BACKGROUND:Fibromyalgia syndrome,as a common rheumatic disease,is related to central sensitization and immune abnormalities.However,the specific mechanism has not been elucidated,and there is a lack of specific diagnostic markers.Exploring the possible pathogenesis of this disease has important clinical significance. OBJECTIVE:To screen the potential diagnostic marker genes of fibromyalgia syndrome and analyze the possible immune infiltration characteristics based on bioinformatics methods,such as weighted gene co-expression network analysis(WGCNA),and machine learning. METHODS:Gene expression profiles in peripheral serum of fibromyalgia syndrome patients and healthy controls were obtained from the gene expression omnibus(GEO)database.The differentially co-expressed genes were screened in the expression profile by differential analysis and WGCNA analysis.Least absolute shrinkage and selection operator(LASSO)and support vector machine-recursive feature elimination(SVM-RFE)machine learning algorithm were further used to identify hub biomarkers,and draw receiver operating characteristic curve(ROC)to evaluate the accuracy of diagnosing fibromyalgia syndrome.Finally,single sample gene set enrichment analysis(ssGSEA)and gene set enrichment analysis(GSEA)were used to evaluate the immune cell infiltration and pathway enrichment in patients with fibromyalgia syndrome. RESULTS AND CONCLUSION:Eight down-regulated differentially expressed genes(DEGs)were obtained after differential analysis of the GSE67311 dataset according to the conditions of log2|(FC)|>0 and P<0.05.After WGCNA analysis,497 genes were included in the module(MEdarkviolet)with the highest positive correlation(r=0.22,P=0.04),and 19 genes were included in the module(MEsalmon2)with the highest negative correlation(r=-0.41,P=6×10-5).After intersecting DEGs and the module genes of WGCNA,seven genes were obtained.Four genes were screened out by LASSO regression algorithm and five genes were screened out by SVM-RFE machine learning algorithm.After the intersection of the two,three core genes were identified,which were germinal center associated signaling and motility like,integrin beta-8,and carboxypeptidase A3.The areas under the ROC curve of the three core genes were 0.744,0.739,and 0.734,respectively,indicating that they have good diagnostic value and can be used as biomarkers for fibromyalgia syndrome.The results of immune infiltration analysis showed that memory B cells,CD56 bright NK cells,and mast cells were significantly down-regulated in patients with fibromyalgia syndrome compared with the control group(P<0.05),and were significantly positively correlated with the above three biomarkers(P<0.05).The enrichment analysis suggested that there were nine fibromyalgia syndrome enrichment pathways,mainly related to olfactory transduction pathway,neuroactive ligand-receptor interaction,and infection pathway.The above results showed that the occurrence and development of fibromyalgia syndrome are related to the involvement of multiple genes,abnormal immune regulation,and multiple pathways imbalance.However,the interactions between these genes and immune cells,as well as their relationships with various pathways need to be further investigated.

Dementia with Lewy bodies(DLB)is the second most common neurodegenerative dementia after Alzheimer's Disease(AD). This article will mainly elaborate the relationship between DLB and blood-brain barrier(BBB)from the following five aspects: (1)The structure and function of BBB; (2)In vivo assessment methods for the blood-brain barrier damage; (3)Evidence for the damage of blood-brain barrier in DLB; (4)The relationship between α-synuclein and the blood-brain barrier; (5)The relationship between APOE and the blood-brain barrier.Future research should focus on the pathogenesis of BBB damage in DLB patients, by which new drug targets for disease diagnosis and treatment may be found.

Objective:To evaluate the safety of diphtheria, tetanus and acellular pertussis (DTaP) containing combination vaccines used in Chengdu.Methods:The AEFI reports data of DTaP vaccine, DTaP-Haemophilus influenza type b combined vaccine (DTaP-Hib) and DTaP-inactivated poliovirus-Hib combined vaccine (DTaP-IPV-Hib) in Chengdu from 2015 to 2019 were collected through the national immunization management system. Description epidemiological method was used to analyze the data.Results:From 2015 to 2019, a total of 8 234 cases of AEFI of DTaP containing combination vaccines were reported in Chengdu, with a reported incidence of 194.55/100 000 doses, including 7 897 cases of common adverse reaction (168.59 per 100 000) and 234 cases of rare adverse reaction (5.53 per 100 000). The DTaP vaccine reported 4 240 cases AEFI (140.63 per 100 000), the DTaP-Hib vaccine reported 2 490 cases AEFI (399.09 per 100 000) and the DTaP-IPV-Hib vaccine reported 1 504 cases AEFI (253.49 per 100 000). All the three vaccines had the highest incidence for the booster doses; the rare adverse reaction were mainly Anaphylactic Reaction (6.27 per 100 000).Conclusions:The AEFI monitor system had high sensitivity, and the rare adverse reaction rate was extremely low, all the vaccines had good safety profiles. The Thrombocytopenic purpura and Laryngeal Edema should be paid more attention to.

Objective:To evaluate the safety of diphtheria, tetanus and acellular pertussis (DTaP) containing combination vaccines used in Chengdu.Methods:The AEFI reports data of DTaP vaccine, DTaP-Haemophilus influenza type b combined vaccine (DTaP-Hib) and DTaP-inactivated poliovirus-Hib combined vaccine (DTaP-IPV-Hib) in Chengdu from 2015 to 2019 were collected through the national immunization management system. Description epidemiological method was used to analyze the data.Results:From 2015 to 2019, a total of 8 234 cases of AEFI of DTaP containing combination vaccines were reported in Chengdu, with a reported incidence of 194.55/100 000 doses, including 7 897 cases of common adverse reaction (168.59 per 100 000) and 234 cases of rare adverse reaction (5.53 per 100 000). The DTaP vaccine reported 4 240 cases AEFI (140.63 per 100 000), the DTaP-Hib vaccine reported 2 490 cases AEFI (399.09 per 100 000) and the DTaP-IPV-Hib vaccine reported 1 504 cases AEFI (253.49 per 100 000). All the three vaccines had the highest incidence for the booster doses; the rare adverse reaction were mainly Anaphylactic Reaction (6.27 per 100 000).Conclusions:The AEFI monitor system had high sensitivity, and the rare adverse reaction rate was extremely low, all the vaccines had good safety profiles. The Thrombocytopenic purpura and Laryngeal Edema should be paid more attention to.

Objective To investigate the frequency and location of cerebral microbleeds(CMB) in dementia with Lewy bodies(DLB)versus in Alzheimer's disease(AD).Methods This retrospective study included three groups of probable AD patients (n =156),dementia with Lewy bodies (n =67) and normal controls(n=172).Frequencies and location of CMBs in the three groups were calculated and recorded.The foci of MRI signal for CMB were confirmed by two radiologists at moments of unknowingness about diagnosis.The correlations of cerebral small vessel disease and cerebral amyloid angiopathy with the development of cognitive decline in AD were analyzed.Results The incidence rate of CMBs was higher in patients with groups of DLB(22.4 ％,15/67) and AD(19.8 ％,31/156) than in normal controls (8.2 ％,14/172) (P =0.002 and 0.002),while there was no significant difference in incidence rate of CMBs between DLB and AD groups(P＞0.05).The MRI signal intensity of CMBs was the highest in the occipital lobe of the DLB group,and was higher in the deep temporal lobe or temporal lobe in the AD group.Conclusions The frequency of CMB is higher in patients with DLB or AD than in normal controls and there is no significant difference in frequency of CMB between DLB and AD groups,which suggests that the pathophysiological mechanisms of CMB may be similar between AD and DLB.

Objective: To investigate the prevalence of autonomic dysfunction and its influencing factors in the elderly in Jizhou community of Tianjin. Methods: By using a cross-sectional study, a questionnaire survey was conducted in the elderly in order to investigate the prevalence of autonomic dysfunction and its influencing factors. Results: A total of 1 292 elderly patients were enrolled.Of them, 196 cases had autonomic dysfunction(15.2%, 196/1 292). The main symptoms of autonomic dysfunction were frequent urination, urination urgency, urination incontinence(19.7%, 255/1 292)and constipation(15.9%, 205/1 292). Multivariate Logistic regression analysis showed that women(OR=1.808, 95%CI: 1.253~2.607), 75-85 years of age(OR=1.573, 95%CI: 1.109~2.232), general anesthesia history(OR=1.552, 95%CI: 1.044~2.307), sleep disorders(OR=2.906, 95%CI: 1.506~2.916), diabetes(OR=1.791, 95%CI: 1.197~2.678)and headache(OR=2.589, 95%CI: 1.482~4.520)were risk factors for autonomic dysfunction. Conclusions The prevalence of autonomic dysfunction is high in the elderly in Jizhou community of Tianjin city.It is necessary to pay great attention to potential risk factors of autonomic dysfunction in the elderly.And the autonomic dysfunction symptoms should be diagnosed and treated as early as possible.

Neurofibrillary tangle-predominant dementia(NFTPD)is one type of late-onset dementia, with memory disorders as the main clinical manifestation.The pathological feature is the presence of a large number of neurofibrillary tangle(NFT)in the hippocampus with no or little amyloid deposition in the brain.In recent years, primary age-related tauopathy(PART)has been proposed as a new pathological term, which means that NFT appears in the medial temporal lobe with aging, but no amyloid deposits, and NFTPD is one type of dementia associated with the progression of PART.

Objective: To determine the basal metabolic rate (BMR) of young adults aged between 20-29 years old in Changsha. Methods: We recruited volunteers to join in our research project from April to May, 2015. All recruited volunteers must meet the inclusion criteria: aged 20-29 years old, height between 164-180 centimeters in males and 154-167 centimeters in females, in good health condition, and with no habit of regular physical exercise in last year. Finally, 81 qualified volunteers were selected as research objects, including 43 males and 38 females. The BMR, resting lying metabolism rate and resting sitting metabolism rate of the subjects were detected, and the determined BMR was compared with the calculated results: from the adjusted Schofield equation. Results The BMR, resting lying metabolism rate and resting sitting metabolism rate among males were (166.10±22.09), (174.22±24.56), and (179.54±23.35) kJ·m^-2·h^-1, respectively, which were all higher than those among females were (137.70±20.04), (149.79±19.25), and (167.78±26.02) kJ·m^-2·h^-1, respectively, (P<0.001). The BMR of males and females calculated from the adjusted Schofield equation were (160.83±3.93), and (140.29±4.18) kJ·m^-2·h^-1, respectively, and there was no significantly statistical difference found between the determined BMR and the calculated results from Schofield equation (adjusted) classified by sex, all P values >0.05. Conclusion The BMR of young adults aged 20-29 years old in Changsha was in the national average level, and the adjusted Schofield equation displayed fine accuracy in predicting BMR of young adults aged 20-29 years old in Changsha.

Objective To study the association of metabolic syndrome (MS)with cardiovascular disease (CVD).Methods According to the diagnostiv criteria for MS,1457 MS patients as the research objects,who were screened out of the tangshian harbor economic development zone hospital.All patients were detected with waist circ-umference,seat systolic blood pressure(SBP),diastolic boold pressure(DBP),fasting Plasma glucose(FPG),total cholesterol(TC),low -density lipoprotein cholesterol(LDL -C),high density lipoprotein cholesterol(HDL -C),tri-glyceride(TG).By 3 years follow -up and the carotid ultrasound detection of carotid intima -media thickness(IMT), all the patients were divided into three groups according to the diagnosis:event group (Coronary heart disease +Hypertensive heart disease,stroke,Coronary heart disease +Hypertensive heart disease +stroke)and control group. Results The patients′SBP[(145.5 ±15.7)mmHg,(149.9 ±13.8)mmHg,(156.3 ±14.6)mmHg],DBP [(92.5 ±8.7)mmHg,(97.9 ±9.0)mmHg,(101.0 ±10.0)mmHg],FPG[(6.3 ±2.6)mmol/L,(6.0 ± 2.5)mmol/L,(6.9 ±2.6)mmol/L],TC[(5.46 ±1.28)mmol/L,(5.10 ±1.15)mmol/L,(5.37 ±1.21)mmol/L], LDL -C[(3.40 ±0.75)mmol/L,(3.08 ±0.65)mmol/L,(3.24 ±0.72)mmol/L],TG[(3.44 ±1.60)mmol/L, (3.31 ±1.52)mmol/L,(3.38 ±1.58)mmol/L]of the event group were significantly higher than the control group [(139.2 ±17.4)mmHg,(85.6 ±9.1 )mmHg,(5.5 ±2.1 )mmol/L,(1.4 ±0.4 )mmol/L,(2.59 ± 0.64)mmol/L,(2.61 ±1.28)mmol/L]and HDL -C[(1.13 ±0.38)mmol/L,(1.2 ±0.4)mmol/L,(0.9 ± 0.23)mmol/L]was significantly lower than the control group[(1.4 ±0.4)mmol/L](P <0.05).Detection rates of all the event groups were significantly higher in age[(53.4 ±6.4)years,(54.6 ±6.6)years,56.3 ±6.8)years], hypertensive heart disease(67.8%,74.8%,88.0%),high blood sugar(46.7%,42.9%,49.7%),and carotid atherosvletosis (19.9%,18.9%,29.3%)than the control group[(47.2 ±6.5)years,47.2%,24.3%,5%)](P <0.05).Conclusion There was a correlation between Mdtabolic syndrome and Cardiovascular disease.

Chemotherapy remains the main treatment for many cancer patients. However, P-glycoprotein (P-gp) mediated multidrug resistance poses severe challenges to current chemotherapies. As ideal vectors to overcome drug resistance, nanovehicles are extensively explored for cancer treatment by diverting P-gp mediated drug efflux mechanisms. Surface engineering of nanocarriers has attracted great attention for targeted therapeutic delivery. The folate receptors, one of the most researched targets in cancer therapeutics, are over-expressed in several carcinomas. And folate has become one of the most investigated ligands in cancer therapeutic direction due to its small size, easy conjugation to nanocarriers, nontoxic, nonimmunogenic nature, and well stability in storage or in circulation. This review discussed the current status of folate functionalized nanoparticles in diverting P-gp mediated drug efflux mechanisms.