To investigate the clinical features and peripheral blood immune cell subsets ofelderly (≥60 years old) onset rheumatoid arthritis (EORA) patients.

Objective:To investigate the prevalence of hyperuricemia (HUA) in Bozidun Kirghiz township of Xinjiang Aksu region, and to explore the risk factors for the occurrence of HUA in the local area.Methods:A cross-sectional survey study was conducted by randomly selecting 9 villages in Bozidun Kirgiz Township by the whole-group sampling method and questionnaire were distributed to the households. The questionnaire included: demographic information, history of past illness, personal history, and all subjects were measured for height, weight, blood pressure, abdominal circumference, etc. The diagnostic of HUA if the serum uric acid (SUA) level >420 μmol/L in men or >360 μmol/L in women. The incidences of HUA in different age, sex, food type and life style behavior were analyzed. T test, non-parametric test and Chi-square test were used to analyze the differences among the groups, and logistic regression was used to analyze the risk factors. Results:①A total of 2 138 subjects were surveyed, among which 68 patients were with HUA, the prevalence of HUA in Bozidun Kirghiz township, Aksu region in the general population was 3.18%(68/2 138); the prevalence rate in men was 4.60%(45/978), 45 patients were identified; and the prevalence rate in women was 1.98%(23/1 160), 23 patients were identified. The peak age of HUA in male and female patients was 51~60 years old. ②The prevalence of HUA was lower in those who consumed dairy products ( χ2=6.91, P=0.017), nuts ( χ2=8.43, P=0.038) and eggs ( χ2=7.38, P=0.023), and lower in those who consumed more. Different intake of cereals ( χ2=0.87, P=0.647), meat( χ2=0.82, P=0.662), vegetables and fruits( χ2=5.22, P=0.073) had no effect on the prevalence of HUA.③In terms of different life behaviors, the prevalence of HUA in men who had been smoking was higher than those who had never smoked (57.78%, 28.89%, 13.33%, χ2=8.16, P=0.017). In the relationship between drinking and HUA, the prevalence rates of male always drinking, ever drinking and never drinking were 80.00%, 11.11% and 3.89%, respectively, the difference was statistically significant ( χ2=6.67, P=0.038). ④Multi-factor logistic regression analysis showed that high BMI, old age, high TG, increased Cr and increased WBC were risk factors for the occurrence of HUA [ OR(95% CI)=1.13(1.04, 1.23), 1.03(1.00,1.05),1.39(1.00, 1.93), 1.03(1.02, 1.05), 1.27(1.07, 1.49), all P<0.05]. Conclusion:The prevalence of HUA in Bozidun Kirgiz township in Aksu prefecture of Xinjiang is lower than that in other areas with continental climate. High BMI, old age, high TG, increased Cr and increased WBC count are risk factors for the development of HUA .

Objective:To investigate the levels and clinical significance of insulin-like growth factor 2 mRNA binding protein 3 (IGF2BP3) in the serum of patients with rheumatoid arthritis (RA).Methods:Serum samples from 82 patients with RA admitted to the Affiliated Dongyang Hospital to wenzhou Medical Umiversity from December 2019 to February 2022 were collected as the experimental group and the serum of 45 healthy individuals from the physical examination center as the control group. Serum levels of IGF2BP3 were measured using enzyme-linked immunosorbent assay (ELISA), and the t-test was used to compare the difference in IGF2BP3 levels between the two groups. The value of IGF2BP3 in the diagnosis of RA was analyzed by plotting a ROC curve, and after determining the cut-off value, serum IGF2BP3 levels were divided into high and low levels. The relationship between serum IGF2BP3 levels and various clinical features of RA patients was then analyzed using the chi-square test. Results:The serum levels of IGF2BP3 in RA patients were significantly higher compared to healthy controls [(0.60±0.55)ng/ml vs. (0.31±0.17)ng/ml, t=4.42, P<0.001]. The cut-off value of IGF2BP3 was determined as 0.308 ng/ml. The high level of IGF2BP3 was significantly more prevalent in active RA patients (78.8%, 41/52) than in non-active patients (56.7%, 17/30) ( χ2=4.52, P=0.033). The level of IGF2BP3 was positively correlated with the C-reactive protein level ( r=0.29, P=0.008), and the prevalence of high IGF2BP3 level in the elevated CRP group (82.0%, 41/50) was significantly higher than that in the decreased CRP group (54.8%, 17/31) ( χ2=6.94, P=0.008). The AUC of the ROC curve for serum IGF2BP3 in the diagnosis of RA was 0.700, with a sensitivity of 70.7% and a specificity of 60.0%. When using 0.575, 0.689, and 0.727 ng/ml as the cut-off values for serum IGF2BP3, the sensitivity was 34.1%, 26.8%, and 23.2%, respectively, with the specificity of 95.6%, 97.8%, and 100.0%, respectively. Conclusion:The level of serum IGF2BP3 is closely associated with RA disease progression.

Objective:To analyze the effect of individualized exercise intervention on weight loss and improvement of metabolic indexes in individuals with metabolic syndrome (MS).Methods:This study was a randomized controlled trial. A total of 1 200 MS patients who underwent health examinations in the Beijing Aerospace General Hospital Healthy Management Center from 2019 to 2022 were selected as the research subjects. The patients were randomly divided into the experimental group (600 cases) and the control group (600 cases) by random number table. Based on the patient′s physical fitness data, a 3-month personalized exercise intervention was implemented for the experimental group, which included aerobic exercise 3 to 4 times/week combined with resistance exercise≥2 times/week, and MS-related health examinations were given too. The control group only received physical examination. Paired t-test was used to compare the changes in weight and metabolic-related indicators before and after the intervention in the two groups. Two-sample t-test was used to compare the differences in intervention effects between groups. The effect of personalized exercise intervention on weight loss and improvement of metabolic indicators in the MS population was analyzed. Results:After the intervention, the weight, body mass index, waist-to-hip ratio, resting heart rate, systolic blood pressure, diastolic blood pressure, fasting glucose, low-density lipoprotein, total cholesterol esters, and triglyceride levels in the experimental group were all significantly lower than those before [(72.5±12.9) vs (74.2±13.6) kg, (27.3±3.5) vs (27.9±3.5) kg/m2, 0.87±0.08 vs 0.91±0.08, (71±7) vs (74±9) times/min, (131±11) vs (138±14) mmHg (1 mmHg=0.133 kPa), (80±8) vs (85±9) mmHg, (6.0±1.1) vs (6.9±1.6) mmol/L, (2.78±0.78) vs (3.12±0.77) mmol/L, (4.62±1.04) vs (5.22±0.97) mmol/L, (1.36±0.42) vs (2.59±2.01) mmol/L], but the high-density lipoprotein level was significantly higher than that before [(1.31±0.31) vs (1.27±0.29) mmol/L] (all P<0.05). The weight, body mass index, waist-to-hip ratio, systolic blood pressure, low-density lipoprotein, total cholesterol esters, and triglyceride levels after the intervention in the control group were all significantly higher than those before [(68.1±5.9) vs (67.1±5.9) kg, (25.3±2.4) vs (24.9±2.4) kg/m2, 0.83±0.07 vs 0.82±0.06, (127±12) vs (125±12) mmHg, (3.50±1.45) vs (3.20±1.21) mmol/L, (5.50±1.80) vs (5.30±1.52) mmol/L, (1.59±0.82) vs (1.40±0.65) mmol/L], but the high-density lipoprotein level was significantly lower than that before the intervention [(1.28±0.28) vs (1.38±0.28) mmol/L] (all P<0.05). The intervention effects on weight, body mass index, waist-to-hip ratio, heart rate, systolic blood pressure, diastolic blood pressure, glucose, high-density lipoprotein, low-density lipoprotein, total cholesterol and triglycerides levels in the experimental group were all significantly better than those in the control group [(-1.4±13.3) vs (1.0±5.9) kg, (-0.6±3.5) vs (0.4±2.4) kg/m2, -0.04±0.08 vs 0.01±0.06, (-3±8) vs (0±7) times/min, (-7±12) vs (2±12) mmHg, (-5±9) vs (0±8) mmHg, (-0.9±1.4) vs (0±0.5) mmol/L, (0.04±0.30) vs (-0.10±0.28) mmol/L, (-0.34±0.77) vs (0.30±1.34) mmol/L, (-0.60±1.00) vs (0.20±1.66) mmol/L, (-1.23±1.45) vs (0.19±0.74) mmol/L ] (all P<0.001). Conclusion:Individualized exercise intervention can effectively promote weight loss and improve metabolic-related indicators in MS patients.

Purpose/Significance To improve the performance of named entity recognition(NER)model of Chinese electronic medi-cal records(EMR)for better organization and mining of medical information.Method/Process The ERNIE-BiGRU-Attention-CRF NER model of Chinese EMR is constructed.Firstly,the ERNIE1.0 pre-training model is used to generate word vectors with semantic features,and then BiGRU is utilized to capture the global semantic features and grammatical structural features,which are fed into the Attention mechanism to further enhance the capture of the semantic features,and finally,the CRF decoding layer is connected to output the label sequences with the maximum global probability.Result/Conclusion Comparison experiments and ablation experiments are car-ried out on the publicly available medical text dataset CCKS2017,and examples analysis is conducted using the generated model.The model proposed in this paper achieves better recognition results.

OBJECTIVE: To explore the genetic etiology for a child with profound intellectual disabilities and obvious behavioral abnormalities. METHODS: A male child who had presented at the Zhongnan Hospital of Wuhan University on December 2, 2020 was selected as the study subject. Peripheral blood samples of the child and his parents were collected and subjected to whole exome sequencing (WES). Candidate variant was verified by Sanger sequencing. Short tandem repeat (STR) analysis was carried out to determine its parental origin. The splicing variant was also validated in vitro with a minigene assay. RESULTS: WES results revealed that the child had harbored a novel splicing variant of c.176-2A>G in the PAK3 gene, which was inherited from his mother. The results of minigene assay have confirmed aberrant splicing of exon 2. According to the guidelines from the American College of Medical Genetics and Genomics, it was classified as a pathogenic variant (PVS1+PM2_Supporting+PP3). CONCLUSION The novel splicing variant c.176-2A>G of the PAK3 gene probably underlay the disorder in this child. Above finding has expanded the variation spectrum of the PAK3 gene and provided a basis for genetic counseling and prenatal diagnosis for this family.
Child ; Female ; Humans ; Male ; Pregnancy ; Exons ; Intellectual Disability/genetics* ; Mothers ; Mutation ; p21-Activated Kinases/genetics* ; Parents ; RNA Splicing

Objective:To observe the application effect of skillful communication combined with pathway pain management on patients with hemorrhoids undergoing endoscopic sclerotherapy.Methods:Using the convenient sampling method, a total of 85 patients who received endoscopic sclerotherapy of internal hemorrhoids in the People's Hospital of Anyang City from September 2020 to August 2021 were selected as the research objects. They were divided into the intervention group (44 cases) and the control group (41 cases) . The control group was given routine nursing intervention, while the observation group was given skillful communication combined with pathway pain management on the basis of the control group. The pain level (VAS) before and 12, 24, 48, and 72 hours after the operation, as well as the negative emotions [anxiety (SAS) , depression (SDS) ], resilience (CD-RISC) and quality of life (WHOQOL-BREF) score of patients before and after the intervention were compared between the two groups.Results:Compared with before operation, the VAS scores of the intervention group at 12, 24, 48 and 72 h after operation were lower, and the VAS scores of the intervention group at each time point after operation were lower than those of the control group, and the differences were statistically significant ( P<0.05) . After the intervention, SAS and SDS scores of patients of the two groups were lower than those before the intervention, and SAS and SDS scores of the intervention group after the intervention were lower than those of the control group, and the differences were statistically significant ( P<0.05) . The scores of each dimension of CD-RISC after intervention in the two groups were higher than those before intervention, and the scores of each dimension of CD-RISC in the intervention group after intervention were higher than those in the control group, and the differences were statistically significant ( P<0.05) . The scores of each dimension of WHOQOL-BREF in the two groups after intervention were higher than those before intervention, and the scores of each dimension of WHOQOL-BREF in the intervention group after intervention were higher than those in the control group, and the differences were statistically significant ( P<0.05) . Conclusions:Skillful communication combined with pathway pain management can reduce the pain level of patients undergoing endoscopic sclerotherapy of internal hemorrhoids, relieve the negative emotions of patients and improve their psychological resilience and quality of life, which is worthy of clinical promotion.

Objective To study the epidemiology of hand,foot,and mouth disease (HFMD) and the spectrum of serotypes in the other enterovirus (EV) (non-EV-A71 and non-Coxsaekievirus group A 16,CV-A 16) from 2016 to 2017 in Guangzhou,to provide the basis for its treatment,prevention and control.Methods Enteroviruses universal type,EV-A71 and CV-A16 were detected by real time reverse transeription-polymerase chain reaction in the specimens from HFMD suspected patients from 2016 to 2017.The positive specimens of non-EV-A71 and non-CV-A16 were amplified and sequenced based on 5'-untranslated region (UTR) region.The spectrum of serotypes was analyzed with BLAST in NCBI on the basis of 5'-UTR region.Results A total of 25779 specimens from HFMD patients were collected during 2016-2017,16 300 (63.23 ％) of which were positive.The positive rates of EV-A71,CV-A16,non-EV-A71 and non-CV-A16 were 4.57％ (1 178/25 779),12.70％ (3 274/25 779) and 45.96％ (11 848/25779),respectively.The average positive rate of non-EV-A71 and non-CV-A16 in 2017 was 55.68％,which was higher than that in 2016.Sequence analysis showed that there were 16 genotypes in 95 non-EV-A71 and non-CV-A16 positive specimen,including CV-A6,CV-A10,CV-A4,CV-A2,CV-A8,CV-A12,CV-A9,Coxsakievirus B5 (CV-B5),CV-B2,CV-B4,CV-B3,Echovirus 1 (E1),E16,E30,E2 and E18.CV-A6 (26.32％),and CV-A10 (15.79％) were the most common genotypes,followed by CV-A4 (6.32％)、CV-A8(4.21％),and CV-A2 (4.21％).Conclusions The infection rate of EV-A71 is very low during 2016-2017.From April to July 2016,there is a small peak of CV-A16 infection.The non-EV-A71 and non-CV-A16 enterovirus becomes the main causative agent of HFMD during 2016 to 2017.CV-A6 and CV-A10 are the most prevalent pathogens of non-EV-A71 and non-CV-A16 enterovirus.Research and monitoring of CV-A6,CV-A10 as the main non-EV-A71and non-CV-A16 virus should be strengthened.

Objective To investigate the effect of donepezil on subventricular zone ( SVZ) neuro-genesis related neurotrophic factors after cerebral infarction. Methods Mice were randomly assigned into three groups: vehicle-treated sham group (Sham+vehicle,n=18),vehicle-treated middle cerebral artery oc-clusion (MCAO) group (MCAO + vehicle,n=30) and donepezil-treated MCAO group (MCAO+donepezil, n=30). Middle cerebral artery occlusion( MCAO) was induced by thread-occlusion method. Nissl staining was used to measure the infarct volume and the modified neurological severity score(mNSS) was used to as-sess neurologic function and brain water content was detected to assess brain edema degree. Proliferative cells and neuroblasts were labeled with 5-bromodeoxyuridine ( BrdU) and doublecortin ( DCX). The SVZ BrdU+/DCX+cells were detected by immunofluorescence. The expression of glial cell line-derived neurotro-phic factor (GDNF),brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF) were detec-ted by Western blot. Results The infarct volume of MCAO + donepezil group ((13. 33±4. 55)%) was sig-nificantly lower than that of MCAO + vehicle group ((31. 33±3. 93)%,t=7. 34,P<0. 05). The neurologic deficits were significantly ameliorated after donepezil treatment,and the brain water content of MCAO + done-pezil group ((71. 82±10. 18)%)was significantly less than that of MCAO + vehicle group ((85. 93± 7. 54)%,F=13. 480,P<0. 05). All differences were statistically significant (P<0. 05). The area of BrdU+/DCX+cells within SVZ of MCAO + vehicle group ((6. 16±1. 79)%) was significantly larger than that of sham + vehicle group ((2. 25±1. 09)%),and was fewer than that of MCAO+donepezil group ((16. 19± 2. 16)%,F=102. 756,P<0. 05). MCAO significantly promoted the expression of GDNF,BDNF and NGF within SVZ compared with sham operation,and donepezil increased these protein levels(F=15. 114,27. 121, 27. 398,P<0. 05). Conclusion Donepezil regulates neurogenesis via increasesing the expression of GDNF, BDNF and NGF within SVZ after cerebral infarction.

Objective To investigate the effects of cholinergic signal on neural stem cell(NSC)differenti-ation in peri-infarction region after ischemic stroke. Methods Mice were randomly assigned into sham + vehicle group,middle cerebral artery occlusion(MCAO)+ vehicle group,MCAO + donepezil group and MCAO + atro-pine group(n = 25). MCAO was induced by thread-occlusion method. Modified neurological severity score (mNSS)was used to evaluate neurological function recovery,and the brain water content was measured by dry-wet weight method. NeuN/5-bromodeoxyuridine(BrdU),CNPase/BrdU,GFAP/BrdU double-labeled cells were tested by immunofluorescence. Results Brain water content of MCAO + vehicle group was significantly higher than that of sham operation group(P < 0.05). Donepezil-treated MCAO mice had lower neurologic deficit scores and brain water content than of MCAO + vehicle group(P < 0.05). On day 14 and day 28 after MCAO,the NeuN/BrdU, CNPase/BrdU and GFAP/BrdU immune-positive cells of MCAO + vehicle group were markedly increased as com-pared with that of sham+vehicle group(P<0.05).Compared with that of MCAO+vehicle group,the number of NeuN/BrdU-positive cells,CNPase/BrdU-positive cells and GFAP/BrdU-positive cells was higher in MCAO+done-pezil group,and the number of NeuN/BrdU-positive cells and CNPase/BrdU-positive cells of MCAO + atropine group was lower(P < 0.05). Conclusions Cholinergic signal could promote NSCs differentiation in peri-infarc-tion region,a lleviate cerebral edema,and improve the brain function restoration after stroke.