Objective To evaluate the agreement of four common HEp-2 indirect immunofluorescence assay(IFA)kits in the patients with antinuclear antibody(ANA)-associated rheumatic immune diseases(AARD)and the patients with non-autoimmune diseases(NAD).Methods The experiment in this study included two stages.In stage 1,the serum samples were randomly selected from 134 patients,and ANAs were detected by IFA at Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from Janu-ary to June 2023.All of the samples were tested using four kinds of HEp-2 IFA kits,and the consistency of qualitative results was eval-uated by statistical analysis.The kit exhibited highest positive rate was defined as Kit X.In the stageⅡ,a total of 554 serum samples(from 218 AARD and 336 NAD patients)with positive results detected by initial screening of reagent X were selected during the same period,and then the samples were tested by the other three HEp-2 IFA kits.The patterns and titers of ANA were recorded,and a semi-quantitative evaluation system was established.The reproducibility of different patterns of ANA and the consistency of the results among varying clinical characteristics,fluorescence reaction intensities and positive reaction sites in nucleus was statistically analyzed.Results There were no significant differences of qualitative results among the results from four kits(P＞0.05).The highest positive rate ap-peared in the kit m(45.86%)which was deemed as the initial screening kit X.Significant differences in the consistency of ANA pat-terns were observed.The reproducibility scores of centromeric pattern and granular pattern were higher than those of homogeneous pat-tern,dense fine speckled pattern,nuclear cytoplasmic mixed pattern and other mixed pattern with significant difference(P＜0.05).The reproducibility score of simple pattern was higher than that of mixed patterns(P＜0.05).In the nucleoplasmic region,the consistency score of the AARD group was higher than that of NAD group(P＜0.01).The consistency scores of each reaction site increased with the rise of the intensity of reaction.In the three reaction parts(nucleoplasm,nucleolus and equatorial plate),the scores between the weak and strong fluorescence reaction intensity groups showed significant differences(P＜0.001).The lowest consistency score occurred in cytoplasmic region.Conclusion The clinical interpretation for IFA ANA reports should be more cautious for the results showing weak fluorescence intensity,mixed patterns,and staining positive cytoplasmic sites.For the choice for reagents,the clinical laboratories should be also mindful of the impacts of fluorescent secondary antibodies of anti-human immunoglobulin on the test results.The develop-ment of standardized official guidelines for the manufacture of HEp-2 IFA kits should be crucial initiative for enhancing the consistency of ANA detection and promoting mutual recognition for the results between laboratories.

Background At present, radiation therapy is widely used in clinical treatment of tumors. However, while radiation therapy damages tumor cells, it also injures surrounding normal tissues. Studies have shown that hydrogen is a potential radiation-protective agent. Objective To investigate the neuroprotective mechanisms of hydrogen-rich water activating phosphoinositide 3-kinase (PI3K)/protein kinase B (AKT)/cysteinyl aspartate specificproteinase-9 (Caspase-9) signaling pathway in acute radiation-induced brain injury. Methods Forty male SD rats were randomly divided into four groups: control group, irradiation only group (IR), high-dose hydrogen-rich water intervention group (IR+HHRW), and low-dose hydrogen-rich water intervention group (IR+LHRW), 10 rats in each group. Except for the control group, animals in each group received a single 20 Gy whole brain irradiation. Animals in all groups were gavaged once a day from 3 d before irradiation to 7 d after irradiation, pure water (20 mL·kg⁻¹) was given to the control and the IR groups, and hydrogen-rich water (20 mL·kg⁻¹, 10 mL·kg⁻¹) was given to the IR+HHRW and the IR+LHRW groups. After 7 d of intervention, 5 rats in each group were selected for the Morris water maze experiment for behavioral evaluation. Autopsies were conducted after anesthesia for the remaining animals and blood samples were collected for hematological analysis. Rat brains were harvested for TUNEL staining to observe neuronal apoptosis. HE staining was performed to observe histopathological changes, enzyme-linked immunosorbent assay was adopted to detect oxidative stress-related indicators, and real-time PCR and Western blotting were used to measure the expressions of PI3K/AKT/Caspase-9 pathway-related genes and proteins. Results The body weight of rats receiving irradiation decreased after 7 d of irradiation compared with the control group (P<0.05), and the symptoms such as arched back and malaise occurred to varying degrees, and the symptoms of rats in the IR+HHRW group were significantly milder than those in the IR group. The behavioral test results showed that the escape latency of rats in the IR+HHRW group or the IR+LHRW group was shorter than that in the IR group from day 2 to day 5 (P<0.05), and it took less time for rats in the IR+HHRW group to reach the original position after removing the platform on day 6 (P<0.05). The hematological test results showed that red blood cell (RBC) count, hemoglobin (HGB) level, and white blood cell (WBC) count were significantly decreased in the IR group (P<0.05), and the changes in the IR+HHRW group were improved (P<0.05). The HE staining results showed that the number of abnormal nerve cells, broken and dissolved nuclei, and the degree of damage in the IR+HHRW group were significantly reduced than those in the IR group. The results of oxidative stress evaluation showed that the ability of the IR group to inhibit free radicals decreased, the level of malondialdehyde (MDA) increased (P<0.01); the MDA level decreased after LHRW intervention (P<0.05); the SOD activity was elevated after HHRW intervention (P<0.05). The TUNEL staining results showed that the apoptosis signals in the IR+HHRW group were sparser than those in the IR group (P<0.05). The real-time PCR results showed that compared with the IR group, the mRNA expression levels of PI3K and AKT in the IR+HHRW group and the IR+LHRW group increased (P<0.05), while the mRNA expression levels of Cytc and Caspase-9 decreased (P<0.05). The Western blotting results showed that compared with the IR group, the phospho-AKT (pAKT) protein expression level in the IR+HHRW group increased significantly (P<0.05), while the expression of Caspase-9 and Cytc proteins decreased significantly (P<0.05). Conclusion Hydrogen-rich water can significantly reduce inflammation and oxidative stress caused by acute irradiation-induced brain injury, and decrease neuronal apoptosis. The mechanism may be related to the PI3K/AKT/Caspase-9 signaling pathway.

Background In the process of radiotherapy, when radiation kills tumor cells, it inevitably damages normal tissue cells. Objective To investigate the role of Toll-like receptor 4 (TLR4)/nuclear factor−kappa B (NF-κB) signaling pathway in the improvement of cognitive impairment induced by ionizing radiation by hydrogen-rich water before and after whole brain irradiation in rats. Methods Fifteen male SD rats were randomly divided into three groups: control group, irradiated group (IR group), and hydrogen-rich water intervention group (IR+HRW group), with 5 rats in each group. The control group was not irradiated, but was given purified water (20 mL·kg⁻¹) by gavage every day, while the IR group and the IR+HRW group were irradiated with a single dose of 20 Gy. Three days before, 10 min before, and 30 days after irradiation, purified water/hydrogen-rich water (20 mL·kg⁻¹) was given by continuous gavage every day. The general condition of the rats was observed every day, and the body weight were measured on the 7th, 14th, 21st, and 30th days after irradiation. On the 30th day after irradiation, the learning and memory ability of the rats was tested by Morris water maze; the pathological changes of hippocampus were detected by hematoxylin-eosin (HE) staining after sacrificing the rats; the contents of glutathione (GSH), malondialdehyde (MDA), interleukin-1β (IL-1β), and hydroxyl radicals in brain tissues were detected by enzyme linked immunosorbent assay (ELISA); the mRNA and protein expression levels of TLR4, NF-κB, NOD-like receptor pyrin domain 3 (NLRP3), and cysteinyl aspartate specific proteinase 1 (Caspase 1) were detected by quantitative real-time PCR (qRT-PCR) and Western blotting in the hippocampus of rats. Results After irradiation, the rats in the IR group showed symptoms such as head hair removal and salivation, while the symptoms of the rats in the IR+HRW group were milder. No animal died in the control and the IR+HRW groups, while one rat died in the IR group. From day 14 to day 30 after irradiation, the body weight of the rats in the IR+HRW group tended to be higher than that in the IR group, but the difference was not statistically significant (P>0.05). The Morris water maze results showed that the escape latency of the IR+HRW group was shortened compared with that of IR group from day 1 to day 5 except day 3, but the difference was not statistically significant (P>0.05). For the rats in the IR+HRW group, it took less time to reach the original location of the platform after removing the platform on day 6 and the number of crossing the platform and the residence time in the original platform quadrant increased (P<0.05). The HE staining showed that the number of hippocampal cells in the IR+HRW group was slightly reduced and arranged neatly, without obvious nuclear hyperchromatic and pyknotic phenomenon. The ELISA results showed that the MDA and hydroxyl radical levels were decreased in the IR+HRW group compared with the IR group (P<0.05), the GSH content was increased, and the IL-1β concentration was decreased, but the differences were not statistically significant (P>0.05). The results of qRT-PCR showed that the mRNA expression levels of TLR4 and Caspase 1 in the hippocampus of the IR+HRW group were decreased compared with the IR group (P<0.05), and the mRNA expression levels of NF-κB and NLRP3 were also decreased, but the differences were not statistically significant (P>0.05). The results of Western blotting showed that the expression levels of TLR4 and Caspase 1 protein in the hippocampus of the IR+HRW group were decreased compared with the IR group (P<0.05), and the expression levels of NF-κB p65 and NLRP3 protein were also decreased, but the differences were not statistically significant (P>0.05). Conclusion Hydrogen-rich water can improve cognitive impairment induced by ionizing radiation in rats, and its mechanism may be related to regulating TLR4/NF-κB signaling pathway, inhibiting inflammatory factors, and attenuating oxidative stress.

Pancreatic adenocarcinoma (PAAD) is one of the most lethal malignancies. Although gemcitabine (GEM) is a standard treatment for PAAD, resistance limits its application and therapy. Secoemestrin C (Sec C) is a natural compound from the endophytic fungus Emericella, and its anticancer activity has not been investigated since it was isolated. Our research is the first to indicate that Sec C is a broad-spectrum anticancer agent and could exhibit potently similar anticancer activity both in GEM-resistant and GEM-sensitive PAAD cells. Interestingly, Sec C exerted a rapid growth-inhibiting effect (80% death at 6 h), which might be beneficial for patients who need rapid tumor shrinkage before surgery. Liquid chromatography/mass spectrometry and N-acetyl-l-cysteine (NAC) reverse assays show that Sec C sulfates cysteines to disrupt disulfide-bonds formation in endoplasmic reticulum (ER) proteins to cause protein misfolding, leading to ER stress and disorder of lipid biosynthesis. Microarray data and subsequent assays show that ER stress-mediated ER-associated degradation (ERAD) ubiquitinates and downregulates YAP to enhance ER stress via destruction complex (YAP-Axin-GSK-βTrCP), which also elucidates a unique degrading style for YAP. Potent anticancer activity in GEM-resistant cells and low toxicity make Sec C a promising anti-PAAD candidate.

Objective　To investigate the morphological changes of Cys C intervention on cerebral cortex AQP4,MMP-2 and BBB ultrastructure after cerebral ischemia reperfusion injury (CIRI) in rats and to explore its underlying mechanisms.Methods　One hundred male SD rats were randomly divided into sham group,IR group，Cys C low,medium and high concentration group.The rat middle cerebral artery embolism model was established by the modified Longa occlusion method.The water content of brain tissue was measured by dry and wet weight method,the content of EB in brain tissue was detected,and the degree of permeability change of the BBB was evaluated by focal ischemia for 2 h with middle cerebral artery occlusion and 24 h reperfusion.TEM was used to observe the ultrastructure changes of BBB.The opening of microvessels was observed under SEM;Western blot was used to detect AQP4 expression in cerebral cortex tissue.MMP-2 was detected expression by immune histochemistry.Results　Compared with IR group,the degree of BBB injury in Cys C low、medium groups was significantly reduced,and the number of capillaries opening increased.The expression of AQP4 protein was decreased,and the OD value of MMP-2 expression was also significantly decreased.In Cys C high group,the BBB was severely damaged.AQP4 protein expression was significantly increased,and the OD value of MMP-2 expression was also significantly increased.Conclusions　The application of Cys C intervention can reduce the damage of the BBB.It is mechanism may be relation to the decrease of AQP4 protein expression and the decrease of OD value of MMP-2 expression.

Objective:To construct an automatic recognition system for PD patients with freezing of gait (FOG) based on mobile phone videos by recording the gait videos of PD patients with FOG.Methods:Forty-nine PD patients with FOG, admitted to our hospital from December 2020 to May 2021, were chosen in our study. Their clinical data were collected. The processes of these patients accepted "3-meter-round trip" and "3-meter-round trip through narrow (0.6 m)" were recorded and 87 valid gait videos were extracted. Position signals of key points in the video were extracted, and featured data were extracted after signal preprocessing. From the featured data, action recognition model, straight FOG recognition model and turn FOG recognition model were established respectively, and finally end-to-end FOG recognition model was formed. Leave-one-subject-out (LOSO) method was used to evaluate the performance of the above models.Results:A total of 22 066 non-FOG window samples and 3815 FOG window samples were obtained from 87 valid videos, which constituted the training sample pool of this study. LOSO method showed that the motion recognition model enjoyed 83.27% sensitivity, 91.38% specificity, and 89.28% accuracy; the straight FOG recognition model enjoyed 57.69% sensitivity and 88.12% specificity; the turn FOG recognition model enjoyed 61.54% sensitivity and specificity 98.72%; and the end-to-end FOG recognition model enjoyed 85.71% sensitivity and 75.73% specificity.Conclusion:The automatic recognition system for PD patients with FOG based on mobile phone videos has relatively high sensitivity and specificity, which can realize remote assessment and is convenient for screening and follow-up of PD patients with FOG.

Objective:To explore the effects of mindfulness therapy on self-efficacy, compliance and quality of life in hemodialysis patients.Methods:A total of 94 patients who underwent hemodialysis treatment at Jiangxi Provincial People′s Hospital from December 2017 to January 2019 were selected. Random numbers were used to divide the control group and the observation group including 47 cases respectively. Patients in the control group were given routine care and medical intervention according to the procedures of the hospital. Patients in the observation group were given mindfulness therapy on the basis of the control group. The self-efficacy and quality of life of the two groups of patients were compared before and after intervention. Comparison of treatment compliance and intervention satisfaction between two groups of patients.Results:The self-efficacy scores of patients in the control group before and after the intervention were (1.25 ± 0.18) and (2.32 ± 0.35) points. The observation group′s self-efficacy scores were (1.28 ± 0.14) and (2.97 ± 0.33) points, respectively. The difference between the two groups before and after the intervention was statistically significant ( t values were -18.638, -32.321, P <0.01). There was a statistically significant difference between the two groups after intervention ( t value was -9.264, P <0.01). The treatment compliance score of the observation group was (82.69±13.59) points, which was higher than (71.53±12.25) points of the control group ( t value was 4.182, P <0.05). The scores of the psychological status, physiological status, environmental domain, and social relationship of the patients in the control group before the intervention were (54.37 ± 8.16), (50.32 ± 5.54), (53.28 ± 7.99), and (51.74 ± 6.21) points. The observation group was (55.03 ± 7.70), (51.38 ± 6.17), (53.94 ± 7.01), (50.88 ± 7.63) points. The control group after the intervention were (62.25 ± 6.85), (61.22 ± 9.18), (60.28 ± 7.23), and (55.69 ± 7.80) points. The observation group was (70.64 ± 8.48), (71.39 ± 7.85), (68.04 ± 8.85), and (60.26 ± 6.63) points. The differences between the two groups before and after the intervention were statistically significant ( t values were -13.739 - -2.716, P <0.01). The difference between the two groups after intervention was statistically significant ( t values were -5.772 to -3.060, P <0.01). The intervention satisfaction rate in the control group was 82.98% (39/47), and the intervention satisfaction rate in the observation group was 95.74% (45/47). The difference was statistically significant ( χ 2 value was 4.029, P <0.05). Conclusion:Intervention of hemodialysis patients with mindfulness therapy is beneficial to improve patients′ self-efficacy level, improve treatment compliance, and improve quality of life.

OBJECTIVE: To explore the relationship between shift work and type 2 diabetes in oil workers. METHODS: A total of 2 666 oil workers in an oil group were selected as the study subjects using the typical sampling method. Questionnaire survey was conducted by a self-designed Questionnaire of Health Assessment for Oil Workers, and blood glucose level was measure. RESULTS: The prevalence of type 2 diabetes in the study subjects was 10.1%(268/2 666). The prevalence of type 2 diabetes in shift workers was higher than that in non-shift workers(13.1% vs 6.0%, P<0.01). After adjusting for the influence of confounding factors such as gender, body mass index, family history of diabetes, history of hypertension, history of hyperlipidemia, and physical exercise, multivariate logistic regression analysis results show that the longer the shift work length, the higher the risk of developing type 2 diabetes(P<0.01), workers with shift work(3 shifts in a day, 2 shifts operating) had a higher risk of type 2 diabetes than that in non-shift workers(P<0.05). CONCLUSION: The shift work length and shift workers with 3 shifts in a day, 2 shifts operating can increase the risk of type 2 diabetes in oil workers.

Objective:To investigate the protective effect and mechanisms of umbilical cord tissue transplantation on radiation-induced learning and memory impairment in rats.Methods:Sixty SD rats were randomly divided into three groups with 20 in each group: control group, model group (whole brain X-ray irradiation, dose 20 Gy) and treatment group (whole brain X-ray irradiation, dose 20 Gy + umbilical cord tissue transplantation). The changes of body mass were observed, and the learning and memory of rats were observed by water maze test on the 14th and 28th day after irradiation, the neuron state of hippocampus was observed by HE staining, and the expressions of NF-κB pathway related proteins and IL-6 in hippocampus were detected by Western blot.Descriptive analysis and hypothesis testing were processed by SPSS 17.0.Results:(1) On the 28th day, the escaping latency in the water maze experiment of the treatment group was significantly higher than that of the control group and lower than that of the model group (control group: (11.77±3.02) s, model group: (23.75±3.27)s, treatment group: (18.49±2.32)s; t=3.940, -2.943, both P<0.05); the number of crossing platform in the treatment group was significantly lower than that in the control group and higher than that in the model group (control group: (7.20±0.84), model group (3.60±1.14 ), treatment group (5.00±1.00); t=-3.773, 2.064, both P<0.05). (2)HE staining showed that the neurons in the control group were arranged orderly and the cytoplasm was transparent.The neurons in the model group were arranged disorderly and the contraction of the cell body was triangular or irregular.The number of neurons in the treatment group was less than that in the model group. (3) On the 14th day, the relative expression of TLR4 in the treatment group was significantly higher than that in the control group and lower than that in the model group (control group: (0.69±0.03), model group: (1.06±0.11), treatment group: (0.90±0.04); t=7.275, -2.368, both P<0.05). The relative expression of NF-κB p65 in the treatment group was significantly higher than that in the control group and lower than that in the model group (control group: (1.67±0.12), model group: (2.08 ±0.06), treatment group: (1.93±0.08); t=3.236, -2.684, both P<0.05). The relative expression of IL-6 in the treatment group was significantly higher than that in the control group and lower than that in the model group (control group: (0.77±0.08), model group: (1.12±0.07), treatment group: (0.95±0.06); t=3.274, -3.495, both P<0.05). The relative expression of Bcl-2 / Bax in the treatment group was significantly lower than that in the control group and higher than that in the model group (control group: (1.40±0.52), model group: (0.48±0.06), treatment group: (0.72±0.0 3); t=-2.263, 6.350, both P<0.05). The expression trend of IL-6 and Bcl-2 / Bax protein on the 28th day was the same as that on the 14th day. Conclusion:Cord tissue transplantation can improve the learning and memory impairment caused by radiotherapy, which may be related with the inhibition of inflammation caused by radiotherapy.

AIM: To study the bioequivalence of rosuvastatin calcium tablets produced by two different manufacturers on a fasting and postprandial basis in Chinese healthy subjects. METHODS: A single-center, randomized, balanced, open, two-sequence, two-cycle, double-crossover, and single-dose trial design was used in this study. Each of the fasting group and the postprandial group was enrolled in 52 healthy subjects. Fasting/postprandial oral rosuvastatin calcium tablets 10 mg test preparation or reference preparation, the validated LC-MS/MS method was used to determine the concentration of rosuvastatin calcium tablets in plasma, and the pharmacokinetic parameters were calculated. Human bioequivalence and safety evaluation of two rosuvastatin calcium tablets were evaluated. RESULTS: The t