[The characteristics and associated factors of functional limitation in patients with rheumatoid arthritis].

Objective: To investigate the characteristics of functional limitation and associated factors in patients with rheumatoid arthritis (RA). Methods: Consecutive patients with RA were recruited from August 2015 to June 2019 at Department of Rheumatology, Sun Yat-Sen Memorial Hospital. Demographic and clinical characteristics including age, gender, erythrocyte sedimentation rate (ESR), visual analogue scale (VAS) of pain, clinical disease activity index (CDAI), modified total Sharp score were collected. Physical function was assessed by the Stanford health assessment questionnaire disability index (HAQ-DI).Ordered logistic regression was used to analyze the related factors of HAQ-DI. Results: A total of 643 RA patients were finally recruited including 114 males and 529 females with mean age (49.7±12.9) years. There were 399 (62.1%) patients having different degrees of functional limitation, who were classified as mild (293, 45.6%), moderate (73, 11.4%) and severe (33, 5.1%). The prevalence of functional limitation was positively correlated with age and disease activity. The most restricted activity was walking [43.5% (280/643)], followed by gripping [36.1% (232/643)], reaching [35.5% (228/643)], daily activities [33.4% (215/643)], hygiene [33.0% (212/643)], dressing and grooming [29.7% (191/643)] and arising [29.1% (187/643)], and the last eating [18.4% (118/643)]. Multivariate ordered logistic regression analysis showed that age (OR=1.019, 95%CI 1.004-1.035),pain VAS (OR=1.820, 95%CI 1.616-2.050), ESR (OR=1.009, 95%CI 1.001-1.017), CDAI (OR=1.080, 95%CI 1.059-1.102) and modified total Sharp score (OR=1.010, 95%CI 1.004-1.015) were associated factors of functional limitation. Conclusion: The majority RA patients have functional limitation. Age, pain and active disease are independent associated factors. Therefore, target treatment and control of pain should be emphasized in RA patients.

[Expression level and prognostic value of PD-L1 in microsatellite instability-high gastric cancer].

Objective: To study the clinicopathological features and PD-L1 expression of microsatellite instability-high (MSI-H) gastric cancer. Methods: The clinicopathological data of the 2 472 patients who had undergone radical surgical resection and been performed immunohistochemical staining of four major mismatch repair (MMR) proteins (MLH1, PMS2, MSH2 and MSH6) from March 2014 to December 2018 at Peking University Cancer Hospital were collected. One hundred and seventy-one patients showed mismatch repair-deficient (dMMR), and microsatellite instability of these patients were detected with polymerase chain reaction (PCR). Then, taken PCR results as the standard, PD-L1 was assessed using immunohistochemistry (IHC) in the MSI-H gastric cancers. Results: MSI-H (vs. MSI-L) in gastric cancers was associated with female gender, advanced age, gastric-antrum location, intestinal type, lesion diameter exceeding 5 cm, absence of lymph node metastasis and positive PD-L1 expression (P<0.05, respectively). Combined positive score (CPS) was an independent risk factor (P=0.026, HR=8.385, 95%CI=1.293-54.367). Although no relationship between PD-L1 expression pattern and prognosis was observed,"diffuse-pattern" of the PD-L1 expression was related to lymphatic-vascular invasion (P=0.007) and infiltration depth (P=0.04). Among the patients with MSI-H and PD-L1 positive gastric cancer, the patients who experienced recurrence or died all had the pattern of "diffuse" PD-L1 expression. Also, regarding the expression level and staining pattern of PD-L1, the metastasis lesion of lymph node had a high coincidence with primary site (P=0.45). Conclusions: MSI-H gastric cancer shows distinctive clinicopathological characteristics. The CPS can be used as a prognostic indicator in MSI-H gastric cancers, while the "diffuse-pattern" of PD-L1 expression could possibly be used as a prognostic indicator. The patients with advanced gastric cancer could obtain the expression level and staining pattern of PD-L1 using the biopsy material of metastatic lesions.

Cloning, expression, and polymorphism at the 5'-flanking region of the GnRH gene and their association with laying traits in Muscovy duck (Cairina moschata).

Gonadotropin-releasing hormone (GnRH), a neuropeptide, plays a vital role in the hypothalamus-pituitary-gonadal (HPG) axis. In vertebrates, GnRH is crucial for the onset of sexual development and the entire reproductive process. The purpose of this study was to identify genetic factors associated with egg-laying traits of Muscovy ducks. The full-length cDNA (474 bp) of Muscovy duck GnRH was obtained and characterised. It encodes 92 amino acids containing a 1-amino acid signal peptide cleavage site. Phylogenetic analysis revealed that Muscovy duck GnRH has a close relationship with Anas platyrhynchos GnRH. GnRH showed significantly different expression profiles between 4 developmental periods in the hypothalamus, pituitary, and ovary. The expression of GnRH in the laying period (36 weeks) was higher than at other periods in the three tissues. GnRH was widely expressed in 12 examined tissues of nesting and laying Muscovy ducks. In the hypothalamus, pituitary and gonads, the expression of GnRH was higher than in other tissues. In laying Muscovy ducks, the expression of GnRH in the hypothalamus, pituitary, ovary, muscular stomach, pancreas, heart, duodenum and spleen was significantly higher than in nesting dusks. Differences were detected in the liver and glandular stomach between laying ducks and nesting ducks. Differences between the kidney and lung were not significant. In the pituitary, the GnRH and GnRH receptor (GnRHR) genes shared the same expression profiles during 4 time points. Both genes had the highest expression at 36 weeks of age. A mutation (g.206G > A) in the 5'-flanking region was associated with egg-laying performance. Individuals with genotype GG had better egg-laying performance than the individuals with genotype AA. GnRH may be used as a marker gene for laying performance in the Muscovy duck.

Cloning and tissue expression profiling of the GnRHR gene of the Muscovy duck (Cairina moschata): polymorphism and association with egg-laying performance.

1. cDNA sequence of gonadotropin-releasing-hormone receptor (GnRHR) gene was cloned and an association analysis between mutations and laying performance was conducted. 2. A 1680-bp cDNA sequence of Muscovy duck GnRHR, which encodes 415 amino acids, was obtained and characterised. Phylogenetic analysis revealed that Muscovy duck GnRHR has a close relationship with Gallus gallus GnRHR. 3. There were significantly different expression profiles between 4 age periods in the hypothalamus, pituitary, and ovary. The expression of GnRHR at the age of 36 weeks (laying period) was higher than other time points in the three tissues. GnRHR was expressed in 12 different tissues. The highest expression levels were observed in hypothalamus, pituitary and gonads. 4. A single nucleotide polymorphism detected in the second intron was associated with egg-laying performance. Individuals with genotype TT had better egg-laying performance from individuals with genotypes CC or TC. Therefore, GnRHR could be used as a marker gene for laying performance in Muscovy duck.

GH gene polymorphisms and expression associated with egg laying in muscovy ducks (Cairina moschata).

Accumulated evidence suggests that the growth hormone (GH) gene plays a physiological role in the control of reproductive function. Here, we examined the correlation between egg-laying traits and GH gene polymorphisms and expression patterns in the muscovy duck (Cairina moschata). PCR single-strand conformation polymorphism was used to identify polymorphisms in intron 3 of GH. One single nucleotide polymorphism (g.3270 A > G) was detected by sequencing, and the frequencies of the A and G alleles in the population were 0.65 and 0.35, respectively. A comparison test showed that the AA genotype group had more consecutive laying days and more eggs at 300 days than the GG genotype group (P < 0.05); however, there was no significant difference for the age at first laying (P > 0.05). Such a significant correlation between GH polymorphisms and egg-laying performance suggested that GH could be a candidate locus affecting the laying trait in muscovy duck. Furthermore, real-time fluorescent quantitative PCR demonstrated that GH is expressed in all selected tissues, but is highly expressed in the hypothalamic-pituitary-gonadal axis and heart. This unique expression pattern suggested that GH may exert its local physiological function through the autocrine or paracrine pathway during gonad development and growth in the muscovy duck. The data presented in this paper revealed GH polymorphisms and expression patterns in the muscovy duck and indicated a potential regulatory effect of GH on reproduction.

[The trends and preventive strategies of esophageal cancer in high-risk areas of Taihang Mountains, China].

OBJECTIVE: To analyze and predict the trends of incidence and mortality rates of esophageal cancer in areas of Taihang Mountains, and explore the strategies for facilitating the reduction of the incidence and mortality of esophageal cancer. METHODS: The data were collected from Linxian and Cixian Counties registries between 1988-1997. The trends of the incidence and mortality rates for esophageal cancer had been fitted and predicted by the model of BP (Back Propagation) Neural Networks. Then Linqi Xiang in Linxian County was taken as an example, to determine the power for reducing incidence and mortality of esophageal cancer using endoscopic technology as an early detection and treatment method. RESULTS: There were slowly declining trends for both incidence and mortality rates during past 10 years in Taihang Mountains. The predicting rates of the esophageal cancer incidence in 2,002 are 115. 70/100,000 for male and 79.88/100,000 for female; mortality rates are 94.00/100,000 and 56.29/100,000 respectively. Both incidence and mortality rates a still in high level. But when using endoscopic technology as an early detection and treatment method, the incidence rate is nearly 1/3 of a control group and the power is 88.30% at the end of eight years. The mortality rate is 1/4 of the control group and power is 89.44% after five years intervention (both powers based on 0.05 significant levels). CONCLUSIONS: The incidence and mortality rates for esophageal cancer are still on high levels in Taihang Mountains. We should continue to enhance our preventive effort there. After using endoscopic technology as an early detection and treatment method, the incidence and mortality rates will be decreased markedly during 5 to 8 years. It is recommended to implement a large-scale secondary prevention strategy in these areas.