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.

Coagulation dysfunction occurs in more than 40% of severe patients. The adverse bleeding events, blood transfusion volume and mortality of severe patients with coagulation dysfunction may be increased by more than 4 times. Early recognition of the coagulation dysfunction and accurate evaluation of coagulation function are the premise and guarantee of correcting the coagulation dysfunction as soon as possible. However, there is still a lack of standards for rapid and accurate evaluation of coagulation dysfunction in severe patients at home and abroad. Therefore, the People's Liberation Army Professional Committee of Critical Care Medicine and Chinese Society on Thrombosis, Hemostasis and Critical Care of China Medicine Education Association jointly formulate this consensus. The related concepts, evaluation methods and diagnostic criteria of coagulation dysfunction in severe patients have been included in the present paper in order to provide corresponding guidance for clinical work.

Objective To investigate the effect of long non-coding small nucleolar RNA host gene 1 (lncRNA-SNHG1) on the proliferation of human hypertrophic scar fibroblasts. Methods The hypertrophic scar tissue and normal skin tissue adjacent to the scar (within 3 cm near the scar) of 22 patients with hypertrophic scar treated and operated in the Department of Burn and Plastic Surgery of the General Hospital of Ningxia Medical University from 2019 to 2021 were collected, and human primary fibroblasts were isolated and cultured from the hypertrophic scar and normal skin tissue adjacent to the scar, while the expression of SNHG1 and miR-382-3p was detected at the tissue and primary cell levels by using qRT-PCR. Proliferative scar fibroblasts were randomly divided into control group, SNHG1 negative control group (adding empty lentivirus vectors), mimic control group (adding control mimic), SNHG1 negative control + mimic control group (adding empty lentivirus vectors and control mimic), SNHG1 overexpression group (adding overexpression lentivirus), miR-382-3p overexpression group (adding miR-382-3p mimics), SNHG1 overexpression + mimic control group (adding overexpression lentivirus and control mimics) and SNHG1 overexpression + miR-382-3p overexpression group (adding overexpression lentivirus and miR-382-3p mimics). qRT-PCR was used to detect the mRNA expression of SNHG1, PCNA, p27 and miR-382-3p in each group; CCK-8 method to detect the proliferation viability of the cells in each group after transfection; EdU staining method to detect the change of proliferation level of each group of cells after transfection;Western blotting to detect the expression levels of p27 and PCNA proteins in each group of cells after transfection. Results SNHG1 presented high expression in hypertrophic scar tissue (3.21±2.65 vs. 1.14±0.61, P<0.001) and primary cells (0.91±0.08 vs. 0.54±0.08, P<0.01), whereas the expression of miR-382-3p was down-regulated (0.53±0.34 vs. 1.15±0.61, P<0.001; 0.84±0.09 vs. 1.01±0.004, P<0.05). Compared with SNHG1 negative control group, the cell proliferation ability of SNHG1 overexpression group increased (0.23±0.03 vs. 0.16±0.01, P<0.001), the percentage of EdU positive cells significantly increased (30.01%±5.70% vs. 7.13%±4.40%, P<0.001), the expression levels of PCNA mRNA and protein increased (mRNA: 2.97±0.33 vs. 0.98±0.25,P<0.01; protein: 2.20±0.09 vs. 0.88±0.20, P<0.05), the expression levels of p27 mRNA and protein decreased (mRNA: 0.30±0.03 vs. 1.42±0.15, P<0.001; protein: 0.47±0.11 vs. 1.13±0.19, P<0.05), and the expression level of miR-382-3p decreased significantly(0.05±0.01 vs. 1.03± 0.12, P<0.001). Compared with SNHG1 overexpression + mimic control group, the cell proliferation ability of SNHG1 overexpression + miR-382-3p overexpression group decreased (0.15±0.02 vs. 0.26±0.01, P<0.001), the percentage of EdU positive cells decreased (5.97%±0.33% vs. 11.70%±0.87%, P<0.001), the expression levels of PCNA mRNA and protein decreased significantly (mRNA: 0.64±0.09 vs. 3.33±0.38, P<0.001; protein: 1.70±0.36 vs. 2.34±0.16, P<0.05), the expression levels of p27 mRNA and protein increased (mRNA: 1.01±0.44 vs. 0.09±0.04, P<0.05; protein: 1.38±0.31 vs. 0.50±0.09, P<0.05). Conclusion SNHG1 presents high expression in hypertrophic scar and can negatively regulate miR-382-3p expression to promote proliferation of primary hypertrophic scar fibroblasts, which may become a potential new target in the treatment of hypertrophic scar.

Objective To explore the effect and potential mechanism of miR-125b-5p targecting ΔNp63α in keratinocyte differentiation. Methods To induce keratinocytes (HaCaT) differentiation, 1.8 mmol/L calcium chloride was added in the culture media. The mRNA level of miR-125b-5p, ΔNp63α, cytokeratin 10 (CK10), involucrin (Inv), transglutaminase 1(TG1), phosphatidylinositol 3-kinase (PI3K), protein kinase B (Akt), and mammalian target of rapamycin (mTOR) during keratinocyte differentiation were quantified by qRT-PCR (at day 0, 1, 5 and 7). The expression of ΔNp63α was detected by cellular immunofluorescence after treatment for 0 and 5 days. The binding site of miR-125b-5p to ΔNp63α was identified by the bibiserv website. The mimics/inhibitors of miR-125b-5p and the mimics/inhibitors of the negative control were transfected into keratinocytes. After five days of culture, the mRNA and protein expression of ΔNp63α, CK10, Inv, TG1, PI3K, Akt and mTOR were determined by qRT-PCR and Western blotting analysis. Results Compared with calcium chloride treatment for 0 days(1.00±0.02), the relative expression level of miR-125b-5p decreased significantly at 1 (0.17±0.02), 5 (0.08±0.01) and 7 days(0.07±0.02) (P<0.001). Compared with calcium chloride treatment for 0 days, the expression of ΔNp63α, CK10, Inv, TG1, PI3K,Akt and mTOR mRNA increased gradually after calcium chloride treatment for 1, 5 and 7 days (P<0.05). The results of cellular immunofluorescence assay showed that the positive rate of ΔNp63α increased after calcium chloride treatment for five days(96.9%±0.9% vs. 43.2%±8.2%, P<0.001). miR-125b-5p can bind to the 3'-UTR site of ΔNp63α. Compared with negative control mimic group, the mRNA expression levels of ΔNp63α, CK10, Inv, TG1, PI3K, Akt, and mTOR decreased significantly in miR-125b-5p mimic group. In addition, the protein expression levels of ΔNp63α, CK10, Inv, TG1, PI3K, Akt, p-Akt, mTOR, and p-mTOR also decreased significantly (P<0.05). Interestingly, the inhibition of miR-125b-5p could reverse the above effects (P<0.05). Conclusion miR-125b-5p targeting ΔNp63α inhibits keratinocyte differentiation by PI3K/Akt/mTOR signal pathway.

Objective To study the mechanism of +Gz environment exposure induced neck muscle injury in rabbits. Methods A total of 20 male rabbits were randomized into the negative control group, +Gz exposure group, +Gz exposure plus neck loading group, and +Gz exposure plus neck loading plus fixation group (5 in each group). The animal centrifuge was used to simulate the +Gz exposure environment. Rabbits in the +Gz exposure group, +Gz exposure plus neck loading group, and +Gz exposure plus neck loading plus fixation group were exposed for 4 weeks in a +6 Gz environment. Before and after the experiment, the rabbits in each group were photographed by X-ray. At the time of 0-, 1-, 2-, 3- and 4-week exposure, ear vein blood was collected from rabbits in each group, and ELISA was performed to detected plasma leveles of lactate dehydrogenase (LDH), creatine kinase (CK) and reactive oxygen species (ROS). After exposure, the trapezius muscle of rabbits was taken for HE staining to detect the muscle morphology.The apoptosis level was detected by TUNEL in the paraffin section of the rabbit trapezius muscle. The expressions of apoptosis-related proteins Bax and Bcl-2 in the trapezius muscle of rabbits were detected by Western blotting. The rabbit's neck trapezius muscle was taken to conduct proteomics testing, select differentially expressed proteins, and perform protein function cluster analysis. Results There was no significant difference in the morphology of the cervical vertebra in each group before and after+Gz exposure. Compared with negative control group, plasma levels of LDH, CK, and ROS in +Gz exposure group, +Gz exposure plus neck loading group, and +Gz exposure plus neck loading plus fixation group significantly increased (P<0.05). Compared with negative control group, the ratio of apoptosis protein Bax/Bcl-2 in +Gz exposure group significantly increased (P<0.05), the number of positive apoptosis cells detected by TUNEL significantly increased (P<0.05). Compared with +Gz exposure group, the+Gz exposure plus neck loading group showed an increased Bax/Bcl-2 ratio (P<0.05) and more TUNEL positive cells (P<0.05).Compared with +Gz exposure plus neck loading group, the ratio of apoptosis protein Bax/Bcl-2 and the positive number of apoptosis were decreased in +Gz exposure plus neck loading plus fixation group, but there were no statistically significant differences (P>0.05).A total of 600 proteins were significantly altered in +Gz exposure group compared to negative control group, and GO functional clustering analysis of the differential proteins revealed significant enrichment of proteins associated with mitochondrial function. Conclusion Exposure to the +Gz environment can cause neck muscle injury and cell apoptosis in rabbits. The muscle injury symptoms can be improved by fixing the stress link of the rabbit neck. Cell apoptosis induced by +Gz exposure may be related to mitochondrial function.

Objective To investigate the relationship between autoantibodies and biochemical responses to different doses of ursodeoxycholic acid (UDCA) in the treatment of primary biliary cholangitis (PBC). Methods Clinical data of 122 patients with PBC admitted to the Department of Gastroenterology, the Second Affiliated Hospital of Kunming Medical University from January 2013 to August 2020 were retrospectively analyzed. According to the treatment dose of UDCA, they were divided into >15 mg/(kg.d)UDCA group (n=71)and ≤15 mg/(kg.d) UDCA group (n=51). The relationship between antibody typing and treatment response to different doses of UDCA group and the effects of different doses of UDCA on biochemical indexes and immune indexes of PBC patients were analyzed. Results Baseline anti-SSA positive PBC patients were associated with >15 mg/(kg.d) UDCA response (P<0.05); Pathological stage Ⅱ was associated with ≤15 mg/(kg.d) UDCA response (P<0.05). The level of alanine transaminase (ALT), aspartase aminotransferase (AST), alkaline phosphatase (ALP), γ-glutamyl transpeptidase (GGT), total bilirubin (TBIL), IgM and the positivity rates of antinuclear antibodies (ANA) in>15 mg/(kg.d) UDCA group were significantly decreased after 1 year of treatment, and the pre-albumin was significantly increased (P<0.05).The levels of ALP and GGT and the positivity rates of anti-mitochondrial antibody type 2 (AMA-M2) in UDCA group ≤15 mg/(kg.d)after one year of treatment were significantly lower than those before treatment, and the pre-albumin level was significantly decreased (P<0.05).From the perspective of pathological stages, the >15 mg/(kg.d) UDCA group was dominated by stages Ⅲ and Ⅳ, and the ≤15 mg/(kg.d)UDCA group by stages Ⅰ and Ⅱ. The positivity rate of anti-gp210 was higher in non-response group than that in response group regardless of dose. Conclusions Both large and small doses of UDCA can improve the biochemical and immune indices of PBC patients, but for patients with severe disease and advanced pathological stage, high-dose UDCA therapy is recommended.

Objective To investigate the clinical value of serum iron in diagnostic and prognostic evaluation of sepsis. Methods Retrospectively analyzed 85 cases of sepsis patients and 50 sex- and age-matched non-septic patients admitted to the ICU of the First Affiliated Hospital of Dali University from September 2018 to September 2019. According to the prognosis at 28 d, 85 sepsis patients were divided into survival group (n=51) and non-survival group (n=34). Serum iron levels were compared between the two groups. Correlation analysis between serum iron and these indices as erythrocytes, hemoglobin, C-reactive protein (CRP), procalcitonin (PCT), interleukin-1β (IL-1β), sequential organ failure assessment (SOFA) scores were performed. The receiver operating characteristic curves (ROC) were plotted to evaluate the ability of serum iron in the diagnosis and prognosis evaluation of sepsis. Kaplan-Meier survival analysis was conducted comparing the survival rates between the patients with different levels of serum iron. Cox proportional hazards regression model was used to screen the risk factors for prognosis of the patients with sepsis. Results The serum iron levels were much lower in the septic patients [8.55(4.80, 15.53) μmol/L] than those in the controls [5.30(3.15,7.90) μmol/L]. And a significantly reduced serum iron level was observed in septic patients who died [4.45(1.80, 6.88) μmol/L]than survival patients [6.30(3.80, 9.50) μmol/L]. ROC analysis indicated that the serum iron exhibited the capability to identify individuals with sepsis, with an area under curve (AUC) of 0.71, and estimated prognosis of sepsis patients, with an AUC of 0.70.Kaplan-Meier survival analysis showed that lower serum iron levels (<2.5 μmol/L) were correlated with poor 28-day survival in septic patients (P=0.003). Spearman correlation analysis suggested a significant negative correlation between serum iron levels and IL-1β levels (r=–0.51, P<0.001). Additionally, univariate Cox proportional hazards regression model suggested that lower serum iron level was a risk factor for sepsis (HR=0.86, P=0.009). Conclusion Serum iron is useful in predicting the 28-day mortality among sepsis patients, especially those with serum iron less than <2.5 μmol/L.

Objective To explore the risk factors of persistent ectopic pregnancy (PEP) in patients with fallopian tubal pregnancy after tubal pregnancy surgery. Methods A total of 38 patients, who underwent the tubal pregnancy surgery in International Peace Maternity and Child Health Hospital affiliated to Medical College of Shanghai Jiao Tong University from January 2000 to December 2020, were selected as the research subjects and included into PEP group; and another 152 patients undergone the same operation during the same period and recovered well were selected as control group. The clinical data of the two groups were analyzed retrospectively. The age, gravidity, body mass index (BMI), menopause duration, previous fallopian tube surgery history, postoperative serum β-human chorionic gonadotropin (β-HCG) decline rate, tubal pregnancy site, ectopic pregnancy focus, and intraoperative pelvic adhesion etc. of all patients were recorded and analyzed. The clinical baseline data of the two groups were analyzed. The chi square test was used to analyze the risk factors of PEP after tubal pregnancy surgery, and Poisson regression analysis was performed to do the multivariate analysis. The independent risk factors of PEP after tubal pregnancy surgery were screened, and then the treatment method of PEP after tubal pregnancy surgery was analyzed. Results There were no significant differences between PEP group and control group in terms of age, gravidity, BMI and menopause duration. Univariate analysis showed that the PEP after tubal pregnancy surgery was related to emergency/elective surgery, pelvic adhesion and the rupture of ectopic pregnancy lesions/abortion, and the difference was statistically significant (P<0.05), while no obvious relation to the operation method, the location of tubal pregnancy and the size of ectopic pregnancy focus. Poisson regression analysis showed that the pelvic adhesion and the rupture of ectopic pregnancy lesions/abortion were the independent risk factors of PEP. The cure rates with methotrexate (MTX) treatment was 95% for PEP patient after tubal pregnancy surgery. Conclusion The pelvic adhesion and the rupture of ectopic pregnancy lesions/abortion were the independent risk factors of PEP after the tubal pregnancy surgery.

Objective To analyze the significance and biological role of MAGEA6 expression in gastric cancer. Methods The tissue microarray samples of 90 cases of gastric cancer resected surgically in the hospital sample bank from December 2009 to June 2010 were collected. The expression of MAGEA6 in gastric cancer tissue microarray was detected by immunohistochemical staining, and the relationship between MAGEA6 expression and clinicopathological features of gastric cancer was analyzed.Kaplan-Meier analyzed the relationship between the expression of MAGEA6 and the prognosis of gastric cancer. BGC-823 gastric cancer cell line was cultured in vitro. Set si-MAGEA6 group (transfected with si-MAGEA6) and si-Ctrl group (transfected with vector), the cell proliferation ability and apoptosis rate were detected by CCK-8 and flow cytometry. Western blotting detected the expression of MAGEA6, apoptosis-related proteins [b lymphoma-2 gene (Bcl-2), bcl-2 related X protein (Bax)], autophagy-related proteins [microtubule associated protein light chain 3-Ⅱ (LC3-Ⅱ), p62 protein (p62), autophagy-related gene 5 (Atg5) protein, yeast Atg6 homolog (Beclin 1)], Akt/mTOR signaling pathway-related proteins [protein kinase B (Akt), phosphorylated protein kinase B (p-Akt), mammalian target of rapamycin (mTOR), phosphorylated mammalian target of rapamycin (p-mTOR)]. The autophagy flow and autophagosome formation were observed by laser confocal microscope and electron microscope. Results The immunohistochemical score of MAGEA6 in gastric cancer tissues was higher than that in adjacent tissues [(3.77±1.50) points vs.(2.58±1.11) points, P<0.05]. Patients with high expression of MAGEA6 were significantly related to age and TNM stage (P<0.05).The cell viability of gastric cancer cells in si-MAGEA6 group was lower than that in si-Ctrl group (P<0.05). The apoptosis rate of gastric cancer cells in si-MAGEA6 group was higher than that in si-Ctrl group (14.97%±0.86% vs. 4.63%±0.55%, P<0.05). The protein expression levels of MAGEA6, Bcl-2, p62, p-Akt, and p-mTOR in si-MAGEA6 group were lower than those in si-Ctrl group, the protein expression levels of Bax, Atg5, Beclin 1, and LC3-Ⅰ/LC3-Ⅱ were higher than those in si-Ctrl group (P<0.05). In the si-MAGEA6 group, autophagy bodies increased significantly, and autophagy bodies and lysosomes formed autophagy lysosomes. Conclusions Gastric cancer tissues showed a significantly increased level of MAGEA6. Silencing MAGEA6 expression inhibits the proliferation of gastric cancer cells, suggesting that MAGEA6 may be an effective biomarker and potential therapeutic target for gastric cancer.

Objective To evaluate the predictors of the occurrence of intramyocardial hemorrhage (IMH) in patients with acute ST-segment elevation myocardial infarction (STEMI) after primary percutaneous coronary intervention. Methods A total of two hundred and four patients, admitted in the First Medical Center of Chinese PLA General Hospital from February, 2014 to March, 2019, diagnosed as STEMI undergoing emergency PCI treatment within the first 12 h of evolution, were screened for our retrospective analysis. IMH lesions were visualized by T₂-weighted sequences on cardiac magnetic resonance (CMR) between days 3 to 7 after PCI. Based on the existence of IMH, all patients were classified into the non-IMH group (n=117) and the IMH group (n=87). We investigate the clinical features between the two groups. Factors influencing were analyzed by logistic regression analysis. Results Compared with the non-IMH group, the ischemia time, admission glucose, admission heart rate, hemoglobin(Hb) reduction, creatine kinase isoenzymes (CK-MB) peak value, troponin T (TnT) peak value, low-density lipoprotein cholesterol, infarct size were significantly higher and the left ventricular ejection fraction (LVEF) was significantly lower in IMH group(P<0.05). Besides, in the IMH group, the proportion of patients with diabetes mellitus history, hyperlipemia history, preprocedural thrombolysis in myocardial infarction (TIMI) flow grades <3, anterior infarction, periprocedural glycoprotein Ⅱb/Ⅲa inhibitor treatment was significantly higher (P<0.05). Logistic regression model presented that diabetes mellitus history (P=0.003, OR=7.782,95%CI 2.009-30.846), ischemia time (P<0.001, OR=1.011, 95%CI 1.007-1.014), admission glucose (P<0.001, OR=1.428, 95%CI 1.182-1.725), admission heart rate (P=0.006, OR=1.041, 95%CI 1.012-1.071), Hb reduction (P<0.001, OR=1.117, 95%CI 1.059-1.178), CK-MB peak value (P=0.007, OR=1.006, 95%CI 1.002-1.010), anterior infarction (P=0.042, OR=2.626, 95%CI 1.037-6.652) and periprocedural glycoprotein Ⅱb/Ⅲa inhibitor treatment (P=0.022, OR=3.362, 95%CI 1.195-9.460) were independent risk factors for IMH in acute STEMI patients undergoing PCI. Conclusion Diabetes mellitus history, ischemia time, admission glucose, admission heart rate, Hb reduction, CK-MB peak value, anterior infarction, periprocedural glycoprotein Ⅱb/Ⅲa inhibitor treatment were independent risk factors for IMH in the patients with acute STEMI undergoing primary PCI. Appropriate strategies for managing acute STEMI patients at high risk for IMH should be taken into consideration.