Colorectal tumorigenesis generally progresses from adenoma to adenocarcinoma, accompanied by dynamic changes in the tumor microenvironment (TME). A randomized controlled trial has confirmed the efficacy and safety of Shen-Bai-Jie-Du decoction (SBJDD) in preventing colorectal tumorigenesis. However, the mechanism remains unclear. In this study, we employed single-cell RNA sequencing (scRNA-seq) to investigate the dynamic evolution of the TME and validated cell infiltration with multiplex immunohistochemistry and flow cytometry. Bulk RNA sequencing was utilized to assess the underlying mechanisms. Our results constructed the mutually verifiable single-cell transcriptomic atlases in Apc ^Min/+ mice and clinical patients. There was a marked accumulation of CCL22⁺ dendritic cells (DCs) and an enhanced immunosuppressive action, which SBJDD and berberine reversed. Combined treatment with cholesterol and lipopolysaccharide induced characteristic gene expression of CCL22⁺ DCs, which may represent "exhausted DCs". Intraperitoneal injection of these DCs after SBJDD treatment eliminated its therapeutic effects. TMEM131 derived CCL22⁺ DCs generation by TNF signaling pathway and may be a potential target of berberine in retarding colorectal tumorigenesis. These findings emphasize the role of exhausted DCs and the regulatory mechanisms of SBJDD and berberine in colorectal cancer (CRC), suggesting that the multi-component properties of SBJDD may help restore TME homeostasis and offer novel cancer therapy.

Objective To explore the role and potential mechanisms of all-trans retinoic acid(ATRA)on activation and oxidative stress of hepatic stellate cell(HSC).Methods Platelet-derived growth factor(PDGF-bb,10 ng/ml)was applied to induce the activation of HSCs,which was then treated with ATRA at a dosage of 5 μmol/L for 48 h.The effects of ATRA on HSC activation were evaluated by detecting changes in cell growth viability and phenotypic marker expression.The effects of ATRA on HSC oxidative stress were evaluated by detecting changes in intracellular reactive oxygen species(ROS),reduced glutathione(GSH)and malondialdehyde(MDA),and the expression of antioxidant genes.The effects of ATRA on HSC autophagic activity were evaluated by detecting changes in autophagy marker expression and autophagic flow.Results Compared with the PDGF-bb group,the cell viability was significantly reduced in ATRA-treated HSCs(P＜0.01),as well as the expression of α-SMA and Collagen I.The intracellular levels of ROS and MDA were significantly reduced in ATRA-treated HSCs(P＜0.01),whereas the GSH level was significantly increased(P＜0.01).The expression levels of antioxidant genes(NRF2,HO-1,and ATF4),were significantly higher in ATRA-treated HSCs than those in the normal ones under PDGF-bb condition(P＜0.01).Meanwhile,the expression of autophagy markers Beclin 1 and LC3 Ⅱ/I,and signal of autophagy flow in ATRA-treated HSCs were found to be significantly reduced(P＜0.01).Conclusion ATRA significantly inhibited PDGF-bb-induced HSC activation and reduced the level of oxidative stress and autophagic activity of HSCs,which had potential applications in the prevention and treatment of liver fibrosis.

Objective? To explore the status of psychological capital of ICU nurses and the correlation between nurses' psychological capital and job burnout, so as to provide the guidance for nursing managers in the management work. Methods? Convenience sampling method was used to select 200 ICU nurses in 4 ClassⅢGrade A Hospitals in Harbin as study subjects. The Nurses' Job Burnout Scale (NBS) and Psychological Capital Scale were used in the study to evaluate the correlation between psychological capital and job burnout. Results? A total of 187 valid questionnaires were collected. The score of Psychological Capital Scale of ICU nurses was (88.38±7.26), the average score of items was (3.68±0.71) , the score of hopefulness was (4.02±0.78) , self-efficacy was (3.84±0.67), flexible anti-resistance was (3.66±0.54) and optimistic was (3.21±0.86). There was a negative correlation between the total score and each dimensional score of ICU nurses Psychological Stress Scale and the scores of NBS including all dimensions (P＜ 0.05). Conclusions? The psychological capital of ICU nurses has negative correlation with their job burnout. Nursing managers should take certain measures based on each nurse's particular situation to improve their psychological capital so as to reduce the occurrence of job burnout.

Objective To predict the presence of impairment of right ventricular function in prediabetes using two-dimensional speckle tracking imaging. Methods From June 2012 to May 2016, a total of 110 patients from Zhejiang Taizhou Hospital of Taizhou Enze Medical Center (group) were recruited, including 40 controls, 33 prediabetes and 37 type 2 diabetes. The routine right ventricular parameters were measured. Longitudinal peak strain of right ventricular free wall (RVLPSF), ventricular septal (RVLPSS) and global longitudinal peak strain of right ventricle (RVLPSG) were measured with two-dimensional spekle tracking imaging, and global systolic strain rate (SRS), global early diastolic strain rate (SRE) and global late diastolic strain rate (SRL) of right ventricle were also measured. LVEDVI, LVESVI, LVEF, RVD, E/A, e/a, E/e, TAPSE, RVFAC, RVLPSF, RVLPSS, RVLPSG, SRS, SRE, and SRL in the above 3 groups were analyzed with LSD-t test. Results Compared with the controls: RVLPSF, RVLPSS, RVLPSG, SRS, and SRE were all statistically reduced in prediabetes[(-27.89±4.11)% vs(-21.78±3.62)%,(-20.08±4.11)% vs (-16.88±2.68)%, (-23.98±2.96)% vs (-19.33±2.13)%, -1.67±0.25 vs -1.18±0.24, and 1.84±0.23 vs 1.35±0.20,t=3.45,3.42,3.44,3.44,and 3.43,all P<0.01].RVLPSF,RVLPSS,RVLPSG,SRS,and SRE were all statistically reduced in diabetes[(-27.89±4.11)% vs(-20.97±3.88)%,(-20.08±4.11)% vs(-15.42±1.92)%, (-23.98±2.96)% vs(-18.19±2.29)%,-1.67±0.25 vs-1.08±0.23,and 1.84±0.23 vs 1.18±0.27,t=3.43,3.45,3.43, 3.42,and 3.42,all P<0.01].Compared the prediabetes:SRE was significantly reduced in diabetes(1.35±0.20 vs 1.18±0.27, t=3.45, P<0.01). Conclusions Diastolic and systolic function of right ventricle were already impaired in prediabetes, and speckle tracking imaging can quantitatively evaluate the impairment.

Objective To evaluate the efficacy of oxycodone in preventing catheter-related bladder discomfort (CRBD) during recovery from anesthesia in the patients undergoing general anesthesia.Methods A total of 155 male patients, aged 18-60 yr, weighing 46-75 kg, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ , scheduled for elective spinal surgery performed under general anesthesia, were randomly divided into 3 groups: control group (group C, n =52), oxycodone group (group O, n=51), and sufentanil group (group S, n=52).After induction of anesthesia, the patients were tracheally intubated and mechanically ventilated.At 15 min before the end of surgery, oxycodone 0.07 mg/kg was injected intravenously in group O, sufentanil 0.10 μg/kg was injected intravenously in group S, and the equal volume of normal saline was given in group C.The emergence time and extubation time were recorded.Riker sedation-agitation scale (SAS) score was recorded at 5, 15 and 30 min, and 1, 2 and 4 h after extubation (T1-6).The occurrence and severity of CRBD within 4 h after surgery, and occurrence of nausea and vomiting and respiratory depression were observed and recorded.Results Compared with group C, the SAS score at T1-4 and incidence and severity of CRBD were significantly decreased, and the emergence time and extubation time were prolonged in group S, and the SAS score at T1-6 and incidence and severity of CRBD were significantly decreased (P＜0.05) , and no significant change was found in emergence time and extubation time in group O (P＞0.05).Compared with the group S, the SAS score at T1-4 was significantly increased, the SAS score at T5-6 and incidence and severity of CRBD were decreased, and the emergence time and extubation time were shortened in group O (P＜0.05).There was no significant difference in the incidence of nausea and vomiting and respiratory depression between the three groups (P＞0.05).Conclusion Oxycodone 0.07 mg/kg injected intravenously at 15 min before the end of surgery can prevent the occurrence of CRBD during recovery from anesthesia in the patients undergoing general anesthesia.

Objective To investigate the expression of hypoxia inducible factor-1α(HIF-1α) and vascular endothelial growth factor C(VEGF-C) in colon carcinoma,and their relation with clinical pathological parameters and prognosis. Methods Immunohistochemistry was used to detect the expression of HIF-1α and VEGF-C in 65 tissues of colon carcinoma. Results In all cases,the expression of HIF-1α had a positive correlation with the expression of VEGF-C(r= 0.638,P＜0.01).The expressions of HIF-1α and VEGF-C had significant correlation with clinical stage and nodal metastasis(P＜0.05) ,but had no relationship with sex,age and tumor size(P＞0.05). Conclusion The expression of HIF-1α and VEGF-C was correlated with nodal metastasis, tumorigenesis and prognosis of colon/carcinoma.

One influenza H3N2 virus, A/swine/Shandong/3/2005 (Sw/SD/3/2005), was isolated from pigs with respiratory disease on a farm in eastern China. Genetic analysis revealed that Sw/SD/3/2005 was a triple-reassortant virus with a PB2 gene from human-like HIN1, NS from classical swine H1NI, and the remaining genes from human-like H3N2 virus. These findings further support the concept that swine can serve as reservoir or mixing vessels of influenza virus strains and maintain genetic and antigenic stability of viruses. Furthermore, we have successfully established a reverse genetics system based on eight plasmids and rescued Sw/SD/3/2005 through cell transfection. HI tests and RT-PCR confirmed that the rescued virus maintained the biological properties of the wild type Sw/SD/3/2005. The successful establishment of the reverse genetics system of Sw/SD/3/2005 will enable us to conduct extensive studies of the molecular evolution of H3N2 influenza viruses in swine.