Objective To investigate the effect of specific small interfering RNA (siRNA) targeting receptor of advanced glycation end products (RAGE) on the production of fibrosis markers (laminin,hyaluronic acid (HA) and N-terminal procollagen Ⅲ propeptide (PⅢ NP) in hepatic fibrosis (HF).Methods The expression vectors of specific siRNA targeting RAGE were constructed.Primary rat hepatic stellar cells (HSC) were isolated and cultured.The primary rat HSC were transfected with the recombinant vector.The blank control group and unspecific siRNA vector pAKD-NC-transfected group were as controls.The expressions of RAGE,laminin,HA and PⅢ NP at mRNA and protein levels were detected by real-time polymerase chain reaction and Western blot,respectively.Least-significant difference (LSD) and Student-Newman-Keuls (SNK) were performed to analyze standard normal distribution or homogeneous variance.Non-normal distribution and heterogeneity of variance data were analyzed by non-parametric Wilcoxon test.Results The expressions of RAGE at mRNA and protein levels in pAKD-GR126-transfected primary HSC were (42.32 ± 6.16)％,(43.24±7.50)％,(51.06±13.79)％ and (47.94±5.36)％ in blank control group and pAKDNC group (F=7.791 and 36.513,all P＜0.05).The expressions of laminin at mRNA and protein levels were (41.07±3.13)％,(40.59±5.87)％,(53.89±2.25)％ and (52.46±4.68)％ in blank control group andpAKD-NC group (F=225.111 and 88.039,all P＜0.05).The expressions of HA at mRNA and protein levels were (45.69 ± 0.87) ％,(46.08 ± 2.36) ％,(54.20 ± 0.56) ％ and (52.30±3.42)％ in blank control group and pAKD-NC group (F=178.317 and 180.646,all P＜ 0.05).The expressions of PⅢ NP mRNA at mRNA and protein levels were (56.10±4.18)％,(55.15±2.39)％,(54.40±2.79)％ and (53.58±6.18)％ in blank control group and pAKD-NC group (F=141.633 and 49.670,all P＜0.05).Conclusion RAGE specific siRNA could inhibit the expression of RAGE in primary rat HSC and could significantly lower the expression of fibrosis markers laminin,HA and PⅢ NP at mRNA and protein level.

Objective:To observe the clinical effect of acupuncture combined with Western medicine in the treatment of skin pruritus in maintenance hemodialysis patients.Methods:Eighty patients were randomly divided into a control group and an observation group,with 40 cases in each group.The control group was given loratadine orally,and the observation group was given acupuncture treatment in addition to the treatment used in the control group.The four-item itch questionnaire(FIIQ)score,indicators for skin barrier function,and serum interleukin(IL)-2 and IL-31 levels were compared.The efficacy was judged after the treatment ended.Results:The total effective rate was higher in the observation group than in the control group(P<0.05).After treatment,the site,frequency,severity of pruritus,sleep impact sub-scores,and FIIQ total score in both groups were reduced compared with those before treatment(P<0.05),and all scores in the observation group were lower than those in the control group(P<0.05).The stratum corneum hydration(SCH)and transepidermal water loss(TEWL)in the V-shaped area of the chest,the flexor side of the forearm,and the extensor side of the lower leg were not significantly changed in the control group(P>0.05);the SCH and TEWL in the V-shaped area of the chest,the flexor side of the forearm,and the extensor side of the lower leg in the observation group were improved(P<0.05),and all were better than those in the control group(P<0.05).The serum IL-2 and IL-31 levels in the control group did not change significantly(P>0.05);the serum IL-2 and IL-31 levels in the observation group were both significantly decreased(P<0.05)and were lower than those in the control group(P<0.05).Conclusion:Acupuncture combined with loratadine is highly effective in the treatment of pruritus in maintenance hemodialysis patients,and it can relieve pruritus,improve skin barrier function,and reduce serum IL-2 and IL-31 levels.

OBJECTIVETo explore the relationship between nonalcoholic fatty liver disease (NAFLD) and the incidence of type 2 diabetes mellitus (T2DM) in Chinese adults.

METHODSA total of 4847 Chinese adults were enrolled in this prospective study. All participants underwent physical examination at one of three hospitals in Nanjing during 2008. According to results from B ultrasound, the participants were grouped according to NAFLD diagnosis, with 1468 in the NAFLD group and 3379 in the control group.Participants were followed up until diagnosis of T2DM or for 4 years. The cumulative incidence rates of T2DM were calculated for and compared between the NAFLD group and the control group. The relationship between NAFLD and risk of T2DM was examined by Cox proportional hazards modeling.

RESULTSDuring the 4-year follow-up,387 (8.0%) of the patients were diagnosed with T2DM. The cumulative incidence rates of T2DM in the NAFLD group and the control group were 17.2% and 4.0%, respectively. After adjusting for age,sex,body mass index,blood pressure,triglyceride level and alanine aminotransferase level, NAFLD was found to be closely related to the incidence of T2DM (relative risk:3.465,95% confidence interval:2.755-4.358).

CONCLUSIONNAFLD is associated with elevated risk of T2DM in adult patients in Nanjing,China. The general population of this region may benefit from focused public health intervention and treatment strategies targeting to prevent development of T2DM in conjunction with NAFLD.

Adult ; Asian Continental Ancestry Group ; China ; epidemiology ; Diabetes Mellitus, Type 2 ; epidemiology ; Humans ; Incidence ; Non-alcoholic Fatty Liver Disease ; epidemiology ; Prospective Studies ; Risk Factors

OBJECTIVE: To explore the clinical characteristics and genetic basis of a child with autism spectrum disorder (ASD) in conjunct with congenital heart disease (CHD). METHODS: A child who was hospitalized at the Third People's Hospital of Chengdu on April 13, 2021 was selected as the study subject. Clinical data of the child were collected. Peripheral blood samples of the child and his parents were collected and subjected to whole exome sequencing (WES). A GTX genetic analysis system was used to analyze the WES data and screen candidate variants for ASD. Candidate variant was verified by Sanger sequencing and bioinformatics analysis. Real-time fluorescent quantitative PCR (qPCR) was carried out to compare the expression of mRNA of the NSD1 gene between this child and 3 healthy controls and 5 other children with ASD. RESULTS: The patient, an 8-year-old male, has manifested with ASD, mental retardation and CHD. WES analysis revealed that he has harbored a heterozygous c.3385+2T>C variant in the NSD1 gene, which may affect the function of its protein product. Sanger sequencing showed that neither of his parent has carried the same variant. By bioinformatic analysis, the variant has not been recorded in the ESP, 1000 Genomes and ExAC databases. Analysis with Mutation Taster online software indicated it to be disease causing. Based on the guidelines from the American College of Medical Genetics and Genomics (ACMG), the variant was predicted to be pathogenic. By qPCR analysis, the expression level of mRNA of the NSD1 gene in this child and 5 other children with ASD was significantly lower than that of the healthy controls (P < 0.001). CONCLUSION The c.3385+2T>C variant of the NSD1 gene can significantly reduce its expression, which may predispose to ASD. Above finding has enriched the mutational spectrum the NSD1 gene.
Male ; Child ; Humans ; Autism Spectrum Disorder/genetics* ; Heart Defects, Congenital/genetics* ; Computational Biology ; Genomics ; Mutation ; RNA, Messenger/genetics* ; Histone-Lysine N-Methyltransferase/genetics*

Objective To understand the homology of sequence type 562 (ST562) strains of Burkholderia pseudomallei which circulated in two separate continents (Asia and Australia) at different times.Methods Spe Ⅰ restriction fragments and 4-locus multiple locus variable number tandem repeat analysis (MLVA-4) profiles were extracted from MSHR5858 (ST562 Australia strain) and 350105 (ST562 historical strain of Hainan) genomes respectively by in silico analysis and then compared with the PFGE and MLVA-4 results of five ST562 clinical isolates from Hainan to test their homology.Synteny and homology between MSHR5858 and 350105 genomes were evaluated with bioinformatics methods.Results Five ST562 clinical strains from Hainan shared same PFGE pattern (similarity ＞97％) and this pattern coincided to the map of Spe Ⅰ restriction fragments of Australian strain MSHR5858.The amounts of genomic restriction fragments (Spe Ⅰ) for MSHR5858 and 350105 were 31 and 34 respectively,with 31 of them matched by each other.Five ST562 clinical strains of Hainan were distinct by MLVA-4 profiles,among which HPPH43 (MLVA-4 profile:10,8,10,8) was close to Australia strain MSHR5858 (10,8,8,6),containing identical repeat numbers at VNTR loci 2341k and 1788k;while HK003 (11,8,15,7) and HK061 (11,8,17,7) similar to Hainan historical strain 350105 (11,8,11,8),with same repeat numbers at loci 2341k and 1788k also.High-degree synteny and consistency on genomic contents were observed between 350105 and MSHR5858,indicating a similar origin for the 2 strains.Conclusion All inter-continental and historical ST562 strains ofB.pseudomallei had similar genomic characteristics,supporting the assumption that they had a common origin.Also,it is possible that Hainan historical strain 350105 is the ancestor of all circulating ST562 strains.

Under the diagnosis-related groups(DRG) prospective payment system, innovative health technologies with high costs and risks may be limited to some extent. How to balance the increase of health care cost and the development of innovative health technology is a difficult problem to be solved in the current reform. By studying the relatively mature payment systems of innovative health technologies in the world, the authors found that countries generally adopted additional payment or compensation to encourage the development of new technologies. But at the same time, a relatively perfect health technology assessment and payment management mechanism had been established to ensure the standardized operation of payment plan. These international advanced experience and practice could provide references for China′s innovative health technology payment strategy under the DRG payment system. It is suggested to establish a scientific and reasonable assessment mechanism of innovative health technology, create a special access channel for innovative health technology with limited short-term evidence, and gradually form a long-term incentive mechanism of innovative health technology in DRG payment system.

BACKGROUND:At present,postoperative timing or subjective criteria by clinicians are commonly employed to determine the return-to-sport timing for patients undergoing anterior cruciate ligament reconstruction.Unfortunately,these criteria do not adequately consider the biomechanical deficits in patients following anterior cruciate ligament reconstruction. OBJECTIVE:To explore the lower extremity kinematic and kinetic characteristics of athletes after anterior cruciate ligament reconstruction during bilateral vertical jumping. METHODS:Twenty athletes undergoing anterior cruciate ligament reconstruction and twenty healthy athletes,aged 20-24 years,were recruited in Wuhan Sports University from December 2021 to December 2022.All the 40 subjects underwent a bilateral vertical jumping test.The kinematic and dynamic characteristics of the lower limbs at propulsion phase,initial landing time and peak vertical ground reaction force moment. RESULTS AND CONCLUSION:At the initial landing time,the athletes undergoing anterior cruciate ligament reconstruction showed higher hip flexion angle(P=0.031)and lower ankle plantar flexion angle(P=0.018)on the operated side compared with the healthy athletes.At the peak vertical ground reaction force moment,the athletes undergoing anterior cruciate ligament reconstruction had higher hip flexion angle(P=0.016),lower hip abduction angle(P=0.019),lower knee flexion angle(P=0.025),higher knee external rotation angle(P=0.030),and higher ankle external rotation angle(P=0.042)on the operated side compared with the healthy athletes.At the peak vertical ground reaction force moment,the athletes undergoing anterior cruciate ligament reconstruction showed lower knee extension moment(P=0.036),lower knee internal rotation moment(P=0.016),lower hip abduction moment(P=0.004),higher hip extension moment(P=0.040),and higher hip external rotation moment(P=0.005)on the operated side compared with the healthy athletes.To conclude,the athletes undergoing anterior cruciate ligament reconstruction exhibit a stiff landing pattern,in which the knee load on the operated side tends to shift to the hip joint,and show inadequate control of lower limb rotational stability.Therefore,detection and correction of abnormal biomechanical characteristics should be part of the rehabilitation after anterior cruciate ligament reconstruction.

【Objective:】 To explore the disease communication between cancer children and their parents from the perspective of their parents. 【Methods:】 Using qualitative description method and semi-structured interview, 16 parents from the pediatric oncology department of a tertiary A hospital were collected. Colaizzi 7-step method was used to analyze the interview data and summarize the theme. 【Results:】 Four themes were summarized, including perception of the psychological changes of children after illness, changes in the future planning of children, different attitude towards informing children’s diseases, different opinions on children’s participation in medical decision-making. 【Conclusions:】 The awareness of disease communication and medical decision-making in cancer families is insufficient. It is difficult for parents to communicate actively and effectively with their cancer children, and the children’s families are unable to make clear plans for the children’s future. Therefore, it is necessary to construct a theoretical system of disease communication and medical shared decision-making from the perspective of Chinese familism, and strengthen the promotion of scientific communication methods.

Objective: To investigate the best amount of TPCK trypsin in Madin Darby canine kidney (MDCK) cell suspension for the culture of H7N9 avian influenza virus. Methods: Different concentrations of TPCK trypsin were added during the periods of cell growth and virus production. Their effects on cell growth, viability, glucose and lactate metabolism, and hemagglutination titer were monitored every 12 h. Inter-batch differences were analyzed. The amount of trypsin added in the cell growth phase was 0, 1 μg/ml, 2 μg/ml, 4 μg/ml, 6 μg/ml, 8 μg/ml, 10 μg/ml and 15 μg/ml. The amount of trypsin added during the virus production period was 0, 0.5 μg/ml, 1 μg/ml, 1.5 μg/ml, 2 μg/ml and 2.5 μg/ml. When the hemagglutination titers were same, the adding amount was further optimized at different multiplicity of infection (MOI) of 0.001, 0.005, 0.025 and 0.05. Results: No significant linear effects of TPCK trypsin concentration on cell number, viability, and glucose and lactate metabolism were observed. No toxicity to cell growth was observed when TPCK trypsin concentration reached 15 μg/ml. After the inoculation of H7N9 avian influenza virus, the hemagglutination titers in the 1 μg/ml, 1.5 μg/ml, 2 μg/ml and 2.5 μg/ml TPCK trypsin groups reached the peaks at 48 h, which were 1∶2^6.5. At 60 h, the hemagglutination titers of the latter two groups decreased faster than those of the former two groups. When the MOI was 0.005, the hemagglutination titer of the 1.5 μg/ml group at 48 h was 2^6.5 higher than 2⁶ in the 1 μg/ml group under the same condition. There were differences between different batches of TPCK trypsin. Conclusions Adding 1 μg/ml and 1.5 μg/ml of trypsin could better promote the proliferation of H7N9 avian influenza virus, and 1.5 μg/ml of trypsin had a wider range of MOI applicability.