Objective To discuss the methods and clinical effects of phased treatment of ankylosing spondylitis (AS) combined with severe hip flexion contracture.Methods The study enrolled 8 cases (12 hips) of AS combined with severe hip flexion contracture hospitalized from September 2011 to November 2012.Phased treatments included lateral hip arthrolysis,articular capsulectomy,stripping of the reflected head of rectus femoris,femoral neck osteotomy,traction and stage Ⅱ biotype total hip arthroplasty (THA).Preoperative and postoperative Harris score,hip range of motion,and complication of femoral nerve injury were detected.Results Period of follow-up was 6-12 months (mean 10 months).One case developed heterotopic ossification,which affected postoperative hip activity and received resection one year later.One case sustained fissure fracture of calcar femorale during implantation of the prosthetic femoral stem,but no special handling was provided.Of all cases,active flexion and extension of the hip were both 0° before operation,but increased to (96.25 ± 4.33) ° and (24.17 ± 4.69)° respectively after operation ; mean Harris score was improved from (26.67 ± 2.39) points preoperatively to (90.92 ± 5.66) points postoperatively (P ＜ 0.01).Besides,no femoral nerve injury was observed.Conclusion Phased treatment of AS combined with severe hip flexion contracture restores hip function and minimizes femoral nerve injury following THA.

OBJECTIVETo test whether the diphtheria toxin A (DT-A) chain coding sequence linked to murine immunoglobulin Kappa light chain (IgKappa) promoter and enhancer have selective cytocidal effects on IgKappa producing cells.

METHODSThe diphtheria toxin A gene or beta galactosidase (beta-gal) gene were linked to a murine IgKappa promoter and enhancer to construct pcDNA3IgKappaDTA or pcDNA3IgKappaLacZ plasmids. These plasmids were transfected into IgKappa producing or non-producing cells by the liposome coated DNA method. Expression of beta-gal activity and effects on cell growth of transfected cells were assessed.

RESULTSThe beta-gal gene, under the control of cytomegalovirus (CMV) promoter, can express in all cell lines. Expression of beta-gal under the control of the IgKappa promoter was detected only in the IgKappa producing cell line, CA46. Expression of beta-gal was greatly suppressed when cotransfected with pcDNA3IgKappaDTA in CA46 cells. Cell growth of CA46 cells transfected with pcDNA3IgKappaDTA plasmid was significantly inhibited compared with CA46 cells transfected with pcDNA3IgKappaLacZ.

CONCLUSIONSelective killing of IgKappa producing cells can be attained by introducing the diphtheria toxin A gene under the control of IgKappa promoter and enhancer.

Diphtheria Toxin ; genetics ; Enhancer Elements, Genetic ; Genes, Immunoglobulin ; Genetic Therapy ; methods ; Humans ; Immunoglobulin kappa-Chains ; genetics ; Neoplasms ; therapy ; Peptide Fragments ; genetics ; Promoter Regions, Genetic ; Tumor Cells, Cultured

Objective To study the best protecting dosage of phycocyanin on PC12 cells after anoxia/re-oxygen in vitro.Methods The anoxia/re-oxygen cell models were established with cultured PC12 cells and treated by phycocyanin.The absorbency of PC12 cells was determined by MTT method to observe the activity and number of PC12 cells after anoxia/re-oxygen.The fluorescent intensity in PC12 cells labeled by Rhodamine123 was measured with laser scanning confocal microscope to observe the mitochondrial membrane potential after anoxia/re-oxygen.Results After anoxia/re-oxygen,the absorbency and fluorescent intensity in PC12 cells were significantly lower than those in control group.After treatment with phycocyanin,the absorbency of PC12 cell in test groups was higher than that in model group,especially in 5?g?mL-1 subgroup,P

Objective To propose an improved discrete wavelet transform (DWT ) and to apply it in multimodal medical im‐age fusion .Methods Firstly ,the source medical images were initially transformed into the high frequency and low frequency images by DWT ;then the high frequency part adopted the big direction absolute values ,which effectively preserved the detailed informa‐tion of image ,while the low frequency part used the fusion rule of local energy ratio for preserving the most of image information ;finally ,the discrete wavelet reverse transform was used for reconstructing the fusion sub‐images into fusion image .Results By comparing the fusion images by 3 groups of medical images ,this proposed algorithm was superior to other existing algorithms in the aspects of subjective visual effect and objective evaluation indicators .Conclusion The proposed algorithm of medical image fusion is rapid and accurate ,has excellent performance in the noise environment and clinical examples ,can obtain the high quality fusion im‐age and has higher clinical application value .

Objective:To analyze the clinical features and prognosis of lymphoma patients with monoclonal immunoglobulin (McIg).Methods:The data of 14 patients who were pathologically diagnosed as lymphoma and with McIg in the First Affiliated Hospital of Fujian Medical University from January 2014 to January 2019 were retrospective analyzed. At the same time, 40 lymphoma patients without McIg were sellected as controls. The patients'age, gender, international prognostic index (IPI) score, B symptoms, tumor cell source and Ki-67 index were analyzed by prognostic single factor analysis. Kaplan-Meier method was used for survival analysis, and the overall survival (OS) and progression-free survival (PFS) were compared between the two groups.Results:Among 14 lymphoma patients with McIg, 6 were males and 8 were females. The median age of onset was 63 years (42-78 years). There were 13 cases of clinical stage Ⅲ-Ⅳ, and 12 cases of extranodal disease. The most common type was IgM-κ. The results of univariate analysis showed that IPI score≥3 points and elevated D-dimer level were related to poor prognosis (both P < 0.05). At the end of follow-up, the median OS time of lymphoma patients with McIg had not reached, the 2-year OS rate was 64.3%, and the median PFS time was 16 months; the median OS time of lymphoma patients without McIg had not reached, the 2-year OS rate was 90.8%, and the median PFS time was 37 months; the difference of OS between the two groups was statistically significant ( P = 0.040). Conclusions:Most lymphoma patients with McIg have extranodal involvement, the clinical stage is more inclined to stage Ⅲ-Ⅳ, IPI score ≥3 points and elevated D-dimer level are poor prognostic factors. The secretion of McIg is an important factor for the poor prognosis of patients with lymphoma.

Objective: To explore the mutations of vitamin D receptor (VDR) gene in patients with multiple myeloma (MM). Methods: Polymerase chain reaction (PCR) and direct DNA sequencing were used to detect the mutations of VDR gene(loci Fok Ⅰ, Bsm Ⅰ, Apa Ⅰ, Taq Ⅰ) in forty MM cases and 84 healthy control subjects. Results: A synonymous mutation (ATC→ATA , both encode isoleucine) at cDNA codon1421 of VDR gene was found in one MM patients, which correlated to a better therapeutic response. Rare Bsm Ⅰ AA genotype and Taq Ⅰ CC genotype were detected in a MM patient, which might be related to the relapsing and refracfory disease. Meanwhile, a rare allele(rs201747972, global MAF: A=0.0005/1), was found in another MM patient, which might be related to MM cell lines of two origins. rs11574113 G>C, rs2229829 C>A and rs201747972 C>T polymorphic loci(the same as Fok Ⅰ, Bsm Ⅰ, Apa Ⅰ and Taq Ⅰ) were found in a MM patient, which were associated with nonsense-mediated mRNA decay(NMD), contributing to the onset of MM. Conclusions A new synonymous mutation, rare genotype, rare allele and new SNP are found in this study. These data enrich the genetic information of MM in China, and are helpful for the further research on MM pathogenesis.

Objective This meta-analysis was performed to analyze the effect ot preserving the native aortic valve on short-and long-term prognosis post aortic root reconstruction surgery for patients with Marfan syndrome.Methods Database including Pubmed,Embase,Cochrane library,CNKI,Wanfang,VIP and CBM were searched to collect studies comparing clinical results of valve sparing surgery with composite valve graft surgery for patients with Marfan syndrome.Study quality was assessed by Newcastle-Ottawa Scale and publication bias was assessed by visual inspection of the funnel plot together with Egger test.Clinical outcomes data was extracted from the manuscripts and analyzed with Revman 5.0 supplied by Cochrane collaboration.Results Seven clinical trials with 690 patients were included.Meta-analysis demonstrated that valve sparing surgery was associated with a lower incidence of re-exploration(RR =0.51,95％ CI:0.29-0.90,P ＜ 0.05),thromboembolism (RR =0.17,95 ％ CI:0.05-0.57,P ＜ 0.01),endocarditis (RR =0.31,95 ％ CI:0.11-0.94,P ＜ 0.05) and significantly lower long-term death rate (RR =0.37,95 ％ CI:0.18-0.74,P ＜ 0.01).Reoperation rate was similar between the two groups(RR =1.07,95％ CI:0.35-3.27,P ＞ 0.05).Conclusion Valve sparing aortic root reconstruction surgery is a superior procedure to composite valve graft surgery in term of improving the short-and long-term prognosis for patients with Marfan syndrome.

Objective:To explore the changes in cardiac rehabilitation information needs of patients undergoing cryobaiioon ablation (CBA) for atrial fibrillation, analyze the influencing factors of different trajectory categories, so as to provide reference for rehabilitation guidance.Methods:From January 2022 to April 2023, convenience sampling was used to select patients who were planning to undergo CBA in the Cardiovascular Department at the First Affiliated Hospital of Xi'an Jiaotong University as participants. Patients were surveyed using the Information Needs in Cardiac Rehabilitation Scale at one day before surgery (T0), one month after surgery (T1), three months after surgery (T2), and six months after surgery (T3) .Results:A total of 257 questionnaires were distributed, and 218 valid questionnaires were collected. The total scores of the Information Needs in Cardiac Rehabilitation Scale for 218 patients at T0, T1, T2, and T3 were (187.86±35.28), (183.27±34.98), (174.03±34.01), and (167.35±33.96), respectively. There was a statistically significant difference in the total scores of the Information Needs in Cardiac Rehabilitation Scale among 218 patients at different time points ( F=18.237, P<0.01). Four potential trajectory categories were fitted, namely the sustained medium high need group (40.83%, 89/218), the medium high need-decline group (36.70%, 80/218), the medium low need-improvement group (7.34%, 16/218), and the medium low need-decline group (15.14%, 33/218). Age, whether to merge underlying chronic diseases, place of residence, social support, and postoperative complications were potential trajectory factors affecting the cardiac rehabilitation information needs of atrial fibrillation patients ( P<0.05) . Conclusions:Medical and nursing staff should assess the development trajectory of patients' cardiac rehabilitation information needs as early as possible, emphasize the importance of cardiac rehabilitation, establish remote and controllable cardiac rehabilitation programs, encourage rural residents to participate in local community related cardiac rehabilitation activities, mobilize patients' social support resources, and improve their needs and compliance with cardiac rehabilitation.

Objective:In order to understand the difference of clinical efficacy between original TNF-α inhibitors (TNFi) and their biosimilars, Bayesian mesh Meta-analysis was compare Etanercept, Infliximab, Adalimumab with their biosimilars in the treatment of ankylosing spondylitis (AS).Methods:A systematic literature search was performed, using Ovid Biomedical, Embase, Cochrane Library, CNKI, Wanfang Database and Weipu Database (up to March 8, 2023 for all resources above), to search publications of randomized controlled trial (RCT) about all original and biosimilar TNFi for the treatment of AS in all language. Two reviewers independently identified the eligible trails, evaluated bias risk and extracted relevant data. Based on Bayesian network, data analysis of included studies was conducted using statistical software R3.6.1 and R Studio.Results:The results of the network meta-analysis showed that, no significant differences was observed among. Etanercept, Infliximab,Adalimumab, and their biosimilars for ASAS20 when Infliximab was compared with Etanercept [ OR (95% CI)=1.4 (0.54, 3.5)], placebo was compared with Etanercept [ OR (95% CI)=0.35 (0.17,0.67)], No significant differences were observed among Etanercept, Infliximab, Adalimumab, and their biosimilars for BASDAI, when Infliximab was compared with Ctanercept [ OR (95% CI)=-0.89 (-1.8, 0.081)], placebo was compared with Etanercept [ OR(95% CI)=1.7(0.86, 2.5)], No significant differences were observed among Etanercept, Infliximab, Adalimumab, and their biosimilars for BASFI, when Infliximab was compared with Etanercept [ OR(95% CI)=-0.46(-1.3, 0.47)], placebo was compared with Etanercept [ OR(95% CI)=1.6(0.8, 2.3)]. Conclusion:Etanercept, Infliximab, Adalimumab with their biosimilars are significantly superior to placebo and sulfasalazine in terms of ASAS20, BASDAI, BASFI, CRP, ESR. Limited evidence have shown that the efficacy of biological biosimilars are similar to that of their corresponding original drugs.

A series of 2-(((5-akly/aryl-1-pyrazol-3-yl)methyl)thio)-5-alkyl-6-(cyclohexylmethyl)-pyrimidin-4(3)-ones were synthesized and their anti-HIV-1 activities were evaluated. Most of these compounds were highly active against wild-type (WT) HIV-1 strain (IIIB) with EC values in the range of 0.0038-0.4759 μmol/L. Among those compounds, had an EC value of 3.8 nmol/L and SI (selectivity index) of up to 25,468 indicating excellent activity against WT HIV-1. anti-HIV-1 activity and resistance profile studies suggested that compounds and displayed potential anti-HIV-1 activity against laboratory adapted strains and primary isolated strains including different subtypes and tropism strains (ECs range from 4.3 to 63.6 nmol/L and 18.9-219.3 nmol/L, respectively). On the other hand, it was observed that those two compounds were less effective with EC values of 2.77 and 4.87 μmol/L for HIV-1A (K103N + Y181C). The activity against reverse transcriptase (RT) was also evaluated for those compounds. Both and obtained sub-micromolar IC values showing their potential in RT inhibition. The pharmacokinetics examination in rats indicated that compound has acceptable pharmacokinetic properties and bioavailability. Preliminary structure-activity relationships and molecular modeling studies were also discussed.