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Purpose: To establish a precise diagnostic method for serosal invasion in gastric cancer (GC) during surgery using therapeutic measures, and facilitate quick decision-making. Methods: A total of 19 GC patients treated in the department of gastrointestinal surgery of Fujian Provincial Hospital between April 2019 and December 2020 were enrolled. An electronic gastroscopy with a magnifying endoscope with narrow-band imaging was used to photograph the serosal surface of the GC lesion site and the normal gastric wall around the lesion during surgery. The endoscopic diagnosis was confirmed on the basis of the microvascular phenotype of the serosal surface and validated by comparison with the pathological diagnosis. Results: Under the specific endoscopy, serosal invasion, including subserosal tissue invasion and serosal layer invasion, was diagnosed by observing the capillary morphology change, and capillary diameter and density increase. According to the pathological diagnosis, the accuracy of serosal invasion diagnosis was 94.7%, the sensitivity was 100%, the specificity was 75%, the positive predictive value was 93.8%, and the negative predictive value was 100%. To further distinguish the subserosal tissue invasion and serosal layer invasion, the magnifying endoscope with narrow-band imaging possessed a 78.9% accuracy by distinguishing irregular changes in microvessels. Conclusions: Magnifying endoscope with narrow-band imaging is less time-consuming than pathological diagnosis. Intraoperative diagnosis using microvascular observation can accurately detect serosal invasion. It is of value for the intraoperative diagnosis in GC patients.

Background: Treatment for adult patients with refractory idiopathic membranous nephropathy (RIMN) by conventional immunosuppressive regimens is not satisfactory. This study aims to evaluate the effectiveness of Chinese herbal medicine, Shulifenxiao formula, as a promising regimen. Methods: A total of 31 RIMN patients resistant to corticosteroid or immunosuppressive agents were retrospectively analyzed. Shulifenxiao treatment lasted a minimum of 12°months in all patients and extended to 24°months in 11 patients. The primary outcomes [the complete remission (CR) and partial remission (PR)] and secondary outcomes (the serum creatinine and estimated glomerular filtration rate (eGFR) levels) were measured at 6, 12, 18, and 24°months. Results: The data provided an average follow-up of 21 ± 9.16°months from baseline. The remission was attained in 25/31 patients (80.7%: CR 29.0% and PR 51.6%) at 12°months and in 10/11 patients (90.9%: CR 54.6% and PR 36.4%) at 24°months, respectively. Proteinuria reduced from 6.02 g/d at baseline to 0.98 g/d at 12°months ( p < 0.001) and to 0.27 g/d at 24°months ( p = 0.003); serum albumin increased from 28 g/L to 37.2 g/L at 12°months ( p < 0.001) and to 41.3 g/L at 24°months ( p = 0.003); eGFR improved from 100.25 ml/min/1.73 m 2 to 118.39 ml/min/1.73 m 2 at 6°months ( p < 0.001) and finally to 111.62 ml/min/1.73 m 2 at 24°months ( p = 0.008). Only two patients developed subsequent relapse. Conclusion: Shulifenxiao formula as a clinical cocktail therapy serves as an alternative therapeutic option for steroid and immunosuppressant-resistant RIMN patients, with a favourable safety profile, though further studies are warranted. Clinical Trial registration: http://www.chictr.org.cn, Chinese Clinical Trials Registry [ChiCTR1800019351]., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Cui, Fu, Liu, Liu and Liu.)

Massa Medicata Fermentata (MMF) has been used for a long time by the Chinese. MMF is used widely in feed additives and human medicinal applications throughout the world; however, there have only been a few reports about the biostudy of its fermentation mechanism and medicinal ingredients. To safely use MMF, we observed the changes in the ingredients and amylase activity for several raw materials during the fermentation process of MMF. We are going to explore the basis of pharmacodynamic substances and the purpose of MMF to provide support for safe use in clinics. This biostudy data demonstrated that the ingredients such as amygdalin, benzaldehyde, and rutin were gradually degraded during the process of fermentation, and the fermented MMF did not contain amygdalin and benzaldehyde. The HPLC fingerprint of fermented MMF for 7 days is similar to the chemical composition of the original unfermented MMF with a similarity of only 0.106. Meanwhile, the activities of amylase in fermented MMF had gradually increased, and the content of organic acids also had increased. According to our biostudy, we found that the raw material chemical composition of MMF in the process of fermentation was affected by microorganisms and various substances. The conclusions of our study determined that the initial components of MMF are not identical to the pharmacodynamic components. We also conclude that amylase activity explains the pharmacological activity of MMF to a certain extent, but it is likely not the only factor. The implication not only provides the initial knowledge of MMF but also implies the further exploration of this popular traditional medicine., Competing Interests: The authors declare no competing financial interest., (Copyright © 2020 American Chemical Society.)

Main Conclusion: Our study demonstrated that CMV resistance was upregulated by brassinosteroids (BRs) treatment, and BR signaling was needed for this BRs-induced CMV tolerance. Plant steroid hormones, brassinosteroids (BRs), play essential roles in variety of plant developmental processes and adaptation to various biotic and abiotic stresses. BR signal through plasma membrane-localized receptor and other components to modulate several transcription factors that modulate thousands of target genes including certain stress-responsive genes. To study the effects of BRs on plant virus defense and how BRs induce plant virus stress tolerance, we manipulated the BRs levels in Arabidopsis thaliana and found that BRs levels were positively correlated with the tolerance to Cucumber mosaic virus (CMV). We also showed that BRs treatment alleviated photosystem damage, enhanced antioxidant enzymes activity and induced defense-associated genes expression under CMV stress in Arabidopsis. To see whether BR signaling is essential for the plant virus defense response, we made use of BR signaling mutants (a weak allele of the BRs receptor mutant bri1-5 and constitutive BRs response mutant bes1-D). Compared with wild-type Arabidopsis plants, bri1-5 displayed reversed tolerance to CMV, but the resistance was enhanced in bes1-D. Together our results suggest that BRs can induce plant virus defense response through BR signaling.

This study focuses on the impacts of service quality and examines the mediating effects of customer satisfaction and customer loyalty on willingness to pay more. The authors collected survey data from 479 actual retail pharmacy customers in China and used the structural equation modeling approach to test the hypotheses. The results reveal six dimensions of service quality and the differential impact of these dimensions on customer satisfaction and behavioral intentions. This study contributes to the existing literature by exploring the dimensionality of the service quality construct and mediating effects of customer satisfaction and customer loyalty in a non-Western setting.

B7-H3, a member of the B7 family of molecules, is expressed in certain types of human cancer and is important in tumor development and progression. Although several studies have reported that the expression of B7-H3 is correlated with poor outcomes in patients with cancer, its exact role in cancer remains unknown. In the present study, the expression levels of B7-H3 in the pathological specimens of 105 patients treated for non-small cell lung cancer (NSCLC) were examined by immunohistochemistry. A high expression level of B7-H3 was observed in 46.9% of the 105 NSCLC tissue specimens. These patients demonstrated a more advanced tumor grade and a shorter survival time. In addition, we also examined the levels of tumor-associated macrophages (TAMs) in NSCLC tissues and observed that the levels were positively correlated with the expression of B7-H3, and that higher levels of macrophages were associated with lower levels of infiltrating T cells and a shorter survival time. These results demonstrated that TAMs are important in the evasion of tumor immune surveillance in NSCLC. Furthermore, through knockdown of B7-H3 by RNA interference, we observed that soluble B7-H3 was capable of inducing macrophages to express higher levels of macrophage mannose receptor (MMR) and lower levels of human leukocyte antigen (HLA)-DR, as well as higher levels of interleukin-10 (IL-10) and lower levels of IL-1β in vitro. These observations are characteristic of an anti-inflammatory/reparatory (alternative/M2) phenotype. Therefore, our data suggests that B7-H3 proteins are involved in the progression of NSCLC by inducing the development of monocytes into anti-inflammatory cells.

Trem-like transcript 2 (TLT-2), one of the TREM family members, which is expressed on B cells, T cells, and macrophages, plays a critical role in immune response mechanism. In this study, two novel mouse anti-human TLT-2 monoclonal antibodies (MAbs) were prepared using hybridoma technology and their immunological characteristics were determined. The results showed that the two MAbs (clones 10F5 and 8C10) were both IgG1 (κ) and bound specifically to human TLT-2. Furthermore, 10F5 and 8C10 seemed to recognize a different site (epitope) of TLT-2 by competition assay. MAb 10F5 was proven in Western blot analysis to specifically bind to denatured TLT-2 protein while both MAbs were proven in dot blot analyses and immunofluorescence to specifically bind to natural TLT-2 protein. In addition, crosslinking of TLT-2 with MAb 8C10 markedly blocked TLT-2 positive signal and T cell proliferation. Taken together, these two monoclonal antibodies might be of great value as tools for further exploration of the expression and function of TLT-2.

Aim: To explore the mechanisms by which splicing factor SC35 regulates the costimulatory molecule B7-H3 expression in vitro through bioinformatic and molecular biological methods., Methods: We screened some regulatory proteins which might take part in regulating B7-H3 expression using bioinformatic methods. Then RNA interference (RNAi) and real-time PCR were performed to test if these proteins took part in the regulation., Results: Splicing factor SC35, SRP40 and SF50 might play an important role in the regulation of B7-H3 expression. In PHA-activated T cells, B7-H3 was upregulated obviously and at the same time SC35 was also upregulated. When we suppressed SC35 expression using RNAi, we found B7-H3 was also downregulated., Conclusion: Splicing factor SC35 might take part in the regulation of B7-H3 expression, which could help understand B7-H3 biological function.

Aim: To obtain mouse B7-H3-Fc fusion protein and to investigate its biological function and effects on T lymphocyte activation., Methods: The genes coding extracellular domain of mouse B7-H3 and the Fc fragment of human IgG1 were amplified from pMD19-T/mouse B7-H3 and pMD19-T/human IgG1 vectors by PCR. The two genes were combined with mouse B7-H3-Fc fragment by overlap PCR. Then the resulting gene fragment was inserted into eukaryotic vector pIRES2-EGFP after digested with EcoR I and Bgl II to construct the recombinant vector pIRES2-EGFP/B7-H3-Fc. The recombinant vector was transfected into CHO cells with LipfectAMINE™ 2000, and the cells were further selected with G418. The collected supernatant of the transfected cell line cultured in serum-free media was ultrafiltrated and concentrated, then purified by Protein G column. The expression of mouse B7-H3-Fc fusion protein was confirmed by Western blot. Effects of fusion protein on T cells proliferation and cytokine production in vitro was studied by methods of CCK8 and ELISA., Results: The results showed that the transfected CHO cell line secreting mouse B7-H3-Fc fusion protein was constructed successfully. In vitro, mouse B7-H3-Fc fusion protein obviously promoted the proliferation of T cells in a dose-dependent manner., Conclusion: A transfected CHO cell line stably expressing mouse B7-H3-Fc fusion protein has been obtained and the B7-H3-Fc fusion protein stimulates the proliferation of T cells and cytokines production in vitro.

We investigated the temporal and spatial changes in cell division, endoreduplication and expression of cell cycle-related genes in developing cucumber fruits at 0-20 days after anthesis (DAA). Cell division was intense at 0-4 DAA and then decreased until to 8 DAA. Meanwhile, endoreduplication started at 4 DAA and increased gradually to 20 DAA, accompanied by an increase in fruit weight. Cell division was mainly observed in the exocarp, while endoreduplication occurred mostly in the endocarp and pulp. Among the six cell cycle-related genes examined, two mitotic cyclin genes (CycA and CycB) and CDKB had the highest transcript levels within 2 DAA, while transcripts of two CycD3 genes and CDKA peaked at 4 DAA and 20 DAA, respectively. Naphthaleneacetic acid (NAA), N-(2-chloro-4-pyridyl)-N'-phenylurea (CPPU) and 24-epibrassinolide (EBR) all induced parthenocarpic growth as well as active cell division, and enhanced transcripts of cell cycle-related genes. In comparison, gibberellic acid (GA(3)) had little effect on the induction of parthenocarpy and transcripts of cell cycle-related genes. These results provide evidence for the important roles of cell division and endoreduplication during cucumber fruit development, and suggest the essential roles of cell cycle-related genes and plant growth substances in fruit development.

Brassinosteroids (BRs) are essential for many biological processes in plants, however, little is known about their roles in early fruit development. To address this, BR levels were manipulated through the application of exogenous BRs (24-epibrassinolide, EBR) or a BR biosynthesis inhibitor (brassinazole, Brz) and their effects on early fruit development, cell division, and expression of cyclin and cyclin-dependent kinases (CDKs) genes were examined in two cucumber cultivars that differ in parthenocarpic capacity. The application of EBR induced parthenocarpic growth accompanied by active cell division in Jinchun No. 4, a cultivar without parthenocarpic capacity, whereas Brz treatment inhibited fruit set and, subsequently, fruit growth in Jinchun No. 2, a cultivar with natural parthenocarpic capacity, and this inhibitory effect could be rescued by the application of EBR. RT-PCR analysis showed both pollination and EBR induced expression of cell cycle-related genes (CycA, CycB, CycD3;1, CycD3;2, and CDKB) after anthesis. cDNA sequences for CsCycD3;1 and CsCycD3;2 were isolated through PCR amplification. Both CsCycD3;1 and CsCycD3;2 transcripts were up-regulated by EBR treatment and pollination but strongly repressed by Brz treatment. Meanwhile, BR6ox1 and SMT transcripts, two genes involved in BR synthesis, exhibited feedback regulation. These results strongly suggest that BRs play an important role during early fruit development in cucumber.