Objective To analyze the overall characteristics, research hotspots, and development trends of immune cell-related studies in radiotherapy for rectal cancer. Methods A systematic search was conducted by using Web of Science Core Collection to retrieve articles related to radiation therapy and immune cells in rectal cancer published from 1991 to 2024. Advanced bibliometric tools, such as VOSviewer and CiteSpace, were utilized to facilitate analysis and describe publication trends, geographic contributions, institutional affiliations, journal prominence, author collaboration, and prominent keywords. Results The annual number of relevant publications has increased steadily, showing remarkable growth over the past five years. Studies focusing on adaptive immune cells (T and B cells) account for the largest proportion of works and form the most extensive collaboration networks, reflecting the central role of T cell–mediated antitumor immunity in radiotherapy. Meanwhile, innate immune cells, including myeloid-derived suppressor cells, macrophages, monocytes, and neutrophils, are increasingly investigated for their regulatory roles in shaping the tumor immune microenvironment and influencing therapeutic responses. Among countries, China and the United States have contributed the highest number of publications and demonstrated strong academic influence. While several stable research groups have been formed, intergroup collaboration remains limited. Keyword analysis revealed that radiotherapy-induced immune modulation, tumor immune microenvironment remodeling, and treatment response have emerged as major research hotspots. Conclusion Research on immune cells in rectal cancer radiotherapy has progressed rapidly in recent years. The emphasis of this field has gradually shifted from single-treatment approaches to mechanistic studies investigating the interaction between radiotherapy and the tumor immune microenvironment. The field still demonstrates considerable potential for future research and clinical translational applications.

Purpose This study aimed to investigate the expression and clinical significance of TLDC2 in colorec-tal adenocarcinoma.Methods Data from the human protein atlas(HPA)and the cancer genome atlas(TCGA)indi-cated that TLDC2 was highly expressed in colorectal adenocarcinoma.We further analyzed the expression of TLDC2 in 400 colorectal adenocarcinomas and 447 other solid tumors using tissue microarrays and immunohistochemical(IHC)staining.Result The positive expression rate of TLDC2 was significantly higher than that of SATB2 in colorectal ade-nocarcinomas(96.5％vs 87.0％,P＜0.000 1).TLDC2 positivity exceeded that of SATB2 in both low-or high-grade colorectal adenocarcinoma(99.4％vs 88.7％,P＜0.000 1;83.3％vs 79.2％,P=0.669 9).In addition,the expression of TLDC2 and SATB2 was evaluated in 447 cases of other types of solid tumors.TLDC2 was expressed in neuroendocrine tumors as well as in gastric and appendiceal adenocarcinomas,whereas SATB2 was detected in a small number of melanomas,ovarian cancers,breast cancers and gallbladder cancers.The positive and specificity of TLDC2 for colorectal adenocarcinoma were 97％(95％CI=0.94-0.98)and 85％(95％CI=0.81-0.88),respectively.Combined detection of TLDC2 and SATB2 yielded a sensitivity of 96％(95％CI=0.93-0.97)and a specificity of 93％(95％CI=0.90-0.95).Conclusion Analysis of large-scale datasets and IHC staining demonstrated that TLDC2 is a highly sensitive and specific biomarker for colorectal adenocarcinoma.

Purpose This study aimed to investigate the expression and clinical significance of TLDC2 in colorec-tal adenocarcinoma.Methods Data from the human protein atlas(HPA)and the cancer genome atlas(TCGA)indi-cated that TLDC2 was highly expressed in colorectal adenocarcinoma.We further analyzed the expression of TLDC2 in 400 colorectal adenocarcinomas and 447 other solid tumors using tissue microarrays and immunohistochemical(IHC)staining.Result The positive expression rate of TLDC2 was significantly higher than that of SATB2 in colorectal ade-nocarcinomas(96.5％vs 87.0％,P＜0.000 1).TLDC2 positivity exceeded that of SATB2 in both low-or high-grade colorectal adenocarcinoma(99.4％vs 88.7％,P＜0.000 1;83.3％vs 79.2％,P=0.669 9).In addition,the expression of TLDC2 and SATB2 was evaluated in 447 cases of other types of solid tumors.TLDC2 was expressed in neuroendocrine tumors as well as in gastric and appendiceal adenocarcinomas,whereas SATB2 was detected in a small number of melanomas,ovarian cancers,breast cancers and gallbladder cancers.The positive and specificity of TLDC2 for colorectal adenocarcinoma were 97％(95％CI=0.94-0.98)and 85％(95％CI=0.81-0.88),respectively.Combined detection of TLDC2 and SATB2 yielded a sensitivity of 96％(95％CI=0.93-0.97)and a specificity of 93％(95％CI=0.90-0.95).Conclusion Analysis of large-scale datasets and IHC staining demonstrated that TLDC2 is a highly sensitive and specific biomarker for colorectal adenocarcinoma.

Objective:To evaluate the effects of different doses of sivelestat sodium on perioperative acute lung injury (ALI) in the patients undergoing emergency surgery for acute Stanford type A aortic dissection (AAAD).Methods:A total of 120 patients of both sexes, aged 30-64 yr, with body mass index of 18.5-24.9 kg/m 2, of American Society of Anesthesiologists Physical Status classification Ⅲ or Ⅳ, scheduled for emergency AAAD surgery, were divided into 3 groups using a random number table method: low-dose sivelestat sodium group (SL group), medium-dose sivelestat sodium group (SM group)and high-dose sivelestat sodium group (SH group), with 40 patients in each group. Sivelestat sodium 4.8, 6.0 and 7.2 mg/kg were intravenously infused starting from 10 min before anesthesia until 24 h after surgery in SL, SM and SH groups, respectively. Blood samples from the radial artery were collected for blood gas analysis after anesthesia induction and before skin incision (T 1), immediately after the end of surgery (T 2), at 24 h after surgery (T 3), and 72 h after surgery (T 4), the alveolar-arterial oxygen tension difference (PA-aDO 2), oxygenation index (OI)and respiratory index (RI) were calculated. The duration of postoperative mechanical ventilation, length of stay in the intensive care unit (ICU) and length of postoperative hospital stay were recorded. Central venous blood samples were collected at T 1-T 4 to measure serum concentrations of tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6)and IL-8. Peripheral venous blood samples were collected on preoperative day 1 and postoperative days 1 and 3 to measure white blood cell (WBC) count, neutrophil (NEUT) count, neutrophil percentage (NEUT%), and C-reactive protein (CRP) concentration. The occurrence of postoperative pulmonary complications (PPCs)and 90-day all-cause mortality were recorded. Results:Compared with the baseline at T 1, PA-aDO 2 and RI were significantly increased, OI was decreased, and the serum concentrations of TNF-α, IL-6 and IL-8 were increased at T 2-T 4 in all the three groups ( P<0.05). WBC, NEUT, NEUT% and concentrations of CRP were significantly higher on postoperative days 1 and 3 than on 1 day before surgery in the three groups ( P<0.05). Compared with SL and SM groups, PA-aDO 2 and RI were significantly decreased, OI was increased, and the serum concentrations of TNF-α, IL-6 and IL-8 were decreased, the WBC count, NEUT count, NEUT% and concentrations of CRP were decreased, the incidence of postoperative hypercapnia, hypoxemia, emerging lung rales and bronchospasm was decreased, and the duration of postoperative mechanical ventilation and length of intensive care unit stay were shortened( P<0.05), and no significant change was found in the postoperative length of hospital stay and 90-day all-cause mortality rate in SH group ( P>0.05). Conclusions:Sivelestat sodium 7.2 mg/kg can significantly inhibit the inflammatory responses, alleviate perioperative ALI, and improve early prognosis in the patients undergoing AAAD surgery.

Objective:To investigate the relationship between lncRNA H19 gene and transforming growth factor (TGF)-β1 in polycystic ovary syndrome (PCOS) granulosa cells and their effects on the proliferation and apoptosis of granulosa cells. Methods:Human ovarian granulosa cell line KGN was treated with TGF-β1 of 2 μg/L, 4 μg/L, and 10 μg/L, and the expression level of H19 was detected by Q-PCR method, and the H19 overexpression plasmid pcDNA3.0-H19 and siH19-1617 were transfected into KGN, the expression of TGF-β1 was detected by Western blotting, the proliferation of granulosa cells was detected by CCK8 method, and the apoptosis of granulosa cells was detected by flow cytometry.Results:After adding TGF-β1, the expression of H19 increased compared with untreated cells. When the concentration of TGF-β1≥4 μg/L, the expression of H19 increased significantly, and the difference was statistically significant ( P=0.023). After H19 was overexpressed, the expression of TGF-β1 was significantly higher than that of control group KGN+pcDNA3.0-NC transfected with empty plasmid ( P=0.017), and the expression of TGF-β1 after H19 silencing was significantly lower than that of control group KGN+NC ( P<0.001). After H19 overexpression, the proliferation ability of KGN cells was enhanced at 48 h and 72 h, but the apoptosis ability was weakened. After H19 was silenced, the proliferation ability of KGN cells was weakened at 48 h and 72 h, but the apoptosis ability was enhanced. Conclusion:H19 can regulate the expression of downstream protein TGF-β1, promote the proliferation of PCOS ovarian granulosa cells, and inhibit cell apoptosis.

Objective:To investigate the relationship between lncRNA H19 gene and transforming growth factor (TGF)-β1 in polycystic ovary syndrome (PCOS) granulosa cells and their effects on the proliferation and apoptosis of granulosa cells. Methods:Human ovarian granulosa cell line KGN was treated with TGF-β1 of 2 μg/L, 4 μg/L, and 10 μg/L, and the expression level of H19 was detected by Q-PCR method, and the H19 overexpression plasmid pcDNA3.0-H19 and siH19-1617 were transfected into KGN, the expression of TGF-β1 was detected by Western blotting, the proliferation of granulosa cells was detected by CCK8 method, and the apoptosis of granulosa cells was detected by flow cytometry.Results:After adding TGF-β1, the expression of H19 increased compared with untreated cells. When the concentration of TGF-β1≥4 μg/L, the expression of H19 increased significantly, and the difference was statistically significant ( P=0.023). After H19 was overexpressed, the expression of TGF-β1 was significantly higher than that of control group KGN+pcDNA3.0-NC transfected with empty plasmid ( P=0.017), and the expression of TGF-β1 after H19 silencing was significantly lower than that of control group KGN+NC ( P<0.001). After H19 overexpression, the proliferation ability of KGN cells was enhanced at 48 h and 72 h, but the apoptosis ability was weakened. After H19 was silenced, the proliferation ability of KGN cells was weakened at 48 h and 72 h, but the apoptosis ability was enhanced. Conclusion:H19 can regulate the expression of downstream protein TGF-β1, promote the proliferation of PCOS ovarian granulosa cells, and inhibit cell apoptosis.

Bacitracin is a broad-spectrum antibiotics mainly produced by Bacillus, and is used as veterinary medicine in the fields of livestock and poultry breeding. Insufficient supply of precursor amino acids might be an important factor that hinders high-level microbial production of bacitracin. We investigated the effect of strengthening L-cysteine supply on bacitracin production by an industrial bacitracin producer, Bacillus licheniformis DW2. Overexpression of cysK encoding L-cysteine synthase led to a 9.17% increase of the bacitracin titer. Moreover, overexpression of cysE encoding L-serine acetyltransferase and cysP encoding thiosulfate/sulfate intracellular transporter increased the bacitracin titers by 7.23% and 8.52%, respectively. Moreover, overexpression of a putative cystine importer TcyP led to a 29.19% increase of intracellular L-cysteine, and bacitracin titer was increased by 7.79%. Subsequently, the strong promoter PbacA was used to replace the promoters of genes cysP, cysE and tcyP in strain DW2::ysK, respectively. The resulted strain CYS4 (DW2::cysK-PbacA-(cysP)-PbacA(cysE)- PbacA(tcyP) produced 910.02 U/mL bacitracin, which was 21.10% higher than that of the original strain DW2 (747.71 U/mL). Together with the experiments in 3 L fermenters, this research demonstrated that enhancing intracellular L-cysteine supply is an effective strategy to increase bacitracin production of B. licheniformis.
Amino Acids ; Bacillus licheniformis/genetics* ; Bacitracin ; Cysteine ; Metabolic Engineering

Objective:To investigate the clinical characteristics and related risk factors of sarcopenia in elderly patients undergoing maintenance hemodialysis.Methods:This was a retrospectively study involving 135 elderly hemodialysis patients aged(70.6±7.7)years, with 46(34.1%)females and a mean hemodialysis duration of(3.2±2.9)years, at Shanghai Sixth People's Hospital.The incidence of sarcopenia in patients was examined by measuring handgrip strength, walking speed and muscle mass of the limbs using bioelectrical impedance analysis.Related risk factors were analyzed with univariate and multivariate logistic regression analysis.Results:Among 135 elderly hemodialysis patients, the incidence of sarcopenia was 62.9%(85 cases), and severe sarcopenia cases accounted for 44.4%(60 cases). Compared with the non-sarcopenia group, patients with sarcopenia were older, had lower body mass index(BMI)and handgrip strength, walked more slowly and had less muscle mass in their limbs.Advanced age, low BMI and long dialysis duration were correlated with the high incidence of sarcopenia in elderly dialysis patients.The odds ratio( OR)for sarcopenia increased by 12% per year, and the OR decreased by 32% with an increase of 1.0 kg/m 2 in BMI.Advanced age and lower BMI were also correlated with a high incidence of severe sarcopenia( OR=1.12, 95% CI: 1.05~1.18; OR=0.84, 95% CI: 0.74~0.95; all P<0.01). Conclusions:The incidence of sarcopenia is high in elderly hemodialysis patients and is closely related to advanced age and low body weight.Improving nutritional status and avoiding low body weight will help reduce the occurrence and development of sarcopenia in elderly hemodialysis patients.

This paper aimed at exploring methods and their effectiveness of cultivating the scientific research quality in medical undergraduates in the early stage of. In combination with teachers' scientific research projects, 3 to 5 medical undergraduates in 3rd grade who applied for the projects initiatively were selected every year to enter into different research groups in the department. According to students' wishes, they may participate in some experiments in scientific research projects, or complete small projects independently, or write a review on a certain topic under teachers' guidance. In the past 10 years, 25 students participated in the program of our section and published 19 papers in total. Most students who participated in the experimental research program were able to carry out some scientific experiments independently with improved scientific research ability and practical ability. Students who wrote reviews not only broadened their knowledge, but also developed the skills of literature search, reading, comprehensive writing and critical thinking. Therefore, it was concluded that the cultivation of scientific research quality in students in the early stage could motivate students to actively participate in scientific research; both scientific experiments and themed reviews could enhance the scientific research ability and scientific research quality of undergraduates from different angles.

Objective To explore the association between white matter hyperintensities volume and cognitive function in patients with hypertension.Methods Eighty-two patients with hypertension enrolled from the Department of Neurology of Nanjing Drum Tower Hospital from January 2017 to December 2017 were recruited in this study sequentially,who aged between 50 and 80 years.All subjects used automatic white matter quantitative technique to get their personal whole white matter hyperintensities volume,periventricular white matter hyperintensities volume and deep white matter hyperintensities volume.Neuropsychological scales were used to evaluate their global cognitive function,memory function,fluency,executive function and processing speed.The association between white matter hyperintensities volume and cognitive function via linear regression analysis was assessed.To explore whether the association between white matter hyperintensities volume and cognitive function be affected by the duration of hypertension,stratification analyses were conducted using the median of the duration of hypertension as separation.Results After adjusting for age,sex,education,lacunar infarctions and global cortical atrophy grade,the Trail Marking Test (2-1) score which reflects executive function was found to be related to whole white matter hyperintensities volume (standardized beta-value=0.268,P=0.019),periventricular white matter hyperintensities volume (standardized beta-value=0.243,P=0.037) and deep white matter hyperintensities volume (standardized beta-value=0.243,P=0.021).Victorial Snoop Test-2 score which reflects processing speed was found to be related to periventricular white matter hyperintensities volume (standardized beta-value=0.270,P=0.023).After additional adjusting for the duration of hypertension,the Trail Marking Test (2-1) score was still found to be related to whole white matter hyperintensities volume (standardized beta-value=0.277,P=0.016),periventricular white matter hyperintensities volume (standardized beta-value=0.251,P=0.032) and deep white matter hyperintensities volume (standardized beta-value=0.248,P=0.019).The Victorial Stroop Test-2 score was found to be related to whole white matter hyperintensities volume (standardized beta-value=0.237,P=0.041) and periventricular white matter hyperintensities volume (standardized beta-value=0.290,P=0.013).Conclusion Whole white matter hyperintensities volume,periventricular white matter hyperintensities volume and deep white matter hyperintensities volume are related to executive function,periventricular white matter hyperintensities volume is also related to processing speed in patients with hypertension,and the association between white matter hyperintensities volume and cognitive domain is not influenced by the duration of hypertension.