Objectiveto investigate the differential expression of intestinal flora and serum metabolites and potential biomarkers in patients with pre-diabetic sputum syndrome. MethodA total of 34 patients with pre-diabetic sputum syndrome were included as the phlegm syndrome group，and 37 healthy people were selected as the normal group. Serum and fecal samples of the two groups were collected，and liquid chromatography-mass spectrometry （LC-MS） non-targeted metabolomics and 16S rRNA high-throughput sequencing technology were used to detect serum metabolites and different intestinal flora of the two groups and explore the relationship among pre-diabetic sputum syndrome，serum metabolites，and intestinal flora. ResultIn the distribution of disease syndrome elements in the phlegm syndrome group，the first five disease syndrome elements in terms of frequency and proportion were dampness （73.53%），Qi stagnation （58.82%），Yin deficiency （50.00%），blood stasis （41.18%），and heat （35.29%）. According to the frequency and proportion of disease location syndrome elements，the first three main disease location syndrome elements were spleen （100.00%），liver （41.18%），and kidney （23.53%）. The results of 16S rRNA high-throughput sequencing showed that there were 44 different intestinal flora between the two groups. In order genus，there were significant differences in Bifidobacterium，Veillonococcus，and Roseococcus between the two groups （P<0.05）. The diversity，abundance，and evenness of intestinal flora in the phlegm syndrome group were lower than those in the normal group，with the difference not statistically significant. There was no significant difference in the community structure between two groups. The results of serum metabolomics showed that there were 13 differential metabolites in the two groups，which were mainly concentrated in amino acid metabolism，bile secretion，bile acid biosynthesis，and lipid metabolism （P<0.05）. The correlation among differential metabolites，intestinal flora，and syndrome elements was analyzed，and the results showed that ① lysine was positively correlated with spleen，Yin deficiency，and blood stasis，while taurocholic acid was positively correlated with liver，kidney，blood stasis，and dampness，and there was a positive correlation between taurocholic acid and yin deficiency and heat. The taurochenodeoxycholic acid was positively correlated with liver and dampness，and there was a negative correlation between arachidonic acid and dampness，as well as a positive correlation between glucose and spleen and blood stasis. ② Clostridium was positively correlated with spleen，kidney，Yin deficiency，and Qi stagnation. Rosepiella was negatively correlated with spleen，and Sutterella was negatively correlated with dampness. Bacteroides was negatively correlated with the spleen and kidney，and Bifidobacterium was negatively correlated with the spleen and dampness. ③ Bifidobacterium was positively correlated with glycine，threonine，lysine，and deoxycholic acid significantly，negatively correlated with cholic acid significantly，and positively correlated with taurochenodeoxycholic acid and pyruvic acid. Clostridium was positively correlated with glycine significantly and positively correlated with threonine and lysine. Lachnospira was negatively correlated with glycine，threonine，and pyruvic acid. Lysine was also negatively correlated with Faecalibacterium and Eubacterium ventriosum and positively correlated with Megamonas. There was a positive correlation between taurocholic acid and glycine bile acid and Campylobacter，between taurochenodeoxycholic acid and Veillonococcus，and between glucose and Rosepiella and Eubacterium ventriosum. There was a negative correlation between pyruvic acid and Escheria-Shigella and between taurochenodeoxycholic acid and Prevotella. Conclusionthere are differences in intestinal flora and serum metabolites between patients with pre-diabetic sputum syndrome and healthy people. The intestinal flora and metabolites have been disturbed in the stage of pre-diabetes，Bifidobacterium，Clostridium，Lachnospira，glycine，threonine，and lysine may be the breakthrough to explore the development of pre-diabetic sputum syndrome.

Objective To perform a bibliometric analysis of researches on the Plasmodium falciparum repetitive interspersed families of polypeptides (RIFIN) protein from 1993 to 2022 and identify the hot topics in the RIFIN protein research, so as to provide insights into future researches on RIFIN protein. Methods RIFIN protein-associated publications were retrieved in the Web of Science Core Collection from 1993 to 2022 and all bibliometric analyses were performed using the software CiteSpace 6.2.4.0. The annual number of RIFIN protein-associated publications was analyzed from 1993 to 2022, and country, author and institution collaboration networks were created. Keywords were extracted from RIFIN protein-associated publications for plotting keyword co-occurrence, clustering, burst and timeline maps to identify the hot topics in the RIFIN protein research. Results A total of 745 English RIFIN protein-associated publications were included in the final bibliometric analysis, and there were 18 to 36 publications each year from 1993 to 2022. The top three countries with the highest activity in the RIFIN protein research included the United States, the United Kingdom and France, universities and research institutes were highly active in the RIFIN protein research; however, no authors were identified with a high activity in the RIFIN protein research. There were three keyword clusters in the RIFIN protein-associated publications, including repetitive DNA sequence, molecular epidemiology and antigenic variation. Keyword co-occurrence, burst and timeline analyses showed that previous RIFIN protein-associated publications mainly focused on gene properties and functions, involving keywords of repetitive DNA sequence and evolution, and recent hot topics for the RIFIN protein research shifted to genetic diversity and immune response, involving keywords of genetic diversity, antigenic variation and binding. Conclusions The annual number of RIFIN protein-associated publications was relatively stable from 1993 to 2022. This bibliometric analysis may provide insights into future researches on the RIFIN protein.

Objective To investigate the antimicrobial susceptibility of clinical isolates of Corynebacterium striatum and the clinical characteristics of the patients infected or colonized with these strains.Methods The C.striatum strains isolated from clinical specimens were collected in Quanzhou First Hospital Affiliated to Fujian Medical University from July 2020 to September 2022.The clinical data were analyzed to examine the clinical characteristics of patients with C.striatum colonization or infection.The susceptibility of these strains to 18 antimicrobial agents were tested by broth microdilution method.The gyrA gene related to quinolone resistance determining region was amplified and sequenced to analyze the position of amino acid mutations.The ribosomal methylase gene ermX and aminoglycoside enzyme gene aphA1 were amplified by PCR and sequenced.Results Antimicrobial susceptibility testing indicated that all of the 72 strains were susceptible to vancomycin,linezolid and daptomycin.All stains were resistant to ceftriaxone,ciprofloxacin and moxifloxacin.The C.striatum strains showed high resistance rate to penicillin(87.5％),cefepime(95.8％),meropenem(95.8％),trimethoprim-sulfamethoxazole(90.3％),erythromycin(98.6％)and clindamycin(98.6％),but relatively lower resistance rate to gentamycin(25.0％),tetracycline(30.6％)and rifampicin(23.6％).Sequencing analysis indicated that 3 strains of C.striatum had single mutation of gyrA gene(Ser87Val),67 strains had double mutations(Ser87Phe,Asp91Ala or Ser87Tyr,Asp91Ala)and 2 strains had three point mutations(Ser87Phe,Ala88Pro and Asp91 Ala),which was newly identified in this study.The ermXgene was detected in all of the isolates and the prevalence of aphA1 gene was 43.1％.The 72 strains of C.striatum were mainly isolated from ICU(65.2％)and lower respiratory tract specimen(91.6％).The average age of patients was 68.0±15.3 years old.About 72.2％(52/72)of the C.striatum strains were isolated from the patients with infection and 27.8％(20/72)were colonizers.Compared to the patients colonized with C.striatum,the patients with C.striatum infection had statistically significant higher percentages of hospital stay ≥ 28 days,cerebral hemorrhage,disturbance of consciousness and disease deterioration(P＜0.05).Conclusions All of the 72 C.striatum isolates were multidrug resistant,and the outcome of patients with C.striatum infection was relatively poor.

Background Hand-arm vibration disease is harmful to human body, but there are no effective diagnosis and treatment so far, and current occupational exposure limits underestimate the health damage caused by high-frequency vibration exposure. Objective To evaluate and compare the damage to workers' peripheral circulation and peripheral nerve caused by different frequencies of vibration operation. Methods Drilling workers (n=187) from a mining company in Shandong Province and golf club head grinding workers (n=228) from a sports equipment factory in Guangdong Province were selected as study subjects. Hand symptoms were investigated. SV106 vibration meter was used to measure the target operation-associated vibration frequency spectrum. The 8 h energy-equivalent frequency weighted acceleration, cumulative vibration exposure level (CVEL), and the working age related to causing white finger in 10% of an exposed group were calculated. Result The study subjects were all male. More grinding workers reported hand symptoms than the drilling workers, e.g. peripheral circulation injury (52.6% vs 19.3%), peripheral nerve injury (71.5% vs 23.0%), hand stiffness (64.0% vs 7.0%), and deformed fingers (69.7% vs 4.3%) (all P<0.001). The main vibration frequencies of grinding operation (500-800 Hz) were much higher than those of drilling operation (125~160 Hz). CVEL and working age of vibration exposure showed a linear rising relationship with the cumulative prevalence rate of peripheral circulation and peripheral never injury, the fitting lines all showed good fitting effects (R²=0.812-0.988), and the slope of the fitting line of the grinding workers was larger than that of the drilling workers. The working age of vibration exposure associated with 10% cumulative prevalence of white finger was shorter in the grinding workers than in the drilling workers (6.81 years vs 10.27 years). According to the ISO prediction formula, the working age of vibration exposure was associated with 10% white finger prevalence shorter in the drilling workers than in the grinding workers (3.12 years vs 8.23 years). Conclusion Both the vibration exposure level and the prevalence of hand symptoms are high in two groups of workers with different vibration frequencies, and vibration exposure at a higher frequency tends to have severer damage to workers' hands.

Background Long-term exposure to hand-transmitted vibration can lead to hand-arm vibration syndrome, one manifestation of which is impaired peripheral blood circulation in the arms. Altered expressions of prostacyclin I₂ (PGI₂) and thromboxane A₂ (TXA₂) in blood may be one of the important mechanisms of vibration-induced hand-arm vibration syndrome. Objective To reveal the effects of rat tail vibration on the expressions of PGI₂ and TXA₂ in plasma, and to establish the correlation between the change of rat plasma PGI₂ to TXA₂ ratio and rat tail vibration. Methods Fifty SPF-grade male SD rats were randomly divided into five groups: control group, 1 d exposure group, 3 d exposure group, 7 d exposure group, and 14 d exposure group, with 10 rats in each group. The rats were placed in rat immobilizes on a immobilization table, and the rats' tails were connected to a shaker and fixed with medical tape. There was no overlap between the immobilizes and between the rats' tails by no contact between the immobilization table and the shaker. The exposure dose was 125 Hz, 5.9 m·s⁻², 4 h·d⁻¹, and the vibration direction was linear vertical vibration. Abdominal aortic blood was taken at the end of vibration exposure, and the expressions of PGI₂, TXA₂, and their hydrolysates 6-keto-prostaglandin F_1α (6-keto-PGF_1α) and thromboxane B₂ (TXB₂) were measured by enzyme-linked immunosorbent assay, and the 6-keto-PGF_1α/TXB₂ values were calculated. Spearman rank correlation was used to analyze whether the expression of vascular factors correlated with the accumulated time of vibration. Results The expression levels of plasma 6-keto-PGF_1α were (896.12±124.37), (1068.13±119.41), (1215.26±122.64), and (1317.94±106.54) ng·L⁻¹ in the 1 d, 3 d, 7 d, and 14 d groups of rats, respectively, which were higher than that in the control group, (830.60±109.47) ng·L⁻¹ (P<0.001). The PGI₂ expression levels were (86.49±2.40), (107.90±2.65), (114.02±2.16), and (126.95±1.94) ng·L⁻¹ in the 1 d, 3 d, 7 d, and 14 d groups of rats, respectively, all higher than (60.09±2.11) ng·L⁻¹ in the control group (P＜0.001). The expression levels of TXB₂ were (132.14±4.10), (145.52±4.09), (179.91±4.98), and (204.10±3.22) ng·L⁻¹ in the 1 d, 3 d, 7 d, and 14 d groups of rats, respectively, which were higher than that in the control group, (106.08±3.26) ng·L⁻¹ (P<0.001). The expression levels of plasma TXA₂ were (211.99±3.24), (236.33±3.88), and (245.45±4.23) ng·L⁻¹ in rats in the 3 d, 7 d, and 14 d groups, respectively, which were all elevated compared with (174.79±4.19) ng·L⁻¹ in the control group (P<0.001). Compared with the control group, the 6-keto-PGF_1α/TXB₂ values were decreased in the 7 d and 14 d groups (P<0.05). The 6-keto-PGF_1α, PGI₂, TXB₂, and TXA₂ expressions were positively correlated with vibration accumulation time (r=0.84, 0.84, 0.80, 0.84, P<0.001) and the 6-keto-PGF_1α/TXB₂ values were negatively correlated with vibration accumulation time (r=-0.24, P=0.003). Conclusion Local exposure of rat tail to vibration could increase the expressions of PGI₂ and TXA₂ in blood, and the elevated expressions show a dose-effect relationship with the duration of vibration exposure, but the PGI₂/TXA₂ tends to decrease with the accumulation of vibration exposure.

Background The metabolites and metabolic pathways of hand-arm vibration syndrome have not yet been elucidated. Objective To investigate the effect of local vibration on endogenous metabolites in rat serum by metabolomic analysis, to preliminarily explore the potential metabolic pathway of endogenous metabolites, so as to provide evidence for further research on the mechanism of hand-arm vibration syndrome. Methods Thirty-two SPF male SD rats, (211.3±11.1) g, 7−8 weeks of age, were selected and randomly divided into three groups: control group (14 rats, without vibration), 7 d vibration group (9 rats, continuously vibration for 7 d), and 14 d vibration group (9 rats, continuous vibration for 14 d). The vibration rats were vibrated every day for 4 h, the frequency weighted acceleration was 4.9 m·s⁻², the vibration frequency was 125 Hz, and the vibration direction was one-way vertical vibration. The control group had the same conditions except not contacting vibration. After the vibration exposure, the blood samples taken from the abnormal aorta of rats were collected, and the changes of rat serum metabolome were analyzed by ultra-performance liquid chromatography-tandem time-of-flight mass spectrometry. Principal components analysis (PCA) was used to explore changes in rat serum metabolic profile, and orthogonal partial least squares-discriminant analysis (OPLS-DA) was used to screen out differential metabolites. Combined with online databases, a metabolic pathway enrichment analysis of differential metabolites was performed. Results The PCA analysis showed that compared with the control group, the rat serum metabolic profiles in the 7 d group and the 14 d group were clearly differentiated, and the rat serum metabolic profiles in the 7 d group and the 14 d group partially overlapped. The OPLS-DA analysis showed significant differences between groups. The main parameters were: model interpretation rate R²Y=0.914, model predictive ability Q²=0.58. The OPLS-DA analysis screened out 26 and 119 differential metabolites from the 7 d group and the 14 d group respectively, and there were 24 common differential metabolites between the 7 d group and the 14 d group. The metabolomic pathway analysis showed that local vibration-induced changes in rat serum metabolism were mainly related to arachidonic acid metabolism in the 14 d group, among which the metabolites with significant effects were arachidonic acid, prostaglandin E₂, and prostaglandin D₂. Conclusion Local vibration could affect the normal metabolism in rats, and the metabolic pathway with significant influence is arachidonic acid metabolism after a 14 d exposure and the involved metabolites are arachidonic acid, prostaglandin E₂, and prostaglandin D₂.

[Abstract] Objective: To investigate the effects of interleukin-18 over-expression on the in vitro and in vivo proliferation of human colorectal cancer (CRC) HCT-116 cells. Methods: A recombinant lentivirus vector containing human IL-18 gene fragment was constructed. Then theCRC HCT-116 cell line stably expressing human IL-18 (HCT-116/IL-18) was obtained by recombinant lentivirus transfection. In vitro proliferation of HCT-116/IL-18 cells and wild-type HCT-116 cells was determined by CCK-8 method. The expressions of IL-18, Cyclin D1, proliferating cell nuclear antigen (PCNA) and DNA damage repair enzyme (PARP) were detected by Western blotting. HCT-116 and HCT-116/IL-18 cells were inoculated into left and right axillas of Balb/c nude mice, respectively. Then the tumorigenicity and the growth of transplanted tumor were observed. The expressions of IL-18 and PCNAin xenograft tissues were detected by immunohistochemistry analysis. Results: IL-18 gene over-expression in HCT-116 cells could delay the proliferation of HCT-116 cells (P<0.05 or P<0.01). PARP expression was increased significantly and PCNA, Cyclin D1 expression were decreased in HCT-116/ IL-18 cells as compared to that of HCT-116 cells (P<0.01).The tumorigenicity of HCT-116/IL-18 cell was significantly decreased in nude mice with a tumor-formation rate of 43%; Compared with control group, HCT-116/IL-18cell line had a longer tumorigensis time, slower growth and smaller tumor volume; moreover, PCNAprotein expression was down-regulated in HCT-116/IL-18 xenograft tissuesas shown by immunohistochemistry analysis (P<0.01). Conclusion: IL-18 over-expression inhibited the growth and proliferation of HCT-116 cells both in vitro and in vivo, and the mechanism might berelated with IL-18 regulating cell cycle and promoting DNA damage.

Objective:To explore the optimal time point for combining chemotherapy and immunotherapy and provide an experimen-tal basis for immunotherapy intervention in clinical. Methods:Twenty-three lung cancer patients who completed five chemotherapy cycles between November 2015 and December 2016 in the First Affiliated Hospital of Xinxiang Medical University were enrolled in this study. Numbers of T lymphocyte subsets, B lymphocytes, and NK lymphocytes in peripheral blood were counted. Expression levels of T lymphocyte co-suppression molecule and cytokines in the peripheral blood mononuclear cell were detected using flow cytometry to analyze the dynamic changes of such indicators from one cycle to five cycles of chemotherapy. Results:Significant decreases in the lev-els of CD8+T lymphocytes, CD19+B lymphocytes, and CD16+CD56+NK cells and an increase in CD4+T lymphocytes were observed in the course of multi-cycle chemotherapy for patients with lung cancer. Differences were statistically significant (P<0.05). The co-suppres-sion molecular expression of PD-1, CTLA-4, and CCR-4 with T lymphocytes was downregulated, and the differences were significant (P<0.05). Conclusion:Profiling the dynamic changes of lymphocyte subsets and the expression of T lymphocyte co-suppression molecule are significant in multiple chemotherapy cycles for patients with lung cancer. In the later stage, the combined application of PD-1, PD-L1, CTLA-4, or CCR-4 antibody may exert good therapeutic effects for patients with a high expression level of related immune check-points.

Objective To investigate the antitumor effects of IL-18 gene transfected T cells on pancreatic cancer cell SW-1990.Methods Construction of IL-18 contained recombinant lentivirus using PCR method and packaged at HEK293T cell, then transfected the human T cells and evaluated the antitumor effects when cocultured with SW-1990.Results The IL-18 gene contained recombinant lentivirus was successfully constructed and packaged, and transfected the T cells, the LDH secretion and IL-2 and IFN-γ content all increased significantly (P<0.01) when cocultured with SW-1990 cell.Conclusions T cells transfected with IL-18 possessed more potent antitumor effects to pancreatic cancer cell SW-1990 as compared to the regular T cells.

Objective:To observe and compare the therapeutic effect of metoprolol by routine increasing dose method and rapid titration method on acute myocardial infarction (AMI).Methods:A total of 60 inpatients,who were di-agnosed with AMI within 24h and without contraindications for metoprolol,were randomly divided into two groups:routine therapy group (received metoprolol using routine methods,the dose was added in seven days)and rapid ti-tration group (metoprolol was added in three days using titration).The dosage maintained with 190 mg/d after both groups reaching the target dose of 190mg/d;then therapeutic effects were observed in both groups.Results: ①There were no re-myocardial infarction,rehospitalization caused by heart failure and sudden death etc.in both groups;② Patients received echocardiography in outpatients after three months.Compared with routine increasing dose group,there was significant reduction in left ventricular end-diastolic diameter [LVEDd,(55.00±7.56)mm vs.(50.00± 5.81)mm]and significant rise in left ventricular ejection fraction [LVEF,(49.13 ± 10.18)% vs. (57.84±10.34)%]in rapid titration group,P <0.01 both.Conclusion:Rapid titration method could make the pa-tients rapidly reach the targeted dose of metoprolol and inhibit renin release earlier,block the renin-angiotensin sys-tem,and improve myocardial remodeling and cardiac function.