Objective To investigate the epidemiology characteristics of crawfish related rhabdomyolysis (RM) in Nanjing, 2016.Methods Outpatient and inpatient electronic medical system of 21 hospitals in Nanjing during 2016 were retrospectively searched, and all the patients diagnosed with RM were selected. The patients with none crayfish-related RM was excluded. The epidemiology characteristics were depicted. The geographic information system (GIS) was used to collect, manage and analyze the spatial data, to visualize it, to analyze the spatial distribution features of the disease, and to explore the cause of disease prediction. GeoDa 1.8 software was used to analyze the global and local spatial auto-correlation.Results A total of 1183 patients with crawfish related RM were initially screened, excluding 59 patients with RM caused by trauma, severe exercise, heat stroke, myositis, poisoning, drugs, and genetic diseases, and 1124 patients were enrolled. The proportion of men was 36.48% (410/1124) with an incidence of 12.54/100 thousands; while of women was 63.52% (714/1124) with an incidence of 21.86/100 thousands. The median age at onset was 34 (28, 43) years. From July to August, the incidence of crawfish related RM was the highest, accounting for 96.53% of the total number of cases. The top four incidence areas were Pukou (41.54/100 thousands), Jianye (25.94/100 thousands), Qixia (25.73/100 thousands), Gulou (25.04/100 thousands), all of which were adjacent to the Yangtze River. Global spatial autocorrelation analysis showed: MoranI = 0.427,Z = 2.646,P = 0.003, suggesting that the crawfish related RM had positive spatial autocorrelation. The results showed that the spatial structure of crawfish related RM existed in Nanjing in 2016. Local spatial autocorrelation analysis showed that the high-high concentration areas were Pukou, Jianye and Liuhe. The incidences of above three areas which were the Nanjing section of the lower reaches of the Yangtze River flowed through the region and surrounding areas were higher than the overall incidence of Nanjing.Conclusion The prevalence of crawfish related RM in Nanjing during 2016 had an obvious region-concentrated character and global spatial autocorrelation with the high prevalent regions mainly concentrated in the urban areas adjacent to the Yangtze River.

Objective To investigate the relationship between promotion of osteogenic differentiation of adipose-derived stem cells (ADSCs) by exosomes secreted by ADSCs and the Wnt/β-catenin signaling pathway. Methods ADSCs were extracted in the Plastic Surgery Department of the First Hospital Affiliated to China Medical University. Exosomes were extracted from ADSCs induced to differentiate into osteoblasts. The ADSCs were separated into four groups and used for measuring activity of alkaline phosphatase (ALP) by using enzyme-labeled assay, formation of calcium nodes by Alizarin red staining, and expression of β-catenin by Western blotting. Results ADSC-derived exosomes promoted differentiation of ADSCs into osteoblasts by upregulating the expression of β-catenin. Addition of Dickkopf-related protein 1 (DKK1), an inhibitor of Wnt/β-catenin pathway, inhibited expression of β-catenin which in turn resulted in reduced potential of ADSCs for osteogenic differentiation. Conclusion The osteogenic differentiation of ADSCs can be promoted by exosomes derived from ADSCs via the Wnt/β-catenin signaling pathway.