Objective To investigate whether dexmedetomidine alleviates lipopolysaccharide (LPS)-induced acute lung injury(ALI) through alpha-7 nicotinic acetylcholine receptor (α7nAChR) mediated TLR4/NF-κB pathways. Methods Twenty-four Wistar rats were randomly divided into 4 groups: control group (n=6), acute lung injury group (n=6), dexmedetomidine treatment group (n=6), and α7nAChR inhibitor α-BGT group (n=6). After anesthesia, rats in the control group were intraperitoneally injected with normal saline to serve as normal control; the rest rats all received LPS (10 mg/kg) via a femoral vein to induce the ALI model. For the dexmedetomidine treatment group, rats were continuously injected with dexmedetomidine (5 μg/kg per hour) via the femoral vein immediately after LPS administration. For the α7nAChR inhibitor α-BGT group, rats received 1 μg/kg α-BGT half an hour before dexmedetomidine administration as the dexmedetomidine treatment group. The rats were sacrificed 12 hours after LPS injection to collect the blood and lung tissues. Histology of the lungs was examined with HE staining. The lung injury score was calculated. In the blood sample, PaO₂, HCO₃^–, Lac, W/D, MPO activity were measured. The number of total cells, neutrophils, and macrophages in bronchoalveolar lavage fluid (BALF) were measured, and the concentrations of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), IL-10 in serum were measured by ELISA. The protein expression of α7nAChR, TLR4, p-NF-κB were determined by Western blotting. Results Compared with the control group, LPS induced marked lung histological injury, which was less pronounced in the dexmedetomidine treatment group. Compared with the control group, the levels of PaO₂ and HCO₃^– were decreased, Lac, W/D, TNF-α, IL-6, IL-10, MPO, the total number of cells, neutrophils, and macrophages were increased in the acute lung injury group (P<0.01). Compared with the acute lung injury group, PaO₂, HCO₃^– and IL-10 were increased, and Lac, W/D, TNF-α, IL-6, MPO, the total number of cells, neutrophils, and macrophages were decreased in the dexmedetomidine treatment group (P<0.01). Compared with the control group, the protein levels of α7nAChR, TLR4, p-NF-κB were increased in the acute lung injury group (P<0.01). Compared with the acute lung injury group, the protein levels of α7nAChR was increased, and TLR4, p-NF-κB were decreased in the dexmedetomidine treatment group (P<0.01).However, the effect of dexmedetomidine was reversed by the α7nAChR inhibitor α-BGT. Conclusion Dexmedetomidine may reduce LPS-induced ALI through α7nAChR mediated TLR4/NF-κB pathways.

Objective To explore the clinical features of patients with end-stage renal disease (ESRD) complicated with pulmonary tuberculosis (PTB) and extrapulmonary tuberculosis (EPTB) and undergoing maintenance hemodialysis (MHD). Methods A total of 133 ESRD patients complicated with tuberculosis, treated at the Tuberculosis Department of the 8th Medical Center of Chinese PLA General Hospital and undergoing MHD at the Blood Purification Center, were selected from July 2012 to February 2021, and divided into PTB group (87 cases) and EPTB group (46 cases). The clinical characteristics, treatment and prognosis of the two groups were compared and analyzed. Results Both PTB group and EPTB group were predominantly male patients (80.5% and 58.7%), but the proportion of female patients was higher in EPTB group (41.3%) than that in PTB group (19.5%, P<0.05). No significant differences existed between the two groups in age, primary kidney disease, comorbidities, dialysis duration, and the detection time-point of tuberculosis after dialysis. Among the first symptoms, the proportion of cough+sputum and fever was significantly higher in PTB group than that in EPTB group (59.8% vs. 23.9% and 60.9% vs. 28.3%, respectively, P<0.05), while the proportion of pain at lesion location was significantly lower in PTB group than that in EPTB group (8.0% vs. 41.3%, P<0.05).CT or MRI imaging was the dominated method for definite diagnosis in both PTB group and EPTB group (67.8% and 76.1%), the secondary method was sputum smear or culture (26.4% and 6.5%) and needle biopsy (5.7% and 17.4%), respectively, with a significant difference between the two groups (P<0.05). No significant difference existed in the positive rate of γ-interferon release assay (γ-IRA) between the two groups. In both PTB group and EPTB group, the proportion of lymphocytes, hemoglobin and albumin decreased markedly, while the proportion of erythrocyte sedimentation rate (ESR) and increased C-reactive protein(CRP) were relatively higher, but there was no statistical difference between the two groups. Both groups were treated with anti-tuberculosis drugs, and one case in EPTB group received anti-tuberculosis drugs plus surgery of tuberculosis focus clearance. No significant difference existed in the incidence of adverse reactions between the two groups, and the improvement rate after treatment was similar. Conclusions Significant differences exist between PTB and EPTB patients with ESRD on MHD in gender ratio, first manifested symptom and diagnosis methods. Paying attention to these differences and conducting individualized monitoring, diagnosis and treatment will be helpful to reduce the morbidity and mortality of patients with PTB and EPTB.

Objective To investigate the efficacy and safety of antithymocyte globulin (ATG) in the immune induction of deceased donor renal re-transplantation. Methods The clinical data of 20 renal re-transplantation patients treated with ATG from June 2017 to November 2020, were retrospectively studied. The safety was assessed with T lymphocyte subsets, pulmonary infection, and bone marrow suppression. The efficacy was assessed with acute rejection (AR) and delayed graft function (DGF). Results The study contained 15 males and 5 females. The average age was 45.7 (25-71) years; 6 patients were positive for prestored antibody and 14 negative antibody; 17 patients received a second transplantation, 3 did a third transplantation. T lymphocytes decreased more than 70% in average induced by ATG on the 1st day after surgery and gradually recovered to 50% of the amount on the 3rd day after surgery (P<0.01). Two weeks after surgery, the number of T lymphocytes recovered to the pretransplant level. NK cells showed a continuous decline (P<0.01). There were 5 patients (25.0%) who suffered AR, 1 patient (5.0%) did DGF, 7 patients(35.0%) presented with pulmonary infection, 5 patients (25.0%) presented with bone marrow suppression, and no ATG allergic reaction cases. The median follow-up period was 17.6 (6-53) months. During the follow-up period, 19 patients (95.0%) survived with allograft and 1 (5.0%) died. Conclusions ATG can significantly suppress the activation and proliferation of T cells, reduce the incidence of AR, and improve the short-term functional recovery of allograft with kidney re-transplantation. ATG induction does not increase the incidence of infection, and the clinical safety of ATG application is reliable.

Objective To investigate the correlation between the ratio of serum non-high-density lipoprotein cholesterol/high-density lipoprotein cholesterol (Non-HDL-C/HDL-C) and microalbuminuria in patients with type 2 diabetes mellitus(T2DM). Methods A total of 576 patients with T2DM hospitalized in the Endocrinology Department of the First Affiliated Hospital of Chongqing Medical University from 2017 to 2019 were included in present study (373 males and 203 females, aged 59±11.8 years). The clinical data of patients were collected including: age, height, weight, history of smoking, duration of diabetes, glycosylated hemoglobin (HbA_1c), comorbidities, medication status, blood lipid level, etc. The values of non-high-density lipoprotein cholesterol (Non-HDL-C) and the ratio of Non-HDL-C and HDL-C (Non-HDL-C/HDL-C) were then calculated. Depending on whether they have microalbuminuria and diabetic retinopathy, patients were divided into groups for comparative statistical analysis, the binary logistic regression model was used to analyze the influencing factors of microalbuminuria and diabetic retinopathy. Finally, the receiver operating characteristic curve (ROC) was adopted to analyze the predictive value of Non-HDL-C/HDL-C for microalbuminuria. Results The age, course of disease, systolic blood pressure, diastolic blood pressure, creatinine, total cholesterol (TC), triglyceride (TG), Non-HDL-C, Non-HDL-C/HDL-C, hypertension and the use of angiotensin-converting enzyme inhibitor (ACEI)/angiotensin receptor blocker (ARB) hypotensive drugs were all higher, but the HDL-C was lower in microalbuminuria group than those in non-proteinuria group with statistically significant differences (P<0.05). The course of disease longer and the proportion of hypertension is higher in retinopathy group than those in non-nephropathy group, with statistically significant differences (P<0.05). The logistic regression analysis revealed that high systolic blood pressure, high creatinine level, and high Non-HDL-C/HDL-C ratio were the influencing factors for the occurrence of microalbuminuria (P<0.05). The area under the ROC curve (AUC) of combined systolic blood pressure, creatinine level and Non-HDL-C/HDL-C to predict microalbuminuria is 0.774. Conclusions A large Non-HDL-C/HDL-C ratio is a risk factor for occurrence of microalbuminuria in patients with T2DM. Combined detection of systolic blood pressure, creatinine level and Non-HDL-C/HDL-C has a high predictive value for microalbuminuria, so is worthy of clinical reference.

Objective To investigate the effect and mechanism of B7-H4 expression on the prognosis of patients with gastric cancer. Methods The databases of Gene Expression Profiling Interactive Analysis (GEPIA), UALCAN and Kaplan-Meier Plotter were used to analyze the expression of B7-H4 in gastric cancer tissues and its relationship with the prognosis of gastric cancer patients. Immunohistochemistry staining was performed to observe the expression of B7-H4 protein in gastric cancer tissues and analyze its correlation with clinicopathological characteristics, cell cycle regulatory proteins, microvessel density (MVD), stemness-related proteins, and PI3K/Akt/NF-κB signaling pathway proteins. Immunofluorescence and Western blotting were used to detect the expressions of B7-H4 and stemness-related proteins in gastric cancer cells. Oncomine database was employed to analyze the correlation between B7-H4 and the expressions of PI3K and Akt mRNA in gastric cancer tissues. Results The expression level of B7-H4 was higher in gastric cancer tissues than in normal tissues, and its expression was significantly related to tumor differentiation, pT staging, lymph node metastasis, distant metastasis and clinical staging (P<0.05), and indicated a poor prognosis in gastric cancer. The expression of B7-H4 was positively correlated with the expressions of cell cycle regulatory protein p16 (r=0.250, P<0.001) and stemness-related proteins LSD1 (r=0.331, P<0.001), SOX9 (r=0.176, P=0.018) and CD133 (r=0.434, P<0.001). The MVD was significantly higher in B7-H4 positive tissue than in B7-H4 negative tissue (P=0.019). Furthermore, B7-H4 was co-expressed with stemness-related proteins LSD1, SOX9, and CD133 in gastric cancer cell lines, and the expression of B7-H4 was positively correlated with the expressions of p-PI3K-p85 (r=0.269, P<0.001), p-Akt-Ser473 (r=0.282, P<0.01), p-Akt-Thr308 (r=0.214, P=0.005) and NF-κB p65 (r=0.157, P=0.034). The expression of B7-H4 in gastric cancer tissue was positively correlated with the expressions of PI3K mRNA (r=0.403, P<0.001) and Akt mRNA (r=0.351, P<0.001). Conclusion B7-H4 can promote gastric cancer progression and is closely related to poor prognosis, and the mechanism may be related to the regulation of gastric cancer stemness via PI3K/Akt/NF-κB.

Objective To analyze the risk factors inducing hyperuricemia (HUA) in helicopter pilots and put forward the corresponding intervention measures. Methods A total of 190 male helicopter pilots, aged 20-50 years and with more than 100 hours of flight time, were recruited from April to October 2020 in a flight brigade. A self-designed questionnaire was used, by which the basic information of subjects were collected including eating habits, physical exercise, smoking and drinking, exposure to noise and vibration at work, mood, disease, work performance, sleep status, genetic factors, and so on. At the same time, 28 SPF grade 6-week-old male C57BL/6J mice were randomly divided into 7 groups (4 each): control group, noise group, noise + vitamin C (Vit C)group, noise + multivitamin (Multi Vit) group, noise + hyperbaric oxygen (HBO) group, noise + HBO + Vit C group, and noise +HBO + Multi Vit group. After continuous intervention for 7 days, Multiskan Ascent was used to detect the uric acid (UA) level in mice sera. Results Finally, 186 subjects, aged 22-50 years and with (1378±569) hours of flight time, were included in present study. Of whom 17 (9.14%) were self-reported with HUA (HUA group) and 169 (9.14%) were with normal uric acid (NUA group).No significant difference existed between the two groups in age, height, body mass index and the proportion of hyperglycemia. The proportions of hyperlipidemia and fatty liver were significantly higher in HUA group (17.6% and 29.4%, respectively) than those in NUA group (4.7% and 10.1%, respectively) with statistically significant difference (P<0.05). The scores of noise exposure and vibration exposure were significantly higher in HUA group [(22.942±3.960) and (16.351±3.552), respectively] than those in NUA group [(19.413±4.086) and (13.323±3.476), respectively] with statistically significant difference (P<0.05); there was no significant difference between the two groups (P>0.05) in the other 8 dimensions. Noise and vibration exposure were closely related to the occurrence of HUA. Among them, strong noise and long daily exposure, great influence on emotion, the poor effect and low use frequency of protective measures would significantly increase the risk of HUA; Long daily exposure and great influence on emotion of vibration would also increase the risk of HUA. Compared with the control group, the serum UA level in noise group increased significantly [(38.710±10.201) μmol/L vs. (191.935±9.542) μmol/L] with significant difference (P<0.05); The serum UA levels in noise + Vit C group [(127.419±5.349) μmol/L], noise + Multi Vit group [(111.290±7.030) μmol/L], noise + HBO group [(53.226±11.518) μmol/L], noise + HBO + Vit C group [(61.290±7.213) μmol/L] and noise + HBO + Multi Vit group[(69.355±13.968) μmol/L] were all lower significantly than that in noise group (P<0.05). The UA levels in noise + Vit C group, noise + Multi Vit group, noise + HBO + Vit C group and noise + HBO + Multi Vit group were still higher than that in control group(P<0.05), while there was no significant difference between noise + HBO group and control group (P>0.05). Conclusions HUA in helicopter pilots is related to noise and vibration exposure in working environment. Hyperbaric oxygen and dietary vitamin supplementation can effectively reduce the increase of serum uric acid level caused by noise exposure.

Objective To investigate the expression and significance of human neutrophil lipocalin (HNL) and neutrophil CD64 (nCD64) in prostatic fluid of chronic prostatitis patients with different infection degrees. Methods One hundred and seventy-eight patients with chronic prostatitis admitted to the Affiliated Ethnic Hospital of Guangxi Medical University from February 2017 to October 2019 were selected as the research objects. According to whether they were infected with bacteria, the patients were divided into chronic prostatitis/chronic pelvic pain syndromes group (CP/CPPS group, n=40) and chronic bacterial prostatitis group (CBP group, n=138). According to National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI)score, CBP group was divided into mild group (n=65), moderate group (n=46) and severe group (n=27), and another 40 healthy people were selected as control group. Age, body mass index (BMI), course of disease, white blood cell (WBC), and NIH-CPSI score were recorded and analyzed. The expression level of HNL in prostatic fluid was detected by enzyme linked immunosorbent assay (ELISA). The expression level of nCD64 in prostatic fluid was detected by flow cytometry. Pearson correlation was used to analyze the correlation between both HNL and NCD64 levels and NIH-CPSI score in the CBP group. Logistic regression analysis was used to analyze the influencing factors of CBP and CP/CPPS. ROC curve was used to evaluate the diagnostic value of HNL and nCD64 for CBP. Results Compared with the control group, WBC, HNL and nCD64 levels in CP/CPPS group, CBP group and its subgroups were significantly increased (P<0.05), while the CBP group was higher than CP/CPPS group, and the CBP subgroup increased with the increase of infection degree, and the difference between the groups was statistically significant (P<0.05). There was no significant difference in NIH-CPSI score between CP/CPPS group and CBP group (P>0.05), but NIH-CPSI score of moderate group was higher than that of mild group, and that of severe group was higher than that of moderate group and mild group(P<0.05). Pearson correlation analysis showed that the levels of HNL and nCD64 in prostatic fluid of CBP group were significantly positively correlated with NIH-CPSI score (r=0.897, P<0.001; r=0.919, P<0.001). Multivariate logistic regression analysis showed that bacterial infection, HNL, and nCD64 were independent risk factors for CBP (P<0.05). Other pathogen infections, urinary dysfunction, neuroendocrine abnormalities, abnormal immune response, and pelvis related diseases were independent risk factors for CP/CPPS (P<0.05). ROC curve analysis showed that HNL and nCD64 in prostatic fluid had higher diagnostic value for the occurrence of CBP, area under the ROC curve (AUC) was 0.837 and 0.899 respectively, and the best critical values were 165.36 μg/L and 4078.28/cells respectively. The combination of the two (HNL and nCD64) had higher diagnostic value, with AUC of 0.949. Conclusion The levels of HNL and nCD64 in prostatic fluid of patients with chronic prostatitis increased with the aggravation of the bacterial infection, showing a positive correlation, and the combined monitoring of HNL and nCD64 is of reference value for clinical diagnosis and the judgment of infection degree.

Long non-conding RNA (lncRNA) is a group of RNA with a length of more than 200 nt and no function of coding protein, and plays a physiological function at the level of heredity, transcription and post transcription. LncRNA can regulate multiple signal pathways. For example, hepatic fibrosis-associated lncRNA1 (LFAR1) promotes the activation of hepatic stellate cells(HSC) through transforming growth factor-β (TGF-β) signal pathway in the progress of liver fibrosis; HOX transcript antisense intergenic RNA (Hotair) promotes the activation of HSC as ceRNA; lncRNA-p21 inhibits the activation of HSC as ceRNA;maternally expressed gene 8 (MEG8) can inhibit the activation of HSC in hepatic cell by inhibiting Notch pathway. With more and more people's understanding of the function of lncRNA in liver fibrosis, it is expected to become a new target in the early diagnosis, prognosis judgment and treatment of fibrosis. This article reviews the research progress of lncRNA in liver fibrosis..

Heat stroke is the most severe form of heat-related illness, characterized by an elevated core body temperature(> 40 ℃) and an altered level of central nervous system dysfunction. The primary goal of treatment for heat stroke is to lower core body temperature, and evidence suggests that timely cooling promotes survival with limited sequelae. Intravascular cooling technique is a new cooling technique gradually applied in intensive care medicine in recent years, which can directly cool or rewarm blood, and can provide a larger cooling rate than traditional cooling methods. The focus of this article is to review the research progress of intravascular cooling technique on clinical application, and discuss the feasibility and safety of intravascular temperature management for heat stroke.

Bone injury is the most common type of war wound, and different from ordinary open bone injury. The war wound bone injury caused by high-energy weapons has the characteristics of deep bleeding site, coagulation dysfunction, multi bacteria infection and large bone defect area, so it is difficult to be treated in battlefield. Mesoporous silica is a new type of inorganic nano biomaterial, which is widely used in bleeding treatment and bone tissue engineering due to its high specific surface area, large porosity and easy modification. Compared with the traditional materials for the treatment of traumatic bone injury, mesoporous silica has the advantages of local sustained hemostasis, broad-spectrum, sustained-release and strong mechanical support. Its main research direction is the composite and multifunctional materials. The surface functionalized mesoporous silica has the functions of hemostasis and infectious bone defect repair. However, there are still some problems such as unclear biological distribution in vivo and hepatorenal toxicity in large doses of mesoporous silica materials; in terms of preparation technology, there are still some problems such as unclear selection of pore size and shape of materials for promoting bone formation. Based on the actual needs of the treatment of war-induced bone injuries, the multifunctional, easy-to-use and portable properties of new mesoporous silica materials are reviewed in this paper.