Objective:To investigate the effect of capsaicin on lipopolysaccharide(LPS)-induced microglial inflammatory response by modulating silent mating type information regulation 2 homolog 1(SIRT1)/high mobility group box-1 protein(HMGB1)/nuclear factor κB(NF-κB)signaling pathway.Methods:BV2 mouse microglia were cultured in vitro,and pretreated with capsaicin(10 μmol/L),SIRT1 inhibitor EX527(100 μmol/L),capsaicin+EX527(10 μmol/L capsaicin+100 μmol/L EX527)for 3 hours,and then treated with LPS(1 μg/ml)for 24 hours,the corresponding groups were LPS group,LPS+capsaicin group,LPS+EX527 group,and LPS+capsaicin+EX527 group,a normal cultured control group(Control)was also set up.Morphological changes of BV2 cells in each group were observed under a microscope;CCK-8 method was used to detect the viability of BV2 cells in each group;immunofluo-rescence staining was applied to detect the positive expressions of ionic calcium adaptor protein(Iba-1)and the polarization of M1(positive for CD16/32)/M2(positive for CD206)subtypes in BV2 cells in each group;ELISA was applied to detect levels of inflamma-tory factors in BV2 cells in each group;Western blot and co-immunoprecipitation were applied to detect expression of SIRT1/HMGB1/NF-κB signaling pathway-related proteins in each group.Results:Compared with Control group,BV2 cells in LPS group were atro-phied,with shortened processes,the cell viability,and levels of IL-1β,TNF-α and IL-6 were increased,Iba-1 positive expression of BV2 cells and M1 type BV2 cells were increased,while expression of SIRT1 protein was decreased,expressions of acetylated(ace)-HMGB1 protein,cytoplasmic HMGB1 protein and nuclear NF-κB protein were increased(P<0.05);after capsaicin pretreatment,the above conditions were improved,and the M2 type BV2 cells were increased;adding EX527 pretreatment on the basis of capsaicin pre-treatment,the above conditions were all aggravated.Conclusion:Capsaicin can inhibit the inflammatory response induced by LPS-in-duced BV2 cell activation,which may be achieved by modulating the SIRT1/HMGB1/NF-κB signaling pathway.

To evaluate the application value of metal clip combined with suture and rubber coil as a simple traction device in endoscopic submucosal dissection (ESD) for intestinal mucosal lesions, a total of 56 patients with early colonic cancer and precancerous lesions who received ESD in Jiangyin People's Hospital from January 2021 to July 2022 were randomly divided into the control group ( n=28, conventional ESD) and the traction group ( n= 28, suture and rubber coil as a simple traction device). The total time of ESD, mucosal dissection time, number of submucosal injections, complete resection rate and complications were compared between the two groups. The operation time of the traction group was shorter than that of the control group (74.64±33.25 min VS 117.18±35.75 min, t=4.61, P<0.001). The desection time of mucosa in the traction group was shorter than that in the control group (51.61±24.87 min VS 99.11±32.73 min, t=6.11, P<0.001). The number of submucosal injection in the traction group was less than that of the control group with significant difference (1.68±1.16 VS 4.96±1.41, t=9.57, P<0.001). There was no significant differences in operation area, complete resection rate or complication between the two groups ( P>0.05). The traction assistance technology of metal clip combined with suture and rubber coil can reduce the technical difficulty of colonic ESD and shorten the operation time.

Papillary thyroid carcinoma metastasizing to the kidney are extremely rare events, which may easily be misdiagnosed as renal cell carcinoma. The diagnosis needs to be based on immunohistochemical examination. We described a case of renal tumor to be proved renal metastatic carcinoma from thyroid origin by pathological examination. Computed tomography (CT) scan shows metastasis nodules in lungs. Following total thyroidectomy, he underwent iodine-131 ( 131Ⅰ), thyroid hormone and sorafenib to treat thyroid remnant tumor and metastases. Partial nephrectomy was conducted to remove the left renal metastatic carcinoma for preserving normal renal function. Follow-up revealed that partial pulmonary nodule gradually shrunk, and no new metastasis appeared.

The combination of chemotherapy and immunotherapy motivates a potent immune system by triggering immunogenic cell death (ICD), showing great potential in inhibiting tumor growth and improving the immunosuppressive tumor microenvironment (ITM). However, the therapeutic effectiveness has been restricted by inferior drug bioavailability. Herein, we reported a universal bioresponsive doxorubicin (DOX)-based nanogel to achieve tumor-specific co-delivery of drugs. DOX-based mannose nanogels (DM NGs) was designed and choosed as an example to elucidate the mechanism of combined chemo-immunotherapy. As expected, the DM NGs exhibited prominent micellar stability, selective drug release and prolonged survival time, benefited from the enhanced tumor permeability and prolonged blood circulation. We discovered that the DOX delivered by DM NGs could induce powerful anti-tumor immune response facilitated by promoting ICD. Meanwhile, the released mannose from DM NGs was proved as a powerful and synergetic treatment for breast cancer in vitro and in vivo, via damaging the glucose metabolism in glycolysis and the tricarboxylic acid cycle. Overall, the regulation of tumor microenvironment with DOX-based nanogel is expected to be an effectual candidate strategy to overcome the current limitations of ICD-based immunotherapy, offering a paradigm for the exploitation of immunomodulatory nanomedicines.

Objective To evaluate the clinical efficacy of early diagnosis by contrast-enhanced ultrasound (CEUS) combined with mesenchymal stem cell (MSC) therapy in the treatment of biliary ischemia after liver transplantation. Methods Clinical data of 9 recipients presenting with biliary ischemia detected by CEUS within 4 weeks after liver transplantation and diagnosed with non-anastomotic biliary stricture (NAS) within postoperative 1 year were retrospectively analyzed. In the conventional treatment group, 4 recipients were treated with conventional treatment including liver protection, cholagogic therapy and interventional therapy. In MSC treatment group, 5 recipients received intravenous infusion of MSC at 1, 2, 4, 8, 12 and 16 weeks after biliary ischemia detected by CEUS on the basis of conventional therapy. The interventional treatment and clinical prognosis within 1 year after liver transplantation were analyzed between two groups. Results Two recipients in the MSC treatment group required interventional therapy, which was initially given at 7-9 months after liver transplantation for 1-2 times. All recipients in the conventional treatment group required interventional therapy, which was initially delivered at postoperative 1-3 months for 2-6 times, earlier than that in the MSC treatment group. Within 1 year following liver transplantation, diffuse bile duct injury occurred in 2 recipients in MSC treatment group, and no graft dysfunction was observed. In the conventional treatment group, all recipients developed diffuse bile duct injury, and 2 recipients presented with graft dysfunction. Conclusions Early diagnosis of biliary ischemia after liver transplantation by CEUS combined with MSC therapy may delay and reduce the requirement of interventional therapy for NAS, and also improve clinical prognosis of the recipients.

Objective To investigate the clinical effect of low/low pressure drainage radical resection in the treatment of high perianal abscess.Methods Eighty-six patients with high perianal abscess treated in Tangshan Traditional Chinese Medicine Hospital from Octorber 2014 to Octorber 2016 were selected and randomly divided into the observation group(44 cases)and the control group(42 cases).The observation group was treated with decompression and drainage radical surgery,while the control group was treated with one-stage incision and thread drawing radical surgery.The postoperative conditions of the two groups were observed, including pain,anal function,healing time and clinical effect,and statistical analysis was made on the quantitative scores of the above indexes.Results The cure rate of the observation group was 100%(44/44), significantly higher than that in the control group(90.47%(38/42)),and the difference between the two groups was statistically significant(χ2=4.395,P=0.036).The postoperative pain score of the observation group was(1.681±0.945)points,significantly lower than that in the control group((3.328±1.300)points),and the difference was statistically significant(t=-4.504,P=0.000); The number of recurrence(0 cases)was significantly lower than that in the control group(4 cases)(P=0.036).The healing time of the observation groups was(22.08± 2.12)d, significantly lower than that in the control group((37.552± 2.61)d),and the difference between the two groups was statistically significant(t=29.0411,P=0.000);The anal function score of the observation group was(1.681±0.838)points,significantly lower than that in the control group((2.809 ±0.928)points),and the difference between the two groups was statistically significant(t = -3.217,P=0.000).Conclusion Low pressure drainage radical is an effective surgical method for sphincter preserving radical treatment of high perianal abscess,which not only preserves the sphincter and anus straight ring,but also reduces the postoperative anal function and the degree of morphological damage and the surgery the pain and length of hospital stay and cost saving.

Objective To investigate the expression of CD133 and CD44 proteins in gastric stromal tumors (GST) and their clinical significances. Methods The expression of CD44 and CD133 proteins in the GST tissues of 112 patients was detected by immunohistochemical staining. The relation between the expression of CD44 and CD133 proteins and the clinicopathological characters was analyzed. The survival and prognosis of GST were also analyzed. Results Both CD44 and CD133 were expressed on the cell membranes. The expression rates of CD44 and CD133 were 58.04 % (65/112) and 42.86 % (48/112) separately; the co-expression rate of CD44 and CD133 was 27.68 % (31/112). CD44 and CD133 were negative in normal peritumoral tissues. No correlation was found between CD44 and CD133 and the clinicopathological parameters including gender, age and lymphatic vessel invasion (all P>0.05), but the expression levels of CD44 and CD133 in patients with the mitotic count ≥ 5/50 high-power field, large diameter and vascular invasion were significantly higher (all P<0.05). No correlation was found between co-expression of CD44 and CD133 and the clinical clinicopathological parameters including gender, age, the mitotic count ≥ 5/50 high-power field and vascular invasion (all P>0.05), but the co-expression level of CD44 and CD133 in patients with tumor diameter ≥5 cm was significantly higher than that in patients with tumor diameter < 5 cm (χ2=5.040, P=0.025). The overall survival rate of the patients with co-expression of CD44 and CD133 was shorter than that in other groups (χ2 = 8.758, P= 0.001). No correlation was found between CD44 and CD133 expression (r=0.126, P=0.210). Multivariate analysis with the Cox regression models showed that the tumor diameter ≥5 cm (P=0.042) and co-expression of CD44 and CD133 (P=0.003) were significantly associated with poor prognosis. Conclusion CD44 and CD133 as robust cancer stem cell markers in GST might be the prognostic factors.

Objective: To describe the distribution and drug resistance of pathogens at hematology department of Jiangsu Province from 2014 to 2015 to provide reference for empirical anti-infection treatment. Methods: Pathogens were from hematology department of 26 tertiary hospitals in Jiangsu Province from 2014 to 2015. Antimicrobial susceptibility testing was carried out according to a unified protocol using Kirby-Bauer method or agar dilution method. Collection of drug susceptibility results and corresponding patient data were analyzed. Results: The separated pathogens amounted to 4 306. Gram-negative bacteria accounted for 64.26%, while the proportions of gram-positive bacteria and funguses were 26.99% and 8.75% respectively. Common gram-negative bacteria were Escherichia coli (20.48%) , Klebsiella pneumonia (15.40%) , Pseudomonas aeruginosa (8.50%) , Acinetobacter baumannii (5.04%) and Stenotropho-monas maltophilia (3.41%) respectively. CRE amounted to 123 (6.68%) . Common gram-positive bacteria were Staphylococcus aureus (4.92%) , Staphylococcus hominis (4.88%) and Staphylococcus epidermidis (4.71%) respectively. Candida albicans were the main fungus which accounted for 5.43%. The rates of Escherichia coli and Klebsiella pneumonia resistant to carbapenems were 3.5%-6.1% and 5.0%-6.3% respectively. The rates of Pseudomonas aeruginosa resistant to tobramycin and amikacin were 3.2% and 3.3% respectively. The resistant rates of Acinetobacter baumannii towards tobramycin and cefoperazone/sulbactam were both 19.2%. The rates of Stenotrophomonas maltophilia resistant to minocycline and sulfamethoxazole were 3.5% and 9.3% respectively. The rates of Staphylococcus aureus, Enterococcus faecium and Enterococcus faecalis resistant wards vancomycin were 0, 6.4% and 1.4% respectively; also, the rates of them resistant to linezolid were 1.2%, 0 and 1.6% respectively; in addition, the rates of them resistant to teicoplanin were 2.8%, 14.3% and 8.0% respectively. Furthermore, MRSA accounted for 39.15% (83/212) . Conclusions Pathogens were mainly gram-negative bacteria. CRE accounted for 6.68%. The rates of Escherichia coli and Klebsiella pneumonia resistant to carbapenems were lower compared with other antibacterial agents. The rates of gram-positive bacteria resistant to vancomycin, linezolid and teicoplanin were still low. MRSA accounted for 39.15%.

Objective To study the influence of Qingzao Runfei Huazhuo Xingxue decoction on pulmonary tissue and lung function in mouse model of lung injury induced by PM2.5, and to provide an idea of clinical prevention and treatment of respiratory diseases induced by PM2.5. Methods Totally 30 clean level male ICR mice were randomly divided into three groups: normal control group, model group and Qingzao Runfei Huazhuo Xingxue decoction intervention group, with 10 mice in each group. Model of PM2.5-induced respiratory disease in mice was reproduced by instilling nasal cavity drip PM2.5 suspension 40 mg/kg once a day for 6 weeks. In the treatment group, the mice were fed with the Qingzao Runfei Huazhuo Xingxue decoction twice a day from the 4th week of instilling PM2.5 suspension until the end of experiment. In the normal control group, the mice were fed as usual. At the end of the experiment, the total protein content in bronchoalveolar lavage fluid (BALF), and lung wet/dry weight (W/D) ratio was determined. Hematoxylin-eosin (HE) staining was used to observe the histopathological changes in lung tissue under light microscope. The inflammatory mediators levels in lung tissue were determined by antibody-sandwich enzyme linked immunosorbent assay (ELISA). Results Respiratory system damage model was successfully reproduced by dripping of PM2.5 suspension in nasal cavity. Compared with normal control group, inflammatory changes and inflammatory cell infiltration in model group were significant, and lung W/D ratio (4.71±0.33 vs. 3.13±0.12), total protein content in BALF (mg/L: 363.98±18.24 vs. 82.13±12.78), tumor necrosis factor-α [TNF-α (ng/L): 185.72±0.23 vs. 31.03±0.16], interleukin-8 [IL-8 (ng/L): 531.85±37.83 vs. 72.64±16.72], and leukotriene B4 [LTB4 (ng/L): 931.74±48.64 vs. 483.81±41.74] in lung tissue were significantly increased (all P < 0.05). Compared with the model group, the inflammatory changes of lung tissue in Qingzao Runfei Huazhuo Xingxue decoction intervention group were significantly reduced, lung W/D ratio (3.92±0.41 vs. 4.71±0.33), total protein content in BALF (mg/L: 213.21±19.62 vs. 363.98±18.24), TNF-α (ng/L: 124.15±0.27 vs. 185.72±0.23), IL-8 (ng/L: 238.42±35.82 vs. 531.85±37.83) and LTB4 (ng/L: 582.85±31.00 vs. 931.74±48.64) levels in lung tissue in Qingzao Runfei Huazhuo Xingxue decoction intervention group were significantly decreased (all P < 0.05). Conclusion Qingzao Runfei Huazhuo Xingxue decoction can improve PM2.5-induced damage and pathological inflammatory changes in lung tissue, which provided some new ideas for the treatment of PM2.5-induced respiratory diseases.