Comprehensive Analysis of Immune Cell Infiltration and M2-Like Macrophage Biomarker Expression Patterns in Atrial Fibrillation.

Background: Macrophages play a crucial role in the progression of AF, closely linked to atrial inflammation and myocardial fibrosis. However, the functions and molecular mechanisms of different phenotypic macrophages in AF are not well understood. This study aims to analyze the infiltration characteristics of atrial immune cells in AF patients and further explore the role and molecular expression patterns of M2 macrophage-related genes in AF. Methods: This study integrates single-cell and large-scale sequencing data to analyze immune cell infiltration and molecular characterization of the LAA in patients with AF, using SR as a control group. CIBERSORT assesses immune cell types in LAA tissues; WGCNA identifies signature genes; cell clustering analyzes cell types and subpopulations; cell communication explores macrophage interactions; hdWGCNA identifies M2 macrophage gene modules in AF. AF biomarkers are identified using LASSO and Random Forest, validated with ROC curves and RT-qPCR. Potential molecular mechanisms are inferred through TF-miRNA-mRNA networks and single-gene enrichment analyses. Results: Myeloid cell subsets varied considerably between the AF and SR groups, with a significant increase in M2 macrophages in the AF group. Signals of inflammation and matrix remodeling were observed in AF. M2 macrophage-related genes IGF1, PDK4, RAB13, and TMEM176B were identified as AF biomarkers, with RAB13 and TMEM176B being novel markers. A TF-miRNA-mRNA network was constructed using target genes, which are enriched in the PPAR signaling pathway and fatty acid metabolism. Conclusion: Over infiltration of M2 macrophages may be an important factor in the progression of AF. The M2 macrophage-related genes IGF1, RAB13, TMEM176B and PDK4 may regulate the progression of AF through the PPAR signaling pathway and fatty acid metabolism.

The incidence of and risk factors for inadequate bowel preparation in elderly patients: A prospective observational study.

Background/Aim: : We conducted a prospective observational study to identify the incidence of and risk factors for inadequate bowel preparation in elderly Chinese patients. Patients and Methods: We enrolled 240 outpatients over 60 years of age scheduled for elective colonoscopy at our university hospital between November 2016 and April 2017. We recorded patient demographics, bowel preparation data, and clinical characteristics. Factors associated with inadequate bowel preparation were identified by multivariate logistical regression analysis. Results: The rate of inadequate bowel preparation was 34.6%. Factors associated with inadequate bowel preparation were a history of abdominal surgery (OR, 2.617; CI, 1.324-5.174; P = 0.006), chronic constipation (OR, 3.307; CI, 1.551-7.054; P = 0.002), non-compliance with dietary instructions (OR, 2.239; CI, 1.122-4.471; P = 0.022), non-compliance with polyethylene glycol (PEG) dosage (OR, 4.576; CI, 1.855-11.287; P = 0.001), walking <30 minutes during preparation (OR, 2.474; CI, 1.261-4.855; P = 0.008), interval between PEG ingestion and the onset of bowel activity (OR, 1.025; CI, 1.010-1.040; P = 0.001), and a last stool that was not clear and watery (OR, 4.191; CI, 1.529-11.485; P = 0.005). Conclusion: The incidence of adequate bowel preparation in elderly patients is not optimal. Walking <30 minutes during the PEG ingestion period may be a surrogate for bowel preparation failure. Future studies should identify elderly patients at risk for poor bowel preparation and develop interventions to improve outcomes in this population.

Schistosoma japonicum scFv-IL18 fusion DNA ameliorates hepatic fibrosis in schistosomiasis-infected mice via improving local concentration of IL-18 in liver.

The pathogenesis of chronic schistosomiasis is caused by irritation of the schistosome eggs trapped in liver that induce delayed hypersensitive reactions from the surrounding tissues, leading to the formation of inflammatory granuloma and subsequent fibrosis. A Schistosoma japonicum (S. japonicum) single-chain fragment variable (SjscFv) which specifically binds to the S. japonicum soluble immature egg antigen (SIEA) can be used as a target to deliver specific cytokine towards the site of hepatic fibrosis. To test this hypothesis, a novel recombinant plasmid, pVAX1/SjscFv-IL18, was constructed by fusing SjscFv to IL-18 gene with a 45bp glycine-rich linker. Furthermore, experiments on mice showed that pVAX1/SjscFv-IL18 could effectively express IL-18 in the liver and in serum. Hepatic contents of IL-2 and IFN-γ (Th1-type) in S. japonicum-infected mice vaccinated with pVAX1/SjscFv-IL18 increased significantly but those of their IL-4 and IL-10 (Th2-type) decreased as compared to the analyzed results of 4 cytokines in the liver cells of control mice vccinated with pVAX1/IL18. Consistent with the levels of Th1 and Th2 cytokines, mice vaccinated with pVAX1/SjscFv-IL18 developed much less hepatic fibrosis 20weeks after infection, which was evaluated by average volumn of granuloma and collagen contents. These data suggested that the linkage of IL-18 to the target-specific SjscFv molecule appears to be a potentially promising trial route of therapy, the hepatic fibrosis in S. japonicum-infected mice may be ameliorated through effective expression of IL18 in liver.

Characterization and vaccination of two novel Schistosoma japonicum genes screened from a cercaria cDNA library.

Two novel genes, SJCWL05 and SJCWL06, were harvested from screening of Schistosoma japonicum (S. japonicum) cercaria cDNA library by using pig sera vaccinated (VPS) with S. japonicum immature egg ws-vaccine (S. japonicum iEw). Prokaryotic recombinant plasmids pGEX-4T-1/SJCWL05 and pGEX-4T-1/SJCWL06 were constructed to analyze their immunogenicity, which was confirmed by SDS-PAGE and Western blotting. Two eukaryotic recombinant plasmids, pcDNA3/SJCWL05 and pcDNA3/SJCWL06, were constructed, and their ability to protect mice against challenge of S. japonicum was evaluated. All mice vaccinated with pcDNA3/SJCWL05 or pcDNA3/SJCWL06 developed ELISA-specific anti-S. japonicum SIEA (S. japonicum soluble immature egg antigens) antibody. Immunoprotection experiments showed that worms and liver eggs reduced 34.64% and 39.14% in the pcDNA3/SJCWL05 group and those reduced 27.17% and 27.95% in the pcDNA3/SJCWL06 group, respectively. The reduction rates of intestine and uterine eggs in female worms of both groups reached 39.45% and 38.5% as well as 30.02% and 28.7%, respectively. Results of our study suggest that novel genes, SJCWL05 and SJCWL06, are potential vaccine candidates against schistosomiasis japonica.