OBJECTIVES: Rheumatoid arthritis (RA) is a chronic autoimmune disease. MicroRNA has been shown to play an important role in RA. MicroRNA-124a (miR-124a) has anti-proliferative and anti-inflammatory effects in RA fibroblast synovial cells. This study aims to explore the effects of miR-124a overexpression on arthritis in collagen-induced arthritis (CIA) mice and the underlying mechanisms. METHODS: Bovine type II collagen and complete Ferris adjuvant were used to induce CIA model from DBA/1 mice. Twenty-eight days after initial immunization (D28), CIA mice were randomly divided into a model group, a miR-124a treatment group, and a negative control (NC) group. Physiological saline, miR-124a agomir, and miR-124a agomir NC were injected into the skin at the tail root of mice every 3 days for 4 times, respectively. The degree of joint swelling and arthritis index of mice were recorded accordingly. Sixty-three days after initial immunization (D63), the mice were sacrificed to obtain the synovial tissue of ankle joint. HE staining was used to observe the proliferation of synovial cell, infiltration of inflammatory cell, pannus, and bone erosion of synovial tissues; TUNEL staining was used to detect cell apoptosis; qRT-PCR was used to detect the mRNA expression of miR-124a, phosphatidylinositol-3-kinase catalytic subunit alpha (PIK3CA) and its downstream genes Bcl-2 and Bax. Immunohistochemistry was used to detect the protein expression of PIK3CA, Bcl-2, and Bax protein in synovial tissues of each group. RESULTS: Different degrees of swelling presented in the paws of DBA/1 mice at D28, which indicated the CIA model was constructed successfully. Forty-eight days after initial immunization (D48), the paws of mice in the miR-124a treatment group were only slightly red and swollen, while the paws of mice in the model group and the NC group were obviously red and swollen. The arthritis index of mice in the miR-124a treatment group were decreased significantly compared to the NC group at D51, D53, D59, and D62 (51, 53, 59, 62 days after initial immunization) (all P<0.05). Sixty-three days after initial immunization (D63), HE staining indicated that the scores of synovial cell proliferation, inflammatory cell infiltration, synovial pannus, and bone erosion were significantly reduced in the miR-124a treatment group (P<0.05 or P<0.01), while cell apoptosis was increased in the miR-124a treatment group compared with the model group and NC group (P<0.01 or P<0.001). Besides, the expression of miR-124a and Bax in the synovial tissue in miR-124a treatment group was significantly higher than those in the model group and NC group (P<0.01 or P<0.001), while the expressions of PIK3CA and Bcl-2 were decreased (P<0.05 or P<0.01 or P<0.001), and the ratio of Bcl-2 to Bax was significantly decreased (P<0.01 or P<0.001). CONCLUSIONS Overexpression of miR-124a can reduce arthritis in CIA mice bacause it could promote synovial cell apoptosis and inhibit synovial cell proliferation via targeting PIK3CA and regulating its downstream pathways.
Animals ; Arthritis, Experimental/metabolism* ; Arthritis, Rheumatoid/genetics* ; Cattle ; Cell Proliferation ; Class I Phosphatidylinositol 3-Kinases/metabolism* ; Mice ; Mice, Inbred DBA ; MicroRNAs/metabolism* ; Proto-Oncogene Proteins c-bcl-2/metabolism* ; Synovial Membrane ; bcl-2-Associated X Protein/metabolism*

In recent years, the clinical experts consensuses or guidelines of ankylosing spondylitis (AS)/spondyloarthritis (SpA) have been constantly updated, but to better understand and practice, patient self-participation management is one of the key points to improve the level of diagnosis and treatment. Through questionnaire survey of these patients, we screened out the most concerned issues, and established the AS/SpA patient practice guideline working group with multidisciplinary physicians and patients. Fifteen opinions, as the AS/SpA patient practice guidelines, are proposed in accordance with the relevant principles of the "WHO guidelines development manual" , and with the international normative process.

In recent years, osteoporosis (OP) has become one of the main diseases affecting the health of middle-aged and elderly people in China, and the prevalence of OP has increased significantly. The clinical diagnosis and treatment guidelines for this disease are also constantly updated. The overall principles speciallyemphasise that doctors and patients need to work together to negotiate the details of the diagnosis and treatment guidelines, in order to improve the OP clinical diagnosis and treatment rate. Therefore, patients′ knowledge of the disease, understanding of clinical guidelines, and cooperation with doctors to implement diagnosis and treatment plans are very important. In this study, from the most concerned issues of the patients, we established the OP patient practice guideline working group. 14 recommendations, as the OP patient practice guidelines, are proposed in accordance with the relevant principles of the "World Health Organization guidelines development manual" and the international normative process.

Objective To determine the clinical value of hysteroscopy technology in high risk planned abortion. Methods A retrospective study of clinical manifestation, medical tests, treatment methods and effects of 97 cases (hospitalized from June, 2013 to October 2014) was made in the research. Of the 97 cases, 53 underwent UAE, and 44 did not undergo UAE. The risk factors and treatment features were concluded. Results The hemorrhage risk relates to menopause period. The longer menopause period, the higher the hemorrhage risk will be. The hemorrhage risk has nothing to do with HCG. For those whose menopause is less than 56 days, hemorrhage risk showed no difference between groups with or without UAE. For those whose menopause is less than 56 days, hemorrhage risk decreases in group with UAE. Hemorrhage risk and hysterectomy possibility are higher if menopause has happened for more than 11 weeks. Conclusion Cesarean scar pregnancy needs to be detected and treated early, in this way, the possibility for complications can be lowered. For cases whose menopause has been more than e weeks, hemorrhage risk should be cautioned.

ObjectiveTo investigate the expression and relationship of pituitary tumor transforming gene (PTTG) and p53 protein in large intestinal adenoma,large intestinal carcinoma and normal large intestinal mucosa tissues.MethodsImmunohistochemistry was employed to determine the expression of PTTG and p53 protein in 50 cases with large intestinal adenoma tissues,42 cases with large intestinal carcinoma tissues and normal large intestinal mucosa tissues.The relationship of the expression of PTTG and p53 protein with the clinicopathological characteristics was analyzed.ResultsThere was no positive expression of p53 protein in normal large intestinal mucosa tissues,while the positive rate of PTTG expression was 7.14％(3/42).The positive rates of PTTG and p53 protein expression were 82.00％(41/50) and 90.00％(45/50) in large intestinal adenoma tissues,88.10％ (37/42) and 95.24％ (40/42) in large intestinal carcinoma tissues.The positive rates of PTTG and p53 protein over expression were 45.24％(19/42) and 69.05％(29/42) in large intestinal carcinoma tissues.The positive rates of PTTG and p53 protein expression in large intestinal carcinoma tissues were higher than those in large intestinal adenoma tissues and normal large intestinal mucosa tissues,the positive rates of PTTG and p53 protein expression in large intestinal adenoma tissues were higher than those in normal large intestinal mucosa tissues,and there were significant differences(P ＜ 0.05).The expression of PTTG was not correlated with p53 protein in large intestinal carcinoma tissues(P＞ 0.05 ),while the positive relationship was found between the expression of PTTG and p53 protein in large intestinal adenoma tissues (P ＜ 0.05 ).The over expression of PTTG was significantly correlated with lymph node metastasis (P ＜ 0.01 ),but the over expression of p53 protein was not correlated with lymph node metastasis(P ＞ 0.05) in large intestinal carcinoma tissues.Conclusions The expression of PTTG is significantly correlated with p53 protein in large intestinal adenoma tissues,and their co-expression may be used as markers for carcinogenesis of large intestinal adenoma tissues.The over expression of PTTG and p53protein is found in large intestinal carcinoma,and the over expression of PTTG is correlated with lymph node metastasis.The over expression of PTTG may be used as a marker for lymph node metastasis of large intestinal carcinoma.

OBJECTIVETo analyze the magnetic resonance imaging (MRI) features of endometrial carcinoma and their value in endometrial carcinoma staging according to the International Federation of Gynecology and Obstetrics (FIGO 2009) staging criteria.

METHODSFifty-four patients with pathologically confirmed endometrial carcinoma and complete clinical data underwent preoperative MRI examination. According to FIGO 2009 staging criteria of endometrial carcinoma, the MRI features of the tumor lesions were evaluated for assessment of myometrial invasion and cervical involvement and preoperative staging.

RESULTSThe 54 cases included 27 stage Ia cases, 9 stage Ib cases, 10 stage II cases, 5 stage III cases, and 3 stage IV cases. The total lesion display rate by MRI was 94% (51/54). With an isointensity or hypo-intensity on T1WI, the tumor lesions showed a moderate hyper-intensity on T2WI. In enhanced MRI scanning, the lesions showed a moderate heterogeneous enhancement, which had a lower intensity than the marked enhancement of the myometrium. Combination of T2WI and T1WI in fat suppression sequence enhanced scan had a diagnostic accuracy of 91% (49/54) for myometrial invasion, and the sensitivity, specificity and accuracy of MRI for detecting cervical involvement were 77%, 89%, and 83%, respectively. The accuracy of preoperative MRI-based staging of endometrial carcinoma was 89% (48/54), showing no significant difference from the results of postoperative FIGO 2009 staging and pathological examination (P>0.05).

CONCLUSIONMRI has a high accuracy in the diagnosis, evaluation of myometrial and cervical invasion depth, and preoperative staging of endometrial carcinoma, and serves as an important modality in assisting clinical decisions on the optimal therapeutic protocols and in prognostic estimation.

Adult ; Aged ; Endometrial Neoplasms ; diagnosis ; pathology ; Female ; Humans ; Magnetic Resonance Imaging ; methods ; Middle Aged ; Neoplasm Staging

ObjectiveTo investigate the postoperative 3D MRI appearances and their evolvement patterns of ACL grafts and bone tunnels at follow-up.Methods There were 26 double bundles ACL reconstructions and 16 single bundle ACL reconstructions,and a total of 56 follow-up 3D MR Imaging.MR images were reconstructed with MPR technique to evaluate grafts,bone tunnels,fixers and associated.complications.Proportions of grafts with hypointensity or hyperintensity and occurrence rates of marrow edema around bone tunnels were calculated respectively among groups of different periods after operation.ResultsThere were 24 grafts of hypointensity and 32 grafts of hyperintensity.Grafts of 2 cases were suspended with cross pins within femoral tunnels,graft of 1 case was suspended with an endobutton within the femoral tunnel,and grafts of other sites were fixed with interference screws.In the three periods as 3 months,6 to 9 months and over 12 months after cruciate ligament reconstruction,proportions of hypointensive grafts were 20/25,0/14 and 4/10 respectively,while proportions of hyperintensive grafts were 5/25,14/14 and 6/10 respectively,occurrence proportions of marrow edema around bone tunnels were 54/54,10/32 and 4/26 respectively.There was 1 tear graft,4 tibial tunnels placed anteriorly with ACL graft impingement on the intercondylar roof,3 femoral tunnels placed anteriorly,and 2 bone tunnels with mismatching interference screws.Conclusion3D MRI can accurately demonstrate the state of ACL grafts,bone tunnels,fixers and associated complications.Intensity of grafts presented a rise and reduce pattern after operation.

Objective To investigate the clinical value of three dimensional dynamic contrast enhanced MRA(3D DCE MRA)on esophageal and gastric varices compared with endoscopy.Methods From April 2003 to June 2008,153 patients with portal hypertension who underwent both 3D DCE MRA and endoscopy were reviewed retrospectively.All the patients were divided into bleeding group and non-bleeding group according to the clinical symptoms.The location and degree of the esophagogastric varices on 3D DCE MRA were assessed with postprocessing images,including subtraction,MIP and thin-slab maximum intensity projection(thin-MIP),and were compared with the results of endoscopy.The maximum,minimum and mean diameters of esophagogastric varices inside and outside of the wall were measured on the reformed images.The correlation between the findings of 3D DCE MRA and endoscopy were analyzed with Spearman rank correlation coefficient test The rates of esophagogastric varices outside of the wall in bleeding and non-bleeding group were compared by means of Chi-square test Results In bleeding group,severe esophageal varices were documented in 59 patients,moderate in 6 patients,mild in 5 patients;in non-bleeding group,severe esophageal varices were documented in 32 patients,moderate in 4 patients,mild in 5 patients.Severe,moderate,and mild gastric varices were documented in 28,34 and 16 in bleeding group,while they were 7,12 and 9 in non-bleeding group.Esophageal and gastric varices can be wholly presented on MIP images after subtraction,while the esophagogastric varices inside and outside of the wall can be differentiated on thin-MIP images.The location and degree of esophagogastric varices on 3D DCE MRA were correlated with the findings of the endoscopy.The range of r was from 0.544 to 0.878(P＜0.01).In 91 patients with severe esophageal varices,27 patients presented outside esophageal varices in bleeding group(n=59)and 24 patients presented outside esophageal varices in non-bleeding group(n=32).There was a significant difference in ratio of outside esophageal varices between bleeding group and nonbleeding group(X~2=7.199,P＜0.01).In 35 patients with severe gastric varices,22 patients showed adventitial gastric varices in bleeding group(n=28)and 4 patients showed adventitial gastric varices in non-bleeding group(n=7).The ratio of adventitial gastric varices in bleeding group was not significantly different from that of non-bleeding group(P=0.340).Conclusions 3D DCE MRA can display and differentiate the esophagogastric varices both inside and outside of the wall by three dimensional reconstruction.The results of 3D DCE MRA and endoscopy have good correlation.It is of importance in evaluating the esophageal varices outside of the wall,because they may indicate decreased risk of haemorrhage in patients with severe degree of esophageal varices.

Objective The purpose of our study was to investigate three dimensional dynamic contrast enhanced MR angiography(3D DCE M RA) in the detection of portosystemic collateral circulation in the falciform ligament in patients with portal hypertension. Methods From April 2003 to July 2008, 53 portal hypertension patients with varices in the falciform ligament were evaluated with 3D DCE MRA.Two radiologists independently assessed the number, diameter, location and drainages of the portosystemic collateral circulation in the falciform ligament according to the information on the 3D DCE MRA.Results The veins in the falciform ligament were classified into the superior and inferior groups, and both groups arise from the left trunk of the portal vein.In our study, the number of varices detected on 3D DCE MRA images varied from 1 to 3, and the diameters of these vessels varied from 0.4 to 2.6 cm.The inferior group consisted of paraumbilical/umbilical veins (47 cases), which flowed toward umbilicus and then drained upwards (n = 16) including deep superior epigastric veins (n = 7), superficial superior epigastric veins (n = 9), downwards (n = 40) including deep inferior epigastric veins (n = 7), superficial inferior epigastric veins (n = 33), or upwards and downwards at the same time (n = 9).The superior group of vessels in the falciform ligament were directly anastomosed with the internal thoracic vessels (n = 6).Conclusion In patients with portal hypertension, 3D DCE MRA can optimally demonstrate the portosystemic collateral circulation in the falciform ligament, which includes the superior and inferior drainage groups.

Objective To detect the distribution of mesenchymal stem cells(MSCs) after total-body irradiation in rats. Methods MSCs were cultured and labeled with green fluorescent protein(GFP). Rats were exposed to total-body irradiation(TB1) or TBI plus total brain irradiation, and then MSCs were injected through the tail vein. The Fluorescent MSCs were observed by fluorescence microscope. The MSCs numbers in different organs were determined by quantitative RT-PCR method. Results GFP-labeled MSCs were ob-tained. After MSCs were infused to the rats,few of them were observed in the organs of nonirradiated group except for a very low number in the lungs,bone marrow(BM) and spleen. TBI of 6 Gy increased the engraft-ment of MSCs in almost all the organs, especially in early response tissues such as the small intestine and BM. TBI of 7 Gy further increased the number of MSCs. The MSCs numbers in the brain and other organs were significantly increased after 20 Gy total brain irradiation in addition to 6 Gy TBI. Conclusions Radi-ation injury can induce the aggregation of MSCs. With the increase of radiation dose and severity of radiation injury,a significant increase of MSCs in different organs were observed. Local irradiation can increase the MSCs distribution in the radiation field as well as other organs.