The study was aimed to assess the impact of Brucea javanica oil emulsion(BJOE)on the responsiveness of programmed death receptor-1(PD-1)monoclonal antibody to lung adenocarcinoma in mice.The experimental approach involved subcutaneously inoculating Lewis's lung adenocarcinoma(LLC)cells into C57BL/6 mice,which were then divided into four groups:model group,25 ml·kg-1 BJOE group,10 mg·kg-1 PD-1 group,and combination group(25 ml·kg-1 BJOE and 10 mg·kg-1 PD-1).Tumor volume,mass,and inhibition rate were evaluated;the apoptosis within tumor tissue was detected by TUNEL staining;CD4+and CD8+T cell proportions within tumor tissues were analyzed by flow cytometry;the levels of tumor necrosis factor-α(TNF-α),interferon-γ(IFN-γ)and granzyme B in tumor tissue were measured by enzyme-linked immunosorbent assay(ELISA).Additionally,LLC cells were categorized into a control group and three BJOE treatment groups(10,30,50 μl·ml-1),and programmed death ligand 1(PD-L1)expression in tumor tissues and LLC cells were assessed by Western blotting.Data showed that as compared with the model group,PD-1 monoclonal antibody alone did not significantly alter tumor volume,tumor mass,CD4+and CD8+T cell proportions,cytokine levels(IFN-γ,TNF-α,Granzyme B),or apoptosis in lung cancer-bearing mice.However,BJOE treatment reduced tumor volume and mass,enhanced CD4+and CD8+T cell proportions,increased cytokine levels,and augmented apoptosis(all P<0.05).Furthermore,the combination therapy of BJOE and PD-1 monoclonal antibody yielded significantly greater reductions in tumor volume and mass,with heightened CD4+and CD8+T cell proportions,cytokine levels,and apoptosis compared to either treatment alone(all P<0.05).Both BJOE treatment and the combination therapy significantly upregulated PD-L1 protein expression in tumor tissues compared to the model or PD-1 monoclonal antibody groups(P<0.05).Similarly,BJOE treatment at all tested concentrations significantly increased PD-L1 protein expression in LLC cells as compared to the control group(P<0.05).In conclusion,BJOE could upregulate PD-L1 expression in LLC cells and enhance the sensitivity of lung adenocarcinoma-bearing mice to PD-1 monoclonal antibodies.

Objective To observe the ultrasonic manifestations and age distribution of internal abdominal hernia in children.Methods Data of 53 children with internal abdominal hernia confirmed by operation were retrospectively analyzed.The ultrasonic findings were observed,and the age distribution of children was analyzed.Results Among 53 cases,"cross sign"was observed in 22 cases(22/53,41.51％),and"hernia ring beak sign"was detected in 26 cases(26/53,49.06％)by preoperative ultrasound,according to which 21 cases were diagnosed as internal abdominal hernia,with the accuracy of 39.62％(21/53).Meanwhile,manifestations of intestinal obstruction were noticed in 48 cases(48/53,90.57％),and intestinal necrosis was considered in 22 cases(22/53,41.51％).Four cases were misdiagnosed as intestinal perforation,appendicitis,intestinal atresia and volvulus,each in 1 case.The onset age of postoperative adhesive band internal hernia was larger than that of mesenteric hiatal hernia(P＜0.05),while no significant difference of onset age was found among other types of internal abdominal hernias(all P＞0.05).Intestinal ischemic necrosis was found in 25 cases,while the incidence of intestinal necrosis in children aged ≤1 year,＞1 and ≤3 years,＞3 and ≤7 years and those＞7 years was 66.67％(12/18),33.33％(4/12),36.36％(4/11)and 41.67％(5/12),respectively.Conclusion The characteristic ultrasonic findings of internal abdominal hernia in children included"cross sign"and"hernia ring beak sign".Internal abdominal hernia in children under 1 year had high risk of intestinal necrosis.

OBJECTIVE To study the clinical characteristics of leflunomide-induced int erstitial pneumonia （Lef-IP），and to provide reference for its clinical diagnosis ，treatment and prevention. METHODS Lef-IP cases published in domestic and foreign journals from January 2004 to June 2021 were collected. Relevant information of patients were extracted and analyzed retrospectively， including basic characteristics ，clinical manifestations ，imaging manifestations ，laboratory examinations ， histopathological examinations ，treatment and outcome. RESULTS A total of 54 Lef-IP patients from case reports of 24 publications were included ，with a median age of 61 years（9-83 years）. Pulmonary symptoms appeared from 3.3 weeks to 132.9 weeks（median time of 14.5 weeks）. Patients with a loading dose of leflunomide have a shorter median time to pulmonary symptoms appearing （7.5 weeks）. The main clinical manifestations were dyspnea （85.2％），cough（57.4％），fever（53.7％）. CT imaging examination showed 19 cases with ground-glass shadow in both lungs ，and 29 cases showed interstitial infiltration in both lungs on chest radiograph；blood gas analysis showed hypoxemia and hypocapnia ；the levels of C-reactive protein and Krebs von Den lungen- 6 （KL-6）increased；histopathological examination mainly showed interstitial pneumonia （8 cases），including 3 cases of diffuse alveolar injury ，4 cases of lymphocytes in bronchoalveolar lavage fluid ，and 1 case of noncaseating granuloma. After discontinued leflunomide and symptomatic treatment （antibiotics，hormones，colecenamine，plasma exchange ），35 patients（64.8％）recovered or improved their lung symptoms. Twelve patients （22.2％）died，and patients with fever may had a higher mortality rate （34.5％， P＝0.02）. CONCLUSIONS The main clinical manifestations of Lef-IP are dyspnea ，cough and fever. Loading doses of leflunomide should be avoided at the beginning of treatment. When lef-IP occurs ，leflunomide is discontinued and corresponding treatment is given，and most of the patients ’pulmonary symptoms can return to normal or be improved.

Objective:To discuss the medical support strategy by summarizing the experience of medical support in Dongfeng landing site.Methods:According to the current situation of medical support at Dongfeng landing site and the practice and experience of previous medical support, a retrospective summary study was conducted.Results:The main methods were summarized: (1) formulate a feasible plan; (2) strictly screen skilled personnel; (3) provide reasonable medicinal materials and equipments; (4) complete the modification of the rescue carrier; (5) attach importance to the training of first aid techniques; (6) strengthen political and ideological education; (7) carry out physical fitness training; (8) seriously participate in actual combat training. Three points of experience were put forward: (1) the importance of thinking and action is the premise of completing the task; (2) the cooperation between training and actual combat is the basis for completing the task; (3) equal emphasis on education and management is the bottom line for completing the task.Conclusions:The medical support experience of the Dongfeng landing site is summarized to provide support and experience for the long-term in-orbit operation of China's space station and on-site medical rescue after the landing of the manned spacecraft.

Objective:To summarize the relationship between the clinicopathological features and prognosis of immunoglobulin A nephropathy (IgAN) after renal transplantation.Methods:A total of 34 patients with IgAN after renal transplantation confirmed by renal biopsy were enrolled. And another 34 patients with primary IgAN confirmed by initial renal biopsy were adopted as controls. Clinical and pathological features of two groups were compared to explore the relationship between clinicopathological features and prognosis of allograft IgAN.Results:As compared with primary IgAN group, renal function in allograft IgAN group included serum creatinine [(158.5±75.9) vs (84.8±26.8) umol/L], urea nitrogen [(9.7±6.1) vs (5.2±1.4) mmol/L], uric acid [(406.7±87.8) vs (359.0±92.6) umol/L], estimated glomerular filtration rate {(57.4±25.4) vs (91.2±28.6) [ml/(min·1.73m 2)]}. All were statistically significantly higher ( P<0.05) while other parameters showed no differences. Pathologically, the proportion of T1 type (50.0% vs 17.6%) of renal tubular atrophy/interstitial fibrosis was significantly higher in allograft IgAN group than control group ( P<0.05). Furthermore, univariate and multivariate Logistic regression analyses were performed between various pathological parameters and prognosis in allograft IgAN patients. It indicated that the degree of mesangial hyperplasia of patients with transplanted IgAN had a significantly negative impact on the prognosis. Conclusions:The clinicopathological features of patients with allograft IgAN show no difference from those of patients with primary IgAN. And among patients with allograft IgAN, those with severe mesangial hyperplasia often have a worse prognosis.

Based on the conservation of resource theory, we proposed a two-path model to examine the double-edged sword effects of career calling on occupational embeddedness via work–family conflict (WFC) and career adaptability. The proposed theoretical model and hypotheses were tested by structural equation modeling technology with a sample of nurses from five hospitals in China (total N = 368). Career calling has a double-edged sword effect on occupational embeddedness via WFC and career adaptability. Career calling has positive effects on WFC and career adaptability. WFC and career adaptability, in turn, negatively and positively influence occupational embeddedness, respectively. In addition to the well-established positive effects, career calling may also have adverse effects on occupational outcomes. Given the worldwide shortage of nursing staff, how career calling affects nurses' occupational embeddedness needs to be more understood. This study highlights the importance of career calling and occupational embeddedness. Nurse managers need to improve the level of nurses' career adaptability and reduce their level of WFC and hence increase their occupational embeddedness.

Based on the conservation of resource theory, we proposed a two-path model to examine the double-edged sword effects of career calling on occupational embeddedness via work–family conflict (WFC) and career adaptability. The proposed theoretical model and hypotheses were tested by structural equation modeling technology with a sample of nurses from five hospitals in China (total N = 368). Career calling has a double-edged sword effect on occupational embeddedness via WFC and career adaptability. Career calling has positive effects on WFC and career adaptability. WFC and career adaptability, in turn, negatively and positively influence occupational embeddedness, respectively. In addition to the well-established positive effects, career calling may also have adverse effects on occupational outcomes. Given the worldwide shortage of nursing staff, how career calling affects nurses' occupational embeddedness needs to be more understood. This study highlights the importance of career calling and occupational embeddedness. Nurse managers need to improve the level of nurses' career adaptability and reduce their level of WFC and hence increase their occupational embeddedness.

Objective Toinvestigateantimicrobialresistanceamonggram-positivecocciinChinain 2013.Methods Retrospectivestudy.FromJune2013toDecember2013,1663consecutiveandnon-repetitive gram-positive cocci were collected from 15 teaching hospitals. The minimal inhibitory concentration ( MIC) of antibacterial agents was determined by agar dilution method. A retrospective study was conducted on rates of resistance to antimicrobial agents. The prevalence of penicillin-resistant Streptococcus pneumoniae ( PRSP) between children and adult patients and the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) between elder group and younger adult patients were compared using chi-square test. Results The prevalence of PRSP in children below 3 years old ( 72. 9%, 51/70 ) was higher than adult patients (55. 2%, 106/192) (χ2 =6. 653,P<0. 05). About 94. 9%(261/275) and (92. 7%,255/275) of S. pneumonia were resistant to erythromycin and clindamycin. All S. pneumoniae strains were susceptible to teicoplanin, vancomycin, linezolid, tigecycline and daptomycin. Penicillin still showed very high activity against Streptococcus spp. β-Hemolytic group. More than 60% of Streptococcus spp.β-Hemolytic group were resistant to erythromycin, clindamycin and tetracyclines. The prevalence of MRSA and methicillin-resistant coagulase-negative Staphylococci(MRCoNS) was 39. 7%(229/576) and 80. 6%(224/278), respectively. The MRSA prevalence ranged from 24. 2% to 70. 0% in different regions. About 52. 6%( 100/190 ) of Staphylococcus aureus from respiratory tract specimens, 38. 5%(40/104)of Staphylococcus aureus from blood samples, and 29. 7%(58/195) of Staphylococcus aureus from wound and pus were resistant to methicillin. The prevalence of MRSA in elder group ( 48. 6%, 84/173 ) was higher than that in younger adult patients (35. 7%, 144/403)(χ2 =8. 322,P <0. 05). The susceptibility rates of MRSA to chloramphenicol and trimethoprim/sulfamethoxazole were 86. 4% ( 244/228 ) and 94. 7% ( 237/228 ) , respectively. Susceptibility rates to gentamycin, erythromycin, clindamycin, tetracyclines, rifampicin and quinolones were ranged from 15. 8% to 59. 6%. All Staphylococci isolates were susceptible to teicoplanin, vancomycin, linezolid, daptomycin and tigecycline. All Enterococcus isolates were susceptible to daptomycin and tigecycline. All E. faecalis ( 158/158 ) and 96. 4% ( 133/138 ) of E. faecium were susceptible to teicoplanin. About 98. 0% ( 150/153 ) of E. faecalis and 97. 1% ( 145/138 ) of E. faecium were susceptible to linezoild. About 45. 8% (70/153) of E. faecalis and 60. 9% (84/138) of E. faecium were resistant to gentamycin with a high concentration. The susceptibility of E. faecalis to all the antibiotics tested exceptchloramphenicolandtetracyclinewashigherthanthatofE.faecium.Conclusions Basedon different age groups and regions, the resistance rates of Gram-positive cocci are different. Teicoplanin, vancomycin, tigecycline, daptomycin, linezolid and tedizolid showed very high activity against Gram-positive cocci. (Chin J Lab Med,2015,38:373-381)

Objective To investigate the effects of 1,25-dihydroxyvitamin D3 [1,25 (OH)2D3] on PCNA expression and cell proliferation in human glomerular mesangial cells. Methods The cultured human mesangial cells, which was subcul?tured 3-8 generations, were randomly divided into four groups: normal control group (plus the DMEM medium containing 5%fetal bovine serum), proliferation in the control group (EGF group, plus 10μg/L of EGF), general intervention group [VD group, plus 10-8 mol/L of 1,25(OH)2D3], proliferation in the intervention group [EGF+VD group, plus 10μg/L EGF and 10-8 mol/L 1,25(OH)2D3] for treatment of 48 h. The cell cycle was detected by flow cytometry,and the expression of PCNA was detected by Western blot assay in four groups. Results (1) Compared with normal control group, G1 phase cells were signifi?cantly reduced, S, G2/M phase cells were increased and PI index was higher in EGF group. And G1 phase cells were signifi?cantly increased, S and G2/M phase cells were significantly decreased, and PI index was lower in VD group. Compared with the EGF group, G1 phase cells were significantly increased in VD group and EGF+VD group, and S, G2/M phase cells de?creased, PI index was lower. (2) Compared with normal control group, the expression of PCNA was higher in EGF group, and lower in VD group. Compared with EGF group, the expression of PCNA was lower in VD group and EGF+VD group. Conclu?sion 1,25 (OH) 2D3 inhibits the proliferation of human glomerular mesangial cells by arresting cell cycle and inhibiting the expression of PCNA protein.

Objective To investigate the effect of 1,25-dihydroxyvitamin D3 on proliferation and apoptosis of glomerular mesangial cells via the PI3K/Akt/mTOR signal pathway. Methods The normal control group, 1,25-dihydroxyvitamin D3 (10-8 mol/L) group, rapamycin (0.1 μg/mL) group and the rapamycin in combination with 1,25-dihydroxyvitamin D3 group. The cell proliferation was measured by cell counting kit-8 assay. The cell cycle and cell apoptosis were detected by flow cytometry assay , respectively. Results Compared with the normal control group, the proliferation of glomerular mesangial cells was significantly inhibited in the 1 ,25-dihydroxyvitamin D3 group, in the rapamycin group and in the rapamycin in combination with 1,25-dihydroxyvitamin D3 group. The cells at G1 phase were significantly increased, but the cells at S phase were significantly decreased, with significant increase of cell apoptosis rate. Compared with the 1,25-dihydroxyvitamin D3 group, the proliferation of human glomerular mesangial cells was significantly inhibited in the rapamycin group and in the rapamycin in combination with 1,25-dihydroxyvitamin D3 group. Compared with the rapamycin group, the cells at G1 phase were significantly increased and the cells at S phase were significantly decreased in the rapamycin in combination with 1,25-dihydroxyvitamin D3 Group. Conclusions 1,25-dihydroxyvitamin D3 inhibits cell proliferation and promotes human glomerular mesangial cell apoptosis of human glomerular mesangial through the PI3K/Akt/mTOR signal pathway. 1,25-dihydroxyvitamin D3 and rapamycin can synergistically inhibit the proliferation of human glomerular mesangial cells.