Recent data suggest that vascular endothelial growth factor receptor inhibitor (VEGFRi) can enhance the anti-tumor activity of the anti-programmed cell death-1 (anti-PD-1) antibody in colorectal cancer (CRC) with microsatellite stability (MSS). However, the comparison between this combination and standard third-line VEGFRi treatment is not performed, and reliable biomarkers are still lacking. We retrospectively enrolled MSS CRC patients receiving anti-PD-1 antibody plus VEGFRi (combination group, n=54) or VEGFRi alone (VEGFRi group, n=32), and their efficacy and safety were evaluated. We additionally examined the immune characteristics of the MSS CRC tumor microenvironment (TME) through single-cell and spatial transcriptomic data, and an MSS CRC immune cell-related signature (MCICRS) that can be used to predict the clinical outcomes of MSS CRC patients receiving immunotherapy was developed and validated in our in-house cohort. Compared with VEGFRi alone, the combination of anti-PD-1 antibody and VEGFRi exhibited a prolonged survival benefit (median progression-free survival: 4.4 vs. 2.0 months, P=0.0024; median overall survival: 10.2 vs. 5.2 months, P=0.0038) and a similar adverse event incidence. Through single-cell and spatial transcriptomic analysis, we determined ten MSS CRC-enriched immune cell types and their spatial distribution, including naive CD4⁺ T, regulatory CD4⁺ T, CD4⁺ Th17, exhausted CD8⁺ T, cytotoxic CD8⁺ T, proliferated CD8⁺ T, natural killer (NK) cells, plasma, and classical and intermediate monocytes. Based on a systemic meta-analysis and ten machine learning algorithms, we obtained MCICRS, an independent risk factor for the prognosis of MSS CRC patients. Further analyses demonstrated that the low-MCICRS group presented a higher immune cell infiltration and immune-related pathway activation, and hence a significant relation with the superior efficacy of pan-cancer immunotherapy. More importantly, the predictive value of MCICRS in MSS CRC patients receiving immunotherapy was also validated with an in-house cohort. Anti-PD-1 antibody combined with VEGFRi presented an improved clinical benefit in MSS CRC with manageable toxicity. MCICRS could serve as a robust and promising tool to predict clinical outcomes for individual MSS CRC patients receiving immunotherapy.
Humans ; Colorectal Neoplasms/drug therapy* ; Male ; Female ; Immunotherapy ; Middle Aged ; Aged ; Tumor Microenvironment/immunology* ; Retrospective Studies ; Microsatellite Instability ; Transcriptome ; Single-Cell Analysis ; Programmed Cell Death 1 Receptor/immunology* ; Gene Expression Profiling ; Immune Checkpoint Inhibitors/therapeutic use* ; Adult ; Receptors, Vascular Endothelial Growth Factor/antagonists & inhibitors*

To investigate the infection status of two arboviruses,akabane orthobunyavirus(AKAV)and bluetongue virus(BTV),in cattle herds of Guizhou Province,we employed the indirect ELISA method to detect AKAV and BTV antibody levels in the present experiment.A total of 1504 bovine serum samples from 37 large-scale farms and 88 free-range households from 26 districts or coun-ties of 7 cities(prefectures)of Guizhou Province were collected to detect AKAV antibody levels.Additionally,1 241 serum samples from 30 large-scale farms and 15 free-range households in 19 districts or counties of 3 cities(prefectures)were tested for BTV antibody levels.Moreover,two influencing factors,breeding mode and sampling season,were statistically analyzed for their effects.The results showed that the overall positive rate of AKAV antibodies was 11.64％(175/1 504),with individual positive rates of 13.20％(123/934)and 9.12％(52/570)in large-scale farms and free-range households,respectively.No significant differences were observed between the two groups.However,the farm positive rate(64.86％,24/37)in large-scale farms was significantly higher than that(26.14％,23/88)in free-range households.Seasonal statistics showed that the positive rate was highest during the summer season at 60.00％(12/20).The total positive rate of BTV antibodies was 25.42％(222/1 241).The farm positive rate and individual positive rate in free-range households were 66.67％(10/15)and 41.91％(57/136),respectively.For large-scale farms,these rates were 60.00％(18/30)and 14.93％(165/1 105),respectively.The individual pos-itive rate in free-range households was significantly higher than that in large-scale farms.Seasonal statistics showed that the positive rates in summer and autumn seasons were 50.00％(5/10)and 72.41％(21/29),respectively,both of which were significantly higher than those in winter and spring seasons.All these findings indicated that both AKAV and BTV were present to a certain ex-tent in Guizhou Province,with seasonality.Furthermore,differences were observed between the different breeding modes.Our results could provide a data reference for the formulation of preven-tion and control measures for the two insect-borne diseases.

Objective:To explore the application effect of fine skin care in patients with psoriasis, and provide evidence-based theoretical basis for the development of skin care in patients with psoriasis.Methods:A randomized controlled trial was conducted. Patients with psoriasis admitted to the People′s Hospital of Wenshan Zhuang and Miao Autonomous Prefecture, Yunnan Province from December 2022 to March 2024 were selected as the research subjects by the convenience sampling method and divided into the control group and the experimental group by the random number table method. The control group was given routine care. The experimental group was given fine skin care on the basis of control group. Before and after the intervention, the itching symptoms, skin lesions, comfort and quality of life were evaluated using 12-item Pruritus Severity Scale (12-PSS), Psoriasis Area and Severity Index (PASI), General Comfort Questionnaire (GCQ), 36-item Short Form (SF-36) and compared between the two groups. The incidence of complications and recurrence rate in the two groups were counted 3 months after intervention.Results:Finally, 96 patients were included in the study, including 48 patients in the experimental group, 28 males and 20 females, aged (59.31 ± 17.31) years old; 48 cases in the control group, 29 males and 19 females, aged (61.54 ± 18.11) years old. Before the intervention, there were no statistically significant differences in the scores of 12-PSS, PASI, GCQ and SF-36 between the two groups (all P>0.05). After the intervention, the scores of 12-PSS and PASI in the experimental group were (3.65 ± 2.96), (5.08 ± 1.15) points respectively, which were lower than (8.29 ± 2.00), (7.37 ± 1.34) points in the control group, the differences were statistically significant ( t=9.00, 8.99, both P<0.05). The scores of GCQ and SF-36 in the experimental group were (41.42 ± 4.01), (95.08 ± 4.47) points respectively, which were higher than (33.94 ± 5.74) and (84.19 ± 8.52) points in the control group, the differences were statistically significant ( t=7.40, 7.84, both P<0.05). The total incidence of complications and recurrence rate in the experimental group were 4.17% (2/48), 2.08% (1/48) respectively, which were lower than 18.75% (9/48), 14.58% (7/48) in the control group, the differences were statistically significant ( χ2=5.03, 4.91, both P<0.05). Conclusions:Fine skin care can improve the itching symptoms of patients with psoriasis and reduce the severity of skin lesions. It can also improve the comfort and quality of life of patients and reduce the incidence of complications and recurrence rate, and the clinical application effect is good.

To investigate the infection status of two arboviruses,akabane orthobunyavirus(AKAV)and bluetongue virus(BTV),in cattle herds of Guizhou Province,we employed the indirect ELISA method to detect AKAV and BTV antibody levels in the present experiment.A total of 1504 bovine serum samples from 37 large-scale farms and 88 free-range households from 26 districts or coun-ties of 7 cities(prefectures)of Guizhou Province were collected to detect AKAV antibody levels.Additionally,1 241 serum samples from 30 large-scale farms and 15 free-range households in 19 districts or counties of 3 cities(prefectures)were tested for BTV antibody levels.Moreover,two influencing factors,breeding mode and sampling season,were statistically analyzed for their effects.The results showed that the overall positive rate of AKAV antibodies was 11.64％(175/1 504),with individual positive rates of 13.20％(123/934)and 9.12％(52/570)in large-scale farms and free-range households,respectively.No significant differences were observed between the two groups.However,the farm positive rate(64.86％,24/37)in large-scale farms was significantly higher than that(26.14％,23/88)in free-range households.Seasonal statistics showed that the positive rate was highest during the summer season at 60.00％(12/20).The total positive rate of BTV antibodies was 25.42％(222/1 241).The farm positive rate and individual positive rate in free-range households were 66.67％(10/15)and 41.91％(57/136),respectively.For large-scale farms,these rates were 60.00％(18/30)and 14.93％(165/1 105),respectively.The individual pos-itive rate in free-range households was significantly higher than that in large-scale farms.Seasonal statistics showed that the positive rates in summer and autumn seasons were 50.00％(5/10)and 72.41％(21/29),respectively,both of which were significantly higher than those in winter and spring seasons.All these findings indicated that both AKAV and BTV were present to a certain ex-tent in Guizhou Province,with seasonality.Furthermore,differences were observed between the different breeding modes.Our results could provide a data reference for the formulation of preven-tion and control measures for the two insect-borne diseases.

BACKGROUND:Quantitative measurement of knee laxity after partial anterior cruciate ligament injury is crucial for timely diagnosis,post-treatment,and rehabilitation.There is a lack of research on the use of articular ligament digital arthrometer in the diagnosis of partial anterior cruciate ligament injury.OBJECTIVE:To investigate the diagnostic value of a new articular ligament digital arthrometer in partial anterior cruciate ligament injury.METHODS:Totally 30 patients with partial anterior cruciate ligament injury and 20 healthy volunteers were included.The anterior tibial translation values under 80,120,and 150 N loads were measured by a homebred digital arthrometer.The anterior tibial translation and side-to-side difference were compared between the partial anterior cruciate ligament group and control group.The receiver operating characteristic curve was analyzed and area under curve was calculated,and the diagnostic sensitivity and specificity of the digital arthrometer were determined.RESULTS AND CONCLUSION:(1)There was no significant difference in age,sex,body mass index,and course of disease between the partial anterior cruciate ligament injury group and control group(P＞0.05).(2)The side-to-side difference values of the partial anterior cruciate ligament injury group were significantly higher than those of the control group(P＜0.05),and the anterior tibial translation values of the injured side were significantly higher than those of the healthy side in the partial anterior cruciate ligament injury group(P＜0.05).(3)When the load was applied at 80 N,the diagnostic accuracy was highest(cutoff value=10.45 mm);the area under curve was 0.813(95％CI:0.708-0.919),and the sensitivity and specificity were 76.7％and 70.0％,respectively.(4)It is indicated that the digital arthrometer can objectively and quantitatively evaluate knee laxity after partial anterior cruciate ligament injury,and provide objective diagnostic basis for patients with partial anterior cruciate ligament iniurv.

Objective:To explore the application effect of fine skin care in patients with psoriasis, and provide evidence-based theoretical basis for the development of skin care in patients with psoriasis.Methods:A randomized controlled trial was conducted. Patients with psoriasis admitted to the People′s Hospital of Wenshan Zhuang and Miao Autonomous Prefecture, Yunnan Province from December 2022 to March 2024 were selected as the research subjects by the convenience sampling method and divided into the control group and the experimental group by the random number table method. The control group was given routine care. The experimental group was given fine skin care on the basis of control group. Before and after the intervention, the itching symptoms, skin lesions, comfort and quality of life were evaluated using 12-item Pruritus Severity Scale (12-PSS), Psoriasis Area and Severity Index (PASI), General Comfort Questionnaire (GCQ), 36-item Short Form (SF-36) and compared between the two groups. The incidence of complications and recurrence rate in the two groups were counted 3 months after intervention.Results:Finally, 96 patients were included in the study, including 48 patients in the experimental group, 28 males and 20 females, aged (59.31 ± 17.31) years old; 48 cases in the control group, 29 males and 19 females, aged (61.54 ± 18.11) years old. Before the intervention, there were no statistically significant differences in the scores of 12-PSS, PASI, GCQ and SF-36 between the two groups (all P>0.05). After the intervention, the scores of 12-PSS and PASI in the experimental group were (3.65 ± 2.96), (5.08 ± 1.15) points respectively, which were lower than (8.29 ± 2.00), (7.37 ± 1.34) points in the control group, the differences were statistically significant ( t=9.00, 8.99, both P<0.05). The scores of GCQ and SF-36 in the experimental group were (41.42 ± 4.01), (95.08 ± 4.47) points respectively, which were higher than (33.94 ± 5.74) and (84.19 ± 8.52) points in the control group, the differences were statistically significant ( t=7.40, 7.84, both P<0.05). The total incidence of complications and recurrence rate in the experimental group were 4.17% (2/48), 2.08% (1/48) respectively, which were lower than 18.75% (9/48), 14.58% (7/48) in the control group, the differences were statistically significant ( χ2=5.03, 4.91, both P<0.05). Conclusions:Fine skin care can improve the itching symptoms of patients with psoriasis and reduce the severity of skin lesions. It can also improve the comfort and quality of life of patients and reduce the incidence of complications and recurrence rate, and the clinical application effect is good.

BACKGROUND:Quantitative measurement of knee laxity after partial anterior cruciate ligament injury is crucial for timely diagnosis,post-treatment,and rehabilitation.There is a lack of research on the use of articular ligament digital arthrometer in the diagnosis of partial anterior cruciate ligament injury.OBJECTIVE:To investigate the diagnostic value of a new articular ligament digital arthrometer in partial anterior cruciate ligament injury.METHODS:Totally 30 patients with partial anterior cruciate ligament injury and 20 healthy volunteers were included.The anterior tibial translation values under 80,120,and 150 N loads were measured by a homebred digital arthrometer.The anterior tibial translation and side-to-side difference were compared between the partial anterior cruciate ligament group and control group.The receiver operating characteristic curve was analyzed and area under curve was calculated,and the diagnostic sensitivity and specificity of the digital arthrometer were determined.RESULTS AND CONCLUSION:(1)There was no significant difference in age,sex,body mass index,and course of disease between the partial anterior cruciate ligament injury group and control group(P＞0.05).(2)The side-to-side difference values of the partial anterior cruciate ligament injury group were significantly higher than those of the control group(P＜0.05),and the anterior tibial translation values of the injured side were significantly higher than those of the healthy side in the partial anterior cruciate ligament injury group(P＜0.05).(3)When the load was applied at 80 N,the diagnostic accuracy was highest(cutoff value=10.45 mm);the area under curve was 0.813(95％CI:0.708-0.919),and the sensitivity and specificity were 76.7％and 70.0％,respectively.(4)It is indicated that the digital arthrometer can objectively and quantitatively evaluate knee laxity after partial anterior cruciate ligament injury,and provide objective diagnostic basis for patients with partial anterior cruciate ligament iniurv.

Objective:To explore the predictive value of the neutrophil-to-lymphocyte ratio (NLR) combined with blood glucose at admission for a positive blood culture for sepsis.Methods:A single-center retrospective cohort study was conducted. According to the 2016 American Society of Critical Care/European Society of Critical Care Medicine (SCCM/ESICM) and diagnostic criteria for sepsis and septic shock-3.0 (sepsis-3.0), patients with sepsis were admitted to the Emergency Department of Fujian Medical University Union Hospital for more than 24 h from January 2019 to December 2021 were enrolled. Age, gender, sequential organ failure assessment, source of infection, NLR, and blood culture results were recorded. Based on the blood culture results, patients were divided into a blood culture positive group (Gram-positive group, Gram-negative group) and blood culture negative group, and the differences between the groups were compared. The risk factors for a positive blood culture were analyzed using multivariate logistic regression. A receiver operating characteristic analysis was performed for the NLR combined with the blood glucose measurement.Results:A total of 265 patients with sepsis were included, of which 62 were positive in blood culture (15 Gram-positive patients, 37 Gram-negative patients and 10 fungal patients). The positive rate of blood culture was 23.4%. The number of patients with history of diabetes, neutrophil count, procalcitonin, blood glucose, and NLR in the positive blood culture group were significantly higher than those in the negative blood culture group (all P<0.001). Multivariate logistic regression analysis revealed that random admission blood glucose ( OR=1.116, 95% CI: 1.051~1.186, P<0.001) and NLR ( OR=1.039, 95% CI: 1.015~1.064, P=0.001) were independent risk factors for blood culture positivity in sepsis patients. For patients with blood culture positive, and with Gram-negative bacterial bloodstream infections, the AUC of the NLR combined with the admission blood glucose level was 0.819 (95% CI: 0.761-0.877, P<0.001) and 0.871 (95% CI: 0.813-0.928, P<0.001), respectively. Conclusions:The combination of NLR and random admission blood glucose could provide a good predictive value for blood culture positive and gram-negative bacterial bloodstream infections in sepsis patients.

Objection:To evaluate the effects of the miniscrew supported removable palatal arch for maxillary molar distalization.Methods:33 patients with mild to moderate crowding teeth and maxillary protrusion were treated with the miniscrew supported remova-ble palatal arch.The lateral cephalograms and dental plaster models were taken at the beginning of the treatment(T0)and at the end of molar distalization(T1).The multicentre variables were measured and compared with statistical software.Results:Cephalometrics showed that the average distance(mm)of the firs molar distalization was 3.6(P＜0.001),molar distal tipping was 6°(P＜0.001)and molar intrusion(mm)was 0.6(P＜0.05).The measurements of right and left molar distalization on plaster models were 4.2 mm(P＜0.001)and 4.0 mm(P＜0.001)respectively,the width of dental arch was increased by 3.1 mm(P＜0.05).The data of distalization of the first molar showed no statistical difference between right and left side on plaster cast and between model and cephalometric meas-urements.On the right side the angle between the mesial-distal tips line and the middle line was increased by 1.6°(P＞0.05),on the left by 4.8°(P＜0.05).Conclusion:The none extraction therapy for mild to moderate crowding teeth and maxillary protrusion can be realized by miniscrew supported removable palatal arch distalization appliance.

In order to establish a rapid,specific and sensitive detection method for Streptococcus equi subspecies zooepidemicus(SEZ)and to understand the infection status of SEZ in horses ente-ring China,specific primers were designed and synthesized based on the conserved gene comB of standard strain SEZ(ATCC 43079)in this work.Then,the pMD19-T-comB recombinant plasmid was constructed and used as a standard positive template.After that,the fluorescence-based quantitative PCR(qPCR)detection method based on SYBR Green Ⅰ dye was established.Totally,477 equine entry serum samples from 6 countries,including Netherlands,Belgium,Japan,Germa-ny,Argentina and New Zealand,during 2018 to 2023,were randomly selected and detected for SEZ by the qPCR method.Results showed that the established qPCR method had specific amplification for only SEZ,which illustrated a good specificity.Sensitivity test of the method showed that the limited detection amount was 4.58 X101 copies/μL.And the repeatability test showed that the coef-ficient of variation of intra-batch repeatability was less than 0.5％,while the inter-batch repeat-ability was less than 3.0％,which indicated good repeatability and high stability.Retrospective a-nalysis showed that totally 11 of 477 positive samples were detected,with a relatively low positive rate of 2.31％(11/477).Among them,all the 40 samples from Netherlands in 2018 were negative(0/40).In the samples of 2019,one positive was detected from Belgium(1/20),while all other 36 samples which form Japan and Germany were negative.In the samples of 2021,three samples(3/34)from Japan and one sample(1/20)from Argentina were positive,and all the other 40 samples from the Netherlands were negative.In the samples of 2022,76 samples from Netherlands were all negative.While in the 2023,5(5/126)of 126 samples from Netherlands and one(1/88)of 88 from New Zealand were found positive with SEZ.To summarize,The SYBR Green Ⅰ qPCR method for the diagnosis of SEZ was successfully established,and it could provide necessary technical support for the rapid quarantine of China's entry-exit and port departments,as well as the epidemiological investigation of the disease.