Comparison of clinical features and outcomes in peritoneal dialysisassociated peritonitis patients with and without diabetes:A multicenter retrospective cohort study

BACKGROUND The number of end-stage renal disease patients with diabetes mellitus(DM)who are undergoing peritoneal dialysis is increasing.Peritoneal dialysis-associated peritonitis(PDAP)is a serious complication of peritoneal dialysis leading to technical failure and increased mortality in patients undergoing peritoneal dialysis.The profile of clinical symptoms,distribution of pathogenic organisms,and response of PDAP to medical management in the subset of end-stage renal disease patients with DM have not been reported previously.Discrepant results have been found in long-term prognostic outcomes of PDAP in patients with DM.We inferred that DM is associated with bad outcomes in PDAP patients.AIM To compare the clinical features and outcomes of PDAP between patients with DM and those without.METHODS In this multicenter retrospective cohort study,we enrolled patients who had at least one episode of PDAP during the study period.The patients were followed for a median of 31.1 mo.They were divided into a DM group and a non-DM group.Clinical features,therapeutic outcomes,and long-term prognostic outcomes were compared between the two groups.Risk factors associated with therapeutic outcomes of PDAP were analyzed using multivariable logistic regression.A Cox proportional hazards model was constructed to examine the influence of DM on patient survival and incidence of technical failure.RESULTS Overall,373 episodes occurred in the DM group(n=214)and 692 episodes occurred in the non-DM group(n=395).The rates of abdominal pain and fever were similar in the two groups(P>0.05).The DM group had more infections with coagulase-negative Staphylococcus and less infections with Escherichia coli(E.coli)as compared to the non-DM group(P<0.05).Multivariate logistic regression analysis revealed no association between the presence of diabetes and rates of complete cure,catheter removal,PDAP-related death,or relapse of PDAP(P>0.05).Patients in the DM group were older and had a higher burden of cardiovascular disease,with lower level of serum albumin,but a higher estimated glomerular filtration rate(P<0.05).Cox proportional hazards model confirmed that the presence of diabetes was a significant predictor of all-cause mortality(hazard ratio=1.531,95%confidence interval:1.091-2.148,P<0.05),but did not predict the occurrence of technical failure(P>0.05).CONCLUSION PDAP patients with diabetes have similar symptomology and are predisposed to coagulase-negative Staphylococcus but not E.coli infection compared those without.Diabetes is associated with higher all-cause mortality but not therapeutic outcomes of PDAP.

Primary sigmoid squamous cell carcinoma with liver metastasis:A case report

BACKGROUND The pathological type of simple squamous carcinoma in colorectal malignancies is rare.Simple squamous cell carcinoma of the colorectum occurs most frequently in the rectum.The clinicopathological features and biological behaviors of squamous colorectal carcinoma are unclear,and its prognosis may be worse than that of simple adenocarcinoma.Studies on squamous colorectal cancer are currently limited to case reports,and there is no standard treatment protocol.Therefore,more case reports are required to fully understand squamous colorectal cancer.CASE SUMMARY We reported the case of a 56-year-old woman who complained of constipation for 2 years.Colonoscopy revealed a sigmoid colon tumor,and the pathological result of colonoscopy was squamous carcinoma.After completing the relevant assessment,the patient was clinically diagnosed with cT4aN0M0,stage IIB,and surgery was performed.Based on postoperative pathological results,the patient was diagnosed with pT4bN0M0,stage IIC.Six cycles of adjuvant chemotherapy were administered after surgery.Liver metastasis and abdominal wall mass were found more than 1 mo after the end of the last chemotherapy session.Targeted local treatment was not performed because the liver had multiple metastases,but I^(125) particle implantation of the abdominal wall mass was performed.Two cycles of first-line chemotherapy were administered after the surgery.The patient underwent 14 mo of treatment and eventually died from the tumor.CONCLUSION Squamous carcinoma of sigmoid colon is a rare tumor with unclear pathogenesis.Its clinicopathological diagnosis should be paid close attention.

Quality evaluation of Pinelliae Rhizoma using network pharmacology and multi-component quantitative analysis

Background:Pinelliae Rhizoma(Banxia)is a valuable traditional Chinese medicine,and its quality issues are related to the safety and effectiveness of the medicine.Several pharmacological experiments have shown that Pinelliae Rhizoma has anti-inflammatory activity,but the specific chemical components remain unclear.Methods:In the present study,network pharmacology was used to analyze the potential active ingredients and molecular mechanisms of Pinelliae Rhizoma’s anti-inflammatory activity.A new approach to simultaneously determine eight components using high performance liquid chromatography-photo-diode array was developed to evaluate the quality of Pinelliae Rhizoma and different processed Pinelliae Rhizoma products.Results:Twelve active ingredients were identified from Pinelliae Rhizoma,andβ-sitosterol may have a greater effect than the other active ingredients.Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analyses revealed the main pathways associated with Pinelliae Rhizoma’s mechanism for treating inflammation.Additionally,theβ-sitosterol content in different processed Pinelliae Rhizoma products decreased significantly,and the level of five nucleosides in Pinelliae Rhizoma was significantly higher than that of the processed Pinelliae Rhizoma products.The 6-gingerol content was detected in eight Pinelliae Rhizoma Praeparatum cum Zingibere et Alumine batches with different origins,and liquiritin and liquiritigenin levels were detected in eight batches of Pinelliae Rhizoma Praeparatum with different origins.Conclusion:Pinelliae Rhizoma quality was affected by different regions and different processing methods,and this research provides a reference for Pinelliae Rhizoma quality evaluation.

Targeting the chromatin structural changes of antitumor immunity

Epigenomic imbalance drives abnormal transcriptional processes,promoting the onset and progression of cancer.Although defective gene regulation generally affects carcinogenesis and tumor suppression networks,tumor immunogenicity and immune cells involved in antitumor responses may also be affected by epigenomic changes,which may have significant implications for the development and application of epigenetic therapy,cancer immunotherapy,and their combinations.Herein,we focus on the impact of epigenetic regulation on tumor immune cell function and the role of key abnormal epigenetic processes,DNA methylation,histone post-translational modification,and chromatin structure in tumor immunogenicity,and introduce these epigenetic research methods.We emphasize the value of small-molecule inhibitors of epigenetic modulators in enhancing antitumor immune responses and discuss the challenges of developing treatment plans that combine epigenetic therapy and immuno-therapy through the complex interaction between cancer epigenetics and cancer immunology.

支气管扩张症外科手术治疗及研究进展

支气管扩张症是常见的呼吸系统疾病,外科手术对部分患者具有良好的治疗效果。外科医生需要严格把握手术适应证,选择适宜的手术方式,对患者进行围手术期精准医疗管理和康复训练,降低术后并发症发生率,使患者更大获益。

High-temperature nodal ring semimetal in two-dimensional honeycomb-kagome Mn_(2)N_(3) lattice

The search for two-dimensional(2D)nodal ring semimetallic materials is a current research hotspot in spintronics,and designing a 2D nodal ring(NR)material with high Curie temperature(TC)and strong robustness to spin-orbit coupling(SOC)is an even greater challenge.Here,based on the first-principles calculations and symmetry analysis,we predict that 2D Mn_(2)N_(3)is a nodal ring semimetal(NRSM)with three energy bands near the Fermi energy level consisting of electrons in the same spin channel.An electron-like energy band and two hole-like energy bands near the Fermi plane cross to form two NRs centered at the pointΓ.Symmetry analysis shows that the spin-polarized NR semimetal is robust to SOC due to the conservation of horizontal mirror symmetry.Monte-Carlo simulations further demonstrate that the TCof the 2D Mn_(2)N_(3)reaches 530 K,well above the room temperature.Notably,the 2D Mn_(2)N_(3)remains an NRSM on h-BN substrate.Our results not only reveal a general framework for designing 2D NR materials,but also promote further research in the direction of multifunctional quantum devices for spintronics.

抗冻型丝蛋白胶黏剂的设计与制备

为应对传统化学黏合剂因环境污染和潜在健康风险所带来的挑战,本研究在成功制备一款天然桑蚕丝蛋白和单宁酸复合胶黏剂的同时,很好地解决了传统黏合剂在低温环境下无法工作或性能不佳等问题.通过在丝蛋白中引入与其有强相互作用的单宁酸,抑制了丝蛋白由无规卷曲构象向β-折叠构象的转变,进而保障了此复合胶黏剂的强黏附力.在优化丝蛋白与单宁酸复合物配比的基础上,选用乙二醇和水二元溶剂体系,不仅有效提升了此生物基胶黏剂溶解性能和对各种基体黏结的普适性,并且显著降低了其冻结点,赋予了其相应的抗冻性能.实验结果证实,此生物基胶黏剂在从-20℃到室温范围内均展现出超越传统商用化学黏合剂和其他生物基黏合剂的黏附能力.因此,所研发的抗冻型丝蛋白生物基胶黏剂,以其环保性、生物降解性及在低温条件下出色的黏结性能,在包装、生物医疗及环境保护等领域中具有很好的应用前景.