The gene RAD51AP1 promotes the progression of pancreatic cancer via the PI3K/Akt/NF-κB signaling pathway.

Pancreatic cancer is one of the most lethal tumors due to its rapid proliferation and aggressiveness. RAD51AP1 is a protein-coding gene with critical functions in many cancers but few studies have assessed RAD51AP1 in pancreatic cancer. Bioinformatics methods and cell function experiments were performed to reveal the functions of RAD51AP1 in vitro. Gene Expression Profiling Interactive Analysis (GEPIA) was used to explore key proteins and their relationships with RAD51AP1 in the PI3K/AKT/NF-κB signaling pathways. Western blotting (WB) was conducted to detect the expression of key proteins after the downregulation of RAD51AP1. Co-Immunoprecipitation (Co-IP) was applied to confirm the binding of RAD51AP1 and PI3K. In addition, the lentivirus was used to construct subcutaneous tumors in nude mice to verify the function of RAD51AP1 in vivo. The Kaplan-Meier curves illustrated that elevated expression levels of RAD51AP1 were significantly correlated with reduced overall survival (OS), disease-specific survival (DSS), and progression-free interval (PFI) in pancreatic cancer patients. The results of WB showed that several key proteins in the PI3K/AKT/NF-κB signaling pathway (including PI3K, AKT, IKK1, IKK2, P65, P50, C-FLIP, and XIAP) exhibited a significant knockdown upon reducing the expression of RAD51AP1. Co-IP suggested that RAD51AP1 could directly bind to PI3K. In vitro, CCK-8, wound healing, and Transwell assays revealed that high RAD51AP1 expression was significantly correlated with increased cell proliferation, migration, and invasion. In vivo, mouse tumor formation experiments showed that RAD51AP1 inhibition significantly inhibited tumor growth. RAD51AP1 plays an important role in fostering cellular proliferation, invasion, metastasis, and tumor enlargement via the PI3K/AKT/NF-κB signaling pathway.

Sexual dimorphism in the relation between sex hormones and osteoporosis in patients with type 2 diabetes mellitus.

INTRODUCTION: To investigate the association between sex hormones and osteoporosis in type 2 diabetic mellitus (T2DM) patients. MATERIALS AND METHODS: We performed a retrospective study in patients with T2DM. The patients were assigned into three groups (normal bone mineral density, osteopenia, and osteoporosis) in both sexes. The clinical characteristics, bone metabolic markers, and sex hormones were compared. The relationship between the sex hormones and osteoporosis was analyzed by ordinary regression analysis. Statistical analysis was performed using SPSS 26.0. RESULTS: A total of 795 T2DM patients (446 men ≥ 50 years old and 349 postmenopausal women) were identified and analyzed. The osteoporosis group had the lowest estradiol level in men (P = 0.013) and the highest follicle-stimulating hormone (FSH) level in women (P = 0.042). In the multivariate analysis, men with lower estradiol levels (< 87.96 pmol/L) had a nearly 1.6-fold increased risk for osteoporosis than those with the higher estradiol levels (> 122.82 pmol/L). In addition, women with lower FSH (< 41.17 IU/L) had nearly 0.6-fold for osteoporosis compared to those with higher FSH (> 60.83 IU/L) after adjusting for age, duration of T2DM, body mass index, pulse pressure, creatinine clearance, glycosylated hemoglobin, fasting C-peptide, and estradiol (in FSH) or FSH (in estradiol). CONCLUSION: In T2DM, the estrogen level was negatively correlated with osteoporosis in men, and the FSH level was positively correlated with the osteoporosis in women.

Prevalence of psoriatic arthritis in Chinese population with psoriasis: A multicenter study conducted by experienced rheumatologists / 中华医学杂志(英文版)

BACKGROUND@#Reports on the prevalence of psoriatic arthritis (PsA) among Chinese patients with psoriasis are very limited. This study, conducted by rheumatologists, estimated the prevalence of PsA in a large number of Chinese patients with psoriasis.@*METHODS@#Consecutive patients with a confirmed diagnosis of psoriasis attending nine dermatology clinics in five hospitals were recruited. All psoriasis patients were asked to complete a questionnaire comprising 16 questions to identify possible cases of PsA. All patients with one or more positive answers to the questionnaire were evaluated by two experienced rheumatologists.@*RESULTS@#A total of 2434 psoriasis patients, including 1561 males and 873 females, were enrolled. Both the questionnaire and rheumatologists' examinations were completed in the dermatology clinics. The results identified 252 patients with PsA, comprising 168 males and 84 females. The overall prevalence of PsA among psoriasis patients was 10.4% (95% confidence interval [95% CI], 9.1%-11.7%). By sex, the prevalence was 10.8% (95% CI, 9.2%-12.5%) for males and 9.6% (95% CI, 7.7%-11.9%) for females and there was no significant sex difference in the prevalence of PsA (P = 0.38). Of the 252 PsA patients, 125 (49.6%, 95% CI, 41.3%-59.1%) were newly diagnosed by rheumatologists. Consequently, the prevalence of undiagnosed PsA among psoriasis patients was 5.2% (95% CI, 4.4%-6.2%).@*CONCLUSION@#The prevalence of PsA in the Chinese population with psoriasis is about 10.4%, which is almost double that of previous reports in the Chinese population, but lower than that in Caucasians.

Analysis on the status and trend of TB burden in China from the global views / 中华疾病控制杂志

@#Objective To analyze the status and trends for the prevalence，morbidity，mortality， and DALY of tuberculosis ( TB) in China from 1990 to 2017，so as to provide scientific basis for TB pre- vention and control． Methods From 1990 to 2017 in China，the United States，India，Japan，and the global，the TB ( standardized) prevalence，( standardized) morbidity，( standardized) mortality，and ( standardized) DALY rates were obtained from Institute for Health Metrics and Evaluation ( IHME) web- site，and comparative analysis of changes in these indicators with years were carried out． Ｒesults In 2017， the prevalence，morbidity，mortality，and DALY rate of TB in China were higher in the high-age group than in the low-age group． The prevalence，morbidity，mortality，and DALY rates were all higher for males than females． The prevalence was 29 641. 59/100 000 and 28 803. 26/100 000 for male and female，respectively． The male and female mortality rates were 72. 23/100 000 and 44. 85/100 000． The male and female mortali- ty rates were 3. 85/100 000 and 1. 67/100 000，and the DALY rate of male and female were 156. 95/100 000 and 84. 73/100 000． From 1990 to 2017，the prevalence of TB decreased from 32 178. 39/100 000 in 1990 to 29 231. 80/100 000 in 2017，the morbidity rate of TB decreased from 141. 83/100 000 in 1990 to 58. 83/100 000 in 2017，the mortality rate of TB decreased from 13. 82/100 000 in1990 to 2. 78/100 000 in 2017，and the DALY rate of TB decreased from 582. 87/100 000 in 1990 to 121. 60/100 000 in 2017． Conclusions The burden of TB in China declined markedly from 1990 to 2017． Although some progress has been made in the prevention and treatment of TB in China，but there is still a certain gap compared with de- veloped countries． It is still necessary to further reduce the morbidity rate and mortality rate of TB．

Analysis of incidence and influencing factors of R-CHOP-like regimen treatment-related interstitial pneumonia in B-cell non-Hodgkin lymphoma / 白血病·淋巴瘤

Objective:To explore the related influencing factors of interstitial pneumonia (IP) in B-cell non-Hodgkin lymphoma (B-NHL) patients treated with R-CHOP-like chemotherapy regimen.Methods:The clinical data of 377 CD20 + B-NHL patients in Minhang Branch of Fudan University Shanghai Cancer Hospital from January 2014 to June 2019 were retrospectively analyzed. According to whether rituximab was used, patients were divided into R-CHOP-like chemotherapy group (275 cases) and CHOP-like chemotherapy group (102 cases). The incidence of IP in patients stratified according to different clinical factors was analyzed, and logistic multivariate regression was used to analyze the risk factors of IP. Results:Thirty-eight out of 377 patients (10.08%) developed IP; the incidence rates of IP in the R-CHOP-like chemotherapy group and the CHOP-like chemotherapy group were 13.09% (36/275) and 1.96% (2/102), respectively, and the difference was statistically significant (χ 2 = 10.169, P < 0.01). There were statistical differences in the incidence rates of IP between patients with or without rituximab, with or without liposomal doxorubicin in the regimen, and with or without grade Ⅳ neutropenia occurred during the treatment [13.09% (36/275) vs. 1.96% (2/102), 18.18% (22/ 121) vs. 6.25% (16/256), 15.43% (27/175) vs. 5.45% (11/202), all P < 0.01]. Logistic regression analysis showed that the application of rituximab ( OR = 6.761, 95% CI 1.369-33.711, P = 0.020) and grade Ⅳ neutropenia ( OR = 7.443, 95% CI 2.132-8.199, P = 0.001) were independent risk factors for the occurrence of IP. Conclusions:R-CHOP-like chemotherapy regimen increases the occurrence of IP in patients with B-NHL. The use of rituximab and grade Ⅳ neutropenia are independent risk factors for the occurrence of IP.

A case of acute radiation injury of right finger caused by 192Ir external irradiation / 中华放射医学与防护杂志

Objective@#To explore the treatment technique, occurrence and development patterns of such radiation injuries as in a major radiological accident in which a victim suffered mild bone marrow radiation sickness combined grade degree Ⅲ acute radiation induced skin injury, based on his dose estimation, clinical manifestations and disease treatments.@*Methods@#History inquiry in detail, earlier physical dose estimation and biological dose estimation were conducted in conjunction with analyzing the chromosome aberration of peripheral blood lymphocytes. The physical dose was estimated by Monte Carlo method.The systematic laboratory and imaging examination was performed to evaluate the condition. The comprehensive analysis was conducted to determine the diagnosis and treatment plan.@*Results@#At 3d after the exposure, "Ren" felt mild pain and discomfortable on the skin of the right index finger. The body of the right hand index finger was covered with blister at 21 d after exposure.The estimation of biological dose was 0.43 Gy (95%CI: 0.31-0.58 Gy), and the physical dose was estimated to be 36-164 Gy for each part of the right hand finger. The hematopoietic system, immune system and endocrine system were normal. The liver function index value was transiently increased. The liver damage resulted from the use of antibiotic-induced combined with the patient′s past medical history and admission examination result, and the relevant antibiotics were discontinued. The liver function returned to normal after liver protection treatment. At 22 d after irradiation, a right finger incision and decompression surgery were performed. The stem cells were extracted and implanted into the right index finger. After 59 days of hospitalization, there was no obvious discomfort in the body, and the right index finger recovered well, as well as the pain significantly relieved, and the knuckle activity was basically normal.@*Conclusions@#The patient with excessive radiation and grade Ⅲ acute radiation skin injury was successfully treated, and local application of autologous adipose-derived stem cell transplantation achieved good result .

Development and validation of a preoperative nomogram for predicting positive surgical margins after laparoscopic radical prostatectomy / 中华医学杂志(英文版)

BACKGROUND@#Positive surgical margins are independent risk factor for biochemical recurrence, local recurrence, and distant metastasis after radical prostatectomy. However, limited predictive tools are available. This study aimed to develop and validate a preoperative nomogram for predicting positive surgical margins after laparoscopic radical prostatectomy (LRP).@*METHODS@#From January 2010 to March 2016, a total of 418 patients who underwent LRP without receiving neoadjuvant therapy at Peking University Third Hospital were retrospectively involved in this study. Clinical and pathological results of each patient were collected for further analysis. Univariable and multivariable logistic regression (backward stepwise method) were used for the nomogram development. The concordance index (CI), calibration curve analysis and decision curve analysis were used to evaluate the performance of our model.@*RESULTS@#Of 418 patients involved in this study, 142 patients (34.0%) had a positive surgical margin on final pathology. Based on the backward selection, four variables were included in the final multivariable regression model, including the percentage of positive cores in preoperative biopsy, clinical stage, free prostate specific antigen (fPSA)/total PSA (tPSA), and age. A nomogram was developed using these four variables. The concordance index (C-index) of the nomogram was 0.722 in the development cohort and 0.700 in the bootstrap validations. The bias-corrected calibration plot showed a limited departure from the ideal line with a mean absolute error of 2.0%. In decision curve analyses, the nomogram showed net benefits in the range from 0.2 to 0.7.@*CONCLUSION@#A nomogram to predict positive surgical margins after LRP was developed and validated, which could help urologists plan surgical procedures.

A Randomized Controlled Study on Efficacy of Perioperative Administration of Houpupaiqi Mixture on Fast Track Surgery in Patients With Laparoscopic Colorectal Cancer / 胃肠病学

Background:Studies have shown that Houpupaiqi mixture is beneficial to the recovery of postoperative gastrointestinal function in patients undergoing open gastrointestinal surgery. However,there is no randomized controlled trial focusing on the efficacy of Houpupaiqi mixture on laparoscopic colorectal cancer patients. Aims:To investigate the efficacy of perioperative administration of Houpupaiqi mixture on fast track surgery in patients with laparoscopic colorectal cancer. Methods:A total of 170 colorectal cancer patients at Renji Hospital from January 2016 to February 2017 were enrolled into the prospective randomized double-blind controlled clinical trial. The patients were randomly divided into experimental group and control group,and Houpupaiqi mixture(50 mL)or placebo(50 mL)were administered 6 hours before surgery, as well as 6 and 12 hours after surgery,respectively. The clinical efficacy and safety were compared between the two groups. Results:The patients in experimental and control groups were well balanced with respect to the baseline characteristics. Compared with the control group,time to first anal exhaust,time to recovery of regular bowel sounds and time of postoperative hospital stay were significantly decreased in experimental group(P<0.05). However,no significant differences were observed in first time to defecation,first time to drink,first time to eat fluid diet and first time to eat solid food between the two groups(P>0.05). One patient with anastomotic fistula was found in each group. Conclusions:Houpupaiqi mixture significantly promotes the recovery of gastrointestinal function of patients undergoing laparoscopic colorectal cancer surgery,with reduction of time to recovery of regular bowel sounds,time to first anal exhaust,and shortening the postoperative hospital stay,which is in favor of rapid rehabilitation.

Advances in Surgical Treatment of Perianal Fistulizing Crohn's Disease / 胃肠病学

Crohn's disease(CD)is a chronic non-specific intestinal inflammatory disease,and the incidence of perianal fistulizing CD(PFCD)is 17%-43%. Non-cutting setons is the first choice for surgical treatment of PFCD. Some new surgical methods are effective for specific types of PFCD,however,the efficacy of most new methods remains to be confirmed by further studies. The multidisciplinary team(MDT)mode has become a new direction of PFCD surgery. This article reviewed the advances in surgical treatment of PFCD.

"Medical follow-up of the exposed victim two years after ""5.7"" radiation accident in Nanjing" / 中华放射医学与防护杂志

Objective To investigate the late effects induced by ionizing radiation and the rehabilitation treatment of local radiation injury by medical follow-up of the patient exposed to192 Ir at 5.7 accident in Nanjing,and to provide more experience for the treatments in the medical emergency of nuclear or radiological accident.Methods According to the history inquiry and physical examination of the patient in detail and the record of clinical symptoms and signs,the changes of the blood system,immune system,reproductive system,eyes,nervous system were systematically evaluated.The effects of rehabilitation treatment for the patient with lower limb dysfunction were also assessed.Results After the medical treatments of the patient,the hematopoietic immune system was restored,but the bone marrow aspiration still showed low bone marrow hyperplasia in right ilium.Meanwhile,the level of sex hormones was within the normal range,but semen examination showed sperm motility was 0.The radiation damage also occurred in the eye lens,retina and fundus.Howevcr,the psychological evaluation showed that the patient was stable and the right lower limb skin wound healing was well except for dysfunction and pain in some extent,which was relieved after the rehabilitation treatment.Conclusions The physiological function of the exposed victim with mild bone marrow type acute radiation sickness could be completely or partially restored after the clinical treatment in the early stage.

Data mining analysis of regularity of formulas containing Salviae Miltiorrhizae Radix et Rhizoma-Carthami Flos medicin pair in Dictionary of Chinese Medicine Prescription / 中国中药杂志

In this study, formulas containing Salviae Miltiorrhizae Radix et Rhizoma-Carthami Flos in the database of Dictionary of Chinese Medicine Prescription (DCMP) were extracted by using traditional Chinese medicine inheritance support system (TCMISS). The drugs pairs and formula composition rules were analyzed with data mining methods, such as association rules, improved mutual information method and complex system entropy clustering. Totally 39 formulas were included in this study and involved 280 Chinese medicines. The top 5 Chinese medicines most frequently used were Danggui (Angelica sinensis), Chuanxiong (Ligusticum chuanxiong), Xiangfu (Cyperi Rhizoma), Baishao(Radix Paeoniae Alba), Taoren(Prunus persica) and Shengdihuang (Radix Rehmanniae Recens). Six core medicinal pairs were obtained through clustering analysis, namely Danshen (Salviae Miltiorrhizae Radix et Rhizoma)-Xiangfu (Cyperi Rhizoma)-Honghua (Carthami Flos), Danshen (Salviae Miltiorrhizae Radix et Rhizoma)-Baishao (Radix Paeoniae Alba)-Honghua (Carthami Flos), Danshen (Salviae Miltiorrhizae Radix et Rhizoma)-Danggui (A. sinensis)-Xiagnfu (Cyperi Rhizoma)-Honghua (Carthami Flos), Danshen (Salviae Miltiorrhizae Radix et Rhizoma)-Danggui (A. sinensis)-Baishao (Radix Paeoniae Alba)-Honghua (Carthami Flos), Honghua (Carthami Flos)-Danshen (Salviae Miltiorrhizae Radix et Rhizoma)-Baishao (Radix Paeoniae Alba)-Danggui (A. sinensis), Danshen (Salviae Miltiorrhizae Radix et Rhizoma)-Baishao (Radix Paeoniae Alba)-Honghua (Carthami Flos)-Danggui (A. sinensis). The support degree was set at 11 (38.46%), with a confidence coefficient of 80%, and then 38 associated pairs were screened. These results suggested that Salviae Miltiorrhizae Radix et Rhizoma, Carthami Flos is often combined with herbs for activating blood and promoting circulation of qi to treat gynecopathy, stasis blood pain syndrome, stroke and other syndromes.

Efficacy of complete mesocolic excision in radical operation for right colon cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the efficacy of complete mesocolic excision (CME) in the radical operation for right hemicolon cancer.</p><p><b>METHODS</b>Clinical data of 336 cases of right hemicolon cancer undergoing radical resection, including 218 cases of CME surgery group and 118 cases of traditional surgery group, from January 2005 to December 2014 in Department of Gastrointestinal Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University were retrospectively analyzed. Intraoperational events, perioperative status and postoperative survival were compared between the two groups.</p><p><b>RESULTS</b>The baseline information was not significantly different between the two groups (all P>0.05). The number of harvested lymph nodes in CME and traditional group was 11.4±0.3 and 9.3±0.5 respectively(P=0.000) and the proportion of greater than or equal to 12 lymph nodes per case was 47.3%(103/218) and 28.8%(34/118)(P=0.002), which both were significantly different. The operation time in CME and traditional group was (147.2±2.9) and (148.8±3.9) minutes, which was not significantly different (P>0.05), whereas operative blood loss was (125.7±7.5) and (305.1±20.5) milliliters in CME and traditional group with significant difference (P=0.000). Postoperative hospital stay was (12.9±0.9) and (16.3±1.0) days in CME and traditional group with significant difference (P=0.018), while the time to postoperative liquid intake and normal diet was not significantly different between two groups (both P>0.05). The morbidity of postoperative complication of CME group was lower compared to traditional group (14.2%, 31/218 vs. 24.6%, 29/118), which was significantly different (P=0.018). Among them, infection occurred in 19 (8.7%) cases and 21 (17.8%) cases with significant difference between the two groups (P=0.014). The average time of follow-up was (34.5±1.2) months and (27.9±1.5) months in CME and traditional group, and the five-year survival rate was 85.6% and 78.0% with significant difference(P=0.043). Moreover, 102 cases underwent laparoscopic-assisted CME and 116 cases underwent open CME in CME group. The 5-year survival rate was 89.8% and 82.2% in laparoscopic and open group with significant difference (P=0.048).</p><p><b>CONCLUSION</b>Compared with traditional radical resection, CME radical resection for right hemicolon cancer can harvest more lymph nodes, decrease operative blood loss, lower the riskof postoperative complication, shorten the postoperative hospital stay, and increase the 5-year survival rate. Furthermore, laparoscopic-assisted CME has more advantages.</p>

Experimental study on relationship between pungent-hot herb property express and calmodulin / 中国中药杂志

<p><b>OBJECTIVE</b>To explain the essence of pungent-hot herb property express according to in vivo and in vitro studies on its effect on calmodulin on the base of the observation of the adjustment in hypothalamic-pituitary-gonad axis functions of Aconiti Lateralis Radix Praeparata, Curculiginis Rhizoma, Cinnamomi Cortex and bitter-cold herb Phellodendri Chinensis Cortex in rats under the state of yang deficiency.</p><p><b>METHOD</b>The yang-deficient model was duplicated by intramuscularly injecting hydrocortisone sodium succinate powder injection. After the intervention with Aconiti Lateralis Radix Praeparata, Curculiginis Rhizoma, Cinnamomi Cortex and bitter-cold herb Phellodendri Chinensis Cortex for seven days, TSH, T3, T4, 17-OHCS, COR, T, E2 of hypothalamus-pituitary-target gland axis and other relevant indexes were detected. The calmodulin expression in livers and L02 cells cultured in vitro was detected by using Western blot.</p><p><b>RESULT</b>Pungent-hot herbs Aconiti Lateralis Radix Praeparata, Curculiginis Rhizoma, Cinnamomi Cortex can significantly correct indicators of hypothalamic-pituitary-gonad axis and calmodulin, whereas the bitter-cold herb Phellodendri Chinensis Cortex showed no obvious effect.</p><p><b>CONCLUSION</b>The pungent-hot herb property expression may be closely related to calmodulin.</p>

The abnormality and clinical significance of follicular helper T cells and T helper 9 cells in patients with rheumatoid arthritis / 中华微生物学和免疫学杂志

Objective To investgate the expression of Tfh and Th9 in the peripheral blood of rheumatoid arthritis ( RA),and to analyze the relationship between those cells and disease activity,organs of involvement,ect.,and to underly the possible immunological mechananism of RA.Methods Peripheral blood Tfh cells and Th9 cells,define as the CD4+ CXCR5 + ICOS+ and CD3 + CD8+ IL-9+ population,were examined by flow cytometry in 36 patients with RA and 22 case of age-and gender-matched health controls.According to 28-joint Disease Activity Score (DAS28),patients were divied into two groups:high disease activity(n=22),moderate disease activity(n=14).And then to analyzed the correlation among the Tfh,Th9 and clinical data of RA,such as ESR,CRP,RF,the number of tender joints,the number of swollen joints and bone destruction,etc..While to analyzed the correlation between Th9 and Tfh.Results The expression of Tfh (Z=-6.082,P=0.000) and Th9 (0.989±0.498 vs 0.213±0.084,t=13.063,P =0.000 )in PBMCs of RA was significantly higher than normal controls.Meanwhile,the expression of Tfh ( 3.880 ±1.255 vs 2.678±1.022,t=2.990,P=0.005 ) and Th9( 1.181 ±0.523 vs 0.686±0.254,t =4.043,P=0.000) in high activity of group were higher than those moderate.The percentage of Tfh and Th9 in the two groups were all signifieantly higher than controls(P＜0.01 ),There was a positive correlation with Tfh and DAS28 ( r =0.571,P=0.000),ESR ( r =0.375,P =0.029),CRP( r =0.357,P =0.032 ),the number of tender joints ( r=0.598,P =0.000 ),RF ( r =0.421,P =0.023 ) and anti-CCP ( r =0.421,P =0.023 ).There were no relationship with Tfh and course,morning stiffness,the number of swollen joints,bone erosion and the abnormal of EKG.There was a positive correlation with Th9 and DAS28( r=0.461,P=0.005 ),ESR(r=0.347,P=0.042),CRP(r=0.384,P=0.210),the number of tender joints(r=0.341,P=0.042),the number of swollen joints (r =0.347,P=0.038 ) and RF( r =0.379,P =0.025 ) respectively.There were no relationship with Th9 and course,morning stiffness,CCP,the abnormal of EKG,bone erosion.There was a positive correlation with Tfh and Th9 (r=0.727,P =0.000),Conclusion The expression of Tfh and Th9 were increase significantly,which those cells were close relationship with the disease activity and some data,These results indicate that the abnormality of Tfh and Th9 may play an important role in the pathogenesis of RA.

The abnormality and clinical significan ce of T helper 9 cells and interleukin-9 in patients with rheumatoid arthritis / 中华风湿病学杂志

Objective To detect the expression of T helper cells 9 (Th9) in the peripheral blood and the level of interleukin (IL)-9 in the plasma of rheumatoid arthritis (RA) patients,and to analyze the relationship between Th9 and clinical characteristics,and their possible role in the immunological pathogenesis of RA were explored.Methods Thirty-six patients with RA and 22 healthy controls were included.RA patients were divided into high disease activity group (n=22) and moderate disease activity group (n=14).Th9 cells were obtained from RA patients and healthy controls and detected by flow cytometery.The levels of IL-9 in RA patients and healthy controls were detected by ELISA tests.T-test and Spearman's correlation were used for statistical analysis.Results The expression of Th9 and the level of IL-9 of RA patients [(0.99±0.50)％,( 1.06±0.42 ) pg/ml,respectively] were significantly higher than normal controls[ (0.21±0.08)％,(0.69±0.13)pg/ml,respectively,all P＜0.01 ].Meanwhile,the expression of Th9 and the level of IL-9 in high disease activity group [ ( 1.18±0.52 )％,( 1.37±0.47 ) pg/ml ] were higher than those of the moderate disease activity group [ (0.69±0.25)％,(0.94±0.30) pg/ml ].There were positive correlations between Th9 and disease activity score(DAS) 28,erythrocyte sedimentation rate (ESR),C-reactive protein (CRP),the number of tender joints,the number of swollen joints and rheumatoid factor (RF),the level of IL-9 respectively.There were positive correlations between IL-9 and DAS28,ESR,the number of tender joints,and the number of swollen joints.Conclusion High expression of Th9 and level of IL-9 maybe involved in the pat-hogenesis of RA,and is associated with disease activity.These results indicate that the abnormality of Th9 may play an important role in the pathogenesis of RA.

The role and clinical significance of follicular helper T cells in patients with rheumatoid arthritis / 中华风湿病学杂志

Objective To test the level of cell factor interleukin (IL)-21,CXCL13 in the plasma of patients with rheumatoid arthritis (RA),and to analyze the relationship between Follicular helper T cells(Tfh)and clinic features and discuss the possible immunological pathogenesis of RA.Methods The Tfh cells were obtained from patients and healthy controls (NC) and detected by Flow cytometery.While the levels of IL-21,CXCL13 in patients and NC were measured by ELISA tests.Those analysis were performed by student's t-test,one-way ANOVA,SNK-q test,Chi-square test,Spearman's correlation and multiple linear regression.Results The expression of CD4+CXCR5+ICOS+ cells (Tfh) in PBMCs of RA was significantly higher than normal controls (3.0±1.2 vs 1.1±0.4,P＜0.01).Meanwhile,the three RA groups of patients were divided to low,moderate and high disease activity groups,and the results showed that the expression of Tfh were increased accordingly (1.8±0.7,2.5±0.6,4.0±1.2).The expression of Tfh in the three groups were all significantly higher than that of controls (P＜0.01).There was a positive correlation between Tfh and DAS28,ESR,CRP,TJC,and bone erosion,RF and anti-CCP respectively.The expression of Tfh in those patients who had bone destruction was higher than those with no or mild bone destructions (2.7±1.1vs 3.4±1.3).The expression of Tfh in patients with un-treated RA patients,when compared to those RA patients who were treated appropriately and those who were not treated appropriately,was decreased significantly.The expression of Tfh in appropriately treated RA patients was lower than that without appropriately treatment.The level of IL-21,CXCL13 was decreased in patients with RA in the order of high,moderate,low disease activity and NC.Conclusion The expression of Tfh and the levels of IL-21,CXCL13 are increased significantly,and are closely related to disease activity and bone ersions.The expression of Tfh is decreased after relevant treatment.These results indicate that the abnormality of Tfh may play an important role in the pathogenesis of RA.

Electrocardiographic characteristics and radiofrequency catheter ablation of ventricular tachycardia and frequent ventricular premature contractions originating from left ventricular outflow tract / 中国基层医药

Objective To investigate the electrocardiographic(ECG) characteristics and assess the safety of radiofrequency catheter ablation (RFCA) of ventricular tachyeardia (VT), and frequent ventricular premature con- tractious(VPCs) originating from left ventricular outflow tract(LVOT). Methods Twelve-lead ECG analysis and RFCA were performed in 9 patient with VT or VPCs originating from LVOT. Results The sites to be successfully ablated were in left valsalva sinus in 6 patients,and subaortic valve in 3 patient. ECG revealed tall R wave in leads Ⅱ, Ⅲ ,aVF, V5 and V6. QS morphology in both leads aVR and aVL,QS morphology in lead Ⅰ in most cases. R wave in lead Ⅰ was relative tall, the R/S wave amplitude in lead V1 was over 0.62 ,and precordia R wave transition was irregular. All 9 patients were successfully ablated. No death or recurrenced case during follow-up. Conclusion Ventricular taehycardia and frequent ventricular premature rcontractions originating from left ventricutar outflow tract could be known by some specific ECG characteristics and could be radically treated safely by RFCA.

Risk factors for critical-ill events of patients with COVID-19 in Wuhan, China: a retrospective cohort study

BackgroundLittle is known about the risk factors for critical-ill events (intensive care, invasive ventilation, or death) in patients with COVID-19. MethodsPatients with laboratory-confirmed COVID-19 admitted to the Wuhan Leishenshan Hospital from February 13 to March 14 was retrospectively analyzed. Demographic data, symptoms, laboratory values at baseline, comorbidities, treatments and clinical outcomes were extracted from electronic medical records and compared between patients with and without critical-ill events. The least absolute shrinkage and selection operator (LASSO) and multivariate logistic regression models were developed to explore the risk factors for critical-ill events. A risk nomogram was established to predict the probability for the critical-ill events. Survival analysis of patients with critical-ill events was performed by the Kaplan-Meier method. Results463 COVID-19 patients were included in this study, of whom 397 were non-critically ill and 66 were critically ill (all from the intensive care unit). The LASSO regression identified four variables (hypersensitive cardiac troponin I, blood urea nitrogen, haemoglobin, and interleukin-6) contributing to the critical-ill events. Multivariable regression showed increasing odds of in-hospital critical-ill events associated with hypersensitive cTnI greater than 0.04 ng/mL (OR 20.98,95% CI 3.51-125.31), blood urea nitrogen greater than 7.6 mmol/L (OR 5.22, 95% CI 1.52-17.81, decreased haemoglobin (OR 1.06, 95% CI 1.04-1.10), and higher interleukin-6 (OR 1.05, 95% CI 1.02-1.08) on admission. ConclusionsHypersensitive cTnI greater than 0.04 ng/mL, blood urea nitrogen greater than 7.6 mmol/L, decreased haemoglobin, and high IL-6 were risk factors of critical-ill events in patients with COVID-19. Main pointHypersensitive cTnI greater than 0.04 ng/mL, BUN greater than 7.6 mmol/L, decreased haemoglobin, and high IL-6 were risk factors of critical-ill events (intensive care, invasive ventilation, or death) in patients with COVID-19.