In recent years, there have been increasing reports of anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis and myelin oligodendrocyte glycoprotein-antibody disease (MOG-Ab disease) appearing simultaneously or sequentially in the same patient. Some scholars have collectively referred to this kind of disease as the overlapping syndrome of MOG-Ab disease and anti-NMDAR encephalitis (MNOS). The clinical manifestations, treatment and prognosis of these syndromes are different from simple anti-NMDAR encephalitis or MOG-Ab disease. However, due to lack of understanding, clinicians tend to diagnose these syndromes as simple anti-NMDAR encephalitis or MOG-Ab disease, resulting in delayed the disease and affected prognosis. In order to strengthen the understanding of MNOS, this paper reviews MNOS from etiological hypothesis, characteristics of affected population, clinical manifestations, imaging manifestations, antibody characteristics in disease progression and treatment, so as to provide reference for the diagnosis and treatment in the future.

Objective To investigate the expression and clinical significance of blood basophil CD16 and CD32 in asthma-chronic obstructive pulmonary disease overlap (ACO) and chronic obstructive pulmonary disease (COPD). Methods COPD and ACO patients in the Third Affiliated Hospital of Jinzhou Medical University from December 2019 to December 2020 (set as COPD group and ACO group) and recruited healthy volunteers (set as healthy control group) were selected as research objects. General information including gender, age, medical history, age at onset, body mass index (BMI) and smoking history, and peripheral venous blood were collected. The expressions of CD16 and CD32 in basophil granulocyte enriched groups were detected by flow cytometry. The expression level of tumor necrosis factor-α (TNF-α) in plasma was determined by ELISA. Results Compared with healthy control group, the proportion of CD16⁺CCR3⁺ cells, CD16⁺CD123⁺HLA-DR^- cells and CD16⁺CCR3⁺CD123⁺HLA-DR^-cells in peripheral blood mononuclear cell population of ACO group and COPD group were increased (P<0.05), the proportion of CD32⁺CD123⁺HLA-DR^- cells and CD32⁺CCR3⁺CD123⁺HLA-DR^- cells in COPD group increased (P=0.003, P=0.030), the proportion of CD32⁺CD123⁺HLA-DR^- cells and CD32⁺CCR3⁺CD123⁺HLA-DR^- cells in ACO group decreased (P=0.019, P=0.031).The CD32 mean fluorescence intensity (MFI) of CCR3⁺ cells and CCR3⁺CD123⁺HLA-DR^- cells was lower in ACO group than in healthy control group (P=0.006, P=0.047). The plasma TNF-α expression level was higher in ACO group than in healthy control group with statistically significant difference (P=0.036). Conclusion Basophil granulocyte source CD16 and CD32 may play an important role as the pathogenesis of ACO and COPD, and TNF-α is involved in the pathogenesis of ACO, which may provide a new target for the subsequent clinical treatment of ACO and COPD.

Irritable bowel syndrome (IBS) is the most common functional bowel disease, and diarrhea-predominant IBS(IBS-D) is the most common type of IBS in our country. There are many causes of IBS, among which abnormal bile acid metabolism and intestinal flora disorder are the main pathogenic factors. Abnormal bile acid metabolism and intestinal flora disorders are found in patients with IBS-D. Intestinal flora is critical in the regulation of bile acid synthesis. Disorders of intestinal flora may lead to abnormal bile acid metabolism. Studies have pointed out that bile acid pathway (farnesoid X receptor, FXR) agonists can improve IBS-D symptoms by regulating receptor bile acid metabolism and intestinal flora. The interaction and corresponding mechanism of bile acid-intestinal flora and IBS-D were summarized in present paper.

Objective To investigate the effect and mechanism of lncRNA NEAT1 activating PI3K/Akt signaling pathway on the influence of Alzheimer's disease (AD) PC12 model cells apoptosis induced by Aβ_25-35. Methods PC12 cells were induced with Aβ_25-35 of concentrations 0, 5, 10 and 20 μmol/L to construct AD cell model. PC12 cells were treated with 5 μmol/L Aβ_25-35, and the relative expression level of lncRNA NEAT1 was detected by qRT-PCR at the time points 24, 48 and 72 hours,respectively. PC12 cells were divided into: (1) control group, lncRNA NEAT1 knockdown group, si-NC group, empty body group and lncRNA NEAT1 overexpression group. Among them the cells in control group were not treated anyway; in the other four groups were cultured with Opti-MEM medium containing si-lncRNA NEAT1, si-NC, pcDNA3.1-NC and pcDNA3.1-lncRNA NEAT1 and transfected for 8 hours, and then treated with 20 μmol/L Aβ_25-35; qRT-PCR was used to detect the relative expression level of lncRNA NEAT1; CCK-8 was used to detect the cell viability; flow cytometry was used to detect the apoptosis of PC12 cells, and the proliferation of PC12 cells was reflected by the ratio of G₁ to G₂ phase of cell cycle; the inflammatory factors interleukin-1β (IL-1β),IL-6, IL-18, and tumor necrosis factor-α (TNF-α) in cell supernatant were detected by ELISA. (2) control group, empty body group,and lncRNA NEAT1 overexpression group, Western blotting was used to detect the relative expression levels of p-PI3K and p-Akt.(3) control group, si-NC group, lncRNA NEAT1 knockdown group, empty body group, lncRNA NEAT1 overexpression group, and lncRNA NEAT1 overexpression+LY294002 group. Cells in lncRNA NEAT1 overexpression+LY294002 group were transfected with pcDNA3.1-lncRNA NEAT1, and 10 μmol/L P13K pathway inhibitor LY294002 were added, and then flow cytometry was used to detect the apoptosis of PC12 cells. Results Different concentrations of Aβ_25-35 could significantly inhibit the expression of lncRNA NEAT1 in a concentration-dependent manner (P=0.001). Compared with empty body group, the relative expression level of lncRNA NEAT1, the cell proliferation rate, and the proportion of cells in G₂ phase of lncRNA NEAT1 overexpression group increased, the cell apoptosis rate and the proportion of cells in G₁ phase decreased (P<0.05). Compared with si-NC group, the relative expression level of lncRNA NEAT1, the cell proliferation rate, and the proportion of cells in G₂ phase of lncRNA NEAT1 knockdown group decreased, the cell apoptosis rate and the proportion of cells in G₁ phase increased (P<0.05). ELISA results showed that, compared with empty body group, the levels of inflammatory factors IL-1β, IL-6, IL-18, and TNF-α decreased significantly in lncRNA NEAT1 overexpression group (P<0.05); compared with si-NC group, the levels of inflammatory factors IL-1β, IL-6, IL-18 and TNF-α increased significantly in lncRNA NEAT1 knockdown group (P<0.05). Western blotting results showed that, compared with empty body group, the expression levels of signal pathway related proteins p-PI3K and p-Akt increased in lncRNA NEAT1 overexpression group (p-PI3K: 0.86±0.05 vs. 0.15±0.02, P=0.003; p-Akt: 0.86±0.06 vs. 0.11±0.04, P=0.000). Compared with lncRNA NEAT1 overexpression group, the apoptosis rate in lncRNA NEAT1 overexpression+LY294002 group increased obviously (9.00%±0.10%vs. 5.13%±0.21%, P=0.004). Conclusion lncRNA NEAT1 can promote Aβ_25-35 induced PC12 cell proliferation and inhibit cell apoptosis by regulating PI3K/Akt pathway.

Objective To study the clinical features, treatment plan, treatment strategy and prognosis of renal clear cell carcinoma in nasal cavity and paranasal sinuses. Methods Five cases of renal clear cell carcinoma in nasal cavity and paranasal sinuses from 2005 to 2020 were retrospectively analyzed. The clinical features, such as age, gender, location of disease, duration of disease and so on, were analyzed. The clinical manifestations, treatment plan and prognosis were fully discussed, and the literature results analyzed comprehensively. Results All the 5 patients were male, and the onset age of nasal cavity and paranasal sinuses ranged from 49 to 81 years old. All the 5 patients had recurrent epistaxis, and one of them was accompanied with visual loss. The site of the disease was maxillary sinus in 2 cases, ethmoid sinus and sphenoid sinus in 1 case, ethmoid sinus and frontal sinus in 2 cases.One case with nasal tumor as the first symptom, renal cell carcinoma was found during comprehensive physical examination, and then the renal cell carcinoma was treated with B-ultrasound-guided intraperitoneal perfusion and microwave ablation; four cases with nasal tumor occurred later than renal cell carcinoma, and all had radical operation of kidney in early years. All the 5 patients underwent radical resection of nasal cavity and paranasal sinus tumor. Among them, 3 cases were treated with oral targeted drugs,and 1 case was treated with local radiotherapy, but all of them had no obvious effect. As of July 2020, 1 patient lost contact, 2 patients died and 2 patients survived with tumor. Conclusions Renal clear cell carcinoma in nasal cavity and paranasal sinuses is a rare disease. The main clinical symptoms were severe epistaxis and invasion of adjacent tissues and organs. This disease had no obvious effect on radiotherapy, targeted drug therapy and immunotherapy. Radical resection of nasal cavity can relieve the clinical symptoms and improve the quality of life.

Exosomes are microcapsules with a diameter of 30-150 nm, which contain such active substances as proteins,lipids, metabolites, microRNAs (miRNAs) and long non-coding RNAs (lncRNAs), and promote tumorigenesis and development by mediating intercellular communication and regulating tumor microenvironment. miRNAs and lncRNAs are the important components of non-coding RNAs, which play an important role in the occurrence and development of breast cancer mediated by exosomes. The present paper mainly summarized the role of exosomal miRNAs and lncRNAs derived from breast cancer cells in breast cancer progression, microenvironment and drug resistance, the effects of exosomal miRNAs and lncRNAs derived from breast cancer microenvironment on the development of breast cancer, and the clinical potential of exosomal miRNAs and lncRNAs as biomarkers in breast cancer.

Objective To investigate the effect of SE-hBCG on the immunogenicity of recombinant cytomegalovirus glycoprotein B (CgB) and freeze-dried rabies human vaccine (Rab). Methods A total of 145 SPF female BALB/c mice aged 6-8 weeks were selected for the following experiments. In experiment one, five groups of mice (five mice per group) received intramuscular injections of 0.2 ml of SE, SE-hBCG, CgB, SE+CgB or SE-hBCG+CgB three times (at week 0, 2 and 4), respectively.Two weeks after the last immunization was the endpoint of this experiment. In experiment two, four groups of mice (30 mice per group) received two intraperitoneally injections at week 0 and 1 with 0.2 ml of PBS, Rab, SE+Rab or SE-hBCG+Rab, respectively.Samples were collected at 4, 8, 10, 12, 14, 35 days after the first immunization. Spleen lymphocytes of mice were isolated after homogenizing spleens. The enzyme-linked immunosorbent spot assay (ELISPOT) was used to detect the number of antigen-specific IFN-γ and IL-4-secreting spot forming cells (IFN-γ-SFC or IL-4-SFC). Sera were harvested from eyeball blood. Antigen-specific IgG was detected using ELISA. Results SE-hBCG induced mice to produce CgB-specific Th1 responses as mice immunized with SE-hBCG produced greater numbers of IFN-γ-SFC than mice immunized with SE (266.0±87.9 vs. 104.5±28.8, P<0.05). Mice immunized with SE-hBCG adjuvanted CgB vaccines produced higher levels of CgB-specific IgG antibodies (18 800.0±2396.0) and greater numbers of IFN-γ-SFC (440.5±38.4) than mice immunized with CgB (3333.0±737.9 for CgB-specific IgG antibody titer and 189.2±21.4 for IFN-γ-SFC, P<0.05). Four days after the first immunization, SE or SE-hBCG adjuvanted Rab vaccines induced low-level anti-Rab IgG antibodies (OD₄₅₀≤0.2). Anti-Rab IgG antibodies of mice immunized with Rab, SE or SE-hBCG adjuvanted Rab peaked 12 days after the first immunization. Mice immunized with SE-hBCG adjuvanted Rab vaccines produced higher levels of anti-Rab IgG antibodies 8, 10, 14, and 35 days (1700.0±200.0, 19 400.0±1661.3, 23 000±358.9, 23 600.0±6038.2, respectively)after the first immunization than mice immunized with Rab (310.0±97.9, 6730.0±1655.4, 6000.0±1655.6, 4400.0±1655.5,respectively, P<0.05) and greater numbers of IFN-γ-SFC 4, 8, 14 and 35 days (110.8±52.5, 213.0±29.7, 105.2±33.7,80.4±36.8, respectively) after the first immunization than mice immunized with PBS (6.4±3.5, 32.2±12.9, 11.4±5.1, 4.4±2.5,respectively, P<0.05). Conclusion SE-hBCG could enhance the immunogenicity of CgB and Rab, and it is likely to become an immunopotentiator.

Objective To investigate the effect and mechanism of total parenteral nutrition (TPN) on the myocardial injury of young rats. Methods Twenty-four male young Sprague-Dawley rats aged 6 to 8 weeks were randomly divided into 4 groups (6 each): normal group, control group, TPN-7 d group and TPN-14 d group. Rats in normal group were not placed into tubes and had free food and water. Rats in control group were catheterized through the right jugular vein and continuously infused with normal saline, free food and water. Those in TPN group were catheterized through the right jugular vein and continuously infused with TPN nutrient solution and abstained from food and water. Rats in the 4 groups were killed and their myocardial tissue were obtained on the 14th, 14th, 7th and 14th day after the establishment of the model, respectively. HE staining was performed to observe the pathological changes of myocardial tissue, TUNEL staining was used to observe the apoptosis of myocardial tissue, the contents of malondialdehyde (MDA) and hydrogen peroxide (H₂O₂) in myocardial tissue were detected by ELISA, the expression of myeloperoxidase (MPO) in myocardial tissue was detected by qRT-PCR, Western blotting and immunofluorescence staining. Results The 50% of myocardial tissue of rats in TPN-7 d group were slightly damaged, and all the rats in TPN-14 d group were slightly to severely damaged. Compared with normal group and control group, the cardiomyocytes apoptosis rate in the TPN groups increased significantly (P<0.05), MDA and H₂O₂ contents increased markedly (P<0.05), the expressions of MPO mRNA, protein and immunofluorescence increased (P<0.05). The apoptotic rate, H₂O₂ content, MPO protein and immunofluorescence expression were higher in TPN-14 d group than those in TPN-7 d group (P<0.05). Conclusions TPN over 1 week can cause myocardial injury in young rats, and the degree of injury increases with the extension of TPN. Oxidative stress may be one of the mechanisms of the injury.

Reticulophagy is a process that selectively clears endoplasmic reticulum through autophagy. Selective degradation of stress endoplasmic reticulum and aggregate-prone proteins is important to maintain endoplasmic reticulum homeostasis.Reticulophagy receptors mediate selective recognition of endoplasmic reticulum by autophagosomal membrane to promote the elimination of endoplasmic reticulum by lysosome. Reticulophagy is associated with human diseases, therefore, further investigation is required to reveal its molecular mechanism. This review focuses on the most recent advances related to mechanisms and physical relevance of reticulophagy.

Objective To explore the value of plasma soluble urokinase-type plasminogen activator receptor (suPAR),urinary neutrophil gelatinase associated apolipoprotein (NGAL) and urinary kidney injury molecule-1 (KIM-1) in the early diagnosis of adult with cardiac surgery-associated acute kidney injury (CSA-AKI). Methods A prospective case-control study was conducted with consecutively recruited 170 patients undergoing cardiac surgery with cardiopulmonary bypass in the Department of Cardiac Surgery, the First Affiliated Hospital of Army Medical University from March 2020 to February 2021. Venous blood and urine were collected before operation, 2 hours, 2 days and 7 days after operation, and the levels of plasma suPAR, urine NGAL and urine KIM-1 were detected by enzyme linked immunosobent assay (ELISA). According to the occurrence of AKI 7 days after operation, the patients were divided into AKI group (n=34) and non-AKI group (n=136). The levels of plasma suPAR, urinary NGAL and urinary KIM-1 were compared between the two groups. The risk factors of CSA-AKI were analyzed by logistic regression,and the value of plasma suPAR, urine NGAL and KIM-1 for the early diagnosis of CSA-AKI was evaluated by receiver operating characteristic (ROC) curve. Results The level of plasma suPAR was significantly higher in AKI group than that in non-AKI group(P<0.01). The levels of urinary KIM-1 at 2 h after operation and urinary NGAL at 2 h and 7 d after operation were significantly higher in AKI group than those in non-AKI group (P<0.05). ROC analysis showed that the area under curve (AUC) of preoperative plasma suPAR, postoperative 2 h plasma suPAR, urine Kim-1 and urine NGAL diagnosed CSA-AKI were 0.683, 0.717, 0.643 and 0.631, respectively. The AUC area which combined detection of postoperative 2 h plasma suPAR + postoperative 2 h urine KIM-1+ 2 h urine NGAL was the largest (AUC=0.793, 95%CI 0.708-0.879, P<0.001), and the sensitivity and the specificity were 64.71%and 82.35%. Logistic regression analysis showed that after adjusting for sex, preoperative left ventricular ejection fraction (LVEF),albumin (ALB), postoperative 2 h creatinine, postoperative 2 h estimated glomerular filtration rate (eGFR), postoperative 2 h blood urea nitrogen (BUN), postoperative 2 h KIM-1 and postoperative 2 h NGAL, postoperative 2 h suPAR was still an independent risk factor for CSA-AKI. Conclusion Plasma suPAR, urine NGAL and urine Kim-1 can be used for early diagnosis of CSA-AKI.The diagnostic efficacy of plasma suPAR at 2 hours after operation is the best when detected alone. Combined detection of plasma suPAR, urine NGAL and urine Kim-1 at 2 hours after operation can further improve the diagnostic efficiency of CSA-AKI.