Objective To analyze the onset time and short-term clinical effect of rituximab(RTX)in the treatment of glomerular diseases.Methods All case data of rituximab used in the treatment of glomerular diseases in a tertiary hospital from January 2021 to December 2022 were extracted for retrospective study.The changes in blood routine,liver function,kidney function,immunity and other related indexes were analyzed after the treatment of RTX and the clinical effect in the short term was observed.Results A total of 52 patients were collected,of which 30 received RTX standardized therapy.During the follow-up period,plasma albumin showed an upward trend,and the 24-hour urine protein and B cell count showed a downward trend.The values of these indexes after 3 months and 6 months after treatment were significantly different from those before treatment,which was statistically significant(P<0.05).The clinical response rates after the first injection,the second injection,the third injection,the fourth injection,3 months later,and 6 months after RTX treatment were 26.92%,36.00%,51.85%,57.69%,76.92% and 81.82%,respectively.No serious adverse effects occurred during the follow-up period.Conclusions RTX can improve 24-hour urine protein,plasma albumin level and B cell count in glomerular-related diseases,stabilize renal functionand have good safety.

Objective:To evaluate the impact of self-crosslinked hyaluronic acid (SCH) gel on endometrium recovery after artificial abortion.Methods:A multicenter, prospective randomized controlled trial was conducted across 18 hospitals from December 2021 to February 2023, involving 382 women who underwent artificial abortion. Participants were randomly allocated to receive either treatment with SCH gel (SCH group) or no treatment (control group) in a 1∶1 ratio. The primary outcome was endometrium thickness in 14 to 18 days after the first postoperative menstruation. Secondary outcomes included changes in menstrual volume during the first postoperative menstruation, menstruation resumption within 6 postoperative weeks, time to menstruation resumption, duration of the first postoperative menstruation, and incidence of dysmenorrhea.Results:Baseline characteristics of participants were comparable between the two groups (all P>0.05), with 95.3% (182/191) in SCH group and 92.7% (177/191) in the control group completed the study. The postoperative endometrial thickness in SCH group was significantly greater than that in the control group [(9.78±3.15) vs (8.95±2.32) mm; P=0.005]. SCH group also had significantly fewer participants with reduced menstrual volume [23 cases (12.6%, 23/182) vs 31 cases (17.5%, 31/177); P=0.038]. Although SCH group experienced less dysmenorrhea during the first postoperative menstrual period, this difference was not statistically significant [28.5% (51/179) vs 37.1% (65/175); P=0.083]. Outcomes were similar between SCH group and the control group regarding the proportion of participants who resumed menstruation within 6 weeks postoperatively, time to menstruation resumption, and duration of the first postoperative menstruation ( P=0.792, 0.485, and 0.254, respectively). No serious adverse events were observed during the study period, and no adverse events were attributed to SCH gel treatment. Conclusion:The application of SCH gel after artificial abortion is safe and might aid in the recovery of the endometrium.

Aromatic compounds are a class of organic compounds with benzene ring(s). Aromatic compounds are hardly decomposed due to its stable structure and can be accumulated in the food cycle, posing a great threat to the ecological environment and human health. Bacteria have a strong catabolic ability to degrade various refractory organic contaminants (e.g., polycyclic aromatic hydrocarbons, PAHs). The adsorption and transportation are prerequisites for the catabolism of aromatic compounds by bacteria. While remarkable progress has been made in understanding the metabolism of aromatic compounds in bacterial degraders, the systems responsible for the uptake and transport of aromatic compounds are poorly understood. Here we summarize the effect of cell-surface hydrophobicity, biofilm formation, and bacterial chemotaxis on the bacterial adsorption of aromatic compounds. Besides, the effects of outer membrane transport systems (such as FadL family, TonB-dependent receptors, and OmpW family), and inner membrane transport systems (such as major facilitator superfamily (MFS) transporter and ATP-binding cassette (ABC) transporter) involved in the membrane transport of these compounds are summarized. Moreover, the mechanism of transmembrane transport is also discussed. This review may serve as a reference for the prevention and remediation of aromatic pollutants.
Humans ; Adsorption ; Bacteria/metabolism* ; Organic Chemicals ; Biological Transport ; ATP-Binding Cassette Transporters ; Polycyclic Aromatic Hydrocarbons/metabolism*

There is currently a huge worldwide demand for donor kidneys for organ transplantation. Consequently, numerous marginal donor kidneys, such as kidneys with microthrombi, are used to save patients' lives. While some studies have shown an association between the presence of microthrombi in donor kidneys and an increased risk for delayed graft function (DGF) (McCall et al., 2003; Gao et al., 2019), other studies have demonstrated that microthrombi negatively impact the rate of DGF (Batra et al., 2016; Hansen et al., 2018), but not graft survival rate (McCall et al., 2003; Batra et al., 2016; Gao et al., 2019). In contrast, Hansen et al. (2018) concluded that fibrin thrombi were not only associated with reduced graft function six months post-transplantation but also with increased graft loss within the first year of transplantation. On the other hand, Batra et al. (2016) found no significant differences in the DGF rate or one-year graft function between recipients in diffuse and focal microthrombi groups. To date, however, the overall influence of donor kidney microthrombi and the degree of influence on prognosis remain controversial, necessitating further research.
Humans ; Thrombotic Microangiopathies ; Transplantation, Homologous ; Tissue Donors ; Kidney ; Allografts

Objective:To explore the effect of precision nursing based on evidence-based concept in the perioperative period of patients with total knee arthroplasty (TKA) .Methods:From January 2018 to December 2020, 200 TKA patients admitted to the First Affiliated Hospital of Zhengzhou University were selected as the study subject by convenience sampling. The patients were divided into the control group and the observation group according to simple random sampling with 100 cases in each group. The control group adopted routine nursing, while the observation group conducted precise nursing based on evidence-based concept on the basis of the control group. The incidence of postoperative complications and knee function between the two groups were compared.Results:The incidence of complications in the observation group was lower than that in the control group, with a statistically significant difference ( P<0.05) . At one, three and six months after operation, the knee function score of New York Hospital for Special Surgery (HSS) in both groups showed an upward trend. The HSS scores of the observation group at one, three, six months after operation were higher than those of the control group, and the difference was statistically significant ( P<0.01) . Conclusions:The precision nursing based on the evidence-based concept has a definite effect in the perioperative nursing of patients with TKA, which can reduce complications and improve the knee function.

Objective:To analyze KCNJ5 mutation of adenomas in patients with aldosterone-producing adenoma (APA) companying with hypokalemia, and to compare the clinical characteristics of patients with and without KCNJ 5 mutations.Methods:Clinical data of 144 APA patients were retrospectively analyzed. DNA were extracted from adenoma tissues, and amplified and sequenced for KCNJ5 gene. The serum potassium level and cardiac complications in patients with and without KCNJ5 gene mutation were compared.Results:Among 144 tumors, 131 tumors (91%) had KCNJ5 mutation, including 68 tumors with G151R, 56 tumors with L168R, 5 tumors with E145Q, and two tumors with novel mutations, V156_K160delITE and G151delinsVR. Compared with patients without KCNJ5 mutation, patients with KCNJ5 mutation had lower preoperative serum potassium levels, more cardiac complications, lower postoperative systolic blood pressure, and better postoperative hypertension relief. There were no statistical differences in age, gender, blood pressure, serum potassium level, plasma renin activity or plasma aldosterone concertration.Conclusion:91% adenomas in patients with APA and hypokalemia had KCNJ5 mutation, suggesting that KCNJ5 mutation is the main cause in these patients.

Objective:To explore the effects of different temperature settings on patients with acute hypoxic respiratory failure (AHRF) during application of high-flow nasal cannula (HFNC) .Methods:A total of 90 patients with AHRF who were admitted to the Department of Critical Care Medicine of Zhejiang Hospital and underwent HFNC from January 2019 to May 2020 were selected as research objects by the convenient sampling method. The patients were randomly divided into 3 groups by the random number table method, namely, group A (T=31 ℃) , group B (T=34 ℃) and group C (T=37 ℃) , with 30 cases in each group. The VAS and Borg Scale were used to compare the comfort and dyspnea of patients of 3 groups, and to compare the satisfaction of patients of 3 groups.Results:After applying HFNC for 2 h and 12 h, the scores of VAS and Borg Scale in group B were lower than those in groups A and C, and the differences were statistically significant ( P<0.01) . The VAS scores of the three groups after applying HFNC for 12 h were higher than that after applying HFNC for 2 h, and the scores of Borg Scale were lower than that after applying HFNC for 2 h, and the differences were statistically significant ( P<0.05) . The satisfaction of patients in group B was higher than that in group A and C, and the differences were statistically significant ( P< 0.01) . Conclusions:Different temperature settings of HFNC will affect the comfort, dyspnea and satisfaction of AHRF patients. Among them, 34 ℃ is a more suitable temperature. As time progresses, nursing staff should intervene in time to maintain the comfort of patients, reduce the degree of dyspnea and provide guidance for the clinical application of HFNC.

Objective:To observe the effects of microRNA-21 (miR-21) on cell invasion, migration and apoptosis of pancreatic cancer PANC1 cells, and explore the potential molecular mechanism.Methods:Recombinant plasmids carrying miR-21 or small interfering RNA targeting miR-21 were constructed. Using blank plasmid as the control, the recombinant plasmids were transfected with human pancreatic cancer PANC1 cells by liposome method, respectively to establish blank group, miR-21 overexpression group (overexpression group) and miR-21 silence group (silence group) PANC1 cell lines. Cell proliferation, apoptosis, invasion and metastasis were detected by MTT method, flow cytometry, transwell chamber and wound scratch test, respectively. ELISA and Western blot were used to measure the protein expression of programmed cell death factor 4(PDCD4), gene of phosphate and tension homology deleted on chromsome ten (PTEN), vascular endothelial growth factor (VEGF), survivin, matrix metalloproteinase 2 (MMP-2) and MMP-9.Results:After 24 h cell culture, the cell proliferation rate of blank group, overexpression group and silence group was (20.72±5.62)%, (28.46±6.12)% and (14.05±3.36 )%; cell apoptosis rate was (5.89±0.26)%, (4.62±0.19)% and (8.66±2.55)%; the number of transmembrane cells was (212.4±32.5), (508.8±50.7) and (50.9±10.6) per 200 times visual field; the area covered by migrated cells was (75.6±12.1), (118.8±20.2) and (48.8±9.5)mm 2 per 200 times visual field; the expression of PDCD4 was 0.85±0.22, 0.72±0.10 and 1.36±0.41; the expression of PTEN was 0.85±0.21, 0.28±0.09 and 1.36±0.45; the expression of VEGF was 0.79±0.24, 1.15±0.31 and 0.46±0.10; the expression of survivin was 1.02±0.33, 1.51±0.42 and 0.52±0.12; the expression of MMP-2 was 1.12±0.22, 1.86±0.52 and 0.56±0.18; the expression of MMP-9 was 1.06±0.15, 1.78±0.48 and 0.49±0.12. All the differences among the three groups were statistically significant (all P<0.05). Compared with blank group, the cell apoptosis rate, PDCD4 and PTEN expression were increased, while cell proliferation, invasion and migration, and the protein expression of VEGF, survivin, MMP-2 and MMP-9 were all decreased; the changes in silence group was totally contrary to those in overexpression group. All the differences among the three groups were statistically significant (all P<0.05). Conclusions:miR-21 silencing can inhibit the proliferation, migration and invasion of PANC1 cells and promote apoptosis, and the mechanism was possibly associated with the upregulation of PDCD4 and PTEN protein expression.

Objective:To investigate the changes in gut microbiota diversity with age in elderly people using high-throughput sequencing.Methods:Ninety healthy volunteers were recruited. People who were <60 years old (middle-aged group) were set up as a baseline control group (Age A group), while those aged ≥60 years old were further divided into four groups (60-<70: Age B group, 70-<80: Age C group, 80-<90: Age D group, ≥90: Age E group). Fecal samples were collected to extract DNA. The second-generation sequencing technology was used to amplify and sequence the V3-V4 hypervariable region of 16S rDNA. Bioinformatics analysis was performed to compare the differences in gut microbiota and functional genes among groups.Results:At the phylum level, gut microbiota were composed mainly of Firmicute, Bacteroidetes, Proteobacteria and Actinobacteria in different groups. The proportion of Firmicute was the highest, accounting for over 60%, followed by that of Bacteroidetes. At the genus level, the abundance of Faecalibacterium genus decreased with age. The α diversity analysis showed that the gut microbiota in the elderly of different ages had higher abundance and uniformity, and there was no significant difference among groups. However, the β diversity analysis showed that in community structure there was difference between Age A and Age B groups, and similarity between Age B and Age C groups. Conclusions:The community structure of gut microbiota changed significantly between young and middle-aged people and the elderly over 60 years old. It tended to be relatively stable in people of 60-80 years old, but changed again when they were over 80 years old. Chronic inflammatory diseases, metabolic diseases and tumors in the elderly might be associated with the decrease in Faecalibacterium.

OBJECTIVE：To struc turally modify shikimic acid ，and to investigate the reversal effects of its derivatives on paclitaxel-resistant human breast cancer cells MCF- 7/PTX. METHODS ：Using shikimic acid as the lead structure ，1-position carboxyl group was structurally modified to synthesize a series of shikimic acid derivatives through esterification ，amidation， hydrogenation and reduction ，etc. Using non-drug resistant cells MCF- 7 as reference ，MTT assay was used to screen derivatives with inhibitory activity as well as half-inhibitory concentration （IC50）and reversal index （RI）of derivatives to MCF- 7/PTX. With the drug resistance-related transgelin 2 as the target ，the molecular docking of the active derivatives with the drug resistance-related protein was carried out by using Glide 1.0 computer-aided design software. RESULTS ：Totally 15 derivatives were obtained （T1-T15）， of which T 4-T15 were obtained for the first time. MTT assay showed that （3R， 4S， 5R） -N-benzyl-3， 4， 5-trihydroxy-1-cyclohexene-1-formamide（T7），（3R，4S，5R）-N-（3，4，5-trihydroxy-1-cyclohexenylmethyl）-benzylamine（T14）， （3R，4S，5R）-3，4-O-isopropyl-5-O-acetyl-1-cyclohexene-1-methyl formate （T15）inhibited MCF- 7 and MCF- 7/PTX cells to a certain extent ；IC50 values of T 7，T14 and T 15 combined with pacliaxel to MCF- 7/PTX cells were significantly lower than that in negative control （Paclitaxel alone ）group（P＜0.05）. RIs of T 14 and T 15 were higher ，and RIs of the highest dose were 8.8 and 9.3， which were equivalent to positive control verapamil （10.8）. Th e results of molecular docking showed that the hydroxyl groups at positions 3，4 of T 7 could form multiple hydrogen bonds with ； Arg625 and Asp 627 in the catalytic region of transgelin 2. In addition to the hydrogen bond mentioned above at T 7，the mail：batistuta28@126.com secondary amine side chain at position 1 of T 14 could also form hydrogen bond with Glu 657 of transgelin 2. When the hydroxyl group on the T 15 mother nucleus was derived from the donor group ，the binding of the hydroxyl group to transgelin 2 was closer and the inhibition was enhanced. CONCLUSIONS ： The derivatives T 7，T14 and T 15 have certain reverse activity to paclitaxel-resistant human breast cancer cells. The polyhydroxy structure of the mother nucleus is the main structural region of the hydrogen bond between shikimic acid and its derivatives and transgelin 2. The derivation of its power supply group or the introduction of secondary amines and hydrophobic groups into the 1-carboxyl group of shikimic acid is benifit for enhancing the drug resistance reversal effect of derivative .