Objective To analyze the epidemiological and clinical features of coronavirus disease 2019 (COVID-19) infected with the Delta variant of SARS-CoV-2. Methods Retrospectively analyze the epidemiological and clinical features of 138 confirmed cases of COVID-19 infected with the Delta variant of SARS-CoV-2 from October 25, 2021 to November 19, 2021 in Yantan Branch of the Second People's Hospital of Lanzhou City. The epidemiological and demographic information, clinical symptoms, laboratory tests, chest CT, treatment and prognosis data were collected, with a final follow-up date of November 27,2021. Results As of November 19, 2021, a total of 144 confirmed cases of COVID-19 were reported in Gansu Province, of which 138 cases [65 males (47.1%) and 73 females (52.9%), aged 2-87 (42.7±21.0) years old, with the clinical classification of mainly common type (48.6%, 67/138)] were concentrically treated in the Yantan Branch of the Second People's Hospital of Lanzhou City. The transmission mode of the Delta variant of SARS-CoV-2 is mainly in confined spaces, with obvious tour group and family aggregation; screening the close contacts and community investigation are the main approaches of finding the infected persons; 86.2% (119/138) of confirmed patients have been vaccinated with the domestic inactivated COVID-19 vaccine. The most common clinical symptoms are cough (57.2%, 79/138), followed by sore throat (28.3%, 39/138), dry throat (24.6%, 34/138), and expectoration (21.0%, 29/138). Only 20.3% (28/138) of patients have fever, and 4 patients (2.9%) have decreased or lost sense of smell and taste. Laboratory tests showed that serum amyloid A and high-density lipoprotein cholesterol increased significantly.The Ct value of SARS-CoV-2 ORF1ab gene is 26.31±7.63, and N gene is 26.35±7.17. Chest CT fined that 71.3% (72/101) of confirmed patients showed bilateral lung lobes involvement, and the lesions are mostly located in the lower lobes of both lungs;the lesions are mainly flaky and patchy ground-glass opacities. All confirmed cases are treated with integrated traditional Chinese and Western medicine, mainly prone position ventilation and traditional Chinese medicine (TCM) treatment. The TCM treatment rate is 100% for severe cases. On the basis of respiratory support, nutritional support and anticoagulation, immunotherapy such as neutralizing antibodies are combined. Conclusions The main clinical features of COVID-19 infected by the Delta variant of SARS-CoV-2 in Gansu Province are low rate of fever, long time for viral nucleic acid turned to negative, low risk of severe illness after vaccination, the good therapeutic effect, no intubation, no extracorporeal membrane oxygenation (ECMO), and no deaths. "One person, one plan" personalized treatment with integrated Chinese and Western medicine can effectively control the progression of the disease and cure the disease.

Healthy skeletal muscle has a certain capacity for regeneration. Muscle regenerative response mainly rely on the action of myogenic stem cells, other structures of muscle tissue are reconstructed with the support of vascular and neural networks.However, endogenous self-regeneration is severely impaired in large muscle injuries or under pathological condition. Consequently,tissue engineering approaches are a promising means to regenerate skeletal muscle. The latest domestic and international research progress of tissue engineering technology in repairing skeletal muscle injury has been reviewed in present paper.

Pancreatic cancer is one of the malignant tumors of digestive system with high malignancy and poor prognosis,so is called the "king of cancer" since resulting in an extremely high mortality rate. The death cases account for more than 90% of new cases in 2020, and there is still a lack of better treatments for pancreatic cancer. Chimeric antigen receptor T cell (CAR-T)immunotherapy has achieved great success in hematological malignancies, with an overall remission rate reached more than 80%. At present, five CAR-T products have been approved by the US FDA for listing, which marks a new era of anti-cancer road. In recent years, many scientists have focused their attention on CAR-T therapy to treatment of pancreatic cancer and have made good progress.The recent progress was summarized in present article of CAR-T therapy in treatment of pancreatic cancer including the selection of CAR-T targets, existed early clinical research, safety assessment, existed problems and challenges, etc., aiming to provide new ideas for pancreatic cancer immunotherapy.

Objective To investigate the correlation between the expressions of TGFβR2 and microsatellite instability (MSI) in colorectal cancer (CRC) tissues, and the relationship between the two protein molecules and clinicopathological parameters. Methods The CRC and adjacent tissues of 184 patients with CRC pathologically diagnosed in the Second Affiliated Hospital of Kunming Medical University from January 1, 2019 to September 30, 2019 were collected, the expression of MSI was detected by capillary electrophoresis (CE), and the expressions of MMR and TGFβR2 proteins were detected by immunohistochemistry (IHC). Kappa consistency test was used to analyze the consistency of IHC and CE MSI results. The relative TGFβR2 mRNA expression was detected by quantitative reverse transcriptase-polymerase chain reaction (qRT-PCR). Rank sum test was used to analyze the correlation between TGFβR2 gene mutation and MSI, and the relationship between TGFβR2 mRNA relative expression level and clinicopathological parameters. Results Among 184 CRC tissue samples, 152 cases (82.6%,152/184) were microsatellite instability low-frequency (MSI-L)/microsatellite stability (MSS) and 32 cases (17.4%, 32/184) were microsatellite instability high-frequency (MSI-H). The main results of MSI detected by CE and IHC were highly consistent, and the Kappa consistency coefficient was 0.922 (P<0.001). Compared with MSI-L/MSS, MSI-H mostly occurred in patients with stagesⅠ-Ⅱ colon cancer without lymph node metastasis (P<0.05). The protein and mRNA expression levels of TGFβR2 in CRC tissues were higher than those in the adjacent tissues (P<0.01). The mutation rate of TGFβR2 gene in MSI-H CRC was higher than that in MSI-L/MSS CRC [93.3%(28/30) vs. 14.9%(23/154), P<0.01]. The relative expression of TGFβR2 mRNA in MSI-H group was higher than that in MSI-L/MSS group (7.93±0.36 vs. 4.47±1.31, P<0.01), was higher in para-cancer tissues than in CRC tissues(9.38±0.82 vs. 4.76±1.63, P<0.01). The relative expressions of TGFβR2 mRNA in colon, tumors without metastasis, lymph node without metastasis and TNM Ⅰ-Ⅱ stages CRC tissues were higher (P<0.05). Conclusion The expressions of MSI and TGFβR2 are consistent and synergistic in tumor site, lymph node metastasis, and TNM stage.

Objective Record and analyze the disease effects and aging effects of eye movement indicators of visual information processing system in target exploration mission through an infrared eye-movement assessment system, and explore the pathogenesis of the visual exploration disorder in patients with Parkinson's disease (PD). Methods It is a cross-sectional study. A total of 32 patients with PD and normal cognition on dopaminergic drugs were recruited (PD group) from the Dyskinesia clinic of Dalian Friendship Hospital from October 2020 to June 2021; 33 age-, gender- and education-matched healthy volunteers with normal cognition were recruited (AMC group) from the medical center of our hospital, and 33 gender- and education-matched healthy young medical intern volunteers were recruited (YC group) from medical interns in our hospital during the same period. Behavioral and eye-movement indicators of all subjects were recorded with an infrared eye movement assessment system by testing to figure-matching tasks representing the visual information processing (clock-matching task and inverted clock-matching task) and saccade tasks representing the oculomotor function. The accuracy, saccade latency, and saccade size of saccade tasks, as well as the accuracy,the reaction time, the number of saccades visiting the sample area of interest (AOI), the number of saccades visiting array AOIs, and the de-efficiency score of clock matching tasks were analyzed. The PD group's clinical characteristics (disease duration, doses of anti-Parkinsonian medication, and Hoehn-Yahr grading) and eye movement indicators with disease effect were analyzed. Results In saccade tasks, there was no significant difference in all indicators between AMC group and YC group (P>0.05). Compared with the indicators of PD group, the saccade amplitude of anti-saccade task increased in AMC group (P=0.003) and the YC group (P<0.001)with statistically significant difference. In clock-matching tasks, compared with the YC group, the reaction time of the AMC group(clock-matching task: P=0.005; reverse clock-matching task: P=0.008) and PD group (clock-matching task: P=0.002; reverse clock-matching task: P<0.001) was significantly prolonged with statistically significant difference. Compared with the PD group, the saccade numbers of visiting sample AOI (AMC group: P=0.011; YC group: P<0.001), the saccade numbers of visiting array AOIs(AMC group: P=0.023; YC group: P<0.001) and the de-efficiency score (AMC group: P=0.017; YC group: P=0.003) decreased with statistically significant differences. No statistically significant difference existed in another indicators among each groups in clock matching tasks (P>0.05). There was no obvious correlation in saccade amplitude of anti-saccade task to the numbers of saccade visiting sample AOI (r=–0.014, P=0.785), the numbers of saccade visiting array AOIs (r=–0.025, P=0.837) and de-efficiency score(r=–0.031, P=0.576) in the reverse clock-matching task. None obvious correlation of the clinical characteristics of PD group to the saccade amplitude in anti-saccade task, the numbers of saccade visiting the sample AOI, the numbers of saccade visiting array AOIs,and de-efficiency score in the inverted clock-matching task (P>0.05). Conclusion The results based on the infrared eye movement system showed that the visual exploration disorder of PD patients may be due to the combined action of visual information processing dysfunction and oculomotor dysfunction; disease effect and aging effect have different influences on the process of visual exploration.

Objective To investigate the effect and mechanism of salvianolic acid B (SB) on proliferation and apoptosis of human rheumatoid arthritis (RA) synovial fibroblasts. Methods Human RA synovial fibroblasts MH7A cells were treated with different concentrations of SB (0, 1, 10, 20, 30, 40 and 50 μmol/L). MTT method was used to detect cell proliferation and flow cytometry was used to detect cell apoptosis, and the optimal concentration of SB was selected. MH7A cells were set as control group(normal cultured cells), SB group (cells cultured with 50 μmol/L SB) and SB+3-MA group (cells cultured with 50 μmol/L SB and 5 mmol/L autophagy inhibitor 3-MA). MTT and flow cytometry were used to detect cell proliferation and apoptosis, qRT-PCR was used to measure the relative expression level of caspase-3 mRNA. Western blotting was used to detect the relative expression levels of caspase-3, LC3-Ⅰ, LC3-Ⅱ, Beclin-1 and p62 protein. Results Compared with 0 μmol/L SB group, the proliferation rate decreased obviously (P<0.05) and the apoptosis rate increased significantly (P<0.05) of MH7A cells treated with 30, 40 and 50 μmol/L SB and 50 μmol/L SB was used for follow-up experiments. Compared with control group, the cell proliferation rate and the relative expression level of p62 protein in SB group decreased significantly, while the apoptosis rate, the relative expression levels of caspase-3 mRNA and protein, as well as the relative expression levels of LC3-Ⅱ/LC3-Ⅰ and Beclin-1 protein increased (P<0.05). Compared with SB group, the proliferation rate and the relative expression level of p62 protein increased obviously (63.47%±1.94% vs.51.33%±4.67%; 0.97±0.06 vs. 0.20±0.02) in SB+3-mA group, and the apoptosis rate (21.4%±1.8% vs. 30.4%±0.6%), the relative expression levels of caspase-3 mRNA (0.83±0.06 vs. 1.27±0.15) and protein (0.64±0.05 vs. 1.10±0.09), as well as the relative expression levels of LC3-Ⅱ/LC3-Ⅰ (0.29±0.07 vs. 1.23±0.21) and Beclin-1 protein (0.36±0.05 vs. 1.05±0.08) decreased(P<0.05). Conclusion SB might inhibit the proliferation and promote apoptosis of human RA synovial fibroblast by inducing autophagy.

Gastrointestinal dysfunction is one of the initiating factors for multiple organ failure. The European Society of Intensive Care Medicine (ESICM) proposed the definition of acute gastrointestinal injury (AGI) to describe dysfunction of the gastrointestinal tract in critically ill patients. AGI occurs frequently in the intensive care unit (ICU) and associates with clinical outcomes of ICU patients. The incidence of pain is high in the ICU, and analgesic drugs can significantly improve the prognosis of patients. But the administration of analgesic drugs is an important factor affecting gastrointestinal function. So, in order to prevent AGI in high-risk patients, both analgesic needs and low impact on gastrointestinal function need to be taken into account before choices of opioids are finalized. This review briefly summarizes the mechanisms of AGI in ICU patients and the studies related to the effects of analgesics on gastrointestinal motility and barrier in ICU patients with opioids as the core, providing a reference for clinical selection.

Objective To analyze the clinical features of 9 patients with renin secreting tumor and review the related literature in order to improve the understanding, diagnosis and treatment of the disease. Methods The clinical data, diagnosis, treatment, pathological and immunohistochemical profiles of 9 patients with renin secreting tumor admitted in the First Medical Center of Chinese PLA General Hospital from January 2010 to February 2020 were retrospectively analyzed. The literature was searched by retrieving the related database from 2001 to 2020, combined with 142 similar cases collected by searching the database to analyze the clinical features of patients with renin secreting tumor. Results All the 9 patients with an average age of 22.6 years presented with hypertension, and 7 of the 9 with hypokalemia. The plasma renin levels in all the patients were significantly higher than normal range, and the plasma aldosterone levels were above the median normal reference interval. Postoperative pathological examination of all cases confirmed juxtaglomerular cell tumor. Immunohistochemical staining showed that all the tumor cell renin, vimentin and CD34 were positive, some neoplastic cells were positive for smooth muscle actin (SMA) and synaptophysin (Syn), and negative for S-100 protein (S-100) and chromogranin A (CgA). The blood pressure and serum potassium level returned to normal range in all patients after surgery. A total of 142 patients with renin secreting tumor have been reported in China from 2001 to 2020.Hypertension was the initial symptom of all the patients. Hypokalemia occurred in 87 of 142 patients. Plasma renin and aldosterone levels were above the normal range in 93 patients. No recurrence or metastasis occurred in all patients after surgery during follow-up. Conclusions Renin secreting tumor mostly is characterized as benign renal tumor with hypertension, hypokalemia, hyperreninemia and hyperaldosteronism. Surgery is preferred in treatment of this tumor for a good prognosis.

Objective To identify the clinicopathologic factors influencing the prognosis of the patients with distal cholangiocarcinoma (dCCA) after radical pancreatoduodenectomy (PD). Methods Retrospectively analyze the clinical data of 231 dCCA post-PD cases in Peking University First Hospital from January 2005 to January 2015. The clinicopathologic parameters were analyzed using univariate and multivariate Cox regression models and Kaplan-Meier method. Results The 1-year, 3-year and 5-year survival rates of the 231 post-PD dCCA patients were 86.6%, 55.0% and 34.6% respectively. Univariate Cox regression analysis showed that the primary tumor invasion depth (T stage) (P=0.000), lymph node metastasis (N stage) (P=0.001), AJCC stage(P=0.000), total number of dissected lymph nodes (P=0.038), metastasis lymph node ratio (P=0.001), vascular tumor thrombus(P=0.001), nerve invasion (P=0.001) and pathological type (P=0.002) were related to the prognosis of patients with dCCA after PD. Multivariate Cox regression analysis showed that the higher degree of lymph node metastasis (P=0.001), total number of lymph nodes dissected ≤10 (P=0.029), positive vascular tumor thrombus (P=0.007), positive nerve invasion (P=0.001) and low differentiation of pathological type (P=0.029) were independent risk factors for poor prognosis of patients with dCCA after PD.Kaplan-Meier analysis showed that the degree of lymph node metastasis, total number of dissected lymph nodes, vascular tumor thrombus, nerve invasion, and pathological type could affect the overall survival (OS) of patients with dCCA after pD (P<0.005), but whether adjuvant chemotherapy or not had no significant effect on OS of positive lymph node metastasis patients with dCCA after PD (P>0.05). Conclusion The higher degree of lymph node metastasis, total number of lymph nodes dissected less than 10, vascular tumor thrombus, nerve invasion and low differentiation of pathological type are considered as the independent poor prognostic factors of post-PD dCCA patients.

Leptin, a fat factor synthesized in adipose tissue, is initially worked as a hormone substance regulating body fat balance. With in depth-study, researchers found that leptin has structural homology with such cytokines as interleukin-6 (IL-6), and its receptor, Ob-R, belongs to class Ⅰ cytokine receptor superfamily. Through binding to corresponding receptor, leptin can not only regulate the food intake and energy balance, but can also regulate the immune system. Rheumatoid arthritis (RA) is one of the common autoimmune diseases caused by many genetic and environmental factors. The fundamental pathological change of RA is chronic synovial inflammation and pannus formation, and leads to the destruction of cartilage, bone and surrounding tissue. Many immune cells and resident stromal cells are involved in RA pathological progress although the exact pathogenesis of RA remained unclear. It has been proved by in vivo experiment of RA animal model that leptin is related to the joint inflammation, and may participate in the pathogenesis and process of the disease. The immunomodulatory effects of leptin on the main effector cells of RA has been reviewed in present paper, aiming to expand ideas for related research.