Objective To analyze the relationship between the expression of serum DNA methyltransferase 1(DNMT1)messenger RNA(mRNA)and long non-coding RNA(LncRNA)urothelial carcinoembryonic antigen 1(UCA1)levels and pregnancy outcomes in patients with hypertensive disorder complicating pregnancy(HDCP).Methods A total of 195 HDCP patients treated in Handan Maternal and Child Health Hospital from March 2021 to August 2023 were selected as the case group,and 195 healthy pregnant women were regarded as the control group.Clinical data of all pregnant women were collected,and biochemical indicators were detected 1 day before delivery.Serum DNMT1 mRNA and LncRNA UCA1 levels were detected by fluorescence quantitative PCR.The case group was divided into pregnancy induced hypertension(PIH)group,mild preeclampsia(PE)group,and severe PE group based on their condition.HDCP patients were divided into good pregnancy outcome group and bad pregnancy outcome group according to the adverse pregnancy outcome at delivery.Clinical data,biochemical indexes,serum DNMT1 mRNA and LncRNA UCA1 levels were compared between control group and case group.The serum DNMT1 mRNA and LncRNA UCA1 levels of HDCP patients with different severity were compared.The clinical data,biochemical indexes,serum DNMT1 mRNA and LncRNA UCA1 levels of HDCP patients with different pregnancy outcomes were compared.The correlation between serum DNMT1 mRNA and LncRNA UCA1 in HDCP patients,factors affecting pregnancy outcomes in HDCP patients,and the predictive value of serum DNMT1 mRNA and LncRNA UCA1 in adverse pregnancy outcomes in HDCP patients were analyzed.Results Compared with control group,the levels of systolic blood pressure,diastolic blood pressure and white blood cell count in case group were increased,while the levels of serum DNMT1 mRNA(0.72±0.18 vs 1.00±0.04)and LncRNA UCA1(0.61±0.16 vs 1.00±0.02)were decreased,and the differences were statistically significant(t=40.651,32.595,7.837,21.205,33.775,all P＜0.001).Serum DNMT1 mRNA(0.85±0.20,0.74±0.18,0.50±0.15)and LncRNA UCA1(0.77±0.18,0.58±0.16,0.43±0.13)levels in PIH group,mild PE group and severe PE group were decreased successively,and the differeences were statistically significant(F=52.687,64.030,all P＜0.001).Serum DNMT1 mRNA in HDCP patients was positively correlated with LncRNA UCA1(r=0.582,P＜0.001).Compared with good pregnancy outcome group,the severity of HDCP,systolic blood pressure,diastolic blood pressure and white blood cell count were increased in the bad pregnancy outcome group,and the serum DNMT1 mRNA(0.80±0.20 vs 0.59±0.15)and LncRNA UCA1(0.72±0.17 vs 0.43±0.14)levels were decreased,and the differences were statistically significant(x2=18.386,t=2.615～12.290,all P＜0.05).Severe PE[OR(95％CI)=1.708(1.193～2.445)],systolic blood pressure[OR(95％CI)=1.495(1.090～2.049)]and diastolic blood pressure[OR(95％CI)=1.621(1.076～2.442)]were risk factors for adverse pregnancy outcomes in HDCP patients,while DNMT1 mRNA[OR(95％CI)=0.833(0.725～0.957)]and LncRNA UCA1[OR(95％CI)=0.796(0.696～0.909)]were protective factors for adverse pregnancy outcomes in HDCP patients(all P＜0.05).The area under curve(AUC)predicted by the combination of DNMT1 mRNA and LncRNA UCA1 for adverse pregnancy outcomes in HDCP patients was greater than that predicted by DNMT1 mRNA alone and LncRNA UCA1 alone(0.926 vs 0.832,0.844),and the differences were statistically significant(Z=2.932,2.345,all P＜0.05).Conclusion Both serum DNMT1 mRNA and LncRNA UCA1 levels are low in HDCP patients,which is related to the degree of disease and pregnancy outcome.DNMT1 mRNA combined with LncRNA UCA1 detection may have a better predictive effect on adverse pregnancy outcome.

BACKGROUND: Pneumonia-like primary pulmonary lymphoma (PPL) was commonly misdiagnosed as infectious pneumonia, leading to delayed treatment. The purpose of this study was to establish a computed tomography (CT)-based radiomics model to differentiate pneumonia-like PPL from infectious pneumonia. METHODS: In this retrospective study, 79 patients with pneumonia-like PPL and 176 patients with infectious pneumonia from 12 medical centers were enrolled. Patients from center 1 to center 7 were assigned to the training or validation cohort, and the remaining patients from other centers were used as the external test cohort. Radiomics features were extracted from CT images. A three-step procedure was applied for radiomics feature selection and radiomics signature building, including the inter- and intra-class correlation coefficients (ICCs), a one-way analysis of variance (ANOVA), and least absolute shrinkage and selection operator (LASSO). Univariate and multivariate analyses were used to identify the significant clinicoradiological variables and construct a clinical factor model. Two radiologists reviewed the CT images for the external test set. Performance of the radiomics model, clinical factor model, and each radiologist were assessed by receiver operating characteristic, and area under the curve (AUC) was compared. RESULTS: A total of 144 patients (44 with pneumonia-like PPL and 100 infectious pneumonia) were in the training cohort, 38 patients (12 with pneumonia-like PPL and 26 infectious pneumonia) were in the validation cohort, and 73 patients (23 with pneumonia-like PPL and 50 infectious pneumonia) were in the external test cohort. Twenty-three radiomics features were selected to build the radiomics model, which yielded AUCs of 0.95 (95% confidence interval [CI]: 0.94-0.99), 0.93 (95% CI: 0.85-0.98), and 0.94 (95% CI: 0.87-0.99) in the training, validation, and external test cohort, respectively. The AUCs for the two readers and clinical factor model were 0.74 (95% CI: 0.63-0.83), 0.72 (95% CI: 0.62-0.82), and 0.73 (95% CI: 0.62-0.84) in the external test cohort, respectively. The radiomics model outperformed both the readers' interpretation and clinical factor model ( P <0.05). CONCLUSIONS The CT-based radiomics model may provide an effective and non-invasive tool to differentiate pneumonia-like PPL from infectious pneumonia, which might provide assistance for clinicians in tailoring precise therapy.
Humans ; Retrospective Studies ; Pneumonia/diagnostic imaging* ; Analysis of Variance ; Tomography, X-Ray Computed ; Lymphoma/diagnostic imaging*

Jasminum pentaneurum Hand.-Mazz is widely used in Yao areas,but there are few reports on its composition,pharmacological effects,and quality markers(Q-markers)both domestically and internationally.On the basis of previous research,this article is based on the"Five Principles"of Q-marker research,predicting and analyzing the Q-marker of Jasminum pentaneurum Hand.-Mazz from aspects such as resource distribution,composition,traditional efficacy,plant phylogeny,and component specificity,providing a basis for further in-depth research.

Glycyrrizae Radix et Rhizoma has high medicinal value and is widely used in compatibility. It is used most frequently in the compatibility of Chinese medicine prescriptions，and is known as ''Guolao''（national medicine） and "master of all medicines". The characteristic active ingredients are mainly liquitin，glycyrrizic acid，glycyrrizin，and licochalcone. In different compatibilities，based on traditional and modern pharmacological theories，the corresponding effect of Glycyrrizae Radix et Rhizoma are brought into play through different mechanisms. Based on the traditional pharmacology of Glycyrrizae Radix et Rhizoma for tonifying spleen，replenishing Qi，clearing heat，removing toxin，dispelling phlegm，relieving cough and pain，and harmonizing various medicines，this paper used herbal authentication to analyze its compatibility application and mechanism. It was found that Glycyrrizae Radix et Rhizoma played corresponding effect in compatibilities through "tonification"，"harmonization"，and "regulation". For example，Glycyrrizae Radix et Rhizoma was combined with tonics including Ginseng Radix et Rhizoma and Atractylodis Macrocephalae Rhizoma to tonify the five Zang-organs through its strong tonifying effect，combined with Paeoniae Radix Alba and Aconiti Lateralis Radix Praeparata to relieve emergencies and pains through harmonizing medicine power and properties，and combined with Rhei Radix et Rhizoma and Natrii Sulfas to reduce medicine intensity through regulating medicine properties and body characteristics. The application law and mechanism of the modern pharmacological compatibility of Glycyrrizae Radix et Rhizoma were analyzed by data mining and network pharmacology. It was found that the modern clinical formula was often compatible with Glycyrrizae Radix et Rhizoma for anti-inflammation，cardiovascular and cerebrovascular protection，anti-virus，and anti-tumor，Ephedrae Herba and Scutellariae Radix for anti-inflammation，Bambusae Caulis in Taenias，Salviae Miltiorrhizae Radix et Rhizoma，and Aurantii Fructus Immaturus for cardiovascular and cerebrovascular protection，and Ophiopogonis Radix and Chuanxiong Rhizoma for nerves protection. Meanwhile，the important targets of the characteristic ingredients were protein kinase B1 （Akt1），interleukin-6 （IL-6），tumor necrosis factor （TNF），and epidermal growth factor receptor （EGFR）. The important characteristic pathways such as tyrosine kinase inhibitor resistance pathway and cyclic guanosine monophosphate （cGMP）/protein kinase G （PKG） signal pathway played the role of cardiovascular and cerebrovascular protection，and proteoglycan pathway in cancer played a neuroprotective role. This study is expected to provide references for the rational compatibility and application of Glycyrrizae Radix et Rhizoma，as well as the compatibility application of Chinese medicine prescriptions.

OBJECTIVE: To analyze the current status of diagnosis and management of acute appendicitis (AA) in China. METHODS: Questionnaire survey was used to retrospectively collect data of hospitalized patients with AA from 43 medical centers nationwide in 2017 (Sort by number of cases provided: Jinling Hospital of Medical School of Nanjing University, The First Affiliated Hospital of Xinjiang Medical University, Lu'an People's Hospital, Tengzhou Central People's Hospital, Dalian Central Hospital, The Affiliated Hospital of Xuzhou Medical University, Dongying People's Hospital, Jinjiang Hospital of Traditional Chinese Medicine, Huangshan Shoukang Hospital, Xuyi People's Hospital, Nanjing Jiangbei People's Hospital, Lanzhou 940th Hospital of PLA, Heze Municipal Hospital, The First College of Clinical Medical Science of China Three Gorges University, Affiliated Jiujiang Hospital of Nanchang University, The Second People's Hospital of Hefei, Affiliated Central Hospital of Shandong Zaozhuang Mining Group, The Third People's Hospital of Kunshan City, Xuzhou First People's Hospital, The 81st Group Army Hospital of PLA, Linyi Central Hospital, The General Hospital of Huainan Eastern Hospital Group, The 908th Hospital of PLA, Liyang People's Hospital, The 901th Hospital of Joint Logistic Support Force, The Third Affiliated Hospital of Chongqing Medical University, The Fourth Hospital of Jilin University, Harbin Acheng District People's Hospital, The First Affiliated Hospital of Zhengzhou University, Nanjing Luhe People's Hospital, Taixing Municipal People's Hospital, Baotou Central Hospital, The Affiliated Hospital of Nantong University, Linyi People's Hospital, The 72st Group Army Hospital of PLA, Zaozhuang Municipal Hospital, People's Hospital of Dayu County, Taixing City Hospital of Traditional Chinese Medicine, Suzhou Municipal Hospital, Beijing Guang'anmen Hospital, Langxi County Hospital of Traditional Chinese Medicine, Nanyang Central Hospital, The Affiliated People's Hospital of Inner Mongolia Medical University).The diagnosis and management of AA were analyzed through unified summary. Different centers collected and summarized their data in 2017 and sent back the questionnaires for summary. RESULTS: A total of 8 766 AA patients were enrolled from 43 medical centers, including 4 711 males (53.7%) with median age of 39 years and 958 (10.9%) patients over 65 years old. Of 8 776 patients, 5 677 cases (64.6%) received one or more imaging examinations, and the other 3 099 (35.4%) did not receive any imaging examination. A total of 1 858 (21.2%) cases received medical treatment, mainly a combination of nitroimidazoles (1 107 cases, 59.8%) doublet regimen, followed by a single-agent regimen of non-nitroimidazoles (451 cases, 24.4%), a nitroimidazole-free doublet regimen (134 cases, 7.2%), a triple regimen of combined nitroimidazoles (116 cases, 6.3%), nitroimidazole alone (39 cases, 2.1%) and nitroimidazole-free triple regimen (3 cases, 0.2%). Of the 6 908 patients (78.8%) who underwent surgery, 4 319 (62.5%) underwent laparoscopic appendectomy and 2589 (37.5%) underwent open surgery. Ratio of laparotomy was higher in those patients under 16 years old (392 cases) or over 65 years old (258 cases) [15.1%(392/2 589) and 10.0%(258/2 589), respectively, compared with 8.5%(367/4 316) and 8.0%(347/4 316) in the same age group for laparoscopic surgery, χ²=91.415, P<0.001; χ²=15.915,P<0.001]. Patients with complicated appendicitis had higher ratio of undergoing open surgery as compared to those undergoing laparoscopic surgery [26.7%(692/2 589) vs. 15.6%(672/4 316), χ²=125.726, P<0.001].The cure rates of laparoscopic and open surgery were 100.0% and 99.8%(2 585/2 589) respectively without significant difference (P=0.206). Postoperative complication rates were 4.5%(121/2 589) and 4.7%(196/4 316) respectively, and the difference was not statistically significant (χ²=0.065, P=0.799). The incidence of surgical site infection was lower (0.6% vs. 1.7%, χ²=17.315, P<0.001), and hospital stay was shorter [6(4-7) days vs. 6(5-8) days, U=4 384 348.0, P<0.001] in the laparoscopic surgery group, while hospitalization cost was higher (median 12 527 yuan vs. 9 342 yuan, U=2 586 809.0, P<0.001). CONCLUSIONS The diagnosis of acute appendicitis is still clinically based, supplemented by imaging examination. Appendectomy is still the most effective treatment at present. Laparoscopic appendectomy has become the main treatment strategy, but anti-infective drugs are also very effective.
Acute Disease ; Adolescent ; Adult ; Aged ; Anti-Bacterial Agents ; therapeutic use ; Appendectomy ; Appendicitis ; diagnosis ; therapy ; China ; Female ; Health Care Surveys ; Humans ; Laparoscopy ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome ; Young Adult

Antineoplastic Combined Chemotherapy Protocols ; Bortezomib ; Dexamethasone ; Humans ; Multiple Myeloma ; Peripheral Blood Stem Cell Transplantation ; Stem Cell Transplantation ; Transplantation, Autologous

Objective To explore the relationship of insulin resistance with serum 25-hydroxyvitamin D levels and arterial stiffness in elderly patients.Methods A total of 162 elderly inpatients (aged 60 years or over) were recruited from 2012 to 2014.Levels of fasting serum insulin,fasting serum glucose,creatinine and vitamin D were determined.Insulin resistance (IR) was evaluated by the homeostasis model assessment of insulin resistance (HOMA-IR).The patients were divided into the following three groups according to HOMA-IR:the low IR group with HOMA-IR less than 2 (n=78),the median IR group with HOMA-IR between 2 and 6 (n=43),and the high IR group with HOMA-IR greater than 6 (n=41).Arterial stiffness was assessed by carotid-femoral pulse wave velocity (cfPWV).Arterial stiffness and serum vitamin D levels were compared among the three groups.Results cfPWV was increased and the serum 25-hydroxyvitamin D level was decreased in the high insulin resistance group compared with the low insulin resistance group[(13.2± 5.7) μg/L vs.(17.8±6.2) μg/L,(14.3±5.2) m/s vs.(11.9±3.0) m/s].Multiple liner regression analysis showed that IR was negatively correlated with the serum 25 hydroxyvitamin D level (r=-0.63,P＜0.05) and positively correlated with arterial stiffness (r=0.45,P＜0.05) after adjustment for age,sex and other confounders.Conclusions Elderly patients with high insulin resistance may have lower levels of serum vitamin D and higher arterial stiffness.

BmK AngM1 is a long-chain scorpion toxin purified from the venom of Buthus martensii Karsch. It has been reported to exhibit evident analgesic effect and low toxicity, and has the potential to be a novel analgesic drug. The BmKAngM1 gene was transformed into Pichiapastoris GS115. Mut+ and Mut(s) recombinant strains were screened by phenotype and Mut+ recombinant strains were used to detect BmK AngMl gene copy number in the real-time PCR. Expression of BmK AngM1 in the Mut+ recombinant strain was compared with that of the Mut(s) recombinant strain with the same single copy of BmK AngM1 gene under the same condition. The results indicated that the transcription level of BmK AngM1 gene in the Mut(s) recombinant strain was 2.7 fold of that in the Mut recombinant strain in the real-time PCR, and the expression of BmK AngM 1 in the Mut(s) recombinant strain was 1.5 fold of that in the Mut+ recombinant strain. Therefore, Mut(s) recombinant strain showed better ability to express BmK AngM1 than Mut+ recombinant strain.

Codon bias is an important factor which influences heterologous gene expression. Optimizing codon sequence could improve expression level of heterologous gene. In order to improve the expression level of BmK AngM1 gene encoding the analgesic peptide from Buthus martensii Karsch in Pichia pastoris, the codon-optimized BmK AngM1 gene according to its cDNA sequence and the preference codon usage of P. pastoris were cloned into expression vector pPIC9K and then transformed into P. pastoris. The expersion of recombinant BmK AngM1 (rBmK AngM1) was inducced by methanol in the medium, and the expression level of the optimized BmK AngM1 gene was 3.7 times of the native one. These results suggested that the expression of BmK AngM1 in P. pastoris could be successfully improved by codon optimization.

ObjectiveTo evaluate the significance of flexion priority strategy and the principle of joint mobilization technique in the rehabilitation of posttraumatic stiffness of the elbow. Methods24 patients with posttraumatic stiffness of the elbow were divided into 2 groups, 12 patients in each group. The treatment group was treated with flexion priority strategy of joint mobilization technique only in the treatment of flexion contracture. In order to decrease the pain caused by joint mobilization training of extension and achieve the restoration of flexion as early as possible, the rehabilitation of extension was altered to self-exercise under the consultation of doctors combined with gentle passive traction by the therapist. The control group was treated with joint mobilization technique of both flexion and extension once a day. All the patients were measured the flexion range, extension range, and flexion-extension arc after 6 weeks of rehabilitation. Results6 weeks after rehabilitation, the treatment group got 124° of flexion (range 95°～135°), much better than the control group of 95° (range 80°～110°) （P<0.01）. There was no significant difference of extension degrees between the treatment group (15°, range 10°～35°) and the control group (16°, range 10°～30°) （P＞0.05）. The final arc of flexion and extension in the treatment group had an increase of 53°, significantly greater than 30° in the control group（P<0.01）. ConclusionFlexion priority strategy of elbow rehabilitation can significantly restore the flexion function of posttraumatic elbow stiffness.