Objective:To analyze the clinical characteristics of anti-cyclic citrullinated peptide (CCP) antibody-negative rheumatoid arthritis (RA) patients.Methods:To retrospectively analyze the medical records of RA patients hospitalized in the department of rheumatology and immunity of Peking University Third Hospital from January 2013 to December 2018, we collected the baseline characteristics, joint manifestations, extra-articular manifestations, and laboratory parameters of RA patients, and compared the differences between anti-CCP antibody-negative patients and anti-CCP antibody-positive patients by U test and chi-square test. Results:A total of 486 RA patients were included in this study, including 153 anti-CCP antibody-negative patients (31.5%) and 333 anti-CCP antibody-positive patients (68.5%). Compared with anti-CCP antibody-positive group, anti-CCP antibody-negative group had shorter disease course ( U=-4.750, P<0.01) and the pro-portion of morning stiffness, shoulder or elbow joint involvement, and hand arthritis ( P<0.05) was lower, while the incidence of phlebothrombosis of leg ( χ2=4.100, P=0.043) was higher, as well as thrombocytosis ( U=-2.179, P=0.029) and elevation of CRP ( U=-2.154, P=0.03). Subgroup analysis based on RF showed that CCP RF + group had higher percentage of women ( P=0.042) and higher incidence of interstitial lung disease ( χ2=5.652, P=0.017) and secondary Sj?gren's syndrome ( χ2=11.211, P=0.001), compared with CCP RF - group. Conclusion:anti-CCP antibody-negative-patients have similar clinical char-acteristics with anti-CCP antibody-positive group, but the involvement of shoulder or elbow joint and hand arthritis are less common in anti-CCP antibody-negative group. Meanwhile the incidence of phlebothrombosis of leg is higher, and the level of platelet(PLT) and C-reactive protein (CRP) is higher, suggesting that anti-CCP antibody-negative RA may have more vident inflammatory response.

AIM:To study the effect of CD73 on breast cancer cell line MB-MDA-231 adhesion to extracellular matrix.METHODS: ① CD73 siRNA plasmid was constructed and transfected into MB-MDA-231 cells by lipofectamine 2000.② The transfection efficiency was analyzed by flow cytometry using eGFP as a marker gene.Stable transfected MB-MDA-231 cells were selected using G418.③ RT-PCR and Western blotting analysis of CD73 expression in MB-MDA-231 cells was performed.④ The effects of CD73 on MB-MDA-231 cells adhesion to extracellular matrix were assessed by cell adhesion assay.RESULTS: ① Transfection of MB-MDA-231 cells with CD73 siRNA plasmid significantly inhibited CD73 expression at mRNA level.The efficiency was up to 91%.② Transfection of MB-MDA-231 cells with CD73 siRNA plasmid significantly inhibited CD73 expression at a protein level.The efficiency was up to 79.3%.③ Treatment of MB-MDA-231 cells with CD73 siRNA resulted in diminished adhesion to extracellular matrix.CONCLUSION: This study demonstrates that CD73 siRNA effectively inhibits CD73 gene expression in MB-MDA-231 cells leading to adhesion to extracellular matrix suppression.

Five patients with mediastinal bronchogenic cyst (MBC) were treated with endoscopic submucosal tunnel dissection (ESTD) between January 2018 and October 2019 at the Department of Gastroenterology in Henan Provincial People′s Hospital. Lesions were located in the middle or lower esophageal level, with diameters≤3.5 cm. The tunnel establishment time was 13-18 min, and the tumor stripping time was 30-51 min. The number of titanium clips used for tunnel closure was 5-8. The tumors were completely resected. No major bleeding or hypoxemia occurred during the operation and no serious adverse reactions occurred after the operation. Postoperative pain scores were all ≤3. The hospital stay was 4-7 days. There was no tumor residue and recurrence during 4-23 months of follow-up.It is suggested that ESTD for MBC which derived from post mediastinum and located at the lower or middle level esophagus is safe and effective.

Objective To investigate the relationship between disease severity and enzyme-linked immunosorbent assay (ELISA) index values of anti-desmoglein (Dsg) 1 and-Dsg3 antibodies in 56 patients with pemphigus,and to characterize fluctuations in anti-Dsg1 and-Dsg3 antibodies in different forms of pemphigus.Methods Fifty-six patients with pemphigus (including 36 cases of pemphigus vulgaris (PV) and 20 cases of pemphigus foliaceus (PF)) were enrolled in this study.Blood samples were obtained from these patients before treatment and at the following four time points:when the condition was relieved and the taper of glucocorticoids began,the dose of glucocorticoids was tapered to half of their initial dose,the maintenance treatment started,and when the duration of maintenance treatment reached two years.ELISA was performed to determine the levels of anti-Dsg1 and-Dsg3 antibodies in these serum samples.Spearman correlation analysis was carried out to assess the relationship between disease severity and ELISA index values,and independent sample's t test to compare the levels of anti-Dsg antibodies among these time points.Results The severity of pemphigus was correlated with anti-Dsg antibody ELISA index values.Both anti-Dsg1 and anti-Dsg3 ELISA index values were significantly reduced at the remission of pemphigus compared with those before treatment (all P ＜ 0.01).At the end of the two-year maintenance treatment,10 (50％) patients with PF and 7 (19.4％) patients with PV became negative for anti-Dsg1 ELISA,whereas only 1 (2.7％) patient with PV became negative for anti-Dsg3 ELISA.Conclusions Anti-Dsg antibody ELISA index value is correlated with disease severity in patients with pemphigus,which may serve as a useful marker for assessing disease severity and activity as well as evaluating therapeutic efficacy.

OBJECTIVE To explore an effective cleaning method to improve the quality of sterilization,in order to control infections in the hospitals. METHODS To adopt orthogonal experimental forms of L_9(3~4) and take water temperature,cleaning agent type and cleaning method as experimental factors,in this way to investigate decontamination method for surgical instruments,using TOSI indicator cards and Browne STF load device to test the effectiveness of cleaning results. RESULTS It showed that by KQ-4200SY medical digital full-automatic ultrasonic cleaner with washing water at 33-35℃ an optimal cleaning result would be obtained. CONCLUSIONS It is practical to clean surgical instruments by KQ-4200SY medical digital full-automatic ultrasonic cleaner,and by TOSI indicator cards and Browne STF used as test method.

Objective To evaluate functional activity of the subcortical nuclei in Wilson's disease (WD) using resting state functional MRI (rs-fMRI),and to evaluate damage to the functional conjunction in the extracorticospinal tract in WD patients.Methods Twenty-two patients with WD (between January 2015 and January 2016),including 18 with cerebral type and 4 with hepatic type,and 20 age-matched healthy controls were enrolled.Neurological symptoms were scored using the modified Young Scale.Patients with cerebral type WD were divided into 4 subgroups.All study subjects underwent rs-fMRI of the brain.The values of amplitude of low-frequency fluctuation (ALFF) and regional homogeneity (REHO) in the thalamus,caudate nucleus,putamen and globus pallidus were determined.The relationships between rsfMRI metrics and clinical status were evaluated.Results ALFF values were lower in the caudate nucleus,putamen and right thalamus of WD patients than in controls (t =-3.07,-3.00,-3.12,-2.46,-2.20;P =0.005,0.006,0.004,0.020,0.036),while REHO values were lower in the left caudate nucleus and left thalamus of WD patients (t =-2.38,-2.16;P =0.025,0.040).In the caudate nucleus (P =0.032,0.029,0.023),thalamus (P =0.022,0.041,0.035) ALFF values were lower in group 4 than in other groups.REHO values of the putamen (P =0.040,0.017,0.040) and thalamus (P =0.024,0.029 7,0.041) were higher in group 4 than in other groups.ALFF values in the caudate nucleus (t =-0.29,P=0.037),and thalamus (t =-1.77,P =0.042) were lower,and REHO values in the caudate nncleus (t =-1.46,P =0.040) were lower,in patients of cerebral type than in hepatic type patients.Conclusions The damage to the functional activity of the subcortical nuclei may occur in the WD patients.The functional activity of nuclei may be different between hepatic and cerebral type patients.Damage to the activity of neurons in the putamen and thalamus may correlate with psychiatric symptoms in WD patients.

Objective To investigate the relationship between CRP, plasminogen activator inhibitor type 1 (PAI-1) levels, PAI-1 gene promoter 4G/5G polymorphism and the type of acute myocardial infarction (ST elevation myocardial infarction, STEMI vs the non-ST elevation Myocardial infarction, NSTEMI). Methods One hundred seventy-six consecutive patients with AMI were included for the study, of whom 60 had STEMI and 56 had NSTEMI, and 60 adults without cardiovascular and cerebrovascular disease were selected as controls. Blood samples were obtained from patients within 6 h of AMI and the plasma PAI-1, CRP, and the gene polymorphism were measured. Results Plasma levels of PAI-1 and CRP were higher in AMI groups, compared those in the control group, and plasma levels of PAI-1 were significantly higher in patients with STEMI compared to those with NSTEMI (80.12ng/ml VS.73.01ng/ml, P <0.01), while CRP levels were not significantly different between patient with STEMI and NSTEMI (3.87±0.79 mg/ml VS.4.01±0.69mg/ml, P>0.05). PAI-1 levels presented a significant correlation with CRP levels in the NSTEMI subjects. However, PAI-1 and CRP levels could explain the lack of a significant relationship between them in control and STEMI subjects.The frequencies of 4G/4G genotype in the AMI group were higher than those in the control group and higher in patient with STEMI than in patient with NSTEMI. Plasma levels of PAI-1 in subjects with 4G/4G genotype were significantly increased as compared to those in subjects with 4G/5G and 5G/5G genotype. Conclusions Plasma PAI-1 levels were associated with different myocardial infarction type, and PAI-1 promoter 4G/5G polymorphisms and CRP may be related to plasma PAI-1 levels.

Objective To explore hypermethylation of RARβ2, GSTP1 and DAPK gene in prostate cancer tissues, and to explore its correlation with clinicopathological features of prostate cancer and its diagnostic value. Methods Hypermethylation of RARe2, GSTP1 and DAPK gene was detected by nested methylation-specific PCR (NMSP) in 57 prostate cancer (PCa) tissues and 35 benign prostate hyperplasia (BPH) tissues. The correlation between hypermethylation and clinicopathological features of prostate cancer and its diagnostic value were analyzed. Results The hypermethylation frequencies of RARβ2, GSTP1 and DAPK gene in PCa were significantly higher than those in BPH (RARβ2: 52.6% vs. 0% GSTP1: 61.4% vs. 2.9%;DAPK: 43.9% vs. 8.6%;all P<0.01). The methylation rate of RARβ2 gene was directly correlated with distinct Gleason scores and clinical stage (4～7 score vs. 8～10 score: 34.8% vs. 64.7%;stage B, C vs. stage D: 37.0% vs. 66.7%;x2=4.927 and 5.004, P=0.026 and 0.025). The methylation rate of GSTP1 gene was significantly different in patients with different Gleason scores (4～7 score vs. 8～10 score: 43.5% vs. 73.5%;x2 =11.530, P=0.001), but had no difference in patients with distinct clinical stage (stage B, C vs. stage D: 51.9% vs. 70.0%;x2=1.975, P=0.16) . There was no difference in DAPK gene methylation rate among patients with different Gleason scores and distinct clinical stage (4 ～7 score vs. 8～10 score: 39.1% vs. 50.0%;stage B, C vs. stage D: 33.3% vs. 53.3%;x2= 1.290 and 2.309, both P～0.05). GSTP1 gene showed the highest sensitivity of 61.4% (35/57)with specificity of 97.1%(34/35), while RARβ2 gene had the highest specificity of 100% (35/35) with the sensitivity of 52.6% (30/57). The sensitivity and specificity of DAPK gene were 43.9% and 91.4% (25/57 and 32/35), respeetively. When the hypermethylation of RARβ2, GSTP1 and DAPK gene were detected together, the diagnostic sensitivity was increased, but the specificity was decreased. Conclusions The aberrant methylation of RARβ2, GSTP1 and DAPK gene is correlated with tumorigenesis and progression of prostate cancer, which may be used as an effective diagnostic marker for prostate cancer.

n be used as a potential marker in the diagnosis of PCa. However, it can not be used as an index to monitor tumor progression or prognosis in PCa patients.