Staphylococcus aureus is a Gram-positive bacterium with strong pathogenicity. With the widespread use of antibiotics， its multi-drug resistance has gradually increased. Among them， methicillin-resistant S. aureus （MRSA） is one of the main pathogens of hospital and community infections. Antimicrobial peptides are short-chain peptides with good antibacterial effects and low drug resistance， which have been widely studied in recent years. This study summarizes the mechanism of action of antimicrobial peptides and related study on antimicrobial peptides against MRSA from different sources. It is found that the mechanisms of action of antimicrobial peptides include targeting bacterial cell membranes， bacterial cells， and bacterial cell walls， etc. Besides isolating antimicrobial peptides with anti-MRSA activity from animals， plants， and microorganisms， antimicrobial peptides can also be obtained through synthetic methods. Among them， GHa-derived peptides from animal sources， Ib-AMP4 from plant sources， Ph-SA from microbial sources， the synthetic peptide LLKLLLKLL-NH2， and so on， due to their effective antibacterial activity， rapid bactericidal speed， and low toxicity， are promising candidates for anti-MRSA drugs.

Background::Histological healing is closely associated with improved long-term clinical outcomes and lowered relapses in patients with ulcerative colitis (UC). Here, we developed a novel diagnostic criterion for assessing histological healing in UC patients.Methods::We conducted a retrospective cohort study in UC patients, whose treatment was iteratively optimized to achieve mucosal healing at Shanghai Tenth People’s Hospital of Tongji University from January 2017 to May 2022. We identified an inflammatory cell enumeration index (ICEI) for assessing histological healing based on the proportions of eosinophils, CD177 + neutrophils, and CD40L + T cells in the colonic lamina propria under high power field (HPF), and the outcomes (risks of symptomatic relapses) of achieving histological remission vs. persistent histological inflammation using Kaplan-Meier curves. Intrareader reliability and inter-reader reliability were evaluated by each reader. The relationships to the changes in the Nancy index and the Geboes score were also assessed for responsiveness. The ICEI was further validated in a new cohort of UC patients from other nine university hospitals. Results::We developed an ICEI for clinical diagnosis of histological healing, i.e., Y = 1.701X 1 + 0.758X 2 + 1.347X 3 - 7.745 (X 1, X 2, and X 3 represent the proportions of CD177 + neutrophils, eosinophils, and CD40L + T cells, respectively, in the colonic lamina propria under HPF). The receiver operating characteristics curve (ROC) analysis revealed that Y <-0.391 was the cutoff value for the diagnosis of histological healing and that an area under the curve (AUC) was 0.942 (95% confidence interval [CI]: 0.905-0.979) with a sensitivity of 92.5% and a specificity of 83.6% ( P <0.001). The intraclass correlation coefficient (ICC) for the intrareader reliability was 0.855 (95% CI: 0.781-0.909), and ICEI had good inter-reader reliability of 0.832 (95% CI: 0.748-0.894). During an 18-month follow-up, patients with histological healing had a substantially better outcome compared with those with unachieved histological healing ( P <0.001) using ICEI. During a 12-month follow-up from other nine hospitals, patients with histological healing also had a lower risk of relapse than patients with unachieved histological healing. Conclusions::ICEI can be used to predict histological healing and identify patients with a risk of relapse 12 months and 18 months after clinical therapy. Therefore, ICEI provides a promising, simplified approach to monitor histological healing and to predict the prognosis of UC.Registration::Chinese Clinical Trial Registry, No. ChiCTR2300077792.

Objective:To compare the eradication rate and incidence of adverse reactions between cefuroxime-containing and amoxicillin-containing bismuth quadruple regimen in the treatment of Helicobacter pylori ( H. pylori), and to evaluate the efficacy and safety of cefuroxime in the H. pylori infection patients with positive penicillin skin test results. Methods:From December 2020 to December 2021, a total of 498 patients who received initial H. pylori eradication treatment at the H. pylori Specialized Outpatient Clinic of the First Affiliated Hospital of Soochow University were selected to participate in this prospective cohort study. According to the history of penicillin allergy or positive penicillin skin test results, the patients were divided into amoxicillin group and cefuroxime group. A total of 394 patients were included in the amoxicillin group, and the treatment regimen was esomeprazole 20 mg, bismuth 220 mg, amoxicillin 1 g and clarithromycin 500 mg orally twice a day. A total of 104 patients were included in the cefuroxime group, and the treatment regimen was esomeprazole 20 mg, bismuth 220 mg, cefuroxime 500 mg and clarithromycin 500 mg orally twice a day. The treatment period was 14 days. 13C-urea breath test was conducted during 4 to 8 weeks after the treatment. The eradication rates of the 2 groups were compared by intention-to-treat (ITT) analysis and per-protocol (PP) analysis. The incidence of adverse reactions was compared between the 2 groups. Chi-square test was used for statistical analysis. Results:The results of ITT analysis and PP analysis indicated that the eradication rates of amoxicillin group were 84.3% (332/394, 95% confidence interval (95% CI) 80.6% to 87.6%) and 90.5% (332/367, 95% CI 87.2% to 93.3%), respectively, and the eradication rates of cefuroxime group were 62.5% (65/104, 95% CI 52.7% to 71.7%) and 69.1% (65/94, 95% CI 58.8% to 78.7%), respectively. The eradication rates of amoxicillin group in ITT and PP analysis were both higher than those of cefuroxime group, and the differences were statistically significant ( χ2=24.11 and 28.44, both P<0.001). The incidence of adverse reactions of amoxicillin group and cefuroxime group was 10.9% (43/394) and 14.4% (15/104), respectively, and there was no significant difference ( P>0.05). Conclusion:Cefuroxime and clarithromycin containing bismuth quadruplex regimen failed to achieve a satisfactory eradication rate in patients with H. pylori infection and penicillin allergy.

Enzyme-driven micro/nanomotors consuming in situ chemical fuels have attracted lots of attention for biomedical applications. However, motor systems composed by organism-derived organics that maximize the therapeutic efficacy of enzymatic products remain challenging. Herein, swimming proteomotors based on biocompatible urease and human serum albumin are constructed for enhanced antitumor therapy via active motion and ammonia amplification. By decomposing urea into carbon dioxide and ammonia, the designed proteomotors are endowed with self-propulsive capability, which leads to improved internalization and enhanced penetration in vitro. As a glutamine synthetase inhibitor, the loaded l-methionine sulfoximine further prevents the conversion of toxic ammonia into non-toxic glutamine in both tumor and stromal cells, resulting in local ammonia amplification. After intravesical instillation, the proteomotors achieve longer bladder retention and thus significantly inhibit the growth of orthotopic bladder tumor in vivo without adverse effects. We envision that the as-developed swimming proteomotors with amplification of the product toxicity may be a potential platform for active cancer treatment.

Background: Glycolytic function is obviously related to the proliferation, metastasis and drug resistance of colorectal cancer, and there is still a lacking of corresponding indicators for quantitatively evaluating the level of glycolysis. Aims: To investigate the correlation between

Recently,Th9 cells have been confirmed to be a subtype of CD4+ helper T lymphocytes co-induced by interleukin(IL)-4 and transforming growth factor(TGF)-β,which is mainly characterized by the secretion of IL-9.Previous studies have shown that Th9 cells play an important role in autoimmune diseases,parasitic infections,and allergic diseases.Further,Th9 cells/IL-9 have been found to be involved in tumor immune responses,especially in solid tumors.Th9 cells/IL-9 exhibit powerful anti-tumor properties.However,the role of Th9 cells/IL-9 in the development of gastrointestinal cancers remains unclear.This article reviewed the mechanism of Th9 cell/IL-9 differentiation,biological characteristics and research progress in gastrointestinal cancer.

Objective:To evaluate the predictive value of the ratio of bedside index of severity in acute pancreatitis (BISAP) to serum calcium (BISAP/Ca) within 24 hours of admission in the severity of acute pancreatitis (AP).Methods:From January 1, 2020, to December 31, 2022, 711 AP patients visited the First Affiliated Hospital of Soochow University were enrolled. According to the severity of AP, the 711 patients were divided into mild AP group (586 cases) and severe AP group (including moderately severe and severe AP patients, 125 cases). According to the occurrence of respiratory dysfunction, the 711 patients were divided into a group without respiratory dysfunction (594 cases) and a group with respiratory dysfunction (117 cases). Acute physiology and chronic health evaluation-Ⅱ (APACHE-Ⅱ) score was calculated based on the worst indicators (highest or lowest values) within 24 hours of admission. BISAP score was calculated based on the indicator values of the patients within 24 hours of admission. And modified computed tomography (CT) severity index (MCTSI) score was calculated based on the results of enhanced CT within 72 hours of admission. Mann-Whitney U test and chi-square test were used for statistical comparison. The predictive value of BISAP/Ca for the severity of AP was assessed by receiver operating characteristic curve (ROC), and the optimal cut-off value was calculated based on sensitivity and specificity. Univariate and multivariate logistic regression analyses were used to analyze the risk factors of developing respiratory dysfunction in AP patients. Results:The hospital stay, proportion of patients with systemic inflammatory response syndrome, proportion of patients with pleural effusion, and scores of APACHE-II, BISAP, MCTSI, and BISAP/Ca of the severe AP group were higher than those of the mild AP group (18.00 d (12.00 d, 29.00 d) vs. 9.00 d (6.00 d, 12.00 d), 74.4% (93/125) vs. 22.5% (132/586), 90.4% (113/125) vs. 42.3% (248/586), 9.00(6.00, 13.50) vs. 4.00(2.00, 7.00), 2.00(2.00, 3.00) vs. 1.00(0.00, 1.00), 4.00(4.00, 6.00) vs. 4.00(2.00, 4.00), 1.05(0.92, 1.54) vs. 0.47(0.00, 0.55)), all the differences were statistically significant ( Z=-12.39, χ2=128.16 and 95.28, Z=-10.83, -12.50, -11.54, and -13.27; all P<0.001). The results of ROC analysis showed that the area under the curve (95% confidence interval) of BISAP/Ca, BISAP, serum calcium, MCTSI, and APACHE-Ⅱ score for predicting the severity of AP were 0.873 (0.842 to 0.904), 0.839 (0.804 to 0.875), 0.797 (0.752 to 0.843), 0.802 (0.762 to 0.842), and 0.807 (0.762 to 0.852), respectively, all the differences were statistically significant (all P<0.001). According to the Youden index, the optimal cut-off value of BISAP/Ca distinguishing mild AP from severe AP was 0.515, with a sensitivity of 0.880 and a specificity of 0.722. The result of multivariate logistic regression analyses showed that BISAP/Ca >0.515 was an independent risk factor of developing respiratory dysfunction in AP ( OR (95% confidence interval) 27.588(14.083 to 54.045), 12.057 (5.762 to 25.229), both P<0.001). Conclusion:BISAP/Ca may be a valuable predictive indicator for the severity and developing respiratory dysfunction in AP patients.

Gastrointestinal cancers are the common malignant tumors of the digestive system, and their morbidity and mortality are in the forefront of malignant tumors. Currently, cancer immunotherapy is the hottest topic in cancer research field. Although cancer immunotherapy has achieved some results in the fundamental research and clinical application of gastrointestinal tumors, there are still a series of problems that need to be resolved. In this article, we review the fundamental and clinical research progress of several common methods of cancer immunotherapy in the field of gastrointestinal tumors.

To evaluate the psychological symptoms of patients with Crohn disease (CD), and to explore the risk factors affecting quality of life (QOL) in CD patients, 50 adult patients with CD, and 50 healthy controls were enrolled. Psychological questionnaires including self-rating anxiety scale (SAS), self-rating depression scale (SDS), the inflammatory bowel disease questionnaire (IBDQ) and the short form-36 health survey (SF-36) were completed. The results showed both the SAS (40.3±8.5 VS 37.6±7.0) and the SDS (47.1±11.1 VS 41.8±9.6) in CD patients were significantly higher than those in the healthy controls ( t=5.4, P<0.05; t=10.6, P<0.05). The IBDQ scores revealed the physical symptoms scores were 49.50±7.62, systemic symptoms scores 23.92±5.07, emotional functions scores 57.13±15.62, and social function scores 22.15±9.08 in CD active phase. However, the above scores were 60.12±4.01, 26.24±3.97, 67.34±15.17, and 25.44±2.03 respectively in the remission phase. Four subscale items of IBDQ in CD active phase were significant lower than those in the remission phase (all P<0.05). The subscale items of SF-36 scores (PF, RP, BP, GH, VT, SF, RE, MH) in CD patients were significant lower than those in healthy controls (all P<0.05). The SF-36 items scores of PF,RP and MH in the remission phase were significant higher than those in the active phase (all P<0.05). The SF-36 items scores of GH and VT in patients with malnutrition were significant lower than those with nutrition (both P<0.05). Multivariate regression analysis showed that disease status and nutritional risk ( P<0.05) significantly affected the patients' IBDQ scores. Factors including sex, age, marital status, education background, medical insurance, use of biologicals, surgery treatment had little influence on the total score of IBDQ ( P>0.05). Psychological conseling and treatment in the active phase may improve QOL of CD patients.