Objective To investigate serum levels of Zonulin and Claudin-5 in patients with schizophrenia (SZ) and their relationship with the severity of psychiatric symptoms. Methods 98 patients with SZ treated in the Third Hospital of Heilongjiang Province form April 2019 to April 2022 were selected as the SZ group,and 50 healthy people who underwent physical examination were selected as the control group. Enzyme-linked immunosorbent assay was used to detect serum levels of Zonulin and Claudin-5. Pearson correlation analysis was used to analyze the relationship between serum Zonulin and Claudin-5 levels and clinical parameters in patients with SZ. Logistic regression was used to analyze the risk factors for SZ. Receiver operating characteristic curve was used to analyze the diagnostic value of serum Zonulin and Claudin-5 for SZ. Results The serum level of Zonulin in SZ group(7.91±0.52μg/L)was higher than that in control group (2.31±0.24μg/L),and the serum level of Claudin-5(12.17±2.34ng/L)was lower than that in control group(26.78±5.15 ng/L),the differences were statistically significant (t=72.235,23.740,all P<0.05).The total scores of Positive and Negative Symptom Scale (PANSS) score,positive and negative symptom scores,general psychiatric symptom scores was positively correlated with serum Zonulin (r=0.660～0.720,all P<0.05),and negatively correlated with serum Claudin-5 (r=-0.720～-0.622,all P<0.05).Serum Zonulin,PANSS total score,positive symptom score and general psychopathology symptom score were risk factors for SZ,and Claudin-5 was a protective factor (all P<0.05).The AUC(95％CI)of serum Zonulin and Claudin-5 combined for SZ diagnosis was 0.932(0.891～0.959),which was higher than that of serum Zonulin and Claudin-5 single diagnosis were 0.814(0.779～0.847),0.846(0.811～0.882),respectively,and the differences were statistically significant (Z=5.145,4.210,all P<0.05). Conclusion The increase in serum Zonulin levels and the decrease in Claudin-5 levels in SZ patients are related to the severity of their mental symptoms. The combined detection of serum Zonulin and Claudin-5 has high diagnostic value for SZ.

Objective To investigate serum levels of Zonulin and Claudin-5 in patients with schizophrenia (SZ) and their relationship with the severity of psychiatric symptoms. Methods 98 patients with SZ treated in the Third Hospital of Heilongjiang Province form April 2019 to April 2022 were selected as the SZ group,and 50 healthy people who underwent physical examination were selected as the control group. Enzyme-linked immunosorbent assay was used to detect serum levels of Zonulin and Claudin-5. Pearson correlation analysis was used to analyze the relationship between serum Zonulin and Claudin-5 levels and clinical parameters in patients with SZ. Logistic regression was used to analyze the risk factors for SZ. Receiver operating characteristic curve was used to analyze the diagnostic value of serum Zonulin and Claudin-5 for SZ. Results The serum level of Zonulin in SZ group(7.91±0.52μg/L)was higher than that in control group (2.31±0.24μg/L),and the serum level of Claudin-5(12.17±2.34ng/L)was lower than that in control group(26.78±5.15 ng/L),the differences were statistically significant (t=72.235,23.740,all P<0.05).The total scores of Positive and Negative Symptom Scale (PANSS) score,positive and negative symptom scores,general psychiatric symptom scores was positively correlated with serum Zonulin (r=0.660～0.720,all P<0.05),and negatively correlated with serum Claudin-5 (r=-0.720～-0.622,all P<0.05).Serum Zonulin,PANSS total score,positive symptom score and general psychopathology symptom score were risk factors for SZ,and Claudin-5 was a protective factor (all P<0.05).The AUC(95％CI)of serum Zonulin and Claudin-5 combined for SZ diagnosis was 0.932(0.891～0.959),which was higher than that of serum Zonulin and Claudin-5 single diagnosis were 0.814(0.779～0.847),0.846(0.811～0.882),respectively,and the differences were statistically significant (Z=5.145,4.210,all P<0.05). Conclusion The increase in serum Zonulin levels and the decrease in Claudin-5 levels in SZ patients are related to the severity of their mental symptoms. The combined detection of serum Zonulin and Claudin-5 has high diagnostic value for SZ.

Objective To observe the inter-observer consistency of diameter of inferior vena cava(IVC)and IVC collapsibility index(IVCCI)measured and assessed with echocardiography and the correlations with right heart parameters in patients with right heart dysfunction.Methods Forty-seven patients with right heart dysfunction were prospectively recruited in observation group,while 50 adults with normal right heart function were taken as controls(control group).Parameters of the right heart were obtained with echocardiography,including the right ventricular fractional area change(FAC),the tricuspid annular plane systolic excursion(TAPSE),the myocardial performance index(MPI),the tricuspid annular systolic velocity(S')as well as early and late diastolic velocity(e',a')and e'/a' ratio,also the tricuspid valve orifice early and late diastolic velocities(E,A)and E/A ratio and E/e',the vena contracta width of tricuspid regurgitation(TR-VCW),the maximum velocity of tricuspid regurgitation(TR-Vmax),the pulmonary artery systolic pressure(PASP)and right atrial area(RAA).Besides,the maximal and minimal diameter of IVC(IVCDmax,IVCDmin)during the respiratory cycle were measured with two dimensional(2D)ultrasound and anatomical M-mode ultrasound,respectively,and the IVCCI were calculated.Then 20 subjects were randomly selected from each group,and IVC parameters were obtained.The basic data,right heart parameters and IVC parameters were compared between groups,intra-class correlation coefficient(ICC)between 2 sonographers of IVC parameters were calculated,and correlations between IVC parameters and right heart parameters were assessed.Results No significant differences of gender,age nor body mass index(BMI)was detected between groups(all P＞0.05).Compared with those in control group,MPI,e',e'/a',E,A,E/e',TR-VCW,TR-Vmax,PASP and RAA increased,whereas FAC,TAPSE,S'and a'decreased in observation group(all P＜0.05).The inter-observer consistencies were good for IVCDmax and IVCCI in observation group(ICC=0.787-0.971)and IVCDmax in the control group(ICC=0.971,0.964)obtained with 2D ultrasound and anatomical M-mode ultrasound,but poor for IVCCI in control group(ICC=0.169,0.456).Compared with those in control group,IVC parameters 2D-IVCDmax,2D-IVCDmin,M-IVCDmax and M-IVCDmin increased but 2D-IVCCI and M-IVCCI decreased in observation group(all P＜0.05).In control group,2D-IVCDmax was weakly negatively correlated with TAPSE and a'(r=-0.392,-0.364),weakly positively correlated with e'/a',E,E/A,TR-VCW and RAA(r=0.396,0.483,0.461,0.565,0.582),2D-IVCCI was weakly negatively correlated with TR-VCW and RAA(r=-0.386,-0.380),while M-IVCDmax was weakly negatively correlated with TAPSE(r=-0.384),and weakly positively correlated with e'/a',E,E/A,TR-VCW and RAA(r=0.357,0.453,0.473,0.549,0.550),M-IVCCI was weakly negatively correlated with MPI,E,TR-VCW and RAA(r=-0.347,-0.337,-0.475,-0.421).Conclusion In patients with right heart dysfunction,IVCD diameter and IVCCI obtained with echocardiography had good inter-observer consistencies.Parameters obtained with 2D ultrasound and anatomic M-mode ultrasound had certain relations with the right heart parameters.

Objective:This article aimed to systematically evaluate the safety, feasibility and short-term outcomes of laparoscopic versus open radical resection for hilar cholangiocarcinoma.Methods:Relevant medical literatures published before November 30, 2021 were searched using PubMed, EMbase, Cochrane Library, Web of Science, CNKI, Wanfang, VIP, CBM databases. Based on predetermined inclusion and exclusion criteria, articles were selected, and RevMan5.4 software was used to conduct the meta-analysis of this study.Results:Twelve comparative cohort articles were enrolled, which included 634 patients. There were 275 patients who underwent laparoscopic radical resection for hilar cholangiocarcinoma in the laparoscopic group, and 359 patients who underwent open radical resection for hilar cholangiocarcinoma in the open group. Meta-analysis showed that when compared with the open group, operation time of the laparoscopic group was significantly longer ( MD=58.36, 95% CI:13.54-103.18). However, intraoperative blood loss ( MD=-79.70, 95% CI:-90.01--69.39), hospital stay ( MD=-3.37, 95% CI:-4.29--2.45) and incision-related complications ( OR=0.36, 95% CI:0.16-0.80) were all significantly less (all P<0.05). The number of lymph node harvested, R 0 resection rates, postoperative bile leakage, intraperitoneal infection and effusion, total complication rates, and perioperative mortality and 1-year survival rates after operation between the two groups were not significantly different (all P>0.05). Conclusion:Laparoscopic radical resection for hilar cholangiocarcinoma was feasible and safe in selected patients carried out in an experienced hepatobiliary surgery center.

BACKGROUND:Osteoarthritis is an age-related joint disease characterized by articular cartilage degeneration.
OBJECTIVE:To assess the expression of miR-140-3p in synovial fluid of knee osteoarthritis, and identify whether miR-140-3p levels in synovial fluid are correlated with disease severity.
METHODS:We col ected 10 healthy volunteers, 10 patients with gouty arthritis, 10 patients with rheumatoid arthritis, and 45 patients with knee osteoarthritis (15 cases in early stage, 15 cases in middle stage and 15 cases in the late stage). Real-time fluorescence quantitative PCR was used to detect miR-140-3p expression in synovial fluid in each group.
RESULTS AND CONCLUSION:(1) Expression of miR-140-3p was significantly down-regulated in knee osteoarthritis group. Significant differences in miR-140-3p expression were detected between non-knee osteoarthritis group and knee osteoarthritis group (P<0.05). No significant difference in miR-140-3p expression was determined among healthy control group, gouty arthritis group and rheumatoid arthritis group (P>0.05). (2) The miR-140-3p expression in the healthy control group was 11.4 times that in the knee osteoarthritis group. The expression of miR-140-3p decreased with the increase of the severity of osteoarthritis. (3) Spearman rank correlation analysis suggested that the expression of miR-140-3p was negatively correlated with osteoarthritis severity. (4) Results suggest that the expression of miR-140-3p in synovial fluid can reflect the progression of knee osteoarthritis to a certain extent.

Objective To detect the gene mutation of thyroid hormone receptor β ( TRβ ) in a family with thyroid hormone resistance syndrome.Methods The genomic DNA was extracted from peripheral blood leukocytes of the patient and his 5 family members.The exons 1-10 ofTRβ gene were amplified by PCR.The products of PCR were sequenced directly to detect the gene mutation.Results Two members of this family were confirmed to have the C y A transition mutation at nucleotide 1642 site within exon 10 of TRβ gene,which was a missense mutation causing the substitution of Proline to Threonine (P453T).The mutation was Heterozygous.Conclusions It was confirmed that the patient has TRβ gene mutation P453T in exon 10.The mutation may lead to the occurrence of thyroid hormone resistance syndrome.

Objective To identify the disease-causing gene mutation and investigate the genotypephenotype correlation in a Chinese pedigree with familial hypertrophic cardiomyopathy.Methods In this study we collected a large multigenerational Chinese family with FHCM.Total genome DNA was extracted from 67 subjects' peripheral leucocytes.The exons and boundary introns of MYH7 gene was amplified by PCR and directly sequenced by ABI PRISM 3700 DNA sequencer.Then,the mutation was examined.Results Fourteen family members had hypertrophic cardiomyopathy,including 4 deceased 2 of whom died from sudden death at young age.Analysis by echocardiography showed all the 10 living affected individuals have a maximal leftventricular-wall thickness of at least 13 mm.Three single nucleotide polymorphisms (SNP) which had been reported in NCBI SNP database,were found mutated.No mutation co-seperated with the disease was identified.Conclusion FHCM of this family was not caused by MYH7 mutation.Other genes should be screened to further identify the disease-causing gene mutation in hypertrophic cardiomyopathy.

Objective To investigate the effects of the genetic polymorphisms in osteoporosis-related genes and the gene-gene interaction on bone mineral density (BMD) and osteoporotic fractures.Methods Thirty-nine single nucleotide polymorphism (SNP) sites in 23 genes that related to bone mineral density ( BMD ) and osteoporotic fractures were scanned in 683 Shanghai Han postmenopausal women.TaqMan SNP Genotyping Assay or Sequenom Mass ARRAY System were applied for genotyping analysis.The relation of these SNP sites with BMD and osteoporotic fractures were analyzed.Results Altogether,12 SNPs in 9 candidate genes ( rs7524102 and rs6696981 in ZBTB40 gene,rs9479055 in ESR1 gene,rs6993813,rs6469804,and rs11995824 in OPG gene,rs3736228 in LRP5 gene,rs1107748 in SOST gene,rs87938 in CTNNB1 gene,rs1366594 in MEF2C gene,rs7117858 in SOX6 gene,and rs10048146 in FOXL1 gene) were associated with BMD at lumbar spine(L1-L4) or total hip.In addition,rs11898505 in SPTBN1 gene was related to osteoporotic fractures ( OR 0.522,95％ CI 0.326-0.838,P =0.007 ).Gene-gene interaction involving rs1038304 in ESR1 gene,rs1366594 in MEF2C gene,and rs10048146 in FOXL1 gene was associated with osteoporotic fractures ( P =0.010 7 ).Conclusions ( 1 ) SNPs in gene ZBTB40,ESR1,OPG,LRP5,SOST,CTNNB1,MEF2C,SOX6,FOXL1,and SPTBN1 are associated with BMD of lumbar spine or total hip,as well as osteoporotic fractures.(2) Gene-gene interaction involving rs1038304,rs1366594,and rs10048146may contribute to the risk of osteoporotic fractures.

Objective To investigate the association of single nucleotide polymorphisms (SNPs) in the SCGB3A2(secretoglobin family 3A member 2) gene promoter with susceptibility of Graves' disease.Methods One-hundred and seventy-nine SNPs within a 3.0 Mb region surrounding marker D5s2090 were scanned in a case-control study.The size of the region(s) associated with GD was then narrowed.Results Total 179 SNPs within a 3.0 Mb region surrounding marker D5s2090 were analyzed.The most significant association signal was found at SNP rs1368408 (P =3.69 × 10-5).Subsequent association analysis was then performed and the results suggested that the SNP76 (P =4.11 × 10-8) and SNP75 (P =1.37 × 10-8) in the promoter of SCGB3A2 gene may be the causal variants of GD.Logistic regression analysis suggested these 2 SNPs in this region may contribute to GD susceptibility.Conclusion A significant association seems to exist between GD with the SCGB3A2 gene.

Objective To investigate the association between polymorphisms of thyroid-stimulating hormone receptor(TSHR)gene intron 1(rs179247, rs12101261)and Graves′ disease(GD)in the China Han population from Xuzhou city, Jiangsu Province. Methods Total 1 066 GD patients and 1 107 control subjects were recruited for genotyping by Taqman probe technique on Fluidigm EP1 platform. Meanwhile, serum concentrations of thyroid hormone and TSH receptor antibodies(TRAb)were determined. Results The rs179247_A, rs12101261_T were significantly associated with GD risk(OR=1.35, 95%CI 1.19-1.54, P=5.92×10-6; OR=1.32, 95%CI 1.16-1.50, P=2.22×10-5). Logistic regression identified that rs179247 was an independent susceptibility locus of GD. Serum TRAb concentration showed a significant difference(P=0.015)among rs179247_AA, AG, and GG genotypes. Conclusion rs179247 and rs12101261 in TSHR intron 1 are both associated with GD, and rs179247 may contribute risk to GD independently. The polymorphism is associated with TRAb, but not with serum concentration of thyroid hormones, age of onset, diffused thyroid goiter, ophthalmic signs, and relapse.