Objective To describe the distribution characteristics of knee and ankle joint range of motion and muscle atrophy related indexes in patients with Kashin-Beck disease(KBD)in Shaanxi Province so as to explore the correlation of knee and ankle joint range of motion(ROM)with muscle atrophy indexes and provide reference for clinical characteristics analysis of KBD patients.Methods To investigate the registered KBD patients from KBD areas in Shaanxi Province,we measured the general demographic data of the patients were collected and the ROM of the knee joint(flexion and extension),the ankle joint(dorsiflexion and plantar flexion),and the muscle atrophy related indexes such as the upper arm circumference,thigh circumference,calf circumference and grip strength.According to the population characteristics,i.e.,gender,age,body mass index(BMI)and KBD grade,the median and quartile of joint ROM and muscle atrophy of KBD patients were reported,and then the differences in each index among different groups were analyzed.Partial correlation analysis was used to explore the correlation between indicators after controlling for variables such as gender,age and BMI.Results A total of 480 patients with KBD were investigated in this study,who consisted of 249(51.9％)males and 231(48.1％)females,with an average age of(63.10±7.32)years and an average BMI of(23.49±8.90)kg/m2.The knee flexion ROM,knee extension ROM,ankle dorsiflexion ROM and ankle plantar flexion ROM were[105.0(95.0,120.0)]°,[0.0(-15.0,0.0)]°,[5.0(0.0,15.0)]° and[20.0(15.0,30.0)]°,respectively,in KBD patients in Shaanxi Province.The left thigh circumference,right thigh circumference,left calf circumference,right calf circumference,and upper arm circumference were[43.0(40.0,47.0)]cm,[43.0(39.0,47.0)]cm,[29.0(27.0,32.0)]cm,[29.5(27.0,32.0)]cm,[27.0(25.0,30.0)]cm,respectively.The left hand grip strength and right hand grip strength were[13.4(9.5,18.4)]kg and[13.9(9.8,18.2)]kg,respectively.With the increase of age,the extension range of the left and right knee joints of KBD patients showed a decreasing trend(H=31.499,31.847;all P＜0.001).The range of motion of bilateral knee flexion was higher in the normal BMI group than in the overweight or obese group,with statistically significant differences(H=7.753,12.333;P=0.021,0.002).The knee flexion,thigh circumference,and calf circumference of the left and right sides showed a decreasing trend under different KBD grades(H=14.345,17.256,8.000,8.462,8.558,9.633;all P＜0.05).Correlation analysis showed that knee flexion ROM was positively correlated with thigh circumference,calf circumference,and grip strength in patients with KBD(all P＜0.05).There was a positive correlation between knee extension ROM and thigh circumference in patients with KBD(P＜0.01).Conclusion The impaired joint ROM and muscle atrophy are serious in KBD patients in Shaanxi Province,and there is a correlation between joint motion and muscle atrophy.

Objective:To design a medical big data center based on data warehouse(DW)and data service platform,to integrate information resources between different information systems and organizational structures,to build a secure channel for data sharing,and to meet the needs of clinical application data.Methods:Based on data flow direction,and according to hospital clinical services,operation management,and scientific research development,a top-down data application layer,data service layer,DW layer,and operational data storage(ODS)layer design architecture was adopted to design a medical big data center based on DW and data service platform.Guided by hospital data and business,according to the"object-event-report"data splitting logic,the activities corresponding to the roles in each subject domain were disassembled and sorted out to facilitate quick invocation in clinical applications.Results:The medical big data center was equipped with basic modules for patient master index management and master data management,covering 16 major business subject domains and 52 business subdomains,including hospital's clinical services,hospital management,and patient identification.The medical big data center application included clinical data center,operation data center and scientific research data center,and clearly defined the correlation logic between major categories of information,centrally managed the whole life cycle of service application program interfaces,combined master data information,comprehensively managed medical data,realized the normalization of hospital data,and established high-quality data assets and flexible DW models with the help of big data technology.Conclusion:The medical big data center based on DW and data service platform can integrate different information systems of the hospital with data within the hospital,realize the convenient invocation of interface services and the standardized and persistent management of hospital data,and ensure the data applications needs of clinical application,operational decision-making,and scientific research analysis.

A decline in mucosal vascularity is a histological hallmark of oral submucous fibrosis(OSF),a premalignant disease that is largely induced by betel quid chewing.However,the lack of available models has challenged studies of angiogenesis in OSF.Here,we found that the expression of thrombospondin 1(THBS1),an endogenous angiostatic protein,was elevated in the stroma of tissues with OSF.Using a fibroblast-attached organoid(FAO)model,the overexpression of THBS1 in OSF was stably recapitulated in vitro.In the FAO model,treatment with arecoline,a major pathogenic component in areca nuts,enhanced the secretion of transforming growth factor(TGF)-β1 by epithelial cells,which then promoted the expression of THBS1 in fibroblasts.Furthermore,human umbilical vein endothelial cells(HUVECs)were incorporated into the FAO to mimic the vascularized component.Overexpression of THBS1 in fibroblasts drastically suppressed the sprouting ability of endothelial cells in vascularized FAOs(vFAOs).Consistently,treatment with arecoline reduced the expression of CD31 in vFAOs,and this effect was attenuated when the endothelial cells were preincubated with neutralizing antibody of CD36,a receptor of THBS1.Finally,in an arecoline-induced rat OSF model,THBS1 inhibition alleviated collagen deposition and the decline in vascularity in vivo.Overall,we exploited an assembled organoid model to study OSF pathogenesis and provide a rationale for targeting THBS1.

Tumor volume increases continuously in the advanced stage, and aside from the self-renewal of tumor cells, whether the oncogenic transformation of surrounding normal cells is involved in this process is currently unclear. Here, we show that oral squamous cell carcinoma (OSCC)-derived small extracellular vesicles (sEVs) promote the proliferation, migration, invasion, and epithelial-mesenchymal transition (EMT) of normal epithelial cells but delay their apoptosis. In addition, nuclear-cytoplasmic invaginations and multiple nucleoli are observed in sEV-treated normal cells, both of which are typical characteristics of premalignant lesions of OSCC. Mechanistically, miR-let-7c in OSCC-derived sEVs is transferred to normal epithelial cells, leading to the transcriptional inhibition of p53 and inactivation of the p53/PTEN pathway. In summary, we demonstrate that OSCC-derived sEVs promote the precancerous transformation of normal epithelial cells, in which the miR-let-7c/p53/PTEN pathway plays an important role. Our findings reveal that cancer cells can corrupt normal epithelial cells through sEVs, which provides new insight into the progression of OSCC.
Carcinoma, Squamous Cell/pathology* ; Cell Line, Tumor ; Cell Movement ; Cell Proliferation ; Cell Transformation, Neoplastic ; Down-Regulation ; Epithelial Cells/metabolism* ; Extracellular Vesicles/pathology* ; Humans ; MicroRNAs/metabolism* ; Mouth Neoplasms/pathology* ; PTEN Phosphohydrolase/metabolism* ; Tumor Suppressor Protein p53/metabolism*

Objective To obtain the PP7 bacteriophage-like particles (BLPs) carrying the polypeptide from 16 kD antigen (16kD91-110) on their surface,and evaluate their diagnostic value in tuberculosis.Methods First,the PP7 capsid protein gene containing the encoding gene of polypeptide 16kD91-110 was amplified by PCR and inserted into the plasmid pETDuet-2PP7.Then,the obtained recombinant plasmid pETDuet-2PP7-16kD91-110 was transferred into Escherichia coli,and the recombinant protein was induced and identified by SDS-PAGE and western blot.Next,the purified 2PP7-16kD91-110 BLPs were used as stimulating antigen to inject into the blood of patients with tuberculosis,and their serum antibody levels against 16 kD antigen were detected by indirect ELISA.Results The results of SDS-PAGE and transmission electron microscope showed that the 2PP7-16kD91-110 BLPs were prepared,and that the 16kD91-110 polypeptide epitopes displayed on the surface of PP7 BLPs could bind with the antibodies against 16 kD antigen specifically.After using 2PP7-16kD91-110 BLPs as antigen to stimulate the blood cells from active tuberculosis and latent tuberculosis patients,respectively,the sensitivity of interferon-γrelease assay was 75.0％ and 82.9％,respectively,in the diagnosis of active tuberculosis and latent tuberculosis,which was similar to the results of Wantai TB-IGRA (interferon-γ release assay) kits from Beijing Wantai Biological Pharmacy Enterprise Co.,Ltd..Conclusion The PP7 BLPs with the 16kD91-110 polypeptide displayed on their surface are prepared successfully,which provides a kind of safe,stable and low cost stimulating antigen for the detection of interferon-γ release,and a new method for the diagnosis of tuberculosis.

Objective To compare analgesic and anti-inflammatory effects of Gentianopsis Paludosa and Sophora Alopecuroide of different kinds of compatibility on the mice.Methods Mice were randomly divided into normal control group, positive medicine group, and different kinds of compatibility groups, 10 mice in each group. Mice received gavage for successive 7 days, once a day. Glacial acetic acid twist body method and hot board to pain method were used to observe and compare analgesic effects of different kinds of compatibility. Xylene to ear swelling method and agar to granulation swollen method were used to observe and compare inflammatory effects of different kinds of compatibility.Results Compared with normal group, compound Gentianopsis Paludosa had obvious analgesic and anti-inflammatory effects (P<0.01). When the ratio of Gentianopsis Paludosa and Sophora Alopecuroide was 20:0.6 and 20:0.9, the analgesic and anti-inflammatory effects were the best.Conclusion Gentianopsis Paludosa and Sophora Alopecuroide have good analgesic and anti-inflammatory effects, among which, when the ratio of Gentianopsis Paludosa and Sophora Alopecuroide is 20:0.6, the best effects show.

Objective To investigate the diagnostic value of macrophage migration inhibitory factor (MIF) for hepatocellular carcinoma (HCC).MethodsThe research was divided into 2 parts,including testing research and confirmatory research.The clinical data of 269 patients with HCC ( group A) and 390 individuals (including 135 patients with hepatic cirrhosis,106 with benign hepatic diseases and 149 healthy individuals,control group A) who were admitted to the Zhongshan Hospital of Fudan University from January to May,2004,and 173 patients with hepatic cancer (group B) and 257 individuals (including 86 patients with hepatic cirrhosis,79 with benign hepatic diseases and 92 healthy individuals,control group B ) who were admitted from August to December,2004,and 80 patients with HCC who received radical hepatic resection in January 2005 were retrospectively analyzed.Samples of plasma of patients in the group A and individuals in the control group A were collected before operation.Samples of plasma of patients received radical hepatic resection were collected preoperatively and at postoperative day 3,7 and 30.HCC and adjacent issues of patients in the group A were collected.The levels of MIF in the plasma and tissues were detected by enzyme-linked immunosorbent assay (ELISA) and immunohistochemistry,respectively.Non-normal distribution data were described as M( QR).Differences between the groups were analyzed by using the Mann-Whitney U test,and the relationship between the levels of MIF in the plasma and tissues was detected by the Spearman correlation coefficient.The diagnostic value of MIF was analyzed by the ROC curve.ResultsThe levels of MIF in the plasma of patients in the group A and individuals in the control group A were 85.7 μg/L (58.8 μg/L) and 15.5 μg/L(31.6 μg/L),respectively.The levels of MIF in the plasma of the patients with hepatic cirrhosis,benign hepatic diseases and healthy individuals were 24.9 μg/L (12.6 μg/L),12.5 μg/L(7.3 μg/L) and 13.2 μg/L (7.7 μg/L),respectively.There was a significant difference in the level of MIF between the group A and the control group A (F =54.235,P ＜ 0.05 ).The area under the ROC curve reached peak when the level of MIF in the plasma was 35.3μg/L.Compared with the control group B,the vdues of AUC,sensitivity and specificity were 92.1％,90.7％ and 93.4％ in the group B.The levels of MIF of the patients with HCC before operation and at 3,7,and 30 days after operation were 81.0 μg/L(54.0 μg/L),76.1 μg/L(47.5 μg/L),50.9 μg/L (40.7 μg/L) and 18.7 μg/L ( 15.1 μg/L),respectively.The levels of MIF decreased with time passed by,and were back to normal at 30 days after the operation.The median expressions of MIF in the HCC and adjacent issues were 0.083 and 0.007,respectively,with a significant difference ( U =3.975,P ＜ 0.05).The expression of MIF in the plasma was positively correlated with its expression in the HCC tissue ( r =0.759,P ＜ 0.05 ).ConclusionMIF plays an important role in the genesis and development of HCC and has potential to be one of the molecular markers for the diagnosis of HCC.

Objective By analyzing the expression of cluster of differentiation 74 (CD74) in hepatocellular carcinoma (HCC) and HCC cell lines,the correlation between the level of CD74 expression and the patients' prognosis was investigated.MethodsThe expression of CD74 in high metastatic potential HCC cell lines(MHCC-LM3,MHCC-97H),low metastatic potential HCC cell line( MHCC-97L),and no metastatic potential HCC cell line(Hep-G2) were estimated by Western blot.The paraffin embedded tissues which include intra-tumor and paratumor tissues were collected from 320 patients who had received HCC curative surgical resection and 5 normal liver tissues from the donors of liver tranplantation.The high density tissue micro-array was made of these specimens. Immunol-histochemistry was applied to discover the different levels of CD74 in tumor,paratumor and normal liver tissues.Survival curves were generated by the Kaplan-Meier method and verified by the Logrank test.Cox proportional hazards regression analysis was applied to estimate the prognostic factors in multivariate analysis.ResultsThe expression level of CD74 was significantly higher in low metastatic potential and no metastatic potential HCC cell lines (MHCC-97L 1.224 ±0.014,Hep-G2 1.374 ±0.006) than that in high metastatic potential ones( MHCC-LM3 0.622 ±0.078,MHCC-97H 0.732 ± 0.083 ).Significant differences can be found between the groups (t =- 13.308,- 16.849,- 10.177,- 13.436,- 17.057; P ＜0.01 ).Meanwhile,in tumor tissues,the CD74 was expressed positively in 221 patients and negatively in 99 patients.But CD74 was expressed slightly in paratumor and negatively in 5 normal liver tissues.There's no significant differences between the groups categorization according to age,HBsAg,cirrhosis,AFP level,tumor number,tumor size,tumor capsule,blood vessel invasion,Edmondson Grades and tumor nodes metastasis classification (TNM) stages (x2 =0.053,0.141,1.200,0.000,0.277,1.975,0.263,1.044,0.000,0.433 ; P ＞ 0.05 ),except gender (x2 =3.954,P ＜ 0.05).Kaplan-Meier method showed that patients with positively expression of CD74 had better prognosis than others (x2 =5.620,P ＜ 0.05 ).Cox proportional hazards regression analysis showed that CD74 was a significant and independent prognostic factor of survival [ hazard ratio (HR) =0.721,95％confidence interval (CI) =0.522 - 0.996,P ＜ 0.05 ].Conclusion The expression of CD74 in hepatocellular carcinoma could be a biomarker of the prognosis and there's some potential correlation with cancer cell apoptosis.

Objective To investigate the expression and prognostic significance of CD151, c-Met and integrin alpha 3, alpha6 in pancreatic ductal adenocarcinoma (PDAC). Methods The expression of CD151, c-Met and integrin alpha3, alpha6 in 71 patients with PDAC and 10 samples of normal pancreas tissues were detected by immunohistochemistry, and the relationship between the expression of CD151, c-Met and integrin alpha 3, alpha 6 and the clinicopathological features, prognosis of these patients was analyzed. Results The positive expression rates of CD151, c-Met and integrin alpha 3, alpha 6 in PDAC were 81.69% (58/71) , 69.01% (49/71), 69.01% (49/71) and 84.51% (60/71) , and there was no expression in normal pancreas tissues. The expressions of CD151, c-Met were significantly associated with TNM stage and lymph node metastasis (P < 0.05). The expression of CD151 was positively correlated with the expressions of c-Met and integrin alpha3, alpha6 (r =0.583, P =0.000, r = 0.457;P =0.000, r = 0.671 ;P =0.000). Univariate analysis suggested the expression of CD151, c-Met and integrin alpha3, alpha6 was associated with survival (P<0.05). Multivariate analysis suggested the expression of CD151, c-Met was the independent prognostic factor for post-operative survival. Conclusions CD151, c-Met and integrin alpha3, alpha6 play a role in the development, metastasis and prognosis of PDAC, and they might be new markers to predict biological behavior and the prognosis of PDAC patients.

Objective To find out the mechanism of strephenopodia and strephexopodia of children with spastic cerebral palsy by analyzing their gait character.MethodsForty children with spastic cerebral palsy and forty healthy children with normal walking ability were involved in this research.Footscan 7 gait analysis system was used to measure foot initial touchdown part,the ratio of different part touchdown phase to single supporting phase,the degree of strephenopodia and strephexopodia in different part.Two groups' characteristic parameters were analyzed by statistics method.ResultsSignificant differences were found in foot first touchdown part between two groups(P<0.05).The phenomenon that toes or metatarsus or whole foot first touch the earth was found in children with spastic cerebral palsy.The ratio of anterior foot and middle foot touchdown phase to single supporting phase were higher than normal children(P<0.05).In spastic cerebral palsy group the phenomenon of strephexopodia was more serious than strephenopodia during anterior foot touchdown phase.ConclusionLots of children with spastic cerebral palsy are suffering long-time compression pain and strephexopodia with anterior foot,active rectification must be performed during rehabilitation care.