Objective:To analyze the differentially expressed genes in PBMCs of patients with systemic lupus erythematosus (SLE) by bioinformatics methods screening and analyzing the key genes related to ferroptosis, and explore the possible mechanism of ferroptosis involved in the pathogenesis of SLE at the transcription level.Methods:The data sets and samples of healthy people (HC) and SLE patients who met the screening criteria were retrieved from the Gene Expression Omnibus (GEO), a sub-database of the National Center for Biotechnology Information (NCBI). The differentially expressed genes, GO enrichment analysis and KEGG pathway enrichment analysis were analyzed by GEO2R, R language and related software packages. The protein interaction network (PPI) of differential genes was analyzed by STRING, Cytoscape and other tools to explore the key genes and pathways. In addition, real-time quantitative reverse transcription PCR (RT-qPCR) was used to verify the expression of key genes. Mann-Whitney U test was used to compare the expression of key genes in PBMCs between the two groups. Spearman rank correlation analysis was used to explore the relationship between SLE disease activity and the level of key genes. Results:Six data sets were included in this study. A total of 166 genes related to ferroptosis were differentially expressed between SLE and HC groups. The differential genes were specifically expressed in alveolar macrophages, neutrophils, CD49 + cells and CD31 + cells. GO enrichment analysis and KEGG pathway enrichment analysis showed that the differentially expressed genes were mainly involved in multiple signaling pathways closely related to SLE, such as oxidative stress response, infection and TNF signaling pathway. Hub genes screened by different algorithms all suggested RELA as a key gene, and RT-qPCR confirmed that compared with the RELA gene expression level in the HC group [0.75(0.37,1.13)], the expression level in SLE group [2.02 (1.19,4.06)] was increased, the difference was statistically significant ( Z=-3.08, P=0.002), and was positively correlated with the corresponding SLEDAI score of SLE samples ( r=0.52, P=0.019). Conclusion:The ferroptosis of many immune cells, including alveolar macrophages and CD49 + NK cells, is involved in the pathogenesis of SLE. RELA may be involved in the ferroptosis of PBMCs in SLE through the NF-κB pathway.

Objective:To compare the efficacy of dapoxetine hydrochloride for the treatment of primary premature ejaculation when taken on time and on demand.Methods:This study was a randomized controlled study. Patients with primary premature ejaculation diagnosed at the Andrology Outpatient Department of the Second Affiliated Hospital of Xi'an Jiaotong University between September 2018 and June 2019 were included. Inclusion criteria included ①non-homosexual patients aged≥18 years, ②regular sexual partner and rapport relationship with their sexual partner for more than 1 year, ③no serotonin reuptake inhibitors application within 3 months before treatment, ④ejaculated within 2 minutes of penile entry into the vagina that lasts>6 months, ⑤on participation in other similar trials in the past 6 months, ⑥had sexual intercourse≥2 times/week. Exclusion criteria included ①erection hardness score<3 points, ②malformation or dysplasia of reproductive organs, ③genitourinary infection, ④patients with severe heart disease, hypertension, diabetes mellitus, ⑤hypogonadism, ⑥allergy to dapoxetine hydrochloride and excipients, ⑦ patients with moderate or severe liver damage. The enrolled patients were divided into an on-time medication group and an on-demand medication group according to the randomized number table method. Patients took dapoxetine hydrochloride 30 mg/time, once a day, immediately after dinner in the on-time medication group, and the patients took dapoxetine hydrochloride 30 mg/time 2-3 h before intercourse in the on-demand medication group. The latency of intravaginal ejaculation (IELT), the score of the diagnostic tool for premature ejaculation (PEDT), the score of premature ejaculation index (IPE), and the score of anxiety level (SAS) of the two groups were observed within 8 weeks of medication intaking and 8 weeks of medication withdraw.Results:A total of 136 patients were enrolled, and finally 88 completed the 8 weeks treatment, including 50 patients (73.53%) in the on-time medication group and 38 patients (55.88%) in the on-demand medication group. There was a statistically significant difference between the two groups in terms of patient adherence ( P = 0.048). There were no significant differences in pre-treatment IELT [(2.23 ± 1.81) min vs. (1.80 ± 1.51) min], PEDT scores [(16.52 ± 1.54) vs. (16.84 ± 1.59)], IPE scores [satisfaction (32.67 ± 7.36) vs. (32.37±5.90), control (23.31 ± 5.48) vs. (22.97 ± 4.82), pain severity (36.43 ± 3.51) vs. (35.82 ± 3.27)], and SAS scores [(51.80 ± 6.93) vs. (53.82 ± 4.47)] between the on-time medication group and on-demand medication group ( P>0.05). After 8 weeks of treatment for patients in the on-time versus on-demand medication groups, the IELT [(5.45 ± 2.64) min vs. (5.01 ± 2.31) min], PEDT scores [(13.68 ± 2.15) vs. (14.92 ± 9.39)], IPE scores [satisfaction (42.58 ± 5.13) vs. (43.39 ± 4.76), control (31.86 ± 4.49) vs. (32.75 ± 5.43), pain severity (62.94 ± 4.07) vs. s (61.22 ± 4.25)], and SAS score [(49.70 ± 4.16) vs. (51.66 ± 4.65)] were not statistically different ( P>0.05). However, the differences were statistically significant when compared with those at the initial consultation ( P<0.05). After 8 weeks of drug withdrawal, the scores of IELT, PEDT and IPE in the two groups were not significantly different from those before treatment( P>0.05). Conclusions:Taking dapoxetine hydrochloride on time and on demand can effectively alleviate the symptoms and anxiety of patients with primary premature ejaculation, and the compliance of the on-time medication group was better. Premature ejaculation symptoms recur after long-term discontinuation of the drug.

Objective:To investigate the status of work performance among rural doctors in Shanxi province and the factors related to their performance.Methods:From July to September 2019, 528 rural doctors in Shanxi province were selected by multi-stage stratified cluster sampling for the survey. Their job competency, job performance, psychological capital and burnout were evaluated. The structural equation model was used to construct the job performance analysis based on post competency.Results:The total score of post competency of rural doctors in Shanxi province was (188.6±20.3), and the total score of job performance was (71.3±11.5), both of which were in the middle level. The structural equation model was well fitted [goodness-of-fit index (GFI)=0.958, normal fix index (NFI)=0.920, adjusted goodness-of-fit index (AGFI)=0.910, root mean square error of approximation (RMSEA)=0.076]. Post competency, psychological capital and job burnout had direct effects on job performance ( P<0.05), with influence coefficients of 0.64, 0.35 and -0.25, respectively. Job competency indirectly affected job performance through psychological capital and job burnout ( P<0.05). Conclusion:The study suggest that higher post competency would facilitate to improve the work performance of rural doctors.

Objective To investigate the changes in cognitive function in patients with early Parkinson's disease (PD) in a 5-year follow-up.Methods A total of 181 PD and 173 normal participants were recruited between January 2009 and January 2012 at the Department of Neurology,the Second Hospital of Jiaxing City.Regression analysis was used to evaluate the risk factors of cognitive impairment,and changes in subdomains of the Montreal Cognitive Assessment (MoCA) were compared annually with baseline data.Results Baseline clinical data were similar between the two groups.The level of cognitive impairment was positively correlated to the age of onset and the Hamilton Anxiety Scale (H AMD) (t =3.326,P＜ 0.05;t =5.211,P＜0.01),and negatively correlated to education level (t=-2.505,P＜0.05).There were no statistical differences in the first (26.5 ± 2.6),second (26.3±3.2) and third year (25.9±2.9) in the total scores of MoCA,which significantly increased in the forth (24.4 ± 2.3,P＜0.05) and fifth (24.1 ± 1.2,P＜0.05) year compared with baseline levels (26.7±2.9).However,in the control group,differences between any two years in total scores were not statistically significant (all P＞0.05).Seven subdomains of MoCA were attenuated,and four of them were significant different between the groups,including delayed recall,attention,abstraction task and orientation after the forth year of follow-up (all P ＜ 0.05).Meanwhile,visuospatial execution capacity was attenuated before the third year,and then rose markedly (P＜0.05).In the control group,the between-year differences of seven subdomains were not statistically significant (all P＞0.05).Conclusions Cognitive function of PD patients decreases significantly in some domains,such as delayed recall,attention,abstraction task and orientation after a five-year followup.

OBJECTIVE: To explore the correlation between the width of lingual varix and changes of hemodynamics of portal system in patients with primary liver cancer so as to supply the data for the forecast of portal hypertension by observing lingual varix. METHODS: The diameter of lingual vein (Dlv) was measured by vernier caliper as dependent variable, and the diameters and indexes of hemodynamics of portal vessels were measured by Doppler as independent variables, then a multipe stepwise analysis was performed. RESULTS: The diameters of portal vein (Dpv) and splenic vein (Dsv) entered the formula Dlv (mm) = 0.185 + 0.311 Dsv (mm) + 0.236 Dpv (mm) when the entry and removal values were alpha(in)=0.10 and alpha(out)=0.15, respectively. CONCLUSION: The width of lingual vein is closely correlated with the diameters of portal vein and splenic vein in patients with primary liver cancer.

OBJECTIVE: To work out a qualitative diagnostic criterion for basic syndromes of traditional Chinese medicine in patients with primary liver cancer. METHODS: Based on the collection and analysis of related medical literature, clinical investigation, and experts' discussion, a preliminary qualitative diagnostic criterion for basic syndromes of traditional Chinese medicine in patients with primary liver cancer was formulated. Then it was used in clinic to be verified and revised repeatedly till it was improved to be a satisfied formal criterion. RESULTS: The basic syndromes listed in the qualitative diagnostic criterion for basic syndromes in patients with primary liver cancer consisted of two parts: excessive syndromes, including the syndromes of stagnation of qi, blood stasis, excess-heat and dampness, and deficient syndromes, including the syndromes of deficiency of qi, deficiency of blood, deficiency of yin and deficiency of yang. Each of the above syndromes could be diagnosed according to specific combination of its corresponding symptoms or signs. The clinical verification results showed that the total matching ratio was 73.92% between the diagnoses made according to the criterion and the diagnoses acquired from the experts' experience. CONCLUSIONS: The qualitative diagnostic criterion for basic syndromes of traditional Chinese medicine in patients with primary liver cancer is coincident with the experts' clinical practice. However, it needs to be further studied.