Liver transplantation (LT) has become a standard treatment for end-stage liver diseases, and graft injury is intricately associated with poor prognosis. Granzyme B (GZMB) plays a vital role in natural killer (NK) cell biology, but whether NK-derived GZMB affects graft injury remains elusive. Through the analysis of single-cell RNA-sequencing data obtained from human LT grafts and the isolation of lymphocytes from mouse livers following ischemia-reperfusion injury (IRI), we demonstrated that 2NK cells with high expression of GZMB are enriched in patients and mice. Both systemically and liver-targeted depletion of NK cells led to a notable reduction in GZMB⁺ cell infiltration, subsequently resulting in diminished graft injury. Notably, the reconstitution of Il2rg ^-/- Rag2 ^-/- mice with purified Gzmb-KO NK cells demonstrated superior outcomes compared to those with wild-type NK cells. Crucially, global knockout of GZMB and pharmacological inhibition exhibited remarkable improvements in liver function in both mouse IRI and rat LT models. Moreover, a phosphorylated derivative of FDA-approved vidarabine was identified as an effective inhibitor of mouse GZMB activity by molecular dynamics, which could provide a potential avenue for therapeutic intervention. Therefore, targeting NK cell-derived GZMB during the LT process suggests potential therapeutic strategies to improve post-transplant outcomes.

Atopic dermatitis (AD) is a prevalent inflammatory skin disorder in which patients experience recurrent eczematous lesions and intense itching. The colonization of Staphylococcus aureus (S. aureus) is correlated with the severity of the disease, but its role in AD development remains elusive. Using single-cell RNA sequencing, we uncovered that keratinocytes activate a distinct immune response characterized by induction of Il24 when exposed to methicillin-resistant S. aureus (MRSA). Further experiments using animal models showed that the administration of recombinant IL-24 protein worsened AD-like pathology. Genetic ablation of Il24 or the receptor Il20rb in keratinocytes alleviated allergic inflammation and atopic march. Mechanistically, IL-24 acted through its heterodimeric receptors on keratinocytes and augmented the production of IL-33, which in turn aggravated type 2 immunity and AD-like skin conditions. Overall, these findings establish IL-24 as a critical factor for onset and progression of AD and a compelling therapeutic target.
Dermatitis, Atopic/genetics* ; Interleukins/metabolism* ; Animals ; Methicillin-Resistant Staphylococcus aureus/immunology* ; Mice ; Keratinocytes/microbiology* ; Humans ; Interleukin-33/immunology* ; Inflammation/microbiology* ; Staphylococcal Infections/microbiology* ; Disease Models, Animal ; Hypersensitivity/microbiology* ; Mice, Inbred C57BL

Objective:To analyze the clinical characteristics，laboratory tests，endoscopic features，treatment，and follow-up of peptic ulcers caused by eosinophilic gastrointestinal disorders（EGIDs）in children，with the aim of improving the level of understanding，diagnosis and treatment of EGIDs in children with the onset of peptic ulcers.Methods:A retrospective analysis was conducted on children admitted to the Department of Gastroenterology，Capital Center for Children's Health，Capital Medical University from January 1st，2019 to October 31st，2023，who underwent complete endoscopic examination. The first examination showed the presence of peptic ulcers（gastric or duodenal ulcers）under the endoscope，and were ultimately diagnosed with peptic ulcers caused by EGIDs through examination and follow-up. The clinical characteristics，laboratory tests，endoscopic results，and treatment follow-up were analyzed.Results:Thirty-five children were EGIDs，22 males and 13 females.Twenty-two cases（62.9%）had abdominal pain as the main symptom.Laboratory tests：17 cases（48.6%）showed a decrease in hemoglobin，15 cases（42.9%）showed an increase in eosinophil count，20 cases（57.1%）tested gastro positive for food allergen specific IgE，and 17 cases（48.6%）showed thickening of the intestinal wall on gastrointestinal ultrasound. Endoscopic features：8 cases（22.9%）showed gastric antral ulcers，including 7 cases（20.0%）with multiple gastric antral ulcers，and 25 cases（71.4%）showed duodenal bulb ulcers.There were 15 cases（42.9%）showed huge ulcers，and 14 cases（40.0%）were located in the duodenal bulb. Comparison of clinical characteristics between children with EGIDs（EGIDs group）and those with peptic ulcers caused by Helicobacter pylori infection（Hp group）：the first clinical symptom in both groups was mainly abdominal pain，but the incidence rate in the EGIDs group was lower（62.9% vs 93.5%），and the weigth for length Z score in the EGIDs group was lower［0（-1.6，0.8）vs 1.1（0，1.9）］，with statistical significance（all P<0.05）. Comparison of laboratory tests：the EGIDs group showed a statistically significant difference in hemoglobin levels［120（101，124）g/L vs 130（100，138）g/L］，eosinophil count［0.28（0.13，0.71）× 10 9/L vs 0.16（0.08，0.22）×10 9/L］，a positive rate of food allergen specific IgE detection（57.1% vs 32.3%），and a positive rate of intestinal wall thickening detected by gastrointestinal ultrasound（48.6% vs 16.1%）compared with the Hp group（all P<0.05）. Comparison of endoscopic examinations：multiple ulcers in the gastric antrum were more common in the EGIDs group than in the Hp group（20.0% vs 0），and the difference was statistically significant（ P<0.05）. Conclusion:For children with peptic ulcers with onset of abdominal pain，with anemia or malnutrition，or multiple ulcers in the gastric antrum and huge ulcers in the duodenal bulb detected by endoscopy，it is recommended to perform multi site biopsies to help diagnose EGIDs early.

Objective To investigate the differences in subchondral bone mineral density(BMD)between the femoral and tibial sides in patients of knee osteoarthritis(KOA)with normal lines of force and varus.Methods The data of 450 knee joints with a definite diagnosis of KOA were included in this study including weight-bearing full-length X-ray films and quantitative computed tomography(QCT)scans of both lower limbs.Among them,131 were in the normal force line group and 319 were in the knee varus group.The hip-knee-ankle(HKA)angle and BMD of the femoral medial condyle,femoral lateral condyle,tibial medial plateau and tibial lateral plateau were measured.BMD ratio of tibial medial plateau to tibial lateral plateau and the BMD ratio of femoral medial condyle to femoral lateral condyle were calculated.BMD in medial and lateral compartments of the femur and tibia were compared between the two groups,followed by subgroup analyses based on gender and age.Spearman correlation was used to analyze the correlation between the BMD ratio of tibial medial plateau to tibial lateral plateau,the BMD ratio of femoral medial condyle to femoral lateral condyle and the degree of varus in the knee varus group.Results The BMD of the medial femoral condyles and medial tibial platforms were higher in the knee varus group than those in the normal force line group.The BMD of femoral lateral condyle and lateral tibial platform was lower in the knee varus group than that in the normal force line group.The BMD ratio of the medial to lateral tibial plateaus was greater than one in both groups,and the ratio of the knee varus group was greater.The BMD ratio of femoral medial to lateral condyle in the knee varus group was significantly higher than that in the normal force line group.For women,these findings were more pronounced and were independent of age.Correlation analysis showed that the BMD ratio of medial tibial plateau to lateral tibial plateau was negatively correlated with HKA angle(rs=-0.436,P＜0.01),and the BMD ratio of the medial femoral condyle to lateral femoral condyle was also negatively correlated with HKA angle(rs=-0.394,P＜0.01).Conclusion The BMD of medial femoral and tibial compartment is increased and the BMD of lateral compartment is decreased in the genu varus group compared with the normal force line group.

AIM: To evaluate the refractive status through computer refractometer and OPD-Scan III auto refractometer in cataract patients after extended depth of focus(EDOF)intraocular lens implantation.METHODS: Retrospective observational study. A total of 61 cases(76 eyes)that received phacomulsification and implanted with TECNIS® Symfony ZXR00 intraocular lens in Shanghai Eye Diseases Prevention & Treatment Center from May 2022 to May 2023 were collected. Measurements from the computer refractometer, OPD-Scan III auto refractometer, and subjective refraction, were taken from all patients on the same day postoperatively.RESULTS: There were statistical significant difference in sphere(S)and spherical equivalent(SE)readings from the computer refractometer and subjective refraction(all P<0.01), with mean differences of -0.67±0.37 D and -0.75±0.35 D, respectively, and the S and SE obtained from computer refractometer more incline to myopia than those from subjective refraction; there were statistical significant difference in computer refractometer and subjective refraction(P<0.01), with a relative small absolute difference(0.21±0.24 D). The S, cylinder(C)and SE of computer refractometer(S, C, SE)were positively correlated with subjective refraction(r=0.7994, 0.7929, and 0.8118, respectively, all P<0.01). Additionally, there were statistical significant differences in S, C and SE of OPD-Scan Ⅲ and subjective refraction(P<0.01), and the absolute differences of S(0.63±0.36 D), C(0.35±0.26 D)and SE(0.53±0.36 D)were small. Furthermore, the S, C and SE of OPD-Scan Ⅲ were positively correlated with subjective refraction(r=0.4410, 0.4982, 0.5224, all P<0.01).CONCLUSION: In patients who received implantation of EDOF lenses, the consistency of computer refractometer, OPD-Scan III auto refractometer and subjective refraction was good. The average difference of the S and SE obtained via computer refractometer was large, but both exhibited a myopic shift relative to those derived from subjective refraction, and the C values demonstrated minimal discrepancy. Furthermore, the differences between OPD-Scan III auto refractometer and subjective refraction were small, but the direction of the difference is unstable, sometimes it is myopic deviation, while sometimes it is hyperopic deviation.

Objective To explore the effect of mirror therapy(MT)based on occupational therapy(OT)on alien hand syndrome(AHS). Methods From January,2022 to December,2023,20 AHS patients from the Affiliated Hospital of Xuzhou Medical Uni-versity were randomly divided into control group(n=10)and observation group(n=10).Both groups received conventional OT,while the observation group additionally received MT,30 minutes per session,twice a day,for four weeks.They were assessed with Wolf Motor Function Test(WMFT),Fugl-Meyer Assessment-Hand(FMA-H),and modified Barthel Index(MBI)before and after treatment. Results The scores of WMFT(t=5.771,P<0.001),FMA-H(t=7.875,P<0.001)and MBI(t=9.544,P<0.001)im-proved in the observation group after treatment,and they were better in the observation group than in the control group(t>3.129,P<0.01). Conclusion MT based on OT may improve hand motor control and activities of daily living in AHS patients.

Objective: To construct a prediction model for preeclampsia (PE) risk in twin-pregnant women, so as to provide the basis for early screening and prevention of PE. Methods: A total of 467 twin-pregnant women who underwent prenatal examination and delivered at Huzhou Maternal and Child Health Hospital were selected. Sixty cases with preeclampsia (PE) were included in the case group, and 60 women without PE were included in the control group. General information, blood biochemical indicators and uterine artery resistance index (UtA-RI) were collected. A logistic regression model was used to screen predictive factors and establish a nomogram. The Bootstrap method was performed for the internal validation; the receiver operating characteristic (ROC) curve, calibration curve and decision curve analysis were employed to evaluate the discrimination, calibration and clinical utility of the nomogram, respectively. Results: In the case group, there were 47 individuals (78.33%) aged younger than 35 years, 21 individuals (35.00%) with pre-pregnancy body mass index (BMI) of 25 kg/m2 and above, and 33 individuals (55.00%) with in vitro fertilization. In the control group, there were 57 individuals (95.00%) aged younger than 35 years, 8 individuals (13.33%) with pre-pregnancy BMI of 25 kg/m2 and above, and 39 individuals (65.00%) with natural pregnancy. Multivariable logistic regression analysis identified age, pre-pregnancy BMI, method of conception, placental growth factor (PLGF) and UtA-RI as risk prediction factors for PE in twin-pregnant women. The established nomogram had an area under the ROC curve of 0.827 (95%CI: 0.755-0.899), a sensitivity of 0.767, a specificity of 0.733, a good discrimination and calibration, and a relatively high clinical net benefit. Conclusion The nomogram established by age, pre-pregnancy BMI, method of conception, PLGF and UtA-RI has a good predictive value for the risk of PE in twin-pregnant women.

Objective:To seek any relationship between the single nucleotide polymorphisms (SNPs) of the apolipoprotein E (ApoE) gene and blood lipid sensitivity to high-intensity interval training (HIIT).Methods:Two hundred and thirty Han Chinese college students (104 males and 126 females) who were not majoring in sports were recruited to perform a 28-minute high-intensity interval workout three times per week for 12 weeks. Before and after the intervention, blood levels of triglycerides (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), and total cholesterol (TC) were measured. The subjects′ DNA was genotyped to obtain SNP loci, and a linear regression model was constructed to quantify any association between ApoE genotypes and phenotypes.Results:(1) A total of 21 SNP loci were identified associated with ApoE genes, one of which (rs7412) was found to be correlated with the training effect on blood lipids. (2) The initial TT and LDL-C values of carriers of the T allele of gene rs7412 (individuals with the CT + TT genotypes) were, on average, significantly lower than those of CC genotype individuals. However, no significant differences in the initial TG and HDL-C values among different genotypes were observed. (3) After the training the average LDL-C levels among the ApoE rs7412 polymorphic groups had changed significantly, with a significantly greater decrease observed among the carriers of the T allele compared with those of CC genotype.Conclusions:ApoE polymorphism may be significantly associated with TT and LDL-C values in Han Chinese youth, with carriers of the T allele tending to display lower levels than those of CC genotype. The polymorphism of ApoE gene rs7412 may be related to LDL-C reduction through HIIT, with carriers of the T allele more sensitive to such training.

Objective To apply the train-the-trainer(TTT)mode in the course of Tactical Combat Casualty Care,so as to improve rescue skills of combat injuries and cultivate group training skills in military college students.Methods Forty students of the 2021-2022 academic year were initially trained for rescue skills of combat injuries and instructional skills.After passing the instructional competency assessment,13 students of them were selected as student instructors to conduct trauma care skill training for 40 new students of the 2022-2023 academic year.After training,a questionnaire survey was carried out in the students of the 2021-2022 academic year,and in-depth individual interview was performed in the 13 student instructors.Results The total score of TTT model training was 4.60±0.44.The score of trainee's satisfaction was 4.53±0.51,and 97.5%of trainees expressed willingness to participate in the TTT model training again.Three themes were extracted through the interview,including self-requirement and active learning,multi-dimensional ability training,and mutual understanding and empathy.Conclusion The TTT mode as an effective teaching method to cultivate group training ability can promote the development of multi-dimensional abilities such as the knowledge,skills and group training ability of combat injury rescue,and cultivate training personnel for self and mutual medical aid.

Objective: To examine the impact of physical intelligence teaching on the function of children s sensory integration, so as to provide reference for promoting the development of sensory integration system. Methods: From February to May 2023, the intervention was implemented for 12 weeks among 136 children aged 4-5 (68 in the intervention group and 68 in the control group). The intervention group received situational and game based physical intelligence teaching, the control group received sports game teaching according to the original curriculum objectives of the kindergarten. Intervention was administered 3 times a week for 40 minutes each time. The sensory integration ability of the intervention group and the control group were evaluated before and after the intervention with Chi square test and t test. Results: The vestibular sensation, proprioception and tactile sensation of between boys and girls in the intervention group were significantly improved compared with before intervention (boys：44.14±11.52 vs. 53.34± 9.49 ，44.57±12.76 vs. 50.54±11.86，49.31±12.18 vs. 55.00±10.24,girls：46.00±11.01 vs. 54.58±10.06，48.79±13.17 vs. 53.64±11.97，52.67±11.67 vs. 56.91±10.42, t =-3.24，-2.49，-2.09，-5.24，-12.94，-2.56， P <0.05). There was no significant difference in vestibular sensation between boys and girls in the control group (boys：45.91±11.66 vs. 46.31± 11.20，girls：48.27±13.56 vs. 48.45 ±13.54, t =-0.87，-0.07， P >0.05), but there was a significant improvement in proprioception and tactile sensation in both boys and girls (boys：46.63±11.76 vs. 48.06±11.69，51.63±11.98 vs. 52.40±12.18，girls：50.45±12.16 vs. 51.67± 12.03 ，53.36±12.48 vs. 54.39±12.57， t =-3.36，-2.08，-4.66，-2.86， P <0.05). After the intervention, compared with the control group, the vestibular sensation of both boys and girls significantly improved ( t=2.83, 2.08, P <0.05), with exception of proprioception and tactile sensation ( t =0.88,0.67,0.97,0.88, P >0.05). In the experimental group, the number of normal boys increased from 12 to 24, while the number of dysfunctional boys decreased from 23 to 11, with a statistically significant difference ( χ 2=11.53, P <0.01). There was no statistically significant difference in sensory integration in boys of the control group before and after the experiment ( χ 2= 1.10 , P >0.05). After intervention,the number of normal girls in the experimental group increased from 15 to 27, while the number of dysfunctional girls decreased from 18 to 6, with a statistically significant difference ( χ 2=10.39, P < 0.05 ). There was no statistically significant difference in sensory integration in girls from the control group before and after the experiment ( χ 2=2.08, P > 0.05 ). Conclusion Physical intelligence teaching can effectively improve children s sensory integration ability, especially for vestibular function.