The Exploration of Glymphatic System Alteration in Pediatric Acute Lymphoblastic Leukemia Using DTI-ALPS Method / 中山大学学报(医学科学版)

ObjectiveThe glymphatic system regulates cerebral spinal fluid and interstitial fluid transport which might be one of the pathways of central nervous system （CNS） leukemia at the early stage. This study aimed to investigate the alteration of glymphatic system based on diffusion tensor image-analysis along the perivascular space （DTI-ALPS） in pediatric acute lymphoblastic leukemia （ALL） without clinically diagnosed CNS infiltration. MethodsTwenty-five ALL and typically developing （TD） children were prospectively recruited， and all subjects underwent DTI. Group differences in brain water diffusivities and ALPS-index were evaluated using the analysis of covariance. The Spearman correlation analysis was used to evaluate the relationship between biological characteristics and significant parameters in pediatric ALL. ResultsCompared with TDs， decreased Dxassoc value （PFDR-corrected = 0.048） and increased Dzassoc value （PFDR-corrected = 0.033） were found in pediatric ALL. Hence， lower ALPS-index was found in children with ALL （PFDR-corrected < 0.001）. ALPS-index was negatively associated with the risk classification （rs = -0.47， P = 0.018） as well as immunophenotype （rs = -0.40， P = 0.046） in pediatric ALL. ConclusionsOur results show dysfunction of the glymphatic system is presented in pediatric ALL without clinically diagnosed CNS infiltration， which suggests that the glymphatic system might be one of pathway in the early-stage of ALL CNS infiltration. The DTI-ALPS method can be used to evaluate the change of glymphatic system， providing a new method for exploring the underlying mechanisms and early detection of pediatric ALL CNS infiltration.

Pathological features and immune microenvironment in HER-2 intratumoral heterogeneous breast cancers / 中华肿瘤杂志

Objective: To observe the clinical pathology features, and immune microenvironment of HER-2 intratumoral heterogeneity breast cancer. Methods: Thirty cases of HER-2 intratumoral heterogeneous breast cancer were retrospectively analyzed in Tianjin Medical University Cancer Institute and Hospital from November 2017 to June 2020. HER-2 expression was detected by immunohistochemistry and verified by dual color silver-enhanced in-situ hybridization (D-SISH). HER-2 intratumoral positive and negative regions were divided. The pathological characteristics, subtype, and the level of tumor infiltrating lymphocytes (TILs) and the expression of programmed cell death-ligand 1 (PD-L1) were evaluated respectively. Results: The proportion of HER-2 positive cells of the breast cancer ranged from 10% to 90%. The pathological type was mainly invasive non-special typecarcinoma. Six cases presented different pathological types between HER-2 positive and negative regions. The HER-2-positive areas included 2 cases of carcinoma with apocrine differentiation, and the negative areas included 2 cases of invasive micropapillary carcinoma, 1 case of invasive papillary carcinoma, and 1 case of carcinoma with apocrine differentiation. In HER-2 positive regions, 17 cases were Luminal B and 13 cases were HER-2 overexpressed types. There were 22 cases of Luminal B and 8 cases of triple negative tumors in the HER-2 negative areas. The levels of TILs in HER-2 positive and negative areas accounted for 53.3% (16/30) and 26.7% (8/30), respectively, with a statistically significant difference (P=0.035). The positive expression of PD-L1 in HER-2 positive area and HER-2 negative area were 6 cases and 9 cases, respectively. Among 8 cases with HER-2 negative regions containing triple negative components, 4 cases were positive for PD-L1 expression. Conclusions: In the case of HER-2 intratumoral heterogeneity, it is necessary to pay attention to both HER-2 positive and negative regions, and evaluate subtype separately as far as possible. For HER-2 intratumoral heterogeneous breast cancer containing triple negative components, the treatment mode can be optimized by refining the intratumoral expression of PD-L1.

The Brain Structure Volume Estimation Based on Synthetic MRI in Pediatric Acute Lymphoblastic Leukemia / 中山大学学报(医学科学版)

ObjectiveCentral nervous system （CNS） infiltration commonly occurs in children with acute lymphoblastic leukemia （ALL）. Early subclinical CNS infiltration in pediatric ALL is hard to detect with conventional methods. This study aimed to investigate the changes of brain structure volume parameters based on Synthetic MRI （SyMRI） in pediatric ALL without clinically diagnosed CNS infiltration. MethodsThirty-six ALL and twenty-nine typically developing （TD） children were prospectively collected and all underwent SyMRI. The Synthetic MR software was used to obtain brain volumetric parameters including total white matter volume （WMV）， gray matter volume （GMV）， cerebrospinal fluid （CSF） volume， etc. and their within-group differences were assessed by analysis of covariance. The Spearman correlation analysis was used to examine the correlation between biological characteristics and statistically significant brain volume parameters. ResultsALL children showed increased CSF volume （PFDR-corrected = 0.009） and decreased GMV （PFDR-corrected = 0.027） when compared to TD children. We also found a moderately negative association between GMV/intracranial volume and risk classification in pediatric ALL （rs = -0.380， P = 0.022）. ConclusionsPediatric ALL without clinically diagnosed CNS infiltration presented with accumulation of CSF and reduction of gray matter. The brain volumetric changes in subclinical CNS infiltration of pediatric ALL provides a new attempt for exploring the underlying mechanism and early detection of CNS infiltration in pediatric ALL.

Effects of integrated orthopedic rehabilitation pathway on motor function after total knee arthroplasty / 中国康复理论与实践

@#Objective To study the effects of integrated orthopedic rehabilitation pathway on motor function in six months after total knee arthroplasty (TKA), including pain, stiffness, range of motion and muscle strength, etc. Methods From March, 2016 to March, 2019, 180 patients who underwent TKA and treated with integrated orthopedic rehabilitation pathway were enrolled. Age, gender, operation time, time of follow-up, the scores of Hospital for Special Surgery-Knee Scale (HSS-KS) and Western Ontario and McMaster Universities osteoarthritis index (WOMAC) at preoperative/postoperative/one-month after operation/three-month after operation/six-month after operation time points were collected. The sub items, such as muscle strength, range of motion, flexion deformity, pain, stiffness, functional difficulty were primarily focused on. Results A total of 42 patients were followed up for three months and 22 patients were followed up for six months. There was no significant difference in the scores of HSS-KS and WOMAC before and after operation (P > 0.05). Within three months after operation, the HSS-KS scores gradually increased (P < 0.05) and the WOMAC scores gradually decreased (P < 0.05). The active knee flexion range of motion and knee extensor muscle strength scores of HSS-KS significantly decreased after operation (P < 0.05), and gradually recovered one month and three months after operation (P < 0.05). The flexion deformity scores of HSS-KS increased after operation (P < 0.05), decreased one month after operation (P < 0.05), and got a trend of incensement again three months after operation. The pain score of WOMAC decreased continuously within three months after operation (P < 0.05); the stiffness score of WOMAC did not change after operation (P > 0.05), decreased significantly one month after operation (P < 0.05), and did not change three months after operation (P > 0.05). The degree of functional difficulty of WOMAC decreased after operation (P < 0.05), and improved continuously within six months after operation (P < 0.05). Conclusion The overall function after TKA shows a trend of improvement within three months, and there is no obvious improvement from three to six months after operation. The flexion deformity score showed a downward trend in one month after operation, and it could be improved again after strengthening rehabilitation, which needs more attention in the postoperative rehabilitation.

Differentially expressed mRNAs and their upstream miR-491-5p in patients with coronary atherosclerosis as well as the function of miR-491-5p in vascular smooth muscle cells

MicroRNAs (miRNAs) regulate gene expression and are biomarkers for coronary atherosclerosis (AS). A novel miRNA-mRNA regulation network of coronary AS still needs to be disclosed. The aim of this study was to analyze potential mRNAs in coronary AS patients and the role of their upstream miR-491-5p in vascular smooth muscle cells (VSMCs). We first confirmed top ten mRNAs according to the analysis from Gene Expression Omnibus database (GSE132651) and examined the expression levels of them in the plaques and serum from AS patients. Five mRNAs (UBE2G2, SLC16A3, POLR2C, PNO1, and AMDHD2) presented significantly abnormal expression in both plaques and serum from AS patients, compared with that in the control groups.Subsequently, they were predicted to be targeted by 11 miRNAs by bioinformatics analysis. Among all the potential upstream miRNAs, only miR-491-5p was abnormally expressed in the plaques and serum from AS patients. Notably, miR-491-5p overexpression inhibited viability and migration, and significantly increased the expression of contractile markers (α-SMA, calponin, SM22α, and smoothelin) in VSMCs. While silencing miR-491-5p promoted viability and migration, and significantly suppressed the expression of α-SMA, calponin, SM22α, and smoothelin. Overall, miR-491-5p targeted UBE2G2, SLC16A3, and PNO1 and regulated the dysfunctions in VSMCs.

Effects of combining mirror visual feedback with robot-assisted gait training on the lower limb functioning of stroke survivors / 中华物理医学与康复杂志

Objective:To investigate any effect of combining mirror visual feedback (MVF) training with robot-assisted gait training (RGT) in promoting the recovery of lower limb motor function among stroke survivors.Methods:Sixty stroke survivors were randomly divided into a combined treatment group, an RGT group and a control group, each of 20. In addition to traditional rehabilitation, the RGT group received 30min of RGT 5 days a week for 4 weeks, while the combined treatment group underwent 30min of RGT and also 20min of MVF training with the same frequency and duration. Before and after the treatment, the lower extremities motor functioning and walking ability of all of the patients were assessed using the Fugl-Meyer Assessment for the lower extremities (FMA-LE), the Berg Balance Scale (BBS) and Functional Ambulation Categories (FAC).Results:There were no systematic differences in any of the measurements before the treatment. After the 4 weeks, however, the average FMA-LE, BBS and FAC scores of the combined treatment and RGT groups were significantly better than the control group′s averages, and those of the combined treatment group were significantly superior to the RGT group′s. All of the groups had, however, improved significantly compared with before the treatment.Conclusions:Robot-assisted gait training is more effective in enhancing the motor functioning of the lower extremities and walking ability when it is combined with MVF.

Research progress on microRNA-21 in regulating osteoclast and osteogenic differentiation in orthodontic treatment / 口腔疾病防治

@#In the process of orthodontic treatment, the balance between the modeling of alveolar bone and the mechanical stress exerted by the appliance is key to the effective movement of orthodontic teeth. Alveolar bone modeling involves many regulatory factors, and microRNAs (miRNAs), as posttranscriptional regulatory factors, play an important role in the occurrence of bone modeling. As an important member of the miRNA family, miRNA-21 promotes the differentiation of periodontal ligament stem cells into osteoblasts and plays an important role in maintaining bone balance and preventing bone resorption as a regulator of osteoclast formation and a promoter of osteoclast differentiation. A literature review showed that miRNA-21 can regulate osteoclast function and promote bone resorption through programmed cell death 4 (PDCD4), phosphate and tension homology deleted on chromosome ten (PTEN), receptor activator of nuclear factor-κB ligand (RANKL) and osteoprotegerin (OPG). MiRNA-21 is highly sensitive to external mechanical stress in the process of orthodontic tooth movement. After orthodontic force is applied, miRNA-21 can promote osteoclast formation and accelerate orthodontic movement; through targeted regulation of periodontal ligament associated protein-1 (PLAP-1), it can regulate periodontal ligament remodeling in the late stage of tooth movement and improve the potential of tooth movement. In addition, miRNA-21 mediates orthodontic tooth movement (OTM) and alveolar bone remodeling in the periodontal inflammatory microenvironment. miRNA-21 can upregulate the expression of hypoxia-inducible factor-1α (HIF-1α) in periodontal ligament stem cells in a hypoxic environment. It can promote the expression of osteogenic markers, such as osteopontin (OPN), osteocalcin (OCN), alkaline phosphatase (ALP) and runt-related transcription factor 2 (Runx2), and promote osteogenic differentiation during orthodontic tooth movement.

A fetal electrocardiogram signal extraction method based on long short term memory network optimized by genetic algorithm / 生物医学工程学杂志

Fetal electrocardiogram signal extraction is of great significance for perinatal fetal monitoring. In order to improve the prediction accuracy of fetal electrocardiogram signal, this paper proposes a fetal electrocardiogram signal extraction method (GA-LSTM) based on genetic algorithm (GA) optimization with long and short term memory (LSTM) network. Firstly, according to the characteristics of the mixed electrocardiogram signal of the maternal abdominal wall, the global search ability of the GA is used to optimize the number of hidden layer neurons, learning rate and training times of the LSTM network, and the optimal combination of parameters is calculated to make the network topology and the mother body match the characteristics of the mixed signals of the abdominal wall. Then, the LSTM network model is constructed using the optimal network parameters obtained by the GA, and the nonlinear transformation of the maternal chest electrocardiogram signals to the abdominal wall is estimated by the GA-LSTM network. Finally, using the non-linear transformation obtained from the maternal chest electrocardiogram signal and the GA-LSTM network model, the maternal electrocardiogram signal contained in the abdominal wall signal is estimated, and the estimated maternal electrocardiogram signal is subtracted from the mixed abdominal wall signal to obtain a pure fetal electrocardiogram signal. This article uses clinical electrocardiogram signals from two databases for experimental analysis. The final results show that compared with the traditional normalized minimum mean square error (NLMS), genetic algorithm-support vector machine method (GA-SVM) and LSTM network methods, the method proposed in this paper can extract a clearer fetal electrocardiogram signal, and its accuracy, sensitivity, accuracy and overall probability have been better improved. Therefore, the method could extract relatively pure fetal electrocardiogram signals, which has certain application value for perinatal fetal health monitoring.

Expression and clinical significance of miRNA-146a-5p and miRNA-155-5p in plasma exosomes of patients with rheumatoid arthritis / 中华微生物学和免疫学杂志

Objective:To investigate the expression of miRNA-146a-5p and miRNA-155-5p in the plasma exosomes of patients with rheumatoid arthritis (RA) and their roles in the pathogenesis of RA.Methods:Plasma exosomes of 56 RA patients and 24 healthy controls were extracted with Qiagen exogenous extraction kit. Real-time quantitative polymerase chain reaction (RT-PCR) was used to detect the expression of miRNA-146a-5p and miRNA-155-5p in exosomes using miRNA-451a as the internal control. The relative expression level was calculated by 2 -△△Ct method. Results:The relative expression of miRNA-146a-5p and miRNA-155-5p in exosomes of RA patients were significantly higher than those in healthy controls [13.662 (6.058, 30.801) vs 5.261 (2.453, 12.103), 33.354 (15.087, 275.309) vs 11.684 (1.551, 17.221), both P<0.05]. Moreover, their expression was also significantly higher in patients with active RA than in patients with inactive RA [27.542 (13.905, 87.017) vs 7.217 (5.218, 13.697), 155.110 (35.600, 437.745) vs 15.526 (10.628, 24.504), both P<0.05]. The levels of miRNA-146a-5p and miRNA-155-5p in plasma exosomes were positively correlated with 28-Joint Disease Activity Score (DAS28) using C-reactive protein (DAS28-CRP), DAS28 using erythrocyte sedimentation rate (DAS28-ESR), tender joint count (TJC) and swollen joint count (SJC). No significant difference in exosome concentration was found between the RA patients and healthy controls [660.381 (581.212, 807.308) μg/ml vs 675.897 (559.328, 752.316) μg/ml, P>0.05], or between patients with active or inactive RA [634.963 (561.095, 756.107) μg/ml vs 676.374 (589.167, 898.333) μg/ml, P>0.05]. Conclusions:Both miRNA-146a-5p and miRNA-155-5p were significantly highly expressed in plasma exosomes of RA patients, especially in patients with active RA, suggesting that miRNA-146a-5p and miRNA-155-5p in plasma exosomes might play important roles in the pathogenesis of RA and be related to disease activity.

Satisfaction analysis on day-parting appointment for elderly hypertension contracted outpatients in community / 上海预防医学

Objective To study the application effect of day-parting appointment for elderly hypertensive contracted outpatients in community. Methods In May 2018 two groups (experiment and control) of 103 elderly hypertensive contracted outpatients, aged between 60 and 80 and looked after by the team of family doctors, who had been diagnosed with hypertension and with medication for at least one year were set up.The experimental group used self-made community hypertension visiting card for appointments, and the control group used the original way of treatment.Six months later, comparison was made in blood pressure control, the number of outpatients, the time consumed and the satisfaction between the two groups. Results It was found in comparison that the blood pressure standard-reaching rate of the experimental group was better than that of the control group (P < 0.05);outpatients′ visits and time consumed were less than those of the control group, the time used in the clinic room was longer than that in the control group; the differences in these aspects between the two groups were significant (P < 0.05);the satisfaction of the overall outpatient perception, attitude of family doctors, treatment technology, visits control, dosage, cost and safety of medication in the experimental group were better than in the control group; there were significant differences in these aspects between the two groups (P < 0.05). Conclusion Community day-parting appointment proves to be more convenient, more time-saving and safer for outpatients, greatly improving the medical quality and satisfaction for community outpatients.

Lower limb ischemia cured by stimulation electrode implantation assisted with microendoscopic discectomy system: A case report / 北京大学学报(医学版)

A 58-year-old male patient diagnosed with thromboangiitis obliterans (Fontaine stage IV) was recently treated with microendoscope discectomy system-assisted spinal cord stimulation electrode implantation and cured by department of vascular surgery combined with department of spinal surgery at Peking University People's Hospital. The patient suffered from cold injury to the right foot 14 years ago, which was cold, painful, numb, and then the toe was ulcerated and gangrene. Only the right foot small toe was left. The right foot skin was swollen from the toe to the proximal segment 1 year ago, accompanied by resting pain. Both pain and autologous bone marrow stem cell transplantation were ineffective. The above symptoms were aggravated three months ago, and the pain was severe. The visual analogue score was 10 points. A high amputation of the left lower extremity was performed 30 years ago due to trauma. Physical examination: the bilateral femoral artery was weak, and the right radial artery, posterior tibial artery, and dorsal artery were not touched. Buerger sign (+). Auxiliary examination: angiography of both lower extremities showed complete occlusion of the bilateral external iliac artery and its distal end. The percutaneous oxygen partial pressure was measured to be 30 mmHg on the right side of the iliac crest. The operation was performed under the local anesthesia. After X-ray positioning, the body projection of the lumbar vertebrae 1-2 lamina gap was marked. The skin had a 1.8 cm incision on the caudal side 2 cm from the mark. Then the dilators were used, and the working sleeve was tilted to the lumbar vertebrae 1-2 lamina gap. The microendoscope discectomy system was installed, the electrode was directly placed into the epidural space from the interlamina space under the microendoscope, the vascular surgeon adjusted the position of the electrode in the spinal canal under fluoroscopy, then connected the stimulator, adjusted the current until the patient had the lower limb fever, fixed electrode position, removed the microendoscope discectomy system after hemostasis under the microendoscope, used the guide needle to lead the electrode through the lumbar subcutaneous and then sutured the incision. After the operation, the electrode was connected to the temporary stimulator to stimulate for several minutes, the patient felt numbness in his lower limbs. In less than one hour, the skin temperature of the affected limb increased, and the painkiller could be stopped while sleeping. After 1 week, the skin temperature of the affected limb increased, and the percutaneous oxygen partial pressure of the foot and ankle was 36 mmHg, and the pain improved, and the score was reduced to 2 points. One month after surgery, the patient underwent permanent stimulator implantation. The pain disappeared after 3 months and half year of follow-up, and the score was reduced to 1 point. Microendoscope discectomy system-assisted spinal cord stimulation electrode implantation can complete the operation quickly, safely and effectively, and greatly reduce the number of intraoperative fluoroscopy and reduce the occurrence of complications.

Decreased expression of gap junction delta-2 (GJD2) messenger RNA and connexin 36 protein in form-deprivation myopia of guinea pigs / 中华医学杂志(英文版)

BACKGROUND@#More than ten genome-wide association studies have identified the significant association between the gap junction delta-2 (GJD2) gene and myopia. However, no functional studies have been performed to confirm that this gene is correlated with myopia. This study aimed to observe how this gene changed in mRNA and protein level in the form-deprivation myopia (FDM) animal model.@*METHODS@#Four-week-old guinea pigs were randomly divided into two groups: control and FDM groups (n = 12 for each group). The right eyes of the FDM group were covered with opaque hemispherical plastic lenses for 3 weeks. For all the animals, refractive status, axial length (AL), and corneal radius of curvature were measured at baseline and 3 weeks later by streak retinoscope, A-scan ultrasonography, and keratometer, respectively. Retinal GJD2 mRNA expression and connexin 36 (Cx36) levels in FDM and control groups were measured by quantitative real-time PCR and Western blot analyses, respectively. Those results were compared using independent t test, Mann-Whitney U test, or paired t test. A significance level of P < 0.05 was used.@*RESULTS@#Three weeks later, the FDM group (form-deprived eyes) showed about a myopic shift of approximately -6.75 (-7.94 to -6.31) D, while the control group remained hyperopic with only a shift of -0.50 (-0.75 to 0.25) D (Z = -3.38, P < 0.01). The AL increased by 0.74 (0.61-0.76) and 0.10 (0.05-0.21) mm in FDM and control groups, respectively (Z = -3.37, P < 0.01). The relative mRNA expression of GJD2 in the FDM group decreased 31.58% more than the control group (t = 11.44, P < 0.01). The relative protein expression of CX36 on the retina was lowered by 37.72% in form-deprivation eyes as compared to the controls (t = 17.74, P < 0.01).@*CONCLUSION@#Both the mRNA expression of GJD2 and Cx36 protein amount were significantly decreased in the retina of FDM guinea pigs. This indicates that Cx36 is involved in FDM development, providing compensating evidence for the results obtained from genome-wide association studies.

Polygalasaponin F inhibits secretion of IL-1β and its molecular mechanisms / 中国药理学通报

Aim To investigate the effects of polyga-lasaponin F( PS-F) on LPS-induced inflammatory cytokine IL-1β expression in BV2 cells and explore the potential anti-inflammatory mechanism of PS-F. Methods Five groups were included in the experiment, including the control group, the model group and PS-F treatment groups(0. 10, 1.00, 10.00 μmol • L-1). ELISA, quantitative real-time PCR and Western blot were used to assay the mRNA and protein expression of IL-1β. The levels of NLRP3, caspase-1, ASC, caspase-11 protein were examined by Western blot. Results Compared with model group, PS-F treatment groups effectively reduced IL-1β expression in LPS-in-duced inflammatory model in a dose-dependent manner ( P <0. 01 or P <0. 05). Moreover, PS-F significantly inhibited ASC and caspase-11 expression (P < 0. 05 ). Conclusions PS-F inhibited the expression of inflammatory mediator IL-1β by suppressing the activation of NLRP3 inflammasome and inhibiting caspase-11 in LPS-stimulated BV2 cells.

Decreased expression of gap junction delta-2 (GJD2) messenger RNA and connexin 36 protein in form-deprivation myopia of guinea pigs / 中华医学杂志(英文版)

Background@#More than ten genome-wide association studies have identified the significant association between the gap junction delta-2 (GJD2) gene and myopia. However, no functional studies have been performed to confirm that this gene is correlated with myopia. This study aimed to observe how this gene changed in mRNA and protein level in the form-deprivation myopia (FDM) animal model.@*Methods@#Four-week-old guinea pigs were randomly divided into two groups: control and FDM groups (n = 12 for each group). The right eyes of the FDM group were covered with opaque hemispherical plastic lenses for 3 weeks. For all the animals, refractive status, axial length (AL), and corneal radius of curvature were measured at baseline and 3 weeks later by streak retinoscope, A-scan ultrasonography, and keratometer, respectively. Retinal GJD2 mRNA expression and connexin 36 (Cx36) levels in FDM and control groups were measured by quantitative real-time PCR and Western blot analyses, respectively. Those results were compared using independent t test, Mann-Whitney U test, or paired t test. A significance level of P < 0.05 was used.@*Results@#Three weeks later, the FDM group (form-deprived eyes) showed about a myopic shift of approximately -6.75 (-7.94 to -6.31) D, while the control group remained hyperopic with only a shift of -0.50 (-0.75 to 0.25) D (Z=-3.38, P < 0.01). The AL increased by 0.74 (0.61–0.76) and 0.10 (0.05–0.21) mm in FDM and control groups, respectively (Z = -3.37, P < 0.01). The relative mRNA expression of GJD2 in the FDM group decreased 31.58% more than the control group (t = 11.44, P < 0.01). The relative protein expression of CX36 on the retina was lowered by 37.72% in form-deprivation eyes as compared to the controls (t = 17.74, P < 0.01).@*Conclusion@#Both the mRNA expression of GJD2 and Cx36 protein amount were significantly decreased in the retina of FDM guinea pigs. This indicates that Cx36 is involved in FDM development, providing compensating evidence for the results obtained from genome-wide association studies.

Association of tumor necrosis factor receptor-associated protein 1 gene copy number variation with susceptibility and clinical characteristics of systemic lupus erythematosus / 中华风湿病学杂志

Objective To explore whether tumor necrosis factor receptor-associated protein 1 (TRAP1)gene copy number variation was associated with susceptibility and clinical characteristics of systemic lupus erythematosus (SLE).Methods The study enrolled 304 SLE patients and 391 healthy controls.They were used to investigate the association between TRAP1 gene copy number variation and SLE susceptibility.Then,304 SLE patients were divided into copy number=2 group and copy number＞2 group to study the association between TRAP1 gene copy number variation and disease activity or clinical characteristics of SLE.AccuCopyTM Kit was used to detect the TRAP1 gene copy number.Data analyses were performed by SPSS 10.01 software.The suitable method was selected among t test,rank sum test and x2 test for analysis based on the data type and distribution,univariate and multivariate logistic regression analysis were performed to investigate the associ-ation between TRAP1 gene copy number variation and susceptibility and clinical characteristics of SLE.Results The copy number variation of TRAP1 gene showed an association with the susceptibility to SLE crude OR=5.257,95％CI (1.108,24.937),P=0.037;the adjusted OR=5.578,95％CI (1.172,26.556),P=0.031].There was no association between TRAP1 gene copy number variation and SLE disease activity index (SLEDAI) score (Z=-0.117,P=0.907).The copy number variation of TRAP1 gene had a marginal association with skin lesions in SLE [OR=0.130,95％CI (0.016,1.069),P=0.058],but it disappeared after adjusting for potential confounders [OR=0.288,95％CI (0.029,2.831),P=0.286,PBH=0.808].There was no correlation between TRAP1 gene copy number variation and arthritis,alopecia,oral ulcers,fever,hematologic disorder,lupus nephritis as well as photosensitivity in SLE [x2=0.751,OR=1.234,95％CI (0.767,1.988),P=0.386].No multiplicative interaction was found between TRAP1 gene copy number variation and age or body mass index (BMI) [age:x2=0.751,OR=1.234,95％CI (0.767,1.988),P=0.386;BMI:x2=0.282,OR=1.172,95％CI(0.652,2.109),P=0.596].Conclusions The copy number variation of TRAP1 gene may be associated with susceptibility to SLE.Increased TRAP1 gene copy number may be a risk factor for SLE.

The characteristics of synovitis under energy Doppler ultrasonography in knee osteoarthritis patients / 中华风湿病学杂志

Objective To investigate the correlation between synovial inflammatory changes (synovial blood signals,synovial thickness,joint effusion) and cartilage injury,meniscus prominence of knee osteoarthritis (KOA) under energy Doppler ultrasound and further to assess the value of ultrasound for prognostic judgment in KOA.Methods A total of 291 KOA patients from our hospital from 2016 to 2018 were collected.The patients with rheumatoid arthritis (RA) with knee joints involved were recruited as control group.The data that conform to the normal distribution were expressed by mean±SD,and others were represented by M (P25,P75).The t test,the rank test and Chi-square test were used between the two groups,and ANOVA or K-W test was used to compare the data between the multiple groups,Spearman correlation analysis was used for correlation analysis.Results ① The proportion of synovial blood flow signal in KOA group was lower than RA group (19.6％ vs 47.7％,x2=286.2,P＜0.01),as well as the typical synovial thickness [2.6(0,3.95) mm vs 3.43 (1.85,6) mm,Z=-3.674,P＜0.01] and popliteal cyst (11.5％ vs 18.5％,x2=4.484,P=0.04).② In KOA group,no significant difference was found between ESR and hs-CRP among different synovial blood signals (H=7.213,H=0.883,all P＞0.05).ESR from KOA group were both significantly lower than controls but the synovial blood signals was the same except for power Doppler signal-2 group (Z=-8.414,Z=-4.991,t=-3.428,all P＜0.05);hs-CRP from KOA group were both significantly lower than controls but the synovial blood signals was the same.③ A total of 489 knee joints were detected in 291 patients with KOA,of which synovial blood flow signals were found in 96 joints,the power Doppler signal-I group was the most frequent in KOA (80/96,83.3％).In addition,joint effusion and synovial thickening were positively correlated with the synovial blood signals,(r=0.277,r=0.411,all P＜0.05).④ At last,the degrees of ultrasound blood flow signal in KOA group was positively associated with the WOMAC score,the Lequsne index and US-1 score (r=0.352,r=0.424,r=0.59,all P＜0.05).Conclusion Energy Doppler ultrasonography can be used to detect the KOA synovitis.Synovitis is not rare in KOA patients,and which is associated with disease activity.However,KOA and RA cannot be differentiated by energy Doppler ultrasonography.

Effects of gait training with rhythmic auditory stimulation on gait ability in elderly stroke patients / 中华老年医学杂志

Walking disorder is the most common sequela in patients with hemiplegia after stroke.More than half of stroke patients can not walk independently after discharge,and still present a gait asymmetry and slow pace,and other abnormalities.Then,the fall risk is increased.With security concerns,patients are more afraid to walk independently and can not complete the walk in community environment.Therefore,gait rehabilitation is considered as the main goal of stroke rehabilitation.Rhythmic auditory stimulation(RAS)is a new rehabilitation method to improve stroke gait.By elucidating the mechanism of RAS and their effects on stroke gait,the aim of this paper is to explore the effective RAS treatment method for hemiplegic patients,so that RAS is not only used in gait training,but also in real-time assessment of gait in any environment for chronic stroke patients.

Recurrence and metastasis in patients with non-small cell lung cancer after minimally invasive surgery / 中国内镜杂志

Objective To analyze the recurrence and metastasis in patients with non-small cell lung cancer (NSCLC) after minimally invasive surgery. Methods 123 patients with NSCLC underwent thoracoscopic lobectomy from January 2008 to December 2013 were enrolled in the study. Their perioperative data and follow-up results were analyzed, and postoperative recurrence and metastasis were recorded. Multivariate logistics regression analysis was performed to investigate the influencing factors of postoperative recurrence and metastasis. Results The median operative time was 165 min (60 ~ 430 min) and the median intraoperative blood loss was 95 ml (20 ~ 3100 ml). Postoperative complications occurred in 15 cases (12.2%). All patients were followed up regularly after discharge, and the median follow-up time was 23.5 months (6 ~ 69 months). During the follow-up period, postoperative recurrence and metastasis occurred in 36 cases (29.3%) and 42 cases (34.1%), including 16 cases (13.0%) patients simultaneously appeared recurrence and metastasis. The ipsilateral lung (52.8%) was the most common site of recurrence, followed by mediastinal lymph nodes (38.9%). Bone (28.6%) was the most common site of metastasis,followed by contralateral lung (26.2%) and brain (19.0%). Multivariate logistic regression analysis showed that stage Ⅱ-Ⅲ, mediastinal lymph node metastasis and low differentiation were independent risk factors of postoperative recurrence (P < 0.05) while stage Ⅱ ~ Ⅲ , number of lymph node metastasis ≥ 3, without postoperative radiotherapy and chemotherapy were independent risk factors of postoperative metastasis (P < 0.05). Conclusions For patients with NSCLC, recurrence and metastasis after thoracoscopic lobectomy occurred mainly in the ipsilateral lung and bone. TNM staging, mediastinal lymph node metastasis, differentiation degree, lymph node metastases, postoperative radiotherapy and chemotherapy were related with postoperative recurrence and metastasis.

Recurrence and metastasis in patients with non-small cell lung cancer after minimally invasive surgery / 中国内镜杂志

Objective To analyze the recurrence and metastasis in patients with non-small cell lung cancer (NSCLC) after minimally invasive surgery. Methods 123 patients with NSCLC underwent thoracoscopic lobectomy from January 2008 to December 2013 were enrolled in the study. Their perioperative data and follow-up results were analyzed, and postoperative recurrence and metastasis were recorded. Multivariate logistics regression analysis was performed to investigate the influencing factors of postoperative recurrence and metastasis. Results The median operative time was 165 min (60 ~ 430 min) and the median intraoperative blood loss was 95 ml (20 ~ 3100 ml). Postoperative complications occurred in 15 cases (12.2%). All patients were followed up regularly after discharge, and the median follow-up time was 23.5 months (6 ~ 69 months). During the follow-up period, postoperative recurrence and metastasis occurred in 36 cases (29.3%) and 42 cases (34.1%), including 16 cases (13.0%) patients simultaneously appeared recurrence and metastasis. The ipsilateral lung (52.8%) was the most common site of recurrence, followed by mediastinal lymph nodes (38.9%). Bone (28.6%) was the most common site of metastasis,followed by contralateral lung (26.2%) and brain (19.0%). Multivariate logistic regression analysis showed that stage Ⅱ-Ⅲ, mediastinal lymph node metastasis and low differentiation were independent risk factors of postoperative recurrence (P < 0.05) while stage Ⅱ ~ Ⅲ , number of lymph node metastasis ≥ 3, without postoperative radiotherapy and chemotherapy were independent risk factors of postoperative metastasis (P < 0.05). Conclusions For patients with NSCLC, recurrence and metastasis after thoracoscopic lobectomy occurred mainly in the ipsilateral lung and bone. TNM staging, mediastinal lymph node metastasis, differentiation degree, lymph node metastases, postoperative radiotherapy and chemotherapy were related with postoperative recurrence and metastasis.

Association of HSP90B1 gene polymorphisms with systemic lupus erythemat-osus patients / 中国免疫学杂志

Objective:To explore the association of HSP90B1 gene polymorphisms with susceptibility of systemic lupus erythematosus(SLE) in Chinese Han population.Methods: We recruited 360 SLE patients from hospital as case group and selected 360 age- and sex-matched individuals without autoimmune diseases as control group.Multiplex SNaPshot was used for genotyp-ing.Benjamin-Hamburg(BH) method based on false discovery rate(FDR) standard was used for multiple testing correction.Results:The rs1165681 polymorphism(Crude OR=0.621,95% CI=0.450-0.856,P=0.004;Adjusted OR=0.619,95% CI=0.449-0.855,P=0.004) was significantly associated with SLE risk reduction in dominant model,and the rs10778306 polymorphism(crude OR=0.568, 95% CI=0.328-0.984,P=0.044;Adjusted OR=0.570,95% CI=0.329-0.988,P=0.045) and the rs2722188 polymorphism(Crude OR=0.227,95% CI=0.076-0.681,P=0.008;Adjusted OR=0.227,95% CI=0.076-0.682,P=0.008) were significantly associated with SLE risk reduction in recessive model.After adjustment using BH method,genotype distribution of rs1165681 was statistical difference in two groups(PBH= 0.044).Significant associations were found between four haplotypes of HSP90B1 gene CCATTAGGCAT (OR=0.323,95% CI=0.154-0.680,P=0.002),CCCTTAGGCAC(OR=1.324,95% CI=1.014-1.729,P=0.039),TCCCTAGTCGC (OR=0.465,95% CI=0.221-0.979,P=0.039)and TTCTCGGGCAT(OR=0.443,95% CI=0.224-0.875,P=0.016)and SLE risk.After adjustment using BH method,the frequency of CCATTAGGCAT distribution difference was statistically significant in two groups(PBH= 0.028),but there were no statistical difference in other haplotypes frequency distributions (P>0.05).Conclusion:HSP90B1gene polymorphisms may be associated with the susceptibility of SLE in Chinese Han population.