BACKGROUND:Spleen has the functions of blood storage,hematopoiesis,and immunity.With the increase of age,the structural degeneration and functional decline of spleen lead to the impairment of immune system function,thus accelerating the aging process of the body.The treatment of spleen aging in tree shrews with highly active umbilical cord mesenchymal stem cells has not been reported. OBJECTIVE:To explore the intervention effect and mechanism of highly active umbilical cord mesenchymal stem cells on spleen aging in tree shrews. METHODS:Highly active umbilical cord mesenchymal stem cells were isolated,cultured,and obtained from the umbilical cord tissue of newborn tree shrews by caesarean section.The differentiation abilities of adipogenesis,osteogenesis,and chondrogenesis were detected by three-line differentiation kit.Cell cycle and surface markers were detected by flow cytometry.The second generation of highly active umbilical cord mesenchymal stem cells were transfected with Genechem Green Fluorescent Protein with infection complex values of 100,120,140,160,180,and 200,respectively,to screen the best transfection conditions.After transfection,the fourth generation of highly active umbilical cord mesenchymal stem cells was injected into the tail vein of tree shrews in the elderly treatment group.The young control group and the aged model group were not given special treatment.After 4 months of treatment,the spleen tissue was taken and the structure of the spleen was observed by hematoxylin-eosin staining.β-Galactosidase staining was used to detect the activity of aging-related galactosidase.Immunohistochemical staining was used to detect the expression levels of p21 and p53 proteins.Ki67 and PCNA immunofluorescence staining was used to detect cell proliferation activity.Immunofluorescence staining was used to detect the expression levels of spleen autophagy protein molecules Beclin 1 and APG5L/ATG5.Reactive oxygen species fluorescence staining was used to detect the content of reactive oxygen species in spleen tissue.CD3 immunofluorescence staining was used to detect the change of the proportion of total T lymphocytes.The secretion levels of interleukin 1β and transforming growth factor β1 in spleen were detected by enzyme linked immunosorbent assay.The distribution of highly active umbilical cord mesenchymal stem cells labeled with green fluorescent protein in spleen tissue was observed by DAPI double staining of nucleus. RESULTS AND CONCLUSION:(1)Highly active umbilical cord mesenchymal stem cells grew in a short spindle shape with fish-like growth,with a large proportion of G0/G1 phase,and had the potential to differentiate into adipogenesis,osteogenesis,and chondrogenesis.(2)Multiplicity of infection=140 and transfection for 72 hours were the best conditions for labeling tree shrews highly active umbilical cord mesenchymal stem cells with Genechem Green Fluorescent Protein.(3)Compared with the aged model group,in the aged treatment group,the spleen tissue cells of tree shrews were arranged closely,and the area of white pulp was increased(P<0.01);the boundary between red pulp and white pulp was clear;the proportion of germinal centers did not show statistically significant difference(P>0.05).The activity level of galactosidase related to spleen tissue aging was decreased(P<0.001),and the expression levels of aging protein molecules p21 and p53 were down-regulated(P<0.001).The expression levels of proliferation-related molecules Ki67 and PCNA were up-regulated(P<0.001,P<0.05);expression levels of autophagy-related molecules Beclin 1 and APG5L/ATG5 were up-regulated(P<0.001),and the content of reactive oxygen species decreased(P<0.001),and the proportion of CD3+T cells increased(P<0.05).The secretion level of interleukin 1β in the aging-related secretion phenotype decreased(P<0.001);no significant difference was found in transforming growth factor β1 level(P>0.05).Compared with the young control group,the above indexes were significantly different in the elderly treatment group(P<0.05).(4)Green fluorescent cells labeled with green fluorescent protein were observed in spleen tissue of tree shrews the elderly treatment group by frozen tissue section observation.The results show that intravenous infusion of highly active umbilical cord mesenchymal stem cells can migrate to spleen tissue,inhibit the production of reactive oxygen species,down-regulate the expression of aging-related proteins,induce autophagy,promote cell proliferation,reduce chronic inflammation,and then improve the structure and function of spleen tissue.

Objective To investigate the effect of"zero channel"emergency mode on the treatment of patients with severe traumatic brain injury.Methods A total of 147 patients with severe traumatic brain injury admitted to the Second Hospital of Jiaxing from January 2020 to December 2021 were selected as study objects.Sixty-two patients hospitalized in traditional emergency mode from January to December 2020 were included in control group,and 85 patients hospitalized in"zero channel"emergency mode from January to December 2021 were included in observation group.The initiation time of rescue,completion time of CT examination,completion time of blood transfusion,duration of operation,clinical prognosis and complication rate were compared between two groups.Results The initiation time of rescue,completion time of CT examination,completion time of blood transfusion,and duration of operation in observation group were significantly shorter than those in control group(P<0.05).The proportion of good recovery in observation group was significantly higher than that in control group(68.20%vs.38.70%,χ2=12.671,P<0.001).The complication rate of observation group was significantly lower than that of control group(21.18%vs.80.65%,χ2=51.000,P<0.001).Conclusion"Zero channel"emergency mode can effectively shorten the treatment time of patients with severe traumatic brain injury,improve the success rate of rescue,reduce the incidence of complications,worthy of clinical use and promotion.

Objective To investigate the awareness rate of colorectal cancer(CRC)prevention and control among residents in Fuzhou City.Methods Random sampling method was used to conduct a questionnaire survey among adults aged 18 to 70 years who came to the Health Management Center of Fujian Provincial Hospital Affiliated to Fuzhou University from June 2022 to December 2023.The questionnaire contained 15 questions on CRC incidence trends,CRC risk factors,CRC screening population,CRC screening methods and screening cycles.Results A total of 2256 people were surveyed,and 2233 valid questionnaires were returned,with an effective rate of 98.9％ .The results showed that the awareness rate was 40.3％ .The correct rate of each question in the core knowledge questionnaire of CRC screening was between 11.33％ to 77.34％ .The rate of fecal occult blood test was 20.7％ ,and the rate of colonoscopy was 23.2％ .There were significant differences in awareness rate and screening rate among different age groups,occupations and income levels(P＜0.05).Conclusion There is still room for improvement in the awareness and participation of CRC screening among residents in Fuzhou.It is necessary to carry out health education on CRC prevention and control knowledge to improve CRC screening rate.

Objective:To evaluate the efficacy of Yiqi Yangyin Jiedu Decoction in the treatment of patients with pulmonary nodules and qi-yin deficiency syndrome after early lung cancer surgery.Methods:Randomized controlled trial was conducted. A total of 76 patients with lung nodules and qi-yin deficiency syndrome after early lung cancer surgery at the Oncology Department of Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from March to September 2020 were selected and randomly divided into two groups using a random number table method, with 38 cases in each group. The control group received symptomatic treatment, while the treatment group took Yiqi Yangyin Jiedu Decoction from the first day after enrollment. Both groups were treated for 6 months and followed up for 2 years. TCM syndrome scores before and after treatment were evaluated; the patients' activity status was evaluated using the Eastern Oncology Collaborative Group Activity Status (ECOG PS) score in the United States, and electrochemiluminescence was used to detect carcinoembryonic antigen (CEA) and neuron specific enolase (NSE). Flow cytometry was used to detect the percentage of T lymphocyte subsets CD3 +and CD4 +, and ELISA was used to detect TGF-β Horizontal. The patients' weight was recorded and their weight changes after treatment were observed. Adverse reactions during treatment were observed and recorded, the efficacy of TCM syndromes and pulmonary nodules was evaluated. Results:During the observation period, one case was lost to follow-up in the treatment group and three cases were lost to follow-up in the control group. Finally, 37 cases in the treatment group and 35 cases in the control group completed the observation. After the treatment, the panting (0.27±0.07 vs. 0.68±0.12, t=17.66), spontaneous sweating and night sweating (0.16±0.16 vs. 0.79±0.16, t=16.55) score of the treatment group were lower than those in the control group ( P<0.01); insomnia (0.15±0.08 vs. 0.54±0.13, t=15.52) score of the control group was lower than that of the treatment group ( P<0.01). The effective rate of TCM syndrome in treatment group was 81.08% (30/37), higher than 54.29% (19/35) in control group ( Z=-2.00, P=0.040). After the treatment, the ECOG PS score stability rate in the treatment group was 89.19% (33/37), higher than 82.86% (29/35) in control group, without statistical significance ( χ2=0.19, P>0.05). The increase and stable rate of body weight was 88.10% (32/37) in treatment group and 62.86% (22/35) in control group ( χ2=5.36, P<0.05). After 2-year follow-up, the control rate of pulmonary nodules in the treatment group was 91.89% (34/37), while in the control group it was 65.71% (23/35). The difference between the two groups was statistically significant ( χ2=7.47, P<0.01). After the treatment, the level of NSE [(12.54±2.52)ng/L vs. (13.85±2.71)ng/L, t=-2.12], TGF-β [(218.38±102.63)ng/L vs. (301.24±193.69)ng/L, t=-2.29] in treatment group were lower than those in the control group ( P<0.05), and the level of CD3 +T cells [(70.60±7.90)% vs. (65.99±9.27)%, t=2.32] in treatment group was higher than that of the control group ( P<0.05). Conclusion:Yiqi Yangyin Jiedu Decoction can delay the development of pulmonary nodules in patients after early lung cancer surgery, increasing the body weight of patients, relieving the TCM syndromes and improve the immune function of patients, with the potential to prevent and treat the occurrence and development of early lung cancer.

Objective:To observe the efficacy and factors influencing sequential or combined tenofovir alafenamide fumarate (TAF) after treatment with entecavir (ETV) in patients with chronic hepatitis B (CHB) with low-level viremia (LLV).Methods:126 CHB cases treated with ETV antiviral therapy in the Department of Infectious Diseases of the First Affiliated Hospital of Nanchang University from January 2020-September 2022 were retrospectively collected. Patients were divided into a complete virologic response (CVR) group ( n = 84) and a low-level viremia (LLV) group ( n = 42) according to the HBV DNA level during treatment. Clinical characteristics and laboratory indicators of the two groups at baseline and 48 weeks were analyzed by univariate analysis. Patients in the LLV group were divided into three groups according to their continued antiviral treatment regimen until 96 weeks: continued use of ETV as a control group; replacement of TAF as a sequential group; and combination of ETV and TAF as a combined group. The data of the three groups of patients were analyzed by one-way analysis of variance for 48 weeks. HBV DNA negative conversion rate, HBeAg negative conversion rate, alanine aminotransferase (ALT), creatinine (Cr), and liver stiffness test (LSM) were compared among the three groups after 96 weeks of antiviral treatment. Multivariate logistic regression was used to analyze the independent factors influencing the occurrence of HBV DNA non-negative conversion in LLV patients at 96 weeks. Receiver operating characteristic curve (ROC) was used to evaluate the effectiveness of predicting the occurrence of HBV DNA non-negative conversion in LLV patients at 96 weeks. Kaplan-Meier was used to analyze the cumulative negative rate of DNA in LLV patients, and the Log-Rank test was used for comparison. HBV DNA and HBV DNA negative conversion rates during treatment were observed dynamically. Results:Univariate analysis showed statistically significant differences in age, BMI, HBeAg positivity rate, HBV DNA, HBsAg, ALT, AST, and LSM at baseline between the CVR group and the LLV group ( P < 0.05). Univariate analysis of variance revealed no statistically significant difference among the three groups of LLV patients at 48 weeks ( P > 0.05). HBV-DNA negative conversion rate in the sequential group and the combination group was significantly higher than that in the control group after 96 weeks of treatment (88.89% vs. 41.18%, 85.71% vs. 41.18%, χ2 = 10.404, P = 0.006). HBeAg negative conversion rate was higher than that of the control group, with no statistically significant difference ( P > 0.05).Compared with the control group, ALT, Cr, and LSM in the sequential group and the combined group were equally improved to varying degrees, with a statistically significant difference ( P < 0.05). Subsequent use of ETV and HBV DNA at 48 weeks were independent risk factors for HBV DNA positivity at 96 weeks in LLV patients ( P < 0.05). The AUC of HBV DNA at 48 weeks was 0.735 (95% CI: 0.578 ~ 0.891), the cut-off value was 2.63 log 10 IU/ml, and the sensitivity and specificity were 76.90% and 72.40%, respectively. DNA conversion rate was significantly lower in LLV patients receiving 48-week ETV and 48-week HBV DNA≥2.63 log10 IU/mL than in patients receiving sequential or combined TAF and 48-week HBV DNA < 2.63 log 10 IU/mL. HBV DNA negative conversion rates in the sequential group and combined group at 72 weeks, 84 weeks, and 96 weeks were higher than those in the control group during the period from 48 weeks to 96 weeks of continuous treatment, and the differences were statistically significant ( P < 0.05). Conclusion:Sequential or combined TAF antiviral therapy could more effectively improve the 96-week CVR rate, as well as hepatic and renal function, and alleviate the degree of hepatic fibrosis in CHB patients with LLV following ETV treatment. Subsequent use of ETV and HBV DNA load at 48 weeks were independent predictors of HBV DNA positivity at 96 weeks in LLV patients.

Objective To investigate the influencing factors for low-level viremia (LLV) and their dynamic changes in chronic hepatitis B (CHB) patients treated with nucleos(t)ide analogues (NAs) for the first time. Methods A retrospective analysis was performed for 78 CHB patients who attended Department of Infectious Diseases, The First Affiliated Hospital of Nanchang University, from November 2020 to March 2022 and received antiviral therapy with NAs for at least 12 months, and according to HBV DNA level during treatment, they were divided into sustained virologic response (SVR) group with 58 patients and LLV group with 20 patients. The independent samples t -test or the Mann-Whitney U test was used for comparison of continuous data between two groups, and the chi-square test or the Fisher's exact test was used for comparison of categorical data between two groups. The multivariate Logistic regression analysis was used to investigate the independent influencing factors for LLV and establish a predictive model, and the receiver operating characteristic (ROC) curve was used to evaluate the predictive value of this model. The Kaplan-Meier method was used to analyze cumulative HBV DNA negative conversion rate, and the Log-rank test was used for comparison. The analysis of variance with repeated measures was used to analyze the differences in HBV DNA and HBsAg between the two groups or within each group at weeks 0, 12, 24, 36, and 48. Results Compare with the SVR group, the LLV group had significantly higher HBeAg positive rate (90.0% vs 48.3%, χ 2 =10.701, P =0.001), log(HBV DNA) value (7.26±1.46 vs 5.65±1.70, t =-4.178, P < 0.001), and log(HBsAg) value (4.53±0.86 vs 3.44±0.93, t =-4.813, P < 0.001) and significantly lower age [29 (26-34) vs 33 (30-43), Z =-2.751, P =0.009], alanine aminotransferase (ALT) [67.0 (54.0-122.0)U/L vs 111.0 (47.0-406.0)U/L, Z =-2.203, P =0.028], aspartate aminotransferase [43.5 (32.8-62.8) U/L vs 77.5 (35.0-213.0)U/L, Z =-2.466, P =0.014], and liver stiffness measurement [7.7 (6.3-8.5)kPa vs 8.9 (7.2-11.4)kPa, Z =-2.022, P =0.043]. The multivariate logistic regression analysis showed that baseline HBV DNA (odds ratio [ OR ]=2.365, 95% confidence interval [ CI ]: 1.220-4.587, P =0.011), HBsAg ( OR =4.229, 95% CI : 1.098-16.287, P =0.036), and ALT ( OR =0.965, 95% CI : 0.937-0.994, P =0.018) were independent influencing factors for LLV in CHB patients, and the predictive model of Logit(MLLV)=-8.668+1.441×lgHBsAg+0.598×lgHBV DNA-0.016×ALT was established based on these factors, which had a larger area under the ROC curve than HBV DNA, HBsAg, and ALT (0.931 vs 0.774/0.856/0.666), with a sensitivity of 85.00% and a specificity of 93.10% at the optimal cut-off value of 0.44. The CHB patients with baseline HBV DNA > 7.29 lgIU/mL or HBsAg > 4.38 lgIU/mL had a significantly lower DNA negative conversion rate than those with DNA ≤7.29 lgIU/mL or HBsAg ≤4.38 lgIU/mL ( χ 2 =22.52 and 26.35, both P < 0.001). In the CHB patients, the highest reduction rates of HBV DNA and HBsAg were observed at weeks 12 and 24, respectively, and the LLV group had significantly higher levels of HBV DNA and HBsAg than the SVR group at weeks 0, 12, 24, 36, and 48 (HBV DNA: t =-4.084, -4.526, -5.688, -7.123, and -6.266, all P < 0.001; HBsAg: t =-4.652, -4.691, -4.952, -4.804, and -4.407, all P < 0.001). Conclusion For the CHB patients treated with NAs for the first time, those with high HBV DNA load, high HBsAg quantification, and low ALT level at baseline are more likely to develop LLV, and dynamic monitoring of these indices is of great significance to observe the onset of LLV.

Objective:To explore the application and nursing of protein A immunosorbent in patients with neuromyelitis optica spectrum diseases.Methods:Ten patients with neuromyelitis optica spectrum diseases were treated with protein A immunoadsorption therapy. Psychological nursing was emphasized. Comprehensive evaluation was conducted before adsorption to determine the prescription of adsorption therapy. During adsorption therapy, hypotension, membrane rupture and hemolysis of plasma separator, shivering and other adverse reactions were accurately prevented and treated. After treatment, attention should be paid to the prevention of nosocomial infection, regeneration and preservation of adsorption column.Results:After immunoadsorption therapy, the serum IgG level, antibody and EDSS score of 10 patients decreased to varying degrees. The serum IgG decreased from (6.04±2.77)g/L to (2.23±1.74)g/L. No serious complications occurred, no failure of immunosorbent operation, and the patients′ condition was better than before.Conclusions:Protein A immunosorbent therapy for neuromyelitis optica spectrum diseases is safe and effective. Standardized evaluation, operation and nursing are the key to achieve good results.

Objective:To examine the infection of the enterovirus and human herpes virus in children with suspected encephalitis.Methods:A total number of 365 suspected encephalitis cases were included in this study from August 2017 to December 2019 in Hunan Children′s Hospital. The clinical samples, the cerebrospinal fluid (CSF), serum, sputum, stool and urine were collected and preserved at-80 ℃condition. The enterovirus (EV) and human herpesvirus (HHV) were examined by a one-step nested reverse transcription PCR(RT-PCR) and a real-time fluorescent quantitative PCR (qPCR), respectively. The positive rate of the two viruses in clinical specimens of children with suspected encephalitis was examined. Among all cases, 132 cases were diagnosed with EV encephalitis or HHV encephalitis.Results:the EV encephalitis were identified in 20.5% (75/365) children with suspected viral encephalitis; whereas HHV encephalitis infection was identified as 15.6% (57/365). Among the 75 cases of EV encephalitis, echo 6 was the main sub-type of these diseases 52.0% (39/75) and others were EV71 (30.7%, 23/75), echo11 (6.7%, 5/75), Coxsackie virus A group 6(CA6, 4.0%, 3/75), echo30 (1.3%, 1/75), echo9 (1.3%, 1/75), echo4 (1.3%, 1/75),Coxsackie virus B group 1(CB1, 1.3%, 1/75))and poliovirus(1.3%, 1/75).Human herpes virus type 6 (HHV6) was the most common pathogen in 57 cases of HHV encephalitis, accounting for 35.1% (20/57).The other pathogens were Cytomegalovirus (CMV, 31.6%, 18/57), Epstein-Barr virus (8.8%, 7/57), Herpes simplex virus 1 (HSV1, 10.5%, 6/57), HSV2 (8.8%, 5/57), and Varicella zoster virus (VZV, 1.8%, 1/57) .The virus in CSF detected significantly earlier than that in serum after onset. Virus could be detected in CSF 2-7 days after onset,but 7-26 days in serum. Conclusions:This study uses nested PCR and qPCR to detect pathogens in clinical specimens of children. This not only expands our understanding of the clinical examination and diagnosis of viral encephalitis in children, but also promotes the method of this study to benefit more children.

Objective:To determine whether amoxicillin had an effect on the enamel mineralization of SD rats.Methods:Eighteen SD rats were randomly divided into three groups. The rats in the control group were given distilled water. The rats in two experimental groups were administered 50 or 100 mg/kg amoxicillin by intragastric administration from day 3 to day 17 after birth. The general condition, the structure of liver and kidney, the enamel surface changes of mandibular first molars and incisors were observed. The changes of Ca/P ratio on enamel surface were analyzed by X-ray energy dispersive spectrometer (EDS). The surface morphology after phosphoric acid treatment was examined by scanning electron microscopy (SEM). Histological changes in the ameloblasts of mandibular incisors were analyzed by hematoxylin and eosin (HE) staining.Results:Compared with the control group, the general conditions as well as liver and kidney structures of SD rats in 50 and 100 mg amoxicillin groups had no significant differences. There was no obvious chalky changes on the first mandibular molars of SD rats in each group. All the incisors in 50 and 100 mg groups showed different degrees of chalkiness in the labial incisal 1/3 enamel. X-ray EDS analysis showed that the Ca/P ratios of occlusal and incisal 1/3 enamel in 50 and 100 mg groups (occlusal 1/3 of mandibular first molars: 1.51±0.03 and 1.52±0.02, incisal 1/3 of mandibular incisors: 1.46±0.01 and 1.43±0.01) was significantly lower than that in the control group (occlusal 1/3 of mandibular first molars: 1.67±0.41, incisal1/3 of mandibular incisors: 1.73±0.07) ( P<0.05). However, there was no significant differences in the cervical 1/3 Ca/P ratio of mandibular first molars and incisors among the three groups (mandibular first molars: 1.56±0.04 for control group, 1.59±0.05 for 50 mg group and 1.57±0.04 for 100 mg group; incisors: 1.52±0.02 for control group, 1.47±0.01 for 50 mg group and 1.51±0.03 for 100 mg group) ( P>0.05). SEM observation showed that the enamel rods of the first molars and incisors in the 50 and 100 mg group varied in size and arranged disorderly. The spaces between the enamel rods were larger than that in the control group and some areas even appeared large pits. HE staining showed that the gaps between ameloblasts in 50 and 100 mg groups were significantly wider than that in the control group. Conclusions:Intake of amoxicillin during the period of enamel development of SD rats might affect enamel mineralization.

Resistance to apoptosis is a key carcinogenic mechanism in hematologic malignancies. bcl-2 is considered to be an important anti-apoptotic protein of endogenous apoptosis pathway and bcl-2 targeting inhibition has become one of research hotspots of anti-hematologic malignancies. Venetoclax, a selective bcl-2 inhibitor, has been used in the treatment of chronic lymphocytic leukemia (CLL), acute myeloid leukemia (AML) and mantle cell lymphoma (MCL). This paper reviews the role of bcl-2 family in the regulation of apoptosis and advances of venetoclax in hematologic malignancies.