OBJECTIVE:To identify risk factors associated with snakebite severity and determine whether tourniquet use can affect the severity and outcome of snakebites. METHODS:The clinical data of patients who sustained limb snakebites from 1 March 2021 to 31 October 2022 were reviewed. The patients were divided into three groups according to snakebite severity: mild (517 cases), moderate (112 cases), and severe (8 cases). We compared the clinical data of mild versus moderate to severe snakebites. Multivariate logistic regression was used to determine the independent risk factors for moderate to severe snakebites. RESULTS:The study involved 637 patients. There were statistically significant differences in age, tourniquet use, onset time, white blood cell increase, platelet decrease, creatine kinase (CK) increase, activated partial thromboplastin time shortening, and length of stay between patients with mild snakebites and those with moderate to severe snakebites. Multivariate logistic regression analysis showed that age, tourniquet use, and CK increase were independent risk factors for moderate to severe snakebites. CONCLUSION:The overall severity of snakebites in Chongqing is mild, and the prognosis is good. Age, tourniquet use, and CK increase are independent risk factors for the severity of snakebites. We do not recommend tourniquet use after snakebites in Chongqing.

The host limits Mycobacterium tuberculosis ( Mtb ) by restricting copper access. This research investigates how Mtb escapes copper stress. The membrane protein encoded by Mtb Rv0102 , when its homolog in M. smegmatis ( MSMEG_4702 ) was knocked out, resulted in a fourfold decrease in intracellular copper levels and enhanced tolerance to elevated extracellular copper concentrations. Similarly, knockout mutants of its homolog in M. marinum ( MMAR_0267 ) showed increased virulence in zebrafish and higher bacterial load within macrophages. In THP-1 cells infected with MMAR_0267 deletion mutants, the intracellular survival of the mutants increased, accompanied by reduced THP-1 apoptosis. Cu deficiency down-regulated the transcriptional level of the M. marinum virulence factor CFP-10, dampened macrophage STING cytosolic signaling, resulting in decreased IFN-β production and cell apoptosis. In conclusion, these findings highlight the significant impact of copper on the survival and reproduction of mycobacteria, underscoring the importance of studying mycobacterial adaptation mechanisms in copper-rich environments.

Objective:To comprehensively analyze the survival status and prognostic factors of colorectal cancer patients with liver metastasis.Methods:The clinical and follow-up data of 84 patients with liver metastasis from colorectal cancer in the Central Hospital Affiliated to Chongqing University from January to June 2019 were analyzed retrospectively.The basic information of patients was collected, Kaplan-Meier method was used to calculate the median survival time, Log-rank test was used for univariate analysis, and Cox regression model was used to analyze the related factors affecting the prognosis of colorectal cancer patients with liver metastasis.Results:All 84 patients with liver metastasis from colorectal cancer were followed up, the median follow-up time was 25.5 months, the follow-up rate was 100.0%, and there was no loss of follow-up.The 1-year, 2-year and 3-year survival rates were 84.52%(71/84), 66.67%(56/84)and 51.19%(43/84), respectively.The median survival time was(25.16±5.48)months.The results of univariate analysis showed that whether the body weight decreased more than 20% in recent 6 months was related to the prognosis(P<0.05). There were statistically significant differences between groups in mrEMVI, pathological type, pathological grade, mrT stage, mrN stage, circumferential resection margin(CRM), invasion length, invasion depth, the distance from the lower end of the tumor to the anal margin, and the number of liver metastatic lesions, which were related to the prognosis(P<0.05). There were statistically significant differences in neoadjuvant chemotherapy, operation time and complications between groups, which were related to the prognosis(P<0.05). The influence of each factor on the prognosis of patients from high to low were: weight loss of more than 20% in recent 6 months(OR=2.264), number of liver metastases(OR=2.035), pathological type(OR=1.751), neoadjuvant chemotherapy(OR=1.382), pathological classification(OR=1.186).Conclusion:Over 20% weight loss, mrEMVI, pathological type, pathological grade, mrT stage, mrN stage, CRM, length of invasion, depth of invasion, distance from the lower end of the tumor to the anal margin, number of liver metastatic lesions, neoadjuvant chemotherapy, operation time and complications are the main factors affecting the prognosis of patients with colorectal cancer with liver transfer.Clinically, timely and effective preventive measures can be taken before and after the operation to benefit the survival of patients and improve the prognosis of patients.

Phagosomes are vesicles produced by phagocytosis of phagocytes, which are crucial in immunity against Mycobacterium tuberculosis (Mtb) infection. After the phagocyte ingests the pathogen, it activates the phagosomes to recruit a series of components and process proteins, to phagocytose, degrade and kill Mtb. Meanwhile, Mtb can resist acid and oxidative stress, block phagosome maturation, and manipulate host immune response. The interaction between Mtb and phagocytes leads to the outcome of infection. The dynamic of this process can affect the cell fate. This article mainly reviews the development and maturation of phagosomes, as well as the dynamics and modifications of Mtb effectors and phagosomes components, and new diagnostic and therapeutic markers involved in phagosomes.

BACKGROUND:Radiotherapy is one of the essential components of breast cancer treatment. It destroys the remaining cells in the chest area after breast cancer surgery and is useful for reducing the necessity of mastectomies. As a single dose of radiation at the time of breast conserving surgery, intraoperative radiotherapy delivers radiotherapy directly and accurately to the tumor itself or the tumor bed whilst delivering minimal dose to the surrounding normal tissues. Hypofractionated postmastectomy radiotherapy with shorter and more convenient hypofractionated dose schedules might help to treat more patients and reduce cost. We will conduct a comprehensive systematic review and meta-analysis to compare the effectiveness of these 2 therapies in the management of early stage breast cancer. METHODS:Four English databases (PubMed, Embase, Cochrane Library, and Web of Science) and 3 Chinese databases (China National Knowledge Infrastructure, China Science and Technology Journal Database, and Chinese Biomedical Literature Database) will be searched from inception of databases to December 2020 without language limitation. Two reviewers will independently conduct selection of studies, data extraction and management, and assessment of risk of bias. Any disagreement will be resolved by the third reviewer. Review Manager 5.3 (The Cochrane Collaboration, Software Update, Oxford, UK) will be used for data synthesis. Cochrane risk of bias assessment tool will be used to assess the risk of bias. RESULTS:This study will provide a systematic synthesis of current published data to compare the effectiveness of intraoperative radiotherapy vs hypofractionated postmastectomy radiotherapy for early stage breast cancer. CONCLUSIONS:This systematic review and meta-analysis will provide clinical evidence for the effectiveness of intraoperative radiotherapy vs hypofractionated postmastectomy radiotherapy for early stage breast cancer, and inform our understanding of the value of intraoperative radiotherapy and hypofractionated postmastectomy radiotherapy for early stage breast cancer. STUDY REGISTRATION NUMBER:INPLASY2020110115.

Background Slow transit constipation (STC) is caused by intestinal peristalsis dysfunction and is closely associated with disturbance of the intestinal microecological balance. Bacillus subtilis plays a positive role in the treatment of STC, but its mechanism needs to be further explored. Aims The purpose of the present study was to explore the effects and mechanism of B. subtilis on the pathophysiology of STC. Methods A STC mouse model was established with compound diphenoxylate, following which B. subtilis was used to treat STC. The effects and possible mechanism of B. subtilis on STC were investigated by assessing intestinal motility, histology of the colon, release of 5-HT in enterochromaffin cells (ECs) and the TGR5/TRPA1 pathway. Moreover, LC-MS targeted metabolomics was used to analyze the regulation of Bacillus subtilis on bile acid metabolisms in STC mice. Results Bacillus subtilis significantly increased 24 h defecations, fecal moisture and intestinal transport rate of STC mice, improved pathological damage of the colon and showed protective effects on the intestinal tract. The release of 5-HT from ECs and the bile acid receptor TGR5/TRPA1 pathway were significantly increased in STC mice treated with B. subtilis. In addition, the metabolomics results showed that the bile acid contents of STC mice were significantly decreased, and B. subtilis could increase the bile acid composition and content of STC mice. Conclusion Bacillus subtilis regulates intestinal peristalsis of STC by promoting the release of 5-HT from ECs through bile acid metabolism and its receptor TGR5 pathway and plays a positive role in the treatment of STC.

Background: As a part of the digestive duct, duodenum, populates abundant commensal microbes, of which Helicobacter pylori was considered as the most widely and only recognized causative agent, especially in perforated duodenal ulcer patients. Although the most researches have been performed between duodenal ulcer diseases and the invader H. pylori , the relationship between perforated duodenal ulcer and the associated microbiome remained to be explored. Results: Metagenomic sequencing were used to profile the microbes underlying duodenal ulcer. The metagenome results of 6 duodenal ulcer samples (3 ulcer foci and3 sites around the ulcer foci) were obtained and compared. Ulcer foci and (healthy control (3 sites around the ulcer foci) were found to exist distinct microbial distributions. And interestingly, Streptococcus mitis was highly enriched in duodenal ulcer foci. Conclusion: The dysbiosis of microbiomes might underlie duodenal ulcer diseases, while the increased abundance of S. mitis is a novel finding. Whether there is causal link between S. mitis and duodenal ulcer remains to be determined. This represents the first report on the gut microbiome of duodenum or duodenal ulcer, that revealed that gut microbiota dysbiosis, especially S. mitis , might play an unexpected role in the disease. The S. mitis and microbiome dysbiosis can be new direction in the duodenal ulcer study.

为筛选胰腺假性囊肿的手术方法,本研究选取胰腺假性囊肿患者73例,观察各患者手术治疗效果.73例患者中,行囊肿十二指肠吻合术者13例(A组),行囊肿胃吻合术者29例(B组),行囊肿空肠吻合术者19例(C组),行胰腺囊肿切除术者12例(D组).研究发现,各组间术后复发率、吻合口瘘发生率、吻合口出血发生率、住院时间和治疗费用差异不显著(p＞0.05);各组术后72 h丙氨酸氨基转移酶(ALT)、天门冬氨酸转氨酶(AST)和尿素氮(BUN)均较术前显著升高(p＜0.05);术后72 h,各组间ALT、AST和BUN差异不显著(p＞0.05).研究表明,可根据胰腺假性囊肿具体位置制定合理的手术方案,取得较好的治疗效果,不同手术方式有其适应条件,不应盲目推崇某种手术方式.

Objective To study the expression of human mitochondrial transcription termination factor 3 (hMTERF3) and C-met in gastric cancer tissues and the relationships with prognosis of gastric cancer. Methods SP immunohistochemistry was used to detect the expressions of hMTERF3 and C-met in gastric cancer tissues and normal gastric mucosa tissues. RT-PCR was applied to detect the mRNA expression of hMTERF3 and C-met, and Western blot was applied to detect the protein expression of hMTERF3 and C-met. Results The expressions of hMTERF3 and C-met can be detected in both gastric cancer tissue and normal gastric mucosa tissue. The positive rate of hMTERF3 was re-spectively 89.66% and 27.59%, and that of C-met was 81.61% and 17.24% respectively. All had significant differences (P<0.01). The mRNA and protein expression levels of hMTERF3 and C-met were all detected higher in gastric cancer tissues than in normal gastric mucosa tissues (P<0.05). In the gastric cancer tissues, the expression of hMTERF3 protein was positively correlated with the expression of C-met protein (Spearman correlation coefficient r=0.419, P<0.05). Patients with negative expressions of hMTERF3 and C-met protein had significantly higher five-year survival rate than those with the positive expressions of hMTERF3 and C-met protein (P<0.05). Conclusion The expression levels of hMTERF3 and C-met was obviously up-regulated in gastric cancer tissues and showed synergistic effect in gene and protein level. Survival analysis showed that positive overexpression of the two proteins was associated with poor prognosis in patients with gastric cancer.

AIM To comparatively investigate the cellular and molecular characteristics of low-grade slightly elevated adenomas and polypoid adenomas. METHODS Colorectal tumors were collected from 24 patients with slightly elevated adenomas and 23 patients with polypoid adenomas. Five commonly mutated genes (APC, BRAF, KRAS, NRAS, and PIK3CA) were selected for mutational analysis. Paraffin-embedded tumor sections were used to calculate the apoptotic index (AI) and Ki-67 labeling index (KLI). Two pure colorectal epithelial cell lines were created by pooling the slightly elevated and polypoid tumors. Western blots, luciferase assays for β-catenin-T-cell factor protein/β-catenin-lymphoid enhancer factor (β-catenin-TCF/LEF)-driven transcriptional activity, and caspase activity assays were conducted on the two cell lines. RESULTS Slightly elevated lesions showed a significantly lower APC mutational frequency and a significantly higher KRAS mutational frequency (both P < 0.05). Slightly elevated lesions showed a significantly lower AI (P < 0.05). β-catenin and β-catenin-TCF/LEF-driven transcriptional activity was significantly upregulated in slightly elevated lesions (both P < 0.05). In slightly elevated lesions, c-Myc was significantly downregulated, while cyclin D1 was significantly upregulated (both P < 0.05). β-catenin-TCF/LEF-driven transcriptional activity was negatively correlated with c-Myc (ρ = -0.78). Slightly elevated lesions displayed significant Bcl-2 and Bcl-xL upregulation (both P < 0.05) along with significant decreases in caspase-9 and caspase-3 activity (both P < 0.05). c-Myc was negatively correlated with Bcl-2 and Bcl-xL (ρ = -0.74 and -0.78, respectively). CONCLUSION The lower apoptotic activity of low-grade slightly elevated adenomas can be partly attributed to upregulated β-catenin pathway activity and downregulated c-Myc expression.

目的 观察胃癌组织中miR-155表达水平,分析miR-155表达与肿瘤的临床分级、分期、疗效以及预后的关系,并初步分析其可能的机制.方法 选取我院收治的胃癌患者30例,采用qRT-PCR方法检测胃癌组织与癌旁组织中miR-155表达,并分析miR-155表达水平与患者临床分级、分期、疗效以及预后的关系.选择AGS以及MKN-28两种胃癌细胞系.采用miR-155 mimics上调细胞中miR-155表达,并观察细胞的增殖能力.结果 胃癌组织中miR-155表达明显低于癌旁组织,差异有统计学意义(P<0.05).12例大小≤4.5 cm的肿瘤组织中,miR-155平均表达值为(0.4097±0.0362),明显高于18例大小>4.5 cm的肿瘤组织平均表达值,差异有统计学意义(P<0.05).TNM分期为III+IV的14例患者中,miR-155平均表达值为(0.2107±0.0164),明显低于TNM分期为I+II的16例患者.miR-155低表达组2年无疾病进展率为35.7％,总生存率为42.9％,均明显低于高表达组,差异有统计学意义(P<0.05).细胞观察结果显示,转染miR-155mimics的AGS与MKN-28细胞系在48 h、72 h、96 h的增殖能力明显降低,差异有统计学意义(P<0.05).结论 miR-155表达异常与胃癌的发生与疾病进展呈明显相关性,是一种对胃癌细胞的生长发挥抑制作用的功能基因.