Objective To explore the correlation between Th1,Th2,Th17,and Treg cells differentiation and related cytokines in patients with rheumatoid arthritis (RA).Methods Seventy-one patients with active RA were enrolled in this study.They were divided into low,moderate and high disease activity groups according to disease activity score (DAS28).The frequencies of Th1,Th2,Th17,and Treg cells in the peripheral blood of RA patients group (n=71) and healthy conlrol group (n=18) were determined by flow cytometry.T test was used for statistical analysis.Results Significant difference could be detected between the proportions of Th1 [ (6.2±4.5)％],Th17 [ (1.1±0.9)％] and Treg [(1.8±1.2)％] cells in the peripheral blood of RA patients and the control group (P＜0.05),and there was correlation between proportions of these three kinds of cell and the DAS28.Conclusion Th1 and Th 17 cells may promote the development of RA disease,but Th2 and Treg cells could prevent further development of RA disease.

OBJECTIVE:To investigate the association of Cytochrome P4503A family polypeptide 5 [(CYP)3A5] and IL-10 poly-morphisms with the concentration/dose(C/D) ratio of tacrolimus in lung transplantation recipients. METHODS:CYP3A5 polymor-phisms at rs774746 and IL-10 polymorphisms at rs1800896 from peripheral blood cell of 51 lung transplant recipients was detected by Se-quenom MassArray iPLEX GOLD system. The relationship between gene polymorphism and tacrolimus C/D ratio was analyzed. RE-SULTS:The tacrolimus C/D ratio of the recipients who carried CYP3A5 rs776746 GG genotype were higher than those with AA+GG genotype,with statistical significance(P<0.01). The tacrolimus C/D ratio of the recipients who carried IL-10 rs1800896 AA genotype were higher than those with AG genotype during 1 week and 2 weeks after transplantation,with statistical significance(P<0.05). Com-bined analysis of these two genes,the tacrolimus C/D ratio of the recipients who carried more fast metabolic alleles were higher than those who didn't carry fast metabolic alleles,with statistical significance(P<0.01). CONCLUSIONS:Determination of recipients CYP3A5 at rs 776746and IL-10 at rs800896 genotype may be performed prospectively to help individualizing tacrolimus dose regimen.

Objective To investigate the relationship between spina bifida occulta in lumbasacral portion and functional defe-cation abnormality among middle-aged and elderly people.Methods The cross-sectional and cluster random sampling survey meth-od was adopted to select the residents aged 45-90 years old in 7 communities of Zhengzhou City as the respondents.All respond-ents underwent the physical examination and lumbosacral digital radiography(DR)examination in the physical examination center of the First Affiliated Hospital of Zhengzhou University,and filled the related questionnaire about defecation abnormality.The rela-tionship between SBO and functional defecation abnormality among middle-aged and elderly people was studied by diagnosing and analyzing the functional constipation(FC)and functional incontinence(FC).Results The effective sample amounts were 1 057 ca-ses,including 497 males and 560 females,167 cases of SBO(86 males and 81 females).The morbidity rate of functional defecation abnormality was 26.02%(275/1 057),23.34%(116/497)in males and 28.39%(159/560)in females.Among 275 cases of functional defecation abnormality,there were 72 cases of complicating SBO.The Logistic regression analysis results showed that age,SOB,physical activity status,diet and living habits,education level and psychological factors were the risk factors for functional defecation abnormality (P<0.05),while there was no relationship between between past-history of stroke and functional defecation abnormality(P>0.05).Con-clusion SBO may be one of risk factors for functional defecation abnormality among middle-aged and elderly people.

Objective:To explore the effect of potentially inappropriate medication (PIM) on frailty among community-dwelling elderly patients with mild cognitive impairment (MCI).Methods:From March to July 2021, a total of 252 elderly patients with MCI in Hefei community were selected.The data of basic information and PIM of subjects were collected.All subjects were assessed by the comprehensive frailty assessment instrument (CFAI), Montreal cognitive assessment scale-basic (MoCA-B), and the Barthel index (BI). The subjects were divided into PIM group ( n=136) and non-PIM group ( n=94) according to whether there was PIM.Taking the confounding factors as the matching condition, the subjects of the two groups were matched with 1∶1 propensity score.After matching, there were 52 in the PIM group and 52 in the non-PIM group.SPSS 23.0 was used for data analysis.Multivariate Logistic regression analysis was performed to analyze the effect of PIM on frailty of subjects. Results:(1)Before matching, the incidence of frailty in PIM group and non-PIM group were 80.9% and 19.1%, respectively, with statistically significant differences ( P<0.01). Logistic regression analysis revealed that PIM was a risk factor for the frailty ( β=1.704, OR=5.495, 95% CI=2.539-11.892). (2)After matching, the confounders of age, hearing status, chewing function, activities of daily living, Charlson comorbidity index, handgrip strength, and cognitive function were balanced and comparable between the two groups.The incidence of frailty in PIM group and non-PIM group were 67.9% and 32.1%, respectively.The differences remained statistically significant ( P<0.01). PIM remained a risk factor for frailty ( β=1.791, OR=5.998, 95% CI=2.393-15.032). Conclusion:PIM is a risk factor for the occurrence of frailty in elderly patients with MCI.Therefore, the accurate screening and standardized management of PIM will provide a new target for the frailty management of elderly patients with MCI.

Objective To explore the molecular mechanism of luteolin in the treatment of cervi-cal cancer based on network pharmacology and molecular docking technology.Methods The drug-like properties of luteolin were analyzed by the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform(TCMSP).The targets of luteolin were obtained from PharmMapper,Super-PRED,and Swiss Target Prediction databases.The targets related to cervical cancer were ac-quired from GeneCards,OMIM,and PharmGKB databases.The intersection targets of luteolin and cervical cancer were obtained through EVenn,and the"luteolin-intersection targets-cervical cancer"network diagram was constructed by Cytoscape 3.8.1.The STRING database was used to analyze the protein-protein interaction(PPI)network of intersection targets and screen the core targets.The Da-tabase for Annotation,Visualization and Integrated Discovery(David)was used to conduct Gene On-tology(GO)gene function analysis and Kyoto Encyclopedia of Genes and Genomes(KEGG)signa-ling pathway enrichment analysis of the targets.PyMoL 2.6.0,AutoDockTool 1.5.7 and OpenBabel 2.4.1 software were used to perform molecular docking between the core targets and luteolin.The survival analysis and pan-cancer analysis of the core targets were performed in the GEPIA database.Results A total of 449 targets of luteolin and 1 334 targets related to cervical cancer were ob-tained;there were 100 intersection targets between luteolin and cervical cancer,of which 24 were core targets,including MMP2,HRAS,MAPK1,AKT1,RHOA and PGR.GO and KEGG enrich-ment analyses revealed that the intersection targets participated in 455 biological processes,70 cel-lular components,119 molecular functions,and 143 KEGG signaling pathways.Molecular docking revealed a good binding of MMP2 with luteolin.The survival curves of cervical cancer patients showed that the risk ratios of RHOA,MAPK1,MMP2 and AKT1 genes were greater than 1,while those of HRAS and PGR were less than 1.Pan-cancer analysis showed that HRAS and MAPK1 were highly ex-pressed in cervical cancer,and HRAS had significant expression differences.Conclusion Luteolin treats cervical cancer through a multi-target and multi-pathway mechanism.

Objective:To analyze the incidence of recent complications in patients with osteoarthritis of the knee (OA) after medial opening wedge high tibial osteotomy(MOWHTO) and its influence on clinical effect.Methods:The clinical data of 131 patients with knee OA who received MOWHTO at Department of Sports Medicine and Arthroscopy,Tianjin Hospital from April 2017 to September 2018 were analyzed retrospectively. There were 75 males and 56 females, aged (62.8±5.1) years (range:48 to 70 years). Complications and clinical outcomes of patients were recorded and the proximal medial angle of tibia (MPTA), the International Knee Documentation Committee Subjective Knee Form (IKDC), the Western Ontario and McMaster Universities(WOMAC) Osteoarthritis Index and Knee Injury and Osteoarthritis Outcome score(KOOS) were collected before and 1 year after operation and compared between complication group and non-complication group. Data were analyzed by paired-samples t test, independent samples t test and χ 2 test. Results:The follow-up time was (18.5±3.4) months (range:13 to 22 months). Complications occurred in 22 patients(16.8%), including 8 cases(6.1%) of hematoma, 5 cases(3.8%) of neurosensory abnormality, 4 cases(3.1%) of intramuscular venous thrombosis, 2 cases(1.5%) of deep venous thrombosis, 3 cases(2.3%) of loss of correction angle, 3 cases(2.3%) of superficial infection, 2 cases(1.5%) of deep infection, 2 cases(1.5%) of delayed union of fracture, 1 case(0.8%) of postoperative stiffness, 1 case (0.8%) of hinge point cortex fracture. There were no significant difference in MPTA ((86.5±2.0)° vs. (86.7±2.1)°, t=-0.41, P=0.68) , IKDC ((86.4±4.8) vs.(85.5±6.9), t=0.74, P=0.50) , WOMAC ((87.7±6.5) vs. (86.1±5.8), t=1.16, P=0.25). There were no significant difference in knee scores except for the KOOS pain score ((79.4±4.4) vs. (87.2±5.9), t=-5.90, P<0.01) and sports and recreation score ((83.2±3.0) vs. (88.0±4.7), t=-6.14, P<0.01) . Conclusion:Short-term complications of MOWHTO can be managed appropriately through early diagnosis and individualized treatment and have no significant negative effect on knee function recovery of patients.

Objective To explore the molecular mechanism of luteolin in the treatment of cervi-cal cancer based on network pharmacology and molecular docking technology.Methods The drug-like properties of luteolin were analyzed by the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform(TCMSP).The targets of luteolin were obtained from PharmMapper,Super-PRED,and Swiss Target Prediction databases.The targets related to cervical cancer were ac-quired from GeneCards,OMIM,and PharmGKB databases.The intersection targets of luteolin and cervical cancer were obtained through EVenn,and the"luteolin-intersection targets-cervical cancer"network diagram was constructed by Cytoscape 3.8.1.The STRING database was used to analyze the protein-protein interaction(PPI)network of intersection targets and screen the core targets.The Da-tabase for Annotation,Visualization and Integrated Discovery(David)was used to conduct Gene On-tology(GO)gene function analysis and Kyoto Encyclopedia of Genes and Genomes(KEGG)signa-ling pathway enrichment analysis of the targets.PyMoL 2.6.0,AutoDockTool 1.5.7 and OpenBabel 2.4.1 software were used to perform molecular docking between the core targets and luteolin.The survival analysis and pan-cancer analysis of the core targets were performed in the GEPIA database.Results A total of 449 targets of luteolin and 1 334 targets related to cervical cancer were ob-tained;there were 100 intersection targets between luteolin and cervical cancer,of which 24 were core targets,including MMP2,HRAS,MAPK1,AKT1,RHOA and PGR.GO and KEGG enrich-ment analyses revealed that the intersection targets participated in 455 biological processes,70 cel-lular components,119 molecular functions,and 143 KEGG signaling pathways.Molecular docking revealed a good binding of MMP2 with luteolin.The survival curves of cervical cancer patients showed that the risk ratios of RHOA,MAPK1,MMP2 and AKT1 genes were greater than 1,while those of HRAS and PGR were less than 1.Pan-cancer analysis showed that HRAS and MAPK1 were highly ex-pressed in cervical cancer,and HRAS had significant expression differences.Conclusion Luteolin treats cervical cancer through a multi-target and multi-pathway mechanism.

Objective:To analyze the incidence of recent complications in patients with osteoarthritis of the knee (OA) after medial opening wedge high tibial osteotomy(MOWHTO) and its influence on clinical effect.Methods:The clinical data of 131 patients with knee OA who received MOWHTO at Department of Sports Medicine and Arthroscopy,Tianjin Hospital from April 2017 to September 2018 were analyzed retrospectively. There were 75 males and 56 females, aged (62.8±5.1) years (range:48 to 70 years). Complications and clinical outcomes of patients were recorded and the proximal medial angle of tibia (MPTA), the International Knee Documentation Committee Subjective Knee Form (IKDC), the Western Ontario and McMaster Universities(WOMAC) Osteoarthritis Index and Knee Injury and Osteoarthritis Outcome score(KOOS) were collected before and 1 year after operation and compared between complication group and non-complication group. Data were analyzed by paired-samples t test, independent samples t test and χ 2 test. Results:The follow-up time was (18.5±3.4) months (range:13 to 22 months). Complications occurred in 22 patients(16.8%), including 8 cases(6.1%) of hematoma, 5 cases(3.8%) of neurosensory abnormality, 4 cases(3.1%) of intramuscular venous thrombosis, 2 cases(1.5%) of deep venous thrombosis, 3 cases(2.3%) of loss of correction angle, 3 cases(2.3%) of superficial infection, 2 cases(1.5%) of deep infection, 2 cases(1.5%) of delayed union of fracture, 1 case(0.8%) of postoperative stiffness, 1 case (0.8%) of hinge point cortex fracture. There were no significant difference in MPTA ((86.5±2.0)° vs. (86.7±2.1)°, t=-0.41, P=0.68) , IKDC ((86.4±4.8) vs.(85.5±6.9), t=0.74, P=0.50) , WOMAC ((87.7±6.5) vs. (86.1±5.8), t=1.16, P=0.25). There were no significant difference in knee scores except for the KOOS pain score ((79.4±4.4) vs. (87.2±5.9), t=-5.90, P<0.01) and sports and recreation score ((83.2±3.0) vs. (88.0±4.7), t=-6.14, P<0.01) . Conclusion:Short-term complications of MOWHTO can be managed appropriately through early diagnosis and individualized treatment and have no significant negative effect on knee function recovery of patients.

Objective To investigate the clinical efficacy of three-dimensional (3D) laparoscopic resection for gastric stump cancer.Methods The retrospective cross-sectional study was conducted.The clinicopathological data of 20 patients who underwent 3D laparoscopic resection for gastric stump cancer in the Henan Provincial People's Hospital between January 2015 and January 2018 were collected.All patients were diagnosed as malignant tumors through gastroscopy and pathological examination before operation,and underwent 3D laparoscopic resection for gastric stump cancer and lymph node dissection according to Japanese Classification of Gastric Carcinoma (ver.14).Observation indicators:(1) intra-and post-operative recovery situations;(2) follow-up and survival situations.Follow-up using outpatient examination and telephone interview was performed to detect postoperative survival and tumor recurrence up to March 2018.Measurement data with normal distribution were represented as (-x)±s.Measurement data with skewed distribution were described as M (range).Results (1) Intra-and post-operative recovery situations:of 20 patients with gastric stump cancer,14 underwent 3D laparoscopic radical resection for gastric stump cancer (R0 resection and negative resection margin),4 underwent 3D laparoscopic palliative resection for gastric stump cancer and 2 were converted to open palliative resection for gastric stump cancer.Operation time,volume of intraoperative blood loss,number of lymph node dissected,time for postoperative out-of-bed activity,time to initial anal exsufflation,time for postoperative semi-fluid diet intake,duration of hospital stay and treatment expenses in 18 patients were (195±60) minutes,(105±85) mL,20±8,(1.6±0.8) days,(3.0±1.0) days,(5.5±1.8)days,(8.0±2.8) days and (5.5± 1.5) ×104 yuan,respectively.There was no surgery-related complication.(2) Follow-up and survival situations:of 20 patients,18 were followed up for 2-36 months,with a median time of 18 months.During the follow-up,6 patients died,including 2 dying of liver metastases and 4 dying of peritoneal metastases,12 had good conditions.Conclusion 3D laparoscopic resection for gastric stump cancer is safe and effective.

Objective To investigate the clinical value of laparoscopic resection techniques in patients with gastric stump cancer.Methods From Oct 2012 to Oct 2015,the clinical data of 30 patients who had undergone laparoscopic resection for gastric stump cancer in the Department of Gastrointestinal Surgery of He'nan Province People's Hospital were analyzed retrospectively.Results Among the 30 patients,22 cases underwent laparoscopic radical gastrectomy,five cases did palliative gastrectomy and three cases were converted to open palliative resection.The average operation time of laparoscopic surgery was (200 ±55) min,average intraoperative blood loss was (110 ± 80) ml,average number of harvested lymph node was(19 ±7).The average time of first flatus was (3.0 ± 1.0) d.The average first time of semi liquid diet intake was (5.3 ±1.6) d.The average hospital stay was (8.0 ±2.8) d (7-15 d),and the cost of hospitalization was (5.9 ± 1.3) × 104 RMB.Postoperative complications occurred in 2 patients (7％),one with ascites and infection,one with pulmonary infection,all were cured.28 patients (93％) were followed up for a median time of 18 months (2-36 months).During the follow-up period,2 patients died of liver metastasis and 6 patients died of peritoneal metastasis.Conclusions Laparoscopic gastrectomy for gastric stump cancer is safe and feasible with satisfactory short-term outcome.