OBJECTIVE To observe the distribution of pathogens isolated from the endoscopic submucosal dissection(ESD)patients with postoperative pulmonary infections and explore the values of serum C-reactive protein(CRP),interleukin-6(IL-6)and procalcitonin(PCT)in prediction of the pulmonary infection.METHODS A total of 246 patients who received ESD in the First Affiliated Hospital of Wenzhou Medical University from Dec.2022 to Dec.2023 were recruited as the research subjects and were divided into the infection group with 50 cases and the non-infection group with 196 cases according to the status of postoperative pulmonary infection.The sputum speci-mens were collected from the patients of the infection group,the isolated pathogens were identified.The risk fac-tors for the postoperative pulmonary infection in the ESD patients were analyzed.The levels of serum CRP,IL-6 and PCT were compared between the infection group and the non-infection group.The values of the indexes in pre-diction of the postoperative pulmonary infection in the ESD patients were observed.RESULTS Totally 67 strains of pathogens were isolated from the 50 patients with infection,21(31.34％)of which were gram-positive bacteria,37(55.22％)were gram-negative bacteria,and 9(13.43％)were fungi.The no less than 60 years of age(OR=4.785),complication with diabetes mellitus(OR=20.627),operation duration no less than 60 min(OR=19.643)and bedridden time no less than1 week(OR=38.641)were the risk factors for the postoperative pulmonary infec-tion in the ESD patients(P＜0.05).There were significant differences in the levels of serum CRP,IL-6 and PCT between the infection group and the non-infection group(P＜0.05).The sensitivity of the joint detection of serum CRP,IL-6 and PCT was 96.00％in prediction of the postoperative pulmonary infection in the ESD patients,with the specificity 83.67％,the AUC value 0.898,which were superior to the single detection of CRP,IL-6 and PCT(P＜0.05).CONCLUSIONS The ESD patients are at high risk of postoperative pulmonary infection.The gram-negative bacteria are dominant among the pathogens.There are a variety of influencing factors for the postopera-tive pulmonary infection in the ESD patients.The CRP,IL-6 and PCT have certain values in prediction of the postoperative pulmonary infection in the ESD patients.

OBJECTIVES: To investigate the role of the calcium/calmodulin (CaM)-mediated activation of calcineurin (CN)-nuclear factor of activated T cells (NFAT) signaling pathway in mediating the regulatory effect of hyperforin (HY) on stress-induced depression-like disorder (DP) in mice. METHODS: C57BL/6J mice were randomly divided into control group, DP model group, and hyperforin treatment group (n=15). Behavioral changes of the mice were assessed using open field test (OFT), sucrose preference test (SPT), tail suspension test (TST), light/dark box test (LDB), and novel object suppression test (NSFT). Immunohistochemistry was used to detect tyrosine hydroxylase (TH) expression in the CA1 region of the hippocampus, and serum serotonin (5-HT) and norepinephrine (NA) levels were detected with ELISA. Western blotting was used to analyze the expressions of TNF-α, IL-1β, IL-2, and CN-NFAT pathway proteins. In cultured BV-2 microglial cells with lipopolysaccharide (LPS) stimulation, the effects of hyperforin and CN inhibitor (CNIS) on expressions of ionized calcium-binding adapter molecule 1 (IBA-1), 5-HT, NA, inflammatory cytokines and CN-NFAT pathway proteins were examined using immunofluorescence assay, ELISA or Western blotting. RESULTS: Compared with the control mice, the mice in DP group showed significantly reduced activity in OFT, decreased sucrose consumption in SPT, reduced shuttle crossing in LDB, and lowered food intake in NSFT with significantly increased immobility in TST. The mice with DP showed significantly decreased TH-positive neurons, lowered 5-HT and NA levels, and increased expressions of TNF-α, IL-1β, IL-2 and CaM-CN-NFAT pathway proteins. In cultured BV-2 cells, LPS stimulation strongly increased cellular IBA-1 expression, decreased the levels of neurotransmitters (5-HT and NA), and increased the levels of inflammatory cytokines and CN-NFAT signaling, and these changes were effectively reversed by treatment with hyperforin or CNIS. CONCLUSIONS Hyperforin improves stress-induced depression-like behaviors in mice and activated BV-2 cells by targeting the CN-NFAT signaling pathway.
Animals ; Mice, Inbred C57BL ; Mice ; Microglia/drug effects* ; Depression/etiology* ; Perylene/pharmacology* ; Calcineurin/metabolism* ; NFATC Transcription Factors/metabolism* ; Calcium Signaling/drug effects* ; Stress, Psychological ; Phloroglucinol/pharmacology* ; Signal Transduction ; Male ; Behavior, Animal/drug effects* ; Terpenes

Objective:To summarize the best evidence for nutrition management of sarcopenia in patients undergoing maintenance hemodialysis (MHD), to guide the development of nutrition management programs.Methods:Using the 6S evidence model, literature on nutrition management of sarcopenia in MHD patients was electronically retrieved from databases and websites including UpToDate, Guidelines International Network, Joanna Briggs Institute Evidence-Based Health Care Center Database, European Society for Clinical Nutrition and Metabolism, UK Kidney Association, PubMed, Web of Science, China Biology Medicine disc, China National Knowledge Infrastructure, and Wanfang Data. The search period was from database establishment to July 30, 2024. After screening and quality assessment of the literature, evidence was extracted and summarized.Results:A total of 19 articles were included, comprising one clinical decision, six guidelines, five systematic reviews, five expert consensus, and two randomized controlled trials. Twenty-six pieces of evidence were summarized from six aspects of nutrition team establishment and counseling, nutritional screening and assessment, nutritional support, nutrient intake, nutritional monitoring, and health education.Conclusions:The evidence summary on nutrition management of sarcopenia in MHD patients provides a basis for implementing nutritional interventions. Evidence transformation and application should be conducted in accordance with patient preferences and the actual clinical context.

Objective:To summarize the best evidence for nutrition management of sarcopenia in patients undergoing maintenance hemodialysis (MHD), to guide the development of nutrition management programs.Methods:Using the 6S evidence model, literature on nutrition management of sarcopenia in MHD patients was electronically retrieved from databases and websites including UpToDate, Guidelines International Network, Joanna Briggs Institute Evidence-Based Health Care Center Database, European Society for Clinical Nutrition and Metabolism, UK Kidney Association, PubMed, Web of Science, China Biology Medicine disc, China National Knowledge Infrastructure, and Wanfang Data. The search period was from database establishment to July 30, 2024. After screening and quality assessment of the literature, evidence was extracted and summarized.Results:A total of 19 articles were included, comprising one clinical decision, six guidelines, five systematic reviews, five expert consensus, and two randomized controlled trials. Twenty-six pieces of evidence were summarized from six aspects of nutrition team establishment and counseling, nutritional screening and assessment, nutritional support, nutrient intake, nutritional monitoring, and health education.Conclusions:The evidence summary on nutrition management of sarcopenia in MHD patients provides a basis for implementing nutritional interventions. Evidence transformation and application should be conducted in accordance with patient preferences and the actual clinical context.

OBJECTIVE To observe the distribution of pathogens isolated from the endoscopic submucosal dissection(ESD)patients with postoperative pulmonary infections and explore the values of serum C-reactive protein(CRP),interleukin-6(IL-6)and procalcitonin(PCT)in prediction of the pulmonary infection.METHODS A total of 246 patients who received ESD in the First Affiliated Hospital of Wenzhou Medical University from Dec.2022 to Dec.2023 were recruited as the research subjects and were divided into the infection group with 50 cases and the non-infection group with 196 cases according to the status of postoperative pulmonary infection.The sputum speci-mens were collected from the patients of the infection group,the isolated pathogens were identified.The risk fac-tors for the postoperative pulmonary infection in the ESD patients were analyzed.The levels of serum CRP,IL-6 and PCT were compared between the infection group and the non-infection group.The values of the indexes in pre-diction of the postoperative pulmonary infection in the ESD patients were observed.RESULTS Totally 67 strains of pathogens were isolated from the 50 patients with infection,21(31.34％)of which were gram-positive bacteria,37(55.22％)were gram-negative bacteria,and 9(13.43％)were fungi.The no less than 60 years of age(OR=4.785),complication with diabetes mellitus(OR=20.627),operation duration no less than 60 min(OR=19.643)and bedridden time no less than1 week(OR=38.641)were the risk factors for the postoperative pulmonary infec-tion in the ESD patients(P＜0.05).There were significant differences in the levels of serum CRP,IL-6 and PCT between the infection group and the non-infection group(P＜0.05).The sensitivity of the joint detection of serum CRP,IL-6 and PCT was 96.00％in prediction of the postoperative pulmonary infection in the ESD patients,with the specificity 83.67％,the AUC value 0.898,which were superior to the single detection of CRP,IL-6 and PCT(P＜0.05).CONCLUSIONS The ESD patients are at high risk of postoperative pulmonary infection.The gram-negative bacteria are dominant among the pathogens.There are a variety of influencing factors for the postopera-tive pulmonary infection in the ESD patients.The CRP,IL-6 and PCT have certain values in prediction of the postoperative pulmonary infection in the ESD patients.

Objective To investigate the effect and mechanism of Congrong Shujing Granules on promoting microglial polarization and inhibiting neuroinflammation through the nucleotide-binding oligomeric domain-like receptor protein 3(NLRP3)/Caspase-1 signaling pathway.Methods Twenty Sprague-Dawley rats were assigned to the blank serum and Congrong Shujing Granules containing serum groups using random number table method,with 10 rats in each group.Rats in the Congrong Shujing Granules containing serum group received intragastric administration of Congrong Shujing Granules(2.57 g/kg)and the rats in the blank serum group received intragastric administration of physiological saline of equal volume.Blank serum and Congrong Shujing Granules containing serum were prepared separately.Mouse microglia cells BV-2 were cultured in vitro,and the optimal concentration of 1-methyl-4-phenylpyridine(MPP+)and optimal volume fraction of Congrong Shujing Granules containing serum were selected by the CCK-8 assay and immunofluorescence staining.And the NLRP3 inhibitor MCC950 was used as a postive control.Cells were divided into the blank serum group(10%blank serum),model group(10%blank serum+500 μmol/L MPP+),Congrong Shujing Granules containing serum group(10%Congrong Shujing Granules containing serum+500 μmol/L MPP+),and MCC950 group(10%blank serum+10 μmol/L MCC950+500 μmol/L MPP+),and intervened separately.After 14 h of intervention,morphological changes in BV-2 cells were observed.The contents of interleukin(IL)-1β,tumor necrosis factor-α(TNF-α),IL-6,and IL-4 were detected by an enzyme-linked immunosorbent assay.The mRNA expressions of differentiation cluster 86(CD86),inducible nitric oxide synthase(iNOS),CD206,and arginase 1(Arg1)were detected by real-time fluorescence PCR.The expressions of CD86,Arg1,Ionized calcium binding adaptor molecule 1(Iba1),and NLRP3 were detected by immunofluorescence staining.The expression of iNOS,Arg1,TNF-α,IL-6,IL-4,NLRP3,pro-cysteinyl aspartate specific proteinase 1(pro-Caspase-1),and Caspase-1 proteins was detected by Western blotting.Results Iba1 activation and expression increased under the MPP+(12 h,500 μmol/L)intervention(P<0.05),and cell viability was not affected.There was no statistically significant effect on cell viability after treatment with 10%Congrong Shujing Granules containing serum alone or in combination with MPP+(P>0.05).Compared to the blank serum group,BV-2 cells in the model group showed multiple branches and protruded in the shape of an amoeba.The contents of IL-1β,TNF-α,and IL-6 increased,while the contents of IL-4 decreased.The mRNA expressions of CD86 and iNOS increased,while mRNA expressions of CD206 and Arg1 decreased.The mean fluorescence intensity of CD86,Iba1,and NLRP3 increased,while the mean fluorescence intensity of Arg1 decreased.The protein expressions of iNOS,TNF-α,IL-6,NLRP3,pro-Caspase-1,and Caspase-1 increased,while the protein expressions of Arg1,IL-4 decreased,P<0.05.Compared to the model group,the Congrong Shujing Granules containing serum group and MCC950 group showed a decrease in the branch of cell protrusions,reduced cell activation,decreased levels of IL-1β,TNF-α,and IL-6,increased levels of IL-4,decreased expression of CD86 and iNOS mRNA,increased expression of CD206 mRNA,the decreased mean fluorescence intensity of CD86,Iba1,and NLRP3,the increased mean fluorescence intensity of Arg1,decreased expression of iNOS,TNF-α,IL-6,NLRP3,pro-Caspase-1,and Caspase-1 proteins,and increased expression of Arg1 and IL-4 proteins,P<0.05.Conclusion Congrong Shujing Granules containing serum may alleviate the MPP+-induced neuroinflammatory response by inhibiting the NLRP3/Caspase-1 signaling pathway to regulate M1/M2 phenotype polarization of microglia.

Objective To investigate the effect and mechanism of Congrong Shujing Granules on promoting microglial polarization and inhibiting neuroinflammation through the nucleotide-binding oligomeric domain-like receptor protein 3(NLRP3)/Caspase-1 signaling pathway.Methods Twenty Sprague-Dawley rats were assigned to the blank serum and Congrong Shujing Granules containing serum groups using random number table method,with 10 rats in each group.Rats in the Congrong Shujing Granules containing serum group received intragastric administration of Congrong Shujing Granules(2.57 g/kg)and the rats in the blank serum group received intragastric administration of physiological saline of equal volume.Blank serum and Congrong Shujing Granules containing serum were prepared separately.Mouse microglia cells BV-2 were cultured in vitro,and the optimal concentration of 1-methyl-4-phenylpyridine(MPP+)and optimal volume fraction of Congrong Shujing Granules containing serum were selected by the CCK-8 assay and immunofluorescence staining.And the NLRP3 inhibitor MCC950 was used as a postive control.Cells were divided into the blank serum group(10%blank serum),model group(10%blank serum+500 μmol/L MPP+),Congrong Shujing Granules containing serum group(10%Congrong Shujing Granules containing serum+500 μmol/L MPP+),and MCC950 group(10%blank serum+10 μmol/L MCC950+500 μmol/L MPP+),and intervened separately.After 14 h of intervention,morphological changes in BV-2 cells were observed.The contents of interleukin(IL)-1β,tumor necrosis factor-α(TNF-α),IL-6,and IL-4 were detected by an enzyme-linked immunosorbent assay.The mRNA expressions of differentiation cluster 86(CD86),inducible nitric oxide synthase(iNOS),CD206,and arginase 1(Arg1)were detected by real-time fluorescence PCR.The expressions of CD86,Arg1,Ionized calcium binding adaptor molecule 1(Iba1),and NLRP3 were detected by immunofluorescence staining.The expression of iNOS,Arg1,TNF-α,IL-6,IL-4,NLRP3,pro-cysteinyl aspartate specific proteinase 1(pro-Caspase-1),and Caspase-1 proteins was detected by Western blotting.Results Iba1 activation and expression increased under the MPP+(12 h,500 μmol/L)intervention(P<0.05),and cell viability was not affected.There was no statistically significant effect on cell viability after treatment with 10%Congrong Shujing Granules containing serum alone or in combination with MPP+(P>0.05).Compared to the blank serum group,BV-2 cells in the model group showed multiple branches and protruded in the shape of an amoeba.The contents of IL-1β,TNF-α,and IL-6 increased,while the contents of IL-4 decreased.The mRNA expressions of CD86 and iNOS increased,while mRNA expressions of CD206 and Arg1 decreased.The mean fluorescence intensity of CD86,Iba1,and NLRP3 increased,while the mean fluorescence intensity of Arg1 decreased.The protein expressions of iNOS,TNF-α,IL-6,NLRP3,pro-Caspase-1,and Caspase-1 increased,while the protein expressions of Arg1,IL-4 decreased,P<0.05.Compared to the model group,the Congrong Shujing Granules containing serum group and MCC950 group showed a decrease in the branch of cell protrusions,reduced cell activation,decreased levels of IL-1β,TNF-α,and IL-6,increased levels of IL-4,decreased expression of CD86 and iNOS mRNA,increased expression of CD206 mRNA,the decreased mean fluorescence intensity of CD86,Iba1,and NLRP3,the increased mean fluorescence intensity of Arg1,decreased expression of iNOS,TNF-α,IL-6,NLRP3,pro-Caspase-1,and Caspase-1 proteins,and increased expression of Arg1 and IL-4 proteins,P<0.05.Conclusion Congrong Shujing Granules containing serum may alleviate the MPP+-induced neuroinflammatory response by inhibiting the NLRP3/Caspase-1 signaling pathway to regulate M1/M2 phenotype polarization of microglia.

Objective:To explore home maintenance acceptance of family members of elderly discharged patients with peripherally inserted central catheter (PICC) catheter and to analyze its influencing factors.Methods:From January to November 2019, a total of 143 family members of elderly patients who were given PICC in three ClassⅢ Grade A hospitals in Wenzhou and discharged with catheter were selected as research objects. A questionnaire survey was conducted on 143 family members of elderly discharged patients with PICC catheter using a general information questionnaire, Catheter Maintenance Related Cognitive Questionnaire and Barthel Index Rating Scale (BI) . A total of 143 questionnaires were distributed in this study and a total of 143 valid questionnaires were recovered. The effective recovery rate was 100%.Results:The acceptance rate of home maintenance of 143 family members of elderly discharged patients with PICC catheter was 60.14% (86/143) . Single factor analysis showed that home maintenance acceptance score of family members of elderly discharged patients with PICC catheter had statistically significant differences in working status of family members, ADL score of patients, whether they stayed in bed, whether the catheter maintenance in the residence was convenient, whether they were confident in catheter observation and treatment and whether they were worried about the effect of home maintenance ( P<0.05) . Multivariate logistic regression analysis showed that the convenience of catheter maintenance in the residence, self-care ability of patients and whether they were worried about the maintenance effect were the influencing factors of the home maintenance acceptance of family members of elderly discharged patients with PICC catheter ( P<0.05) . Conclusions:The family maintenance acceptance of elderly discharged patients with PICC catheter is at a medium level. It is necessary to strengthen the maintenance knowledge education and operation skills training of family members with inconvenient catheter maintenance in residence and poor self-care ability of patients and help them to improve the maintenance effect so as to better carry out home maintenance.

Objective ThispaperpresentedaninvestigationonthesimilaritiesanddifferencesintheclinicalfeaturesandCTfindings betweenallogeneichematopoieticstem celltransplantation (allo-HSCT)inducedandnon-transplantinducedair-leaksyndromes (ALS)inpatientssufferingfromhematopathy,toimprovetheunderstandingofALSinpatientswithhematopathy.Methods Retrospective analysesandcomparisonsofclinicaldataandCTimageswereconductedbetweenGroupA (12patientswithALSafterallo-HSCT) andGroupB (26patientswithnon-transplant-relatedALS).A M annG W hitney U testwasperformedtoevaluatethemeasurementdata, andthe χ 2testor Fisher exacttestwasconductedtoexaminetheenumerationdata.Differencethresholdsof P＜0.05from bothsides weretakentobethedeterminantforstatisticalsignificance.Results TheincidenceratesofALSinpatientswithhematopathyafter anallo-HSCTwerefoundtobesignificantlyhigherthanthoseinpatientsonwhomsuchtransplantshadnotbeenperformed(1.84%. vs.0.06%),P＜0.001.SymptomsofdyspneaweremuchmorefrequentlyobservedingroupAcomparedtogroupB (7/12vs1/26), P＜0.01;whereasthedifferencesforthesymptomsofchesttightness,chestpain,andpharyngalgia werenotadequateintermsofstatistical significance,P＞0.05.IngroupA,theoccurrencesofALSsecondarytolongonsetnon-infectionpulmonarycomplications(LONIPC) associatedwithchronicgraft-versus-hostdisease(cGVHD)werefoundin8/12patients,whereastheoccurrencesin15/26patients weresecondarytopulmonaryinfectioningroupB,P＜0.01.Therewerenostatisticallysignificantdifferencesinage,gender,BMI, backgroundblooddisease,basictreatmentcounts,CTtype,treatmentmethodsandCTdisappearancetimelengthbetweenthetwo groups,P＞0.05.Conclusion Thereweredifferencesintheincidencerates,basiclungdiseasesandclinicalsymptomsbetweenallo-HSCT inducedandnon-transplantinducedALSinpatientssufferingfromhematopathy.Hematopathy-associatedALSwascommoninyoung adultswithlankypostures,patientswithleukemiaasback-grounddisease,patientswithahistoryofchemotherapyandpatientswith pulmonarydiseases.Thecommonsymptomsofpatients with hematopathy-associated ALS were chesttightness and chest pain,andpatients’overallprognosisweregood,meanwhileCT manifestationsweremainlycharacterizedbymixedpulmonary interstitialemphysema(PIE)+pneumomediastinum (PM)andsimplepneumothorax (PT).

Objective: To investigate the effect of long-chain non-coding RNA Fez family zinc finger protein 1 antisense RNA1 (lncRNA FEZF1-AS1) on the biological function of hepatocellular carcinoma (HCC). Methods: SMMC771 and BEL-7402 cells were transfected with sh-FEZF1-AS1 and OE-FEZF1-AS1, respectively. The expression of lncRNA FEZF1-AS1 was detected by real-time quantitative PCR. Cell proliferation was detected by Cell Counting Kit-8 (CCK-8), and apoptosis was detected by flow cytometry. The effects of lncRNA FEZF1-AS1 on invasion and migration were detected by Transwell and wound healing assays. The expression levels of adhesion molecules were detected by Western blot. The effect of lncRNA FEZF1-AS1 on the in vivo growth was verified by nude mice xenograft experiments. Results: The silencing or ectopic expression of lncRNA FEZF1-AS1 inhibited or promoted the proliferation of hepatocellular carcinoma cells. CCK-8 assay showed that the proliferation abilities of SMMC7721 and BEL-7402 cells in sh-FEZF1-AS1 transfection group significantly decreased, achieving (35.43±4.06)% and (34.68±3.97)%, respectively, on the fifth day. There were significant differences between sh-FEZF1-AS1 group and sh-NC group [52.21±8.46)% and (53.76±7.64)%] (all P<0.05). In contrast, the proliferation ability of SMMC7721 and BEL-7402 cells transfected with OE-FEZF1-AS1 was significantly increased, achieving (83.49±6.92)% and (80.31±3.13)%, respectively, on the fifth day. There were significant differences between OE-FEZF1-AS1 and OE-NC group [53.03±8.84)% and (55.11±7.09)%] (all P<0.05). The subsequent flow cytometry results showed that cell apoptotic rates of SMMC7721 and BEL-7402 cells transfected with sh-FEZF1-AS1 were (13.02±1.38)% and (11.88±1.29)%, respectively, which were significantly higher than those in sh-NC groups [(5.57±1.46)% and (8.06±1.42)%, respectively, all P<0.05]. In contrast, the apoptotic rates of SMMC7721 and BEL-7402 cells transfected with OE-FEZF1-AS1 were (3.01±0.39)% and (3.22±0.43)%, which were significantly lower than those in OE-NC groups [(6.68±0.96)% and (6.63±0.45)%, all P<0.05]. In addition, knockdown or overexpression of lncRNA FEZF1-AS1 expression inhibited or enhanced the migration and invasion abilities as well as the levels of adhesion molecules in hepatocellular carcinoma cells. After 30 days of feeding under the same conditions, the tumor volumes of sh-FEZF1-AS1 and sh-NC SMMC7721 cells xenograft mice models were (0.26±0.03) cm³ and (0.63±0.06) cm³, respectively, showing significant difference (P<0.05). The tumor volumes of sh-FEZF1-AS1 and sh-NC BEL-7402 cells were (0.31±0.02) cm³ and (0.72±0.08) cm³, and the difference was statistically significant (P<0.05). Conclusion lncRNA FEZF1-AS1 may strengthen the growth, migration and invasion of hepatocellular carcinoma cells.