Objective To investigate the impacts and mechanism of circular RNA polyribonucleotide nucleotidyltransferase 1(Circ-PNPT1)on glucose and lipid metabolism and offspring outcomes in rats with GDM through microRNA-345-3p(miR-345-3p)/lipid raft scaffold protein 2(FLOT2)axis.Methods 75 pregnant female rats were divided into normal control(NC)group,GDM group,si-NC group,si-Circ-PNPT1 group,and si-Circ-PNPT1+miR-345-3p-inhibitor group,with 15 rats in each group.Glucose and lipid metabolism indexes were detected in each group.FIns was detected by ELISA.The survival rate and body weight of fetal rats were compared in each group.The expression of Circ-PNPT1,miR-345-3p and FLOT2 mRNA in placenta was detected by qRT-PCR.The double luciferase reporter gene experiment verified the targeting relationship between miR-345-3p and Circ-PNPT1 and FLOT2.Western blot was used to detect the expression of FLOT2 protein in rat placenta.Results Compared with the NC group,the level of FPG,FIns,HOMA-IR,TC,TG,LDL-C,embryo weight,and the expressions of Circ-PNPT1,FLOT2 in GDM group increased,the level of HDL-C,embryo survival rate and the expression of miR-345-3p decreased(P<0.05).Compared with GDM group,the level of FPG,FIns,HOMA-IR,TC,TG,LDL-C,embryo weight,and the expression of FLOT2 in si-Circ-PNPT1 group decreased,the level of HDL-C,embryo survival rate and the expression of miR-345-3p increased(P<0.05);MiR-345-3p-inhibitor reversed the improvement of si-Circ-PNPT1 on GDM rats(P<0.05).Conclusions Knocking down Circ-PNPT1 can up-regulate miR-345-3p and down-regulate FLOT2 to improve glucose and lipid metabolism and offspring outcome in GDM rats.

Objective To investigate the regulatory effect of lipocalin 2(LCN2)on epidermal growth factor receptor(EGFR)phosphorylation and its impact on inflammatory damage in human fallopian tube epithelial cells.Methods Human fallopian tube epithelial cells were isolated and a lipopolysaccharide(LPS)intervention was applied to establish an in vitro cell model.The cells were randomly assigned into the following groups:a blank control group(Control),a model group(Model),experimental groups(Model+si-LCN2 or Model+oe-LCN2),and negative control groups(Model+si-NC or Model+oe-NC).Changes in cell viability,apoptosis rates,inflam-matory levels,as well as the expression of EGFR mRNA,LCN2,EGFR,p-EGFR,and the ratio of p-EGFR/EGFR proteins were evaluated.Results Compared to the Model group,the Model+si-LCN2 group exhibited enhanced cell viability,a reduced apoptosis rate,and decreased expression of inflammatory factors(P＜0.05).Immunopre-cipitation analysis confirmed a direct interaction between LCN2 and EGFR.In comparison with the Model group,the Model+oe-LCN2 group demonstrated elevated levels of p-EGFR and the p-EGFR/EGFR ratio(P＜0.05),while no significant change was observed in total EGFR expression(P＞0.05).Conclusion Inhibition of LCN2-mediated EGFR phosphorylation enhances cell viability,reduces apoptosis,and mitigates inflammatory responses,thereby ameliorating LPS-induced inflammatory injury in human fallopian tube epithelial cells.

Prostaglandin D2(PGD2)is a biologically active substance with important roles in a variety of physiological and pathological processes.PGD2 exerts its biological functions mainly through prostaglandin D2 synthase(PGDS),which is closely related to inflammation and immune regulation.Recent studies have found that PGD2 and its synthase,PGDS,are able to directly inhibit tumor cell proliferation,induce apoptosis,suppress migration and invasion,and further regulate the tumor immune microenvironment to affect the immunotherapy of tumors,demonstrating good tumor therapeutic potential.In this paper,we review the biological properties of PGD2 and its synthase,focusing on its role in the immunotherapy of tumor models.We explore the immunotherapeutic efficacy of PGD2 and its synthase,and their roles in promoting immune cell infiltration in the tumor microenvironment,and discuss their potential as new targets for tumor therapy.

Objective To investigate the regulatory effect of lipocalin 2(LCN2)on epidermal growth factor receptor(EGFR)phosphorylation and its impact on inflammatory damage in human fallopian tube epithelial cells.Methods Human fallopian tube epithelial cells were isolated and a lipopolysaccharide(LPS)intervention was applied to establish an in vitro cell model.The cells were randomly assigned into the following groups:a blank control group(Control),a model group(Model),experimental groups(Model+si-LCN2 or Model+oe-LCN2),and negative control groups(Model+si-NC or Model+oe-NC).Changes in cell viability,apoptosis rates,inflam-matory levels,as well as the expression of EGFR mRNA,LCN2,EGFR,p-EGFR,and the ratio of p-EGFR/EGFR proteins were evaluated.Results Compared to the Model group,the Model+si-LCN2 group exhibited enhanced cell viability,a reduced apoptosis rate,and decreased expression of inflammatory factors(P＜0.05).Immunopre-cipitation analysis confirmed a direct interaction between LCN2 and EGFR.In comparison with the Model group,the Model+oe-LCN2 group demonstrated elevated levels of p-EGFR and the p-EGFR/EGFR ratio(P＜0.05),while no significant change was observed in total EGFR expression(P＞0.05).Conclusion Inhibition of LCN2-mediated EGFR phosphorylation enhances cell viability,reduces apoptosis,and mitigates inflammatory responses,thereby ameliorating LPS-induced inflammatory injury in human fallopian tube epithelial cells.

Objective To investigate the impacts and mechanism of circular RNA polyribonucleotide nucleotidyltransferase 1(Circ-PNPT1)on glucose and lipid metabolism and offspring outcomes in rats with GDM through microRNA-345-3p(miR-345-3p)/lipid raft scaffold protein 2(FLOT2)axis.Methods 75 pregnant female rats were divided into normal control(NC)group,GDM group,si-NC group,si-Circ-PNPT1 group,and si-Circ-PNPT1+miR-345-3p-inhibitor group,with 15 rats in each group.Glucose and lipid metabolism indexes were detected in each group.FIns was detected by ELISA.The survival rate and body weight of fetal rats were compared in each group.The expression of Circ-PNPT1,miR-345-3p and FLOT2 mRNA in placenta was detected by qRT-PCR.The double luciferase reporter gene experiment verified the targeting relationship between miR-345-3p and Circ-PNPT1 and FLOT2.Western blot was used to detect the expression of FLOT2 protein in rat placenta.Results Compared with the NC group,the level of FPG,FIns,HOMA-IR,TC,TG,LDL-C,embryo weight,and the expressions of Circ-PNPT1,FLOT2 in GDM group increased,the level of HDL-C,embryo survival rate and the expression of miR-345-3p decreased(P<0.05).Compared with GDM group,the level of FPG,FIns,HOMA-IR,TC,TG,LDL-C,embryo weight,and the expression of FLOT2 in si-Circ-PNPT1 group decreased,the level of HDL-C,embryo survival rate and the expression of miR-345-3p increased(P<0.05);MiR-345-3p-inhibitor reversed the improvement of si-Circ-PNPT1 on GDM rats(P<0.05).Conclusions Knocking down Circ-PNPT1 can up-regulate miR-345-3p and down-regulate FLOT2 to improve glucose and lipid metabolism and offspring outcome in GDM rats.

Prostaglandin D2(PGD2)is a biologically active substance with important roles in a variety of physiological and pathological processes.PGD2 exerts its biological functions mainly through prostaglandin D2 synthase(PGDS),which is closely related to inflammation and immune regulation.Recent studies have found that PGD2 and its synthase,PGDS,are able to directly inhibit tumor cell proliferation,induce apoptosis,suppress migration and invasion,and further regulate the tumor immune microenvironment to affect the immunotherapy of tumors,demonstrating good tumor therapeutic potential.In this paper,we review the biological properties of PGD2 and its synthase,focusing on its role in the immunotherapy of tumor models.We explore the immunotherapeutic efficacy of PGD2 and its synthase,and their roles in promoting immune cell infiltration in the tumor microenvironment,and discuss their potential as new targets for tumor therapy.

The current situation of multidrug-resistant bacteria infection in surgical patients is becoming increasingly severe.Effective prevention of cross transmission of multidrug-resistant bacteria and common site infections in ICU patients is the key step.In response to the key issues in the prevention and control of multidrug-resistant bacteria infection,a comprehensive strategy is implemented.Core measures such as early recognition,preemptive isolation,active screening,and graded prevention and control are taken for patients,and targeted preventive measures for common infection sites are combined to form a detection and control system of multidrug-resistant bacteria for ICU patients.By moving forward and extrapolating to the general ward,the prevention and control system effectively reduced the incidence of multidrug-resistant bacteria colonization/infection in surgical patients.

Objective Comprehensive mortality risk analyses and therapeutic assessment in real-world practice are beneficial to guide individual treatment in patients with Carbapenem-resistant Klebsiella pneumoniae bloodstream infections(CRKP-BSI).Methods Retrospective analysis of the clinical characteristics of 81 CRKP-BSI patients in our intensive care unit from July 2016 to June 2020,to indentify the risk factors of death and treatment effects of different antibiotic regimens.Results In 81 CRKP-BSI cases,the majority source were from abdominal and respiratory,accounting for 56.79%(46 cases)and 22.22%(18 cases),respectively.The 28-day mortality and hospitalization mortality of CRKP-BSI were 54.32%(44 cases)and 65.43%(53 cases).Multivariate regression analysis suggested that biliary tract disease before admission(P=0.026)and increased SOFA score at the onset of BSI(P=0.006)were independent risk factors for 28-day mortality.There was no statistically significant difference in 28-day mortality between the groups of antibiotic treatment based on tigecycline(44 cases)and polymyxin B(26 cases)[56.82%(25/44)vs.57.69%(15/26),P=0.943].Patients were evaluated based on their age(≤65 years vs.>65 years),gender,body mass index(≤25 kg/m2 vs.>25 kg/m2),and APACHEⅡ score(≤20 vs.>20),the use of renal replacement therapy and mechanical ventilation,there was no difference in the mortality among each subgroup.Conclusions Biliary tract disease before admission and SOFA score were independent risk factors for 28-day mortality.There was no significant difference outcomes between tigecycline-and polymyxin B-based therapy.

OBJECTIVE： To investigate the pratice of pharmaceutical care provided by clinical pharmacists in orthopedics department. METHODS： Based on the characteristics of orthopedic diseases and clinical drug use， combined with case analysis， the content， work focus and working methods of pharmaceutical care provided by clinical pharmacists were summarized in orthopedics department of our hospital. RESULTS： Clinical pharmacists of our hospital provided basal pharmaceutical care， such as pharmacy consultation， drug reforming， medication education. Focusing on the application standardization of antibiotics in perioperative period， pain evaluation， analgesic regimen optimization， hemostasis and anticoagulation medication safety monitoring of patients undergoing orthopaedic surgery， clinical pharmacists went deep into ward work to assist physicians in formulating treatment plans. Results of case analysis showed that the work of clinical pharmacists was recognized by doctors and promoted rational drug use in clinic. CONCLUSIONS： Clinical pharmacists should combine different specialty characteristics to carry out pharmacy services for specific groups， continuously improve the professional level and their ability to work， and improve the level of pharmaceutical care.

Objective To evaluate an effective and feasible quantitative evaluation table of traditional Chinese medicine (TCM) syndrome differentiation, and to observe the effect of combination of TCM syndrome differentiation and standard bundle therapy in patients with septic shock. Methods A prospective randomized controlled trial was conducted. The septic shock patients with acute deficiency syndrome admitted to department of critical care medicine of Ruijin Hospital, Shanghai Jiao Tong University School of Medicine from January 1st, 2016 to December 31st, 2017 were enrolled. The patients were randomly divided into control group and Shenfu group. The patients in both groups received early application of standardized bundle therapy; those in Shenfu group received 60 mL Shenfu injection infusion in addition for 7 days. The TCM syndrome score was evaluated by classification and scoring method of TCM symptoms. The circulation and tissue perfusion, severity of disease, organ function, inflammation response, adjuvant treatment and 28-day mortality were compared between the two groups. Results A total of 50 patients with septic shock were enrolled in the analysis, 25 in control group and 25 in Shenfu group. The markedly effective rate of TCM symptoms score in Shenfu group was significantly higher than that in control group [60.0% (15/25) vs. 16.0% (4/25), P < 0.01]. There was no significant difference in all parameters before treatment between the two groups. After treatment, the observation indexes of both groups were improved. Compared with control group, the mean arterial pressure (MAP) in Shenfu group increased more significantly [mmHg (1 mmHg = 0.133 kPa): 13.0 (2.5, 28.5) vs. 6.0 (0, 13.5)], the lactate (Lac) and procalcitonin (PCT) decreased more significantly [Lac (mmol/L): 0.8 (0.1, 3.7) vs. 0.5 (-0.6, 1.7), PCT (μg/L): 2.0 (0.7, 32.3) vs. 0 (-1.8, 3.8)], activated partial thromboplastin time (APTT) was shortened more significantly [s: 8.5 (0, 12.9) vs. 0 (-7.2, 10.0)], and interleukins (IL-2 receptor and IL-6) levels decreased more significantly [IL-2 receptor (ng/L):1 031.0 (533.0, 1 840.0) vs. 525.5 (186.0, 1 166.8), IL-6 (ng/L): 153.1 (21.4, 406.8) vs. 35.1 (16.3, 110.1)] with significant differences (all P < 0.05). There was no significant difference in the use time of vasoactive drugs, duration of mechanical ventilation, severity of the disease or 28-day mortality between the two groups. However, the use time of vasoactive drugs in Shenfu group was shorter than that in control group (days: 5.48±4.81 vs. 8.28±7.83), and the 28-day mortality was decreased [8.0% (2/25) vs. 20.0% (5/25)]. Conclusions TCM syndrome score is helpful to evaluate the effect of TCM syndrome differentiation and treatment, and it is effective and feasible in clinical application. Septic shock patients treated with TCM syndrome differentiation and treatment combined with standard bundle therapy were significantly improved in circulation, tissue perfusion, coagulation function and inflammation reaction.