BACKGROUND:Studies have found that after stimulation, chemerin can further amplify the inflammatory signal, resulting in the release of inflammatory factors and matrix metaloproteinases. It indicates that chemerin may serve as an important regulator of cartilage metabolism, and plays an important role in the pathogenesis of osteoarthritis. OBJECTIVE: To explore the correlation between level of chemerin in synovia and serum and severity of knee osteoarthritis. METHODS: Eighty patients with knee osteoarthritis were enroled in the study. Knee osteoarthritis grading was evaluated according to the Kelgren-Lawrence classification. Chemerin levels in synovia and serum were examined with enzyme-linked immunosorbent assay. RESULTS AND CONCLUSION:The level of chemerin in synovia and serum in patients with knee osteoarthritis were positively correlated with the Kelgren-Lawrence classification (r=0.981,P< 0.001;r=0.901,P < 0.001). And there was a positive correlation between the level of chemerin in synovia and in serum (r=0.596,P < 0.01). Experimental findings suggest that the levels of chemerin in synovial fluid and serum that are positively correlated with the Kelgren-Lawrence classification can be used as a reference biomarker of severity of knee osteoarthritis.

Objective To study the changes of T lymphocyte subsets, immunoglobulin and complements in infants with bronchiolitis and explore the immunopathogenesis of bronchiolitis in in-fants. Methods Sixty-seven infants with bronchiolitis (bronchiolitis group) and forty healthy controls (control group) were enrolled in the study. T lymphocyte subsets were determined by indirected im-munofluorescent assay, and while serum levels of immunoglobulin and complements were determined by timing nephelometry. Results The percentage of CD3+ and CD8+ T cells, the concentrations of se-rum lgA and IgM showed no obvious differences between bronchiolitis group and control group (P>0.05). As compared with those of normal group, the percentage of CD4+ T cells and the ratio of CD4+ to CD8+ were significantly higher (P<0.05 or <0.01) and the levels of serum IgG, C3, C4 were significantly lower in bronchiolitis group(P<0.05 or <0.01). Conclusion Immune function disorder and abnormality occurs in infants with bronchiolitis. T lymphocyte mediated immunity may exert an important antiviral effect. The research from the point of view of cell immunity contributes to evaluation of severity of illness and more effective therapy.

Objective To investigate the expression of B-cell lymphoma/leukemia-2 gene (Bcl-2) in the gastric carcinoma,and the relationship between Bcl-2 and clinical biological behaviour and prognosis.Methods To use SP immunohistochemistry to detect respectively the expression level of Bcl-2 in the gastric carcinoma and incisal margin epithelial tissue of 42 gastric carcinoma patients.Results The positive expression rates of Bcl-2 in the gastric carcinoma and incisal margin epithelial tissue were 69.05％ and 21.43％.It had statistical significance (P ＜0.05) ; the expression of Bcl-2 in gastric carcinoma had not significantly correlation repectively with patient' s age,gender and invasive depth (P ＞ 0.05),but had significantly correlation with differentiation,TNM stage and lymph node metastasis of the tumor (P ＜ 0.05).Conclusion The expression level of Bcl-2 in gastric carcinoma may be one of biology indexes of the inwsion,migration,advancement and prognosis of the gastric carcinoma.

Objective To investigate the expression of GrB and Bid gene in gastric carcinoma and development of gastric carcinoma,exploring their effect on the mechanism of immune tolerance of tumor.Methods S-P method was used to detect the expression status of GrB and Bid gene in gastric carcinoma and margin tissue.Results The positive expression rate of GrB of gastric carcinoma tissues was 47.62％,the positive rate in the margin tissue was 40.48％,there was no significant difference(P ＞ 0.05) ; The positive expression rate of Bid of gastric carcinoma tissues (26.19％) was significantly lower than that of margin tissue(76.19％) (P ＜ 0.05) ; The expression of GrB had significantly correlation with TNM stage and lymph node metastasis of the tumor (P ＜ 0.05),the expression of Bid in gastric cancer had significantly correlation with differentiation,invasive depth,TNM stage and lymph node metastasis of the tumor (P ＜ 0.05) ; the expression of GrB was negatively correlated with that of Bid in gastric cancaer(rs =-0.311,P ＜ 0.05).Conclusion The expression of GrB and Bid may be involved in development of gastric carcinoma,down-regulated or scarce expression of Bid may be cause cancer cells escaping from endogenous or exogenous GrB-mediated cell apoptosis,and acquire immune tolerance,potential,to escape the immune response.

Objective: To investigate clinical effect of improved flushing method applied in anastomotic leakage (AL) atfer low anterior resection for rectal cancer. Methods: We performed a retrospective study to analyze the therapeutic effect for 39 AL from 438 patients who received Dixon surgery in the Affliated Hospital of Luzhou Medical College. Among them, 23 patients received the traditional lfushing method (the traditional group) and 16 received the improved lfushing method (the improved group). Results: hTe rate of AL was 8.9% (39/438). All patients were cured with non-operative treatment. hTe cleanliness degree of the surrounding skin of drainage tube in the improved group was higher than that in the traditional group. hTe duration of average hospitalization and extubation of drainage tube was shorter in the improved group than that in the traditional group (P<0.05). Conclusion: Compared with the traditional methods, the improved one is better for the ALpatients. Both the patients themselves or their family members can chose it. hTe improved lfushing method is worth to be spread in clinic.

In this study, the rescue effect of receptor activator for nuclear factor-kappaB ligand (RANKL) on zoledronate acid (ZOL) induced inhibition of osteoclastogenesis and gene expression of NF-kappaB p50 and c-Jun was investigated. Mice calvarial osteoblasts (OBs) were harvested and co-cultured with RAW264.7 cells and the cells were divided into 4 groups and received treatment with ZOL and RANKL, either single or combined. The formation of multi-nucleated osteoclast (OC) was examined and gene expression of NF-kappaB p50 and c-Jun was detected. Group B (ZOL) showed least multi-nucleated OC and resorption lacunae among the 4 groups (P < 0.05 or P < 0.01) and it was followed by group C (ZOL+RANKL). Group D (RANKL) showed highest OC and resorption lacunae while it was similar to Group A (control) (P > 0.05). Gene expression of NF-kappaB p50 and c-Jun was the lowest in group B (P < 0.05 or P < 0.01) among the four groups and was significantly increased in group C when compared with group B (P < 0.05). Group A and D showed highest gene expression and they were similar to each other (P > 0.05). This study suggest that RANKL might partly rescue ZOL induced inhibition of osteoclastogenesis, and the effect of RANKL and ZOL on osteoclastogenesis may be mediated by NF-kappaB p50 and c-Jun.
Animals ; Bone Resorption ; drug therapy ; Cell Line ; Diphosphonates ; pharmacology ; Gene Expression ; Imidazoles ; pharmacology ; Mice ; NF-kappa B p50 Subunit ; metabolism ; Osteoblasts ; drug effects ; Osteoclasts ; drug effects ; Proto-Oncogene Proteins c-jun ; metabolism ; RANK Ligand ; pharmacology

China ; epidemiology ; Humans ; Incidence ; Liver Neoplasms ; epidemiology ; mortality

Objective: To investigate the current application status of continuous blood purification (CBP) technology and equipment in pediatric intensive care unit (PICU) in China. Methods: A cross-sectional survey was conducted to understand the current popularization of CBP technology and equipment, the management of CBP equipment and consumables, and the application of CBP in different diseases. A questionnaire named Application Status of Continuous Blood Purification Technology was applied. Children's hospitals and polyclinic hospitals with the pediatric qualification (pediatric emergency or critical care unit members of Chinese Medical Association and Chinese Medical Doctor Association) were selected. Results: From December 2016 to February 2017, 53 hospitals completed the questionnaire, including 7 in northeast, 6 in north China, 16 in east China, 9 in south China, 5 in central China, 4 in the northwest, and 6 in the southwest region. Continuous renal replacement therapy (CRRT), the most widely used technology, was carried out in 51 hospitals. Other technologies were peritoneal dialysis (IPD) (n=37), artificial liver support (ALSS) (n=26) and blood adsorption (PA) (n=13). There were 107 CBP machines in the 51 hospitals used CBP technology, with an average of 2.10/hospital. In 36 hospitals CBP machines were managed independently by PICU (70%). Hospitals made their own displacement liquid (n=40, 78%), or purchased displacement liquid (n=11, 22%). Hospitals prepared dialysate on their own (n=38, 75%), or purchased dialysate (n=13 hospitals, 25%). In 46 (90%) hospitals, hemodialysis catheter was placed independently by PICU doctors. The routine operation and maintenance of CBP were mainly completed by the PICU nurses in 36 hospitals (71%). There were 39 hospitals (76%) where professional nurses manage and maintain CBP. Puncture sites were femoral vein (n=26, 51%), internal jugular vein (n=21, 41%) and venae subclavia (n=4, 8%). Forty-two hospitals (82%) selected B-mode ultrasound positioning and guidance when performing internal jugular vein puncture. A total of 40 (78%) hospitals have developed post dilution and combined dilution techniques during the implementation of CBP. The most common indications of CBP technology were different in different regions. They were sepsis in northeast (24.0%, 243/1 011) and east China region (32.0%, 982/3 069), multiple organ dysfunction syndrome in south China (29.2%, 444/1 520), north China (15.8%, 126/796), and southwest region (30.1%, 460/1 526), drug poisoning in central China region (21.6%, 325/1 506), and renal failure in northwest region (53.0%, 44/83). Conclusions CBP technology is widely used in the field of pediatric severe diseases in China. The eastern regions possess more CBP equipment than the western regions. CBP is widely used in the treatment of sepsis.

Objective:To explore the adjunctive diagnostic value of transcranial sonography (TCS) combined with olfactory test in early Parkinson′s disease (PD) and the clinical value of both in the cognitive function of PD patients.Methods:TCS and olfactory test were performed in 157 early PD patients(PD group) and 157 healthy controls(control group) in the Second Affiliated Hospital of Soochow University from January 2018 to January 2022. The differences in clinical characteristics, TCS, and olfactory test results between the two groups were analyzed. The values of TCS, olfactory test, and their combination in diagnosing early PD were evaluated using clinical diagnosis as the gold standard. The correlations of the midbrain area, the midbrain substantia nigra hyperechoic area, and the third ventricle width in TCS examination with the cognitive score were analyzed in the PD group. According to the olfactory test scores, 157 patients with early PD were divided into two groups: 110 cases of PD with olfactory dysfunction (PD-OD) and 47 cases of PD without olfactory dysfunction (PD-NOD). The differences in clinical scores and TCS results between the two groups were compared.Results:The midbrain substantia nigra hyperechoic area, substantia nigra hyperechoic positivity rate, third ventricle width, and olfactory dysfunction rate were higher in the PD group compared to the control group, while the midbrain area and olfactory test scores were lower than those in the control group (all P<0.001). The sensitivity and the coincidence rate of TCS combined with the olfactory test for early PD diagnosis (90.0%, 77.1%) were higher than those of TCS alone (60.0%, 71.3%) and olfactory test alone (70.1%, 72.3%), but the specificity (63.7%) was lower than that of both alone (82.8% for TCS and 75.2% for olfactory test), (all P<0.001). MoCA score, visual space and executive ability, memory, attention, and language were positively correlated with the area of the midbrain ( rs=0.38, 0.32, 0.27, 0.25, 0.23; all P<0.05) and negatively correlated with the width of the third ventricle ( rs=-0.39, -0.22, -0.39, -0.22, -0.32; all P<0.05), and orientation was negatively correlated only with the width of the third ventricle ( rs=-0.24, P<0.05). The MoCA score of PD-OD group[22(18, 25)] was lower than that of PD-NOD group[24(20, 26)]( P=0.040). Conclusions:The combination of TCS and olfactory test can enhance the sensitivity and diagnostic agreement rate for early PD diagnosis, providing some auxiliary value. The cognitive function of PD patients is positively correlated with the midbrain area and negatively correlated with the width of the third ventricle. The cognitive function of PD patients with olfactory dysfunction is lower than that of PD patients without olfactory dysfunction. TCS and olfactory test may help assess cognitive function in PD patients.

Objective: To analyze the clinical characteristics of community-acquired pneumonia (CAP) in children under five years of age and analyze the safety and efficiency of nasal continuous positive airway pressure (NCPAP) ventilation for CAP in this population. Method: This was a prospective multicenter study. Children who were admitted to these six centers with CAP and met the NCPAP ventilation indications, aged from 29 d to 5 years, were continuously included during November 2013 to October 2015. The baseline data were collected and NCPAP ventilation were then followed up by operation standards, and the vital signs and arterial blood gas change at special time points were observed and recorded. Any side effect associated with NCPAP were recorded. For categorical variables, comparisons were performed using Fisher test. Rank-sum test and t test were performed respectively for abnormal and normal distribution continuous variables. The variables pre-NCPAP and post-NCPAP were analyzed by repeated measures ANOVA analysis. Result: Totally 145 children were included, and 13 children were excluded due to incomplete data. One hundred and two children(77.3%)were ≤12 months; 91 children (68.9%) were from rural area. NCPAP ventilation was effective in 123 children, with a response rate of 93.2%, were all discharged with a better condition; it was ineffective in 9 children(6.8%), and they were all intubated and went on mechanical ventilation, 5 were discharged with a better condition, and 4 died after gaving up treatment. The gender, age, body weight, residence, main symptoms, main signs, imaging diagnosis, medications, partial pressure of oxygen(PaO₂), breath and heart rate before NCPAP treatment of two groups had no significant differences(allP>0.05). The rates of combining underlying diseases, trouble with feeding and cyanosis, and the partial pressure of carbon dioxide(PaCO₂ ) before NCPAP ventilation were higher in NCPAP ineffective group ((59±11 )vs.( 49±11) mmHg, 1 mmHg=0.133 kPa, t=-2.597, P=0.028); while the PaO₂/fraction of inspiration O₂ (FiO₂ ) before NCPAP was lower((150±37) vs. (207±63) mmHg, t=2.697, P=0.008). The breathing, heart rate and PaCO₂ of NCPAP effective group decreased significantly, while the PaO₂ and PaO₂/FiO₂ increased significantly after 2, 8, 24 h of NCPAP ventilation(all P=0.000). PaCO₂ in children with hypercapnia before NCPAP ventilation in NCPAP effective group decreased significantly ((48±9), (47±12), (45±11)vs.(58±7)mmHg, all P=0.000). All children tolerated well to NCPAP ventilation, and there were no severe side effects or complications associated with NCPAP ventilation. Conclusion NCPAP ventilation is safe and effectively improved the oxygenation and hypercapnia in infants with CAP. But it may not work well in children with underlying diseases, manifest as difficulty in feeding/cyanosis and extremely high PaCO₂ or low PaO₂/FiO₂, and they may need early intubation.