Objective To explore the level of energy balance related protein antibody,adropin,and its correlation with collateral circulation status in elderly patients with AMI.Methods A total of 193 elderly AMI patients admitted to our department from February 2022 to February 2024 were enrolled,and based on their collateral circulation status,they were divided into a good circulation group(121 cases)and a poor circulation group(72 cases).The level of adropin was determined.Multivariate logistic regression analysis was employed to determine the influencing factors of poor collateral circulation in elderly AMI patients.Results The poor circulation group had significantly larger proportion of hypertension,higher fasting blood glucose(FBG),and larger red blood cell distribution width(RDW),but lower adropin level and mean platelet volume(MPV)when com-pared with the good circulation group(P＜0.05,P＜0.01).Multivariate logistic regression analy-sis showed that adropin,FBG,RDW,MPV,and hypertension were all influencing factors for poor collateral circulation in elderly AMI patients(P＜0.05,P＜0.01).The AUC value of adropin,FBG,RDW,MPV,and hypertension was 0.810,0.762,0.761,0.715 and 0.563,respectively in pre-dicting poor collateral circulation.Among them,adropin level had the highest predictive value(P＜0.01).Conclusion The decrease in adropin level in elderly AMI patients is closely associated with poor collateral circulation,and it is a predictive factor for collateral circulation.

Objective To explore causal relationship between 25-hydroxyvitamin D[25(OH)D]and ankylosing spondylitis(AS).Methods Genetic data of 25(OH)D and AS were extracted from the genome-wide association study.The causal effect of 25(OH)D on AS was estimated by MR-Egger regression method,weighted median,inverse variance weighted(IVW),simple mode and weighted mode,and sensitivity analysis was conducted for verification.Results The IVW results indicated that there was a causal relationship between 25(OH)D concentration and AS(OR=0.805,95％CI:0.686-0.944,P=0.008),and the maximum likelihood ratio(OR=0.799,95％CI:0.678-0.940,P=0.007)showed consistent results.The IVW results of the reverse Mendelian randomization study showed that there was no causal relationship between the two(OR=1.019,95％CI:0.995-1.043,P=0.110).In addition,MR-Egger intercept,Cochran Q test,"leave-one-out"and MR-PRESSO analysis showed no horizontal pleipotency or heterogeneity.Conclusion There may be a genetic causal relationship between the concentration of 25(OH)D and the onset of AS.AS cannot cause changes in the concentration of 25(OH)D in the body.

Objective:To investigate the underlying mechanism behind the significant reduction in intracellular virus loads after respiratory syncytial virus (RSV) and influenza viruses infect respiratory epithelial cells overexpressing the chemokine (C-C motif) receptor 1 (CCR1).Methods:A549 cells were infected with respiratory syncytial virus (RSV), influenza A viruses (H1N1, H3N2), or influenza B virus (FluB), and the expression of chemokine (C-C motif) ligand 5 (CCL5) and CCR1 were detected by qRT-PCR, ELISA, and Western blot. After overexpressing or knocking down CCR1 in A549 cells, these cells were infected with RSV, H1N1, H3N2, or FluB, and the expression of CCR1, heat shock protein 90 (HSP90), cyclin-dependent kinase 1 (CDK1), and viral proteins were detected by qRT-PCR and Western blot. After stimulating CCR1-overexpressed A549 cells with CCL5, Western blot was used to detect the expression of HSP90 and CDK1, and co-immunoprecipitation was used to detect the interaction between HSP90 and CCR1. CCR1 -/- mice were infected with RSV, H1N1, or H3N2 to observe the changes in the expression of HSP90, CDK1, and viral proteins with Western blot, and the inflammation in lung tissues with HE staining. One-way analysis of variance and t test were used for statistical analysis. Results:RSV, H1N1, H3N2, and FluB infections induced high expression of CCL5 in A549 cells ( P<0.05), but the expression of CCR1 showed an overall downward trend. After activating its receptor CCR1, CCL5 inhibited the replication of RSV and influenza viruses by suppressing the activity of HSP90 ( P<0.05). The experiments conducted on CCR1 -/- mice confirmed that the enhanced activity of HSP90 facilitated the replication of RSV and influenza viruses. Conclusion:RSV and influenza viruses may reduce the binding of CCL5 to CCR1 by downregulating the expression of CCR1 in respiratory epithelial cells, thereby weakening the inhibitory effect of CCR1 on HSP90 activity, which enables them to evade host immune defense.

Objective To observe the clinical efficacy of Dan Qi Yishen Prescription in treating diabetic nephropathy(DN)and explore its renal protective mechanism.Methods A total of 150 patients with DN of qi-yin deficiency complicated with blood stasis syndrome who admitted to Sanya Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Chinese Medicine from October 2021 to April 2023 were divided into a control group and an observation group according to the random number table method,with 75 patients in each group.Both groups were given conventional therapies such as dietary treatment,blood glucose control,blood pressure control,lipid-lowering treatment and treatment of complications.Additionally,the control group was given intravenous injection of reduced glutathione,while the observation group was given oral use of the decoction of Dan Qi Yishen Prescription and ionic introduction of Dan Qi Yishen Prescription in renal region.Thirty days constituted one course of treatment,and both groups were treated for three courses.Before and after treatment,the scores of traditional Chinese medicine(TCM)syndrome,and the levels of renal function indicators,renal hemodynamic indicators,coagulation and fibrinolysis indicators,and vascular endothelial function indicators in the two groups were observed.Results(1)After treatment,the scores of TCM symptoms such as fatigue and weakness,palpitations and shortness of breath,dizziness and tinnitus,spontaneous sweating and night sweating,restlessness and insomnia,and thirst with preference for drinks in the two groups were decreased compared with those before treatment(P<0.01),and the decrease in the observation group was significantly superior to that in the control group(P<0.01).(2)After treatment,the levels of renal function indicators such as blood urea nitrogen(BUN),serum creatinine(SCr),collagen Ⅳ(CⅣ),and plasma laminin(LN)of patients in the two groups were improved compared with those before treatment(P<0.01),and the improvement in the observation group was significantly superior to that in the control group(P<0.01).(3)After treatment,the levels of renal hemodynamic indicators such as systolic maximum blood flow velocity(Vsmax)and diastolic minimum blood flow velocity(Vdmin)of the main renal artery(MRA)and interlobar artery(IRA)in the two groups were increased compared with those before treatment(P<0.05 or P<0.01),while the resistance index(RI)and pulsatility index(PI)of MRA and RI of IRA in the two group as well as PI of IRA in the observation group were decreased compared with those before treatment(P<0.05 or P<0.01).The increase of Vsmax and Vdmin of MRA and IRA as well as the decrease of RI and PI of MRA and IRA in the observation group was significantly superior to that in the control group(P<0.05 or P<0.01).(4)After treatment,the levels of coagulation and fibrinolysis indicators such as prothrombin time(PT),activated partial thromboplastin time(APTT),D-dimer(D-D),and fibrinogen(FIB)in the two groups were improved compared with those before treatment(P<0.01),and the improvement in the observation group was significantly superior to that in the control group(P<0.01).(5)The analysis of vascular endothelial function indicators showed that after treatment,the serum vasohibin 1(VASH-1)level in the two groups was increased compared with that before treatment(P<0.01),and the serum vascular endothelial growth factor(VEGF)and endothelin 1(ET-1)levels were decreased compared with those before treatment(P<0.01),and the increase of serum VASH-1 level as well as the decrease of serum VEGF and ET-1 levels in the observation group was significantly superior to that in the control group(P<0.01).Conclusion Dan Qi Yishen Prescription exerts good clinical efficacy in treating patients with DN of qi-yin deficiency complicated with blood stasis syndrome,and it has protective effect on renal function probably by improving the coagulation and fibrinolysis system and vascular endothelial function of the patients.

Objective To analyze the efficacy of different nucleoside(acid)analogs(NAs)used as monotherapy and in combination with pegylated interferon α-2b(Peg-IFN-α-2b)in the treatment of chronic hepatitis B(CHB).Methods A retrospective analysis was conducted on 229 CHB patients who visited the Hepatology Department of the Third People's Hospital of Kunming from September 2022 to August 2023.Patients were divided into six groups based on their antiviral regimen:entecavir(ETV)group(A,n=47),ETV combined with Peg-IFN-α-2b group(B,n=19),Tenofovir Alafenamide(TMF)group(C,n=64),TMF combined with Peg-IFN-α-2b group(D,n=35),Tenofovir Disoproxil Fumarate(TDF)group(E,n=29),and TDF combined with Peg-IFN-α-2b group(F,n=35).The blood routine,liver function,kidney function,HBV serological markers,and HBV-DNA levels were compared before and after 24 weeks of treatment.Results After 24 weeks of treatment,there were no statistically significant differences in efficacy rates and HBV-DNA positivity rates between the monotherapy with NAs and the combination with Peg-IFN-α-2b(P>0.05).Comparing before and after treatment,the ETV group had the highest effective rate,while TDF combined with Peg-IFN-α-2b group had the lowest effective rate.TDF group had the highest efficiency,while ETV combined with Peg-IFN-α-2b group had the lowest efficiency.Except for ETV+Peg-IFN-α-2b and TDF+Peg-IFN-α-2b groups,the HBV-DNA positivity rates in the other four groups were significantly lower after treatment compared to before(P<0.05).There was a significant difference in HBsAg levels among the different treatment regimens of monotherapy with NAs and combination with Peg-IFN-α-2b(P=0.0483).Additionally,except for the ETV and TDF groups,the serum HBsAg levels in the other four groups were significantly lower after treatment compared to before(P<0.05).There were no significant difference in LSM and GFR before and after treatment(P>0.05).In the monotherapy groups,ALT and GGT levels were significantly lower after treatment compared to before(P<0.05),while in the combination Peg-IFN-α-2b group,WBC,NEUT,and PLT levels were significantly lower after treatment compared to before(P<0.05).Conclusion Combination therapy with Peg-IFN-α-2b can reduce HBsAg levels and may be more effective in controlling the virus;however,it may cause adverse reactions such as bone marrow suppression,increasing risks.Physicians and patients need to weigh the benefits against the risks and develop personalized treatment plans based on individual circumstances.

Virus-like particles(VLPs)are hollow nanoparticles composed of one or several virus structural proteins,which have a morphological structure similar to natural viruses but do not contain any genetic material.Due to the excellent innate immunogenicity and safety of VLPs,they are often used in the development of tumor vaccines.In addition,compared with traditional drug delivery vectors,VLPs have better biocompatibility and strong targeting ability,making them highly valued in the delivery of anti-tumor drugs.In recent years,the efficient delivery of gene editing tools using VLPs has provided new possibilities for tumor treatment.VLPs can inhibit tumor growth and spread through various mechanisms,such as activating immune responses to suppress tumor growth,stimulating the body's immune system,promoting the expression of tumor associated antigens,and enhancing the body's ability to recognize and clear tumor cells.These studies not only broaden the application scope of VLPs in the field of anti-tumor therapy,but also provide a broader prospect for future research and application.This article reviewed the research progress of VLPs derived from different viruses in preventive or therapeutic vaccines and drug delivery carriers,and explored new development strategies.

Objective To compare the effectiveness of cobalt chloride test papers and borescope in evaluating the drying of endoscopes,providing a reference for clinical selection of appropriate assessment tools.Methods 10 gastroscopes and 10 colonoscopes procedures were selected from November 2023 to March 2024 for circulation experiments.After endoscope reprocessing,they were randomly divided into five groups with different drying times(30 s,3 min,6 min,9 min,and 12 min)with 200 samples.Cobalt chloride test paper and borescope were used to evaluate the drying effectiveness.Results The qualified rate of gastrointestinal endoscope by borescope was significantly higher than that by cobalt chloride test paper,but cobalt chloride test paper was obviously better than that by borescope in convenience and cost-effectiveness.The borescope had the function of visualization,and the quantitative positioning observation of residual droplets showed that there were a large number of droplets left after gastrointestinal endoscope drying for 30 s,and the number of droplets was obviously reduced after drying for 3 min.Among them,the gastroscope was mainly light(1～5 drops/strip)and none(0 drops/strip),and the colonoscope was mainly moderate(6～10 drops/strip)and light droplets.Compared with different drying times,there was a significant statistical difference in the number of residual droplets in the endoscope(P<0.01),and the localized droplets mainly remained in the distal bending part and the proximal bifurcation part of the lumen.Conclusion Both cobalt chloride test papers and borescope are important methods for assessing endoscope drying efficacy,each with its own advantages and limitations.Clinicians can use both methods in combination to comprehensively evaluate the overall dryness of endoscopes,thereby ensuring the safety and effectiveness of the endoscope reprocessing process.

Objective To investigate the bacterial contamination of water specimens at different pre-discharge time of flexible endoscopic final rinse water before daily use,and provide reference basis for choosing the optimal pre-dis-charge time in clinical work.Methods From August to December 2023,the water produced by the purified water equipment of the digestive endoscopy centers of 4 tertiary first-class medical institutions in Jiangxi Province,as well as the final rinsing water at the terminal-point at different pre-discharge times(before pre-discharge,discharge of 1,3,5,and 10 minutes)were subjected to on-site sampling,the collected water specimens were performed microbio-logical cultures by pouring and filter membrane methods,unqualified water specimens were performed bacterial i-dentification.Results 48 specimens of water produced by purified water equipment were collected,with qualified rate of 100％.480 final water specimens were collected,with a qualified rate of 0 before pre-discharge.The quali-fied rates of pre-discharge at 1,3,5,and 10 minutes were 0,21.88％,55.21％,and 73.96％,respectively.Bac-terial colony counts in the final rinse water with different pre-discharge times in 4 medical institutions showed statis-tically significant differences(all P＜0.001).As the pre-discharge time increased,bacterial colony counts in the fi-nal rinse water of all four medical institutions showed a decreasing trend.The pairwise comparison of the overall bacterial colony count of the final rinse water at different pre-discharge time showed that there was no statistically significant difference in the bacterial colony count of the final rinse water at 5 and 10 minutes of pre-discharge(P＞0.05),while the pairwise comparison between other time points showed statistically significant differences(all P＜0.001).Environmental contaminated bacteria such as Micrococcus luteus,Cupriavidus paucula,and Sphin-gononas paucimobilis were detected from the unqualified water specimens.Conclusion With the extension of pre-discharge time,the degree of bacterial contamination in the final rinse water significantly decreases.All levels of medical institutions need to pre-discharge the final rinse water daily,and the pre-discharge time should last for at least 5 minutes.

Objective To investigate the current status of cleaning and disinfection of endoscopic biopsy valves in three digestive endoscopy centers in Jiangxi Province,and evaluate the effectiveness of establishing a standard opera-tional procedure(SOP)of cleaning and disinfection for flexible endoscopic biopsy valves.Methods The cleaning and disinfection procedures of biopsy valves in three digestive endoscopy centers were recorded using on-site investi-gation method(the control group).Based on relevant literature and manufacturer manuals at home and abroad,SOP was established and cleaning and disinfection training for cleaning professional was provided(the trial group).Biop-sy valve specimens from two groups were taken.The disinfection qualified rate,microbial positivity rate before dis-infection,and microbial load after disinfection before and after procedure improvement were compared between two groups.Results A total of 180 biopsy valve specimens were taken from two groups(60 specimens from endoscopy centers A,B,and C each).On-site investigation showed that the cleaning and disinfection procedure for biopsy valves was inconsistent among the three endoscopy centers.The total qualified rate of disinfection in the trial group was higher than that in the control group(95.5％vs 83.3％),with statistically significant difference(P＜0.05).The total microbe positive rate of biopsy valves from the trial group was lower than that from the control group(25.0％ vs 57.2％),with statistically significant difference(P＜0.05).The difference in microbial load after disin-fection between two groups of biopsy valves was statistically significant(Z=-6.47,P＜0.05).Conclusion Al-though being a tiny accessory,the flexible endoscopic biopsy valve can be a potential source of infection if not tho-roughly cleaned and disinfected.Developing SOP can help improve the cleaning effectiveness of biopsy valves.At present,there is no unified standards for the cleaning and disinfection procedure of endoscopic biopsy valves.In the future,standardization of the SOP for biopsy valves should be continuously explored,so as to reduce the risk of cross infection.

Objective To understand the current status of application,management,and maintenance of automa-ted endoscope reprocessors(AERs)in China.Methods A questionnaire survey was conducted using convenience sampling method on the application,management,maintenance,and monitoring of AERs,as well as personnel training in digestive endoscopy centers of 292 medical institutions(MIs).Results A total of 316 questionnaires were distributed,and 292 were available,with an effective response rate of 92.41％.Among the 292 MIs,198(67.81％)were equipped with AERs,with equipment rates of 75.11％in tertiary MIs and 41.27％in secondary MIs.88.38％of MIs performed manual cleaning before placing endoscopes into AERs,while 2.02％of MIs still didn't perform this step,mainly in tertiary MIs.The most common problems in the application of AERs were the detachment or damage of connecting pipes(83.33％),followed by disinfectant leakage of AERs(43.94％),mal-function of control panel(43.94％),and failure or poor water flow of AER pipeline(42.93％).92.42％of MIs regularly disinfected AERs,72.73％of MIs regularly replaced AER air filters,and 80.30％of MIs regularly re-placed AER water filters.96.46％of MIs monitored the concentration of disinfectants before daily application of AERs,87.88％of MIs regularly monitored the final rinse water of AERs,and 96.97％of MIs provided professio-nal training for new employees to use AERs for the first time.Conclusion The equipping rate of AERs at all levels of MIs in China still needs to be improved.Most MIs are able to monitor and maintain AERs well,but there are still many problems in the application process.Due to the large volume of endoscopic diagnosis and treatment as well as insufficient execution rate of manual cleaning in tertiary MIs,it is necessary to optimize workflow and strengthen training.Secondary MIs face challenges such as equipment shortages and low monitoring execution rates,requiring increased funding and regulatory efforts.It is recommended that manufacturers continuously optimize AER design,MIs establish standardized AER application protocol,and relevant departments improve AER application and ma-nagement standards,in order to improve the quality of endoscopic cleaning and disinfection and ensure patient safety during diagnosis and treatment.