BACKGROUND: Reumatoid arthritis (RA) is a well-known autoimmune disease. Recently, polyglycosides of tripterygium wilfordii hook F (T Ⅱ), a traditional Chinese herb, has been widely used to treat rheumatoid arthritis.But the effects of TⅡ on the joints' synovium inflammation and whether TⅡcan prevent the reumatoid arthritis need to be investigated further.OBJECTIVE: To study the effects of T Ⅱ on the relative data of ankle joints of adjuvant arthritis (AA) rats.DESIGN: A randomized controlled experiment based on rats. SETTING: Departments of Histology and Embryology and Neurobiology, West China School of Preclinical and Forensic Medicine, Sichuan University. MATERIALS: A total of 20 healthy clean grade female SD rats, aged 2 to 3 months old, weighing 185-215 g, were provided by the Experimental Animal Center of West China Medical Center of Sichuan University. Fre und's complete adjuvant (FCA) was produced by Sigma Company. TⅡ was produced by Zhuzhou 3rd pharmacy of Hunan Province (certification number: 2005 No 055172, 10 mg/pill).METHODS: The experiment was completed in Department of Histology and Embryology and Neurobiology in Sichuan University from May 2004 to March 2005. ① All the 20 rats were randomly divided into 4 groups with 5 rats in each group by lots: normal group, without Freund's complete adjuvant (FCA) injection and TⅡ administration; model group, with FCA intradermal injection (0.2 mL) into the left hind paw and without TⅡ administration; TⅡ preventive group, first we use the same way as model group to replicate the AA model in rats, then on the 7th day AA rats were feed by TⅡ 30 mg/kg every day for 7 days; TⅡ therapeutic group, AA rats model were built with the same way as model group, on the 19th day AA rats were feed by TⅡ 30 mg/kg every day for 7 days. During this period, the swelling dimension of hind paw both primary and secondary are mea sured before immunization with FCA and after immunization, that was, on the 2nd, 10th, 15th, 19th, 22nd and 26th days. ② Arthritis index have been recorded according to inflammatory state of other three uninjected limbs.③ On the 28th day, all the rats were killed, the ankle joints are collected after perfusion-fixation. These joints were sectioned and colorated with H. E staining. Then we observe the histopathological changes in the synovium of ankle joints. MAIN OUTCOME MEASURES: Swelling dimension of joints and arthritis index, histopathology of anklebone joint's synovium. RESULTS: All of the 20 rats completed the experiment without missing. ① On the 2nd day after FCA injection, the primary hind paw of other three groups beside normal group appeared obvious swelling; from 2nd to 26th days, the volume of hind paw in other three groups was larger than that of normal group (t=2.315-3.041, P ＜ 0.05). The volume of primary hind paw in TⅡ preventive group at different time points (10th, 15th, 19th, 22nd and 26th days) was obviously less than that of model group (t=2.064-2.683, P ＜ 0.05). The volume of primary hind paw in TⅡ therapeutic group on the 22nd and 26th days was less than that of model group (t=2.112-2.578, P ＜ 0.05). Fifteen days after FCA injection, the volume of secondary hind paw in model group and T Ⅱ therapeutic group was larger than that of normal group (t=2.201-2.546, P ＜ 0.05). On the 15th, 19th, 22nd and 26th days, the volume of secondary hind paw in T Ⅱ preventive group was obviously less than that of model group (t=2.373-2.425, P ＜ 0.05). The volume of secondary hind paw in T Ⅱ therapeutic group on the 26th day was obviously less than model group (P ＜ 0.05). ② On the 14th day after FCA injection(after T Ⅱ preventive administration for 7 days), arthritis index of model group was (8.3±2.0) points, while arthritis index of TⅡ preventive group was (0.4±0.95) points (t=2.64, P ＜ 0.05), there was an obvious decline in T Ⅱ preventive group compared with model group. On the 26th day after FCA injection (after TⅡ therapeutic administration for 7 days), arthritis index of model group was (11.2±0.7), whileinflammatory disease in AA rats and prevent the secondary arthritis in the rats of AA as well.

Objective: To investigate the prevalence of depression and anxiety among transgender populations and the correlation with defense mechanism, so as to provide the evidence for improving mental health among transgender populations. Methods: Transgender populations that visited Psychosexual Outpatient Department of Beijing Huilongguan Hospital for the first time from December 2020 to December 2021 were enrolled. Participants' demographics, depression, anxiety and type of defense mechanisms were collected using self-designed questionnaires, Self-rating Depression Scale, Self-rating Anxiety Scale and Defense Style Questionnaire (DSQ). Factors affecting depression and anxiety were identified using a multivariable logistic regression model. Results: Totally 126 transgender individuals were enrolled, including 95 men (75.40%) with a mean age of (21.53±4.55) years and 31 women (24.60%) with a mean age of (23.58±5.55) years. The prevalence of depression was 46.83% among participants, including 44.07% of participants with mild depression, 30.51% with moderate depression and 25.42% with severe depression, and the prevalence of anxiety was 26.19% among participants, including 60.61% of participants with mild anxiety, 21.21% with moderate anxiety and 18.18% with severe anxiety. The detection of depression was 54.74% among men and 22.58% among women (P<0.05), and the detection of both depression (62.79% vs. 38.55%, P<0.05) and anxiety (41.86% vs. 18.07%, P<0.05) was significantly higher among transgender populations with self-injury or suicide behaviors than among those without. Multivariable logistic regression analysis showed that immature defense mechanisms increased the risk of depression (OR=1.034, 95%CI: 1.018-1.051) and anxiety (OR=1.031, 95%CI: 1.014-1.049) among transgender populations, while mature defense mechanisms reduced the risk of depression (OR=0.887, 95%CI: 0.832-0.946) and anxiety (OR=0.878, 95%CI: 0.821-0.938) among transgender populations. Conclusions The prevalence of depression and anxiety was 46.83% and 26.19% among transgender populations included in this study. Mature defense mechanisms are beneficial to reduce the risk of depression and anxiety among transgender populations. Key words： transgender population depression anxiety defense mechanism

Objective To study the characteristics of ? cell function change and to explore the predictive value of glutamic acid decarboxylase (GAD)-Ab and other factors for ? cell function in the patients with latent autoimmune diabetes of adults (LADA). Methods Sixteen LADA patients (positive GAD-Ab) and 24 type 2 diabetic patients (negative GAD-Ab) were followed-up at 0, 6th, 12th, 30th, 36th, 42th and 48th months respectively. Their fasting and postprandial 2h C-peptide and glycemic control were measured. GAD-Ab was determined by radioimmunoprecipitation assay and C-peptide by RIA. Results Decreased fasting C peptide (FCP) levels (Month 30, 36, 42, 48 compared with Month 0, P

Objective To explore the expressions and significances of p 53、bcl-2、Ki-67 and apopto-sis in keratoacanthoma(KA)and well differentiated squamous cell carcinoma (WDSCC).Methods The expres-sions of p53、bcl-2、Ki-67 were detected by immunohistochemical technique in 44 cases of KA and 20 cases of WDSCC.Apoptosis was identified by using terminal deoxynucleotidyl transfers ( TdT) -mediated dUTP -biotin nick and labelling(TUNEL)method.Results The positive expressive rates of p53 in proliferative、mature and re-gressive of KA were 22.23%、26.18% and 6.52%, which was lower than the positive rate of WDSCC (41.82%).Significant differences were found between every period of KA with WDSCC in p 53 expression;The intensity of expression and pattern were similar in KA of Ki -67 and p53.There were a positive correlation be-tween p53 and Ki-67 expression rate(r=0.986,P<0.001).The bcl-2 staining showed weak expression in 1 case in WDSCC and 2 cases in KA ,but only a few positive tumor cells was limited to basal cell layer in KA .The average apoptosis rate in KA was 21.72%,which was apparently higher than in WDSCC (9.925%).There were a negative correlation between the apoptosis rate and proliferation rate of Ki -67(r=-0.824,P<0.001).Con-clusion The proliferation and apoptosis in KA can coexist .However ,the apoptosis will occupy a dominance posi-tion in regressive phase ,which results in the regression of tumor .The expressions of p53、Ki-67 and apoptosis would be a certain significance in differentiated KA and WDSCC .

Objective To investigate the impacts of carvedilol combined with pravastatin,on aminoterminal pro-brain natriuretic peptide(NT-proNBP),cardiac troponin Ⅰ(cTnI)and cardiac function in coronary heart disease patients with chronic heart failure.Methods One hundred and tewnty five cases of coronary heart disease patients with chronic heart failure were randomly divided into the carvedilol group(63 cases)and carvedilol combined with pravastatin group(62 cases).In addition to using certain dosage of the above-mentioned drugs respectively,both groups underwent routine anti heart failure treatment with the course of 12 weeks.The class of heart function and changes of heart rate(HR) were observed before and after treatment.Left ventricular end diastolic diameter(LVEDD),left ventricular end systolic diameter(LVESD) and left ventricular ejection fraction(LVEF) were determined by using ultrasound heartbeat graph.Six min walk test(6MWT)was also observed before and after treatment and the level of NT-proBNP and cTnI level were determined by using an enzyme immunoassay method.And patients readmission rates and the incidence of cardiovascular events were also observed.Results The condition of carvedilol and pravastatin group were improved after treatment compared with before treatment[HR:(78±12) CICCS/min vs(100±112) CICCS/min,t =13.682,P ＜ 0.05 ;LVEDD:(43±5)mmvs(53±8)mm,t=5.284,P＜0.01;LVESD:(42±6)mmvs(56±7)mm,t=6.454,P＜0.01;LVEF:(50±5)％ and(35±8)％,t=-6.091,P<0.01);NT-proBNp:(986±713)ng/Lvs (3328±1109) ng/L,t =17.626,P ＜ 0.05) ; CInI:(0.85±0.16) μg/L vs(2.03±0.63) μg,/L,t =5.879,P ＜ 0.01 ;6MWT:(355.6±92.5)m vs(238.8±101.4) m,t =-8.255,P ＜ 0.01].After 3 months follow-up,the condition of carvedilol combined with pravastatin group were better than carvedilol group;LVEDD:(43±5)mm vs(57±6)mm,t =5.892,P ＜0.05 ;LVESD:(42±6)mm vs(49±7) mm.t =3.243,P ＜0.01 ;LVEF:(50±5) ％ vs(42±8) ％,t =-12.036,P ＜ 0.01 ; NT-proBNP:(986±713) ng/L vs(1626±968) ng/L,t =3.603,P ＜0.01 ;cTnI:(0.85±0.16) μg/L vs(1.15±0.36) μg/L,t =3.200,P ＜ 0.01 ;6MWT:(355.6±92.5) mvs(296.2±99.5) m,t =-10.119,P ＜ 0.01].The rehospitalization rate(3.3 ％ vs 12.7％,x2 =6.224,P ＜ 0.05) and the incidence of cardiovascularevents(3.3％ vs 15.9％,x2 =5.974,P ＜ 0.05) were both decreased Significantly after treated with carvedilol combined with pravastatin.Conclusion Carvedilol combined with pravastatin can reduce the level of NT-proBNP and cTnI,improve heart function in coronary heart disease patients with chronic heart failure.

Liver transplantation is a vital treatment for end-stage liver disease. However, the shortage of donor livers has limited the development of liver transplantation. How to expand the source of donor livers has become a challenge in the academic community. In recent years, the proportion of donors with non-alcoholic fatty liver disease (NAFLD) has been increased. Rational use of steatotic donor livers is a feasible approach to expand the donor pool. Cold ischemia injury during donor liver preservation before liver transplantation increases the risk of postoperative organ dysfunction. Therefore, it is of significance to unravel the mechanism and intervention measures of cold ischemia injury of steatotic donor livers. Cold ischemia injury of steatotic donor livers is characterized as the damage of mitochondria, lysosomes and endoplasmic reticulum at the organelle level, and up-regulated expression of adenosine monphosphate activated protein kinase (AMPK), aldehyde dehydrogenase 2 (ALDH2) and heme oxygenase (HO)-1 at the protein level. In this article, the research progresses on cold ischemia injury of steatotic donor livers and relevant intervention measures were reviewed.

Objective To investigate the incidence of fatigue in maintenance hemodialysis(MHD)patients and its related factors.Methods A total of 289 patients on MHD between January 2016 and March 2017 in hemodialysis centers of the First Affiliated Hospital of Xinjiang Medical University,Xinjiang Yili Kazak Autonomous Prefecture Friendship Hospital,and Yili Prefecture Hospital were enrolled.Internationally standard fatigue rating scale(FAI)was applied to assess the incidence of fatigue in MHD patients,and subjective comprehensive nutrition assessment(SGA)protein energy wasting rating scale was used to assess protein energy wasting(PEW)conditions.All patients were divided into the fatigue group and the non-fatigue group according to the FAI score.The clinical data and the blood biochemical indicators in two groups were compared.The risk factors of fatigue in MHD patients were analyzed by logistic regression method.Results The incidence of fatigue was 83.0％in MHD patients,and the rate of PEW was 62.6％.Blood total cholesterol in the fatigue group was lower than that of the non-fatigue group(P ＜ 0.05).The difference between SGA scores of two groups had statistical significance(P ＜ 0.001).Single factor logistic regression analysis results showed that higher SGA score(OR=1.312,95％CI:1.163-1.481,P ＜ 0.001),lower blood total cholesterol(OR=0.661,95％CI:0.496-0.880,P=0.005)were risk factors of fatigue in MHD patients.Multivariable logistic regression analysis results showed that higher SGA score(OR=5.286,95％CI:2.078-13.442,P ＜ 0.001)was an independent risk factor of fatigue in MHD patients.Conclusions The incidence of fatigue and PEW are high in MHD patients.PEW is an independent risk factor of fatigue in MHD patients.

Objective To evaluate the etiology,epidemiological characteristics,clinical diagnosis,and outcomes of hospitalized patients with AKI in Xinjiang,analyzing the risk factors of their clinical prognosis.Methods A multicenter retrospective survey was conducted,investigating adult patients admitted to four hospitals in Xinjiang in January and July 2013.Patients with AKI were screened out based on KDIGO's inclusion and exclusion criteria.Clinical variables of patients with AKI including demographics,clinical data,laboratory tests,treatment measures and prognosis were collected.Results Among 32,157 adult hospitalized patients,there were 722 AKI patients.Excluding those with incomplete data,719 patients were enrolled in this study.The detection rate of AKI was 2.25％ (722 of 32,157) by KDIGO criteria.The main cause for AKI was pre-renal injury,led mainly by cardiac output,low blood volume,and the use of nephrotoxic drugs.The non-recognition rate of AKI was 72.4％ (407/557).Multivariate binary logistic regression analysis showed that AKI stage,peripheral vasodilation and renal parenchyma were protective factors of the omission diagnosis.In the short-term prognostic analysis,the overall mortality rate was 12.8％(92/719).Among the 323 patients with AKI who survived discharge,43.7％(141) had renal function recovery;40.2％(130) did not fully recover their renal function but ceased maintenance dialysis;16.4％ (53) were still on dialysis at discharge.Multivariate Cox regression model suggested that DIC,shock and department of obstetrics were independent risk factors for death during hospitalization of AKI.In addition,the risk of death for AKI from department of obstetrics and gynecology patients was higher than that of other departments.Conclusions The most common reason for AKI in hospitalized patients in Xinjiang was pre-renal injury.The main risk factors were low cardiac output and low blood volume.The omission diagnosis of AKI was serious;AKI stage,peripheral vasodilation and renal parenchymal injury however were its protective factors.Poor-DIC,shock,hospitalization in obstetrics were independent risk factors for death in patients with AKI.

Objective:To retrospectively analyze clinical efficacy and safety of omalizumab in the treatment of chronic urticaria (CU) in southern Zhejiang, China.Methods:A retrospective observational study was conducted on CU patients who received omalizumab treatment at the First Affiliated Hospital of Wenzhou Medical University from January 1st, 2018 to August 1st, 2021. Through the outpatient follow-up visits, the disease activity, condition control, and quality of life were evaluated using the 7-day urticaria activity score (UAS7) , urticaria control test (UCT) , and dermatology life quality index (DLQI) . In addition, changes in disease condition, recurrence after withdrawal, and adverse events were assessed. Independent-sample t test was used for intergroup comparisons of normally distributed measurement data, Wilcoxon signed-rank sum test or Kruskal-Wallis H test was used for comparisons of non-normally distributed measurement data, and chi-square test or Fisher′s exact test was used for comparisons of enumeration data. Results:A total of 252 CU patients with poor response to antihistamines were included, with a baseline UCT score of 5.0 ± 2.4 points, a UAS7 score of 25.6 ± 6.2 points, and a DLQI score of 17.5 ± 4.7 points; among them, 204 (81.0%) were treated with omalizumab at an initial dose of 300 mg, and 48 (19.0%) with omalizumab at an initial dose of 150 mg. At the end points (12.0 ± 1.4 months after the start of treatment) , an overall control rate of 90.3% (224/248) was achieved after the omalizumab treatment; concretely, 137 (55.2%) patients achieved complete control (UCT = 16 points) , 87 (35.1%) achieved partial control (12 points ≤ UCT < 16 points) , and 24 (9.7%) showed no response (UCT < 12 points) , while 10 with partial response shifted to complete control after dose increase. During the treatment period, recurrence occurred in 50 patients (36.5%) , of whom 32 patients opted for retreatment with omalizumab, and then 30 (93.8%) achieved partial or complete control. Adverse events were reported in 8 patients (3.2%) , and all were mild or moderate.Conclusion:Omalizumab was effective in the real-world treatment of CU, and could improve patients′ quality of life, with a favorable safety profile.

Objective: To investigate the mechanism of miR-31-5p/tension protein 1 gene (TNS1) axis modulating radiotherapy resistance in breast cancer. Methods: The breast cancer tissues and corresponding para-cancerous tissues of 21 patients with breast cancer, who underwent surgical resection at Department of Cancer Radiotherapy of Nanyang Central Hospital from July 2017 to December 2017, were collected for this study; breast cancer cell lines (MCF-7，MDA-MB-23 and SKBR-3) were also collected; qPCR was applied to detect the expression level of miR-31-5p in breast cancer tissues and cell lines. The radiation resistant cell line MCF-7R was constructed by using 6 MV-X ray radiotherapy treatment. Subsequently, the influence of over-expression/kockdown of miR-31-5p on radiation sensitivity of MCF-7 and MCF-7R cells were detected by colony formation assay, Transwell assay and Annexin V-FITC/PI double staining flow cytometry assay, respectively. Moreover, luciferase reporter assay was used to verify whether TNS1 was a target gene of miR-31-5p. Results: Compared with para-cancerous tissues, normal mammary epithelial MCF-10A cells and MCF-7 cells, miR-31-5p was low-expressed in breast cancer, cell lines and MCF-7R (all P<0.01). Over-expression of miR-31-5p resulted in inhibited invasion and promoted apoptosis of MCF-7R cells (P<0.01), whereas miR-31-5p knockdown got opposite results in MCF-7 cells. Moreover, luciferase reporter assay confirmed that TNS1 was a target gene of miR-31-5p. Over-expression of miR-31-5p inhibited invasion and increased radio-sensitivity, apoptosis of MCF-7R cell via targeting TNS1 (P<0.01), whereas knockdown of miR-31-5p significantly promoted the invasion but reduced apoptosis of MCF-7R cells (all P<0.01), and further up-regulated the radio-sensitivity of MCF-7R cells. Conclusion: miR-31-5p/TNS1 axis regulates the radiotherapy resistance of breast cancer, and over-expression of miR-31-5p may reverse the resistance of MCF-7R to radiotherapy.