AIM:To investigate the mechanism by which wogonin(WOG)induces ferroptosis in collagen-in-duced arthritis rat fibroblast-like synoviocytes(rat CIA-FLS cells)through the nuclear factor E2-related factor 2(NRF2)/heme oxygenase-1(HO-1)signaling pathway.METHODS:Rat CIA-FLS cells were divided into:control group,low,medium,and high dose of(25,50 and 100 μmol/L)WOG group,ferroptosis inhibitor(LIP-1)group,LIP-1+high dose WOG group,HO-1 agonist cobalt protoporphyrin(COPP)group,and COPP+high dose WOG group.CCK-8 assay was used for cell viability.Crystal violet staining was used for for cell morphology.The levels of oxidative stress markers gluta-thione(GSH),malondialdehyde(MDA),and superoxide dismutase(SOD)were measured.DCFH-DA fluorescent probe was used to detect the intracellular reactive oxygen species(ROS)content as well as Western blot to detect the protein ex-pression levels of Kelch-like ECH-associated protein 1(KEAP-1),NRF2 and HO-1.RESULTS:Compared with the nor-mal control group,administration of WOG treatment resulted in a significant decrease in CIA-FLS cell viability(P<0.01),a significant increase in the level of oxidative stress(P<0.01),a significant increase in the content of ROS(P<0.01),a significant decrease in the level of expression of NRF2 and HO-1 proteins(P<0.01),and a significant increase in the level of KEAP-1(P<0.01)in the rat.Compared with the WOG group,the LIP-1-treated group showed a significant increase in cell viability(P<0.01),a significant decrease in the level of oxidative stress(P<0.01),and a significant de-crease in the content of ROS(P<0.01).Compared with the WOG group,the addition of COPP resulted in a significant in-crease in the protein expression levels of NRF2 and HO-1(P<0.01)and a significant decrease in KEAP-1 levels(P<0.01).CONCLUSION:WOG can induce ferroptosis in rat CIA-FLS cells by promoting oxidative stress through the NRF2/HO-1 signaling pathway.

Objective To investigate the regulatory mechanism of apurnic/apyrimidinic endonuclease 1(APE1)in the transformation of chronic intestinal inflammation to colitis-associated colorectal cancer(CAC).Methods C64S mutant(APE1C64S)mice and APE1 wild type(APE1WT)mice were randomly divided into experimental group and control group.In vivo CAC model was established by azoxymethane(AOM)and dextran sulfate sodium salt(DSS)solution.Immunohistochemistry(IHC)and multiple IHC(mIHC)assays were used to observe the expression of APE1 and immune cell infiltration in colon tissues of each group.A mouse colon cancer cell line MC38 with stable knockdown of APE1 was constructed by lentivirus transfection,and subcutaneous tumor bearing experiments were performed in APE1WT and APE1C64S mice to confirm that tumor cell-derived APE1 caused immunosuppressive tumor microenvironment.The expression of APE1 and CXCL1[chemokine(C-X-C motif)ligand 1]and the infiltration of immune cells in tumor-bearing specimens were analyzed by IHC and mIHC assays.The tumor specimens of a 28-year-old female patient with CAC from Army Medical Center of PLA were analyzed for the expression of APE1 and CXCL1 and the infiltration of immune cells in the tumor and adjacent inflammatory tissues by IHC and mIHC assays.Results Compared with the control group and APE1WT erperimental group,APE1C64S erperimental group had significantly reduced disease activity index and tumor formation,polymorphonuclear myeloid-derived suppressor cells(PMN-MDSCs)infiltration,and CD4+and CD8+T cells(P＜0.05).No significant differences were observed in tumor growth and immune cells between APE1WT and APE 1C64S mice bearing subcutaneous tumors.However,in the tumor-bearing experiment using tumor cells with knockdown of APE1,the tumor growth was significantly lower and the number of infiltrated PMN-MDSCs was reduced,while those of CD4+and CD8+T cells were significantly increased(P＜0.05).Furthermore,high expression of APE1 and increased infiltration of PMN-MDSCs were found in the tumor tissues of the young CAC patient,and CD8+T cells were significantly reduced in the tumor tissues compared with the inflammatory tissues(P＜0.05).Conclusion APE1-redox in tumor cells can promote the infiltration of PMN-MDSCs and reduce the number of T cells,thereby forming an immunosuppressive tumor microenvironment and mediating the occurrence and development of CAC.

Objective:To investigate the initial effectiveness of manual techniques versus navigation positioning system-assisted reconstruction for anterior cruciate ligament (ACL) injuries in children and adolescent populations.Methods:A retrospective analysis was conducted on 28 patients with ACL rupture who underwent primary total epiphyseal ACL reconstruction in the Sports Medicine Treatment Center of Honghui Hospital Affiliated to Xi'an Jiaotong University from January 2019 to October 2022. Patients were categorized into two groups based on the method of guide needle insertion: the manual group (guide needle insertion relying on the operator's expertise) and the robot-assisted group (guide needle insertion assisted by the Tianji robot navigation and positioning system). The manual group comprised 14 cases (9 males, 5 females) with an average age of 13.59±1.59 years, while the robot-assisted group included 14 patients (10 males, 4 females) with an average age of 13.27±1.66 years. The operation time, intraoperative fluoroscopy times, guide needle placement times, the distance between the central point of the internal articular opening of the tibial and femoral bone tunnel and the ideal point, the rate of epiphyseal inflammation, and the International Knee Documentation Committee (IKDC) subjective score, Lysholm score, KT-2000 ligament relaxation, lower limb force line were compared between the two groups.Results:The follow-up duration was 19.9±6.3 months for the manual group and 18.8±4.9 months for the robot group ( t=0.546, P=0.589). The manual group's operation duration was 123.0±12.6 min, significantly longer than the robot group's 96.4±12.9 min ( t=5.502, P<0.001). Intraoperative fluoroscopy was performed 11.8±3.1 times in the manual group, markedly more than the robot group's 3.7±0.8 times ( t=9.434, P<0.001). The robot group required only one guide needle placement for both femur and tibia, while the manual group had 5.7±1.2 placements on the femur side and 4.6±1.8 on the tibia side. The distance between the femoral joint's central point and the ideal point was 0.87±0.20 mm in the robot group, superior to the manual group's 1.92±0.64 mm ( t=5.816, P<0.001). Similarly, the distance between the central point and the ideal point was 1.15±0.34 mm for the robot group, better than the manual group's 1.94±0.55 mm ( t=4.582, P<0.001). No cases of epiphyseal irritation were observed in the robot group, while 21% (3/14) of the manual group experienced tibial or femoral epiphyseal plate involvement. At 3 months post-surgery, the robot group exhibited higher IKDC subjective scores (90.57±8.46) and Lysholm scores (86.29±5.09) compared to the manual group (83.50±6.19 and 80.93±5.93), respectively ( P<0.05). However, at the final follow-up, there were no significant differences in IKDC subjective scores, Lysholm scores, or KT-2000 ligament relaxation between the two groups ( P>0.05). Both groups showed normal lower limb force alignment and no abnormal growth or development. Conclusion:Tianji robot navigation and positioning system-assisted ACL reconstruction in children and adolescents offer advantages such as precise positioning, shorter operation times, reduced intraoperative fluoroscopy, faster recovery, and enhanced epiphyseal protection compared to manual methods.

Objective: The objective of this study was to analyze the different brain oxygen metabolism statuses in preeclampsia using magnetic resonance imaging and investigate the factors that affect cerebral oxygen metabolism in preeclampsia. Materials and Methods: Forty-nine women with preeclampsia (mean age 32.4 years; range, 18–44 years), 22 pregnant healthy controls (PHCs) (mean age 30.7 years; range, 23–40 years), and 40 non-pregnant healthy controls (NPHCs) (mean age 32.5 years; range, 20–42 years) were included in this study. Brain oxygen extraction fraction (OEF) values were computed using quantitative susceptibility mapping (QSM) plus quantitative blood oxygen level-dependent magnitude-based OEF mapping (QSM + quantitative blood oxygen level-dependent imaging or QQ) obtained with a 1.5-T scanner. Voxel-based morphometry (VBM) was used to investigate the differences in OEF values in the brain regions among the groups. Results: Among the three groups, the average OEF values were significantly different in multiple brain areas, including the parahippocampus, multiple gyri of the frontal lobe, calcarine, cuneus, and precuneus (all P-values were less than 0.05, after correcting for multiple comparisons). The average OEF values of the preeclampsia group were higher than those of the PHC and NPHC groups. The bilateral superior frontal gyrus/bilateral medial superior frontal gyrus had the largest size of the aforementioned brain regions, and the OEF values in this area were 24.2 ± 4.6, 21.3 ± 2.4, and 20.6 ± 2.8 in the preeclampsia, PHC, and NPHC groups, respectively. In addition, the OEF values showed no significant differences between NPHC and PHC. Correlation analysis revealed that the OEF values of some brain regions (mainly involving the frontal, occipital, and temporal gyrus) were positively correlated with age, gestational week, body mass index, and mean blood pressure in the preeclampsia group (r = 0.361–0.812). Conclusion Using whole-brain VBM analysis, we found that patients with preeclampsia had higher OEF values than controls.

Objective:To explore the correlation between blood glucose level and parental education level in children with type 1 diabetes mellitus (T1DM) based on mobile health APP.Methods:The data of T1DM children enrolled in China′s T1DM registration management program and registered to use TangTangquan ? were collected, as well as the blood glucose monitoring information uploaded quarterly after registration. Children were divided into low education group (middle school or below) and high education group (junior college or above) according to their parents′ education level. Blood glucose levels were compared between the two groups at different time points. Spearman correlation analysis and multivariate logistic regression analysis were used to evaluate the correlation between blood glucose level and parents′ education level in children with T1DM. Results:A total of 2 263 eligible children with T1DM were included and 1 246 were female (55.1%). The median age was 7.9(4.4, 11.4)years and T1DM duration was 0.07(0.02, 0.46)years. Among them, 1 513 cases were in the low-education group while 750 cases were in the high-education group. Within three years after registration, the glucose levels of each interval in the low-education group were increasing gradually (all P<0.05 except post-breakfast glucose). The glucose levels of each interval in the high-education group in the third year were lower than those in the low-education group (all P<0.05 except nocturnal glucose). The result of multivariate logistic regression analysis showed that after the adjustment of factors including T1DM duration and treatment, parental educational levels were still the separate related factors of premeal glucose, bedtime glucose and nocturnal glucose (premeal glucose: OR=0.385, 95% CI: 0.164-0.874, P=0.025; bedtime glucose: OR=0.444, 95% CI: 0.204-0.949, P=0.038; nocturnal glucose: OR=0.226, 95% CI: 0.582-0.747, P=0.020). Conclusions:The blood glucose levels of children with T1DM were negatively associated with parental educational levels. It is suggested that parental educational levels should be taken into consideration in the management of T1DM for children.

Objective:To investigate the utilization of health management services and its influencing factors among new urban population.Methods:It is a cross-sectional study. From July 2020 to March 2021, a stratified random sampling method was used to extract 1978 new urban population in Jining city, and an anonymous self-administered questionnaire survey was conducted using a self-made questionnaire ′Residents Health Questionnaire′. The survey included general demographic characteristics, personal behavior lifestyle and medical care status. The χ2 test and binary logistic regression were used to analyze the factors influencing the utilization of health management services by new urban population. Results:The overall utilization of health management services in the new urban population was 47.22%. There were significant differences in utilization of health management services among new urban population with different gender, age, education level, occupation and monthly income. Binary logistic regression analysis showed that female ( OR=1.354, 95% CI: 1.094-1.676), people aged over 60 years ( OR=1.873, 95% CI: 1.413-2.483), people with a mean monthly income over 3 000 yuan ( OR=1.498, 95% CI: 1.123-1.997), people engaged in light manual labor ( OR=1.596, 95% CI: 1.003-2.539), people who exercise regularly( OR=2.400, 95% CI: 2.028-2.841) and people having social basic medical insurance ( OR=2.633, 95% CI: 2.042-3.394) had better utilization of health management projects. People who sat more than 3 hours a day ( OR=0.630, 95% CI: 0.532-0.745) had lower utilization of health management care. Conclusion:The utilization of health management projects in the new urban population is low. Gender, age, monthly income, physical exercise, sedentary time, daily labor intensity and social basic medical insurance status are the main influencing factors.

Objective:To explore the relationship between microsatellite instability (MSI) and Ki-67 expression level and the clinicopathological features of colorectal cancer, and investigate their impact for prognosis, so as to provide reference for prognostic judgment of colorectal cancer.Methods:The data of 183 patients who underwent radical colorectal cancer surgery and were diagnosed pathologically in the Department of General Surgery, the First Affiliated Hospital of Xinxiang Medical University from January 2017 to December 2019 were retrospectively analysed, including 101 males (55.2%)and 82 females(44.8%), ranged from 20 to 86 years and the mean age was(60.27±13.13)years. According to the results of mismatch repair protein immunohistochemical staining, the patients were divided into MSI-H group ( n=32) and MSI-L/MSS group ( n=151). According to the results of Ki-67 antigen immunohistochemical staining, the patients were divided into low Ki-67 expression group (<82.5%, n=136) and high Ki-67 expression group (≥82.5%, n=47) , among which 62 cases (78.5%) with low Ki-67 expression and 17 cases (21.5%) with high Ki-67 expression were in patients with Ⅲ+ Ⅳ stage colorectal cancer. The data of clinicopathological features, disease-free survival, and overall survival were collected and analyzed. The cotegorical variables were presented as n(%), and the comparisons between groups were performed using Chi-square test or Fisher′s exact test. The multivariate Logistic regression model was used to estimate the correlation between microsatellite instability and Ki-67 expression level and clinicopathologic characteristics of colorectal cancer. Kaplan-Meier survival curve and COX proportional hazards regression model were used to analyze the correlation between microsatellite instability and Ki-67 expression level and disease-free survival and overall survival. Results:Single factor analysis showed that the differences in gender ( χ2=4.37, P=0.037), tumor site ( χ2=26.40, P<0.001), tumor maximum diameter ( χ2=11.12, P=0.001) and nerve invasion ( χ2=5.53, P=0.019) between MSI-H group and MSI-L/MSS group were statistically significant. Multivariate Logistic regression model analysis showed that only gender ( OR=3.013, 95% CI: 1.183-7.672, P=0.021), tumor location ( OR=0.167, 95% CI: 0.067-0.419, P<0.001) and nerve invasion ( OR=0.202, 95% CI: 0.042-0.968, P=0.045) were independently correlative factors for MSI status. In Ⅲ+ Ⅳ stage colorectal cancers, the difference in tumor site between low Ki-67 expression group and high Ki-67 expression group was statistically significant( χ2=3.91, P=0.048). Multivariate Cox proportional hazards regression model analysis revealed that high Ki-67 expression ( HR=0.301, 95% CI: 0.118-0.768, P=0.012; HR=0.275, 95% CI: 0.083-0.912, P=0.035) and MSI-H ( HR=0.072, 95% CI: 0.010-0.525, P=0.009; HR=0.122, 95% CI: 0.017-0.900, P=0.039) were independently protective factors for disease-free survival and overall survival. Conclusions:MSI-H colorectal cancer is common in males, right-sided colonic cancers and non-neuroinvasive patients. In stage Ⅲ+ Ⅳ colorectal cancer, the expression level of Ki-67 in right-sided colonic cancer was lower than in left-sided colorectal cancer. Patients with MSI-H and high Ki-67 expressive colorectal cancer had longer disease-free survival, longer overall survival and better prognosis.

BACKGROUND: The clinical features of enthesitis in patients with psoriatic arthritis (PsA) have been reported in some Western countries, but data in China are very limited. This study aimed to describe the characteristics of enthesitis in Chinese patients with PsA and compared them with those in other cohorts. METHODS: Patients with PsA enrolled in the Chinese Registry of Psoriatic Arthritis (CREPAR) (December 2018 to June 2021) were included. Data including demographics, clinical characteristics, disease activity measures, and treatment were collected at enrollment. Enthesitis was assessed by the Spondyloarthritis Research Consortium of Canada (SPARCC), Maastricht ankylosing spondylitis enthesitis score (MASES), and Leeds enthesitis index (LEI) indices. A multivariable logistic model was used to identify factors related to enthesitis. We also compared our results with those of other cohorts. RESULTS: In total, 1074 PsA patients were included, 308 (28.7%) of whom had enthesitis. The average number of enthesitis was 3.3 ± 2.8 (range: 1.0-18.0). More than half of the patients (165, 53.6%) had one or two tender entheseal sites. Patients with enthesitis had an earlier age of onset for both psoriasis and arthritis, reported a higher proportion of PsA duration over 5 years, and had a higher percentage of axial involvement and greater disease activity. Multivariable logistic regression showed that axial involvement (odds ratio [OR] 2.21, 95% confidence interval [CI], 1.59-3.08; P <0.001), psoriasis area and severity index (PASI) (OR: 1.03, 95% CI: 1.01-1.04; P = 0.002), and disease activity score 28-C reactive protein (DAS28-CRP) (OR: 1.25, 95% CI: 1.01-1.55; P = 0.037) were associated with enthesitis. Compared with the results of other studies, Chinese patients with enthesitis had a younger age, lower body mass index (BMI), a higher rate of positive human leukocyte antigen (HLA)-B27, more frequent dactylitis, and a higher proportion of conventional synthetic disease-modifying antirheumatic drugs' (csDMARDs) use. CONCLUSIONS Enthesitis is a common condition among Chinese patients with PsA. It is important to evaluate entheses in both peripheral and axial sites.
Humans ; Arthritis, Psoriatic/drug therapy* ; East Asian People ; Enthesopathy/complications* ; Registries ; Severity of Illness Index ; Spondylarthritis/epidemiology*

Humans ; Vaccines, Inactivated ; COVID-19/prevention & control* ; Vaccination ; Viral Vaccines ; Immunity ; Antibodies, Viral

Objective:To establish the normal values of water-perfused high resolution esophageal manometry (HREM)(GAP-36A) at resting period, water swallowing, semisolid swallowing and solid swallowing in Chinese population.Methods:From September 1, 2019 to June 30, 2020, 91 healthy volunteers receiving water-perfused HREM (GAP-36A) at resting period, water swallowing, semisolid swallowing and solid swallowing were selected from 9 hospitals (Union Hospital, Tongji Medical College, Huazhong University of Science and Technology; the First Affiliated Hospital of Dalian Medical University; the Second Hospital of Hebei Medical University; the Second Affiliated Hospital, Naval Medical University; the First Affiliated Hospital, Sun Yat-sen University; the First Affiliated Hospital, University of Science and Technology of China; Aviation General Hospital of China Medical University; the Affiliated Hospital of Medical School of Nanjing University and the First People′s Hospital of Yichang). Parameters included the position of the upper and lower edges of the upper esophageal sphincter (UES) and lower esophageal sphincter (LES), the length of the LES and UES, the position of the pressure inversion point (PIP), the resting pressure of UES and LES and swallow-related parameters such as the distal contraction integral (DCI), 4 s integrated relaxation pressure (IRP), distal latency (DL) and UES residual pressure. One-way analysis of variance, post-hoc test and sum rank test were used for statistical analysis.Results:A total of 87 healthy volunteers were enrolled, including 40 males and 47 females, aged (38.5±14.2) years old (ranged from 19 to 65 years old). The position of the upper and lower edges of the LES was (42.7±2.8) and (45.6±2.8) cm, respectively, the length of the LES was (2.9±0.4) cm, and the position of PIP was (43.3±2.8) cm. The position of the upper and lower edges of the UES was (18.1±3.0) and (22.6±2.0) cm, respectively, and the length of the UES was (4.8±1.0) cm. The resting pressure of LES and UES was (17.4±10.7) and (84.1±61.1) mmHg (1 mmHg=0.133 kPa), respectively. The DCI value at solid swallowing was higher than those at water swallowing and semisolid swallowing ((2 512.4±1 448.0) mmHg·s·cm vs. (2 183.2±1 441.2) and (2 150.8±1 244.8) mmHg·s·cm), and the differences were statistically significant ( t=-4.30 and -3.74, both P<0.001). The values of 4 s IRP at semisolid swallowing and solid swallowing were lower than that at water swallowing ((4.6±4.1) and (4.9±3.9) mmHg vs. (5.4±3.9) mmHg), and the differences were statistically significant ( t=3.38 and 2.09, P=0.001 and 0.037). The DL at water swallowing was shorter than those at semisolid swallowing and solid swallowing ((8.5±1.8) s vs. (9.8±2.2) and (10.6±2.8) s), and the DL at semisolid swallowing was shorter than that at solid swallowing, and the differences were statistically significant ( t=-10.21, -13.91 and -4.68, all P<0.001). The UES residual pressure at water swallowing was higher than those at semisolid swallowing and solid swallowing (9.5 mmHg, 6.5 to 12.3 mmHg vs. 8.0 mmHg, 4.5 to 11.7 mmHg and 5.5 mmHg, 2.0 to 9.3 mmHg), and the UES residual pressure at semisolid swallowing was higher than that at solid swallowing, and the differences were statistically significant ( t=3.48, 10.30 and 6.35, all P<0.001). Conclusions:The normal values of water-perfused HREM (GAP-36A) in Chinese population at resting period, water swallowing, semisolid swallowing and solid swallowing can provide a reference basis for clinical diagnosis and treatment for patients receiving water-perfused HREM examination.