Ornidazole induced Stevens-Johnson syndrome without body surface involved: A case report.

RATIONALE: Ornidazole is a synthetic nitroimidazole derivative that is commonly prescribed for antiparasitic or anti-anaerobic infections. It is generally well tolerated, with known side effects including gastrointestinal tract, anaphylaxis, and central nervous system reactions. Ornidazole-induced binocular reactive keratitis and several mucocutaneous lesions have been rarely reported. PATIENT CONCERNS: A 52-year-old woman who suffered from vaginitis and received an ornidazole vaginal plug (0.5 g). Approximately 20 minutes after the suppository was inserted into the vagina, her lips were swollen and valva and labia were burning. Her eyes were red, sore, and watery. DIAGNOSIS: She was diagnosed as Steven-Johnson syndrome by the ophthalmologist. According to the Naranjo scale, the adverse drug reaction was evaluated to be probable and severe. INTERVENTIONS: Dexamethasone was intravenous administrated as anti-inflammatory therapy for 10 days. Eye drops were locally given to relieve edema and promote healing of the epithelium. The symptoms of her eyes, lips, vulva and crissum were soon relieved. OUTCOMES: The patient was discharge from hospital with improved symptoms. LESSONS: In order to avoid severe adverse effect, the patient should not use metronidazole ether orally or vaginally. The case emphasized the importance of rapid and accurate diagnosis of Steven-Johnson syndrome induced by ornidazole vaginal plug, especially when the eye symptoms were the chief complaint without body skin involved.

Association between Triglyceride-Glucose Index and 1-year Recurrent Stroke after Acute Ischemic Stroke: Results from the Xi'an Stroke Registry Study of China.

INTRODUCTION: The triglyceride-glucose (TyG) index is reported to be related to poor functional outcomes and all-cause mortality post-stroke. However, the association between TyG index and recurrent stroke after acute ischemic stroke (AIS) has not been well described. We aimed to identify whether the TyG index was associated with 1-year recurrent stroke after AIS. METHODS: Baseline patient information was collected at admission, and the TyG index was calculated. Recurrent stroke events were followed up at 1, 3, 6, and 12 months after diagnosis. We then examined the association between the TyG index and risk of 1-year recurrent stroke using multivariable Cox regression models and restricted cubic spline analyses. RESULTS: Among 2,288 participants, the mean TyG index was 8.8  0.7. Those in the fourth quartile (Q4) demonstrated higher recurrent stroke risk than those in Q1 (adjusted hazard ratio [HR] = 1.63; 95% confidence interval [CI], 0.98-2.72; p = 0.059). Subgroup analysis revealed a sex-specific association between TyG index and recurrent stroke (p for interaction = 0.022). Additionally, restricted cubic splines analyses showed a non-linear association between the TyG index and 1-year recurrent stroke. In females, patients in the Q4 had a 2.95-fold increased recurrent stroke risk than did patients in the Q1 (adjusted HR =2.95; 95% CI, 1.09-7.94; p = 0.032); the risk increased when the TyG index was > 8.73. However, no significant correlation was observed in males. CONCLUSION: A non-linear association was found between the TyG index and 1-year recurrent stroke risk. Subsequently, a high TyG index could predict an increased 1-year recurrent stroke risk in female AIS patients.

ATAC-seq reveals the roles of chromatin accessibility in the chondrocytes of Kashin-Beck disease compared with primary osteoarthritis.

Objective: This study aimed to investigate the roles of accessible chromatin in understanding the different pathogeneses between Kashin-Beck disease (KBD) and primary osteoarthritis (OA). Methods: Articular cartilages of KBD and OA patients were collected, and after tissue digestion, primary chondrocytes were cultured in vitro. Assay for transposase-accessible chromatin with high-throughput sequencing (ATAC-seq) was performed to compare the accessible chromatin differences of chondrocytes between KBD and OA groups. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses were executed for the promoter genes. Then, the IntAct online database was used to generate networks of significant genes. Finally, we overlapped the analysis of differentially accessible region (DAR)-associated genes and differentially expressed genes (DEGs) obtained from whole-genomic microarray. Results: We obtained 2,751 total DARs, which contained 1,985 loss and 856 gain DARs and belonged to 11 location distributions. We obtained 218 motifs associated with loss DARs, 71 motifs associated with gain DARs, 30 motif enrichments of loss DARs, and 30 motif enrichments of gain DARs. In total, 1,749 genes are associated with loss DARs, and 826 genes are associated with gain DARs. Among them, 210 promoter genes are associated with loss DARs, and 112 promoter genes are associated with gain DARs. We obtained 15 terms of GO enrichment and 5 terms of KEGG pathway enrichment from loss DAR promoter genes, and 15 terms of GO enrichment and 3 terms of KEGG pathway enrichment from gain DAR promoter genes. We obtained CAPN6 and other 2 overlap genes from loss DARs-vs-down DEGs, AMOTL1 from gain DARs-vs-down DEGs, EBF3 and other 12 overlap genes from loss DARs-vs-up DEGs, and ADARB1 and other 10 overlap genes from 101 gain DARs-vs-up DEGs. These overlap genes were built into 4 gene interaction networks. Conclusion: FGF7, GPD1L, NFIB, RUNX2, and VCAM1 were the overlapped genes from the DAR-associated genes and DEGs. These genes were associated with the abnormal chondrocyte function, which may play crucial roles in different processes between KBD and OA in the way of accessible chromatin.

Spatio-temporal variation of soil microplastics as emerging pollutant after long-term application of plastic mulching and organic compost in apple orchards.

Microplastics (MPs) pollution in agroecosystems have aroused great alarm and widespread concern. However, the spatial distribution and temporal variation characteristics of MPs in apple orchards with long-term plastic mulching and organic compost input are still poorly understood. This study investigated MPs accumulation characteristics and vertical distribution after applying plastic mulch and organic compost in apple orchards for 3 (AO-3), 9 (AO-9), 17 (AO-17), and 26 (AO-26) years on the Loess Plateau. The clear tillage (no plastic mulching and organic composts) area was used as a control (CK). At a soil depth of 0-40 cm, AO-3, AO-9, AO-17, and AO-26 treatments increased the abundances of MPs, and the black fibers and fragments of rayon and polypropylene were dominant. In the 0-20 cm soil layer, the abundances of MPs increased with the treatment time; the abundance was 4333 pieces kg-1 after 26 years of treatment, gradually decreasing with soil depth. In different treatments and soil layers, the percentages of MPs <1000 µm were dominant (>50%). The AO-17 and AO-26 treatments significantly increased the MPs with the size of 0-500 µm at 0-40 cm and the abundances of pellets in 0-60 cm soil. In conclusion, the long-term (≥17 years) application of plastic mulching and organic composts increased the abundances of small particles at 0-40 cm, and plastic mulching contributed the most to MPs, while organic composts increased the complexity and diversity of MPs.

Immunomodulatory activity of glycoproteins isolated from chickpea (Cicer arietinum L.).

Chickpea (Cicer arietinum L.) is a well-known legume widely used as traditional medicine. This study aimed to characterize the structure and evaluate the immunomodulatory activity of one glycoprotein [crude chickpea glycoprotein-1 (CAG-1)] isolated from chickpea. CAG-1 was extracted with hot alkaline water and purified with DEAE-Sepharose Fast Flow and Superdex-200 column chromatography. CAG-1, with a molecular weight of 8,106 Da, contained 57.12% polysaccharide and 35.41% protein. The polysaccharide part was mainly composed of glucose (Glc). The protein part was connected mainly by aspartic (Asp) and glutamic (Glu). The results of nuclear magnetic resonance (NMR) analysis indicated the presence of α-d-Glcp-(1 → 4)-α-d-Glcp-(1 → 4)-α-d-Glcp-(1 → . In addition, the sugar chains of the glycoprotein were not hydrolyzed under alkaline conditions, suggesting that the glycoprotein was N-glycosidic; thus, the sugar chain was linked to the protein chain by Asp. An immunological study showed that CAG-1 stimulated the production of nitric oxide (NO), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and monocyte chemotactic protein 1 (MCP-1) in RAW 264.7 macrophages in a dose-dependent manner.

Non-Linear Association Between Serum Alkaline Phosphatase and 3-Month Outcomes in Patients With Acute Stroke: Results From the Xi'an Stroke Registry Study of China.

Background: Alkaline phosphatase (ALP) is associated with an increased risk of cardiovascular events and is closely related to adverse outcomes after stroke. However, the regional investigation into the associations of ALP with acute stroke (AS) outcomes is limited. This study aimed to identify the association between serum ALP levels and clinical outcomes 3 months after AS in the Xi'an district of China. Methods: We enrolled all patients with AS from 4 hospitals in the Xi'an district from January to December 2015. ALP levels and related patient information were collected at admission, and the events of stroke outcomes were followed up 1 and 3 months after diagnosis. ALP levels were analyzed as continuous variables and quartiles (Q1-Q4). The outcomes included all-cause mortality, recurrent stroke, and poor functional outcomes (modified Rankin Scale score of 3-6) within 3 months. A multivariate logistic regression and interaction analyses were performed to evaluate the independent association between serum ALP level and 3-month stroke outcomes. Results: Overall, 2,799 patients with AS were enrolled in this study. The mean age was 63.9 ± 12.5 years. In the Q4 (≥93.0 U/L) group, the incidences of all-cause mortality, recurrent stroke, and poor functional outcomes were 7.8, 2.7, and 24.9%, respectively. After being adjusted for confounding variables, patients in Q4 (≥93.0 U/L) were related to an increased risk of all-cause mortality [odds ratio (OR) = 2.17, 95% CI: 1.19-3.96; P = 0.011] and patients in Q3 (76.8-92.9 U/L) were related to a lower risk of recurrent stroke (OR = 0.37, 95% CI: 0.14-0.97; P = 0.043) at the 3-month time point, compared to those in Q2 (63.0-76.7 U/L). The optimal range of ALP for all-cause mortality was seen in Q2, with a nadir level of 70 U/L. However, differences were statistically insignificant between ALP levels and poor functional outcomes (P > 0.05). Moreover, there was no significant interaction between ALP levels and age, gender, drinking status, smoking status, or pneumonia (P > 0.05) for all outcomes. Conclusion: Non-linear associations were observed between serum ALP levels and 3-month outcomes in patients with AS. It might be beneficial to reduce the risk of all-cause mortality and recurrent stroke by maintaining ALP at optimal ranges.

Structural characterization and bioactivity evaluation of water-extractable polysaccharides from chickpeas (Cicer arietinum L.) seeds.

Two water-extractable polysaccharide fractions designated as CWP (7. 37 × 105 Da) and CWP-0.2 (1.58 × 104 Da) were isolated and purified from chickpea (Cicer arietinum L.) seeds. The chemical structure of the two polysaccharides was characterized by various methods. Monosaccharide composition and methylation analysis showed that CWP was composed of Man and Glc in a molar ratio of 44.6:55.4, and CWP-0.2 was composed of Rha, Ara, Man, Glc, and Gal in a molar ratio of 10.6:23.3:5.2:4.9:56. Further structural characterization indicated that the main chain connection of CWP was → (2-ß-d-Fruf-1) n →, and the main chain connection of CWP-0.2 was explored as → 2,4)-α-l-Rhap-(1 → 3)-α-d-Galp-(1 → with the branched chain of → 2,4)-α-l-Rhap-(1 → o-4. Besides, both CWP and CWP-0.2 had antioxidant and immunoregulatory activity in vitro, through scavenging DPPH· and ABTS·+ as well as stimulating production of NO, IL-6, TNF-α and MCP-1 in RAW 264.7 macrophages. CWP-0.2 revealed significantly higher bioactivity than CWP.

The spatio-temporal change in soil P and P-solubilizing bacteria under clover mulching in apple orchards of Loess Plateau.

Cover crop is an effective practice for improving soil quality and increase soil nutrients. However, the spatio-temporal change of soil phosphorus (P) components and P-solubilizing microorganisms in the process of grass succession is not evident. Here, we studied the variation of soil P components and P-solubilizing bacteria at 0-60 cm soil layer under clean tillage (CT) and white clover (WC, Trifolium repens L.) grown for 5, 9, and 14 years in an apple test station on the Loess Plateau, China. This study suggested that clover cover could effectively increase the total P, available P (AP), microbial P, organic P (Po), and inorganic P (Al-P, Ca2-P, Ca8-P and Fe-P) in topsoil (0-20 cm) and AP, Po and inorganic P at 20-40 cm soil layer to improve the soil P bioavailability. The effects of WC living mulch on the soil P forms were more significant with the increase in grass growing years, but this effect was difficult to extend to deep soil. In addition, the WC treatments were beneficial to the growth of P-solubilizing microorganisms in surface soil and improved the alkaline phosphatase activity at 0-40 cm soil layer, mainly including Bacillus, Bradyrhizobium, Nocardioides, Sphingomonas and Streptomyces. This study provided a perspective on the dynamic changes of soil P forms and P-solubilizing microorganisms and under long-term cover crop.

Soil phytoremediation reveals alteration in soil microbial metabolic activities along time gradient of cover crop mulching.

The vitality and diversity of soil microbial metabolism are the core of soil function expression, cover crop is an environmentally friendly agricultural production practice; however, shifts in soil microbial metabolic activities along time gradient of cover crop remain unclear. Here, we used metagenomic and biological techniques to investigate soil microbial potential function and carbon (C) source utilization capacity in the time series of white clover (WC, Trifolium repens L.) for 6, 10, and 15 years in a typical semiarid apple orchard. Conventional tillage (CT) was taken as the control. This study demonstrated that living mulch 6 years of WC had little effect on soil microbial functions. However, after 10 and 15 years of crop cover, an enrichment of genes related to amino acid metabolism, carbon cycle, and nitrogen metabolism was observed in soil microorganisms. Furthermore, average well color development (AWCD) was increased in 10 and 15 years of cover crop, soil microbiome exhibited a stronger preference for carbohydrates, amino acids, and polymers as C sources. The results mainly provided insight into the variation character of microbial metabolic function under increasing duration of cover crop.

Mung Bean Protein Suppresses Undernutrition-Induced Growth Deficits and Cognitive Dysfunction in Rats via Gut Microbiota-TLR4/NF-kB Pathway.

Early undernutrition has been found to be closely associated with subsequent neurodevelopment. However, studies examining crude growth in terms of body weight/tail length cannot clarify how diets might mediate associations between the gut microbiota and cognitive dysfunction. In the present study, Sprague-Dawley (SD) rats were fed a 7% protein diet and mung bean protein diet (MBPD) for 6 weeks to assess central nervous system functions. Bifidobacterium longum subsp, Alloprevotella, and Lactobacillus were significantly altered after supplementary MBPD. Additionally, tryptophan, tyrosine, and glycine significantly restored in the brain, and the choline system also improved. Moreover, mung bean supplementation also upregulated expression of the brain-derived neurotrophic factor, postsynaptic density 95 protein (PSD95), synaptosome-associated protein 25 (SNAP25), downregulated toll-like receptor 4 (TLR4), and nuclear factor kB (NF-kB). Metabolites in the serum also underwent changes. Together, these results showed that malnutrition perturbed neurodevelopment, while MBPD reversed this trend.

Long-term cover crops improved soil phosphorus availability in a rain-fed apple orchard.

The objective of this present study was to understand the distribution patterns of various forms of soil phosphorus (P) and the biotic and abiotic factors affecting the soil P fractions under long-term cover crops. Here, we investigated the characteristics of soil P forms, community structure of P-solubilizing bacteria (using 16S rRNA) and the related enzyme activity under clean tillage (CT), 14 years of white clover (WC, Trifolium repens L.) and orchard grass (OG, Dactylis glomerata L.) cover crops in a rain-fed apple orchard on the Weibei Loess Plateau, China. Relative to CT treatment, long-term cover crops enhanced the bioavailability of soil P by increasing the contents of total phosphorus (TP), microbial phosphorus (MBP), organic phosphorus (Po) and certain forms of inorganic phosphorus (e.g. Al-P, Ca2-P, Ca8-P and Fe-P) in the surface soil, in addition, WC treatment also increase the available P (AP) contents in the topsoil. A redundant analysis (RDA) showed that soil organic matter (SOM), NH4+-N and pH were the key environmental factors affecting the morphological changes of soil P. In addition, the effects of long-term cover crops on soil P forms were mainly concentrated in the topsoil, and the WC treatment had a greater impact on soil P composition than the OG treatment. Interestingly, long-term cover crops effectively increased the abundances of P-solubilizing bacteria, such as Streptomyces, Sphingomonas, Nocardioides and Haliangium, and enhanced the alkaline phosphatase (ALP) activity. Overall, long-term cover crops were an effective strategy to activate soil P as they improve the soil environment.

Mulching practices alter soil microbial functional diversity and benefit to soil quality in orchards on the Loess Plateau.

To improve our understanding about the responses of microbial functional diversity to different mulching practices, this study used a metagenomic approach to reveal soil microbial functional specificity under four tillage regimes: conventional tillage (CT), organic mulch practices with ryegrass (Lolium perenne L.) intercropping cover (RE) and cornstalk mulch (CS), and inorganic mulching with black ground fabric (BF) in a 7-year field experiment in an apple orchard of the Loess Plateau in China. Enzyme activity and soil physicochemical properties were measured. A redundancy analysis showed that the RE and CS treatments had positive effects on soil nutrient and enzyme activity compared to that of the BF and CT treatments. The CS and RE treatments increased ß-glucosidase, cellobiohydrolase, and ß-xylosidase activities. In addition, the CS treatment significantly enhanced the ß-N-acetylglucosaminidase and urease activities compared to that under CT treatment. However, the activity of these enzyme was reduced in the BF treatment compared with that of the CT treatment. The results also indicated that the enzymes activities were not completely consistent with the changing trends of the genes encoding these enzymes. In addition, the RE and CS treatments also increased the abundance of genes encoding carbohydrate enzymes. It is interesting that the RE and CS treatments had more pathway genes associated with the carbon cycle, nitrogen cycle, and amino acid metabolism compared with the BF treatment. Remarkably, RE and CS treatments effectively increased the abundance of carbon fixation gene cbbL compared to CT treatment. In summary, organic mulching practices increased the soil microbiological functional diversity related to the carbon and nitrogen cycle, while inorganic mulching practice reduced them. This study enhanced our understanding of how mulching practices may alter soil microbial functional diversity and benefit soil quality.

Mulching practices alter the bacterial-fungal community and network in favor of soil quality in a semiarid orchard system.

The study aimed to investigate how mulching practices can improve soil quality by altering microbial community composition and the interrelations among its members. The experiment was conducted for 7 years (from 2012 to 2018) in an apple (Malus domestica cv. Fuji) orchard located on the Loess Plateau, China. Four treatments were applied: conventional tillage (CT), intercrop ryegrass (Lolium perenne L.) cover (RE), inter-row cornstalk mulch (CS), and black ground fabric mulch (BF). The results indicated that compared to CT treatment, all the three mulching practices significantly increased soil moisture content. The RE and CS treatments improved soil organic matter content by 11.8% and 36.5%, respectively, and CS treatment also increased available nitrogen content in soil by 42.0% compared with CT treatment. The soil environmental heterogeneity under different mulching practices shaped the microbial community structure and the dominant populations. All the mulching practices significantly increased the operational taxonomic unit (OTU) abundance and alpha diversity of fungi, and positively affected bacterial richness. Network analyses showed that the microbial structure was significantly affected by soil water and microbial biomass nitrogen. Interestingly, based on network correlation analysis among microorganisms, the BF treatment reduced competition between bacteria, whereas RE treatment increased their cooperation, however, the CS treatment not only promoted cooperation between fungi, but also increased correlations between fungi and bacteria. Finally, our results indicated that mulching practices not only increased the diversity of microorganisms and abundance of dominant species, but also promoted the interrelations among microorganisms in favor of soil quality.

The diversity of microbial community and function varied in response to different agricultural residues composting.

Microbial activities are the dynamic core in the soil nutrient cycle. To improve the knowledges about the responses of soil microbial community structure and potential function to long-term cover crops practice. The co-occurrence patterns of soil microbial community structure and functional genes were evaluated using 16SrRNA, ITS and metagenomic technique in 13 years cover crops of orchard grass (OG, Dactylis glomerata L.) with high C/N and white clover (WC, Trifolium repens L.) with low C/N. Conventional tillage (CT) was control. The experiment was implemented in an apple orchard located on the Loess Plateau, China, from 2006 to 2018. We also measured soil physicochemical properties and enzyme activities related to carbon and nitrogen cycling. The conclusions showed that the dominant bacterial phyla were Actinobacteria 27.68% in OG treatment and Proteobacteria 25.89% in WC treatment. Organic matter inputs stimulated growth of the phyla of Actinobacteria, Firmicutes, Chloroflexi, Ascomycota and genera of Bacillus, Blastococcus, Streptomyces and Penicillium. Interestingly, the OG and WC treatments promoted the fungal and bacterial alpha-diversity compared to CT treatment, respectively. In addition, compared to CT treatment, OG treatment was beneficial to the increase of C-cycle enzyme activity, while WC treatment tended to increase the N-cycle enzyme activity. Notably, compared to CT treatment, they both enriched carbon fixation and cycle pathways genes, while WC treatment increased the nitrogen metabolism pathway genes. Moreover, OG treatment was more conducive to the enrichment of carbohydrate enzymes genes involved in the hydrolysis of cellulose and hemicellulose compared to WC treatment. Overall, different quality of plant residues stimulated the specific expressions of soil microbial community structure and function. Long-term planted white clover was effective strategy to improve soil quality.

Intercropped relationship change the developmental pattern of apple and white clover.

Intercropping can introduce greater plant diversity and functional complementarity in an arable crop system but inter- and intracompetition can between intercropped crops. The rhizo-box was established of apple-white clover intercropped system to examine the competitive relationship between intercropped crops on the Loess Plateau. The results showed that the competitive relationship between intercropped crops was dynamic and changed with the crop competitiveness. Crop competitiveness was characterized by root development, although intercropping inhibited the development and nutrient accumulation aboveground of apple trunks and branches, intercropped apples still maintained a larger root system than under monoculture and the root morphology of intercropped apples changed significantly. White clover had lower competitiveness than apple at the beginning of the year, which was reflected in the inhibited development in May. However in July and October, intercropped white clover had more biomass and nutrient accumulation than under monoculture.

Upregulation of long non-coding RNA NNT-AS1 promotes osteosarcoma progression by inhibiting the tumor suppressive miR-320a.

OBJECTIVE: To investigate the role and mechanism of action of nicotinamide nucleotide transhydrogenase antisense RNA 1 (NNT-AS1) in osteosarcoma (OS). METHODS: Bioinformatic analysis suggested miR-320a as potential target of NNT-AS1. Influence of NNT-AS1 overexpression or knockdown on OS cell proliferation, colony-formation, apoptosis, migration and invasion capacity was first investigated. Expression levels of NNT-AS1, miR-320a, beta-catenin, RUNX2, IGF-1R, c-Myc, Cyclin D1 and MMP13 were also evaluated by RT-qPCR and western blotting accordingly. Xenograft models using U2OS and OS-732 cells with different NNT-AS1 gene modifications were constructed for tumor formation assay as well as evaluation of miR-320a, beta-catenin and RUNX2 expression in primary lesion. NNT-AS1-overexpressing U2OS cells and NNT-AS1-knockdown OS-732 cells were subject to miR-320a mimic and inhibitor transfection, respectively, to investigate the miR-320a dependency of the osteosarcoma-promoting role of NNT-AS1. RESULTS: NNT-AS1 overexpression significantly increased proliferation, survival and mobility of U2OS cells in vitro as well as its tumor formation ability in vivo, while NNT-AS1 knockdown showed opposite effect on OS-732 cells. In both in vitro and in vivo model, NNT-AS1 expression level significantly correlated with that of beta-catenin, RUNX2, IGF-1R, c-Myc, Cyclin D1 and MMP13 as well as Akt phosphorylation level, and inversely correlated with miR-320a expression. Transfection of miR-320a mimic significantly inhibiter the promoting effect of NNT-AS1 on cell proliferation, survival and mobility of U2OS cells, while miR-320 inhibitor partially rescued that of OS-732 cells. CONCLUSION: NNT-As1 functions as a cancer-promoting lncRNA by downregulating miR-320a, thus increasing the protein expression level of beta-catenin, RUNX2 and IGF-1R as well as activation of Akt in osteosarcoma.

Pathway analysis based on Monte Carlo Cross-Validation in polyarticular juvenile idiopathic arthritis.

INTRODUCTION: Juvenile idiopathic arthritis (JIA) is a common chronic disease with onset before the 16 years old in a child. Polyarticular JIA has been reported as the main form of JIA in several locations. Until now, understanding of the genetic basis of JIA is incomplete. The purpose of this study was to identify pathway pairs of great potential functional relevance in the progression of polyarticular JIA. MATERIALS AND METHODS: Microarray data of 59 peripheral blood samples from healthy children and 61 samples from polyarticular JIA were transformed to gene expression data. Differential expressed genes (DEG) between patients and normal controls were identified using Linear Models for Microarray Analysis. After performed enrichment of DEG, differential pathways were identified with Fisher's test and false discovery rate. Differential pathway pairs were constructed with random two differential pathways, and were evaluated by Random Forest classification. Monte Carlo Cross-Validation was introduced to screen the best pathway pair. RESULTS: 42 DEG with P-values<0.01 were identified. 19 differential pathways with P-values<0.01 were identified. Area under the curve (AUC) of pathway pairs was generated with RF classification. After 50 bootstraps of Monte Carlo Cross-Validation, the best pathway pair with the highest AUC value was identified, and it was the pair of tumoricidal function of hepatic natural killer cells pathway and erythropoietin signaling pathway. CONCLUSION: These identified pathway pairs may play pivotal roles in the progress of polyarticular JIA and can be applied for diagnosis. Particular attention can be focused on them for further research.

[Clinical efficiency and activity range of stiff knee by total knee arthroplasty].

OBJECTIVE: To observe clinical effect and influencing factor of total knee arthroplasty (TKA) for the treatment of stiff knee. METHODS: From January 2010 to October 2014, 20 patients(25 knees) with stiff knee were treated with TKA. Among them, including 2 males(3 knees) and 18 females(22 knees), aged from 55 to 78 years old with an average of(64.5± 4.9) years old, the courses of disease ranged from 5 to 21 years with an average 8.3 years. Preoperative and postoperative HSS (hospital for special surgery knee score) score, activity range and complications were observed and compared. RESULTS: All patients were followed up from 12 to 69 months with an average of 35.3 months. Ten patients occurred complications after operation. HSS score was improved from 32.36±12.31 preoperatively to 80.70±18.52 postoperatively, and had statistical difference between two groups;7 knees obtained excellent results, 15 knees good and 3 knees moderate. Activity range was improved from(39.4±5.3)°preoperatively to (92.5±11.2)° at the latest follow up. CONCLUSIONS: Total knee arthroplasty for stiffness knees is feasible and could obtain satisfied activity range and function.

A Novel Method for Pathway Identification Based on Attractor and Crosstalk in Polyarticular Juvenile Idiopathic Arthritis.

BACKGROUND Juvenile idiopathic arthritis (JIA) is one of the most common inflammatory disorders of unknown etiology. We introduced a novel method to identify dysregulated pathways associated with polyarticular JIA (pJIA). MATERIAL AND METHODS Gene expression profiling of 61 children with pJIA and 59 healthy controls were collected from E-GEOD-13849; 300 pathways were obtained from Kyoto Encyclopedia of Genes and Genomes (KEGG) database and 787,896 protein-protein interaction sets were gathered from the Retrieval of Interacting Genes. Attractor and crosstalk were designed to complement each other to increase the integrity of pathways assessment. Then, impact factor was used to assess the interactions inter-pathways, and RP-value was used to evaluate the comprehensive influential ability of attractors. RESULTS There were seven attractors with p<0.01 and 14 pathways with RP<0.01. Finally, two significantly dysfunctional pathways were found, which were related to pJIA progression: p53 signaling pathway (KEGG ID: 04115) and non-alcoholic fatty liver disease (NAFLD) (KEGG ID: 04932). CONCLUSIONS A novel approach that identified the dysregulated pathways in pJIA was constructed based on attractor and crosstalk. The new process is expected to be efficient in the upcoming era of medicine.