Evaluation and Application of Flowback Effect in Deep Shale Gas Wells

The pivotal areas for the extensive and effective exploitation of shale gas in the Southern Sichuan Basin have recently transitioned from mid-deep layers to deep layers.Given challenges such as intricate data analysis,absence of effective assessment methodologies,real-time control strategies,and scarce knowledge of the factors influencing deep gas wells in the so-called flowback stage,a comprehensive study was undertaken on over 160 deep gas wells in Luzhou block utilizing linear flow models and advanced big data analytics techniques.The research results show that:(1)The flowback stage of a deep gas well presents the characteristics of late gas channeling,high flowback rate after gas channeling,low 30-day flowback rate,and high flowback rate corresponding to peak production;(2)The comprehensive parameter AcmKm1/2 in the flowback stage exhibits a strong correlation with the Estimated Ultimate Recovery(EUR),allowing for the establishment of a standardized chart to evaluate EUR classification in typical shale gas wells during this stage.This enables quantitative assessment of gas well EUR,providing valuable insights into production potential and performance;(3)The spacing range and the initial productivity of gas wells have a significant impact on the overall effectiveness of gas wells.Therefore,it is crucial to further explore rational well patterns and spacing,as well as optimize initial drainage and production technical strategies in order to improve their performance.

Gut microbiota dysbiosis contributes toα-synuclein-related pathology associated with C/EBPβ/AEP signaling activation in a mouse model of Parkinson’s disease

Parkinson’s disease is a neurodegenerative disease characterized by motor and gastrointestinal dysfunction.Gastrointestinal dysfunction can precede the onset of motor symptoms by several years.Gut microbiota dysbiosis is involved in the pathogenesis of Parkinson’s disease,whether it plays a causal role in motor dysfunction,and the mechanism underlying this potential effect,remain unknown.CCAAT/enhancer binding proteinβ/asparagine endopeptidase(C/EBPβ/AEP)signaling,activated by bacterial endotoxin,can promoteα-synuclein transcription,thereby contributing to Parkinson’s disease pathology.In this study,we aimed to investigate the role of the gut microbiota in C/EBPβ/AEP signaling,α-synuclein-related pathology,and motor symptoms using a rotenone-induced mouse model of Parkinson’s disease combined with antibiotic-induced microbiome depletion and fecal microbiota transplantation.We found that rotenone administration resulted in gut microbiota dysbiosis and perturbation of the intestinal barrier,as well as activation of the C/EBP/AEP pathway,α-synuclein aggregation,and tyrosine hydroxylase-positive neuron loss in the substantia nigra in mice with motor deficits.However,treatment with rotenone did not have any of these adverse effects in mice whose gut microbiota was depleted by pretreatment with antibiotics.Importantly,we found that transplanting gut microbiota derived from mice treated with rotenone induced motor deficits,intestinal inflammation,and endotoxemia.Transplantation of fecal microbiota from healthy control mice alleviated rotenone-induced motor deficits,intestinal inflammation,endotoxemia,and intestinal barrier impairment.These results highlight the vital role that gut microbiota dysbiosis plays in inducing motor deficits,C/EBPβ/AEP signaling activation,andα-synuclein-related pathology in a rotenone-induced mouse model of Parkinson’s disease.Additionally,our findings suggest that supplementing with healthy microbiota may be a safe and effective treatment that could help ameliorate the progression of motor deficits in patients with Parkinson’s disease.

Intelligent diagnosis of retinal vein occlusion based on color fundus photographs

AIM:To develop an artificial intelligence(AI)diagnosis model based on deep learning(DL)algorithm to diagnose different types of retinal vein occlusion(RVO)by recognizing color fundus photographs(CFPs).METHODS:Totally 914 CFPs of healthy people and patients with RVO were collected as experimental data sets,and used to train,verify and test the diagnostic model of RVO.All the images were divided into four categories[normal,central retinal vein occlusion(CRVO),branch retinal vein occlusion(BRVO),and macular retinal vein occlusion(MRVO)]by three fundus disease experts.Swin Transformer was used to build the RVO diagnosis model,and different types of RVO diagnosis experiments were conducted.The model’s performance was compared to that of the experts.RESULTS:The accuracy of the model in the diagnosis of normal,CRVO,BRVO,and MRVO reached 1.000,0.978,0.957,and 0.978;the specificity reached 1.000,0.986,0.982,and 0.976;the sensitivity reached 1.000,0.955,0.917,and 1.000;the F1-Sore reached 1.000,0.9550.943,and 0.887 respectively.In addition,the area under curve of normal,CRVO,BRVO,and MRVO diagnosed by the diagnostic model were 1.000,0.900,0.959 and 0.970,respectively.The diagnostic results were highly consistent with those of fundus disease experts,and the diagnostic performance was superior.CONCLUSION:The diagnostic model developed in this study can well diagnose different types of RVO,effectively relieve the work pressure of clinicians,and provide help for the follow-up clinical diagnosis and treatment of RVO patients.

Determination of Ten Kinds of Alpha-2 Agonists Residues in Animal Derived Food by UHPLC-Triple Quadrupole/Composite Linear Ion Trap Mass Spectrometry

[Objectives]The paper was to establish an ultra high performance liquid chromatography-quadrupole/linear ion trap complex mass spectrometry for the determination of 10 kinds ofα2-receptor agonists in animal derived food.[Methods]The samples were extracted with sodium carbonate buffer solution and ethyl acetate,and analyzed by mass spectrometry after solid phase extraction and high performance liquid chromatography separation.[Results]Ten kinds ofα2-receptor agonists showed a good linear relationship in the range of 1-100μg/mL,with the average recovery of over 69%and the relative standard deviation less than 8.32%.The detection limit of 10 kinds of α_(2)-receptor agonists was up to 1μg/kg.[Conclusions]The method has good selectivity and strong anti-interference ability,and can meet the requirements of 10 kinds ofα2-receptor agonists residues in animal derived food.

Diagnosis of Acute Q Fever in an Elderly Patient Using Metagenomic Next-Generation Sequencing:A Case Report

Query fever(Q fever)is a globally spread zoonotic disease caused by Coxiella burnetii,commonly found in natural foci but rarely seen in Hebei Province.The clinical manifestations of Q fever are diverse and nonspecific,which often leads to missed or incorrect diagnoses in clinical practice.This article reports a case of acute Q fever diagnosed in an elderly patient using metagenomic next-generation sequencing.

The characteristics of shear wave splitting in the source region of the April 20,2013 Lushan earthquake

Using seismic data of the aftershocks sequence of the April 20, 2013 Lushan earthquake recorded by seismic temporary and permanent stations in the source region, with the visual inspection of particle motion diagrams, this paper preliminarily contains the polarization directions of fast shear wave and the time-delays of split shear waves at every station, and analyzes the crustal anisotropic characteristics in the source region. In the study area, the polarization direc- tions at stations BAX, TQU, L 132, L 133, L 134, and L 135 are northeast, which is consistent with the strike of Dachuan- Shuangshi fault. There are two polarization directions at MDS and L131, which are northeast and southeast. The scatter of polarization directions suggests the complex stress field around these two stations where two faults intersect. For the normalized time-delays at every station, the range is 1.02-8.64 ms/km. The largest time-delay is from L134 which is closest to the mainshock, and the smallest one is from L133. The variations in time-delays show the decreasing at stations BAX, L134, and L135 because of the stress-relaxation after earthquake.

High-resolution seismic tomography of the upper crust in the source region of the April 20,2013 Lushan earthquake and its seismotectonic implications

Both P- and S-wave arrivals were collected for imaging upper crustal structures in the source region of the April 20, 2013 Lushan earthquake. High-resolution, three- dimensional P and S velocity models were constructed by travel-time tomography. Moreover, more than 3700 after- shocks of the Lushan earthquake were relocated via a grid search method. The P- and S-wave velocity images of the upper crust show largely similar characters, with high and low velocity anomalies, which mark the presence of sig- nificant lateral and vertical heterogeneity at the source region of the Lushan earthquake. The characteristics of the velocity anomalies also reflect the associated surface geo- logical tectonics in this region. The distributions of high velocity anomalies of both P- and S-waves to 18 km depth are consistent with the distributions of relocated after- shocks, suggesting that most of the ruptures were localized inside the high velocity region. In contrast, low P and S velocities were found in the surrounding regions without aftershocks, especially in the region to the northeast of the Lushan earthquake. For the relocated aftershocks of the Lushan earthquake from this study, we found that mostaftershocks were concentrated in a zone of about 40 km long and 20 km wide, and were located in the hanging wall of Dayi-Mingshan fault. The focal depths of aftershocks increase from the southeast to the northwest region in the direction perpendicular to the fault strike, suggesting that the fault ruptured at an approximate dip angle of 45°. The main depths of the aftershocks in the northwest of the main shock are significantly shallower than expected, revealing the different seismogenic conditions in the source region.

Shear wave splitting analysis of local earthquakes from dense arrays in Shimian,Sichuan

The Shimian area of Sichuan sits at the junction of the Bayan Har block.Sichuan-Yunnan rhombic block,and Yangtze block,where several faults intersect.This region features intense tectonic activity and frequent earthquakes.In this study,we used local seismic waveform data recorded using dense arrays deployed in the Shimian area to obtain the shear wave splitting parameters at 55 seismic stations and thereby determine the crustal anisotropic characteristics of the region.We then analyzed the crustal stress pattern and tectonic setting and explored their relationship in the study area.Although some stations returned a polarization direction of NNW-SSE.a dominant polarization direction of NW-SE was obtained for the fast shear wave at most seismic stations in the study area.The polarization directions of the fast shear wave were highly consistent throughout the study-area.This orientation was in accordance with the direction of the regional principal compressive stress and parallel to the trend of the Xianshuihe and Daliangshan faults.The distribution of crustal anisotropy in this area was affected by the regional tectonic stress field and the fault structures.The mean delay time between fast and slow shear waves was 3.83 ms/km.slightly greater than the values obtained in other regions of Sichuan.This indicates that the crustal media in our study area had a high anisotropic strength and also reveals the influence of tectonic complexity resulting from the intersection of multiple faults on the strength of seismic anisotropy.

Construction of a transposase accessible chromatin landscape reveals chromatin state of repeat elements and potential causal variant for complex traits in pigs

Background:A comprehensive landscape of chromatin states for multiple mammalian tissues is essential for elucidating the molecular mechanism underlying regulatory variants on complex traits.However,the genome-wide chromatin accessibility has been only reported in limited tissue types in pigs.Results:Here we report a genome-wide landscape of chromatin accessibility of 20 tissues in two female pigs at ages of 6 months using ATAC-seq,and identified 557,273 merged peaks,which greatly expanded the pig regulatory ele-ment repository.We revealed tissue-specific regulatory elements which were associated with tissue-relevant biologi-cal functions.We identified both positive and negative significant correlations between the regulatory elements and gene transcripts,which showed distinct distributions in terms of their strength and distances from corresponding genes.We investigated the presence of transposable elements(TEs)in open chromatin regions across all tissues,these included identifications of porcine endogenous retroviruses(PERVs)exhibiting high accessibility in liver and homology of porcine specific virus sequences to universally accessible transposable elements.Furthermore,we prior-itized a potential causal variant for polyunsaturated fatty acid in the muscle.Conclusions:Our data provides a novel multi-tissues accessible chromatin landscape that serve as an important resource for interpreting regulatory sequences in tissue-specific and conserved biological functions,as well as regula-tory variants of loci associated with complex traits in pigs.

尿失禁孕妇对盆底肌训练态度的质性研究

目的旨在探讨尿失禁孕妇对盆底肌训练(pelvic floor muscle training,PFMT)的态度与看法。方法采用半结构式个人访谈收集资料。于2021年10月—11月在深圳市1所三级甲等医院产科门诊,通过目的抽样的方法选取无PFMT禁忌症、存在尿失禁症状的孕妇参与研究。采用Braun&Clarke主题分析法进行数据分析。结果16名孕妇参与了访谈,平均年龄为(30.81±3.66)岁。“我也很犹豫”,孕妇对PFMT总体持矛盾的态度。共提炼出4个主题,9个子主题:“这很正常”(妊娠期尿失禁正常化,对PFMT不重视);“我做不了什么”(进行PFMT的主观动力不足,实施PFMT的客观条件受限,PFMT的社会支持不足);“我们得照顾好自己”(自我爱护意识增强,进行PFMT的自主动机显现);“培训要有保障”(需要专业的指导与监督,需要感知获益)。结论孕妇在对PFMT的态度上存在矛盾,表现出对其重视程度不一致。为了更好地促进孕妇参与PFMT,医护人员需要采取提供专业指导、增强孕妇自我意识、改善社会支持和强调PFMT的益处等措施。

角膜塑形镜配戴不同时长对青少年近视影响的Meta分析

目的:系统评价角膜塑形镜配戴不同时长对青少年近视患者的角膜曲率、屈光度、裸眼视力及眼轴的影响。增加青少年近视患者对配戴角膜塑形镜的认识及对配戴时长的合理把握,为广大青少年近视患者提供相应的戴镜指导。方法:计算机检索PubMed、CBM、WanFang Data、VIP和CNKI等数据库,检索角膜塑形镜对控制青少年近视进展的相关文献,检索时限均为建库至2019-04。经过两名本课题参与的研究人员独立进行文献的筛选和相关数据资料的提取及方法学质量评价之后,使用RevMan软件(Ver5.3)进行Meta分析。结果:最后本课题共纳入了8个相关的研究,包含了1 136例患有近视的青少年。Meta分析结果显示:在戴镜后1wk角膜曲率变化无统计学意义[1wk:MD=0.91,95%CI(-0.01~1.83),P=0.05]。但戴镜后1、3、6、12mo时,角膜曲率有一定程度降低[1mo:MD=0.82,95%CI(0.12~1.53),P=0.02;3mo:MD=1.31,95%CI(0.63~2.00),P<0.05;6mo:MD=1.35,95%CI(0.62~2.09),P<0.05;12mo:MD=1.41,95%CI(0.68~2.14),P<0.05]。戴镜后12mo,屈光度增长得到有效控制[12mo:MD=2.61,95%CI(1.52~3.71),P<0.05]。裸眼视力也得到了提高[12mo:MD=-0.81,95%CI(-0.84^-0.79),P<0.05]。在戴镜12mo后,眼轴增长无统计学意义[12mo:MD=-0.06,95%CI(-0.21~0.09),P=0.44]。结论:角膜塑形镜不仅能够降低角膜的曲率,还可以控制眼轴的增长,然而,这些结果都是长期才会发生。

三种不同干预方法对近视儿童调节参数及屈光度的影响

目的:通过观察低浓度阿托品、角膜塑形镜、框架眼镜对包头市近视儿童的控制效果,分析其近视相关调节参数的变化规律,为近视防控提供依据。方法:选取2018-06/12在包头医学院第一附属医院眼科门诊就诊的8~14岁近视儿童120例240眼,分为低浓度阿托品组、角膜塑形镜组和框架眼镜组,并在1、3、6、12mo分别对调节滞后量、正相对调节、负相对调节及屈光度进行随访。结果:随访3、6、12mo,低浓度阿托品组与角膜塑形镜调节滞后量有差异(P<0.05);随访6、12mo时,角膜塑形镜组与框架眼镜组调节滞后量有差异(P<0.05)。随访3、6、12mo时,低浓度阿托品组与角膜塑形镜组、框架眼镜组负相对调节均有差异(P<0.05)。在各随访时间点角膜塑形镜组与低浓度阿托品组、框架眼镜组正相对调节均有差异(P<0.05)。随访6、12mo,低浓度阿托品组与框架眼镜组屈光度有差异(P<0.05);随访12mo,角膜塑形镜组与框架眼镜组屈光度有差异(P<0.05)。结论:角膜塑形镜可以通过降低调节滞后量,解决远视离焦的问题,同时还可以提高正相对调节,但需要长期坚持配戴。低浓度阿托品可以提高负相对调节,但可能有其他途径来控制近视的发展。相较其它组而言,框架眼镜对于各调节指标影响较小,对近视的控制效果并不显著。

用于治疗非小细胞肺癌的阿法替尼脂质体的制备与包封率的测定

背景与目的阿法替尼是针对非小细胞肺癌及继发性耐药研发的第二代不可逆表皮生长因子受体抑制剂,目前仅停留在口服给药方式,其生物利用度低,不良反应较多。本研究旨在制备新型药物传递系统-阿法替尼脂质体,并建立包封率的测定方法。方法 4种不同方法制备阿法替尼脂质体,通过对比包封率和粒径确定最佳制备工艺。结果经验证可采用葡聚糖凝胶微柱离心法纯化脂质体,并通过紫外分光光度法测定脂质体的包封率。不同制备方法中硫酸铵梯度法制备的脂质体,包封率约为90.73%,平均粒径为108.6 nm。结论硫酸铵梯度法制备阿法替尼脂质体包封率高、粒径小,紫外分光光度法用来测定脂质体的包封率简单易行、准确度高。

高度近视合并白内障植入Symfony与ZMB00 IOL视觉质量比较

目的:对比高度近视合并白内障患者植入tecnis Symfony人工晶状体(IOL)与tecnis ZMB00多焦点IOL的术后视觉质量。方法:采用前瞻性非随机对照研究,纳入2020-06/2021-07在包头医学院第一附属医院行超声乳化吸除联合IOL植入术的高度近视合并白内障患者。依据患者所选IOL不同,分为Symfony组32例32眼和ZMB00组31例31眼。术后随访3mo,主要观察指标:比较术后1、3mo等效球镜,裸眼、最佳矫正远视力(5m),裸眼、最佳矫正远视力下中(80、60cm)、近(33cm)距离视力,术后3mo离焦曲线、对比敏感度、IOL偏心量及倾斜度。次要指标:术后3mo残余散光耐受度(90°、180°轴位,正、负柱镜)、视觉质量问卷。结果:术后1、3mo两组裸眼、最佳矫正远视力、等效球镜比较均无差异(P>0.05),Symfony组裸眼、最佳矫正远视力下中视力优于ZMB00组,ZMB00组裸眼、最佳矫正远视力下近视力高于Symfony组(均P<0.05)。术后3mo Symfony组在+1.0~-3.0D跨度上,离焦曲线形成缓慢下降的平台期、视力优于0.3LogMAR,且在-1.0~-2.5D跨度上优于ZMB00组(均P<0.05);ZMB00组离焦曲线呈双峰状、在0、-3.00D上为波峰,-3.0~-3.5D跨度上优于Symfony组(P<0.05)。暗环境空间频率(3、6、12、18c/d)对比敏感度(CS),Symfony组优于ZMB00组(均P<0.05)。术后3mo两组IOL偏心量、倾斜度及视觉质量评分比较均无差异(P>0.05)。残余散光耐受度ZMB00组在+0.75D和-1.00D,Symfony组在+1.00D和-1.50D上表现出不适及视力低于0.3LogMAR(均P<0.05)。术后两组均不同程度出现眩光、光晕等不适,但随时间的推移症状大部分适应或消失。结论:在高度近视合并白内障术后,两种IOL都有良好的囊袋稳定性及居中性,均能提供优秀的视觉质量。Symfony IOL可提供有效的连续视程、中视力更有优势、近视力表现略有不足,而ZMB00 IOL更适合对近距离视力有高要求者,Symfony IOL表现出更好的术后残余散光耐受度。

Müller胶质细胞在视网膜神经损伤中的作用研究进展

Müller胶质细胞(Müller glial cells,MGCs)是视网膜中的主要神经胶质细胞,呈放射状横跨整个视网膜。MGCs与视网膜神经元紧密接触,相互作用,参与维持视网膜内稳态。在视网膜神经损伤后,MGCs启动多种调控途径应答视网膜内环境改变和损伤,产生视网膜神经保护作用,如:调节神经递质释放,释放神经保护因子及抗氧化因子,重编程进行内源性修复。但在视网膜持续损伤状态下,MGCs增生也能加重神经元功能障碍和丢失。因此,正确认识MGCs对病理刺激的反应及其产生的保护和损害作用,对于研究视网膜神经损伤性疾病的机制及指导疾病治疗具有重要意义。本文围绕MGCs在视网膜神经损伤及修复过程中的作用展开综述,旨在为视网膜神经保护提供新的策略。

Metabolic alteration of neuroactive steroids and protective effect of progesterone in Alzheimer's disease-like rats

A correlation between metabolic alterations of neuroactive steroids and Alzheimer’s disease remains unknown. In the present study, amyloid beta （Aβ） 25-35 （Aβ25-35） injected into the bilateral campus CA1 region significantly reduced learning and memory. At the biochemical level, hippocampal levels of pregnenolone were significantly reduced with Aβ25-35 treatment. Furthermore, progesterone was considerably decreased in the prefrontal cortex and hippocampus, and 17β-estradiol was signifi-cantly elevated. To our knowledge, this is the first report showing that Aβ25-35, a main etiological factor of Alzheimer’s disease, can alter the level and metabolism of neuroactive steroids in the prefrontal cortex and hippocampus, which are brain regions significantly involved in learning and memory. Aβ25-35 exposure also increased the expression of inflammatory mediators, tumor necrosis factor-αand interleukin-1β. However, subcutaneous injection of progesterone reversed the upregulation of tumor necrosis factor-αand interleukin-1βin a dose-dependent manner. Concomitant with improved cognitive abilities, progesterone blocked Aβ-mediated inflammation and increased the survival rate of hippocampal pyramidal cells. We thus hypothesize that Aβ-mediated cognitive deficits may occur via changes in neuroactive steroids. Moreover, our findings provide a possible therapeutic strategy for Alzheimer’s disease via neuroactive steroids, particularly progesterone.

Efficacy of concurrent chemoradiotherapy plus adjuvant chemotherapy on advanced cervical cancer

Background and Objective: Concurrent chemoradiotherapy for cervical carcinoma develops rapidly and has become a common and standard therapy in recent years. Both the local control rate and survival rate of patients were increased and the risk of death fell by 30%-50%. This study aimed to explore the efficacy of concurrent chemoradiotherapy plus adjuvant chemotherapy on and the treatment compliance of the patients with advanced cervical squamous cell carcinoma. Methods: A total of 156 patients with stage IIa-IIIb cervical squamous cell carcinoma were randomly divided into the concurrent chemoradiotherapy group (experimental group) and radiotherapy group (control group). Intracavity and external beam radiation therapy were administered. At point A, 40-48 Gy were given by 10-12 fractions; at point B, 46-50 Gy were given by 23-25 fractions. In the same time, experimental group was treated by cisplatin (DDP, 40 mg) on day 1, repeated every week. Ten days after radiation therapy, TP regimen was administered as adjuvant chemotherapy. Results: For the experimental and control groups, the objective response rates were 88.61% and 75.32%, 1-year survival rates were 88.57% and 70.77%, 1-year local control rates were 81.43% and 64.62%, 3-year survival rates were 82.14% and 57.69%, and 3-year local control rates were 75.00% and 46.15%, with significant differences (P < 0.05). Quality of life of all patients were significantly improved after treatment (P< 0.05). Conclusion: Concurrent chemoradiotherapy plus adjuvant chemotherapy for advanced cervical cancer can improve short-term and long-term survival and local control rates of patients, improve the quality of life, and the toxicity can be tolerated.

Cancer-associated fibroblasts in digestive tumors

The significant influence of tumor stroma on malignant cells has been extensively investigated in this era of targeted therapy. The tumor microenvironment, as a dynamic system, is orchestrated by various cells including tumor vascular composing cells, inflammatory cells and fibroblasts. As a major and important component in tumor stroma, increasing evidence has shown that spindle-shaped cancer-associated fibroblasts (CAFs) are a significant modifier of cancer evolution, and promote tumorigenesis, tumor invasion and metastasis by stimulating angiogenesis, malignant cell survival, epithelial-mesenchymal transition (EMT) and proliferation via direct cell-to-cell contact or secretion of soluble factors in most digestive solid tumors. CAFs are thought to be activated, characterized by the expression of &#x003b1;-smooth muscle actin, fibroblast activated protein, fibroblast specific protein, vimentin, fibronectin, etc. They are hypothesized to originate from normal or aged fibroblasts, bone marrow-derived mesenchymal cells, or vascular endothelial cells. EMT may also be an important process generating CAFs, and most probably, CAFs may originate from multiple cells. A close link exists between EMT, tumor stem cells, and chemo-resistance of tumor cells, which is largely orchestrated by CAFs. CAFs significantly induce immunosuppression, and may be a prognostic marker in various malignancies. Targeted therapy toward CAFs has displayed promising anticancer efficacy, which further reinforces the necessity to explore the relationship between CAFs and their hosts.

Iguratimod promotes transformation of mononuclear macrophages in elderly patients with rheumatoid arthritis by nuclear factor-κB pathway

BACKGROUND The role of macrophages in rheumatoid arthritis(RA)and its mechanism have attracted much attention in RA pathogenesis.Macrophages accumulate in the synoviums of RA,and the proportion of M1 type pro-inflammatory macrophages is higher than that of M2 type anti-inflammatory macrophages,leading to the secretion of inflammatory molecules and the aggravation of inflammatory reaction,which has made macrophages a potential target of RA drugs.Iguratimod is a kind of cyclo-oxygenase-2 inhibitor that affects macrophage polarity.It is speculated that its anti-inflammatory and anti-rheumatic effects may be related to the regulation of macrophage M1/M2 ratio.AIM To investigate the effects of Iguratimod on the polarity of mononuclear macrophages in elderly patients with RA.METHODS Elderly patients with RA and joint effusion were selected,including 10 men and 25 women,with an average age of 66.37±4.42 years.Patients were treated with oral administration of 25 mg Iguratimod(Iremod,State Food and Drug Administration Approval No.H20110084)twice daily for 12 wk.Disease Activity Score 28 and Health Assessment Questionnaire score were collected according to the disease severity before and after treatment.Venous blood and joint effusion fluid were collected,mononuclear macrophages were extracted and expression of cell surface markers CD86,CD64,CD163,and CD206 was analyzed by flow cytometry.The concentration of inflammatory factors interleukin(IL)-6,IL-1β,transforming growth factor-β,and IL-4 in the joint effusion fluid was analyzed by enzyme-linked immunosorbent assay.Expression of mononuclear cells inhibitor of nuclear factor-κB(IκB)and phosphorylated IκB in peripheral blood was analyzed by western blotting.RESULTS Disease Activity Score 28 score and Health Assessment Questionnaire score of patients treated with Iguratimod decreased significantly.The percentage of cell surface markers CD86 and CD64 decreased significantly,and the percentage of CD163 and CD206 increased significantly(P<0.05).The inflammatory factors IL-6 and IL-1βdecreased significantly,and transforming growth factor-βand IL-4 increased significantly.Western blot analysis showed that mononuclear cell inhibitor of nuclear factor-κB in peripheral blood was significantly increased after treatment,and its phosphorylation level was significantly decreased(P<0.05).CONCLUSION Iguratimod can promote the transformation of mononuclear macrophages from M1 to M2 in elderly patients with RA by inhibiting the nuclear factor-κB pathway,thus improving symptoms of RA.

Mesh migration into the sigmoid colon after inguinal hernia repair presenting as a colonic polyp:A case report and review of literature

Mesh migration and penetration into abdominal visce-ra rarely occur after laparoscopic inguinal hernia repair. We present the first case of mesh migration into the sigmoid colon identified as a colonic polyp at initial co-lonoscopic examination. The patient complained of mild abdominal distention in the lower abdomen over the previous year without changes in bowel habits or stool appearance and without weight loss. By complement-ary endoscopic ultrasonography, a cavity--like structure beneath the suspected polyp was further confirmed. Enhanced abdominal computed tomography merely re-vealed local bowel wall thickening and inflammation of the colosigmoid junction. The migrating mesh, which was lodged in the sigmoid colon and caused intra--abdomi-nal adhesion in the lower abdominal cavity, was finally identified via exploratory surgery. The components of inflammatory granulation tissue around the mesh mate-rial were diagnosed based on histological examination of the surgical specimen after sigmoidectomy. In this patient, nonspecific endoscopic and imaging outcomes during clinical work--up led to the diagnostic dilemma of mesh migration. Therefore, the clinical, radiological and endoscopic challenges specific to this case as well as the underlying reasons for mesh migration are discussed in detail.