Objective To investigate the correlation and consistency between the parameters of thromboelastography(TEG)and routine coagulation tests,and to evaluate the application value of the two methods in heparin anticoagulation monitoring and coagulation function monitoring in patients receiving extracorporeal membrane oxygenation(ECMO)therapy.Methods A total of 138 patients who recieved ECMO in the Department of Critical Care Medicine of the People's Hospital of Guangxi Zhuang Autonomous Region from October 2021 to December 2022 were selected.A total of 317 pairs of ordinary TEG and heparinase-modified TEG(hmTEG)parameters measured simultaneously were analyzed for correlation and consis-tency with activated partial thromboplastin time(APTT),fibrinogen(Fib),and platelet count(Plt),and the parameters tested when ECMO was established and 24 hours after ECMO operation were compared.Results The correlation coefficient between R values and APTT of hmTEG(r=0.441,P<0.05)was lower than that of ordinary TEG(r=0.547,P<0.05).The parameters α-Angle and K value of ordinary TEG were not correlated with Fib(P>0.05),while as for hmTEG,the correla-tion was 0.359(P<0.05)and-0.343(P<0.05),respectively.The correlation between MA value of hmTEG and Plt was 0.456(P<0.05),which was much lower than its correlation with Fib(r=0.715,P<0.05).APTT and hmTEG had moderate agreement in judging the anticoagulant effect of UFH(P<0.05).Plt at 24 hours after ECMO was significantly lower than that at establishment of ECMO(P<0.05).Fib,APTT and hmTEG parameters were not significantly different between the two groups(P>0.05).Conclusion The parameters of hmTEG can better reflect the real level of coagulation factors in patients receiving ECMO.The results of hmTEG and APTT are complementary to assess whether heparin in ECMO patients is over-dosed,and hmTEG has unique advantages.Routine coagulation tests and TEG cannot replace each other,and the combina-tion of them can achieve better anticoagulation and coagulation management.

Objective To compare the effectiveness and safety of semaglutide with dulaglutide in patients diagnosed with type 2 diabetes.Methods A multicenter retrospective cohort study was conducted to include patients with type 2 diabetes who received semaglutide or dulaglutide treatment at three hospitals between April 2021 and July 2023 in the study.The patients were divided into the semaglutide group(SEMA group)and the dulaglutide group(DULA group)based on their treatment.Propensity score matching was used to pair the two groups in a 1:1 ratio,aligning them based on baseline characteristics such as gender,age,body mass index,blood glucose levels,duration of diabetes,and complications.Various parameters including fasting blood glucose,2-hour postprandial blood glucose,glycosylated hemoglobin(HbA1c),serum creatinine,urea nitrogen levels,estimated glomerular filtration rate(eGFR),urinary albumin/creatinine ratio(UACR),and occurrences of adverse reactions were assessed at 3,6,9,and 12 months after the treatment.Results After propensity score matching,98 patients were included in both the SEMA and DULA groups,showing no statistically significant differences in baseline characteristics between the groups(P＞0.05).At each follow-up point,the fasting blood glucose,2-hour postprandial blood glucose,and HbA1c levels of both groups showed a significant decrease compared to the baseline(P≤0.05).The inter-group comparison revealed no statistically significant differences in the changes in fasting blood glucose,2-hour postprandial blood glucose,and HbA1c levels between the two groups(P＞0.05).At the 6th month,the SEMA group exhibited a statistically significant higher rate of HbA1c＜7％compared to the DULA group(P＜0.05).In the SEMA group,serum creatinine and urea nitrogen decreased significantly at the 6th month compared to baseline,while eGFR showed an increase at the 3rd and 6th month,and UACR decreased,all with statistical significance(P＜0.05).In the DULA group,there was a statistically significant increase in serum creatinine and decrease at the 3rd and 6th months in eGFR,respectively.Additionally,urea nitrogen levels decreased significantly at the 9th month,all differences were statistically significant(P＜0.05).The inter-group comparison revealed that at the 3rd and 6th month,the SEMA group exhibited a greater reduction in serum creatinine levels compared to the DULA group.Additionally,the SEMA group demonstrated a more pronounced increase in eGFR levels than the DULA group,with statistical significance(P＜0.05).At the 6th month,the SEMA group exhibited a significantly greater decrease in UACR and a significantly lower incidence of renal insufficiency compared to the DULA group(P＜0.05).There were no significant difference in the incidence of adverse reactions between the two groups(P＞0.05).Conclusion Semaglutide and dulaglutide can significantly improve blood glucose control,exhibit comparable effectiveness and safety in lowering blood glucose levels,and semaglutide has a potentially protective effect on renal function.

Ulcerative colitis (UC) is one of types of inflammatory bowel disease with high recurrence. Recent studies have highlighted that microbial dysbiosis as well as abnormal gut immunity are crucial factors that initiate a series of inflammatory responses in the UC. Modulating the gut microbiota-intestinal immunity loop has been suggested as one of key strategies for relieving UC. Many Chinese herbal medicines including some of single herb, herbal formulas and the derived constituents have been reported with protective effect against UC through modulating gut microbiome and intestinal immunity. Some clinical trials have shown promising results. This review thus focused on the current knowledge on using Chinese herbal medicines for treating UC from the mechanism aspects of regulating intestinal homeostasis involving microbiota and gut immunity. The existing clinical trials are also summarized.

Objective:To analyze the monitoring results of iodine deficiency disorders in Nanning City in 2020, learn about the consumption of iodized salt among residents and the iodine nutrition status of key populations, and provide scientific basis for formulating or adjusting targeted prevention and control measures of iodine deficiency disorders.Methods:According to the Guangxi Iodine Deficiency Disorders Monitoring Plan, monitoring was carried out in all of 12 districts (counties) in Nanning City. One township (street) was selected from each of the five directions of east, west, south, north, and central. Forty non-boarding children aged 8 to 10 and 20 pregnant women were selected as monitoring subjects in each township (street). Edible salt samples were collected from children and pregnant women to detect salt iodine content, random mid-course urine samples from children and morning urine samples from pregnant women were collected to detect urinary iodine content; in addition, thyroid examination of children was conducted in Qingxiu District, Liangqing District, Long an County and Shanglin County.Results:In 2020, a total of 2 434 children aged 8 to 10 and 1 207 pregnant women were surveyed in Nanning City. The coverage rate of iodized salt, the qualified rate of iodized salt and the qualified iodine salt consumption rate were 99.67%(3 629/3 641), 97.99%(3 556/3 629) and 97.67%(3 556/3 641), respectively. The median urinary iodine of children was 182.0 μg/L, and the median values ranged from 146.5 to 234.8 μg/L in different districts (counties), there were significant differences in median urinary iodine between urban and non-urban areas, different gender and age groups ( U = 2.38, 2.41, P = 0.017, 0.016; H = 16.42, P < 0.001). The goiter rate of children was 0.99%(8/807), and the rate ranged from 0 to 2.00% (4/200) in the 4 districts (counties) examined, there were significant differences in thyroid volume between urban and non-urban areas and different ages ( U = - 3.52, P < 0.001; H = 47.67, P < 0.001). The median urinary iodine of pregnant women was 191.0 μg/L. The median urinary iodine of different districts (counties) ranged from 141.0 to 241.5 μg/L, and the difference was statistically significant at different gestational stages ( H = 24.37, P < 0.001). Conclusion:In 2020, the coverage rate of iodized salt, the qualified rate of iodized salt and the qualified iodine salt consumption rate by residents in Nanning City are high, and the iodine nutrition of both children and pregnant women are at an appropriate level.

Objective To analyze karyotype,genetic characteristics and clinical features of Turner syn-drome.Methods Cytogenetic analysis and genetic counseling were performed for patients with the diagnosis of Turner syndrome.Results Analyzed karyotype of forty-nine patients with Turner syndrome,there are five major categories such as simple type,numerical abnormality and chimeras,structural abnormality and chime-ras,both numerical abnormality and structural abnormality chimeras,contained the Y chromosome.Abnormal karyotypes were presented at eighteen species.Simple type was the most prevalent type of patients with Turn-er syndrome(43%).Conclusion Different karyotype exhibit some different phenotype.The clinical manifesta-tion of chimeras might depend on the proportion of abnormal karyotype,Case contained the Y chromosome would be hermaphrodismy mostly.Timely diagnosis of the disease would have positive significance to preven-tion and therapy.Hormonal therapy could improve patient's height and gonad development,the case contained the Y chromosome should pay attention to prevent gonadoblastoma.

Objective:To study the effect of chemokines CCL20 and CCL22 combined with skin-induced Treg on survival time of grafted skin.Methods: Skin grafting mice were divided into four groups, three mice per group, namely Treg group, Treg+CCL20 group,Treg+CCL22 group and control group.C57BL/6 mice were used as donor and BALB/c as acceptor, and the Treg cells were isolated from the mice induced by skin allograft.After skin grafted,CCL20 and CCL22 were subcutaneous injection every day,which lasted for 10 day.Survival time of skin in each group were observed and recorded.The Treg colonzation experiments were performed as follows.We firstly isolated Treg with Magnetic cell sorting system( MACS) and then labled them with 99 Tcm.After that we intravenously injected them into the mice.3 hours later,the mice were sacrifced and the radioactivity of organs were detected by GC-2016γradioim-munoassay counter.Results:①After Treg treated the survival time of skin grafted in antigen-induced Treg group was signifiantly longer than control group,when treg were cooperated with CCL20 and CCL22,the skin grafted showed more longer survival time than Treg and control groups( P<0.001 ).②After injection of induced Treg, Treg in autologous and allogeneic skin grafts goups were mainly distributed in autologous and allogeneic skin,accounting for 60% and 98% respectively.When cooperated with CCL20 or CCL22,the Treg were mainly distributed in liver.Conclusion:Chemokines CCL20 and CCL22 synergistically improved the effects of skin antigen induced Treg on survival time of skin graft,which probably related with the Treg colonization into the liver.

Objective:To explore the expression and location of TLR5 and NLRC4 on different breast cancer cell lines MDA-MB-231,MCF-7 and MDA-MB-435 and TLR5 activation in breast cancer cell line by recombinant flagellin . Methods:The mRNA level of TLR5 and NLRC4 in MDA-MB-231, MCF-7 and MDA-MB-435 cell were detected with quantitative Real-time PCR and TLR5 expression and location in MDA-MB-231 and MCF-7 cell were detected with Flow cytometry. Induction,expression,purification and i-dentification of recombiant flagellin,including FliC (activating both TLR5 and NLRC4),FliC△90-97(unable to activate TLR5),FliC-L3A (unable to activate NLRC4),FliC△90-97:L3A (unable to activate both TLR5 and NLRC4). 1 μg/ml recombinant flagellin were used to stimulate MCF-7 cell lines,12 h later,the supernate were collected,and ELISA was performed to assess the secretion of IL-8. Results:The mRNA level of TLR5 in MCF-7 cell was 1 700 folds higher than that of MDA-MB-435. TLR5 was expressed in MCF-7 cell surface and ctyosol,while expressed only in cytosol in MDA-MB-231 cell. FliC and FliC-L3A,which were able to activate TLR5 pathway,stimualted MCF-7 cell line to secret IL-8,but FliC△90-97 and FliC△90-97:L3A did not. Conclusion:TLR5 and NLRC4 have been expressed in different breast cancer lines,but there exists difference on the expression level and location of TLR5. Expression level of TLR5 and NLRC4 in MCF-7 cell were higher than other breast cancer lines. TLR5 receptor which is expressed on the surface of breast cancer cell can be activated by flagellin,and these work also provide us experimental basis to further understand the impact of TLR5 activation on breast cancer cell proliferation.

Objective:To investigate the chemokine receptors expression on regulatory T cells induced by different antigens and chemotaxis of T cells conducted by CCL20 and CCL22.Methods:BALB/c mice were divided into different groups and inoculated with skin-antigen derived from C57BL/6 mice or BCG vaccine respectively.The changes of CCR4 and CCR6 expression on CD4+CD25-T cells and CD4+CD25+CD127-T cells were detected at 1st,2nd,3rd and 4th week using flow cytometer.The chemotactic effects of CCL20 and CCL22 on CD4+CD25-T cells and CD4+CD25+CD127-T cells subsets were assayed by chemotaxis assay.Results: ①In skin-antigen group,the average fluorescence intensity ( MFI) of CCR4 on CD4+CD25-T cells at 4 week was significantly stronger than that at 3 week (P<0.05).There were no significant changes of CCR4 expression in BCG group.②The MFI of CCR6 on CD4+CD25-T cells was strongest at 2 week in skin-antigen group (P<0.05) while in other groups at 4th week (P<0.05).Besides,the expression of CCR6 on CD4+CD25+CD127-T cells was stronger during the first two weeks than the later two weeks ( P<0.05) in skin-antigen group, while in BCG group,the MFI was stronger at 2nd and 4th week than 1st week (P<0.05).③The chemotactic index of CD4+CD25+CD127-T cells was highest at 4th week in BCG group (P<0.05) in CCL20 induced chemotaxis,while in other groups were higher at 2nd and 4th week(P<0.05).In CCL22 induced chemotaxis ,there were no significantly differences of chemotactic index of CD4+CD25+CD127-T cells between skin-antigen group and BCG group.Conclusion:①The expression of chemokine receptor on the surface of Treg was associated with antigenic properties.②CCL22 had a notable chemotactic effect on Treg at the early stage of post-induction, while CCL20 did that at the late stage of post-induction.

BACKGROUND:In high-intensity exhaustive exercise process, the body must bear the exercise intensity decreasing splanchnic blood flow“ischemia”, at the same time, along with the movement of energy and material consumption, metabolite accumulation and oxidative stress in the body cause pathological damage, leading to a decline in exercise capacity. Thus, what is the impact on kidney filtration barrier? How to adapt to the change of renal tissue? Houttuynia cordata has the functions of heat clearing and detoxifying, dieresis for treating strangurtia, hemostatic, expel ing phlegm to arrest coughing and analgesia, if it has a protective effect on the renal injury caused by acute exhaustive exercise and its mechanism has not been reported in the literature. OBJECTIVE:To explore the effect of acute exhaustive exercise on kidney filtration barrier in rats and the intervention effect of Houttuynia cordata.METHODS:After resting and watching for 3 days, Sprague-Dawley rats received adaptive running for 15 minutes at a speed of 10 m/min on a 0° treadmil . A total of 24 rats, which can finish the running, were selected. They were divided into normal control group, exhaustive exercise group and dosed exhaustive exercise group according to the weight of layer (n=8). Rats in the exhaustive exercise group and dosed exhaustive exercise group on the 10° treadmil received once exhaustive exercise. Dosed exhaustive exercise group received intraperitoneal injection of sodium houttuyfonate 10 mL/kg at 30 minutes before exercises. The normal control group did not do any exercise. RESULTS AND CONCLUSION:Compared with the normal control group, serum urea nitrogen, serum creatinine, urine protein content, malondialdehyde concentration, renal cellapoptosis and apoptosis index were significantly increased, but nitric oxide content and nitric oxide synthase activity in the renal tissue were significantly deceased in the exhaustive exercise group (P<0.05 or 0.01). Glomerular filtration epithelial cells, the kidney filtration barrier of basement membrane and podocyte damage were obvious, showing abundant cellapoptosis, occasional y necrosis. Compared with the exhaustive exercise group, urine protein content, serum creatinine, malondialdehyde concentration, renal cellapoptosis and apoptosis index were significantly reduced, but nitric oxide content and nitric oxide synthase activity were significantly increased in the dosed exhaustive exercise group (P<0.05). No obvious pathological changes were detected, but apoptosis was visible. These findings confirmed that houttuynine made a reduction in renal cellinjury induced by exhaustive exercise and possibly significantly reduced apoptosis, increased nitric oxide synthase content, decreased malonaldehyde, and apparently increased superoxide dismutase activity, and final y protected injured renal tissue induced by exhaustive exercise.

BACKGROUND: With the improvement of biomaterial and further recognition in aetabular revision, the main tendency is using biologic prosthesis for mild or moderate acetabular bone defect in total hip revision. OBJECTIVE: To observe the clinical effect of simple particulate bone grafting on mild or moderate acetabular bone defect in total hip revision. DESIGN, TIME AND SETTING: A retrospective case analysis. All cases were from Department of Orthopedics, Shanghai East Hospital Affiliated to Tongji University from June 2003 to June 2008. PARTICIPANTS: A total of 10 patients with mild or moderate acetabular bone defect who received total hip revision were from Department of Orthopedics, Shanghai East Hospital Affiliated to Tongji University. Among them, there were 5 male and 5 female, with an average of 58.8 years old from 43 to 77 years old. Their last replace time were 3-10 years, with an average of (7.0?0.5) years. Two of them in the last replacement used cement components, three used cementless, four used mixture, and one used dipolar artificial thigh bone. According to AAOS typing, there were 6 cases of type Ⅰ and 4 cases of type Ⅱ. The average preoperative Harris hip joint score was 40.6. METHODS: Simple particulate bone grafting combined with biologic prosthesis was used to treat the 10 patients with mild or moderate acetabular defects. All operations were at the posterolateral approach. The acetabular cup and screw fixation were performed after grafting. The postoperative effect should be evaluated by clinical and X-ray manifestations. MAIN OBJECTIVE INDEX: The bone grafting time, bleeding volume, Harris score and complications in the perioperative period were recorded. RESULTS: All patients were adopted simple particulate bone grafting combined with biologic prosthesis to reconstruct the acetabular bone defects. One acetalum cup was found loose after one month. The titanium plate combined with particulate bone grafting was used in the second revision. At 3 months after operation, the patient could walk without crutch. No complication was found in other patients. An average of 3 years following-up was obtained. The average Harris score was 87.0. Except one acetalum cup was found loose, the X-ray showed that the bed of acetabulum and particulate bone was good healing and there was no complete transparent zone. There was no patient with displacement of acetalum cup. No osteolysis in any patient. The particulate bone and host bone had a good healing. CONCLUSION: The simple particulate bone grafting is simple and effective for mild or moderate acetabular bone defects with the good follow-up result in early period.