With the improvement of living standards and dietary changes,obesity has become a serious threat to human health.In this huge group,the proportion of children is increasing.Many factors play significant roles in obesity-related research areas.Fatty acid blinding protein has become a hot topic in recent years.

Objective To study the relationship between the level of serum epithelial fatty acid binding protein (E-FABP) and cardiovascular disease in obese children. Methods Thirty children with metabolic syndrome (MS), 32 obesity children with no MS and 50 healthy children were recruited. Serum E-FABP and glucose/lipid metabolic indices were measured. Results Com-pared with the healthy children, levels of serum E-FABP in MS children were signiifcantly elevated (P=0.001). Compared with obesity children, levels of serum E-FABP of MS children were elevated, but the difference was not signiifcant (P>0.05). The cor-relations of E-FABP with waist to hip ratio, waist-to-height ratio, atherogenic index, fasting insulin, insulin resistance index were positive (P<0.05). According to the multivariate stepwise regression analysis, E-FABP was the independent risk of atherogenic index (P=0.018). Conclusions E-FABP plays a role in the development of atherosclerosis in obesity and MS.

Objective To explore the effect of calories supplement or protein supplement on the skeletal muscle in the elderly.Methods The ambulatory elderly (≥65 yrs) with reduced handgrip strength and/or gait speed were enrolled,who did not suffer from any neurological or arthritic disease impairing mobility,or any severe pulmonary or heart disease,or chronic kidney failure.The subjects were recruited with their written informed consent from clinical practices in five hospitals in China.The subjects were randomized to control group(n=26),nutrition supplementation (Nutren 400 kcal/ d) group (n=27) or protein supplementation(Biopro Protein 20 g/d) group (n=21).All the subjects were given healthy lifestyle education.The physical performances i.e.gait speed and handgrip strength were measured at baseline and at 2 and 3 months of followed up.Lean soft tissue mass (muscle mass) was measured by BIA at baseline and at 3 months of follow-up.Results A total of 74 subjects completed the trial,including 26 in controls,27 in Nutren,and 21 in protein group.At the end of the trial,the changes from baseline in appendicular muscle mass were-490.0 g (95％CI:-801.9--245.5,P=0.001)in control group,90.0 g (95％CI:-346.8--442.0,P=0.241) in Nutren group,and 290.0 g (95％CI:-746.6-20.1,P=0.007) in protein group.There were no significant difference in above indices among the three groups (P=0.051),except between Nutren group and control group (P=0.020).The handgrip strength and gait speed in the three groups were improved obviously as compared with those at baseline,but not statistically significant between different groups.Conclusions Caloric supplementation group may have greater effect in maintaining muscle mass than the protein supplement group in the elderly.Both the caloric supplement and the protein supplement produce no additional effect on muscular function as compared with healthy lifestyle education.

Adult ; China ; epidemiology ; Female ; Hemorrhagic Fever with Renal Syndrome ; epidemiology ; prevention & control ; Humans ; Male ; Middle Aged ; Prevalence ; Seasons ; Vaccination ; Viral Vaccines ; immunology ; Weather

Objective To investigate the effect of EZH2 on apoptosis and radiosensitivity of squamous cell carcinoma of tongue.Methods Tongue squamous carcinoma cells Tca-8113 were transfected with small interfering RNA of EZH2 (EZH2 siRNA1,EZH2 siRNA2) and its negative controls (siRNA-NC),the expression levels of EZH2 were detected by RT-PCR and Western blot and EZH2 siRNA2 was used for further studied since its better interference efficiency.The cells with siRNA transfection were irradiated with 8 Gy doses,and cell proliferation was detected by MTT,apoptosis was detected by flow cytometry,the expression of p-STAT3,STAT3 and Cleaved Caspase-3 was detected by Western blot.In addition,the cells were irradiated with 0,2,4,6,and 8 Gy to detect radiosensitivity by cell colony formation assay.Results EZH2 siRNA1 and EZH2 siRNA2 decreased the expression of EZH2 in Tca-8113 cells and EZH2 siRNA2 had a better interference efficiency (tmRNA =8.660,PmRNA ＜ 0.01;tprotein =2.883,Pprotein ＜0.05).The apoptotic rate in the EZH2 siRNA group was (29.90 ± 1.64)％,and was increased by 8 Gy irradiation to (38.17 ± 1.59) ％ (t =4.742,P ＜ 0.05).At the same time,EZH2 siRNA reduced the level of p-STAT3,but promoted the expression of Cleaved Caspase-3 protein,and enhanced the sensitivity of Tca-8113 cells to 1.668-times of control.Conclusions Interfering EZH2 could promote apoptosis,inhibit proliferation and increase radiosensitivity of squamous cell carcinoma of tongue.

BACKGROUND:Warm-needling moxibustion can effectively treat knee osteoarthritis.Degeneration,injury and fracture of the anterior cruciate ligament can affect the local stability of the knee joint,and then induce the formation of knee osteoarthritis.Whether warm-needling moxibustion can repair the injured cruciate ligament and the mechanism of action are still unclear. OBJECTIVE:To observe the effects of warm-needling moxibustion on the morphology of the anterior cruciate ligament and the expression of insulin growth factor-1 and transforming growth factor-β in rabbits with knee osteoarthritis and to clarify the mechanism of anterior cruciate ligament repair by warm-needling moxibustion. METHODS:Thirty New Zealand rabbits were randomly divided into blank group,model group and warm-needling moxibustion group,with 10 rabbits in each group.Knee osteoarthritis model was established by plaster cast immobilization.The blank group was not intervened.Rabbits in the model group rabbits were fixed in a rabbit holder for 15 minutes every day.The warm-needling moxibustion group was treated with warm acupuncture,once a day,7 days as a course of treatment,a total of two courses.After treatment,the imaging changes of the anterior cruciate ligament were observed by MRI and MRI grading statistics were performed.Morphological changes of the anterior cruciate ligament were observed by transmission electron microscope and hematoxylin-eosin staining.mRNA and protein expressions of insulin growth factor-1 and transforming growth factor-β were detected by RT-PCR and western blot,respectively. RESULTS AND CONCLUSION:MRI examination:Compared with the blank control group,the anterior cruciate ligament in the model group was thickened,edematous,and partially torn,and the difference in grading statistics was statistically significant(P＜0.05).Compared with the model group,the anterior cruciate ligament in the warm-needling moxibustion group was slightly thickened,with mild edema and no tearing,and the difference in grading statistics was statistically significant(P＜0.05).General observation:In the model group,the surface of the anterior cruciate ligament was glossy and faded,with the edge being covered with flocculent periosteum and obvious tissue necrosis;in the warm-needling moxibustion group,the surface of the ligament was glossy,and the ligament was in a normal helical shape.Hematoxylin-eosin staining:In the model group,there was obvious tissue necrosis in the anterior cruciate ligament,a large number of new capillaries,loosely arranged fibroblasts and collagen fibers.In the warm-needling moxibustion group,there was a small amount of tissue necrosis and few new vessels in the anterior cruciate ligament,and the cells and collagen fibers were loosely and irregularly arranged.Transmission electron microscopy:In the model group,the fibers in the anterior cruciate ligament were arranged in a disordered way with uneven thickness and distribution,and there are more fibroblasts that were irregular in morphology;in the warm acupuncture group,the fibers were basically arranged longitudinally,with uneven thickness and distribution,and a small number of oval-shaped fibroblasts were observed.RT-PCR and western blot assay:mRNA and protein expressions of insulin growth factor-1 and transforming growth factor-β were significantly decreased in the model group compared with the blank control group(P＜0.05),but significant increased after treatment with warm-needling moxibustion(P＜0.05).To conclude,warm-needling moxibustion can alleviate anterior cruciate ligament injury and regulate the expression of insulin growth factor-1 and transforming growth factor-β to treat knee osteoarthritis.

Objective To explore the incidence and clinical characteristics of sarcopenia in hospitalized elderly patients with coronary heart disease and search for the related factors. Methods This study was a single?center observational study. According to the inclusion criteria, elderly patients hospitalized with coronary heart disease from Peking Union Medical College Hospital between December 2017 and December 2018 were enrolled. The patients were divided into sarcopenic group and non?sarcopenic group according to the diagnostic criteria of the Asian Working Group for Sarcopenia. Activities of daily living of the patients were assessed (including ADL and IADL). Comorbidity of the patients was evaluated by the Charlson comorbidity index (CCI). Long?term medication use of the patients was recorded to assesse whether there was polypharmacy. The nutritional status of the patients was examined by the mini nutritional assessment?short form (MNA?SF). The full tandem stance time of the patients was evaluated. The history of falls over the previous year, urinary incontinence, and living conditions of the patients were also recorded. Multivariate logistic regression was used to analyze the related factors for sarcopenia of elderly patients with coronary heart disease. Results A total of 364 patients were enrolled in the study. The patients were aged 65-96 (74.6±6.5) years and there were 218 (59.9%) male patients. There were 264 cases of stable coronary heart disease and 100 cases of acute coronary syndrome. The median number of long?term used medication was 7. One hundred and fifty-two (41.8%) patients were complicated with type 2 diabetes, 38 (10.4%) patients were complicated with anxiety/depression, and 98 (26.9%) patients had the history of falls over the previous year. Eighty-two (22.5%) patients were complicated with urinary incontinence, 12 patients (3.3%) were complicated with malnutrition and 33 patients (9.2%) were living alone. There were 81 (22.3%) sarcopenic patients and 283 (77.7%) non?sarcopenic patients among all the hospitalized elderly patients with coronary heart disease. The sarcopenic patients were more older, with lower body mass index(BMI)(both P<0.001), higher CCI and more long?term used medication (both P<0.05), higher proportions of malnutrition, urinary incontinence, history of falls, and living alone (all P<0.05) compared to non?sarcopenic patients. ADL and IADL scores of sarcopenic patients were significantly lower than those of non?sarcopenic patients (both P<0.001). There was also a higher proportion of unable to accomplish full tandem stance among sarcopenic patients compared to non?sarcopenic patients (P<0.001). Moreover, higher hs?CRP level (P=0.047), lower albumin level (P=0.004) and significantly lower prealbumin level (P<0.001) were observed in sarcopenic patients compared to non?sarcopenic patients. Stepwise multivariate binomial logistic regression analysis revealed that male ( OR=5.036, 95%CI 1.782-14.230, P=0.002), low BMI ( OR=0.883, 95%CI 0.796-0.980, P=0.019), as well as low prealbumin level ( OR=0.990, 95%CI 0.980-1.000, P=0.045) were related factors for sarcopenia among elderly patients with coronary heart disease. Conclusions Sarcopenia is a geriatric condition commonly seen in hospitalized elderly patients with coronary heart disease. Male, low BMI, and low prealbumin level were the factors related to sarcopenia for older adults with coronary heart disease.

Objective:To propose and verify a surgical classification system for the axial primary malignant and aggressive benign tumor.Methods:The CZH surgical classification system was originally developed for the axial primary malignant and aggressive benign tumor. The CZH surgical classification system includes seven types, according to the anatomic features and the extension of tumor violation. A total of 136 patients (79 males and 57 females) with axial primary malignant and aggressive benign tumor from multiple tertiary centers who received surgery from July 2006 to July 2019 were included. The average age was 44.40±17.55 years (8-83 years) old. There were 99 malignant tumors and 37 aggressive benign tumors included. The number of patients with each classification was presented as followed, Type I 13, Type II 15, Type IIIa 3, Type IIIb 20, Type IVa 43, Type IVb 12, Type Va 21, Type Vb 3, Type VI 2, Type VIIa 3 and Type VIIb 1. Surgical procedures were selected according to different types in classification. The inter- and intra-observer consistencies were evaluated by the Kendall's W test. The VAS, Frankel score, overall survival and recurrence free survival were recorded during the follow-up. Results:The inter- and intra-observer consistent coefficient was 0.973 and 0.996, respectively ( P<0.05). The single posterior approach was adopted for the Type II tumors. Other patients underwent surgery by the combined antero-posterior approach. The majority in anterior approach (113 cases) was the modified submandibular approach. The reconstruction modes included anterior "T" shape titanium mesh (112 cases) or the 3D printed prothesis (7 cases) combined with the posterior occipto-cervical fusion (92 cases) or the pedicle screw system (44 cases). The average surgical duration and the volume of intraoperative bleeding was 348.40±136.14 min (60-760 min) and 1 225.69±859.40 ml (80-4 000 ml), respectively. The operation duration and volume of intraoperative bleeding among each type were with statistical difference. The patients with Type IV, V tumors had longer operation duration than those with Type II tumors. Those with Type V and VII tumors had longer operation duration than those with Type I tumors. The patients with Type V tumors had more intraoperative bleeding than those with Type I-IV tumors. The average preoperative VAS score was 4.15±2.25 and then was reduced significantly to 0.62±0.71 and 0.38±0.59 at one and three months after operation, respectively. The Frankel score was also significantly ameliorated at one and three months postoperatively. There were 22 postoperative complications (16.2%). The complications included cerebral spinal fluid leak (12.5%), dysphagia and/or dysphonia (7.4%), dyspnea (5.1%), wound infection (3.7%), wound hemorrhage (2.2%) and pharyngeal dehiscence (1.5%). The incidence of postoperative complication was 25.9% in Type IV-VII tumors, while 11.8% in Type I-III tumors. Conclusion:CZH surgical classification system was verified with high observer consistency. This classification system could assist surgeons to select proper surgical approaches, resection modes and reconstruction modes, and thus ensure the safety of surgery and reduce the recurrence. The tumors in Type IV, V and VII may be with more challenging for surgeons. The incidence of postoperative complication in Type IV-VII tumors may be higher than that in Type I-III tumors.

Objective To explore the association between frailty and muscle performances of hospitalized elder adults with coronary artery disease.Methods A total of 122 hospitalized patients aged 65-85 years old with coronary artery disease from Department of Geriatrics and Cardiology,Peking Union Medical College Hospital between December 2017 and March 2018 were enrolled in the study.A comprehensive geriatric assessment was performed to evaluate existing comorbidity and geriatric syndromes of the patients.Frailty was assessed using the Clinical Fraity Scale.The patients were classified as frail and non-frail,according to the scale.Muscle performances were assessed using grip strength,gait speed,etc.Whole body and appendicular skeletal muscle mass was detected with bioelectrical impedance analysis in patients with reduced grip strength or slowed gait speed.Appendicular skeletal muscle index (ASMI) was calculated.Results Among all subjects,28 were with frailty (23.0％) and 94 were without (77.0％).The frail patients were older [(76.7±5.4) years vs.(72.2±5.6)years],had higher Charlson comorbidity index [2.0(1.0,2.75)vs.1.0(0,2.0)],and higher proportion of malnutrition (14.29％ vs.1.06％),urinary incontinence (39.29％ vs.15.96％),using walking-aid (28.57％ vs.6.38％),and more kinds of taken drugs (8.1±3.0 vs.6.6±2.7),than the non-frail patients.Prealbumin levels [(207.8±60.0)mg/L vs.(234.3±45.4)mg/L] were lower,and highly sensitive C-reactive protein levels [(5.89±9.57)mg/L vs.(1.89±2.49)mg/L] were higher in the frail patients than in the non-frail patients (all P＜0.05).Compared with non-frail patients,the frail patients had poorer grip strength [(19.67±7)kg vs.(29.23±8.29)kg] and slower gait speed [(0.54±0.2)m/s vs.(0.91±0.22)m/s](all P＜0.001).Spearman rank correlation analyses showed that grip strength was positively correlated with the appendicular skeletal muscle mass(r =0.811),whole body skeletal muscle mass(r =0.74) and the ASMI (r =0.783),respectively.Conclusions The incidence of frailty among hospitalized older adults with coronary artery disease is high.Poor muscle performances were common in these patients.Assessment of frailty and muscle performances can help to evaluate the overall function of older adults with cardiovascular disease in a comprehensive way.

Objective:Recently, increasing number of lung cancer patients benefit from immune-checkpoint inhibitors (ICIs). However, the data of Chinese small cell lung cancer (SCLC) patients is limited. This study aims to analyze the response and survival data of ICIs treatment in SCLC and to explore the predictive biomarkers.Methods:Forty-seven SCLC patients who received ICIs treatment from Peking University Cancer Hospital from May 2017 to September 2019 was recruited. Clinical characteristics including sex, age, smoking status, ICIs strategy, PD-L1 expression and therapeutic efficacy were collected to explore the clinical predictive biomarkers for SCLC ICIs treatment.Results:Among the 47 patients, 18 (38.3%) cases were partial repose (PR), 11 (23.4%) were stable disease (SD), 18 (38.3%) were progressive disease (PD), and the objective response rate (ORR) was 38.3%, disease control rate (DCR) was 61.7%, the median progression-free survival (PFS) was 5.3 months. ICIs monotherapy accounts for 27.7%, the ORR was 15.4%, DCR was 53.8%, median PFS was 2.7 months. Combined therapy accounts for 72.3%, the ORR was 47.1%, DCR was 64.7%, median PFS was 5.4 months. Fourteen (29.8%) patients received ICIs as the first line treatment, their ORR was 85.7%, DCR was 100%, median PFS was 9.1 month. The ORR was not related to the age, sex, body mass index (BMI), smoking status and programmed death-ligand 1 (PD-L1) expression ( P>0.05). The ORRs were higher in patients underwent PD-L1 monotherapy ( P=0.001), combined therapy ( P=0.002) and received ICIs as the first line treatment ( P<0.001). Log-rank analysis indicated that the PFS of female patients were 12.0 months, significantly longer than 4.4 months of male patients in ICIs treatment ( P=0.038). Patients who received PD-L1 monotherapy, combined treatment, or ICIs as the first line treatment had longer PFS than their counterparts, though no statistical significant was observed ( P>0.05). Cox multivariate analysis showed that, the gender was not an independent predictor for PFS in ICIs treatment ( HR=3.777, 95% CI=0.974~30.891, P=0.054). Conclusions:Immunotherapy is an effective treatment strategy for SCLC. Patients who receive combined ICIs treatment, first line ICIs treatment and PD-L1 treatment may get greater benefits. PD-L1 expression cannot predict the response and PFS in SCLC ICIs treatment.