Objective To compare the differences in clinical features and treatment choices between periph-eral spondyloarthritis(pSpA)and axial spondyloarthritis(axSpA),and better understand the clinical charac-teristics and medication needs of pSpA.Methods Our study is a retrospective cohort study.The patients who first visited the First Medical Center of Chinese PLA General Hospital between January 2016 and December 2022 and were diagnosed with axSpA or pSpA according to the classification criteria established by the Assess-ment of SpondyloArthritis International Society were selected as the study subjects.Demographic data,clinical characteristics,laboratory tests,and treatment information of these patients were obtained through the electronic medical records management system and the intelligent management system for spondyloarthritis.The research compared the distribution of swollen and tender joints between pSpA and axSpA patients,as well as that between pSpA1(excluding patients with psoriatic arthritis)and axSpA patients.Additionally,we analyzed differences in clinical features and treatment options among these groups.Results A total of 1639 pa-tients were included in the study,of which 184 had pSpA(including 97 with psoriatic arthritis),and 1455 had axSpA.Compared to axSpA patients,pSpA patients had fewer male patients(62.5％vs.79.7％,P＜0.001),later onset age(33.8 years vs.22.0 years,P＜0.001),shorter diagnostic delays(6.0 months vs.14.2 months,P=0.004),more associated peripheral arthritis(71.7％vs.9.3％,P＜0.001)and dac-tylitis(6.5％vs.0.3％,P＜0.001),more cases of psoriasis(52.7％vs.1.1％,P＜0.001)and a more common family history of psoriasis(11.4％vs.3.4％,P＜0.001).pSpA patients had higher levels of in-flammatory markers but a lower positive rate of human leukocyte antigen(HLA)-B27(43.5％vs.87.4％,P＜0.001).A positive HLA-B27 was associated with an earlier onset age,fewer cases of psoriasis,and a fami-ly history of ankylosing spondylitis.pSpA patients had a higher proportion of using conventional synthetic dis-ease-modifying antirheumatic drugs(csDMARDs),biologic disease-modifying antirheumatic drugs(bDMARDs),and oral glucocorticoids,and they also more frequently used a combination of bDMARDs and csDMARDs(19.0％vs.12.2％,P=0.009)or multiple csDMARDs(65.8％vs.12.5％,P＜0.001).Compared to axSpA patients,pSpA1 patients(excluding psoriatic arthritis)did not show significant differences in the prevalence of psoriasis,uveitis,family history of psoriasis,or the use of bDMARDs,but the subgroup analysis of other variables was consistent with the results of pSpA patients.Conclusions pSpA patients tend to have a later onset of disease,a lower proportion of male and HLA-B27 positivity,more associ-ated peripheral arthritis,dactylitis,psoriasis,and a more common family history of psoriasis.The disease bur-den in terms of treatment for pSpA is not lower than that for axSpA.Due to the presence of more peripheral symptoms,psoriasis,and higher levels of inflammation,they also require more medication.

OBJECTIVE: To assess the feasibility of first polar body transfer (PB1T) combined with preimplantation mitochondrial genetic testing for blocking the transmission of a pathogenic mitochondrial DNA 8993T>G mutation. METHODS: A Chinese family affected with Leigh syndrome which had attended the Reproductive Medicine Centre of the First Affiliated Hospital of Anhui Medical University in September 2021 was selected as the study subject. Controlled ovarian hyperstimulation was carried out for the proband after completing the detection of the mitochondrial DNA 8993T>G mutation load among the pedigree members. Mature MII oocytes were inseminated by intracytoplasmic sperm injection (ICSI), cultured in vitro for 5 to 6 days to the blastocyst stage, and trophoblastocytes were obtained by microbiopsy. Mitochondrial DNA testing (PGT-MT) and chromosomal aneuploidy (PGT-A) analyses were carried out after whole-genome amplification, and the embryos with zero mutation load were selected for transfer. Amniotic fluid and umbilical cord blood samples were collected during middle pregnancy and after birth respectively for mitochondrial DNA testing to verify the reliability of embryo screening. As an attempt, PB1 with good morphology of MII oocytes was selected for transfer into the enucleated oocytoplasm from healthy donors, followed by ICSI fertilization, blastocyst culture and PGT of embryos using the same procedure. This study has been approved by the Ethics Committee of the First Affiliated Hospital of Anhui Medical University (No. 2021zhyx-B12). RESULTS: An antagonist protocol was used for ovarian stimulation, and a total of 19 oocytes were obtained, of which 14 MII were fertilized by ICSI, and 2 had developed into blastocysts. PGT-MT was carried out on biopsied trophoblastocytes, in which the mitochondrial DNA 8993T>G mutation load was not detected in one embryo, the other was 100% mutated, and the mutation loads of the remaining unfertilized eggs and developmentally arrested embryos ranged from 0% ~ 100%, presenting a clear biased distribution. With fully informed consent, one PGT-MT zero mutation load blastocyst was transferred and clinical pregnancy was achieved. Mitochondrial DNA and chromosomal testing of amniotic fluid cells during middle pregnancy had revealed no abnormalities. The proband had delivered a healthy boy through Caesarean section at 39⁺⁵ weeks of gestation, and no mutation was detected in the cord blood sample. Five well-formed PBs from 14 eggs were selected for PB1 transfer, followed by ICSI and culture, and two of the reconstituted embryos had formed blastocysts, with none of the above mutations detected in the biopsied samples. CONCLUSION The PGT-MT technology can help families affected with mitochondrial diseases to have healthy offspring. PB1 transfer in combination with ICSI and PGT-MT holds the promise of turning waste into treasure and providing an alternative means of fertility for such families.
Humans ; Preimplantation Diagnosis/methods* ; Female ; DNA, Mitochondrial/genetics* ; Genetic Testing/methods* ; Pregnancy ; Mitochondrial Diseases/genetics* ; Polar Bodies ; Adult ; Feasibility Studies ; Sperm Injections, Intracytoplasmic/methods* ; Embryo Transfer/methods* ; Mutation ; Male ; Blastocyst/metabolism* ; Pedigree

To compare the differences in clinical features and treatment choices between peripheral spondyloarthritis(pSpA) and axial spondyloarthritis(axSpA), and better understand the clinical characteristics and medication needs of pSpA.

The condylar movement trajectories in healthy people usually have relatively consistent characteristics,while the change of the trajectory of the temporomandibular condyle often indicates the occurrence of various oral diseases.An in-depth understanding of the condylar movement can help physicians diagnose and evaluate the efficacy of oral diseases.This article reviews the development of con-dylar motion tracing technique,and introduces the research progress and clinical application status of condylar motion tracing analysis in various oral diseases.At the same time,the limitations of the current condylar motion tracing technique and the prospect of future clinical application are proposed.

Objective To establish a HPLC method for simultaneous determination of oleanolic acid and ursolic acid and provide the basis for quality control of Hawthorn extract .Methods Chromatographic separation was performed on Agilent Zorbax SB C18 column(250 mm × 4 .6 mm ,5 μm) with mobile phase of methanol (A)-0 .06 mol/L ammonium acetate solution (B) (85∶15 ,V/V ) under isocratic elution for 30 min .The flow rate was set at 0 .8 ml/min and the detection was set at the wavelength of 210 nm .Results Oleanolic acid and ursolic acid showed good linearity (r> 0 .999 5) in the ranges of 0 .496-2.480 g and 0 .498-9 .960 g ,respectively .Repeatability ,precision ,recovery and stability were conform to the method valida-tion requirements of China Pharmacopoeia .Conclusion The method could provide the basis for the quality control of Hawthorn extract and its preparation .

There has always been no lack of discussion on Biaoben and Genjie theory in traditional Chinese medical acupuncture circles, but many questions still exist. This article expounds the original meaning of Biaoben and Genjie, traces the origin of the theory and sorts out the questions in Biaoben and Genjie theory, e.g. the difference in the position between Biaoben and Genjie, no record of the location of Genjie of six hand meridians, regularities in meridional qi circulation, understanding and valuing, and application and development to confirm the importance of Biaoben and Genjie theory and to give reference.

Objective To investigate expression and promoter methylation status of BRCA1 in sporadic breast cancer .Meth-ods The expression of BRCA1 mRNA and protein were detected in 60 cases of sporadic breast cancer ,the adjacent breast tissues , and 30 cases of breast benign lesion tissue by RT-PCR and and immunohistochemical staining respectively .The methylation status of BRCA1 promoter in those tissues were detected using bisulfite genomic sequencing PCR (BSP) combined with TA clone for se-quencing .The relation between BRCA1 expression in sporadic breast cancer and promoter methylation status was analyzed .Results The expression level of BRCA1 mRNA and protein were down-regulated in sporadic breast cancer tissues compared to the corre-sponding adjacent breast tissues and breast benign lesion tissue(P<0 .001) .The positive rates of BRCA1 protein was 51 .7% (31/60)in sporadic breast tissue ,which were significantly lower than those of in the adjacent breast tissues 71 .7% (43/60)and breast benign lesion tissue 66 .7% (20/30)(P< 0 .001) .The methylation rate of BRCA1 promoter CpG was 31 .7% (19/60)in sporadic breast ,while it wasn′t found in adjacent breast tissues and breast benign lesion tissue(P=0 .000) .The statistical analysis showed the expression of BRCA1 had significant negative correlation with promoter methylation(r= -0 .345 ,P=0 .007) .Conclusion The hypermethylation of BRCA1 promoter could induce BRCA1 down-regulating ,which may be involved in the occurrence and develop-ment of sporadic breast cancer .

BACKGROUND: Acellular dermalmatrix (ADM), as a new material, is generally applied to tissue repair after head and neck tumorectomy. However, hypopharyngeal carcinoma surgery always involves in repair and functional reconstruction of defected tissue; therefore, the application effect of ADM needs to be further studied for repairing laryngopharynx defect. OBJECTIVE: To evaluate the clinical effect of ADM in repairing laryngopharynx defect following tumorectomy. DESIGN, TIME AND SETTING: A retrospective case analysis was performed at the Department of Otolaryngology-Head and Neck Surgery, Institute of Battle Surgery, Daping Hospital, the Third Military Medical University of Chinese PLA from May 2005 to June 2006.PATICIPANTS: A total of 25 male cases aged 45-68 years including 22 patients with tumor in the lateral wall of the unilateral piriform fossa and 3 patients with in the posterior wall of laryngopharynxat were finally diagnosed as squamous cell carcinoma. METHODS: According to clinical stages, patients underwent partial or complete laryngopharyngectomy. ADM was used to repair oropharynx mucosa following the laryngopharyngectomy. However, ADM alone was used to repair piece-shaped oropharynx mucosa, limiting by being unable to complete reconstruction of spatial structure. Therefore, myocutaneous flap or other materials combined with ADM was beneficial for reconstruction of laryngopharyngeal cavity following complete laryngopharyngectomy. MAIN OUTCOME MEASURES: The effect of ADM on functional reconstruction of swallowing, breathing, and pronouncing. RESULTS: A total of 25 patients were included in the final analysis. No patients suffered with the pharyngeal fistula. Only one case encountered the subcutaneous infection at day 20 after surgery, but recovering after regular change of dressing and treatment of antibiotics. About 15 patients who accepted the surgery of partial laryngopharyngectomy suffered with bucking, but after 30-60 days, the symptom relieved, even disappeared, in spite of 3 cases still bucking when they swallowed liquid diet. Breathing function was recovered, and tracheal cannula was removed 6-12 months after surgery. Ten of them who accepted total laryngopharyngectomy had resumption of normal oral diet after 20 days. The follow-up periods after the surgery lasted 12-30 months. The allograft became normal mucosa finally, without rejection or scar formation. The follow-up of 10 patients lasted more than 24 months, one case had relapse of tumor, still alive after the second surgery. CONCLUSION: ADM with perfect histocompatibility and easy operability, can be applied to repair deletion of laryngeal or pharyngeal tissue and recover functions of pronouncing, breathing, and swallowing after tumorectomy. The combined use of ADM and musculo-cutaneous flap was effective and satisfactory.

Objective To evaluate the efficacy and safety of desloratadine for the treatment of allergic rhinitis. Methods A total of 50 cases of chronic or acute allergic rhinitis confirmed clinically were randomized into control and experimental groups for double blind study. Scoring of clinical symptoms, examinations of the nasal cavity, blood and urine routine examination, functions of liver and kidney and electrocardiogram (ECG) were conducted on day 14 before and after the experiment. The collected data were analyzed statistically. Results The clinical data of the two groups were comparable. The effective rate of desloratadine was significant in allergic rhinitis, being 95.45%. No remarkable adverse effect was noted in this experiment. Conclusion Desloratadine is more effective and safe than loratadine in the treatment of allergic rhinitis and it may be feasible for clinical application.