receptor subtype selectivity.

Objective: To examine the association between visceral fat metabolic levels and cardiovascular disease (CVD) among middle-aged and elderly population, so as to provide the evidence for the early identification and prevention of CVD risk in this population. Methods: Based on the database of the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2020, baseline demographic information, lifestyle, disease history, and CVD status of participants aged ≥45 years were collected. Data on height, weight, waist circumference, and blood biochemical indicators from 2012 and 2015 were collected and used to calculate the metabolic score for visceral fat (METS-VF) and cumulative METS-VF, enabling an assessment of visceral fat metabolism levels. The K-means clustering algorithm was applied to analyze the categories of METS-VF. Multivariable logistic regression models were used to analyze the association between different METS-VF categories, cumulative METS-VF and CVD. A restricted cubic spline model was employed to examine the dose-response relationship between cumulative METS-VF and CVD. Results: A total of 3 146 participants were included, with a median age of 57.00 (interquartile range, 12.00) years. There were 1 405 males (44.66%) and 1 741 females (55.34%). METS-VF was clustered into three distinct categories: a persistently low-level group, a persistently moderate-level group, and a persistently high-level group, comprising 497, 1 302, and 1 347 individuals, accounting for 15.80%, 41.39%, and 42.82%, respectively. By the 2020 follow-up, there were 540 cases of CVD, with an overall prevalence of 17.16%. The prevalence of CVD among different METS-VF categories were 12.47%, 14.36%, and 21.60%, respectively. Multivariable logistic regression analysis showed that, after adjusting for demographic factors, lifestyle, and disease history, compared with the persistently low-level group, the persistently high-level group had a higher risk of CVD (OR=1.710, 95%CI: 1.263-2.342). Cumulative METS-VF was positively associated with CVD risk (OR=1.197, 95%CI: 1.113-1.289). Restricted cubic spline analysis indicated a linear relationship between cumulative METS-VF and CVD risk (P for nonlinearity >0.05). Conclusion Persistently high levels of METS-VF can increase the risk of CVD among middle-aged and elderly population, and there is a positive dose-response relationship between cumulative METS-VF and CVD risk.

Objective To explore the role of quality control circle in reducing the rate of extravasation during"bolus-type"intravenous injection of radiopharmaceuticals.Methods A total of 624 patients who underwent emission computed tomography(ECT)examinations were retrospectively selected as the pre-quality control circle use analysis group,125 patients who underwent ECT examinations were selected as the post-quality control circle use experiment group,and 70 patients were selected as the control group.This study applied the continuous quality improvement tools of the quality control circle,including grasping the current situation,selecting injection tools,personnel training,brainstorming,root cause analysis,key factor evaluation,true cause verification,strategy formulation and measure implementation,to continuously improve the quality of"bolus-type"radioisotope injection and reduce the rate of radiopharmaceuticals extravasation.Results In the experiment group,the rate of radioisotope extravasation after nurses performed"bolus-type"intravenous injection was 14.2％,compared to 33.3％in the control group,an improvement of 19％,and the situation of radiopharmaceuticals extravasation was significantly improved.Skillful use of quality improvement tools,especially in areas such as insufficient compression time,improper compression method,slow blood flow speed in fine blood vessels,and failed puncture,was crucial for radioisotope sur-face imaging.Conclusion Through continuous quality improvement by the quality control circle,this study successfully reduces the rate of extravasation during"bolus-type"intravenous injection of radiopharmaceuticals,reduces skin contamination,and improves the quality of nuclear medicine images,which is of great significance for improving the safety and diagnostic accuracy of nuclear medicine ECT examinations.

Objective:To explore the effect of Kangfuxin solution combined with triamcinolone and Econazole cream in elderly patients with hip fracture complicated with incontinence dermatitis, and to provide reference for clinical nursing.Methods:A randomized controlled trial was conducted to select 80 elderly patients with hip fracture complicated with incontinence dermatitis who were hospitalized in the Orthopedics Department of the First Medical Center of the PLA General Hospital from February 2023 to March 2024 by convenient sampling method. They were divided into the experimental group and the control group with 40 cases in each group according to random number table method. The experimental group was treated with Kangfuxin solution combined with triamcinolone and econazole cream for incontinence dermatitis. Intervention was stopped after 2 weeks of intervention or the incontinence dermatitis reached the clinical healing standard. In the control group, 3M spray was used to care the affected area of incontinence dermatitis, intervention was stopped after 2 weeks or the incontinence dermatitis reached the clinical healing standard. Incontinence dermatitis Skin Injury Assessment Scale (IADS) and perineal skin assessment tool PAT were used to evaluate the skin status of the two groups, and the healing time and treatment effectiveness of the two groups were compared.Results:In the control group, there were 11 males and 29 females, with age of (76.53 ± 8.67)years. There were 9 males and 31 females in the experimental group, with age of (76.56 ± 8.69)years, and there was no significant differences in baseline data between the two groups (all P>0.05). After intervention, the IADS and PAT scores of the control group were (27.13±5.22) points and (5.11 ± 0.94) points respectively, which were significantly higher than those of the experimental group (25.43 ± 4.15) points and (3.73 ± 1.21) points, and the differences were statistically significant ( t=7.22, 8.21, both P<0.05). The effective treatment in the experiment group was 97.5% (39/40), which was significant higher than 72.5% (29/40) in the control group ( χ2=13.25, P<0.05). The healing time of experimental group was (4.57 ± 3.44) d, which was significantly shorter than that of control group (9.23 ± 4.19) d, with statistical significance ( t=11.61, P<0.05). Conclusions:The combined application of Kangfuxin solution and triamcinolone and Econazole cream has a significant effect on improving incontinence dermatitis and perineal health in elderly patients with hip fracture, can effectively reduce symptoms and accelerate skin healing, and has certain clinical application value.

Objective To investigate the effects of inhibiting KDM2A gene on the proliferation,invasion and migration of liver cancer cells and its possible regulatory mechanism.Methods Forty pairs of HCC tissues and their adjacent normal counterparts were collected from 2014 to 2017 in Tongji Hospital,Tongji Medical College Affiliated to Huazhong University of Science and Technology.Human liver cancer cell lines HepG2,Huh7,HCCLM3,MHCC-97H and normal liver cells LO2 were cultured in vitro.The mRNA and protein expression levels of KDM2A in HCC tissues and cells were detected by qRT-PCR and Western blotting.Huh7 cells were taken and set up as follows:(1)si-NC group(transfected with si-NC)and si-KDM2A group(transfected with si-KDM2A);(2)mimic-NC group(transfected with mimic-NC),miRNA-29a-3p mimic group(transfected with miRNA-29a-3p mimic),inhibitor-NC group(transfected with inhibitor-NC)and miRNA-29a-3p inhibitor group(transfected with miRNA-29a-3p inhibitor).The mRNA and protein expression levels of KDM2A were detected by qRT-PCR and Western blotting.The invasion and migration of cells were detected by Transwell,the proliferation of cells was detected by CCK-8 methods.The online databases TargetScan,miRDIP,miRWalk,Starbase and miRDB were used to predict the binding sites of KDM2A and miR-29a-3p.The KDM2A 3'-UTR(WT)or KDM2A 3'-UTR(MUT)report plasmid was co-transfected with NC-miRNA or miR-29a-3p mimics respectively for 48 h in 293T cells,and the luciferase activity was detected by the luciferase reporter gene detection system.Results Compared with adjacent normal counterparts,the relative mRNA and protein expression levels of KDM2A in HCC tissues increased significantly(P＜0.05).Compared with LO2,the relative mRNA and protein expression levels of KDM2A in HepG2,Huh7,HCCLM3 and MHCC-97H increased significantly(P＜0.05).Compared with si-NC group,the proliferation,invasion and migration of Huh7 cells in si-KDM2A group decreased significantly(P＜0.05 or P＜0.01).The analysis results of TargetScan,miRDIP,miRWalk,Starbase and miRDB showed that there were binding sites between KDM2A and miR-29a-3p.The results of the dual luciferase reporter assay showed that miR-29a-3p mimic significantly reduced KDM2A-MUT luciferase activity(P＜0.01).After overexpression of miRNA-29a-3p,the relative mRNA and protein expression levels of KDM2A were decreased(P＜0.01),the proliferation,invasion and migration abilities were decreased(P＜0.05)in Huh7 cells.After inhibiting the expression of miRNA-29a-3p,the relative mRNA and protein expression levels of KDM2A were increased(P＜0.05),the proliferation,invasion and migration abilities were enhanced(P＜0.05)in Huh7 cells.Conclusion Inhibiting the expression of KDM2A can reduce the proliferation and migration ability of Huh7 cells.miR-29a-3p may be the upstream regulator of KDM2A and participate in the occurrence and development of hepatocellular carcinoma.