[Progress in diagnosis and treatment of gangrenous cholecystitis]

Gangrenous cholecystitis is a kind of acute cholecystitis, whose course of disease progresses rapidly, early diagnosis is difficult and mortality is high, and clinicians are prone to misdiagnosis and missed diagnosis in clinical work.However, gangrenous cholecystitis has been ignored in various guidelines.This paper systematically summarized the pathogenesis, pathological manifestations, epidemiology, clinical diagnosis and treatment of gangrenous cholecystitis, hoping to provide a complete and clear diagnosis and treatment process for clinicians.

Impact of the Glycemic Level on the Salivary Proteome of Middle-Aged and Elderly People With Type 2 Diabetes Mellitus: An Observational Study

Type 2 diabetes mellitus (T2DM) is an increasing global public health concern, but its impact on the salivary proteome is still unclear. To evaluate the effect of glycemic levels in middle-aged and elderly individuals with T2DM on salivary proteomics, we compared the differences by liquid chromatography tandem mass spectrometry (LC–MS/MS). Unstimulated whole saliva samples from 8 T2DM patients with good glycemic control (G group, HbA1c <6.5%) and 16 patients with poor control (P group, HbA1c ≥6.5%) were analyzed by LC–MS/MS in the data-independent acquisition mode (Clinical register number: ChiCTR1900023582.). After functional annotation, cluster analysis and receiver operating characteristic (ROC) curve analysis were carried out to screen and evaluate candidate proteins. A total of 5,721 proteins were quantified, while 40 proteins differed significantly. In the P group, proteins involved in oxidative stress-related processes were upregulated, whereas proteins related to salivary secretion were downregulated. The combination of thioredoxin domain-containing protein 17, zymogen granule protein 16B, and FAM3 metabolism regulating signaling molecule D yielded an area under the curve of 0.917 which showed a robust ability to distinguish the P and G groups. In conclusion, poorly controlled hyperglycemia may affect salivary proteins through various pathways, including oxidative stress and glandular secretion. Furthermore, the differentially expressed proteins, especially the three proteins with the best differentiation, might serve as an anchor point for the further study of hyperglycemia and oral diseases.

[Progress in molecular mechanism of hepatolenticular degeneration induced by ATP7B gene mutation]

Hepatolenticular degeneration, also named Wilson disease, is an autosomal recessive genetic disease that characterized by copper metabolism disorder. WD mainly caused by the dysfunction of mutant ATP7B variants. This review summaries the mechanisms that different mutations affect the function of ATP7B, including inducing the mislocalization of mutant proteins, affecting the interactions between proteins or domains, regulating catalytic activity of ATP7B, and modifying the splicing of ATP7B gene. Further more, the genotype-phenotype correlation of a few mutations has been reviewed. Several mutations, such as p.R778L, are considered to be associated with more serious clinical symptoms, and the differences in environmental, diet, and lifestyle habits may also have effects on the susceptibility or the onset age of the patients. The research of the pathogenesis and clinical characterization of ATP7B gene mutations in the molecular level helps to deepen the understanding of WD, and suggests that personalized treatments should be used in future clinical practice.

[Progress in research of vaccination for patients with cancer]

Due to the tumor malignancy or immunosuppressive treatment, patients with cancer in general are more susceptible to vaccine-preventable infections. The types, timing, dose of vaccination or even the immunization program for them may differ from those for the normal persons. At present, it is recommended to use inactivated vaccines for patients with cancer rather than attenuated live vaccines, Vaccinations should be avoided during immunosuppressive therapy; patients with cancer should receive double dosage of hepatitis B vaccines and two doses of inactivated influenza vaccines yearly. This paper summarizes the progress in clinical trials of vaccination for cancer patients in foreign countries, and provide reference for the development and implementation of vaccination strategy for cancer patients in China.