Regulatory effects of the p38 mitogen-activated protein kinase-myosin light chain kinase pathway on the intestinal epithelial mechanical barrier and the mechanism of modified Pulsatilla decoction in the treatment of ulcerative colitis.

OBJECTIVE: To investigate the mechanism of the protective effect of modified Pulsatilla decoction (, MPD) on the mechanical barrier of the ulcerative colitis (UC) intestinal epithelium in vitro and in vivo. METHODS: We established an intestinal epithelial crypt cell line-6 cell barrier injury model by using lipopolysaccharide (LPS). The model was then treated with p38 mitogen-activated protein kinase-myosin light chain kinase (p38MAPK-MLCK) pathway inhibitors, p38MAPK-MLCK pathway silencing genes (si-p38MAPK, si-NF-κB, and si-MLCK), and MPD respectively. Transepithelial electronic resistance (TEER) measurements and permeability assays were performed to assess barrier function. Immunofluorescence staining of tight junctions (TJ) was performed. In in vivo experiment, dextran sodium sulfate-induced colitis rat model was conducted to evaluate the effect of MPD and mesalazine on UC. The rats were scored using the disease activity index based on their clinical symptoms. Transmission electron microscopy and hematoxylin-eosin staining were used to examine morphological changes in UC rats. Western blotting and real-time quantitative polymerase chain reaction were performed to examine the gene and protein expression of significant differential molecules. RESULTS: In in vitro study, LPS-induced intestinal barrier dysfunction was inhibited by p38MAPK-MLCK pathway inhibitors and p38MAPK-MLCK pathway gene silencing. Silencing of p38MAPK-MLCK pathway genes decreased TJ expression. MPD treatment partly restored the LPS-induced decreased in TEER and increase in permeability. MPD increased the gene and protein expression of TJ, while down-regulated the LPS-induced high expression of p-p38MAPK and p-MLC. In UC model rats, MPD could ameliorate body weight loss and disease activity index, relieve colonic pathology, up-regulate TJ expression as well as decrease the expression of p-p38MAPK and p-MLC in UC rat colonic mucosal tissue. CONCLUSIONS: The p38MAPK-MLCK signaling pathway can affect mechanical barrier function and TJ expression in the intestinal epithelium. MPD restores TJ expression and attenuates intestinal epithelial barrier damage by suppressing the p38MAPK-MLCK pathway.

Optimized new Shengmai powder inhibits myocardial fibrosis in heart failure by regulating the rat sarcoma/rapidly accelerated fibrosarcoma/mitogen-activated protein kinase kinase/extracellular regulated protein kinases signaling pathway.

OBJECTIVE: Exploring the effect of Optimized New Shengmai powder (, ONSMP) on myocardial fibrosis in heart failure (HF) based on rat sarcoma (RAS)/rapidly accelerated fibrosarcoma (RAF)/mitogen-activated protein kinase kinase (MEK)/extracellular regulated protein kinases (ERK) signaling pathway. METHODS: Randomized 70 Sprague-Dawley rats into sham (n = 10) and operation (n = 60) groups, then established the HF rat by ligating the left anterior descending branch of the coronary artery. We randomly divided the operation group rats into the model, ONSMP [including low (L), medium (M), and high (H) dose], and enalapril groups. After the 4-week drug intervention, echocardiography examines the cardiac function and calculates the ratios of the whole/left heart to the rat's body weight. Finally, we observed the degree of myocardial fibrosis by pathological sections, determined myocardium collagen (COL) I and COL Ⅲ content by enzyme-linked immunosorbent assay, detected the mRNA levels of COL I, COL Ⅲ, α-smooth muscle actin (α-SMA), and c-Fos proto-oncogene (c-Fos) by universal real-time, and detected the protein expression of p-RAS, p-RAF, p-MEK1/2, p-ERK1/2, p-ETS-like-1 transcription factor (p-ELK1), p-c-Fos, α-SMA, COL I, and COL Ⅲ by Western blot. RESULTS: ONSMP can effectively improve HF rat's cardiac function, decrease cardiac organ coefficient, COL volume fraction, and COL I/Ⅲ content, down-regulate the mRNA of COL I/Ⅲ, α-SMA and c-Fos, and the protein of p-RAS, p-RAF, p-MEK1/ 2, p-ERK1/2, p-ELK1, c-Fos, COL Ⅰ/Ⅲ, and α-SMA. CONCLUSIONS: ONSMP can effectively reduce myocardial fibrosis in HF rats, and the mechanism may be related to the inhibition of the RAS/RAF/MEK/ERK signaling pathway.

Application effect of remote intelligent rehabilitation system in rehabilitation of patients with rotator cuff injury following minimally invasive arthroscopic surgery / 中华创伤杂志

Objective:To compare the application effect of remote intelligent rehabilitation system and conventional rehabilitation in rehabilitation of patients with rotator cuff injury following minimally invasive arthroscopic surgery.Methods:A retrospective cohort study was used to analyze the clinical data of 47 patients with rotator cuff injury admitted to Xinhua Hospital, Shanghai Jiao Tong University School of Medicine from January to July 2022, including 18 males and 29 females; aged 45-65 years [(56.7±6.3)years]. All patients underwent minimally invasive arthroscopic surgical repair of rotator cuff rupture. After surgery, 25 patients underwent self-rehabilitation with conventional education (conventional rehabilitation group), and 22 patients underwent systematic rehabilitation with remote intelligent rehabilitation system (remote rehabilitation group). Constant shoulder score, University of California at Los Angeles (UCLA) shoulder score, self-rating anxiety scale (SAS) score, self-rating depression scale (SDS) score and visual analog score (VAS) were compared between the two groups on the day of admission, 4, 8, 12 weeks after surgery and at the last follow-up. Shoulder MRI was applied at 6 weeks after surgery to compare the degree of intra-articular effusion and bone marrow edema between the two groups. The shoulder range of motion of the two groups was compared at 12 weeks after operation. The satisfaction with the rehabilitation of the two groups was compared at the last follow-up.Results:All the patients were followed up for 6-10 months [(8.5±2.2)months]. There was no significant difference in Constant shoulder score, UCLA shoulder score, SAS score, SDS score and VAS between the two groups on the day of admission (all P>0.05). There was no significant difference in Constant score, UCLA score and SAS score between the two groups at 4 weeks after surgery (all P>0.05). The values of SDS score and VAS at 4 weeks after surgery were (31.8±6.6)points and (3.6±1.1)points in the remote rehabilitation group, which were better than those in the conventional rehabilitation group [(40.5±5.6)points and (4.7±1.3)points] (all P<0.05). The values of Constant score, UCLA score, SAS score, SDS score and VAS at 8 weeks after surgery were (62.5±5.5)points, (18.5±3.3)points, (20.5±4.7)points, (22.5±4.6)points and (2.5±0.6)points in the remote rehabilitation group, which were better than those in the conventional rehabilitation group [(41.3±4.7)points, (15.3±3.1)points, (28.5±4.8)points, (38.5±3.7)points and (3.3±1.3)points] ( P<0.05 or 0.01). The values of Constant score, UCLA score, SAS score and SDS score at 12 weeks after surgery were (85.4±6.4)points, (32.2±3.8)points, (13.6±2.8)points and (18.4±3.9)points in the remote rehabilitation group, which were better than those in the conventional rehabilitation group [(60.3±6.7)points, (25.2±4.1)points, (21.5±4.9)points and (26.7±6.6)points] (all P<0.05), while there was no significant difference in VAS between the two groups ( P>0.05). At the last follow-up, there were no significant differences in Constant score, UCLA score, SAS score, SDS score and VAS between the two groups (all P>0.05). MRI of the shoulder joint at 6 weeks after surgery indicated that the degree of intra-articular effusion in the shoulder joint and bone marrow edema of the proximal humerus in the remote rehabilitation group was significantly reduced than that in the conventional rehabilitation group. At 12 weeks after surgery, the remote rehabilitation group had better shoulder range of motion than the conventional rehabilitation group ( P<0.05 or 0.01). At the last follow-up, the satisfaction with the rehabilitation of the remote rehabilitation group was better than that of the conventional rehabilitation group ( P<0.01). Conclusion:For patients with rotator cuff injury who undergo minimally invasive arthroscopic surgery, postoperative application of remote intelligent rehabilitation system, in comparison with the conventional rehabilitation system, can help to facilitate shoulder function recovery, anxiety and depression improvement and pain relief in the early stage, reduce shoulder soft tissue and bone marrow edema of the shoulder, and increase shoulder range of motion and patients′ satisfaction with the rehabilitation.

Pathway analysis of influencing factors of self-management in elderly patients with type 2 diabetes mellitus based on health belief model / 中华健康管理学杂志

Objective:To explore the pathway of influencing factors of self-management in elderly patients with type 2 diabetes mellitus (T2DM) based on health belief theory.Methods:It was a cross-sectional study. A total of 210 elderly patients with T2DM admitted to Shanghai 10th People′s Hospital from January 2021 to March 2022 were selected as research subjects.The surveys of general data questionnaire, social support rating scale, the diabetes self-management scale, the health literacy survey scale for patients with chronic diseases, and the self-efficacy scale for patients with diabetes were conducted in all the subjects. The t test and Spearman correlation analysis were used to test the correlation among variables. Results:Social support, health literacy and self-efficacy were positively correlated with self-management scores in these patients ( r=0.380, 0.392, 0.274, all P<0.001). Univariate analysis showed that there were statistically significant differences in self-management among patients with different age, education level, physical exercise, medical payment method, family history and sleep quality (all P<0.05). Path analysis showed that the mediating effect of social support in the relationship between health literacy and self-efficacy was significant (95% CI: 0.014-0.117), social support, self-efficacy and health literacy directly affected self-management( β=0.25, 0.27, 0.35, all P<0.01). Self-efficacy and health literacy also positively affected self-management through multiple mediators of social support ( β=0.16, 0.27, both P<0.01). Conclusion:Social support, self-efficacy and health literacy mediate in the self-management of elderly patients with T2DM complicated with chronic complications and interact with each other.

Effects of Jianpi Mixture on Colonic miRNA Expression Profile in Diarrheal Irritable Bowel Syndrome Rats / 世界科学技术-中医药现代化

Objective To observe the difference in the expression of micro-ribonucleic acid(miRNA)in the colon tissue of irritable bowel syndrome-diarrhea(IBS-D)rats and rats treated with Jianpi Mixture,and predict The miRNA and corresponding genes involved in the treatment of IBS-D with Jianpi Mixture,providing a basis for finding potential therapeutic targets for IBS-D.Methods The rats were randomly divided into a blank group,a model group and a traditional Chinese medicine group,with 8 rats in each group.Both the model group and the Chinese medicine group used acute and chronic stimulation + senna leaf gavage to make the IBS-D model.The Chinese medicine group was gavaged with Jianpi Mixture after model building for 14 days.General condition,body weight and Bristol score were observed and recorded.Hematoxylin-eosin(HE)staining was used to observe the histopathological changes of colon in each group of rats.Transcriptome sequencing of rat colon tissue in each group to screen and map differentially expressed miRNAs.Perform GO(Gene oncology)functional enrichment analysis and KEGG(Kyoto Encyclopedia of Genes and Genomes)pathway enrichment analysis on the target genes corresponding to the screened common miRNAs.Results Compared with the model group,the weight of the rats in the Chinese medicine group increased significantly(P<0.01),and the Bristol score of the feces decreased significantly(P<0.01).The pathological damage of the colon tissue of rats in the Chinese medicine group was significantly reduced.Compared with the blank group,there were 109 differentially expressed genes in the model group,of which 80 were up-regulated and 29 were down-regulated.Compared with the model group,there were 109 differentially expressed genes in the traditional Chinese medicine group,of which 19 were up-regulated and 90 were down-regulated.Mapping the genes of the two comparisons found that 74 miRNAs in the model group were increased and 7 were decreased.The changes of these miRNAs were all reversed after the intervention of traditional Chinese medicine.The GO function enrichment analysis of target genes showed that Jianpi Mixture was mainly involved in synaptic vesicle positioning and transport,cytoplasmic transport,negative regulation of growth and development,and sugar transport after acting on rats.KEGG pathway enrichment analysis showed that MAPK,Wnt,Hippo,TNF,oxygen toxin,cAMP and other pathways were enriched.Conclusion After the intervention of Jianpi Mixture,IBS-D-related miRNA expression profiles have changed significantly;Jianpi Mixture may play a protective role in the treatment of IBS-D by regulating the MAPK signaling pathway and Wnt signaling pathway.Screening the core genes and predicting the miRNAs interacting with them provide a theoretical basis for the study of the pathogenesis of IBS-D and the therapeutic targets of Jianpi Mixture.

The mechanism of occurrence and differential assessment of unavoidable pressure injuries: a literature review / 中国实用护理杂志

This article started from the definition of unavoidable stress injury, analyzed the mechanism of occurrence and the current development of unavoidable pressure injury assessment methods and assessment tools, discussed the limitations of the current differential assessment of unavoidable stress injury, and putted forward relevant suggestions to provide reference for the research on the assessment and prevention strategies of unavoidable pressure injury in China.

Evaluation of the protective effect of foam dressings on intraoperative acquired pressure injuries based on propensity score matching / 中国实用护理杂志

Objective:To evaluate the protective effect of foam dressing in preventing intraoperative acquired pressure injury (IAPI), and to provide reference basis for prevention and treatment of IAPI during clinical operation.Methods:The clinical data of 455 surgical patients admitted to Xinhua Hospital Affiliated to Shanghai Jiao Tong University from October 2020 to January 2021 were retrospectively collected. According to whether foam dressing was used at the compression site during operation, the patients were divided into dressing group (101 cases) and control group (354 cases). The two groups were matched with age, body mass index, preoperative Braden and cerebrovascular disease as covariates, and were finally divided into 89 patients in the dressing group and 162 patients in the control group. Logistic regression analysis and stratified analysis were used to comprehensively evaluate the actual effect of foam dressing on the occurrence of IAPI in the surgical patients.Results:Among the 251 patients, there were 14 (15.7%) cases with IAPI in the dressing group and 13 (8.0%) cases in the control group, and the difference was not statistically significant ( χ2=3.41, P>0.05). Among the patients in the prone position, compared to the control group, the dressing group can effectively reduce the risk of IAPI in surgical patients by 77% ( OR=0.23, 95% CI 0.05-0.98, P<0.05). There was no interaction between foam dressing and intraoperative surgical characteristics ( P>0.05). Conclusions:Foam dressing plays a protective role in preventing the occurrence of IAPI in patients undergoing surgery in the prone position. There was no significant protective effect of intraoperative foam dressing in patients with other surgical characteristics.

Pyroptosis of syncytia formed by fusion of SARS-CoV-2 Spike and ACE2 expressing cells

SARS-Cov-2 infected cells fused with the ACE2-positive neighboring cells forming syncytia. However, the effect of syncytia in disease development is largely unknown. We established an in vitro cell-cell fusion system and used it to mimic the fusion of SARS-CoV-2 infected cells with ACE2-expressing cells to form syncytia. We found that Caspase-9 was activated after syncytia formation, and Caspase-3/7 was activated downstream of Caspase-9, but it triggered GSDME-dependent pyroptosis rather than apoptosis. What is more, single cell RNA-sequencing data showed that both ACE2 and GSDME were expression in alveolar type 2 cells in human lung. We propose that pyroptosis is the fate of syncytia formed by SARS-CoV-2 infected host cells and ACE2-positive cells, which indicated that lytic death of syncytia may contribute to the excessive inflammatory responses in severe COVID-19 patients.

The value of microvascular flow imaging method for the evaluation of placenta perfusion and prediction of fetal growth restriction: a pilot study / 中华超声影像学杂志

Objective:To evaluate the placental micro-vascular circulation by microvascular flowing imaging (MVFI) method, and to explore the clinical value of microvascular index (MVI) for the diagnosis of fetal growth restriction (FGR).Methods:A total of 21 fetuses at 24-34 weeks of gestation at the Peking Union Medical College Hospital from October to November 2019 were enrolled in this study, including 7 fetal growth restriction (FGR) fetuses, and 14 normal fetuses as control group. The fetuses of the two groups were matched according to the gestational weeks at the ratio of 1∶2. Fetal biometry parameters were measured and the placenta was observed by two-dimensional ultrasound.Uterine artery pulse index (UtA-PI), middle cerebral artery pulse index (MCA-PI), and umbilical artery S/D ratio were evaluated by color and pulse-wave Doppler. The placenta mico-circulation was displayed by the MVFI method and MVI was measured.Results:The study included 14 normal fetuses and 7 FGR fetuses. Compared with the control group, more placenta in the FGR group manifested as thickened and heterogeneous with decreased MVI and increased UtA-PI. There was statistically significant difference in placental mean MVI between two groups ( P=0.044). Besides, a trend towards significant negative correlation was observed between MVI and placenta thickness, although this was not statistically significant ( rs=-0.35, P=0.065). MVI had a higher specificity (100%) in the prediction of FGR. Conclusions:MVFI can display the micro-circulation of the placenta, and provide a direct and quantitative assessment method for placental perfusion.

MicroRNA-98-5p Inhibits Tumorigenesis of Hepatitis B Virus-Related Hepatocellular Carcinoma by Targeting NF-κB-Inducing Kinase

Purpose@#MicroRNAs play key regulatory roles in the tumorigenesis of hepatitis B virus-related hepatocellular carcinoma (HBVHCC). This study aimed to explore the regulatory effects of microRNA-98-5p (miR-98-5p) on the proliferation, migration, invasion, and apoptosis of HBV-HCC cells, as well as the underlying mechanisms involving nuclear factor-κB-inducing kinase (NIK). @*Materials and Methods@#The expressions of miR-98-5p and NIK in HBV-HCC tissues and cells, and the level of HBV DNA in HBVHCC cells were measured by quantitative real-time polymerase chain reaction (qRT-PCR). The proliferation, migration, invasion, and apoptosis of HBV-HCC cells were analyzed by cell counting kit-8, wound healing, transwell, and flow cytometry assay, respectively. The targeting relationship between miR-98-5p and NIK was predicted by StarBase3.0 and verified by dual-luciferase reporter assay. HBV-HCC xenograft tumor model was constructed in mice to observe the tumor growth in vivo. @*Results@#The expression of miR-98-5p was declined in HBV-HCC tissues and cells. Overexpression of miR-98-5p markedly reduced the level of HBV DNA; inhibited the proliferation, migration, and invasion; and promoted the apoptosis of HBV-HCC cells. NIK was a target of miR-98-5p. Overexpression of miR-98-5p markedly decreased the protein expression of NIK in MHCC97H-HBV cells. NIK reversed the tumor-suppressing effect of miR-98-5p on HBV-HCC cells. Furthermore, overexpression of miR-98-5p significantly inhibited the xenograft tumor growth and decreased the expression of NIK in mice. @*Conclusion@#MiR-98-5p inhibits the secretion of HBV, proliferation, migration, and invasion of HBV-HCC cells by targeting NIK.

The value of texture analysis based on T 2WI and apparent diffusion coefficient map in discriminating low grade from high grade prostate cancer / 中华放射学杂志

Objective:To investigate the value of texture analysis based on T 2WI and apparent diffusion coefficient (ADC) maps in discriminating low grade from high grade prostate cancer (PCa). Methods:Retrospective analysis was performed on patients who were confirmed to be PCa by pathology after surgery and underwent MRI examination in the department of radiology,Tongji Hospital,Tongji Medical College, Huazhong University of Science and Technology before radical surgery, including routine T 1WI, T 2WI and diffusion weighted imaging (DWI) sequences. 3D data analysis module of the MaZda software was used to manually draw region of interest (ROIs) slice by slice on T 2WI and ADC images, and generate volume of interest (VOI) of the entire tumor. MaZda software was also used to extract texture features. The independent sample t test or Mann-Whitney U test were used to identify the texture features with statistically significant differences between low and high grade PCa groups. Lasso regression model was used to select the best combination of texture features for identifying low and high grade PCa, and then the model was built. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic performance of the model in both training cohort and test cohort. Results:The best texture feature combination selected by Lasso regression model were the S (1, 0, 0) correlation of T 2WI and the S (1, 0, 0) correlation, S (1, -1, 0) sum entropy and vertical-run length nonuniformity of ADC maps. The area under the ROC curve (AUC) of the model in training cohort was 0.823, and the sensitivity and specificity were 70.4% and 80.8%, respectively, which were better than the single texture feature. The AUC of the model in test cohort was 0.714, which was worse than training cohort. Conclusion:The texture analysis of T 2WI and ADC maps is valuable for the identification of low and high grade PCa.

Effects of cardiac rehabilitation on elderly patients with coronary heart disease and its current situa-tion / 中国医师杂志

Coronary heart disease is one of the leading causes of death worldwide. Advanced age is associated with increased prevalence, morbidity and mortality of coronary heart disease. Older adults are at higher risk of complications and accelerated physical deterioration following cardiovascular events than youn-ger patients. In recent years, researchers have proposed that exercise-based cardiac rehabilitation is an im-portant part of the treatment of patients with coronary heart disease, especially contributing to the improve-ment of the quality of life of elderly patients. This review summarizes the current status and influence of car-diac rehabilitation on elderly patients with coronary heart disease.

Discriminating low grade from high grade prostate cancer based on MR apparent diffusion coefficient map texture analysis / 中华放射学杂志

Objective To investigate the value of texture analysis based on MR ADC map of prostate in differentiating between low?grade and high?grade prostate cancer (PCa). Methods PCa confirmed by pathology after radical prostatectomy were analyzed retrospectively, all patients underwent multiparametric MRI before radical prostatectomy, including T1WI,T2WI and DWI. On the ADC map, ROI was drawn manually to encompass the whole tumor by ITK?SNAP software. The python?based pyradiomics package was used to extract 105 texture features. The intraclass correlation coefficient was used to evaluate the repeatability of the texture features. The independent sample t test or Mann?Whitney U test was used to exclude features that had no significant difference between low grade and high grade PCa. Lasso regression model and 5 fold cross validation method were used to obtain texture feature combination of the highest performance and develop a classification modelfor discriminating low from high grade PCa. ROC curve was used to evaluate the diagnostic efficiency of the model. Result Ninety patients with PCa confirmed by pathology after radical prostatectomywere analyzed retrospectively,including 36 patients with low?level PCa (GS≤3+4) and 54 patients with high?level PCa (GS≥4+3). The area under curve of the model was 0.841, with sensitivity 69.6% and specificity 91.2%, which was significantly higher than single texture feature or traditional mean ADC value. Conclusion Texture analysis based on MRI?ADC map of prostate could be used to discriminate low grade PCa from high grade PCa.

Discriminating low grade from high grade prostate cancer based on MR apparent diffusion coefficient map texture analysis / 中华放射学杂志

Objective@#To investigate the value of texture analysis based on MR ADC map of prostate in differentiating between low-grade and high-grade prostate cancer (PCa).@*Methods@#PCa confirmed by pathology after radical prostatectomy were analyzed retrospectively, all patients underwent multiparametric MRI before radical prostatectomy, including T1WI,T2WI and DWI. On the ADC map, ROI was drawn manually to encompass the whole tumor by ITK-SNAP software. The python-based pyradiomics package was used to extract 105 texture features. The intraclass correlation coefficient was used to evaluate the repeatability of the texture features. The independent sample t test or Mann-Whitney U test was used to exclude features that had no significant difference between low grade and high grade PCa. Lasso regression model and 5 fold cross validation method were used to obtain texture feature combination of the highest performance and develop a classification modelfor discriminating low from high grade PCa. ROC curve was used to evaluate the diagnostic efficiency of the model.@*Result@#Ninety patients with PCa confirmed by pathology after radical prostatectomywere analyzed retrospectively,including 36 patients with low-level PCa (GS≤3+4) and 54 patients with high-level PCa (GS≥4+3). The area under curve of the model was 0.841, with sensitivity 69.6% and specificity 91.2%, which was significantly higher than single texture feature or traditional mean ADC value.@*Conclusion@#Texture analysis based on MRI-ADC map of prostate could be used to discriminate low grade PCa from high grade PCa.

The abnormalities demonstrated by spine MRI indicate the possibility of etiology for refractory lower urinary tract symptoms in female patients / 中华泌尿外科杂志

Objective To approach the spine MRI features and its possibility of etiology for refractory lower urinary tract symptoms(LUTS) in female patients.Methods We conducted prospectively a cross sectional description study of female patients with refractory LUTS during January 16 through March 27 in 2017 based on a urologist's outpatient work.The including criteria were adult female patients with refractory LUTS which defined as having LUTS more than three months and having poor response to behavior therapy and medication treatment.The excluding criteria were patients having evidence of infection,tumor,stone in urinary tract,any central nerve system diseases,or any other diseases may potentially producing LUTS.Data collected included patients demographic information,main complains,present disease features,disease history,physical examination,urine routine,urodynamic study and spine MRI.The characteristics of clinical manifestation,urodynamic study and spine MRI were analyzed.Results During the time span of study,totally 70 cases had been diagnosed as having refractory LUTS and had qualified data of clinical recordings,urodynamic study and spine MRI.Among these 70 cases,63 (90.9％) had storage phase symptoms,11 (15.7％) had voiding phase symptoms,8 (11.4％) had postmicturition symptoms,12 (17.1％) also had disorders in defecating,45 (64.3％) had pain in lower abdomen or pelvic region.69 cases (98.6％) had urodynamic disorders,33 (47.1％) had oversensitivity of bladder,12 (17.1％) had smaller bladder volume,16(22.9％) had detrusor overactivity,15 (21.4％) had bladder outlet obstruction,39(55.7％) had detrusor underactivity.69 cases(98.6％)had spine MRI abnormalities,54(77.1％) had sacral nerve lesions,49 (70.0％) had cervical lesions,48 (68.6％) had lumbar lesions,4 had thorathic lesions.Conclusions The present study revealed extraordinary high prevalence of abnormality in urodynamic parameters and spine MRI in female patients with refractory LUTS,which implies possibility that the refractory LUTS are caused by lesions in spinal nerve system.

Type Ⅶ secretion system in Mycobacteria / 中华微生物学和免疫学杂志

Type Ⅶ secretion system(T7SS) is a novel and specialized secretion system discovered in recent years. It was first found in Mycobacterium tuberculosis. Type Ⅶ secretion system is involved in the secretion of virulence-associated proteins, the interaction between pathogens and hosts and the balance of zinc/iron ions. Moreover,it plays a critical role in the growth and pathogenesis of Mycobacteria. This review summarizes the components,substrates and translocation mechanisms of the type Ⅶ secretion system and its relation to the virulence of Mycobacteria aiming to provide references for developing novel strategies for disea-ses diagnosis,treatment and prevention.

Relationship of Fusobacterium nucleatum levels in gut microbiota with type 2 diabetes mellitus in Uygurs of Xinjiang / 中国临床药理学与治疗学

AIM:To detect the levels of Fusobacterium nucleatum in Uygurs of Xinjiang with normal glucose tolerance (NGT) or type 2 diabetes mellitus (T2DM) and to analyze the correlation between Fusobacterium nucleatum level and type 2 diabetes mellitus.METHODS:Blood and fecal samples were collected from Uygurs of Xinjiang with NGT or T2DM respectively.16SrDNA quantitative real-time PCR technology was used to detect the levels of Fusobacterium nucleatum in fecal samples.The correlations between Fusobacterium nucleatum and BMI,TC,TG,HDL and LDL levels were analyzed by Pearson.RESULTS:(1) The levels of Fusobacterium nucleatum in Uygurs T2DM group were significantly higher than those in Uygurs NGT group (P =0.011).(2) Fusobacterium nucleatum was positively correlated with the levels of BMI (r =0.335,P =0.049),TC(r =0.472,P =0.011)and LDL(r =0.368,P =0.029).CONCLUSION:The levels of Fusobacterium nucleatum may be closely related to lipid metabolism of T2DM in Uygurs.

Factors influencing the outcome of the first 131I radiotherapy in patients with papillary thyroid carcinoma after total thyroidectomy / 中华核医学与分子影像杂志

Objective To investigate the influential factors for the outcome of the first 131I therapy in patients with PTC after total thyroidectomy.Methods One hundred and fifty-nine patients (45 males,114 females,average age (43.4± 12.2) years) with PTC after total thyroidectomy who underwent 131I therapy from July 2014 to December 2015 were retrospectively analyzed.Curative efficacy was evaluated 6 months after 131I therapy.Therapeutic outcome was evaluated according to TSH stimulated Tg (sTg) level,Dx-WBS and evidences of other imaging modalities.Twelve possible factors affecting therapeutic outcome of 131I therapy,including patients' age,gender,time interval between thyroidectomy and 131I therapy,primary tumors size and extrathyroidal extension,number and range of primary tumor lesions,lymph node metastases in surgery,status of thyroid remnant in 99TcmO4-imaging,pre-treatment laboratory measurements (TSH,sTg and TgAb),131I therapeutic dose,results of Rx-WBS and SPECT after 131I therapy,were analyzed with univariate and multivariate logistic regression.ROC curve and diagnostic critical point were analyzed to evaluate the predictive value of influential factors for the outcome of 131I therapy.Results The cure rate of the first 131I therapy was 64.2％ (102/159).Univariate logistic regression analysis showed that age,gender,lymph node metastases,sTg and 131I therapeutic dose (all P＜0.01) were the influential factors for the outcome of 131I therapy.Multivariate logistic regression analysis showed that lymph node metastases (regression coefficient:1.118) and sTg (regression coefficient:0.314) were influential factors (both P＜0.05).The regression equation was:Logit P =-4.155+ 1.118×lymph node metastases+0.314×sTg (x2 =93.7,P＜0.001).Taking sTg as a predictive factor for the outcome of 131I therapy,the AUC of ROC curve was 0.926 (95％ CI:0.888-0.963).The cut-off value of sTg was 2.97 μg/L with a sensitivity of 94.7％ (54/57) and a specificity of 76.5％ (78/102).Conclusions PTC patients with low sTg levels and few lymph node metastases after total thyroidectomy are more likely to be cured in the first 131I therapy.

The molecular mechanism of two-component system of MprAB and TrcRS in synergistically regulating gene rv1057 expression of Mycobacterium tuberculosis / 中华传染病杂志

Objective To study the mechanism of two-component system of MprAB and TrcRS in synergistically regulating gene rv1057 expression of Mycobacterium tuberculosis.Methods The in vivo specific binding capability of MprA and TrcR with the target gene promoter region was analyzed using electrophoretic mobility shift assay.The transcription level of target gene was analyzed by using fluorescence quantitative polymerase chain reaction,and all results were compared with the fold changes in H37Rv strain plus SDS group,which was set as one unit.The expression level of target gene was analyzed by using western blot;the transcription ability of different promoter region of rv1057 was detected through lacZ report gene.The t test was used for statistical analysis.Results MprA was able to bind to trcR promoter.The expressions of trcR in D981 and H37Rv strains without SDS were 1.7 and 2.5 folds of the expression of H37Rv strains with SDS groups,respectively.The difference between these two groups was statistically significant (t=18.54,P＜0.05).With SDS,the expressions of trcR in D981 and H37Rv strains were 1.0 and 2.1 folds of the expression of H37Rv strains plus SDS group,respectively.The expressions of trcR in D981 and H37Rv strains were significantly different (t=15.86,P＜0.05).After adding SDS during the culture of H37Rv strains,the expression of trcR in H37Rv decreased.The difference between these two groups was statistically significant (t=16.99,P＜0.05).Both MprA and TrcR were able to bind to rv1057 promoter and regulate its expression.MprA activated the expression of rv1057,while TrcR repressed the expression of rv1057.Conclusions MprAB and TrcRS synergistically regulate the expression of rv1057.MprA is activated in the presence of SDS,which represses the transcription of trcR and activates the transcription of rv1057.However,TrcR represses the transcription of rv1057 in the absence of SDS.

Diagnostic value of prostate image report and data system (PIRADS version 2) in prostate cancer with grey zone of prostate specific antigen / 重庆医学

Objective To access the diagnostic value of Prostate Imaging Reporting and Data System (PIRADS version 2)for prostate cancer (PCa) in prostate specific antigen (PSA) grey zone(4-10 ng/mL).Methods Treatment naive PCa and BPH patients with an increase of PSA 4-10 ng/mL from 2200 patients underwent prostate MRI from 2012 to 2016 were included,multiparameter magnetic resonance imaging (mp-MRI) prior biopsy or prostatectomy and clinical data were obtained,mp-MRI were retrospectively analyzed quantitatively by a radiology expert with 15 years experience in urogenital system imaging diagnosis and a doctor with 5 years experience in radiology diagnosis blind to the pathology results according to PIRADS v2,PIRADS v2 score and lesion zone were recorded respectively,in case of disagreement,dicision was made through discuss.TRUS guided biopsy or prostatectomy pathology serves as gold reference.Diagnostic value of PIRADS v2 for PSA grey zone PCa was calculated by receiver operating characteristic (ROC) curve,logistic regression analysis was used to access the risk factors of PCa.Results 15 PCa and 30 BPH patients were in eluded.There was no significant difference between these two groups in age,tPSA,fPSA,f/tPSA,prostate volume and PSA density.The area under ROC curve of PIRADS v2 in diagnosing PCa was 0.932[95 ％ CI 0.822-0.984],P＜0.01.Using a cutoff PIRADS＞4,the diagnosis sensitivity was 88.89 ％,specificity 87.10 ％,and positive predictive value 80 ％,negative predictive value 93.10％,respectively.Logistic regression analysis showed that PIRADS v2 score was an independent risk factor for predicting PCa,with a hazard ratio 17.847[3.745-85.078],P＜0.01.There was a positive correlation between PIRADS v2score and gleason score,r=0.585,P=0.022.Conclusion PIRADS v2 has a significantly high diagnosis value in diagnosing PSA grey zone PCa and a good correlation with pathology results.