BACKGROUND:Immunosuppression leads to impaired body immune function and aggravates the disease.Herb-partitioned moxibustion can effectively regulate immune function and improve immunity in the body,but its regulatory mechanism has not been elucidated. OBJECTIVE:To sequence immunosuppressed model rats treated with herb-partitioned moxibustion using bioinformatics techniques based on transcriptomics and to explore the mechanisms by which it regulates immunity. METHODS:Twenty-four Sprague-Dawley rats were randomly assigned to three groups:control,model,and herb-partitioned moxibustion groups,with eight rats in each group.The model and herb-partitioned moxibustion groups were subjected to establishment of an immune suppression model by intraperitoneal injection of cyclophosphamide at a dose of 35 mg/kg for 3 consecutive days.No interventions were administered to the control and model groups after modeling.In contrast,the herb-partitioned moxibustion group received moxibustion treatment at Zhongwan,Shenque,Guanyuan,and Zusanli acupoints using a combination of moxa and herbal cakes,once a day,for 10 consecutive days,with samples being collected the day after the end of the intervention.Peripheral blood was collected from all groups of rats to measure their white blood cell count.RNA-seq was performed on the Illumina sequencing platform,and differentially expressed genes were selected for bioinformatics analysis using the GO and KEGG databases. RESULTS AND CONCLUSION:Compared with the control group,the model group exhibited a significant decrease in white blood cell count(P<0.001).RNA-seq analysis identified 3 026 differentially expressed genes between the model and control groups,with 1 565 upregulated and 1 461 downregulated.There were 535 differentially expressed genes identified between the herb-partitioned moxibustion group and the model group,with 280 upregulated and 255 downregulated.The Venn diagram analysis revealed that 159 genes were downregulated in the model group compared with the control group.However,after moxibustion with herbal cakes,these genes were upregulated.Protein-protein interaction network analysis identified 10 core targets,including Oasl,Oas2,Isg15,Herc6,Mx2,Helz2,Mx1,Syk,Hspa1a,and Ret.According to GO and KEGG analyses,moxibustion with herbal cakes regulated the body through pathways related to immune response,viruses,angiogenesis,and the autoimmune system.To conclude,there is a significant association between herbal cake-separated moxibustion intervention and immune suppression targets,including Oasl,Oas2,Isg15,Herc6,Mx2,Helz2,and Mx1.The intervention exhibits regulatory effects in the pathways related to immune responses,viral activities,and angiogenesis.

Gastrointestinal fistula (GIF) is one of the serious complications in the middle to late stage of acute pancreatitis (AP). The co-existence of AP and GIF can significantly prolong the course of the disease and increase the risks of infection and bleeding. Understanding the relevant mechanisms and influencing factors of GIF and taking effective measures to prevent its occurrence is crucial. The diagnosis of AP with GIF is relatively difficult. Therefore, it is essential to understand the related influencing factors and diagnostic methods of AP complicated with GIF, and to implement individualized comprehensive treatment measures, which is the key to improve the prognosis of the patient to the greatest extent. This article reviewed the influence factors and progress in diagnosis and treatment of AP complicated with GIF.

Objective:To investigate the expressions of miRNA-4686 (miR-4686) and protein disulfide isomerase A4 (PDIA4) in esophageal cancer tissues, and the effect of miR-4686 on the proliferation and migration of esophageal cancer cells in vitro and possible mechanisms.Methods:The complementary integration of miR-4686 and PDIA4 mRNA were predicted using the miRWalk version 3 online website. The expression profiles of miR-4686 and PDIA4 mRNA were obtained from the University of California, Santa Cruz Genome (UCSC) database, and the relative expression of miR-4686 and PDIA4 mRNA in esophageal cancer tissues and paracancerous tissues were analyzed. The UCSC database was used to obtain the localization of miR-4686 in human cells. The relative expressions of miR-4686 and PDIA4 mRNA in esophageal cancer Eca109, TE-13, EC9706 and KYSE-510 cells and normal esophageal epithelial HET-1A cells were detected by real-time fluorescent quantitative polymerase chain reaction (qRT-PCR). Eca109 cells with the lowest relative expression of miR-4686 were selected for subsequent research, and the Eca109 cells were divided into miR-4686 group (transfected with miR-4686 mimic) and miR-NC group (transfected with miR-4686 negative control sequence mimic). The proliferation ability of Eca109 cells in the two groups was detected by colony formation assay, the migration ability of Eca109 cells was detected by scratch healing assay, and the targeting relationship between miR-4686 and PDIA4 mRNA was verified by dual luciferase reporter gene assay; the expressions of PDIA4 protein and PI3K-AKT-mTOR signaling pathway-related proteins were detected by Western blotting.Results:Compared with the paracancerous tissues, miR-4686 expression was low and PDIA4 mRNA expression was high in esophageal cancer tissues (both P < 0.01). Compared with normal esophageal epithelial HET-1A cells (0.98±0.15), the relative expression of miR-4686 in esophageal cancer Eca109 (0.11±0.04), TE-13 (0.58±0.10), EC9706 (0.34±0.05) and KYSE-510 cells (0.69±0.06) were all decreased (all P < 0.05). Compared with the miR-NC group, the relative expression of miR-4686 in Eca109 cells of the miR-4686 group increased (9.4±2.1 vs. 1.0±0.4, t = 3.88, P = 0.008), the number of colony formation decreased (38±9 vs. 114±18, t = 3.78, P = 0.009), the scratch healing rate decreased [(27.13±0.91)% vs. (45.05±3.89)%, t = 4.48, P = 0.004], and the relative expression of PDIA4 mRNA decreased [1.0±0.5 vs. 6.3±0.9, t = 5.04, P = 0.002]. Compared with wild type (WT)-PDIA4+miR-NC group, the relative luciferase activity of Eca109 cells in WT-PDIA4+ miR-4686 group decreased (0.31±0.08 vs. 0.99±0.08, t = 5.96, P < 0.001). Compared with miR-NC group, the expressions of PDIA4, p-PI3K, p-AKT and p-m-TOR proteins in Eca109 cells of the miR-4686 group were all decreased. Conclusions:In esophageal cancer tissues, miR-4686 is lowly expressed and PDIA4 mRNA is highly expressed. miR-4686 may inhibit the proliferation and migration of esophageal cancer Eca109 cells by targeting regulation of PDIA4 expression.

Background: Autoimmune pancreatitis (AIP) is a chronic pancreatitis associated with immune factors. IgG4-related sclerosing cholangitis (IgG4-SC) is a common extrapancreatic manifestation of AIP, however, its optimal treatment still needs to be clarified. Aims: To summarize the experience in the clinical diagnosis and treatment of AIP, especially IgG4-SC. Methods: Twenty-five patients with AIP admitted from the First Affiliated Hospital of Nanchang University between January 2015 and May 2021 were recruited, and a retrospective analysis was conducted on the clinical symptoms, laboratory and imaging findings, pathological results, as well as the treatment regimens and clinical outcomes. Results: All the patients were diagnosed as type 1 AIP (84.0% male, mean age 63.5 years). Obstructive jaundice (56.0%) and epigastric pain (44.0%) were the main clinical symptoms. The main imaging findings were diffuse enlargement of the pancreas, capsule-like rim, and distal biliary stricture associated with intra- and extra-hepatic duct dilation. The serum IgG4 elevated significantly. In 14 patients with IgG4-SC, the total bilirubin was between 1-2 upper limit of normal (ULN) in 3 cases, between 2-5 ULN in 3 cases, and > 5×ULN in 8 cases. Fifteen (83.3%) patients obtained pathological diagnosis by endoscopic ultrasonography-guided fine-needle aspiration (EUS-FNA). Six IgG4-SC patients were treated with steroids alone, and 6 received biliary stenting with or without steroids, no differences in liver function tests were existed between the two groups prior to treatment (all P> 0.05). Liver function tests in most of these patients were normalized after treatment. Conclusions: AIP is a rare disease in clinical practice, and is more frequently seen in elderly male patients. Biliary involvement (IgG4-SC) is common and often presents initially as obstructive jaundice, which can be effectively managed with steroids alone, without the need for biliary stenting.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can cause acute respiratory distress syndrome, hypercoagulability, hypertension, and multiorgan dysfunction. Effective antivirals with safe clinical profile are urgently needed to improve the overall prognosis. In an analysis of a randomly collected cohort of 124 patients with COVID-19, we found that hypercoagulability as indicated by elevated concentrations of D-dimers was associated with disease severity. By virtual screening of a U.S. FDA approved drug library, we identified an anticoagulation agent dipyridamole (DIP) , which suppressed SARS-CoV-2 replication . In a proof-of-concept trial involving 31 patients with COVID-19, DIP supplementation was associated with significantly decreased concentrations of D-dimers ( < 0.05), increased lymphocyte and platelet recovery in the circulation, and markedly improved clinical outcomes in comparison to the control patients. In particular, all 8 of the DIP-treated severely ill patients showed remarkable improvement: 7 patients (87.5%) achieved clinical cure and were discharged from the hospitals while the remaining 1 patient (12.5%) was in clinical remission.

Chronic pancreatitis (CP) is a refractory disease with persistent symptoms, which seriously affects the quality of life. In recent years, the global prevalence of CP has been rising, yet the diagnosis of CP still has many difficulties, especially the early diagnosis. Therefore, clinicians need to further improve the understanding of CP, so as to diagnose, evaluate and treat CP more early and effectively. In this article, the management of CP was briefly reviewed.

Objective To explore the normal values for two-dimension solid state high resolution anorectal manometry (HRAM) in healthy adult volunteers.Methods The healthy adult volunteers were recruited by advertisement and underwent solid state HRAM in the left lateral position.Anorectal pressures and rectal sensation were recorded and analyzed.Results (1) A total of 126 Chinese healthy adult volunteers (male:50 cases (39.7％);age:(37.5 ± 14.2) years old) were recruited in this study.(2)Mean anal resting pressure (MERP) was (71.8 ± 17.3) mmHg (1 mmHg =0.133 kPa).Maximum anal resting pressure (MARP) was (79.3 ± 17.8) mmHg,Maximum anal squeeze pressure (MSP) was (178.7 ± 52.8) mmHg.Anal high pressure zone (HPZ) length was (3.4 ± 0.6) cm.During simulated evacuation,residual anal pressure (RAP) was (63.8 ±20.5) mmHg,and anal relaxation rate (ARR) was (37.0 ± 11.5) ％.Rectal threshold volume for first sensation (FST),desire to defecate (DDT),urgency to defecate (UDT) and maximum discomfort (MDT) was (47.4 ±10.0) ml,(84.5 ±18.2) ml,(125.8 ± 28.5) ml,and (175.5 ±36.1) ml,respectively.(3) Compared with female subjects,male subjects had higher MSP [(211.0 ± 50.7) mmHg vs (157.5 ± 42.5) mmHg],RAP [(71.6 ± 18.1) mmHg vs (58.8 ± 20.5) mmHg]and rectal MDT[(187.0 ±36.4) mmHg vs (168.0 ±34.1)mmHg],but lower ARR [(32.1 ±8.0)％ vs (40.2 ±12.3)％],all P＜0.01.(4) MERP,MARP,MSP and rectal MDT were higher in young group (≤ 40 years old),all P ＜ 0.05.Conclusions These observations provide normal values for two-dimension solid state HRAM,which have significant difference between genders and different age groups.

Objective:To evaluate the actual measurement accuracy of 2 three-dimensional(3D)facial scanners for real person. Methods:3D digital face models of 1 0 volunteers with normal ficial form were obtained by 3dMD and FaceScan facial scanners respec-tively.The measurement values of 1 0 feature lengths and 5 feature angles were measured on each 3D model by the software respective-ly.The reference values of all characteristics were acquired by line laser scanner (Faro)with high accuracy.Statistical and surveying analysis were taken between the measurement values and reference values.Facial morphology measurement error and actual accuracy of facial scanners were obtained finally.Data were statistically analysed.Results:The length measurement accuracy of 3dMD and FaceS-can was(-0.37 ±0.68)mm and (-0.29 ±0.53)mm(P =0.223),the angle measurement accuracy was (-0.22 ±2.1 4)°and (0.1 2 ±2.69)°(P =0.428),respectively.Conclusion:The 3D data of ficial morphology obtained by the 2 scanners are not signifi-cantly different.

Objective:To compare two digital methods of quantitatively accessing the degree of facial asymmetry by three-dimensional data.Methods: The three-dimensional data of 20 subjects were got by the FaceScan, and then were input to the reverse engineering software Imageware 13.0 and Geomagic 12 .Their mirror data were acquired and superimposed with the original data by the methods of interactive closest points ( ICP) and Procrustes analysis ( PA) .The mid-sagittal planes of the two methods were ex-tracted respectively, the degree of facial asymmetry and the distance of 21 automatic landmarks to mid-sagittal plane were calculated and compared.Results:The paired t test was taken and t=1.346, P=0.193.Conclusion:We can safely come to the conclusions that for the subjects with no evident facial asymmetry, there are no significant difference between the PA and the ICP methods for extracting the mid-sagittal plane from three-dimensional data.

It is difficult for medical students to understand electrocardiogram theory. The sec-ond clinical medical college of Wuhan University has explored clinical pathophysiology and therapy (CPPT) pattern in electrocardiogram education. Basic medical knowledge and clinic medical knowl-edge are combined with electrocardiogram theory to reinforce students ' comprehension and attract theit interest in order to obtain better teaching effect. Drawing themselves, analyzing electrocardiogram sys-tematically and memorizing theory with figure is aimed at solving forgetful problems. In addition, the problems such as lack of conformable teaching material, professional teaching teams and objective mode of examination are raised, and the solutions are explored under CPPT pattern.