As a crucial microelement of human body, iron is involved in many important physiological processes. Serum ferritin (SF) is the main form of protein for iron storage, and regulates the storage and metabolism of iron. Although detection of ferritin has been applied for clinical use for a long time, some biological properties of ferritin still remain controversial, including its tissue origin, secretory pathway, interactions with receptors and cellular effects. Although many researches paid attention to the relationship between the changes of ferritin and liver diseases, the cut-off points of ferritin used varies in different studies, which hinders the consistency analysis of the results of different studies. It is urgent to explore and establish uniform standard for the parameter of ferritin, so as to better elucidate the iron status in the body reflected by changes in ferritin. This paper reviews the in vivo metabolic process of iron, the structural composition and pathophysiological function of ferritin, and the relationship between SF and liver diseases for providing guidance for future research.

Objective To investigate the distribution of inhaled allergens and analyze the related risk factors among allergic rhinitis (AR) patients in Zhangjiakou area. Methods Serum specific IgE antibody of inhaled allergens was detected in 532 suspected AR patients in the Department of Otolaryngology, Head and Neck Surgery of the First Affiliated Hospital of Hebei North University form April 2019 to August 2020. A total of 245 family members of outpatient and inpatient patients (except family members of respiratory department, dermatology department and otolaryngology department) in the same period were selected as the control group. AR questionnaire survey was conducted in the AR patients and control group, and the survey results were statistically analyzed. Results Of the 532 patients with suspected allergic rhinitis, 388 (72.9%) were positive for at least one allergen. The top three positivity rates of inhalation allergens were mugwort (89.9%), common ragweed (44.1%) and cat epithelium(21.4%) among the AR patients. In the single allergen positive patients, the mudwort has a much higher positive detection rate(86.0%). The positive degree of allergens was mainly distributed in class 2, class 3 and class 6 of mugwort, in class 1 of house dust and house dust mite, and in class 2 of other allergens. There were statistically significant differences in the allergen positive rate of AR patients in different months, regions and ages (P<0.05). The allergen positivity rate from July to September was significantly higher than that in other months, in bar-upper region was significantly higher than that in bar-lower region, and the positive rate of allergen gradually declined with the increase of age. The differences of allergens in ragweed, cat epithelium, house dust, house dust mite and streptomyces alternaria between genders of AR patients were statistically significant (P<0.05). Multivariate logistic analysis showed that previous allergies, parents with allergic rhinitis, history of asthma, secondhand smoke exposure, staying up late, age 3-24 years old were AR high-risk factors (OR>1), regular physical exercise was an effective protective factor for AR (OR<1). Conclusions The most common inhalation allergens in Zhangjiakou area are mugwort and common ragweed. The distribution of allergens is correlated with the month, region, and gender and age of the patients. Previous allergies, history of asthma, parents having allergic rhinitis, age and so on are risk factors for AR.

Objective To explore the relationship of body mass index (BMI) to short-term and long-term clinical outcomes in patients with sepsis. Methods To retrospectively analyze 5571 clinical data of sepsis patients in the Beth Israel Deaconess Medical Center (Boston, MA, USA) registered from 2001 to 2012 in the Medical Information Market Intensive Care (MIMIC-Ⅲ) database. Cox proportional hazards regression model was used to assess the relationship between BMI and 30-day and 1-year mortality. Results Patients were divided into four groups according to BMI: underweight 336 cases (6.0%); normal weight 1752 cases (31.4%);overweight 1563 cases (28.1%); and obesity 1920 cases (34.5%). The 30-day mortality of the patients mentioned above were 42.3%, 36.6%, 32.2% and 29.6%, respectively (P<0.001), the 1-year mortality were 64.6%, 56.8%, 52.5% and 46.7%, respectively (P<0.001), and in-hospital mortality were 35.4%, 34.3%, 31.6% and 29.9%, respectively (P=0.018). The Cox proportional hazards regression analysis confirmed that, compared to the patients with normal weight, the 30-day and 1-year risk of death increased by 13% and 24%, respectively, in underweight patients; decreased by 17% and 14%, respectively, in overweight patients; and decreased by 22% and 21%, respectively, in obese patients. Conclusion The 30-day and 1-year survival rate is higher in overweight or obese sepsis patients than in those sepsis patients with underweight and normal weight after admission to the intensive care unit.

Objective To analyze the clinical characteristics of myositis autoantibody detection in the diagnosis of interstitial lung disease (ILD), and explore the diagnosis and treatment of ILD with the help of clinical manifestations combined with antibody results. Methods Sixty-three patients of ILD accurately diagnosed with the help of myositis autoantibody detection were collected retrospectively and divided into three groups: anti-synthetase syndrome associated interstitial lung disease group(ASS-ILD group, n=22), polymyositis/dermatomyositis associated interstitial lung disease group (PM/DM-ILD group, n=18) and interstitial pneumonia with autoimmune features group (IPAF group, n=23). Their clinical characteristics, treatment and prognosis were analyzed and compared. Results The positive rates of Raynaud's phenomenon, joint symptoms, mechanic's hand and anti-ARS antibodies in ASS-ILD group were higher than those in IPAF group (P<0.0167). Compared with PM/DM-ILD group, ASS-ILD group had higher positive rates of Raynaud's phenomenon, cough, dyspnea, respiratory system symptoms as the first manifestation, anti-ARS antibodies but lower positive rates of fever, muscle symptoms, skin/muscle symptoms as the first manifestation (P<0.0167).Compared with IPAF group, PM/DM-ILD group had higher positive rates of muscle symptoms, skin symptoms, skin/muscle symptoms as the first manifestation, anti-ARS antibodies and anti-MDA5 antibody but lower positivity rates of respiratory system symptoms as the first manifestation (P<0.0167). In this study, chest radiological findings of all patients were mainly nonspecific interstitial pneumonia (NSIP). The abnormality in pulmonary functions manifested mainly as diffusion disturbance and restrictive ventilatory dysfunction. 87.3% of all patients were treated with glucocorticoid combined with immunosuppressants. After treatment, 81.0% of these patients showed improvement or stability, while 19.0% showed deterioration or death. The difference in prognosis between the three groups was not statistically significant (P>0.05). Conclusion The detection of myositis autoantibody should be paid more attention in ILD patients. Diagnosis, classification, treatment and prognosis evaluation of ILD could be made with the help of myositis autoantibodies.

Objective To observe the effect of increasing brain cortical neuronal activity in mice on axon remyelination and motor function recovery after mild spinal cord contusion injury by chemical genetics technology (DREADDs). Methods 33 C57/BL male adult mice accepted stereotactic injection of adeno-associated virus with activated receptor [AAV-hM3D(Gq)-mCitrine] into the right cerebral cortex. Then all of the mice were randomly divided into three groups: sham group (n=11), SCI group (n=11) and activated group (n=11). SCI spinal cord injury model was established in SCI group and activation group. Two weeks later, activation group was intraperitoneally injected with 1 mg/(kg·d) clozapine N-oxide (CNO) to activate the electrical activity of cortical neurons. Sham group and SCI group were intraperitoneally injected with the same amount of normal saline once a day for 4 weeks. Animals were perfused at last, using immunofluorescence to observe the results of infection of virus, the expression of cellular Fos (cFos) within neurons and myelin basic protein (MBP) in dorsal corticospinal tract; transmission electron microscopy to show the result of axonal myelination; BMS scale and irregular horizontal ladders were used to evaluate the motor function of mice. Results Immunofluorescence microscopy confirmed successful transfection of virus into neurons at mice motor cortex, and there was no statistical significance of number of neurons infected by GFP labled adeno-associated virus between the three groups. Neuronal cFos fluorescence intensity at the transfection site in activated group was significantly higher than that in SCI group(P<0.001); MBP fluorescence intensity in the spinal cord injury center in activated group and sham group were significantly higher than that in SCI group (P<0.001). The G-ration value in activated group was apparently lower than that in SCI group (P<0.001). For the BMS score, there was no statistical significance between activated group and SCI group; the evaluation of irregular horizontal ladders found that after 2 weeks intraperitoneal injection, the error rate in activated group and SCI group decrease, and the error rate in activated group was significantly lower than that in SCI group (P<0.001); after 4 weeks intraperitoneal injection, the error rate in activated group and SCI group continued to decline, and the error rate in activated group was significantly lower than that in SCI group (P<0.001). Conclusion Using DREADDs strategies to improve the neuronal activity of cerebral cortical neurons can effectively promote the axon remyelination and the recovery of motor function after mild spinal cord contusion injury in mice.

Alzheimer's disease (AD) is one of the common chronic neurodegenerative diseases, and characterized mainly by the deposition of amyloid β-protein (Aβ), hyperphosphorylation of tau protein, and neuronal and synaptic loss. Currently approved drugs can only alleviate the symptoms and cannot completely cure the disease. Stem cells have specific abilities of self-renewal, proliferation, differentiation and reprogramming. In particular, the induced pluripotent stem cells (iPSCs) developed in recent years have provided a new research strategy for the treatment of AD. The combination of iPSCs technology with gene editing,3D-like organs, and biomaterial scaffolds has resulted in a new approach to the recognition and treatment of AD. This review mainly summarizes the latest applications of iPSCs in AD, including the application of disease modeling in the research of pathogenesis of AD and early biomarker detection, the combination of iPSCs and 3D scaffold in cell therapy, and the application of iPSCs in high-throughput drug screening.

Immune checkpoint inhibitors (ICIs) are new anticancer agents in recent years, and are monoclonal autoantibodies specifically targeting T cell inhibitory receptors, may enhance the anti-tumor effect by blocking negative regulatory factors that inhibit T cell function. ICIs can generate peculiar immunotoxicity, called immune-related adverse events (irAEs), which can potentially affect many tissues, the most frequent toxic reactions to endocrine system include hypophysitis, thyroid dysfunction, adrenal insufficiency, and autoimmune diabetes mellitus. The treatment process of such adverse reactions has been further elaborated in present review through the introduction of the endocrine irAEs induced by ICIs in immunotherapy, aiming to provide clinicians with ideas for the treatment of endocrine irAEs.

Objective To investigate the gender difference of cognitive function in neonatal rats treated with sevoflurane. Methods Eighty two postnatal 7-day (P7) SD rats were randomly divided into control group and sevoflurane treated group, then divided into the following subgroups according to gender: female control group, male control group, female sevoflurane treated group, and male sevoflurane treated group. After inhaling air or 4% sevoflurane for 4 hours, the levels of serum cortisone and estradiol (E₂) were detected by ELISA, and the expressions of Ki-67 and neuronal core antigen (NeuN) in hippocampus were detected by immunohistochemistry. The open field experiment was performed with rat P21 and Morris water maze experiment was performed with rat P35 to explore the effects of sevoflurane exposure on the spatial cognitive function in different gender of rats. Results ELISA reveled that, compared with the control group, the serum cortisone level in sevoflurane treated group was significantly higher [(11.60±1.41) ng/ml vs. (7.93±1.58) ng/ml, P<0.05], while the serum E₂ level showed no significantly different [(35.0±8.25) pmol/L vs. (34.2±9.73) pmol/L, P>0.05]; and no significant difference existed in the levels of cortisone and E₂ between different genders (P>0.05). Immunohistochemistry showed that the number of Ki-67 and NeuN positive cells in hippocampal CA1 and dentate gyrus (DG) decreased significantly in sevoflurane treated group than those in control group(P<0.05). Also, no significant difference existed in the expression of hippocampal neurons between different genders (P>0.05).Morris water maze test showed that no significant difference was found among female rats (P>0.05); compared with male control group, the platform latency and moving distance of male sevoflurane treated group were significantly prolonged at the forth and fifth day of acquired training (P<0.01 or P<0.05). At the second day of counterpoint training, the platform latency and movement distance of rats in male sevoflurane treated group were significantly prolonged (P<0.05). In counterpoint exploration training, the platform latency of rats in male sevoflurane treated group was significantly prolonged (P<0.01), and the time spent in the target quadrant reduced significantly (P=0.031). Conclusions Sevoflurane treatment has a great influence on the serum cortisone level of postnatal rats, may inhibit the proliferation of hippocampal neural stem cells and neurogenesis. The learning ability of male rats decreased after adulthood, but no obvious effect on female rats.

Objective To analyze the clinical features of primary appendiceal mucinous adenocarcinoma (AMAC), and investigate the diagnosis and treatment principles of the disease. Methods Thirty cases of primary AMAC from October 2011 to September 2019 in Daping Hospital of the Army Medical University were retrospectively analyzed, including demography, imaging, hematology, pathology and treatment method. Results The main clinical features of the 30 cases were right lower abdominal pain. Of whom 12 cases were diagnosed as acute or chronic appendicitis before operation, and 8 cases were as combined with ovarian space occupying. Preoperative routine abdominal B ultrasonography combined with other imaging examinations (including abdominal CT, MRI and PET/CT) obviously improved the diagnostic accuracy (68.2%) than that with B ultrasonography alone(25.0%, P=0.049). Carcinoembryonic antigen (CEA) and carbohydrate antigens (CA199, CA125 and CA242) were the most common tumor markers, which had the highest diagnostic value for AMAC. Intestinal obstruction occured in four patients undergoing stage Ⅱ extended surgery, while in only three patients without undergoing stage Ⅱ extended surgery (Fisher's exact test, P=0.181). The mean survival time of patients with R₀ resection was (57.5±9.5) months and the median survival time was 59.0 months. The mean survival time of patients without R₀ resection was (29.8±4.1) months and the median survival time was 33.0 months (χ²=1.255, P=0.263). Conclusions Appendiceal B ultrasound combined with abdominal enhanced MRI, CT or PET/CT can significantly improve the diagnostic rate of appendiceal mucinous adenocarcinoma. The monitoring of CEA, CA199, CA125, CA242 is helpful for the preoperative diagnosis of appendiceal mucinous adenocarcinoma.

Traumatic arthritis (TA) is a kind of osteoarthritis secondary to joint trauma, and its pathogenesis is not clear at present. It is mainly related to the apoptosis of chondrocytes involved in a variety of cytokines and related signal pathways. Curcumin has anti-inflammatory, anti-oxidant and anti-apoptotic effects. Curcumin is used to treat TA mainly by inhibiting oxidase, scavenging free radicals' antioxidant effects, inhibiting the anti-inflammatory effects of cyclooxygenase, lipoxygenase and various inflammatory mediators, and acting on various signal transduction pathways to inhibit apoptosis of chondrocytes. This paper describes some of the biological functions of curcumin, and introduces its related mechanism of action in the treatment of TA.