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Ovarian cancer (OC) is ranked the first among the cancers threatening women's health. It attracts tremendous attention of cancer researchers because of its extremely high mortality rate. Recent studies have indicated that traditional herbal medicines (THMs) can play a pivotal role in cancer prevention and treatment. THMs are gaining popularity as a source of anti‐cancer agents. The plant of Balanophora polyandra, which has been used as a traditional herbal medicine, has been known for exhibiting potential haemostatic, analgesic, anti‐inflammatory and anti‐cancer properties. However, few studies on inhibitory effect of B. polyandra on OC have been performed. In the present study, we found that B. polyandra polysaccharides (BPP) induced cell cycle arrest at S phase, triggered apoptosis and inhibited migration and invasion of OC cells. Furthermore, we also found that there was a potential and close relationship between BPP and P53‐mediated pathway. Overall, these findings suggest that BPP can be a potential therapeutic agent for the treatment of OC.

This study aimed to investigate the independent risk factors for the occurrence of postpartum depression (PPD) in elderly primiparas and the effect of mindfulness-based intervention (MBI) on improving the PPD. Two hundred cases of elderly primiparas who underwent delivery in our hospital from January 2016 to December 2019 were enrolled as study participants and divided into an occurrence group (n = 60) and a nonoccurrence group (n = 140) according to whether they developed PPD. The occurrence group was divided into a study group (n = 30) receiving MBI and a control group (n = 30) without any intervention. Independent risk factors influencing the occurrence of PPD were identified using univariate and multivariate logistic regression analyses. The effect of the intervention was also analyzed in the study group. Education level, marital status, household monthly income per person, sex of the newborn, milk volume, sleep quality, and relationship with in-laws were risk factors for the development of PPD. After the intervention, Five Facet Mindfulness Questionnaire scores were increased in the study group and were higher than in the control group ( P < 0.05 ). The study group also exhibited higher 10-item Connor-Davidson Resilience Scale scores, lower Hamilton Depression Rating Scale and Schizophrenia Quality of Life Scale scores than the control group ( P < 0.05 ). A variety of independent risk factors affected the occurrence of PPD in elderly primiparas, and MBI should be targeted clinically to reduce their negative emotions, increase psychological resilience, and improve their quality of life.

Poor glycemic control increases the risk of diabetes complications. Serum cancer antigen 125 (CA125) has been associated with diabetes status in patients with type 2 diabetes mellitus (T2DM). Our aim was to focus on the association between serum CA125 and renal impairment in patients with T2DM.Retrospective study included 151 patients with T2DM, with review of clinical and laboratory data.Serum CA125 levels were positively correlated with urinary microalbumin and 24-hours urinary protein (r=0.170,Serum CA125 levels are positively correlated with urinary microalbumin and 24-hours urinary protein in T2DM patients; renal impairment may increase serum CA125 levels in T2DM patients.

The aim of this study was to investigate the association between first-trimester platelet count and neonatal birth weight in pregnant woman at advanced maternal age. Our study included 148 pregnancy women of advanced maternal age, the clinical and laboratory materials were retrospective obtained from medical record system. The neonatal birth weight was positively correlated with maternal body mass index and fetus gestational age ( r = 0.332, P < .001; r = 0.469, P < .001), even more interestingly, the neonatal birth weight was positively correlated with first-trimester platelet count in pregnant women of advanced maternal age ( r = 0.203, P = .013). Multiple linear regression analysis revealed that neonatal birth weight had an independently association with first-trimester platelet count in pregnant women of advanced maternal age (multiple-adjusted r values 0.167, P = .013). First-trimester platelet count is positively associated with neonatal birth weight, suggesting that first-trimester platelet count may be a predictive biomarker for neonatal birth weight in pregnant women of advanced maternal age.

Context.— Bilirubin has strong anti-inflammatory and antioxidative stress action. Progression of inflammation involving arteries is a crucial activator in pathogenesis of Takayasu arteritis (TA). Objective.— To investigate the relationship between serum bilirubin and TA. Design.— Our study involved 115 consecutive TA patients. Patients with active-phase disease were followed and received prednisone therapy. Results.— Lower concentrations of serum bilirubin were detected in TA patients compared with healthy subjects (0.6 ± 0.31 versus 0.7 ± 0.22 mg/dL, P = .02). Serum bilirubin concentrations in active TA patients were lower than those in inactive patients (0.5 ± 0.20 versus 0.8 ± 0.32 mg/dL, P < .001). In all patients with TA, serum bilirubin correlated positively with total protein (r = 0.193, P = .04) and negatively with C-reactive protein and erythrocyte sedimentation rate (r = −0.213, P = .03, and r = −0.532, P < .001, respectively). Multiple logistic regression analysis showed that each decrease of 1 mg/dL in serum bilirubin was associated with a 1.10 times increase in the odds for TA compared with the controls (odds ratio = 0.913, 95% CI, 0.856–0.974; P = .006). Serum bilirubin was correlated with erythrocyte sedimentation rate (β = −0.170, P < .001) in multiple linear regression analysis. The area under the curve for serum bilirubin in predicting active TA patients was 0.802. Serum bilirubin levels were found to be significantly increased after prednisone treatment (0.5 ± 0.20 versus 0.7 ± 0.15 mg/dL, P = .002). Conclusions.— Lower serum bilirubin levels are associated with TA, and serum bilirubin may be influenced by prednisone therapy in active TA patients. Serum bilirubin levels in TA patients correlate negatively with erythrocyte sedimentation rate.

This study is to evaluate whether Aspartate Aminotransferase (AST) is necessary to screen for liver function in apparently healthy elderly individuals.We derived the proportions of elevated ASTs that would not be measured based on 2018-year of paired Chinese elderly (Age ≥ 65 years old) check-up. Defined as AST 40U/L is elevated. The relationship between alanine aminotransferase (ALT) and AST was analyzed by using Pearson's approach. Receiver operating characteristics curve analysis was used to evaluate the predictive accuracy of ALT for abnormal AST.52,857 pairs of ALT and AST were analyzed. Serum AST was found to be positively correlated with serum ALT, r = 0.81, p 0.01 for the entire cohort. The receiver operating characteristics (ROC) curve of ALT for predicting positive AST is 0.918. The optimal threshold for ALT is 28 U/L with the sensitivity of 82.6%, and specificity of 86.8%. At the threshold, below 0.7% of subjects with positive AST were missed, but approximately 83% of the AST tests were eliminated.Our study showed that tests of AST were not necessary along with every ALT test for health check in elderly individuals. An estimated 84.5% of subjects were not needed for AST tests which could have saved about CN¥ 815 million (USD$115 million or EURO$100 million) every year.

Increasing evidence has demonstrated that hypoxia was an aggressive feature in endometrial cancer (EC), which is significantly associated with the tumor grade, lymph node metastasis, and tumor resistance to chemotherapy. However, the relationship between hypoxia and the immune microenvironment in EC is not very clear. Exosomes are small membrane vesicles secreted from a variety of cell types which mediate cell-to-cell communication through transported biomolecules. Here, we investigated whether exosomes can play an immunomodulatory role in intercellular communication between EC cells and macrophages. EC KEL cells were cultured under hypoxia or normoxic condition to collect exosomes. After identification, the exosomes derived from hypoxic or normoxic KEL cells were cultured with the monocyte cell line THP-1 to study the immunoregulation function of KEL cells. The results showed that the total number of exosomes produced by hypoxic KEL cells was significantly higher than that in normoxic condition. In addition, hypoxia markedly stimulated the increase in miRNA-21 expression in the exosomes. After coculture, we found that exosomal miRNA-21 could be horizontally transferred into THP-1 cells. And then, the notably enhanced mRNA expression levels of IL-10 and CD206 in THP-1 cells were observed, suggestive of M2 polarization. To further study the effect of miRNA-21-containing exosomes, we transfected miRNA-21 mimics or inhibitor into THP-1 cells. The results showed that miRNA-21 mimics promoted IL-10 and CD206 mRNA expression levels, and the miRNA-21 inhibitor significantly prevented the alteration induced by intake of hypoxic KEL cell-derived exosomes. In summary, we found that endometrial cancer KEL cells in hypoxic condition promoted monocyte THP-1 cell transformation to M2-like polarization macrophages through delivering exosomal miRNA-21, which may be a potential mechanism of the formation of the immune microenvironment in EC progression.

Pancreatic stone protein/regenerating protein Iα(PSP/REG Iα) is a secretory protein produced in the pancreas, but its expression has also been observed in the kidney. It may be associated with kidney dysfunction. This study investigates the possible association between PSP/REG Iαand kidney function in pregnant women. Serum PSP/REG Iαlevels were measured by a specific ELISA enzyme-linked immunosorbent assay. Maternal information and clinical and biochemical parameters were collected. Estimated glomerular filtration rate (eGFR) was calculated for all individuals to evaluate their renal function. Spearman’s correlation and multiple linear regression analyses were performed to assess the associations between PSP/REG Iαand eGFR, serum creatinine (Cr), blood urea nitrogen (BUN), and uric acid (UA). A total of 595 pregnant women were enrolled in the study. Participants with mildly reduced eGFR had higher PSP/REG Iαlevels [50.49 (35.02, 58.64)] than in the general population [26.84 (21.02, 33.07)] (p < 0.001). Included participants were stratified into PSP/REG Iαquartiles; significant differences were observed in the levels of eGFR, serum Cr, BUN, and UA. PSP/REG Iαwas negatively correlated with eGFR (r = −0.402, p < 0.001) and positively associated with serum Cr (r = 0.468, p < 0.001), BUN (r = 0.166, p < 0.001), and UA (r = 0.207, p < 0.001). The linear regression analysis indicated that PSP/REG Iαwas associated with UA, BUN, and eGFR. High PSP/REG Iαconcentrations were closely associated with renal dysfunction in pregnant women. Our study provides clinical evidence that serum PSP/REG Iαlevels could be a novel biomarker for assessment of renal function in pregnant women.

Ethnopharmacological relevance Eucommia ulmoides Oliv. leaves are the dry leaves of Eucommia ulmoides Oliv. Modern studies have shown that Eucommia ulmoides Oliv. leaves and its extracts have many pharmacological effects, such as regulating hypothalamus pituitary ovary (HPO) axis function, estrogen like effects, correcting insulin resistance (IR), regulating lipids, and reducing weight, which are consistent with the clinical manifestations in polycystic ovary syndrome (PCOS) patients. PCOS patients often have HPO axis disorder, low estrogen, high androgen, high IR complication rate, and obesity. Previous preclinical studies have shown that total flavonoids from Eucommia ulmoides Oliv. leaves (TFEL) can improve the imbalance in sex hormone secretion in perimenopausal animal models by regulating the function of the HPO axis. Thus, it is important to understand if flavonoids are the active parts of Eucommia ulmoides Oliv. leaves that interfere with polycystic ovary syndrome with insulin resistance (PCOS-IR), and determine the regulatory role they play in sex hormones and IR? Aim of the study Investigate the phosphatidylinositol 3-kinase/protein kinase B (PI3K/AKT) signaling pathway in the ovary and kisspeptin/insulin like growth factor/leptin receptor1/androgen receptor (Kiss1/IGF-1/LEPR/AR) in the HPO axis to determine the mechanism of TFEL intervention in a rat model of PCOS-IR model rats. Materials and methods A rat model of PCOS-IR was established using a high-fat diet (49 d) combined with letrozole (1 mg/kg·d, for 28 d). Then, metformin (300 mg/kg·d) and TFEL (220 mg/kg·d, 110 mg/kg·d, and 55 mg/kg·d) were administered continuously for 21 days. At the end of the experiment, samples were taken and the related indexes were measured. Results TFEL reduced the body weight, Lee's index, ovarian index, ovarian area and ovarian volume, increased serum E2, SHBG levels and ISI, decreased serum levels of T, LEP, INS, and FBG (whole blood), and reduced the HOMA-IR in rats with PCOS-IR. TFEL downregulate Kiss1, IGF-1, and AR in the arcuate nucleus of hypothalamus, and upregulate Kiss1, downregulate IGF-1 and AR in the pituitary gland, and upregulate Kiss1, downregulate IGF-1, LEPR, and AR in the ovary of rats with PCOS-IR. TFEL could downregulate p-IRS-1Ser307, upregulate IRS-1, p-IRS-1Tyr895, PI3Kp85α, p-PI3Kp85α, AKT, p-AKT, and GLUT4 in the ovary, and ameliorated histopathological changes in the ovary and pancreas of rats with PCOS-IR. Conclusion TFEL can inhibit ovarian hyperplasia, regulate disorders of glucose and lipid metabolism and improve the secretion of sex hormones, by regulating the expression of PI3K/AKT signaling pathway-related proteins in the ovary and Kiss1/IGF-1/LEPR/AR in the HPO axis.

The serum level of IL-33 was upregulated in systemic lupus erythematosus (SLE), which may be used as biomarkers and/or therapeutic targets for SLE. The aim of this study was to investigate the association of four novel polymorphisms of IL-33 with risk of SLE. The study population comprised 540 Chinese individuals, including 257subjects with SLE and 283 healthy controls. The gene polymorphism was measured using Snapshot SNP genotyping assays and confirmed by sequencing. Serum IL-33 (sIL-33) levels were measured by ELISA. The serum SLE levels were significantly higher in the group of patients with SLE than those in the control group (P

As a privileged scaffold, the quinazoline ring is widely used in the development of EGFR inhibitors, while few quinazoline-based MET inhibitors are reported. In our ongoing efforts to develop new MET-targeted anticancer drug candidates, a series of quinazoline-based 1,6-naphthyridinone derivatives were designed, synthesized, and evaluated for their biological activities. The preliminary SARs studies indicate that the quinazoline scaffold was also acceptable for the block A of class II MET inhibitors. The further pharmacokinetic studies led to the identification of the most promising compound 22a with favorable in vitro potency (MET, IC50 = 9.0 nM), human microsomal metabolic stability (t1/2 = 621.2 min) and oral bioavailability (F = 42%). Moreover, 22a displayed good in vivo antitumor efficacy (IR of 81% in 75 mg/kg) in MET-positive human glioblastoma U-87 MG xenograft model. These positive results indicated that 22a is a potential new MET-targeted antitumor drug lead, which is worthy of further development.

BACKGROUND Serum fructosamine (SF) has been considered to be an indicator that estimates glycemic control in patients with diabetes mellitus (DM). There is increasing evidence that SF concentration and oxidative stress are significantly elevated in patients with chronic kidney disease (CKD). However, the data about SF and its association with kidney function are lacking in nondiabetic individuals without CKD. We included 1891 nondiabetic individuals who had not been diagnosed with CKD to determine the association between SF and kidney function. MATERIAL AND METHODS We conducted a retrospective analysis on the basis of the biochemistry database in nondiabetic individuals without CKD. RESULTS When eligible participants were stratified in accordance with SF quartiles, from the bottom to the top quartile of SF, a significant decrease of estimated glomerular filtration rate (GFR) was observed in baseline data. SF concentration was negatively associated with estimated GFR (r=-0.066, P=0.004) in the Pearson correlation analysis. Estimated GFR was associated with SF levels independently of glucose (GLU), total cholesterol (TC), triglyceride (TG), and total protein (TP) in multivariable logistic regression analysis (OR=0.984; CI 95% 0.977-0.991; P

We examined the epidemiological associations between serum fructosamine and dyslipidemia indices in community-dwelling adults. Clinical characteristics and lipid profiles were analyzed in 1352 community-dwelling adults. The demographic characteristics and laboratory results were grouped according to the quartiles of serum fructosamine concentrations in all eligible individuals. From the bottom to the top quartile of serum fructosamine, there were graded increases in age, total cholesterol (TC), fasting blood glucose (FBG), total protein (TP), triglyceride (TG), total cholesterol/ high density lipoprotein-cholesterol (TC/HDL-C) and atherogenic index of plasma (AIP). Serum fructosamine was positive correlated with age, TC, FBG, TP, TG, TC/HDL-C and AIP in whole individuals. The positive correlations were then observed in both genders between serum fructosamine and TC, FBG, TP, TG. Two dominant factors were identified by principal component analysis. Logistic regression analysis showed that the two factors were associated with increased serum fructosamine with adjustment for gender, age, body mass index (BMI), FBG and TP. The similar results were observed in males, but not in females. Dyslipidemia tends to contribute to increased serum fructosamine concentrations in study population, suggesting that elevated serum fructosamine may herald an increased risk of cardiovascular disease among community-dwelling adults, especially in males.

BACKGROUND Depressive symptoms have been linked with insulin resistance in middle-aged and elderly populations. A strong relationship between peripheral insulin resistance and glucose homeostasis imbalance has been well established in previous studies. The role of serum fructosamine and fasting blood glucose (FBG) in elevating glucose homeostasis has been documented in the literature. OBJECTIVES The aim of the study was to examine the association of serum fructosamine and FBG with major depressive disorder (MDD). MATERIAL AND METHODS The study analyzed the clinical characteristics and biochemical parameters of 305 patients with MDD and 312 healthy individuals. RESULTS Serum concentrations of lipoprotein-cholesterol (HDL-C), total protein (TP) and creatinine (Cr) were found to be significantly different between the two groups. Serum fructosamine and fasting blood glucose (FBG) concentrations were high in patients with MDD compared with healthy individuals (2.3 ± 0.26 vs. 2.1 ± 0.27, p = 0.018; 4.7 ± 0.45 vs. 4.5 ± 0.45, p < 0.001). The levels of serum fructosamine and FBG were also significantly higher in patients with MDD when all participants were stratified by gender. Age was found to be positively correlated with FBG, serum fructosamine and Cr (r = 0.203, p < 0.001; r = 0.129, p = 0.025; r = 0.129, p = 0.024), and negatively correlated with TP (r = -0.114, p = 0.047) in patients with MDD. However, there were no correlations between age and FBG, serum fructosamine or Cr in the healthy controls. In a multivariate logistic regression analysis, increased serum fructosamine and FBG concentrations were positively associated with MDD independently of age and gender, after adjustment for age and potential confounding factors (OR = 6.313, CI95 %:2.953-13.393, p < 0.001; OR = 2.251, CI95 %: 1.464-3.462, p < 0.001). CONCLUSIONS The study results suggest that increased serum fructosamine and FBG concentrations are associated with depressive conditions, which may influence glucose metabolism and impair glucose homeostasis in patients with MDD.

Left ventricular (LV) pseudoaneurysm is a fatal and rare condition with a high risk of rupture. The symptoms are nonspecific and diagnosis is often delayed. The purpose of this study is to analysis a series of cases in our institution. Between March 2009 and April 2016, 10 patients (5 males and 5 females) with LV pseudoaneurysm were retrospectively enrolled. Clinical information, diagnostic imaging modalities, treatment, and outcomes were evaluated. The mean age was 58.2 ± 11.0 years (28–71 years). The common symptoms were chest pain (3 cases), dyspnea (3 cases), and syncope (2 cases). All patients had nonspecific abnormalities on the electrocardiogram, and 7 patients had chest X-ray abnormalities. Three etiologies including myocardial infarction (6 cases), mitral valve replacement (3 cases), and suspected endocarditis (1 case) were identified. LV pseudoanerysm was diagnosed in 8 patients by transthoracic echocardiography, and the other 2 patients were diagnosed by computed tomography angiogram. Posterior (4 cases) and lateral (4 cases) of the left ventricle were the most common positions of the rupture orifice. Eight patients accepted surgery repair and 2 patients were treated conservatively. In 2 patients, residual apical aneurysm was found, 1 patient was detected with a residual LV pseudoaneurysm, and 1 patient had myocardial infarction at 61 months’ follow-up. Myocardial infarction was the most common etiology of patients with LV pseudoaneurysm. The most frequently ruptured orifices were lateral and posterior walls of the left ventricle. Surgery is recommended as the first option, and conservative therapy can be considered for appropriate patients.

The aim of this study was to investigate the association of three polymorphisms of CD154 with risk of SLE in Chinese population. The study population comprised 770 Chinese individuals, including 350 SLE patients and 420 healthy controls. The gene polymorphism was measured using Snapshot SNP genotyping assays and confirmed by sequencing. Serum CD154 (sCD154) level was measured by ELISA. Compared with control group, sCD154 levels were significantly increased in case group (P

Current evidence shows that growth differentiation factor-15 (GDF-15) plays an important role in the progression of ischemic stroke (IS). The aim of this study was to investigate the association between 3 single-nucleotide polymorphisms of the GDF-15 gene and IS susceptibility in the Chinese population.The study subjects comprised 601 Chinese individuals, including 298 stroke patients and 303 age- and gender-matched healthy controls. The polymorphisms were measured using snapshot single-nucleotide polymorphism genotyping assays and confirmed by sequencing. Serum GDF-15 (sGDF-15) levels were measured by enzyme-linked immunosorbent assay.The distribution of rs1804826G/T polymorphism was significant different between the 2 groups (P .05). Compared with the rs1804826 G allele, the rs1804826 T allele was significantly associated with an increased risk of IS (P .05). Haplotype analyses showed that the T-T-G haplotype was significantly associated with an increased risk of IS (odds ratio = 1.671, 95% confidence interval = 1.231-2.268; P = .001). Compared with the normal controls, the sGDF-15 levels were significantly increased in stroke patients (P .001). Besides, patients carrying rs1804826 GT/TT genotypes had higher sGDF-15 levels compared with those carrying GG genotypes (P .05).The GDF-15 gene rs1804826G/T polymorphism and sGDF-15 levels are associated with IS in the Chinese population. Our data indicate that the GDF-15 gene may play a role in the development of IS.

Background We investigated the relationship between serum bilirubin and disease activity in patients with rheumatoid arthritis (RA). Methods We included a total of 173 consecutive RA patients without steroid treatment and 346 healthy subjects; the disease activity score in 28 joints (DAS28) was used to assess disease activity in patients with RA. Results Serum bilirubin concentrations were significantly lower in RA patients than in controls. Serum bilirubin was found to be negatively correlated with C-reactive protein (CRP) concentration and erythrocyte sedimentation rate (ESR) ( r = − 0.165, P = 0.030; r = − 192, P = 0.012) in patients with RA. There was a negative correlation between the serum bilirubin and DAS28 score ( r = − 0.331, P P = 0.001) in the multiple linear regression analysis. Conclusions Serum bilirubin concentrations are lower in patients with RA compared to controls and correlate with disease activity in patients with RA.

To explore the race- and gender-specific distribution characteristics of rs1891385A/C and rs10975519C/T polymorphism of interleukin-33 (IL-33) gene in Zhuang and Han populations.The polymorphisms of rs1891385A/C and rs10975519C/T of IL-33 gene in 283 subjects from Guangxi Zhuang Autonomous Region were analyzed with single base extension (PCR-SEB) and DNA sequencing to analyze the differences in their distribution frequencies between genders and between Zhuang and Han populations.Three genotypes (AA, AC and CC) were found in rs1891385A/C with frequencies of 64.3%, 32.5% and 3.2%, respectively. The genotype and allele frequencies of rs1891385A/C in this Guangxi population showed no significant difference between Zhuang and Han subpopulations and between genders (P0.05), but differed significantly from those in European and African black populations (P0.01). Three genotypes (CC, CT and TT) were identified in rs10975519C/T with frequencies of 34.3%, 53.0%, and 12.7%, respectively, showing no significant ethnic or gender-specific differences in this population (P0.05). The genotype frequency of rs10975519C/T in this population differed significantly from those in the European and Japanese populations (P0.01), but the allele frequencies only showed significant differences from those in the European population (P0.01).rs1891385A/C and rs10975519C/T polymorphisms of IL-33 gene show a race-specific difference.

Background Takayasu arteritis is a chronic non-specific inflammatory disease and mean platelet volume can either be decreased or increased during inflammation. However, there are no published data to confirm an association between mean platelet volume and Takayasu arteritis. Our aim was to evaluate the role of mean platelet volume in patients with Takayasu arteritis. Methods A total of 119 consecutive patients with Takayasu arteritis and 217 healthy individuals were included in this study. Forty-five Takayasu arteritis patients with active disease were followed with prednisone therapy. Results Mean platelet volume of patients was low compared with control groups (10.1 ± 1.47 fL vs. 11.2 ± 0.91 fL; P Conclusions Our results suggest that mean platelet volume may identify active disease in patients with Takayasu arteritis, and the values of mean platelet volume may help to establish remission of active disease after treatment in Takayasu arteritis patients.

Background:The aim of this study was to evaluate the relationship between serum γ-glutamyl transferase (γ-GGT) activity and serum copper in an adult population.Methods:We analyzed 281 adult subjects who regularly attended the physical examination center at the Affiliated Hospital of Youjiang Medical University for Nationalities.Results:The demographic and laboratory data of the participants were divided into two groups according to the median of serum γ-GGT activity. Serum copper concentrations in individuals with higher γ-GGT levels were significantly increased compared with those with lower γ-GGT concentrations (9.9±2.41 vs. 11.2±3.36 μmol/L, pConclusions:This study suggests that serum γ-GGT activity is correlated with copper in the study population, indicating that serum γ-GGT may be a biomarker to evaluate serum copper levels in an adult population.

Our aim in this study was to explore the relationship between red blood cell distribution width (RDW) and homocysteine levels in an adult population.The study included 344 subjects who underwent health check-up in our hospital. The demographic characteristics and laboratory parameters of participants were grouped in accordance with tertiles of RDW.An increase of homocysteine levels was found from the first to third tertiles of RDW in all participants. There was a positive correlation between RDW and homocysteine (r=0.227, P0.001) in all participants. After adjustment for gender, age, neutrophil count (NC), lymphocyte count (LC), hemoglobin (Hb), mean corpuscular volume (MCV), platelet count (PLC), creatinine (Cr), vitamin BThe findings of the present study suggest that RDW may predict homocysteine levels among the study population, the results may support that elevated RDW should be considered to be a marker of cardiovascular events. However, the results need to be affirmed in future studies with larger samples.

The expression of miR-143/miR-145 was up-regulated in ischemic stroke (IS), which may be used as biomarkers and/or therapeutic targets for IS. We aimed to investigate the association of rs4705342 and rs4705343 polymorphisms in the promoter of miR-143/145 with risk of IS. The study population comprised 445 patients with IS and 518 controls. The rs4705342 genotype was analyzed by using a TaqMan Assay and the rs4705343 genotype was determined by using a polymerase chain reaction-restriction fragment length polymorphism assay. Relative expression of miR-143/miR-145 was measured by quantitative real-time PCR. We found that the rs4705342 was associated with a decreased risk of IS (TC vs. TT: adjusted OR = 0.74, 95% CI, 0.57–0.97; CC vs. TT: adjusted OR = 0.53, 95% CI, 0.34–0.83). Haplotype analysis showed that the TC haplotype was associated with an increased risk of IS risk (OR = 1.33, 95% CI, 1.01–1.75), whereas the CT haplotype was associated with a decreased risk of IS risk (OR = 0.68, 95% CI, 0.50–0.92). Importantly, patients carrying the rs4705342TC/CC genotypes had a lower level of miR-145 (P = 0.03). We found for the first time that the rs4705342 CC was a protective factor for IS, probably by reducing the level of miR-145.

Aim: With the emergence of drug-resistant bacteria, finding alternative agents to treat antibiotic-resistant bacterial infections is imperative. Materials & methods: A mouse pneumonia model was developed by combining cyclophosphamide pretreatment and Acinetobacter baumannii challenge, and a lytic bacteriophage was evaluated for its therapeutic efficacy in this model by examining the survival rate, bacterial load in the lung and lung pathology. Results: Intranasal instillation with bacteriophage rescued 100% of mice following lethal challenge with A. baumannii. Phage treatment reduced bacterial load in the lung. Microcomputed tomography indicated a reduction in lung inflammation in mice given phage. Conclusion: This research demonstrates that intranasal application of bacteriophage is viable, and could provide complete protection from pneumonia caused by A. baumannii.

The commercial preparation named “Tripterygium glycosides” prepared by column chromatography has been used for the treatment of inflammatory and autoimmune diseases with significant efficacy but concurrent toxicity. The aim of this study was to reduce the toxicity of Tripterygium extracts, using cytotoxicity and anti-inflammatory activity of the three principal active components of Tripterygium wilfordii Hook. F. (TWHF) as guiding parameters. Column chromatography was replaced by sodium carbonate extraction for removing the acidic compounds and enriching epoxyditerpenoids and alkaloids in the extract. Results showed that the therapeutic index (IC50/EC50) on murine macrophage Raw 264.7 cells and rat mesangial HBZY-1 cells of the extract prepared by sodium carbonate extraction was significantly higher than that of Tripterygium glycosides (0.8 and 5.2 vs. 0.3 and 2.6, p < 0.05), while its cytotoxicity on human liver HL7702 cells was significantly lower (14.5 ± 1.4 vs. 6.8 ± 0.9, p < 0.05). Further acute oral toxicity experiments showed that the LD50 value of this extract was 1,210 mg/kg compared to 257 mg/kg for Tripterygium glycosides. All the above results suggest that Tripterygium extract prepared by sodium carbonate extraction may represent a potentially optimal source of medicine with good therapeutic index.

The major objective of successful development of tissue-engineered vascular grafts is long-term in vivo patency. Optimization of matrix, cell source, surface modifications, and physical preconditioning are all elements of attaining a compatible, durable, and functional vascular construct. In vitro model systems are inadequate to test elements of thrombogenicity and vascular dynamic functional properties while in vivo implantation is complicated, labor-intensive, and cost-ineffective. We proposed an ex vivo ovine arteriovenous shunt model in which we can test the patency and physical properties of vascular grafts under physiologic conditions. The pressure, flow rate, and vascular diameter were monitored in real-time in order to evaluate the pulse wave velocity, augmentation index, and dynamic elastic modulus, all indicators of graft stiffness. Carotid arteries, jugular veins, and small intestinal submucosa-based grafts were tested. SIS grafts demonstrated physical properties between those of carotid arteries and jugular veins. Anticoagulation properties of grafts were assessed via scanning electron microscopy imaging, en face immunostaining, and histology. Luminal seeding with endothelial cells greatly decreased the attachment of thrombotic components. This model is also suture free, allowing for multiple samples to be stably processed within one animal. This tunable (pressure, flow, shear) ex vivo shunt model can be used to optimize the implantability and long-term patency of tissue-engineered vascular constructs.

OBJECTIVE: The aim of our study was to investigate the correlation between serum carbohydrate antigen 153 (CA153) and renal function in patients with type 2 diabetes mellitus (T2DM). METHODS: A total of 184 patients with T2DM were included, and renal function was assessed by the modification of diet in renal disease (MDRD) formula adjusted coefficient of the Chinese people. RESULTS: Serum CA153 concentrations were positively correlated with blood glucose (BG) and glycated hemoglobin (HbA1c) (r = .204, P = .005; r = .165, P = .025) in patients with T2DM. There was a negative correlation between serum CA153 and estimated glomerular filtration rate (GFR) (r = −.229, P = .002) in whole patients with T2DM; similarly, the correlations were observed in both women and men (r = −.228, P = .028 for women, r = −.231, P = .028 for men). Multiple linear regression analysis suggested that serum CA153 was still significantly correlated with estimated GFR (beta = −0.286, P

BACKGROUND In patients with colorectal cancer, a defunctioning ileostomy is commonly constructed to reduce anastomotic complications. However, many patients do not undergo a subsequent procedure to have their temporary stoma closed. OBJECTIVE This study investigated the incidence of nonclosure of ileostomies and identified factors associated with nonclosure. DESIGN This study is a retrospective analysis of prospectively collected data. SETTING This study was conducted at a tertiary referral cancer hospital. PATIENTS A total of 296 patients who received anterior resection with a defunctioning ileostomy with protective intention from 2006 to 2013 were included. MAIN OUTCOME MEASURES The primary outcomes measured were the incidence of nonclosure of ileostomy and associated risk factors. RESULTS Patients were followed for a median time of 29 months (range, 21-100 months). At the end of the study, 51 (17.2%) patients were left with a permanent ileostomy. The median time interval from the creation of a defunctioning ileostomy to closure was 192 days (range, 14-865 days). Multivariate analyses using a logistic regression model showed that metastatic diseases (OR, 0.179, p 1 (OR, 0.268; p < 0.01), and complications from the index surgery (OR, 0.391; p = 0.013) were significant independent risk factors for failing to close a defunctioning ileostomy. LIMITATIONS Although our study has a large patient cohort, it is limited by its retrospective nature. It is difficult to fully evaluate stoma complications after hospital discharge, and the prevalence may be underestimated. CONCLUSION One in 6 temporary ileostomies constructed during an elective anterior resection for rectal cancer was not closed. Patients should be told before the index surgery that there is a risk of nonclosure and possible complications associated with permanent ileostomy.

BACKGROUND: Increased levels of C‐reactive protein (CRP) have been considered as a marker in assessing neurogenic inflammation of migraine patients. An inverse relationship between serum bilirubin and CRP has been observed in various diseases. Therefore, we analyzed serum bilirubin levels in migraine patients, and investigated the relationship between serum bilirubin and CRP in migraineurs. METHODS: A total of 86 newly diagnosed migraine patients were consecutively recruited to this study. RESULTS: Significantly lower median serum total bilirubin, conjugated bilirubin (CB) and unconjugated bilirubin were found in patients with migraine than healthy controls, and the levels of CRP were significantly higher in migraine patients than healthy controls. A negative correlation between CRP and CB was observed in patients with migraine (r = −0.255, P = 0.018). In a multiple linear regression model, the concentrations of CRP remained negatively correlated with CB. CONCLUSIONS: Our study demonstrates that serum bilirubin concentrations are decreased in migraineurs, and CB levels were found to be positively correlated with CRP in migraine patents. However, larger cross‐sectional and prospective studies are needed to establish whether serum bilirubin may be a useful biomarker for assessing neurogenic inflammation in migraine patients and eventually guiding the therapy.

To evaluate whether an abdominoperineal excision (APE) is associated with increased local recurrence (LR) and shortened disease-free survival (DFS) in mid-low rectal cancer with a negative circumferential resection margin (CRM).283 consecutive cases of mid-low rectal cancer underwent preoperative 30 Gy/10 F radiotherapy and surgery in Peking University Cancer Hospital between August 2003 and August 2009. Patients with positive CRM and intraoperative distant metastasis were precluded according to exclusion criteria. Survival analyses were performed in patients with APE or non-APE procedures.256 of the 283 (90.5%) cases were enrolled in the analysis, including 78 (30.5%) and 178 (69.5%) cases who received APE and non-APE procedures. Fewer female patients (P = 0.016), lower level of tumor (P = 0.000) and higher body mass index (P = 0.006) were found in the APE group. On univariate analysis, the APE group had a higher LR rate (5.1% vs 1.1%, P = 0.036) and decreased DFS (73.1% vs 83.4%, P = 0.021). On multivariate analysis, APE procedure was also an independent risk factor for LR (HR = 5.960, 1.085-32.728, P = 0.040) and decreased DFS (HR = 2.304, 1.298-4.092, P = 0.004). In stratified analysis for lower rectal cancer, APE procedure was still an independent risk factor for higher LR rate (5.6% vs 0%, P = 0.024) and shortened DFS (91.5% vs 73.6%, P = 0.002).Following preoperative 30 Gy/10 F radiotherapy, APE procedure was still a predictor for LR and decreased DFS even with negative CRM. More intensive preoperative treatment should be planned for the candidates who are scheduled to receive APE with optimal imaging assessment.

The advent of methicillin-resistantStaphylococcus aureus(MRSA) and the frequent and excessive abuse of ventilators have made MRSA pneumonia an inordinate threat to human health. Appropriate antibacterial therapies are crucial, including the use of lysostaphin as an alternative to antibiotics. To explore the potential use of lysostaphin as a therapeutic agent for MRSA pneumonia, mice were intranasally infected with MRSA and then treated with recombinant lysostaphin (rLys; 45 mg/kg in the high-dose group and 1 mg/kg in the low-dose group) (0.33 mg/mL, 15 mg/mL), vancomycin (120 mg/kg) (40 mg/mL), or phosphate-buffered saline (PBS, negative control) 4 h after infection. Therapeutic efficacy was assessed by mouse survival, lung histopathology, bacterial density in the lungs, bodyweight, lung weight, temperature, white blood cells counts, lymphocytes counts, granulocytes counts, and monocytes counts. The mice treated with rLys showed lower mortality, less lung parenchymal damage, and lower bacterial density at metastatic tissue sites than mice treated with PBS or vancomycin. The overall mortality was 100%, 60%, 40%, and 60% for the control, vancomycin, high-dose rLys, and low-dose rLys groups, respectively. These findings indicate that, as a therapeutic agent for MRSA pneumonia, lysostaphin exerts profound protective effects in mice against the morbidity and mortality associated withS. aureuspneumonia.

Both selenium (Se) and polysaccharides from Pyracantha fortuneana (Maxim.) Li (PFPs) (P. fortuneana) have been reported to possess antioxidative and immuno-protective activities. Whether or not Se-containing polysaccharides (Se-PFPs) have synergistic effect of Se and polysaccharides on enhancing the antioxidant and immune activities remains to be determined. We previously reported that polysaccharides isolated from Se-enriched P. fortuneana (Se-PFPs) possessed hepatoprotective effects. However, it is not clear whether or not they have anti-mutagenic effects. In the present study, we compared and evaluated anti-mutagenic effects of Se-PFPs at three concentrations (1.35, 2.7 and 5.4 g/kg body weight) with those of PFPs, Se alone or Se + PFPs in mice using micronucleus assay in bone marrow and peripheral blood as well as mitomycin C-induced chromosomal aberrations in mouse testicular cells. We also elucidated the underlying mechanism. Our results demonstrated that Se-PFPs inhibited cyclophosphamide (CP)-induced micronucleus formation in both bone marrow and peripheral blood, enhanced the activities of superoxide dismutase (SOD) and glutathione peroxidase (GPx) in mouse liver, and reduced the activity and expression of cytochrome P450 1A (CYP4501A) in mouse liver in a dose-dependent manner. In addition, we found that the anti-mutagenic potential of Se-PFPs was higher than those of PFPs, Se alone or Se + PFPs at the same level. These results suggest that the anti-mutagenic potential of Se-PFPs may be mediated through the inhibition of the activity and expression of CYP4501A. This study indicates that application of Se-PFPs may provide an alternative strategy for cancer therapy by targeting CYP1A family.

To compare the safety and efficacy perioperatively between hand-assisted laparoscopic surgery (HALS) and conventional open sigmoidectomy.Prospectively collected data on 115 patients with sigmoid colon cancer between January 2009 to June 2010 were analyzed. There were 62 patients in the HALS group and 53 in the conventional sigmoidectomy group (CS). Patient characteristics, operative parameters, and perioperative outcomes were compared.HALS patients were similar to CS patients in age(60.2 yrs vs. 63.4 yrs, P=0.163), gender (53.2% vs. 60.4% male, P=0.441), tumor size (4.7 cm vs. 5.3 cm, P=0.114) and tumor stage. The two groups were comparable in operative time [(122.4±32.0) min vs.(126.7±37.4) min, P=0.510], lymph node harvest (15.1±4.6 vs. 16.8±6.4, P=0.163), free margin length [(4.1±1.8) cm vs.(4.3±1.7) cm, P=0.601], and postoperative complications. However, HALS group had less intraoperative bleeding [(62.6±35.4) ml vs. (168.9±137.1) ml, P=0.000], shorter time to flatus [(2.3±0.8) d vs. (3.3±1.1) d, P=0.000], and shorter hospital stay [(8.8±2.7) d vs.(12.6±8.0) d, P=0.001].HALS results in similar short-term outcomes compared to conventional surgery. HALS is safe and minimally invasive.

To evaluate the safety and efficacy of hand-assisted laparoscopic surgery (HALS) in colorectal tumors.Clinical data of 70 patients with colorectal tumors were retrospectively analyzed. All the patients had received HALS colectomy in the Beijing Cancer Hospital. Lapdisc was used for the hand port at the umbilicus. Two additional trocars were used.There were 38 males and 32 females. The median age was 61(29-89) years. Diagnoses included sigmoid cancer(n=48), sigmoid adenoma(n=4), descending colon cancer (n=3), ascending colon cancer (n=1), rectal cancer (n=13), total colectomy(n=1). The operative time was (126.0±22.5) minutes. The intraoperative blood loss was (75.0±18.8) ml. The mean number of lymph node dissection was(16.8±4.2). The median postoperative hospital stay was 9.4 days. There were no perioperative deaths. One patient developed anastomotic stricture and two anastomotic leak, all of which were successfully managed with conservative treatment.HALS is a safe and effective technique for colectomy.

To address the difference of pathologic and clinical characteristics of the young and the middle-aged and elderly patients with advanced rectal cancer after neoadjuvant radiotherapy.A total of 252 patients undergoing radical surgery from January 2000 to January 2005 were included in this study. The patients were divided into two groups according to the age at diagnosis:young-patient group (40 years) and old-patient group (≥ 40 years). The pathologic and clinical materials were collected and the oncologic outcome was compared between the two arms.A total of 252 patients were included in this study, included 54 patients in young-patient group and 198 patients in old-patient group, respectively. There was no significant difference in gender, clinical stage and pretreatment serum carcinoembryonic antigen (CEA) between the two groups. However, the proportion of mucinous and signet-ring cell cancer was significantly higher in young-patient group (20.4% vs. 4.0%, P0.05), and furthermore, the proportion of pathologic stage later than IIIA was also significantly higher in the young-patient group (61.1% vs. 42.9%, P0.05). There was no significant difference in local recurrence rate between the patients who received neoadjuvant radiotherapy and those who did not in the young-patient group, whereas the difference was observed significant in the old-patient group (3.3% vs. 11.2%, P0.05). There was no significant difference in both the disease free survival and overall survival between the two arms (5y-DFS: 63.3% vs. 68.5%, P0.05; 5y-OS: 73.5% vs. 72.9%, P0.05).Rectal cancer in young patients has poorer histologic differentiation and more advanced pathologic stage, but the long-term survival is similar to that in middle-aged and elderly patients. The local control effect of neoadjuvant radiotherapy on rectal cancer in young patients still need to be further investigated.

To observe the therapeutic effect of continuous electroacupuncture at Neiguan (PC 6) on the basis of routine treatment of western medicine for arousing consciousness of comatose patinents with severe craniocerebral trauma.Fifty-six cases of severe cranio cerebral trauma patients whose scores of Glasgow Coma Scale (GCS) lower than 8 were randomly divided into an observation group (29 cases) and a control group (27 cases). Both groups were treated with routine western medicine. The observation group were additionally treated with continuous electroacupuncture at Neiguan (PC 6) as the main point. Arousal rate and time after one month and three months of two groups were observed, arousal rate and the total therapeutic effect of recovery of the patients with different types after three months were compared between two groups.The arousal time of the observation group was (18.57 +/- 7.14) days and the arousal rate was 72.4% (21/29) after one month, while (24.60 +/- 5.00) days and 37.0% (10/27) in control group, respectively. They were suprior in observation group to those in control group (P0.01, P0.05); the arousal time was (25.04 +/- 16.68) days in the observation group after three months of treatment, also shorter than (37.90 +/- 16.94) days in control group (P0.05). The arousal rate of patients with diffuse axonal injury was significantly higher than that of patients with non-diffuse axonal injury in the observation group and patients with the same type in control group after one month (P0.05). The cured-markedly effective rate of 72.4% (21/29) in observation group was significantly higher than that of 37.0% (10/27) in control group (P0.05).The therapy of continunous electroacupuncture at Neiguan (PC 6) on the basis of routine western medicine has a better therapeutic effect for comatose patients with severe cranio cerebral trauma, especially for those with diffuse axonal injury.

The staging and treatment of bronchioloalveolar carcinoma (BAC) with pulmonary metastasis are still controversial. This study aimed at evaluating the current staging of BAC with ipsilateral intrapulmonary metastatic nodules and the therapeutic effectiveness of surgical resection.The clinicopathological data of 729 completely and surgically resected patients with non-small cell lung cancer (NSCLC) from December 1999 to December 2006 were retrospectively reviewed. Prognostic factors affecting the overall survival were analyzed by the Kaplan-Meier method and compared by the log rank test.Among 67 NSCLC patients with ipsilateral intrapulmonary metastatic nodules, 54 had multiple nodules in the lobe with primary lesion (T4, PM1) and 13 had additional nodules in the other ipsilateral lobes (M1, PM2). This series consisted of 40 males and 27 females, with a median age of 60.0 years. Of those, 28 had the lesions containing pure or some bronchioloalveolar carcinoma component, while the other 39 had a NSCLC lesions containing non-bronchioloalveolar carcinoma components. The median overall survival time of this series was 24.0 months. Prognostic study demonstrated that bronchioloalveolar carcinoma histology and mediastinal lymph node metastasis had significant adverse impact on the overall survival. The median survival time of the patients with bronchioloalveolar carcinoma was 58.0 months versus 27.0 months in patients with other subtypes of NSCLC (P0.01). The median survival times were 39.0 months for the patients with N0 or N1 versus 14.0 months for patients with N2, with a significant difference between the two groups (P0.01). There was no significant difference in the survival time between the patients with PM1 (36 months) and those with PM2 (24 months) (P0.05).Surgical resection is effective for NSCLC patients with ipsilateral intra-pulmonary metastasis, especially for those with bronchioloalveolar carcinoma components. Our results suggest that the current TNM classification system may be inappropriate for the NSCLC patients with ipsilateral intrapulmonary metastatic nodules, and may need a modification.

The staging and treatment of multi-focal non-small cell lung cancer (NSCLC) are controversial. This study evaluated the effectiveness of surgical treatment for the ipsilateral multi-focal NSCLC.Sixty-eight patients with multi-focal NSCLC underwent complete resection from December 1999 to December 2006. This series included 44 males and 24 females, with a mean age of 60.3 years old (range from 33 to 81 years old). Fifty-four patients had multiple nodules in primary lobe (T4) and 13 patients had additional nodules in non-primary lobe (M1), and a patient was proved to have synchronous primary NSCLC lesions. Surgical treatments included lobectomy in 53 cases, bilobectomy in 4 cases, pneumonectomy in 2 cases, and lobectomy combined with wedge resection in 9 cases.The median overall survival time of this series was 30 months. Prognostic study demonstrated that mediastinal lymph node metastasis and bronchioloalveolar carcinoma histology had significant impact on overall survival. The median survival times were 39 months for patients with N0 and N1, and 14 months for patients with N2, respectively, and there was significant difference between the groups (P0.01). The difference in survival was significant between patients with bronchioloalveolar carcinoma components and other NSCLC histologic types (P0.01), and the median survival times were 46 months and 20 months, respectively.Surgery could provide choice for multi-focal NSCLC patients (T4 and M1), especially for patients with bronchioloalveolar carcinoma components and without mediastinal lymph node metastasis.

The incidence of synchronous colorectal and lung cancer is relatively rare. We report three cases of patients with tumors located in the rectum, ascending colon, the lower lobe of the left lung, and the upper lobe of the right lung. Synchronous curative resection of the two lesions was performed in two patients, whereas colectomy was performed in an elderly patient with a poor lung function. Pathological examination showed the colorectal cancer was a moderately differentiated adenocarcinoma and the lung cancer was a squamous cell carcinoma. Surgical treatment and postoperative adjuvant chemotherapy for the lung cancer were different from those for colorectal cancer with pulmonary metastasis. If possible, radical resection should be performed for each cancer when synchronicity is found.

BACKGROUND Platelet to lymphocyte ratio (PLR) has been regarded as a parameter in assessing systemic inflammation. Polymyositis (PM) is a rare connective tissue diseases characterized by chronic muscle inflammation, which led to a hypothesis with respect to PLR in PM patients. Therefore, it is reasonable to investigate the relationship between PLR and PM. METHODS The present study included 46 newly diagnosed PM patients and 128 healthy subjects as controls. The muscle weakness of PM patients was measured using the manual muscle test (MMT) to evaluate disease activity in patients with PM. RESULTS Neutrophil to lymphocyte ratio (NLR) and PLR were higher in patients with PM compared with healthy controls (4.1 ± 1.32 vs. 1.6 ± 0.58, p < 0.001, 158.4 ± 86.39 vs. 103.8 ± 29.82, p < 0.001). PLR was positively correlated with NLR, ESR, and platelet counts (r = 0.392, p = 0.008, r = 0.422, p = 0.020, r = 0.366, p < 0.001), and negatively with lymphocyte counts (r = -0.872, p < 0.001) in patients with PM. Interesting, a reverse correlation between PLR and MMT score was observed in patients with PM (r = -0.383, p = 0.010). However, there was no correlation between NLR and MMT score (r = -0.266, p = 0.074). In logistic regression analysis, PLR was independently associated with PM after adjustment for age, gender, ESR, lymphocyte counts, neutrophil counts, leukocyte counts, and NLR. The resulting odds ratio (OR) and 95% confidence interval (95% CI) were 1.017 (95% CI 1.003 - 1.031; p = 0.015) for PLR. CONCLUSIONS Our research suggests that PLR is associated with PM, and PLR may be used to estimate disease activity of PM patients.

Background The Forgotten Joint Score (FJS) is a newly developed health-related quality of life (HRQoL) questionnaire designed to evaluate the awareness after total knee arthroplasty (TKA). This study cross-culturally adapted and psychometrically validated a simplified Chinese version of the FJS (SC-FJS). Methods Cross-cultural adaptation was performed according to the internationally recognized guidelines. One-hundred and fifty participants who underwent primary TKA were recruited in this study. Cronbach’s α and intra-class correlations were used to determine reliability. Construct validity was analyzed by evaluating the correlations between SC-FJS and the Knee Injury and Osteoarthritis Outcome Score (KOOS) and the short form (36) health survey (SF-36). Results Each of the 12 items was properly responded and correlated with the total items. SC-FJS had excellent reliability [Cronbach’s α = 0.907, intra-class correlation coefficient (ICC) = 0.970, 95% CI 0.959–0.978). Elimination of any one item in all did not result in a value of Cronbach’s α of 0.05) correlation with mental subscale of SF-36. Conclusions SC-FJS demonstrated excellent acceptability, internal consistency, reliability, and construct validity, which can be recommended for patients who underwent joint arthroplasty in Mainland China. Electronic supplementary material The online version of this article (doi:10.1186/s13018-016-0508-5) contains supplementary material, which is available to authorized users.

Accumulated data have indicated that bilirubin has antiinflammatory, antioxidative, and immunosuppressive properties. Polymyositis (PM) belongs to an autoimmune disease characterized by chronic inflammation in skeletal muscle. Until now, to the best of our knowledge, there are no literature investigating bilirubin levels in patients with PM. Therefore, the aim of this investigation was to assess a relationship between bilirubin and PM.Our study included newly diagnosed 77 patients with PM who were admitted to the Affiliated Hospital of Youjiang Medical University for Nationalities (Guangxi, China) and 108 healthy subjects as controls. Clinical characteristics and laboratory parameters of patients were analyzed, retrospectively.The serum concentrations of total bilirubin (TB), conjugate bilirubin (CB), unconjugated bilirubin (UCB) were significantly lower in patients with PM than healthy controls. Serum concentrations of TB were negatively correlated with erythrocyte sedimentation rate (ESR), creatine kinase (CK) and lactic dehydrogenase (LDH) in patients with PM (r=-0.494, p0.001; r=-0.274, p=0.017; r=-0.282, p=0.014), and serum concentrations of UCB were negatively correlated with ESR and CK in PM patients (r=-0.424, p0.001; r=-0.234, p=0.041). Both serum TB and UBC concentrations were positively correlated with manual muscle test (MMT) score in patients with PM (r=0.328, p=0.004; r=0.333, p=0.004). In multiple linear regression analysis, serum UBC levels were independently associated with MMT score (r=0.239, p=0.003).We observed significantly lower serum concentrations of TB, CB and UCB in patients with PM, and suggested a potential association between serum concentrations of UBC and disease activity in PM patients.