Objective To analyze the various common causes of acute pancreatitis distribution and related factors.Methods 131 cases of acute pancreatitis patients from April 2007 to August 2013 were chosen.The medical records were retrospectively analyzed .Patients were recorded and analyzed in age ,gender,etiology,clinical pancreatitis type.With biliary tract disease,overeating or high-fat meal,alcoholism,hyperlipidemia,other causes such as to cause the group to 18-29 years of age(youth group),29-44 years old(middle-aged group),44-59 years old(middle-aged group),≥59 years of age(age group) for the sector for the age group,for different reasons,the AP′s gender,age and different clinical types such as distribution were analyzed .Results Biliary disease 61 cases(46.3%);overeating or high-fat meal 38 cases(29.4%);alcoholism 21 cases(16.1%);high ester hyperlipidemia 8 cases(5.9%);other three cases(2.3%).Adult group overeating or high-fat meal,alcoholism and hyperlipidemia constituent ratio were higher than other groups,but with no significant difference(Pearson χ2 =19.1,df=12,P=0.085).Clinical types in a variety of different etiology than AP was no significant difference ( Pearson χ2 =1.9, df =4, P =0.753 ). Conclusion Biliary tract disease remains a major cause of AP ,followed by overeating or a high-fat meal,alcoholism, hyperlipidemia.AP has a clear upward trend,the treatment must remove the cause,to strengthen the integrated man-agement of AP .

Objective To investigate the effects of the zinc finger protein A20 on LPS-TLR4 signaling pathways in severe acute pancreatitis(SAP) rats.Methods 24 SD rats were randomly divided into 3 groups:group A(the sham operation group),group B (the SAP group),group C (the SAP group treated with LPS).SAP model was induced by retro-injection of intraductal 5％ sodium taurocholate into the biliary-pancreatic duct as previously described.The protein expression of A20,TLR4,NF-κBp65 and p38MAPK in pancreatic tissues was evaluated by immunohistochemistry.Results The positive area of A20 in pancreatic tissues was decreased in group B and group C compared with that in group A (t =17.234,19.698,all P ＜ 0.05).On the contrary,the expression of TLR4,NF-κBp65 and p38MAPK in pancreatic tissues were up-regulated(t =15.909,20.432,16.543,18.629,22.105,19.006,all P ＜ 0.05).A20 was decreased in group C than that in group B (t =14.894,P ＜ 0.05),while TLR4、NF-κBp65 and p38MAPK were increased in group C than those in group B (t =14.047,15.582,17.070,all P ＜0.05).Conclusion The expression of A20 reduced and TLR4,NF-κBp65 and p38MAPK enhanced in the pancreas of rats with SAP,which indicated that A20 inhibited LPS-TLR4 signaling pathways which play important roles in the pathogenesis of SAP.

Background:1 α,25-dihydroxyvitamin D3 [1,25 (OH) 2 D3],the active form of vitamin D,is reported in some studies having antifibrotic potential in liver fibrosis,however,its mechanism is not fully clarified.MicroRNAs (miRNAs) have recently been shown could regulate the proliferation and activation of hepatic stellate cells (HSCs),and are involved in the promotion or inhibition of liver fibrosis.Aims:To explore whether the inhibiting effect of 1,25 (OH) 2 D3 on activation of HSCs is by regulating miRNAs expression.Methods:Literature review and qPCR method were used to screen out the differentially expressed miRNAs between transforming growth factor-β1 (TGF-β1)-stimulated (activated) HSCs and the inactivated HSCs.Then the HSCs were co-cultured with TGF-β1 and the mimic of differentially expressed miRNA,the negative control mimic,1,25(OH)2D3 and DMSO,respectively,and the cell viability and apoptosis were determined by CCK-8 assay and flow cytometry.Results:Expression of miR-146a was down-regulated in activated HSCs (P ＜ 0.05).Compared with HSCs in DMSO group,the expression of miR-146a was significantly up-regulated in HSCs treated with 1,25 (OH) 2 D3;meanwhile,the cell viability was decreased and the apoptosis was increased (P all ＜ 0.05).In HSCs transfected with miR-146a mimic,the expression of miR-146a was up-regulated,the cell viability was decreased,and the apoptosis was increased similarly with HSCs in 1,25 (OH)2D3 group (P all ＜ 0.05).Conclusions:Regulation of miR-146a expression might be one of the important mechanisms of 1,25 (OH) 2 D3 in inhibiting TGF-β1-stimulated HSC activation and inducing apoptosis in HSCs.

Objective To investigate the expression of sialic acid-binding immunoglobulin-like-lectin-1 (Siglec-1)in the peripheral blood mononuclear cell (PBMC) of patients with autoimmune thyroiditis ( AIT) and its relationship with AIT. To explore the moduratory role of activated Siglec-1 on the differentiation of T cells and the promotion of in flammation after PBMC culture. Methods The peripheral whole blood and serum samples were collected from 30 AIT patients with normal thyroid function and 30 sex-and age-matched controls. The expression of sSiglec-1 in serum was detected by ELISA. The expression of Siglec-1 in PBMC was detected by RT-PCR and WB. The expression of Siglec-1 in CD14+ monocytes and the proportion of Th1 and Th17 cells in each group were detected by flow cytometry. The PBMC in AIT or control was stimulated with NaI in the presence or absence of LPS for 72 h. The expression of Siglec-1 in CD14+ monocytes and the proportion of Th1 and Th17 cells were detected by flow cytometry. Results sSiglec-1 in serum, Siglec-1 mRNA, and Siglec-1 protein in AIT patients'PBMC were higher than those in control group ( P＜0. 01). The expression of Siglec-1 in CD14+ monocytes by flow cytometry and differentiation of Th1 and Th17 cells were significantly higher than that in control group ( both P＜0. 01). The expression of Siglec-1 in control and AIT patients was up-regulated by 5×10-5 mmol/L to 1×10-2 mmol/L stimulated with NaI in the presence or absence of LPS for 72 h (P＜0.01), but the differentiation of Th1 and Th17 cells was up-regulated only in patients (P＜0.01), and in a dose-dependent manner. Conclusion Elevated Siglec-1 expression in PBMCs and monocytes can potentially serve as a biomarker for AIT. Iodine may affect Th1 and Th17 cell differentiation by activating Siglec-1 to adjust the AIT immune response.

Objective:To examine associations of sex hormone levels with bone turnover markers(BTMs) among men in the Northeast region of Henan Province.Methods:From December 2015 to March 2016, 707 male subjects were selected from a National Epidemiological Survey-2014(Thyroid Disorders, Iodine status and Diabetes, TIDE)research—Henan sub-center survey by using multistage stratified cluster random sampling. Fasting venous blood was collected to determine the levels of luteinizing hormone(LH), follicle stimulating hormone(FSH), estradiol(E 2), testosterone(T), dehydroepiandrosterone-sulfate (DHEAS), androstenedione(AD), sex hormone binding globulin(SHBG), dihydrotestosterone(DHT), free testosterone(FT), osteocalcin(OC), pro-collagen type 1 N-terminal propeptide(PINP), C-terminal-cross-linking telopeptide of type 1 collagen(β-CTX), 25-hydroxyvitamin D [25(OH)D], and parathyroid hormone(PTH). Results:A total of 697 men with an average age of(46.6±15.9)years were included in the study. Pearson correlation analysis showed that age was positively associated with LH, FSH, T, and SHBG, while negatively associated with E 2, DHEAS, AD, FT, β-CTX, OC, and PINP, without significant correlation with DHT, 25(OH)D, and PTH. Pearson correlation analysis and linear regression analysis showed that E 2 was negatively associated with β-CTX; T was positively associated with OC, FSH was negatively associated with OC; LH, FSH, and SHBG were negatively associated with PINP; E 2, T, FT, DHT, and AD were positively associated with PINP. After adjusting for age and BMI, linear regression analysis showed that T was still significantly positively associated with OC and PINP, with 0.302 ng/ml and 0.015 ng/ml increasing for OC and PINP every 1 ng/ml increase in T; E 2 and DHT were positively associated with PINP, with 0.250 and 0.047 ng/ml increasing for PINP every 1 pg/ml increase in E 2 and DHT. Conclusions:Age is an important factor influencing sex hormones and BTMs. Serum levels of T, E 2, and DHT are associated with bone formation and bone absorption markers.

BACKGROUND:The application of robot-assisted technology for total knee arthroplasty is one of the current research hotspots.Since the 1980s,robot-assisted technology has been introduced into total knee arthroplasty outside China to achieve accurate osteotomy and good recovery of lower limb alignment.After decades of use,the robot has continuously improved its performance with new iterations,but has been criticized for increasing perioperative time and surgical trauma. OBJECTIVE:To summarize the advantages and disadvantages of current orthopedic surgical robots in total knee arthroplasty. METHODS:PubMed database and CNKI were searched to analyze the advantages and disadvantages of robot-assisted total knee arthroplasty in surgical trauma.English search terms were"arthroplasty,replacement,knee,knee replacement arthroplasty,procedure,robotic surgical,total knee arthroplasty,arthroplasty,replacement,knee,robotic-assisted".The Chinese search terms were"robot-assisted,robotic arm,knee osteoarthritis,arthritis".After the initial screening of all articles according to the inclusion and exclusion criteria,62 articles with high quality and relevance were reviewed. RESULTS AND CONCLUSION:(1)Robot-assisted total knee arthroplasty did not increase the degree of surgical trauma in patients,and showed a lower trauma effect than conventional manual total knee arthroplasty.(2)Robot-assisted total knee arthroplasty has the advantages of accurate auxiliary osteotomy,individualized prosthesis implantation,better protection of soft tissue around the knee joint,reduction of analgesic drug use,reduction of postoperative inflammatory index changes,and shortening of hospital stay.However,there are also shortcomings such as prolonged operation time,increased complications,and increased medical costs.(3)It is concluded that preliminary clinical application studies have shown that robot-assisted total knee arthroplasty can reduce surgical trauma,but it is necessary to be alert to potential risks.Simultaneously,its exact advantages compared with conventional manual total knee arthroplasty need to be verified by large-sample randomized controlled studies and long-term follow-up.

Objective:To compare the early clinical outcomes between domestic robot-assisted total knee arthroplasty (RA-TKA) and conventional manual total knee arthroplasty (CM-TKA) for patients with primary knee osteoarthritis.Methods:Embase, Pubmed, Web of Science, Zhi.com and Wanfang databases from January 2015 to April 2023 were searched for clinical controlled trials (RCTs) comparing the clinical outcomes between RA-TKA and CM-TKA. After literature screening, quality evaluation and data extraction according to the criteria required, Revman 5.3 software was applied to perform a Meta-analysis of the literature data. The operation time, intraoperative bleeding, hip-knee-ankle angle (HKA), HKA bias value, frontal femoral component (FFC), frontal tibia component (FTC), lateral femoral component (LFC), lateral tibia component (LTC), Knee Society Score (KSS), visual analogue scale (VAS), Western Ontario and McMaster University Osteoarthritis Index (WOMAC), knee mobility, Hospital for Specialty Surgery (HSS) knee score, length of hospital stay, and rate of complications were compared between the RA-TKA and CM-TKA patients.Results:Eight RCTs and 449 patients were included, with 221 patients in the RA-TKA group and 228 ones in the CM-TKA group. The Meta-analysis showed that the RA-TKA group had significantly longer operation time ( MD=18.41, 95% CI: 11.28 to 25.23, P<0.001), significantly better HKA ( MD=0.41, 95% CI: 0.06 to 0.76, P=0.020), significantly better HKA bias value ( MD=-0.92, 95% CI: -1.25 to -0.60, P<0.001), significantly better FTC ( MD=0.38, 95% CI: 0.08 to 0.67, P=0.010), significantly better LTC ( MD=1.71, 95% CI: 0.94 to 2.48, P<0.001), and significantly better knee mobility ( MD=-2.23, 95% CI: -4.18~-0.27, P=0.030) than the CM-TKA group. However, the differences were not statistically significant between the 2 groups in the intraoperative bleeding, FFC, LFC, KSS, VAS, WOMAC, HSS, length of hospital stay, or rate of complications ( P>0.05). Conclusion:Use of a domestic robot to assist conventional manual TKA can significantly improve the accuracy of prosthesis fixation and reconstruct the alignment of lower limb better, showing potential advantages in promoting functional recovery of the knee for the patients.