Objective: To analyze the prevalence and related factors of pediatric flexible flatfoot (PFF) among 7-8 year old children in Changzhou, so as to provide a feasible basis for the prevention and treatment of PFF. Methods: From December 2023 to February 2024, a total of 1 685 children aged 7-8 from 10 primary schools in Changzhou were selected by stratified cluster random sampling method, and screened for PFF by using a foot optical assessment recording device. Information including sex, body mass index (BMI), diet, exercise and shoe wearing habits were collected. The valgus angle of the hindfoot was measured on the body surface by using an orthopedic measuring ruler in the standing position. Pain levels were evaluated by using visual analogue score (VAS) for children with flatfoot syndrome. Multivariate Logistic analysis was used to analyze related factors of PFF. Results: The overall detection rate of PFF was 27.4%, and there was a significant difference in the detection rate of PFF between boys and girls, with 30.3% and 24.1% respectively ( χ 2=7.96, P < 0.01 ). Most cases of PFF were mild flatfoot (60.8%) and bilateral ( 60.4% ). Approximately 13.2% of children with PFF had flatfoot syndrome, with a mean VAS of (2.86±0.73). About 56.1% of children with PFF had a normal valgus angle of the hindfoot. Sex, high BMI and preference for shoe last with front upturned shoe shape were positively correlated with the detection of PFF ( OR= 1.74, 1.54, 1.13, P <0.05). After stratified by sex, regular exercise in boys and age in girls were negatively correlated with the detection of PFF ( OR=0.40, 0.64, P <0.05). Conclusions The detection rate of PFF in 7-8 year old children is high. Additionally, PFF combined with flatfoot syndrome or valgus hindfoot is relatively rare and is likely to be underestimated, which emphasizes the importance of early detection and intervention for PFF.

FibroTouch (FT) has been used widely in clinic. Studies of the FT diagnostic efficiency and influencing factors of liver stiffness measurement (LSM) of liver fibrosis in autoimmune liver diseases (AILD) have shown that FT has a good diagnostic efficiency and accuracy, especially in AIH. However, for patients with primary biliary cholangitis and overlap syndrome of autoimmune hepatitis, FT results should be vigilant. In addition, the diagnostic efficiency of FT. Notably, when using FT to diagnose AILD, the value of elastic stiffness depends on five influencing factors, such as, age, total bile acid, international standardized ratio, FIB-4 index, and prothrombin time.

Objective:Non-alcoholic fatty liver disease (NAFLD) is a common chronic liver disease. Macrophages are an important cell-mediated immune response in the pathogenesis of NAFLD. However, the dynamic changes of intrahepatic infiltration during the pathogenesis of NAFLD remains unclear. Therefore, this study intends to investigate the changes and their correlations with morphological indicators, hepatic histopathological index, and intrahepatic macrophage infiltration in the progression of NAFLD induced by high-fat diet in mice.Methods:C57BL/6J mice were fed with 42% high-fat diet, and the morphological data and liver tissue were obtained at 1, 2, 4, 8 and 12 months, respectively. Hepatic histopathological characteristics were evaluated by HE stain. Immunohistochemical staining was used to detect the number of F4/80 positive cells in liver tissue at different stages to evaluate the degree of intrahepatic macrophage infiltration.Results:(1) The body weight, liver weight, and liver weight/body weight of mice fed with high-fat diet had gradually increased. (2) HE staining results showed that mice fed with high-fat diet had mainly developed simple steatosis within 1 to 2 months. In addition, a balloon-like hepatocyte degeneration and intralobular inflammation had begun to appear at 4 months, indicating that non-alcoholic steatohepatitis had started, and can be seen very clearly at 8 to 12 months. (3) Immunohistochemical staining results suggested that in the simple steatosis stage of NAFLD, the intrahepatic macrophage infiltration was not significant. However, after NAFLD activity score > 3, a large amount of infiltration had appeared and cluster-like changes in the later stage. (4) Correlation analysis results indicated that the degree of macrophage infiltration was not related to the mice morphological indicators (body weight, liver weight and liver weight/body weight) and pathological indicators (percentage of hepatic steatotic change, and degree of hepatocyte ballooning and intralobular inflammation), but was significantly related to the NAFLD activity score.Conclusion:High-fat diet can successfully induce NAFLD in mice and progress to the stage of non-alcoholic steatohepatitis. At the same time, high-fat diet can induce macrophage infiltration in liver tissue of mice and the changing trend of infiltration is related to NAFLD activity score.

The incidence rate of nonalcoholic fatty liver disease (NAFLD) has been increasing in China in recent years and has reached 11％-15％.At present,the multiple-hit hypothesis is considered the main pathogenesis of NAFLD,yet the specific pathogenesis remains unknown.This article elaborates on the roles of carcinoembryonic antigen-related cell adhesion molecule 1 highly expressed in the liver,vitamin D/vitamin D receptor axis,and psychological factors in the development and progression of NAFLD,in order to provide new directions for the research on the pathogenesis of NAFLD in future.

Hepatitis, Autoimmune ; Humans ; Immunoglobulin G

Objective To explore the correlation between hyperlipidemia and colorectal polyps by compare the level of serum lipids in patients with colorectal polyps.Methods The levels of total cholesterol (TC),triglyceride (TG) and low density lipoprotein-cholesterol (LDL-C) of 159 patients with colorectal polyps and 138 controls were tested.The serum lipids between colorectal polyps group and control group,of colorectal polyps with different pathological type,of adenomatous polyps with different pathological type,of adenomatous polyps with different location,colorectal polyps of different gender were compared.Chi square test or t test were performed for data analysis.Results The incidence of hyperlipidemia of colorectal polyps group was 41.5％ (66/159),which was higher than that of control group (16.7％,23/138) and the difference was statistically significant (x2 =36.56,P＜0.01),its levels of TG,TC and LDL-C were all higher than those of the latter ((1.52±0.56) mmol/L vs (1.06 ± 0.42) mmol/L,(5.22±0.86) mmol/L vs (4.52±0.96) mmol/L,(2.85±0.66) mmol/L vs (2.52± 0.35) mmol/L; t=4.23,4.02,3.72,all P＜0.01).There were no significant differences in the levels of TC,TG and LDL-C between colorectal polyps with different pathological type (all P＞ 0.05).The incidence of hyperlipidemia of tubular villous adenoma and villous adenoma (progressive adenomas) was 60.0％ (15/25),which was higher than that of tubular adenoma group (33.3％,20/60) and the difference was statistically significant (x2=5.18,P＜0.05).The incidence of hyperlipidemia of left colon and rectal polyps group was 46.2％ (49/106),which was higher than that of right colon polyps group (28.6 ％,12/42) and the difference was statistically significant (x2 =3.87,P＜0.05).The incidence of hyperlipidemia of male colorectal polyps group was 47.2％ (51/108),which was higher than that of female group (29.4％,15/51) and the difference was statistically significant (x2 =4.53,P＜0.05).The level of TG of male colorectal polyps group was higher than that of female group ((1.84 ± 0.73) mmol/L vs (1.55±0.65) mmol/L) and the difference was statistically significant (t=3.98,P＜0.05).Age (r=0.766,P=0.009),TG level (r=0.535,P=0.012) and TClevel (r=0.688,P=0.025) were positively correlated with genesis of colorectal polyps.Conclusion There is a significant correlation between hypertriglyceride,hypercholesteremia and colorectal polyps.

Objective To investigate the effects of exogenous transforming growth factor-β3 (TGF-β3) on the expression of endogenous TGF-β3 and proliferation of rat hepatic stellate cells (HSC).MethodsRat HSC cells were seeded in 24-well plates and were divided into 2 groups.One group of cells were exposed to TGF-β3 of different concentrations (0.08,0.4,2,10 and 50 ng/ml) for 2 hours and then the cell culture supernatant was collected; the other group of cells were exposed to 10 ng/ml TGF-β3 and the cell culture supernatant was collected at different time point (0.25,0.5,1,2,4,8 and 13 h).The content TGF-β3 was determined by ELISA method.Some other HSC cells were seeded in 96-well plates and divided into 2 groups.One group of cells were cultured in the presence of exogenous TGF-β3 of different concentrations (0.001,0.005,0.02,0.08,0.32,1.25,5,20,100,500 ng/ml) for 24 hours and then the cell proliferation was detected; the other group of cells were treated with 5 ng/ml TGF-β3 for 24 and 48 hours.The cell proliferation was measured by MTT method.The HSC cell morphology of control group and TGF-β3 treated group was observed under inverted microscope. Results The endogenous TGF-β3 expression of HSC cells obviously increased after exogenous TGF β3 treated at 2 ng/ml and reached the peak at 3 hour [(0.845±0.028) ng/ml vs (0.026±0.021) ng/ml,F=210.168,P=0.00].Low concentrations of exogenous TGF-β3 did not affect the proliferation of HSC cells.Above 0.32 ng/ml,exogenous TGF-β3 could promote HSC proliferation.There was no dose-dependent relationship between HSC cell proliferation and the concentration of exogenous TGF-β3 (F=0.68,P=0.57).Under microscope,lhere was no significant difference in HSC cell morphology between control group and TGF-β3 treated group.Conclusions Exogenous TGF-β3 can promote the expression of endogenous TGF-β3 in HSC cells,and can promote HSC cell proliferation.There is no obvious effect of exogenous TGF-β3 on HSC morphology.

Objective To study the effects of dynamic,support-inducing exercise on the support,balance and gait ability of patients with moderate-to-severe hemiplegia after stroke.Methods Fourteen stroke patients were randomly assigned to an experimental or a control group (7 cases to each).The patients in the experimental group received both dynamic,support-inducing exercise and routine exercises,while the patients in the control group received routine exercises only.Before training and after 40 and 60 days of training,their functional capacity was evaluated with the Chinese stroke scale (CSS) for neurological deficits,Berg's balance scale (BBS) and using functional ambulation categories (FACs).Results Before training there was no inter-group difference in average CSS or BBS scores or in FACs.For the experimental group there were significant intra-group differences compared with 0th day in all three items at both time points.At days 40 and 60 there were also significant intra-group differences in BBS scores and FACs in the control group,and CSS scores improved significantly only in the experimental group.At day 40 there were significant inter-group differences in average CSS,BBS and FAC results.However,by day 60 a significant difference persisted only in average CSS scores.Conclusions Dynamic,support-inducing exercise can improve support,balance and gait in patients with moderate-to-severe hemiplegia after stroke.

Objective To investigate effect of transforming growth factor β3(TGFβ3)on expression of MMP-9,MMP-2,TIMP-1 and collagen I in rats with liver fibrosis through transduction by recombinant adeno-associated virus 2(rAAV2).Methods Rats were randomly divided into 4 groups:normal control group,model group,negative control group and TGFβ3 group.Liver fibrosis model was induced by hypodermic injection of 40% CCl4.rAAV2-TGFβ3,was injected via vena caudalis of the rats one week before CCl4 Was given.All rats were sacrificed and the liver tissues were taken 8 weeks afler injection of CCl4.The histopathological changes were observed on HE sections;the expressions of MMP-9,MMP-2,TIMP-1 and collagen I were examined by histochemistry and the positive area rates were semi-quantitatively analyzed.Results Compared with the model group and negative control group,the decreases of inflammatory infiltration and collagen fibers hyperplasia were observed in the TGFβ3 group,and the expression of MMP-9 increased(q=23.664,27.746,P<0.01),the expression of collagen I(q=5.503,5.251,P<0.01)and TIMP-1(q=5.800,8.608,P<0.01)decreased,but that of MMP-2 was not changed(q=2.1 08,0.996,P>0.05).Conclusion rAAV2-TGFβ3 can reduce the histological damage and degree of liver fibrosis in rats by inhibiting expression of TIMP-1 and collagen I,and upregulating expression of MMP-9.

Objective To investigate the effects of transforming growth factorβ1(TGFβ1)and β3 (TGFβ3)gene transfer on MMP-2,MMP-9 and TIMP-1 expression in hepatic stellate cells(HSC-T6).Methods TGFβ1 and TGFβ3 expression plagmids were constructed.The recombinant expression plasmid pcDNA3.1(+)-=TGFβ1 and pcDNA3.1(+).TGFβ3 were transfected or cotransfected into HSC-T6.At 24,48 and 72 h after transfection,the expression of MMP-2,MMP-9 and TIMP-1 mRNA were detected by real-time quantitative PCR,and the expression of MMP-2,MMP-9 and TIMP-1 protein were detected by Western blot.The recombinant expression plasmid pcDNA3.1(+).TGFβ1 was transfected into HSC-T6,and positive clones were selected by G418.The positive clones were transfected by the recombinant expression plasmid pcDNA3.1(+).TGFβ1,and the expression of MMP-2,MMP-9 and TIMP-1 were detected at 48 h after transfection.Results After transfection with peDNA3.1-TGFβ1,MMP-2 and TIMP-1 increaged remarkably in HSC-T6 cells(P＜0.05),but MMP-9 remained at the sanle level;After transfection with pcDNA3.1-TGFβ3,expression levels of MMP-2,MMP-9 and TIMP-1 mRNA were not changed,but TIMP-1 protein increased remarkably(P＜0.05);in cotransfection group,the expression of MMP-2 was higher than that in the blank and the control groups(P＜0.05),but MMP-9 level was not changed and TIMP-1was decreased compared with that in the TGF-β1 transfection group(P＜0.05).After TGFβ3was transfected into positive clones,the change of MMP-2 wag not significant(P＞0.05).but MMP-9 increaged and TIMP-1 decreased significantly at 48 h after transfection(P＜0.05).Conclusions TGFB3 may inhibit liver fibrosis by increase the activity of MMP-2 and MMP-9,and decrease the activity of TIMP-1.