Rheumatoid arthritis(RA)is a common chronic autoimmune disease with synovitis as its pathological basis and erosive arthritis as its main symptom.Pathogenesis of RA is complex,combination of genetic factors,environmental factors,immune cells,cytokines and autoantibodies causes joint injury,bone destruction and multi-system disease of RA.However,the above mecha-nisms can not fully explain the poor prognosis,high disability rate and poor clinical treatment effect of RA.Therefore,exploring new pathogenesis and therapeutic targets of RA is the focus of RA research.In recent years,with the deepening of RA research,it has been found that there is a new form of cell death in pathological process of RA,namely ferroptosis.Ferroptosis is a type of cell death caused by inhibition of glutathione peroxidase activity and accumulation of lipid reactive oxygen species.Previous studies have con-firmed the close correlation between RA and ferroptosis,this paper mainly explores ferroptosis-related signal pathways that affect the change and development of RA disease from the perspective of regulating the main signal pathways of ferroptosis,so as to find new therapeutic targets for RA and new therapeutic ideas for research.

Objective:To study the role and possible molecular mechanism of neural precursor cell-expressed developmentally down-regulated gene 4-like ( NEDD4 L) in the replication of hepatitis B virus (HBV). Methods:Small interfering RNA (siRNA) targeting NEDD4 L, plasmid expressing NEDD4 L with hemagglutinin(HA) C-terminal tag (pcDNA3.1- NEDD4 L-HA), plasmid expressing 1.3×HBV genome (pGEM-HBV1.3) and poly (dAT: dAT) were respectively transfected into HepG2 cells using Lipofectamine2000. HepG2.2.15 cells, a cell line that can stably express HBV, were used as control. The mRNA levels of NEDD4 L, interferon (IFN)-α, IFN-β, interferon-stimulated gene 56 ( ISG56), myxovirus resistance protein A ( MxA), oligoadenylate synthetase ( OAS), and the levels of HBV DNA or 3.5 kb HBV RNA were detected by real-time fluorescent quantitative polymerase chain reaction (qRT-PCR). Western blot was used to detect the silence and over-expression of NEDD4 L, and the protein levels of the related signaling molecules. The amount of IFN-β in the cellular supernatant was measured by enzyme linked immunosorbent assay (ELISA). Student t test was used for comparison of continuous data between groups. Results:The levels of NEDD4L mRNA and protein in HepG2.2.15 cells were 10.53±0.47 and 4.17±0.43, respectively, which were both statistically higher than those in HepG2 cells (1.00±0.05, t=3.27, P=0.008 and 1.26±0.25, t=1.68, P=0.030, respectively). In HepG2 cells with knockdown of NEDD4 L, the expression level of HBV DNA in cellular supernatant was 0.32±0.09, which was statistically lower than that in the control (1.00±0.05, t=-0.93, P=0.020), and the expression level of 3.5 kb HBV RNA was 0.49±0.11, which was statistically lower than that in the control (1.00±0.05, t=-0.68, P=0.040), while the mRNA levels of IFN-β and downstream effector molecules ( ISG56, MxA and OAS) were all significantly increased compared with the control ( t=4.66, 9.38, 7.29 and 7.01, respectively, all P<0.01). With poly (dAT: dAT) treatment and vesicular stomatitis virus (VSV) stimulation, the levels of IFN-β in HepG2 cells with knockdown of NEDD4 L were (776.41±115.49) ng/L and (961.21±130.19) ng/L, respectively, which were both statistically higher than those of the control group ((320.15± 56.05) ng/L, t=2.43, P=0.020; (440.17±67.82) ng/L, t=2.85, P=0.030, respectively). With poly (dAT: dAT) treatment and VSV stimulation, the levels of IFN-β in HepG2 cells with overexpression of NEDD4 L were (156.18±26.47) ng/L and (176.67±34.51) ng/L, respectively, which were both statistically lower than those of the control group ((320.38±49.39) ng/L, t=-2.03, P=0.040; (440.59±68.83) ng/L, t=-1.93, P=0.030, respectively). Western blot showed that the replication of HBV reduced the protein level of melanoma differentiation-associated protein 5 (MDA5), a key molecule in upstream of IFN-β, but the down-regulation was not obvious in cells with the knockdown of NEDD4 L. Conclusion:The replication of HBV could promote the up-regulation of NEDD4L protein and subsequently reduce the protein level of MDA5, thereby inhibiting the production of IFN-β, which facilitates HBV to escape the innate immune response.

Objective To observed the influence of preoperative enteral nutrition(EN) on postoperative nutritional status,immune function and complications in elderly patients with colorectal cancer complicating nutritional risk.Methods The NRS2002 nutritional risk screening criteria was used to select 70 elderly patients with colorectal cancer complicating nutritional risk,including 36 cases in the EN group and 34 cases in the control group.The EN support was given in the ENN group on preoperative 3 d.The levels of plasma total protein,prealbumin,albumin,transferrin,total lymphocyte count,plasma D-lactate(D-LAC) and plasma diamine oxidase (DAO) were detected on postoperative 1,3,5 7 d.The intraoperative intestinal cleanliness and postoperative complications were observed.Results The levels of plasma total protein,prealbumin,albumin,transferrin and total lymphocyte count in the EN group were significantly higher than those in the control group and the levels of D-LAC and DAO,and the incidence rates of abdominal infection and wound infection were significantly lower than those in the control group,the differences were statistically significant(P＜0.05).There was no statistically significant differences in the incidence rates of intestinal cleanliness and anastomotic leakage between the two groups (P＞0.05).Conclusion Preoperative EN support therapy in the patients with colorectal cancer complicating nutritional risk can significantly improve clinical prognosis.

Objective To study the relationship between the changes of TRIM16 in hippocampus of type 2 diabetic rats induced by streptozotocin (STZ) and cognitive dysfunction and apoptosis of hippocampal cells.Methods The male Sprague-Dawley (SD) rats of 8 weeks old were randomly divided into diabetic group (DM group) (n=25) and normal control group (NC group) (n=15).NC group were given normal feed, DM rats were fed with high glucose and high fat diet,followed by low dose of STZ (25 mg/kg, intraperitoneal injection), induced compensatory secretion of insulin, five days after the detection of tail vein blood glucose>16.7 mmol/L, and established the STZ.Meanwhile, citric acid buffer was injected to rats in group as control.After successful modeling, the rats in the two groups were fed with 17 weeks.Morris water maze test was used to detect the cognitive function of the two groups of rats.The protein expression of TRIM16, Bax and Bcl-2 protein in fresh hippocampus tissue of DM group and NC group rats was detected using western blotting.Rats in DM group and NC group were perfused with brain, and the hippocampal tissues were stained with immunohistochemistry.TUNEL method was used to detect the apoptosis of hippocampus cells.ResultsCompared with NC group, morris water maze test showed that the escape latency of rats in DM group is longer than NC group, staying at the original platform quadrant time in DM group is less than the NC group.TUNEL assay showed that after injection of 17 weeks, hippocampal CA1 pyramidal cells in type 2 diabetic rats appeared obvious apoptosis, positive neurons in the nuclei were brown, karyopyknosis anachromasis, while control group of neurons in the nucleus without brown coloring.Compared with the NC group, hippocampus immunohistochemistry results showed that the protein of TRIM16 in hippocampus CA1 region of type 2 diabetic rats was increased, cytoplasm brown, coarse granular.Compared with the NC group, the expression of Bcl-2 had no obvious change in hippocampus of type 2 diabetic rats at 17 weeks, while the expression of TRIM16, Bax and the ratio of Bax/Bcl-2 was significantly increased (P<0.05).Conclusion The protein expression of TRIM16 using immunohistochemical and Western blotting in hippocampus of diabetic rats induced by STZ was increased.There is apoptosis in hippocampus of diabetic rats induced by STZ, the expression of Bcl-2 was not significantly changed, the expression of Bax and the ratio of Bax/Bcl-2 were significantly increased.TRIM16 is involved in diabetic cognitive dysfunction by promoting apoptosis of diabetic rat hippocampus.

OBJECTIVE:To observe clinical efficacy of bevacizumab or cetuxizumab combined with FOLFOX4 regimen in the treatment of advanced rectal cancer. METHODS:114 patients with rectal cancer were randomly assigned to cetuxizumab group and bevacizumab group,with 57 cases in each group,among which one patient of bevacizumab group withdrew from therapy. Both groups received FOLFOX4 regimen:oxaliplatin 85 mg/m2+calcium folinate 200 mg/m2,ivgtt,2 h,and 5-FU 400 mg/m2,ivgtt, last,5-FU 600 mg/m2,ivgtt,22 h. Cetuxizumab group was additional given cetuxizumab 500 mg/m2;bevacizumab group was addi-tionally given bevacizumab 5 mg/kg,ivgtt. A treatment course lasted for 2 weeks. Both groups received 4 courses of treatment,and then clinical efficacy,toxic reaction and progression-free survival (PFS) were evaluated. RESULTS:Objective remission rate (RR),disease control rate(DCR)and median PFS of cetuxizumab group was 45.61%,92.98%and 10.0 months,those of bevaci-zumab group were 48.21%,87.50%and 11.0 months;there was no statistical significance between 2 groups(P>0.05). No signifi-cant differences were found in the incidence of ADR such as sensory neurotoxicity,aleucocytosis,thrombopenia,nausea and vomit-ing,diarrhea and erythra between 2 groups(P>0.05). CONCLUSIONS:Both bevacizumab or cetuxizumab combined with FOLF-OX4 regimen have a similar effect on patients with advanced cancer,with low incidence of toxic reaction.

Objective To investigate adherence and the influence factors among patients who are on antiretrovirus therapy (ART) of 3 provinces in China. Methods This study selected 18?year?old and older AIDS patients as the survey objects who initiated anti?retrovirus therapy between April and September of 2014 and kept on the treatment for one year in Yunnan,Sichuan,and Hu'nan province. Information of demography, treatment and social support was collected by questionnaires. Adopt SSRS questionnaire to calculate the information of objective support, subjective support and utilization of social support.χ2 test and logistic regression were performed to examine relationships between factors and adherence. Results A total of 386 patients with medication were investigated. Among them, there were 365 (94.6%) cases who were compliant to the ART, and 357 (92.5%) cases can take their pills on time, and 29 (7.5%) cases take their medication in excess of the prescribed time more than two hours. Social support score was 27.2 ± 7.3, including objective support score (5.6 ± 2.7), subjective support score (16.1 ± 4.8), and utilization of social support (5.5 ± 1.9). Multivariate logistic regression analysis revealed that adherence was significantly associated with the correct cognition of medication (OR (95%CI):3.24 (1.17-9.00)), the self?awareness of the drug regimen was not complexity (OR (95%CI): 9.34 (3.27-26.68)), taking medication 1 time a day (OR (95%CI): 4.00 (1.35-11.84)), and the batter utilization of social support (OR (95%CI): 1.49 (1.06-2.01)). Married/cohabiting or farmers tend to be nonadherenced, while the OR (95%CI) was 0.24 (0.08-0.67) and 0.23 (0.08-0.69), respectively. Conclusion The patients among these provinces were compliant to the ART, and most of them can take their pills on time. The social support score of these patients was lower than normal person. Participants who have correct cognition of medication, thinking their drug regimen was not complexity; Taking medication 1 time a day or have high level of utilization of social support showed a significantly higher level of self?reported adherence.

Objective To investigate adherence and the influence factors among patients who are on antiretrovirus therapy (ART) of 3 provinces in China. Methods This study selected 18?year?old and older AIDS patients as the survey objects who initiated anti?retrovirus therapy between April and September of 2014 and kept on the treatment for one year in Yunnan,Sichuan,and Hu'nan province. Information of demography, treatment and social support was collected by questionnaires. Adopt SSRS questionnaire to calculate the information of objective support, subjective support and utilization of social support.χ2 test and logistic regression were performed to examine relationships between factors and adherence. Results A total of 386 patients with medication were investigated. Among them, there were 365 (94.6%) cases who were compliant to the ART, and 357 (92.5%) cases can take their pills on time, and 29 (7.5%) cases take their medication in excess of the prescribed time more than two hours. Social support score was 27.2 ± 7.3, including objective support score (5.6 ± 2.7), subjective support score (16.1 ± 4.8), and utilization of social support (5.5 ± 1.9). Multivariate logistic regression analysis revealed that adherence was significantly associated with the correct cognition of medication (OR (95%CI):3.24 (1.17-9.00)), the self?awareness of the drug regimen was not complexity (OR (95%CI): 9.34 (3.27-26.68)), taking medication 1 time a day (OR (95%CI): 4.00 (1.35-11.84)), and the batter utilization of social support (OR (95%CI): 1.49 (1.06-2.01)). Married/cohabiting or farmers tend to be nonadherenced, while the OR (95%CI) was 0.24 (0.08-0.67) and 0.23 (0.08-0.69), respectively. Conclusion The patients among these provinces were compliant to the ART, and most of them can take their pills on time. The social support score of these patients was lower than normal person. Participants who have correct cognition of medication, thinking their drug regimen was not complexity; Taking medication 1 time a day or have high level of utilization of social support showed a significantly higher level of self?reported adherence.

China ; Counseling ; Female ; HIV Infections ; diagnosis ; Humans ; Pregnancy

Objective To study the possibility of microvascular permeability (PS) value derived from perfusion CT (PCT) in predicting hemorrhagic transformation (HT) in acute cerebral infarction in elderly patients.Methods 52 consecutive patients with middle cerebral artery acute ischemic stroke who received thrombolytic therapy were divided into HT group and control group,and patients in HT group were further divided into hemorrhagic infarction (HI) group and parenchymal hematoma (PH) group.PCT data and Alberta stroke program early CT scores (ASPECTS) from CT angiography source images (CTA-SI) achieved within 6 hours after symptom onset of each group was retrospectively analyzed and statistically processed.Results In 52 patients,there were 22 cases developed HT,14 cases with HI,8 cases with PH.Cerebral blood flow (CBF) and cerebral blood volume (CBV) values were decreased and permeability surface area product (PS) was increased in ipsilateral in HT group and control group as compared with the contralateral (all P＜0.05).PS value in ipsilateral was significantly higher in HT group than in control group (P＜0.01),but CBF and CBV values in affected side showed no significant difference between the HT group and control group.The area under the receiver operator characteristic (ROC) curve of PS Az value was 0.968.When PS ≥5.77 ml · min-1 · 100 g-1,the sensitivity and specificity of predicting HT were 95.5％ and 86.7％ respectively.The ASPECTS was lower in HT group than in the control group (P＜0.01),and ASPECTS was higher in HI group than in PH group (P＜0.01).The differences in PCT results in affected side between the HI group and PH group was not significant.Conclusions The significantly increased PS value can be a reference in predicting HT risk and guiding thrombolytic therapy.

BACKGROUND:It remains controversial in term of efficacy for the lightweight mesh and heavyweight mesh in inguinal hernia repair.
OBJECTIVE:To compare the clinical therapeutic effects of lightweight mesh and heavyweight mesh in open methods of inguinal hernia repair with Meta-analysis.
METHODS:Comprehensive electronic search strategies were developed using the fol owing electronic databases:PubMed, Cochrane Library, EMBASE, Medline, Ovid, CNKI, VIP, Wanfang and FMJS. The Literature published before February 2013 was searched. The randomized control ed trials about comparing lightweight mesh and heavyweight mesh in open methods of inguinal hernia repair were included. A data-extraction sheet was developed based on the preset standards. The data from eligible studies were pooled using RevMan5.1 software through Meta-analysis.
RESULTS AND CONCLUSION:Eighteen trials with a total of 4 450 hernias met the inclusion criteria. The meta-analysis showed that there was a statistical difference between lightweight mesh group and the heavyweight mesh group on short-term pain [odd ratio (OR)=0.57, 95%confidence interval (CI) (0.43, 0.74), P<0.05] and a reduced risk of developing foreign body sensations [OR=0.49, 95%CI (0.35, 0.69), P<0.05]. No significant differences were found between the two groups in recurrence rate, testicular atrophy, seroma, hematoma, wound infection, urine retention (P>0.5). According to limited evidence, there are some findings as fol ows:the lightweight mesh is of feasibility, safety and effectiveness for inguinal hernia repair. Because of the limits of sample and quality, more large-sample and high-quality trials are required to make a definite clinical evidence to use lightweight mesh for inguinal hernia repair.