Objective To investigate the development, role, and regulatory mechanism of macrophage efferocytosis in the liver of hosts infected with Schistosoma japonicum. Methods The expression of efferocytosis-related gene like efferocytosis receptors, efferocytosis-related bridging molecules,“eat me” signal and “don’t eat me” signal was detected in the livers of patients and mice infected with S. japonicum in the Gene Expression Omnibus (GEO) database. Ten wild-type (WT) male mice (6 ~ 8 weeks old, weighing 20 ~ 25 g) were randomly divided into a Schistosoma japonicum infection (SJ) group and a normal control (NC) group, with 5 mice in each group. The efferocytosis of neutrophils and T cells by liver macrophages was detected in mice from SJ group and NC group using flow cytometry and immunofluorescence assay, respectively. The expression of efferocytosis-related Mer receptor tyrosine kinase (MerTK) and Axl receptor tyrosine kinase (Axl) proteins was determined in mouse liver tissues using Western blotting assay, and the proportion of MerTK⁺ macrophages and the average fluorescence intensity of macrophage MerTK were detected in mouse livers using flow cytometry. Changes in liver granulomas and fibrosis were observed in mice infected with S. japonicum following injection of efferocytosis inhibitors, and S. japonicum-infected mice without injection of efferocytosis inhibitors served as controls. Bone marrow-derived macrophages (BMDMs) were isolated from macrophage scavenger receptor class A (SR-A) conditional knockout (CKO) and wild-type (WT) mice, and changes in apoptotic neutrophils were detected in SR-A CKO mouse macrophages in vitro using flow cytometry. Then, BMDMs was divided into the WT mono-culture group, the WT and apoptotic neutrophils co-culture group, the SR-A CKO mono-culture group, and the SR-A CKO and neutrophils co-culture group, and the expression of MerTK and Axl was quantified in vitro using Western blotting and real-time quantitative PCR (RT-qPCR) assays during neutrophil efferocytosis. The efferocytosis of neutrophils and T cells by mouse liver macrophages was detected in the SR-A CKO SJ group and the WT SJ group using flow cytometry and immunofluorescence assay, and the expression of MerTK and Axl proteins was determined in mouse liver tissues in both groups using Western blotting. In addition, the proportion of MerTK⁺ macrophages and the average fluorescence intensity of macrophage MerTK were detected in mouse livers in both groups using flow cytometry. Results Data from the GEO database showed that the expression of some efferocytosis receptors and efferocytosis-related bridging molecules, and “eat me” and “don’t eat me” signals all appeared a tendency towards a rise in livers of patients and mice in the SJ group relative to the NC group, suggesting that S. japonicum infection-induced liver diseases may be associated with efferocytosis. Flow cytometry detected higher proportions of Ly6G⁺ cells [(13.13 ± 0.45)% vs. (6.48 ± 0.25)%; t = 22.30, P < 0.05] and CD3⁺ cells [(7.60 ± 0.33)% vs. (3.30 ± 0.42)%; t = 13.98, P < 0.05] in mouse liver macrophages in the SJ group than in the NJ group, and the expression of MerTK protein [(2.30 ± 0.14) vs. (1.14 ± 0.46); t = 4.19, P < 0.05], the mean fluorescence intensity of macrophages [(160.67 ± 15.28) vs. (94.50 ± 19.61); t = 4.81, P < 0.05], and the proportion of MerTK⁺ macrophages [(20.78 ± 4.17)% vs. (6.85 ± 0.39)%; t = 6.57, P < 0.05] were significantly higher in mouse liver tissues in the SJ group than in the NC group. The Axl expression was lower in mouse liver tissues in the SJ group than in the NC group [(1.25 ± 0.08) vs. (1.93 ± 0.37); t = 2.79, P < 0.05], and the area of granulomas around single eggs [(9.18 ± 1.81) × 10⁴μm² vs. (5.24 ± 1.35) × 10⁴ μm²; t = 3.03, P < 0.05] and proportion of collagen fibers [(25.27 ± 3.99)% vs. (15.14 ± 4.02)%; t = 3.10, P < 0.05] were significantly greater in livers of S. japonicum-infected mice with injection of efferocytosis inhibitors than in mice without injection of efferocytosis inhibitors. The in vitro efferocytosis efficiency of BMDMs [(32.83 ± 3.17)% vs. (45.43 ± 2.34)%; t = 5.54, P < 0.05], and the proportions of Ly6G⁺ [(9.37 ± 0.48)% vs. (13.13 ± 0.72)%; t = 7.50, P < 0.05] and CD3⁺ cells [(4.95 ± 0.17)% vs. (7.64 ± 0.50)%; t = 8.87, P < 0.05] in liver macrophages post-infection with S. japonicum were significantly lower in SR-A CKO mice than in WT mice, and the expression of MerTK protein [(0.65 ± 0.25) vs. (1.96 ± 0.69); t = 3.10, P < 0.05], the average fluorescence intensity of macrophages [(138.33 ± 8.39) vs. (160.67 ± 15.28); t = 3.03, P < 0.05] and the proportion of MerTK⁺ macrophages [(13.17 ± 5.01)% vs. (22.63 ± 2.06)%; t = 3.56, P < 0.05] were significantly lower in mouse liver tissues in the SR-A CKO SJ group than in the WT group. Western blotting detected no significant difference in the Axl protein expression in mouse liver tissues between the SR-A CKO SJ group and the WT SJ group [(0.48 ± 0.07) vs. (0.68 ± 0.30); t = 1.09, P > 0.05]. There were significant differences in the relative MerTK mRNA and protein expression during efferocytosis of BMDMs among the WT monoculture group, the WT and apoptotic neutrophils co-culture group, the SR-A CKO mono-culture group, and the SR-A CKO and neutrophils co-culture group (F = 9.41 and 40.68, both P values < 0.05). In addition, there was a significant difference in the relative Axl mRNA expression during efferocytosis of BMDMs among the four groups (F = 13.62, P < 0.05); however, no significant difference was seen in the relative Axl protein expression (F = 1.27, P > 0.05). Conclusions Efferocytosis of liver macrophages is seen in mice infected with S. japonicum and inhibits liver fibrosis. SR-A may up-regulate the efficiency of macrophage efferocytosis through regulating the expression of efferocytosis receptors.

In order to further standardize the vaccination of kidney transplant candidates and recipients in China, the Branch of Organ Transplantation of Chinese Medical Association has organized experts in kidney transplantation and infectious diseases. Based on the "Vaccination of Solid Organ Transplant Candidates and Recipients: Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice", and in combination with the clinical reality of infectious diseases and vaccination after organ transplantation in China, as well as referring to relevant recommendations from home and abroad in recent years, these guidelines are formulated from aspects such as epidemiology, types of vaccines, vaccination principles, target population, and specific vaccine administration. The "Guidelines for Vaccination of Kidney Transplant Candidates and Recipients in China" aims to provide theoretical reference for medical workers in the field of kidney transplantation in China, regarding the vaccination of kidney transplant candidates and recipients. It is expected to better guide the vaccination of kidney transplant candidates and recipients, reduce the risk of postoperative infection, and improve survival outcomes.

Morita therapy has been bom for more than 100 years.Inpatient Morita therapy is highly oper-able and easy to master.It can improve many refractory neuroses through four-stage treatment.But more neuroses are treated in outpatient clinics,and Morita therapy cannot be used in hospitalized patients.Therefore,the formula-tion of expert opinions on outpatient operations is particularly important.This paper is based on domestic and for-eign references,and after many discussions by domestic Morita therapy experts,and then drew up the first version of the expert opinions on operation of outpatient Morita therapy.Meanwhile the operation rule of Morita therapy in three stages of outpatient treatment was formulated:in the etiological analysis stage,under the theoretical guidance of Morita therapy,analyze the pathogenic factors,to improve treatment compliance and reduce resistance;during the operating stage,guide patients to engage in constructive and meaningful actions,realizing the achievement of letting nature take its course principle;in the cultivating character and enriching life stage,pay attention to positive infor-mation,expanding the scope and content of actions,improving the ability to adapt to complex life,and preventing recurrence caused by insufficient abilities.It will lay a foundation for the promotion of Morita therapy in domestic outpatient clinics,so that more patients with neurosis and other psychological diseases could receive characteristic Morita therapy treatment in outpatient clinics.

Objective　To investigate the contamination status of Bacillus cereus in food, the profile of virulence factors carried, and drug sensitivity characteristics in Liaoning Province. Methods　A total of 620 samples were isolated from 15 monitoring sites, covering four major sample types of food products in Liaoning Province between 2021 and 2022. Bacillus cereus was isolated and identified by GB4789.14—2014, and its virulence was assessed using PCR detection of the groEL and gyrB genes specific to the bacterial group, as well as 11 other virulence genes. Broth microdilution method was used to detect the antibiotic sensitivity of the strain. Results　All 79 Bacillus cereus strains were found to carry virulence genes. The detection rates of non-hemolytic enterotoxin genes nheC, nheA, and nheB were 100% (79/79), 93.3% (74/79), and 83.5% (66/79), respectively. The detection rate of enterotoxin entFM gene was 98.7% (78/79). The 79 strains of Bacillus cereus carried 19 types of virulence gene patterns, with IX and XVII gene patterns being the most prevalent, each accounted for 16.5% (13/79). The resistance rates of 79 strains of Bacillus cereus to 10 antibacterial drugs were 100% for both ampicillin and penicillin. The resistance rates to cotrimoxazole, imipenem, erythromycin, clindamycin, ciprofloxacin, and tetracycline 65.8% (52/79), 10.1% (8/79), 73.4% (58/79), 60.8% (48/79), 75.9% (60/79), and 70.9% (56/79) respectively. The resistance rates to chloramphenicol and gentamicin were both 0%. Conclusion　Food from catering services in Liaoning Province shows contamination by Bacillus cereus, with isolated strains carrying at least four kinds of virulence genes. About 100% of the isolates were resistant to ampicillin and penicillin, whereas high sensitivity was observed to chloramphenicol and gentamicin. Active monitoring, timely targeted prevention and control interventions should be strengthened to provide a theoretical basis for future traceability studies.

Abstract: Objective　To analyze the molecular serotyping and drug resistance of foodborne Listeria monocytogenes (LM)isolates from the food monitoring network of Liaoning Province, and to provide a reference for identifying and tracing the outbreaks of foodborne diseases. Methods　The Listeria monocytogenes isolates were identified, biochemical typing was conducted by VITEK biochemical identification and PCR amplification techniques were applied for molecular serotyping of 67 strains of Listeria monocytogenes detected from 2 797 food samples collected from 15 monitoring sites across the province during 2021-2022. Verification was performed according to the instructions of the serodiagnosis manual. The sensitivity of the strains to ampicillin, penicillin, meropenem, cotrimoxazole, and erythromycin was determined by broth dilution method. Results　In food from Liaoning Province, the molecular serotypes of Listeria monocytogenes carried were identified as 1/2a(3a), 1/2b(3b, 7), 1/2c(3c), and 4b (4d, 4e), with the predominant serotypes being 1/2a accounting for 62.7% (42/67), and 1/2b accounting for 28.4% (19/67). Among them, the 4b strain was isolated in 3 strains, representing 4.5%. The dominant strains of Listeria monocytogenes in 2021 and 2022 in Liaoning Province were 1/2a(3a) and 1/2b(3b, 7), with the most diverse types carried by meat and meat products. Double resistance to cotrimoxazole and erythromycin accounted for 11.9% (8/67), while resistance to only one cotrimoxazole accounted for 9.0% (6/67). Conclusions　The presence of pathogenic serotypes 1/2a(3a), 1/2b(3b, 7), 1/2c(3c), and 4b (4d, 4e) in food in Liaoning Province and the emergence of strains with one or more drug resistances indicate the existence of food safety issues caused by Listeria monocytogenes, posing a potential risk of listeriosis. There is a need to optimize source tracing methods and strengthen the confirmation of Listeria monocytogenes outbreaks.

Objective: To investigate the antimicrobial resistance in and multilocus sequence typing (MLST) of Campylobacter jejuni in meat and meat products in Liaoning Province, so as to provide insights into the management of C. jejuni infection. Methods: Nine C. jejuni isolates from meat and meat products in 2020 were subjected to whole genome sequencing, and the minimum inhibitory concentration was measured with the agar dilution method. MLST of C. jejuni isolates was performed with the microbial resistance mechanism traceability reference database and analysis system. Results: Six drug-resistant C. jejuni isolates were detected, and there were four multidrug-resistant isolates. There were six C. jejuni isolates resistant to tetracycline, five isolates resistant to nalidixic acid, four isolates resistant to ciprofloxacin, two isolates resistant to florfenicol, one isolate resistant to gentamicin and one isolate resistant to streptomycin. Nine C. jejuni isolates showed sensitive to azithromycin, chloramphenicol and clindamycin. MLST identified six ST types in nine C. jejuni isolates, with ST45 and ST2274 as the predominant type, and detected one isolate with unclassified ST type. Phylogenetic analysis showed that KW028 and KW029 of ST45 type were closely related and had high homology, and KW040 and KW042 of ST2274 type were closely related with high homology, while KW007 of ST6701 type was closely related to KW040 and KW042 of ST2274 type, with only one pgm housekeeper gene in difference. Conclusions High resistance to tetracycline, nalidixic acid and ciprofloxacin was detected in nine C. jejuni isolates from meat and meat products, and ST45 and ST2274 were predominant ST types of C. jejuni.

Objective:To analyze the expression of targeting protein for Xklp2 (TPX2) in kidney renal clear cell carcinoma (KIRC) and its clinical significance.Methods:The postoperative tissue samples of 54 patients with KIRC admitted to the Department of Urology, the First Affiliated Hospital of Bengbu Medical College from July 2017 to June 2019 were collected. Immunohistochemistry was used to detect the protein expression of TPX2 in renal carcinoma and paracancerous tissues. The difference of TPX2 mRNA expression between KIRC tissues and normal tissues was analyzed by using the TIMER database, which verified the immunohistochemical results. The UALCAN database and the Kaplan-Meier plotter database were used to analyze the relationship between TPX2 mRNA expression and clinical stage, molecular subtypes, lymph node metastasis, and prognosis of patients with KIRC. The protein interaction network was constructed by STRING database to obtain TPX2-related proteins, and the genes corresponding to the related proteins were enriched for the KEGG pathway. The relationship between TPX2 expression and immune cell infiltration and the immune checkpoint was studied by using the TIMER database.Results:Immunohistochemical results showed that the positive expression rate of TPX2 protein was 48.15% (26/54) in cancer tissues, which was higher than that in paracancerous tissues (20.37%, 11/54) ( χ2=9.25, P=0.002). The results of bioinformatics analysis showed that TPX2 mRNA expression was significantly up-regulated in KIRC [cancer tissue: 1.89 (1.49, 2.42), normal tissue: 0.35 (0.24, 0.57), U=2 297.00, P<0.001]. The expression of TPX2 mRNA was related to the clinical stage ( χ2=34.36, P<0.001), molecular subtypes ( χ2=30.15, P<0.001), and lymph node metastasis status ( χ2=27.21, P<0.001) of KIRC patients. The 5-year survival rate (53.80%) in patients with high TPX2 expression was lower than that in patients with low TPX2 expression (74.40%, χ2=18.87, P<0.001). STRING database protein interaction network construction obtained 20 TPX2-related proteins, and the genes corresponding to the related proteins were enriched in the cell cycle. The expression of TPX2 was positively correlated with B cells ( r=0.30, P<0.001), CD8 + T cells ( r=0.23, P<0.001), CD4 + T cells ( r=0.18, P<0.001), macrophages ( r=0.20, P<0.001), neutrophils ( r=0.31, P<0.001), dendritic cells ( r=0.39, P<0.001) infiltration and most of its biomarkers (all P<0.05). It was positively correlated with immune checkpoint PD-1 ( r=0.31, P<0.001) and CTLA-4 ( r=0.27, P<0.001), but not correlated with PD-L1 ( r=0.07, P=0.146) . Conclusion:TPX2 is highly expressed in KIRC and is closely associated with poor prognosis. It is expected to be a new therapeutic target for KIRC.

Objective:To investigate the relationship between red blood cell distribution width (RDW) and activity of Crohn′s disease (CD), and explore the diagnostic value of RDW for CD activity.Methods:A cross-sectional study was conducted. Clinical data of CD patients treated continuously at the Sixth Affiliated Hospital of Sun Yat-sen University from November 2012 to October 2014 (CD group) were collected, including the first results of routine hematological examinations and C-reactive protein (CRP) levels after admission. Routine hematological examination results were also collected from healthy peoples undergoing regular health check-ups at the same time, who served as the normal control group. CD patients were divided into remission, mild activity, and moderate-severe activity groups based on the Crohn′s disease activity index (CDAI). The levels of routine hematological indicators including RDW and platelet-to-lymphocyte ratio (PLR) were compared between the CD group and the normal control group, as well as among different subgroups of CD patients. The correlations between RDW, PLR and CD activity or CRP were analyzed, and the diagnostic value of RDW for CD activity was evaluated by using ROC curve. Logistic univariate and multivariate regressions were performed to analyze the influencing factors of the activity of CD. Logistic regression equation was constructed to calculate the diagnostic efficacy of the influencing factors.Results:A total of 303 CD patients (216 males, 87 females; mean age 28.6 ± 11.7 years) were assigned to CD group and 293 healthy peoples (190 males, 103 females; mean age 30.1 ± 12.3 years) were assigned to normal control group. There was no significant differences in age and gender between the two groups (both P>0.05), indicating comparability. Among the CD patients, 109 were in remission group, 106 in mild activity group, and 88 in moderate-severe activity group. There was no significant differences in age and gender among the three subgroups (all P>0.05), indicating comparability. Compared with the normal control group, RDW (15.26% ± 2.51% vs. 13.10% ± 1.13%, P<0.001), PLR (245.09 ± 158.69 vs. 119.07 ± 36.52, P<0.001), neutrophil-to-lymphocyte ratio (NLR) [3.22 (2.06, 4.75) vs. 1.76 (1.39, 2.32), P<0.001], white blood cell count [ (7.68 ± 3.30) ×10 9/L vs. (6.52 ± 1.68) × 10 9/L, P<0.001] and platelet count [ (320.69 ± 116.10) × 10 12/L vs. (230.10 ± 51.08) × 10 12/L, P<0.001] were significantly higher in the CD group, while hemoglobin [ (112.8 ± 21.0) g/L vs. (137.1 ± 13.5) g/L, P<0.001] and platelet distribution width (PDW) [ (10.70 ± 1.91) fl vs. (11.89 ± 1.75) fl, P<0.001] were significantly lower. Compared with patients in remission group, the patients in mild activity group had higher RDW and platelet count, and lower hemoglobin (all P<0.05). Compared with the patients in remission and mild activity groups, the patients in moderate-severe activity group had higher RDW, PLR and NLR, and lower hemoglobin (all P<0.05). Correlation analysis showed the positive correlations between RDW, PLR and CD activity ( r = 0.423, P<0.001; r = 0.295, P<0.001), and RDW was positively correlated with CRP ( r = 0.438, P<0.001). The cut-off value of RDW for predicting CD activity was 13.85%, while the area under curve (AUC) was 0.723 (95% CI: 0.664-0.782, P<0.001), sensitivity was 0.784 and specificity was 0.550. Logistic multivariable regression analysis showed that RDW ( OR = 1.532, 95% CI: 1.291-1.818, P<0.001) and PLR ( OR = 1.003, 95% CI: 1.001-1.006, P = 0.013) were independent risk factors. The combination of RDW and PLR in diagnosing CD activity yielded an AUC of 0.730 (95% CI: 0.673-0.787, P<0.001), sensitivity of 0.407, and specificity of 0.927. Conclusions:CD patients with high RDW have more severe activity. RDW is a simple and practical indicator for diagnosing the activity of CD.

Objective:To investigate the relationship between red blood cell distribution width (RDW) and activity of Crohn′s disease (CD), and explore the diagnostic value of RDW for CD activity.Methods:A cross-sectional study was conducted. Clinical data of CD patients treated continuously at the Sixth Affiliated Hospital of Sun Yat-sen University from November 2012 to October 2014 (CD group) were collected, including the first results of routine hematological examinations and C-reactive protein (CRP) levels after admission. Routine hematological examination results were also collected from healthy peoples undergoing regular health check-ups at the same time, who served as the normal control group. CD patients were divided into remission, mild activity, and moderate-severe activity groups based on the Crohn′s disease activity index (CDAI). The levels of routine hematological indicators including RDW and platelet-to-lymphocyte ratio (PLR) were compared between the CD group and the normal control group, as well as among different subgroups of CD patients. The correlations between RDW, PLR and CD activity or CRP were analyzed, and the diagnostic value of RDW for CD activity was evaluated by using ROC curve. Logistic univariate and multivariate regressions were performed to analyze the influencing factors of the activity of CD. Logistic regression equation was constructed to calculate the diagnostic efficacy of the influencing factors.Results:A total of 303 CD patients (216 males, 87 females; mean age 28.6 ± 11.7 years) were assigned to CD group and 293 healthy peoples (190 males, 103 females; mean age 30.1 ± 12.3 years) were assigned to normal control group. There was no significant differences in age and gender between the two groups (both P>0.05), indicating comparability. Among the CD patients, 109 were in remission group, 106 in mild activity group, and 88 in moderate-severe activity group. There was no significant differences in age and gender among the three subgroups (all P>0.05), indicating comparability. Compared with the normal control group, RDW (15.26% ± 2.51% vs. 13.10% ± 1.13%, P<0.001), PLR (245.09 ± 158.69 vs. 119.07 ± 36.52, P<0.001), neutrophil-to-lymphocyte ratio (NLR) [3.22 (2.06, 4.75) vs. 1.76 (1.39, 2.32), P<0.001], white blood cell count [ (7.68 ± 3.30) ×10 9/L vs. (6.52 ± 1.68) × 10 9/L, P<0.001] and platelet count [ (320.69 ± 116.10) × 10 12/L vs. (230.10 ± 51.08) × 10 12/L, P<0.001] were significantly higher in the CD group, while hemoglobin [ (112.8 ± 21.0) g/L vs. (137.1 ± 13.5) g/L, P<0.001] and platelet distribution width (PDW) [ (10.70 ± 1.91) fl vs. (11.89 ± 1.75) fl, P<0.001] were significantly lower. Compared with patients in remission group, the patients in mild activity group had higher RDW and platelet count, and lower hemoglobin (all P<0.05). Compared with the patients in remission and mild activity groups, the patients in moderate-severe activity group had higher RDW, PLR and NLR, and lower hemoglobin (all P<0.05). Correlation analysis showed the positive correlations between RDW, PLR and CD activity ( r = 0.423, P<0.001; r = 0.295, P<0.001), and RDW was positively correlated with CRP ( r = 0.438, P<0.001). The cut-off value of RDW for predicting CD activity was 13.85%, while the area under curve (AUC) was 0.723 (95% CI: 0.664-0.782, P<0.001), sensitivity was 0.784 and specificity was 0.550. Logistic multivariable regression analysis showed that RDW ( OR = 1.532, 95% CI: 1.291-1.818, P<0.001) and PLR ( OR = 1.003, 95% CI: 1.001-1.006, P = 0.013) were independent risk factors. The combination of RDW and PLR in diagnosing CD activity yielded an AUC of 0.730 (95% CI: 0.673-0.787, P<0.001), sensitivity of 0.407, and specificity of 0.927. Conclusions:CD patients with high RDW have more severe activity. RDW is a simple and practical indicator for diagnosing the activity of CD.

Objective:To compare the efficacy of the second generation tyrosine kinase inhibitor dasatinib combined with allogeneic hematopoietic stem cell transplantation(allo-HSCT)or chemotherapy in the treatment of Ph + acute lymphoblastic leukemia (Ph + ALL). Methods:A total of 56 Ph + ALL patients received dasatinib from January 2014 to June 2018. According to whether or not allo-HSCT was performed, they were divided into transplantation group(n=22)and chemotherapy group(n=34). The total survival rate(OS), disease-free survival rate(DFS), relapse and non-recurrence mortality(NRM)were compared between two groups. Results:The 2-year OS, DFS and cumulative recurrence rates were 69.1 % vs 47.8 %, 62.2 % vs 43.1 % and 14.6 % vs 44.1 % in transplantation and chemotherapy groups respectively. Significant inter-group differences existed in 2-year DFS, DFS and cumulative recurrence rates. The value of NRM was higher in transplantation group than that in chemotherapy group(18.6 % vs 14.1 %). However, the difference was statistically insignificant( P=0.476). Conclusions:The efficacy of dasatinib plus allo-HSCT is superior to that of dasatinib plus chemotherapy in the treatment of Ph + ALL.