Atherosclerosis is a chronic inflammatory disease characterized by autoimmune component,ser-ving as a primary factor in cardiovascular diseases.The atherosclerotic plaques involve a variety of immune cells which mediated complex immune and inflammatory responses at each stage of the disease's progression.Notably,within atherosclerotic plaques,T-cells,as the predominant immune cells,can be differentiated into various subsets with distinct functions.These T-cell subsets modulate the progression of atherosclerosis by se-creting either pro-inflammatory or anti-inflammatory cytokines.Understanding the impact of these immune cells on the disease's development is imperative for formulating novel therapeutic strategies.This article aims to review the roles of T-cell subsets and their secreted cytokines in atherosclerosis,aiming to offer new in-sights for the scientific research and clinical management of this condition.

Objective:To develop and validate the models based on mixed enhanced computed tomography (CT) radiomics and deep learning features, and evaluate the efficacy for differentiating pancreatic adenosquamous carcinoma (PASC) from pancreatic ductal adenocarcinoma (PDAC) before surgery.Methods:The clinical data of 201 patients with surgically resected and histopathologically confirmed PASC (PASC group) and 332 patients with surgically resected histopathologically confirmed PDAC (PDAC group) who underwent enhanced CT within 1 month before surgery in the First Affiliated Hospital of Naval Medical University from January 2011 to December 2020 were retrospectively collected. The patients were chronologically divided into a training set (treated between January 2011 and January 2018, 156 patients with PASC and 241 patients with PDAC) and a validation set (treated between February 2018 and December 2020, 45 patients with PASC and 91 patients with PDAC) according to the international consensus on the predictive model. The nnU-Net model was used for pancreatic tumor automatic segmentation, the clinical and CT images were evaluated, and radiomics features and deep learning features during portal vein phase were extracted; then the features were dimensionally reduced and screened. Binary logistic analysis was performed to develop the clinical, radiomics and deep learning models in the training set. The models' performances were determined by area under the ROC curve (AUC), sensitivity, specificity, accuracy, and decision curve analysis (DCA).Results:Significant differences were observed in tumor size, ring-enhancement, upstream pancreatic parenchymal atrophy and cystic degeneration of tumor both in PASC and PDAC group in the training and validation set (all P value <0.05). The multivariable logistic regression analysis showed the tumor size, ring-enhancement, dilation of the common bile duct and upstream pancreatic parenchymal atrophy were associated with PASC significantly in the clinical model. The ring-enhancement, dilation of the common bile duct, upstream pancreatic parenchymal atrophy and radiomics score were associated with PASC significantly in the radiomics model. The ring-enhancement, upstream pancreatic parenchymal atrophy and deep learning score were associated with PASC significantly in the deep learning model. The diagnostic efficacy of the deep learning model was highest, and the AUC, sensitivity, specificity, and accuracy of the deep learning model was 0.86 (95% CI 0.82-0.90), 75.00%, 84.23%, and 80.60% and those of clinical and radiomics models were 0.81 (95% CI 0.76-0.85), 62.18%, 85.89%, 76.57% and 0.84 (95% CI 0.80-0.88), 73.08%, 82.16%, 78.59% in the training set. In the validation set, the area AUC, sensitivity, specificity, and accuracy of deep learning model were 0.78 (95% CI 0.67-0.84), 68.89%, 78.02% and 75.00%, those of clinical and radiomics were 0.72 (95% CI 0.63-0.81), 77.78%, 59.34%, 65.44% and 0.75 (95% CI 0.66-0.84), 86.67%, 56.04%, 66.18%. The DCA in the training and validation sets showed that if the threshold probabilities were >0.05 and >0.1, respectively, using the deep learning model to distinguish PASC from PDAC was more beneficial for the patients than the treat-all-patients as having PDAC scheme or the treat-all-patients as having PASC scheme. Conclusions:The deep learning model based on CT automatic image segmentation of pancreatic neoplasm could effectively differentiate PASC from PDAC, and provide a new non-invasive method for confirming PASC before surgery.

Objective:To investigate the effect of symptom management theory(SMT)-based nursing care for the prevention of postoperative abdominal distension in patients with primary hepatocellular carcinoma.Methods:A total of 80 primary hepatocellular carcinoma patients in the Second Affiliated Hospital of Wenzhou Medical University from May 2016 to May 2019 were assigned to the experimental group and the control group according to the admission time, there were 40 cases in each group. The patients in the control group received routine postoperative nursing care, while the patients in the experimental group added SMT-based intervention. The postoperative first exhaust time and defecation time were recorded; the abdominal distension degree after 1, 3, 7 days of surgery were evaluated. In addition, the symptom distress was assessed by The Symptom Module Specific to Primary Liver Cancer (TSM-PLC).Results:The postoperative first exhaust time and defecation time were (69.08±11.44), (78.80±15.54) h in the experimental group, which were significantly lower than those in the control group (76.03±12.26), (86.03±13.48) h, the differences were statistically significant ( t=2.62, 2.22, both P<0.05). After 3, 7 days of surgery, the abdominal distension degrees were significantly alleviated in the experimental group compared to the control group, the differences were statistically significant ( Z =2.31, 2.34, both P<0.05). After 7 days of surgery, the abdominal distension, weight loss, fever symptom scores in TSM-PLC were 1.80±0.28, 0.76±0.21, 0.48±0.19 in the experimental group, which were significantly lower than those in the control group 2.16±0.31, 0.93±0.25, 0.74±0.20, the differences were statistically significant ( t=5.38, 3.27, 5.90, all P<0.05). Conclusions:SMT-based intervention can promote the recovery of postoperative gastrointestinal function and alleviate abdominal distension symptom distress of patients with primary hepatocellular carcinoma.

Objective:To study the influencing factors for shoulder stiffness after rotator cuff tear.Methods:The data of 228 patients were retrospectively analyzed who had been diagnosed with rotator cuff tear by arthroscopic surgery at Department of Articular Surgery, Hospital Affiliated to Chengde Medical College from June 2019 to May 2021. Their baseline data were recorded immediately after admission, including possible risk factors for shoulder stiffness. The patients were divided into a stiffness group and a non-stiffness group based on passive range of motion of shoulder joint. Univariate and multivariate analyses were performed to find out the influencing factors for shoulder stiffness after rotator cuff tear.Results:Preliminary univariate analysis showed that advanced age, smoking history, misdiagnosis history, no standardized physiotherapy history, high body mass index (BMI) and long duration of disease were all likely risk factors for shoulder stiffness in patients with rotator cuff tear ( P<0.05). Multivariate analysis confirmed that advanced age( OR=1.474, 95% CI: 1.013~2.145, P=0.043), smoking history( OR=2.239, 95% CI: 1.147~4.368, P=0.018), no standardized physiotherapy history( OR=0.167, 95% CI: 0.065~0.424, P<0.001), high BMI( OR=3.029, 95% CI: 1.657~5.536, P<0.001) and long duration of disease ( OR=1.775, 95% CI: 1.384~2.276, P<0.001) were the risk factors for shoulder stiffness. Conclusion:Age>60 years, smoking history, misdiagnosis history, no standardized physiotherapy history, high body mass index and long course of disease may be the important influencing factors for shoulder stiffness after rotator cuff tear.

Objective: Based on observational, longitudinal and intervention study of common diseases among students in Jiangsu Province, this paper presents the current progress of two year follow up of myopia cohort regarding the association between growth parameters with progression of myopia among children and adolescents in areas with rapid economic growth. Methods: This survey adopted the stratified cluster sampling method for school selection. The full automatic computer optometry (TOPCON RM800) was used to track myopia related parameters for all participants from 2019 to 2020 under the condition of mydriasis (compound topicamide eye drops). Relationship between growth parameters of children and adolescents and the incidence and progression of myopia was analyzed by using Cox regression multiple statistical model. Results: The myopia rates of students from grade 1 to grade 3 in 2019 were 5.4%, 21.5% and 37.3% respectively. After one year, the myopia rates of all school stages increased to 25.3%, 43.3% and 58.1% respectively( χ 2=53.59, 49.63, 32.52, P <0.01). The mean diopter of right eye and left eye after mydriasis were ( 0.30± 1.24/0.39±1.26)D in 2019 and (-0.33±1.54/-0.19±1.55)D in 2020, respectively based on Cox multiple regression results, age ( HR =1.21, 95% CI =1.09-1.34), naked eye vision ( HR =0.08, 95% CI =0.07-0.11), height ( HR =0.98, 95% CI =0.97-0.99) showed a strong correlation with the incidence and progression of myopia( P <0.05). Conclusion Myopia is growing rapidly in the central region of Jiangsu Province. It is suggested that diopter, axial length, naked eye vision, age, height and other indicators should be included in the refractive archives of children and adolescents in the region.

Objective: To investigate the refractive progression and associated factors of children of different ages and refractive status, and to provide guidance on myopia prevention and control program formulation and work practice. Methods: A total of 20 kindergartens, primary schools, and secondary schools in 2 districts of Shanghai were selected based on the existing cohort, and baseline data in 2015 and one year follow up data in 2016 were collected from 1 510 children aged 4 to 14, including cycloplegic spherical equivalent refraction (SER), axial length (AL), and corneal curvature. The distribution and progression of SER and AL in children of different ages and refractive status were analyzed, and the influencing factors of SER progression (ΔSER) were explored using multiple linear regression. Results: ΔSER remained relatively stable at age 4 and 5 (average -0.08 to -0.07 D/year), and SER drifted significantly towards myopia (average -0.50 to -0.31 D/year) in all groups older than 6 years, dropping back to -0.44 to -0.33 D/year after age 11; Elongation of AL (ΔAL) was 0.27 to 0.35 mm/year in 4 to 10 years group, and decreased to 0.15 to 0.22 mm/year in 11 to 14 years group. The ΔSER and ΔAL were greatest in the new onset myopes [(-0.90± 0.05 )D, (0.51±0.02)mm], followed by the low myopia group [(-0.68±0.04)D, (0.36±0.02)mm], then followed by the moderate to high myopia group[(-0.49±0.06)D，(0.23±0.03)mm] and the lowest in the hyperopia group[(-0.21±0.02)D, ( 0.26 ±0.01)mm], with a statistically significant difference among these groups ( P <0.05). Age ( β =-0.07), baseline SER ( β = 0.05 ) and ΔAL ( β =-0.78) were independent influencing factors for refractive progression in the 4 to 10 years old group, while ΔAL( β =-1.55) was the only independent influencing factor in the 11 to 14 years old group ( P <0.05). Conclusion The elongation of AL in preschoolers is mostly physiologically and should be prevented from growing beyond the physiological range by increasing outdoor activities. The primary students, as well as students with pre myopia or low myopia are the priority groups for dynamic monitoring and intervention in myopia prevention and control.

Objective: To understand the correlation between myopia related health belief and screen time of primary and secondary school students in Jing-an District of Shanghai, and to provide suggestions for reducing screen time and preventing myopia. Methods: Using the method of cluster sampling,1 585 students from grade one to grade eight of a primary school and a junior high school in Jing-an District were selected for a questionnaire survey regarding myopia related health belief, screen time and the correlation between them. Results: About 18.8%-44.4% of the students perceived themselves as myopia susceptible,which increased with grade (χ 2=33.25,P<0.01), 51.5%-78.0% of the students were aware of the adverse health impart of myopia, 39.3%-55.6% of the students were aware of unhealthy behaviors associated with myopia and 48.7%-77.5% of the students. More than 47.6% of the students daily screen time was more than 2 h/day, and daily screen time increased with grade (χ 2=12.18, P<0.01). Perceived susceptibility for myopia, awareness on adverse health impact of myopia and unhealthy behaviors associated with myopia, as well as self-efficacy associated with myopia prevention were associated with screen time of students. Conclusion The primary and middle school students in Jing an District show low lever of knowledge on myopia susceptibility and threat, but higher lever of knowledge on myopia severity and self-efficacy of preventing myopia. nearly half of the students use electronic screens too long or too close to their eyes. Awareness on myopia susceptibility, myopia-related behaviors and health impacts of myopia and self-efficacy, combined with screen time reduction might help myopia prevention.

Background: Esophageal cancer is one of the leading causes of cancer deaths worldwide. T-cell immunoglobulin and mucin domain-containing protein 3 (Tim-3) has been shown to be implicated in the tumor immune escape, and associated with tumor progression and poor prognosis in a variety of malignancies. Aims: To investigate the expression of Tim-3 in esophageal tumorigenesis and its clinical significance. Methods: Paraffin-embedded tissues from 103 esophageal cancer, 21 high-grade esophageal intraepithelial neoplasia, 16 low-grade esophageal intraepithelial neoplasia, and 20 chronic esophagitis were collected in this study. Using immunohistochemistry, the expression level of Tim-3 was evaluated; and the correlation of Tim-3 expression in cancerous tissue with the clinicopathological parameters of esophageal cancer was analyzed. Results: Tim-3 expression was increased from chronic esophagitis, low-grade intraepithelial neoplasia, high-grade intraepithelial neoplasia to esophageal cancer (0.271±0.138, 0.368±0.198, 0.443±0.147, and 0.639±0.119, P<0.05). Moreover, Tim-3 expression was significantly correlated with depth of tumor invasion, regional lymph node metastasis and TNM staging of esophageal cancer (P<0.05), whereas no relationship was found between Tim-3 expression and gender, age and tumor location of esophageal cancer (P>0.05). Conclusions: Tim-3 expression is increased in esophageal tumorigenesis; overexpression of Tim-3 in esophageal cancer is closely correlated with tumor progression. Tim-3 might be served as a biomarker for development, progression and prognosis of esophageal cancer.

In eukaryotes, protein phosphorylation is specifically catalyzed by numerous protein kinases (PKs), faithfully orchestrates various biological processes, and reversibly determines cellular dynamics and plasticity. Here we report an updated algorithm of Group-based Prediction System (GPS) 5.0 to improve the performance for predicting kinase-specific phosphorylation sites (p-sites). Two novel methods, position weight determination (PWD) and scoring matrix optimiza-tion (SMO), were developed. Compared with other existing tools, GPS 5.0 exhibits a highly com-petitive accuracy. Besides serine/threonine or tyrosine kinases, GPS 5.0 also supports the prediction of dual-specificity kinase-specific p-sites. In the classical module of GPS 5.0, 617 individual predic-tors were constructed for predicting p-sites of 479 human PKs. To extend the application of GPS 5.0, a species-specific module was implemented to predict kinase-specific p-sites for 44,795 PKs in 161 eukaryotes. The online service and local packages of GPS 5.0 are freely available for academic research at http://gps.biocuckoo.cn.

Objective: To select alkaloid-producing endophytic fungi strains from Fritillaria anhuiensis. Methods: The endophytic fungi were selected from the bulbus of Fritillaria anhuiensis, by tissue explants, thin layer chromatography, the high performance liquid chromatography and high performance liquid chromatography-evaporative light scattering detection, morphologic observation and molecular biological methods. Results: One strain as an endophytic fungi capable of producing alkaloid was selected from the bulbus of Fritillaria anhuiensis, and was classified as Alternaria tenuissima. Conclusion: The selected alkaloid-producing endophytic fungi strain bm-2 from Fritillaria anhuiensis provide theoretical foundation for solving the problem of the deficient medical resources of Fritillaria anhuiensis.