Aim To investigate the mechanism of eata- pol (CAT) inhibiting differentiation and glyeolysis of Thl7 eel Is through miR-143-3p.Method The peripheral hloorl CD4 ∗ T eells of HA patients were obtained to deteet the expression of miR-143-3p and the mRNA levels of key glycolytic enzymes, ineluding glucose transporter 1 ( Glutl ) , hexokinase 2 ( HK2 ) , pyruvate kinase 2 (PKM2) , laetate dehydrogenase A ( LDHA).The differentiation of Thl7 eells was induced in vitro, and the ShRNA/lentivirus was applied to achieve the overexpression or knockdown of miR- 143-3 p.Un-transfected eells were divided into control group and CAT group (20, 40, 80 mg • L 1 ) , and transfected eells were divided into four groups: negative control group, miR-143-3p inhibitor group, miR- 143-3p mimies group, miR-143-3p inhibitor + CAT group.The percentage of Thl7 eells was deteeted by flow cytometry, and the level of IL-17A was detected by EL1SA.Quantitative real-time PCR was used to detect the mRNA expression of miR-143-3p and key glycolytic enzymes, and the levels of pyruvate and lactate were also detected.Results The mRNA expression of miR-143-3p in RA peripheral blood CD4 ∗ T cells was negatively correlated with disease severity ( DAS28 ) , transcription factor ROR-yt, and the key glycolytic enzymes Glutl/HK2/LDHA.Compared with negative control group, the down-expression of miR-143-3p markedly elevated the mRNA expression of ROR-yt, Glutl, HK2, LDHA, and the levels of IL-17A, pyruvate, lactate.Catalpol groups significantly up-regula- ted the expression of miR-143-3p, decreased the mRNA expression of HK2/LDHA and the levels of pvru- vate/lactate, and inhibited Thl7 cells differentiation.Compared with miR - 1 4 3 - 3 p inhibitor group , catapol could significantly inhibit the abnormal up-regulated of HK2/LDHA mRNA relative expression, pyruvate/lactate levels and the abnormal differentiation of Thl7 eells.Conclusion MiR-143-3p inhibits the differentiation and glycolysis of Thl7 cells.Catalpol could sup-press the glycolysis and differentiation of Thl7 eells by regulating mill-143-3p.

BACKGROUND: Coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has rapidly spread throughout the world. In this study, we aimed to identify the risk factors for severe COVID-19 to improve treatment guidelines. METHODS: A multicenter, cross-sectional study was conducted on 313 patients hospitalized with COVID-19. Patients were classified into two groups based on disease severity (nonsevere and severe) according to initial clinical presentation. Laboratory test results and epidemiological and clinical characteristics were analyzed using descriptive statistics. Univariate and multivariate logistic regression models were used to detect potential risk factors associated with severe COVID-19. RESULTS: A total of 289 patients (197 nonsevere and 92 severe cases) with a median age of 45.0 (33.0, 61.0) years were included in this study, and 53.3% (154/289) were male. Fever (192/286, 67.1%) and cough (170/289, 58.8%) were commonly observed, followed by sore throat (49/289, 17.0%). Multivariate logistic regression analysis suggested that patients who were aged ≥ 65 years (OR: 2.725, 95% confidence interval [CI]: 1.317-5.636; P = 0.007), were male (OR: 1.878, 95% CI: 1.002-3.520, P = 0.049), had comorbid diabetes (OR: 3.314, 95% CI: 1.126-9.758, P = 0.030), cough (OR: 3.427, 95% CI: 1.752-6.706, P < 0.001), and/or diarrhea (OR: 2.629, 95% CI: 1.109-6.231, P = 0.028) on admission had a higher risk of severe disease. Moreover, stratification analysis indicated that male patients with diabetes were more likely to have severe COVID-19 (71.4% vs. 28.6%, χ2 = 8.183, P = 0.004). CONCLUSIONS The clinical characteristics of those with severe and nonsevere COVID-19 were significantly different. The elderly, male patients with COVID-19, diabetes, and presenting with cough and/or diarrhea on admission may require close monitoring to prevent deterioration.
Adult ; COVID-19/pathology* ; China/epidemiology* ; Comorbidity ; Cough ; Cross-Sectional Studies ; Diarrhea ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Risk Factors

Objective:Due to the limitation of traditional identification methods of Chinese medicinal materials， the study established a rapid method to identify Persicae Semen mixed with Armeniacae Semen Amarum by allele-specific polymerase chain reaction （PCR）. Method:By comparing the ribosomal DNA internal transcribed spacer （ITS） gene sequences of Persicae Semen and Armeniacae Semen Amarum， single nucleotide polymorphism （SNP） sites were searched and specific primers were designed. Different Persicae Semen and Armeniacae Semen Amarum samples were amplified by PCR， the effects of annealing temperature， primer concentration and cycle number on the PCR reaction system were optimized， and the specificity and detection limit of this method were investigated. In addition， the established PCR method was used to detect the samples of Persicae Semen mixed with different proportion of Armeniacae Semen Amarum from different sources and producing areas. Result:A specific PCR method for identifying Persicae Semen mixed with Armeniacae Semen Amarum was established. When the annealing temperature was 63 ℃ and the number of primer cycles was 30， only Armeniacae Semen Amarum could be amplified with 432 bp specific band， while Persicae Semen samples did not have this band. The minimum detection limit of this method for Armeniacae Semen Amarum was 0.2 ng， and the detection limit for Armeniacae Semen Amarum adulterated in Persicae Semen was 1%. Conclusion:The established allele-specific PCR method can accurately detect whether there is Armeniacae Semen Amarum in Persicae Semen， which can provide experimental basis for the quality control of Persicae Semen and guarantee the safety of its clinical use.

Objective:To summarize the surgical treatment of malignant carotid body tumor (MCBT).Methods:A retrospective analysis of 14 MCBT patients admitted at our hospital from Mar 2005 to Nov 2019 was made, and the imaging data, surgical records, perioperative complications and follow-up data were collected.Results:There were 8 males and 6 females, with an average age of (40.8±11.3) years. 10 patients underwent surgical resection of CBT, with one case undergoing tumor enucleation only, nine cases underwent internal carotid artery reconstruction, and all patients underwent intraoperative lymph node biopsy.Tumors were completely removed in all 10 patients. No perioperative death or cerebral infarction occurred. The intraoperative blood loss was (955±658.5) ml. Four patients had permanent nerve injury after surgery. The follow-up time ranged 1-132 months. There were no cases of cerebral infarction or death, and the reconstructed graft remained patent. Apart from the 2 patients who developed tumor metastasis after surgery, other patients recovered uneventfully with no disease progression.Conclusions:Surgery is still the main treatment for MCBT, but MCBT is large and Shamblin class is more advanced. Therefore, complete tumor removal and reconstruction of the carotid arteries are difficult. Surgery should seek to completely remove the tumor and neck lymph node biopsy should be performed to determine the lymph node metastasis.

The advantages of the tourniquet in total knee arthroplasty are favored by surgeons. However, tourniquets can aggravate the swelling and pain of postoperative limbs，which is not good for early functional exercise. Researchers conducted many related studies which only stayed in clinical manifestations and did not clarify the causes and mechanisms of swelling and pain，So there are no positive effect on the prevention and treatment of swelling and pain. Tourniquets can cause ischemia, hypoxia and reperfusion injury in limbs, leading to local tissue inflammatory reactions, vascular injury, microcirculatory disorders, abnormal coagulation, deep venous thrombosis, lymphatic drainage disorders, joint cavity occult hemorrhage, effusion and the damage of distant organs, which eventually exacerbated the degree of swelling and pain of the limb. Therefore, the above factors are reviewed in this article.

Patients with rotator cuff tears often have repeated irregular neck and shoulder pain, and all of them are aggravated at night. The patient is very painful and cannot suffer from lateral position. Most of them cannot or do not do the exercises such as stretching the elbow and bending the arm, which seriously affect sleep. Numerous studies have shown that in addition to inflammation, the two-way interaction to the circadian clock, the circadian clock also regulated many aspects of the immune system. And the mechanism of night pain caused by rotator cuff injury was related to factors such as inflammation of the acromion sac. This suggests that the night pain of rotator cuff tears may have a circadian rhythm. This article mainly reviews the mechanism of night pain caused by rotator cuff tears.

Objective Shoulder surgery is associated with moderate to severe pain, but there is a lack of consensus on the best analgesic method. This study was conducted to evaluate whether intra-articular injections of cocktails (betamethasone hydrochloride combined with ropivacaine) achieved better clinical effects than betamethasone hydrochloride alone after arthroscopic rotator cuff repair.Methods Eighty-six patients with rotator cuff repair under arthroscopy in our hospital from March 2017 to October 2017 were selected and divided into experiment group( ropivacaine75 mg+(betamethasone hydrochloride 2 mL) and control group((betamethasone hydrochloride 4 mL), each group 43. Visual acuity score(VAS) and the satisfaction of patients were evaluated before operation and at 4, 8, 12, 24, 48 h postoperatively.Results There was no significant difference in VAS before operation and 48 h after operation between experimental group and control group (P>0.05). But at 4, 8, 12 and 24 h after operation the VAS in experimental group is lower than that in control group(P<0.05); At 4, 8, 12 and 24 h after operation the satisfaction of patients in experimental group is higher than that in control group (P＜0.01) and at 48h after operation there was no significant difference between the two groups(P>0.05).Conclusion Cocktail (betamethasone combined with ropivacaine) intra-articular injection can significantly reduce the postoperative earlier pain within 24 hours and can improve the satisfaction of patients.

Objective The dynamic detection of endotoxin is of great significance for the early diagnosis and treatment of prosthesis loosening after joint replacement. This study aimed to explore and analyze the clinical significance and efficacy of endotoxin detection in prosthetic joint loosening after joint replacement.Methods Fifty-eight patients who underwent arthroplasty in the department of orthopedics in Nanjing General Hospital from January 2015 to June 2016 were selected for prospective study. The patients were divided into the infection loosening group (patients with infectious loosening after arthroplasty, n=15), the aseptic loosening group (patients with aseptic loosening of after arthroplasty, n=23) and the control group (patients were normal after arthroplasty, n=20) according to the postoperative complications. Endotoxin was detected with MB-80 microbial dynamic rapid detection system. We compared the endotoxin level and the ROC curve was made to acquire the sensitivity and specificity under the different cut-off values. Eventually find the best diagnostic threshold.Results The levels of endotoxin in the infection loosening group and the aseptic loosening group \[(0.56±0.11, 0.49±0.08) ng/mL\] were significantly higher than that in the control group \[(0.24±0.06) ng/mL\]. The difference was statistically significant (P<0.01). The difference was not statistically significant between the infection loosening group and the sterile loosening group (P>0.05). ROC curve analysis showed that when the serum endotoxin concentration was 0.36 ng/mL, the Youden index was the highest, which could be the best cut-off value for diagnosis. It had the best accuracy to judge the prosthesis loosening with a sensitivity of 66.7% and specificity of 88.2%.Conclusion The endotoxin can be a good indicator for early diagnosis of prosthesis looseness. It is helpful to the diagnosis of the prosthesis loosening after arthroplasty.

Objective The application of metal augments in the revision of total hip arthroplasty(THA)has achieved re-markable results in the treatment of bone defects.However,there are limited studies compared this effective method with the traditional treatment.The purpose of this article is to investigate the curative effect of both metal augmentation and impacted bone grafting in the revision of acetabular bone defect. Methods We retrospectively analyzed 20 patients(20 hips)with bone defects after THA in Au-thority of Nanjing General Hospital of Nanjing Military Region from August 2010 to February 2017.These 20 patients were allocated into 2 groups:impacted bone grafting group(n=11,filling acetabular bone defect with autogenous iliac bone and artificial bone)and metal aug-mentation group(n=9,filling acetabular bone defect with metal aug-ment).The duration of surgery,blood loss and the hospital for special surgery knee score(HSS)were compared between these two groups and the Harris score was applied to evaluate the hip function and full weight bearing. Results The surgery duration and blood loss of impacted bone grafting group were significantly increased when compared with the metal augmentation group(44.5±7.82 min vs 36.22±5.19 min and 431.82±57.76 mL vs 333.33±72.80 mL respec-tively).there were 3 cases showed mild bone resorption in the I regions in the impacted bone grafting group, while only one case showed mild bone resorption in the II region in the metal augmentation group.The HSS scores in the metal augmentation group were higher than those in the impacted bone grafting group at the time of postoperative 2 weeks(43.89±2.76 vs 40.82±4.42), 3 months (49.89±2.03 vs 45.27±3.90)and 6 months(53.44±2.46 vs 50.55±3.67), the differences were statistically significant(P<0.001). The Harris scores in the metal augmentation group were higher than those in the impacted bone grafting group(P<0.01).The metal augmentation group had a shorter time of getting out of bed compared with the impacted bone grafting group(P<0.01). Conclusion For those patients with upper acetabular bone defect,revision surgery using metal augments can save the operation time.Meanwhile, it is also superior to the impacted bone grafting in the early prosthesis stability and bone ingrowth,and thus enables to shorten the time on getting out of bed and promote functional.

Objective The use of tourniquets in total knee arthroplasty has been controversial. Many studies have focused only on the different time courses and neglected the effects of pressures. Currently,there is no study explaining the mechanism of tourniquet-induced injury. The aim of this study was to explore the effects of different tourniquet pressures on pain and swelling after total knee arthroplasty and to explore the mechanism of injury. Methods Ninety-six patients who underwent total knee arthroplasty at Nanjing General Hospital from June 2017 to December 2017 were randomly as-signed to 240 mmHg group (low pressure),270 mmHg group (medi- um pressure),and 300 mmHg group (high pressure). The patient's pain and thigh circumference were measured before and 1-2 days after surgery. Blood samples were taken before and 3,8,and 24 hours after surgery. Superoxide dismutase 1 (SOD1),prostaglandin E2 (PGE2) and myoglobin were detected,analysed and compared. Results In the perspective of the pain and swelling of affected limb after surgery,the 300 mmHg group (73.24±10.51) was significantly different from the 240 mmHg group (58.18±9.66) and the 270mmHg group (63.06±10.06). In the perspective of the SOD1 level in serum,the 300mmHg group (97.77±13.82) was significant-ly different from the 240mmHg group (63.72±15.02) and the 270 mmHg group (70.58±5.85) at 3h after surgery,and then the diver-gence was gradually decreased. In the perspective of the PGE2 level in serum,the 300 mmHg group (478.05±35.80) was significantly different from the 240mmHg group (334.42±33.12) and the 270mmHg group (391.85±19.41) at 3h after surgery,and the divergence was started to decrease after 8 h. In the perspective of the myoglobin level in serum,the 300 mmHg group (30.43±9.79) was also sig-nificantly different from the 240 mmHg group (17.58±1.93) and the 270 mmHg group (22.28±4.21) at 8 h after operation,the diver-gence was started to decrease after 24 h. which began to decrease after 24 h. Correlation analysis showed that there was a significant cor-relation between pain (correlation coefficient 0.518,P<0.001),swelling (correlation coefficient 0.345,P<0.05) and stress after sur-gery. Conclusion The pain and swelling of the affected limb is positively correlated with the pressure of the tourniquet during the operation. Muscle necrosis is the main mechanism of the injury. Oxidative stress occurs in the ischemic phase and inflammation occurs in the reperfusion phase.