Tuberculosis,as a chronic infectious disease caused by Mycobacterium tuberculosis(MTB)infection,presenting a serious threat to human and animal health.When human body is infected by MTB,it quickly initiates an immune response,in which T lymphocyte-mediated cellular immunity plays a key role,as it can effectively recog-nize and eliminate MTB,serving as an important defense line for the body against MTB.However,during MTB in-fection process,myeloid-derived suppressor cells(MDSCs)undergo amplification and activation,which exhibit in-hibitory effect on the immune function of T lymphocytes and interfere the normal immune response of the body,making MTB easier to survive and reproduce in the body.This article discusses the role of MDSCs in the occu-rrence,development and prognosis of tuberculosis from two different perspectives,expects to provide new perspec-tives and ideas for the immunotherapy of tuberculosis as well as the research and development of targeted drugs,so as to open up a new way for the prevention and treatment of tuberculosis.

Tuberculosis,as a chronic infectious disease caused by Mycobacterium tuberculosis(MTB)infection,presenting a serious threat to human and animal health.When human body is infected by MTB,it quickly initiates an immune response,in which T lymphocyte-mediated cellular immunity plays a key role,as it can effectively recog-nize and eliminate MTB,serving as an important defense line for the body against MTB.However,during MTB in-fection process,myeloid-derived suppressor cells(MDSCs)undergo amplification and activation,which exhibit in-hibitory effect on the immune function of T lymphocytes and interfere the normal immune response of the body,making MTB easier to survive and reproduce in the body.This article discusses the role of MDSCs in the occu-rrence,development and prognosis of tuberculosis from two different perspectives,expects to provide new perspec-tives and ideas for the immunotherapy of tuberculosis as well as the research and development of targeted drugs,so as to open up a new way for the prevention and treatment of tuberculosis.

OBJECTIVE To evaluate the performance of commonly used molecular biological identification methods in differential identification of Citrobacter freundii complex(Cfc)and find out the differences in the mass spectra among the prevalent species of Cfc so as to facilitate the rapid and accurate identification.METHODS Totally 150 clinical strains were isolated from The First Medical Center of Chinese PLA General Hospital from 2015 to 2020 and were identified as Cfc by means of matrix assisted laser desorption ionization-time-of-flight mass spectrometry(MALDI-TOF MS),the genome data were obtained by the next generation sequencing and were compared with reference genome of Citrobacter species from National Center of Biotechnology Information(NCBI)based on aver-age nucleotide identity(ANI),phylogenetic analyses of rec N gene,concatenated alignments of four housekeeping genes(fusA,pyrG,leuS and rpoB as well as gyrB,rplB,fusA and leuS),core genome single nucleotide poly-morphism(coreSNP)and whole genome(WG),digital DNA-DNA hybridization(dDDH)analysis,ribosomal multilocus sequence typing(rMLST)and typical(strain)genome service(TYGS)analysis.ANI was set as the'gold standard' for the identification of the Cfc strains,and the capabilities of the various methods were evaluated.A certain number of strains of Citrobacter freundii(Cfr),Citrobacter braakii(Cbr)and Citrobacter portucalen-sis(Cpo)were randomly selected to obtain and compare the mass spectra so as to find out the differences in the mass spectra.RESULTS The identification capability of the Cfc strains is limited based on the available database for MALDI-TOF MS,Cpo was prone to be misidentified as Cfr or Cbr.The mass spectrum between Cpo and Cfr ranged between 2600 and 2660 m/z,the mass spectrum between Cpo and Cbr ranged between 5200 and 5300 m/z,showing significant difference.The concatenated alignments of four housekeeping genes gyrB,rplB,fusA and leuS,CoreSNP and WG phylogenetic analysis had high accurate rate of identification.CONCLUSIONS The meth-ods have certain limitations in identification of Cfc.The joint application of ANI with the methods such as WG phylogenetic analysis,update of mass spectrum database and timely establishment of database can achieve the ac-curate identification of the species of Cfc.

OBJECTIVE To evaluate the performance of commonly used molecular biological identification methods in differential identification of Citrobacter freundii complex(Cfc)and find out the differences in the mass spectra among the prevalent species of Cfc so as to facilitate the rapid and accurate identification.METHODS Totally 150 clinical strains were isolated from The First Medical Center of Chinese PLA General Hospital from 2015 to 2020 and were identified as Cfc by means of matrix assisted laser desorption ionization-time-of-flight mass spectrometry(MALDI-TOF MS),the genome data were obtained by the next generation sequencing and were compared with reference genome of Citrobacter species from National Center of Biotechnology Information(NCBI)based on aver-age nucleotide identity(ANI),phylogenetic analyses of rec N gene,concatenated alignments of four housekeeping genes(fusA,pyrG,leuS and rpoB as well as gyrB,rplB,fusA and leuS),core genome single nucleotide poly-morphism(coreSNP)and whole genome(WG),digital DNA-DNA hybridization(dDDH)analysis,ribosomal multilocus sequence typing(rMLST)and typical(strain)genome service(TYGS)analysis.ANI was set as the'gold standard' for the identification of the Cfc strains,and the capabilities of the various methods were evaluated.A certain number of strains of Citrobacter freundii(Cfr),Citrobacter braakii(Cbr)and Citrobacter portucalen-sis(Cpo)were randomly selected to obtain and compare the mass spectra so as to find out the differences in the mass spectra.RESULTS The identification capability of the Cfc strains is limited based on the available database for MALDI-TOF MS,Cpo was prone to be misidentified as Cfr or Cbr.The mass spectrum between Cpo and Cfr ranged between 2600 and 2660 m/z,the mass spectrum between Cpo and Cbr ranged between 5200 and 5300 m/z,showing significant difference.The concatenated alignments of four housekeeping genes gyrB,rplB,fusA and leuS,CoreSNP and WG phylogenetic analysis had high accurate rate of identification.CONCLUSIONS The meth-ods have certain limitations in identification of Cfc.The joint application of ANI with the methods such as WG phylogenetic analysis,update of mass spectrum database and timely establishment of database can achieve the ac-curate identification of the species of Cfc.

Objective To analyze the perioperative outcomes of cardiac valve surgery in patients with asymptomatic SARS-CoV-2 infection. Methods The perioperative clinical data of patients receiving heart valve replacement in the Department of Cardiovascular Surgery, the First Affiliated Hospital of University of Science and Technology of China from November 2022 to February 2023 were retrospectively analyzed. According to whether the patients were infected with SARS-CoV-2, they were divided into a non-infected group and an asymptomatic group. The perioperative data of the patients were compared between the two groups, and the effect of asymptomatic infection on the result of heart valve replacement surgery was analyzed. Results A total of 66 patients were enrolled including 36 males and 30 females with a mean age of 58.0±11.1 years. There were 51 patients in the non-infected group and 15 patients in the asymtomatic group. There were 2 patients of mitral valve replacement, 20 patients of aortic valve replacement, 1 patient of double valve replacement, 3 patients of aortic valve replacement with tricuspid valvoplasty, 22 patients of mitral valve replacement and tricuspid valvoplasty, 18 patients of double valve replacement and tricuspid valvoplasty. Asymptomatic infected patients received more emergency surgery than uninfected patients (26.7% vs. 0.0%, P<0.01). There was no statistical difference in the duration of extracorporeal circulation, aortic occlusion, mechanical ventilation time after the surgery, ICU stay, postoperative drainage volume, or postoperative complications between the two groups. Conclusion Perioperative results of cardiac valve surgery in patients with asymptomatic SARS-CoV-2 infection and non-infection are almost the same.

Objective To gain more pathophysiolgic knowledge about acute obstructive hydrocephalus and to explore its rapid and effective treatment by establishing canine acute obstructive hydrocephalus model.Methods Acute obstructive hydrocephalus model was established by injecting cyan-acrylic gel glue into the fourth ventricle via posterior fosse craniotomy in 9 male adult mongrel dogs.At the same time,lateral ventricle catheterization were performed and were fixed on the scalp to connect reservoir bag so that the changes of intracranial pressure (ICP) could be measured dynamically,and the changes of neurological function were observed.Results Acute obstructive hydrocephalus model was successfully established in 6 of the total 9dogs.ICP was (48.2 ± 6.1 ) cm H2 O at 48 hours after the injection and was (56.4 ± 5.7 ) cm H2 O at 72 hours after the injection,it increased 392％ and 459 ％ respectively.And the ICP after injection was significantly different(P ＜ 0.01 )compared with that before injection (12.3 ± 3.1 )cm H2O.Conclusion The establishment of acute obstructive hydrocephalus model has high success rate,and is easy to reduplicate; ICP could be measured dynamically and also could be reduced by releasing CSF;Thus,ventricular drainage is the most rapid and effective treatment for acute obstructive hydrocephalus.

Objective To approach the normal manifestations of the hypopharynx of the adults at the level of cricoid cartilage as seen on CT images, and to evaluate their clinical value. Methods Eighty-four CT images of the normal hypopharynx were reviewed. The hypopharynx was divided into three regions:(1) the piriform sinus, (2) the retropharynx area, and (3) the postcricoid region. The postcricoid region of hypopharynx was subdivided into three levels as follows : (1) the upper margin slice of the cricoid cartilage at the cricoarytenoid joint level, (2) the middle portion slice of the cricoid cartilage, and (3)the inferior margin slice of the cricoid cartilage. The anteroposterior and transverse diameters, and anterior and posterior wall thicknesses in the postcricoid region were measured. Depiction of the layers of the musculature and adjacent fat planes was evaluated. Statistical comparisons of measured results were made by using ttest and x2 test. Results The posterior wall tended to be (0. 9±0. 4) mm thicker than the anterior wall. The average transverse extension of the postcricoid musculature was (4. 5±0. 3)mm shorter in female than that in male at CT images. There were statistically significant differences related to sex (at the upper margin level of the cricoid cartilage : the transverse extension was (38. 6±3. 3)mm in male, (34. d±2. 5) mm in female, t = 6. 26,P < 0. 05 ; at the middle portion level of the crieoid cartilage: (33.6±3. 6) mm in male,(28.9±2.8) mm in female t =6.36, P <0.01;at the inferior margin level of the cricoid cartilage:(28.6 ±3. 1) nun in male, (24. 0 ±2. 1) mm in female, t = 7.52, P <0. 01). The transverse diameter tended to taper (10. 1±2. 4) mm from the upper cricoid slice level to the lower cricoid slice levelDemonstration of the intramural fat planes of the postcricoid region decreased from the upper [ 81.0%(68/84)] to the lower region [23.8% (20/84)] of the cricoid cartilage. In fat planes around the postcricoid region at all levels, the posterior fat plane was seen least frequently, and the left-sided fat plane was seen most frequently. There was a statistically significant difference at every level(at the upper margin level of the cricoid cartilage, the visibilities of the left-sided, the right-sided, and the posterior fat plane around the postcricoid region were 77.4% (65/84), 72. 6% (61/84), and 28. 6% (24/84) ,x<'2> =24. 64,P <0.01 ; at the middle portion level of the cricoid cartilage, the visibilities were 89.3% (75/84), 75.0%(63/84), and 34.5% (29/84) ,x<'2> =24. 76, P <0. 01 ; at the inferior margin level of the cricoid cartilage:the visibilities were 95.2% (80/84), 88. 1% (74/84), and 52. 4% (44/84), x<'2> = 13.59, P < 0. 01.Conclusion Knowledge of the normal appearances and variations of the hypopharynx at the level of cricoid cartilage is essential in detecting abnormalities in this area.

OBJECTIVETo study the effect of retinoid kappa receptor alpha (RXRalpha) transfection plus treatment with the RXRalpha ligand, 9-cis-RA, on the proliferation and phenotype of platelet-derived growth factor (PDGF) activated hepatic stellate cells (HSCs).

METHODSPDGF activated rat hepatic stellate cells were transfected with eukaryotic expression vector pcDNA3.1- human RXRalpha, and confirmed by Western blot. Proliferation of transfected HSC was assayed by bromodeoxyuridine (BrdU) incorporation as well as MTT, and the phenotype (alpha-smooth muscle actin, desmin) was observed by immunocytochemistry with image analysis.

RESULTSTransfection of the RXRalpha gene and treatment with ligand 9-cis-RA of PDGF-activated HSCs extended the increased expression of RXRalpha protein for at least 168 hours. Cell proliferation and expressions of alpha- smooth muscle actin (alpha-SMA) and desmin were blocked, compared with groups of sham-transfected, PDGF-activated, no transfection, no ligand treatment, and irrelevant ligand treated HSCs.

CONCLUSIONTransfection with the RXRalpha gene followed by 9-cis-RA ligand treatment will inhibit the proliferation and reverse the phenotype of activated HSC.

Animals ; Cell Division ; Cells, Cultured ; Liver ; cytology ; Liver Cirrhosis ; etiology ; Male ; Phenotype ; Platelet-Derived Growth Factor ; pharmacology ; Rats ; Rats, Sprague-Dawley ; Receptors, Retinoic Acid ; genetics ; physiology ; Retinoid X Receptors ; Transcription Factors ; genetics ; physiology ; Transfection

Objective To explore the clinical significance of the resection of the cardia and fundus for patients suffering from cardiac cancer of the gastric stump.Methods Twenty-five patients suffering from cardiac cancer with a mean period of 13 years and 3 months after subtotal gastrectomy were included in this study. Their average age was 59.1 years. Among them, 19 patients got exploratory thoracotomy.Results Of the 19 patients, 1 was inoperable, 1 underwent resection of the gastric stump and esophagojejunostomy because of his huge tumor, 17 underwent resection of the cardia and fundus of the gastric stump and accepted gastroesophagostomy (9 were subjected to tunnel gastroesophagostomy and 8 to end-to-end esophagogastrostomy). The largest tumor was 5 cm×4 cm in size. Except for a death resulting from intestinal obstruction following operation, the others attained a good recovery. The longest period of survival was 4.5 years. Conclusions Resection of the cardia and fundus and gastroesophagostomy can be carried out for patients suffering from cardiac cancer of the gastric stump. The method is in line with the principle of the conservation surgery.