Objective To investigate the status quo of pain catastrophizing(PC)in the patients with di-abetic peripheral neuropathic pain(DPNP),and to analyze the influencing factors to provide reference for for-mulating clinical preventive intervention strategies.Methods A total of 206 patients with DPNP admitted and treated in the People's Hospital of Guangxi Zhuang Autonomous Region were selected as the research sub-jects by convenience sampling method.The general data questionnaire,Numerical Rating Scale(NRS),Pain Catastrophizing scale(PCS),Perceived Social Support Scale(PSSS)and diabetes distress scale(DDS)were used to conduct the investigation.Results The incidence rate of PC in 206 cases of DPNP patients was 44.66％(92/206),and the total score of PCS was(30.10±5.16)points.The results of multiple linear regres-sion analysis showed that the gender,duration of diabetes(≥10 years),multiple drug use,number of compli-cations(＞5),NRS score,PSSS score and scores of DDS dimensions were the main influencing factors of PC(all P＜0.05),which could explain 92.3％of the total variation of PC.Conclusion The PC incidence rate in the patients with DPNP is high.Clinical healthcare workers should pay attention to the evaluation of PC in these patients,and formulate the scientific and effective targeted intervention measures according to the main influen-cing factors to help the patients to reduce the pain burden in order to reduce the level of PC.

Objective: To describe the distribution characteristics of hyperlipidemia in adult twins in the Chinese National Twin Registry (CNTR) and explore the effect of genetic and environmental factors on hyperlipidemia. Methods: Twins recruited from the CNTR in 11 project areas across China were included in the study. A total of 69 130 (34 565 pairs) of adult twins with complete information on hyperlipidemia were selected for analysis. The random effect model was used to characterize the population and regional distribution of hyperlipidemia among twins. The concordance rates of hyperlipidemia were calculated in monozygotic twins (MZ) and dizygotic twins (DZ), respectively, to estimate the heritability. Results: The age of all participants was (34.2±12.4) years. This study's prevalence of hyperlipidemia was 1.3% (895/69 130). Twin pairs who were men, older, living in urban areas, married,had junior college degree or above, overweight, obese, insufficient physical activity, current smokers, ex-smokers, current drinkers, and ex-drinkers had a higher prevalence of hyperlipidemia (P<0.05). In within-pair analysis, the concordance rate of hyperlipidemia was 29.1% (118/405) in MZ and 18.1% (57/315) in DZ, and the difference was statistically significant (P<0.05). Stratified by gender, age, and region, the concordance rate of hyperlipidemia in MZ was still higher than that in DZ. Further, in within-same-sex twin pair analyses, the heritability of hyperlipidemia was 13.04% (95%CI: 2.61%-23.47%) in the northern group and 18.59% (95%CI: 4.43%-32.74%) in the female group, respectively. Conclusions: Adult twins were included in this study and were found to have a lower prevalence of hyperlipidemia than in the general population study, with population and regional differences. Genetic factors influence hyperlipidemia, but the genetic effect may vary with gender and area.
Adult ; Female ; Humans ; Male ; Middle Aged ; Young Adult ; China/epidemiology* ; Diseases in Twins/genetics* ; Hyperlipidemias/genetics* ; Metabolic Diseases ; Twins, Dizygotic ; Twins, Monozygotic/genetics*

Objective To investigate the effects of GO-CoA-Tat,an inhibitor of ghrelin O-acyltransferase(GOAT),on lipid metabolism and oxidative stress in mice with non-alcoholic fatty liver disease(NAFLD)induced by high-fat diet(HFD).Methods Twenty-four C57BL/6 male mice were selected and divided into control group,HFD group and GO-CoA-Tat group,with 8 mice in each group.The mice in control group was given standard diet,the mice in HFD group and GO-CoA-Tat group were given HFD,and the mice in GO-CoA-Tat group was given daily intraperitoneal injection of GO-CoA-Tat from 3rd week of feeding.Food intake and body mass of mice were measured weekly.After 8 weeks,serum and liver samples were collected,liver weight was measured,and fat droplets were detected by hepatocyte oil red O staining;biochemical indexes such as serum triglyceride(TG),total cholesterol(TC),alanine aminotransferase(ALT),aspartate aminotransferase(AST)and oxidative stress indexes of liver such as glutathione(GSH),superoxide dismutase(SOD)and malondialdehyde(MDA)were measured.Results Hepatic steatosis was observed after feeding with HFD for 8 weeks,which was significantly relieved in GO-CoA-Tat group compared with HFD group.Compared with HFD group,the food intake,body weight and liver weight of mice in GO-CoA-Tat group decreased(P＜0.05).Compared with HFD group,the content of TG in liver of mice in GO-CoA-Tat group decreased,the concentrations of serum TG and TC decreased(P＜0.05),and the concentrations of liver GSH and SOD increased(P＜0.01),liver MDA decreased(P=0.005),and the serum ALT and AST decreased(P＜0.05).Conclusion GO-CoA-Tat can improve lipid metabolism and oxidative stress in the liver of NAFLD mice,thus play a protective role in the liver.

Objective: To develop a nomogram model for the differential diagnosis of benign and malignant breast BI-RADS (Breast Imaging Reporting and Data System) category 4 nodules based on serum tumor specific protein 70 (SP70) and conventional laboratory indicators and validate its predictive efficacy. Methods: A case-control study design was used to retrospectively analyze the data of 429 female patients diagnosed with BI-RADS category 4 breast nodules by breast color doppler flow imaging at the First Affiliated Hospital of Nanjing Medical University from January 2021 to April 2022 with an age range of 16 to 91 years and a median age of 50 years, and the patients were divided into a training cohort (314 patients) and a validation cohort (115 patients) according to the inclusion time successively. Using postoperative pathological findings as the"gold standard", univariate and multivariate logistic regression analyses were used to identify the predictor variables used for the model. The nomogram, receiver operating characteristic (ROC) curves and calibration curves were drawn for the prediction model, and the discrimination and calibration of the model were evaluated using the consistency index (C-index) and calibration plots. Results: The postoperative pathological results showed that 286 (66.7%) were malignant nodules and 143 (33.3%) were benign nodules of 429 breast BI-RADS category 4 nodules. The serum SP70 (OR=1.227,95%CI: 1.033-1.458,P=0.020), NLR (OR=1.545,95%CI: 1.047-2.280,P=0.028), LDL-C (OR=2.215, 95%CI: 1.354-3.622, P=0.002), GLU (OR=2.050,95%CI:1.222-3.438,P=0.007), PT (OR=1.383,95%CI: 1.046-1.828,P=0.023), nodule diameter (OR=1.042, 95%CI: 1.008-1.076, P=0.015) and age (OR=1.062,95%CI: 1.011-1.116,P=0.016) were independent risk factors which could be used to distinguish benign and malignant breast BI-RADS category 4 nodules (P<0.05). The nomogram was plotted by the above seven independent variables, and the concordance index (C-index) for the training cohort and validation cohort were 0.842 (95%CI:0.786-0.898) and 0.787 (95%CI:0.687-0.886), respectively. The sensitivity and specificity of using this model to identify benign and malignant breast BI-RADS category 4 nodules in the training and validation cohort were 83.5%, 72.5% and 79.2%, 73.6%, respectively. The calibration curves showed good agreement between the predicted and actual values in the nomogram. Conclusions: This study combined serum SP70, conventional laboratory indicators and breast color doppler flow imaging to develop a nomogram model for the differential diagnosis of benign and malignant breast BI-RADS category 4 nodules. The model may have good predictive efficacy and may provide a basis for clinical treatment options, which is beneficial for guiding breast cancer screening and prevention.
Female ; Humans ; Middle Aged ; Adolescent ; Young Adult ; Adult ; Aged ; Aged, 80 and over ; Diagnosis, Differential ; Retrospective Studies ; Case-Control Studies ; Breast/pathology* ; Breast Neoplasms/pathology*

OBJECTIVE: To compare the clinical effects of ultrasonic subgingival debridement and ultrasonic subgingival debridement combined with manual root planing on severe periodontitis and then to investigate the necessity and significance of manual root planing. METHODS: Twenty-three patients with severe periodontitis participated in this split-mouth randomized-controlled clinical trial. Baseline examination and randomization were performed after supragingival scaling: each of the upper and lower jaws had a quadrant as the test group treated with ultrasonic subgingival debridement combined with manual root planing, whereas the other two quadrants were the control group treated with ultrasonic subgingival debridement. Treatment of each patient was at intervals of one week and completed in two visits. Clinical indicators concerning probing depth (PD), clinical attachment loss (CAL) and bleeding index (BI) were recorded at baseline and 1 month, 3 months, 6 months after treatment. RESULTS: There was no significant difference of periodontal indicators between the test group and the control group at baseline. Both the test group and control group resulted in significant improvement of PD, CAL and BI. One and three months after treatment, reduction of PD in the test group was higher than that in the control group [1 month: (2.13±1.31) mm vs. (1.79±1.33) mm, P<0.01; 3 months: (2.46±1.33) mm vs. (2.17±1.38) mm, P<0.01] and reduction of CAL in the test group was higher than that in the control group [1 month: (1.89±2.03) mm vs. (1.65±1.93) mm, P<0.01; 3 months: (2.03±2.05) mm vs. (1.83±1.97) mm, P<0.05]. Six months after treatment, PD in the test group and the control group decreased by (2.52±1.40) mm and (2.35±1.37) mm respectively, and the improvement in the test group was significantly better than that in the control group (P<0.01). CAL in the test group and the control group decreased by (1.89±2.14) mm and (1.77±2.00) mm respectively, and there was no statistical difference between the groups. There was no significant difference in the changes of BI between the two groups 1, 3 and 6 months after treatment. CONCLUSION Ultrasonic subgingival debridement combined with manual root planing has more reduction in PD and CAL compared with ultrasonic subgingival debridement. Therefore, it is still necessary to use manual instruments for root planing following ultrasonic subgingival debridement.
Debridement ; Dental Scaling ; Humans ; Periodontitis ; Root Planing ; Treatment Outcome ; Ultrasonics

ObjectiveLymphatic epithelial cells (LECs) are important links involved in lymphatic metastasis in the microenvironment of cholangiocarcinoma. This study aims to detect the modulation of inflammatory factors and chemokines secreted by LECs after stimulation of cholangiocarcinoma cells, and observe the effects of highly expressed factors on lymphangiogenesis.MethodsThe culture medium of cholangiocarcinoma (RBE, HCCC9810), LECs stimulated by cholangiocarcinoma cell culture medium (CCM), and normal LECs were prepared. Inflammatory factors and chemokines in the culture medium were detected using protein chip. The experiments are divided into the following groups, including a blank control group, CCM group, CCM coupled with Anti-ENA-78 group, Anti-ENA-78 group, ENA-78 group, ENA-78 coupled with SB2252002, and SB225002 group. The relationship between the content of factor and time was investigated using ELISA, while the relation between target factors and lymphangiogenesis obtained by cell proliferation and tubule formation assay.ResultsWe found ENA-78, IP-10, GCP-2, MCP-2, MCP-3, MIP-3a, HCC-1, and Lymphotactin expression increased in LECs supernatant after CCM stimulation. However, I-TAC, MIP-1d, IL-10, MIG, PDGF-BB, and CXCL16 factors showed down-regulation. The secretion of ENA-78 in CCM was relatively low. By ELISA, we found that the ENA-78 protein in RBE-LECs and HCCC9810-LECs gradually increased over time, and reached the plateau phase at the point of 48h. The lymphatic tube forming ability of LECs cultured in CCM was significantly increased compared with that of the control group, and this ability could be partially weakened by ENA-78 neutralizing antibodies. In the exogenous ENA-78 protein group, the lymphatic tube formation ability was as well significantly increased compared with that in the control group, and this ability could be effectively blocked by the IL-8B inhibitor.ConclusionThe increased secretion ENA-78 of lymphatic epithelial cells induced by cholangiocarcinoma may play a role in promoting lymphangiogenesis through the IL-8B receptor.

Objective A variety of miRNAs have been found to be involved in the occurrence and development of colorectal cancer. This paper aim to investigate the clinical and biological relevance of miR-217 and the pathway by which miR-217 may be involved in progression in colorectal cancer. Methods According to the diameter of tumor, the tumor was divided into tumors>5 cm(n=22) and tumors≤5 cm(n=28); 18 cases of colorectal cancer I-II specimens and 32 of III-IV patients; according to median expression of miR-217, the specimens were divided into high expression group and low expression group. The expression of miR-217 in 50 colon cancer patients’ carcinoma and adjacent tissues was determined by qRT-PCR. Cells were grouped: overexpression control Group (transfected control mimic) and miR-217 overexpression group(transfected miR-217 mimic), low expression control group((transfected control inhibitor) and miR-217 low expression group(transfected miR-217 inhibitor), miR-217&ERK1/2 low expression group(transfected miR-217 inhibitor+U0126). MiR-217 and HCT116 cells were over expressed in SW480 cells,and miR-217 was knocked down. A series of biological function assays were performed to assess cell viability (cck-8 assay), clony formation ability (clony formation assay), proliferation (edu assay), Changes in ERK1/2 expression were measured at protein level, and the relationship between miR-217 and ERK1/2 in colorectal cancer cells was explored by relevant rescue experiments. Results Compared with colorectal adjacent noncancerous tissues, the expression of miR-217 was significantly decreased in carcinoma tissues(-1.360±0.645 vs 2.244±0.168, P<0.01); the expression of miR-217 in tumors with a diameter >5cm was significantly lower than that of tumors with a diameter ≤5cm(-1.718±0.272 vs -0.587±0.288, P<0.01); the expression of miR-217 in stage I-II colorectal cancer tissues was significantly higher than that stage III-IV(-0.413±0.330 vs -01.463±0.230, P<0.05); the expression of miR-217 in the miR-217 overexpression group was significantly higher than miR-217 overexpression control group(15.120±0.522 vs 1.004±0.003, P<0.01), and the number of clone formation was significantly less than that of the overexpression control group(199.30±15.62 vs 439.70±18.91, P<0.01) . In HCT116 cells, the expression of miR-217 in the miR-217low expression group was significantly lower than miR-217 low expression control group(0.2070±0.021 vs 1.006±0.003, P<0.01), and the number of clone formation was significantly higher than that control group(237.30±12.14 vs 117.00±7.00, P<0.01) . When miR-217 overexpressed in SW480, the protein expression of ERK1/2 decreased; when miR-217 was inhibited in HCT116, the protein expression of ERK1/2 increased. The number of colons in ERK1/2 low expression group was significantly lower than that miR-217&ERK1/2 low expression group(221.70±12.73 vs 108.00±5.51) , the difference was statistically significant(P<0.01). Conclusion Low expression of miR-217 is observed in both colorectal cancer tissues and cells, and miR-217 can affect tumor cell proliferation in the progression of colorectal cancer partly by inhibiting the expression of ERK1/2.

Objectives Anticardiolipin antibody (aCL) is an important component of antiphospholipid antibody (aPL) and a marker antibody of antiphospholipid syndrome (aPS). APL is positive in 20% to 40% of patients with systemic lupus erythematosus(SLE). This article investigated the clinical features and prognosis of SLE patients with aCL. Methods From January 1999 to December 2009, 495 cases of SLE patients detected aCL who were hospitalized for the first time in 26 hospitals in Jiangsu Province including Nanjing Drum Tower Hospital were divided into aCL-positive group and aCL-negative group according to the test results. The patients were followed up in survival status, and the demographic characteristics, affected organs, laboratory tests, treatment drugs, and prognosis were compared between two groups. Results 146 of the SLE patients in this group were positive for aCL. The proportion of women in aCL- positive group (96.6%) was significantly higher than that in aCL-negative group (90.8%), and the difference was statistically significant (P<0.05). The proportion of anemia (74.7% vs 61.3%), decreased C3(81.5% vs 71.1%), positive antinuclear antibody(97.2% vs 92.4%), and positive anti-dsDNA antibody (61.9% vs 49.6%) in aCL-positive group were significantly higher than those of aCL-negative group, and the difference was statistically significant (P<0.05). The aCL-positive group received a higher proportion of cyclophosphamide immunosuppressive therapy (39.5% vs 50.7%, P<0.05). At the end of follow-up, the mortality rate of aCL-positive group was 13.7%, and the mortality rate of aCL-negative group was 14.9% and there was no significant difference in mortality (P>0.05). Kaplan-Meier survival analysis showed that the 1-year, 5-year, and 10-year survival rates of aCL-positive group were 94.5%, 89.0%, and 82.9%, respectively, and there was no significant difference compared with aCL-negative group(P=0.776). The main causes of death in aCL-positive group were lupus encephalopathy (6 cases, 30.0%), renal failure (5 cases, 25.0%), heart failure (4 cases, 20.0%) and infection (3 cases, 15%). The main causes of death in aCL-negative group were infection (21 cases, 40.4%), lupus encephalopathy (11 cases, 21.2%) and heart failure (5 cases, 9.6%) and renal failure (4 cases, 7.7%). Conclusion SLE patients with aCL represent a high propotion in anemia, decreased C3, positive antinuclear antibody, positive anti-dsDNA antibody. There was no significant difference in disease activity and significant organ involvement between two groups. More SLE patients with aCL were treated with cyclophosphamide, and there was no significant difference in survival status between SLE patients with and without aCL during long-term follow-up.

To observe influence of endothelial progenitor cells (EPCs) mobilized by rosuvastatin on ven‐tricular remodeling in patients with myocardial infarction (MI).Methods : A total of 128 MI patients received PCI treated in our department from Jan 2017 to Jan 2018 were selected , randomly and equally divided into routine treat‐ment group and rosuvastatin group (received rosuvastatin based on routine treatment group ) , both groups were con‐tinuously treated for 28d .Peripheral blood percentage of EPCs before and 28d after treatment , LVEF , LVESd and LVEDd before and six months after treatment , and incidence rate of adverse reactions were measured and compared between two groups .Results : Compared with before treatment , there was significant rise in peripheral blood per‐centage of EPCs [ (0. 64 ± 0. 15)% vs.(1. 08 ± 0.23)%] in only rosuvastatin group on 28d after treatment , P＝0.001 ;and was significantly higher than that of routine treatment group [(1.08 ± 0.23)% vs.(0.58 ± 0.12)%] , P＝ 0. 001. Compared with before treatment , there was significant rise in LVEF , and significant reductions in LVEDd and LVESd in two groups on six months after treatment , P＝0.001 all ;compared with routine treatment group , there was significant rise in LVEF [ (52.24 ± 7.18)% vs.(58. 36 ± 8.62)%] , and significant reductions in LVESd [ (33.46 ± 5. 04) mm vs.(30. 26 ± 4. 15) mm] and LVEDd [ (56.17 ± 8. 24) mm vs.(51. 38 ± 7.62) mm] in rosuvastatin group , P＝0. 001 all .There was no significant difference in incidence rate of adverse reactions be‐tween two groups , P＝0. 752. Conclusion : Rosuvastatin can mobilize EPCs to inhibit ventricular remodeling , sig‐nificantly improve cardiac function with good safety in patients with myocardial infarction , which is worth exten‐ding .

BACKGROUNDPlatelet function tests are widely used in clinical practice to guide personalized antiplatelet therapy. In China, the thromboelastography (TEG) test has been well accepted in clinics, whereas VerifyNow, mainly used for scientific research, has not been used in routine clinical practice. The aim of the current study was to compare these two point-of-care platelet function tests and to analyze the consistency between the two tests for evaluating on-clopidogrel platelet reactivity in Chinese acute myocardial infarction patients undergoing percutaneous coronary intervention (PCI).

METHODSA total of 184 patients admitted to Fuwai Hospital between August 2014 and May 2015 were enrolled in the study. On-clopidogrel platelet reactivity was assessed 3 days after PCI by TEG and VerifyNow using adenosine diphosphate as an agonist. Based on the previous reports, an inhibition of platelet aggregation (IPA) <30% for TEG or a P2Y12 reaction unit (PRU) >230 for VerifyNow was defined as high on-clopidogrel platelet reactivity (HPR). An IPA >70% or a PRU <178 was defined as low on-clopidogrel platelet reactivity (LPR). Correlation and agreement between the two methods were analyzed using the Spearman correlation coefficient (r) and kappa value (κ), respectively.

RESULTSOur results showed that VerifyNow and TEG had a moderate but significant correlation in evaluating platelet reactivity (r = -0.511). A significant although poor agreement (κ = 0.225) in identifying HPR and a significantly moderate agreement in identifying LPR (κ = 0.412) were observed between TEG and VerifyNow. By using TEG as the reference for comparison, the cutoff values of VerifyNow for the Chinese patients in this study were identified as PRU >205 for HPR and PRU <169 for LPR.

CONCLUSIONSBy comparing VerifyNow to TEG which has been widely used in clinics, VerifyNow could be an attractive alternative to TEG for monitoring on-clopidogrel platelet reactivity in Chinese patients.

Adenosine Diphosphate ; therapeutic use ; Aged ; Aspirin ; therapeutic use ; Blood Platelets ; drug effects ; China ; Female ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; drug therapy ; surgery ; Percutaneous Coronary Intervention ; methods ; Platelet Aggregation ; drug effects ; Platelet Aggregation Inhibitors ; therapeutic use ; Point-of-Care Systems ; Receptors, Purinergic P2Y12 ; metabolism ; Thrombelastography ; Ticlopidine ; analogs & derivatives ; therapeutic use