Association of attention deficit hyperactivity disorder symptoms and bullying behavior in children / 中国学校卫生

Objective@#The association between school bullying and attention deficit hyperactivity disorder (ADHD) symptoms among students in primary schools and the moderating role of gender was explored to provide scientific evidence for the prevention and control of school bullying.@*Methods@#A total of 4 764 students from 2 primary schools in Wuhan were selected using the convenience sampling method in March 2023. The Olweus Bully/Victim Questionnaire and Strengths and Difficulties Questionnaire were used. A Pearson χ 2 test was used to compare differences in school bullying rates among children with and without ADHD symptoms. Pearson correlation analysis and Process 3.3 were used to analyse the association between ADHD symptoms, and school bullying behaviour and the moderating role of gender.@*Results@#The reported rate of bullying victims in primary schools was 24.2% and the rate of bullying perpetration was 3.8%. The rate of ADHD symptom detection among primary school students was 5.9%. ADHD symptoms were positively associated with bullying and bullying victim behaviour ( r =0.16, 0.27, P <0.01). Specifically, the association between ADHD symptoms and bullying behavior tended to be stronger among boys than girls ( β boy =0.17, t =11.13; β girl =0.07, t =4.11, P <0.01).@*Conclusions@#ADHD symptoms are an important factor influencing school bullying behaviors in students, and gender moderates the association. In the process of preventing and controlling school bullying, ADHD symptoms and gender differences should be emphasized and comprehensive interventions should be implemented.

Analysis of the effect of cold snare endoscopic mucosal resection in the treatment of colorectal polyps / 中国医师进修杂志

Objective:To explore the effect of cold-strap endoscopic mucosal resection (CS-EMR) in patients with colorectal polyps.Methods:A prospective randomized clinical trial was conducted to 320 selected patients with colorectal polyps diagnosed by Shenzhen Luohu District People′s Hospital from May 2019 to June 2021. The patients were randomly divided into CS-EMR group and HS-EMR group with 160 cases each, using a random number table generated by Excel 2007. The main parameters for statistical analysis contain the process indicators of the two groups of surgical methods, the complete polypectomy rate of patients after surgery, the degree of postoperative pain and the recovery of gastrointestinal function, and the differences in surgical complications.Results:The polypectomy time of CS-EMR group was shorter than that of HS-EMR group: (4.11 ± 1.20) min vs. (4.42 ± 0.98) min, with a statistically significant difference ( P<0.05). The score of visual analogue pain scale (VAS) in CS-EMR group was lower than that in HS-EMR group at 4 and 12 hours after operation: (3.11 ± 0.78) scores vs. (3.48 ± 0.80) scores, (3.38 ± 0.80) scores vs. (3.61 ± 0.92) scores, with a statistically significant difference ( P<0.05). The first anal exhaust time and first defecation time in CS-EMR group were lower than those in HS-EMR group: (27.83 ± 5.01) h vs. (29.66 ± 4.84) h, (43.73 ± 7.80) h vs. (47.28 ± 8.14) h, with a statistically significant difference ( P<0.05). The complications in CS-EMR group were significantly lower than those in HS-EMR group: 5.63% (9/160) vs. 12.50% (20/160), with a statistically significant difference ( P<0.05). Conclusions:The effect of CS-EMR in the treatment of colorectal polyps is not different from that of HS-EMR, but the former has the advantages of short resection time, rapid recovery of gastrointestinal function after operation, light pain and less complications.

Research progress of extracellular vesicles in the treatment of renal disease / 生理学报

Extracellular vesicles (EVs) are lipid bilayer-enclosed structures containing diverse bioactive cargoes that play a major role in intercellular communication in both physiological and pathological conditions. Currently, the field of EV-based therapy has been rapidly growing, and two main therapeutic uses of EVs can be surmised: (i) exploiting stem cell-derived EVs as therapeutic agents; and (ii) employing EVs as natural therapeutic vectors for drug delivery. This review will discuss the recent advances in EV-based therapy in the treatment of renal disease.

Research progress of vascular endothelial growth factor-A and its isoforms in kidney disease / 生理学报

Vascular endothelial growth factor-A (VEGF-A) is a critical angiogenic factor which is mainly secreted from podocytes and epithelial cells in kidney and plays an important role in renal pathophysiology. In recent years, functions of different isoforms of VEGF-A and the new secretion approach via extracellular vesicles (EVs) have been identified. Thus, further understanding are needed for the role of VEGF-A and its isoforms in renal injury and repair. In this review, we summarized the expression, secretion and regulation of VEGF-A, its biological function, and the role of different isoforms of VEGF-A in the development of different renal diseases. Meanwhile, the research progress of VEGF-A as diagnostic marker and therapeutic target for renal diseases were discussed.

Screening and diagnostic efficacy evaluation of metabolomics biomarkers in patients with active tuberculosis / 中华检验医学杂志

Objective:Based on UPLC-Q-TOF/MS, to screen a panel of plasma metabolite biomarkers for TB diagnosis and evaluate its diagnostic efficacy.Methods:102 active TB patients [49 males, 53 females, age 40.0(24.0, 48.5) years] from Shanghai Pulmonary Hospital and Shanghai East Hospital from January 2017 to January 2018, 100 TB-IGRA positive patients [55 males, 45 females, age 44.0(37.0, 52.0) years] and 96 healthy controls [55 males, 41 females, age 43.0(32.2, 52.8) years] from Shanghai East Hospital were randomly enrolled. UPLC-Q-TOF/MS technology was used to detect small molecule metabolites in plasma. Combined with multivariate statistical methods VIP and univariate statistic analysis Student's t-test, the main differential metabolites in the plasma of patients with active tuberculosis were filtered. The ROC curve was analyzed for the differential metabolites, and the AUC value, specificity, and sensitivity for diagnosis were used to screen metabolic biomarkers with diagnostic potential. Results:All the samples examined resulted in 10 266 variables, and 1 153 substances were identified by qualitative retrieval through the human metabolome database. After pairwise comparison of samples from the three groups, differential metabolites that simultaneously satisfied VIP > 1 and P<0.05 were plotted into a Venn diagram, and the resulting intersection set contained 38 major differential metabolites. The ROC curve analysis of 38 major metabolites showed that the area under the curve of lactic acid, dopamine, 9-pentadecenoic acid, and 12,13-dihydroxy octadecadienoic acid in the diagnosis of active tuberculosis were 0.92, 0.98, 0.94, and 0.94, respectively, the specificity was both more than 90% and the sensitivity was both more than 80%. The specificity and sensitivity of four metabolites in the combined diagnosis of active tuberculosis were both 94%. Conclusion:Lactic acid, dopamine, 9-pentadecenoic acid, and 12, 13-dihydroxy octadecadienoic acid can be used as potential metabolic biomarkers for tuberculosis diagnosis.

Effect of changes in body mass index on left heart function in early breast cancer patients undergoing anthracycline chemotherapy / 肿瘤研究与临床

Objective:To explore the effect of changes in BMI (ΔBMI) on left ventricular function in early breast cancer patients undergoing anthracycline chemotherapy.Methods:The clinical data of 170 breast cancer patients treated in the Lianyungang Oriental Hospital from January 2018 to October 2021 were retrospectively analyzed. The clinicopathological data and cardiac color doppler ultrasound examination results of the patients were collected. Single-factor and multiple-factor were used to analyze the risk factors of cardiotoxicity in patients after chemotherapy. ΔBMI was calculated and the receiver operating characteristic (ROC) curve was drawn; the cut-off value of the ΔBMI was measured to obtain the diagnostic accuracy.Results:Compared with before chemotherapy, the mean values of BMI, left ventricular end-diastolic volume (EDV), left ventricular end-systolic volume (ESV), left ventricular end-diastolic diameter (LVD), and left ventricular end-systolic diameter (LVS) were increased after chemotherapy, while left ventricular ejection fraction (LVEF) value was decreased. Before and after chemotherapy, the differences between BMI [(22.30±1.88) kg/m 2 vs. (23.59±2.32) kg/m 2] and LVEF [(63.69±4.69)% vs. (59.08±4.28)%] were statistically significant ( t = 3.40 and 4.98, all P < 0.05). The range of ΔBMI was 0-41.3%, and the range of the change of LVEF (ΔLVEF) was 0-15.9%. There was a significant correlation between ΔLVEF and ΔBMI ( r = 0.709, P < 0.001). The incidence of cardiotoxicity was 21.2% (36/170). Logistic regression analysis showed that BMI( OR = 1.639, 95% CI 1.263-2.127, P = 0.000) and ΔBMI ( OR = 1.147, 95% CI 1.071-1.228, P = 0.000) were independent risk factors for cardiotoxicity in early breast cancer patients undergoing anthracycline chemotherapy. According to the cardiotoxicity, the area under the ROC curve of ΔBMI and BMI was 0.757 and 0.687, respectively. When the ΔBMI value was 4.28%, the maximum Youden index was 0.399, the sensitivity was 0.750, and the specificity was 0.649. Conclusion:For breast cancer patients treated with anthracycline chemotherapy, ΔBMI can be used as an effective indicator for predicting cardiotoxicity; when ΔBMI exceeds 4.28%, the risk of cardiotoxicity is high.

Application of asthenopia survey scale in patients with accommodative asthenopia / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate the visual fatigue of patients with accommodative asthenopia and the difference in scores before and after treatment by using the asthenopia survey scale(ASS), and to evaluate its reliability, validity and responsiveness in this population.METHODS: A total of 112 patients with accommodative asthenopia were admitted to the department of ophthalmology, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine and recruited online were investigated using the ASS questionnaire, and 48 subjects were randomly selected and retested 1wk later. A variety of reliability, validity and responsiveness indicators were used to evaluate the scale.RESULTS: The overall Cronbach's α coefficients of the scale entries was 0.91; The split-half reliability coefficients was 0.86; Repeated measurement correlation coefficient of the scale total score was 0.74, there was no significant difference before and after(P&#x003E;0.05); The results of confirmatory factor analysis showed that the absolute fit index of the three-factor structural model was χ2/df&#x003C;2.0, RMSEA=0.08; The correlation coefficients of each dimension's total score and the scale's total score were 0.92, 0.90 and 0.83 respectively; The standard association validity analysis showed statistically significant differences between groups(P&#x003C;0.01). Response analysis was statistically significant before and after treatment(P&#x003C;0.01).CONCLUSION: The ASS has high reliability, validity and responsiveness in the clinical evaluation of accommodative asthenopia, and it's an effective tool for clinical research and screening of asthenopia in this population.

Anti-inflammatory and Analgesic Activities of Angelicae Sinensis Radix： A Review / 中国实验方剂学杂志

Angelicae Sinensis Radix， derived from a medicinal and edible plant Angelica sinensis， is one of the traditional bulk Chinese medicines. In addition to gynecological blood stagnation and deficiency， its indications also include dysmenorrhea， deficiency and cold-induced abdominal pain， and rheumatoid arthritis. With the in-depth study of Angelicae Sinensis Radix， its anti-inflammatory and analgesic activities have attracted widespread attention. However， there has been no systemic report. The present study comprehensively reviewed the anti-inflammatory and analgesic activities of Angelicae Sinensis Radix （including its compositions， extracts， and different processed products） and mechanisms published in recent 30 years. The anti-inflammatory effect of Angelicae Sinensis Radix was achieved mainly by blocking the expression of proteins and genes in nuclear factor-κB （NF-κB）， mitogen-activated protein kinases （MAPK）， and Janus kinase （JAK）/signal transducer and activator of transcription （STAT） signaling pathways， inhibiting the release of inflammatory mediators including tumor necrosis factor-α （TNF-α）， interleukin-6 （IL-6）， nitric oxide （NO）， prostaglandin E2 （PGE2） and IL-1β， and maintaining the high sensitivity of immune cells in the host to external stimuli. The mechanism of analgesic effect may be related to the suppression of the production of algesic substances （such as inflammatory factors and chemokines） or blocking of the amplification and transmission of pain perception in cascade reaction. Furthermore， the study also pointed out some problems in modern research and proposed suggestions on its future research to provide references for investigation and clinical applications of Angelicae Sinensis Radix.

Primary Study on Chronic Myeloid Leukemia in NCG Mice from Qinba Mushroom / 中国实验血液学杂志

OBJECTIVE@#The present study was to evaluate the anti-tumor effects of acidic RNA protein complex (FA-2-b-β) extracted from the wild edible Qinba mushroom in inducing of apoptosis and immunoregulation of tumor cell.@*METHODS@#Cell proliferation inducing rate of FA-2-b-β to K562 cell was measured using CCK-8. Apoptosis rate was detected by using flow cytometry. Chronic myeloid leukemia model was developed by tail vein injection/subcutaneous inoculation of K562 cells in NCG mice. The tumor burden of mice was observed. The general condition of the mice was monitored twice daily. The peripherivcal full blood counts of mice was tested daily. RT-qPCR and Western blot was FA-2-b-β performed to determine involvement of apoptotic-related gene and protenin, Immunofluorescence and immunohistochemistry was used to detected the expression of CD3, CD4 and CD8.@*RESULTS@#The proliferation and apoptosis of K562 cell could be inhibitied and induced by FA-2-b-β, there was 100% successful in the tumor formation in vivo, after treated by drug for 21 days there were significantly increased peripheral leucocytes, but decreased hemoglobin of mice treated by FA-2-b-β as compared with those in control group. The CD3, CD4 and CD8 showed positive in mice, and the propotation was imbalance, but it showed reserved after treated by FA-2-b-β.@*CONCLUSION@#FA-2-b-β is strong anti-leukemia effect in vitro and in vivo, suggesting the traditional Chinese medicine maybe contribute to the anti-cancer and immunoregulation research.

Application of island flap and its combined flap on repairing nasal alae defects / 中华耳鼻咽喉头颈外科杂志

Objective: To evaluate the application of island flap and combined flap in one-stage reconstruction of nasal alae defects after external nasal tumor resection. Methods: Data of 11 patients with perforating or full-thickness defects of the alae after nasal tumor resection in XuanWu Hospital, Capital Medical University between June 2016 and February 2021 were analyzed retrospectively. There were 7 males and 4 females, and the ages ranged from 51 to 89 years. Island flap, island flap combined with nasolabial flap or V-Y advancement flap, and island flap combined with bilobed flap were applied according to the range of defects. Descriptive statistical method was applied to analyze the treatment effects. Results: All flaps of the 11 patients were successful survival and the incisions were primary healing. Being followed up for 5 to 59 months, the patients had satisfying appearance and ventilation function, and no tumor relapsed. Conclusion: For the patients with nasal alae defects after external nose tumor resection, selecting suitable island skin flap or combined skin flap can be used to reconstruct the ideal nasal appearance and function of the nose.

Preparation of evodiamine-glycyrrhizic acid micelles with glycyrrhizic acid as carrier and their anti-hepatic fibrosis activity / 中国中药杂志

This study aimed to prepare evodiamine-glycyrrhizic acid(EVO-GL) micelles to enhance the anti-hepatic fibrosis activity of evodiamine. Firstly, EVO-GL micelles were prepared with use of thin film dispersion method. With particle size, encapsulation efficiency, loading capacity of micelles and the solubility of evodiamine as the indexes, the effect of different factors on micelles was observed to screen the optimal preparation methods and process. Then the pharmaceutical properties and the therapeutic effects of EVO-GL micelles prepared by optimal process were evaluated on CCl_4-induced hepatic fibrosis. The results showed that the micelles prepared by the thin film dispersion method had an even size, with an average particle size of(130.80±12.40)nm, Zeta potential of(-41.61±3.12) mV, encapsulation efficiency of 91.23%±1.22%, drug loading of 8.42%±0.71%, high storage stability at 4 ℃ in 3 months, and slow in vitro release. Experimental results in the treatment of CCl_4-induced hepatic fibrosis in rats showed that EVO-GL micelles had a synergistic anti-hepatic fibrosis effect, which significantly reduced the liver function index of hepatic fibrosis rats. In conclusion, the EVO-GL micelles prepared with glycyrrhizic acid as a carrier would have a potential application prospect for the treatment of hepatic fibrosis.

Research progress on anti-inflammatory mechanism of natural sesquiterpenoids / 中国中药杂志

Sesquiterpenoid is a kind of compound widely distributed in nature, which has a wide range of biological activities, such as anti-inflammatory, anti-tumor and immunomodulatory activities. This paper would review the anti-inflammatory mechanism of sesquiterpenoid. The mechanism is mainly by inhibiting the activation of nuclear factor (NF-κB), mitogen-activated protein kinase (MAPKs) and signal transducers and activators of transcription (STAT) signaling pathways and down-regulating the inflammatory gene expression including tumor necrosis factor- (TNF-), prostaglandin E₂ (PGE₂), nitric oxide (NO), interleukin-1(IL-1), IL-6, IL-8 and other inflammatory factors. Thereby, the production and release of inflammatory cytokines are reduced to exert anti-inflammatory effect. This review is intended to provide reference for related research.

Urinary biomarkers for chronic kidney disease: a focus on gene transcript / 生理学报

Chronic kidney disease (CKD) is becoming an alarming health burden worldwide, however, there is still lack of early biomarkers and effective treatment options. Thus, in the upcoming era of precision medicine, searching for the sensitive, non-invasive biomarkers has been the cornerstone and major challenge in the management of CKD. Urine contains rich biological information which could be an ideal source for non-invasive biomarkers of CKD. This review will discuss the recent advances in biomarker study from urine sediment, urine supernatant and urinary extracellular vesicles with special interest in gene transcript (miRNA, mRNA) biomarkers. Besides, the challenges and future directions for urinary gene transcript biomarker study will be discussed.

Polymorphism in rs2229783 of the Alpha 1(XI) Collagen Gene Is Associated with Susceptibility to but not Severity of Kashin-Beck Disease in a Northwest Chinese Han Population / 生物医学与环境科学（英文）

A case-control study was conducted to investigate associations between organophosphate pesticide (OP) exposure, aggression, impulsivity, and attempted suicide. The purpose of this study was to explore whether genomic polymorphisms in the alpha 1(XI) collagen gene (COL11A1) were associated with the risk and severity of Kashin-Beck disease (KBD). Twenty-two single nucleotide polymorphisms (SNPs) in COL11A1 were genotyped in 274 KBD cases and 249 healthy controls using the Sequenom MassARRAY system. The expression of type XI collagen (COL11A) in the knee articular cartilage of 22 KBD patients and 21 controls was analyzed by immunohistochemistry. Our results showed that the frequency distribution of genotypes of the rs2229783 polymorphism in COL11A1 was significantly different between the KBD and control groups (P = 0.0003). Moreover, the expression level of COL11A in cartilage was significantly lower in the KBD group than in the controls (t = 2.637, P = 0.02). However, no association was found between the rs2229783 and the severity of KBD, suggesting a role of COL11A1 in the susceptibility to but not the severity of KBD.

Normal reference values for left ventricular peak systolic longitudinal strain and strain rate in healthy children at different ages: a preliminary analysis / 第三军医大学学报

Objective To analyze the normal reference values of left ventricular longitudinal peak systolic strain (LS) and strain rate (LSr) by two-dimensional speckle tracking imaging (2D-STI) in healthy children at different ages.Methods Clinical ultrasound data of 330 healthy children who taking physical examination in our hospital from September 2015 to November 2016 were collected and retrospectively.They were divided into 7 groups according to their ages,that is,neonate group (0 to 28 days old),infant group (28 days to 1 year old),toddle group (1 to 3 years old),pre-school group (3 to 6 years old),school age group (6 to 9 years old),pre-adolescence group (9 to 13 years old) and adolescence group (13 to 18 years old).2D-STI was performed in the 3 apical projections of left ventricle (LV).The regional peak systolic longitudinal strain and strain rate of LV were measured.Results ① Significant differences were found in the LS and LSr values from 6 segments of the same wall (P ＜ 0.05),and the LS and LSr values were gradually increased from basal segment to apical segment.②There were no significant differences in the LS,LSr and global LS (GLS) values of 18 segments between sexes (P ＞ 0.05).③ Except the basal segments of posterior wall,inferior wall and posterior septum,LS value was gradually elevated with the increase of age (LS ＜LSinfant ＜ LStoddler,pre-shool and school age ＜ LSpre-adolescence and adolescence),So was GLS value.④LS in 18 segments had a positive correlation with age,and the value of apical segment in lateral wall was most remarkably correlated (r =0.551,P ＜0.01);Regional LS had a negative correlation with heart rate,and that of middle segment in lateral wall was the most apparent (r =-0.625,P ＜ 0.01);GLS was positively influenced by age (r =0.665,P ＜ 0.01) and negatively affected by heart rate (r =-0.625,P ＜ 0.01).⑤The heterogeneities were found in the correlations of regional LSr with age and heart rate in segments and in the LSr among different age groups.Conclusion Normal reference values of LV peak LS and LSr are established for healthy children at different ages,and they possess their own characteristics.

Postprocedural Outcomes and Risk Factors for Arrhythmias Following Transcatheter Closure of Congenital Perimembranous Ventricular Septal Defect: A Single-center Retrospective Study / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Currently, transcatheter closure of perimembranous ventricular septal defect (pmVSD) is a widely accepted therapeutic modality. However, arrhythmias, especially postprocedural heart blocks, are a concern and outcomes are not very clear. This study explored the outcomes and risk factors of arrhythmias associated with transcatheter device closure of pmVSD.</p><p><b>METHODS</b>A total of 395 patients diagnosed with pmVSD who successfully underwent transcatheter intervention between January 2010 and December 2015 in our center were retrospectively reviewed. Electrocardiographic data before and after the procedure were collected and analyzed. We first evaluated the potential risk factors including gender, age, weight, inlet and outlet diameters of defect, subaortic rim length, occluder size, corrected occluder size into body surface area, fluoroscopy time, presence of aneurysm, and deployment position. We compared the potential risk factors between arrhythmia and nonarrhythmia groups using univariate analysis, followed by logistic analysis for independent risk factors.</p><p><b>RESULTS</b>Various arrhythmias were detected in 95 cases (24.1%) following transcatheter closure procedure. Logistic regression analysis revealed that eccentric (odds ratio [OR] 2.9, 95% confidence interval [CI]: 1.2-7.2) and large occluders (OR 2.0, 95% CI: 1.6-2.5), as well as long fluoroscopy time (OR 1.1, 95% CI: 1.1-1.2), were correlated with postprocedural arrhythmia. During 35.5 months (range: 9-80 months) of follow-up, most of the patients (74 out of 95) reverted to normal heart rhythm.</p><p><b>CONCLUSIONS</b>The mid-term outcome of patients with arrhythmias after transcatheter closure of pmVSD was satisfactory as most of the patients recovered normal rhythm. Eccentric, large device and long fluoroscopy time increase the risk of arrhythmias after transcatheter closure of pmVSD.</p>

Urinary Biomarkers for Chronic Kidney Disease with a Focus on Gene Transcript / 中华医学杂志(英文版)

<p><b>Objective:</b>In the upcoming era of precision medicine, searching for the early, noninvasive biomarkers has been the cornerstone and major challenge in the management of chronic kidney disease (CKD). Urine contains rich biological information which could be the ideal source for noninvasive biomarkers of CKD. This review will discuss the recent advance in urinary biomarker.</p><p><b>Data Sources:</b>This review was based on data in articles published in the PubMed databases up to June 20, 2017, with the following keywords: "Chronic kidney disease", "Biomarker", and "Urine".</p><p><b>Study Selection:</b>Original articles and important reviews on urinary biomarker were selected for this review.</p><p><b>Results:</b>Urinary biomarker studies of CKD mainly focused on urine sediment, supernatant, and urinary extracellular vesicles. The gene transcript (microRNA [miRNA], messenger RNA [mRNA]) biomarkers have been recently shown with diagnostic potential for CKD reflecting kidney function and histological change. However, challenges regarding technique and data analysis need to be resolved before translation to clinic.</p><p><b>Conclusions:</b>Different fractions of urine contain rich information for biomarker discovery, among which urine (extracellular vesicles) mRNA, miRNA, might represent promising biomarker for CKD.</p>

Exploring Genome-wide DNA Methylation Profiles Altered in Kashin-Beck Disease Using Infinium Human Methylation 450 Bead Chips / 生物医学与环境科学（英文）

To understand how differentially methylated genes (DMGs) might affect the pathogenesis of Kashin-Beck disease (KBD). Genome-wide methylation profiling of whole blood from 12 matched KBD and controls pairs was performed using a high-resolution Infinium 450 K methylation array. In total, 97 CpG sites were differentially methylated in KBD compared to the normal controls; of these sites, 36 sites were significantly hypermethylated (covering 22 genes) and 61 sites were significantly hypomethylated (covering 34 genes). Of these genes, 14 significant pathways were identified, the most significant P value pathway was type I diabetes mellitus pathway and pathways associated with autoimmune diseases and inflammatory diseases were included in this study. Subsequently, 4 CpG sites in HLA-DRB1 were validated using bisulfite sequencing polymerase chain reaction (BSP) in articular cartilage, and the results showed significant differences in the methylation status between KBD and controls, consistent with the results of the high-resolution array. These results suggested that differences in genome-wide DNA methylation exist between KBD and the controls, and the biological pathways support the autoimmune disease and inflammatory disease hypothesis of KBD.