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BACKGROUND:In chronic gout patients,sodium urate is deposited in bone joints and around synovial membranes,eroding and destroying bone,leading to serious complications such as gouty arthritis and deformity.Research on the mechanisms by which sodium urate crystals erode and destroy bone can help early clinical intervention in gouty diseases and prevent and delay the complications caused by bone destruction. OBJECTIVE:To explore the destructive effects of gout crystals on bone through clinical imaging studies and experimental basic research,review the current progress and development prospects of research on the phenomenon and mechanism of bone destruction caused by gout,guide the clinical early intervention of gouty bone destruction,and guide the direction of research on the role of bone destruction. METHODS:The Chinese search terms were"gout,bone destruction,bone erosion"and the English search terms were"tophi,gout,RANKL,bone destruction,bone erosion,"which were used in the computer search of WanFang and PubMed databases.Finally,64 articles were selected for review according to the inclusion and exclusion criteria. RESULTS AND CONCLUSION:The specific manifestations of clinical studies(imaging,histopathology)to some extent elaborate the osteolytic process of gout,and in basic studies,the mechanism of gout-causing bone destruction can be divided into the five aspects:(1)Sodium acid crystals have an important role in bone destruction,directly affecting osteocytes,chondrocytes,osteoblasts and proresorptive factors that promote bone destruction;(2)Receptor activator of nuclear factor-κB ligand and other proresorptive factors are involved in bone destruction;(3)T cell-mediated cellular immunity functions as a bridge in bone destruction,and activated T cells induce osteoclast differentiation;(4)Monocytes/macrophages are not only precursors of osteoclast-like cells,but also induce the expression of proresorptive factors such as Receptor activator of nuclear factor-κB ligand;(5)Neutrophils affect the morphology of osteoclast arrangement,and neutrophil extracellular trap networks promote osteolysis by promoting osteoclast differentiation.
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ABSTRACT Introduction: Reducing the risk of joint injuries is especially important in combative contact sports such as basketball. Objective: Analyze the joint injuries of college basketball students and outline methods of improving sports skills to prevent sports injuries. Methods: The experimental group used a specific training for basketball skills training and knee joint recovery. The control group remained in ordinary basketball training, lasting 60 minutes, thrice a week for eight weeks. Results: The experimental group increased their squat level from 1.83 to 2.14 after the experiment; in terms of hurdles, there was a change from 2.09 to 2.62, the experimental group increased from 1.37 to 2.48, and in terms of active lower limb lifting, the experimental group increased from 2.19 to 2.72 after the test. Conclusion: The training presented showed a clear effect on the recovery of knee joint function and improvement in the competitive level of college basketball athletes. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.
RESUMO Introdução: Reduzir o risco de lesões articulares no esporte é principalmente importante em esportes combativos de contato, como o basquete. Objetivo: Analisar as lesões articulares dos estudantes universitários de basquetebol e traçar métodos de aperfeiçoamento das habilidades esportivas para prevenir as lesões esportivas. Métodos: O grupo experimental utilizou um treinamento específico para treino de habilidades de basquetebol e recuperação articular dos joelhos. O grupo de controle manteve-se no treinamento de basquetebol comum, com duração de 60 minutos, três vezes por semana durante 8 semanas. Resultados: O grupo experimental aumentou o nível de agachamento de 1,83 para 2,14 após o experimento, em termos de obstáculos, houve alteração de 2,09 para 2,62, o grupo experimental aumentou de 1.37 para 2.48, e em termos de elevação ativa dos membros inferiores, o grupo experimental aumentou de 2.19 para 2.72 após o teste. Conclusão: O treinamento apresentado revelou um efeito evidente na recuperação da função articular do joelho e na melhoria do nível competitivo dos atletas universitários de basquetebol. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.
RESUMEN Introducción: Reducir el riesgo de lesiones articulares en el deporte es especialmente importante en los deportes combativos de contacto, como el baloncesto. Objetivo: Analizar las lesiones articulares de los estudiantes universitarios de baloncesto y esbozar métodos de mejora de las habilidades deportivas para prevenir las lesiones deportivas. Métodos: El grupo experimental utilizó un entrenamiento específico para el entrenamiento de las habilidades en el baloncesto y la recuperación de la articulación de la rodilla. El grupo de control siguió con el entrenamiento ordinario de baloncesto, de 60 minutos, tres veces por semana durante 8 semanas. Resultados: El grupo experimental aumentó el nivel de sentadilla de 1,83 a 2,14 después del experimento, en cuanto a las vallas, se produjo un cambio de 2,09 a 2,62, el grupo experimental aumentó de 1,37 a 2,48, y en cuanto a la elevación activa de las extremidades inferiores, el grupo experimental aumentó de 2,19 a 2,72 después de la prueba. Conclusión: El entrenamiento presentado reveló un claro efecto en la recuperación de la función de la articulación de la rodilla y en la mejora del nivel competitivo de los atletas universitarios de baloncesto. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.
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Objective:To screen and analyze ferroptosis-related genes (FRG) impacting the prognosis of colorectal adenocarcinoma patients based on bioinformatics.Methods:RNA sequencing data including the clinical information of 545 colorectal adenocarcinoma patients and 602 data sets were downloaded from the Cancer Genome Atlas (TCGA) database. FRG gene sets were downloaded from FerrDb database. FRG expression dataset could be obtained after taking the intersection between FRG gene sets and TCGA database gene sets. Differentially expressed FRG and prognosis-related genes between colorectal adenocarcinoma tissues and the adjacent tissues were screened by using R software, and finally FRG influencing the prognosis of colorectal adenocarcinoma were obtained. According to protein-protein interaction networks, the interaction and the expression association of proteins were analyzed. LASSO regression analysis was used to build a risk model for patients' 5-year overall survival rate. The risk value was calculated for 509 colorectal adenocarcinoma samples in the TCGA database, and then the median risk value was taken as the cut-off value. All patients were divided into the high-risk group (≥ median risk value) and the low-risk group (< median risk value), and the survival curves of the two groups were drawn. The receiver operating characteristic (ROC) curve was drawn for predicting the 5-year overall survival rate of colorectal adenocarcinoma patients in a time-dependent way in TCGA database according to the risk value of FRG prognosis model. Cox proportional risk model was used to make univariate and multivariate survival analysis in order to screen factors affecting the prognosis. The pathway enrichment analysis of prognosis-related FRG of colorectal adenocarcinoma was performed based on gene ontology (GO) database and Kyoto Encyclopedia of Genes and Genomes (KEGG) database.Results:The clinical information of 545 patients and 602 datasets were extracted from the database. A total of differential expressed 199 FRG in colorectal adenocarcinoma and 28 prognosis-related FRG were identified. After taking the intersection, 21 FRG affecting the prognosis of colorectal adenocarcinoma patients were identified. DUOX2, NOX4, NOX1, DDIT3, JDP2, ATP6V1G2, ULK1, ATG3 were probably associated with WIPI1; expressions of NOX4, NOX5, PLIN4 were positively correlated with ATP6V1G2, while the expression of ULK1 was negatively correlated with MAPK1, MYB, FANCD2, ATG3 and ATP5MC3. LASSO regression analysis showed that 15 FRG were finally screened out (ATP5MC3, NOX4, NOX5, ALOX12B, ATG3, WIPI1, MAPK1, MYB, AKR1C1, DDIT3, JDP2, ATP6V1G2, DRD4, SLC2A3, PLIN4), and the risk model was constructed by calculating the risk value, and the risk value = NOX4×0.139-ATP5M3×0.108+NOX5×1.486+ALOX12B×0.475-ATG3×0.030-WIPI1×0.170-MAPK1×0.271-MYB×0.063+AKR1C1×0.021+DDIT3×0.186+JDP2×0.292+ATP6V1G2×0.777+DRD4×0.294+SLC2A3×0.059+PLIN4×0.113. The overall survival of patients in the high-risk group was worse than that in the low-risk group ( P < 0.001). The 5-year overall survival rate was 48.2% in the high-risk group and 76.8% in the low-risk group. Multivariate survival showed that the age and risk value were independent affecting factors of the prognosis. ROC curves revealed that the risk model constructed by using prognosis-related FRG could well predict the 5-year overall survival rate of patients (the area under the curve was 0.728). The differential expressed genes of both groups may be associated with genetic pathways such as extracellular matrix composition, extracellular structure composition and focal adhesion. Conclusions:The prognostic risk model constructed by the screened FRG can better evaluate the prognosis of colorectal adenocarcinoma patients. These FRG are expected to become new candidate biomarkers related to the prognosis of colorectal adenocarcinoma.
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Smoldering multiple myeloma is a kind of heterogeneous asymptomatic plasma cell disease. Some patients have a high risk of developing symptomatic multiple myeloma. However, the starting point and options of treatment for smoldering multiple myeloma patients are still unclear. This article reviews the risk stratification and treatment progress of smoldering multiple myeloma.
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The clinical study of multiple myeloma at various stages has been reported at 2019 American Society of Hematology Annual Meeting. This article focuses on several key studies of the treatment of high-risk smoking multiple myeloma (HR-SMM), newly diagnosed multiple myeloma (NDMM) and relapsed/refractory multiple myeloma (RRMM), especially the chimeric antigen receptor T-cell (CAR-T) therapy, in order to guide clinical selection of better treatment options. However, most of these studies are phase Ⅰ-Ⅱ studies, and the median follow-up period is short, the long-term follow-up and the results of phase Ⅲ studies with enlarged samples are needed to further determine the effectiveness and safety of each treatment plan.
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Systemic amyloidosis is caused by misfolding of heavy or light chain in immune globulin and extracellular deposition of proteins as amyloid fibrils. The most common form is light chain amyloidosis, which results in dysfunction of vital organs. Specific biomarkers and amyloid imaging can prompt organ dysfunction at early diagnosis and prevent the organ failure at end stage. Combination therapy is the direction of light chain amyloidosis therapy in the future. The studies on the target therapy concerning clone light chain and amyloid deposition, and new drugs that can control light chain gathering and hydrolysis are under exploration. This paper reviews the treatment progress of light chain amyloidosis.