Background At present, high level of depression is a serious problem in medical staff and may affect their immune function. The role of psychological resilience between depression and immunity cannot be ignored. However, it is still lack of research report in this area. Objective To explore the mediating effect of psychological resilience on the association between depression and humoral immunological biomarkers in medical staff. Methods A total of 108 medical staff from a tertiary hospital in Henan Province were selected using stratified cluster sampling from September 2022 to December 2022. The Connor-Davidson Resilience Scale and Patient Health Questionnaire-9 were used to evaluate their psychological resilience and depression. Serum immunoglobulin (Ig) M (IgM), IgG, IgA, complement 3 (C3), and complement 4 (C4) were detected in fasting venous blood samples. Mann-Whitney U test, Kruskal-Wallis H test, independent-samples t-test, and One-way ANOVA were used for comparisons among different demographic groups. Spearman correlation was used to evaluate correlations among measured variables. PROCESS plug-in was used to verify potential mediating effect of psychological resilience on the relationship between depression and humoral immunological biomarkers. Results The M (P₂₅, P₇₅) score of psychological resilience was 65.50 (53.25, 75.00) in the participating medical staff. The ratios of low, medium, and high levels of psychological resilience were 2.78% (3/108), 51.85% (56/108), and 45.37% (49/108), respectively. The M (P₂₅, P₇₅) score of depression was 6.00 (2.00, 8.00). The positive rate of depression was 61.11% (66/108). The correlation analysis results showed that psychological resilience was negatively correlated with depression and serum complement C3 (r=−0.416 and −0.309, P＜0.01), positively correlated with serum IgG and serum IgA (r=0.302 and 0.517, P＜0.01); optimism, self-improvement, and resilience were negatively correlated with depression (r=−0.387, −0.446, and −0.312, P<0.01), positively correlated with IgG (r=0.194, 0.284, and 0.239, P<0.05), and positively correlated with IgA (r=0.377, 0.378, and 0.444, P<0.01), respectively; resilience was negatively correlated with C3 (r=−0.304, P<0.01), and depression was negatively correlated with serum IgG and serum IgA (r=−0.516 and −0.522, P＜0.01), positively correlated with serum complement C3 (r=0.195, P＜0.05). The mediating effect test showed that psychological resilience showed mediating effects on the relationship between depression and serum IgA and serum complement C3, with mediating effect values of −0.148 (95%CI: −0.051, −0.012) and 0.111 (95%CI: 0.001, 0.010), and their mediating effect ratios were 28.30% and 56.92%. Conclusion The mental health status of the target medical staff is not optimistic. Depression is associated with changes in some humoral immunological biomarkers. Psychological resilience can mediate the correlations between depression and humoral immunological biomarkers. The managers should take measures to improve the levels of psychological resilience and promote the physical and mental health of medical staff.

BACKGROUND:At present,bone marrow mesenchymal stem cells are the main seed cells used in cell therapy for the treatment of intervertebral disc degeneration.However,the use of bone marrow mesenchymal stem cells as seed cells for the regeneration of fibrous rings is at risk of heterotopic ossification and teratoma at the repair site.Therefore,it is of great economic and social significance to find a new kind of seed cells for tissue engineering of annulus fibrosus for the treatment of intervertebral disc degeneration. OBJECTIVE:To isolate and purify rat annulus fibrosus-derived stem cells by adherent method combined with fibronectin differential adhesion screening method,and to observe its purification effect and biological characteristics. METHODS:Annulus fibrosus tissue was obtained from a SD rat intervertebral disc.Primary annulus fibrosus-derived stem cells were obtained by the mechanical-enzymatic digestion method.Annulus fibronectin differential adhesion method was used to purify annulus fibrosus-derived stem cells.Morphological changes and proliferation of cells were observed through a microscope.The expression levels of stem cell markers were detected by immunofluorescence technique and qPCR.The screened cells were subjected to multi-lineage cell differentiation and characteristic gene detection. RESULTS AND CONCLUSION:(1)The purified cells grew well,and most of them were angular and star-shaped multi-process cells,which had good proliferation ability.(2)Cells were positive for cell membrane surface antigens CD73,CD90 and CD105,while negative for CD45 and CD34.(3)After specific induction,cells could successfully differentiate into osteoblasts,chondroblasts and lipoblasts.(4)Collagen-I,Runx-2 after osteogenic induction,Collagen Ⅱ,Sox-9 after chondrogenic induction,and PPAR-γ and LPL after lipogenic induction were highly expressed in cells,and the difference was significant compared with that before induction(P<0.05).(5)These findings confirm that the adherent method combined with fibronectin differential adhesion method is effective enough to screen,isolate and purify rat annulus fibrosus-derived stem cells,and has good cell biological properties,good proliferation ability and multiple differentiation potential.

BACKGROUND:Intervertebral disk degeneration is a pathological change caused by a series of complex molecular mechanisms that result in the aging and damage of intervertebral discs,ultimately leading to severe clinical symptoms.Traditional Chinese medicine has unique advantages in the treatment of intervertebral disk degeneration due to its low cost,non-addictive nature,multi-target effects,minimally toxic and side effects,and high patient acceptance. OBJECTIVE:To review the latest research results of traditional Chinese medicine monomer intervention-related signaling pathways in the treatment of intervertebral disk degeneration,describe and analyze the action mechanism of traditional Chinese medicine monomer on intervertebral disk degeneration,and provide a new approach and theoretical basis for future basic research and clinical treatment. METHODS:The first author searched for relevant literature from January 2018 to February 2023 in CNKI,PubMed,VIP,and WanFang using the search terms"intervertebral disc,signal pathway".The articles that did not meet the criteria were excluded after preliminary screening of the titles and abstracts.Finally,72 articles were selected for review and analysis. RESULTS AND CONCLUSION:Traditional Chinese medicine monomers can regulate multiple classical signaling pathways such as Wnt/β-catenin,PI3K/Akt,mTOR,NF-κB,and MAPK.They achieve this by regulating oxidative stress,adjusting the expression of pro/anti-apoptotic proteins in cells,stimulating cellular autophagy function,reducing stimulation of cell inflammatory factors,increasing the expression of extracellular matrix markers,reducing the production of matrix-degrading enzymes,maintaining the synthesis and stability of extracellular matrix,inducing differentiation of mesenchymal stem cells in the nucleus pulposus into nucleus pulposus cells,promoting endogenous repair and reconstruction,controlling apoptosis and aging of nucleus pulposus cells,and increasing the activity of nucleus pulposus cells.These actions improve the microenvironment within the intervertebral disc,maintain the normal physiological function of the intervertebral disc,and delay intervertebral disc degeneration.

Objective This study aimed to identify PAX9 variants in non-syndromic tooth agenesis families of Chi-na,as well as to analyze the genotype-phenotype of non-syndromic tooth agenesis caused by PAX9 variants,which can provide a basis for the genetic diagnosis of tooth agenesis.Methods We collected the data of 44 patients with non-syn-dromic oligodontia who underwent treatment at Stomatological Hospital of Hebei Medical University between 2018 and 2023.Whole-exome sequencing was performed on the peripheral blood of the proband and its core family members,and the variants were verified by Sanger sequencing.Pathogenicity analysis and function prediction of the variants were per-formed using bioinformatics tools.The correlation between the genotype of PAX9 variant and its corresponding pheno-type was examined by reviewing 55 publications retrieved from PubMed.The studies involved 232 tooth agenesis pa-tients with PAX9 variants.Results A novel PAX9 c.447delG(p.Pro150Argfs*62)and a reported PAX9 c.406C>T(p.Gln136*)were identified in two Chinese families.Through bioinformatics analysis and three-dimensional structural mod-eling,we postulated that the frameshift variant was pathogenic.The outcome was the premature cessation of PAX9 pro-tein,which caused severe structural and functional deficiencies.Summarizing the PAX9 genotype-phenotype relationship revealed that patients carrying the PAX9 variant commonly led to loss of the second molars.Conclusion We identified the novel PAX9 c.447delG(p.Pro150Argfs*62)in a Chinese family of non-syndromic oligodontia,expanding the known variant spectrum of PAX9.The most susceptible tooth position for PAX9 variants of tooth agenesis was the second mo-lars and the deciduous molars during the deciduous dentition.

AIM:To investigate the molecular mechanism of a novel bromobenzene substituted trifluoromethylbenzo Cyclopentanone WW02 inhib-iting the viability and proliferation of human lung cancer A549 and H1299 cells.METHODS:The ef-fect of different concentrations of WW02(6.25,12.5,25,50 μg/mL)on cell viability and prolifera-tion of A549 and H1299 were measured using CCK-8 and EdU methods.After 24 hours of stimulation of A549 and H1299 cells with different concentra-tions of WW02,the changes in Akt and mTOR phos-phorylation levels under different concentrations of WW02 were detected through Western blot as-say.Macromolecular docking was carried out be-tween WW02,AKT and mTOR through MOE Dock.RESULTS:After treating A549 and H1299 cells with WW02 using different concentrations(6.25,12.5,25,50 μg/mL),the activity of A549 and H1299 cells decreased in a concentration dependent manner compared with the DMSO control group(P<0.05).The proliferation of cells showed a concentration dependent decrease compared to the DMSO con-trol group(P<0.05).Compared with the DMSO con-trol group,after 24 hours of WW02 stimulation,the phosphorylation levels of Akt and mTOR in A549 cells decreased under the concentration of WW02(12.5,25,50 μg/mL,P<0.05).Compared with the DMSO control group,the phosphorylation levels of Akt and mTOR in H1299 cells decreased af-ter 24 hours of WW02 stimulation(25,50 μg/mL,P<0.05).Based on pattern analysis,it was found that WW02 had a strong binding with Akt and mTOR,with the highest score of-8.3 kcal/mol for WW02 and mTOR,while the highest score for WW02 and Akt was-7.3 kcal/mol.CONCLUSION:WW02 inhib-its the activity and proliferation of lung cancer A549 and H1299 cells,and its mechanism of action may be achieved by directly binding to Akt and mTOR proteins to inhibit Akt and mTOR phosphory-lation.

Objective To analyze the values of serum Delta-like protein 4(DLL4)and cAMP response element-binding protein(CREB)levels in predicting microvascular injury of patients with different stages of diabetic retinopathy(DR).Methods Eighty diabetic patients from February 2020 to February 2023 were selected as research objects,and they were divided into no DR group(n=37),non-proliferative DR group(n=19)and proliferative DR group(n=24)according to different stages of DR;serum DLL4 and CREB levels in the blood were detected,and the FACS Count flow cytometry was used to detect levels of endothelial progenitor cells(EPC),circulating endothelial cells(CEC)and circulating progenitor cells(CPC)in patients.Results The levels of DLL4 and CREB in the blood of proliferative DR group were the highest,while the levels of DLL4 and CREB in the no DR group were the lowest,and the differences were statistically significant(P＜0.05);different stages of DR were significantly positively correlated with the levels of DLL4 and CREB(P＜0.05);the high levels of DLL4 and CREB in the blood of diabetic patients were the independent risk factors affecting staging of DR(P＜0.05).The levels of EPC and CPC in the blood of proliferative DR group were the lowest,while the level of CEC was the highest;in the no DR group,the levels of EPC and CPC were the highest,while the level of CEC was the lowest,and the differences were statistically signifi-cant(P＜0.05);the levels of DLL4 and CREB were significantly negatively correlated with EPC and CPC levels(P＜0.05),while the levels of DLL4 and CREB were significantly positively corre-lated with CEC level(P＜0.05);the area under the curve(AUC)of both DLL4 and CREB in pre-dicting microvascular injury in DR patients was greater than 0.85.Conclusion As the staging of DR increases,the levels of serum DLL4 and CREB show a significant upward trend,and DLL4 and CREB have higher predictive values for microvascular injury.

Objective To analyze the values of serum Delta-like protein 4(DLL4)and cAMP response element-binding protein(CREB)levels in predicting microvascular injury of patients with different stages of diabetic retinopathy(DR).Methods Eighty diabetic patients from February 2020 to February 2023 were selected as research objects,and they were divided into no DR group(n=37),non-proliferative DR group(n=19)and proliferative DR group(n=24)according to different stages of DR;serum DLL4 and CREB levels in the blood were detected,and the FACS Count flow cytometry was used to detect levels of endothelial progenitor cells(EPC),circulating endothelial cells(CEC)and circulating progenitor cells(CPC)in patients.Results The levels of DLL4 and CREB in the blood of proliferative DR group were the highest,while the levels of DLL4 and CREB in the no DR group were the lowest,and the differences were statistically significant(P＜0.05);different stages of DR were significantly positively correlated with the levels of DLL4 and CREB(P＜0.05);the high levels of DLL4 and CREB in the blood of diabetic patients were the independent risk factors affecting staging of DR(P＜0.05).The levels of EPC and CPC in the blood of proliferative DR group were the lowest,while the level of CEC was the highest;in the no DR group,the levels of EPC and CPC were the highest,while the level of CEC was the lowest,and the differences were statistically signifi-cant(P＜0.05);the levels of DLL4 and CREB were significantly negatively correlated with EPC and CPC levels(P＜0.05),while the levels of DLL4 and CREB were significantly positively corre-lated with CEC level(P＜0.05);the area under the curve(AUC)of both DLL4 and CREB in pre-dicting microvascular injury in DR patients was greater than 0.85.Conclusion As the staging of DR increases,the levels of serum DLL4 and CREB show a significant upward trend,and DLL4 and CREB have higher predictive values for microvascular injury.

Objective:To investigate clinical efficacy of nail removal in combination with periungual dermis-fat flap tamponade in the treatment of bilateral severe curved ingrown nails.Methods:A retrospective analysis was conducted on clinical data collected from 7 patients with bilateral severe curved ingrown nails visiting the hospital between January 2018 and January 2020. There were 3 males and 4 females, aged 25-49 years (average: 35 years) . All patients were treated with nail removal in combination with periungual dermis-fat flap tamponade at outpatient clinics.Results:All the 7 patients experienced primary healing of incisions without infections, and achieved pain relief 1-2 weeks after surgery. During the follow-up of 12 to 24 months, new nail plates grew back without curling deformity, no erythematous swelling occurred in the nail grooves, and no recurrence of paronychia was observed. All patients were satisfied with the clinical efficacy.Conclusion:Nail removal in combination with periungual dermis-fat flap tamponade is effective for the treatment of bilateral severe curved ingrown nails.

Objective:To investigate the clinical characteristics, treatment and prognosis of children with acquired thrombotic thrombocytopenic purpura (TTP).Methods:The clinical manifestations, laboratory examination, treatment and prognosis of 5 children with acquired TTP hospitalized in Beijing Children′s Hospital, Capital Medical University from January 2016 to July 2019 were analyzed retrospectively.Results:There were 5 children with acquired TTP including 2 males and 3 females, with the onset age of 8.9(0.8-14.5) years, while 11 children with TTP in the same period. Thrombocytopenia and microangiopathic hemolytic anemia were found in all 5 patients. Only one patient had typical pentalogy of TTP, 3 patients had nervous system symptoms and 3 patients had fever, while renal impairment was relatively rare (1 case). Laboratory examination showed severe thrombocytopenia (7(4-14) ×10 9/L) and low level of hemoglobin (70(58-100)g/L) in all 5 children. Blood biochemical examination showed that total bilirubin (mainly indirect bilirubin) increased in 3 patients, lactate dehydrogenase increased in 5 patients, and urea nitrogen increased in 1 patient. Bone marrow smear showed megakaryocyte did not decrease. Plasma ADAMTS13 activity was 0 in all 5 patients while ADAMTS13 inhibitor was positive in 4 patients and negative in 1 patient. All 5 children received glucocorticoid therapy, rituximab was added in the early stage of the disease, and 3 children received plasma exchange. The time of platelet recovery to normal was 19 (9-29) days. One child had TTP recurrence after 9 months of treatment. The condition was stable after being treated with glucocorticoid and rituximab again. This case was finally diagnosed as systemic lupus erythematosus after more than 3 years followed up. By December 1, 2020, the follow-up time was 24(16-57) months.The clinical symptoms of all patients disappeared and the platelet level was stable at 159(125-269) ×10 9/L. Conclusions:Childhood acquired TTP is relatively rare, which can occur in all age groups. The clinical manifestations are mainly thrombocytopenia and microangiopathic hemolytic anemia, the plasma ADAMTS 13 activity and inhibitor test are helpful for the diagnosis of acquired TTP. Plasma exchange and rituximab are effective treatment. This disease requires long-term follow-up.

Objective To investigate the clinical and CT features of basal cell adenomas (BCA)of parotid gland,and to improve the understanding of the disease.Methods Clinical and CT data of 1 8 patients with BCA of parotid gland confirmed by surgery and pathology were collected.The characteristics of age,sex,clinical symptom,lesion site,number,size,shape,density and CT dualGphase enhancement of the lesions were retrospectively analyzed.Results (1)Age and sex of onset:1 2 cases(6 6.6 7%)of age stage from 30 to 5 9,5 cases (27.78%)of the elder over 60,1 case of the younger below 29,5 cases (27.78%)for males,1 3cases (72.22%)for females,the incidence ratio of male to female being 1 ︰ 2.5.(2)Clinical manifestations:there were sporadic masses in the parotid region,3 cases were accompanied by mild pain and all patients had no facial nerve symptoms.(3)Location site,number,size:23 lesions in 18 cases, of which 15 cases (83.3%)were single and 3 cases (16.7%)had multiple lesions on one side.17 lesions (73.9%)were located in superficial lobe, and 6 lesions (26.1%)were located in the deep lobe;(4)Shape and cross section diameter:the shape of the tumor was round or ellipse with wellG defined margin,13 cases (56.5%)of the round shape,10 cases (43.5%)of the ellipse;the maximum cross section diameter was (2.49±1.3 8)cm,the superficial lobe group was (2.05 ±1.02)cm,and the deep lobe group was (3.73 ±1.59)cm.The difference between the two groups on the maximum cross section diameter was significant (P＜ 0.05).(5)Density:the density of most lesions was heterogeneous.17 lesions were accompanied by central or peripheral cystic degeneration of varying degrees,of which 10 lesions with cystic regions ＞ 50% and 2 lesions with maximum transverse diameter ＜ 0.8 cm.(6)CT dualGphase enhancement:19 lesions showed obvious homogeneous or heterogeneous enhancement on the arterial phase,and persistent enhancement on the venous phase.4 lesions showed progressive heterogeneous enhancement,and the enhancement degree of venous phase was even higher than that of arterial phase.Conclusion The BCA of the parotid gland aremainly occuring in middleGaged and older women,displaying regular shape of lesions,developing to cystic degeneration easily and presenting＂fastGelevation and sustained enhancement＂or progressive enhancement patterns in the dualGphase enhanced scans.These characteristics are helpful to make a diagnosis preoperatively.