With persistent breakthrough and maturity of surgical procedures and postoperative immunosuppressive therapy, the survival rate of liver transplant recipients and grafts has been significantly increased. The shortage of donor liver has become the main obstacle for clinical development of liver transplantation. How to expand the source of donor liver has become an urgent issue. Groundbreaking progresses have been made in the use of common marginal donor livers in clinical liver transplantation, such as elderly donor liver, steatosis donor liver, viral hepatitis donor liver and liver from donation after cardiac death. Nevertheless, multiple restrictions still exist regarding the use of marginal donor liver. Consequently, the definition of marginal donor liver and research progress in the application of common marginal donor livers were reviewed, and the opportunities and challenges of mariginal donoor liver were illustrated, aiming to provide reference for expanding the donor pool for clinical liver transplantation and bringing benefits to more patients with end-stage liver disease.

Objective:To analyze the genus, drug resistance/virulence and phylogenetic characteristics of Brucella strains isolated from brucellosis surveillance sentinels in Henan Province from 2013 to 2022, and provide baseline data for the surveillance, early warning and outbreak tracing of brucellosis. Methods:Blood samples were collected from patients with Brucella infection for strain isolation, culture and species identification, drug susceptibility test, whole genome sequencing, splicing and assembly, functional/virulence/resistance gene prediction analysis and phylogenetic tree drawing based on single nucleotide polymorphism (SNP). Results:In 36 brucellosis patients, the majority were men (86.11%, 31/36), young adults aged 18-50 (88.89%, 32/36) and farmers/herdsmen (72.22%, 26/36). A total of 36 strains of Brucella melitensis were isolated, and average 1 305 functional proteins of 21 categories were predicted by strain genome; all the strains carried four main virulence factors (pmm, VirB group, BtpA/BtpB, BvrS/BvrR). The drug sensitivity rate was 100.00% to six types of antibiotics including levofloxacin, rifampicin, doxycycline, streptomycin, tetracycline and gentamicin, they showed different resistances to three antibiotics including compound trimethoprim-sulfamethoxazole, ciprofloxacin and ampicillin. The strains carried four types of resistance genes and two clusters of resistance genes, with four combinations of genotypes, the resistance mechanisms included antibiotic degradation/modification enzymes, resistant nodular cell differentiation (RND) efflux pumps, 16S/23S ribosomal rRNA binding site mutations, etc. The number of SNP differed in the genomes of 36 Brucellamelitensis strains ranged from 0 to 454 and phylogenetic tree was divided into three major branches, with relative branch distances between 0.000 0 and 0.498 6 for each strain. Conclusions:Human Brucellamelitensis strains isolated from surveillance sentinels in Henan from 2013 to 2022 carried multiple virulence and antibiotic resistance genes and had different drug resistance phenotypes. Single nucleotide polymorphism analysis and phylogenetic tree analysis showed significant differences in phylogenetic relationships among different strains.

Messenger RNA(mRNA) CCT6A can encode chaperone proteins and plays an important role in malignant tumors such as colorectal cancer, lung cancer and breast cancer. CCT6A is highly expressed in malignant tumors, which can be used as a biomarker to assess patients' prognosis, and promote malignant biological behaviors such as tumor proliferation and metastasis by regulating transforming growth factor β signals, cell cycles, and other pathways. CCT6A can also modulate immune cell infiltration in the tumor microenvironment and may be a potential target for tumor immunotherapy. The paper reviews the expression and function of CCT6A in malignancies.

Objective:To analyze the dynamic changes and possible influencing factors of anti-2019 novel Coronavirus (2019-nCoV) neutralizing antibody in confirmed Coronavirus Disease 2019 (COVID-19) cases.Methods:Microneutralization was used to test the anti-2019-nCoV neutralizing antibody. Excel 2007 and SPSS 22.0 were used for data processing and analysis.Results:There were 420 serum samples collected from 155 confirmed COVID-19 cases. These serum samples contained acute phase serum, convalescent phase serum and serum from cases recovered for about six months. The sampling time was 0-221 days after the onset of COVID-19. The geometric mean titer (GMT) of anti-2019-nCoV neutralizing antibody was 1∶13 at 1 week, and 1∶31 at 2 week. The titers of anti-2019-nCoV neutralizing antibody of individual cases were still<1∶4 on the 15 th day. The GMT was all over 1: 52 (13×4) at 6-32 week. Taking 1: 64 as the cut-off point, the serum anti-2019-nCoV neutralizing antibody positive rates was 30.56% in acute phase serum samples (0-14 d, 0-2 w), 82.31% in convalescent phase serum samples (36-63 d, 6-9 w) and 86.52% in serum samples from cases recovered for about six months (183-210 d, 27-30 w). Statistical analysis showed that there was no significant difference in anti-2019-nCoV neutralizing antibody levels at the other weeks except 1-2 week ( χ2=9.270, P=0.931), there was no statistically differences in gender, age and occupation of the cases, and also between the normal and mild cases ( P>0.05). Conclusions:The serum anti-2019-nCoV neutralizing antibody level is only statistically correlated with the disease progression of COVID-19, and maintain the protective level from 3 to 30 week.

Objective:To investigate the performance of real-time RT-PCR for the detection of SARS-CoV-2 nucleic acid in clinical diagnosis of COVID-19.Methods:Laboratory test data and basic case information of Henan COVID-19 cases were collected from the China′s Infectious Disease Information System as of March 5, 2020. All information was entered by local hospitals and Center for Disease Control and Prevention (CDC). Local hospitals or country CDC were responsible for sampling and municipal CDC was responsible for nucleic acid testing.Results:A total of 6 714 specimens were detected and the positive rate of SARS-CoV-2 nucleic acid was 23.82%. The specimens were collected from 1 200 confirmed cases, 2 178 suspected cases and 77 asymptomatic cases. The nucleic acid diagnosis rate of COVID-19 was 36.96% (1 277/3 455). In all cases, the positive rates of SARS-CoV-2 nucleic acid in nasal swabs, sputum samples and throat swabs were 19.38%, 28.59% and 23.53%, respectively (χ 2=15.896, P<0.01). The positive rate of SARS-CoV-2 nucleic acid in confirmed COVID-19 cases was 63.10%. The positive rates in nasal swabs, sputum samples and throat swabs were 50.80%, 58.71% and 65.21 (χ 2=18.612, P<0.01). The positive rates of SARS-CoV-2 nucleic acid were 43.51%, 23.98%, 22.82%, 12.17%, 14.46% and 13.21% in samples collected on the day of symptom onset and one week, two weeks, three weeks, four weeks, five weeks and above five weeks after the onset, respectively. The positive rates in confirmed cases were respectively 89.03%, 86.57%, 52.30%, 17.53%, 17.69% and 24.14% at those time points. Conclusions:Real-time RT-PCR is the most effective method for early pathogenic diagnosis of COVID-19. The highest detection rate of nucleic acid is achieved within one week after the onset of COVID-19, and the latest time for nucleic acid detection is 38 d after the onset.

Objective:To investigate the etiological characteristics and drug resistance of non-typhoid Salmonella isolated from stool samples of children under 5 years old with diarrhea in Henan Province. Methods:Intestinal bacteria were isolated from fecal samples of 4 250 diarrhea children under five years old in five monitoring sites in Henan Province from 2015 to 2018. Serotypes and drug sensitivity of Salmonella strains were analyzed. The annual change in drug resistance was analyzed by Chi-square test and all data were analyzed retrospectively. Results:The detection rate of non-typhoid Salmonella in fecal samples was 8.73% (371/4 250). The highest detection rate was in the 0-1 age group (51.75%) and the peak season for Salmonella infection was from May to October. The most common serotype was Salmonella enteritidis (36.93%), followed by 4, 5, 12: i: - Salmonella (14.82%) and Salmonella typhimurium (14.02%). The non-typhoid Salmonella isolates were resistant to ampicillin and sulfamethoxazole with drug resistance rates of more than 80%, but more sensitive to ceftazidime, cefepime and cefoxitin. There were significant differences in drug resistance to cefepime, levofloxacin, ciprofloxacin, amikacin, doxycycline, chloramphenicol and compound neoforman among the strains isolated in different years ( P<0.05). Multidrug-resistant strains accounted for 86.52%. Conclusions:There was diversity in the serotypes of non-typhoid Salmonella in diarrheal children under five years old in Henan Province. The predominant serotype was Salmonella enteritidis. Drug resistance to common antibiotics was detected in the isolates, and most of them were multidrug-resistant.

Objective:To explore the serotype distribution and drug resistance of Shigella in stool samples of children under five years old with diarrhea from 2008 to 2017 in Sui County, Henan Province. Methods:A total of 4 721 stool samples of children under five years old with diarrhea were collected from Doufuyuan Clinic of Sui County during 2008 to 2017, and Shigella strains were isolated through bacterial culture. The slide agglutination test was used for serotyping of Shigella strains. Two hundred of seventy-one Shigella strains were selected in proportion, and multiple gradient polymerase chain reaction was used to detect virulence genes and Kirby-Bauer agar method was used for drug sensitivity. Trend chi square test was used to analyze the annual trend of drug resistance. Results:The detection rate of Shigella strains in 4 721 fecal samples was 20.69% (977/4 721). A total of 977 Shigella strains were divided into 13 serotypes in two groups, including 77.79%(760/977) Shigella flexneri strains and 22.21%(217/977) Shigella sonnei strains.The top three serotypes detected alternately every year.The dominant gene pattern of Shigella flexneri was Shigella enterotoxin ( shET)-1+ , shET-2+ , invasion plasmid antigen H ( ipaH)+ , invasion-associated locus ( ial)+ , accounted for 84.04%(179/213) and that of Shigella sonnei was shET-1-, shET-2+ , ipaH+ , ial+ , accounted for 46.55%(27/58). The drug resistance rates of 271 Shigella strains to ampicillin, nalidixic acid and tetracycline were more than 90% and the strains were more sensitive to cefepime and ceftazidime.The drug resistance rates to cefotaxime, cefepime, ciprofloxacin, chloramphenicol and sulfamethoxazole/trimethoprim increased year by year, and all had statistically significant differences ( χ2=24.027, 7.232, 6.039, 4.764 and 6.809, respectively, all P< 0.05). There were 98.52%(267/271) strains resistant to more than three kinds of drugs. The resistance rates of Shigella flexneri to ciprofloxacin, norfloxacin, and chloramphenicol were higher than those of Shigella sonnei, and the resistance rates to gentamicin and sulfamethoxazole/trimethoprim were lower than those of Shigella sonnei. The differences were statistically significant ( χ2=31.866, 14.868, 83.036, 68.534 and 14.738, respectively, all P<0.01). Conclusions:The major serotypes of Shigella in children under five years old in Sui County are constantly changing from 2008 to 2017. The dominant gene patterns of different serotypes are different. Most isolated strains have multiple drug resistances, and different serotypes have different resistance profiles.

Objective :To explore influence of ticagrelor on levels of serum high sensitive C reactive protein (hsCRP) and plasma homocysteine (Hcy) in patients with acute coronary syndrome (ACS).Methods :A total of 135 ACS pa‐ tients hospitalized in our department from Jan 2016 to Feb 2017 were selected .Based on routine treatment ,Patients were randomly and equally divided into routine group ,clopidogrel group and ticagrelor group (based on routine treatment respectively received clopidogrel or ticagrelor ) for four weeks .Levels of serum hsCRP and plasma Hcy were measured and compared among all groups before and after treatment .Results :Compared with before treat‐ment ,after four‐week treatment , there were significant reductions in levels of serum hsCRP and plasma Hcy in three groups (P＜0. 05 or ＜0.01).Compared with routine group and clopidogrel group after four‐week treatment , there were significant reductions in levels of serum hsCRP [ (12.95 ± 1.99) mg／L , (8. 56 ± 1. 24) mg／L vs.(4. 47 ± 1. 92) mg／L] and plasma Hcy [ (13.48 ± 2.12) μmol／L , (9.55 ± 0. 94) μmol／L vs.(6. 61 ± 1. 15) μmol／L] in ticagrelor group ( P＜0.05 or ＜0.01).Conclusion :Ticagrelor can significantly reduce levels of serum hsCRP and plasma Hcy while effective antiplatelet therapy ,then significantly inhibit inflammatory response ,improve vascular endothelial function ,contribute to stabilizing atherosclerotic plaques ,improve prognosis in ACS patients .

Objective To explore the effects of Qa-1 and PD-L1 loaded artificial liposomal treatment in allograft rejection and its outcomes .Methods The extracellular domains of Qa-1 and PD-L1 were loaded on liposome surface by streptavidin-biotin system . Mixed lymphocyte reaction (MLR) was performed for measuring Qa-1/PD-L1 liposome biological function .Then liposome was co-transplanted with allo-islets via portal vein .The levels of blood glucose and C-peptide were detected daily after transplantation .Also hepatic lymphocytes after transplantation were isolated for determining the proportion of activated cells and signaling pathway changes .Results Artificial liposome could be easily loaded with biotinylated peptide and its diameter was between 50 to 500 nm . Qa-1/PD-L1 liposome could significantly suppress lymphocyte proliferation , activation and secretion of IFN-γ in MLR by an activation of SHP1/2 and an inhibition of Syk pathway .Qa-1/ PD-L1 liposomes could suppress the activation of hepatic lymphocytes in vivo by activating SHP1/2 ,protecting islet allografts and maintaining a normal level of blood glucose in recipients .Conclusions Qa-1/PD-L1 loaded liposome can effectively suppress allograft rejection and improve the outcomes of islet transplantation .

Objective To investigate the etiological,antimicrobial resistance status and pulsed field gel electrophoresis (PFGE) patterns of S.enteritidis strains in Henan Province.Methods Totally 82 strains of S.enteritidis strains were isolated from seven sentiel hospitals which were able to detect multiple pathogens from April,2013 to December,2015.According to Salmonella K-B drug susceptibility testing and molecular typing method published by the USA clinical and Laboratory Standards Institute (2015),the drug sensitivity to 7 kinds of antimicrobial agents and PFGE molecule characteristics of 82 S.enteritidis strains were tested.The PFGE patterns were analyzed by BioNumerics 6.0 software based on international PulseNet bacterial infectious disease monitoring network.Results Forty-seven strains of S.enteritidis were isolated from male patients,35 strains isolated from female patients.A total of 56 S.enteritidis strains were isolated from young children aged from 0 to 5 years old,including 29 strains isolated from 6 months to 2 years old.The strains were mainly isolated between May and November of the year,and 15 (18.3％) strains were isolated between March and April,27(32.9％) strains between May and July,34 (41.5％) strains between August and October,6 (7.3％) strains were isolated in the rest time of the year,with a typical seasonal characteristics of summer and autumn.Sxity-four (78.0％)strains of S.enteritidis were resistant to ampicillin;23 (28.0％) strains were resistant to ceftazidime;39 (47.6％) strains were resistant to cefotaxime:13 (15.9％) strains were resistant to cefepime;55 (67.1％) strains were resistant to nalidixic acid;24 (29.3％) strains were resistant to ciprofloxacin;32 (39.0 ％) strains were resistant to gentamicin;14 (17.1 ％) strains were resistant to chloramphenicol;47 (57.3％) strains were resistant to methicillin benzyl ammonium;13 (15.9％) strains were resistant to sulfamethoxazole and trimethoprim;21 (25.6 ％) strains were resistant to tetracycline.All strains weremuhi-drug resistant,and 21 (25.6％) isolates were resistant to 3-4 kinds of antibiotics,32 (39.0％)isolates were resistant to 5-6 kinds of antibiotics, 29 (35.4 ％) isolates were resistant to 7-8 kinds ofantibiotics.These 82 strains of S.enteritidis were divided into 25 molecular patterns by digestion withXba Ⅰ enzyme.Each pattern contained 1 to 26 strains with similarity ranged from 59.33％-100.00％.EN1 and EN2 were the main PFGE belt types and included 26 and 16 strains,respectively.Conclusions The drug resistance of clinical isolates of S.enteritidis in Henan province is serious.PFGE patterns show polymorphism and the dominant patterns,part of which are associated with drug-resistance spectrum and show aggregation.