Objective Based on the phosphatidylinositol kinase(PI3K)/protein kinase B(AKT)pathway and M2 polarization of macrophages,the effects of polydatin on malignant phenotype of osteosarcoma cells were investigated.Methods The macrophages were divided into M0 group,M2 group,polydatin group,and polydatin+PI3K pathway agonist 740Y-P group.The expression of arginase-1(Arg-1)and CD206 mRNAs and proteins in macrophages were detected by RT-qPCR and Western blot.Western blot was used to detect p-PI3K/PI3K and p-AKT/AKT protein expression in macrophages.The osteosarcoma cells MG-63 were divided into control group,control group(RPMI-1640 medium culture),CM-M0 group(M0 group M0 macrophage supernatant is collected for osteosarcoma cells),CM-M2 group(M2 group M2 macrophage supernatant is collected for osteosarcoma cells),CM-polydatin group(M2 macrophage supernatant in the polydatin group was collected on osteosarcoma cells),and CM-polydatin+740Y-P group(M2 macrophage supernatant was collected on osteosarcoma cells in the CM-polydatin+740Y-P group).Edu staining assay was used to detect the proliferation of MG-63 cells.Scratches and Transwell assays were used to detect the migration and invasion of MG-63 cells.Results Compared with the M0 group,the Arg-1,CD206,IL-10,p-PI3K/PI3K,p-AKT/AKT increased in the M2 group significantly(P<0.05).Compared with the M2 group,the Arg-1,CD206,IL-10,p-PI3K/PI3K,p-AKT/AKT decreased in the polydatin group significantly(P<0.05).Compared with the polydatin group,the Arg-1,CD206,IL-10,p-PI3K/PI3K,p-AKT/AKT increased in the polydatin+740Y-P group significantly(P<0.05).Compared with the CM-M0 group,the proportion of Edu-positive cells in the CM-M2 group increased significantly(P<0.05),and MG-63 cell migration and invasion rates increased significantly(P<0.05).Compared with the CM-M2 group,the proportion of Edu-positive cells in the CM-polydatin group decreased significantly(P<0.05),and MG-63 cell migration and invasion rates decreased significantly(P<0.05).Compared with the CM-polydatin group,the proportion of Edu-positive cells in the CM-polydatin+740Y-P group increased significantly(P<0.05),and MG-63 cell migration and invasion rates increased significantly(P<0.05).Conclusion Polygonum cuspidatum can inhibit the proliferation,migration and invasion of osteosarcoma cells by inhibiting the M2 polarization of macrophages,and its mechanism may be related to the inhibition of PI3K/AKT signaling pathway.

Objective:To study the consistency between post-processing bone mineral density(BMD)values of multi-slice spiral computed tomography(MSCT)scan and the BMD value of quantitative computed tomography(QCT)for lumbar vertebra,so as to explore the feasibility of utilizing MSCT scan-based post-processing BMD values for lumbar vertebra in clinical practice.Methods:The MSCT equipment and QCT equipment were respectively adopted to conduct imaging scan for the L2-L4 of lumber vertebra of QRM-ESP145 European Spine Phantom(ESP),and L2-L4 of lumbar vertebra of adult sheep,and L2-L4 of lumbar vertebra of adult volunteer.The L2-L4 of ESP lumber vertebra and L2-L4 of lumbar vertebra of adult sheep were scanned respectively MSCT and QCT for three times,so as to measure BMD values.The L2-L4 of lumbar vertebrae of volunteers were scanned respectively by the two methods for one time according to the standard of clinical examination,which were reconstructed by three times so as to obtain mean of them.The BMD values of QCT scan were set as control group,and the BMD values of MSCT scan were set as experiment group.The experiment group was further divided into experiment 1 group[two dimension(2D)regional volumetric BMD values of the lumbar vertebra]and experiment 2 group[three dimension(3D)global volumetric BMD post-processing of the lumbar vertebra]according to the reliability of experiment.Then,the consistency between the MSCT 3D post-processing BMD values of three groups and QCT-measured BMD values was compared and analyzed.Results:The MSCT 3D post-processing BMD values of L2-L4 of ESP lumbar vertebra of three groups were respectively(120.83±0.97),(199.57±0.54)and(119.19±1.04)mg/cm3,and that of L2-L4 of lumbar vertebra of adult sheep of three groups were respectively(414.89±1.72),(410.50±0.77)and(420.25±2.71)mg/cm3,and that of L2-L4 of lumbar vertebra of volunteer were respectively(141.22±0.09),(137.38±0.37)and(152.03±1.03)mg/cm3.There were not statistically significant differences in BMD values between MSCT examination and QCT examination(P＞0.05).Conclusion:MSCT 3D post-processing BMD values on lumbar vertebra has high consistency with that of QCT measurements,which post-processing technique can replace QCT to conduct BMD examination,and reduce unnecessary radiation exposure and examination costs for patients.

Objective Based on the phosphatidylinositol kinase(PI3K)/protein kinase B(AKT)pathway and M2 polarization of macrophages,the effects of polydatin on malignant phenotype of osteosarcoma cells were investigated.Methods The macrophages were divided into M0 group,M2 group,polydatin group,and polydatin+PI3K pathway agonist 740Y-P group.The expression of arginase-1(Arg-1)and CD206 mRNAs and proteins in macrophages were detected by RT-qPCR and Western blot.Western blot was used to detect p-PI3K/PI3K and p-AKT/AKT protein expression in macrophages.The osteosarcoma cells MG-63 were divided into control group,control group(RPMI-1640 medium culture),CM-M0 group(M0 group M0 macrophage supernatant is collected for osteosarcoma cells),CM-M2 group(M2 group M2 macrophage supernatant is collected for osteosarcoma cells),CM-polydatin group(M2 macrophage supernatant in the polydatin group was collected on osteosarcoma cells),and CM-polydatin+740Y-P group(M2 macrophage supernatant was collected on osteosarcoma cells in the CM-polydatin+740Y-P group).Edu staining assay was used to detect the proliferation of MG-63 cells.Scratches and Transwell assays were used to detect the migration and invasion of MG-63 cells.Results Compared with the M0 group,the Arg-1,CD206,IL-10,p-PI3K/PI3K,p-AKT/AKT increased in the M2 group significantly(P<0.05).Compared with the M2 group,the Arg-1,CD206,IL-10,p-PI3K/PI3K,p-AKT/AKT decreased in the polydatin group significantly(P<0.05).Compared with the polydatin group,the Arg-1,CD206,IL-10,p-PI3K/PI3K,p-AKT/AKT increased in the polydatin+740Y-P group significantly(P<0.05).Compared with the CM-M0 group,the proportion of Edu-positive cells in the CM-M2 group increased significantly(P<0.05),and MG-63 cell migration and invasion rates increased significantly(P<0.05).Compared with the CM-M2 group,the proportion of Edu-positive cells in the CM-polydatin group decreased significantly(P<0.05),and MG-63 cell migration and invasion rates decreased significantly(P<0.05).Compared with the CM-polydatin group,the proportion of Edu-positive cells in the CM-polydatin+740Y-P group increased significantly(P<0.05),and MG-63 cell migration and invasion rates increased significantly(P<0.05).Conclusion Polygonum cuspidatum can inhibit the proliferation,migration and invasion of osteosarcoma cells by inhibiting the M2 polarization of macrophages,and its mechanism may be related to the inhibition of PI3K/AKT signaling pathway.

Objective:To study the consistency between post-processing bone mineral density(BMD)values of multi-slice spiral computed tomography(MSCT)scan and the BMD value of quantitative computed tomography(QCT)for lumbar vertebra,so as to explore the feasibility of utilizing MSCT scan-based post-processing BMD values for lumbar vertebra in clinical practice.Methods:The MSCT equipment and QCT equipment were respectively adopted to conduct imaging scan for the L2-L4 of lumber vertebra of QRM-ESP145 European Spine Phantom(ESP),and L2-L4 of lumbar vertebra of adult sheep,and L2-L4 of lumbar vertebra of adult volunteer.The L2-L4 of ESP lumber vertebra and L2-L4 of lumbar vertebra of adult sheep were scanned respectively MSCT and QCT for three times,so as to measure BMD values.The L2-L4 of lumbar vertebrae of volunteers were scanned respectively by the two methods for one time according to the standard of clinical examination,which were reconstructed by three times so as to obtain mean of them.The BMD values of QCT scan were set as control group,and the BMD values of MSCT scan were set as experiment group.The experiment group was further divided into experiment 1 group[two dimension(2D)regional volumetric BMD values of the lumbar vertebra]and experiment 2 group[three dimension(3D)global volumetric BMD post-processing of the lumbar vertebra]according to the reliability of experiment.Then,the consistency between the MSCT 3D post-processing BMD values of three groups and QCT-measured BMD values was compared and analyzed.Results:The MSCT 3D post-processing BMD values of L2-L4 of ESP lumbar vertebra of three groups were respectively(120.83±0.97),(199.57±0.54)and(119.19±1.04)mg/cm3,and that of L2-L4 of lumbar vertebra of adult sheep of three groups were respectively(414.89±1.72),(410.50±0.77)and(420.25±2.71)mg/cm3,and that of L2-L4 of lumbar vertebra of volunteer were respectively(141.22±0.09),(137.38±0.37)and(152.03±1.03)mg/cm3.There were not statistically significant differences in BMD values between MSCT examination and QCT examination(P＞0.05).Conclusion:MSCT 3D post-processing BMD values on lumbar vertebra has high consistency with that of QCT measurements,which post-processing technique can replace QCT to conduct BMD examination,and reduce unnecessary radiation exposure and examination costs for patients.

BACKGROUND:After the internal fixation of cannulated screws in femoral neck fractures,because the affected limb is often unable to bear weight in the short term and the implants with high stiffness have a stress shielding effect on the fracture end,it is easy to cause osteoporosis of the affected limb and changes in the biomechanical distribution of the proximal femur,the incidence of osteonecrosis of the femoral head is high after surgery.At present,few studies have been conducted on the biomechanical effects of osteoporosis at the proximal end of the femur occurring after femoral neck fracture surgery on femoral neck fracture treated with cannulated screws. OBJECTIVE:Using finite element analysis,to investigate the biomechanical effects of osteoporosis occurring after femoral neck fracture surgery on femoral neck fracture treated with cannulated screws and explore the role of biomechanical factors in osteonecrosis of the femoral head. METHODS:Based on the obtained CT scan data of the femur in a patient with a femoral neck fracture,a proximal femoral model for internal fixation for femoral neck fracture was established by Mimics 19.0,3-Matic,UG 11.0,Hypermesh 14.0,and Abaqus software.One finite element model of the proximal femur without osteoporosis and three finite element models of the proximal femur with osteoporosis were analyzed using Abaqus software.The stress,contact pressure,displacement peak and cloud map under different components of the four models were measured and analyzed,and the internal stress changes and distribution of the femoral head were compared and analyzed. RESULTS AND CONCLUSION:The stresses and contact pressures of the femoral head and lower anterior cannulated screws varied more with the degree of osteoporosis.The peak displacement of the four models increased slowly with the degree of osteoporosis.By one-way analysis of variance,there was no significant effect of the degree of osteoporosis on the peak stress,contact pressure,and displacement of the different components.The internal stress distribution of the femoral head changed with the degree of osteoporosis.Changes in the biomechanical environment of the proximal femur have an important impact on osteonecrosis of the femoral head.

Objective:To study the risk factors and treatment of portal vein thrombosis (PVT) in patients after liver transplantation.Methods:The clinical data of 290 recipients who underwent liver transplantation at the Department of Hepatology, the Fifth Medical Center of PLA General Hospital from July 2015 to April 2019 were retrospectively analyzed. There were 245 males and 45 females, with a median age of 51(44, 56) years old. The liver transplantation recipients were divided into two groups according to whether PVT occurred or not after operation: the PVT group ( n=16) and the non-PVT group ( n=274). Gender, age and other clinical data of the recipients were compared between the two groups. Outpatient and inpatient follow-up were performed. The risk factors of postoperative PVT were analysed in the liver transplantation recipients. Results:The median follow-up of these 290 liver transplant recipients was 59(42, 73) months, and 16 patients were confirmed to have PVT after operation, with an incidence of 5.5%(16/290). Multivariate logistic regression analysis showed that preoperative PVT ( OR=12.773, 95% CI: 3.887-41.973) was an independent risk factor for PVT after liver transplantation. For the 16 patients with postoperative PVT, 10 were treated with portal vein intervention, and the remaining 6 patients were treated with oral aspirin or rivaroxaban anticoagulation due to mild symptoms. The 3-year survival rate of the PVT group was 93.8% (15/16), while that of the non-PVT group was 90.1% (247/274). There was no significant difference in the 3-year survival rates between the two groups (χ 2<0.01, P=0.969). Conclusions:Preoperative PVT in recipients was an independent risk factor for PVT after liver transplantation. For patients with postoperative PVT, appropriate treatment resulted in good results without affecting the long-term prognosis of these patients.

Objective:To summarize the clinical characteristics and the features of electroencephalograph (EEG) of children with DEPDC5 gene variants related epilepsy.Methods:The clinical data, gene variation, EEG and head magnetic resonance image (MRI) of 20 epileptic children with DEPDC5 gene variants admitted to Department of Pediatrics, Peking University First Hospital from May 2017 to November 2020 were retrospectively analyzed.Results:Twenty patients with heterozygous DEPDC5 gene variants were enrolled, 8 of 20 patients were nonsense variants, 6 were missense variants, 3 were frame-shift variants, 2 were splicing variants, and 1 was large fragment deletion. Sixteen cases had hereditary variation and 4 had de novo variation. Fifteen of variations were novel. Nine were male, while 11 were female. Their latest follow-up age ranged from 10 months to 13 years and one month.The epilepsy onset age ranged from 3 hours to 11 years and 3 months, the median age was 10.5 months. Twelve (60%) patients had developmental delay. Nineteen patients had focal seizures, 7 had epileptic spasms, 1 had multiple seizure types including tonic, atypical absence, dystonic and myoclonic seizures. Epileptic form discharges were observed in 18 patients during the interictal phase, and 11 were focal discharges, 7 were multifocal discharges. Ten (50%) patients had abnormal brain MRI, including focal cortical dysplasia in 5 patients, undefined malformation of cortical development in 4 patients, hemimegalencephaly in 1 patient. Four patients were diagnosed as West syndrome and one patient was diagnosed as Lennox-Gastaut syndrome. Fourteen (70%) patients were diagnosed as drug-resistant epilepsy. Four patients became seizure-free by treatment with anti-epileptic drugs. Three children were treated with surgery, and 2 of them became seizure-free, 1 had more than 75% reduction in seizures.Conclusions:DEPDC5 gene variant epilepsy is inherited with incomplete penetrance and focal seizure is the major seizure type. However, epileptic spasms, generalized seizures can also be observed. Half of the patients brain malformations. Most of the patients are drug-resistant epilepsy. Patients with clear epileptogenic zones can be treated with surgery. Treatment-resistant patients are more likely to be complicated with developmental delay.

Objective: To explore the relationship between serum complement 1q (C1q) and C1q/tumor necrosis factor-related protein 1 (CTRP1) levels in patients with coronary atherosclerotic heart disease (CHD) and their clinical value. Methods: Case-control study.115 patients with CHD who were hospitalized in the Department of Cardiology of Ningxia Medical University General Hospital from January 2018 to November 2018 were selected as the case group, including 72 males and 43 females, aged 35-82 years, average (59.96±9.49) years old. There were three subgroups: stable angina group (SAP, n=12), unstable angina group (UA, n=69), and acute myocardial infarction group (AMI, n=34). The control group was selected from 43 healthy subjects in the same period, including 21 males and 22 females, aged 23-71 years, with an average of (45.00±10.66) years old. Serum C1q and CTRP1 levels were tested by immunoturbidimetry and ELISA, and other biochemical indicators such as triglyceride (TG) and total cholesterol (CHOL) were detected.Multiple linear regression was used to analyze the influence of various factors on C1q level. ROC curve and area under the curve (AUC) to explore the diagnostic value of C1q and CTRP1. Results: The C1q level in the CHD group (184.06±31.05) mg/L was higher than that in the control group (122.22±28.18) mg/L (t=-11.405, P<0.001). The AMI group (192.80±34.08) mg/L was significantly higher than the SAP group (169.17±27.13) mg/L (t=-2.328, P=0.021).The CTRP1 level in the CHD group [241.85(79.38)] ng/ml was lower than that in healthy control group [292.7(67.64)] ng/ml (Z=-3.64, P<0.001). Group B with higher Gensini score (t=3.672, P<0.001) and group C (t=2.529, P=0.013) had higher C1q levels than group A.After adjusting for the effects of age, sex and other indicators, C1q levels were correlated with HDL-C (β=-0.582, P<0.001),CHOL (β=0.384,P<0.001) and systolic blood pressure (β=0.142,P=0.038). The ROC curve shows that when the CHD is diagnosed, the sensitivity of C1q level >150.82 mg/L is 87%,the specificity is 88.4%, and the AUC is 0.942. The corresponding sensitivity and specificity of CTRP1 <281.80 ng/ml are 76.5% and 60.5% respectively, and the AUC is 0.688. The AUC obtained by combined predictors was 0.944, and the sensitivity and specificity were 89.6% and 86.0% respectively. When AMI is diagnosed, C1q level >178.3 mg/L, corresponding sensitivity and specificity are 70.6% and 66.1%, the AUC is 0.726, CTRP1 has no diagnostic value. Conclusions Serum C1q levels in patients with CHD are elevated, and AMI patients are higher than SAP patients; C1q may be a potential marker reflecting the severity of coronary artery disease; there is no significant correlation between serum C1q and CTRP1 in CHD patients.

An 80-year-old male patient with lumbar vertebral tuberculosis took tiopronin (0. 2 g, thrice daily)to protect liver during chemotherapy for tuberculosis. After 7 months of treatment,eyelids and lower limbs edema appeared,then abdominal distension and urine volume decrease appeared gradually (urine volume was about 800 ml within 24 hours). Laboratory test showed that the serum total protein was 49 g/ L,albumin was 18 g/ L,urine protein was positive (+ + +),24-hour urine protein quantitation was 3720 mg (24-hour urine volume was 750 ml ). Tiopronin was stopped,antituberculotic therapy was continued,and symptomatic supportive treatments including antihypertensive,anticoagulant,diuretic,and kidney-protective therapy were given. Two weeks later,the patient′s edema disappeared,serum albumin increased to 25 g/ L,and 24-hour urine protein quantitation decreased to 1296 mg (24 hours urine volume was 1500 ml). Four weeks later,urine protein test turned negative. At 6 months of follow-up,above mentioned symptoms did not recur.

An 80-year-old male patient with lumbar vertebral tuberculosis took tiopronin (0. 2 g, thrice daily)to protect liver during chemotherapy for tuberculosis. After 7 months of treatment,eyelids and lower limbs edema appeared,then abdominal distension and urine volume decrease appeared gradually (urine volume was about 800 ml within 24 hours). Laboratory test showed that the serum total protein was 49 g/ L,albumin was 18 g/ L,urine protein was positive (+ + +),24-hour urine protein quantitation was 3720 mg (24-hour urine volume was 750 ml ). Tiopronin was stopped,antituberculotic therapy was continued,and symptomatic supportive treatments including antihypertensive,anticoagulant,diuretic,and kidney-protective therapy were given. Two weeks later,the patient′s edema disappeared,serum albumin increased to 25 g/ L,and 24-hour urine protein quantitation decreased to 1296 mg (24 hours urine volume was 1500 ml). Four weeks later,urine protein test turned negative. At 6 months of follow-up,above mentioned symptoms did not recur.