The innate immune sensor NLRP3 inflammasome overactivation is involved in the pathogenesis of ulcerative colitis. PGAM5 is a mitochondrial phosphatase involved in NLRP3 inflammasome activation in macrophages. However, the role of PGAM5 in ulcerative colitis and the mechanisms underlying PGAM5 regulating NLRP3 activity remain unknown. Here, we show that PGAM5 deficiency ameliorates dextran sodium sulfate (DSS)-induced colitis in mice via suppressing NLRP3 inflammasome activation. By combining APEX2-based proximity labeling focused on PGAM5 with quantitative proteomics, we identify NEK7 as the new binding partner of PGAM5 to promote NLRP3 inflammasome assembly and activation in a PGAM5 phosphatase activity-independent manner upon inflammasome induction. Interfering with PGAM5-NEK7 interaction by punicalagin inhibits the activation of the NLRP3 inflammasome in macrophages and ameliorates DSS-induced colitis in mice. Altogether, our data demonstrate the PGAM5-NEK7 interaction in macrophages for NLRP3 inflammasome activation and further provide a promising therapeutic strategy for ulcerative colitis by blocking the PGAM5-NEK7 interaction.

Objective To discuss the accuracy and effectiveness of digital subtraction angiography(DSA)in determining the cause of limb ischemia after extra corporeal membrane oxygenation(ECMO.Methods The clinical data of 3 child patients,who developed 4 times of acute limb ischemia during perioperative period of ECMO at the Affiliated Children's Hospital of Zhengzhou University of China from July to October of 2023,were retrospectively analyzed.In all the child patients,emergency angiography was carried out to quickly identify the cause,then,appropriate treatment plan was adopted to open the blood vessels of the right lower limb.Results After the child patients entered the operating room and received DSA examination,the causes of the limb ischemia were quickly identified.After treatment,the blood supply to the lower limbs was restored.Except for one child who experienced irreversible necrosis of the distal limb due to repeated ischemia-reperfusion injury and required amputation,the other two child patients recovered well.Conclusion It is of great significance to perform DSA examination as soon as possible when the child patients develop limb ischemic manifestations after ECMO so as to quickly identify the cause,promptly restore blood supply to ischemic limbs and increase limb preservation rate,besides,DSA examination can also be used as a preventive measure for child patients after ECMO.

Objective To discuss the application value of intracavitary semiconductor laser therapy in improving facial appearance for child patients with facial venous malformations(VM)after receiving sclerotherapy.Methods The clinical data of 12 child patients with facial VM after receiving sclerotherapy,for whom the improvement of their facial appearance was difficult and who were admitted to the Affiliated Children's Hospital of Zhengzhou University of China from February 2023 to February 2024,were retrospectively analyzed.Intracavitary semiconductor laser treatment was adopted in all the 12 child patients.All the child patients were followed up to check the degree of appearance improvement and lesion volume reduction,and the curative effect was evaluated.Results Three months after intracavitary semiconductor laser treatment,obvious improvement of facial appearance was obtained in all the 12 child patients.The mean postoperative PAC-QOL psychological discomfort score was(10.4±3.9)points,when compared with the preoperative(23.7±4.3)points the difference was statistically significant(P＜0.05).MRI examination showed that after treatment no obvious improvement of the lesion was seen in 0 case,moderate improvement in one case,significant improvement in 4 cases,and cure in 7 cases.Conclusion Intracavitary semiconductor laser therapy has significant therapeutic effect in improving facial appearance for child patients with facial VM after receiving sclerotherapy,for whom the improvement of their facial appearance is difficult,therefore,this therapy has high clinical application value.

Objective Through in vitro experiments,biomechanical data of the transtibial pullout suture(TPS),tendon reconstruction(TR),and tendon reconstruction with suture augmentation(TRS)were collected,so as to evaluate the biomechanical effectiveness of tendon reconstruction for repairing medial meniscus posterior root tear(MMPRT).Methods Eighteen porcine knee joint models were divided into TPS,TR,and TRS groups.Sutures were used to fix the meniscal root in TPS group.Tendons were passed through an incision at the meniscal root in TR group.Tendons were passed through an incision at the meniscal root and secured at tendon-meniscus contact area with additional sutures in TRS group.The sutures and tendons were pulled out through tibial tunnels and fixed at the anteromedial tibia.All groups underwent failure load tests,and ultimate failure load,displacement at failure load,load at clinical failure,stiffness,and failure modes of the samples were recorded.Results The maximum failure load in TPS group was significantly higher than that in TR group(P＜0.05),but there was no significant difference between TPS group and TRS group(P＞0.05).The maximum failure load in TRS group was significantly higher than that in TR group(P＜0.05).The displacement under failure load in TR group and TRS group was significantly lower than that in TPS group(P＜0.05),but there was no significant difference between TR group and TRS group(P＞0.05).There were no significant differences in the load under clinical failure among the 3 groups(P＞0.05).The stiffness of TRS group was significantly greater than that of TPS group(P＜0.05),but no significant difference was observed between TR group and TPS group,as well as between TR group and TRS group(P＞0.05).All failures were caused by suture or tendon cutting through the meniscus.Conclusions The tendon reconstruction techniques is superior to the TPS in terms of failure displacement and stiffness,while the TRS further enhances the stability of the repair.

Objective Through in vitro experiments,biomechanical data of the transtibial pullout suture(TPS),tendon reconstruction(TR),and tendon reconstruction with suture augmentation(TRS)were collected,so as to evaluate the biomechanical effectiveness of tendon reconstruction for repairing medial meniscus posterior root tear(MMPRT).Methods Eighteen porcine knee joint models were divided into TPS,TR,and TRS groups.Sutures were used to fix the meniscal root in TPS group.Tendons were passed through an incision at the meniscal root in TR group.Tendons were passed through an incision at the meniscal root and secured at tendon-meniscus contact area with additional sutures in TRS group.The sutures and tendons were pulled out through tibial tunnels and fixed at the anteromedial tibia.All groups underwent failure load tests,and ultimate failure load,displacement at failure load,load at clinical failure,stiffness,and failure modes of the samples were recorded.Results The maximum failure load in TPS group was significantly higher than that in TR group(P＜0.05),but there was no significant difference between TPS group and TRS group(P＞0.05).The maximum failure load in TRS group was significantly higher than that in TR group(P＜0.05).The displacement under failure load in TR group and TRS group was significantly lower than that in TPS group(P＜0.05),but there was no significant difference between TR group and TRS group(P＞0.05).There were no significant differences in the load under clinical failure among the 3 groups(P＞0.05).The stiffness of TRS group was significantly greater than that of TPS group(P＜0.05),but no significant difference was observed between TR group and TPS group,as well as between TR group and TRS group(P＞0.05).All failures were caused by suture or tendon cutting through the meniscus.Conclusions The tendon reconstruction techniques is superior to the TPS in terms of failure displacement and stiffness,while the TRS further enhances the stability of the repair.

Objective:To explore the relationship between gene amplification status of human epidermal growth factor receptor 2 (HER2) and its clinicopathological features in breast cancer, and to analyze the affecting factors of axillary lymph node metastasis in breast cancer.Methods:The clinicopathological data of 262 patients with breast cancer at Tengzhou Central People's Hospital between January 2016 and March 2019 were collected, including age, tumor diameter, histological grade, pathological type, lymph node metastasis, tumor number, tumor location. The patients had routine pathology examination and the immunohistochemistry (IHC) result of HER2 was ++. The expressions of p53, Ki-67, estrogen receptor (ER), progesterone receptor (PR) were detected by using IHC. The gene amplification status of HER2 was detected by using fluorescence in situ hybridization (FISH). The relationship between gene amplification status of HER2 and clinicopathological features, the relationship between axillary lymph node metastasis and clinicopathological features was respectively analyzed.Results:HER2 gene amplification-positive was detected in 69 cases of 262 breast cancer patients, and the positive amplification rate was 26.3%. The gene amplification status of HER2 was correlated with Ki-67 proliferation index and the expression of ER as well as PR, and the differences were statistically significant (χ 2=13.27, P < 0.01; χ 2= 34.97, P < 0.01; χ 2=38.31, P < 0.01). There was no correlation with age, tumor diameter and other clinicopathological features (all P > 0.05). Among 262 cases of breast cancer, 106 (40.5%) cases had axillary lymph node metastasis. Lymph node metastasis was correlated with tumor diameter (χ 2=29.10, P < 0.01), and there was no correlation with other clinicopathological features (all P > 0.05). Conclusions:HER2 gene amplification of breast cancer is associated with Ki-67 proliferation index, the expression of ER and PR. The tumor diameter is a factor for affecting axillary lymph node metastasis. Accurate judgment of the above indicators can better guide the treatment and evaluate the prognosis of breast cancer.

Objective: To detect the expression and the differential significance of CK5/6, DSG3, P40, TTF-1, CK7, NapsinA in small biopsy specimens of non-small cell lung cancer (NSCLC), squamous cell carcinoma (SCC) and adenocarcinoma (AC). Methods: Immunohistochemical SP method was used to detect the expressions of CK5/6, DSG3, P40, TTF-1, CK7 and NapsinA in 120 small biopsy specimens of NSCLC hospitalized in the Central People's Hospital of Tengzhou from January 2016 to December 2017, and the results were analyzed combined with the clinical characteristics of NSCLC. Results: The positive expression rates of CK5/6, DSG3 and P40 in lung SCC were 100.0%(56/56), 89.3%(50/56) and 96.4%(54/56), respectively, with specificity of 90.6%, 100.0% and 100.0%, respectively.The positive expression rates of NapsinA, TTF-1 and CK7 in lung AC were 81.3%(52/64), 90.6%(58/64) and 93.8%(60/64), respectively, with specificity of 100.0%, 92.9% and 96.4%, respectively.The positive expression rates of CK5/6, DSG3, P40 in SCC had statistically significant differences compared with those in AC (all P<0.05), and the expression of TTF-1, CK7 and NapsinA in AC had statistically significant differences compared with those in SCC (all P<0.05). Conclusion CK5/6, DSG3, P40, TTF-1, CK7 and NapsinA are of great significance in the differential diagnosis of SCC and AC in small biopsy specimens of NSCLC.

Objective:To observe the clinical efficacy and safety of decitabine combined with low-dose cytarabine in treatment of high-risk myelodysplastic syndrome.Methods:The data of 47 newly treated MDS patients who had high-risk or above scores according to revised international prognostic scoring system (IPSS-R) in the Affiliated Hospital of Qingdao University from January 2016 to September 2018 were retrospectively analyzed. The patients were divided into decitabine combined with low-dose cytarabine group (15 cases) and decitabine group (32 cases). The clinical efficacy and adverse reactions in two groups were compared.Results:After 4 courses of treatment, the bone marrow remission rate, partial remission rate and hematologic remission rate was 20.0% (3/15), 6.7% (1/15), and 13.3% (2/15), respectively in decitabine combined with low-dose cytarabine group, and was 28.1% (9/32), 3.1% (1/32), and 9.4% (3/32), respectively in decitabine group, and there were no statistically differences of both groups (both P > 0.05). The overall response rate in decitabine combined with low-dose cytarabine group was higher than that in decitabine group [93.3% (14/15) vs. 62.5% (20/32), P = 0.037], and the complete remission rate in decitabine combined with low-dose cytarabine group was higher than that in decitabine group [53.3% (8/15) vs. 21.9% (7/32), P = 0.046]. The 1-year overall survival (OS) rate of decitabine combined with low-dose cytarabine group was 86%; and the median OS time of decitabine combined with low-dose cytarabine group was 24 months (95% CI 15.5-32.5 months), which was higher than that of decitabine group (20 months), but there was no statistically significant difference ( χ2 = 0.058, P = 0.810). The incidence of grade Ⅲ-Ⅳ bone marrow suppression and infection in decitabine combined with low-dose cytarabine group was higher than that in decitabine group, but there were no statistically significant differences of both groups (both P > 0.05). Grade Ⅲ-Ⅳ bone marrow suppression and infection were commonly found within the first 2 courses of treatment in decitabine combined with low-dose cytarabine group, and the adverse reactions gradually decreased in the subsequent treatment. Conclusions:Decitabine combined with low-dose cytarabine can achieve better remission rate and prolong survival time for MDS patients with high-risk and above. There is no significant increase in the incidence of grade Ⅲ-Ⅳ bone marrow suppression and infection. For high-risk MDS patients who are not suitable or unable to receive hematopoietic stem cell transplantation, it can be the preferred option.

In China,peritoneal metastasis of gastric cancer has main characteristics of high incidence,late staging and poor prognosis.However,the proposal of conversion therapy has brought hope to patients.Conversion therapy of peritoneal metastasis in gastric cancer is a novel concept,which aims at down-staging of the gastric cancer's primary lesion and effectively controlling the peritoneal metastases at the same time through valid chemotherapy and other means.Then the surgeons strive for performing radical gastrectomy and lymph node dissection (D2) to prolong survival time of the patients with advanced gastriccancer and improve their life quality.Systemic chemotherapy is the core of the methods of conversion therapy,while the local intraperitoneal chemotherapy can be used as a supplement.Neoadjuvant intraperitoneal-systemic chemotherapy (NIPS) is the most promising technique as conversion therapy due to the comprehensive advantages of the systemic chemotherapy and local intraperitoneal chemotherapy.In recent years,there were many clinical studies reporting NIPS for conversion therapy of peritoneal metastasis in gastric cancer.Therefore,this paper systematically reviews experiences of clinical application in order to provide references for clinical practice of conversion therapy in gastric cancer.

Objective: To know the incidence of heat stroke and explore it's prediction model in Pudong New Area of Shanghai. Methods: An epidemiological investigation was conducted on heat stroke cases in Pudong New Area of Shanghai from 2013 to 2017. Daily temperature data during this period were collected to explore it’s influence. Results: 246 heat stroke cases were reported and investigated, 70.3% (173/246) of them were male. 170 cases are severe heat stroke, accounting for 69.1%. 28 patients died, accounting for 11.4% of all cases of heat stroke, and 16.5% (28/170) of severe heat stroke cases. Thermoplegia (56.5%, 96/170) was the most popular type among severe heat stroke cases. Heat prostration, heat cramps and mixed type account for 17.1% (29/170) , 12.4% (21/170) and 14.0% (24/170) respectively. Scatter plot and linear regression demonstrated that there was a significant linear relation between number of high temperature days and number of heat stroke cases (P<0.01) . And the prediction model is: Predictive number of annual heat stroke cases=β×Number of annual high temperature days+Intercept. Leave-one-out cross validation result shows that the predictive number of annual heat stroke cases from 2013 to 2017 were 85.7%, 90.9%, 83.3%, 91.9 and 84.3% respectively. Conclusion There was a significant linear relation between number of high temperature days and number of heat stroke cases in Pudong New Area. The related work arrangement for heat stroke prevention could be well planed according to the prediction model.