Causes and Countermeasures of Complications After Bariatric Surgery / 中国医学科学院学报

Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy characterized by simple operation and few postoperative complications have gradually become the two most commonly used surgical methods in clinical practice.A series of complications often occur after bariatric surgery,including gallstone disease,anemia,malnutrition,gastroesophageal reflux disease,kidney stones,and birth defects in offspring of women of childbearing age.There are controversies regarding the causes and countermeasures of these complications.This article mainly reviews the risk factors and countermeasures for the complications after bariatric surgery.

Adding acupoint identification into the textbook Meridians and Acupoints: preliminary assumption / 中国针灸

To deepen the understanding of the acupoint indications, clarify the targeting of acupoints, and provide a basis for the composition of acupuncture prescriptions, it is suggested to add acupoint identification into the textbook Meridians and Acupoints, and a preliminary assumption that relevant acupoints can be identified by taking the indications, locations, and meridians as the key points is proposed. In this paper, acupoints for treating stomach disease, acupoints of eye region, and five-shu points of lung meridian are taken as examples, combined with ancient literature and modern scientific research achievements, the main indications of acupoint is identified, which is of great significance to the discipline's development, talent training, and achievement transformation.

Research progress on the regulation and mechanism of reactive oxygen species on tumor immune checkpoints / 药学学报

Immune checkpoints (ICs) are immunosuppressive molecules expressed on immune cells, which can regulate immune cells' activation. Immune checkpoint inhibitors (ICIs) which can block the interaction of immune checkpoints and their ligands, improve the cytotoxic effect of the immune system on tumor cells. Immunotherapy such as employing ICIs has gradually become a conventional therapeutic strategy for cancer treatment. However, the low response rate and the emergence of drug resistance have seriously affected the clinical efficacy of ICIs. Reactive oxygen species (ROS) are electronic reduction products of active oxygen, as well as natural by-products of cell metabolism, which can be used as regulators of intercellular signals. Tumor microenvironment (TME) is often in the state of oxidative stress (OS), which is the imbalance between oxidative system and antioxidant system. ROS can affect the interaction with its ligands by regulating the expression and activity of immune checkpoints in TME, thus affecting the anti-tumor effect of immune cells. Accumulating studies have shown that ROS could regulate tumor immune checkpoints through several pathways. Due to different types and stages of tumor, it would be clinical beneficial to understand the mechanistic link of ROS on tumor immune checkpoint, and choose appropriate ROS regulators combined with immune checkpoint inhibitors to maximize anti-tumor effects. This article reviews the common metabolic sources and characteristics of ROS, the regulatory effect and mechanism of ROS on tumor immune checkpoints and its therapeutic application.

Research progress of inflammatory cytokines in rheumatoid arthritis / 中国药理学通报

Rheumatoid arthritis (RA) is the most common eause of autoimmune arthritis in the world.In RA patients serum or plasma cytokine levels may indicate the severity of the disease.Cytokine gene polymorphism can be used as a marker of RA susceptibility and severity.Rheumatoid arthritis is a systemic connective tissue disease.Not only joints, but other organs (lungs.lymph nodes, spleen, skin, heart or eyes) may also he involved.'Hie main goal of treatment for rheumatoid arthritis is to avoid joint destruction through early and aggressive anti-inflammatory treatment.In the past few decades, various therapies were used for patients when methotrexate was ineffective or intolerant to alter the joint and systemic prognosis and the patients' disability.Among them, cytokine targeted therapy have long been identified to be the most promising therapy.This article re- views the effector functions of different inflammatory factors and their role in the RA pathogenesis and the targeted inhibitors targeting inflammatory factors that can currently be used for the treatment of RA.

Relationship between the Expression of miRNA181a-5p and the Imbalance of Treg/Th17 in Primary Immune Thrombocytopenia / 中国实验血液学杂志

OBJECTIVE@#To investigate the role of relationship between the expression of miRNA181a-5p and imbalance of Treg/Th17 in the pathogenesis of primary immune thrombocytopenia(ITP), which contributes to clarify the mechanism of T cell immune imbalance in ITP patients.@*METHODS@#Peripheral blood was collected from 37 ITP patients, concluding 21 untreated patients and 16 effectively treated patients, and 19 healthy controls; Peripheral blood mononuclear cells (PBMC) were isolated and the expression of miRNA181a-5p and Notch1 was analyzed by RT-PCR. The proportion of Th17 subsets and Treg cells in the peripheral circulation was detected by flow cytometer (FCM). Clinical data of ITP group was collected, including age, platelet count and disease course.@*RESULTS@#The expression of miR-181a-5p was significantly decreased in ITP group than that of healthy control group (P＜0.01). After effective treatment, the expression of miR-181a-5p was significantly higher than that of ITP group (P＜0.05), but still significantly lower than that of healthy control group (P＜0.01); The expression of Notch1 was significantly increased in ITP group and effectively treated group than that of healthy control group (P＜0.01). There was no significant difference in proportion of Treg cells in ITP group, effectively treated group and healthy control group (P＞0.05). The proportion of Th17 subsets in ITP group was significantly increased than that of healthy control group (P＜0.05), while the ratio of Treg/Th17 was significantly decreased (P＜0.05). There was a positive correlation between the expression of miR-181a-5p and ratio of Treg/Th17 in ITP group (r=0.555).@*CONCLUSION@#The expression of miR-181a-5p is significantly decreased in ITP patients, which is closely related to the imbalance of Treg/Th17 cells. After effective treatment, the expression of miR-181a-5p can be significantly corrected, but still failed to reach the level of healthy people. While the expression of Notch1 is significantly increased in ITP patients, and could not reach the level of healthy people after effective treatment.

Effect of astragaloside IV on the expression of NOD-like receptor protein 3 inflammasome in neonatal rats with hypoxic-ischemic brain damage / 中国当代儿科杂志

OBJECTIVE@#To study the effect of astragaloside IV (AS-IV) on NOD-like receptor protein 3 (NLRP3) inflammasome in neonatal rats with hypoxic-ischemic brain damage (HIBD).@*METHODS@#A total of 24 Sprague-Dawley rats, aged 7 days, were randomly divided into a sham-operation group, an HIBD group, and an AS-IV treatment group, with 8 rats in each group. After 24 hours of modeling, brain tissue was collected for hematoxylin-eosin staining, yo-PRO-1 staining, and EthD-2 immunofluorescent staining in order to observe the cerebral protection effect of AS-IV in vivo. HT22 cells were used to prepare a model of oxygen-glycogen deprivation (OGD), and a concentration gradient (50-400 μmol/L) was established for AS-IV. CCK-8 assay was used to measure the viability of HT22 cells. RT-PCR and Western blot were used to observe the effect of different concentrations of AS-IV on the mRNA and protein expression of NLRP3, gasdermin D (GSDMD), caspase-1, and interleukin-1β (IL-1β).@*RESULTS@#Yo-Pro-1 and EthD-2 staining showed that compared with the sham-operation group, the HIBD group had an increase in pyroptotic cells with a small number of necrotic cells, and the AS-IV group had reductions in both pyroptotic and necrotic cells. Compared with the sham-operation group, the HIBD group had significantly higher protein expression levels of NLRP3, IL-1β, caspase-1, and GSDMD (@*CONCLUSIONS@#AS-IV may alleviate HIBD in neonatal rats by inhibiting the expression of NLRP3, GSDMD, caspase-1, and IL-1β.

Mechanism of tanshinone IIA to prevent spontaneous breast cancer in mice / 药学学报

To explore the effect of tanshinone IIA (TanIIA) on the occurrence and development of breast cancer, we employed the mouse mammary tumor virus-polyomavirus middle T antigen (MMTV-PyMT) transgenic mice as a spontaneous breast cancer mouse model. Animal welfare and experimental procedures were in accordance with the regulations of the Animal Ethics Committee of Nanjing University of Chinese Medicine. The animals were divided into control group, low-dose TanIIA treatment group (30 mg·kg-1·day-1), and high-dose TanIIA treatment group (60 mg·kg-1·day-1). The treatment was administered orally and daily for 5 weeks. The mice were sacrificed after final treatment. Mammary gland and lung were collected for histopathology studies. We evaluated the chemoprophylaxis effect of TanIIA on breast cancer in mice according to the pathological characteristics of breast cancer at different stages of development. Immunofluorescence staining were employed for blood vessel analysis. The expression levels of E-cadherin, proliferating nuclear antigen (PCNA), and oncogene c-Myc were detected by immunohistochemistry. Flow cytometry was used to analyze cell cycle and Cytoscape was used to construct drug-disease protein-protein interaction (PPI) network. Our results showed that TanIIA inhibits breast tumor progression by delaying malignancy from adenoma to early carcinoma, and inhibits blood vessel formation during tumor development. TanIIA (60 mg·kg-1·day-1) inhibits the expression levels of PCNA and c-Myc, upregulates the expression of E-cadherin. In addition, cell cycle experiments showed that the cell cycle of PyMT primary mammary cells in the high-dose TanIIA group was arrested in the G0/G1 phase. Our study demonstrated that TanIIA can significantly inhibit breast tumor progression in MMTV-PyMT mouse model, which may be related to the inhibition of angiogenic switch and cell cycle arrest.

Double Lock of a Potent Human Monoclonal Antibody against SARS-CoV-2

Receptor recognition and subsequent membrane fusion are essential for the establishment of successful infection by SARS-CoV-2. Halting these steps can cure COVID-19. Here we have identified and characterized a potent human monoclonal antibody, HB27, that blocks SARS-CoV-2 attachment to its cellular receptor at sub-nM concentrations. Remarkably, HB27 can also prevent SARS-CoV-2 membrane fusion. Consequently, a single dose of HB27 conferred effective protection against SARS-CoV-2 in two established mouse models. Rhesus macaques showed no obvious adverse events when administrated with 10-fold of effective dose of HB27. Cryo-EM studies on complex of SARS-CoV-2 trimeric S with HB27 Fab reveal that three Fab fragments work synergistically to occlude SARS-CoV-2 from binding to ACE2 receptor. Binding of the antibody also restrains any further conformational changes of the RBD, possibly interfering with progression from the prefusion to the postfusion stage. These results suggest that HB27 is a promising candidate for immuno-therapies against COVID-19. HighlightsO_LISARS-CoV-2 specific antibody, HB27, blocks viral receptor binding and membrane fusion C_LIO_LIHB27 confers prophylactic and therapeutic protection against SARS-CoV-2 in mice models C_LIO_LIRhesus macaques showed no adverse side effects when administered with HB27 C_LIO_LICryo-EM studies suggest that HB27 sterically occludes SARS-CoV-2 from its receptor C_LI

SARS-CoV-2 infection causes transient olfactory dysfunction in mice

Olfactory dysfunction caused by SARS-CoV-2 infection represents as one of the most predictive and common symptoms in COVID-19 patients. However, the causal link between SARS-CoV-2 infection and olfactory disorders remains lacking. Herein we demonstrate intranasal inoculation of SARS-CoV-2 induces robust viral replication in the olfactory epithelium (OE), resulting in transient olfactory dysfunction in humanized ACE2 mice. The sustentacular cells and Bowmans gland cells in OE were identified as the major targets of SARS-CoV-2 before the invasion into olfactory sensory neurons. Remarkably, SARS-CoV-2 infection triggers cell death and immune cell infiltration, and impairs the uniformity of OE structure. Combined transcriptomic and proteomic analyses reveal the induction of antiviral and inflammatory responses, as well as the downregulation of olfactory receptors in OE from the infected animals. Overall, our mouse model recapitulates the olfactory dysfunction in COVID-19 patients, and provides critical clues to understand the physiological basis for extrapulmonary manifestations of COVID-19.

Structural basis for neutralization of SARS-CoV-2 and SARS-CoV by a potent therapeutic antibody

The COVID-19 pandemic caused by the SARS-CoV-2 virus has resulted in an unprecedented public health crisis. There are no approved vaccines or therapeutics for treating COVID-19. Here we reported a humanized monoclonal antibody, H014, efficiently neutralizes SARS-CoV-2 and SARS-CoV pseudoviruses as well as authentic SARS-CoV-2 at nM level by engaging the S receptor binding domain (RBD). Importantly, H014 administration reduced SARS-CoV-2 titers in the infected lungs and prevented pulmonary pathology in hACE2 mouse model. Cryo-EM characterization of the SARS-CoV-2 S trimer in complex with the H014 Fab fragment unveiled a novel conformational epitope, which is only accessible when the RBD is in open conformation. Biochemical, cellular, virological and structural studies demonstrated that H014 prevents attachment of SARS-CoV-2 to its host cell receptors. Epitope analysis of available neutralizing antibodies against SARS-CoV and SARS-CoV-2 uncover broad cross-protective epitopes. Our results highlight a key role for antibody-based therapeutic interventions in the treatment of COVID-19. One sentence summaryA potent neutralizing antibody conferred protection against SARS-CoV-2 in an hACE2 humanized mouse model by sterically blocking the interaction of the virus with its receptor.

Rapid adaptation of SARS-CoV-2 in BALB/c mice: Novel mouse model for vaccine efficacy

Coronavirus disease 2019 (COVID-19) threatens global public health and economy. In order to develop safe and effective vaccines, suitable animal models must be established. Here we report the rapid adaption of SARS-CoV-2 in BALB/c mice, based on which a convenient, economical and effective animal model was developed. Specifically, we found that mouse-adapted SARS-CoV-2 at passage 6 (MACSp6) efficiently infected both aged and young wild-type BALB/c mice, resulting in moderate pneumonia as well as inflammatory responses. The elevated infectivity of MACSp6 in mice could be attributed to the substitution of a key residue (N501Y) in the receptorbinding domain (RBD). Using this novel animal model, we further evaluated the in vivo protective efficacy of an RBD-based SARS-CoV-2 subunit vaccine, which elicited highly potent neutralizing antibodies and conferred full protection against SARS-CoV-2 MACSp6 challenge. This novel mouse model is convenient and effective in evaluating the in vivo protective efficacy of SARS-CoV-2 vaccine. SummaryThis study describes a unique mouse model for SARS-CoV-2 infection and confirms protective efficacy of a SARS-CoV-2 RBD subunit vaccine.

An artificial intelligence system reveals liquiritin inhibits SARS-CoV-2 by mimicking type I interferon

The pandemic COVID-19 has spread to all over the world and greatly threatens safety and health of people. COVID-19 is highly infectious and with high mortality rate. As no effective antiviral treatment is currently available, new drugs are urgently needed. We employed transcriptional analysis to uncover potential antiviral drugs from natural products or FDA approved drugs. We found liquiritin significantly inhibit replication of SARS-CoV-2 in Vero E6 cells with EC50 = 2.39 M. Mechanistically, we found liquiritin exerts anti-viral function by mimicking type I interferon. Upregulated genes induced by liquiritin are enriched in GO categories including type I interferon signaling pathway, negative regulation of viral genome replication and etc. In toxicity experiment, no death was observed when treated at dose of 300 mg/kg for a week in ICR mice. All the organ indexes but liver and serum biochemical indexes were normal after treatment. Liquiritin is abundant in licorice tablet (~0.2% by mass), a traditional Chinese medicine. Together, we recommend liquiritin as a competitive candidate for treating COVID-19. We also expect liquiritin to have a broad and potent antiviral function to other viral pathogens, like HBV, HIV and etc.

Antibody responses to SARS-CoV-2 in COVID-19 patients: the perspective application of serological tests in clinical practice

BackgroundWe aim to investigate the profile of acute antibody response in COVID-19 patients, and provide proposals for the usage of antibody test in clinical practice. MethodsA multi-center cross-section study (285 patients) and a single-center follow-up study (63 patients) were performed to investigate the feature of acute antibody response to SARS-CoV-2. A cohort of 52 COVID-19 suspects and 64 close contacts were enrolled to evaluate the potentiality of the antibody test. ResultsThe positive rate for IgG reached 100% around 20 days after symptoms onset. The median day of seroconversion for both lgG and IgM was 13 days after symptoms onset. Seroconversion of IgM occurred at the same time, or earlier, or later than that of IgG. IgG levels in 100% patients (19/19) entered a platform within 6 days after seroconversion. The criteria of IgG seroconversion and > 4-fold increase in the IgG titers in sequential samples together diagnosed 82.9% (34/41) of the patients. Antibody test aided to confirm 4 patients with COVID-19 from 52 suspects who failed to be confirmed by RT-PCR and 7 patients from 148 close contacts with negative RT-PCR. ConclusionIgM and IgG should be detected simultaneously at the early phase of infection. The serological diagnosis criterion of seroconversion or the >; 4-fold increase in the IgG titer is suitable for a majority of COVID-19 patients. Serologic test is helpful for the diagnosis of SARS-CoV-2 infection in suspects and close contacts.

Effects of electroacupuncture of different frequencies on electromyography, NOS and ICC of colon in rats with slow transit constipation / 针灸推拿医学（英文版）

Objective: To observe the effects of electroacupuncture (EA) of different frequencies on transmission function, electromyography, nitric oxide synthase (NOS) content and interstitial cells of Cajal (ICC) expression of colon in rat models with slow transit constipation (STC). Methods: Of the 50 healthy male Wistar rats, 10 were randomly selected as a normal group and fed with ordinary diet, and the remaining 40 rats were fed with the diet added with the compound diphenoxylate at a dose of 8 mg/(kg·bw) each day for continuous 120 d. The 40 successfully established STC rat models were randomly divided into a model group, a low-frequency EA group (2 Hz), a high-frequency EA group (100 Hz), and a variable-frequency EA group (2 Hz/100 Hz), with 10 rats in each group. Rats in the normal and the model groups were not given any treatment; the low-frequency EA and the high-frequency EA groups were given EA at Tianshu (ST 25), Zusanli (ST 36) and Zhigou (TE 6) with continuous wave at the designated frequency, and the variable-frequency EA group received sparse-dense wave (2 Hz/100 Hz) EA at the same acupoints, once a day for a total of 15 d. After treatment, the colonic transmission function, electromyography, NOS content and ICC expression (calculated by the difference in the area of the C-kit positive cells) of the rats in each group were measured. Results: For the colonic transmission function, compared with the normal group, the first black stool excretion durations of rats in the other groups were significantly prolonged (all P<0.05); compared with the model group, the first black stool excretion durations of rats in the three EA groups were significantly shortened (all P<0.05), which was significantly shorter in the variable-frequency EA group than in the low-frequency EA and high-frequency EA groups (both P<0.05). For the colonic electromyography, compared with the normal group, the amplitude was significantly increased and the frequency was accelerated in rats of the other groups (all P<0.05); compared with the model group, the amplitude was significantly reduced and the frequency was slowed down in the three EA groups (both P<0.05); compared with the low-frequency EA and the high-frequency EA groups, the amplitude was reduced and the frequency was significantly reduced in rats of the variable-frequency EA group (both P<0.05). Compared with the normal group, the colonic NOS contents were significantly increased in the other groups (all P<0.05); compared with the model group, the NOS contents were significantly reduced in the three EA groups (all P<0.05); compared with the low-frequency EA and the high-frequency EA groups, the content was significantly reduced in the variable-frequency EA group (all P<0.05). For the area of rat colonic C-kit-positive cells, compared with the normal group, the areas were significantly reduced in rats of other groups (all P<0.05); compared with the model group, the areas were increased significantly in the three EA groups (all P<0.05); compared with the low-frequency EA group, the area was increased significantly in the variable-frequency EA group (P<0.05). Conclusion: EA, especially EA at the 2 Hz/100 Hz variable-frequency, has a positive treatment effect on the STC model rats. It may improve rats' colonic function by regulating the electromyography, NOS content and ICC expression of colon.

Exploration of dominant diseases and clinical application characteristics of wrist-ankle acupuncture therapy based on data mining technology / 中国针灸

OBJECTIVE@#To analyze the literature regarding wrist-ankle acupuncture therapy by data mining technology, and the dominant diseases of wrist-ankle acupuncture therapy were summarized to provide reference for evaluation of specificity effect of wrist-ankle acupuncture therapy.@*METHODS@#The journal articles regarding wrist-ankle acupuncture therapy from the CNKI, WANFANG, and VIP since January 1, 1975 to December 31, 2017, and the medical cases regarding wrist-ankle acupuncture therapy in - and were retrieved. Based on the disease types of wrist-ankle acupuncture therapy in the journal articles and medical cases, the association rules method of data mining technology was applied to calculate frequent itemsets. The self-developed database platform for wrist-ankle acupuncture therapy was used to extract and summarize the information to explore the rules of clinical application.@*RESULTS@#The scope of disease involved a total of 7 disease entities in the literature regarding wrist-ankle acupuncture therapy. In the journal articles, there were 83 disease types and the most common surgical diseases were soft tissue injury and periarthritis of shoulder, the frequency were 34 and 24 times respectively. The total effective rates of wrist-ankle acupuncture therapy were 92.74% in internal medicine, 91.39% in surgery, 91.51% in gynecology, 90.88% in dermatology, 96.20% in pediatric, 89.05% in ophthalmology and otorhinolaryngology and 88.78% in psychiatry. In the medical cases of wrist-ankle acupuncture therapy, there were 118 disease types and the most common diseases were pain and syndrome, herpes zoster was also a common disease. Psychiatric diseases used more wrist-ankle acupuncture therapy, and the common diseases were anxiety and mania.@*CONCLUSION@#Wrist-ankle acupuncture therapy is widely used in treatment of clinical diseases and has significant therapeutic effects. It is mostly used in the treatment of surgery, internal medicine (neurology particularly), dermatology (herpes zoster particularly). Besides, the wrist-ankle acupuncture therapy is also applicable in the treatment of diseases of ophthalmology and otorhinolaryngology, gynecology, pediatric and psychiatry.

Effects of ER Stress and PUMA on 5-FU-induced Liver Cell Injury and Apoptosis / 中山大学学报(医学科学版)

@#【Objective】To investigate the role of ER stress and PUMA in 5-FU-induced liver cells injury and apoptosis.【Methods】We established 5-FU-induced liver injury models by intraperitoneally injecting the isodose 5-FU to 10 PUMA knockout mice(PUMA-KO)and 20 PUMA Wild type mice(PUMA-WT). Meanwhile,10 WT mice were intraperitoneally injected with 4-Phenylbutyric acid,the ER stress inhibitor. In the control group,10 KO mice and 20 WT mice were given the same amount of normal saline.After the modeling,serum and liver tissues of the mice were collected to assess the degree of liver pathological injury,measure the expression levels of ALT and AST in serum,and detect the expression levels of PUMA and GRP78 in liver tissues. The changes of these indicators in different treatment groups were observed and compared.【Results】Compared with the WT control group,serum ALT and AST levels were significantly increased in the 5-FU group,H&E staining showed punctate focal necrosis,accompanied by hemorrhage and inflammation. TUNEL staining showed apoptotic cells were markedly added(Z = 3.78,P < 0.001),and expressions of PUMA and GRP78 were obviously augmented,suggesting that both PUMA and ER stress were involved in 5-FU-induced liver cells injury and apoptosis. Then,in the 4-PBA group,we found that the expression levels of GRP78 and PUMA were down-regulated,and apoptosis of liver cells was reduced under the same dose of 5-FU(χ~2= 32.99,Z = 3.78,P <0.001),further confirming that both PUMA and ER stress were involved in this process. Subsequently,it was found that,when induced by the same dose of 5-FU,cleaved caspase-3 staining showed that the liver apoptosis signal of the PUMA knockout mice was lower than the WT mice(χ~2= 33.99,Z = 3.78,P < 0.001),but the difference in the expression of GRP78 between the two groups was not statistically significant. In summary,the expression of PUMA was reduced and the apoptosis of liver cells was attenuated after the inhibition of ER stress;PUMA knockdown could not influence the activation of ER stress but alleviated apoptosis of liver cells.【Conclusions】PUMA mediates ER stress-up-regulated liver cells apoptosis in 5-FU-induced Chemotherapeutic liver injury.

Family history of rheumatic diseases in patients with rheumatoid arthritis: a large scale cross-sectional study / 北京大学学报(医学版)

OBJECTIVE@#To determine the associations between the family history of rheumatic diseases and clinical features in patients with rheumatoid arthritis (RA).@*METHODS@#In total, eight hundred and ninety patients with RA were enrolled. The demographic and clinical data were collected, including gender, age, height, body weight, age of disease onset, history of smoking and drinking, family history of rheumatic diseases, clinical and laboratory features, pain and global visual analogue scale (VAS), and multi-dimensional health assessment questionnaire (MDHAQ). Finally, 803 patients were completed the dataset and were included in the study.@*RESULTS@#In this cohort, the male/female ratio was 1:3.5, and the age of onset was (45.09±14.50) years. A total of 123 (15.32%) patients were accompanied with family history of rheumatic diseases, including RA, spondyloarthritis, Sjögren's syndrome, systemic lupus erythematosus and systemic sclerosis. The percentages of first degree, second degree and both first and second degree relatives were 91 (73.98%), 22 (17.89%), and 10 (8.13%) respectively. The most common disease was RA (70.73%), followed by other rheumatic diseases (21.95%), and RA combined with other rheumatic diseases (7.32%). The clinical and laboratory characteristics were compared between the patients with and without family history. The onset-age of the subjects was significantly different between those with and without family history of rheumatic diseases (39.97 ±13.68 vs. 46.01±14.46; P<0.01), which meant that the onset-age in patients with family history was 6.04 years earlier than that in patients without family history. The patients with family history had higher positive rate of rheumatoid factor (RF) compared with those without family history (78.48% vs. 66.67%, P<0.05). By adjusting with gender, body mass index (BMI), smoking and alcohol drinking, anti-cyclic citrullinated peptide (CCP) antibody and RF level, the age at disease onset in the patients with family history was 4.54 years earlier than that in the patients without family history (β=-4.54; 95%CI:-8.70, -0.38; P<0.05). Further hierarchical regression analysis showed that, the age at onset of the RA patients with family history was 10.02 years earlier than that without family history among the smoking patients (β= -10.02; 95%CI:-17.60, -2.43; P=0.01), while the age at onset of the RA patients with family history was 3.27 years earlier than that without family history among the never smoking patients (β=-3.27; 95%CI:-8.37, 1.82; P=0.21).@*CONCLUSION@#The family history of rheumatic diseases is a risk factor for early onset of RA, and may interact with smoking.

Detection of EGFR Gene Mutation in Lung Adenocarcinoma by ARMS and Its Clinical Significance / 现代检验医学杂志

Objective To investigate the efficacy and clinical significance of amplification refractory mutation system (ARMS)in epidermal growth factor receptor (EGFR) gene mutation in lung adenocarcinoma.Methods Collected 566 specimens of lung adenocarcinomia in pathology from Department of the First Affiliated Hospital of Xi'an Jiaotong University from January 2015 to August 2016.As the research object,which included 34 cases of pleural cell specimens,401 cases of lung biopsy specimens and surgical specimens from 131 patients with ARMS to complete the above specimens EGFR gene mutation detection,analysis of EGFR gene mutations associated with non-small cell lung cancer patients clinical data.Results Among 566 cases of lung cancer specimens,the EGFR mutation rate of 239 cases of patients with smoking had no obvious correlation with age,gender and surgical methods(P＞0.05),but primary lung site was closely related (P＜0.05),and EGFR mutation rate of 327 cases of patients with non smoking had no obvious correlation withage,sex,operation mode and primary lung site (P＞0.05).Conclusion ARMS is an ideal method for the detection of EGFR gene mutation in non-small cell lung cancer.Smoking is a great influence on EGFR mutation rate in both lung tissue,and for right lung tissue is more dramatic.

Platelet-rich plasma combined with naringin induces osteogenic differentiation of human bone marrow mesenchymal stem cells in vitro / 中国组织工程研究

BACKGROUND: Platelet-rich plasma (PRP) and naringin can both promote proliferation and induce osteogenic differentiation of mesenchymal stem cells. However, their combined use is rarely reported. OBJECTIVE: To observe the effect of PRP combined with naringin on the osteogenic differentiation of human bone marrow mesenchymal stem cells(hBMSCs)in vitro. METHODS: BMSCs at passage 3 were divided into four groups: (1) blank control group, cells were cultured in α-MEM; (2) PRP group, cells were cultured in α-MEM containing PRP; (3) naringin group, cells were cultured in α-MEM containing naringin; and (4) combined group, cells were cultured in α-MEM containing PRP and naringin. The contents of used PRP and naringin were 12.5% and 50 μg/L respectively. Cell proliferation was detected by MTT assay. Expression of related genes in hBMSCs was detected by RT-PCR. Alkaline phosphatase staining, collagen type I immunohistochemical staining, and alizarin red staining were used to analyze the osteogenic differentiation of hBMSCs. RESULTS AND CONCLUSION: The proliferation of hBMSCs was increased in each group, especially in the combined group. Cells in all the groups except the blank control group were positive for alkaline phosphatase staining, collagen type I immunohistochemical staining, and alizarin red staining, and the positive effect was more obvious in the combined group. However, negative or weakly positive response was found in the blank control group. At 7 and 14 days, the expression of alkaline phosphatase and collagen type I was significantly higher in the PRP, naringin and combined groups than the blank control group (P < 0.05); at 14 days, the expression of alkaline phosphatase and collagen type I was significantly higher in the combined group than the PRP and naringin groups (P < 0.05). To conclude, PRP combined with naringin can promote the proliferation of hBMSCs and induce the osteogenic differentiation of hBMSCs. Moreover, there is a synergistic effect between PRP and naringin.

Effect of Rong Huang granules of patients with non-dialysis kidney deficiency damp heat syndrome and chronic kidney disease mineral and bone metabolism disorder to serum OPG and RANKL levels / 中国免疫学杂志

Objective:To observe serum osteoprotegerin (OPG),receptor activator of NF-kB ligand (RANKL) levels and the therapeutic effect of Rong Huang granules of patients with non-dialysis chronic kidney disease mineral and bone metabolism disorder (CKD-MBD) and kidney deficiency damp heat syndrome.Methods:70 cases of non-dialysis CKD-MBD with kidney deficiency damp heat syndrome,were randomly divided into treatment group and control group,the actual completion of 61 cases,30 cases in treatment group,31 cases in the control group;and a healthy normal group of 20 cases of patients was established.Two groups of patients were given symptomatic treatment,in addition,Rong Huang granules was plused in treating at treatment group and it was used three times a day,each time blunt one bag.The course of treatment was 8 weeks.The changes of kidney deficiency damp heat syndrome,blood urea nitrogen (BUN),serum creatinine (Scr),estimated glomerular filtration rate (eGFR),serum of calcium (Ca),phosphorus (P), alkaline phosphatase (ALP),parathyroid hormone (iPTH),OPG and RANKL levels were observed in two groups of patients.Results:The total effective rate in treatment group was significantly better than the control group(P<0.01).The integral value of syndrome decreased more significantly with the course of treatment increased of two groups of patients(P<0.01).Compared with the same period of therapy,the descender in the treatment group was significantly better than that in the control group(P<0.01).The levels of BUN, Scr,eGFR,Ca,P,iPTH and ALP were improved in the treatment group after treatment(P<0.05 or P<0.01),BUN and iPTH were improved in the control group(P<0.05 or P<0.01),other indexes were not improved(P>0.05).After treatment,BUN,Scr,eGFR,Ca, P,iPTH,ALP of treatment group were significantly better than the control group(P<0.05 or P<0.01).Compared with the normal group,the levels of OPG and RANKL were significantly higher in CKD-MBD patients (P<0.01).After treatment,serum OPG level, serum RANKL level and OPG/RANKL ratio were significantly improved than before treatment in treatment group(P<0.05 or P<0.01),and in the control group,only the OPG/RANKL ratio increased(P<0.01).After treatment,OPG,RANKL and OPG/RANKL ratio in the treatment group were obviously improved compared with them in the control group(P<0.05 or P<0.01).Conclusion:The levels of OPG and RANKL in non-dialysis CKD-MBD patients with kidney deficiency damp heat syndrome were higher than those in healthy people,and the ratio of OPG/RANKL was lower than that in healthy people.Rong Huang granules can ameliorate clinical symptoms,prevent calcium and phosphorus metabolism,improve renal function,the mechanism may be related to the ameliorate of serum OPG and the decrease of serum RANKL level and the raise of ratio of OPG/RANKL.