Objective To investigate the basic information of human immunodeficiency virus/acquired immune deficiency syndrome(HIV/AIDS)patients who infected with Epstein-Barr virus(EBV)or human Cytomegalovirus(HCMV),collect the relevant clinical immunological data and analyze the influencing factors.Method A total of 1 093 HIV/AIDS patients treated in the First Hospital of Changsha from January to December 2022 and underwent EBV and HCMV screening were collected.Flow cytometry was used to detect the CD4+T lymphocytes.Fluorescence quantitative PCR was applied for HIV-RNA,EBV-DNA,and HCMV-DNA testing.Statistical analysis was carried out by using SPSS 27.0,and logistic regression was used to analyze the risk factors of HIV/AIDS patients complicated with viral infection.Results Among 1 093 HIV/AIDS patients,the positive rates of EBV-DNA and HCMV-DNA were 48.22%(527/1 093)and 19.03%(208/1 093),respectively.As the number of CD4+T lymphocytes increased,the positive rates of EBV-DNA and HCMV-DNA decreased,and the differences was statistically significant(χ2=39.50,143.0,all P<0.001).As the level of HIV-RNA increased,the positive rates of EBV-DNA and HCMV-DNA increased,and the differences were statistically significant(χ2=46.18,124.3,all P<0.001).The patients receiving antiretroviral therapy(ART)significantly decreased the positive rates of EBV-DNA and HCMV-DNA(χ2=30.60,96.59,all P<0.001).There was a significant negative correlation between the number of CD4+T lymphocytes and the level of HIV-RNA(r=-0.49,P<0.001).Logistic regression analysis showed that the CD4+T lymphocyte count<200/μl(OR=1.46,95%CI:1.02～2.08,P=0.037),HIV-RNA load>200 copies/ml(OR=1.70,95%CI:1.18～2.44,P=0.004)and the age>30 years old(OR=2.15,95%CI:1.44～3.19,P<0.001)were risk factors for HIV/AIDS patients infected with EBV.Without regularly receiving ART(OR=1.83,95%CI:1.10～3.02,P=0.019),HIV-RNA load>200 copies/ml(OR=2.56,95%CI:1.50～4.35,P<0.001)and the CD4+T lymphocyte count<200/μl(OR=4.61,95%CI:2.57～8.28,P<0.001)were risk factors for HCMV infection in HIV/AIDS patients.Conclusion To reduce the possibility of opportunistic infection in HIV/AIDS patients,the surveillance of EBV and HCMV and regular ART should be strengthened,especially when the number of CD4+T lymphocytes decreases(<200/μl),the level of HIV RNA increases(>200 copies/ml)or the age>30 years old.

Objective To observe the effect of Zuogui Jiangtang Shuxin Decoction on diabetes atherosclerosis in ApoE-/-mice induced by streptozotocin combined with high-fat diet;To explore its mechanism of diabetes atherosclerosis by regulating intestinal flora and glucose and lipid metabolism.Methods Diabetic atherosclerosis model was constructed by intraperitoneal streptozotocin 40 mg/kg combined with a high-fat diet in 8-week-old male ApoE-/-mice,which were randomly divided into model group,Zuogui Jiangtang Shuxin Decoction group and metformin group,with 5 mice in each group,another 5 C57BL/6 mice were set as the blank control group.Zuogui Jiangtang Shuxin Decoction group were given Zuogui Jiangtang Shuxin Decoction 28.86 g/kg for gavage,the metformin group was given metformin 0.065 g/kg for gavage,and the model group and blank control group were given same volume of distilled water for gavage for consecutive 8 weeks.Fasting blood glucose(FBG)was detected,automatic biochemical analyzer was used to detect serum triglycerides(TG)and total cholesterol(TC)contents,morphology of pancreas,aorta and colonic tissue were observed by HE staining.Intestinal contents were collected to detect the changes of intestinal flora by sequencing with 16S rRNA amplicon.Results Compared with the blank control group,the FBG,TG,TC content in the model group significantly increased(P<0.01);the pancreatic lobules had an unclear lobe structure and a large number of atrophied glandular follicles;the intima-media of the aorta was hyperplastic,exhibiting visible atheromatous plaques and lumen stenosis;the structure of colonic tissue was unclear,and the intestinal mucosa in certain parts was vesiculously eroded,accompanied by inflammatory cells infiltration.Compared with the model group,the FBG,TG,TC content in Zuogui Jiangtang Shuxin Decoction group and metformin group significantly decreased(P<0.01);the pancreatic tissue structure was improved,atherosclerotic plaque and lipid deposition reduced,the colonic mucosal epithelium repaired,and inflammatory cell infiltration reduced.Alpha and Beta diversity analyses showed that the groups of samples were able to separate significantly,with the total number and abundance of intestinal flora species being lower in the model group.Compared with the blank control group,the relative abundance of the model group increased in Firmicutes,Desulfobacterota,Clostridia,Desulfovibrionia and Lachnospiraceae,decreased in Bacteroidota,Bacteroidia,Muribaculaceae and Muribaculaceaes(P<0.01).Compared with the model group,the relative abundance of Zuogui Jiangtang Shuxin Decoction group decreased in Firmicutes,Desulfobacterota,Clostridia,Desulfovibrionia and Lachnospiraceae,and increased in Bacteroidota,Bacteroidia,Muribaculaceae and Muribaculaceaes(P<0.05,P<0.01).Conclusion Zuogui Jiangtang Shuxin Decoction can regulate the intestinal microecology,thereby inhibiting the formation of diabetic atherosclerotic plaque.The mechanism may be related to its regulation of intestinal flora structure,improvement of glucose and lipid metabolism,protection of pancreatic tissues,and repair of the intestinal mucosal barrier.

Clinical trials are an important method for evaluating the safety and efficacy of in vitro diagnostic reagents, and are a key basis for product registration review and approval. In order to strengthen the management of clinical trials of in vitro diagnostic reagents, the National Medical Products Administration and relevant departments have formulated a series of regulations at the regulatory level, and require applicants and clinical trial institutions to establish a quality management system for clinical trials of in vitro diagnostic reagents. Medical laboratory is the main department and implementer of in vitro diagnostic reagent clinical trials in medical institutions. In recent years, with the rapid development of the in vitro diagnostic industry, the clinical trial projects of in vitro diagnostic reagents conducted by medical laboratory have been increasing day by day. However, there are currently few discussions on the clinical trial of in vitro diagnostic reagents from the perspective of researchers. Therefore, this article summarizes the characteristics of clinical trials of in vitro diagnostic reagents, analyzes the problems and difficulties in conducting clinical trials of in vitro diagnostic reagents in current medical laboratories, and introduces the laboratory′s experience in management; to provide reference for medical testing laboratories that have not yet conducted or have already conducted clinical trials of in vitro diagnostic reagents, in order to improve the quality and efficiency of clinical trials.

Clinical trials are an important method for evaluating the safety and efficacy of in vitro diagnostic reagents, and are a key basis for product registration review and approval. In order to strengthen the management of clinical trials of in vitro diagnostic reagents, the National Medical Products Administration and relevant departments have formulated a series of regulations at the regulatory level, and require applicants and clinical trial institutions to establish a quality management system for clinical trials of in vitro diagnostic reagents. Medical laboratory is the main department and implementer of in vitro diagnostic reagent clinical trials in medical institutions. In recent years, with the rapid development of the in vitro diagnostic industry, the clinical trial projects of in vitro diagnostic reagents conducted by medical laboratory have been increasing day by day. However, there are currently few discussions on the clinical trial of in vitro diagnostic reagents from the perspective of researchers. Therefore, this article summarizes the characteristics of clinical trials of in vitro diagnostic reagents, analyzes the problems and difficulties in conducting clinical trials of in vitro diagnostic reagents in current medical laboratories, and introduces the laboratory′s experience in management; to provide reference for medical testing laboratories that have not yet conducted or have already conducted clinical trials of in vitro diagnostic reagents, in order to improve the quality and efficiency of clinical trials.

Objective:This study was performed to assess the effect of glycemic control on atrial fibrillation recurrence rates after heart surgery concomitant with Cox-Maze Ⅳ ablation.Methods:A retrospective analysis was performed on 317 diabetic patients with atrial fibrillation who underwent cardiac surgery combined with Cox-Maze Ⅳ ablation in our hospital from May 2016 to February 2020. The patients were followed up for(37.7±27.7) months, and the data of atrial fibrillation recurrence and clinical outcome were collected and compared. The limited cubic spline model was used to analyze the dose-relationship between HbA1c level and the recurrence of atrial fibrillation. The univariate and multivariate Cox proportional regression analysis was used to explore the risk factors of recurrent atrial fibrillation after Cox-Maze Ⅳ ablation. Results:Higher glycated hemoglobin(HbA1c) at the time of ablation was associated with higher post-ablation recurrence rates. The cumulative survival freedom from atrial fibrillation recurrence for patients with HbA1c ≥7.4% at time of operation at 12, 24, 36 and 48 months were 96.3%、75.8%、52.7% and 35.7%, respectively( P<0.001). Besides, the rates of all-cause mortality, cardiac mortality and rehospitalization were significantly lower in patients with HbA1c<7.4%(1.7% vs. 6.3%, P=0.03; 1.1% vs. 5.6%, P=0.02 and 5.7% vs. 20.4%, P=0.01). The multivariate Cox regression model showed that HbA1c was an independent risk factor for atrial fibrillation recurrence( P<0.05). Conclusion:Higher preoperative HbA1c levels were associated with increased recurrence of atrial fibrillation and adverse clinical outcomes in patients undergoing cardiac surgery combined with Cox-Maze Ⅳ ablation.

The solute carrier family 12(SLC12)of cation-chloride cotransporters(CCCs)comprises potassium chlo-ride cotransporters(KCCs,e.g.KCC1,KCC2,KCC3,and KCC4)-mediated Cl-extrusion,and sodium po-tassium chloride cotransporters(N[K]CCs,NKCC1,NKCC2,and NCC)-mediated Cl-loading.The CCCs play vital roles in cell volume regulation and ion homeostasis.Gain-of-function or loss-of-function of these ion transporters can cause diseases in many tissues.In recent years,there have been considerable ad-vances in our understanding of CCCs'control mechanisms in cell volume regulations,with many tech-niques developed in studying the functions and activities of CCCs.Classic approaches to directly measure CCC activity involve assays that measure the transport of potassium substitutes through the CCCs.These techniques include the ammonium pulse technique,radioactive or nonradioactive rubidium ion uptake-assay,and thallium ion-uptake assay.CCCs'activity can also be indirectly observed by measuring y-aminobutyric acid(GABA)activity with patch-clamp electrophysiology and intracellular chloride con-centration with sensitive microelectrodes,radiotracer 36Cl-,and fluorescent dyes.Other techniques include directly looking at kinase regulatory sites phosphorylation,flame photometry,22Na+uptake assay,structural biology,molecular modeling,and high-throughput drug screening.This review sum-marizes the role of CCCs in genetic disorders and cell volume regulation,current methods applied in studying CCCs biology,and compounds developed that directly or indirectly target the CCCs for disease treatments.

T 3 rectal cancer patients are a heterogeneous group of populations. T 3 stage patients with good prognosis are similar to their T 2 stage counterparts, and T 3 stage patients with poor prognosis are similar to T 4 stage counterparts. Although small sample clinical trials, meta-analyses and retrospective analyses have been conducted, clinical guidelines are not completely consistent with the definition of risk factors and treatment recommendations for this group of populations. At present, the treatment strategy for T 3 rectal cancer is still controversial, especially the application of perioperative radiotherapy. In this article, current application status and research progress in perioperative chemoradiotherapy for T 3 rectal cancer were reviewed.

The incidence of lateral lymph node metastases (LLN) of locally advanced middle-low rectal cancer (II-Ⅲ stage) is high and clinical prognosis is poor. At present, the treatment plan of LLN is controversial between the East and the West. Scholars from the East represented by Japan believe that LLN is a regional disease. Lateral pelvic lymph node dissection (LPLND) is recommended when the tumor is located under the peritoneal reflection and invades into the muscular layer, regardless of the presence or absence of LLN. However, European and American scholars believe that LLN is a systemic disease and recommend neoadjuvant chemoradiotherapy (nCRT) combined with total mesorectal excision (TME). Nevertheless, recent studies have found that neither nCRT nor LPLND can significantly reduce the locoregional recurrence (LR) rate in patients with LLN, while nCRT combined with LPLND yields better prognosis. Some studies have also demonstrated that increasing the radiotherapy dose of metastatic lymph nodes can improve the local control rate. In this article, current treatment status of this population was reviewed, aiming to provide a basis for clinical treatment.

BACKGROUND: The screening of periprosthetic joint infection (PJI) in patients with inflammatory diseases before revision arthroplasty remains uncertain. Serum C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), plasma fibrinogen (FIB), monocyte/lymphocyte ratio, and neutrophil/lymphocyte ratio (NLR) can help screening PJI, but their values in patients with inflammatory diseases have not been determined. METHODS: Patients with inflammatory diseases who underwent revision hip or knee arthroplasty at West China Hospital, Sichuan University, from January 2008 to September 2020 were divided into infected and non-infected groups based on the 2013 International Consensus Meeting criteria. Sensitivity and specificity of the tested biomarkers for diagnosing infection were determined based on receiver operating characteristic (ROC) curves, and optimal cutoffs were determined based on the Youden index. The diagnostic ability of these biomarkers was re-assessed after combining them with each other. RESULTS: A total of 62 patients with inflammatory diseases were studied; of them 30 were infected. The area under the ROC curve was 0.813 for CRP, 0.638 for ESR, 0.795 for FIB, and 0.656 for NLR. The optimal predictive cutoff of CRP was 14.04 mg/L with a sensitivity of 86.2% and a specificity of 68.7%, while FIB had a sensitivity of 72.4% and a specificity of 81.2% with the optimal predictive cutoff of 4.04 g/L. The combinations of CRP with FIB produced a sensitivity of 86.2% and specificity of 78.1%. CONCLUSION: CRP with a slightly higher predictive cutoff and FIB are useful for screening PJI in patients with inflammatory diseases, and the combination of CRP and FIB may further improve the diagnostic values. TRIAL REGISTRATION ChiCTR.org.cn, ChiCTR2000039989.
Humans ; C-Reactive Protein/analysis* ; Prosthesis-Related Infections/diagnosis* ; Fibrinogen ; Arthroplasty, Replacement, Hip ; Arthritis, Infectious/surgery* ; Blood Sedimentation ; Sensitivity and Specificity ; Biomarkers ; Retrospective Studies

ObjectiveTo investigate the mechanism of Huangqi Guizhi Wuwutang （HQGZWWT） in the treatment of diabetic peripheral neuropathy （DPN） in MKR mice via regulating endoplasmic reticulum （ER） stress. MethodThirty-two 8-week-old MKR mice （half were male and half were female） were fed with a high-fat diet for four weeks， and then 1% streptozotocin （STZ） was injected intraperitoneally for five days. After the blood glucose was stabilized， the mice were housed in the cage covered with ice bags for another one hour stimulation per day for four weeks. Mice with fasting blood glucose （FBG） value ≥11.1 mmol·L^-1 were randomly divided into model group ， Huangqi Guizhi Wuwutang in original dosage group （30 g·kg^-1·d^-1）， Huangqi Guizhi Wuwutang in formula dosage group （6.25 g·kg^-1·d^-1）， and positive drug group （mecobalamin tablets， 0.17 mg·kg^-1·d^-1）. Another eight MKR mice of the same age were set as blank group and eight FVB mice were normal group. After four weeks of intragastric administration in each group， the change in FBG was tested， and hematoxylin and eosin （HE） staining and transmission electron microscope were used for observing the morphology of sciatic nerve tissue. In addition， the expression of c-Jun N-terminal kinase （JNK）， phosphorylated c-Jun N-terminal kinase （p-JNK） and inositol requiring enzyme 1α （IRE1α） proteins was determined by immunohistochemical test and Western blot （WB）. ResultCompared with the conditions in the normal group and blank group， the time of paw withdrawal， paw licking and tail flick in the model group was shortened （P<0.01）， and the conduction velocity of sciatic nerve was decreased （P<0.01）. Compared with the conditions in the model group， the behavioral and functional indicators were improved by HQGZWWT （P<0.05，P<0.01）. The immunohistochemical test revealed the JNK expression was elevated in the model group compared with the conditions in the normal group and blank group （P<0.05）， while that was lowered by HQGZWWT compared with the condition in the model group （P<0.05）. However， there was no difference among the treatment groups. According to the WB， the expression of IRE1α and p-JNK in the model group was enhanced compared with the conditions in the normal group and blank group （P<0.05，P<0.01）， while that was decreased by HQGZWWT compared with the condition in the model group （P<0.05，P<0.01）. No difference was observed between the HQGZWWTO and HQGZWWTF groups. ConclusionHQGZWWT can improve the neurophysiological function and pathological damage of sciatic nerve， which may be related to its delaying the ER stress response of sciatic nerve.