Objective:To construct an estimating equation to accurately reflect the aging phenomenon of the glomerular filtration rate(GFR).Methods:Healthy subjects receiving physical examinations at the First Affiliated Hospital of Nanjing Medical University between January 2017 and April 2018 were included in the study, and the aging phenomenon of renal function indicators such as serum creatinine(Scr)was used as the reference standard to evaluate the accuracy of four Scr-based GFR equations during GFR aging, including the full age spectrum(FAS)equation, the Chronic Kidney Disease Epidemiology Collaboration(CKD-EPI)equation, the Osaka equation and the Xiangya equation.Results:Of 37 636 individuals receiving physical examinations, 6 534 met the criteria specified in this study.Scr, serum urea nitrogen, serum uric acid, and serum albumin showed a significant aging phenomenon( H=191.640, 196.693, 83.271, 414.585, P<0.001 for all).The GFR estimated by the four equations all decreased with aging, but the starting point and rate of decline were significantly different.The GFR aging phenomenon estimated by the FAS equation was closer to the trend of renal function indicators. Conclusions:The FAS equation may be more applicable to healthy people to understand the aging phenomenon of GFR.

Objective:To analyze the correlation of cyclin-dependent kinase 4 (CDK4) and breast cancer resistance protein (BCRP) expression with pathological features and prognosis of breast cancer.Methods:From Jan. 2020 to Jun. 2021, 132 breast cancer patients admitted to our hospital were chosen. The surgically removed breast cancer tissues and adjacent tissues of all patients were collected, and the expressions of CDK4 and BCRP were detected by immunohistochemical staining. Clinical data of all patients were collected, and the correlation among CDK4, BCRP expression and pathological features, prognosis was analyzed.Results:The positive expression rates of CDK4 and BCRP in breast cancer tissues were higher than those in adjacent tissues ( P <0.05) ; The positive expression rate of CDK4 and BCRP was associated with differentiation degree, TNM stage and lymph node metastasis (all P <0.05) ; Kaplan-Meier analysis showed that the cumulative survival rate of CDK4 and BCRP negative expression group was higher than that of positive expression group ( P <0.05) ; Differentiation degree, TNM stage, lymph node metastasis, CDK4 expression and BCRP expression were independent prognostic factors for overall survival of breast cancer patients (all P <0.05) . Conclusions:CDK4 and BCRP have high positive expression rates in breast cancer tissues, and their expression is related to pathological features, with certain value in evaluating the prognosis of breast cancer patients.

OBJECTIVE To investigate the present equipment and management situation of narcotic drugs in primary healthcare institutions from Qiandongnan prefecture of Guizhou province. METHODS The questionnaire survey was conducted among pharmacy department heads and medical staff from primary healthcare institutions in Qiandongnan prefecture of Guizhou province. Descriptive statistical analysis was conducted on the survey results. RESULTS Of 251 healthcare institutions in this survey， 29 healthcare institutions were equipped with narcotic drugs， accounting for 11.55%. The reasons for the narcotic drugs unequipped were mainly as follows: insufficient attention， no storage conditions for narcotic drugs， complex program of narcotic drug management， small amount usage and so on. Among the 29 primary healthcare institutions equipped with narcotic drugs， all of them did not monitor patient usage， accounting for 100%； 29 healthcare institutions did not implement a return visit or follow-up every 3 months， accounting for 100%. CONCLUSIONS The health administration departments should strengthen the administration of narcotic drugs in primary healthcare institutions. At the same time， training on standardized management and clinical rational application of narcotic drugs for medical staff in primary healthcare institutions should be enhanced by the health administrative department.

Objective:To explore differences of resting brain regional homogeneity (ReHo) between patients with major depressive disorder (MDD) and their siblings.Methods:From January to December 2013, the resting-state functional magnetic resonance imaging (fMRI) data of 87 patients with MDD and 21 healthy siblings were collected.DPABI v5.1 software was used to preprocess the resting-state fMRI data, and ReHo maps of each subject was obtained. A two-sample t-test was used to compare differences between the patients with MDD and their siblings in ReHo values throughout the brain. ReHo values within the significant brain regions were extracted out, and used to calculate Spearman correlation with the total score of 17-items Hamilton depression rating scale(HAMD-17) in the patients with MDD and their siblings respectively.The software of SPSS 20.0 was used for statistical analysis. Results:The patients with MDD exhibited lower ReHo values in the precuneus extending to the posterior cingulate cortex (PCu/PCC) compared with their siblings (cluster-size=126 voxel, cluster-level PFDR=0.033; MNI: x=-4, y=-58, z=38, t=4.30). ReHo values of the PCu/PCC in patient with MDD were positively correlated with the severity of depressive symptoms ( r=0.255, P=0.021). Conclusion:Compared with the siblings, local brain activity of the PCu/PCC in the patients with MDD was decreased, and related to the severity of depressive symptoms. It is helpful to further reveal the intrinsic neural mechanism of MDD.

As an important part of tumor microenvironment, neutrophils are poorly understood due to their spatiotemporal heterogeneity in tumorigenesis. Here we defined, at single-cell resolution, CD44-CXCR2- neutrophils as tumor-specific neutrophils (tsNeus) in both mouse and human gastric cancer (GC). We uncovered a Hippo regulon in neutrophils with unique YAP signature genes (e.g., ICAM1, CD14, EGR1) distinct from those identified in epithelial and/or cancer cells. Importantly, knockout of YAP/TAZ in neutrophils impaired their differentiation into CD54+ tsNeus and reduced their antitumor activity, leading to accelerated GC progression. Moreover, the relative amounts of CD54+ tsNeus were found to be negatively associated with GC progression and positively associated with patient survival. Interestingly, GC patients receiving neoadjuvant chemotherapy had increased numbers of CD54+ tsNeus. Furthermore, pharmacologically enhancing YAP activity selectively activated neutrophils to suppress refractory GC, with no significant inflammation-related side effects. Thus, our work characterized tumor-specific neutrophils in GC and revealed an essential role of YAP/TAZ-CD54 axis in tsNeus, opening a new possibility to develop neutrophil-based antitumor therapeutics.
Humans ; Animals ; Mice ; Adaptor Proteins, Signal Transducing/metabolism* ; Transcription Factors/metabolism* ; Stomach Neoplasms/pathology* ; Neutrophils/pathology* ; Signal Transduction/genetics* ; YAP-Signaling Proteins ; Tumor Microenvironment ; Hyaluronan Receptors/genetics*

Objective To analyze the main factors affecting early using enteral nutrition and the effect of enteral nutrition within 72 h after burning on outcomes by presenting a retrospective cohort study of 11 years of hospitalization data,to provide evidence for enteral nutrition regimens for severe burn patients.Methods A retrospective study analyzed adult extensive burn patients between January 2009 and December 2020.Patients enrolled in this study who admitted to the burn department within 24 h after burning and with a burned area of more than 30%.Univariate and multiple regression were used to analyze the main factors affecting early using enteral nutrition in patients with severe burn.Non parametric Mann-Whitney U test was used to compare the main influencing factors of enteral nutrition implementation within or after 72 h,as well as the impact on the treatment outcomes such as 28-day survival rate and in hospital survival rate.Results The univariate analysis found that total burn area,full-thickness burn area,burn type,and inhalation injury were the main factors of the time to initation of enteral nutrition in patients with severe burn(P<0.05).Incorporating the above single factors into multiple regression analysis,we found that the main factors affecting enteral nutrition using in patients with severe burn were full-thickness burn area(P=0.017)and inhalation injury(P=0.001).To analysis whether enteral nutrition was started within 72 h after burning,we found that inhalation injury and larger area of full-thickness burn area in patients was the main factors for initiating enteral nutrition.After matching injury situation with pre-injury situation,we found that using enteral nutrition within or after 72 h after injury were no significant differences in the survival rate,28-day survival rate,and positive blood culture rate(P>0.05),but was associated with the lower incidence of bacteria positive in intravenous catheters(P=0.001)and the lower rate of parenteral nutrition treatment used within 7 d after burning(P= 0.001).Conclusions The main factor for influencing early implement enteral nutrition in patients with severe burn were large area of full-thickness burn and inhalation injury.Enteral nutrition using within 72 h after burning reduces the incidence of catheter infection and the use of parenteral nutrition,thereby reducing the risk of treatment in patients with severe burn.

Objective:To observe the variation rend of serum creatinine(SCr)and estimated glomerular filtration rate(eGFR)with aging, and to explore the warning range of SCr for screening low eGFR of the elderly.Methods:A retrospective cross-sectional study was performed in 10 3513 participants, including 14 221 in 18-29 years old, 29 763 in 30-39 years old, 23 151 in 40-49 years old, 18 838 in 50-59 years old, 10 019 in 60-69 years old, 5 009 in 70-79 years old, 2 512 aged ≥80 years old.We adopted CKD-EPI formula based on Chronic Kidney Disease Epidemiology Collaboration(CKD-EPISCR)formula recommended by the Global Organization for Improving Outcomes in Kidney Disease 2012 to calculate eGFR.The SCr and eGFR levels were calculated according to age to show the trend of these with aging.Further, we used percentage to investigate the distribution of eGFR in population with normal SCr, and the percentile method to establish the warning range of SCr in the older adults.Results:With aging, SCr level showed an elevating trend in women( F=340.80, P<0.001), and gradually increased in men older than 50 years( F=111.05, P<0.001)and eGFR declined with increasing age( F=8 301.60, 9 114.53, P<0.001). In population with normal SCr, the proportions of eGFR<60 and 60-75 ml·min -1·1.73m -2 were 3.83%(661/17 280)and 12.50%(2 160/17 280)in older adults aged 60-74 years respectively, but were 10.39%(488/4 699)and 22.75%(1 069/4 699)in old-older adults aged 75 years and over respectively, and were 0.07%(56/84 145)and 0.91%(762/84 145)in younger adults below 60 years old respectively.In the same distribution of eGFR, SCr levels of older adults aged 60-74 years and old-older adults aged 75 years and over were lower than that of younger population( P<0.001). In old-older adults aged 75 years and over, the warning range of SCr was 98.76-126.03 μmol/L for men and 95.12-130.00 μmol/L for women in individuals with 45 ≤ eGFR<60 ml·min -1·1.73m -2. Conclusions:The SCr level of older adults is lower than younger individuals in same distribution of eGFR.SCr level is still in the reference range in some of older individuals with eGFR-confirmed renal function impairment.The warning range of SCr is needed, especially in older adults, so as to provide reference for the rational use of medicine and disease management.

Objective To investigate the effect and mechanism of isorhapontigenin (ISO) in the protection of mice from the lipopolysaccharide (LPS)-induced acute lung injury (ALI). Methods RAW264.7 cells were cultured in vitro with different concentrations of ISO and the viability of the cells was measured by CCK-8 assay.Further,RAW264.7 cells were induced with 200 ng/ml LPS and then treated with ISO and the autophagy inhibitor 3-methyladenine (3-MA).Western blotting was employed to determine the expression of inflammatory cytokines [interleukin (IL)-1β,IL-6,tumor necrosis factor-α (TNF-α),P65,phospho-P56 (p-P65),IκB,phospho-IκB (p-IκB),inducible nitric oxide synthase (iNOS),cyclooxygenase-2 (COX-2),and high mobility group box-1 (HMGB1)] and autophagy markers (LC3Ⅱ/Ⅰ,Beclin1,and P62).The reactive oxygen species (ROS) production of the cells was measured with the DCFH-DA probe.The mouse model of ALI was established by intraperitoneal injection of LPS (15 mg/kg).The pathological changes of the lung tissue were observed via HE staining.The expression of inflammatory cytokines and autophagy markers in the lung tissue was determined by Western blotting and the content of ROS in bronchoalveolar lavage fluid (BALF) by flow cytometry. Results ISO down-regulated the expression of IL-1β,IL-6,TNF-α,iNOS,COX-2,and HMGB1 and inhibited the ROS production in the LPS-induced RAW264.7 cells (all P<0.05).Furthermore,it promoted the expression of LC3Ⅱ/Ⅰ and Beclin1 and inhibited the expression of P62,thereby activating autophagy (all P<0.05).However,the addition of 3-MA up-regulated the expression of p-P65/P65,p-IκB,iNOS,COX-2,and HMGB1,down-regulated that of IκB (all P<0.001),and promote the production of ROS.ISO mitigated the pathological changes in the lung tissue of ALI mice.It down-regulated the expression of p-P65/P65,p-IκB,iNOS,COX-2,and HMGB1 and up-regulated that of IκB in the lung tissue (all P<0.001) and decreased the ROS production in BALF.However,such protective effect was reversed by 3-MA. Conclusion ISO may induce autophagy of macrophages to protect mice from LPS-induced ALI.
Animals ; Mice ; Acute Lung Injury/pathology* ; Beclin-1/pharmacology* ; Cyclooxygenase 2/metabolism* ; Cytokines ; HMGB1 Protein/metabolism* ; Interleukin-6 ; Lipopolysaccharides ; Lung/pathology* ; NF-kappa B/metabolism* ; Reactive Oxygen Species/metabolism* ; Tumor Necrosis Factor-alpha/metabolism*

【Objective】 To establish and evaluate a fluorescent antibody to membrane antigen (FAMA) method for detecting antibodies against varicella-zoster virus (VZV) based on Vero E6 cells. 【Methods】 Based on the adapted VZV-Oka-E6 strain that VZV-Oka live attenuated varicella vaccine strain grew in Vero E6 cells, Vero E6 cells were infected with VZV-Oka-E6 of three different doses (10^4.65, 10^4.95 and 10^5.25 TCID50), and the cytopathic effect was observed under a microscope to determine the optimal infection dose of VZV-Oka-E6 strain. Then the detectable sensitivity of the infected cell antigen slides prepared after fixing the infected cells with different fixatives was compared to determine the optimal fixative. As a result, the FAMA method based on Vero E6 cells for the determination of neutralizing anti-VZV has been developed. The established FAMA assay was used to detect the international standard for varicella zoster immunoglobulin with different titers to determine the sensitivity of the assay. The specificity of the assay was evaluated by detecting specific antibodies against human herpes simplex virus (HSV) type 1 and type 2. The neutralizing anti-VZV antibodies of the international standard for varicella zoster immunoglobulin were detected using VZV-infected cell antigen slides prepared in the same batch and four different batches, respectively, to determine the intra-assay repeatability and inter-assay repeatability. The international standard for varicella zoster immunoglobulin with three known titers was detected to evaluate the relative accuracy of this assay. The anti-VZV titers in 20 apheresis plasma samples were determined with the newly established FAMA test and ELISA test, respectively, and the detection results of the two methods were compared using Spearman’s correlation test. 【Results】 The optimal infection dose of the VZV-Oka-E6 strain in FAMA assay was determined to be 10^5.25 TCID50, and acetone precooled at -20℃ was used as the fixative. The FAMA test has a high sensitivity with a detecting limit of 31.25 mIU/mL for neutralizing anti-VZV titers. The negative result was observed when detecting herpes simplex virus (HSV) type 1 and 2 specific antibodies. The international standard for varicella zoster immunoglobulin was detected by VZV infected cell antigen slides prepared in the same batch and 4 different batches, with the coefficient of variation being 29.95% and 26.71%, respectively. The detection value of the international standard for varicella zoster immunoglobulin with three different titer levels was consistent with their theoretical value. The correlation coefficient of the detection results of 20 apheresis plasma samples by the FAMA test and ELISA test was 0.268. 【Conclusion】 The VZV FAMA assay has good sensitivity, specificity, repeatability, and relative accuracy in detecting neutralizing anti-VZV titers. It can be applied for detecting neutralizing anti-VZV titers in apheresis plasma samples as well as the varicella-zoster immunoglobulin (VZIG) preparations.

Objective:To explore the current status and the influencing factors of knowledge, attitude and behavior of radiodermatitis in patients with nasopharyngeal carcinoma undergoing radiotherapy, so as to provide a scientific basis for nursing staff to formulate effective health education programs.Methods:A self-designed questionnaire was used to investigate 220 radiotherapy patients with nasopharyngeal carcinoma in the radiotherapy department of 4 tertiary A hospitals in Hunan Province.Results:The scores of knowledge, attitude, and behavior of radiodermatitis patients with nasopharyngeal carcinoma were (61.58±19.93), (75.70 ±15.64), (65.87±14.21) points, respectively. The main factors influencing of behavior are knowledge, attitude, radiodermatitis grade, radiotherapy frequency, and family personal monthly income level ( t values were 1.978-8.081, P<0.05). Conclusion:At present, patients with nasopharyngeal carcinoma undergoing radiotherapy have a partial understanding of radiodermatitis and poor self-observation of radiodermatitis. Nursing staff should pay special attention to the patients with incomplete knowledge, negative attitudes, low family personal monthly income, low frequency of radiotherapy, and low grade of radiodermatitis.