Effects of Fretting Stimulation Amplitude on Bone Growth and Micro-Injury at the Interface Between Bone Tissues and TitaniuBead Coating / 医用生物力学

Objective To improve the performance of artificial joint at biological fixed interface by frettingmechanical stimulation. Methods Taking the bonding sample of active rat bone tissues and inactive titanium bead coating as the research object, by using the self-developed fretting mechanical stimulation test device, the effects of mechanical stimulation with different tangential fretting amplitudes on growth promotion and micro-injury of bone tissues at fixed interface were explored, and the mechanism of growth promotion and micro-injury of bonetissues on the surface of titanium bead coating under fretting stimulation was revealed. Results The mechanical stimulation group with 40 μm fretting amplitude showed the maximum interface bonding force between bone tissues and titanium bead coating. The tangential fraction force-displacement curves changed from elliptic shape to linear shape, and the bonding interface was in adhesion area, which was difficult to become loose. The bone tissues had the most complete structure, and the number of tissue cells adhering and growing on the surface of titanium bead coating was the largest, as well as the distribution range was the widest. With the increase of fretting amplitude, the promoting effect of fretting stimulation on bone growth weakened, the bonding strength between bone tissues and titanium bead coating interface gradually decreased, the internal cavity area increased, the number and proliferation activity of tissue cells decreased to varying degrees as well. Conclusions Fretting stimulation with different amplitudes can promote the growth of bone tissue and cause micro-injury at the same time, and the optimal fretting amplitude is 40 μm.

Application of prenatal bacterial artificial chromosome-on-beads identification/isolation technology in the diagnosis of chromosomal aneuploidy and microdeletion/microduplication syndrome / 中华检验医学杂志

Objective:To explore the indication of bacterial artificial chromosome-on-beads identification/separation technology in prenatal diagnosis and its application value.Methods:The inclusion criteria were as follows: age ≥35 years, high risk/critical risk of serological prenatal screening, high risk of non-invasive gene testing (NIPT), abnormal ultrasonic indexes or adverse pregnancy history. From April 2016 to December 2020, 3579 amniotic fluid samples collected from pregnant women with singletons were detected by bacterial artificial chromosome-on-beads identification/separation technique (BoBs) and G-banding karyotype analysis simultaneously. The aneuploid abnormality/microdeletion/microdeletion samples detected by karyotype analysis or BoBs were verified by fluorescence in situ hybridization (FISH)/SNP array as needed.Results:(1) The percentage of samples with indications of advanced maternal age, high risk of NIPT and high risk of serological screening was 89.44%(3 201/3 579), the detection rate of aneuploidy was 96.19%(202/210), and the detection rate of microdeletion/microduplication was 87.5%(28/32),the total abnormal detection rate was 95.04% (230/242). The samples with abnormal ultrasonic indexes, adverse pregnancy history and critical risk indications of serological screening in the second trimester accounted for 10.66%, and the abnormality of aneuploidy and micro-duplication/micro-deletion was 4.96%. (2) 198 common chromosome aneuploidies (13/18/21/X/Y) were detected by BoBs, and 12 cases with chimeras ≥20% were found, which were consistent with karyotype results. Two copies of 21-trisomy, three copies of X/Y, seven copies of 2, 7, 8, 9, 10, 20, mar karyotype chimerism, eight copies of arm inversion and five copies of translocation outside the detection range of probes were detected by karyotype analysis. The sensitivity, specificity and false negative rate of BoBs detection for five aneuploidies were 94.6%(210/222), 100% and 5.4%(12/222), respectively. BoBs and karyotype analysis detected 32 and 9 cases of microdeletions/microduplications respectively. Compared with single karyotype analysis, the combined application of G-banding karyotype analysis and BoBs can detect an additional 9.4% (23/244)positive samples.Conclusion:The samples with elder age, high risk of NIPT, and high risk of serological screening are more suitable as indications for the application of BoBs in prenatal diagnosis.

Effect of dendritic cells on immune function regulated by programmed cell death-1/programmed cell death-ligand 1 in sepsis / 中华危重病急救医学

Objective:To study the effect of programmed cell death-1/programmed cell death-ligand 1 (PD-1/PD-L1) regulating dendritic cells (DC) on the immune status of sepsis, and analyze the effect of PD-1/PD-L1 on prognosis.Methods:Twenty-five patients with sepsis in the intensive care unit (ICU) of the Affiliated Hospital of Zunyi Medical University from October 2018 to September 2019 were collected and followed up for 28 days. According to the 28-day survival of patients, patients were divided into survival group and death group. Among them, 10 cases were in the survival group and 15 cases were in the death group. Simultaneously, 20 healthy subjects in our hospital during the same period served as the healthy control group. Peripheral blood of patients with sepsis was taken within 24 hours after diagnosis, and the healthy control group was taken at the time of enrollment. Flow cytometry was used to detect the proportion of CD4 +T and CD8 +T cells, the ratio of T cell subsets (CD4/CD8), the expression of PD-1 on CD4 +T and CD8 +T cells, and the expression of PD-L1 and CD86 in DC. Enzyme linked immunosorbent assay (ELISA) was used to detect the levels of interleukin-10 (IL-10) and tumor necrosis factor-α(TNF-α) in serum. Spearman correlation analysis was used to analyze the correlation between CD11c +PD-L1 and CD4 +PD-1, CD8 +PD-1, TNF-α, DC, CD11c +CD86, T cell subpopulation ratio, CD4 +T cells, CD8 +T cells, and IL-10. Binary Logistic regression was used to analyze the risk factors affecting the death of patients with sepsis, and receiver operator characteristic curve (ROC curve) was drawn to evaluate the predictive value of independent risk factors on the prognosis of patients. Results:The scores of acute physiology and chronic health evaluationⅡ (APACHEⅡ) and sequential organ failure assessment (SOFA) in the death group were higher than that in the survival group (APACHEⅡ score: 27.0±7.3 vs. 17.0±3.9, SOFA score: 15.1±4.1 vs. 10.7±2.7, both P < 0.05). The ratio of T cell subsets in the survival group and the death group was less than 1, the death group was lower than that in the survival group (CD4/CD8: 0.54±0.15 vs. 0.79±0.09, P < 0.05), and the ratio of T cell subsets in the healthy control group was greater than 1. Compared with healthy control group, the levels of CD4 +T cells, CD8 +T cells, CD11c +DC, CD11c +CD86, IL-10 and TNF-α in survival group and death group were significantly decreased, the level of CD4 +PD-1, CD8 +PD-1, CD11c +PD-L1 were significantly increased, and the changes in the above indicators in the death group were significant compared with the survival group [CD4 +T cells: 0.14±0.07 vs. 0.22±0.08, CD8 +T cells: 0.24±0.07 vs. 0.28±0.10, CD11c +DC: 0.84±0.14 vs. 0.93±0.03, CD11c +CD86: (58.83±20.77)% vs. (78.24±9.39)%, IL-10 (ng/L): 34.22±13.98 vs. 18.49±5.55, TNF-α(ng/L): 95.30±29.33 vs. 67.00±20.16, CD4 +PD-1: (39.58±10.08)% vs. (27.03±6.35)%, CD8 +PD-1: (38.77±11.91)% vs. (29.15±8.37)%, CD11c +PD-L1: (21.13±11.54)% vs. (12.11± 8.34)%, all P < 0.05]. Spearman correlation analysis showed that CD11c +PD-L1 was positively correlated with CD4 +PD-1, CD8 +PD-1, and IL-10 ( r values were 0.748, 0.713, 0.898, all P < 0.05), while was negatively correlated with DC, CD11c +CD86, T cell subpopulation ratio, CD4 +T cells, CD8 +T cells, and TNF-α( r values were -0.587, -0.906, -0.840, -0.706, -0.513, -0.820, all P < 0.05). Multivariate binary Logistic regression analysis showed that CD4 +T PD-1 was an independent risk factor for the prognosis of sepsis patients [odds ratio ( OR) = 1.463, 95% confidence interval (95% CI) = 1.032-2.074, P = 0.033]. ROC curve analysis showed that CD4 +TPD-1 had certain predictive value for the prognosis of patients with sepsis [area under ROC curve (AUC) = 0.857, 95% CI was 0.709-1.000, P < 0.01). When the best predictive value was 34.48%, the sensitivity, specificity, and accuracy were 66.7%, 90.0%, and 85.7% respectively. Conclusions:Up-regulation of PD-1/PD-L1 in peripheral blood could inhibit the activation and proliferation of DC, affect the activation of T cells, and induce immunosuppressive state. PD-1/PD-L1 can reflect the immune status of patients with sepsis. The expression of PD-1 on CD4 +T cells may have important significance for the evaluation of prognosis.

Study on the repairation of intestinal mucosal barrier by infliximab in patients with Crohn′s disease / 中华消化杂志

Objective:To explore the role of infliximab (IFX) in the repairation of intestinal mucosal barrier in Crohn′s disease (CD).Methods:From January 2018 to October 2019, in Shanghai Tenth People′s Hospital, 382 CD patients were selected. All the patients were treated with IFX. And 103 individuals who underwent colonoscopy were selected as healthy control group. The general clinical data, fasting blood samples and intestinal mucosa tissue samples of CD patients and healthy controls were collected. The body mass index (BMI), hemoglobin, albumin, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and relative inflammation factors, including tumor necrosis factor (TNF)-α, interferon (IFN)-γ, interleukin (IL)-1, IL-2, IL-6, IL-8, IL-10 and IL-17A, and their mRNA expression levels were detected. Crohn′s disease activity index (CDAI) and simplified endoscopic score for Crohn′s disease (SES-CD) were used to evaluate the disease activity of CD patients. The expression levels of occudin, claudin-1, zonula occluden-1 (ZO-1) and junctional adhesion molecule-A (JAM-A) were measured by Western blotting. The intestinal mucosal epithelial cells were observed by transmission electron microscope. T test was used for statistical analysis. Results:Before treatment, BMI, and hemoglobin and albumin levels of CD patients were all lower than those of healthy control group ((18.3±1.8) kg/m 2 vs. (20.2±1.2) kg/m 2, (95.3±8.4) g/L vs. (129.2±5.7) g/L, (33.2±5.4) g/L vs. (50.3±3.2) g/L), and the differences were statistically significant ( t=3.457, 5.342 and 2.674, all P<0.05). After treatment the BMI and hemoglobin levels of CD patients were higher than those before treatment ((19.5±2.1) kg/m 2 vs. (18.3±1.8) kg/m 2, (117.2±10.3) g/L vs. (95.3±8.4) g/L), and the CRP level, CDAI score and SES-CD score were lower than those before treatment ((16.3±2.3) mg/L vs. (47.2±9.3) mg/L, 113.2±12.5 vs. 245.2±23.5, 5.0±2.1 vs. 10.0±4.3), and the differences were statistically significant ( t=2.090, 2.339, 2.432, 6.345 and 5.234, all P<0.05). The expression levels of TNF-α, IFN-γ, IL-2, IL-6, IL-8, IL-17A and their mRNA levels of healthy control group were lower than those of CD patients before treatment ((1.1±0.4) ng/L vs.(158.2±38.3) ng/L, (3.2±0.8) ng/L vs. (28.3±13.4) ng/L, (2.7±1.3) ng/L vs. (3.3±2.4) ng/L, (5.2±0.3) ng/L vs. (16.3±7.4) ng/L, (16.3±6.3) ng/L vs. (18.9±10.2) ng/L, (10.5±2.3) ng/L vs. (38.5±11.2) ng/L; 1.00±0.00 vs. 4.68±0.34, 7.83±0.32, 1.25±0.46, 8.36±0.44, 2.01±0.89 and 6.83±0.53, respectively), and the differences were statistically significant ( t=2.345, 6.456, 3.008, 4.009, 7.045, 10.223, 8.345, 11.235, 1.114, 12.334, 5.304 and 5.678, all P<0.05). After treatment the TNF-α, IFN-γ, IL-2, IL-6, IL-8, IL-17A expression levels and their mRNA levels of CD patients were lower than those before treatment ((106.4±29.9) ng/L vs. (158.2±38.3) ng/L, (25.7±10.8) ng/L vs. (28.3±13.4) ng/L, (2.9±1.7) ng/L vs. (3.3±2.4) ng/L, (15.4±4.2) ng/L vs. (16.3±7.4) ng/L, (17.2±8.7) ng/L vs. (18.9±10.2) ng/L, (29.9±12.7) ng/L vs. (38.5±11.2) ng/L, 2.45±0.21 vs. 4.68±0.34, 3.75±0.18 vs. 7.83±0.32, 1.09±0.22 vs. 1.25±0.46, 3.78±0.21 vs. 8.36±0.44, 1.67±0.33 vs. 2.01±0.89, 2.96±0.11 vs. 6.83±0.53), and the differences were statistically significant ( t=9.345, 2.456, 2.334, 2.090, 3.009, 8.345, 4.567, 6.445, 2.046, 7.774, 3.008 and 8.867, all P<0.05). The results of Western blotting showed that the expression levels of occudin, claudin-1, ZO-1 and JAM-A in the intestinal mucosa of CD patients before treatment were lower than those of the healthy control group (0.21±0.03 vs. 1.00±0.02, 0.17±0.07 vs. 1.00±0.01, 0.16±0.06 vs. 1.00±0.04, 0.26±0.08 vs. 1.03±0.04). After treatment the expression levels of occudin, claudin-1, ZO-1 and JAM- A mRNA in the intestinal mucosa of CD patients were higher than those before treatment (0.77±0.08 vs. 0.21±0.03, 0.69±0.08 vs. 0.17±0.07, 0.78±0.09 vs. 0.16 ±0.06, 0.72±0.07 vs. 0.26±0.08), and the differences were statistically significant ( t=4.567, 6.346, 5.557, 8.456, 9.678, 8.671, 10.456 and 7.456, all P<0.05). Conclusions:IFX can effectively relieve the disease activity and improve the nutritional status of CD patients. IFX maintains the expression of intestinal epithelial tight junction protein by reducing inflammatory response, and repairs the intestinal mucosal barrier of CD patients.

The clinical value of serum Mir-208a in early differential diagnosis of acute coronary syndrome / 中华老年医学杂志

Objective:To investigate the clinical value of serum miR-208a in early differential diagnosis of acute coronary syndrome(ACS).Methods:One hundred ACS patients admitted to our department from January 2016 to January 2018 were randomly divided into the non-ST elevation myocardial infarction(NSTEMI)group(n=50)and the unstable angina(UA)group(n=50). Fifty healthy people during the same period were included as the control group(control). Serum levels of miR-208a, cardiac troponin-T(cTnT)and creatine kinase MB isoenzyme(CK-MB)were detected immediately, 4 h, 12 h and 24 h after admission and compared among the three groups of NSTEMI, UA and control.Receiver operating characteristic(ROC)curve was used to analyze the early diagnostic value of above serum indexes in NSTEMI and UA group, and the correlations of miR-208a level with cTnT and CK-MB were analyzed.Results:Serum miR-208a and cTnT levels had significant differences( P<0.05), while serum CK-MB level had no significant difference( P>0.05)among the NSTEMI and UA groups immediately after admission and the control group in the fasting state.There were significant differences in serum miR-208a, cTnT and CK-MB levels between NSTEMI group and UA group at different time points( P<0.05). After further multiple comparisons, the results showed that serum miR-208a and cTnT levels had statistical differences( P<0.05)and serum CK-MB level had no difference( P>0.05)between the NSTEMI group and the UA group immediately after admission.The above three biochemical indexes showed statistically significant differences between the NSTEMI group and the UA group at 4 h, 12 h and 24 h after admission( P<0.05). ROC curve analysis showed that miR-208a had a high diagnostic value in ACS(AUC>0.9, P=0.004), and the best diagnostic cut-off point was 9.278.The cTnT had a medium diagnostic value in ACS(0.7<AUC<0.9, P=0.013), and the diagnostic cut-off point was 5.147 μg/L.CK-MB had a low diagnostic value in ACS(0.5<AUC<0.7, P=0.031), and the diagnostic cut-off point was 82.716 u/l.Serum miR-208a level was positively correlated with cTnT level in ACS patients( P<0.05), and there was no correlation between serum miR-208a level and CK-MB level( P>0.05). Conclusions:Serum miR-208a has a higher value in early diagnosis of ACS than cTnT and CK-MB, and it has a better differentiation ability of NSTEMI than UA.

Research progress of microRNAs in cardiovascular diseases / 中国综合临床

Objective:MicroRNAs (miRNAs) are endogenous short stranded RNAs with a length of about 22 NT, which are highly conserved and have no coding function.Mature miRNAs play a role by specifically binding to the 3′untranslated region of the target gene, degrading the mRNA of the gene or hindering its translation at the post transcriptional level, so as to negatively regulate the expression of the target gene and play a biological role.In recent years, the research of miRNAs in cardiovascular diseases is increasingly in-depth.A large number of evidences show that miRNAs play a role in the pathogenesis of many cardiovascular diseases, and will become a potential marker and new treatment target for the diagnosis and prognosis evaluation of cardiovascular diseases.

Research progress of microRNAs in cardiovascular diseases / 中国综合临床

Objective@#MicroRNAs (miRNAs) are endogenous short stranded RNAs with a length of about 22 NT, which are highly conserved and have no coding function.Mature miRNAs play a role by specifically binding to the 3′untranslated region of the target gene, degrading the mRNA of the gene or hindering its translation at the post transcriptional level, so as to negatively regulate the expression of the target gene and play a biological role.In recent years, the research of miRNAs in cardiovascular diseases is increasingly in-depth.A large number of evidences show that miRNAs play a role in the pathogenesis of many cardiovascular diseases, and will become a potential marker and new treatment target for the diagnosis and prognosis evaluation of cardiovascular diseases.

Correlation between myeloperoxidase levels and adverse cardiac events in patients undergoing coronary stent implantation / 中华老年医学杂志

Objective To investigate the correlation between myeloperoxidase(MPO)levels and adverse cardiac events in patients undergoing coronary stent implantation.Methods A total of 76 patients undergoing coronary stent implantation from January 2015 to June 2016 in the cardiac surgery department of our hospital were enrolled in this study.Serum levels of MPO,high sensitivity C-reactive protein(hs-CRP),and interleukin 6 (IL-6)were detected by enzyme-linked immunosorbent assays(ELISA).After a one-year follow-up,the receiver operating characteristic(ROC)curve was used to determine the predictive value of the difference in MPO before and after the operation(△MPO)on the long-term prognosis of patients after coronary stent implantation.The correlations of △MPO with the traditional risk factors for coronary heart disease and adverse cardiac events were analyzed using multi factor Logistic regression analysis.Results Serum levels of MPO,hs-CRP and IL 6 increased in patients after coronary stent implantation,compared with those before treatment (P ＜ 0.05).The results of ROC curve analysis showed that the area under the curve(AUC)value of serum △MPO was 0.786,the 95 ％ confidence interval was 0.471～ 1.000 and the predictive value of serum △MPO for adverse cardiac events was significant(P ＜0.05).There was a significant correlation between △MPO and age,and the incidence of adverse cardiac events increased with increased △MPO levels.Logistic regression analysis showed that serum △MPO levels could preliminarily diagnose the cardiovascular risk after coronary stent implantation and independently predict the occurrence of adverse cardiac events.Conclusions MPO levels in peripheral blood are notably elevated in patients after coronary stent implantation when compared with pre-treatment levels.Serum △MPO levels can preliminarily diagnose adverse cardiac events after coronary stent implantation and can be used as a marker to predict adverse cardiac events.

Rs17042171 at chromosome 4q25 is associated with atrial fibrillation in the Chinese Han population from the central plains / 中南大学学报(医学版)

Objective:To determine the correlations of single nucleotide polymorphisms (SNPs) with atrial fibrillation (AF) in the Chinese Han population from the central plains.Methods:A total of 168 hospitalized patients,including 56 AF and 112 controls,were recruited in this case-control study.The clinical data were obtained from the medical records.All 5 SNPs,rs337711 in KCNN2,rs11264280 near KCNN3,rs17042171 near PITX2,rs6771157 and rs6795970 in SCN10A,were genotyped using amplification refractory mutation system-polymerase chain reaction or direct sequencing.The x2 test was used to compare categorical variables and preliminarily examine correlations between the genotype frequencies and AF.Subsequently,a logistic regression model was constructed to determine the associations between the SNPs and AF based on the above screened results.Odds ratios (ORs) and 95％ confidence interval (CI) were calculated to assess the strength of the correlations.Moreover,we downloaded the genotype data from the HapMap Project for linkage disequilibrium analysis ofrs17042171.Results:AF patients were likely to be of older age and longer left atrial diameter and had more coronary artery disease and higher hypertension compared with the control group (P＜0.05).Among the 5 SNPs,the frequency distribution of genotype AA for rs17042171 was significantly different between the AF and control groups (P＜0.05).After adjusting for several covariates,there was still a high risk ratio in patients with the AA genotype compared with the AC+CC genotype (OR:5.591,95％CI 2.176 to 14.365,P-B＜0.008).Similarly,stratification analysis on the AA genotype demonstrated significant differences between rs17042171 and persistent AF.However,there were not significant correlations between AF and the control groups for the other 4 SNPs (P＜0.05).Conclusion:Rs17042171,near PITX2 on chromosome 4q25,is associated with AF susceptibility in the Chinese Han population from the central plains,suggesting that this SNP can provide a new strategy for clinical diagnosis in AF patients.

Factors influencing the outcomes of the traditional Chinese medicine percutaneous release treatment for the stenosal tendosynovitis / 国际中医中药杂志

Objective The aim of this study is to analyze the factors influencing the outcomes of the traditional Chinese medicine (TCM) percutaneous release treatment for the stenosal tendosynovitis. Methods A total of 119 eligible participants, from outpatient of Dongzhimen Hospital during June, 2014 to April, 2017, were included into the study. The participants received TCM percutaneous release treatment, and were followed-up and assessed outcomes at 27 w. Responders were defined as participants with normal movement in week 27 compared with the baseline period. The NRS assessment in both groups was described, and the baseline characteristics of participants potentially related to cure response were mainly analyzed using Logistic regression analysis. Results Cure group and non-cure group were determined according to the cure response. And the outcomes of pain relief along the timeframe showed the feasibility of criteria of cure response. The uni-factor Logistic regression analysis showed that the factors age,course of disease,interventions and pain severity were significantly different between the cure and non-cure groups,and the multi-factor Logistic regression confirmed the four factors influenced the cure response of the TCM percutaneous release treatment for the stenosal tendosynovitis. The cutting knife was 5.85 fold than the traditional needling knife at increasing the cure response (OR=5.853,95% CI 1.853-18.485;P=0.003).All the factors that age equal to or older than 60 years(OR=6.170, 95% CI 1.890-20.141; P=0.003), course of disease more than six months (OR=4.696, 95% CI 1.371-16.085;P=0.014)and pain severity from 6 to 7(OR=5.184,95% CI 1.416-18.975;P=0.013)were negatively associated with clinical response. Conclusions The patients with increasing age, long course of disease and distinct pain severity may be less likely to respond to the TCM percutaneous release treatment. These findings contribute to guiding clinical practice in terms of pretreatment patient selection. Further research is needed to confirm the association.

Value of KRAS mutation predicting prognosis of patients with colorectal liver-only metastasis after hepatectomy / 中华消化外科杂志

Objective To explore the value of KRAS mutation predicting prognosis of patients with colorectal liver-only metastasis after hepatectomy.Methods The retrospective case-control study was conducted.The clinicopathological data of 79 patients with colorectal liver-only metastasis who underwent hepatectomy in the Sun Yat-sen University Cancer Center between October 2010 and October 2016 were collected.KRAS mutation in colorectal cancer tissue was detected by fluorescent quantitative polymerase chain reaction (PCR) and laser flight mass spectrometer.Observation indicators:(1) KRAS mutation;(2) relationship between KRAS mutation and clinicopathological factors of patients with colorectal liver-only metastasis;(3) follow-up and survival situations.Follow-up using outpatient examination and telephone interview was performed to detect recurrence-free survival and overall survival up to June 30,2017.The relationship between KRAS mutation and clinicopathological factors of patients with colorectal liver-only metastasis was analyzed by the chi-square test or Fisher exact probability.The survival curve and time were respectively drawn and calculated by the Kaplan-Meier method,and COX regression model was used for survival analysis.Results (1) KRAS mutation:79 patients received KRAS gene detection of surgical tumor tissues,including 54 in wide-type mutation and 25 in mutant-type mutation.Of 25 patients in mutant-type mutation,mutation at codon 12 of KRAS exon 2 was in 21 patients,and GGT＞GAT (G12D),GGT＞GTT (G12V),GGT＞TGT (G12C),GGT＞GCT (G12A) and GGT＞CGT (G12R) of mutation types were respectively detected in 13,4,2,1 and 1 patients;mutation at codon 13 of KRAS exon 2 was in 3 patients,with a mutation type of GGC＞GAC (G13D);mutation at codon 61 of KRAS exon 3 was in 1 patient,with a mutation type of CAA＞CAT (Q61H).(2) Relationship between KRAS mutation and clinicopathological factors of patients with colorectal liver-only metastasis:primary tumor located in right and left hemicolon were detected in 11,14 patients with mutant-type mutation and 7,47 patients with wide-type mutation,respectively,with a statistically significant difference (x2=9.357,P＜0.05).(3) Follow-up and survival situations:79 patients were followed up for 2.0-71.0 months,with a median time of 29.0 months.Median recurrence-free survival time and median overall survival time were respectively 11.3 months,43.5 months in patients with mutant-type mutation and 9.9 months,44.3 months in patients with wide-type mutation,respectively,with no statistically significant difference in recurrence-free and overall survivals [hazard ratio (HR)=1.255,1.108,95％ confidence interval (CI):0.741-2.126,0.521-2.355,P＞0.05].Further analysis:of patients with low clinical risk score (CRS) of Memorial Sloan Caitlin Cancer Center (MSKCC),median recurrence-free survival time was 11.3 months in 17 patients with mutant-type mutation and 23.5 months in 26 patients with wide-type mutation,with a statistically significant difference in recurrence-free survival of patients (HR=2.082,95％CI:1.006-4.307,P＜0.05).The median overall survival time was 44.6 months in 17 patients with mutant-type mutation and 49.0 months in 26 patients with wide-type mutation,with no statistically significant difference in overall survival of patients (HR =1.165,95％CI:0.413-3.282,P＞0.05).Of patients with high CRS of MSKCC,median recurrence-free survival time and median overall survival time were respectively 5.6 months,28.7 months in 7 patients with mutant-type mutation and 4.5 months,36.7 months in 24 patients with wide-type mutation,with no statistically significant difference in recurrence-free and overall survivals (HR=0.402,1.197,95％CI:0.284-1.656,0.371-3.866,P＞0.05).Conclusions KRAS mutation is often detected in patients with right colon cancer.Recurrence-free survival time is obviously reduced in patients with KRAS mutation and low CRS of MSKCC.

Varied therapeutic effects of Human Amniotic Mesenchymal Stem Cell Transplantation with Different Transplantation Methods for Spinal Cord Injury Therapy in Rats / 实用医学杂志

Objective To compare the therapeutic effects of orthotopic injection and tail vein injection of human amniotic mesenchymal stem cells(hAMSCs)on histological restoration and neurological functions of rats with spinal cord injury. Methods Transected spinal cord injury model in rats was established by transplanting DAPI prelabelled hAMSCs one week after injury.BBB scores were used to evaluate the hindlimb movement of rats. The histological patterns.and morphology of medullary sheath of spinal cord were observed. Results BBB scores in the orthotopic injection group and tail vein injection group were increased gradually from one to six week after hAM-SCs transplantation and reached 6.5 ± 0.5 and 7.12 ± 1.61 respectively 6 weeks after cell transplantation,higher than that of the control group(both P < 0.01). However,there was no statistical significance between the two groups.Histological results indicated that the repair of injured tissue in the orthotopic injection group and tail vein injection group were both better than that in the control group,and there were more vesica and loosened layers forming in the injured spinal cord of rats in the PBS control group as compared with the orthotopic and tail vein transplantation group. Conclusion hAMSCs transplantation through tail vein injection could promote histological restoration and neurological regeneration of rats with spinal cord injury,which has the similar therapeutic effects with hAMSCs orthotopic transplantation.

The effects of early neck isometrics exercise on neck discomfort in patients underwent cerebellopontine angle surgeries / 中华护理杂志

Objective To evaluate the effects of early neck isometrics exercise on relieving neck discomfort in patients after cerebellopontine angle surgeries.Methods The non-synchronous control study was conducted.The control group(40 patients recruited from March to June,2017) received routine nursing,while the intervention group (40 patients recruited from July to November,2017) performed early neck isometrics exercise in addition to routine nursing.Neck discomfort degree,neck rotation range,and Barthel score were measured and compared between two groups on Day 1,Day 3,Day 5,and Day 7 after surgeries.Results The intervention group had a high level of participation and no adverse events occurred.Neck discomfort degree of the intervention group was significantly lower than that of the control group on Day 1,Day 3,and Day 5(P＜0.05).Neck rotation range of the intervention group was improved on Day 1 and Day 3 compared with the control group(P＜0.05).Barthel score of the intervention group on Day 3,Day 5 and Day 7 was significantly better than that of the control group(P＜0.05).Conclusion Early neck isometrics exercise in patients underwent cerebellopontine angle surgeries is safe and feasible,which can alleviate discomfort of neck,and improve patients' early postoperative experience and quality of life.

Status quo of colorectal cancer screening in Guangzhou community / 中华胃肠外科杂志

The incidence of colorectal cancer (CRC) in China is gradually increasing as a result of the economic development and dietary change. Since it usually takes a long time for precancerous lesions (e.g. adenoma) to develop into cancer, proper cancer screening is useful to discover and to remove these early lesions, while the patients can achieve long-term survival. Hence, developing a well-organized cancer screening system is necessary for the early detection and intervention of potential CRC. Sun Yat-sen University Cancer Center (SYSUCC) has been developing a community-based cancer screening program, using questionnaires and fecal occult blood test to identify the residents with high risks of CRC. These people will be further subjected to colonoscopy and biopsy for the suspected lesions. Among the 1 030 participants in Guangzhou Yuexiu District who received colonoscopy at SYSUCC from January to November in 2015, polyps, inflammation or tumors were found in 361 (35.0%) patients, in whom 13 were colorectal cancers (1.3%), 327 were polyps (31.7%), 239 were adenoma (23.2%), and 140 were prophase adenoma(13.6%). Besides, no significant difference of CRC detection rate between male and female was found (P>0.05), while the detection rate of polyps and prophase adenoma was higher in male than that in female, which also increased significantly with age (P<0.01). We envision such systematic cancer screening extremely useful to enhance the understanding of cancer screening in the public and eventually to realize the early detection and treatment of cancer.

Expression and identification of recombinant chimeric CARDS of Mycoplasma pneumoniae / 中国人兽共患病学报

We expressed multi-epitope chimeric protein of CARDS toxin protein of Mycoplasma pneumonia (Mp) in prokaryotic cells,and purified and investigated its immunoreactivity.A recombinant multi-epitope chimeric gene including ten critical epitopes was connected by linker and cloned into prokaryotic expression vector pET-28a(+),and transformed into E.coli BL21(DE3) cells for expression under induction of IPTG.The antigenicity of expressed recombinant protein was identified with 6 × His monoclonal antibody and human positive serum by Western blot.The recombinant expression vector pET-CARDS was constructed and the about 30 kDa recombinant chimeric protein expressed in BL21(DE3) successfully.Western blot analysis showed that it can react respectively with 6 × His monoclonal antibodies and human positive serum.This study showed that the chimeric CARDS protein has an obvious immunoreactivity and a potential to be a new antigen for the diagnosis of Mp infection.

Detecting the Expression of ST3GalⅤ in Human Hepatic Carcinoma Cell Lines by Sialyltransferase DNA Microarray / 沈阳医学院学报

Objective: To investigate the differential expression of ST3GalⅤ in human hepatic carcinoma cell lines, HepG?2 and SMMC?7721 and normal hepatic cell line, L?02 by sialyltransferase DNA microarray. Methods: Expression of ST3Gal family was measured with DNA microarray. Western blot was used to verify DNA microarrays data. Result:ST3GalⅤ downregulated in HepG?2 and SMMC?7721 cell lines, compared with control cell line. Conclusion: The downregulation of ST3GalⅤ in HepG?2 and SMMC?7721 cell lines may result in the reduction of GD1a and influence the hepatocyte proliferations.

Effect of pretreatment with botulinum toxin A on NK-1 receptor internalization in spinal dorsal horn in a rat model of incisional pain / 中华麻醉学杂志

Objective To evaluate the effect of pretreatment with botulinum toxin A injected intrath?ecally or locally at the incision site on the neurokinin?1 ( NK?1) receptor internalization in the spinal dorsal horn in a rat model of incisional pain. Methods Male Sprague?Dawley rats, weighing 280-300 g, aged 6-8 weeks, were used in the study. The experiment was performed in two parts. ExperimentⅠ Twenty?seven rats with no sign of nerve injury at day 7 after successful catheterization were selected and divided into 3 groups (n=9 each) using a random number table: control group (C1 group), incisional pain group (IP1 group) and intrathecal botulinum toxin A group (BoNT∕A1 group). At 24 h before operation, botulinum tox?in A 0.5 U ( in 10μl of normal saline) was injected intrathecally in group BoNT∕A1, and normal saline 10μl was injected intrathecally in group IP1. ExperimentⅡ Twenty?seven rats were selected and divided into 3 groups (n=9 each) using a random number table: control group (group C2), incisional pain group (IP2 group) and locally injected botulinum toxin A at the incision site group (BoNT∕A2 group). At 24 h before op?eration, botulinum toxin A 2 U ( in 0.4 ml of normal saline) was injected subcutaneously at the incision site and into the plantar surface, and normal saline 0.4 ml was injected subcutaneously at the incision site and into the plantar surface in group IP2. Six rats in each group were selected, and the cumulative pain score (CPS) was recorded, and the mechanical paw withdrawal threshold ( MWT) in the right hindpaw was measured be?fore administration, before operation, and at 3 h and 1, 3, 5 and 7 days after operation. At 3 h after opera?tion, 3 rats in each group were selected and sacrificed, and the lumbar segment ( L4,5 ) of the spinal cord was removed for determination of the expression of NK?1 receptors in the spinal dorsal horn by immunofluores?cence. Results ExperimentⅠ Compared with group C1, the CPS was significantly increased at 3 h and 1, 3, 5 and 7 days after operation, the MWT was significantly decreased at 3 h and 1 and 3 days after opera?tion, and the expression of NK?1 receptors in the spinal dorsal horn was significantly up?regulated in group IP1, and the CPS was significantly increased at 3 h and 1, 3 and 5 days after operation, the MWT was sig?nificantly decreased at 3 h after operation ( P0.05). Compared with group IP1, the CPS was significantly decreased, and the MWT was significantly increased at 3 h and 1, 3, and 5 days after oper?ation, and the expression of NK?1 receptors in the spinal dorsal horn was significantly down?regulated in group BoNT∕A1 (P0.05) . Compared with group IP2, the CPS was significantly decreased at 3 h and 1, 3, and 5 days after operation, the MWT was signifi?cantly increased at 3 h and 1 and 3 days after operation, and the expression of NK?1 receptors in the spinal dorsal horn was significantly down?regulated in group BoNT∕A2 (P<0.05). Conclusion Pretreatment with botulinum toxin A injected intrathecally or locally at the incision site can inhibit the internalization of NK?1 re?ceptors in the spinal dorsal horn in a rat model of incisional pain.

Analysis of Clinical Response on Cardiac Resynchronization Therapy in Patients of Chronic Heart Failure With Different QRS Wave Morphology / 中国循环杂志

Objective: To explore the clinical response on cardiac resynchronization therapy (CRT) in patients of chronic heart failure (CHF) with different QRS wave morphology. Methods: A total of 52 CHF patients received CRT in our hospital and the Seventh People's Hospital of Zhengzhou City from 2010-03 to 2013-07 were retrospectively studied. The patients were divided into 3 groups: True-complete left bundle branch block (t-CLBBB) group,n=20, Classic LBBB (CLBBB) group,n=15 and IVCD group,n=17. The general clinical condition, the indexes of echocardiography at 6 months of follow-up study including left ventricular end diastolic diameter (LVEDD), left ventricular ejection fraction (LVEF), NYHA classiifcation and 6-MWT were examined and compared among different groups. Results: In general clinical condition, the ratio of non-ischemic heart disease patients in t-CLBBB group was higher than those in CLBBB group and IVCD group, allP<0.05. By 6 months follow-up study, LVEDD in t-CLBBB group (62.6 ± 8.9) mm was lower than those in CLBBB group (70.0 ± 8.9) mm and IVCD group (72.8 ± 8.0) mm, LVEF was higher in t-CLBBB group (38.5 ± 6.2) % than those in CLBBB group (31.7 ± 6.7) % and IVCD group (30.1 ± 6.7) %. NYHA classiifcation in t-CLBBB group (2.00 ± 0.45) grade was lower than those in CLBBB group (2.73 ± 0.80) grade and IVCD group (3.12 ± 0.78) grade . 6-MWT in t-CLBBB group (302.0 ± 57.9) m was longer than those in CLBBB group (257.3 ± 59.0) m and IVCD group (220.2 ± 57.9) m, allP<0.05. Conclusion: CRT is an effective method for treating CHD patients, different QRS morphology may have different response, the patients with t-CLBBB would make better response.

Clinical analysis of 190 patients with myomectomy by laparoscope / 中国基层医药

Objective To investigate the clinical effect of laparoscopic operation and laparotomy in the treat-ment of uterine fibroids.Methods A retrospective analysis of uterine fibroids and requests to retain the clinical data of 380 cases of uterine of patients,according to treatment methods,they were divided into laparoscopic myomectomy group (group A)and cesarean section uterine fibroids removed surgery group (B group),there were 190 cases,two groups of patients,surgery,clinical effect were analyzed.Results In group A,operation time,postoperative exhaust time,postoperative ambulation time,postoperative VAS score,duration of hospitalization,injection of analgesics appli-cation proportion were (96 ±35)min,(24 ±8.5)h,(12 ±4)h,(2.0 ±1.5),(4.0 ±1.2)d,17.8%,patients in the group B respectively (98 ±28)min,(40 ±12)h,(20 ±8)h,(6.0 ±1.3),(8 ±2)d,84.6% there was a significant differences between the two groups (t=-2.558,33.96,45.810,50.571,34.120,χ2 =169.89,all P0.05);group A,the complication rate was 7.34%,lower than the 12.6%in the group B,there was significant difference between the two groups (χ2 =3.923,P<0.05).Conclusion Laparoscopic myo-mectomy in treatment of uterine fibroids,good effect,less trauma,quicker recovery,shorter hospitalization time of patients,should be further popularized in clinic.

Effect of catheter radiofrequency ablation on C-reactive protein, brain natriuretic peptide and echocardiograph in patients with persistent and permanent atrial fibrillation / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Radiofrequency catheter ablation (RFCA) for atrial fibrillation (AF) has developed rapidly, and is a commonly performed ablation in many major hospitals throughout the world, due to its satisfactory results. The aim of this study was to detect the effect of RFCA on C-reactive protein (CRP), brain natriuretic peptide (BNP), and echocardiograph in patients with persistent and permanent AF.</p><p><b>METHODS</b>A total of 120 patients (71 males, mean age (50.8 ± 12.0) years) with persistent and permanent AF undergoing RFCA under guidance of the Carto merge technique were studied. Left atrial diameter (LAD), right atrial diameter (RAD), left ventricular ejection fraction (LVEF), CRP, and BNP were observed 3, 6 and 12 months after RFCA and compared with results before RFCA. The recurrence of atrial arrhythmias was observed 3 and 12 months after the procedure.</p><p><b>RESULTS</b>Compared with that before RFCA, LAD and RAD decreased and LVEF increased significantly after RFCA. Meanwhile, the levels of CRP and BNP were reduced significantly at 3, 6, and 12 months after RFCA (P < 0.05). In the non-recurrent patients, LVEF was increased significantly compared with the recurrent patients at 3, 6, and 12 months after RFCA (P < 0.05). CRP and BNP levels were decreased significantly in the non-recurrent patients compared with the recurrent patients at 3, 6, and 12 months after RFCA (P < 0.05). After one or two applications of RFCA, during a follow-up of 12 months, 12 patients (10.0%) had AF, 10 patients (8.3%) had atrial flutter, and 5 patients had atrial tachycardia (4.2%).</p><p><b>CONCLUSIONS</b>Conversion of AF to sinus rhythm by RFCA, has been shown to reduce LA size and improve LVEF. It can also significantly decrease the levels of CRP and BNP in patients with persistent and permanent AF and reduce the risk of inflammation and developing heart failure.</p>