Objective To analyze the expressions of astrocyte elevated gene-1 (AEG-1 )and Beclin-1 (BECN-1 )in papillary thyroid carcinoma (PTC)and their clinical significances.Methods Thirty patients with PTC who were performed total thyroidectomy in the General Hospital Affiliated to Tianjin Medical University from October 201 5 to May 201 6 were collected.All patients were diagnosed with unilateral PTC.The tumor tissues were taken from the patients′ipsilateral thyroids,and 30 cases of normal tissues were taken from the patients′contralateral normal thyroids.The expressions of AEG-1 and BECN-1 in PTC tissues were detected by reverse transcription-poly-merase chain reaction (RT-PCR).The relationships between the expression status and clinicopathologic features were analyzed.Results The positive expression levels [M(QR )]of AEG-1 in PTC and the normal tissues were 0.626 1 (0.741 4)and 0.049 8 (0.01 1 8)respectively,with a significant difference (Z=-4.488,P=0.000). The positive expression levels of BECN-1 in PTC and the normal tissues were 0.067 9 (0.1 98 1 )and 0.785 7 (0.361 7)respectively,with a significant difference (Z=-5.441 ,P=0.000).In PTC,the expressions of AEG-1 and BECN-1 were related to TNMstaging (Z=-3.980,P=0.000;Z=-2.265,P=0.023)and lymphatic metas-tasis (Z=-3.1 90,P=0.001;Z=-2.640,P=0.008),but they were not related to age (Z=-1 .203,P=0.229;Z=-1 .1 62,P=0.245),gender (Z=-1 .222,P=0.222;Z=-0.453,P=0.651 )and tumor size (Z=-1 .496,P=0.1 35;Z=-1 .1 66,P=0.244).The expression of AEG-1 was negatively correlated with that of BECN-1 (r=-0.343,P=0.007).Conclusion The expression of AEG-1 in PTC is higher than that in normal tissues and the expression of BECN-1 in PTC is lower than that in normal tissues,and the expressions of AEG-1 and BECN-1 are related to TNM staging and lymphatic metastasis,which are expected to become prognostic indicators.

BACKGROUND: Hypoxic training in combined with exercise training can increase the hypoxia levels of the body to mobilize the potentials of the body, resist to and actively adapt physiological responses resulted from hypoxia, so as to improve athletic performance.OBJECTIVE: To summarize the influence of hypoxic training on skeletal muscle structure and function, to provide a theoretical basis and guidance for hypoxic training.METHODS: Using "hypoxic training, skeletal muscle, function, structure" in English as the search terms, PubMed database was ratrieved from 1990 to March 2009; Using "hypoxic training, skeletal muscle, function and structure" in Chinese as the search terms,CNKI database was searched from 2000 to May 2009. Literatures are limited to English and Chinese languages. The content related to the effect of hypoxic training on skeletal muscle structure and function was selected, and repetitive researches were eliminated.RESULTS AND CONCLUSION: Totally 144 literatures were obtained from computer screening, and then analyzed according to the inclusion and exclusion criteria. Hypoxic training could avoid the disadvantages caused by conventional altitude training, the hypoxia environment is regulated according to the body's ability to adapt hypoxia, the normal training is ensured, so that skeletal muscle obtains beneficial physiological adaptation. Compared with pure hypoxia stimulation, different forms of hypoxia and different training methods may integrate into different modes of hypoxic training, which makes skeletal muscle function and structure more complex. The combination form of hypoxia and training is the main factor of the effect of hypoxia training on skeletal muscle function and structure. Different objects of experiments and test methods are likely to interfere with the conclusions, which also affect the mechanism of the role of hypoxic training on skeletal muscle.

Fed with high-fat diet and assessed by hyperinsulinemia-euglycemia clamp technique, rat models with insulin resistance were successfully induced. Compared with normal chow group ( NC ), serum concentrations of free-fatty acids(FFAs) and baseline insulin in high-fat diet group(HF) was higher( P＜0.05 ), the average glucose infusion rate from 60 to 120 min( GIR60-120 ) was lower( P＜0.01 ), and the expression of p-IRE-lα in the liver was higher( P＜0.05 ). Furthermore, the expression of p-IRE-1α in the liver was positvely correlated with the serum concentration of FFAs. All these data indicate that high-fat diet may induce endoplasmic reticulum stress in the liver by elevating serum concentration of FFAs, and may participate in the genesis of insulin resistance via p-IRE-1α.

Objective To explore the effect of quality control circle (QCC) on health education in stroke rehabilitation nursing. Methods Such activities were conducted in the VIP ward of neurological rehabilitation in our hospital as: theme selecting, activity planning, status mastering, cause analyzing, countermeasures formulating and implementing, etc., in accordance with QCC theory from January to April, 2014. Results The satisfaction of stroke patients to health education rose from 80.1% to 91.1% (P<0.001), and the dissatisfaction to guidance of activities of daily living and prevention of complications decreased significantly (P<0.05) after the implementation of QCC program. All the circle members benefited from the improvement of QCC technique, team work, professional knowledge, communication and coordination, activity confidence, duty and honor. Conclusion Carrying out the QCC activities can play a positive role on health education in stroke rehabilitation nursing.

Objective:To investigate the value of ultrasound elastography combined with serum urokinase plasminogen activator (uPA) in differential diagnosis of benign and malignant thyroid nodules.Methods:From May 2018 to May 2019, 150 patients with thyroid nodules (160 nodules) were selected, 69 patients with benign nodules (76 benign nodules) and 81 patients with malignant nodules (84 malignant nodules) were diagnosed by postoperative pathology. In the same period, 40 healthy people underwent health examination were selected as the control group. All preoperative patients were subjected to ultrasound elastography. The results of pathological examination were diagnosed as "gold standard"; the characteristics of ultrasound elastography were observed and scored, and compared with the results of pathological examination. The level of serum uPA was measured by enzyme-linked immunosorbent assay (ELISA), the sensitivity, specificity, and the area under the receiver operating characteristic (ROC) curve (AUC) were compared among single real-time ultrasound elastography, serum uPA and combined diagnosis.Results:Among the 150 patients (160 nodules), for ultrasound elastography, the sensitivity was 97.37% (74/76), the specificity was 85.71% (72/84), the accuracy was 91.25% (146/160), and the Kappa value was 0.726. The ratio of 0 to 2 points in malignant group was significantly lower than that in the benign group, the ratio of 3 to 4 points was significantly higher than that in the benign group ( P < 0.05). Compared with the control group, the levels of serum uPA in the benign group and the malignant group increased significantly ( P < 0.05). Compared with the benign group, serum uPA level in the malignant group increased significantly ( P < 0.05). The AUC of combined diagnosis was 0.869, 95% confidence interval ( CI): 0.789 - 0.949, and the best cut-off point for the combined diagnosis was uPA = 982.16 mU/L, at this time, the diagnostic sensitivity was 0.646, and the diagnostic specificity was 0.575. The AUC of ultrasound elastography was 0.814, 95% CI: 0.721 - 0.907, and the AUC of combined diagnosis was higher than that of ultrasound elastography. Conclusion:The clinical value of ultrasound elastography combined with serum uPA in differentiating benign and malignant thyroid nodules is higher than that of ultrasound elastography.

Objective:To analyze the diagnosis of renal injury caused by chronic arsenism by color Doppler ultrasound and the observation of renal hemodynamics.Methods:From January 2018 to April 2019, 74 patients with occupational chronic arsenism admitted to Binzhou People's Hospital were selected and divided into two groups according to whether the patients were complicated with renal injury or not, 26 patients in renal injury group and 48 patients in non-renal injury group. The renal function indexes [serum creatinine (SCr), blood urea nitrogen (BUN), urine and blood β2-microglobulin (β2-MG)] were measured and the renal hemodynamics [peak blood flow velocity during systole (Vmax), minimum blood flow velocity during diastole (Vmin), resistance index (RI)] of the two groups were analyzed by color Doppler ultrasound, and the correlation between renal function indexes and renal hemodynamics was analyzed.Results:The levels of SCr, BUN, urine β2-MG and blood β2-MG in renal injury group were significantly higher than those in non-renal injury group [(136.28 ± 21.05) vs (108.42 ± 26.49) μmol/L, (8.03 ± 1.04) vs (5.36 ± 0.97) mmol/L, (157.48 ± 25.63) vs (127.42 ± 18.95) μg/L, (3.97 ± 1.12) vs (2.35 ± 0.84) mg/L, t = 4.625, 11.022, 5.740, 7.028, P < 0.05]. The Vmax and Vmin of the main renal artery and interlobular artery in renal injury group were significantly lower than those in non-renal injury group [cm/s: (50.34 ± 13.42) vs (75.32 ± 16.52), (18.13 ± 5.21) vs (29.83 ± 7.05), (12.31 ± 3.82) vs (17.22 ± 5.07), (4.08 ± 1.15) vs (6.03 ± 1.93), t = 6.833, 7.084, 4.657, 4.775, P < 0.05], and the RI of the main renal artery and interlobular artery in renal injury group was significantly higher than that in non-renal injury group [(0.71 ± 0.06) vs (0.62 ± 0.08), (0.68 ± 0.10) vs (0.56 ± 0.08), t = 5.017, 5.634, P <0.05]. Vmax and Vmin of the main renal artery and interlobular artery were negatively correlated with SCr, BUN, urine β2-MG and blood β2-MG ( P < 0.05). RI of the main renal artery and interlobular artery were positively correlated with SCr, BUN, urine β2-MG and blood β2-MG ( P < 0.05). Conclusions:Color Doppler ultrasound can effectively reflect the status of renal injury in chronic arsenism patients. The renal blood flow perfusion in renal injury patients is decreased, and the blood flow resistance is increased, which is closely related to the degree of renal injury and deserves clinical attention.

Background: There is an urgent need to find reliable and rapid bovine tuberculosis (bTB) diagnostics in response to the rising prevalence of bTB worldwide. Toll-like receptor 2 (TLR2) recognizes components of bTB and initiates antigen-presenting cells to mediate humoral immunity. Evaluating the affinity of antigens with TLR2 can form the basis of a new method for the diagnosis of bTB based on humoral immunity. Objectives: To develop a reliable and rapid strategy to improve diagnostic tools for bTB. Methods: In this study, we expressed and purified the sixteen bTB-specific recombinant proteins in Escherichia coli. The two antigenic proteins, MPT70 and MPT83, which were most valuable for serological diagnosis of bTB were screened. Molecular docking technology was used to analyze the affinity of MPT70, MPT83, dominant epitope peptide of MPT70 (M1), and dominant epitope peptide MPT83 (M2) with TLR2, combined with the detection results of enzyme-linked immunosorbent assay to evaluate the molecular docking effect. Results: The results showed that interaction surface Cα-atom root mean square deviation of proteins (M1, M2, MPT70, MPT83)-TLR2 protein are less than 2.5 A, showing a high affinity.It is verified by clinical serum samples that MPT70, MPT83, MPT70-MPT83 showed good diagnostic potential for the detection of anti-bTB IgG and M1, M2 can replace the whole protein as the detection antigen. Conclusions Molecular docking to evaluate the affinity of bTB protein and TLR2 combined with ELISA provides new insights for the diagnosis of bTB.

Objective To explore RIZ1 mRNA expression level in different subtypes and risk classification groups of the patients with myelodysplastic syndromes (MDS) and to analyze the correlation between the clinical features and RIZ1 mRNA expression. Methods A total of 46 newly diagnosed as MDS patients and 10 healthy controls who were the donors of hematopoietic stem cell transplantation from Chuiyangliu Hospital Affiliated to Tsinghua University and the Second Hospital of Shanxi Medical University between January 2014 and December 2017 were collected. The real time fluorescence quantitative polymerase chain reaction (RT-PCR) was used to detect the expression level of RIZ1 mRNA in bone marrow cells from MDS patients and the healthy controls. Results Compared with the healthy control group, the relative expression level of RIZ1 mRNA in MDS patients was decreased [the median (P25, P75):1.003 (0.895, 1.812) vs. 0.557 (0.333, 0.815)], and the difference was statistically significant (Z= -2.991, P= 0.0003). According tothe World Health Organization (WHO) classification criteria, compared with the healthy control group, the relative expression of RIZ1 mRNA in refractory anemia/refractory anemia with ring sideroblasts/refractory cytopenia with multiple dysplasia (RA/RAS/RCMD), refractory anemia with excess blasts Ⅰ (RAEB-Ⅰ), RAEB-Ⅱand MDS transformed into acute myeloid leukemia (MDS/AML) groups had statistically significant differences (χ2= 19.500, P< 0.01). Further pairwise comparison showed that the relative expression level of RIZ1 mRNA in RAEB-Ⅰ, RAEB-Ⅱand MDS/AML groups was lower than that in the healthy control group, and the differences were statistically significant (all P < 0.05). According to the international prognostic scoring system (IPSS), compared with the healthy control group, the expression of RIZ1 mRNA in low-risk, inter-risk-1, inter-risk-2 and high-risk group had statistical differences (χ2= 19.214, P= 0.001). Further pairwise comparison showed that the relative expression of RIZ1 mRNA in inter-risk-1, inter-risk-2 and high risk group was lower than that in the healthy control group, and the differences were statistically significant (all P<0.05). And RIZ1 mRNA expression showed a decreasing trend with the increase of disease risk grade. RIZ1 mRNA expression level had no relationship with age, gender, peripheral blood white cell count, the hemoglobin, platelet count and karyotype (all P> 0.05). Conclusion RIZ1 mRNA expression level is decreased in MDS patients, and it is different in various subtypes and risk classification. RIZ1 may involve in the pathogenesis of MDS and play an important role in the progression of MDS.

Objective: To analyze the clinical manifestation and CYP4V2 mutations of Bietti crystalline corneoretinal dystrophy( BCD) families. Methods: Total of 234 patients (173 families) diagnosed as BCD were recruited in Peking University Third Hospital from 2010 to 2018.All of the subjects underwent comprehensive eye examinations to observe the clinical manifestations.Blood samples were collected and genomic DNA was extracted.The Sanger sequencing or high- throughput sequencing was applied for CYP4V2 gene mutation analysis.This study was approved by the Ethics Committee of Peking University Third Hospital (NO.2012093). All patients and their family members signed informed consent. Results: Some patients manifested the typical phenotype of BCD characterized by yellowish-white crystalline deposits throughout the fundus.However, some patients in advanced stage were easily misdiagnosed as other inherited retinal degeneration because the crystalline deposits diminished or even disappeared.Forty-nine probands in our cohort were misdiagnosed as other inherited retinal degeneration at first visit, with a misdiagnosis rate of 28.3%.Genetic diagnosis results showed that 161 patients carried CYP4V2 mutation, and the positive rate was 93.1%.Eight novel mutations were obtained.The three known mutations c. 802-8 _810del17bp, c.1091-2 A>G and c. 992 A>C accounted for 73.5% of the mutations, which were hotspots in Chinese Han populations for BCD. Conclusions Patients with BCD have characteristic fundus manifestation, but are easily misdiagnosed in advanced stage.Molecular diagnosis is valuable in clinical diagnosis of the disease, thus contribute to the prevention and treatment of the disease.A single hybrid mutation is not enough to lead to BCD.No apparent genotype- phenotype correlation between the CYP4V2 gene and occurrence of BCD is identified.

Objective To examine the effect of aerobic exercise training on plasma metabolites in pre-diabetes mellitus(PDM)subjects.Methods Twenty-five PDM subjects were selected,and each 10 age-and sex-matched with normoglycemia and new-onset T2DM subjects were enrolled.PDM subjects underwent aerobic exercise(n=13)or health education (n=12) for 12 weeks.The aerobic exercise was con ducted 3 times/week,50 min/time at 40％-60％ of oxygen uptake reserve.Liquid chromatography-mass spectrometry(LC-MS)was used to analyze the spectrum of plasma metabolites.Principal component analysis was employed to study the differences in plasma metabolite profiles between subjects with different glycemic level and between PDM subjects before and after aerobic exercise.Results After training,the body fat percentage,2-hour plasma glucose,and low density lipoprotein cholesterol of PDM subjects reduced significantly(by 4.6％,16.22％ and 9.27％ on average).Comparison of plasma metabolizers in PDM subjects before and after exercise revealed 31 differential metabolites,with 25 metabolites such as phosphatidylcholine,lysophosphatidylcholines,sphingomyelin and betaine increasing,and 6 metabolites,such as oleic acid and cytosine decreasing.Conclusion Aerobic exercise has a marked effect on the plasma metabolites in PDM subjects.Phosphatidylcholine,lysophosphatidylcholines,sphingomyelin and oleic acid may be the potential biomarkers of aerobic exercise improving the glycolipid metabolism in PDM subjects.These findings can help us better understand the mechanism of aerobic exercise preventing T2DM diabetes.