OBJECTIVE To study the effects of enteral immune microecological nutrition combined with ω-3 fish oil fat emulsion on postoperative recovery， immune function， liver function and inflammation level in patients with hepatocellular carcinoma resection， as well as the safety of the medication. METHODS A total of 106 patients with hepatocellular carcinoma admitted to our Hospital from June 2020 to December 2023 were selected and divided into control group and study group according to the random number table method， with 53 cases in each group. After undergoing hepatocellular carcinoma resection， control group was given Intacted protein enteral nutrition solution+Enhanced enteral immune microecological nutrition， and the study group was given ω-3 fish oil fat emulsion injection based on the control group. The clinical indicators （postoperative exhaust time， defecation time， postoperative ambulation， and hospital stay）， liver function indicators [alanine transaminase （ALT）， lactate dehydrogenase （LDH）， aspartate transaminase （AST）]， immune function indexes （CD3+ ， CD4+ ， CD8+ ， CD4+/CD8+）， inflammatory factor indexes [tumor necrosis factor-α （TNF-α）， interleukin-1β （IL-1β）， IL-6， IL-8]， and indicators of intestinal mucosal barrier [D-lactic acid， intestinal fatty acid binding protein （I-FABP）] were compared between 2 groups， and the occurrence of ADR was recorded. RESULTS Compared with the control group， the postoperative exhaust time， postoperative defecation time， and hospital stay of the study group were shortened significantly， and postoperative ambulation increased significantly （P＜0.05）. After treatment， ALT， LDH， AST， CD8+， inflammatory factors， D-lactic acid and I-FABP of 2 groups were significantly lower than before treatment， and the study group was significantly lower than the control group （P＜0.05）； CD4+， CD3+， and CD4+/CD8+ of two groups were significantly higher than before treatment， and the study group was significantly higher than the control group （P＜0.05）. There was no significant difference in the incidence of ADR between 2 groups （P＞0.05）. CONCLUSIONS Enteral immune microecological nutrition combined with ω-3 fish oil fat emulsion injection can shorten the recovery time of patients after hepatocellular carcinoma resection， improve immune function， reduce inflammatory response， and improve liver function with good safety.

Objective:To investigate the level of the transporter RNA (tRNA) derivative tRF-5026a in the serum of breast cancer patients and its value for the diagnosis of breast cancer, and to investigate its effect on the biological functions of breast cancer cells in vitro and the possible mechanisms.Methods:Sixty female breast cancer patients (breast cancer group) hospitalized in Jiangsu Cancer Hospital from January 2016 to February 2019 and 20 healthy women undergoing physical examination during the same period (healthy control group) were retrospectively selected. The relative expression of serum tRF-5026a in the study subjects was detected by real-time quantitative polymerase chain reaction (RT-qPCR). The receiver operating characteristic (ROC) curve of serum tRF-5026a level for the diagnosis of breast cancer was drawn with pathological diagnosis as the gold standard. tRF-5026a mimics (tRF-5026a group) and negative control sequences (negative control group) were transiently transfected into MCF-7 and BT549 cells by lipofectamine method; CCK-8 assay and 5-ethynyl-2-deoxyuridine (EdU) assay were used to detect the ability of cell proliferation in cells of each group; cell apoptosis in cells of each group was detected by flow cytometry; the abilities of cell invasion and migration in cells of each group were detected by Transwell assay; the expressions of epithelial mesenchymal transition-related proteins in cells of each group were detected by Western blotting.Results:The relative expressions of tRF-5026a [ M ( Q1, Q3)] in serum of healthy control group and breast cancer group were 16.58 (6.37, 26.31) and 3.46 (0.32, 9.01), with a statistically significant difference ( Z = -4.27, P < 0.001). ROC curve analysis showed that the area under the curve (AUC) for diagnosis of breast cancer by the relative expression of serum tRF-5026a was 0.820 (95% CI: 0.722-0.918), with an optimal cut-off value of 9.082, and the corresponding sensitivity and specificity were 75.0 % and 76.7%, respectively. The apoptosis rates of MCF-7 cells in the tRF-5026a group and the corresponding negative control group were (16.52±0.51)% and (12.28±1.75)%, and the BT549 cells were (13.27±2.18)% and (8.86±0.29)%, the differences were not statistically significant (both P > 0.05). MCF-7 and BT549 cells in the tRF-5026a group had lower proliferative, invasive and migratory abilities than cells in the corresponding negative control group (all P < 0.05). MCF-7 and BT549 cells in the tRF-5026a group had lower protein expressions of N-cadherin, matrix metalloproteinase (MMP)-9 and MMP-3 than cells in the corresponding negative control group. Conclusions:tRF-5026a has low level in the serum of breast cancer patients and it may be an indicator for breast cancer diagnosis. tRF-5026a can inhibit the proliferation, invasion and migration of breast cancer MCF-7 and BT549 cells in vitro, which may be related to the regulation of epithelial mesenchymal transition.

Objective To analyze the mechanism of Biochanin A in the treatment of Gliomas based on network pharmacology and molecular docking.Methods Traditional Chinese medicine systems pharmacology database and analysis platform(TCMSP),TargetNet,Swiss Target Prediction were used to search the active components and targets of Biochanin A.DisGeNET,GeneCards databases were used to search the corresponding targets of Gliomas.The intersection of active components of Biochanin A and gliomas target were selected to obtain the potential target of Biochanin A in treating Gliomas.Protein gene interaction data were obtained by STRING database,and protein-protein interaction network was constructed by importing into Cytoscape software.Gene ontology(GO)function and Kyoto encyclopedia of genes and genomes(KEGG)pathway enrichment analysis of the same target proteins of drug and disease were carried out by DAVID database.Molecular docking was performed by using DockThor and Pymol software.Results A total of 149 targets of Biochanin A,5654 gliomas relate-genes,97 common targets of Biochanin A and gliomas are collected.The key targets were epidermal growth factor receptor(EGFR),estrogen receptor(ESR1),heat shock protein(HSP)90AA1,matrix metalloproteinase(MMP)9,PPARG and PTGS2.The targets were mainly play an essential role in cell proliferation,invasion,cell apoptosis,and other biological pathways.GO enrichment analysis demonstrated that Biochanin A could involve the treatment of Gliomas in biological process,cell composition and molecular function.KEGG 108 signaling pathways mainly related to pathways in cancer,chemical carcinogenesis-receptor activation,Lipid and atherosclerosis,PI3K/Akt pathway.Molecular docking indicated that Biochanin A had a good bonding activity with the key targets.Conclusion Biochanin A may play a role in the treatment of glioma by inhibiting tumor cell proliferation,inducing apoptosis and enhancing chemotherapy sensitivity.The study built a foundation for drug development and innovative research.

Objective To analyze the distribution and drug resistance patterns of carbapenem-resistant Acinetobacter baumannii(CRAB),and evaluate the antimicrobial effects in vitro of colistin(COL)combined with cefoperazone/sulbactam(SCF),tigecycline(TGC),imipenem(IPM),meropenem(MEM),amikacin(AK),and levofloxacin(LEV)against CRAB to provide guidance for anti-infective therapy.Methods A total of 75 non-duplicate CRAB strains isolated from clinical specimens in 2022 were collected.WHONET 5.6 software was used for retrospective analysis of their clinical distribution and resistance profiles.Among them,25 strains were selected for combined antimicrobial susceptibility tests using broth microdilution to determine minimum inhibitory concentrations(MICs).The fractional inhibitory concentration(FIC)index was calculated based on checkerboard method to assess the combined effects.Results In 2022,a total of 145 Acinetobacter baumannii strains were isolated,including 75 CRAB(detection rate of 51.7％).CRAB was most prevalent in the patients over 70 years old(40.0％),mainly from blood(41.3％)and sputum(37.3％)specimens,and the intensive care unit was the top isolating department.All the 75 CRAB strains were resistant to piperacillin,piperacillin/tazobactam,ceftriaxone,1PM and MEM with resistance rates of 100％.The resistance rates for ampicillin/sulbactam,cefepime and tri-methoprim/sulfamethoxazole were all exceeded 95％.The resistance rates were 86.7％for LEV,82.7％for SCF,77.4％for AK,2.4％for TGC,and 0.0％for COL.The results of combined tests of 25 strains revealed the synergy rates of 92％and 80％for COL+SCF and COL+TGC respectively with sums of both synergy and additive rates of 100％.Synergy rates for COL combined with IPM,MEM,AK and LEV were 64％,72％,56％and 48％respectively.No antagonism was observed in any combination.Conclusion The drug resist-ance of CRAB exhibited high levels at our hospital,and the elderly and ICU patients were the major susceptible populations.Among all the combinations tests,COL+SCF showed optimal synergy while COL+LEV only had the lowest combined effect with the findings that warrants clinical consideration.

Objective To observe the susceptibility test result in vitro of the combination of two drugs to carbapenem-resistant Enter-obacteriaceae(CRE)for screening the effective anti-infective therapy.Methods A total of 60 CRE strains which were isolated from the specimens from the clinic of Qingdao Eighth People's Hospital from January 2023 to December 2023.Carbapenem enzyme type was detected by colloidal gold immunochromatography.The minimal inhibitory concentration(MIC)was determined by micro broth dilution method.Ceftazidime/avibactam(CZA)combined with aztreonam(ATM),COL combined with tigecycline(TGC),meropenem(MEM),cefoperazone/sulbactam(SCF),amikacin(AK)and levofloxacin(LEV),TGC combined with MEM,SCF and AK,MEM combined with SCF and ertapenem(ETP)were performed by the checkerboard dilution method respectively.Fractional inhibitory con-centration(FIC)index was used to determine the combined effects.Results Carbapenem enzyme was detected in all the 60 CRE strains,including 49 Klebsiella pneumoniae carbapenemases(KPC)-type,10 New Delhi metallo-β-lactamase(NDM)-type and 1 Imi-penem enzyme(IMP)-type.The MICs of CZA to 49 KPC-producing strains were ≤8 mg/L,showing all sensitive,and to 11 NDM-and IMP-producing strains were＞128 mg/L,showing all resistant.The synergy rate of CZA was 100％after combining with ATM.MEM combined with SCF had the highest synergy rate of 63.4％,and the sum of synergistic rate and addition rate was 96.7％.The syn-ergistic rate and additive rate of TGC combined with AK were the lowest,which was 31.7％.Among KPC and NDM enzyme types strains,the sum of synergy rate and addition rate of MEM combined with SCF were the highest,which were 100.0％and 80.0％respec-tively.The sum of synergy rate and addition rate of COL combined with LEV were the lowest,which were 32.6％and 30.0％.None of the 11 combination regimens showed antagonistic effect.The MICrange,MIC50 and MIC90 of combination regimens for CRE strains were decreased to some extent compared with those of each single drug.Conclusion CZA alone or in combination with ATM were effective for CRE strains.The MEM combined with SCF had the highest synergy rate and addition rate,which could provide reference for clinical experience medication.

Objective To investigate the expression level of serum tRNA derived tRF-17-79MP9PP(tRF-17)in patients with breast cancer and evaluate its correlation with the prognostic of the patients.Methods The serum samples were collected from 70 patients with breast cancer admitted to Jiangsu Cancer Hospital during June 2016 and December 2019 and 25 age-matched healthy women,and the clinical data of the patients were recorded.The expression level of serum tRF-17 was detected by real-time fluorescence quantitative PCR(qRT-PCR).The receiver operating characteristics(ROC)curve was used to evaluate the diagnosis value of tRF-17 in breast cancer patients.The correlations of tRF-17 with blood inflammatory indicators and tumor markers were analyzed by Spearman correlation analysis.The deadline for follow-up was April 2023.The factors influencing the prognosis of breast cancer were analyzed by the univari-ate and multivariate COX regression analysis.Results The expression levels of serum tRF-17 in breast cancer patients(3.99[0.70,10.46])were significantly lower than that in healthy controls(14.09[5.14,21.34],Z=-3.575,P＜0.01).The area under the ROC curve of tRF-17 for diagnosing breast cancer was 0.742(95％CI:0.635-0.849,P＜0.01).The average survival time of patients with high expression of tRF-17 was significantly higher than that of patients with low expression(75.97 months vs 56.06 months,log-rank P＜0.01).The COX proportional hazards model analysis showed that lymph node metastasis and the expression level of serum tRF-17 were independent risk factors affecting the prognosis of the patients(HR=1.723,95％Cl:1.084-2.739,P＜0.05;HR=0.189,95％CI:0.041-0.862,P＜0.05).Conclusion Serum tRF-17 is low expressed in breast cancer patients,and its expression level is an inde-pendent risk factor affecting the prognosis of breast cancer patients,which may be used as a biomarker to evaluate the prognosis of the patients.

Objective:To investigate the impacts of fatty acid binding protein 4(FABP4)silencing on endoplasmic reticulum stress(ERS)and insulin resistance(IR)in gestational diabetes mellitus(GDM)rats by regulating protein kinase R-like endoplasmic reticulum kinase(PERK)/eukaryotic initiation factor 2α(eIF2α)/transcription factor 4(ATF4)/C/EBP homologous protein(CHOP)signaling pathway.Methods:GDM rat model was established by intraperitoneal injection of streptozotocin(STZ).Rats were injected with FABP4 siRNA plasmid(si-FABP4),negative control plasmid(NC)and PERK activator(CCT020312)via tail vein,and were randomly grouped into Normal group,GDM group,GDM+NC group,GDM+si-FABP4 group and GDM+si-FABP4+CCT020312 group.The levels of FABP4,blood lipids,inflammatory markers and oxidative stress markers in pancreatic tissue were detected,the expres-sions of PERK/eIF2α/ATF4/CHOP signaling pathway-related proteins in pancreatic tissue were detected.HTR-8/SVneo cells were divided into 5 groups:Control group,high glucose(HG)group,HG+NC group,HG+si-FABP4 group,HG+si-FABP4+CCT020312 group.After 24 h,the expressions of FABP4 and PERK/eIF2α/ATF4/CHOP signaling pathway related proteins were detected.Results:Compared with Normal group,the level of FABP4 in the serum and pancreatic tissue of the GDM group were obviously up-regu-lated(P<0.05).FABP4 silencing obviously reduced FBG and IR,decreased the levels of blood lipids,CRP,TNF-α,IL-6 and MDA,and increased the levels of SOD and CAT(P<0.05).Furthermore,FABP4 silencing attenuated pancreatic and placental tissue damages.After CCT020312 up-regulated the phosphorylation levels of PERK and eIF2α and the protein expressions of ATF4 and CHOP,the inhibitory effects of FABP4 silencing on IR,inflammation,oxidative stress,and pancreatic and placental damages in GDM rats were reversed(P<0.05).FABP4 was up-regulated in HTR-8/SVneo cells induced by HG,and silencing FABP4 inhibited the protein ex-pression of the PERK/eIF2α/ATF4/CHOP pathway,while CCT020312 reversed this change(P<0.05).Conclusion:FABP4 silencing improves IR and ERS in GDM rats by inhibiting inflammation and oxidative stress,and the mechanism is related to the inhibition of PERK/eIF2α/ATF4/CHOP signaling pathway.

Unplanned readmission is one of the adverse outcomes of patients after left ventricular assist device implantation,which seriously affects the prognosis of patients.This article reviews the incidence,causes,influencing factors and intervention measures of unplanned readmission of patients after left ventricular assist device implantation,in order to improve the attention of nursing staff,early identify high-risk groups of unplanned readmission of patients after left ventricular assist device implantation and provide references for formulating personalized intervention measures.

Objective To investigate the relationship between vertebrobasilar artery tortuosity and vasogenic dizziness/vertigo-related cerebral infarction in the elderly.Methods A total of 160 elderly patients with vasogenic dizziness/vertigo-related cerebral infarction admitted to the Department of Neurology of Taiyuan Xishan Hospital from January 2022 to October 2023 were selected.The patients were divided into tortuous group and non-tortuous group,80 cases in each group,according to the presence of vertebrobasilar artery abnormality by magnetic resonance angiography.The general clinical data,vascular disease risk factors,and the expanded-National Institutes of Health stroke scale(e-NIHSS)score of two groups were compared.The tortuous group was divided into simple abnormality group and mixed abnormality group according to vertebrobasilar artery morphology,and the degree of influence on related cerebral infarction was analyzed.Results The proportion of hypertension,vertebral artery dominance,smoking history and e-NIHSS score in ortuous group were significantly higher than those in non-tortuous group(P＜0.05).Multivariate Logistic regression analysis showed that history of hypertension,vertebral artery dominance,and smoking history were independent risk factors for elderly patients with vasogenic dizziness/vertigo-related cerebral infarction with vertebrobasilar artery abnormality(P＜0.05).54.3％of patients in simple abnormality group were moderate to severe stroke patients,and 58.8％of patients in mixed abnormality group were moderate to severe stroke patients,and there was no statistical significance between two groups(x2=0.029,P=0.864).Conclusion History of hypertension,vertebral artery dominance,and smoking history were independent risk factors for vasogenic dizziness/vertigo-related cerebral infarction in elderly patients with vertebrobasilar artery tortuosity,and these patients had higher neurological deficit scores.

Background/Aims: The shortage of donor liver hinders the development of liver transplantation. This study aimed to clarify the poor outcomes of functionally marginal liver grafts (FMLs) and provide evidence for the improvement of ischemia-free liver transplantation (IFLT) after FML transplantation. Methods: Propensity score matching was used to control for confounding factors. The outcomes of the control group and FML group were compared to demonstrate the negative impact of FMLs on liver transplantation patients. We compared the clinical improvements of the different surgical types. To elucidate the underlying mechanism, we conducted bioinformatic analysis based on transcriptome and single-cell profiles. Results: FMLs had a significantly greater hazard ratio (HR: 1.969, P=0.018) than did other marginal livers. A worse 90-day survival (Mortality: 12.3% vs. 5.0%, P=0.007) was observed in patients who underwent FML transplantation. Patients who received FMLs had a significant improvement in overall survival after IFLT (Mortality: 10.4% vs 31.3%, P=0.006). Pyroptosis and inflammation were inhibited in patients who underwent IFLT. The infiltration of natural killer cells was lower in liver grafts from these patients. Bulk transcriptome profiles revealed a positive relationship between IL-32 and Caspase 1 (R=0.73, P=0.01) and between IL-32 and Gasdermin D (R=0.84, P=0.0012). Conclusions FML is a more important negative prognostic parameter than other marginal liver parameters. IFLT might ameliorate liver injury in FMLs by inhibiting the infiltration of NK cells, consequently leading to the abortion of IL-32, which drives pyroptosis in monocytes and macrophages.