Objective To explore the role of DExD/H box helicase 60(DDX60)in the development of systemic lu-pus erythematosus(SLE)by regulating the dsDNA-cGAS-IFN-Ⅰ pathway.Methods Differences in DDX60 mRNA level in peripheral blood mononuclear cells(PBMCs)from SLE patients and healthy people were examined by analyzing RNA sequencing data and verified by RT-qPCR.The correlation between DDX60 mRNA level in PBMCs and disease activity of SLE patients was analyzed.Whether DDX60 was an interferon-stimulated gene(ISG)was clarified by interferon-alpha(IFN-α)stimulation of human acute monocyte leukemia cell line THP-1.The mRNA level of interferon-beta1(IFNB1)was detected by RT-qPCR after silencing and knockdown of DDX60 and followed by double-stranded DNA(dsDNA)poly(dA:dT)transfection.Results RNA sequencing data and RT-qPCR result found high expression of DDX60 in PBMCs of SLE patients.DDX60 mRNA level in PBMCs was positively correlated with disease activity of SLE patients.IFN-α induced THP-1 cells to express DDX60,suggesting that DDX60 was an ISG.Silencing DDX60 resulted in a decrease in poly(dA:dT)-induced IFNB1 mRNA level.Conclusions DDX60 is highly expressed in PBMCs of SLE patients and involved in the development of SLE through the positive feedback loop of IFN-Ⅰ-DDX60-dsDNA-cGAS-IFN-Ⅰ,which suggests that DDX60 may be a target for the clinical diagnosis and treatment of SLE.The result of this research may support diagnosis and progno-sis evaluation of SLE patients.

Xi'an Jiaotong University has proposed the concept of "less teaching and more learning, interaction between guiding and learning" in medical education, based on its sedimentary deposits, and carried out reform for all clinical medical students since 2001. After more than ten years of educational reform, we have built brand new management framework, and established integrated organ system-based curriculum and PBL teaching pattern. This pattern involves eight aspects of comprehensive reform, including training program, curriculum model, textbook, teaching method, learning style, assessment and evaluation, teaching organization, teaching conditions and guarantee. It will provide paradigm for the integrated curriculum reform in peer colleges, and will be a milestone in the history of medical education in China.

OBJECTIVE: To compare clinical effects of different postoperative rehabilitation modes on lumbar degenerative diseases, and explore influence of rehabilitation mode and other factors on postoperative effect. METHODS: From June 2013 to July 2016, totally 900 patients were admitted from nine tertiary hospitals in Beijing to perform single segment bone grafting and internal fixation due to lumbar degenerative diseases were prospectively analyzed. There were 428 males and 472 females, the age of patient over 18 years old, with an average of (51.42±12.41) years old;according to patients' subjective wishes and actual residence conditions, all patients were divided into three groups, named as observation group 1 (performed integrated rehabilitation approach and orthopedic treatment model intervention), observation group 2 (performed integrated rehabilitation approach and orthopedic treatment, classified rehabilitation model intervention), and control group(performed routine rehabilitation model intervention). Visual analogue scale(VAS), Oswestry Disability Index(ODI) and Japanese Orthopaedic Association (JOA) were used to evaluate postoperative efficacy among three groups at 24 weeks. Possible factors affecting the postoperative efficacy including age, age grouping, gender, body mass index (BMI), BMI grouping, education level, visiting hospital, payment method of medical expenses, preoperative complications, preoperative JOA score, clinical diagnosis, surgery section, operative method, intraoperative bleeding volume, postoperative complications and rehabilitation mode were listed as independent variables, and postoperative ODI score at 24 weeks as dependent variables. Univariate analysis was used to analyze relationship between influencing factors and postoperative efficacy. Multiple linear regression was used to analyze relationship between influencing factors, rehabilitation mode and postoperative ODI score at 24 weeks, in further to find out the main reasons which affect postoperative efficacy, and to analyze impact of rehabilitation mode on postoperative efficacy. RESULTS: All patients were followed up for 24 weeks after operation. All incisions healed at stage I with stable internal fixation. (1)Evaluation of postoperative efficacy:① There were no statistical differences in preoperative VAS and ODI among three groups( CONCLUSION Preoperative JOA score, gender, age could predict postoperative clinical effects of lumbar degenerative diseases in varying degrees treated with single level bone graft fusion and internal fixation. Different rehabilitation modes could improve clinical effects. Intergrated rehabilitation orthopedic treatment model and integrated rehabilitation approach and orthopedic treatment with classifiedrehabilitation model are superior to conventional rehabilitation model in improving patients' postoperative function and relieving pain, which is worthy of promoting in clinical.
Adolescent ; Adult ; Aged ; Female ; Humans ; Infant ; Lumbar Vertebrae/surgery* ; Lumbosacral Region ; Male ; Middle Aged ; Retrospective Studies ; Spinal Fusion ; Treatment Outcome

Objective:To evaluate the efficacy of modified Xiaoji Baozhong granules combined with scraping in the treatment of abdominal obesity with gastric heat and dampness syndrome and its effect on adipocytokines. Method:One hundred and forty-four patients were randomly divided into the control group and the observation group， 72 cases in each group. The lifestyle adjustments were conducted in both groups. The observation group was given a comprehensive traditional Chinese medicine regimen of modified Xiaoji Baozhong granules combined with scraping. The control group was given modified Xiaoji Baozhong granules combined with scraping. The course of treatment was three months. The body mass index （BMI）， body fat percentage （FP）， waist circumference （WC）， waist to hip ratio （WHR）， obesity and abdominal fat thickness of the two groups were compared before and after treatment. The levels of fasting blood glucose （FBG）， insulin resistance index （HOMA-IR）， high density lipoprotein （HDL）， low density lipoprotein （LDL）， triglyceride （TG）， total cholesterol （TC）， adiponectin， leptin， resistin， endolipid and tumor necrosis factor-α （TNF-α） were compared between the two groups before and after treatment. The clinical efficacy and safety were evaluated. Result:After treatment， the BMI， FP， obesity， WC and WHR of the observation group were lower than those of the control group （P<0.01）. After treatment， the abdominal wall fat thickness and intra-abdominal fat thickness of patients in the observation group were lower than those in the control group （P<0.01）. The FBG， HOMA-IR， TG， TC and LDL of the observation group were lower than those of the control group （P<0.01）， while the HDL level was higher than the control group （P<0.01）. Adiponectin in the observation group was higher than the control group after treatment （P<0.01）. The leptin， resistin， visfatin and TNF-α were lower than those in the control group （P<0.01）. The total clinical efficacy rate of patients in the observation group was 88.24% （60/68）， which was better than 73.53% （50/68） in the control group （χ²=4.755， P<0.05）. Conclusion:In addition to lifestyle adjustments， modified Xiaoji Baozhong granules combined with scraping treatment can reduce the degree of obesity and fat thickness in patients with abdominal obesity， and regulate lipid， carbohydrate metabolism and adipocytokines， with a better clinical efficacy than simple scraping therapy and the safety in practice.

At present,the unrealistically high drug prices become an indisputable fact to cause the chaos in the medical field.They are the main reasons of "difficult and too expensive to see doctors".And they are deeply loathed by the people in the country.In addition,the unrealistically high drug prices have become the shackles in deepening medical and health reform.Therefore,a determined effort must be made to resolve the serious problems.Through analyzing the status of high drug prices,the main reasons of the unrealistically high drug prices,and the hazards of high drug prices,the article puts forward countermeasures of state monopoly in national essential drugs to solve the unrealistically high drug prices problems for structural reform of supply side.

Food intake has a great influence on blood glucose in patients with diabetes.This study was to determine the glycemic index (GI) and glycemic load (GL) of a particular pomelo named Majia pomelo and its effects on postprandial glucose (PPG) in patients with type 2 diabetes (T2D).Twenty healthy subjects and 20 T2D patients (controlled on lifestyle measures and/or metformin) were tested on 2 separate days with 50 g of glucose and 50 g equivalent of carbohydrates from Majia pomelo for GI measurement.To test effects of Majia pomelo on PPG,19 hospitalized T2D patients (controlled on insulin therapy) were selected for a 9-day study.The dose of insulin for each patient was adjusted on the first 3 days.A total of 100 mg Majia pomelo was consumed per meal in the last 3 tested days.Blood glucose was measured to evaluate the glycemic excursions.The GIs for Majia pomelo in healthy individuals and T2D patients were 78.34± 1.88 and 72.15±1.95 respectively.The value of GL was as low as 4.23 in diabetic patients with serving size of 100 g pomelo,indicting Majia pomelo as a high GI but low GL fruit.Consumption of Majia pomelo in hospitalized T2D patients did not cause significant glucose fluctuation.It was concluded that high GI pomelo can serve as a low GL fruit if it is consumed with a limited daily amount and thus can be supplied to diabetic patients.These results may mean more varieties of food choices for T2D patients.

The survey aimed to explore the association of liver transaminases with the prevalence of type 2 diabetes mellitus (T2DM) and pre-diabetes (pre-DM) in the middle-aged rural population in China. A cross-sectional study was conducted in 10 800 middle-aged subjects who lived in rural area of central China. The 75-g oral glucose-tolerance test (OGTT) was performed. Participants were asked to complete physical examination and standard questionnaire. The serum liver transaminases (ALT and GGT), HbA1C and serum lipids were measured. In middle-aged rural population, the prevalence of impaired fasting glucose (IFG), impaired glucose tolerance (IGT), impaired fasting glucose combined with impaired glucose tolerance (IFG+IGT) and DM was 4.0%, 11.8%, 2.6% and 10.0%, respectively. Some measurements were higher in males than in females, such as waist hip ratio (WHR), blood pressure, fasting blood glucose (FBG), high density lipoprotein-cholesterol (HDL-C), and liver enzymes (ALT and GGT). Further, we found that elevated serum GGT and ALT levels were significantly positively correlated with the prevalence of DM, independent of central obesity, serum lipid and insulin resistance (IR) in both genders. However, the correlation of GGT and ALT with pre-DM was determined by genders and characteristics of liver enzymes. Higher serum GGT was indicative of IGT in both genders. The association of serum ALT with pre-DM was significant only in female IGT group. In conclusion, our present survey shows both serum GGT and ALT are positively associated with DM, independent of the cardiovascular risk factors in both genders.
Age Factors ; Aged ; Alanine Transaminase ; blood ; Blood Glucose ; metabolism ; Blood Pressure ; China ; Cholesterol, HDL ; blood ; Female ; Glycated Hemoglobin A ; metabolism ; Humans ; Male ; Middle Aged ; Prediabetic State ; blood ; epidemiology ; Rural Population ; gamma-Glutamyltransferase ; blood

OBJECTIVETo investigate the whole genome expression profiles between gastric high-grade intraepithelial neoplasia (HGIN) tissues with cancer and HGIN tissues without cancer.

METHODSGastric specimens from an upper magnifying chromoendoscopic targeted biopsy were collected at Peking Union Medical College Hospital from March 2010 to May 2013. Each of the forceps biopsies from the 21 patients was HGIN,but there were 10 HGIN and 11 HGIN with cancer after the endoscopic submucosal dissection. The whole genome expression profiling was performed on 10 HGIN samples and 11 HGIN with cancer samples using Agilent 4 × 44K Whole Human Genome microarrays. Differentially expressed genes between different types of lesions were identified using an unpaired t-test and corrected with the Benjamini and Hochberg false discovery rate algorithm. A gene ontology(GO)enrichment analysis was performed using the GeneSpring software GX 12.6.

RESULTSThe gene expression patterns were different between HGIN tissues with cancer and HGIN tissues without cancer. There were 470 significantly differentially expressed transcripts between them (P<0.05,Fold Change>2), with 180 up-regulated genes and 290 down-regulated genes in HGIN tissues with cancer. A GO enrichment analysis demonstrated that the most striking over-expressed transcripts in HGIN with cancer were in the category of triglyceride biosynthetic process,acylglycerol biosynthetic process,neutral lipid biosynthetic process,glycerol ether metabolic process,organic ether metabolic process,and glycerolipid metabolic process.

CONCLUSIONThe change of lipid metabolism may contribute to the pathogenesis of gastric cancer at an early stage.

Algorithms ; Down-Regulation ; Gene Expression Regulation, Neoplastic ; Genome, Human ; Humans ; Lipid Metabolism ; Software ; Stomach Diseases ; Stomach Neoplasms ; Up-Regulation

Objective To investigate the protective effects of sildenafil to noise-induced hearing loss in guinea pigs.Methods Guinea pigs were randomly divided into control group,noise exposure group and the sildenafil treatment group,with 10 in each group.One week after the exposure of 110 dB (A) white noise,sildenafil [10 mg/( kg · d)] and normal saline [4 ml/( kg · d)] were injected into guinea pigs of noise plus sildenafil group(NSG) and noise plus normal saline group (NNG) respectively.One week after noise exposure to four weeks continuous administration.ABR thresholds were measured respectively prior to the experiment,1 week post-noise,1,2 and 4 weeks post-drugs.The changes of cochlea hair cells were also observed by scanning electron microscope (SEM).Results Mter noise exposure,the ABR threshold shifts in NSG were significantly fewer than that in the NNG.An average of 19.1 dB in NNG compared with 19.8 dB in NSG.Four weeks after exposure,the threshold shifts were become larger to 22.0 dB in NNG while become smaller to 4.8 dB in NSG.Compared NNG with NSG,in addition to noise exposure time point,there were statistically significant differences in the rest time points after administration of the ABR threshold (P ＜ 0.05).SEM showed that the inner and outer hair cells in NNG displayed mess,fusion and imperfections.In NSG,the hair cells displayed slight pathological changes,there was no significant difference when compared with control group.Conclusion Sildenafil is able to reduce the ascending of ABR thresholds shift,and it can significantly protect against noise-induced hearing loss.

Objective:To obtain a large amount of erythromycin B and to investigate the activity site in eryK. Methods:The key sequence of the BC loop region in eryK gene was knocked out and the eryK gene with 101 bp deleted was amplified by overlapping PCR,and cloned into vector pWHM3 to construct recombinant plasmid. The Saccharopolyspora erythraea mutant AK17 was constructed through chromosomal homologous recombination technique.Results and Conclusions:The S.erythraea mutant AK17 was constructed. The results of TCL and MS analysis showed that the major fermentation product of AK17 is erythromycin B.