[Effect of changes in posterior tibial slope on the mid-term clinical outcomes of Oxford unicompartmental knee arthroplasty].

Objective: To investigate the impact of changes in the posterior tibial slope (PTS) in Oxford unicompartmental knee arthroplasty (OUKA) on the mid-term clinical outcomes of postoperative patients. Methods: This study was a follow-up study. The data of 135 patients (150 knees) who underwent OUKA at the China-Japan Friendship Hospital from January 2012 to January 2013 were analyzed retrospectively. The patients were followed-up for at least ten years. According to the changes in PTS of the medial tibial plateau before and after surgery, patients were divided into three groups: group A (PTS decreased by more than 5°), group B (PTS changed by 5° or less), and group C (PTS increased by more than 5°). The Knee Society Clinical Score (KSS-C), Knee Society Functional Score (KSS-F), Oxford Knee Score (OKS), Forgotten Joint Score (FJS), and knee range of motion (ROM) among the three groups were compared at the last follow-up. Results: Prior to the final follow-up assessment, six patients expired, and an additional nine patients were lost to follow-up. A total of 120 patients (135 knees) were enrolled in this study (30 males and 90 females). The mean age was (66.29±8.62) years, and the follow-up time was (10.54±0.72) years. Group A consisted of 32 patients (34 knees), group B comprised 77 patients (90 knees), and group C included 11 patients (11 knees). One knee in group A suffered prosthesis loosening, and two knees in group C experienced postoperative bearing dislocation, one knee encountered bearing fragmentation. The incidence of postoperative complications differed significantly among the three groups (P<0.05). The preoperative OKS was (33.91±6.59) points, KSS-F was (43.46±8.99) points, KSS-C was (41.05±5.70) points and ROM was 115.23°±13.53°; after the surgery, they changed to (18.82±7.01) points, (81.51±7.34) points, (82.64±7.94) points, and 119.07°±8.62°, respectively, and all the differences were statistically significant (all P<0.001). In terms of postoperative outcomes, group A had an OKS of (21.44±8.46) points and a FJS of (63.83±11.40) points, group B had an OKS of (17.07±5.81) points and a FJS of (70.49±12.45) points, group C had an OKS of (25.09±5.07) points and a FJS score of (59.48±10.09) points; the differences among the three groups were all statistically significant (all P<0.05), but there were no significant differences in the postoperative KSS scores and ROM among the three groups (all P>0.05). Conclusions: After OUKA, better mid-term clinical outcomes are achieved when ΔPTS is<5°. Although the recommended central value for PTS in OUKA is 7° according to Oxford, it should be individualized, and it is recommended to consider the preoperative angle, with a change of less than 5° before and after surgery.

[Clinical results of medial mobile bearing unicompartmental knee arthroplasty using kinematic alignment technique with at least 5-years follow-up].

Objective: To evaluate the mid-term results of kinematic alignment technique in Oxford mobile bearing unicompartmental knee arthroplasty (OUKA). Methods: The clinical data of first 98 knees OUKA performed from June 2015 to January 2017 using kinematic alignment technique with at least 5-year follow-up were retrospectively analyzed, including 28 knees in 24 males and 70 knees in 62 females. The mean surgical age was (68.4±8.0) years. The clinical data of patients before operation and at the last follow-up were recorded and compared. The knee Hospital for Special Surgery (HSS) score, visual analogue scale (VAS) of pain, range of motion, surgical complications and radiological assessment were analyzed to evaluate the efficacy of kinematic alignment technique in OUKA. Results: The mean follow-up was (70.9±5.9) months (60-81 months). The mean operation time was (56.4±9.1) minutes. There was no conversion to total knee replacement, no collateral ligament injury and no fracture in operation. The postoperative hospital stay was (5.8±1.9) days. Postoperative hemoglobin drop was (12.7±5.5) g/L. There was no blood transfusion. No patient died during perioperative period. No serious adverse events related to surgery occurred after operation, such as pulmonary embolism, fat embolism, cardio-cerebrovascular accident, etc. No revision, bearing dislocation, periprosthetic joint infection, prosthesis aseptic loosening, contralateral compartment arthritis progression occurred at final follow-up. Three patients reported persistent unexplained knee pain. Afther the operation, the HSS score increased from 59.1±8.2 to 91.8±5.6 after the operation, the range of motion increased from 122.4°±10.0° to 125.6°±7.1°, and the VAS score decreased from 6.9±0.8 to 1.6±1.2 (all P<0.05). Radiological assessment showed that 92.9%(91/98) implant positions were ideal and 7 knees were outliers. The mean HKAA was 173.3°±3.7° before surgery and it was 177.2°±3.0° after surgery (P=0.038). The mean A angle of femur varus/valgus angle was 2.0°±2.8° (-11°-13°), and the mean B angle of femur flexion/extension angle was 4.8°±3.4°(0°-17°). The mean tibia valgus/valgus angle E angle was 1.0°±1.9°(-4°-9°), and the mean F angle was 6.7°±2.3°(1°-12°). The mean postoperative prosthesis distance was (4.29±2.46)mm(2-7 mm). Conclusions: It's demonstrated that the kinematic alignment technique follows the design principle of OUKA, has satisfactory mid-term results. The radiological assessment of the prosthesis is acceptable.

[A multicenter cross-sectional study of quality of life and nonsurgical treatment in patients with knee osteoarthritis].

Objective: To explore the influencing factors of health-related quality of life (HRQoL) in patients with knee osteoarthritis, and to analyze the non-surgical treatment of knee osteoarthritis. Methods: Demographic variables, treatment modalities, imaging data, and 12-item short form health survey (SF-12) scores of patients with knee osteoarthritis in orthopedic outpatient departments of five hospitals in Beijing from December 2017 to November 2018 were collected to analyze influencing factors of HRQoL and non-surgical treatment. Results: A total of 2 034 patients were included. There were 530 males (26.1%) and 1 504 females (73.9%), with a mean age of (59.17±10.22) years. In terms of physical quality of life, female patients with knee osteoarthritis had lower physical components summary (PCS) compared with male patients (ß=-0.521, P=0.036); patients aged ≥64 years had lower PCS than those aged<55 years (ß=-0.636, P=0.026). Patients with an education of more than 12 years had higher PCS than those with less than 10 years (ß=1.063, P<0.001). Compared to patients with mild clinical symptoms, the PCS of patients with moderate clinical symptoms was lower (ß=-0.860, P=0.002), while the PCS of those with severe clinical symptoms was much lower (ß=-1.126, P<0.001). Patients treated with combination therapy had higher PCS than untreated patients (ß=0.731, P=0.005). In terms of mental quality of life, compared to patients engaged in sedentary work, the mental components summary (MCS) of patients engaged in mild manual labor jobs was lower (ß=-0.712, P=0.015); Compared to patients with a Charson comorbidity index of 0, patients with a Charlson comorbidity index ≥ 2 had lower MCS (ß=-1.183, P=0.007). In the past 12 months, 648 (31.9%), 143 (7.0%), 406 (20.0%), 680 (33.4%), 343 (16.9%), 681 (33.5%), 170 (8.4%) patients had used non-steroid anti-inflammatory drugs (NSAIDs), acetaminophen, glucosamine/chondroitin formulations, physical therapy, articular cavity puncture injection, traditional Chinese medicine treatment and exercise therapy, respectively. Total of 451 patients (22.2%) received monotherapy and 889 patients (43.7%) received combination therapy. Conclusions: The major non-surgical treatment methods for patients with knee osteoarthritis in Beijing are NSAIDs, physiotherapy and traditional Chinese medicine. Combination therapy is used more frequently than monotherapy. Physical quality of life is related to gender, age, education, severity of symptoms and treatment, while mental quality of life is related to occupational labor and comorbidities.

Risk factors for Clostridioides difficile infection in children: a systematic review and meta-analysis.

BACKGROUND: Clostridioides difficile is considered an urgent threat to human health by the US Centers for Disease Control and Prevention. In recent years, C. difficile has been reported increasingly as a cause of gastrointestinal disease in children, and the prevalence of hospital-acquired C. difficile infection and community-acquired CDI in children is increasing. AIM: To perform a systematic review and meta-analysis of risk factors for CDI in children. METHODS: MEDLINE/PubMed, EMBASE, Web of Science, Scopus, OVID, China National Knowledge Infrastructure, Wanfang (Chinese), SinoMed (Chinese) and Weipu (Chinese) were searched from inception to 12th January 2022. Observational studies (cohort, case-control and cross-sectional) on CDI in children were included in the analysis. Data were pooled using a fixed or random-effects model, and odds ratios (OR) were calculated. FINDINGS: In total, 25 observational studies were included in the analysis. Prior antibiotic exposure [OR 1.93, 95% confidence interval (CI) 1.25-2.97], prolonged hospitalization (OR 14.68, 95% CI 13.24-16.28), history of hospitalization (OR 3.67, 95% CI 1.91-7.06), gastric acid suppressants (OR 1.96, 95% CI 1.41-2.73), male gender (OR 1.18, 95% CI 1.05-1.32), neoplastic disease (OR 3.40, 95% CI, 2.85-4.07), immunodeficiency (OR 4.18, 95% CI 3.25-5.37), solid organ transplantation (OR 4.56, 95% CI 3.95-5.27) and enteral feeding (OR 2.21, 95% CI 1.05-4.62) were associated with increased risk of CDI. CONCLUSION: This systematic review and meta-analysis provides further evidence for the susceptibility factors of CDI to improve clinicians' awareness of CDI, and prevent C. difficile-associated diarrhoea in children.

[The association of posterior tibial slope changes between joint gap contact force and the range of motion in Oxford mobile bearing unicompartmental knee arthroplasty].

Objective: To investigate the correlation between the change of posterior tibial slope (PTS) after unicompartmental knee arthroplasty (UKA) and the contact force at the end stage of knee flexion and extension, as well as the postoperative range of motion. Methods: The data of 38 cases (46 knees) of UKAs undertaken in China-Japan Friendship Hospital from June 2020 to June 2021 were analyzed in this study. A custom-designed force sensor was used to measure gap contact force in the medial gap of UKA. The correlations between each two of the three factors-the change of PTS (∆PTS), the gap contact force of full extension and deep flexion and the range of knee motion were analyzed. Results: Totally of 38 patients (46 knees) were enrolled, including 14 males and 24 females, aged (69.1±7.4) years, with an average follow-up of (11.2±3.7) months. The average gap contact force was (88.3±40.6)N, the adjusted contact force of the full extension gap was 81.7%±33.8%, while that of the deep flexion gap was 55.6%±31.0%. At the last follow-up, the fixed flexion degree[M(Q1, Q3)] was 0°(0°, 3°), which was significantly lower than the preoperative value of 0°(0°, 5°) (P<0.05); the postoperative max flexion degree was 115.9°±16.4°, it was increased when compared with the preoperative value of 112.0°±16.8° (P<0.05); and the postoperative PTS was 8.3°±2.7°, and there was no significant difference with the preoperative value (8.6°±2.1°,P>0.05). There was a positive correlation between ∆PTS and both the contact force of full extension gap and the fixed flexion degree (r=0.334 and 0.317, P<0.05). Besides, there was a negative correlation between ∆PTS and the contact force of the deep flexion gap (r=-0.397, P<0.05). However, the correlations between these two factors and the max flexion degree were not significant (P>0.05). Conclusions: The reduction of PTS in UKA would reduce the contact force of the full extension gap, as well as the postoperative fixed flexion deformity. Besides, it could increase the contact force of the deep flexion gap, but would not influence the max flexion degree of the knee postoperatively.

[Analysis on causes and influencing factors of sudden death on job of workers in a large oil field branch plant during 2014-2020].

Objective: To investigate the epidemiological characteristics of sudden death on job among workers in the large oil field, and to provide scientific basis for dealing with such incidents. Methods: In April 2021, the medical records of employees who died in a large oilfield from 2014 to 2020, and the occupational health examination data in the first year of life were collected, and 85 employees who died suddenly on duty were included in the study. According to whether the employees are exposed to the occupational disease hazards, they are divided into the injured type of work (66 persons) and the non injured type of work (19 persons) . The characteristics of the clinical data of the sudden death employees are analyzed retrospectively. The gender, age, length of service, type of work, distribution of causes of sudden death of the cases are analyzed. The detection of abnormalities in various occupational health examination indicators is analyzed. The chi square test is used to analyze the distribution of the types of work, length of service and abnormal physical examination indicators. Results: Among the 85 employees who died suddenly on duty, the ratio of men and women was 16∶1. The proportion of sudden death among employees aged 40 to 50 years was the highest (54.12%, 46/85) , which was mainly the first-line workers in the affected departments (43.53%, 37/85) and those with 20-30 years of service (57.64%, 49/85) . The main cause of sudden death was cardiogenic sudden death (78.82%, 67/85) . There were statistically significant differences in abnormal rates of blood pressure and blood glucose among workers of different types of work (χ(2)=7.24, 24.22, P<0.05) , and there were statistically significant differences in abnormal rates of blood lipid and blood glucose among workers of different ages of service (χ(2)=12.37, 31.44, P<0.05) Conclusion: Higher risks of sudden death on job are male, older than 40 years old, front-line workers in disaster receiving departments, worked for more than 30 years, and have abnormal cardiovascular indicators. Workers with these high risks are the major target population for the prevention and treatment of sudden death on the job. It's necessary to supervise enterprises to implement protective measures against risk factors, and to strengthen health education and reduce the incidence of cardiovascular and cerebrovascular diseases, in order to reduce the occurrence rate of sudden death in oilfield workers.

HIF-1α repairs degenerative chondrocyte glycolytic metabolism by the transcriptional regulation of Runx2.

OBJECTIVE: HIF-1α and Runx2 expression usually increase in chondrocytes (CHs) during osteoarthritis (OA), which involves the changes in glycolytic metabolism. However, the molecular regulation of HIF-1α related to the CHs glycolytic metabolism is still unclear. In this study, we aimed to reveal the mediation of HIF-1α by Runx2 and its effect on the glycolytic metabolism of degenerative CHs. PATIENTS AND METHODS: The expression of HIF-1α, Runx2, and the degenerative markers of CHs in both natural conditions from the OA patients and IL-1ß treated in vitro model was analyzed by a Western blot or real-time polymerase chain reaction (RT-PCR). The glycolytic metabolism was determined by the intracellular glucose uptake and adenosine triphosphate (ATP) generation. Transfection of siRNA coding HIF-1α or Runx2 was used to clear the function between HIF-1α and Runx2 in the glycolytic metabolism of degenerated CHs caused by IL-1ß. Chromatin immunoprecipitation (ChIP) and Luciferase reporter gene assay were used to verify the Runx2 protein binds to the promoter of HIF-1α and promote its expression. RESULTS: HIF-1α and Runx2 were increased, and glucose uptake and ATP generation were decreased in the degenerative CHs from both OA and IL-1ß conditions. Under the stimulation of IL-1ß, Runx2 silencing rejected the upregulation of HIF-1α and further aggravated the glycolytic metabolism. When HIF-1α was silenced, the glycolytic metabolism of CHs was also suppressed. Besides, Runx2 protein could regulate HIF-1α expression in the transcriptional level by binding to its promoter. CONCLUSIONS: OHIF-1α plays a role in the self-repair of the glycolytic metabolism of degenerative CHs via the transcriptional regulation of Runx2.

Esophagectomy combined with off-pump coronary artery bypass grafting through left posterolateral incision is safe and feasible for esophageal cancer associated with coronary artery disease.

Controversy still exists as to whether surgical treatment has any impact on the long-term survival of esophageal cancer (EC) patients with coronary artery disease treated with curative esophagectomy combined with off-pump coronary artery bypass grafting (OPCABG). Therefore, the aim of this study was to introduce and assess the effect of esophagectomy combined with OPCABG on both short- and long-term outcomes. From January 2010 to January 2015, 1428 EC or esophagogastric junction cancer patients underwent surgical treatment at Henan Chest Hospital, Zhengzhou, China. The clinical data of 25 patients who underwent EC resection through a left thoracotomy following OPCABG and the perioperative characteristics and follow-up results were analyzed. The majority of the patients were male, and the EC stage was predominantly cT2N0-1M0 II. The most common pathological types were squamous cell carcinoma. The EC surgeries consisted of 15 chest anastomosis procedures and 10 cervical anastomosis procedures with aortocoronary graft implantation (mean: 2.36 grafts per patient). The mean total operative time was 330.8 ± 83.5 minutes. The median intensive care unit and hospital lengths of stay were 1.72 and 21.16 days, respectively. Resection without macroscopic residual disease (R0) was achieved in all of the patients. The most frequent complications included pulmonary infections (24%), arrhythmias (24%), pleural effusion (12%), and esophageal anastomotic leakage (8%). There were no postoperative deaths or myocardial infarctions within 30 days after the surgery. The overall 1-, 3-, and 5-year survival rates were 88%, 40%, and 24%, respectively, with a median survival time of 43 months. In the short-term, radical resection of EC following OPCABG is a safe and feasible treatment with low postoperative mortality rates. In the long-term, simultaneous surgery is acceptable and is associated with favorable overall and disease-free survival.

Voltage-Controlled Antiferromagnetism in Magnetic Tunnel Junctions.

We demonstrate a voltage-controlled exchange bias effect in CoFeB/MgO/CoFeB magnetic tunnel junctions that is related to the interfacial Fe(Co)O_{x} formed between the CoFeB electrodes and the MgO barrier. The unique combination of interfacial antiferromagnetism, giant tunneling magnetoresistance, and sharp switching of the perpendicularly magnetized CoFeB allows sensitive detection of the exchange bias. We find that the exchange bias field can be isothermally controlled by magnetic fields at low temperatures. More importantly, the exchange bias can also be effectively manipulated by the electric field applied to the MgO barrier due to the voltage-controlled antiferromagnetic anisotropy in this system.

Teriparatide alleviates osteoporosis by promoting osteogenic differentiation of hMSCs via miR-375/RUNX2 axis.

OBJECTIVE: To investigate whether Teriparatide (TP) contributed to the osteogenic differentiation of human marrow mesenchymal cells (hMSCs) through the regulation of miR-375, thereby alleviating osteoporosis (OP). PATIENTS AND METHODS: The expression levels of miR-375 in the serum and hMSCs of patients with OP were determined by quantitative real time-polymerase chain reaction (qRT-PCR). hMSCs were extracted from bone marrows of OP patients and underwent osteogenic differentiation for 1 day, 3 days, 7 days and 10 days, respectively. The mRNA levels of alkaline phosphatase (ALP), osteocalcin (OCN) and runt-related transcription factor 2 (RUNX2) in TP-treated hMSCs transfected with miR-375 mimics or negative control were detected by qRT-PCR. Western blot was conducted to determine the protein expression of RUNX2 in TP-treated hMSCs transfected with miR-375 mimics or negative control. Besides, the osteogenic capacity and mineralization capacity of hMSCs were evaluated by the detection of ALP activity, ALP staining and Alizarin red staining, respectively. Dual-Luciferase reporter gene assay was performed to verify the binding between RUNX2 and miR-375. Subsequently, RUNX2 expression was detected in hMSCs transfected with miR-375 mimics or inhibitor. Rescue experiments were finally performed to determine whether miR-375 was involved in TP-induced osteogenic differentiation by targeting RUNX2. RESULTS: MiR-375 remained at a high level in serum of OP patients, while gradually decreased with the prolongation of osteogenic differentiation in isolated hMSCs. TP induction increased the osteogenic and mineralization capacities of hMSCs, which were inhibited after miR-375 overexpression. Through Dual-Luciferase reporter gene assay, we confirmed the binding relationship between miR-375 and RUNX2. Besides, both mRNA and protein levels of RUNX2 were negatively regulated by miR-375. Finally, we verified that co-overexpression of miR-375 and RUNX2 in TP-induced hMSCs significantly enhanced the mineralization capacity compared to overexpression of miR-375 alone. CONCLUSIONS: Teriparatide promoted the osteogenic differentiation of hMSCs through miR-375/RUNX2 axis.

[Efficacy and safety of compound betamethasone cocktail therapy in primary unilateral unicompartmental knee arthroplasty].

Objective: To evaluate the efficacy and safety of an intraoperative betamethasone periarticular injection in patients undergoing primary unicompartmental knee arthroplasty (UKA). Methods: Seventy patients with knee anteromedial osteoarthritis who underwent the primary unilateral UKA in China-Japan Friendship Hospital from July 2017 to October 2018 were randomized into two groups with random number table. In the group A, an analgesic mixture of morphine, ropivacaine, epinephrine, ketorolac and betamethasone was infiltrated intraoperatively into the soft tissue. While in the group B, a same volume of mixture without betamethasone was injected alternatively. The visual analogue scale (VAS) of pain and analgesic consumption were evaluated to compare the effectiveness of pain control between the two groups. In addition, maximal flexion of the knee andinitial time of the straight leg raising were monitored. Complications were assessed too. The data were compared with independent-sample t test. Results: No significant differences in VAS score was found between the groups at 6 h and 12 h after the operation (t=-1.154, -1.108, both P>0.05), but the pain level and analgesic consumption were significantly lower in the group A from 18 h to 72 h post operation (t=-2.959, -2.808, -2.080, -2.519, -3.378, -3.237, all P<0.05). The maximal flexion in group A was significantly higher than that in the group B from 1 d to 3 d (t=2.985, 4.575, 4.013, all P<0.05). The straight leg raising ability and incidence of complications were similar between the groups (χ(2)=0.141, 0.000, both P>0.05). Conclusions: The cocktail analgesics injection containing small dose of betamethasone during UKA can provide effective acute pain control early after the surgery, which is conducive to knee joint function, and it does not increase the incidence of postoperative complications.

HDAC6 regulates microRNA-27b that suppresses proliferation, promotes apoptosis and target MET in diffuse large B-cell lymphoma.

Diffuse large B-cell lymphoma (DLBCL) is the most common type of non-Hodgkin lymphoma. Histone deacetylase 6 (HDAC6) is frequently altered in DLBCL and inhibition of HDAC6 has potent anti-tumor effects in vitro and in vivo. We profiled miRNAs that altered in the HDAC6 knockdown DLBCL cells with NanoString nCounter assay and identified microRNA-27b (miR-27b) as the most significantly increased miRNA. We validated decreased expression of miR-27b in DLBCL tissues, and we found that low expression of miR-27b was associated with poor overall survival of patients with DLBCL. In addition, forced expression of miR-27b suppressed DLBCL cell viability and proliferation in vitro, and inhibited tumor growth in vivo. Mechanistically, Rel A/p65 is found to negatively regulate miR-27b expression, and its acetylation and block of nuclear translocalization caused by HDAC6 inhibition significantly elevates miR-27b expression. Furthermore, miR-27b targets MET and thus represses the MET/PI3K/AKT pathway. These findings highlight an important role of miR-27b in the development of DLBCL and uncover a HDAC6-Rel A/p65-miR-27b-MET signaling pathway. Elevating miR-27b through HDAC6 inhibition would be a promising strategy for DLBCL treatment.

Positron emission tomography modalities prevent futile radical resection of pancreatic cancer: A meta-analysis.

BACKGROUND: Numerous distant metastases were not detected preoperatively. Positron emission tomography (PET) has been used for oncology diagnosis recently. However, it remains controversial whether PET modality is a more efficient way in detecting unresectable features for radical resection of pancreatic cancer (PC). This meta-analysis aims to validate the efficiency of PET modalities (including PET and PET/CT) in preoperative assessment of PC, and compare them with computed tomography (CT). METHODS: PubMed, EMBASE, Science Citation Index and The Cochrane Library were searched to identify relevant studies. Both PET modality and CT had been performed for all the included patients. A meta-analysis was performed to compare the ability of PET modalities in detecting occult distant metastases and regional lymph nodes invasion with that of CT. RESULTS: 17 clinical studies that recruited 1343 patients were included. This meta-analysis indicated that PET modalities were more efficient in detecting true positive distant metastases compared with CT (OR = 1.52, 95%CI: 1.23-1.88). In subgroup analysis, when compared with CT alone, PET/CT also showed greater utility in detecting distant metastases (OR = 1.66, 95%CI: 1.31-2.08). There was no definite difference in detecting regional lymph nodes invasion between PET modalities and CT (OR = 0.97, 95%CI: 0.63-1.47). CONCLUSION: Compared with CT, PET/CT provides extensive possibility to avoid futile radical resection by detecting occult metastases of PC preoperatively. Surgeons, especially in developing countries, should take PET modalities as a routine preoperative assessment before making operative plan for PC patients.

Voltage-controlled interlayer coupling in perpendicularly magnetized magnetic tunnel junctions.

Magnetic interlayer coupling is one of the central phenomena in spintronics. It has been predicted that the sign of interlayer coupling can be manipulated by electric fields, instead of electric currents, thereby offering a promising low energy magnetization switching mechanism. Here we present the experimental demonstration of voltage-controlled interlayer coupling in a new perpendicular magnetic tunnel junction system with a GdOx tunnel barrier, where a large perpendicular magnetic anisotropy and a sizable tunnelling magnetoresistance have been achieved at room temperature. Owing to the interfacial nature of the magnetism, the ability to move oxygen vacancies within the barrier, and a large proximity-induced magnetization of GdOx, both the magnitude and the sign of the interlayer coupling in these junctions can be directly controlled by voltage. These results pave a new path towards achieving energy-efficient magnetization switching by controlling interlayer coupling.

[Effect and related mechanism of microRNA-181 attenuates oxidized low density lipoprotein induced vascular endothelial cell injury].

Objective: To observe the expression level of microRNA-181 (miR-181) and importin-α3 in oxidized low density lipoprotein (ox-LDL) induced vascular endothelial cell injury models, and explore the effect and mechanism of miR-181 on endothelial cell injury. Methods: Human vein endothelial cell line CRL-1730 were cultured and vascular endothelial cell injury model was established by intervention with ox-LDL. The cells were divided into control group (intervened by double distilled water), low-dose group (intervened by 10 µg/ml ox-LDL) and high-dose group (intervened by 20 µg/ml ox-LDL). In addition, cells of low-dose group were divided into miR-181 mimic group (miR-181 mimic was transfected) and mimic control group (miR-181 mimic control was transfected). Cell viabilities, mRNA and protein expression level of interleukin-6 (IL-6), miR-181, importin-α3, and nuclear transcription factor-κB (NF-κB) were measured by methyl thiazolyl tetrazolium (MTT), real-time PCR and Western blot, respectively. Results: (1) The cell viabilities in low-dose group and high-dose group were lower than control group (0.207±0.012 and 0.204±0.007 vs. 0.323±0.018, all P<0.01). The relative IL-6 mRNA expression in low-dose group and high-dose group were higher than control group (1.24±0.16 and 1.36±0.23 vs. 0.22±0.03, all P<0.01). The relative miR-181 mRNA expression in low-dose group and high-dose group were lower than control group (0.91±0.11 and 0.88±0.07 vs. 2.20±0.13, all P<0.01). The relative importin-α3 mRNA expression in low-dose group and high-dose group were higher than control group (1.23±0.22 and 0.55±0.03 vs. 0.44±0.06, all P<0.01). The relative NF-κB mRNA expression in low-dose group and high-dose group were higher than control group (1.67±0.34 and 0.41±0.11 vs. 0.11±0.04, all P<0.01). The relative importin-α3 protein expression in low-dose group and high-dose group were higher than control group (1.44±0.23 and 1.31±0.22 vs. 0.29±0.08, all P<0.01). The relative NF-κB protein expression in low-dose group and high-dose group were higher than control group (0.43±0.05 and 0.37±0.04 vs. 0.16±0.03, all P<0.01). (2)The cell viabilities in miR-181 mimic group was higher than in mimic control group (0.262±0.008 vs. 0.211±0.021, P<0.01). The relative miR-181 mRNA expression level in miR-181 mimic group was higher than in mimic control group (4.23±0.34 vs. 0.88±0.16, P<0.01). The relative importin-α3 mRNA expression level in miR-181 mimic group was lower than in mimic control group (0.24±0.03 vs. 1.08±0.13, P<0.01). The relative NF-κB mRNA expression level was lower in miR-181 mimic group than in mimic control group (0.13±0.03 vs. 0.51±0.06, P<0.01). The relative importin-α3 protein expression level was lower in miR-181 mimic group than in mimic control group (0.34±0.06 vs. 1.67±0.26, P<0.01). The relative NF-κB protein expression level was lower in miR-181 mimic group than in mimic control group (0.43±0.02 vs. 1.53±0.36, P<0.01). Conclusions: Lower miR-181 expression but higher importin-α3 and its downstream NF-κB signaling are associated with ox-LDL induced vascular endothelial cell injury and up-regulation of miR-181 could alleviate ox-LDL induced vascular endothelial cell injury possibly via importin-α3/NF-κB pathway.

[RET pro-oncogene and medullary thyroid carcinoma].

Medullary thyroid carcinoma (MTC) originats from the parafollicular C cells of the thyroid, which is one of the most aggressive forms of thyroid malignancy with the poor prognosis. Hereditary MTC has multiple endocrine neoplasia types 1, 2A and 2B. The mutation of RET proto-oncogene has been identified as the main cause of MTC, and all mutations locate among the exons 5, 8, 10, 11, 13, 14, 15, and 16. Mutation analysis of the RET may provide a theoretical basis for the prevention, diagnosis and treatment of MTC.

[Clinical features and gene mutation analysis of 13 Chinese juvenile patients with nephronophthisis].

Objective: To explore the clinical features and pathogenic gene mutation of juvenile nephronophthisis (NPHP) in Chinese patients. Method: Clinical data and blood samples of 27 juvenile NPHP patients from 25 families who were initially clinically diagnosed in six hospitals in Guangdong province were collected. NPHP1 homozygous deletions were detected in all patients. Sequencing of NPHP1 gene was performed when homozygous deletions were not found in patients without eye involvement. In patients with eye involvement, NPHP5 sequencing was carried out initially and subsequently NPHP10 gene and NPHP1 when there were no NPHP5 gene mutation found. Result: Diagnosis was confirmed in 13 patients by renal pathology and (or) gene sequencing, including four boys and nine girls with a median onset age of 8.5(0.1-12.8) years. Seven of the 13 patients had a normal routine urine test and six patients had mild to moderate proteinuria. None had persistent hematuria. The estimated glomerular filtration rate of the 13 patients was (12.7±10.7) ml/(min·1.73 m2) at the time of diagnosis. Renal cysts were found in only five patients by iconography. Decreased renal size was observed in nine cases and normal renal size in four patients. Renal pathology was available in five patients, renal cysts formation at the cortical-medullar area, thickening and laying tubular basement membrane, were observed. Two of the thirteen children had eye involvement, one had liver impairment and one had growth retardation. NPHP1 gene defects were detected in seven patients with a mutation rate of 25.9%, and large homozygous deletions were observed in three patients. Four patients had single point mutations, i. e. compound heterozygous mutations (c.13 C>T and c. 1520+ 5 G>A) in one patient; homozygous mutation in three patients, two patients were siblings from the same pedigree harbored c. 1756 C>T and the other one harbored c. 1298delA. NPHP5 gene homozygous mutation was found in one pedigree. The fourteen children without renal pathology and whose genetic tests were negative shared similar clinical features with the thirteen patients whose diagnosis were confirmed by gene mutation and (or) renal pathology. Conclusion: The onset of juvenile NPHP is insidious. Urine and renal iconography changes are mild or negative. The ratio of NPHP1 mutant patient is similar with previous reports, but the proportion of NPHP1 gene homozygous deletions is much lower and all of the NPHP1 gene single point mutations detected in this research were novel, which indicates a genetic discrepancy existed between Chinese NPHP patients and the western ones.

Expression and clinical significance of obesity-associated gene STEAP4 in obese children.

The aim of this study was to investigate the expression and clinical significance of the obesity-associated gene STEAP4 in obese children. Fifty-three obese children and 33 children with a standard body weight (control) from our hospital were recruited to this study. The expression of STEAP4 mRNA and protein in the adipose tissue were detected by reverse transcriptase polymerase chain reaction and enzyme-linked immunosorbent assay, respectively, in order to analyze the relationship between STEAP4 mRNA and protein levels and blood pressure, blood lipid profile, blood glucose levels, and inflammation in obese children. Obese children showed significantly lower levels of STEAP4 mRNA and protein in the adipose tissue compared to the control subjects (P < 0.05). The obese subjects exhibited significantly higher diastolic blood pressure (DBP), systolic blood pressure (SBP), total cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL), fasting plasma glucose (FPG), interleukin (IL)-6, and tumor necrosis factor (TNF)-α levels, and a significantly lower high-density lipoprotein (HDL) level, compared to the control subjects (P < 0.05). Correlation analysis revealed that STEAP4 expression was negatively correlated with the DBP, SBP, TC, TG, LDL, FPG, IL-6, and TNF-α levels, and was positively correlated with the HDL level (P < 0.05). In conclusion, the expression of STEAP4 was significantly downregulated in the adipose tissue of obese children and was closely related to the blood pressure, blood lipid, blood glucose, and inflammation in these patients; therefore, these results could provide a theoretical basis for the treatment of childhood obesity.