Objective To investigate MR imaging features of parotid gland in Sj?gren′s syndrome ( SS).Methods Twenty-seven cases of xerostomia patients were collected and divided into SS group ( n=21) and non-SS group (n=6) according to the international classification (diagnosis) criteria for SS.Ten healthy volunteers were recruited as the control group.All the subjects underwent conventional MRI of parotid gland and MR sialography ( MRS).Standard deviation of T 1 WI and T2 WI signal intensity among 3 groups was observed, meanwhile, grading was made according to parotid glands , fat signal and parotid duct expansion degree respectively.With clinical diagnosis as the gold standard , diagnostic value of conventional MRI , MRS and their combination used in SS was compared.One-way ANOVA was used in comparison of standard deviation of parotid gland′s signal intensity among 3 groups , and Chi-square test was applied in comparison of conventional MRI and MRS diagnostic value.Moreover , Kappa value was calculated to assess the consistency of two grading results in SS.Results Signal intensity of parotid glands in control group and non-SS group was homogeneous.However , bilaterally diffused and heterogeneous high signal intensity on both T1WI and T2WI was found in SS patients, which was depressed on T2WI fat suppression sequences.Forty-two parotid glands were graded by fat signal:Grade 0 (n=2 glands), Grade 1 (n=10), Grade 2 (n=10), Grade 3 (n=6) and Grade 4 (n=14).Parotid peripheral ducts of control group and non-SS group were unexpanded , while bilaterally expanded parotid peripheral ducts were shown in SS patients.The grading of 42 parotid glands by expansion degree of parotid duct , Grade 0 was rated in 12, Grade 1 in 8, Grade 2 in 10, Grade 3 in 5, and Grade 4 in 7.Standard deviation of T1WI signal intensity of parotid glands among SS group , non-SS group and control group were 124.1 ±30.0, 81.8 ±27.6, and 86.3 ±35.0 respectively;and standard deviation of T 2 WI signal intensity were 115.1 ±35.2, 69.8 ±23.5, and 80.1 ±31.4 respectively; the standard deviation of T 1 WI and T2 WI signal intensity of SS group was higher than both non-SS group and control group′s ( F value =13.780 and 13.301, respectively, P <0.01), however, the difference of standard deviation of signal intensity of non-SS group and control group had no statistical significance (P>0.05).Among 42 parotid glands with SS, conventional MRI and MRS showed parotid gland lesions in 40 and 30 respectively , and the difference was statistically significant (χ2 =13.04, P=0.013).There was no false positive result.The combination of the two methods detected all 42 lesions.The consistency of detecting parotid abnormalities with SS between conventional MRI and MRS was poor (Kappa=0.12, P=0.092).Conclusions Diffuse fatty infiltration on conventional MRI and diffuse peripheral duct dilatation on MRS in the parotid gland are characteristic features of SS , and conventional MRI could be used as the preferred technique for the SS.combination with MRS may improve diagnostic accuracy.

Objective To investigate the regulation of IFN-γ to Th17 response in Chlamydia muridarum (Cm) lung infection in mice. Methods A murine model of pneumonia induced by intranasal inoculation of Cm was used for this study. Anti-mouse IFN-γ McAbs were used to neutralize endogenous IFN-γfollowing Cm lung infection. Control group received the same dose of isotype antibody (IgG2a). Mice were sacrificed at day 7 postinfection. Chlamydial growth in the lung was assessed by immunoenzyme technique.IL-17 and IL-23 mRNA expression in the lung was assayed by RT-PCR and the proliferation of IL-17 + CD4 +T cells in the spleen was assayed by intracellular cytokine staining. Results IFN-γ-neutralized mice exhibited serious disease course, include greater body weight loss, higher organism growth and much more severe pathological changes in the lung compared with control mice. The mRNA expression of IL-17 and IL-23 in the lung and the proliferation of IL-17 + CD4 + T cells in the spleen significantly decreased in the IL-17- neutralized mice. Conclusion IFN-γ was protective in Cm lung infection through up-regulating the antigen specific Th17 responses.

Objective:To observe chicken typeⅡcollagen-induced arthritis( CIA) in serum of mice with the dynamic changes of IL-27,IL-17,IL-10. Methods: 54 DBA1/J mice were randomly divided into control group(n=6) and model group(n=12), according to the progress of CIA mouse course early,middle and late(7,14,and 35 days after booster immunization) ,taking the eyeball for blood and separating the serum under sterile condition. The dynamic levels of cytokines IL-27,IL-17,IL-10 were detected by flow cy-tometry. Results:The level of IL-27 in the model group was significantly declined in the the progress of CIA mouse course early and middle(P<0. 05,P<0. 01) compared with the control group,but there was no significant difference between late disease and control group(P> 0. 05);the level of IL-17 in the disease early and late was no significant difference(P> 0. 05) compared with the control group,while in the mid course significantly higher than control group(P<0. 05) during the course of disease. The level of IL-10 showed no difference from the experiment beginning(P> 0. 05). Conclusion: IL-27,IL-17,IL-10 paticipate in the pathogenesis of CIA and their alterations at different stages of the disease have a relation to the development of arthritis.

Objective:To analyze the EGFR gene polymorphism in the non-small cell lung (NSCLCs) cancer in southern of Shaanxi Province.Methods:The next generation sequencing technology was used to detect the mutation of exon 18,19,20 and 21 of EGFR gene.We analyzed EGFR gene mutation rate in NSCLCs patients.233 patients was involved in our study.Results:82 cases with EGFR gene mutations was found,the mutation rate of exon18,19,20 and 21 was 1.3％,16.3％,0％ and 18％ respectively.The mutation rate of EGFR in male patients was lower (31.2％,39/125) than that of female cases (39.8％,43/108),the mutation rate of squamous cell carcinoma (22％,9/41) was lower than that of adenocarcinoma (39.1％,75/192).Conclusions:NSCLCs patients from southern Shaanxi Province had high mutation rate ofEGFR gene,and exon 19 and exon 21 mutations were in the majority.EGFR gene mutation rate was not related to gender and pathological types.

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Objective:To evaluate the health related quality of life (HRQoL) of hip fracture patients after surgery and build a prediction model to identify high-risk patients with HRQoL decline.Methods:A cross-sectional research method was applied to select 135 patients with unilateral hip fractures from January 2020 to June 2021 in Hainan Provincial Hospital of Traditional Chinese Medicine using convenience sampling as the study population. HRQoL was self-assessed using the European Five-Dimensional Health Scale (EQ-5D).Logistic regression models were used to identify risk factors for HRQoL decline. The columnar plots′ predictive accuracy and net clinical benefit were assessed using calibration curves, ROC curves, and decision curve analysis (DCA).Results:The final number of patients with valid follow-up was 122.At 6 and 12 months postoperatively, the EQ-5D index was lower than before the fracture in 41(33.6%) patients, showing a strong correlation with the Barthel index ( r=0.833, 0.705, both P<0.05). Nutritional Risk Screening 2002 (NRS-2002) ( OR=1.352), Charlson Comorbidity Index (CCI) ( OR=1.121), hip replacement ( OR=0.795), and lung infection ( OR=1.328) were independently associated with a decrease in HRQoL in patients with hip fracture (all P<0.05). The consistency index (C-index) of the column line plot was 0.889 (0.791 to 0.955), and the area under the curve (AUC) was 0.871 (0.784 to 0.947). The DCA results showed that the model provided good net clinical benefit. Conclusions:The model can effectively identify patients at high risk of declining HRQoL, which is helpful to determine priority patients to provide nursing strategies.

OBJECTIVE: To assess the association of CYP2C19 and CYP3A5 gene polymorphisms with the risk of myocardial infarction. METHODS: Five hundred patients with myocardial infarction and 500 healthy controls were randomly selected. Fluorescent PCR and Sanger sequencing were used to detect the CYP2C19 and CYP3A5 gene polymorphisms. Logistic regression was used to analyze the correlation between the polymorphisms and myocardial infarction. Quanto software was used to evaluate the statistical power. RESULTS: The two groups had significant difference in the frequency of AG, GG genotypes and A allele of the CYP2C19 gene rs4986893 locus and the AA, AG, GG genotypes and G allele of the CYP3A5 gene rs776746 locus ( P<0.05), but not in the frequency of genotypes and alleles of CYP2C19 gene rs4244285 and rs12248560 loci, and the AA genotype of the rs4986893 locus. After correction for age, gender, and body mass index, Logistic regression indicated that the AG genotype and A allele of the CYP2C19 gene rs4986893 locus, and the GG genotype and G allele of CYP3A5 gene rs776746 locus are associated with susceptibility of myocardial infarction, while rs4986893 GG genotype and AA and AG genotypes of rs776746 may confer a protective effect. Based on the sample size and allele frequency, analysis with Quanto software suggested that the result of this study has a statistical power of 99%. CONCLUSION CYP2C19 and CYP3A5 gene polymorphisms may increase the risk for myocardial infarction.
Cytochrome P-450 CYP2C19/genetics* ; Cytochrome P-450 CYP3A/genetics* ; Gene Frequency ; Genotype ; Humans ; Myocardial Infarction/genetics* ; Polymorphism, Genetic ; Polymorphism, Single Nucleotide

Objective To compare the effects of different local intervention temperatures of pressure ulcer on endoplasmic reticulum stress (ERS) and apoptosis in rats, and to provide an experimental evidence for clinical prevention and treatment of pressure ulcer. Methods The rat model of pressure ulcer was established by ischemia reperfusion, and a total of 40 SPF adult, male SD rats were divided into 4 groups: the sham group (anesthesia only, without other treatment), model group (ischemia at 22℃ for 1 h and reperfusion at 22℃ as one cycle, repeated for 5 cycles), high-temperature intervention group (ischemia at 22℃ for 1 h and reperfusion at 32℃ as one cycle, repeated for 5 cycles) and low-temperature intervention group (ischemia at 22℃ for 1 h and reperfusion at 12℃ as one cycle, repeated for 5 cycles). At the end of the experiment, muscle tissues at the sites under pressure of the rats were taken on ice. The pathological changes of skeletal muscle tissues were observed by HE staining. The expression levels of ERS-related proteins GRP78, caspase-12 and CHOP were detected by Western blot, and the expression of caspase-12 and CHOP was also observed by immunofluorescence. Moreover, apoptosis in the skeletal muscle cells was examined by TUNEL staining. Results Compared with the model group, skeletal muscle cell damages became more severe and apoptotic cells were increased in the high-temperature intervention group. Besides, the results of the immunofluorescence assay showed an increased positive expression of caspase-12 and CHOP, and the results of Western blot showed that the expression levels of GRP78, caspase-12 and CHOP were all higher than those of the model group (P＜ 0. 05). In contrast, skeletal muscle cell damages were alliviated and apoptotic cells were reduced in the low-temperature intervention group. Meanwhile, the positive expression of caspase-12 and CHOP was decreased, as shown by immunofluorescence, and all the expression levels of GRP78, caspase-12 and CHOP detected by Western blot were lower than the control group (P ＜ 0. 05). Conclusions Local low-temperature intervention can alleviate the pressure ulcer damages in rats through inhibition of the ERS-mediated apoptotic pathway. Local high-temperature intervention may exacerbate the pressure ulcer damages in rats by activating the ERS-mediated apoptotic pathway and promoting cell apoptosis. Local low-temperature intervention may be promising in clinical prevention and treatment of pressure ulcer.

OBJECTIVETo investigate human papilloma virus (HPV) infection and typing in 7 640 cases of women in Shanxi province in order to provide theoretical basis for the prevention and treatment of the cervical cancer.

METHODSTotally, 7 640 cases of cervical cell specimens in Shanxi provincial tumor hospital, screening and physical examination from 2012 January to 2013 May and 23 HPV genotypes were analyzed by PCR and reverse dot blot gene chip technology.

RESULTSA total of 1 441 cases of patients with HPV infection were to be found in 7 640 cases of women with an average age of (42.26 ± 19.15)years old. The total infection positive rate, infection rate of high-risk HPV, infection rate of low-risk HPV and infection rate of mixed high and low risk were 18.86% (1 441/7 640), 16.03% (1 225/7 640, including multiple high-risk of HPV infection), 4.88% (373/7 640, including multiple low-risk of HPV infection) and 2.05% (157/7 640) respectively. The rate of high-risk HPV infection was 85.01% (1 225/1 441) in total infection positive women. The most common subtype was HPV16 (34.70%, 523/1 507) and followed by HPV58 (11.48%, 173/1 507), HPV18 (7.43%, 112/1 507), HPV33 (7.10%, 107/1 507), HPV56 (6.04%, 91/1 507) and HPV52 (5.51%, 83/1 507) respectively in tested 18 high-risk HPV subtypes, and there was no HPV82. The most common subtype was HPV43 (38.13%, 151/396) and followed by HPV42 (22.22%, 88/396), HPV81 (20.45%, 81/396), HPV6 (11.87%, 47/396) and HPV11 (7.32%, 29/396) respectively in tested 5 low-risk HPV subtypes. The HPV infection positive rates were significantly different in different age groups and HPV total infection rate, high-risk infection rate in 41-50 year-old age group was the highest, 23.23%. The infection rates of single subtype of HPV and single high-risk subtype of HPV were 75.71% (1 091/1 441) and 61.35% (884/1 441) respectively in all cases of infection women and single high-risk subtype infection rate was 81.03% (884/1 091) in all cases of single subtype infection women. The infection rate of multiple subtype of HPV was 24.29% (350/1 441) in all cases with HPV infection. The double infections was most common (18.18%, 262/1 441) in which the women of double high-risk infections of HPV were 151 cases (10.48%, 151/1 441). The rates of double infection, triple infection and quadruple or more infection of HPV were 74.86% (262/350), 20.29% (71/350) and 4.89% (17/350) respectively in all cases with HPV multiple infection. The positive rates of HPV infection in different age groups were obvious difference. The positive rate of single infection of HPV was 17.80% (574/3 224) in cases of 41-50 years old group which higher than that in other groups(χ² = 20.18, P < 0.05).

CONCLUSIONThe more common high-risk HPV subtype is HPV16, HPV58, HPV18, HPV33, HPV56 and HPV52 and low-risk HPV subtype is HPV43, HPV42 in Shanxi province. HPV infection is most common in the age group of 41- 50 years old female.

Adult ; Aged ; Cervical Intraepithelial Neoplasia ; epidemiology ; virology ; China ; epidemiology ; Cross-Sectional Studies ; DNA, Viral ; genetics ; Female ; Genotype ; Human papillomavirus 16 ; genetics ; Humans ; Middle Aged ; Oligonucleotide Array Sequence Analysis ; Papillomaviridae ; classification ; genetics ; Papillomavirus Infections ; epidemiology ; virology ; Risk Factors ; Uterine Cervical Neoplasms ; epidemiology ; virology ; Young Adult

Objective:To compare perioperative differences between posterior lumbar interbody fusion(PLIF)by a posterior median approach or open transforaminal lumbar interbody fusion(TLIF)and minimally invasive surgery TLIF(MIS-TLIF)by a paravertebral approach for lumbar spondylolisthesis(Ⅰ~Ⅱ°)in elderly patients.Methods:A retrospective study was conducted to analyze clinical data of patients aged 60 years and over with lumbar spondylolisthesis(n=68)who underwent PLIF or MIS-TLIF from January 2014 to December 2017.Patients were divided into the PLIF group(n=40, 12 males and 28 females)and the MIS-TLIF group(n=28, 6 males and 22 females)according to the type of surgery.Differences in operating time, blood loss, exposure frequency, postoperative drainage volume, indwelling duration, hospital stay length and complications were compared between the groups.Results:There was no significant difference in operative time between the PLIF group and the MIS-TLIF group(156±51)min vs.(153±38)min( P=0.77). There were significant differences in intraoperative blood loss and radiation exposure frequency between the PLIF group and the MIS-TLIF group(458±272)ml vs.(157±104)ml( P<0.001); (6.7±1.5)times vs.(30.6±6.9)times( P<0.01). There was no significant difference in intraoperative complications between the PLIF group and the MIS-TLIF group(25% or 10/40 vs.7.1% or 2/28, P=0.057). There were more postoperative drainage, longer indwelling time and hospitalization in the PLIF group than in the MIS-TLIF group(664±351)ml vs.(210±127)ml( P<0.001); (3.7±2.9)d vs.(2.2±0.8)d( P=0.002); (9.2±3.6)d vs.(6.9±1.7)d( P=0.001). The incidence of postoperative neurological complications was not significantly different between the PLIF group and the MIS-TLIF group(7.5% or 3/40 vs.14.3% or 4/28, P=0.365). The incidence of postoperative non-neurological complications was higher in the PLIF group than in the MIS-TLIF group(27.5% or 11/40 vs.7.1% or 2/28, P=0.036). Conclusions:Compared with PLIF, MIS-TLIF has the advantages of less intraoperative bleeding and postoperative drainage, shorter indwelling duration of urinary catheters, shorter hospital stays and fewer complications of non-neurological complications in treating Ⅰ-Ⅱ degree lumbar spondylolisthesis in the elderly, but it requires more radiation exposure.