Objective To determine the prognostic factors in systemic sclerosis.Methods Clinical data of definite systemic sclerosis patients were collected,including disease onset age,sex,disease course,Raynaud's phenomenon,skin involvement,gastroesophageal reflux,interstitial pneumonia,cardiac lesions,kidney lesions and scleroderma renal crisis.serum antibodies to scl-70.RNP and anti-centromere antibody were detected.Pulmonary artery pressure was measured by ultrasound cardiography.Cox hazard ratio model was employed to assess the mortality risk of systemic sclerosis patients.Results No difference in Raynaud's phenomenon,gastroesophageal reflux,anti-nuclear antybody,anti-sol-70 antibody,anti-centromere antibody,interstitial pneumonia,diffusion capacity (DLco),coronary artery disease,and peripheral artery atherosclerotic disease could be found between the dead and alive systemic sclerosis patients(P>0.05).Dead systemic sclerosis patients had later disease,onset(older than 60 years old)(P=0.002).Male gender(P=0.023),more diffuse skin involvement(P=0.000),more positive anti-RNP antibody(P=0.014),more pulmonary artery hypertension(P=0.000).more cardiac lesions(P=0.000),more cerebral infarets (P=0.035),more kidney lesions(P=0.000),and more scleroderma renal crisis(P=0.000) could be found jn dead sclerosis patients.Cox regression analysis showed that,onset later than 60 years old(OR=5.441.95% CI 2.126～13.926,P=0.000),male sex (OR=5.531,95%CI 2.014～15.190,P=0.001),anti-RNP antibedy positivity (OR=2.664,95%CI 1.016～6.592,P=0.034),diffuse skin involvement(OR=3.432,95%CI 1.400～8.411,P=0.007),pulmonary artery hypertension (OR=25.718,95% CI 5.954～111.085,P=0.000),cardiac lesions (OR=4.141.95%CI 1.685～10.159,P=0.002),kidney lesions(OR=4.214,95%CI 1.654～10.737,P=0.003) and scleroderma renal crisis (OR=20.677,95% CI 4.161～102.764.P=0.000)were risk factors for mortality in systemic sclerosis.Severe pulmonary hypertension was the most strong predictive factor for mortality in systemic sclerosis (OR=55.809,95% CI 12.879～241.832.P=0.000).Conclusion Aggressive therapy should be given to those systemic sclerosis patients with onset later than 60 years old,male sex,diffuse skin involvement,anti-RNP antibody positivity,cardiac involvement,kidney lesions,scleroderma renal crisis and pulmonary artery hypertension,especially seevere pulmonary hypertension.

Objective To explore the clinical significance of anti-nuclear protein B23 antibody in systemic sclerosis. Methods Enzyme-linked immunosorbent assay was employed to detect the serum antinuclear B23 autoantibody. Mann-Whitney U test was used to compare the clinical and autoantibody profiles between SSc patients with B23 antibody and those without B23 antibody. Logistic regression analysis was employed to analyze the correlation between B23 antibody and clinical manifestations and autoantibody profiles. Results Mann-Whitney U test showed that, forced vital capacity (FVC) diffusion capacity of CO (DLco) in B23 positive SSc was significantly lower than that in B23 negative counterparts, pulmonary artery hypertension was more prevalent in B23 positive SSc patients. While anti-fibrillarin, anti-U1RNP, and antic entromere antibodies were more prevalent in B23 positive SSc. Multivariate logistic regression showed that anti-B23 antibody positivity was an independent risk factor for pulmonary artery hypertension in SSc (OR=123.92, 95％CI 26.67～575.66, P＜0.01), and a protective factor for severe gastrointestinal involvement (OR=0.08, 95％CI 0.01 ～0.70, P＜O.05). Logistic analysis showed that anti-B23 antibody was correlated with antifibrillarin (OR=11.50, 95％CI3.85～34.37, P＜0.01) and anti-U1RNP antibodies (OR=3.43, 95％CI 1.01～11.63, P＜0.05), and correlated with different degree of pulmonary artery hypertension. Conclusion The pulmonary artery pressure should be monitored closely in those SSc patients with a positive B23 antibody.

Objective:To investigate the levels of dose to eye lens of interventional radiology workers in China from 2017 to 2019.Methods:The monitoring data on eye lens doses to the interventional radiology workers in 28 provinces across the country were collected from National Individual Dose Registry. Monitoring was carried out using TLDs on their left eyes and evaluated in terms of the personal dose equivalent Hp(3). By using Mann-Whitney U test and Kruskal-Wallis H test, statistical analyses were made of the average annual lens doses to interventional radiology workers in the hospitals of different types at different levels for different years. Results:From 2017 to 2019, the data on eye lens doses to 2 981 interventional radiology workers were collected, with doses ranging from below the minimum detectable level (MDL) to 64.48 mSv, the average annual eye dose of 1.38 mSv, and the annual doses incurred by 0.97% monitored workers exceeding the recently recommended dose limits, 20 mSv per year. The average annual lens dose monitored in general hospitals and in cancer hospitals were 1.33 and 1.77 mSv, respectively, without statistically significant difference ( P>0.05). The average annual lens dose in tertiary hospitals was 1.39 mSv, significantly higher than that in secondary hospitals where the value was 1.16 mSv ( Z=2.894, P<0.05). Conclusions:The estimated annual eye lens doses to the interventional radiology workers during 2017-2019 were in accordance with the current national standard GB 18871-2002, but with a few exceptions exceeding the current international standards. This means that there exists, to a certain degree, a potential risk for the eye lens in this work category to exceed the international limits. It is suggested to continue in effort to enhance the monitoring of eye lens dose for these workers and to increase risk awareness, and take effective protective measures so as to lower the level of eye lens doses.

Objective:To ascertain the levels of individual doses to radiation workers arising from occupationally external exposure in China in 2017, with an aim to provide basic data and scientific basis for prevention and control of occupational radiation sickness.Methods:Data on individual doses to monitored workers engaged in medical and industrial applications of radiation sources were collected through National Individual Dose Registry, with statistical analysis being carried out using Kruskal-Wallis H test, Mann-Whitney U test and Bonferroni method. Results:A total of 361 727 radiation workers were investigated in 2017, of which 81.6% was from medical application and 18.4% from industrial application, respectively. The average annual effective dose from medical and industrial applications were 0.353 and 0.270 mSv, respectively, with the former significantly higher than the latter ( Z=48.547, P<0.05). Furthermore, a statistically significant difference was seen in the average annual effective dose for each occupational category of medical application ( H=1 136.217, P<0.05), suggesting that the dose values for the monitored workers in nuclear medicine and interventional radiology were significantly higher than for other four medical categories ( Z=2.877-26.967, P<0.05). These dose values for the radiation workers was 0.361 mSv in tertiary hospitals, 0.397 mSv in secondary hospitals, and 0.308 mSv in primary and unrated hospitals, respectively. The dose values for the monitored workers in industrial radiography and well logging were significantly higher than for other five industrial categories of industrial applications ( Z=4.172-36.908, P<0.05). Conclusions:The average annual effective doses to the of monitored workers meet the relevant national standards. The exposure doses to the workers in nuclear medicine, interventional radiology, industrial radiography and well logging are relatively high. The necessary measures and devices for radiation protection should be further strengthened to reduce occupational exposure of workers.

Objective To clone human Sjogren's syndrome antigen A(SSA)for expressing of antigen SSA-52kD and establishing a new clinical detecting method.Methods According to the human SSA-52kD cDNA sequence reported in GenBank,primers of human SSA-52kD cDNA were designed and synthesized.Human SSA-52kD cDNA was amplified from RNA of cultured Hela cell by reverse transcriptase polymerase chain reaction(RT-PCR).The production of amplification was ligated to PET-30a vector and then transformed into the competent bacteria DH5?to construct the recombinant plasmid PET-30a-SSA-52kD.The recombinant plasmid was digested with Bgl Ⅱ and Hind Ⅲ,and positive clones were sequenced.Results The Human SSA-52kD cDNA fragment containing 1447bp was amplified by RT-PCR.Restriction endonuclease mapping using Bgl II and Hind III showed that the target gene was inserted into the recombinant plasmid.The complete coding sequence of Human SSA-52kD was consistent with that of GenBank through DNA sequencing.Conclusions The full length of human SSA-52kD cDNA was successfully cloned and the recombinant plasmid PET-30a-SSA-52kD was constructed.

N 6-methyladenosine (m 6A) methylation modification is defined as the methylation at the N 6 position of adenosine. This dynamic process is regulated by writer, eraser and reader. Accumulating evidence indicates that m 6A methylation modification is involved in the initiation and development of various digestive system neoplasms including proliferation, invasion, metastasis and chemoresistance. A further understanding about the role of m 6A methylation modification in digestive system neoplasms will benefit the development of a novel precise diagnostic and therapeutic strategy and finally improve the overall prognosis of patients.

Objective:To investigate the changes of advanced glycosylation end product(AGEs)/sodium-glucose cotransporter-1(SGLT-1) in intestinal and renal tissues and intestinal flora of mice with diabetes kidney disease.Methods:Twenty KKay mice were divided into diabetic group(DM group, n=10) and diabetic kidney disease group(DKD group, n=10). The concentrations of serum AGEs, lipopolysaccharide(LPS), tumor necrosis factor-α(TNF-α), and intereukin-6(IL-6) were measured. Western blot technique was used to detect the protein expression of AGEs and SGLT-1 in kidney and intestinal tissue, and high-throughput sequencing was used to analyze the difference of intestinal flora. Results:The levels of inflammatory markers TNF-α, IL-6, and serum endotoxin in DKD group were significantly higher than those in DM group( P<0.05). The contents of AGEs in serum and intestine and kidney were increased, and the contents of SGLT-1 in intestine and kidney were increased( P<0.05). Metastats test showed that the abundance of Verrucomicrobia decreased and the abundance of Proteobacteria increased in DKD group( P<0.05). G - bacteria such as Aeromonas, Enterobacter, Morgan, Klebsiella, Serratia, and Burkholderia were relatively dominant, and the abundance of Akkermansia was significantly lower than that in DM group( P<0.05). Conclusion:The increase of AGEs in intestinal tract of DKD mice may induce intestinal dysbacteriosis, especially the increase of Proteobacteria, the decrease of Verrucosa and Wilhelm Ackermann, and the leakage of G-bacteria into the blood to produce intestinal endotoxemia and cause inflammatory reaction, this may be an important factor in the development of DKD. SGLT-1 is elevated in intestinal tissue, which may be involved in the development of DKD.

To determine the direct effect of leptin on adipose tissue apoptosis in vitro using rat adipose-derived stem cells (ADSCs), we isolated the ADSCs of rat epididymis adipose tissue by collagenase digestion, filtration, and subsequent centrifugation. Cell cultures with or without leptin (10(-9) mol/L, 10(-8) mol/L, 10(-7) mol/L and 10(-6) mol/L) were incubated for different time. We examined the cell surface phenotype by immunofluorescence and detected the apoptosis morphological changes of ADSCs by laser scanning confocal microscope (LCSM). The number of apoptotic cells was determined by flow cytometry assay after annexin V binding and PI staining. Caspase-3 activity was measured by spectrofluorometry. The present study demonstrates that leptin treatment causes a marked increase in adipose-derived stem cell apoptosis. With the LCSM, after being treated with leptin, ADSCs showed the typical characteristic of apoptosis. Leptin in used concentrations (0 mol/L, 10(-8) mol/L, 10(-7) mol/L, 10(-6) mol/L) caused a marked increase in cell apoptosis after 48 h incubation time (for 2.50% +/- 0.72%, 6.78% +/- 1.99%, 11.99% +/- 1.58% and 17.93% +/- 4.82%, respectively, P < 0.05). Caspase-3 activity increased and reached a maximal level after 48 h in a linear fashion. The effect of leptin was dose-dependent and time-dependent. Leptin has been demonstrated to induce preadipocyte and adipocyte apoptosis, and today we demonstrate that leptin can induce ADSCs apoptosis, which can contribute to the decrease of adiposity. To our knowledge, this is the first study demonstrating the direct peripheral effect of leptin on ADSCs.
Adipose Tissue ; cytology ; Animals ; Apoptosis ; drug effects ; Caspase 3 ; metabolism ; Cells, Cultured ; Epididymis ; cytology ; Leptin ; pharmacology ; Male ; Mesenchymal Stromal Cells ; cytology ; Rats ; Rats, Wistar

Objective To observe the clinical efficacy and related complications of modified suture method in treating perimembranous ventricular septal defect(VSD). Methods The clinical data of 110 children with perimembranous VSD were retrospectively analyzed. Among them, 51 cases were treated with conventional suture method (conventional suture group), and 59 cases were treated with modified suture method(modified suture group).The extracorporeal circulation time,intraoperative blood transfusion volume, postoperative drainage volume, total hospital stay and related complications were recorded. The transthoracic echocardiography was performed 1, 6 and 12 months after operation. Results The children successfully completed the operation,and no intraoperative death occurred.The extracorporeal circulation time, intraoperative blood transfusion volume, postoperative drainage volume, total hospital stay and rate of related complications in modified suture group were significantly lower than those in conventional suture group: (41.2 ± 9.6) min vs. (52.1 ± 10.6) min, (182.2 ± 42.9) ml vs. (255.3 ± 56.7) ml, (73.2 ± 18.7) ml vs. (102.3 ± 23.5) ml, (12.8 ± 2.5) d vs. (16.1 ± 3.6) d and 13.6% (8/59) vs. 29.4% (15/51), and there were statistical differences (P<0.01 or <0.05). The blood flow velocity of pulmonary valve and blood flow velocity of aortic valve 1,6 and 12 months after operation in modified suture group were significantly better than those in conventional suture group, blood flow velocity of pulmonary valve: (113.8 ± 21.4) cm/s vs. (126.5 ± 22.6) cm/s, (104.6 ± 18.2) cm/s vs. (112.3 ± 18.5) cm/s, (102.3 ± 15.8) cm/s vs. (113.8 ± 16.5) cm/s; blood flow velocity of aortic valve:(141.9 ± 24.6)cm/s vs.(136.0 ± 25.7)cm/s,(148.3 ± 18.7)cm/s vs.(142.3 ± 20.3)cm/s,(148.8 ± 18.1) cm/s vs. (141.6 ± 18.1) cm/s, and there were statistical differences (P<0.05). Conclusions The modified suture method has the characteristic of short operating time, less blood transfusion and postoperative drainage,and swift recovery.It also can reduce postoperative arrhythmia and residual reflux.

Objective To investigate the compliance and the self-efficacy of catheter maintenance in patients with PICC, convenience sampling methods were used to analyze the influence of the self-efficacy on compliance of catheter maintenance. Methods From January 2017 to July 2017, a total of 200 cases patients with PICC in the oncology department of the Second Affiliated Hospital of Nanchang University were selected. The general information, the self- efficacy and compliance of catheter maintenance were investigated. Results The self-efficacy of PICC catheter patients was positively correlated with the total score of catheter maintenance compliance, living habits, self-monitoring and cognitive behavior score (r=0.56-0.92, P<0.01), and it was linearly dependent with the total compliance of catheter maintenance, and the correlation coefficient of Pearson was 0.82. The self-efficacy, monthly income, education level, place of residence, complications and payment methods hadsignificant influence on the compliance of catheter maintenance (P<0.05), among which the self-efficacy had the greatest impact. Conclusions The self-efficacy of patients with PICC catheter is one of the essential factors in improving the compliance of catheter maintenance, and it can improve the compliance of catheter maintenance in PICC patients by looking for the self-efficacy of patients with PICC catheter.