ObjectiveTo investigate the awareness and clinical practice of guidelines for the prevention and treatment of chronic hepatitis B （2022 edition） among clinicians. MethodsFrom July 19 to December 31， 2024， a self-designed electronic questionnaire was distributed via the WeChat mini program to collect related data from 1 588 clinicians nationwide， including their awareness and practice based on 18 questions regarding testing and referral， diagnosis and treatment， and follow-up. ResultsAmong all respondents， only 350 clinicians correctly understood all the updated key points of antiviral indications and treatment for special populations in the 2022 edition of guidelines for the prevention and treatment of chronic hepatitis B， with an overall awareness rate of 22.0%. Only 20% ‍—‍ ‍40% of the patients with positive HBV DNA and an age of >30 years receive antiviral therapy， while 80% ‍—‍ ‍100% of the patients with positive HBV DNA and a family history of hepatitis B cirrhosis or hepatocellular carcinoma receive antiviral therapy. The median follow-up rates at 1 year， 3 years， and 5 years were 67.5% 57.5% and 47.5%，respectively， showing a trend of gradual reduction， which might be associated with the influencing factors such as insufficient time for follow-up management by clinicians， insufficient awareness of the disease among patients， and poor adherence to follow-up. ConclusionThere is a gap between the awareness and practice of guidelines for the prevention and treatment of chronic hepatitis B （2022 edition） among clinicians. It is recommended to further strengthen training and focus on the whole process of “detection， diagnosis， treatment， and management” for patients with chronic hepatitis B in healthcare institutions， in order to promote the implementation of the guidelines.

The connection between tendons and bones is called the tendon bone connection. With the continuous improvement of national sports awareness, excessive exercises and the related intensity are prone to damage the tendon bone connection. Tendon bone healing is a complex repair and healing process involving multiple factors, and good tendon bone healing is a prerequisite for its physiological function. The complexity of tendon bone structure also poses great challenges to the repair of tendon bone injuries. In recent years, researches have found that stem cells, growth factors, macrophages, and other factors are closely related to the healing process of tendon bone injuries, among which macrophages play an important role in the healing process. The authors reviewed relevant research literature in recent years and summarized the role of macrophages in tendon bone healing, in order to provide new ideas and directions for treatment strategies to promote tendon bone healing.
Humans ; Macrophages/metabolism* ; Wound Healing ; Animals ; Tendons/physiology* ; Bone and Bones/injuries* ; Tendon Injuries

Tooth germ injury can lead to abnormal tooth development and even tooth loss, affecting various aspects of the stomatognathic system including form, function, and appearance. However, the research about tooth germ injury model on cellular and molecule mechanism of tooth germ repair is still very limited. Therefore, it is of great importance for the prevention and treatment of tooth germ injury to study the important mechanism of tooth germ repair by a tooth germ injury model. Here, we constructed a Tg(dlx2b:Dendra2-NTR) transgenic line that labeled tooth germ specifically. Taking advantage of the NTR/Mtz system, the dlx2b⁺ tooth germ cells were depleted by Mtz effectively. The process of tooth germ repair was evaluated by antibody staining, in situ hybridization, EdU staining and alizarin red staining. The severely injured tooth germ was repaired in several days after Mtz treatment was stopped. In the early stage of tooth germ repair, the expression of phosphorylated 4E-BP1 was increased, indicating that mTORC1 is activated. Inhibition of mTORC1 signaling in vitro or knockdown of mTORC1 signaling in vivo could inhibit the repair of injured tooth germ. Normally, mouse incisors were repaired after damage, but inhibition/promotion of mTORC1 signaling inhibited/promoted this repair progress. Overall, we are the first to construct a stable and repeatable repair model of severe tooth germ injury, and our results reveal that mTORC1 signaling plays a crucial role during tooth germ repair, providing a potential target for clinical treatment of tooth germ injury.
Animals ; Mice ; Mechanistic Target of Rapamycin Complex 1/pharmacology* ; Signal Transduction ; Tooth/metabolism* ; Tooth Germ/metabolism* ; Odontogenesis

OBJECTIVE: To investigate the short-term effectiveness of transverse antecubital incision in the treatment of failed closed reduction of Gartland type Ⅲ supracondylar humeral fractures (SHFs) in children. METHODS: Between July 2020 and April 2022, 20 children with Gartland type Ⅲ SHFs who failed in closed reduction were treated with internal and external condylar crossing Kirschner wire fixation through transverse antecubital incision. There were 9 boys and 11 girls with an average age of 3.1 years (range, 1.1-6.0 years). The causes of injuries were fall in 12 cases and fall from height in 8 cases. The time from admission to operation ranged from 7 to 18 hours, with an average of 12.4 hours. The healing of the incision and the occurrence of complications such as nerve injury and cubitus varus were observed after operation; the elbow flexion and extension range of motion after removing the gypsum, after removing the Kirschner wire, and at last follow-up were recorded and compared, as well as the elbow flexion and extension and forearm rotation range of motion at last follow-up between healthy and affected sides; the Baumann angle was measured on the X-ray film, and the fracture healing was observed. At last follow-up, the effectiveness was evaluated according to the Flynn elbow function evaluation criteria. RESULTS: All incisions healed by first intention, and there was no skin necrosis, scar contracture, ulnar nerve injury, and cubitus varus. Postoperative pain occurred in the radial-dorsal thumb in 2 cases. The gypsum was removed and elbow flexion and extension exercises were started at 2-4 weeks (mean, 2.7 weeks) after operation, and the Kirschner wire was removed at 4-5 weeks (mean, 4.3 weeks). All the 20 patients were followed up 6-16 months, with an average of 12.4 months. The fracture healing time was 4-5 weeks, with an average of 4.5 weeks, and there was no complication such as delayed healing and myositis ossificans. The flexion and extension range of motion of the elbow joint gradually improved after operation, and there were significant differences between the time after removing the gypsum, after removing the Kirschner wire, and at last follow-up ( P<0.017). There was no significant difference in the flexion and extension of the elbow joint and the forearm rotation range of motion between the healthy and affected sides at last follow-up ( P>0.05). There was no significant difference in Baumann angle between the time of immediate after operation, after removing the Kirschner wire, and at last follow-up ( P>0.05). According to Flynn elbow function evaluation standard, 16 cases were excellent and 4 cases were good, the excellent and good rate was 100%. CONCLUSION The treatment of Gartland type Ⅲ SHFs in children with failed closed reduction by internal and external condylar crossing Kirschner wire fixation through transverse antecubital incision has the advantages of complete soft tissue hinge behind the fracture for easy reduction and wire fixation, small incision, less complications, fast fracture healing, early functional recovery, reliable reduction and fixation, and can obtain satisfactory results.
Male ; Female ; Humans ; Child ; Child, Preschool ; Calcium Sulfate ; Humerus ; Humeral Fractures/surgery* ; Plastic Surgery Procedures ; Fracture Fixation, Internal/methods* ; Bone Wires ; Fracture Healing ; Treatment Outcome ; Range of Motion, Articular

[摘 要] 目的：通过生物信息学方法探索并实验验证胃癌相关标志物miR-1-3p对胃癌细胞增殖的作用及其分子机制。方法：收集TCGA数据库中胃癌（n=375）及癌旁组织（n=45）的转录组数据，构建胃癌特异性mRNA-miRNA网络，筛选潜在的miRNA类标志物，利用TargetScan预测标志物的下游靶基因且分析它们的功能。选取人正常胃上皮细胞GES-1及胃癌细胞AGS、MKN45、NCI-N87，用qPCR法检测细胞中miR-1-3p和心肌蛋白（MYOCD）的表达，用lipofectamine 2000将miR-1-3p模拟物转染至胃癌细胞中，CCK-8法测定轨染后细胞的增殖能力，WB法测定MYOCD的表达量，双荧光素酶报告基因实验验证miR-1-3p与MYOCD之间的靶向结合关系。结果：通过数据库数据分析得到差异表达的259个miRNA和7 545个mRNA，构建胃癌特异性mRNA-miRNA调节网络，分析网络中脆弱结构后确定miR-1-3p为潜在的胃癌标志物，ROC曲线和Kaplan-Meier分析显示其对胃癌的诊断和预后评估有重要意义。细胞实验显示miR-1-3p在胃癌细胞中呈低表达（P<0.05），过表达miR-1-3p可抑制胃癌细胞AGS和MKN-45的增殖能力（P<0.05或P<0.01），且可抑制MYOCD的表达（P<0.01）。TargetScan数据库预测到MYOCD的3'UTR区域中有两个与miR-1-3p结合的位点，双荧光素酶报告基因实验证实miR-1-3p与MYOCD靶向结合且负调控MYOCD的表达（P<0.01）。结论: miR-1-3p可能是胃癌诊断和预后相关潜在的标志物，且miR-1-3p可能是通过靶向MYOCD来影响胃癌细胞的增殖。

Objective:To investigate the levels and correlation between myeloid-derived suppressor cell (MDSC) and T lymphocyte subsets in peripheral blood of patients with active pulmonary tuberculosis.Methods:A total of 38 patients with active pulmonary tuberculosis in Nanjing Second Hospital from February 2019 to June 2020 were selected as the tuberculosis group, and 23 healthy outpatient physical examination patients were selected as the healthy control group during the same period. The levels of MDSC, clinically related indicators, inflammatory cytokines and lymphocyte subsets were compared between each group, and the correlation between MDSC and lymphocyte subsets was analyzed. Meanwhile, the levels of MDSC and lymphocyte subsets before and after treatment were compared.Results:The MDSC and CRP in tuberculosis group were higher than those in healthy group: (16.41 ± 2.13)% vs. (1.82 ± 0.54)%, (25.42 ± 10.56) mg/L vs. (5.82 ± 1.39) mg/L ( P<0.05). Serum inflammatory cytokines tumor necrosis factor (TNF)-α, interleukin (IL)-6, IL-1β, IL-10 and interferon (IFN)-γ in tuberculosis group were significantly higher than those in healthy control group ( P<0.05). T lymphocyte subsets CD 3+ T cell, CD 4+ T cell, CD 8+ T cell and CD 16/56+ nature killer (NK) cell in tuberculosis group were significantly lower than those in healthy control group ( P<0.05), while the number of CD 19+ B cell was not statistically significant ( P>0.05). Correlation analysis showed that MDSC was negatively correlated with T lymphocyte subsets CD 3+ T cell ( r = -0.73, P<0.001), CD 4+ T cell ( r = -0.68, P<0.001) and CD 8+ T cell ( r = -0.53, P = 0.001), but had no significant correlation with CD 16/56+ NK cell ( r = -0.10, P = 0.561). CD 3+ T cell, CD 4+ T cell, CD 8+ T cell and CD 16/56+ NK cell were significantly different in peripheral blood MDSC before and after treatment ( P<0.05). Conclusions:MDSC, CD 3+ T cell, CD 4+ T cell, CD 8+ T cell and CD 16/56+ NK cell have a guiding role in the diagnosis and evaluation of the curative effect of active pulmonary tuberculosis, with high value in clinical application.

The transcription factor nuclear factor kappa B (NF-B) is activated in hepatocytes in the pathogenesis of hepatic steatosis. However, the action mechanism of NF-B remains to be established in the hepatic steatosis. In this study, the subunit of NF-B was found to promote the hepatic steatosis through regulation of histone deacetylase 1 (HDAC1) in hepatocytes. The activity was supported by the phenotypes of knockout (-KO) mice and knockout (-KO) mice. Hepatic steatosis was reduced in the -KO mice, but not in the -KO mice. The reduction was a result of inhibition of HDAC1 activity in the -KO cells. Knockdown of gene led to suppression of hepatocyte steatosis in HepG2 cells. A decrease in sterol-regulatory element binding protein 1c (SREBP1c) protein was observed in the liver of -KO mice and in cell with knockdown. The decrease was associated with an increase in succinylation of SREBP1c protein. The study suggests that stabilizes HDAC1 to support the SREBP1c activity in hepatic steatosis in the pathophysiological condition. Interruption of this novel pathway in the -KO, but not the -KO mice, may account for the difference in hepatic phenotypes in the two lines of transgenic mice.

[Abstract] Objective: To investigate the pathogenesis of prostate cancer by analyzing the associated hub gene modules of prostate cancer and identifying key transcription factors and genes that affect these modules. Methods: WGCNA (weighted gene co-expressed network analysis) was used to identify hub gene modules associated with important clinicopathological features of prostate cancer, such as pathological staging, Gleason grading etc. The OPOSSUM online tool was used to analyze the transcription factors enriching and regulating those genes. Pathway enrichment analysis and protein-protein interaction network analysis were used to identify key genes in prostate cancer. Finally, the effects of these genes on clinical features and disease-free survival (DFS) of prostate cancer patients were analyzed. Results: Three hub modules were identified, and they were highly associated with pathologic T stage, pathologic N stage and Gleason grading of prostate cancer, respectively. Further screening revealed 13 key dysregulated transcription factors that participated in the regulation of these three hub modules. The differentially expressed genes regulated by the 13 key transcription factors were significantly enriched in Calcium signaling pathway, cGMP-PKG signaling pathway and cAMP signaling pathway. 14 key genes (PRKG1, PRKG2, CYSLTR2, GRPR, CHRM3, ADCY5, ADRA1D, EDNRA, EDNRB, CYSLTR2, AGTR1, GRPR, GRIA1 and OXT) were at important nodes in the gene network. Among them, the high expression of ADRA1A, PRKG2, CHRM3, ADRA1D and EDN3 significantly extended the DFS of patients with prostate cancer (all P<0.01). Conclusion: ADRA1A, PRKG2, CHRM3, ADRA1D and EDN3 are regulated by key dysregulated transcription factors and highly associated with clinical features of prostate cancer. Their high expressions will significantly prolong the DFS of prostate cancer patients, which may shed light to the discovery of mechanism in prostate adenocarcinoma.

[Abstract] Objective: To explore the regulatory relationship between enhancer and miRNA and the characteristics of the enhancers that regulate miRNA in hepatic carcinoma and normal hepatic tissues, and to screen the differentially expressed miRNAs regulated by enhancers as well as their association with the treatment targets in liver cancer. Methods: Based on the TCGA and FANTOM5 databases, Co-expression and 3D genomic analysis were performed on 417 samples of enhancers and miRNAs in liver cancer and normal liver tissues. The difference in signal value of the enhancer that regulates miRNA was analyzed by ChIP-seq data of histone modification and transcription factor in liver cancer and normal liver tissues in ENCODE database. The differentially expressed miRNAs regulated by enhancers were screened out, and the correlation analysis was performed on the patient's survival and treatment targets. Results: 93 and 40 pairs of enhancer-miRNA were identified in liver cancer and normal liver tissues, respectively. ChIP-seqdata comparison analysis found that the signal of H3K27ac, H3K4me1 and sH3K4me3 histone modification in the region of enhancers regulating miRNA was significantly higher than that in the region of enhancers not regulating miRNA (|rho|>0.3, P<0.05). Moreover, the enrichment of multiple transcription factors in liver cancer-related enhancers was significantly lower than that in normal liver tissue-realted enhancers (|rho|>0.3, P<0.05). Differential expression analysis of enhancer-regulated miRNAs identified 6 miRNAs related to the survival of liver cancer patients(hsa-miR-4664, hsa-miR-5003,hsa-miR-1915,hsa-miR-3619,hsa-miR-4745, hsa-miR-6728),and found that these miRNAs were significantly associated with 87 genes for targeted therapy and 8 tumor immune checkpoint genes (|rho|>0.1, FDR<0.05). Conclusion: The enhancer-miRNA regulatory pairs and the characteristics of the enhancer that regulates miRNA were successfully identified in liver cancer. The miRNAs regulated by enhancers and related to the therapeutic targets and survival of patients with liver cancer were also screened out. It provides a valuable preliminary basis for future in-depth basic and clinical research in hepatic carcinoma.

Objective: To analyze the magnitude of blood flow energy and characteristics of frequency domain between pulsatile flow and nonpulsatile flow during cardiopulmonary bypass and physiological flow. Methods: From January 2017 to December 2017, 60 cases of patients with mitral valve disease scheduled for mitral valve replacement or repair at Department of Cardiasurgery, Shanghai Chest Hospital, Shanghai Jiaotong University were randomly divided into 2 groups: pulsatile perfusion (PP) and non-pulsatile perfusion (NP). The magnitude of blood flow energy during pulsatile and non-pulsatile was calculated using energy equivalent pressure (EEP) and surplus hemodynamic energy (SHE) while fast Fourier transformation (FFT) was used to perform power spectral density analysis to identify the frequency domain characteristics between artificial and physiological flow (prior to CPB). The data was analyzed by analysis of variance or t test. Results: At the different time-points after occlusion, the EEP and SHE in PP group were respectively 1.52 to 1.62 and 2.03 to 2.22 times higher than NP at the distal of artery filter. The power density analysis revealed that the blood flow energy of physiological pulsatile flow patterns was within 40 Hz and the ratio of low frequency energy was more than 90% before clamp. The spectral energy ratio of low frequency decreased in both group compared with physiological flow was more obvious in NP group at the radial artery. The ratio of estimated value of power density of PP and NP groups analysis showed the corresponding 0 to 5 Hz, 0 to 10 Hz, 0 to 40 Hz frequency range values measured at the radial artery and filter were 9.51, 4.68, 3.59 and 3.87, 2.69, 2.38 respectively after occulusion. In each frequency range, the energy of PP is higher than that of NP, and the lower the frequency, the greater the difference. The ratio of estimated value of power density of PP and NP groups for the three frequencies measured at the radial artery before and after occlusion were 2.86, 2.83, 2.75 and 14.70, 12.74, 9.85 respectively, and decreased significantly in NP group and low frequency energy. The ratio of estimated value of power density of PP and NP groups under the three different frequencies measured at the radial artery and filter were 26.35, 33.15, 37.36 and 37.41, 54.18, 56.64 respectively, in the conduction process from filter to radial artery, energy exhaustion is significant, especially in group NP. Conclusions The PP provides significantly more energy than the NP whereby the PP is closer to the physiological pulsatile on the energy frequency structure and attenuation characteristics, with mainly low frequency energy of 0 to 5 Hz and weak energy attenuation. The energy loss of non-pulsatile flow is obvious, especially the low frequency energy.