Objective:To observe the influence of NOD-like receptor thermal protein domain associated protein 6 (NLRP6) on hepatic ischemia-reperfusion injury (IRI), and elucidate the related mechanism.Methods:Thirty C57BL/6 mice with body weight of (18.80±1.99) g, were divided randomly into 5 groups, with 6 mice in each group: the mice that experienced only exploratory laparotomy were Sham group; that only underwent an operation to establish a hepatic IRI model were IRI group; that were treated with tail intravenous injection of clodronate (Clo) liposomes before the establishment of hepatic IRI model were Clo group; that received tail intravenous injection of clodronate liposomes and transfusion of bone marrow derived macrophages (BMDM) before the operation were Clo+ BMDM group; that received preoperative tail intravenous injection of clodronate liposomes and transfusion of BMDM with NLRP6 knockdown were Clo+ NLRP6-knockdown group. Real time quantitative polymerase chain reaction analysis (RT-PCR) and Western blot were performed to analyze the expressions of pyroptosis related proteins and factors. Simulate a hypoxia/reoxygenation (H/R) model in vitro, and set up experimental groups: lipopolysaccharide (LPS) + adenosine triphosphate (ATP), LPS+ ATP+ NLRP6-knockdown, H/R, and H/R+ NLRP6-knockdown. The changes of expressions of pyroptosis related proteins and factors were detected by RT-PCR and Western blot. Expression of NF-κB in vivo and in vitro was measured.Results:Compared with those in Sham group, protein expressions of NLRP6, NLRP3, Caspase-1, gasdermin D (GSDMD), IL-1β and IL-18 were remarkably increased in IRI group, but the levels of these proteins were dramatically decreased in Clo group with the exhaustion of macrophages in comparison with in IRI group, which were significantly different statistically (all P<0.05). The levels of these proteins were enhanced again in Clo+ BMDM group with the reconstruction of macrophages in contrast to those in Clo group, while the enhancements were more obvious in Clo+ NLRP6-knockdown group comparing to those in Clo+ BMDM group, with significant differences (all P<0.05). In vitro, pyroptosis rate for LPS+ ATP group was (16.39±1.06)%, which was lower than (27.34±2.79)% for LPS+ ATP+ NLRP6-knockdown group, with a statistical significance ( P<0.05). Meanwhile, pyroptosis rate for H/R group was (20.59±5.66)%, also much more reduced than (37.76±2.00)% for H/R+ NLRP6-knockdown group ( P<0.05). Expressions of NLRP3, Caspase-1, GSDMD, IL-1β, IL-18 and NF-κB p65 in LPS+ ATP+ NLRP6-knockdown group were more elevated than in LPS+ ATP group, and these indices were also more enhanced in H/R+ NLRP6-knockdown group than which in H/R group. Compared to the Sham group, expression of NF-κB p65 significantly increased in IRI group, which was reversed in Clo group, but enhanced again in Clo+ BMDM group and reached a peak in Clo+ NLRP6-knockdown group. Conclusions:Macrophage plays a critical role in immune response to hepatic IRI, wherein NLRP6 functions specifically. NLRP6 acts to suppress inflammation during hepatic IRI through regulating macrophage pyroptosis via inhibiting NF-κB.

Objective: To examine the association of body mass index (BMI) and waist circumference (WC) with frailty among oldest-old adults in China. Methods: A total of 7 987 people aged 80 years and older (oldest-old) who participated in the Chinese Longitudinal Healthy Longevity Survey (CLHLS) in 2017-2018 were included. Information on demographic characteristics, behavior pattern, diet, activities of daily living, cognitive function, health status, disease condition were collected by questionnaire and physical examination. Generalized linear mixed model and restricted cubic splines (RCS) were used to analyze the association of BMI and WC with frailty. Results: The mean age of all participants was 91.7 years, and their mean BMI and WC were (21.3±3.5) kg/m² and (82.9±10.5) cm, respectively. The proportion of male was 42.3% (3 377/7 987), and the proportion of people with frailty was 33.7% (2 664/7 987). After controlling confounding factors, compared with T₂ (19.1-22.1 kg/m²) of BMI, the OR (95%CI) of the female T₁ (<19.1 kg/m²) and T₃ (≥22.2 kg/m²) group was 1.39 (1.17-1.65) and 1.27 (1.07-1.52), respectively. Compared with T₂ (77-85 cm) of WC, the OR (95%CI) of female T₁ (<77 cm) and T₃ (≥86 cm) group was 1.20 (1.01-1.42) and 1.10 (0.93-1.31), respectively. The results of multiple linear regression model with restrictive cubic spline showed that there was a non-linear association of BMI and WC with frailty in female. Conclusion: There is a U-shaped association of BMI and WC with frailty in female participants.
Adult ; Male ; Female ; Humans ; Aged, 80 and over ; Waist Circumference ; Body Mass Index ; Frailty/epidemiology* ; Activities of Daily Living ; China/epidemiology* ; Risk Factors

O'Sullivan-Mcleod syndrome is a very rare variant of MND with a good prognosis. Its clinical feature is distal lower motor neuron syndrome of both upper limbs, and there is no effective treatment at present. We reported a case of O'Sullivan-Mcleod syndrome in this paper.The patient exhibited with middle-aged progressive distal muscle weakness and atrophy of both upper limbs, without sensory, cognitive or behavioral impairment and without pyramidal tract sign. Laboratory examination, imaging and genetic tests showed no obvious abnormalities. EMG revealed neurogenic damage to the small muscles of both hands. Now we retrospectively analyzed the clinical features of a patient with O'Sullivan-McLeod syndrome, and data from 18 cases for comparative analysis, in order to improve its understanding by clinicians.

Objective:To explore multidisciplinary team (MDT) for the treatment of hip fracture in the elderly.Methods:A retrospective analysis was done of the 196 elderly patients who had been admitted to Department of Joint Surgery, Beijing Shijitan Hospital from September 2017 to December 2018 for hip fractures. They were divided into 2 groups depending on whether MDT had been applied or not. In the MDT group of 102 patients, there were 43 males and 59 females with an age of 81.9±8.4 years, and 63 femoral neck fractures and 39 intertrochanteric fractures. In the traditional treatment group of 94 patients, there were 37 males and 57 females with an age of 81.3±8.6 years, and 55 femoral neck fractures and 39 intertrochanteric fractures. The 2 groups were compared in terms of complications and mortality during hospitalization, interval from admission to surgery, total hospital stay, and Harris hip scores at 6 months after surgery.Results:There were no statistically significant differences in general data before surgery between the 2 groups, indicating comparability ( P>0.05). Eighty-four patients (89.4%) in the traditional treatment group and 98 patients (96.1%) in the MDT group underwent surgery, showing no significant difference between the groups ( χ2=3.327, P=0.068). In the patients undergoing surgery in the MDT group, the incidences of postoperative delirium [12.2% (12/98)], pulmonary infection [11.2% (11/98)], cardiogenic disease [13.3%(13/98)], electrolyte disturbance[12.2%(12/98)] and deep venous thrombosis of lower extremity [6.1% (6/98)] were significantly lower, the interval from admission to surgery (1.9 d±0.9 d) and total hospital stay (10.2 d±0.9 d) significantly shorter, and Harris hip scores (81.3±6.2) at 6 months after surgery significantly higher than those in the patients undergoing surgery in the traditional treatment group [31.0%(26/84), 22.6% (19/84), 25.0% (21/84), 28.6% (24/84), 16.7%(14/84); 3.1 d±1.6 d and 14.1 d±6.2 d; 75.4±7.8; respectively] (all P<0.05). Conclusion:In the treatment of hip fracture in the elderly, multidisciplinary team is effective in reducing complications during hospitalization, shortening the interval from admission to surgery and total hospital stay, and promoting functional recovery of the hip.

Objective To explore the expression and significance of Rac1 and WAVE2 protein in glomerulus of high-
fat diet induced C57BL/6J model mice. Methods Thirty-two male C57BL/6J mice (3-week old) were randomly assigned into two groups(16 in each group). The control group was fed with basic diet (10%fat) for 4 weeks. The high-fat diet group was fed with high-fat diet (60%fat) for 4 weeks. The kidney morphological changes were examined by HE and PAS staining. The expressions of Rac1 and WAVE2 protein were examined by Western blot and immunohistochemistry analysis. Results HE and PAS results showed that there were glomeruli mesangial matrix hyperplasia and exudation in high-fat diet group compared with control group. The immunohistochemistry and Western blotting results showed that expressions of Rac 1 and WAVE2 in glomerulus were both increased in high-fat diet group compared with those of control group. Conclusion Rac1 and WAVE2 protein may be involved in glomerular injuries induced by high-fat diet.

OBJECTIVE: To investigate the changes in water content in the lumbar intervertebral discs by quantitative T2 MR imaging in the morning after bed rest and evening after a diurnal load. MATERIALS AND METHODS: Twenty healthy volunteers were separately examined in the morning after bed rest and in the evening after finishing daily work. T2-mapping images were obtained and analyzed. An equally-sized rectangular region of interest (ROI) was manually placed in both, the anterior and the posterior annulus fibrosus (AF), in the outermost 20% of the disc. Three ROIs were placed in the space defined as the nucleus pulposus (NP). Repeated-measures analysis of variance and paired 2-tailed t tests were used for statistical analysis, with p < 0.05 as significantly different. RESULTS: T2 values significantly decreased from morning to evening, in the NP (anterior NP = -13.9 ms; central NP = -17.0 ms; posterior NP = -13.3 ms; all p < 0.001). Meanwhile T2 values significantly increased in the anterior AF (+2.9 ms; p = 0.025) and the posterior AF (+5.9 ms; p < 0.001). T2 values in the posterior AF showed the largest degree of variation among the 5 ROIs, but there was no statistical significance (p = 0.414). Discs with initially low T2 values in the center NP showed a smaller degree of variation in the anterior NP and in the central NP, than in discs with initially high T2 values in the center NP (10.0% vs. 16.1%, p = 0.037; 6.4% vs. 16.1%, p = 0.006, respectively). CONCLUSION: Segmental quantitative T2 MRI provides valuable insights into physiological aspects of normal discs.
Adult ; Female ; Humans ; Image Processing, Computer-Assisted ; Intervertebral Disc/*radiography ; Lumbar Vertebrae/*radiography ; Magnetic Resonance Imaging ; Male ; Water/*chemistry

OBJECTIVETo evaluate the frequency of the nucleophosmin (NPM1) gene and the CCAAT/enhancer binding protein α gene (CEBPA) through polymerase chain reaction (PCR) array in pediatric patients with cytogenetically normal acute myeloid leukemia (CN-AML) and explore the clinical significances of these mutations.

METHODBetween August 2009 and December 2012, 30 children (<16 years old) with newly diagnosed CN-AML were included. The clinical characteristics were analyzed in these patients. PCR combined with direct sequencing was used to detect NPM1, CEBPA gene mutations. All the data were statistically analyzed using SPSS17.0 software.

RESULTThe gene mutations were detected in each of the 30 patients. NPM1 mutation was positive in three patients (10%) with type A mutation, while CEBPA mutation was positive in two patients (6.7%) with double mutations (TAD, bZIP) . Besides, FLT3/ITD mutation was positive in three patients. Patients with NPM1 or FLT3/ITD had a significantly elevated diagnostic WBC count with a median diagnostic WBC count of 102.80×10(9)/L compared with 18.56×10(9)/L for the patients without mutations(t = 2.353, P = 0.043), as well as the marrow blast percentage (94.0% vs. 80.0%, t = 3.804, P = 0.002). The complete remission was achieved in all the 3 patients with NPM1 mutations and 2 patients with CEBPA mutations. All the patients with these mutations also achieved 2-year event-free survival (EFS) and 2-year overall survival (OS), while 2-year EFS and 2-year OS of the other patients were (40.1 ± 11.2)% and (51.8 ± 10.9)% (P = 0.044, 0.091, respectively).

CONCLUSIONNPM1 and CEBPA mutations may indicate a favorable prognosis in pediatric CN-AML.

Adolescent ; CCAAT-Enhancer-Binding Proteins ; genetics ; Child ; Child, Preschool ; DNA Mutational Analysis ; Disease-Free Survival ; Female ; Genotype ; Humans ; Infant ; Leukemia, Myeloid, Acute ; genetics ; mortality ; pathology ; Male ; Mutation ; Nuclear Proteins ; genetics ; Prognosis ; Retrospective Studies ; fms-Like Tyrosine Kinase 3 ; genetics

To evaluate lesion detection of MRI in knee joint osteoarthritis in patients with symptoms of pain, the correlation between MRI findings and varying degrees of reported pain was assessed. Twenty-eight patients (31 knees) with osteoarthritis were recruited for this study. The degree of knee pain was assessed by VRS scores. The knees were evaluated by plain film radiograph utilizing Kellgren-Lawrence scores. Multiple MR sequences were performed on a 1.5T MR-system, including sagittal and coronal dual fast spin echo (TR/TE 3660/11/120 ms, slice thickness 5 mm), coronal spin echo T1-weighted (TR/TE 360/9 ms, slice thickness 5 mm), sagittal fat saturated 3D-spoiled gradient-recalled echo (TR/TE 50/6 ms; slice thickness 1.5 mm; flip angle 40 degrees ), and 3D steady-state free precession (TR/TE 6/2.2 ms; slice thickness 1.6 mm; flip angle 30 degrees ) pulse sequences for the purpose of detecting abnormities of cartilage, menisci, the anterior cruciate ligaments, bone marrow edema-like lesions, osteophytes, synovitis, and joint effusions. MR findings were compared with the degree of pain using Fisher exact test with P values less than 0.05 indicating a statistically significant difference. The results showed that, of the 31 knees evaluated, mild pain was reported in 11 and severe pain in the remainder. Kellgren-Lawrence scores of all 31 evaluated OA knees were as follows: grade 1 lesions (n=6), grade 2 lesions (n=14), grade 3 lesions (n=8), and grade 4 lesions (n=3). Articular cartilaginous defects were found in 37.1% of knees. Abnormalities of the menisci and anterior cruciate ligaments, bone marrow edema-like lesions, osteophytes, synovitis, and joint effusions were detected in 32.3%, 38.7%, 45.2%, 100%, 15.1% and 67.7% of knees, respectively. Of these variables, only the differences in prevalence of joint effusions were significantly different in the mild and severe pain groups (P=0.004). It is concluded that MRI evaluates the entire joint structure of the osteoarthritic knee, demonstrating abnormalities of the cartilage, menisci, and anterior cruciate ligaments as well as bone marrow edema-like lesions, osteophytes, synovitis, and joint effusions. The difference in pain grading between OA patients reporting mild and severe degrees of pain is related to the presence of joint effusion.

To evaluate lesion detection of MR1 in knee joint osteoarthritis in patients with symptoms of pain,the correlation between MRI findings and varying degrees of reported pain was assessed.Twenty-eight patients(31 knees)with osteoarthritis were recruited for this study.The degree of knee pain was assessed by VRS scores.The knees were evaluated by plain film radiograph utilizing Kellgren-Lawrence scores.Multiple MR sequences were performed on a 1.5T MR-system,including sagittal and coronal dual fast spin echo(TR/TE 3660/11/120 ms,slice thickness 5 mm),coronal spin echo T1-weighted(TR/TE 360/9 ms,slice thickness 5 mm),sagittal fat saturated 3D-spoiled gradient-recalled echo(TR/TE 50/6 ms; slice thickness 1.5 mm; flip angle 40°),and 3D steady-state free precession (TR/TE 6/2.2 ms; slice thickness 1.6 mm: flip angle 30°)pulse sequences for the purpose of detecting abnormities of cartilage,menisci,the anterior cruciate ligaments,bone marrow edema-like lesions,osteophytes,synovitis,and joint effusions.MR findings were compared with the degree of pain using Fisher exact test with P values less than 0.05 indicating a statistically significant difference.The results showed that,of the 31 knees evaluated,mild pain was reported in 11 and severe pain in the remainder.Kellgren-Lawrence scores of all 31 evaluated OA knees were as follows: grade 1 lesions(n=6),grade 2 lesions(n=14),grade 3 lesions(n=8),and grade 4 lesions(n=3).Articular cartilaginous defects were found in 37.1% of knees.Abnormalities of the menisci and anterior cruciate ligaments,bone marrow edema-like lesions,osteophytes,synovitis,and joint effusions were detected in 32.3%,38.7%,45.2%,100%,15.1% and 67.7% of knees,respectively.Of these variables,only the differences in prevalence of joint effusions were significantly different in the mild and severe pain groups(P=0.004).It is concluded that MRI evaluates the entire joint structure of the osteoarthritic knee,demonstrating abnormalities of the cartilage,menisci,and anterior cruciate ligaments as well as bone marrow edema-like lesions,osteophytes,synovitis,and joint effusions.The difference in pain grading between OA patients reporting mild and severe degrees of pain is related to the presence of joint effusion.

Objective The purpose of this study was to describe the effect of behavioral intervention of secondary prevention on stroke. Methods 204 patients with stroke were divided into the observation group and the control group with 102 patients in each group at random. The health records were set up and self-designed scale for assessment of risk factors of recurrence of stroke was used to assess the patients' general conditions. Individual intensified education and behavior intervention were adopted in the observation group. Routine treatment and health education were used in the control group. The collected data before intervention, the third and 6th month after intervention were evaluated. The medication compliance, limbs rehabilitation exercises, bad living style, coming to hospital at regular intervals and recurrence rate of stroke were compared between the two groups. Results The observation group was superior to the control group in the following aspects, the mastering rate of disease knowledge, changes in bad living style and therapy compliance (P<0.01). Conclusions Behavioral intervention of secondary prevention could effectively reduce the recurrence of stroke and improve the living quality of patients.