High mobility group box-B1 (HMGB1)is a non histone DNA-binding protein and extracellular molecule related to damage.Normally it is located inside the cell and exerts a variety of biological effects. It has been demonstrated that the expression of HMGB1 presents in almost all gastrointestinal tumors and is closely correlated with the cell growth, proliferation, invasion and metastasis of gastrointestinal tumors. It has been discovered that HMGB1 inhibitor inhibits growth and metastasis of gastrointestinal tumors, which might become a new approach to the treatment of gastrointestinal tumors.

Objective To analysis of clinical symptoms and influencing factors of anti-platelet aggregation drugs in patients with upper gastrointestinal bleeding.Methods Using the research methods of retrospective analysis, collected 110 cases of gastrointestinal bleeding patients from June 2012 to June 2015 into the first affiliated hospital of xiamen university,and divided into two groups,the control group,79 patients were treated without antiplatelet aggregation drugs,the experimental group,31 patients were treated with single antiplatelet aggregation drug.observed the degree of gastrointestinal bleeding,the mode of bleeding, and the characteristics of endoscopic findings between two groups,according to the age,INR, and the type of drug taken, the clinical symptoms and influencing factors of the patients were analyzed further.Results The rate of gastrointestinal bleeding was significantly higher in the experimental group than in the control group(P<0.05).The older the patient,the higher rate of gastrointestinal bleeding,the main manifestations were gastritis or ulcers in endoscopy,patients with INR>3 had a significantly higher rate of gastrointestinal bleeding than patients with INR<3.Conclusion Anti-platelet aggregation drugs can significantly increase the chance of serious bleeding in the digestive tract,the patient's age, INR value and the type of medication can affect the incidence of gastrointestinal bleeding;long-term use of these drugs lead the most serious impact on the duodenum, can lead to the site intestinal mucosa damage,with the increasing age of patients,adverse reactions of the digestive tract increased.

Purpose The diagnosis of adult onset Still's disease (AOSD) is usually difficult due to the lack of specific clinical manifestation.This paper summarizes the manifestations of 18F-FDG PET/CT in adult onset Still's disease and investigates the value of PET/CT in diagnosis and differential diagnosis of AOSD.Materials and Methods Fiftyfour patients who was diagnosed as AOSD were selected and underwent 1 8F-fluorodeoxyglueosepositron emission tomography/computed tomography (18F-FDG PET/CT).The clinical features,laboratory examination and the maximum standard uptake value (SUVmax) of liver,spleen,bone marrow,lymph node were collected.Then the main PET/CT manifestations of patients with AOSD,the influence factor of SUVmax and correlation between SUVmax and laboratory indexes were analyzed.Results FDG accumulation occurred mainly in bone marrow (88.89％;SUVmax:3.91 ± 1.16),spleen (79.63％,SUVmax:3.24±0.89) and lymph node (77.78％;SUVmax:3.83± 1.97).FDG accumulation can also occurred in joints,parotid gland,submandibular gland,pleural and other organs.Compared with the nonglucocorticoid group,SUVmax of the spleen,bone marrow and lymph node were significantly decreased in the glucocorticoid group with or without fever (P＜0.05),whereas the SUVmax of liver,spleen,bone marrow and lymph node between the two glucocorticoid groups were not statistically different (P＞0.05).The SUVmax of liver,spleen,bone marrow and lymph node between two groups with or without disease-modifying anti-rheumatic drugs were not statistically different (P＞0.05).Correlation analysis showed that spleen SUVmax and lactate dehydrogenase,bone marrow SUVmax and C reactive protein were weakly correlated (r=0.33 and 0.30,P＜0.05).Conclusion The main manifestations of 18F-FDG PET/CT of AOSD are FDG accumulation in spleen,bone marrow and lymph nodes.Glucocorticoid can reduce the SUVmax.18F-FDG PET/CT can help to rule out malignancy,guide biopsy and assist in definite diagnosis of AOSD.

Objective To explore the distinctive ultrasonographic characters of enthesitis in patients with spondyloarthritis (SpA) and evaluate the diagnostic value of ultrasonography in SpA by comparing ultrasonography of enthesis in the lower limbs of patients with SpA,rheumatoid arthritis (RA) and osteoarthritis(OA).Methods Entheses in the lower limbs (quadriceps tendon,proximal patellar ligament,distal patellar ligament,achilles tendon and plantar aponeurosis) were detected in SpA,RA,OA patients and health controls by ultrasonographic examination.Results A total of 46 SpA,23 RA and 12 OA patients were enrolled in this study,with 26 SpA and 7 RA patients complaining of heel pain(P ＜0.05).There were 126 enthesal sites(126/460,27.2％) were detected abnormal in SpA group,compared with 54 of 230 (23.5 ％) sites in RA group and 27 of 120 (22.5 ％) sites in OA group (P ＞ 0.05).Sixty five (70.7 ％) sites of the distal patellar ligaments were abnormal in SpA group,while that were 19(41.3％)in RA group(P ＜ 0.05)and 13 (54.2％)in OA group.Twenty six sites of tendon thickness and 22 sites of bone erosion in the distal patellar ligaments were found in SpA group,while only one site of each in RA group(P ＜ 0.05) and 4 sites of tendon thickness in OA group (P ＜ 0.05) were found.Tendon thickness,bursal synovitis and bone erosion coexisting in one distal patellar ligament indicated SpA,the sensitivity,specificity and the area under the curve (AUC) of which were 70.7％,65.5％ and 0.740,respectively.Conclusion Tendon thickness and bone erosion of entheses were more likely the distinctive ultrasonographic characters of enthesitis in SpA patients.Tendon thickness,bursal synovitis and bone erosion in the distal patellar ligament could be an ideal tool for SpA diagnosis.

To investigate the effects of oxymatrine injection (OI) combined with low-dose paclitaxel on expressions of mRNAs and proteins of vascular endothelial growth factor (VEGF) and CXC chemokine receptor 4 (CXCR4) in human gastric carcinoma SGC-7901 cells.

Objective To investigate mutation patterns in core promoter(CP)region of hepatitis B virus(HBV).Methods HBV DNA was extracted from sera of patients with chronic HBV infection.The CP sequence was amplified by polymerase chain reaction(PCR)and cloned into pMD19 T vector.The positive clones were then sequenced.The sequences were compared with known HBV genome in GenBank to identify the mutation sites and patterns of patients with chronic HBV infection.Results There were 74 clones from 21 patients with chronic HBV infection which were sequenced.The sequence comparisons showed that there was a 234-nucleotide deletion in CP region of HBV genome in 54 clones and a 245-nucleotide deletion in one clone.These deletion regions included CP,HBeAg initiation codon and direct repeat sequence(DR)Ⅰ regions,which named CP deletion(CPD).A1585T replacement mutation was also found in HBV strain with CPD,which indicated that there was linkage between these two mutations.Conclusions A novel mechanism of HBeAg negative chronic hepatitis B is observed,which includes deletions of CP and HBeAg initiation codon.Meanwhile,a simple and useful PCR method is developed to detect CPD.

Objective To evaluate the outcome of posterior screw-rod fixation system in reduction and internal fixation of atlantoaxial dislocation. Methods A retrospective study was done on 27 patients with atlantoaxial instability including 18 male and 9 female (at age range of 13-51 years, mean 31 years) from January 2007 to May 2009. There were 11 patients with chronic odontoid fractures, five with isolated bone odontoid, seven with transverse ligament rupture of atlas and four with rheumatoid arthritis. Skeletal reduction was performed in all the patients. The anterior atlantodens interval (ADI)ranged from 8 mm to 15 mm, average 11 mm. All the patients underwent an intraoperative reduction by posterior C1 lateral mass and C2 pedicle screws with rod fixation. According to American Spine Injury Association (ASIA) impairment scale, there were eight patients at grade B, 15 at grade C and four at grade D. Results All patients were followed up for 6-24 months (average 13 months), which showed that the neck symptoms were improved, with bony union. The ADI was reduced to 2-4 mm (average 2.8 mm)postoperatively. Postoperative ASIA scale was grade C in four patients, grade D in 12 and grade E in 11.There were no neurologic or vascular complications occurred, or no failure of the internal fixtors, pseudarthrosis or instability. Conclusion Posterior screw-rod fixation system has advantages of simple procedures, few complications and good results and can be used for intraoperative reduction of atlantoaxial dislocation.

Objective To study the characteristics of work disability and its influencing factors in patients with ankylosing spondylitis (AS). Methods The demographic data, work conditons and disease related characteristics of 277 patients with AS were recorded, and randomly selected from the Department of Rheumatology, Chinese PLA General Hospital from November 2014 to January 2016. Work and productivity activity impair-ment questionnaire (WPAI) was used to survey the work disability and productivity loss, then explore its in-fluencing factors and the relationships between patient-reported outcomes and WPAI scores. Logistic regression was used to analyze the associated factors of work disability. Multivariate linear regression was used to analyze the predictive factors of lose of work productivity. Results The prevalence of work disability was 30.3%. Twenty patients were unemployed because of working disability. Two hudreds patients were employed, with average 36.5 (24.0, 50.0) hours workingtime in the past week. Average AS related absenteeism was 4.4 (0, 10) hour. Average workproductivity loss was 26.4%(2.5%, 40.0%). Logistic multiple regression analysis showed that Bath AS disease activity index (BASDAI), SF-36 physical component summary (PCS) scores might be the important influencing factors among those clinical measures ( OR=1.270, 0.959). Presenteeism and overall work impairment were moderately correlated with patients' global assessment of disease activity (VAS), BASDAI, bath AS functional index (BASFI), SF-36 physical Functioning (PF), SF-36 body pain (BP) and SF-36 Physical Component Summary (PCS) (|r|=0.539-0.648). Linear multivariate analyses indicated that work presente-eismand absenteeismwere significantly associated with BASDAI (P<0.01). Conclusion High prevalence of work disability in patients with AS is noted, which is closely related with disease activity and body function;High attention should be paid to AS patients with work disability.

Objective To understand the prevalence and the factors associated with depression and anxiety among patients attending the community-based methadone maintenance treatment(MMT) program.Methods 9 MMT clinics in 3 provinces were randomly selected,in which 1 301 MMT patients who met the criteria of recruitment were all interviewed.A cross-sectional study by administrative questionnaire was employed to investigate the demographics,drug abuse and MMT treatment status of the respondents.The 1301 respondents were also evaluated for depression and anxiety by SDS(Self-Rating Depression Scale) and SAS(Self-Rating Anxiety Scale) respectively.ANOVA and multivariate linear regressions analysis was used to verify the factors associated with depression and anxiety respectively.Results The prevalence of depression and anxiety among the MMT patients were 38.3%(498/1 301) and 18.4%(239/1 301).The multivariates linear regression analysis indicated that at the level of ?=0.05,gender,employment status were associated with depression,while gender,employnment status,educational level,drug abuse and methadone daily dosage were associated with anxiety.Conclusions There are certain proportions of MMT clients who suffer from depression and anxiety.The MMT clinic staff should put more emphasis on the efforts to reduce psychological disorders and its potential risks by enhancing psychological councelling,intervention and social support towards the MMT patients.

Alphapapillomavirus ; Humans ; Lupus Erythematosus, Systemic ; Papillomavirus Infections/prevention & control* ; Vaccination