Objective To explore the effects of 24-h fluid accumulation ratio on the prognosis of patients after cardiopulmonary bypass cardiac operation. Methods A single-center prospective observational study was conducted. The adult patients admitted to the Shanxi Bethune Hospital from January 2018 to January 2020 for selective cardiopulmonary bypass cardiac operation were selected. All the patients received therapy with comprehensive strategy after admission to the intensive care unit (ICU)and were divided into two groups: group A with 24-h fluid accumulation equal to or more than 10% and group B with less than 10%.Sex, age, body mass index (BMI), preoperative acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score, preoperative complications, preoperative creatinine levels, intraoperative cardiopulmonary bypass time, deep hypothermic circulatory arrest time, blood loss, fluid intake, incidence of postoperative hypoxemia (oxygenation index ≤150 mmHg), incidence of acute renal injury (AKI), use of mechanical ventilation, duration of ICU stay, and 28-day mortality were compared between the two groups.Risk factors affecting the death of patients after cardiopulmonary bypass cardiac operation were analyzed using logistic regression. Results No significant differences were found between the two groups in gender, age, BMI, preoperative APACHE Ⅱ score,preoperative acute physiology preoperative creatinine, intraoperative cardiopulmonary bypass time, deep hypothermic circulatory arrest time, blood loss, intraoperative infusion, and crystalcolloid ratio (P>0.05). Compared with group B, incidence of combination with hypoxemia (oxygenation index ≤150 mmHg) and AKI was significantly increased in group A (67.9% vs. 43.3%; 57.1% vs. 36%,P<0.01), but there was no significant difference in usage of continuous renal replacement therapy (CRRT) after ICU admission between the two groups (46.4% vs. 32.3%, P=0.052). Both the duration of mechanical ventilation and the length of stay in the ICU in group A were significantly longer than those in group B [(4.3±2.8) d vs. (3.5±1.7) d, (5.1±3.1) d vs. (4.3±1.9) d, P<0.01].No significant differences were found between both groups in 28-day mortality (P>0.05). After further subgroup analysis found that compared with group B, there were statistically significant differences in the utilization rate of CRRT, duration of mechanical ventilation, and length of ICU stay in group A regardless of whether patients had AKI or not (P<0.05). Compared with group B,there were statistically significant differences in incidence of combination with hypoxemia and 28-day mortality in group A patients with AKI (P<0.05), while there was no statistically significant difference in group A patients without AKI (P>0.05). The results of the univariate logistic regression analysis showed that 24-h fluid accumulation ratio ≥10%, postoperative hypoxemia and AKI,fluid accumulation ratio 24-h after surgery ≥10% combined with AKI were the risk factors of patients after cardiopulmonary bypass cardiac operation (P<0.05). The multivariate logistic regression analysis suggested that postoperative 24-h fluid accumulation ratio≥10% combined with AKI was the independent risk factor of patients after cardiopulmonary bypass cardiac operation (P<0.05). Conclusion 24-h fluid accumulation ratio ≥10% after cardiopulmonary bypass not only increases the risk of hypoxemia and AKI, but also prolongs the duration of mechanical ventilation and ICU hospitalization, and 24-h fluid accumulation ratio ≥10%combined with AKI can increase the risk of death in patients after cardiopulmonary bypass.

Objective To analyze the expression of chemerin and Sprouty1 proteins in common psoriasis lesion tissues and their correlation with the severity of the disease. Methods Sixty-eight patients with common psoriasis who received treatment at the dermatology outpatient clinic of the Wuxi Fifth People's Hospital and the Affiliated Hospital of Jiangnan University from February 2018 to November 2020 were selected as the experimental group, and another 68 healthy individuals who underwent physical examination at the dermatology outpatient clinics of the two hospitals during the same period were selected as the control group. The skin lesions of the trunk or limbs of patients with psoriasis vulgaris and normal skin tissues of healthy subjects were collected. Immunohistochemistry and Western blotting were used to detect the expression of chemerin and Sprouty1 protein in skin tissues, and RT-PCR was used to detect the relative expression of chemerin and Sprouty1 mRNA in skin tissues, and Pearson correlation was used to analyze the correlation between the expression of chemerin and Sprouty1 protein with the psoriasis area and severity index (PASI). Results The results of immunohistochemical assay showed that chemerin and Sprouty1 proteins were expressed in the skin tissues of both groups. Chemerin protein was strongly expressed in the adipose tissue of the skin lesions in experimental group, and in the subcutaneous adipose tissue of the control group with a small amount of expression; Sprouty1 protein was expressed in the cell membrane of the granular layer cells of the skin lesions in experimental group with a small amount of expression, and in control group, Sprouty1 protein was strongly expressed in the cell membrane and cytoplasm of the whole epidermal layer cells. The relative expressions of chemerin mRNA (1.478±0.14 vs. 0.858±0.08, P<0.001) and protein (1.138±0.12 vs. 0.789±0.06, P<0.001) were significantly higher in experimental group than in control group, and the relative expressions of Sprouty1 mRNA (0.837±0.04 vs. 1.346±0.09, P<0.001) and protein (0.646±0.05 vs. 1.212±0.12, P<0.001) were significantly lower than that of control group. Pearson correlation analysis showed that the relative expression of chemerin protein was positively correlated with PASI score (r=0.536, P<0.05), and the relative expression of Sprouty1 protein was negatively correlated with PASI score (r=-0.619, P<0.05). Conclusion The relative expression of chemerin and Sprouty1 protein in the lesion tissue of common psoriasis correlated with PASI score.

Patient-derived xenograft (PDX) model of liver cancer is created by transplanting the primary tumor tissue of patients with liver cancer into immunodeficient mice to simulate the biological characteristics of primary tumors, similar genetic characteristics and tumor heterogeneity with patients, which has been widely used in liver cancer research and plays an important role in drug research and clinical tumor treatment. This review firstly summarize the methodology to establish PDX models of liver cancer, four new PDX models of live cancer, and then go over recent application and function of liver cancer PDX models in basic cancer research and in preclinical explorations and finally give our perspectives on the future prospects of liver cancer PDX models.

Deep learning (DL), as a branch of artificial intelligence, is the mainstream artificial intelligence recognition method for image, voice and language. In recent years, it has attracted more and more attention in the medical field. The DL technique characterizes and analyzes the original features of a particular large amount of data. By using a multi-layered machine learning model, it simulates the activity of neurons in the brain and finally the computer outputs a single diagnosis. With reference to related research findings in China and foreign countries, this paper introduces the advances of its development and application in the diagnosis and treatment of spinal degenerative diseases such as lumbar disc herniation and cervical spondylosis, as well as its future prospetive.

Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a highly malignant hematological tumor derived from plasmacytoid dendritic cells (pDC) precursor cells, which has both lymphoma and leukemia characteristics, and is clinically rare. The disease easily involves the bone marrow, with low long-term survival rate and poor prognosis. Skin lesions can be seen in most BPDCN patients as the fi rst symptom, and their skin manifestations lack speci fi city, so is easy to be misdiagnosed and missed in clinic. High dose induction chemotherapy combined with hematopoietic stem cell transplantation (HSCT) are the main treatment methods for BPDCN,and new targeted therapies and immunotherapeutic drugs have also been put into clinical use. The de fi nition, epidemiology, pathogenesis,diagnosis and differential diagnosis, the latest research progress of treatment and prognosis of BPDCN have been summarized and discussed in present article, aiming to provide new ideas and references for the clinical diagnosis and treatment of BPDCN.

Osteoarthritis (OA) is a degenerative disease causing irreversible progressive destruction of articular cartilage,and still no effective treatment at present. The development of stem cell technology has brought light to the treatment of OA, but the investigate of using exogenous stem cells to repair or regenerate cartilage faces many difficulties, as the chondroid tissue produced by exogenous stem cells is different from the normal articular cartilage in terms of biological characteristics and function. To solve this problem, researchers have proposed mobilizing endogenous stem cells of articular cartilage to promote self-healing of the defect sites. Although articular cartilage lacks intrinsic reparative ability, numerous studies have confirmed the existence of cartilage-derived stem/progenitor cells (CSPCs) in the superficial zone (SPZ) of cartilage. The research progress of superficial zone cartilage-derived stem/progenitor cells (SPZ-CSPCs) and their roles in OA were reviewed in present paper.

TANK binding kinase 1 (TBK1) and IKKε, are new members of the IKK family. They are important regulators of nuclear factor κB (NF-κB) signaling pathway and play an important role in metabolic disease. IKKε and TBK1 not only reduce the sensitivity of β adrenergic receptors to catecholamines in adipocytes of obese mice, reduce the level of second messenger cAMP,but also regulate the regeneration of pancreatic β cells. Blocking the IKKε and TBK1 signaling pathways can promote adipose tissue energy consumption, reduce the expression of chronic inflammatory factors in adipocytes, enhance insulin sensitivity, reduce insulin resistance, reduce body weight, and prevent obesity caused by high fat diet. In this review, we reviewed the structure and function of TBK1 and IKKε, as well as the molecular mechanisms of TBK1 and IKKε in the regulation of metabolism in obesity, type 2 diabetes mellitus (T2DM), and non-alcoholic fatty liver disease (NAFLD). Finally, we discussed the potential of TBK1and IKKε in the treatment of metabolic diseases.

Combat casualty care is a systematic project which ensures order and high-efficient rescue of casualties. The US army gradually established a joint trauma system in the wars in Afghanistan and Iraq, which reduced the combat casualty rate to a historically lowest level and improved the efficiency of combat casualty care. The present article reviews the background and development of the US military joint trauma system, expounds its mission and management system, emphasizes its characteristics and positive role in combat casualty care, and discusses its enlightment for PLA. The in-depth study of the US joint trauma system may provide a useful reference for building the PLA joint trauma system, which can improve the efficiency of combat casualty care during modern wars.

Gut microbiome is a critical contributor to host health. It mostly through production of effector molecules possessing biological activity of catabolism modulates metabolic responses at different organ sites including liver, lung, and brain.Skeletal muscle is considered as the largest organ in the body, playing a pivotal role in voluntary movements, postural maintenance and energy homeostasis. Within the past few years, accumulating evidences have revealed biologically important association between the gut microbiota and skeletal muscle and demonstrated muscle function greatly depend on the bacterial population and structure,resulting in a novel and intriguing concept of "gut-muscle axis". This article aims at reviewing the modulatory effects and potential mechanisms of gut microbiota on skeletal muscle and mechanism of short-chain fatty acids (SCFAs) mediated "gut-muscle axis", as well as making recommendations on future research in order to provide a theoretical reference for improving muscle function and physical performance based on gut microbiota intervention.

The colonization of the gut microbiota in adolescents is unstable and more diverse than adults. Studies have shown that the intestinal bacterial flora of depression patients is imbalanced, indicating that there is a certain connection between depression and the intestinal flora. Probiotics refers to active microorganisms that are beneficial to the human body, mainly including yeast, probiotic spores, Clostridium butyricum, Lactobacillus, Bifidobacterium, Actinomycetes, etc. Pharmacological studies have found that it has various pharmacological effects such as stabilizing gut microbiomes, promoting digestion and absorption, and improving immunity. Recent studies have shown that probiotics also has an anti-depressant effect, can improve mood through the microbiota-gut-brain axis and other ways, and has been confirmed by experiments in animals and humans. This article reviews recent studies on the characteristics of adolescent intestinal flora and the antidepressant mechanism of probiotics in adolescents.