Objective:To investigate the distribution of pathogenic bacteria in the ear canal secretions of patients with chronic suppurative otitis media（CSOM）, the changes in the levels of interleukin-8（IL-8） and Toll like receptor 4（TLR4） in the ear canal secretions, and their clinical significance. Methods:This study selected 128 CSOM patients who visited our hospital from January 2022 to February 2024 as the study subjects and recorded them as the CSOM group. Additionally, 135 volunteers who underwent physical examinations at our hospital during the same period were regarded as the control group. Video otoscopy was used to collect and cultivate ear canal secretions, and a fully automated microbial identification instrument was used to identify the bacterial species. ELISA was applied to detect levels of IL-8, TLR4. Multivariate logistic regression was employed to examine the factors that affect the occurrence of CSOM. Pearson correlation was applied to analyze the correlation between IL-8, TLR4 levels and various influencing factors. ROC curve was applied to analyze the diagnostic value of IL-8 and TLR4 levels for the occurrence of CSOM. Z-test was applied to compare the differences in AUC. Results:Among 128 patients, the detection rate was 89.06%, and a total of 181 strains of pathogenic bacteria were cultured, among them, Gram positive bacteria accounted for the highest proportion of 54.14%, followed by Gram negative bacteria, accounting for 34.25%, and finally fungi, accounting for 11.60%. The common bacteria were Staphylococcus aureus （20.44%）, Pseudomonas aeruginosa （13.26%）, and Staphylococcus epidermidis （8.29%）. The resistance of Gram-positive bacteria to penicillin, clindamycin, erythromycin, and amoxicillin is high. Gram-negative bacteria are highly resistant to penicillin, ampicillin and erythromycin. Fungi are resistant to ketoconazole and fluconazole. The levels of IL-8 and TLR4 in CSOM group were higher than those in the control group, and gradually increased with the increase of hearing impairment. （P<0.05）. Elevated levels of IL-8, TLR4 were independent risk factors for the occurrence of CSOM（P<0.05）. The AUC of CSOM diagnosed by IL-8 and TLR4 alone was 0.790 and 0.777, respectively, while the AUC of combined diagnosis was 0.898, which was better than their respective individual diagnoses（both P<0.05）. Conclusion:The distribution of pathogenic bacteria in the ear canal secretions of CSOM patients is mainly Gram positive, with common ones being Staphylococcus aureus and Pseudomonas aeruginosa. The levels of IL-8 and TLR4 in CSOM patients are higher than those in the control group. The higher the levels, the higher the degree of hearing loss, which can be used for clinical diagnosis.
Humans ; Toll-Like Receptor 4/metabolism* ; Interleukin-8/metabolism* ; Otitis Media, Suppurative/metabolism* ; Ear Canal/metabolism* ; Chronic Disease ; Male ; Female ; Adult ; Middle Aged ; Clinical Relevance

Objective This study aims to develop and validate a dynamic web-based nomogram for predicting kinetophobia in patients following percutaneous coronary intervention(PCI).Methods A prospective design was employed to selectively enroll 330 PCI patients admitted to a hospital in Hangzhou from December 2022 to July 2023.Single-factor analysis and Lasso regression were utilized to identify independent risk factors for kinesophobia post-PCI.Logistic regression was performed using R software,and a nomogram was constructed.The model was assessed through the area under the receiver operating characteristic curve(AUC)and Hosmer-Lemeshow tests.Results There were 206 cases of kinesiophobia in 330 patients after PCI,and the incidence was 62.4％.Logistic regression analysis identified combined heart failure,emergency surgery,NYHA cardiac function grade,ADL level,sedentary behavior,Chinese version of PROMIS Physical Function Summary Table score,and Chinese version of Perceptive Social Support Scale score as independent influencing factors for kinesophobia after PCI(P＜0.05).The AUC value of the model was 0.821,with a sensitivity of 70.4％and specificity of 82.0％.The Hosmer-Lemeshow fit test yielded a non-significant result(x2=9.350,P=0.314).Calibration and decision curves demonstrated the model's favorable calibration and clinical practicability.The C-index of the nomogram prediction model was 0.778,0.774,and 0.800,respectively,by 5-fold cross-validation,10-fold cross-validation,and the Bootstrap method.Conclusion The dynamic nomogram model developed in this study effectively predicts kinesophobia in patients after PCI.It provides valuable references and support for clinical staff in early identification of high-risk patients,enabling the formulation of individualized health education strategies and exercise rehabilitation plans.

We aimed to evaluate the effectiveness and safety of single-course initial regimens in patients with low-risk gestational trophoblastic neoplasia (GTN). In this trial (NCT01823315), 276 patients were analyzed. Patients were allocated to three initiated regimens: single-course methotrexate (MTX), single-course MTX + dactinomycin (ACTD), and multi-course MTX (control arm). The primary endpoint was the complete remission (CR) rate by initial drug(s). The primary CR rate was 64.4% with multi-course MTX in the control arm. For the single-course MTX arm, the CR rate was 35.8% by one course; it increased to 59.3% after subsequent multi-course MTX, with non-inferiority to the control (difference -5.1%,95% confidence interval (CI) -19.4% to 9.2%, P = 0.014). After further treatment with multi-course ACTD, the CR rate (93.3%) was similar to that of the control (95.2%, P = 0.577). For the single-course MTX + ACTD arm, the CR rate was 46.7% by one course, which increased to 89.1% after subsequent multi-course, with non-inferiority (difference 24.7%, 95% CI 12.8%-36.6%, P < 0.001) to the control. It was similar to the CR rate by MTX and further ACTD in the control arm (89.1% vs. 95.2%, P =0.135). Four patients experienced recurrence, with no death, during the 2-year follow-up. We demonstrated that chemotherapy initiation with single-course MTX may be an alternative regimen for patients with low-risk GTN.
Antineoplastic Combined Chemotherapy Protocols/adverse effects* ; Dactinomycin/adverse effects* ; Female ; Gestational Trophoblastic Disease/drug therapy* ; Humans ; Methotrexate/therapeutic use* ; Pregnancy ; Retrospective Studies

Objective:To investigate the effect and mechanism of G protein-coupled receptor, class C, group 5, member A (GPRC5A) on the proliferation and apoptosis of laryngeal cancer cells (LCC).Methods:From June 2015 to December 2018, 22 patients with laryngeal cancer were selected from the People's Hospital of Xinjiang Uygur Autonomous Region. Tumor tissue samples and paracancerous tissue were collected. The expression of GPRC5A in laryngeal cancer tissues and laryngeal cancer cells was detected by real-time fluorescent quantitative polymerase chain reaction (qRT-PCR) and Western blot; pcDNA3.1-GPRC5A and control plasmid pcDNA3.1 were transfected into Hep-2 and AMC-HN-8 cells respectively. Methyl thiazolyl tetrazolium (MTT) assay was used to detect the effect of GPRC5A on the proliferation of laryngeal cancer cells; V-FITC/PI assay was used to detect the effect of GPRC5A on the apoptosis of laryngeal cancer cells; DCFH-DA was used to detect the level of reactive oxygen species (ROS) in laryngeal cancer cells; Western blot was used to detect the protein expression of vascular endothelial growth factor (VEGF), E-cadherin and vimentin in laryngeal cancer cells.Results:(1) The expression of GPRC5A in laryngeal carcinoma tissues and laryngeal carcinoma cells was lower than that in adjacent tissues and normal laryngeal epithelial cells ( P<0.05). (2) Overexpression of GPRC5A could inhibit the proliferation of laryngeal cancer cells and the expression of VEGF, E-cadherin and vimentin ( P<0.05); overexpression of GPRC5A could significantly increase the level of ROS, decrease the level of NAD + and adenosine triphosphate (ATP) ( P<0.05), increase the apoptosis rate ( P<0.05), and significantly increase the protein expression of Caspase-3 and Caspase-9 ( P<0.05). Overexpression of GPRC5A could inhibit the expression of signal transducer and activator of transcription 3/suppressor of cytokine signal transduction 3/myelocytomatosis oncogene (STAT3/SOCS3/C-MYC) pathway related proteins ( P<0.05); the expression of GPRC5A in 22 patients with laryngeal cancer were negatively correlated with STAT3 ( P<0.05). (3) STAT3 and C-MYC inhibitors significantly inhibited the expression of VEGF and E-cadherin in Hep-2 cells ( P<0.05), promoted apoptosis ( P<0.05), decreased the level of interleukin (IL)-6 in Hep-2 cells ( P<0.05), and significantly increased the level of ROS in Hep-2 cells. Conclusions:It suggests that GPRC5A inhibits proliferation and epithelial-mesenchymal transition (EMT), induces oxidative stress and apoptosis of LCC cells potentially by regulating STAT3/SOCS3/C-MYC signaling. These results provide a molecular basis for clinical treatment and diagnosis of laryngeal cancer.

Objective To investigate the genomic characteristics and virulence factors of emetic-type Bacillus cereus strains isolated from food in Hangzhou for better understanding their pathogenic potential. Methods Real-time PCR was performed to detect the ces gene cluster ( cereulide) in 132 Bacillus cereus strains isolated from food from 2015 to 2017. Genomes of cereulide-positive strains were sequenced using Illumina MiSeq sequencing platform. Genome annotation, virulence factor detection, comparative and evolu-tionary analysis were performed after the sequences of genomes were assembled. Results Twelve strains (9. 09％) carried the ces gene. Their genome sizes ranged from 5. 35 to 5. 75 Mb and GC contents from 35. 25 to 35. 43 mol％. All of them harbored the full cereulide biosynthesis gene cluster, nonhemolytic ente-rotoxin ( NHE)-encoding gene cluster ( nheA, nheB and nheC) and hemolysinⅢ( hlyⅢ) . The average nu-cleotide identity ( ANI ) between the 12 isolates and the reference strain NC7401 ( Accession number:AP007209) was over 99. 35％. Phylogenetic analysis demonstrated these strains were clustered into the same branch with local clinical isolates and the emetic-type Bacillus cereus strains of NC7401 and AH187. Con-clusions The genomic sequences of the emetic-type Bacillus cereus strains isolated from food in Hangzhou area were highly similar to that of the reference strain NC7401. Results of the genomic analysis suggested that these isolates carried many virulence factors that were related to pathogenicity.

Objective To analyze the colonization of Candida, Rhodotorula, Penicillium and Aspergillus in skin surfaces of patients with atopic dermatitis, and to assess the relationship between the four common fungal allergens and severity of atopic dermatitis. Methods Fifty patients with atopic dermatitis and 20 healthy controls were enrolled. Scales were scraped from lesional and non?lesional skin of flexural extremities of the patients, as well as from normal skin of the flexural elbow of healthy controls, then were subjected to microscopic examination and culture. Scale specimens were inoculated onto Sabouraud dextrose agar medium and cultured at 25 ℃ in a constant temperature incubator. Subsequently, suspected fungal or yeast?like colonies were collected for pure culture. Finally, fungal strains were identified according to colony morphology, color, growth speed, as well as microscopic features of spores and hyphae. Results No hyphae or pseudohyphae were found in any case by microscopic examination. Candida albicans and Rhodotorula were detected in 29(58%)and 17(34%)out of the 50 patients, respectively, and in 5(25%)and 2 (10%) out of the 20 healthy controls, respectively. The detection rates of Candida albicans and Rhodotorula were significantly higher in the patients than in the controls(χ2=6.23, 4.10, respectively, both P<0.05). Of 25 patients with severe lesions, 19(76%)and 12(48%)were colonized by Candida albicans and Rhodotorula respectively;among 25 patients with moderate lesions, 10 (40%) and 5 (20%) were colonized by Candida albicans and Rhodotorula respectively. An increase was observed in the detection rates of Candida albicans and Rhodotorula in the patients with severe lesions compared with those with moderate lesions(χ2=6.65, 4.37, respectively, both P<0.05). There was no significant difference in the detection rate of Penicillium or Aspergillus between the patients and health controls. Conclusion The colonization rates of Candida albicans and Rhodotorula on skin surfaces were higher in patients with atopic dermatitis than in healthy controls, and higher in patients with severe lesions than in patients with moderate lesions, indicating that the types of colonizing fungi are associated with the health status of skin and severity of symptoms in patients with atopic dermatitis.

Abnormal activation of Wnt signaling pathway is closely related to the occurrence of tumor, and T cell factor 4 (Tcf4 ) and beta-catenin are important signal transmission factors of this pathway. The aim of the present study is to explore the significance and correlation between expression of Tcf4, beta-catenin and secreted frizzled related protein 1(SFRP1), suppressor gene of Wnt signaling pathway, in colorectal carcinoma and their correlations to the clinicopathological factors. The expressions of Tcf4, beta-catenin and SFRP1 were performed with immunohistochemistry staining in 97 cases of primary colorectal carcinoma and 40 cases of normal colorectal mucosa tissues. The results showed that the abnormal expression rates of Tcf4 and beta-catenin in colorectal carcinoma were significantly higher than those in the control groups (P<0.01). The positive rate of SFRP1 was significantly lower than those in the control groups (P<0.01). The abnormal expression rates of Tcf4 and beta-catenin were also related to the lymph node metastasis and Dukes stage (P<0.05). A significant correlation was found between the expressions of SFRP1 and Tcf4, beta-catenin (P<0.05). Overexpression of Tcf4 and beta-catenin was related to poor prognosis (P<0.05). But the survival rates of the group with SFRP1 expressions were higher than those in group without SFRP1 expressions (P<0.05). Cox multifactor regression analysis indicated that Dukes stage, expression of beta-catenin and SFRP1 were independent risk factors of colorectal carcinoma (P<0.05). The results suggested that the abnormal expression of Tcf4 and beta-catenin in colorectal cancer may be related to the reduced or absent expression of SFRP1. beta-catenin accumulation in the nuclei formed complexes with Tcf4 is one of the important molecular switch maintaining colorectal malignant phenotype. The combined detection of these indexes may perform an important role in predicting the progression and prognosis of colorectal cancer, and could provide new molecular targets for gene treatment of colorectal cancer.
Carcinoma ; metabolism ; Colorectal Neoplasms ; metabolism ; Disease Progression ; Humans ; Intercellular Signaling Peptides and Proteins ; metabolism ; Lymphatic Metastasis ; Membrane Proteins ; metabolism ; Phenotype ; Prognosis ; Risk Factors ; Transcription Factor 7-Like 2 Protein ; metabolism ; Wnt Signaling Pathway ; beta Catenin ; metabolism

Objective To explore the expressions and clinical significance of Toll-like receptor (TLR) 3 and TLR4 in peripheral blood mononuclear cells in Henoch-Schsnlein purpura nephritis (HSPN) children.Methods According to their 24-hour urinary albumin and whether children with HSP had renal damage or not,105 cases were divided into group A,B and C.Group A were children only with HSP but without renal damage,while group B were children only with HSPN not proteinuria and group C were children with both HSPN and proteinuria.Thirty healthy children were in healthy control group(group N).Flow cytometry (FCM) and real-time PCR detected the mRNA and protein expressions of TLR3 and TLR4 in peripheral blood mononuclear cells.Results 1.The mRNA and protein expressions of TLR4 in peripheral blood mononuclear cells were significantly higher in group A,B,C than those in group N (F =37.33,24.01,all P ＜ 0.05).The mRNA and protein expressions of TLR4 in group C were much higher than those in group A and B (all P ＜ 0.05).Meanwhile,there was no significant difference between group A and B(all P ＞0.05).2.Moreover,there was a positive relationship between protein expression of TLR4 and 24-hour urinary albumin in group C(r =0.69,P ＜ 0.01).3.Expression of TLR3 was of no significant difference in all groups(F =0.86,1.78,all P ＞ 0.05).4.The expression of TLR4 mRNA had a positive correlation with protein expression of TLR4(r =0.61,P ＜ 0.0 1).Conclusions Expressions of TLR4 in peripheral blood mononuclear cells significantly increased and had a positive correlation with urinary protein excretion from HSPN in children.This implied that aberrant activation of TLR4might be relevant to the development of HSPN.

OBJECTIVE: To compare the bacteriologic features of anterior ethmoidal biopsy specimens between chronic rhinosinusitis without nasal polyps (CRSNP-), chronic rhinosinusitis with nasal polyps(CRSNP+) and control patients. METHOD: The biopsy specimens obtained during the nasal endoscopic surgery were cultured for aerobic and anaerobic bacteria. RESULT: One hundred and nineteen biopsy specimens were processed for homogenization and semiquantitatively bacterial culture of aerobe and anaerobe. Bacterial culture were positive in 104 specimens (total culture-positive rate was 87.4%). The positive rate of aerobe or facultative anaerobe culture were 86.5%, 85.7%, 90.0% in CRSNP- group, CRSNP+ group and control group, respectively. There were no significant differences between 3 groups (P > 0.05). Mixed growth of aerobe and anaerobe bacteria were mainly detected in the biopsy specimens and the positive rate were 78.4%, 81.0% and 85.0% in CRSNP- group, CRSNP+ group and control group. There were no significant differences in 3 groups (P > 0.05). The most common aerobe bacteria found in 3 groups were coagulase-negative staphylococci and corynebacterium species and there were no significant differences between 3 groups (P > 0.05). The positive rate of anaerobic bacteria culture were 78.4%,76.2% and 77.5% in 3 groups. There were no significant differences between the groups (P > 0.05). Propionibacterium and peptostreptococcus species were the most common anaerobes, and there were no significant differences between 3 groups (P > 0.05). CONCLUSION There are no significant differences in the bacteriologic features of ethmoidal biopsy specimens between CRSNP+, CRSNP- and control patients. Therefore, bacterial infection may not play a key role in the pathogenesis of nasal polyps in CRS patients.
Adolescent ; Adult ; Aged ; Biopsy ; Case-Control Studies ; Chronic Disease ; Ethmoid Sinus ; microbiology ; Female ; Humans ; Male ; Middle Aged ; Nasal Polyps ; complications ; microbiology ; Sinusitis ; complications ; microbiology ; Young Adult

Trojan peptides,also named cell-penetrating peptides or protein transduction domains,are a class of small cationic peptides that often contains less than 30 amino acids.They can deliver a wide range of "cargos" such as peptides,proteins and nucleic acids efficiently through the cellular membrane.This review mainly focuses on the recent progress on utilizing Trojan peptides to deliver plasmid DNA and siRNA into cells in vitro and in vivo,and also highlights the implications of this technology in both gene function study and therapeutic potential.