Spatial transcriptomics:recent developments and insights in respiratory research

The respiratory system's complex cellular heterogeneity presents unique challenges to researchers in this field.Although bulk RNA sequencing and single-cell RNA sequencing(scRNA-seq)have provided insights into cell types and heterogeneity in the respiratory system,the relevant specific spatial localization and cellular interactions have not been clearly elucidated.Spatial transcriptomics(ST)has filled this gap and has been widely used in respiratory studies.This review focuses on the latest iterative technology of ST in recent years,summarizing how ST can be applied to the physiological and pathological processes of the respiratory system,with emphasis on the lungs.Finally,the current challenges and potential development directions are proposed,including high-throughput full-length transcriptome,integration of multi-omics,temporal and spatial omics,bioinformatics analysis,etc.These viewpoints are expected to advance the study of systematic mechanisms,including respiratory studies.

内镜黏膜下剥离术治疗食管环周早癌的临床分析(附38例报告)

目的评价内镜黏膜下剥离术(ESD)治疗食管环周早癌的有效性、安全性和术后并发症情况。方法回顾性分析郑州大学第一附属医院2018年-2020年38例行ESD治疗食管环周早癌的患者的临床资料,按术后食管狭窄的治疗方式分为术后直接置入支架组(n=6)、未置入支架组(n=26)和因ESD术后狭窄定期扩张后再置入支架组(n=6)。结果环周缺损长度平均4.5 cm;术中穿孔1例、术后迟发性出血1例、术后发热5例、术后食管狭窄行扩张治疗中发生穿孔1例,术后穿孔的1例并发食管纵隔瘘,经保守治疗后好转。食管狭窄为其最常见的并发症,发生率为100.0%。患者平均住院8.6 d,平均手术时间186.8 min。ESD术后直接置入支架组的术后首次扩张时间及平均扩张间隔明显长于未置入支架组,因ESD术后狭窄定期扩张后再置入支架组置入后平均扩张间隔明显长于置入支架前,组间和组内比较,差异均有统计学意义(P>0.05)。平均随访时间507.0 d,患者无复发。结论ESD治疗食管环周早癌是安全、有效的,虽然术后食管狭窄不可避免,但行食管扩张术或预防性支架置入/中途支架置入均能明显缓解狭窄进程,具有较良好的临床应用价值。

Characterizing the composition of intestinal microflora by 16S rRNA gene sequencing

BACKGROUND This study determined the composition and diversity of intestinal microflora in patients with colorectal adenoma(CRA),which may provide precedence for investigating the role of intestinal microflora in the pathogenesis of colorectal tumors,the composition of intestinal microflora closely related to CRA,and further validating the possibility of intestinal flora as a biomarker of CRA.AIM To study the relationship between intestinal microflora and CRA.METHODS This is a prospective control case study from October 2014 to June 2015 involving healthy volunteers and patients with advanced CRA.High-throughput sequencing and bioinformatics analysis were used to investigate the composition and diversity of intestinal microflora in 36 healthy subjects and 49 patients with advanced CRA.Endpoints measured were operational taxonomic units of intestinal flora,as well as their abundance and diversity(αandβtypes).RESULTS In this study,the age,gender,body mass index,as well as location between controls and patients had no significant differences.The mucosa-associated gut microbiota diversity and bacterial distribution in healthy controls and colorectal adenomas were similar.The operational taxonomic unit,abundance,andαandβdiversity were all reduced in patients with CRA compared to controls.At the phylum level,the composition of intestinal microflora was comparable between patients and controls,but the abundance of Proteobacteria was increased,and Firmicutes and Bacteroides were significantly decreased(P<0.05).The increase in Halomonadaceae and Shewanella algae,and reduction in Coprococcus and Bacteroides ovatus,could serve as biomarkers of CRA.High-throughput sequencing confirms the special characteristics and diversity of intestinal microflora in healthy controls and patients with CRA.CONCLUSION The diversity of intestinal microflora was decreased in patients with CRA.An increase in Halomonadaceae and Shewanella algae are markers of CRA.

前视超声内镜治疗食管-胃底静脉曲张的初步研究

目的探讨前视超声内镜在食管-胃底静脉曲张(EGV)诊疗中的优势。方法选取2019年5月-2021年5月郑州大学第一附属医院消化内科收治的EGV患者40例,行前视超声内镜引导下治疗的为观察组(n=19),普通内镜下治疗的为对照组(n=21)。术后随访3~6个月,比较两组患者组织胶使用情况、术后并发症、治疗效果和再出血情况等。结果观察组组织胶注射次数及用量均较对照组少,两组患者比较,差异有统计学意义(P<0.05)。术后均无严重并发症发生,两组患者并发症总发生率比较,差异无统计学意义(P>0.05)。术后72 h~3个月,观察组总出血率为10.52%,与对照组的19.05%比较,差异无统计学意义(P>0.05)。术后1个月所有患者复查胃镜,观察组中治疗效果显著、一般和无效的占比分别为63.16%、31.58%和5.26%,与对照组的33.33%、38.10%和28.57%比较,差异有统计学意义(P<0.05)。结论前视超声内镜引导下治疗EGV,较普通内镜可减少组织胶用量,提高治疗效果。

Efficacy and safety of oral Chinese herbal medicine combined with nucleoside antiviral drugs against recurrent genital herpes:a systematic review and meta-analysis

Background:To compare the efficacy and safety of Chinese herbal medicine combined with nucleoside antiviral drugs and nucleoside antiviral drugs alone in treating recurrent genital herpes.Methods:PubMed,Embase,Web of Science,Cochrane Library,Chinese Biomedical Literature Database,China National Knowledge Internet,VIP Database,and Wanfang Data were searched from inception to April 2021.Randomized controlled trials on the efficacy and safety of oral Chinese herbal medicine combined with nucleoside antiviral drugs for recurrent genital herpes were collected.All included trials were independently assessed by two reviewers with the Cochrane risk-of-bias tool,and a meta-analysis was conducted using Review Manager 5.4.Results:Compared with the use of nucleoside antiviral drugs alone,combination therapy with oral Chinese herbal medicine plus nucleoside antiviral drugs effectively reduced the herpes recurrence rate after the end of treatment(3 months:P=0.0002;6 months:P<0.00001;1 year:P<0.00001)and the number of recurrences each year(P<0.00001),improved the recurrent Genital Herpes Quality of Life Questionnaire score(P<0.00001),and regulated the levels of interferon-γ,interleukin-2,tumor necrosis factor-α,and T lymphocyte subsets in the peripheral blood,and the difference was statistically significant.Different subgroups reported mixed results with respect to the efficacy in the short term.The incidence of adverse reactions and the time of symptom disappearance between the two groups were not significantly different.Conclusion:Chinese herbal medicine combined with nucleoside antiviral drugs can effectively reduce the recurrence rate of recurrent genital herpes,improve the patient’s quality of life and enhance the body’s immunity.Considering the possible risk of publication bias,more high-quality randomized controlled trials are still needed to verify the conclusions of this article.

Novel fast FFR derived from coronary CT angiography based on static first-pass algorithm:a comparison study

BACKGROUND Fractional flow reserve(FFR)is the invasive gold standard for evaluating coronary arterial stenosis.However,there have been a few non-invasive methods such as computational fluid dynamics FFR(CFD-FFR)with coronary CT angiography(CCTA)images that can perform FFR assessment.This study aims to develop a new method based on the principle of static first-pass of CT perfusion imaging technique(SF-FFR)and evaluate the efficacy in direct comparisons between CFD-FFR and the invasive FFR.METHODS A total of 91 patients(105 coronary artery vessels)who were admitted from January 2015 to March 2019 were enrolled in this study,retrospectively.All patients underwent CCTA and invasive FFR.64 patients(75 coronary artery vessels)were successfully analyzed.The correlation and diagnostic performance of SF-FFR method on per-vessel basis were analyzed,using invasive FFR as the gold standard.As a comparison,we also evaluated the correlation and diagnostic performance of CFD-FFR.RESULTS The SF-FFR showed a good Pearson correlation(r=0.70,P<0.001)and intra-class correlation(r=0.67,P<0.001)with the gold standard.The Bland-Altman analysis showed that the average difference between the SF-FFR and invasive FFR was 0.03(0.11–0.16);between CFD-FFR and invasive FFR was 0.04(-0.10–0.19).Diagnostic accuracy and area under the ROC curve on a per-vessel level were 0.89,0.94 for SF-FFR,and 0.87,0.89 for CFD-FFR,respectively.The SF-FFR calculation time was about 2.5 s per case while CFD calculation was about 2 min on an Nvidia Tesla V100 graphic card.CONCLUSIONS The SF-FFR method is feasible and shows high correlation compared to the gold standard.This method could simplify the calculation procedure and save time compared to the CFD method.

针灸调节固有免疫治疗克罗恩病的研究进展

Crohn's disease(CD) is an inflammatory bowel disease whose pathogenesis remains unclear.In this paper,we reviewed the basic research of acupuncture and moxibustion in treating CD by regulating intestinal intrinsic immunity,and summarized in more detail that acupuncture and moxibustion can regulate the intestinal intrinsic immune system through the intestinal epithelial cell barrier,monocytes/macrophages,natural killer cells(NK cells),dendritic cells(DC),and neutrophils.Specifically,acupuncture and moxibustion can reduce the expression of inflammatory factors in the intestinal mucosa,alleviate intestinal fibrosis to repair the mechanical barrier of the intestinal mucosa,inhibit the expression of molecules of the MAPK,TLR/NF-κB signaling pathway and inflammatory factors,block the NK cell-mediated cytotoxicity pathway,and prevent the overactivation of neutrophils to control inflammatory responses,repairing the damaged intestinal tract and alleviating CD symptoms.This paper illustrated the characteristics of acupuncture and moxibustion for CD,which involves multi targets and pathways,aiming to provide guidance for the clinical application and basic research of acupuncture and moxibustion for CD.It also pointed out the current drawbacks of acupuncture and moxibustion therapy,and finally proposing the shortcomings of the current research,including the insufficient number of studies on acupuncture and moxibustion in the treatment of CD through the modulation of NK cells and neutrophils,the lack of standardization in acupuncture point selection,duration and treatment course,and the geographical limitations of the research locations for acupuncture and moxibustion in treating CD.

Acupuncture for acute gastrointestinal injury:A systematic review and meta-analysis

Objective:To systematically review the clinical therapeutic effect of acupuncture on acute gastrointestinal injury(AGI)in critically ill patients.Methods:The randomized control trials of acupuncture for AGI in critically ill patients were retrieved from the databases,from inception to the cutoff date in August,2021,including China National Knowledge Infrastructure(CNKI),Wanfang,VIP,China Biology Medicine disc(CBM),PubMed,Science Direct and Cochrane Library.Simultaneously,the accomplished and published RCTs were further searched from American clinical trial registry platform(https://clinicaltrials.gov)and Chinese clinical trial registry platform(www.chictr.org.cn).Two researchers extracted the data and performed the quality evaluation of the eligible articles independently.The meta-analysis was undertaken,by using RevMan 5.4.Results:Totally,15 papers were included,involving 1316 patients.The results of meta-analysis showed that after treated with acupuncture,the differences were statistical significance as compared with the routine treatment group in the score of the second edition of Acute Physiology and Chronic Health Evaluation(APACHEII)(MD=-1.98,95%CI[-3.23,-0.73],P=0.002),gastrointestinal dysfunction score(MD=-0.33,95%CI[-0.41,-0.24],P<0.00001),the intra-abdominal pressure(mmHg)(MD=-2.74,95%CI[-3.81,-1.67],P<0.00001),intensive care unit(ICU)length of stay(MD=-3.15,95%CI[-5.99,-0.30],P<0.00001)and fatality rate in 28-day(RR=0.57,95%CI[0.39,0.85],P=0.006)in critically ill patients with AGI,respectively.Conclusion:The limited available evidence suggests that acupuncture relieves clinical symptoms and poor prognosis in the critically ill patients with AGI,thus,it is one of the potential therapies to AGI.Hence,acupuncture should be recommended into the regimen of AGI in critically ill patients and more highquality and multi-central trials can be undertaken in the further.

The Chinese herbal prescription JieZe-1 inhibits caspase-1-dependent pyroptosis induced by herpes simplex virus-2 infection in vitro

Objective:JieZe-1(JZ-1),a Chinese herbal prescription,has an obvious effect on genital herpes,which is mainly caused by herpes simplex virus type 2(HSV-2).Our study aimed to address whether HSV-2 induces pyroptosis of VK2/E6E7 cells and to investigate the anti-HSV-2 activity of JZ-1 and the effect of JZ-1 on caspase-1-dependent pyroptosis.Methods:HSV-2-infected VK2/E6E7 cells and culture supernate were harvested at different time points after the infection.Cells were co-treated with HSV-2 and penciclovir(0.078125 mg/mL)or caspase-1 inhibitor VX-765(24 h pretreatment with 100μmol/L)or JZ-1(0.078125-50 mg/mL).Cell counting kit-8 assay and viral load analysis were used to evaluate the antiviral activity of JZ-1.Inflammasome activation and pyroptosis of VK2/E6E7 cells were analyzed using microscopy,Hoechst 33342/propidium iodide staining,lactate dehydrogenase release assay,gene and protein expression,coimmunoprecipitation,immunofluorescence,and enzyme-linked immunosorbent assay.Results:HSV-2 induced pyroptosis of VK2/E6E7 cells,with the most significant increase observed 24 h after the infection.JZ-1 effectively inhibited HSV-2(the 50%inhibitory concentration=1.709 mg/mL),with the 6.25 mg/mL dose showing the highest efficacy(95.76%).JZ-1(6.25 mg/mL)suppressed pyroptosis of VK2/E6E7 cells.It downregulated the inflammasome activation and pyroptosis via inhibiting the expression of nucleotide-binding oligomerization domain-like receptor family pyrin domaincontaining protein 3(P<0.001)and interferon-γ-inducible protein 16(P<0.001),and their interactions with apoptosis-associated speck-like protein containing a caspase recruitment domain,and reducing cleaved caspase-1 p20(P<0.01),gasdermin D-N(P<0.01),interleukin(IL)-1β(P<0.001),and IL-18 levels(P<0.001).Conclusion:JZ-1 exerts an excellent anti-HSV-2 effect in VK2/E6E7 cells,and it inhibits caspase-1-dependent pyroptosis induced by HSV-2 infection.These data enrich our understanding of the pathologic basis of HSV-2 infection and provide experimental evidence for the anti-HSV-2 activity of JZ-1.

Analysis on the key factors of allergic rhinitis treated with acupuncture and moxibustion

Allergic rhinitis(AR)is the frequently-encountered disease and commonly seen in clinic.Acupuncturemoxibustion therapy brings the significant therapeutic effects on it.In order to achieve the significant effects on AR,the relevant key factors should be determined definitely in treatment with acupuncturemoxibustion therapy.In the combination of the theoretic study with clinical practice,the authors expounded the key factors in acupuncture-moxibustion treatment for AR,including the identification of disease and syndrome of traditional Chinese medicine(TCM),the differentiation of meridians,acupoint selection,manipulation key factors and timing.Moreover,the authors proposed a new pointcut for the future clinical research,aiming to further optimize the therapeutic regimen of acupuncture and moxibusiton for AR.