Objective To analyze the levels and functions of CD4+T cell subsets in mouse spleen and lung tissues after Streptococcus pneumoniae(S.P.)infection,and to explore the immune regulatory mechanisms S.P.infection.Methods Flow cytometry was used to detect the proportions of CD4+T cell subsets(Th1,Th2,Th17,and Treg cells)in mouse spleen tissues from control group(n=4),S.P.infection at 12 h(n=4),and 24 h(n=4).H&E staining was used to examine lung tissue pathological characteristics.Differential gene sets and functional changes in lung tissues were analyzed after S.P.infection for 2 and 5 days,and immune cell abundance was predicted.Results Significant inflammatory pathological features were observed in the lung tissues of mice after S.P.infection.The proportions of Th1 and Treg cells in the spleen tissues gradually increased after S.P.infection,with Th1 and Treg cell proportions significantly higher than the control group at 24 h post-infection(P<0.05).At 5 d post-infection,only Treg cell proportion was significantly higher than the control group(P<0.05).Functional analysis revealed abnormal activation of IL6,IL10,and IL4/IL13 signaling pathways 2 days after infection,and abnormal enrichment of IL-2 and IL-6/TGF-β pathways 5 days after infection.Conclusion Treg and Th1 cells are key immune regulatory cells in mice following S.P.infection.Modulating Treg cell function mediated by IL-10 and Th1 cell function mediated by IL-2 can improve immune responses after S.P.infection.

The liver,as the core metabolic organ of the human body,undertakes multiple critical physiological functions such as protein synthesis,xenobiotic metabolism,and immune regulation.Liver failure represents a major disease process in patients with end-stage liver disease,characterized clinically by coagulopathy,abnormal bilirubin metabolism,and multiple organ dysfunction.Depending on the disease course,liver failure can be classified into four types:acute,subacute,acute-on-chronic,and chronic.The pathogenic mechanisms are complex,involving interactions among various factors such as pathogen infections,dysregulation of the immune microenvironment,and gut microbiota disturbances,which pose significant challenges for clinical diagnosis and treatment.This review summarizes the abnormalities in innate and adaptive immune responses,as well as the molecular mechanisms of immune metabolic dysregulation during the occurrence and progression of liver failure.It further explores the pivotal role of immune cell dysfunction in the disease process,aiming to provide a theoretical basis for targeted immune therapies in liver failure.

Objective:To investigate the distribution of HIV-1 genotypes and drug resistance characteristics among newly reported HIV-infected men who have sex with men in Yunnan Province, and to analyze the correlation between HIV-1 genotypes and concurrence with other sexually transmitted diseases (STDs) .Methods:A single-center cross-sectional study was conducted. A total of 79 newly reported HIV-infected men who have sex with men were collected from the Yunnan Provincial Hospital of Infectious Diseases from September 2020 to May 2021. Meanwhile, their blood and initial-stream urine samples were collected. Antibodies against Treponema pallidum or herpes simplex virus type 2 were detected in blood samples, while nucleic acid amplification tests were performed for the detection of Neisseria gonorrhoeae, Chlamydia trachomatis, and Mycoplasma genitalium in urine samples. Viral RNA was extracted from plasma samples, and the gag, env, and pol gene fragments were amplified by nested reverse transcription polymerase chain reaction for genotyping and drug resistance analysis. Differences between groups were analyzed using the chi-square test, and correlations between HIV-1 genotypes and concurrence with STDs were analyzed using logistic regression. Results:Totally, 72 samples were successfully genotyped, and 5 genotypes were identified, including CRF07_BC (43.06%, 31/72), CRF01_AE (33.33%, 24/72), URF (18.06%, 13/72), CRF55_01B (2.78%, 2/72), and CRF68_01B (2.78%, 2/72). The 13 cases of URF were classified into 3 recombination patterns, including 11 cases of CRF01_AE/CRF07_BC, 1 case of CRF08_BC/CRF07_BC, and 1 case of B/CRF07_BC. Drug resistance analysis was conducted for 36 cases according to the pol sequences, and the HIV drug resistance rate was 5.56% (2/36). The rate of concurrence with other STDs was 40.28% (29/72), and HIV infection mostly coexisted with syphilis (20.83%, 15/72), followed by herpes simplex virus type 2 infection (16.67%, 15/72), Mycoplasma genitalium infection (11.11%, 8/72), gonorrhea (5.56%, 4/72) and Chlamydia trachomatis infection (2.78%, 2/72). The rate of concurrence with two or more STDs was 12.50% (9/72). Logistic regression analysis showed that there was no significant correlation between HIV-1 genotypes and concurrence with different STDs (all P < 0.05) . Conclusions:The HIV-1 genotypes among men who have sex with men in Yunnan Province were complex, the drug resistance in HIV strains had reached a moderately epidemic level, and HIV-infected patients were often accompanied by other STDs. Thus, it is necessary to pay close attention to the change of HIV-1 genotypes and simultaneous screening and treatment of STDs in HIV-infected patients.

Objective:To investigate the distribution of HIV-1 genotypes and drug resistance characteristics among newly reported HIV-infected men who have sex with men in Yunnan Province, and to analyze the correlation between HIV-1 genotypes and concurrence with other sexually transmitted diseases (STDs) .Methods:A single-center cross-sectional study was conducted. A total of 79 newly reported HIV-infected men who have sex with men were collected from the Yunnan Provincial Hospital of Infectious Diseases from September 2020 to May 2021. Meanwhile, their blood and initial-stream urine samples were collected. Antibodies against Treponema pallidum or herpes simplex virus type 2 were detected in blood samples, while nucleic acid amplification tests were performed for the detection of Neisseria gonorrhoeae, Chlamydia trachomatis, and Mycoplasma genitalium in urine samples. Viral RNA was extracted from plasma samples, and the gag, env, and pol gene fragments were amplified by nested reverse transcription polymerase chain reaction for genotyping and drug resistance analysis. Differences between groups were analyzed using the chi-square test, and correlations between HIV-1 genotypes and concurrence with STDs were analyzed using logistic regression. Results:Totally, 72 samples were successfully genotyped, and 5 genotypes were identified, including CRF07_BC (43.06%, 31/72), CRF01_AE (33.33%, 24/72), URF (18.06%, 13/72), CRF55_01B (2.78%, 2/72), and CRF68_01B (2.78%, 2/72). The 13 cases of URF were classified into 3 recombination patterns, including 11 cases of CRF01_AE/CRF07_BC, 1 case of CRF08_BC/CRF07_BC, and 1 case of B/CRF07_BC. Drug resistance analysis was conducted for 36 cases according to the pol sequences, and the HIV drug resistance rate was 5.56% (2/36). The rate of concurrence with other STDs was 40.28% (29/72), and HIV infection mostly coexisted with syphilis (20.83%, 15/72), followed by herpes simplex virus type 2 infection (16.67%, 15/72), Mycoplasma genitalium infection (11.11%, 8/72), gonorrhea (5.56%, 4/72) and Chlamydia trachomatis infection (2.78%, 2/72). The rate of concurrence with two or more STDs was 12.50% (9/72). Logistic regression analysis showed that there was no significant correlation between HIV-1 genotypes and concurrence with different STDs (all P < 0.05) . Conclusions:The HIV-1 genotypes among men who have sex with men in Yunnan Province were complex, the drug resistance in HIV strains had reached a moderately epidemic level, and HIV-infected patients were often accompanied by other STDs. Thus, it is necessary to pay close attention to the change of HIV-1 genotypes and simultaneous screening and treatment of STDs in HIV-infected patients.

Objectives:To evaluate the role of pancreas multidisciplinary team(MDT) clinic in the diagnosis of pancreatic diseases,patient compliance with MDT advice,and the impact of MDT on the postoperative survival of patients with pancreatic cancer.Methods:The study included 927 patients(554 males,373 females,aged (58.1±13.3)years (range: 15 to 89 years)) that had visited the pancreas MDT clinic of Zhongshan Hospital from May 2015 to December 2021,and 677 patients(396 males, 281 females, aged (63.6±8.9)years(range: 32 to 95 years)) who underwent radical surgery and with pathologically confirmed pancreatic adenocarcinoma from January 2012 to December 2020,of whom 79 patients had attended the pancreas MDT. The clinical and pathological data were collected and analyzed retrospectively. Diseases were classified in accordance with 2010 WHO classification of tumors of the digestive system and usual clinical practices. The Kaplan-Meier method was used for drawing the survival curve and calculating the survival rate. The univariate analysis was done by Log-rank test and the multivariate analysis was done by COX proportional hazards model. Survival rates were compared using χ 2 test. Results:Among the 927 patients that had visited the MDT clinic,233 patients(25.1%) were referred due to undetermined diagnosis. A direct diagnosis was made in 109 cases (46.8%,109/233) by the MDT clinic, of which 98 were consistent with the final diagnosis,resulting in an accuracy of 89.9%(98/109). The direct diagnosis rate in the recent years(36.6%(41/112),from June 2019 to December 2021) decreased compared to that in the previous years(56.2%(68/121),from May 2015 to May 2019),yet the accuracy in the recent years(90.2%,37/41) was basically the same as before (89.7%,61/68). The rate of compliance of the entire cohort was 71.5%(663/927), with the compliance rate in the recent two and a half years(81.4%,338/415) remarkably higher than that in the previous four years(63.4%,325/512). Patients with pancreatic cancer that attended the MDT exhibited a trend toward longer median postoperative survival than patients that did not attend the MDT,but the difference was not statistically significant(35.2 months vs.30.2 months, P>0.05). The 1-year and 3-year survival rates of patients that attended the MDT were significanly higher than patients that did not attend the MDT(88.6% vs. 78.4%, P<0.05;32.9% vs. 21.9%, P<0.05,respectively),but the 5-year survival rate was not statistically different(7.6% vs. 4.8%, P>0.05). Conclusions:The pancreas MDT clinic is an accurate and convenient way to diagnose intractable pancreatic diseases,and in the recent years the patients′ compliance rate with MDT advice has increased. Pancreatic cancer patients that have attended the MDT have higher 1-year and 3-year postoperative survival rates,but the long-term survival benefits of MDT still needs to be proved by clinical studies on a larger scale.

Objectives:To evaluate the role of pancreas multidisciplinary team(MDT) clinic in the diagnosis of pancreatic diseases,patient compliance with MDT advice,and the impact of MDT on the postoperative survival of patients with pancreatic cancer.Methods:The study included 927 patients(554 males,373 females,aged (58.1±13.3)years (range: 15 to 89 years)) that had visited the pancreas MDT clinic of Zhongshan Hospital from May 2015 to December 2021,and 677 patients(396 males, 281 females, aged (63.6±8.9)years(range: 32 to 95 years)) who underwent radical surgery and with pathologically confirmed pancreatic adenocarcinoma from January 2012 to December 2020,of whom 79 patients had attended the pancreas MDT. The clinical and pathological data were collected and analyzed retrospectively. Diseases were classified in accordance with 2010 WHO classification of tumors of the digestive system and usual clinical practices. The Kaplan-Meier method was used for drawing the survival curve and calculating the survival rate. The univariate analysis was done by Log-rank test and the multivariate analysis was done by COX proportional hazards model. Survival rates were compared using χ 2 test. Results:Among the 927 patients that had visited the MDT clinic,233 patients(25.1%) were referred due to undetermined diagnosis. A direct diagnosis was made in 109 cases (46.8%,109/233) by the MDT clinic, of which 98 were consistent with the final diagnosis,resulting in an accuracy of 89.9%(98/109). The direct diagnosis rate in the recent years(36.6%(41/112),from June 2019 to December 2021) decreased compared to that in the previous years(56.2%(68/121),from May 2015 to May 2019),yet the accuracy in the recent years(90.2%,37/41) was basically the same as before (89.7%,61/68). The rate of compliance of the entire cohort was 71.5%(663/927), with the compliance rate in the recent two and a half years(81.4%,338/415) remarkably higher than that in the previous four years(63.4%,325/512). Patients with pancreatic cancer that attended the MDT exhibited a trend toward longer median postoperative survival than patients that did not attend the MDT,but the difference was not statistically significant(35.2 months vs.30.2 months, P>0.05). The 1-year and 3-year survival rates of patients that attended the MDT were significanly higher than patients that did not attend the MDT(88.6% vs. 78.4%, P<0.05;32.9% vs. 21.9%, P<0.05,respectively),but the 5-year survival rate was not statistically different(7.6% vs. 4.8%, P>0.05). Conclusions:The pancreas MDT clinic is an accurate and convenient way to diagnose intractable pancreatic diseases,and in the recent years the patients′ compliance rate with MDT advice has increased. Pancreatic cancer patients that have attended the MDT have higher 1-year and 3-year postoperative survival rates,but the long-term survival benefits of MDT still needs to be proved by clinical studies on a larger scale.