Objective To analyze the epidemiological characteristics of influenza in Nantong city, explore its changing trend, and provide evidence for effective prevention and control measures. Methods The incidence data of influenza in Nantong city from 2010 to 2022 were collected and analyzed by descriptive statistical software. Joinpoint regression model was used to analyze the trend of influenza incidence. Results The annual reported incidence of influenza in Nantong city showed an exponential upward trend from 2010 to 2022 (APC=25.25, P=0.002). The annual reported incidence rate of males was higher than that of females, and the incidence trend of both showed an exponential upward trend(Male: APC=24.40, P=0.002; Female: APC=26.11, P=0.002). The seasonal index showed a unimodal distribution, with a peak from December to February of the next year, and the highest value was 2.78 in January. The average annual reported incidence in each age group showed a rapid upward trend from 0 to 7 years old (β₁=16.13, P<0.001), a cliff decline from 7 to10 years old (β₁=-44.50, P=0.037), and a low slow downward trend from 10 to 45 years old (β₁=-0.20, P=0.001), and lower tailing was observed in 45-85 years group (β₁=0.04, P=0.162). Conclusion The overall incidence rate of influenza in Nantong City is on the rise. Children under 7 years old are the key protected population. We should control the key season, do a good job of publicity and education, encourage vaccination,and at the same time do a good job in pathogen monitoring, timely pay attention to the situation of epidemic strains, and scientific prevention and control.

Objective A serum proteomic approach was used to explore the targets of action of Peitu Qingxin Granules(composed of Rhizoma Atractylodis Macrocephalae,Forsythiae Fructus,Imperatae Rhizoma,Pseudostellariae Radix,etc.)in the treatment of atopic dermatitis.Methods Five patients with atopic dermatitis were selected and treated with Peitu Qingxin Granules for 12 weeks,and five healthy volunteers were used as controls.The clinical core evaluation indexes of atopic dermatitis patients after treatment,including Eczema Area and Severity Index/Scoring Atopic Dermatitis(EASI/SCORAD),Pruritus Score,Patient-Oriented Eczema Measure(POEM),and quality of life index,were assessed.Serum samples were examined using data-independent acquisition-mass spectrometry(DIA-MS)technology,and serum differential proteins between atopic dermatitis patients and healthy people,as well as serum differential proteins in atopic dermatitis patients before and after treatment with Peitu Qingxin Granules were screened according to P＜0.05 and Fold Change>1.2.GO function enrichment analysis and KEGG pathway enrichment analysis were performed on the differential proteins.Results(1)Compared with the pre-treatment period,the clinical core evaluation indexes of patients with atopic dermatitis,including the EASI/SCORAD,Pruritus Score,POEM,and quality-of-life index,were significantly improved after treatment,and the differences were all statistically significant(P＜0.05,P＜0.01).(2)A total of 28 differential proteins were analyzed in the healthy control group and atopic dermatitis group,of which 12 proteins expressions were increased and 16 proteins were decreased,including ALAD(δ-aminolevulinic acid dehydrogenase),LTA4H(leukotriene A-4 hydrolase),CA1(carbonic anhydrase 1),F11(coagulation factor XI),and LCP1(lymphocyte cytoplasmic protein 1),etc..The main signaling pathways involved are PI3K-AKT signaling pathway,lipids and atherosclerosis,ECM-receptor interaction,platelet activation,NF-κB signaling pathway,and neutrophil extracellular trap formation.(3)A total of 12 different proteins were analyzed in atopic dermatitis patients before and after treatment with Peitu Qingxin Granules,of which 8 proteins were increased and 4 proteins were decreased,including ALAD,FGA(fibrinogen α-chain),IGHV3-64D,and IGHV3-38.They were mainly involved in signaling pathways such as lipids and atherosclerosis,complement pathway,Staphylococcus aureus infection,NF-κB signaling pathway,fluid shear stress and atherosclerosis.(4)The expressions of three protein targets including ALAD,FGA and IGHV3-64D,were significantly down-regulated in patients with atopic dermatitis and significantly up-regulated after treatment with Peitu Qingxin Granules.Conclusion The differentially expressed proteins ALAD,FGA and IGHV3-64D may be the action targets of Peitu Qingxin Granules in the treatment of atopic dermatitis,which lays the foundation for further experimental validation.

Objective To investigate the risk factors for biliary stricture within two years after orthotopic liver transplantation,and analyze the survival.Methods A retrospective analysis was performed for the data of 495 patients who underwent liver transplantation at Liver Transplantation Center of The First Hospital of Jilin University from January 2014 to January 2022,and according to the presence or absence of biliary stricture within two years after liver transplantation,the 495 patients were divided into stricture group with 89 patients and non-stricture group with 406 patients.The risk factors for biliary stricture and prognosis were analyzed.The independent-samples t-test was used for comparison of normally distributed continuous data between two groups,and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups;the chi-square test was used for comparison of categorical data between two groups.Univariate and multivariate Cox regression analyses were used for the analysis of risk factors,and the Kaplan-Meier method was used for survival analysis.Results Recipient sex(hazard ratio[HR]=1.808,95%confidence interval[CI]:1.055-3.098,P=0.031),preoperative total bilirubin of the recipient(HR=1.002,95%CI:1.001-1.003,P=0.001),cold ischemia time(HR=1.003,95%CI:1.001-1.005,P=0.007),history of abdominal surgery for the recipient(HR=3.851,95%CI:2.273-6.524,P<0.001),and mismatch of donor-recipient bile ducts(HR=1.962,95%CI:1.041-3.698,P=0.037)were identified as independent risk factors for biliary stricture within two years after transplantation.The median follow-up time was 4.09 years,and the 1-,3-,and 5-year survival rates were 92.7%,80.5%,and 75.4%,respectively,after liver transplantation.The onset of biliary stricture within two years after liver transplantation had no significant impact on the survival of patients undergoing orthotopic liver transplantation.Conclusion Recipient sex,preoperative total bilirubin of the recipient,cold ischemia time,history of abdominal surgery for the recipient,and mismatch of donor-recipient bile ducts are independent risk factors for biliary stricture within two years after transplantation.The onset of biliary stricture within two years after transplantation does not affect the survival time of patients undergoing orthotopic liver transplantation.

Objective To systematically review the safety and efficacy of irreversible electroporation(IRE)combined with immunotherapy in patients with unresectable pancreatic cancer.Methods This study was conducted according to the PRISMA guideline,with a PROSPERO registration unmber of CRD42024531984.Datebases including PubMed,Embase the Cochrane Library,Web of Science,CNKI,Wanfang Data,and VIP were searched for related articles on IRE combined with immunotherapy for unresectable pancreatic cancer published up to February 2024.The articles were screened and related data were extracted according to the established inclusion and exclusion criteria,and the quality of the articles was assessed.Review Manager 5.3 and Stata 17.0 software were used to perform the meta-analysis.Results Six studies were finally included,with three prospective studies,two retrospective studies,and one randomized controlled trial.There were 376 patients with unresectable pancreatic cancer in total,among whom there were 222 patients in the IRE group and 154 patients in the IRE+immunotherapy group.The meta-analysis showed that compared with IRE alone,IRE combined with immunotherapy significantly prolonged progression-free survival(hazard ratio[HR]=0.82,95%confidence interval[CI]:0.72-0.92,P=0.001)and overall survival(HR=0.86,95%CI:0.80-0.93,P=0.000 1),increased T lymphocyte count in the patients(mean difference=217.93,95%CI:192.87-242.99,P<0.000 01),and improved the immune function of patients.However,there were no significant differences between the two groups in reducing the incidence rate of adverse events(odds ratio[OR]=1.43,95%CI:0.76-2.72,P=0.27)and improving the objective remission rate of patients(OR=1.49,95%CI:0.87-2.56,P=0.15).Conclusion IRE combined with immunotherapy is safe and effective in patients with unresectable pancreatic cancer and can significantly improve overall survival and progression-free survival and enhance immune function,with little effect on objective remission rate and the incidence rate of adverse events.

Objective:To investigate the effect of hepatocyte nuclear factor 4 gamma(HNF4G)on the proliferation,migration,cell cycle and apoptosis of gallbladder cancer cells and the underlying molecular mechanisms. Methods:The expression levels of HNF4G mRNA and protein in gallbladder cancer cell lines(GBC-SD,NOZ and ZJU-0430)were examined by real-time fluorescence quantitative PCR and Western blotting,respectively.Stable HNF4G-silencing or overexpressing GBC-SD,NOZ and ZJU-0430 cell lines were established by lentiviral infection.Then,the effect of HNF4G silencing or overexpression on the proliferation,migration,cell cycle and apoptosis of gallbladder cancer cell lines were evaluated by CCK-8 assay,colony formation assay,Transwell assay and FCM assay.The effect of changes in HNF4G gene expression level on the expression levels of cell cycle associated proteins(Cyclin A2 and Cyclin B1),apoptotic proteins(Bax and Bcl-2),epithelial-mescenchymal transition associated proteins(E-cadherin,N-cadherin,vimentin,Snail and Slug)as well as ErbB2 and phosphorylated AKT in the ErbB2/PI3K/AKT signaling pathway was examined by Western blotting. Results:Real-time fluorescence quantitative PCR and Western blotting results demonstrated that the expression level of HNF4G mRNA and protein in NOZ cells was significantly lower than that in GBC-SD and ZJU-0430 cells(P＜0.001).The successful establishment of HNF4G-sliencing and HNF4G-overexpressing gallbladder cancer cell lines was verified by Western blotting analysis.Over expression of HNF4G could enhance the proliferation and migration of GBC-SD,NOZ and ZJU-0430 cells(P＜0.001),promote the transition of S-phase to G2/M-phase,and inhibit the apoptosis of these gallbladder cancer cell lines.Western blotting analysis showed that overexpression of HNF4G could increase the expression of Cyclin A2,Cyclin B1,Bcl-2,N-cadherin,Vimentin,Snail,Slug,ErbB2 and phosphorylated AKT,and decrease the expression of Bax and E-cadherin(P＜0.001).In contrast,HNF4G silencing could induce the opposite changes in the biological behaviors and protein expression in GBC-SD cells. Conclusion:HNF4G affects the proliferation and migration of gallbladder cancer cells by participating in the regulation of the epithelial-mescenchymal transition and ErbB2/PI3K/AKT signaling pathway.The influence of HNF4G on gallbladder cancer cells suggests that HNF4G may be a potential gene target for gallbladder cancer treatment.

Objective:The safety and effectiveness of the enhanced recovery after surgery (ERAS) in the treatment of distal pancreatectomy (DP) were evaluated by meta-analysis.Methods:Pancreatic body and tail resection, distal pancreatic resection, ERAS, rapid recovery after surgery, pancreatectomy, DP and ERAS were used as key words, and the network database such as Chinese journal full-text database, Wanfang data knowledge service platform, Weipu database, Chinese biomedical literature database, Pubmed, Embase, Cochrane library, Web of science, Sciencedirect and so on were searched. The retrospective literatures published from the database establishment to May 2022 were retrieved from the network database, and the papers were screened and the quality was evaluated according to the pre-set inclusion and exclusion criteria; and important data were extracted. The software Review Manager 5.4 was used for meta-analysis.Results:9 papers were finally included, and a total of 650 patients with DP were enrolled (311 in the ERAS group and 339 in the NO-ERAS group). Meta-anaysis showed that compared with NO-ERAS group, ERAS group could reduce intraoperative bleeding ( MD=-73.88, 95% CI -121.21--26.55, P=0.002), decrease the incidence of postoperative complications ( OR=0.48, 95% CI 0.32-0.72, P<0.001) and pulmonary complications ( OR=0.47, 95% CI 0.24-0.93, P=0.030), shorten the postoperative exhaust time (MD=-8.76, 95% CI -11.23--6.29, P<0.001), postoperative length of hospital stay ( MD=-2.65, 95% CI -3.06--2.07, P<0.001) and abdominal drainage tube removal time ( MD=-1.45, 95% CI -1.81--1.09, P<0.001). However, ERAS could not shorten the operative time ( MD=6.25, 95% CI -4.56-17.07, P=0.260), reduce the incidence of postoperative pancreatic fistula ( OR=0.92, 95% CI 0.53--1.60, P=0.780) and the re-admission rate within 30 days after surgery ( OR=1.00, 95% CI 0.47-2.11, P=0.990). Conclusions:ERAS is safe and effective for patients undergoing DP, because it can reduce intraoperative bleeding and postoperative complications, shorten postoperative hospital stay and postoperative abdominal drainage tube removal time.

The condition of patients with severe traumatic brain injury (sTBI) complicated by corona virus 2019 disease (COVID-19) is complex. sTBI can significantly increase the probability of COVID-19 developing into severe or critical stage, while COVID-19 can also increase the surgical risk of sTBI and the severity of postoperative lung lesions. There are many contradictions in the treatment process, which brings difficulties to the clinical treatment of such patients. Up to now, there are few clinical studies and therapeutic norms relevant to sTBI complicated by COVID-19. In order to standardize the clinical treatment of such patients, Critical Care Medicine Branch of China International Exchange and Promotive Association for Medical and Healthcare and Editorial Board of Chinese Journal of Trauma organized relevant experts to formulate the Chinese expert consensus on clinical treatment of adult patients with severe traumatic brain injury complicated by corona virus infection 2019 ( version 2023) based on the joint prevention and control mechanism scheme of the State Council and domestic and foreign literatures on sTBI and COVID-19 in the past 3 years of the international epidemic. Fifteen recommendations focused on emergency treatment, emergency surgery and comprehensive management were put forward to provide a guidance for the diagnosis and treatment of sTBI complicated by COVID-19.

Objective:To investigate the effects and molecular mechanism of neuropilin and tolloid-like 2 (NETO2) on proliferation, migration, cell cycle, and apoptosis in gallbladder cancer (GBC).Methods:The NETO2 mRNA and protein expression in GBC-SD, ZJU-0430, NOZ GBC cells were detected by quantitative real-time polymerase chain reaction and Western blot. NETO2 overexpression and knockdown stable cell lines were constructed by plasmid transfection. Cell counting kit-8 assay, colony formation assay, transwell assay, flow cytometry and WB assay were performed to evaluate proliferation, migration, cell cycle, apoptosis, epithelial-mesenchymal transition (EMT) and changes of phosphatidylinositol-3 kinase/protein kinase B (PI3K/Akt) signaling pathway.Results:GBC-SD and ZJU-0430 cells with NETO2 gene overexpression and NOZ cells with NETO2 gene knockdown were effectively constructed. NETO2 overexpression in gallbladder cancer cell lines significantly improved cell proliferation and migration, advanced cell cycle progression from G0/G1 to S phase, and inhibited cell apoptosis. In the ZJU-0430 and GBC-SD cells, the clone number increased from (78.5±9.2), (217.0±6.4) to (213.5±10.3), (296.3±9.3)( t=10.98, 6.51; P=0.008, 0.023); The number of migrating cells increased from (198.6±8.4), (233.3±11.0) to (382.7±12.4), (379.0±7.3) ( t=16.98, 16.85, both P<0.001); The total apoptosis rate reduced from (29.7±0.9)%, (35.6±1.1)% to (19.2±0.5)%, (29.1±0.4)% ( t=9.74, 9.05; both P<0.001); The expression of EMT related proteins such as N-cadherin, Vimentin, Snail, and Slug were upregulated, while E-cadherin expression was downregulated. Phosphorylated PI3K (p-PI3K) and Akt (p-Akt) protein expression were significantly increased (all P<0.05). In contrast, NETO2 knockdown had the opposite effect on all these parameters. Conclusion:NETO2 influences the EMT process by regulating the PI3K/Akt signaling pathway, thus promotes GBC cell proliferation, migration and cell cycle progression, and inhibits cancer cell apoptosis.

Objective:To investigate the effect of autophagy related gene Atg101 on white adipocyte senescence.Methods:An Atg101 knockdown model of 3T3-L1 mature adipocytes was constructed to probe the effect of Atg101 on autophagy-related proteins LC3 and p62 protein. The RNA-seq database of human subcutaneous adipose tissue was constructed and analyzed, and the co-expressed gene set was predicted based on the pearson correlation coefficient( R2>0.4, P<0.05) between FPKM values of Atg101 and other gene, followed by KEGG and Reactome enrichment analysis. Young mouse(8 weeks old) and old mouse(18 months old) models were established, and the expression levels of Atg101 in inguinal white adipose tissue and epididymal white adipose tissue were detected by quantitative real-time PCR(RT-qPCR) and Western blot. Furthermore, the differences in white adipocyte senescence-associated secretory phenotype(SASP), cell cycle and mitochondrial homeostasis-related genes were detected by RNA-seq, Western blot, and RT-qPCR to analyze the effects of Atg101 silencing on adipocyte senescence. Results:The autophagy-related protein LC3-Ⅱ expression was significantly decreased and p62 protein was induced after Atg101 was knockdowned in 3T3-L1 adipocytes, suggesting impaired cell autophagy. KEGG enrichment analysis revealed that Atg101 co-expressed gene set was mainly enriched in autophagy and senescence-related pathways; Reactome enrichment analysis revealed that this gene set was associated with multiple cell cycle signaling pathways. RT-qPCR and Western blot confirmed that both mRNA and protein levels of Atg101 were down-regulated in inguinal white adipose tissue of aging mice, and protein levels in epididymal white adipose tissue were also significantly reduced. Finally, it was further confirmed that SASP-related genes were induced after Atg101 knockdown in white adipocytes, and cell cycle-specific gene expression was restricted and cytokine-dependent protein kinase inhibitors p16 and p21 expressions were significantly increased, while mitochondrial homeostasis regulatory genes were also suppressed.Conclusions:Knockdown of Atg101 may regulate white adipocyte senescence by inhibiting autophagic activity, presenting impaired mitochondrial homeostasis.

Primary adrenal lymphoma (PAL) is a rare extranodular lymphoma. It is subject to misdiagnosis due to atypical clinical and imaging features. Histopathology is required to establish the diagnosis. Patients often present to the Endocrinology Department upon revelation of adrenal incidentalomas by imaging. PAL is often accompanied by invasion of other tissues and organs, with a high mortality rate and a poor prognosis. In this paper, the clinical features of a patient with primary adrenal lymphoma and intracranial invasion were summarized, and the pathogenesis, clinical manifestations, diagnosis and treatment of this disease were reviewed.