Objective To explore the association between serum cartilage oligomeric matrix protein (COMe) levels and joint destruction in rheumatoid arthritis (RA) and inflammatory arthritis patients. Methods Serum level of COMP was measured with ELISA in 154 arthritis patients.The results of serum COMe were compared with clinical parameters and the modified SHARe scores after 2 years in RA patients. Results Serum COMP level of RA patients was higher than that of normal controls and patients with other forms of arthritis in which only synovial membrane was involved (P＜0.05).We found a significant difference between sCOMP in osteoarthritis (OA) and psoriatic arthritis (PSA) patients with normal controls ,but not with other forms of arthritis.There was no difference of sCOMP between RA,OA or PSA patients.We found a positive correlation between baseline sCOMP and deterioration of modified SHARP scores after 2 years (P＜ 0.001,r=0.848),but did not find correlation between the baseline sCOMP and the titer of anti-CCP,RF, grade of joint function and modified SHARP scores at baseline.We also found a significant correlation between sCOMP and ESR or CRP levels,duration of morning stiffness,joint swelling scores and tenderness scores re spoctively (P＜0.05).Conclusion Serum COMP level is elevated in arthritis patients whose joint cartilage is also involved,particularly in patients with RA.The results of this study indicate that serum COMe may be used as a diagnostic and prognostic marker for cartilage destruction in established RA patients.

Objective To investigate the urinary tract infection by Mycoplasma in systemic lupus erythematosus (SLE) patients. Methods Mycoplasma hominis (Mh) and Ureaplasma urealyticum (Uu) from serum, eye, pharynx and urethra secretions were detected by nested polymerase chain reaction (nPCR) in 129 SLE patients, and DNA sequences of positive product were detected and analysed. Results Seventy-nine were positive and 50 were negative, 50 of 79 positive subjects (63.2%) were urinary tract infection, and 11 of 50 negative subjects (22.0%) were infected (P=0.001). Ninty-five active SLE patients, 66(69%) were positive and 29(30.5%) were negative for mycoplasma infection. Thirty-four inactive SLE patients, 13(38%) were positive and 21(61.7%) were negative for mycoplasma infection (P=0.000). Comparing these two setsof patients, the urinary tract infection in the active SLE was significantly higher than in stable patients. Conclusion Mycoplasma infection is the major pathogen inducing SLE flare and may be one of the infective pathogene of SLE.

Objective To study the association of serum cartilage oligomeric matrix protein (COMP)with disease activity and early joint destruction of rheumatoid arthritis (RA). Methods The serum levels of COMP were measured with ELISA in 94 patients with RA and 40 controls. The serum level of erythrocyte sedimentation rate (ESR), rheumatoid factor (RF), anti-cyclic citrullinated peptide antibodies (ACCP) and hand X-ray were examined at the same time. Results Significantly increased serum level of COMP was found in RA patients (11.3±5.2) U/L as compared to that in healthy controls (9.2±1.7) U/L (P=0.017).Serum level of COMP was higher in 64 active patients (14±6) U/L than that in 30 inactive disease (9±4) U/L(P=0.005). COMP level was positively correlated with the number of the affected joints, X-ray stage, CRP and ESR level (P<0.05); but had no correlation with age, disease course, grade of joint function, RF and ACCP levels. Thirty patients were followed for two years and their radiographic changes were evaluated at the baseline and the end of this study. Sixteen of 18 patients with high concentration serum COMP level had radi-ologic progression, but only 5 of 12 patients with no increase of serum COMP had radiologic progression. A significant difference (P=0.013) was founded in the two groups. Conclusion The present data suggests that the level of COMP is high in patients with RA. High serum levels of COMP indicate high disease activity and early progressive of bone destruction in RA patients. We can us COMP as a laboratory marker of RA.

Objective:Eph is the largest member of the family of receptor tyrosine kinases (RTK). Hypermethylation of CpG island is an important mechanism leading to down-regulation of EphA7 in gastric cancer. The objective of this study is to investigate the expression level of EphA7 in gastric carcinoma and its roles in the development,progression and prognosis of gastric carcinoma. Methods:The expression level of EphA7 transcript in gastric carcinoma specimens and normal mucosa tissues was detected using real-time RT-PCR. Results:The expression level of EphA7 in gastric carcinoma was divided into three groups according to the expression rate in gastric cancer tissue and matched normal mucosa. Statistics analysis showed that the expression of EphA7 is significantly related to age and stage. Overexpression of EphA7 has a tendency to relate to metastasis. Conclusion:EphA7 is differentially expressed in gastric carcinoma specimens. Overexpression of EphA7 may play a role in the development and progress of gastric carcinoma.

Objective To evaluate the diagnostic and therapeutic effects of endoscopic retrograde cholangiopancreatography (ERCP) in biliary papillomatosis. Methods Data of 6 patients, who underwent ERCP and diagnosed as biliary papillomatosis from 2000 to 2008, were retrospectively analyzed. Results There were 3 males and 3 females, with the mean age of onset at 72.8 years (range 52-83 years). Recurrent cholangitis and jaundice were common presentations in all patients, with 5 patients having right upper abdominal pain and 3 others exhiting fever and algor. History of partial hepatectomy was observed in 2 patients. Endoscopic findings included dilated papillary orifice with mucin discharge in 5 patients and papillary-occupying lesion in 1 patient. Multiple filling defects in the lumen of the biliary system in dilated common bile duct were detected in all patients, accompanied with extra-hepatic ducts dilatation in 3, right intra-hepatic duct dilatation in 1, and major pancreatic duct dilation in 1. Of 6 patients, 5 underwent multiple ERCP, inclucling stents and endoscopic nasobiliary drainage (ENBD), and have survived for 10-30 months. Another 83-year-old patient underwent palliative endoscopic treatment with balloons, baskets and ENBD, but died of cholangitis 10 days after the procedure. Conclusion This case series reports the typical endoscopic findings of biliary papiliomatosis. For inoperable or postoperative recurrent patients, endoscopic palliative treatment is a safe, convenient and effective procedure.

Objective: To investigate EphA7 protein expression of gastric carcinoma cells and its clinicopathological parameters.Methods: The expression level of EphA7 protein in gastric carcinoma and normal mucosa was detected using immunohistochemical staining.Results: The overexpression of EphA7 protein in gastric carcinoma was significantly related to age(P=0.016) and stage(P =0.033).Conclusion: EphA7 was differentially expressed in gastric carcinoma cells.

Objective To analyze the influencing factors of poor anal function after laparoscopic intersphincteric resection(Lap-ISR)for extremely low rectal cancer,and to construct and verify a prediction model based on this model,in order to provide guidance for improving the anal function of patients with extremely low rectal cancer after Lap-ISR.Method A total of 127 patients with extremely low rectal cancer who underwent Lap-ISR in Taizhou People's Hospital from June 2020 to June 2022 were retrospectively selected.Patients were followed up for 12 months after surgery,and postoperative anal function was evaluated by the anal incontinence score(Wexner).According to Wexner score,the patients were divided into good anal function group(106 cases)and poor anal function group(21 cases).The clinical data of patients were collected and the risk factors affecting postoperative poor anal dysfunction were analyzed,and a Nomogram model was constructed to predict the risk of postoperative anal dysfunction in patients after Lap-ISR,and the receiver operating characteristic curve(ROC)was drawn.The area under the curve(AUC)was used to analyze the predictive efficacy of the prediction model for poor anal dysfunction after Lap-ISR.Result The incidence of anal dysfunction after Lap-ISR in patients with extremely low rectal cancer was 16.54％(21/127).Univariate analysis showed that there was no significant difference in gender,age,body mass index,clinical stage,combined underlying diseases,operation time,intraoperative blood loss,anastomosis method,and the distance from the lower edge of the tumor to the dentate line between the two groups(P＞0.05).The proportion of tumor diameter≥5 cm,the proportion of neoadjuvant chemotherapy,the distance between anastomosis and anal verge＜2 cm,and the proportion of anastomotic leakage in the anal dysfunction group were higher than those in the good anal function group(P＜0.05).Cox multivariate regression analysis showed that tumor diameter≥5 cm(OR=5.124),neoadjuvant chemotherapy(OR=5.761)and anastomotic leakage(OR=6.881)were risk factors for postoperative anal function(P＜0.05).Wexner score of patients with tumor diameter ≥5 cm was higher than that of patients with tumor diameter＜5 cm,Wexner score of patients with neoadjuvant chemotherapy was higher than that of patients without neoadjuvant chemotherapy,and Wexner score of patients with anastomotic leakage was higher than that of patients without anastomotic leakage(P＜0.05).Internal validation of Bootstrap method showed that the C-index was 0.785(95％CI:0.692-0.851).The results of ROC curve showed that the sensitivity and specificity of the nomogram model in predicting postoperative poor anal function of patients were 85.70％and 88.70％,respectively,and the AUC was 0.895(95％CI:0.795-0.984).Conclusion Tumor diameter,neoadjuvant chemotherapy and anastomotic leakage are risk factors for poor anal function after Lap-ISR in patients with extremely low rectal cancer.The nomogram risk prediction model based on the above risk factors has a good risk efficiency in evaluating the risk of postoperative anal dysfunction in patients.

This paper reviewed the obesity harm, concept of home care, home care after bariatric and metabolic surgery, measure tools of home care needs, home care needs and intervention for postoperative home care needs. This paper also put forward that we can formulate home nutrition plan, promote shape recovery and rebuild psychology to satisfy the postoperative home care needs of obesity patients, and explored the home care model for patients undergoing bariatric and metabolic surgery suitable for national conditions.

Objective:To explore and understand the home rehabilitation experience of obese patients after metabolic bariatric surgery (MBS) , and provide a reference for the development of home nursing after MBS.Methods:Totally 12 patients who came for reexamination after MBS at the Department of Metabolic Bariatric Surgery in a Class Ⅲ Grade A hospital were selected by purposive sampling between February and May 2019. Descriptive research methods were used to conduct in-depth interviews over the patients and record the results, and content analysis was employed to organize and analyze the data.Results:Four themes were refined: suffering from changes in body image; constantly facing the puzzles of diet management; gradually choosing to give up rehabilitation exercise; and feeling emotional fluctuations, the hardship of seeking medical service and inner expectations.Conclusions:Medical staff should pay attention to the true feelings of patients' home rehabilitation post operation, strengthen the professional support outside the hospital for the health-related problems and different mental states during the rehabilitation process, provide standardized home care services, and improve the quality of life of the patients.

Body image is a common concept in the field of psychology and an important indicator for evaluating the quality of life of patients after bariatric and metabolic surgery. This paper reviews the concept of body image, the measurement tools, influencing factors and the intervention of the body image after bariatric and metabolic surgery, so as to provide a reference for domestic research on the body image of patients after bariatric and metabolic surgery.