Objective·To investigate the immunotherapeutic effects of exosomes derived from leukemia cells with high expression of B7 molecules(co-stimulatory molecules CD80 and CD86)in tumor-bearing mice.Methods·L1210 leukemia cells were transfected with lentiviral vectors containing the CD80 and CD86 genes,and thereby the leukemia cells with high expression of CD80 and CD86 molecules were obtained.Exosomes LEX-8086 with high expression of CD80 and CD86 molecules were then isolated from the culture supernatant.The biological characteristics of LEX-8086 were analyzed by using transmission electron microscopy(TEM)and Western blotting.A DBA/2-leukemia tumor-bearing mouse model was established.The tumor-bearing mice were divided into LEX-8086 group and PBS group.The LEX-8086 group received intravenous injections of 500 μL LEX-8086(150 μg/mL)via the tail vein 7 d and 12 d after tumor cell inoculation,while the PBS group received injections of equal volumes of PBS at the same time points.Differences in body weight,tumor volume,tumor mass,and survival of the mice between the two groups were observed.Flow cytometry was used to analyze the changes in the immune cells in spleens and lymph nodes of the mice in both groups.Western blotting and real-time fluorescent quantitative PCR(qPCR)were used to detect the expression of markers for M1 and M2 macrophages in the spleens of the mice in both groups.Results·The exosomes LEX-8086 were isolated from the supernatant of L1210 cells overexpressing CD80 and CD86 molecules.TEM revealed that LEX-8086 exhibited a disc-shaped vesicular structure with a diameter of approximately 100 nm.Western blotting demonstrated the expression of exosome-specific markers.In the animal experiments,compared with the PBS group,the body weight of the LEX-8086 group showed no significant change,while both the tumor volume and the relative tumor mass ratio decreased significantly,and the survival was significantly prolonged(all P<0.05).Flow cytometry results indicated that the proportions of natural killer(NK)cells and CD4+T cells in the lymph nodes and spleens of the LEX-8086 group significantly increased(all P<0.05);as for CD8+T cells,they only increased in the lymph modes(P=0.012).Moreover,flow cytometry results showed that the proportion of M1 macrophages in the spleens of mice in the LEX-8086 group was significantly elevated(P=0.003),while the proportion of M2 macrophages remained unchanged.Western blotting and qPCR also revealed that the mRNA and protein expression levels of M1 macrophage markers interleukin-6 and tumor necrosis factor-α in the spleens of mice in the LEX-8086 group increased significantly(all P<0.05).Conclusion·Exosomes derived from leukemia cells with high expression of co-stimulatory molecules CD80 and CD86 can induce a therapeutic anti-leukemic effect,which may be achieved by increasing the proportions of NK cells,M1 macrophages,CD4+T cells,and CD8+T cells.

Objective To investigate changes in gut microbiota during diabetic nephropathy(DN)pro-gression using 16S rDNA sequencing technology.Methods A total of 90 male SD rats were randomly divided into a normal control group(n=10,no modeling,regular feeding)and a model group(diabetes model).The diabetes model was established by a single intraperitoneal injection of streptozotocin(STZ)at 60 mg/kg,with regular feeding.According to the feeding time after modeling,the rats were divided into 2-week,4-week,8-week,and 12-week model groups(fed for 2,4,8,and 12 weeks after model establishment),with 20 rats in each group.Blood urea nitrogen(BUN)was measured using the urease method,serum creatinine(Scr)was deter-mined by the picric acid method,and ELISA was used to detect urinary kidney injury molecule-1(KIM-1)and neutrophil gelatinase-associated lipocalin(NGAL)levels.HE,PAS,and Masson staining were used to observe renal tissue pathological changes.Gut microbiota was collected from the rats,and 16S rDNA gene sequencing was used to analyze the gut microbiota to understand changes in the gut microbiota.Results Compared with the normal control group,the levels of KIM-1 and NGAL in urine of rats in all model groups were significantly increased(P<0.05).Pathological staining results showed that,compared with the normal control group,rats in all model groups exhibited diffuse thickening of the glomerular basement membrane and pathological chan-ges such as local necrosis and vacuolar degeneration in renal tubular epithelial cells.16S rDNA sequencing re-sults indicated that the abundance and structure of intestinal microbiota in rats of all model groups changed.Compared with the normal control group,in the 8-week and 12-week model groups,the relative abundance of Bacteroides and Akkermansia decreased,while the relative abundance of Roseburia,Alloprevotella,Prevotel-laceae-Ga6A1,and Ruminococcaceae UCG-005 increased.Compared with the normal control group,in the 12-week model group,the abundance of Akkermansia decreased and that of Prevotellaceae-NK3B31 increased.Conclusion The abundance and structure of gut microbial community in DN rats under conventional feeding at different time points change significantly,further confirming the"gut-kidney axis"theory.

Objective:To analyze the liver histological characteristics and clinically related factors in inactive hepatitis B surface antigen (HBsAg) carriers (IHC), and also explore whether antiviral treatment is necessary for IHC, as defined in the 2022 version of the hepatitis B prevention and treatment guidelines.Methods:A multicenter, retrospective cohort study was conducted. Two hundred and thirty-one IHC cases who underwent liver biopsy histopathological examination in nine medical institutions, including Beijing Youan Hospital affiliated with Capital Medical University, from January 2018 to December 2023 were included. General informative data, clinical serological markers, and transient elastography (TE) examination results were collected. Patients were divided into a positive (148 cases) and a negative group (83 cases) according to the results of hepatitis B virus (HBV) DNA detection. The differences in liver pathological inflammatory activity (G) and liver fibrosis stage (S) were analyzed between the two groups to explore the correlation between liver tissue conditions and clinically related factors. Comparsions of normally distributed continwous data, skeukd continuous data, and categorical data between groups are performed using t tests, Mann-Whitney U tests and χ2 tests, respectively. Results:The age of 231 IHC cases was 43 (38, 51) years old, with 95.2% (220/231) aged ≥30 years, and males accounted for 64.9% (150/231). HBsAg and HBV DNA levels were 131.9 (20.8, 400.9) IU/mL and 94.0 (0, 448.5) IU/mL, respectively, of which 35.9% (83/231) were HBV DNA negative (<20 IU/mL). The remarkable proportions of G≥2, S≥2, and liver injury (G≥2 and/or S≥2) in liver tissue were 16.5% (38/231), 29% (67/231), and 35.9% (83/231), respectively. The S≥2 proportion was significantly higher in the HBV DNA-negative group than the positive group (42.2% vs. 21.6%, P<0.001), and it mainly occurred in the population cohort over 30 years old (44.9% vs. 31.0%, P=0.04). The liver stiffness measurement (LSM), aspartate transaminase to platelet ratio index (APRI), and platelet (PLT) were significantly higher in the S≥2 group than the S<2 group ( P<0.05). Conclusion:Clinicians can comprehensively evaluate the degree of liver fibrosis in IHC based on clinical factors such as age, PLT, APRI, and LSM, even if the liver histological results are lacking. The China 2022 version guidelines define that nearly half of IHC has histological indications for antiviral therapy, and liver biopsy and prompt treatment can be recommended.

Objective:To explore the association between A Body Shape Index (ABSI) and sarcopenia in Chinese older adults.Methods:Totally 1 728 participants in waves 1 and 3 of the China Health and Retirement Longitudinal Survey (CHARLS) were enrolled in this cohort-based cross-sectional analysis. ABSI was calculated by using anthropometric measurements from CHARLS. According to the Asian Working Group for Sarcopenia (AWGS) 2019 consensus update on sarcopenia, low muscle strength and low muscle mass were used as the diagnostic criteria for sarcopenia. Logistic regression and restricted cubic spline (RCS) were used to assess the relationship between ABSI and sarcopenia, and subgroup and interaction analyses were conducted to evaluate the influence of other factors on this association.Results:High ABSI showed a significant association with the risk of sarcopenia among older adults in China, and RCS analysis demonstrated a positive linear correlation between ABSI and sarcopenia. Additionally, the relationship of ABSI with sarcopenia was significantly modified by educational level and depressive status.Conclusion:ABSI, a novel anthropometric measure, serves as an effective threshold for assessing sarcopenia risk in the Chinese older population, providing a basis for developing clinical interventions and public health strategies for the prevention and early identification of sarcopenia.

Objective:To explore the association between A Body Shape Index (ABSI) and sarcopenia in Chinese older adults.Methods:Totally 1 728 participants in waves 1 and 3 of the China Health and Retirement Longitudinal Survey (CHARLS) were enrolled in this cohort-based cross-sectional analysis. ABSI was calculated by using anthropometric measurements from CHARLS. According to the Asian Working Group for Sarcopenia (AWGS) 2019 consensus update on sarcopenia, low muscle strength and low muscle mass were used as the diagnostic criteria for sarcopenia. Logistic regression and restricted cubic spline (RCS) were used to assess the relationship between ABSI and sarcopenia, and subgroup and interaction analyses were conducted to evaluate the influence of other factors on this association.Results:High ABSI showed a significant association with the risk of sarcopenia among older adults in China, and RCS analysis demonstrated a positive linear correlation between ABSI and sarcopenia. Additionally, the relationship of ABSI with sarcopenia was significantly modified by educational level and depressive status.Conclusion:ABSI, a novel anthropometric measure, serves as an effective threshold for assessing sarcopenia risk in the Chinese older population, providing a basis for developing clinical interventions and public health strategies for the prevention and early identification of sarcopenia.

Objective:To analyze the relationship between 24-hour urinary calcium (24 h UCa) level and the risk of end-stage kidney disease (ESKD), cardiovascular disease (CVD), and all-cause mortality.Methods:In the Chinese Cohort Study of Chronic Kidney Disease, we examined 3 375 patients aged 18-74 years with CKD stages 1-4. Kaplan-Meier survival and Cox proportional hazard regression models were used to test a time-to-event association between levels of 24 h UCa and incidence of ESKD, CVD, and all-cause mortality.Results:During a follow-up of 4.17 (3.37, 5.20) years, 179, 145, 104 and 38 ESKD events occurred in <0.60, 0.60-, 1.20-, ≥2.32 mmol 24 h UCa groups. Higher levels of 24 h UCa (1.20-,≥2.32 mmol) were independently associated with a lower incidence of ESKD events in patients with CKD, with HR (95% CI) of 0.71 (0.54-0.93) and 0.43 (0.29-0.64), respectively. No significant associations with CVD and all-cause mortality endpoints were detected. Conclusion:Among patients with CKD, levels of 24 h UCa displayed an association with the risk of ESKD among patients with CKD stages 1-4.

Objective:To analyze the relationship between 24-hour urinary calcium (24 h UCa) level and the risk of end-stage kidney disease (ESKD), cardiovascular disease (CVD), and all-cause mortality.Methods:In the Chinese Cohort Study of Chronic Kidney Disease, we examined 3 375 patients aged 18-74 years with CKD stages 1-4. Kaplan-Meier survival and Cox proportional hazard regression models were used to test a time-to-event association between levels of 24 h UCa and incidence of ESKD, CVD, and all-cause mortality.Results:During a follow-up of 4.17 (3.37, 5.20) years, 179, 145, 104 and 38 ESKD events occurred in <0.60, 0.60-, 1.20-, ≥2.32 mmol 24 h UCa groups. Higher levels of 24 h UCa (1.20-,≥2.32 mmol) were independently associated with a lower incidence of ESKD events in patients with CKD, with HR (95% CI) of 0.71 (0.54-0.93) and 0.43 (0.29-0.64), respectively. No significant associations with CVD and all-cause mortality endpoints were detected. Conclusion:Among patients with CKD, levels of 24 h UCa displayed an association with the risk of ESKD among patients with CKD stages 1-4.

To formulate an expert consensus on the principles of preoperative hair removal and provide scientific guidance for standardized removal of hair before surgical procedures so as to reduce the incidence of surgical site infections.METHODS Led by the Hospital Management Institute of National Health Commission of the People's Republic of China,this consensus was reached with the joint efforts from the expects of relevant fields such as surgeries,interventional therapies,nursing,and infection prevention and control.The consensus facilitates the classification and evaluation of literatures by following the evidence grade formulated by Oxford Evidence-based Medicine Center and focuses on the association of preoperative hair removal with surgical site infection,it reaches the evidence grade of expert consensus and recommendation intensity by integrating with discussions on meetings and clinical experience of the expects from relevant fields.RESULTS A total of 6 items of consensus were reached by summarizing the latest evidence on the aspects including the indications for preoperative hair removal,tools,range,timing and places.CONCLUSION The consensus,to some extent,make supplements to and complete the exiting regulations and standards.It provides guidance for the medical institutions to carry out the preoperative hair removal.

Objective·To investigate the immunotherapeutic effects of exosomes derived from leukemia cells with high expression of B7 molecules(co-stimulatory molecules CD80 and CD86)in tumor-bearing mice.Methods·L1210 leukemia cells were transfected with lentiviral vectors containing the CD80 and CD86 genes,and thereby the leukemia cells with high expression of CD80 and CD86 molecules were obtained.Exosomes LEX-8086 with high expression of CD80 and CD86 molecules were then isolated from the culture supernatant.The biological characteristics of LEX-8086 were analyzed by using transmission electron microscopy(TEM)and Western blotting.A DBA/2-leukemia tumor-bearing mouse model was established.The tumor-bearing mice were divided into LEX-8086 group and PBS group.The LEX-8086 group received intravenous injections of 500 μL LEX-8086(150 μg/mL)via the tail vein 7 d and 12 d after tumor cell inoculation,while the PBS group received injections of equal volumes of PBS at the same time points.Differences in body weight,tumor volume,tumor mass,and survival of the mice between the two groups were observed.Flow cytometry was used to analyze the changes in the immune cells in spleens and lymph nodes of the mice in both groups.Western blotting and real-time fluorescent quantitative PCR(qPCR)were used to detect the expression of markers for M1 and M2 macrophages in the spleens of the mice in both groups.Results·The exosomes LEX-8086 were isolated from the supernatant of L1210 cells overexpressing CD80 and CD86 molecules.TEM revealed that LEX-8086 exhibited a disc-shaped vesicular structure with a diameter of approximately 100 nm.Western blotting demonstrated the expression of exosome-specific markers.In the animal experiments,compared with the PBS group,the body weight of the LEX-8086 group showed no significant change,while both the tumor volume and the relative tumor mass ratio decreased significantly,and the survival was significantly prolonged(all P<0.05).Flow cytometry results indicated that the proportions of natural killer(NK)cells and CD4+T cells in the lymph nodes and spleens of the LEX-8086 group significantly increased(all P<0.05);as for CD8+T cells,they only increased in the lymph modes(P=0.012).Moreover,flow cytometry results showed that the proportion of M1 macrophages in the spleens of mice in the LEX-8086 group was significantly elevated(P=0.003),while the proportion of M2 macrophages remained unchanged.Western blotting and qPCR also revealed that the mRNA and protein expression levels of M1 macrophage markers interleukin-6 and tumor necrosis factor-α in the spleens of mice in the LEX-8086 group increased significantly(all P<0.05).Conclusion·Exosomes derived from leukemia cells with high expression of co-stimulatory molecules CD80 and CD86 can induce a therapeutic anti-leukemic effect,which may be achieved by increasing the proportions of NK cells,M1 macrophages,CD4+T cells,and CD8+T cells.

To formulate an expert consensus on the principles of preoperative hair removal and provide scientific guidance for standardized removal of hair before surgical procedures so as to reduce the incidence of surgical site infections.METHODS Led by the Hospital Management Institute of National Health Commission of the People's Republic of China,this consensus was reached with the joint efforts from the expects of relevant fields such as surgeries,interventional therapies,nursing,and infection prevention and control.The consensus facilitates the classification and evaluation of literatures by following the evidence grade formulated by Oxford Evidence-based Medicine Center and focuses on the association of preoperative hair removal with surgical site infection,it reaches the evidence grade of expert consensus and recommendation intensity by integrating with discussions on meetings and clinical experience of the expects from relevant fields.RESULTS A total of 6 items of consensus were reached by summarizing the latest evidence on the aspects including the indications for preoperative hair removal,tools,range,timing and places.CONCLUSION The consensus,to some extent,make supplements to and complete the exiting regulations and standards.It provides guidance for the medical institutions to carry out the preoperative hair removal.