Objective To study the expressions of Toll-like receptor 9 protein (TLR9) in peripheral B and T lymphocytes in newly diagnosed, untreated patients with systemic lupus erythematosus (SLE) and their relationship with clinical parameters. Methods Blood samples were obtained from 35 newly diag-nosed, untreated patients with SLE and 16 healthy human controls. B, T lymphocytes and TLR9 protein were labeled with fluorescent antibodies, and the expressions of TLR9 protein were detected by flow cytometry in peripheral B and T lymphocytes. The relationship between TLR9 expression and clinical parameters was assessed. Results The proportions of B and T lymphocytes expressing TLR9 in newly diagnosed, untreated patients were (53.94±17.95)% and (49.33 ± 23.30)%, respectively, compared to (29.40 ± 10.54)% and (29.18 ± 14.78)%, respectively, in healthy controls (t = 6.11,3.73, respectively, both P < 0.01). Additionally,the proportion of B lymphocytes expressing TLR9 correlated negatively with SLE disease activity index (SLEDAI)(r = -0.39, P < 0.05), but positively with the level of serum IgA antibody (r = 0.74, P < 0.01).Condnsions The expression of TLR9 is elevated in peripheral T and B lymphocytes from patients with newly diagnosed, untreated SLE, and the proportion of TLR9-expressing B lymphocytes negatively correlates with SLEDAI, but positively correlates with the serum level of IgA antibody.

Objective To investigate the expression of regulatory T cells in the peripheral blood of rheumatoid arthritis patients and to explore the possibility of using CD127 instead of FOXP3 in the study of regulatory T cells. Methods Thirty-two patients with active rheumatoid arthritis (RA) [ including 20 patients who hadn't been treated with disease modifying antirheumatic drugs (DMARDs) and 12 patients whose disease were poorly improved after DMARDs therapy], 25 patients with primary Sjogren's syndrome (pSS) and 24 healthy controls were selected. The percentages of CD4+CD25high, CD4+CD25+CD127low/'- and CD4+CD25+ FOXP3+T cells were analyzed by 3-color flow cytometry. Meanwhile, the levels of CRP, ESR, immunoglobulin and complement were measured. Results Percentages of CD4+CD25+CD127low/-T cells and CD4+CD25+FOXP3+ T cells in RA patients were significantly lower than those of healthy controls (P<0.01 for each category of T cells),but the percentage of CD4+CD25high T cells didn't show significant changes (P>0.05). The expression of CD4+CD25+CD127ow/- and CD4+CD25+FOXP3+T cells showed no difference between RA and pSS patients (P> 0.05 for each). Differences of the three group cells between untreated RA patients and poorly-improved RA patients were not significant (P>0.05 for each case). CD4+CD25+CD127low/-T cells were positively associated with CD4+CD25+FOXP3+T cells (r=0.698, P=0.001), but the two groups had no correlation with the levels of CRP, ESR and anti-CCP antibody and RF (P>0.05 for each case). Conclusion The percentage of CD4+CD25+CD127low/-T cells is decreased in the peripheral blood of active RA patients and positively correlates with CD4+CD25+FOXP3+T cells.It suggests that CD127 may be an ahemative marker of FOXP3 in the study of Treg cells.

Objective To evaluate the clinical effects of combined therapy of Fuyuan Huoxue decoction and transcatheter hepatic arterial chemoembolization in the treatment of primary hepatic carcinoma. Methods 80 patients with primary hepatic carcinoma were randomly divided into a control group, treated by transcatheter hepatic arterial chemoembolization, and a treatment group, additionally treated by Fuyuan Huoxue decoction on the basis of the control group. By observing the change of gross tumor volume、tumor markers、clinical symptoms、Karnofsky Performance Status(KPS) score、quality of life and so on,compare the clinical effects and quality of life between the two groups. Results The effective rate of solid tumor was 47.50%and 35%in the treatment and the control group respectively, with no significant difference(χ2=-1.229, P>0.05);The total effect rate was 87.50%and 32.50%in the treatment and the control group respectively, with significant difference(χ2=-5.633, P<0.05);The rate of patients merged with portal vein tumor thrombus whose cancer embolus narrowed more than 1/2 after the treatment was 78.95%and 33.33%in the treatment and the control group respectively, with significant difference(χ2=7.836, P<0.05);The rate of alpha fetoprotein(AFP) decreasing or turning negative was 78.95%and 37.83%after the treatment in the treatment and the control group respectively, with significant difference(χ2=-3.857, P<0.05);Both groups have improvement in Karnofsky Performance Status(KPS) score after the treatment, the ratios was 80% and 72.50% in the treatment and the control group respectively, with no significant difference(χ2=-1.203, P>0.05);The accumulated scores change of quality of life(QOL) has asignificant difference(χ2=-3.025, P<0.05) between the two groups after the treatment. Conclusion The combined therapy of Fuyuan Huoxue decoction and transcatheter hepatic arterial chemoembolization can alleviate the clinical symptoms, improve treatment effects and quality of life of patients with primary hepatic carcinoma.

BACKGROUNDThe trachea, bronchus, blood vessel and left atrium plasty can maximumly remove tumor tissus and preserve the functional pulmonary tissues so as to improve patients' quality of life and prolong their survival.

METHODSFrom January 1990 to August 2004, 125 patients with lung cancer underwent trachea, bronchus, bloood vessel and left atrium plasty.

RESULTSThere were 116 patients who underwent bronchoplasty, in which angioplasty was performed concurrently in 26 cases. And reconstruction of superior vena cava was performed in 3 patients, and left atrium plasty in 6 patients. Three patients died after operation.

CONCLUSIONSTrachea, bronchus, blood vessel and left atrium plasty may be a promising direction in thoracic surgery.

OBJECTIVE: To assess the association between myeloperoxidase (MPO) gene polymorphism and coronary artery disease (CAD). METHODS: Several databases were used to retrieve relevant literature up to March 2013 by keywords. A Meta-analysis was performed by Stata12.0 software to estimate the pooled odds ratio (OR) and the 95% confidence interval (CI). Heterogeneity among studies was tested and sensitivity analysis was applied. Publication bias was examined using Begg's funnel plot and Egger's linear regression test. RESULTS: A total of 17 studies were included in this Meta-analysis. For MPO -463 G/A polymorphism, the pooled OR of A allele vs G allele was 0.58 [95% CI (0.47-0.72)] and the pooled OR of genotypes AA+AG vs GG was 0.58 [95% CI (0.46-0.72)]. In subgroup analysis of study population, AA and AG genotypes were significantly associated with CAD in Asians but not in Europeans. The MPO -463 G/A polymorphism in the stable angina pectoris subgroup was evaluated in 3 studies and the pooled OR of A allele vs G allele and genotypes AA+AG vs GG for proven CAD was 0.45 [95% CI (0.15-1.37)] and 0.57 [95% CI (0.19- 1.65)]. For MPO -129 A/G gene polymorphism, the pooled OR of genotype GG vs AA+AG was 0.91 [95% CI (0.74-1.10)]. CONCLUSION A allele of MPO -463 G/A gene is associated with decreased risk of CAD except in the Europeans. There is no association between MPO -129 A/G gene polymorphisms and CAD risk.
Alleles ; Asian Continental Ancestry Group ; Coronary Artery Disease ; genetics ; European Continental Ancestry Group ; Genetic Predisposition to Disease ; Genotype ; Humans ; Odds Ratio ; Peroxidase ; genetics ; Polymorphism, Single Nucleotide

Objective To investigate job burnout and related influencing factors in community medical staff in Nanchong,China.Methods From June to July,2015,cluster random sampling was performed to select 181 medical staff members in Nanchong Community Health Service Center as study subjects.The Chinese Maslach Burnout Inventory (CMBI) was used to measure the level of job burnout.Results The overall detection rate of job burnout in community medical staff in Nanchong was 95.0％,and among these staff members with job burnout,119(65.7％) had mild job burnout,44(24.3％) had moderate job burnout,and 9(5.0％) had severe job burnout.There were significant differences in the scores of emotional exhaustion and reduced sense of personal accomplishmentbetween the medical staff members with different ages (F=5.820 and 3.180,both P＜0.05).There was a significant difference in the score of emotional exhaustion between the medical staff members with different working years(F=2.909,P＜0.05).There was also a significant difference in the score of reduced sense of personal accomplishment between the medical staff members with different types of work (F=5.797,P＜0.05),and the nurses had the lowest score.Conclusion The medical staff members in Nanchong have a high incidence rate of job burnout,with the feature of reduced sense of personal accomplishment.An old age,long working years,and nursing occupation are major risk factors for job burnout.

Objective To investigate job burnout and related influencing factors in community medical staff in Nanchong,China.Methods From June to July,2015,cluster random sampling was performed to select 181 medical staff members in Nanchong Community Health Service Center as study subjects.The Chinese Maslach Burnout Inventory (CMBI) was used to measure the level of job burnout.Results The overall detection rate of job burnout in community medical staff in Nanchong was 95.0％,and among these staff members with job burnout,119(65.7％) had mild job burnout,44(24.3％) had moderate job burnout,and 9(5.0％) had severe job burnout.There were significant differences in the scores of emotional exhaustion and reduced sense of personal accomplishmentbetween the medical staff members with different ages (F=5.820 and 3.180,both P＜0.05).There was a significant difference in the score of emotional exhaustion between the medical staff members with different working years(F=2.909,P＜0.05).There was also a significant difference in the score of reduced sense of personal accomplishment between the medical staff members with different types of work (F=5.797,P＜0.05),and the nurses had the lowest score.Conclusion The medical staff members in Nanchong have a high incidence rate of job burnout,with the feature of reduced sense of personal accomplishment.An old age,long working years,and nursing occupation are major risk factors for job burnout.

Objective:To compare the clinical efficacy of robot-assisted versus fluoroscopy-assisted sacroiliac screw internal fixation for posterior pelvic ring fractures.Methods:China National Knowledge Infrastructure (CNKI), Wanfang Data, Chinese Medical Journal Full-text Database, PubMed, Web of Science and ScienceDirect were searched for literature on robot-assisted versus fluoroscopy-assisted sacroiliac screw internal fixation for posterior pelvic ring fractures. The search time was from the establishment of each database to March 2023. Meta-analysis was performed on the included literature. The random-effects model was used when the heterogeneity between groups was large, and the fixed-effects model was used when the heterogeneity between groups was small.Results:A total of 15 studies were included in the meta-analysis, including 465 patients in the robot-assisted group and 396 patients in the fluoroscopy-assisted group. Meta-analysis showed that the number of fluoroscopies [ SMD=-3.12, 95% CI (-4.34, -1.89), P<0.001], the number of guide pin adjustments [ SMD=-3.75, 95% CI (-6.77, -0.72), P=0.015], intraoperative blood loss [ SMD=-0.83, 95% CI (-1.18, -0.49), P<0.001], and operative time [ SMD=-2.59, 95% CI (-4.11, -1.08), P<0.001] were smaller than those in the fluoroscopy-assisted group. The rate of excellent screw implantation [ OR=10.13, 95% CI (3.67,27.98), P<0.001] of the robot-assisted was larger than the fluoroscopy-assisted group. There was no significant difference in Majeed functional score [ SMD=0.28, 95% CI (-0.0003, 0.55), P=0.050] and fracture healing time [ SMD=-0.14, 95% CI (-0.46, 0.17), P=0.367] between the two groups. Conclusion:Robot-assisted percutaneous sacroiliac screw fixation for posterior pelvic ring fractures has the advantages of less fluoroscopy, less guide pin adjustment, less intraoperative blood loss, shorter operation time, and higher rate of excellent screw position. However, there is no difference in Majeed score and fracture healing time between robot-assisted percutaneous sacroiliac screw fixation and fluoroscopy-assisted percutaneous sacroiliac screw fixation.

Objective:Type H blood vessels are a subtype of bone-specific microvessels(CD31hiEmcnhi)that play an important regulatory role in the coupling of angiogenesis and osteogenesis.Despite reports on the distinct roles of type H and L vessels under physiological and pathological bone conditions,their genetic differences remain to be elucidated.This study aims to construct a competitive endogenous RNA(ceRNA)network of key gene for differencial expression(DE)in type H and L vascular endothelial cells(ECs)through integrated bioinformatic methods. Methods:We downloaded relevant raw data from the ArrayExpress and the Gene Expression Omnibus(GEO)database and used the Limma R-Bioconductor package to screen for DE lncRNAs,DE miRNAs,and DE mRNAs between type H and L vascular ECs.A total ceRNA network was constructed based on their interactions,followed by refinement using protein-protein interaction(PPI)networks to select upregulated and downregulated key genes.Enrichment analysis was performed on these key genes.Random validation was conducted using flow cytometry and real-time RT-PCR. Results:A total of 1 761 DE mRNAs,187 DE lncRNAs,and 159 DE miRNAs were identified,and a comprehensive ceRNA network was constructed based on their interactions.Six upregulated(Itga5,Kdr,Tjp1,Pecam1,Cdh5,and Ptk2)and 2 downregulated(Csf1r and Il10)key genes were selected via PPI network to construct a subnetwork of ceRNAs related to these key genes.Upregulated key genes were mainly enriched in negative regulation of angiogenesis and vascular apoptosis.Results from flow cytometry and real-time RT-PCR were consistent with bioinformatics analysis. Conclusion:This study proposes a ceRNA network associated with upregulated and downregulated type H and L vascular ECs based on selected key genes,providing new insights into the regulatory mechanisms of type H and L vascular ECs in bone metabolism.

To explore the basics of integrated curriculums and the reform plan of integrated organ-system based curriculum of clinical subjects, this paper takes the integrated musculoskeletal system based curriculum in the third semester for undergraduates majoring in clinical medicine as an example, elaborates on the following five aspects: the organ system-centered curriculum system, the integration of teaching content, curriculum implementation plans, curriculum advantages, major issues and measures for improvement. This paper puts forward some urgent problems such as writing teaching materials, changing teachers' traditional teaching concepts, arranging the course reasonably, achieving learning outcomes, and deepening the integration of knowledge in various subjects. It is also provides suggestions for building a coherent and complete teaching model and knowledge system of the integrated organ-system based curriculum, helping students better understand the organic relationships between various disciplines, and promoting the curriculum reform. The reform of the integrated organ-system based curriculum has achieved initial results.