Objective Investigating the correlation between fluctuations in proliferation-inducing ligand(APRIL),M-type phospholipase A2 receptor antibody(PLA2R Ab),and 25-hydroxyvitamin D3[25-(OH)D3]levels and their impact on the severity and prognosis of primary membranous nephropathy(PMN).Methods A prospective study design was employed,wherein 100 confirmed PMN patients from Xingtai People's Hospital were recruited as the PMN group,and 100 healthy volunteers served as the control group.The levels of APRIL,PLA2R Ab,and 25-(OH)D3 were compared between the two groups of participants,stratified by PMN disease stage and treatment outcomes.A simple linear correlation analysis was conducted to evaluate the correlation between APRIL,PLA2R Ab,and 25-(OH)D3 with renal function indicators.Additionally,a multiple regression model was utilized to analyze the associations between these indicators and patient treatment outcomes as well as prognosis.Results The levels of APRIL and PLA2R Ab in the MN group were significantly higher than those in the control group,whereas the levels of 25-(OH)D3 were significantly lower than those in the control group(P<0.05).Among 100 patients with PMN,there were 20 in stage I,42 in stage Ⅱ,34 in stage Ⅲ,and 4 in stage Ⅳ.The levels of APRIL and PLA2R Ab in stage Ⅲ+Ⅳ patients were significantly higher than those in stage Ⅰ+Ⅱ patients,while the level of 25-(OH)D3 was significantly lower in stage Ⅲ+Ⅳ patients compared to stage Ⅰ+Ⅱ patients(P<0.05).In PMN patients,serum APRIL and PLA2R-Ab levels were negatively correlated with urea nitrogen(BUN),creatinine(Scr),and 24-h urinary protein(P<0.05).Additionally,APRIL and PLA2R-Ab levels were positively correlated with total protein(TP)and albumin(ALB)(P<0.05),while serum 25-(OH)D3 levels were negatively correlated with BUN,Scr,and 24-h urinary protein(P<0.05).After treatment,42 patients achieved complete remission,while 58 patients did not meet the remission criteria.Serum APRIL and PLA2R-Ab levels in the remis-sion group were significantly lower than those in the non-remission group both before treatment and after 12 months of treatment.Furthermore,serum 25-(OH)D3 levels in the remission group were significantly higher than those in the non-remission group both before treatment and after 12 months of treatment(P<0.05).Conclusions Elevated levels of serum APRIL and PLA2R antibodies,which contribute to immune dysfunction,are closely asso-ciated with the onset and severity of PMN.Renal impairment leads to a substantial reduction in serum 25-(OH)D3 levels.Collectively,these three indicators serve as critical markers for the occurrence,progression,and prognosis of PMN.

Objective Investigating the correlation between fluctuations in proliferation-inducing ligand(APRIL),M-type phospholipase A2 receptor antibody(PLA2R Ab),and 25-hydroxyvitamin D3[25-(OH)D3]levels and their impact on the severity and prognosis of primary membranous nephropathy(PMN).Methods A prospective study design was employed,wherein 100 confirmed PMN patients from Xingtai People's Hospital were recruited as the PMN group,and 100 healthy volunteers served as the control group.The levels of APRIL,PLA2R Ab,and 25-(OH)D3 were compared between the two groups of participants,stratified by PMN disease stage and treatment outcomes.A simple linear correlation analysis was conducted to evaluate the correlation between APRIL,PLA2R Ab,and 25-(OH)D3 with renal function indicators.Additionally,a multiple regression model was utilized to analyze the associations between these indicators and patient treatment outcomes as well as prognosis.Results The levels of APRIL and PLA2R Ab in the MN group were significantly higher than those in the control group,whereas the levels of 25-(OH)D3 were significantly lower than those in the control group(P<0.05).Among 100 patients with PMN,there were 20 in stage I,42 in stage Ⅱ,34 in stage Ⅲ,and 4 in stage Ⅳ.The levels of APRIL and PLA2R Ab in stage Ⅲ+Ⅳ patients were significantly higher than those in stage Ⅰ+Ⅱ patients,while the level of 25-(OH)D3 was significantly lower in stage Ⅲ+Ⅳ patients compared to stage Ⅰ+Ⅱ patients(P<0.05).In PMN patients,serum APRIL and PLA2R-Ab levels were negatively correlated with urea nitrogen(BUN),creatinine(Scr),and 24-h urinary protein(P<0.05).Additionally,APRIL and PLA2R-Ab levels were positively correlated with total protein(TP)and albumin(ALB)(P<0.05),while serum 25-(OH)D3 levels were negatively correlated with BUN,Scr,and 24-h urinary protein(P<0.05).After treatment,42 patients achieved complete remission,while 58 patients did not meet the remission criteria.Serum APRIL and PLA2R-Ab levels in the remis-sion group were significantly lower than those in the non-remission group both before treatment and after 12 months of treatment.Furthermore,serum 25-(OH)D3 levels in the remission group were significantly higher than those in the non-remission group both before treatment and after 12 months of treatment(P<0.05).Conclusions Elevated levels of serum APRIL and PLA2R antibodies,which contribute to immune dysfunction,are closely asso-ciated with the onset and severity of PMN.Renal impairment leads to a substantial reduction in serum 25-(OH)D3 levels.Collectively,these three indicators serve as critical markers for the occurrence,progression,and prognosis of PMN.

Mesocotyl elongation is a key trait influencing seedling emergence and establishment in direct-seeding rice cultivation. The phytohormone gibberellin (GA) has positive effects on mesocotyl elongation in rice. However, the physiological and molecular basis underlying the regulation of mesocotyl elongation mediated by GA priming under deep-sowing conditions remains largely unclear. In the present study, we performed a physiological and comprehensive transcriptomic analysis of the function of GA priming in mesocotyl elongation and seedling emergence using a direct-seeding

Objective:To analyze the application of Chronic Obstructive Pulmonary Disease (COPD) Screening Questionnaire and pulmonary function test in dust-exposed migrant workers.Methods:In May 2019, 149 cases of dust exposed migrant workers were selected as the research subjects through the free clinic in the countryside. COPD Screening Questionnaire and lung function test were carried out to analyze the high-risk groups and the influencing factors of positive pulmonary function test results.Results:Among 149 cases of dust-exposed migrant workers, 107 (71.8%) were positive for questionnaire screening, 73 (49.0%) were positive for pulmonary function test, 75 (50.3%) were diagnosed with coal worker's pneumoconiosis, and 101 (67.8%) were diagnosed with lung function injury. The positive rate of pulmonary function of migrant workers with positive questionnaire screening results was significantly higher than that of those with negative results ( P<0.05) . The results of multivariate analysis showed that compared with non-pneumoconiosis, the risk of positive pulmonary function test results was higher in dust-exposed migrant workers with stage Ⅲ pneumoconiosis ( OR=16.462, 95% CI: 3.390-79.946; P<0.01) . Compared with non-smoking, the risks of positive pulmonary function test results of dust-exposed migrant workers with smoking index of 11-20 package years and >20 package years were higher ( OR=19.814, 95% CI: 3.854-101.883; OR=9.733, 95% CI: 2.310-41.008; P<0.01) . Conclusion:The risk of COPD in dust-exposed migrant workers is high, so we should strengthen the early examination of the high pneumoconiosis stage and smoking population. The screening questionnaire can better screen out the high-risk groups of COPD, and it can be used as a basic screening tool.

Objective:To analyze the application of Chronic Obstructive Pulmonary Disease (COPD) Screening Questionnaire and pulmonary function test in dust-exposed migrant workers.Methods:In May 2019, 149 cases of dust exposed migrant workers were selected as the research subjects through the free clinic in the countryside. COPD Screening Questionnaire and lung function test were carried out to analyze the high-risk groups and the influencing factors of positive pulmonary function test results.Results:Among 149 cases of dust-exposed migrant workers, 107 (71.8%) were positive for questionnaire screening, 73 (49.0%) were positive for pulmonary function test, 75 (50.3%) were diagnosed with coal worker's pneumoconiosis, and 101 (67.8%) were diagnosed with lung function injury. The positive rate of pulmonary function of migrant workers with positive questionnaire screening results was significantly higher than that of those with negative results ( P<0.05) . The results of multivariate analysis showed that compared with non-pneumoconiosis, the risk of positive pulmonary function test results was higher in dust-exposed migrant workers with stage Ⅲ pneumoconiosis ( OR=16.462, 95% CI: 3.390-79.946; P<0.01) . Compared with non-smoking, the risks of positive pulmonary function test results of dust-exposed migrant workers with smoking index of 11-20 package years and >20 package years were higher ( OR=19.814, 95% CI: 3.854-101.883; OR=9.733, 95% CI: 2.310-41.008; P<0.01) . Conclusion:The risk of COPD in dust-exposed migrant workers is high, so we should strengthen the early examination of the high pneumoconiosis stage and smoking population. The screening questionnaire can better screen out the high-risk groups of COPD, and it can be used as a basic screening tool.

Stroke is an acute cerebro-vascular disease with high incidence and poor prognosis, most commonly ischemic in nature. In recent years, increasing attention has been paid to inflammatory reactions as symptoms of a stroke. However, the role of inflammation in stroke and its underlying mechanisms require exploration. In this study, we evaluated the inflammatory reactions induced by acute ischemia and found that pyroptosis occurred after acute ischemia both in vivo and in vitro, as determined by interleukin-1β, apoptosis-associated speck-like protein, and caspase-1. The early inflammation resulted in irreversible ischemic injury, indicating that it deserves thorough investigation. Meanwhile, acute ischemia decreased the Sirtuin 1 (Sirt1) protein levels, and increased the TRAF6 (TNF receptor associated factor 6) protein and reactive oxygen species (ROS) levels. In further exploration, both Sirt1 suppression and TRAF6 activation were found to contribute to this pyroptosis. Reduced Sirt1 levels were responsible for the production of ROS and increased TRAF6 protein levels after ischemic exposure. Moreover, N-acetyl-L-cysteine, an ROS scavenger, suppressed the TRAF6 accumulation induced by oxygen-glucose deprivation via suppression of ROS bursts. These phenomena indicate that Sirt1 is upstream of ROS, and ROS bursts result in increased TRAF6 levels. Further, the activation of Sirt1 during the period of ischemia reduced ischemia-induced injury after 72 h of reperfusion in mice with middle cerebral artery occlusion. In sum, these results indicate that pyroptosis-dependent machinery contributes to the neural injury during acute ischemia via the Sirt1-ROS-TRAF6 signaling pathway. We propose that inflammatory reactions occur soon after oxidative stress and are detrimental to neuronal survival; this provides a promising therapeutic target against ischemic injuries such as a stroke.

To meet the requirement of pathological practice and development, we systematically analyzed the situation of pathological residents training and the importance of initiating the clinical scientific research training. Additionally, we proposed the principle and implementation strategy for clinical scientific research training. According to features of pathological practice, we employed the modularized teaching to divide the training courses into several modules: discussion module for clinical pathology, lecture module for advanced research, and training modules for basic scientific theory, technology and writing skill. With these approaches, the systematic and structured system of standardized residents training is implemented to improve the clinical research ability of pathological residents.

Objective To investigate the effects of glucocorticoid and blood purification on cellular immune function and prognosis in children with severe sepsis/septic shock. Methods Fifty-five pediatric patients with severe sepsis/septic shock admitted to PICU of Shandong Provincial Hospital between January 2015 and June 2017 were enrolled in the study and were divided into control group,hormone group and con-tinuous blood purification group according to treatment. PCIS,PICU stay,immune function,3\7\28-day mor-tality rate,the level of HLA-DR/CD14,TNF-α and IL-10 of pre-treatment,24 h and 72 h post-treatment were studied and compared among three groups. Results (1) Three-day (26. 7% vs. 20. 0% vs. 20. 0%) and 7-day mortality rates in blood purification group,hormone group,and control group were 4/15,4/20,4/20 and 5/15,5/20,5/20,respectively,which were the highest in blood purification group,but 28-day mortality rate(5/15 vs.7/20 vs.8/20)was the lowest in blood purification group. (2) PCIS,the expressions of HLA-DR/CD14,CD4 +,CD8 +and CD4 +/CD8 +increased in all groups while they increased significantly in blood purification group(P<0. 05). The levels of TNF-α and IL-10 in peripheral blood of children decreased gradually in each group,especially in blood purification group. Conclusion Comparing with hormone group, continuous blood purification therapy can remove inflammatory mediators more quickly and effectively,reduce cytokine level and improve cellular immune function in children with severe sepsis/septic shock,and reduce their 28-day mortality.

Objective To conduct the molecular epidemiologic analysis of Staphylococcus aureus (S.aureus) in the intensive care units(ICUs) and general wards and to compare their clinical characteristics.Methods Ninety-six clinically isolated strains of S.aureus(43 strains from the emergency intensive care unit(EICU) and neurosurgical intensive care unit(NICU) and 53 strains from the general wards) collected from Sepetember 2015 to April 2016 were performed the bacterial identification and antibiotic susceptibility test.The molecular typing was performed by adopting staphylococcal protein A (spa) typing method.Results Among 96 strains of S.aureus,the detection rate of methicillin-resistant S.aureus(MRSA) was 40.6%(39/96),which among 43 strains in ICU was 62.8%(27/43) and which among 53 strains in the general words was 22.6%(12/53).The resistance rates of strains from ICUs to gentamicin,levofloxacin,clindamycin,fosfomycin and minocycline were 23.3%,48.8%,46.5%,32.6% and 32.5% respectively,while which from the general wards were 7.5%,24.5%,18.9%,2.1% and 0% respectively.The Spa typing results showed that the main types of ICUs were t002,t091 and t311.The major epidemic strain was t002(n=16,37.2%) and mainly isolated from EICUs(12 strains),26 spa types were identified among the general wards trains,mainly were t189,t377,t571,t034,t091,t127.Conclusion The detection rate of MRSA in ICUs is higher than that in the general wards,these strains have high resistant rate to routine antibacterial drugs.t002 is the major epidemic strain.The general wards have more spa types with higher genetic diversity.

Objective: To analyze and discuss the clinicopathologic characteristics of triple-negative breast cancer with initial visceral metastasis after surgery, as well as the efficacy of first-line chemotherapy and the prognostic factors. Methods: A retrospective analysis was performed using the clinical data of 107 triple-negative breast cancer patients with postoperative initial visceral metastasis, who were treated in Department of Medical Oncology, Fudan University Shanghai Cancer Center from January 1, 2011 to June 30, 2013. The analysis also included their first-line chemotherapy efficacy, survival situation and prognostic factors. Results: Among 107 patients, there were 101 patients (94.4%) with invasive ductal carcinoma and 6 patients (5.6%) with other pathological types or mixed patterns. The postoperative median disease-free interval was 14.4 months; the 1-, 2- and 3-year survival rates after visceral metastasis were 75.7%, 41.1% and 22.4%, respectively. The objective response rate of first-line platinum-based chemotherapy was 60.0%, and the median progressionfree survival time was 8.6 months; which were significantly higher or longer than that in the non-platinum chemotherapy group (36.2%, P = 0.014; 5.1 months, P = 0.023). However, there was no significant difference in the median survival time between the two groups (19.9 vs 20.9 months, P = 0.423). Univariate analysis showed that neoadjuvant chemotherapy, postoperative radiotherapy, lymph node metastasis status, clinical stage, disease-free interval, best curative effect of first-line chemotherapy, plurivisceral metastasis, and progression-free survival after first-line chemotherapy had significant effects on the overall survival (all P < 0.05). Additionally, multivariate analysis showed that neoadjuvant chemotherapy and disease-free interval had significant effects on overall survival (both P < 0.05). Conclusion: The triple-negative breast cancer patients with initial visceral metastasis have short disease-free interval time and low long-term survival rate. The first-line platinumbased chemotherapy is a good choice for these patients. The neoadjuvant chemotherapy and disease-free interval within one year may be the independent prognostic factors for their overall survival.