[Associations between multimorbidity patterns of 4 chronic diseases and physical activity with all-cause mortality].

Objective: To identify the prevalence of multimorbidity among a Chinese population, analyze the risk of all-cause mortality with different multimorbidity patterns, and the impact of exercise on the risk of multimorbidity-related mortality and life lost. Methods: The study was based on 437 408 MJ Health Management Center participants. The classification decision tree was used to explore multimorbidity patterns composed of hypertension, diabetes, chronic kidney disease (CKD), and chronic obstructive pulmonary disease (COPD). The Cox proportional hazards model was used to calculate the all-cause mortality hazard ratio (HR) for different multimorbidity patterns. Using Chiang's life table method, years of life lost were the difference in life expectancy for those with and without multimorbidity. Results: The prevalence rate of multimorbidity was 8.7%. Among multivariate patterns, the most common ones were "hypertension+CKD" (3.6%), "hypertension + diabetes + CKD" (1.1%) and "hypertension+diabetes+CKD+COPD" (0.1%). Compared with a healthy population, patterns with the highest mortality risk were "diabetes+CKD" (HR=3.80, 95%CI: 3.45-4.18), "diabetes+CKD+COPD" (HR=4.34, 95%CI: 3.43-5.49) and "hypertension+ diabetes+CKD+COPD" (HR=4.75,95%CI:4.15-5.43). Through low-intensity and moderate to high-intensity exercise, the increased HRs were attenuatedcompared with the inactive population. People with single disease and multimorbidity shortened life by 4.6 and 13.4 years, while exercise attenuated 2.3 and 4.6 years of life lost, of which low-intensity and moderate to high-intensity exercise saved 1.5 and 3.7 years of life lost due to chronic diseases. Conclusions: Multimorbidity patterns based on "diabetes + CKD" cause the highest mortality risk, and physical activity in reducing mortality was significant for either with or without multimorbidity. Higher exercise intensity leads to a greater relative reduction of mortality risk.

[An exploratory clinical study of the efficacy and safety of tumor-infiltrating lymphocytes in the treatment of metastatic osteosarcoma].

Objective: To explore the safety and efficacy of tumor-infiltrating lymphocytes (TILs) extracted from tumor tissue in patients with pulmonary metastasis of osteosarcoma, the TILs were amplified in vitro to reach clinical dosage and reinfused to the patients combined with high-dose interleukin 2 (IL-2). Methods: Twelve subjects with pathologically diagnosed osteosarcoma were enrolled from December 2019 to June 20, 2021 in Shanghai General Hospital. All subjects progressed with metastasis after standard chemotherapy and failed multiple lines of treatments. Fresh tumor tissue was obtained from the metastatic site and extracted and amplified by Good Manufacturing Practice (GMP) workshop to produce TILs to clinical treatment dosage (109-1011). High-dose IL-2 (100 000-200 000 U/kg) was administered immediately after autogenous TILs infusion to promote the activation, proliferation and antitumor cytolytic activity in vivo. Adverse events (AE) were graded according to Common Terminology Criteria for Adverse Events (CTCAE) standard and tumor response was assessed according to Response Evaluation Criteria in Solid Tumors (RECIST) 1.1. Results: One patient did not receive treatment due to failure in isolating TILs, total of 11 patients received a single re-infusion of autologous TILs. There were 10 males and 1 female with a median age of 19.9 years (12-33 years). Six of these patients received higher dose levels of 1.0×1010 TILs. The 11 patients were followed-up for 1 to 13 months and tolerated well. The most common adverse events reported were fever (10/11), constipation (3/11) and elevated gamma-glutamyl transferase (GGT) (3/11). The high incidence of fever was due to the IL-2 infusion. All patients experienced a transient drop in lymphocyte count and leukopenia leading to non-myeloid ablative lymphocyte clearance. The AE included grade 4 hematologic toxicity, including 8 cases of lymphocytopenia, 2 cases of neutropenia and 1 case of thrombocytopenia. No AE of neurotoxicity occurred. Of all the 11 patients, 9 patients got stable disease (SD) and 2 patients had progressive disease (PD). The disease control rate was 9/11. The median duration of SD was more than 4 months, and the maximum tumor volume decreased by close to 20%. Patient number 9 had sustained SD status for more than 6 months. Conclusions: TILs with in vitro expansion ability could be isolated from tumor tissues of advanced osteosarcoma patients. TILs amplified and reinfused in vitro have anti-osteosarcoma activity.

Distribution of high-risk human papillomavirus genotypes in male attendees at a clinic for sexually transmitted infections in Northern China.

OBJECTIVE: High-risk (HR) human papillomavirus (HPV) is one of the major causes for most anal and penile cancers and oropharyngeal cancers in men, and vaccination against HPV is recommended for the prevention of these cancers. Data on HPV infection in Chinese men is still limited, which requires further investigation to guide vaccine development and assess the effectiveness of HPV vaccines. We thus studied the HR-HPV genotype distribution in HPV-infected men in Northern China. PATIENTS AND METHODS: Genital specimens were obtained from male patients (≥18 years old) at the clinic for sexually transmitted infections of the Shandong Provincial Hospital between January 2016 and December 2018. Samples were analyzed for 15 HR-HPV genotypes, and 2 low-risk HPV (LR-HPV) genotypes using a multiplex real-time quantitive polymerase chain reaction (qPCR) assay. RESULTS: Of 1,163 participants enrolled, 426 patients were diagnosed as verruca acuminata (CA) and 737 were asymptomatic men. The overall prevalence of HPV infection was 42% (489/1,163), and 27.4% (319/1,163) were positive for HR-HPV. HPV 16 (5.2%, 61/1,163) was the most common HR genotype overall, followed by HPV 52 (4.6%, 54/1,163), 51 (4.3%, 50/1,163), 18 (4.1%, 48/1,163), and 39 (4.0%, 47/1,163). Genotypes 16, 52, 39, 51, and 18 were most prevalent in CA patients, and 16, 51, 18, 59, and 39 in asymptomatic men. Prevalence of genotypes 31, 33, and 45 covered by the 9-valent HPV prophylactic vaccine was low in the assessed region. CONCLUSIONS: HPV 16, 52, 51, 18, 39, and 59 were the most common HR genotypes detected in men in Northern China. Importantly, HPV 39, 51, and 59 are not currently covered by either the 4-valent or 9-valent HPV vaccines.

[Understanding the China Blue Paper on Obesity Prevention and Control and policy implications and recommendations for obesity prevention and control in China].

With the rapid economic development and dramatic changes in lifestyle, the prevalence of overweight and obesity in China has been increasing significantly and become a serious public health threat. This article introduced the main contents of "China Blue Paper on Obesity Prevention and Control", aiming to facilitate understanding and applications of the "China Blue Paper on Obesity Prevention and Control" by policymakers, researchers and practitioners in related fields. Built upon these, recommendations were made for obesity screening, diagnosis, treatment and management, prevention and control policies and strategies, and future research priorities in China.

Effects of curcumin on the role of MMP-2 in endometrial cancer cell proliferation and invasion.

OBJECTIVE: This study aims to investigate the effect of curcumin concentrations on the proliferation and invasion of endometrial cancer cells. MATERIALS AND METHODS: Endometrial cancer cells were cultured with 0, 15, and 30 µmol/l curcumin, and were divided into control group, low concentration group, and high concentration group. The treatment included the silencing and overexpression of MMP-2. The expression of MMP-2 and E-cadherin were detected by Western blot and the expression level changes were recorded after MMP-2 was silenced and overexpressed. Pearson's analysis was used to determine the relationship of curcumin concentration between MMP-2 mRNA. CCK-8 was used to detect the optical density of cancer cells in three groups. Transwell invasion assay was performed to analyze the invasion inhibition rate in the three groups. RESULTS: Western blot and qPCR results: MMP-2 expression levels were lower and E-cadherin was higher in high concentration group than that in the low concentration group (p<0.01). MMP-2 protein and mRNA decreased after ShRNA and increased after overexpression (p<0.01). Pearson analysis revealed that the curcumin concentration was negatively correlated with the MMP-2 mRNA (r=-0.497, p=0.036). Cell optical density was lower with curcumin and the lowest was in high concentration group (p<0.01). After MMP-2 silencing, optical cell density decreased and this value increased after overexpression (p=0.000). Cell invasion results: Curcumin improves the rate of cell invasion (p<0.01). After silencing of MMP-2, cell invasion inhibition rate increased, while the invasion inhibition rate decreased after overexpression (p<0.01). CONCLUSIONS: Curcumin can downregulate MMP-2, inhibit the proliferation and invasion of cancer cells.

[Analysis of body composition and resting metabolic rate of 858 middle-aged and elderly people in urban area of Beijing].

Objective: To understand the overweight rate and obesity rate in middle-aged and elderly people in urban area of Beijing, and analyze the changes of body composition and resting metabolic rate with age. Methods: From November 2014 to December 2015, body composition measurement and resting metabolic rate detection were conducted among 858 people aged 51 to 99 years, including 760 men, 98 women, who received physical examination at Beijing Hospital. Results: The overweight rate was 51.4%, and the obesity rate was 16.9%. The overweight rate was 26.5% and the obesity rate was 14.3% in women, significantly lower than those in men (54.6% and 17.2%) (P<0.001). The distribution of skeletal muscle volume, muscle index, body fat percentage, visceral fat area and resting metabolic rate in different age groups were different (P<0.001). In the normal weight group, the skeletal muscle volume, muscle index and resting metabolic rate in age group ≥80 years decreased obviously (P<0.05). At the same time, the body fat percentage and visceral fat area increased obviously (P<0.05). However, the skeletal muscle volume, muscle index and resting metabolic rate of the overweight and obese groups began to decrease obviously in age group 70- years (P<0.05), and the decrease in age group ≥80 years was more obvious. At the same time, body fat percentage and visceral fat area increased significantly in age group 70- years (P<0.05). Conclusion: The overweight and obesity rates were high in the middle-aged and elderly people in the urban area of Beijing, and the rates were higher in men than in women. With the increase of age, the skeletal muscle volume, muscle index and resting metabolic rate gradually decreased, while the percentage of body fat and visceral fat area increased; Overweight and obese people had earlier changes in body composition and resting metabolic rate.

[Analysis of early response to the antipsychotic treatment and related factors in acute schizophrenia patients].

Objective: The objective was to assess the relationship between early response and later response to antipsychotics, and the relationship between antipsychotics and early response. Methods: Data were retrospectively analyzed from patients with schizophrenia and they were hospitalized in the Second Affiliated Hospital of Xinxiang Medical College from May, 2013 to September, 2015.The patients were divided into theearly response group (PANSS total score improvement ≥20% at week 2) and early nonresponse group.General information, the use of drug and the Positive and Negative Syndrome Scale (PANSS) on before and 2, 4, 6 weeks after treatment were compared between the two groups.The relation between early response and late response and the effect of drug selection on early response were analyzed by correlation analysis and regression analysis. Results: Relative to early nonresponders, early responders were significantly more likely to have lower PANSS scores (total scores on 2, 4, 6 weeks after treatment 66.2±11.8 vs 84.5±10.9, 55.9±13.2 vs 70.9±13.7, 48.9±13.1 vs 60.6±14.9, all P<0.05) and higher PANSS scores improvement at 2, 4, 6 weeks after treatment (total scores improvement on 2, 4, 6 weeks after treatment (37±14)% vs (9±7)%, (56±19)% vs (32±18)%, (68±20)% vs (49±21)%, all P<0.05). The correlation coefficient between PANSS total score improvement at week 2 and at week 4, 6 were 0.730 and 0.541, respectively (all P<0.05). Olanzapine had more PANSS total score improvement than aripiprazole, quetiapine and ziprasidone (2 weeks after treatment (29±19)% vs (19±16)%, (18±15)%, (17±15)%, 4 weeks after treatment (51±21)% vs (37±25)%, (39±18)%, (37±22)%, all P<0.05). The protective factor for early response was olanzapine (P<0.05). Conclusions: Early responders are associated with faster and greater improvement in symptoms, the type of antipsychotic has impacts on early response, early non-responders can benefit from adjustment of treatment.

Identification of genes related to floral organ development in pak choi by expression profiling.

Pak choi is a highly nutritious vegetable that is widely grown in China, Southeast Asia, and other parts of the world. Because it reproduces by seed, it is very important to understand the mechanism of floral organ development. Therefore, using the Chinese cabbage genome as a reference, this study analyzed the expression profiles of shoot apex genes at flower bud differentiation stages 1 and 5, in order to identify genes related to floral organ development. The results showed that the proportion of mapped genes was high, with 84.25 and 83.80% of clean reads from the two sample saligned to the reference genome, respectively. A total of 525 differentially expressed genes (DEGs) were identified, 224 of which were upregulated and 301 were downregulated. The expression levels of genes homologous to Chinese cabbage flowering genes were also analyzed at stages 1 and 5; the expression levels of Bra012997 (ap1), Bra000393 (SOC1), and Bra004928 (SOC1) were significantly upregulated at stage 5, suggesting that these three genes positively regulate floral development in pak choi. DEGs involved in floral organ development were analyzed with homologous genes from Arabidopsis thaliana; the homologous genes Bra029281 (AGL42), Bra026577 (ARPN), Bra022954 (SPL3), Bra029293 (ARF2), Bra007978 (AtRLP12), Bra033221 (SPL8), Bra008037 (LOX4), Bra001598 (IAA19), Bra003892 (PATL1), Bra038778 (AT4G21323), Bra025315 (KLCR2), and Bra013906 (DTX35) are directly related to floral organ development in Arabidopsis, suggesting that these genes have corresponding functions during flower organ development in pak choi, and could be candidates for further genetic research. These results provide a foundation for research on the molecular mechanism of flower organ development in pak choi and other Brassica rapa vegetables.

[Schwannoma of the ethmoid sinus in children: a case report].

A ten years old male patient，the main symptom was prsented as the left nasal obstruction, repeated hemorrhage with hyposmia. Large translucent neoplasm can be seen in the left side of the nasal cavity. CT and MRI of the nasal sinus showed that the soft tissue density shadow in the left side of the ethmoid sinus and the surrounding bone with no damage. He was treated with nasal endoscopic surgery. Postoperative pathology showed schwannoma. The tumor recurred three years later, and the patient underwent nasal endoscopic surgery again. In the literature we reviewed the case to analyze the reasons of recurrence.

Detection and study of plasma D-dimer change in patients with acute exacerbation of chronic obstructive pulmonary disease.

The purpose of this study was to observe the change in plasma D-dimer of patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). The patients were divided into three groups, i.e., AECOPD group, stable COPD group (COPD kept stable after treatment) and a healthy control group. The content of plasma fibrinogen (FIB) and D-dimer of all research subjects was detected and the difference between groups was analyzed. Moreover, pulmonary functions of patients in the AECOPD group and the stable COPD group, including forced expiratory volume in 1 second (FEV1%) and forced vital capacity rate of 1 second (FEV1/FVC), and blood gas (oxygen partial pressure (PO2) and partial pressure of carbon dioxide (PaCO2), were detected; and the differences between the two groups and the possible correlation were analyzed. Compared to the COPD stable group and the control group, the AECOPD group had a statistically significant higher content of plasma FIB and D-dimer (p less than 0.05); the content of plasma FIB and D-dimer of the COPD stable group was much higher than that of the healthy control group, but the difference had no statistical significance (p > 0.05); the content of D-dimer of AECOPD patients was in a negative correlation with FEV1 and PO2 (p smaller than 0.05) and in a positive correlation with PCO2 (p smaller than 0.05). It can be concluded that D-dimer is correlated to the severity of AECOPD; hence, it can be used as an evaluation index for the severity of AECOPD.

Polar distribution dynamics of Con A binding sites in embryo sacs is temporally coupled by the fertilization process.

The binding site distribution of concanavalin agglutinin (Con A) and wheat germ agglutinin (WGA) on embryo sacs at various developmental stages of Torenia fournieri L was studied by using a cooled Charge Coupled Device (CCD) and fluorescent Con A and WGA probes. The distribution patterns of Con A and WGA binding sites on embryo sacs changed during the fertilization process. The fluorescent signal indicating Con A binding sites was distributed evenly on the surface of the embryo sac wall before anthesis, was much denser on the micropylar end of the embryo sac wall and looked like a corona on the day of anthesis. After pollination, stronger fluorescence was present on the micropylar end of the embryo sac wall and the filiform apparatus (FA), showing an obvious polar distribution. When the pollen tube entered the embryo sac and reached a synergid, the fluorescence was still concentrated on the micropylar end and FA, and started to appear on the synergid. After fertilization, the polar distribution of the fluorescence gradually disappeared and an even distribution pattern was observed again on the embryo sac wall. These results revealed that the dynamic distribution of Con A binding sites was temporally coupled with the process of fertilization. WGA binding site distribution on the embryo sac was also investigated and showed a simple pattern but also regularly changed during the process of fertilization. The variation of these lectin binding sites during the fertilization process suggests that lectin binding site interactions may play a role in the process.