An effective therapeutic regimen for hepatic fibrosis requires a deep understanding of the pathogenesis mechanism. Hepatic fibrosis is characterized by activated hepatic stellate cells (aHSCs) with an excessive production of extracellular matrix. Although promoted activation of HSCs by M2 macrophages has been demonstrated, the molecular mechanism involved remains ambiguous. Herein, we propose that the vitamin D receptor (VDR) involved in macrophage polarization may regulate the communication between macrophages and HSCs by changing the functions of exosomes. We confirm that activating the VDR can inhibit the effect of M2 macrophages on HSC activation. The exosomes derived from M2 macrophages can promote HSC activation, while stimulating VDR alters the protein profiles and reverses their roles in M2 macrophage exosomes. Smooth muscle cell-associated protein 5 (SMAP-5) was found to be the key effector protein in promoting HSC activation by regulating autophagy flux. Building on these results, we show that a combined treatment of a VDR agonist and a macrophage-targeted exosomal secretion inhibitor achieves an excellent anti-hepatic fibrosis effect. In this study, we aim to elucidate the association between VDR and macrophages in HSC activation. The results contribute to our understanding of the pathogenesis mechanism of hepatic fibrosis, and provide potential therapeutic targets for its treatment.
Humans ; Hepatic Stellate Cells/pathology* ; Receptors, Calcitriol ; Liver Cirrhosis/pathology* ; Macrophages/metabolism*

Objective:To explore the effect of intraoperative blood salvage (IBS) in the operation of infective endocarditis (IE) and the risk factors of death within half a year after operation.Methods:Used retrospective research methods, a total of 61 patients who were diagnosed as IE and received surgical treatment in Department of Cardiovascular and Large Vascular Surgery, Huizhou Central People′s Hospital from April 2017 to November 2020 were selected as subjects. The patients were divided into autologous group ( n=30) and allogeneic group ( n=31) according to different blood transfusion methods. Patients in the autogenous group received IBS, and patients in the allogeneic group received allogeneic blood transfusion. The indexes of coagulation function [activated partial thromboplastin time(APTT), thrombin tim(TT), prothrombin time(PT), D-dimmer(D-D), fibrinogen degradation product(FDP)], immune reaction (CD3 + CD4 + T cells, CD3 + CD8 + T cells, CD16 + CD56 + NK cells, TLR2 + cells, TLR4 + cells) and inflammatory reaction [soluble CD40 ligand(sCD40L), neutrophil chemokine -1(CINC-1), tumor necrosis factor-α(TNF-α), interleukin-6(IL-6)] were compared between the autologous group and the allogeneic group, as well as the incidence of postoperative adverse reactions. The end event was death half a year after operation, and the subjects were divided into death group ( n=15) and survival group ( n=46). The clinical data of the death group and the survival group were compared. Measurement data were expressed as mean ± standard deviation ( ± s), and t-test was used for comparison between groups; Chi-square test was used for comparison of enumeration data between groups, and the IBS variables were included and excluded to establish the prediction models of death half a year after operation, respectively. The model was evaluated by the receiver operating characteristic curve (ROC), and the model was internally verified by the method of Bootstrap repeated sampling. IBS was included and removed to establish the prediction model of death within half a year after surgery, and ROC was used to evaluate the model. Bootstrap repeated sampling was used to verify the model internally. Results:Cardiac insufficiency, hypotension, IBS, multivalvular disease and age were independent risk factors for postoperative death ( P<0.05). The model with IBS variables has higher predictive value. 5 days after operation, there were significant differences in the indexes of immune reaction [CD3 + CD4 + T cells: (37.49±5.74)% vs (31.68±4.46)%, CD3 + CD8 + T cells: (23.07±3.24)% vs (17.82±2.29)%, CD16 + CD56 + NK cells: (1.61±0.18)% vs (1.02±0.15)%, TLR2 + cells: (9.24±1.15)% vs (18.40±2.21)%, TLR4 + cells: (7.79±0.82)% vs (12.33±1.57)%] and inflammatory reaction [sCD40L: (59.21±7.80) pg/mL vs (84.33±9.35) pg/mL, CINC-1: (40.27±5.83) pg/mL vs (72.86±9.35) pg/mL, TNF-α: (10.86±1.26) ng/mL vs (17.03±2.20) ng/mL and IL-6: (6.32±0.77) ng/mL vs (11.35±1.74) ng/mL] between autologous group and allogeneic group ( P<0.01). Intra-group comparison of patients in autologous group, before and 5 days after operation, there were significant differences in the indexes of immune response [CD3 + CD4 + T cells: (48.55±6.67)% vs (37.49±5.74)%, CD3 + CD8 + T cells: (30.38±4.69)% vs (23.07±3.24)%, CD16 + CD56 + NK cells: (2.53±0.44)% vs (1.61±0.18)%, TLR2 + cells: (6.50±0.61)% vs (9.24±1.15)%, TLR4 + cells: (4.02±0.63)% vs (7.79±0.82)%] and inflammatory response [sCD40L: (38.64±6.75) pg/mL vs (59.21±7.80) pg/mL, CINC-1: (31.65±5.68) pg/mL vs (40.27±5.83) pg/mL, TNF-α: (7.59±0.85) ng/mL vs (10.86±1.26) ng/mL and IL-6 (5.10±0.63) ng/mL vs (6.32±0.77) ng/mL] ( P<0.01). Intra-group comparison of patients in allogeneic group, before and 5 days after operation, there were significant differences in the indexes of immune reaction [CD3 + CD4 + T cells: (49.13±6.82)% vs (31.68±4.46)%, CD3 + CD8 + T cells: (30.65±4.91)% vs (17.82±2.29)%, CD16 + CD56 + NK cells: (2.51±0.26)% vs (1.02±0.15)%, TLR2 + cells: (6.36±0.66)% vs (18.40±2.21)%, TLR4 + cells (4.08±0.56)% vs (12.33±1.57)%] and inflammatory response [sCD40L: (39.14±6.03) pg/mL vs (84.33±9.35) pg/mL, CINC-1: (31.24±5.77) pg/mL vs (72.86±9.35) pg/mL, TNF-α: (7.64±0.76) ng/mL vs (17.03±2.20) ng/mL and IL-6: (5.04±0.82) ng/mL vs (11.3±1.74) ng/mL] ( P<0.01). There were 3 cases of hypoproteinemia, 2 cases of incision infection and 1 case of cardiac adverse event in the autologous group; 4 cases of hypoproteinemia, 3 cases of incision infection and 1 case of cardiac adverse event in the allogeneic group. There was no significant difference in the incidence of postoperative adverse reactions between the two groups ( P>0.05). Conclusions:The predictive model included in IBS can better predict the mortality of within half a year after IE. The use of IBS in IE surgery will not significantly affect the blood coagulation function and the incidence of postoperative adverse reactions, but can improve immune function and inhibit inflammatory reaction.

Objective:To observe the peripapillary atrophy (PPA) and peripapillary choroidal vascularity index (CVI) in patients with different degrees of myopia and to analyze their correlations.Methods:A cross-sectional clinical study. From September 2021 to December 2021, 281 mypoic patients of 281 eyes treated in Eye Hospital of Wenzhou Medical University at Hangzhou were included in this study, and the right eye was used as the treated eye. There were 135 eyes in 135 males and 146 eyes in 146 females. The age was 28.18±5.78 years. The spherical equivalent refraction (SE) was -5.13±2.33 D. The patients were divided into three groups: low myopia group (group A, -3.00 D

Endophytic fungi strains (n = 81) were isolated from the leaves, barks, and fruits of Camellia oleifera from Hunan province (China) to delineate their species composition and potential as biological control agents of C. oleifera anthracnose. The fungi were identified by morphological and phylogenetic analyses. Fungal colonization rates of the leaves, barks, and fruits were 58.02, 27.16, and 14.81%, respectively. The isolates were identified as 14 genera, belonging to two subdivisions, Deuteromycotina and Ascomycotina; 87.65% of all isolates belonged to Deuteromycotina. The dominant species, occurring with a high relative frequency, were Pestalotiopsis sp. (14.81%), Penicillium sp. (14.81%), and Fusarium sp. (12.35%). The Simpson’s and Shannon’s diversity indices revealed the highest species diversity in the leaves, followed by the barks and fruits. The similarity index for the leaves versus barks comparison was the highest, indicating that the number of endophytic fungal species shared by the leaves and barks was higher than barks and fruits or leaves and fruits. Based on the results of dual culture experiments, only five strains exhibited antifungal activity against C. oleifera anthracnose pathogen, with isolate ty-64 (Oidium sp.) generating the broadest inhibition zones. Our results indicate that the endophytes associated with C. oleifera could be employed as natural agents controlling C. oleifera anthracnose.
Biological Control Agents ; Camellia* ; Colon ; Endophytes ; Fruit ; Fungi* ; Fusarium ; Penicillium

Objective · To observe the changes of cerebral gray matter pre- and post-treatment with short term drugs in patients with schizophrenia. Methods · T1-weighted brain MRIs were obtained on a 3T scanner in 21 controls and 27 subjects with schizophrenia who were not given antipsychotic medication. The controls and 21 schizophrenia patients received the second scan after 8 weeks of antipsychotic treatment. Voxel-based morphometry (VBM) were used to investigate the differences in gray matter (GM), mainly about the regional GM volumes. Results · GM volumes were significantly smaller in the patient group than those of healthy controls in left cerebellum posterior lobe , left and right parahippocampalgyrus, left middle temporal gyrus(P=0.000, voxels>50). GM volumes extensively decreased after 8 weeks of antipsychotic-treatment compared with pre-treatment in the superior, middle, and inferior temporal gyri, superior,middle and inferior frontal gyri, parahippocampa gyri, cingulate gyri, right supramarginal gyrus, right cerebellum posterior lobe, and right lingual gyrus(P=0.000, voxels>50). Conclusion · Short term antipsychotic treatment (8 weeks) may have adverse effects on the gray matter of patients with acute schizophrenia by reducing the volume of gray matter.

[Objective] To observe the effect of different acupoint application therapies :a summer treatment for the winter disease on allergic rhinitis ,and compare the relationship between the different acupoints and therapeutic effect. [Methods ] The 81 cases of allergic rhinitis who met inclusion criteria were divided into 12 acupoint group and 6 acupoint group. The time of application was in first ten-day period of the hot season. The duration of application was 2h. The days later, namely in the second ten-day period of the hot season, and twenty days later, in the third ten-day period of the hot season, the application was repeated respectively. Before treatment and half year after the treatment, the score of quality of life, symptoms of allergic rhinitis were observed to compare the relationship between the different acupoints and therapeutic effect. [Results] The effective rate was higher in 12 acupoints group than 6 acupoints group. After treatment, the score of quality of life, symptoms of allergic rhinitis were significantly improved( P<0.05 or P<0.01). And the comparison of the therapeutic effect of two groups showed significant difference in statistics( P<0.01). [Conclusion] The acupoint application therapy is effective for allergic rhinitis, and the comprehensive combination of acupoint is influential on the effect.

Background and purpose:Adrenal schwannoma is extremely rare, mostly benign, lack of special characteristics in clinical and imaging presentation. The aim of this study was to analyze the computed tomography (CT) and magnetic resonance imaging (MRI) findings of adrenal schwannoma, in order to improve the accuracy of diagnosis. Methods:The CT and MRI features of 8 patients with pathology-proven adrenal schwannoma were reviewed. Among the 8 patients, 4 patients underwent CT scanning, 3 patients underwent MR scanning, 1 patient underwent both CT and MR scanning.Results:The tumors were located at the left adrenal in 5 cases and at the right in 3 cases. Tumors showed no signs of endocrine activity in all cases. All tumors were well-circumscribed, oval or lobulated masses, 2 cases with calcification, 5 cases with cystic change, 2 cases with intratumoral hemorrhage. CT or MR enhancement showed moderate, heterogeneously delayed enhancement in 7 cases with enhanced capsule. Four cases showed rabbit tail sign.Conclusion:The imaging and pathological features of adrenal schwannoma have certain characteristics. The CT and MRI features, such as intact capsule, cystic degeneration, rabbit tail sign, calcification and progressive enhancement, are helpful to improve the accuracy of diagnosis of adrenal schwannoma.

Cerebrospinal Fluid Leak ; surgery ; Endoscopy ; Humans ; Iatrogenic Disease ; Male ; Meningocele ; surgery ; Middle Aged ; Nose ; surgery

Objective This retrospective study is to analysis the special medical conditions that most Chinese secondary hospitals are facing with,and to review the safeguards and pitfalls for arterial switch operations,in order to probe intothe feasibility of this procedure for Chinese secondary hospitals and provide our experiences to help other surgeons to avoid pitfalls on complex procedures.Methods Between January 2006 and December 2011,totally 21 newborns and infants with TGA/VSD and TGA/IVS underwent arterial switch operation.There were 15 males and 6 females.In the TGA/VSD group,there were 16 cases,ranging from 30 days to 1 year at surgeries,and weight from 3.4-8.5 kg with average of (5.33 ± 1.42) kg.In the TGA/IVS group,there were 5 cases,ranging from 13 days to 1 month at surgeries,and weight from 3.1-5.5 kg with average of (3.75 ± 1.17)kg.All patients underwent one stage of arterial switch operation.Routine follow-up checking points are set at discharging,3 months,half year and every year after operation.Results The early death rate is 9.5％ (2/21),and the reexploration rate is 9.5％ (2/21).In the TGA/VSD group,average cardiopulmonary bypass time is (151 ± 33) minuntes with the aortic crossclamp time is (1 19 ± 26) minutes.Ventilator support time is 24-159 hours,and the length of ICU stay is 3-17 days.1 case has residual VSD with the diameter less than 2 mm.The pulmonary flow velocity in 2 cases increase mildly to 2.0 m/s and 2.2 m/s,and another 2 cases increase severely to 3.1 m/s and 3.7 m/s.The aortic flow velocity in 3 cases increase to 2.0m/s.ECG instructs no case has myoinfarction signs.In the TGA/IVS group,average cardiopulmonary bypass time is (170 ± 52) minuntes with the aortic crossclamp time is (137 ± 48) minutes.Ventilator support time is 51-144 hours,and the length of ICU stay is 4-14 days;The pulmonary flow velocity in 2 cases increase mildly to 2.0 m/s.The aortic flow velocity in 1 cases increase to 2.0 m/s.ECG instructs no case has myoinfarction signs.Conclusion Unbalanced medical resources distribution causes significant differences between heart centers and the secondary hospitals in China,especially on the complex congenital heart diseases procedures.However,with relatively solid background on correction of the simple congenital heart diseases,the Chinese secondary hospitals can still perform arterial switch operation with satisfactory mortality and morbidity,and provide more prompt medical services for more population.

OBJECTIVE: To compare the results of skin prick test with allergens of Allergopharma company or ALK company in Shanghai area. METHOD: The study included 9 233 patients diagnosed as allergic rhinitis. The patients were divided in to two groups (Allergopharma group and Alutard-SQ group) SPT was given from June, 2005 to Feb, 2013. The results of the positive rate using two reagents were analyzed and compared. RESULT: There were no significant differences between the two groups in age and gender (P > 0.05). The total positive rate in Allergopharma group was 62.90%, and 59.68% in Alutard-SQ group. The positive rate in Allergopharma group was significantly higher than that in Alutard-SQ group (P < 0.01). Dermatophagoides farinae (Der f) and Dermatophagoides pteronyssinus (Der p) were identified as the mostly responsible allergens. The positive rate of Der f in Allergopharma group and Alutard-SQ group was 55.23% and 45.57% respectively. The same rate were 54.83% and 47.89% of Der p. There were significant differences of the positive rate of two allergens in both groups (P < 0.01). CONCLUSION The total positive rate was different using different allergens for SPT among the patients diagnosed as allergic rhinitis of the same area. Dust mites were identified as main allergens. The positive rate was different when using different reagents, which needed more attention to make the decision of specific immune therapy.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Allergens ; immunology ; Antigens, Dermatophagoides ; immunology ; Child ; Child, Preschool ; China ; Female ; Humans ; Indicators and Reagents ; Male ; Middle Aged ; Rhinitis, Allergic ; diagnosis ; Skin Tests ; Young Adult