Objective To investigate the effect of cordyceps sinensis(CS)on the activation of fibroblasts through IL-6 trans-signaling pathway and its specific mechanism in the treatment of renal fibrosis.Methods Renal fibrosis mouse model was established by unilateral ischemia/reperfusion(UIR),and the mice were administered intragastrically CS,soluble glycoprotein 130 Fc(sgp130Fc)or Hyper-IL-6.Masson's trichrome staining was utilized to identify tubulointerstitial fibrosis.PAS staining was utilized to assess the extent of renal injury.Western blot was employed to analyze the expression levels of fibrosis markers[alpha-smooth muscle actin(α-SMA),fibronectin(FN)]and proteins associated with IL-6 trans-signaling pathway[phosphorylated signal transducer and activator of transcription 3(p-STAT3),soluble interleukin-6 receptor(sIL-6R)].The expression and localization of proteins were additionally detected by immunohistochemistry,immunofluorescence and qPCR.The effect of cordyceps sinensis extract cordycepin on IL-6 trans-signaling in fibroblasts was further investigated in vitro.Results The results from in vivo experiments showed that administration of CS during the chronic phase demonstrated a beneficial protective impact on inflammation and fibrosis in the affected kidney,and serum creatinine levels and collagen deposition were decreased.Western blot analysis revealed a decrease in the expression levels of α-SMA,FN,as well as IL-6 trans-signaling pathway protein p-STAT3,sIL-6R in the treatment group.Additionally,the mRNA expression levels of chemokines monocyte chemoattractant protein-1(MCP-1)and C-X-C motif chemokine ligand 12(CXCL12)were also decreased in the CS treatment group.Additionally,Hyper-IL-6 can partially counteract the therapeutic effects of CS.In vitro experiments further demonstrated that cordycepin inhibited the secretion of IL-6 from NRK-52E.Combined treatment of recombinant IL-6 and sIL-6R protein activated NRK-49F,leading to a significant increase in α-SMA,FN,and p-STAT3 expression levels.Cordycepin or sgp130Fc treatment significantly inhibited the proliferation of fibroblasts induced by IL-6 trans-signaling pathway.Conclusion CS can significantly reduce IL-6 secretion by renal tubular epithelial cells and inhibit the activation of IL-6 trans-signaling pathway in fibroblasts,thereby ameliorating renal interstitial fibrosis.

OBJECTIVE: To analyze the factors associated with mortality after allogeneic hematopoietic stem cell transplantation (allo-HSCT) in children with severe aplastic anemia (SAA). METHODS: The clinical data of 90 children with SAA who received allo-HSCT in the Department of Hematology, Wuhan Children's Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology from August 2016 to July 2023 were collected. The clinical features and causes of death were analyzed retrospectively. Cox proportional hazards model was used to screen the risk factors of death. RESULTS: Only 9 children died with a median time of 6.3(2.6, 8.3) months among the 90 children with SAA after allo-HSCT. Among the 5 deaths due to infection, 3 were pulmonary infection, including 2 cases of cytomegalovirus pneumonia. One case developed septic shock due to gastrointestinal infection. One case experienced graft failure, which was complicated by bloodstream infection, and developed septic shock. Three cases died of transplantation-associated thrombotic microangiopathy (TA-TMA). One case died of gastrointestinal graft-versus-host disease (GVHD). The results of multivariate analysis showed that post-transplant +60 d PLT≤30×10⁹/L (HR=7.478, 95%CI : 1.177-47.527, P =0.033), aGVHD Ⅲ-Ⅳ (HR=7.991, 95%CI : 1.086-58.810, P =0.041), and TA-TMA occurrence (HR=13.699, 95%CI : 2.146-87.457, P =0.006) were independent risk factors for post-transplant mortality. CONCLUSION Allo-HSCT is an effective therapy for SAA in children. Post-transplant +60 d PLT≤30×10⁹/L, aGVHD Ⅲ-Ⅳ, and TA-TMA occurrence are independently associated with post-transplant mortality, which may be helpful for early detection of potential high-risk children and optimization of clinical diagnostic and treatment strategies.
Humans ; Anemia, Aplastic/therapy* ; Hematopoietic Stem Cell Transplantation/adverse effects* ; Risk Factors ; Retrospective Studies ; Child ; Transplantation, Homologous ; Male ; Female ; Graft vs Host Disease ; Child, Preschool ; Proportional Hazards Models ; Adolescent ; Infant

Objective To investigate the effect of cordyceps sinensis(CS)on the activation of fibroblasts through IL-6 trans-signaling pathway and its specific mechanism in the treatment of renal fibrosis.Methods Renal fibrosis mouse model was established by unilateral ischemia/reperfusion(UIR),and the mice were administered intragastrically CS,soluble glycoprotein 130 Fc(sgp130Fc)or Hyper-IL-6.Masson's trichrome staining was utilized to identify tubulointerstitial fibrosis.PAS staining was utilized to assess the extent of renal injury.Western blot was employed to analyze the expression levels of fibrosis markers[alpha-smooth muscle actin(α-SMA),fibronectin(FN)]and proteins associated with IL-6 trans-signaling pathway[phosphorylated signal transducer and activator of transcription 3(p-STAT3),soluble interleukin-6 receptor(sIL-6R)].The expression and localization of proteins were additionally detected by immunohistochemistry,immunofluorescence and qPCR.The effect of cordyceps sinensis extract cordycepin on IL-6 trans-signaling in fibroblasts was further investigated in vitro.Results The results from in vivo experiments showed that administration of CS during the chronic phase demonstrated a beneficial protective impact on inflammation and fibrosis in the affected kidney,and serum creatinine levels and collagen deposition were decreased.Western blot analysis revealed a decrease in the expression levels of α-SMA,FN,as well as IL-6 trans-signaling pathway protein p-STAT3,sIL-6R in the treatment group.Additionally,the mRNA expression levels of chemokines monocyte chemoattractant protein-1(MCP-1)and C-X-C motif chemokine ligand 12(CXCL12)were also decreased in the CS treatment group.Additionally,Hyper-IL-6 can partially counteract the therapeutic effects of CS.In vitro experiments further demonstrated that cordycepin inhibited the secretion of IL-6 from NRK-52E.Combined treatment of recombinant IL-6 and sIL-6R protein activated NRK-49F,leading to a significant increase in α-SMA,FN,and p-STAT3 expression levels.Cordycepin or sgp130Fc treatment significantly inhibited the proliferation of fibroblasts induced by IL-6 trans-signaling pathway.Conclusion CS can significantly reduce IL-6 secretion by renal tubular epithelial cells and inhibit the activation of IL-6 trans-signaling pathway in fibroblasts,thereby ameliorating renal interstitial fibrosis.

Objective To explore the effects of Yupingfeng powder on pneumoconiosis macrophage cells through tumor necrosis factor-α/NOD like receptor protein 3/cysteinyl aspartate specific proteinase-1/interleukin-1β(TNF-α/NLRP3/Caspase-1/IL-1β)signaling pathways.Methods Using lipopolysaccharides to replicate a cellular inflammatory model.Raw264.7 macrophage cells were divided into normal group(conventional culture),model group(cellular inflammation model,administer lipopolysaccharide treatment),positive group(1 × 10-7 mol·L-1 dexamethasone)and experimental-L,-M,-H groups(0.3,0.6,0.8 g·mL-1 Yupingfeng powder containing serum).Real time fluorescence quantitative polymerase chain reaction was used to detect the expression of mRNA in each group of cells.Results The relative expression levels of TNF-α mRNA in normal group,model group,positive group and experimental-L,-M,-H groups were 1.00±0.05,2.17±0.07,1.17±0.08,1.90±0.08,1.54±0.07 and 1.35±0.05;the relative expression levels of nuclear factor-κB mRNA were 1.00±0.04,2.24±0.06,1.16±0.06,1.98±0.06,1.65±0.11 and 1.35±0.03;the relative expression levels of Caspase-1 mRNA were 1.00±0.04,1.90±0.03,1.13±0.04,1.73±0.08,1.56±0.06 and 1.30±0.06;the relative expression levels of IL-18 mRNA were 1.00±0.04,1.51±0.04,1.12±0.06,1.41±0.05,1.31±0.06 and 1.21±0.04;the relative expression levels of IL-1β mRNA were 1.00±0.04,1.70±0.08,1.12±0.01,1.52±0.07,1.37±0.04 and 1.22±0.06;the relative expression levels of NLRP3 mRNA were 1.00±0.03,1.90±0.05,1.12±0.05,1.70±0.10,1.50±0.04 and 1.23±0.06;the relative expression levels of Gasdermin D(GSDMD)mRNA were 1.00±0.06,1.70±0.08,1.11±0.01,1.53±0.05,1.37±0.07 and 1.22±0.03.The above indicators in the model group showed statistically significant differences compared to the normal group(P＜0.05,P＜0.01);there were statistical differences between the above indicators of experimental-L,-M,-H groups and model group(P＜0.05,P＜0.01).Conclusion Yupingfeng powder can inhibit the activation of the TNF-α/NLRP3/Caspase-1/IL-1β signaling pathway and alleviate alveolar inflammation.

Objective To investigate the incidence rate,clinical characteristics,and prognosis of neonatal stroke in Shenzhen,China.Methods Led by Shenzhen Children's Hospital,the Shenzhen Neonatal Data Collaboration Network organized 21 institutions to collect 36 cases of neonatal stroke from January 2020 to December 2022.The incidence,clinical characteristics,treatment,and prognosis of neonatal stroke in Shenzhen were analyzed.Results The incidence rate of neonatal stroke in 21 hospitals from 2020 to 2022 was 1/15 137,1/6 060,and 1/7 704,respectively.Ischemic stroke accounted for 75％(27/36);boys accounted for 64％(23/36).Among the 36 neonates,31(86％)had disease onset within 3 days after birth,and 19(53％)had convulsion as the initial presentation.Cerebral MRI showed that 22 neonates(61％)had left cerebral infarction and 13(36％)had basal ganglia infarction.Magnetic resonance angiography was performed for 12 neonates,among whom 9(75％)had involvement of the middle cerebral artery.Electroencephalography was performed for 29 neonates,with sharp waves in 21 neonates(72％)and seizures in 10 neonates(34％).Symptomatic/supportive treatment varied across different hospitals.Neonatal Behavioral Neurological Assessment was performed for 12 neonates(33％,12/36),with a mean score of(32±4)points.The prognosis of 27 neonates was followed up to around 12 months of age,with 44％(12/27)of the neonates having a good prognosis.Conclusions Ischemic stroke is the main type of neonatal stroke,often with convulsions as the initial presentation,involvement of the middle cerebral artery,sharp waves on electroencephalography,and a relatively low neurodevelopment score.Symptomatic/supportive treatment is the main treatment method,and some neonates tend to have a poor prognosis.

Objective:To analyze the research hotspots and trends of the consolidated framework for implementation research (CFIR) in nursing through bibliometrics, so as to provide reference for implementation research in nursing in China.Methods:The article on the application of CFIR in nursing was searched in the Web of Science core collection, with a search period from database establishment to August 8, 2023. CiteSpace 6.2.R4 software was used for analysis.Results:A total of 165 articles were included. The overall number of articles on the application of CFIR in nursing was on the rise. The top five countries with the highest number of publications were the United States, Canada, Australia, the United Kingdom, and the Netherlands. The top five institutions in terms of publication volume were the United States Department of Veterans Affairs, the Veterans Health Administration, the University of North Carolina, the University of Pennsylvania, and the Feinberg School of Medicine. Research hotspots included implementation science, implementation research, qualitative research, acceptability, barriers, systematic review, health disparities, symptom management, quality improvement, primary health care, and so on.Conclusions:The research on CFIR in the domestic nursing field is still in its early stages. We should draw on the experience of foreign study, verify the applicability of the Chinese version of CFIR and the connotation of its various elements, and promote the development of high-quality nursing implementation research.

Objective To explore the effects of Yupingfeng powder on pneumoconiosis macrophage cells through tumor necrosis factor-α/NOD like receptor protein 3/cysteinyl aspartate specific proteinase-1/interleukin-1β(TNF-α/NLRP3/Caspase-1/IL-1β)signaling pathways.Methods Using lipopolysaccharides to replicate a cellular inflammatory model.Raw264.7 macrophage cells were divided into normal group(conventional culture),model group(cellular inflammation model,administer lipopolysaccharide treatment),positive group(1 × 10-7 mol·L-1 dexamethasone)and experimental-L,-M,-H groups(0.3,0.6,0.8 g·mL-1 Yupingfeng powder containing serum).Real time fluorescence quantitative polymerase chain reaction was used to detect the expression of mRNA in each group of cells.Results The relative expression levels of TNF-α mRNA in normal group,model group,positive group and experimental-L,-M,-H groups were 1.00±0.05,2.17±0.07,1.17±0.08,1.90±0.08,1.54±0.07 and 1.35±0.05;the relative expression levels of nuclear factor-κB mRNA were 1.00±0.04,2.24±0.06,1.16±0.06,1.98±0.06,1.65±0.11 and 1.35±0.03;the relative expression levels of Caspase-1 mRNA were 1.00±0.04,1.90±0.03,1.13±0.04,1.73±0.08,1.56±0.06 and 1.30±0.06;the relative expression levels of IL-18 mRNA were 1.00±0.04,1.51±0.04,1.12±0.06,1.41±0.05,1.31±0.06 and 1.21±0.04;the relative expression levels of IL-1β mRNA were 1.00±0.04,1.70±0.08,1.12±0.01,1.52±0.07,1.37±0.04 and 1.22±0.06;the relative expression levels of NLRP3 mRNA were 1.00±0.03,1.90±0.05,1.12±0.05,1.70±0.10,1.50±0.04 and 1.23±0.06;the relative expression levels of Gasdermin D(GSDMD)mRNA were 1.00±0.06,1.70±0.08,1.11±0.01,1.53±0.05,1.37±0.07 and 1.22±0.03.The above indicators in the model group showed statistically significant differences compared to the normal group(P＜0.05,P＜0.01);there were statistical differences between the above indicators of experimental-L,-M,-H groups and model group(P＜0.05,P＜0.01).Conclusion Yupingfeng powder can inhibit the activation of the TNF-α/NLRP3/Caspase-1/IL-1β signaling pathway and alleviate alveolar inflammation.

Patients with congenital unilateral absence of the vas deferens (CUAVD) manifest diverse symptoms from normospermia to azoospermia. Treatment for CUAVD patients with obstructive azoospermia (OA) is complicated, and there is a lack of relevant reports. In this study, we describe the clinical features and evaluate the treatments and outcomes of CUAVD patients with OA. From December 2015 to December 2020, 33 patients were diagnosed as CUAVD with OA in Shanghai General Hospital (Shanghai, China). Patient information, ultrasound findings, semen analysis, hormone profiles, and treatment information were collected, and the clinical outcomes were evaluated. Of 33 patients, 29 patients were retrospectively analyzed. Vasoepididymostomy (VE) or cross VE was performed in 12 patients, the patency rate was 41.7% (5/12), and natural pregnancy was achieved in one of the patients. The other 17 patients underwent testicular sperm extraction as the distal vas deferens (contralateral side) was obstructed. These findings showed that VE or cross VE remains an alternative treatment for CUAVD patients with OA, even with a relatively low rate of patency and natural pregnancy.
Pregnancy ; Female ; Humans ; Male ; Vas Deferens/abnormalities* ; Azoospermia/surgery* ; Epididymis/surgery* ; Retrospective Studies ; Tertiary Care Centers ; China ; Semen

Humans ; Consensus ; Hypersensitivity ; Desensitization, Immunologic/adverse effects* ; Immunotherapy/adverse effects* ; Injections, Subcutaneous ; Allergens