Prediction of high-grade soft-tissue sarcoma using a combined intratumoural and peritumoural MRI-based radiomics nomogram.

AIM: To develop an intratumoural and peritumoural magnetic resonance imaging (MRI)-based radiomics nomogram for predicting tumour grade to improve clinical treatment and long-term prognosis. MATERIALS AND METHODS: MRI (3 T) features and T2-weighted imaging with fat-saturation (T2WI-FS)-based radiomics features of 57 patients with soft-tissue sarcoma (STS) were analysed retrospectively. Tumour size, ratio of width and length, relative depth to the peripheral fascia, peritumoural oedema, heterogeneity on T2WI, necrosis signal, enhancement model, and peritumoural enhancement were obtained. Independent risk factors were screened to construct an MRI feature nomogram. Radiomics features were obtained from intratumoural and peritumoural images on T2WI-FS. The optimal radiomics model was selected by the four-step dimensionality reduction method of minimum and maximum normalisation, optimal feature selection, selection based on support vector machine with L1-norm regularisation model, and iterative feature selection. MRI features and optimal radiomics features were used to construct a radiomics nomogram. The MRI feature nomogram model, the radiomics model, and the radiomics nomogram model were assessed by receiver operating characteristic (ROC) curves and calibration curves of the training and validation sets. RESULTS: Heterogeneity on T2WI and peritumoural enhancement were independent risk factors for predicting high-grade STS. The areas under the curves of the training set and verification set of the three models were as follows: MRI feature nomogram, 0.86 and 0.83, respectively; intratumoural and peritumoural combined radiomics model, 0.99 and 0.86, respectively; and radiomics nomogram model, 0.98 and 0.96, respectively. CONCLUSION: The radiomics nomogram model based on MRI features and combined intratumoural and peritumoural radiomic features was best able to predict high-grade STS.

[Clinical efficacy of femoral neck screw system combined with supported hollow screw in treatment of femoral neck fractures with posterometral comminution in young and middle-aged patients].

Objective: To investigate the clinical efficacy of dynamic cross screw system (FNS) for femoral neck fractures in young and middle-aged patients with posterior medial comminution. Methods: A retrospective cohort study. Clinical data of 197 young and middle-aged patients with femoral neck fractures accompanied by posterior medial comminution treated with closed reduction FNS and internal fixation with anti-rotation cannulated screws in Beijing Luhe Hospital, Beijing Jishuitan Hospital and Beijing Tongren Hospital from October 2019 to October 2021 were analyzed retrospectively. According to different surgical methods, the patients were divided into two groups. There were 102 patients in the FNS group, included 55 males and 47 females with a mean age of (40.49±19.79) years; and there were 95 patients in the FNS plus anti-rotation hollow screw group (combined group), included 51 males and 44 females with an average age of (40.03±18.82) years. All patients were followed-up for at least 1 year after surgery. The general clinical data, surgical conditions and Harris score of the hip joint at the last follow-up of the two groups were compared. And the clinical efficacy of the two surgical schemes were evaluated and compared. After surgery, routine X-ray and CT examinations were performed to evaluate the fracture reduction and internal fixation, and the shortening of the femoral neck on the affected side was compared to that of healthy side according to the Zlowodzki method. Results: At the last follow-up, the incidence of fracture reduction loss, screw resection and coxa vara in the combined group were all significantly lower than those in the FNS group [10 (10.5%) vs 28 (27.4%), 1 (1.0%) vs 7 (6.8%) and 9 (9.4%) vs 21 (20.5%), respectively, all P<0.05]. The incidence of nonunion and necrosis of the femoral head in the combined group were both lower than those in the FNS group, but there was no significant difference between two groups (both P>0.05). The postoperative mild, moderate and severe femoral neck shortening in the combined group were all lower than those in the FNS group, and the difference were not statistically significant (all P>0.05). At the last follow-up, the Harris score in the combined group was 84.60±2.08, and it was higher than that in the FNS group (79.57±4.31), but the difference was not statistically significant (P=0.403). Conclusion: FNS plus supporting hollow screw has a good clinical effect on femoral neck fractures in young and middle-aged adults with posterior medial comminution.

[Clinical value of plasma scaffold protein SEC16A in evaluating hepatitis B-related liver cirrhosis and hepatocellular carcinoma].

Objective: To investigate the clinical value of plasma scaffold protein SEC16A level and related models in the diagnosis of hepatitis B virus-related liver cirrhosis (HBV-LC) and hepatocellular carcinoma (HBV-HCC). Methods: Patients with HBV-LC and HBV-HCC and a healthy control group diagnosed by clinical, laboratory examination, imaging, and liver histopathology at the Third Hospital of Hebei Medical University between June 2017 and October 2021 were selected. Plasma SEC16A level was detected using an enzyme-linked immunosorbent assay (ELISA). Serum alpha-fetoprotein (AFP) was detected using an electrochemiluminescence instrument. SPSS 26.0 and MedCalc 15.0 statistical software were used to analyze the relationship between plasma SEC16A levels and the occurrence and development of liver cirrhosis and liver cancer. A sequential logistic regression model was used to analyze relevant factors. SEC16A was established through a joint diagnostic model. Receiver operating characteristic curve was used to evaluate the clinical efficacy of the model for liver cirrhosis and hepatocellular carcinoma diagnosis. Pearson correlation analysis was used to identify the influencing factors of novel diagnostic biomarkers. Results: A total of 60 cases of healthy controls, 60 cases of HBV-LC, and 52 cases of HBV-HCC were included. The average levels of plasma SEC16A were (7.41 ± 1.66) ng/ml, (10.26 ± 1.86) ng/ml, (12.79 ± 1.49) ng /ml, respectively, with P < 0.001. The sensitivity and specificity of SEC16A in the diagnosis of liver cirrhosis and hepatocellular carcinoma were 69.44% and 71.05%, and 89.36% and 88.89%, respectively. SEC16A, age, and AFP were independent risk factors for the occurrence of HBV-LC and HCC. SAA diagnostic cut-off values, sensitivity, and specificity were 26.21 and 31.46, 77.78% and 81.58%, and 87.23% and 97.22%, respectively. The sensitivity and specificity for HBV-HCC early diagnosis were 80.95% and 97.22%, respectively. Pearson correlation analysis showed that AFP level was positively correlated with alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBil), and γ-glutamyltransferase (GGT) with P < 0.01, while the serum SEC16A level was only slightly positively correlated with ALT and AST in the liver cirrhosis group (r = 0.268 and 0.260, respectively, P < 0.05). Conclusion: Plasma SEC16A can be used as a diagnostic marker for hepatitis B-related liver cirrhosis and hepatocellular carcinoma. SEC16A, combined with age and the AFP diagnostic model with SAA, can significantly improve the rate of HBV-LC and HBV-HCC early diagnosis. Additionally, its application is helpful for the diagnosis and differential diagnosis of the progression of HBV-related diseases.

[Real-world study on the efficacy and safety of first-line antiviral therapy for chronic hepatitis B].

Objective: To clarify the clinical efficacy of first-line oral antiviral drugs tenofovir alafenamide (TAF), tenofovir disoproxil fumarate (TDF), and entecavir (ETV) in the treatment of chronic hepatitis B (CHB) and their safety profiles with lipid, bone, and kidney metabolism. Methods: 458 CHB cases diagnosed and treated at the Department of Hepatology of Integrated Traditional Chinese and Western Medicine of the Third Hospital of Hebei Medical University from February 2010 to November 2022 were selected. TAF (175 cases), TDF (124 cases), and ETV (159 cases) were used as therapies. At 24 and 48 weeks, the virology, biochemical response, changes in liver stiffness measurement (LSM), and bone, kidney, and blood lipid metabolism safety profiles were compared and analyzed. Results: After 24 and 48 weeks of TAF, TDF, and ETV therapy, HBV DNA load decreased by 3.28, 2.69, and 3.14 log10 IU/ml and 3.28, 2.83, and 3.65 log10 IU/ml, respectively, compared with the baseline, and the differences between the three groups were statistically significant, P < 0.001. The complete virological response rates were 73.95%, 66.09%, 67.19%, and 82.22%, 72.48%, and 70.49%, respectively. The incidence rates of low-level viremia were 16.67%, 21.70%, and 23.08%, while poor response rates were 1.11%, 3.67%, and 4.10%. ALT normalization rates were 64.00%, 63.89%, 67.96%, and 85.33%, 80.56%, 78.64%, respectively, and there was no statistically significant difference among the groups. LSM was significantly improved in patients treated with TAF for 48 weeks, P = 0.022. Serum phosphorus level gradually decreased with the prolongation of TDF treatment. The TAF treatment group had a good safety profile for kidney, bone, and phosphorus metabolism, with no dyslipidemia or related occurrences of risk. Conclusion: There are some differences in the therapeutic effects of first-line anti-HBV drugs. TAF has the lowest incidence of low-level viremia after 48 weeks of treatment and has a good safety profile in kidney, bone, and blood lipid metabolism.

Long-term particulate matter 2.5 exposure and dementia: a systematic review and meta-analysis.

OBJECTIVES: This study aimed to analyse the existing evidence on the association between particulate matter 2.5 (PM2.5) and dementia, including two of its subtypes, namely, Alzheimer's disease (AD) and vascular dementia (VaD). STUDY DESIGN: This was a systematic review and meta-analysis. METHODS: The PubMed, EMBASE, Cochrane and Web of Science databases were comprehensively searched for articles published between January 1900 and June 2022. All cohort studies that reported the influence of long-term exposure to PM2.5 on dementia, together with its subtypes, in adults aged ≥40 years, without any regional restriction were included. A random effects model was used to pool the hazard ratios (HRs) of PM2.5 for dementia, AD and VaD. Funnel plots, sensitivity analyses and subgroup analyses were performed to test publication bias and result stability. In addition, an explanation for the heterogeneity of the results was suggested. RESULTS: In total, 20 articles were selected for review; 18 included results on the long-term effects of PM2.5 on dementia, 13 on AD, and eight on VaD. Three group meta-analyses were performed to obtain the HRs and 95% confidence intervals (CIs). The pooled HRs were 1.40 (95% CI 1.23, 1.60) for dementia, 1.47 (95% CI 1.22, 1.78) for AD and 2.00 (95% CI 1.30, 3.08) for VaD per 10.0 µg/m3 PM2.5 increase. CONCLUSIONS: Long-term exposure to PM2.5 may increase the risk of dementia, including AD and VaD. These results highlight the need for further study on the detrimental impact of PM2.5 and the importance of strategies to mitigate increasing air pollution.

Replacing true unenhanced imaging in renal carcinoma with virtual unenhanced images in dual-energy spectral CT: a feasibility study.

AIM: To investigate the clinical value of virtual unenhanced (VNC) spectral computed tomography (CT) images to replace the conventional true unenhanced spectral CT images (TNC) in diagnosing renal carcinoma. MATERIALS AND METHODS: Fifty-six cases of renal carcinoma confirmed by histopathology underwent conventional plain CT and contrast-enhanced spectral CT at arterial phase (AP) and venous phase (VP). VNC images were generated on an AW4.6 workstation. The CT attenuation, image noise, contrast-to-noise ratio (CNR), and signal-noise-ratio (SNR) of the renal lesions and normal kidneys, long and short axis diameters of the lesion were measured from the three image sets and analysed using one-way analysis of variance (ANOVA). Two radiologists evaluated image quality subjectively using a five-point score, and lesion signature using a three-point score. Image quality scores were compared statistically and tested for consistency. RESULTS: The two reviewers had good agreement for subjective evaluation (Kappa>0.70) and there was no difference in the quality of the scores among the three image groups. The lesion signature scores were all above the acceptable level. The CNR and SNR values in VNC were significantly higher than in TNC (p<0.05). VNC images had lower renal noise than in TNC (p<0.05). There was no difference in the long and short axis diameters of the lesion among the three image groups. VNC had higher CT attenuation values for the lesion and kidney than TNC (p<0.05), but the differences were <5 HU. CONCLUSION: VNC images in spectral CT may be used to replace the conventional plain CT to reduce imaging duration and radiation dose in diagnosing renal carcinoma.

[Multivariate analysis of varus after Oxford unicompartmental knee arthroplasty].

OBJECTIVE: To analyze the preoperative influencing factors of varus after Oxford unicompartmental knee arthroplasty. METHODS: A total of 660 patients (767 knees) undergoing Oxford unicompartmental knee arthroplasty in adult joint reconstruction surgery department of Beijing Jishuitan Hospital from January 2018 to December 2019 were retrospectively analyzed. Inclusive criteria: diagnosis was osteoarthritis, single compartment lesions in the medial side of the knee; preoperative flexion deformity was less than 10°, active range of motion was greater than 90°; preoperative X-ray full-length images of both lower limbs showed less than 15° varus (Noyes method); anterior cruciate ligament was well functioned, The cartilage of lateral compartment of knee joint was intact. EXCLUSION CRITERIA: combined with other inflammatory arthropathy; combined with extraarticular deformity; previous knee surgery history. The average age of the patients was (64.4±8.1) years, including 153 males and 497 females. The degree of post-operative varus was measured with Noyes method. The total patients were divided into varus group (Noyes≥3 °) and normal group (Noyes < 3 °). Gender, age, body mass index (BMI), range of motion (ROM), preoperative flexion deformity (FD), American Knee Society pain score (AKS) and American Knee Society function score (AKS function) were recorded. The standard anteroposterior and lateral X-ray films of knee joint and full-length lower extremity kinematic line films were taken by Sonialvision Safine Ⅱ (Shimadzu, Japan) multi-function digital tomography system. The image was measured by picture archiving and communication system (PACS). The following angles were measured preoperative Noyes angle, lateral distal femoral angle (LDFA), medial proximal tibial angle (MPTA) and joint line converge angle (JLCA) were measured and analyzed. RESULTS: Gender(P=0.346), operative side (P=0.619), age (P=0.746), BMI (P=0.142), preoperative ROM (P=0.102), preoperative knee pain score (P=0.131) and functional score (P=0.098) were not risk factors for postoperative varus. The influencing factors of postoperative varus were preoperative MPTA < 84 ° (P= 0.018, OR= 3.712, 95%CI: 1.250-11.027), preoperative Noyes > 5°(P=0.000, OR= 3.105, 95%CI: 1.835-5.254), preoperative FD > 5° (P= 0.001, OR=1.976, 95%CI: 1.326-3.234). Pre-operative LDFA (P=0.146) and preoperative JLCA (P= 0.709) had no significant effect on postoperative kinematic line. CONCLUSION: Patients with severe preoperative varus, especially those with varus deformity mainly from the tibial side, and those with preoperative flexion deformity are more prone to get varus lower extremity kinematic line after Oxford unicompartmental knee arthroplasty.

[Levels of human milk oligosaccharides in breast milk of mothers delivering preterm infants of different gestational ages and their effects on early growth and development].

Objective: To investigate the human milk oligosaccharides (HMOs) levels in breast milk of mothers delivering preterm infants and their effects on the early growth and development of infants. Methods: In this prospective cohort study, full-term and preterm newborns whose parents decided to breastfeed were recruited from Peking University Third Hospital between December 1, 2017 and November 30, 2018. The preterm infants were divided based on their gestational ages into extremely preterm (<28 weeks), very preterm (28-31+6 weeks) and moderate to late preterm (32-36+6 weeks) groups. Breast milk was collected from mothers at 7, 14, 28 and 120d postpartum. 368 breast milk samples were collected from 125 mothers in this study, including 54 mothers of full-term infants, 23 mothers of moderate to late preterm infants, 39 mothers of very preterm infants, and 9 mothers of extremely preterm infants. Ultra-performance liquid chromatography-mass spectrometer (UPLC-MS/MS) was used to determine the concentration of 2'-fucosyllactose (2'FL), 3-fucosyllactose (3FL), 3'-sialyllactose (3'SL), A-tetrasaccharide (P1), lacto-N-tetraose (LNT), lacto-N-neotetraose (LNnT), lacto-N-fucopentaose Ⅱ (LNFP-Ⅱ) and lacto-N-fucopentaose Ⅴ (LNFP-Ⅴ). Secretor status of mothers was defined as 2'-fucosyllactose (2'FL) concentration in colostrum and transitional milk greater than 200 µg/mL. Weight gain and the occurrence of allergic diseases of infants were collected at 120 d(4 months) postpartum. The chi-square test or the Fisher's exact test was used for the comparison of categorical data between groups; Kruskal-Wallis test and Wilcoxon rank sum test were used for comparison of continuous data between groups. Nemenyi test was used for multiple comparison. Results: 79.2% (99/125) of the mothers were secretor. There were no statistical differences between groups in the secretor status of mothers (χ²=1.31,P>0.05). The total concentration of HMOs peaked at 1-2 weeks postpartum. Compared to the preterm milk, the HMOs from the term milk was trending downwards at an earlier time. In the breast milk of secretor mothers on 28 d, total concentration of HMOs significant differed among the three groups of preterm milk and the term milk, with the median value of 4 587.09,4 615.25,5 277.44,5 476.03 µg/mL, respectively (Kruskal-Wallis χ²=8.1234,P=0.044). When analyzed by the median weight gain of the infants (low vs high weight gain) at 4 months postpartum, 2'FL was significantly lower in the high weight gain group at 7 d (1 818.04 µg/mL vs 2 181.67 µg/mL, W=1 386,P=0.018), while LNT & LNnT were significantly higher (1 182.36 µg/mL vs 1 053.62 µg/mL, W=816,P=0.044). The level of 3FL at 120 d was significantly affected by presence of allergic disease in infants, breast milk from mothers of infants with allergic disease had lower 3FL than those from mothers of infants without allergic disease (256.17 µg/mL vs 286.18 µg/mL, W=564,P=0.026). Conclusions: The overall profiles of HMOs in breast milk of mothers delivering preterm infants was basically the same as that of mothers delivering term infants; individual HMOs play a role in weight gain and the development of allergic diseases in preterm infants, but the mechanism is unclear and needs further study.

[A single center study on antimicrobial use and bacterial resistance in burn ward].

Objective: To investigate the effect of antibiotics on bacterial resistance through analyzing the use of common antibiotics and the bacterial prevalence in single-center burn ward. Methods: The epidemiological data of pathogenic bacteria and the use of common antibiotics in burn ward of Ruijin Hospital Affiliated to Shanghai Jiaotong University Medical College was investigated in the past 9 years. Bacteria samples were collected from the wounds, catheters, blood, feces, urine and sputum of inpatients in the unit from January 2010 to December 2018. The antibiotics use density was calculated by defined daily doses (DDDs)/(1 000 patient-days). Results: (1) In the proportion of bacteria detected, Staphylococcus aureus was the first and sensitive to glycopeptide antibiotics. Klebsiella pneumonia (19.8%), Pseudomonas aeruginosa (11.9%) and Acinetobacter baumannii (11.5%) were the top three Gram-negative bacteria in 2018; the proportion of Klebsiella pneumoniae was significantly increased (R(2)=0.861, P<0.001). (2) The Pseudomonas aeruginosa resistance rate to ceftazidime (R(2)=0.447, P=0.049) and ciprofloxacin (R(2)=0.663, P=0.008) increased significantly. The Klebsiella pneumoniae resistance rate to piperacillin (R(2)=0.999, P=0.018), meropenem (R(2)=0.999, P=0.023), ciprofloxacin (R(2)=1.000, P=0.010) increased significantly. There was no significant trend in the Acinetobacter baumannii resistance rate. (3) The use density of meropenem increased significantly (R(2)=0.492, P=0.035), and that of ciprofloxacin decreased significantly (R(2)=0.572, P=0.018). (4) Carbapenems use density was positively correlated with resistance rate of Klebsiella pneumoniae to cefoperazone sulbactam (r=0.733, P=0.025), piperacillin tazobactam (r=0.684, P=0.042), cefuroxime (r=0.821, P=0.023), ceftazidime (r=0.741, P=0.022), imipenem (r=0.718, P=0.029), meropenem (r=0.690, P=0.040), amikacin (r=0.750, P=0.020). (5) Ciprofloxacin use density was negatively correlated with the Pseudomonas aeruginosa resistance rate to ceftazidime (r=-0.751, P=0.020), Ciprofloxacin (r=-0.873, P=0.002) and with the Klebsiella pneumoniae resistance rate to cefuroxime (r=-0.767, P=0.044), ceftazidime (r=-0.712, P=0.031), imipenem (r=-0.780, P=0.013), meropenem (r=-0.793, P=0.011), ciprofloxacin (r=-0.871, P=0.002), Sulfamethoxazole/trimethoprim (r=-0.793, P=0.011). Conclusion: Carbapenems can induce Klebsiella pneumoniae to be multiple drug resistance; through the relationship between ciprofloxacin use intensity and drug resistance, the strategy of only restricting a certain antimicrobial agent may not restore the bacterial sensitivity.

Lipolysis defect in white adipose tissue and rapid weight regain.

Weight regain after weight loss is a well-described phenomenon in both humans and animal models of obesity. Reduced energy expenditure and increased caloric intake are considered the main drivers of weight regain. We hypothesized that adipose tissue with obesity memory (OM) has a tissue-autonomous lipolytic defect, allowing for increased efficiency of lipid storage. We utilized a mouse model of diet-induced obesity, which was subjected to 60% caloric restriction to achieve lean body weight, followed by a short period of high-fat diet (HFD) rechallenge. Age-matched lean mice fed HFD for the first time were used as the control group. Upon rechallenge with HFD, mice with OM had higher respiratory exchange ratios than lean mice with no OM despite comparable body weight, suggesting higher utilization of glucose over fatty acid oxidation. White adipose tissue explants with OM had comparable lipolytic response after caloric restriction; however, reduced functional lipolytic response to norepinephrine was noted as early as 5 days after rechallenge with HFD and was accompanied by reduction in hormone-sensitive lipase serine phosphorylation. The relative lipolytic defect was associated with increased expression of inflammatory genes and a decrease in adrenergic receptor genes, most notably Adrb3. Taken together, white adipose tissue of lean mice with OM shows increased sensitization to HFD compared with white adipose tissue with no OM, rendering it resistant to catecholamine-induced lipolysis. This relative lipolytic defect is tissue-autonomous and could play a role in the rapid weight regain observed after weight loss.

[Predictive value of typical cataplexy+ DQB1*0602 positive to hypocretin-1 reduction in cerebrospinal fluid in patients with narcolepsy].

Objective: To discusses the predictive value of typical cataplexy+ HLA-DQB1*0602 positive to hypocretin-1 (HCRT-1) reduction in cerebrospinal fluid (CSF) in patients with narcolepsy. Methods: A total of 165 narcoleptic patients, who were diagnosed at the Sleep Center of Peking University People's Hospital and Peking University International Hospital from March 2003 to March 2017, were recruited. The CSF HCRT-1 level and DQB1*0602 were measured in all the subjects. The narcoleptic patients were divided into two groups: typical cataplexy+ DQB1*0602 positive were CH group, and others who were not typical cataplexy and DQB1*0602 positive simultaneously were NCH group. The HCRT-1 level in CSF was declared to have a serious reduction when HCRT-1≤110 ng/L. According to this standard, the CH group and NCH group were subdivided into sub-groups and the data was analyzed to investigate the predictive value of typical cataplexy+ HLA-DQB1*0602 positive to HCRT-1 reduction. Results: There were 142 patients in CH group, including 137 patients with HCRT-1 reduction and 5 patients without. There were 23 patients in NCH group, including 15 patients with HCRT-1 reduction and 8 patients without. The positive predictive value of typical cataplexy+ DQB1*0602 positive for the reduction of HCRT-1 in CSF was 96.5%. Typical cataplexy+ DQB1*0602 positive had a good consistency with the HCRT-1 reduction in CSF (χ(2)=26.7, P<0.001). Conclusion: Typical cataplexy+ DQB1*0602 positive has a good predictive value to the HCRT-1 reduction in CSF in patients with narcolepsy.

[Impact of liver cancer deaths on life expectancy in 14 counties (districts) from the Huai River Basin, 2013: relationship between the water environment and liver cancer].

OBJECTIVE: To investigate the relationship between liver cancer and the water environment, we analyzed the life expectancy in 14 counties (districts), which form the Huai River Basin with respect to liver cancer deaths in 2013 and changes in the surface water quality from 2004 to 2010. METHODS: The study area included the 14 counties (districts) of the Huai River Basin in China. We obtained surveillance data for all causes of death in the study area during 2013, as well as data for International Classification of Diseases,Tenth Edition(ICD-10) code C22 or liver cancer. Life expectancy and life expectancy after elimination of liver cancer were then calculated. Based on water quality monitoring data from the China Environment Yearbook 2005-2011, we analyzed the water environment of the Huai River Basin, and changes in the water quality. According to the " Encyclopedia of Rivers and Lakes in China" (Huai River Basin section), we divided the river basin into five categories: upstream basin (upstream); midstream, north shore of the basin (midstream-north); midstream, south shore of the basin (midstream-south); downstream basin (downstream); and the Yishusi River Basin. To calculate the life expectancy and life expectancy after elimination of liver cancer in the study area, we used the Nemerow Pollution Index (NPI), to investigate the relationship between liver cancer and the water environment. RESULTS: Life expectancy in the 14 study districts varied from 68.99 years (Shenqiu County) to 78.85 years (Jinhu County). Gains in life expectancy after elimination of liver cancer varied from 0.86 to 0.31 years. Midstream-north showed the greatest improvement, with overall gain in life expectancy of 0.77 years; this gain was 1.04 years for males and 0.40 years for females. Yishusi River Basin showed the least improvement, with overall gain in life expectancy of 0.41 years; this gain was 0.54 years for males and 0.24 years for females. For the 7 years from 2004 to 2010, midstream-north had the highest annual NPI values, at 2.08, 1.74, 1.64, 1.81, 1.41, 1.26, and 1.06, respectively. There was a positive correlation between NPI and life expectancy gain for both males and females (r=0.64, P=0.014). There was positive correlation between NPI and life expectancy gain among males alone (r=0.64, P=0.014); there was no significant correlation between NPI and life expectancy gain among females (r=0.44, P=0.115). CONCLUSION: Liver cancer had a significant impact on life expectancy in the Huai River Basin. The gain in life expectancy was higher for males than for females. There is a possible relationship between liver cancer deaths and the water environment in the research area, but this study did not infer a causal association.

Isolation and characterization of polymorphic EST-SSR and genomic SSR markers in spotted mandarin fish (Siniperca scherzeri Steindachne).

Spotted mandarin fish (Siniperca scherzeri Steindachne) feed solely on live fry of other fish species once the fry start feeding in the wild. In the present study, 26 polymorphic transcriptome-derived simple sequence repeat (SSR) markers and 14 genomic SSR markers were developed and characterized in S. scherzeri Steindachne by combining a biotin-enrichment protocol and transcriptome of F1 interspecies hybrids between S. chuatsi (♀) and S. scherzeri (♂). These 40 polymorphic SSRs amplified 168 alleles (mean 4.2). The number of alleles, observed heterozygosity, expected heterozygosity, and polymorphic information content per locus were in the range of 2 to 7 (mean 4.3), 0.1111 to 1.000 (mean 0.6718), 0.3118 to 0.8276 (mean 0.6901), and 0.2735 to 0.7902 (mean 0.6298), respectively. Ten of these microsatellite loci deviated significantly from Hardy-Weinberg equilibrium (P < 0.00125) after Bonferroni correction for multiple tests and no significant linkage disequilibrium (P < 0.00006) was observed. The microsatellite markers characterized from S. scherzeri could be a valuable tool in genetic evaluation for conservation and for assessment of the mechanism associated with unique food preference of S. scherzeri from a genetic point of view.

Characterization of microsatellite markers and their correlations with growth traits in Mandarin fish (Siniperca chuatsi).

Mandarin fish (Siniperca chuatsi) is a traditionally cultured freshwater fish with high commercial value in China. To facilitate marker-assisted selection for genetic improvement of this species, 100 microsatellite markers identified in previous studies were characterized in the 25 largest and 25 smallest individuals. Twenty polymorphic loci were used to genotype 200 individuals, and the associations between their genotypes and growth traits were examined. We found that 9 genotypes at 8 loci (SC-10, Sin 135, Sin 166, AP 34-23, AP 38-11, AP 37-22, AP 37-08, and AP 37-37) were positively correlated with growth traits (body weight, body length, body height) in the mandarin fish population. The average of observed and expected heterozygosities were 0.71 and 0.59, respectively, and the average polymorphism information content value was 0.54, indicating that the population had high genetic diversity. The markers developed in this study are useful for selection of genetic breeding in this species and its related species.

Microsatellite DNA markers and their correlation with growth traits in mandarin fish (Siniperca chuatsi).

The mandarin fish (Siniperca chuatsi) is a traditionally cultured freshwater fish with high commercial value in China. To facilitate marker-assisted selection in genetic improvement of this species, 120 microsatellite markers from the literature were characterized in the 25 largest and 25 smallest individuals. Eighteen polymorphic loci were then used to genotype 200 individuals, and the associations between their genotypes and growth traits were examined. We found that eight genotypes of six loci (AP 37-06, AP 37-11, AP 37-16, AP 37-48, AP 38-32, and AP 39-05) were positively correlated with growth traits (body weight, length, and height) in the mandarin fish population. The average observed and expected heterozygosities were 0.68 and 0.59, respectively, and the average PIC value was 0.50, indicating a population with high genetic diversity. Therefore, these markers could be useful for assisted selection in genetic breeding of this species and its related species.

[Assessment of quality of life after multiple arthroplasty].

OBJECTIVE: To evaluate the effectiveness of conducting multiple arthroplasty to treat multiple joints disease in terms of quality of life (QOL) and function improvement. METHODS: We compared our results with the reported results of single and dual arthroplasty to see if there is any improvement in QOL, functional scores or complications. In this study, 13 patients admitted to Department of Adult Reconstructive Surgery, Beijing Jishuitan hospital from 2005 to 2009 were included. Questionnaires SF-36 were used to evaluate the QOL. Harris hip score, American Knee Society Score (KSS) were used to evaluate the joint function. The patients were evaluated before surgery to the latest follow up. RESULTS: SF-36 has changed as follow: physical function 4.17 ± 14.43 → 65.83 ± 24.76, role physical 25.00 ± 26.11 → 60.42 ± 45.8, bodily pain 23.83 ± 21.41 → 76.88 ± 20.89, general health 53.33 ± 33.87 → 76.67 ± 14.67, vitality 50.42 ± 17.25 → 71.67 ± 16.28, social functioning 29.17 ± 33.50 → 73.96 ± 33.90, role emotional 22.08 ± 35.61 → 77.77 ± 41.03, mental health 53.33 ± 25.70 → 82.67 ± 14.41, which indicated that they all improved greatly after the surgery (P < 0.05). Harris score increased from 37.68 ± 14.71 before the surgery to 83.36 ± 13.54 after the surgery. KSS has also showed sharp improvement (P < 0.001) in both clinical score (42.52 ± 23.83 → 77.74 ± 20.67) and function score (-2.61 ± 22.56 → 65.65 ± 30.76). CONCLUSION: Multiple arthroplasty is one of the most effective methods which can markedly improve the quality of life in patients with multiple joints disease. But complications are common and joint functions are relatively poor.

Role of cathepsin B in regulating migration and invasion of fibroblast-like synoviocytes into inflamed tissue from patients with rheumatoid arthritis.

Cathepsin B (CB), an important proteinase that participates in joint destruction in rheumatoid arthritis (RA), exhibits higher expression in fibroblast-like synoviocyte (FLS) of abnormal proliferative synovial tissues. Whether and how it affects the biological behaviours of RA-FLS, such as migration and invasion, are poorly understood. In the present study, CB expression in synovial tissues of patients with RA and ostearthritis (OA) were measured by quantitative polymerase chain reaction (qPCR) and immunohistochemistry (IHC), respectively. Stable depletion of endogenous CB was achieved by small interfering RNA (siRNA) transfection, and decrease of CB activity was acquired by using its specific inhibitor (CA074Me). The effects of CA074Me and RNA interference (RNAi) treatments on proliferation, migration, invasion, matrix metalloproteinase (MMP)-2/-9 expression, focal adhesion kinase (FAK) activation, and mitogen-activated protein kinases (MAPKs) phosphorylation of FLS were analysed. In RA synovial tissues, CB was expressed at elevated levels compared with OA synovial tissues. CA074Me could inhibit invasion of FLS obtained from RA patients in an ex-vivo invasion model. CA074Me and siRNA treatments suppressed the migration and invasion of FLS, reduced the activity, expression and mRNA level of MMP-2, restrained the activation of FAK and reduced the expression of F-actin. Moreover, CA074Me decreased the phosphorylation of P38 MAPK and c-Jun N-terminal kinase (JNK) in FLS, while siCB treatment reduced the phosphorylation of P38 but not JNK. CB substantially contributes to the invasive phenotype of FLS that leads to joint destruction in RA. This proteinase may show promise as a therapeutic target in inflammatory arthritis.

Clinical characteristics and therapy exploration of active human cytomegalovirus infection in 105 lupus patients.

Systemic lupus erythematosus (SLE) has protean clinical manifestations of varying severity over the course of its onset, exacerbation, remission and flare that could often pose significant challenges for clinicians in their decision making as to whether to treat aggressively or to look for concurrent conditions such as infection with opportunistic pathogens. Human cytomegalovirus (HCMV) is one of those pathogens and is frequently encountered in our daily management of lupus patients. To investigate the clinical characteristics and therapeutic options of active HCMV infection in patients with SLE, we retrospectively reviewed clinical data of 105 inpatients in our department of Rheumatology and Clinical Immunology of Peking Union Medical College Hospital (PUMCH) diagnosed with both SLE and active HCMV infection from January 2006 to January 2012. Three groups were designated that included 42 cases of HCMV triggering SLE, 31 cases of HCMV exacerbating SLE, and 32 cases of HCMV mimicking SLE flare based on the relationship of HCMV infection and SLE. 1) Hematocytopenia (81%), fever (73.3%) and liver dysfunction (54.3%) were the most common clinical manifestations. The differences among the three groups with regard to butterfly erythema, cutaneous vasculitis, arthritis, serositis, central nervous system involvement and renal involvement were statistically significant (p < 0.05). 2) Positive rate of HCMV-pp65, compared with HCMV-IgM and HCMV-DNA, was the highest (84.9%) in patients with SLE and active HCMV infection. 3) Following 14-21 days of inductive treatment with ganciclovir, a total of 26 out of 56 patients were still positive with HCMV-IgM (nine of 19, 47.6%) and pp65 (17/37, 45.9%). Among them, seven cases suffered HCMV relapses in three months with six cases of sustained HCMV-pp65 antigenemia. In conclusion, hematocytopenia, fever and liver dysfunction should remind us to consider HCMV infection. Butterfly erythema, cutaneous vasculitis, arthritis, serositis, central nervous system involvement and renal lesion were relatively characteristic symptoms of lupus activity. HCMV-pp65 is a sensitive indicator to guide antiviral therapy. Induction therapy using ganciclovir with a duration of 14∼21 days is not sufficient, and continued HCMV-pp65 positivity may require prolonged antiviral treatment in lupus patients.

New microsatellite loci for the mandarin fish Siniperca chuatsi and their application in population genetic analysis.

The mandarin fish is a popular fresh water food fish in China. Fifty-three polymorphic microsatellite markers were isolated through construction of an enriched library of genomic DNA of Siniperca chuatsi (Percichthyidae). We found 2 to 7 alleles per locus. The observed and expected heterozygosity values varied from 0.059 to 1.000 and from 0.305 to 0.818, respectively. The polymorphic information content value varied from 0.255 to 0.782. Twelve microsatellite loci deviated significantly from Hardy-Weinberg equilibrium after Bonferroni's correction. These markers were evaluated in five species of sinipercine fish; 98% of the 265 locus/taxon combinations tested gave cross-amplification. Eight polymorphic microsatellite markers were randomly selected for genetic characterization of three S. chuatsi populations. The Ganjiang River and Yuanjiang River populations had moderate levels of genetic diversity, while the Mudanjiang River population had a relatively low level genetic diversity. Genetic distance-based cluster analysis showed clustering of the Ganjiang River and Yuanjiang River populations in a single group and the Mudanjiang River population in a separate group. Based on these results, we suggest that S. chuatsi from the Yangtze River watershed are distinct from the Mudanjiang River population. These SSR markers will be useful for diversity, mapping and marker assisted studies of S. chuatsi and other sinipercine fishes.