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Purpose : To investigate the clinical effects and complications that may arise as a result of ipsilateral clavicle turnover during tumorous bone defect repair of the proximal humerus, and to explore the feasibility of performing combined free fibula transplantation and internal fixation in reducing complications Methods: We treated 13 patients with clavicle turnover or free fibular transplantation from September 1998 to February 2020. There were 7 males and 6 females with the average age of 26.2 years (7–50 years). The histological diagnoses were osteosarcoma in 6 patients (Enneking IIB), giant cell tumors in 3 patients (Campanacci III) and one patient each with Ewing’s sarcoma (Enneking IIB), chondrosarcoma (Canceration of multiple osteochondromatosis), fibrosarcoma and metastatic cancer of bone (Bone metastasis of lung cancer). Pathological fractures were found in 7 of the 13 patients. Results : The operation was successfully performed for all 13 patients. We followed 12 patients for 18 to 274 months (average 92.7 months). For 6 patients treated with simple clavicle turnover using a short plate, the average healing time was 7 months (4–12 months). Among them, there were 3 cases of clavicle fracture and 3 cases of overturned bone healed well. For the 7 patients treated with clavicle turnover and free fibula using a long plate, the healing time was 6.7 months. However, one patient died of tumor metastasis 19 months after operation, without reversal of clavicle fracture and other complications. Conclusion : Clavicle turnover is a feasible method for the treatment of tumorous bone defect of the proximal humerus. Flipping clavicle fracture is the most common complication. The application of total clavicle fixation and free fibular transplantation strengthens the flipping clavicle and reduces the risk of clavicle fracture.

To determine the effect of different lengths of kinesiology tape (KT) on ankle inversion proprioceptive performance in individuals with or without chronic ankle instability (CAI).A repeated measures study.Fifteen participants with unilateral CAI and fifteen participants with no CAI volunteered. The Ankle Inversion Discrimination Apparatus for Landing (AIDAL) was used to measure ankle proprioceptive acuity. All participants were tested under four KT conditions: no tape (baseline), short tape length (only foot and ankle complex involved), mid length (below the knee) and long length (above the knee) taping. After the baseline test, participants underwent the 3 different taping tests in a random order.Repeated measures ANOVA indicated that, compared to those without CAI, individuals with CAI performed significantly worse across the 4 different conditions (F = 8.196, p = 0.008). There was a significant KT main effect (F = 7.489, p 0.001) and a significant linear effect (F = 17.083, p 0.001), suggesting that KT significantly improved ankle proprioceptive performance in landing, and with longer tape length there was greater proprioceptive enhancement. Post-hoc analysis showed that for the CAI group, both mid length (p = 0.013, 95%CI = -0.063, -0.009) and long length (p = 0.010, 95%CI = -0.067, -0.011) taping can significantly improve ankle proprioceptive performance compared to no tape, whereas for the non-CAI group, ankle proprioceptive acuity was significantly improved only with long length taping (p = 0.007, 95%CI = -0.080, -0.015).KT can be used to improve ankle inversion proprioceptive performance during landing in both individuals with and without CAI and increasing tape length may achieve greater proprioceptive improvement.

Quadriceps atrophy and morphological change is a known phenomenon that can impact significantly on strength and functional performance in patients with acute or chronic presentations conditions. Real-time ultrasound (RTUS) imaging is a noninvasive valid and reliable method of quantifying quadriceps muscle anatomy and architecture. To date, there is a paucity of normative data on the architectural properties of superficial and deep components of the quadriceps muscle group to inform assessment and evaluation of intervention programs. The aims of this study were to (1) quantify the anatomical architectural properties of the quadriceps muscle group (rectus femoris, vastus intermedius, and vastus lateralis) using RTUS in healthy older adults and (2) to determine the relationship between RTUS muscle parameters and measures of quadriceps muscle strength. Thirty middle aged to older males and females (age range 55-79 years; mean age =59.9 ± 7.08 years) were recruited. Quadriceps muscle thickness, cross-sectional area, pennation angle, and echogenicity were measured using RTUS. Quadriceps strength was measured using hand-held dynamometry. For the RTUS-derived quadriceps morphological data, rectus femoris mean results; circumference 9.3 cm; CSA 4.6 cm2 ; thickness 1.5 cm; echogenicity 100.2 pixels. Vastus intermedius mean results; thickness 1.8 cm; echogenicity 99.1 pixels. Vastus lateralis thickness 1.9 cm; pennation angle 17.3°; fascicle length 7.0 cm. Quadriceps force was significantly correlated only with rectus femoris circumference (r = 0.48, p = 0.007), RF echogenicity (r = 0.38, p = 0.037), VI echogenicity (r = 0.43, p = 0.018), and VL fascicle length (r = 0.43, p = 0.019). Quadriceps force was best predicted by a three-variable model (adjusted R2 = 0.46, p

BackgroundThe human leukocyte antigen (HLA) susceptibility gene is the main genetic risk factor for primary biliary cholangitis (PBC). The prognosis of patients with PBC is linked to gut microbiota dysbiosis. However, whether the HLA alleles are associated with the gut microbiota distribution and disease severity remains unknown.MethodsA cohort of 964 Chinese patients with PBC was enrolled at Beijing YouAn Hospital, Beijing, China. High-resolution genotyping of the HLA class I and class II loci from 151 of these patients was performed using sequence-based PCR. Stool samples were collected from 43 of the 151 fully HLA-typed patients to analyze their microbiota compositions via 16S RNA gene sequencing.ResultsOf the 964 patients, the male:female ratio was 114:850, and 342 of these patients (35.5%) had already developed liver cirrhosis (LC) before enrollment. Patients with PBC showed a significantly higher frequency of HLA DRB1*08:03 than did the controls (21.2% vs. 9.0%, P=0.0001). HLA-DRB1*03:01, DRB1*07:01, DRB1*14:05, and DRB1*14:54 frequencies were also increased but did not reach significance after Bonferroni’s correction. Conversely, the DQB1*03:01 frequency was significantly lower in patients with PBC than in the controls (24.5% vs. 39.2%, P=0.0010). The patients’ gut microbiota were analyzed from four perspectives. The microbial community abundances were significantly lower in FHRAC-positive patients (patients with a combination of five HLA DRB1 high-risk alleles) than in FHRAC-negative patients (PLachnospiraceae_incertae_sedis was higher in the FHRAC-positive patients than in the FHRAC-negative patients (PDQB1*03:01-positive patients contained mostly Lactobacillaceae at the family level. A comparison of the FHRAC-positive patients with and without liver cirrhosis showed that the abundances of Veillonella were significantly higher in patients with cirrhosis and FHRAC than in those without cirrhosis and are FHRAC-negative.ConclusionThe HLA class II genes may influence the gut microbiota compositions in patients with PBC. Differential gut microbiota were expressed at different taxonomic levels. Some bacterial abundances may be increased in FHRAC-positive patients with PBC and cirrhosis.

Background While decreased hip abductor strength, functional performance, and self-reported instability scores have all been shown in association with CAI, any sex difference in the relationship between these indicators is unclear. This study was to determine whether sex differences are present in the relationship between these indicators in individuals with CAI. Methods Thirty-two women and twenty-nine men with unilateral CAI took part. Hip abductor strength and functional performance were respectively assessed using a hand-held dynamometer and the figure-8-hop test. All 61 participants scored the Cumberland Ankle Instability Tool (CAIT) for self-reported ankle instability. Independent sample t-tests and correlation analysis were conducted. Results Normalized hip abductor strength and functional performance measures for females were lower than for males. The self-reported ankle instability CAIT score, where higher values represent less instability, was significantly and positively correlated with both normalized hip abductor strength (p = 0.003) and functional performance (p = 0.001) on the affected side in females, but not in males (p = 0.361 and p = 0.192 respectively). Conclusions Sex differences were observed in that there were significant relationships between normalized hip abductor strength, functional performance, and CAIT scores in female CAI participants, but not males, suggesting that CAI evaluation and rehabilitation strategies should be sex-specific. Highlights In females with CAI, hip abductor strength and functional performance showed significant relationships with self-reported instability scores. Correspondingly, in clinical practice with individuals with CAI, evaluation criteria may be formulated according to these observed sex differences. Sex differences should be factored into the evaluation and treatment of CAI individuals. Hip strength assessment should be employed with CAI individuals. Hip strengthening and functional hopping may be recommended for the rehabilitation of CAI, especially in female patients.

BACKGROUND Non-alcoholic fatty liver disease (NAFLD), in which abnormal lipid metabolism plays an important role in disease progression, has become a pandemic. Abnormal lipid metabolism, for example an increased fat intake, has been thought to be an initial factor leading to NAFLD. The small intestine is the main site of dietary lipid absorption. A number of clinical trials have shown that acupuncture has positive effects in the regulation of lipid metabolism, which is closely associated with the progression of NAFLD. We therefore hypothesized that, acupuncture can improve the conditions of NAFLD by regulating intestinal absorption of lipid. AIM To study the role of acupuncture treatment in the improvement of metabolic syndrome secondary to NAFLD by mouse model. METHODS 8-wk-old male C57BL/6J mice were fed a methionine- and choline-deficient diet for 3 wk. Then, all mice were separated randomly into acupoints group (AG) or non-acupoints group (NG) with high fat diet feeding. Needling treatment was performed at Zu san li, Guan yuan and Yong quan acupoints as acupuncture treatment to AG mice while non-acupoints place to NG mice. Finally, mice were anesthetized with an injection of ketamine-medetomidine and euthanized by exsanguination. RESULTS An apparent improvement of obesity was found in AG mice after acupuncture treatment. In AG mice, the body weight was much lower (22.6 ± 1.2 g vs 28.1 ± 1.0 g, P < 0.005) in comparison to NG mice. The length of small intestine in AG mice was significantly shorter (26.7 ± 2.3 cm vs 32.7 ± 2.7 cm, P < 0.005). A large amount of chyme was observed in the lumen of the AG small intestine. The expression of microsomal triglyceride transfer protein, apolipoprotein B and apolipoprotein C2 was downregulated. Triacylglycerols (TGs), total cholesterol and nonesterified fatty acid (NEFA) levels of the small intestinal tissue were significantly higher in AG mice, but the serum TGs and NEFA levels were reduced in AG mice. CONCLUSION These results indicate that acupuncture at Zu san li, Guan yuan and Yong quan suppressed lipid absorption by downregulating the expression of apolipoproteins in the small intestine.

The aim of this study was to investigate the effectiveness of customised safety interventions in improving the safety cultures of both clinical and non-clinical hospital staff. This was assessed using the Safety Attitude Questionnaire-Chinese at baseline, 2 years and 4 years after the implementation of safety interventions with a high response rate ranging from 80.5% to 87.2% and excellent internal consistency (Cronbach’s alpha=0.93). The baseline survey revealed a relatively low positive attitude response in the Safety Climate (SC) domain. Both SC and Working Conditions (WC) domains were shown to have increased positive attitude responses in the second survey, while only the Management Perception domain had gained 3.8% in the last survey. In addition, safety dimensions related to collaboration with doctors and service delays due to communication breakdown were significantly improved after customised intervention was applied. Safety dimensions related to safety training, reporting and safety awareness had a high positive response in the initial survey; however, the effect was difficult to sustain subsequently. Multilevel analysis further illustrated that non-clinical staff were shown to have a more positive attitude than clinical staff, while female staff had a higher positive attitude percentage in job satisfaction than male staff. The results showed some improvements in various safety domains and dimensions, but also revealed inconsistent changes in subsequent surveys. The change in positive safety culture over the years and its sustainability need to be further explored. It is suggested that hospital management should continuously monitor and evaluate their strategies while delivering multifaceted interventions to be more specifically focused and to motivate staff to be enthusiastic in sustaining patient safety culture.

The aim of this study was to assess the effects of two rigid taping methods, tibial internal rotation taping and external rotation taping, on knee pain during three clinical function tests in individuals with patellofemoral pain syndrome.Repeated measures study.Fifteen participants (male, height 174.9 ± 5.8 cm, weight 68.3 ± 10.2 kg) with unilateral patellofemoral pain syndrome were treated by applying internal rotation taping and external rotation taping, in randomized order. While taped, participants were asked to perform three clinical tests in random order: single-leg squat, double-leg squat, and quadriceps maximum isometric contraction. Pain was scored using a Visual Analog Scale.Compared with no taping, both internal rotation taping and external rotation taping significantly improved pain during each of the three clinical tests (F = 224.10, p 0.001, partial η² = 0.94). Furthermore, there was a tape direction effect, where external rotation taping was more effective than internal rotation taping (F = 4.90, p = 0.044, partial η² = 0.26). For each test, the amount of pain improvement after taping was positively correlated with initial pain level (0.539 ≤ rho ≤ 0.921, all p 0.05).Both internal rotation taping and external rotation taping were effective in improving pain in individuals with patellofemoral pain syndrome, and external rotation taping was more effective than internal rotation taping. The significant correlations observed between initial pain levels and pain improvement after taping suggest that those with greater patellofemoral pain achieve greater relief from tibial rotation taping.

Colorectal cancer (CRC) is one of the most common malignancies with high levels of invasiveness, drug resistance and mortality, but the internal mechanisms of CRC are largely unknown. MicroRNAs (miRs) have been reported to be involved in the development of CRC, and numerous studies have demonstrated that the abnormal expression of miR-33a-5p might be associated with CRC. However, the function and downstream mechanism of miR-33a-5p in colorectal cancer (CRC) remains unclear. Methylenetetrahydrofolate dehydrogenase 2 (MTHFD2), a mitochondrial enzyme involved in folic acid metabolism, interestingly was confirmed to be one of the target genes of miR-33a-5p in the present study. We first confirmed that miR-33a-5p in CRC tissues and cell lines were downregulated (P

1) to develop a reliable device for assessing somatosensory perception sensitivity in voluntary postural sway movement, specifically a sway discrimination apparatus (SwayDA) for testing voluntary lateral sway discrimination sensitivity (VLSDS); 2) to explore the relationship between mobility performance and VLSDS in older adults, and 3) to determine the effects of age, gender and sway magnitude on VLSDS.First, eighteen healthy young adults (8 males, 10 females, age ranging from 22 to 70) were recruited for a test-retest reliability study. During the SwayDA test, the participants were asked to discriminate between four possible medial-lateral sway extents when moving away from neutral standing. For Objective 2, twenty-five older participants (9 males, 16 females, mean age 70.1) undertook both the SwayDA and the mobility tests. The mobility testing battery consisted of single task and cognitive dual task timed-up and-go tests, and the 5 times sit-to-stand test. Pearson's correlation was calculated between SwayDA scores and mobility performance. For Objective 3, 20 community-dwelling adults over 65 years old (10 males, 10 females, mean age 71.3) and 20 young volunteers (10 males, 10 females, mean age 23.6) were recruited to study the effects of age, gender and sway magnitude on VLSDS. To obtain a bias-free measure of VLSDS, the probability of correct response was considered as the true-positive judgment, while the probability of incorrect response was considered as false-positive judgment, and these were cumulated across the response values. A receiver operating characteristic (ROC) curve was then generated and the Area Under the ROC Curve (AUC) was used to measure VLSDS.There was no significant difference in AUC scores between Day 1 and Day 8 (p 0.05). ICC(3,1) reliability indices were 0.750 for sway to the left and 0.879 for sway to the right. Pearson's correlation revealed a significant correlation between the SwayDA sores and timed-up-and-go (TUG), cognitive dual task TUG, 5 times sit-to-stand test (r = -0.456, -0.522, and - 0.416 respectively, all p 0.05). Factorial ANOVA showed age and gender main effects (F = 8.144, p 0.01, and F = 8.806, p 0.01, respectively), suggesting older adults and females had worse VLSDS. In addition, a significant difference was found between the young and older participants in the inner range of VLSDS (t = -2.875, p 0.017), indicating that the decline of somatosensory perception of postural sway in older people may be magnitude-specific, and greatest for small deviations from upright stance.The SwayDA has good to excellent test-retest reliability. The finding that VLSDS score was significantly correlated with mobility performance in older adults highlights the importance of somatosensory perception in postural control. More importantly, the significantly worse VLSDS in older people observed in the inner lateral movement range may represent a unique characteristic of neuromuscular degeneration associated with aging, which should be monitored and addressed in rehabilitation programs.

Question Can manual therapy improve functional outcomes for individuals with chronic ankle instability? Design Systematic review with meta-analysis of randomized controlled trials. Participants Individuals with chronic ankle instability. Intervention Manual therapy is defined as an intervention that involves joint mobilization, and mobilization with movement. Outcome measure The primary outcome is patient reported function (PRF) questionnaires scores, the secondary outcomes are ankle dorsiflexion range of motion (DFROM) and balance control. Results Four studies were included (n = 208, mean age = 24.4) in the meta-analysis, with moderate to high quality on the PEDro scale (range 6–8). For patient reported function (PRF) questionnaires, two studies reported significant improvement after six-session manual therapy measured by foot and ankle ability measures sport subscale (FAAMS) and Cumberland ankle instability tool (CAIT), respectively. For DFROM, one session manual therapy had no significant effect on the weight-bearing lunge test (WBLT) (3 studies, n = 147, SMD = 1.24 (95%CI -0.87 to 3.36), I2 = 96%) or non-weight-bearing inclinometer test (2 studies, n = 47, MD = 3.41° (95%CI -0.26 to 7.09),I2 = 43%), while six-sessions manual therapy showed, a significantly positive effect on WBLT(2 studies, n = 80, SMD = 2.39, (95% CI 0.55, to 4.23), I2 = 93%). For the SEBT, one-session manual therapy had no significant effect on overall star excursion balance test (SEBT) score (3 studies, n = 137,MD = 2.05,95%CI (−0.96,5.05), I2 = 75%), while qualitative analysis of 2 included studies showed significant improvement both on the SEBT score and single limb balance test (SLBT). Conclusions Six sessions rather than one session of manual therapy improves ankle functional performance for individuals with CAI. Trial registration number PROSPERO CRD42017054715.

Hyperlipidemia is a metabolic disorder characterized by high lipid levels, which may lead to cardiovascular diseases. Evidence suggests that improving the gut microbiota homeostasis is of great importance in lipid metabolism. Dietary fiber may positively regulate blood lipid and intestinal microbiota, therefore, we have investigated the effect of chickpea dietary fiber (CDF) on high-fat diet (HFD)-induced hyperlipidemia and gut bacterial dysbiosis. Fifty male Sprague Dawley rats purchased for this study were randomly divided into 5 groups of 10 rats each. The control group was fed with normal diet (ND), while the other four groups were all fed with HFD for inducing hyperlipidemia. Then one of the four HFD groups continued to be fed with only HFD, and the other three groups were fed with CDF in different doses: high CDF (30 g CDF/kg of HFD), medium CDF (15 g CDF/kg of HFD), and low CDF (5 g CDF/kg of HFD). After CDF treatment, the lipid level in serum was determined through biochemical methods, and microbial content of the fecal sample was determined by 16S rDNA sequencing. We found that CDF could decrease the levels of total cholesterol, triglyceride, and low-density lipoprotein cholesterol and increase the level of high-density lipoprotein cholesterol significantly. The diversity of gut microbiota in the ND group and CDF-treated groups were higher than HFD group. The

Background. Diabetes is one of the common chronic diseases in which susceptibility is determined by a combination of genetic and environmental factors, and more than 90% of diabetic patients are diabetes mellitus type 2 (T2DM). The existing studies on the association between CDKAL1 rs10946398 gene polymorphism and susceptibility to type 2 diabetes are inconsistent across populations. Aim. We aim to explore the association between CDKAL1 rs10946398 gene polymorphism and susceptibility to type 2 diabetes in different populations. Methods. We examined all studies before June 12, 2021, that associated CDKAL1 rs10946398 with T2DM. Heterogeneity was assessed by meta-analysis of allelic inheritance models (A vs. C), dominant inheritance models (AA vs. AC+CC), and recessive inheritance model (AA+AC vs. CC); I 2 was used to assess the heterogeneity (if I 2 < 50 %, the fixed-effects model was used; if I 2 ≥ 50 %, the random-effects model was used for data consolidation); correlation was judged by a forest map; potential publication bias was tested by the Egger test ( p > 0.05 indicates that there is no publication bias). Results. Fourteen data totaling 30288 subjects, including 19272 controls and 11016 patients with T2DM, met our inclusion criteria. In the Asian population, the differences were statistically significant ( p < 0.01 ) for dominant genetic model ( OR = 0.75 , 95 % CI = 0.64 -0.88, p = 0.0003 ). But the allelic effect model ( OR = 0.87 , 95 % CI = 0.75 -1.02, p = 0.08 ) and the recessive genetic model ( OR = 0.85 , 95 % CI = 0.66 -1.10, p = 0.23 ) were not statistically significant ( p > 0.01 ). In the non-Asian population, the differences were statistically significant ( p < 0.01 ) for the allelic effect model ( OR = 0.83 , 95 % CI = 0.77 -0.88, p < 0.00001 ), the dominant model ( OR = 0.79 , 95 % CI = 0.72 -0.87, p < 0.00001 ), and the recessive model ( OR = 0.78 , 95 % CI = 0.70 -0.87, p < 0.0001 ). Conclusion. In this study, CDKAL1 RS10946398 was positively associated with T2DM, but the association was different in Asian populations.

Background. Type 2 diabetes mellitus (T2DM) is one of the most common chronic diseases in adults, causing high morbidity and mortality worldwide. In recent years, the prevalence of T2DM has been increasing significantly, and genome-wide association studies (GWAS) have shown that KCNQ1 significantly increases the risk of T2DM. Objective. To find large-scale evidence on whether the KCNQ1rs2237892C⟶T gene polymorphism is associated with T2DM susceptibility. Methods. A comprehensive review of the Chinese and English literature on the association of T2DM with KCNQ1rs2237892 is published by PubMed and Baidu Academic. The included literature was part or all of the studied loci which were evaluated for association with T2DM. Forest plots were made of the included literature to analyze the association of KCNQ1 with polymorphisms of the studied loci, and funnel plots and Egger’s test were used to evaluate the publication bias of the selected included literature. Results. Ten case-control studies including a total of 7027 cases and 8208 controls met our inclusion criteria. Allele (C allele frequency distribution) (OR: 1.19; 95% CI: 0.87,1.62; P < 0.00001 ), recessive (OR: 0.73; 95% CI: 0.45,1.18; P < 0.00001 ) genetic model under the full population was observed between KCNQ1rs2237892C⟶T gene polymorphism and T2DM without a significant relationship. In a stratified analysis by race, a meaningful association was found in non-Asian populations under the allelic genetic model, but no association was found in Asian populations. Conclusion. This meta-analysis showed no significant association between the rs2237892 polymorphism of the KCNQ1 gene and the risk of T2DM.

Acute myocardial ischaemia and reperfusion (I–R) are major causes of ventricular arrhythmias in patients with a history of coronary artery disease. Ursodeoxycholic acid (UDCA) has previously been shown to be antiarrhythmic in fetal hearts. This study was performed to investigate if UDCA protects against ischaemia-induced and reperfusion-induced arrhythmias in the adult myocardium, and compares the effect of acute (perfusion only) versus prolonged (2 weeks pre-treatment plus perfusion) UDCA administration. Langendorff-perfused adult Sprague–Dawley rat hearts were subjected to acute regional ischaemia by ligation of the left anterior descending artery (10 min), followed by reperfusion (2 min), and arrhythmia incidence quantified. Prolonged UDCA administration reduced the incidence of acute ischaemia-induced arrhythmias (p = 0.028), with a reduction in number of ventricular ectopic beats during the ischaemic phase compared with acute treatment (10 ± 3 vs 58 ± 15, p = 0.036). No antiarrhythmic effect was observed in the acute UDCA administration group. Neither acute nor prolonged UDCA treatment altered the incidence of reperfusion arrhythmias. The antiarrhythmic effect of UDCA may be partially mediated by an increase in cardiac wavelength, due to the attenuation of conduction velocity slowing (p = 0.03), and the preservation of Connexin43 phosphorylation during acute ischaemia (p = 0.0027). The potential antiarrhythmic effects of prolonged UDCA administration merit further investigation.

Background Research evidence has suggested that a more sensitive ankle proprioceptive testing method with higher ecological validity is needed for assessing proprioceptive deficits in individuals with chronic ankle instability (CAI). Objectives (1) To determine the test–retest reliability of a novel ankle proprioception assessment tool, the Ankle Inversion Discrimination Apparatus for Landing (AIDAL); (2) To assess whether AIDAL scores were sufficiently sensitive to detect proprioceptive deficits in chronic ankle instability (CAI); and (3) To examine whether AIDAL scores correlated with Cumberland Ankle Instability Tool (CAIT) scores. Design Cross-sectional study. Methods The AIDAL was purpose-built to assess ankle discrimination in four positions of ankle inversion (10°, 12°, 14° and 16°) upon landing from a 10 cm drop. Area Under the Receiver Operating Curve (AUC) was employed as the ankle proprioceptive discrimination score. Seven-day test–retest reliability was evaluated with 23 university students (12 CAI and 11 non-CAI), and another 36 university students (18 CAI and 18 non-CAI) were in the comparison study. Results The test–retest reliability ICC score for the whole group was 0.763 (95% CI = 0.519–0.892), which showed an excellent reliability level. ICC (3,1) was 0.701 for the non-CAI group (95%CI = 0.210–0.910) and 0.804 for the CAI group (95%CI = 0.451–0.939). The CAI group performed at a significantly lower level on the AIDAL assessment than the non-CAI group (0.777 ± 0.05 vs. 0.815 ± 0.05, F = 5.107, p = 0.03). The discriminative AUC value for the AIDAL test was 0.756 with a cut point of 0.819 (sensitivity = 0.733, specificity = 0.800). The MDC90 scores for CAI and non-CAI groups were both 0.04. Spearman's correlation showed that the CAIT scores were significantly correlated with the ankle proprioceptive discrimination scores (rho = 0.401, p = 0.015). Conclusion The AIDAL showed good test–retest reliability for both non-CAI and CAI groups. Measuring ankle inversion proprioception during landing may be important for assessing the outcomes of CAI rehabilitation, as proprioceptive performance obtained from the AIDAL was significantly correlated with severity of functional ankle instability CAIT scores.

Background The purpose of the current study was to assess the reliability and validity of the lower extremity functional test (LEFT) for predicting low back and lower limb injury in active athletes. Methods Seventy athletes (45M, 25F; mean age: 21 ± 2 years) from seven different sports volunteered. The LEFT was a battery of five weight-bearing functional movements involving different movement planes, directions, modes, and at varying intensities. Both legs were assessed in a random order and each athlete was given both movement quality and associated symptom scores. Intra-tester, intra-rater and inter rater reliability were evaluated. Participants were followed up for 12 months, and their exposure to sport and subsequent injuries were recorded. Independent samples t-tests were performed to determine if a significant difference existed in LEFT scores between injured and non-injured athletes. Receiver operating characteristic (ROC) curve analysis was employed to assess the instrument's capacity to predict injury. Results The intra-tester reliability ICC2, 1 was 0.875. The ICC2, 3 of intra-rater reliability was 0.953 and the inter-rater reliability was 0.949, respectively. Nineteenparticipants had an injury in the low back or lower limb within the following 12 months. Injured athletes had significant lower movement quality and symptom scores of the LoLiFST than non-injured (t=4.278, p=0.000, Cohen's d=1.2; t=3.654, p=0.001, Cohen's d=1.3, respectively). When movement quality or symptom score alone was included in the ROC analysis, the area under the ROC curve (AUC) scores were 0.772 (p=0.000, 95%CI: 0.653-0.891) and 0.771 (p=0.001, 95%CI: 0.638-0.905), respectively. When movement quality and symptom scores were combined to predict injury, the AUC discrimination score was 0.853 (p=0.000, 95%CI: 0.754-0.953), resulting in 85.3% of cases being correctly predicted as low back or lower limb injured/non-injured. Conclusions The findings from the current study suggest that the LEFT appears to be a reliable and valid functional assessment tool for predicting low back or lower limb injury risk in these college athletes, especially when movement quality and symptom scores were used in combination.

ObjectiveThis study was performed to explore the relationship between various clinical factors and the prognosis of limb osteosarcoma.MethodsWe retrospectively analyzed the clinical data of 336 patients with limb osteosarcoma treated from June 2000 to August 2016 at 7 Chinese cancer centers. Data on the patients’ clinical condition, treatment method, complications, recurrences, metastasis, and prognosis were collected and analyzed. Kaplan–Meier analysis and Cox regression models were used to analyze the data.ResultsThe patients comprised 204 males and 132 females ranging in age from 6 to 74 years (average, 21.1 years). The overall 3- and 5-year survival rates were 65.0% and 55.0%, respectively. The 5-year overall survival rate was 64.0% with standard chemotherapy and 45.6% with non-standard chemotherapy. Cox regression analysis demonstrated that standard chemotherapy, surgery, recurrence, and metastasis were independent factors associated with the prognosis of limb osteosarcoma.ConclusionThe survival of patients with limb osteosarcoma can be significantly improved by combining standard chemotherapy and surgery. The overall survival rate can also be improved by adding methotrexate to doxorubicin–cisplatin–ifosfamide triple chemotherapy.

Nonalcoholic fatty liver disease (NAFLD) is one of the most common liver diseases with no approved treatment. Zonarol, an extract from brown algae, has been proven to have anti-inflammatory and antioxidant effects. In this study, we investigated the role of zonarol in the progression of methionine- and choline-deficiency (MCD) diet-induced NAFLD in mice. After oral treatment with zonarol, a lighter body weight was observed in zonarol group (ZG) mice in comparison to control group (CG) mice. The NAFLD scores of ZG mice were lower than those of CG mice. Hepatic and serum lipid levels were also lower in ZG mice with the reduced expression of lipid metabolism-related factors. Furthermore, ZG mice showed less lipid deposition, less inflammatory cell infiltration and lower inflammatory cytokine levels in comparison to CG mice. Moreover, the numbers of 8-hydroxy-20-deoxyguanosine (8-OHdG)-positive hepatocytes and levels of hepatic and serum thiobarbituric acid reactive substances (TBARS) were significantly lower in comparison to CG mice. The expression levels of nuclear factor erythroid 2 related factor 2 (Nrf2), as well as its upstream and downstream molecules, changed in ZG mice. Zonarol could prevent the progression of NAFLD by decreasing inflammatory responses, oxidative stress and improving lipid metabolism. Meanwhile the Nrf2 pathway may play an important role in these effects.

Bipolar electrosurgery in the minimally invasive endoscopic surgery theater has been traditionally limited to the use of standard bipolar forceps, which are minimally versatile, have a limited range of motion, and are associated with visualization and handling constraints. The authors designed a novel surgical device system in which commonly used surgical instruments (suction, microscissors, micrograspers, and dissectors) co-function as individually insulated and modular electrodes for bipolar electrosurgery. In this feasibility study, the successful use of these prototypes in endonasal endoscopic transsphenoidal surgery was demonstrated on 2 human cadavers, and in an in vivo arterial coagulation model on 2 live rats. This prototype system provided improved bipolar instrument mobility, minimized the requirement to exchange surgical instruments when performing electrosurgery, and allowed for new maneuvers that optimized surgical workflow, such as the ability to suction blood and smoke while cauterizing. This multifunctional bipolar cautery system may improve surgical efficiency and workflow and facilitate surgical microdissection and electrocautery during minimally invasive, endoscopic, robotic or traditional open surgery.

Excess glutamate release from the presynaptic membrane has been thought to be the major cause of ischemic neuronal death. Although both CA1 and CA3 pyramidal neurons receive presynaptic glutamate input, transient cerebral ischemia induces CA1 neurons to die while CA3 neurons remain relatively intact. This suggests that changes in the properties of pyramidal cells may be the main cause related to ischemic neuronal death. Our previous studies have shown that the densities of dendritic spines and asymmetric synapses in the CA1 area are increased at 12h and 24h after ischemia. In the present study, we investigated changes in synaptic structures in the CA3 area and compared the expression of glutamate receptors in the CA1 and CA3 hippocampal regions of rats after ischemia. Our results demonstrated that the NR2B/NR2A ratio became larger after ischemia although the expression of both the NR2B subunit (activation of apoptotic pathway) and NR2A subunit (activation of survival pathway) decreased in the CA1 area from 6h to 48h after reperfusion. Furthermore, expression of the GluR2 subunit (calcium impermeable) of the AMPA receptor class significantly decreased while the GluR1 subunit (calcium permeable) remained unchanged at the same examined reperfusion times, which subsequently caused an increase in the GluR1/GluR2 ratio. Despite these notable differences in subunit expression, there were no obvious changes in the density of synapses or expression of NMDAR and AMPAR subunits in the CA3 area after ischemia. These results suggest that delayed CA1 neuronal death may be related to the dramatic fluctuation in the synaptic structure and relative upregulation of NR2B and GluR1 subunits induced by transient global ischemia.

Background The current World Health Organization (WHO) classification of nasopharyngeal carcinoma (NPC) conveys little prognostic information. This study aimed to propose an NPC histopathologic classification that can potentially be used to predict prognosis and treatment response. Methods We initially developed a histopathologic classification based on the morphologic traits and cell differentiation of tumors of 2716 NPC patients who were identified at Sun Yat-sen University Cancer Center (SYSUCC) (training cohort). Then, the proposed classification was applied to 1702 patients (retrospective validation cohort) from hospitals outside SYSUCC and 1613 patients (prospective validation cohort) from SYSUCC. The efficacy of radiochemotherapy and radiotherapy modalities was compared between the proposed subtypes. We used Cox proportional hazards models to estimate hazard ratios (HRs) with 95% confidence intervals (CI) for overall survival (OS). Results The 5-year OS rates for all NPC patients who were diagnosed with epithelial carcinoma (EC; 3708 patients), mixed sarcomatoid-epithelial carcinoma (MSEC; 1247 patients), sarcomatoid carcinoma (SC; 823 patients), and squamous cell carcinoma (SCC; 253 patients) were 79.4%, 70.5%, 59.6%, and 42.6%, respectively (P

Objective Glucose and lipid metabolism disorders are a major risk factor for type II diabetes and cardiovascular diseases. Evidence has indicated that the interplay between the liver and adipose tissue is crucial in maintaining energy homeostasis. Recently, the interaction between two distant endocrine organs mainly focuses on the regulation of hormones and receptors. However, as a novel carrier in the inter-tissue communication, exosomes plays a role in liver-fat crosstalk, but its effects on glucose and lipid metabolisms are still unclear. In this study, we sought to investigate the effects of hepatic exosome-derived miR-130a-3p in the regulation of glucose/lipid metabolism in adipose tissues. Measure In vivo, we constructed generalized miR-130a-3p knockout (130KO) and overexpressed (130OE) mice. Wild type (WT), 130KO and 130OE mice (n = 10) were assigned to a randomized controlled trial and were fed diets with either 10% (standard diet, SD) or 60% (high-fat diet, HFD) of total calories from fat (lard). Next, hepatic exosomes were extracted from WT-SD, 130KO-SD and 130OE-SD mice (WT-EXO, KO-EXO, OE-EXO), and 130KO mice were injected with 100 mg hepatic exosomes of different sources via tail-vein (once every 48 h) for 28 days, fed with HFD. In vitro, 3T3-L1 cells were treated with miR-130a-3p mimics, inhibitor and hepatic exosomes. Growth performance and glucose and lipid metabolic profiles were examined. Results After feeding with HFD, the weights of 130KO mice were markedly higher than WT mice. Over-expression of miR-130a-3p in 130OE mice and intravenous injection of 130OE-EXO in 130KO mice contributed to a positive correlation with the recovery of insulin resistance. In addition, miR-130a-3p mimics and 130OE-EXO treatment of 3T3-L1 cells exhibited decreasing generations of lipid droplets and increasing glucose uptake. Conversely, inhibition of miR-130a-3p in vitro and in vivo resulted in opposite phenotype changes. Furthermore, PHLPP2 was identified as a direct target of miR-130a-3p, and the hepatic exosome-derived miR-130a-3p could improve glucose intolerance via suppressing PHLPP2 to activate AKT-AS160–GLUT4 signaling pathway in adipocytes. Conclusions We demonstrated that hepatic exosome-derived miR-130a regulated energy metabolism in adipose tissues, and elucidated a new molecular mechanism that hepatic exosome-derived miR-130a-3p is a crucial participant in organismic energy homeostasis through mediating crosstalk between the liver and adipose tissues.

Background Patients with complex medical comorbidities travel for protracted periods to remote destinations, often with limited access to medical care. Few descriptions are available of their preexisting health burden. This study aimed to characterize preexisting medical conditions and medications of travelers seeking pre-travel health advice at a specialized travel medicine clinic. Methods Records of travelers attending the Galway Tropical Medical Bureau clinic between 2008 and 2014 were examined and information relating to past medical history was entered into a database. Data were recorded only where the traveler had a documented medical history and/or was taking medications. Results Of the 4,817 records available, 56% had a documented medical history and 24% listed medications. The majority of travelers with preexisting conditions were female. The mean age of the cohort was 31.68 years. The mean period remaining before the planned trip was 40 days. Southeast Asia was the most popular single destination, and 17% of travelers with medical conditions were traveling alone. The most frequently reported conditions were allergies (20%), insect bite sensitivity (15%), asthma (11%), psychiatric conditions (4%), and hypertension (3%). Of the 30 diabetic travelers, 14 required insulin; 4.5% of travelers were taking immunosuppressant drugs, including corticosteroids. Half of the female travelers were taking the oral contraceptive pill while 11 travelers were pregnant at the time of their pre-travel consultation. Conclusions This study provides an insight into the medical profile of travelers attending a travel health clinic. The diverse range of diseases reported highlights the importance of educating physicians and nurses about the specific travel health risks associated with particular conditions. Knowledge of the effects of travel on underlying medical conditions will inform the pre-travel health consultation.

Proprioceptive ability has been suggested to underpin elite sports performance. Accordingly, this study examined the relationship between an athlete's proprioceptive ability, competition level achieved, and years of sport-specific training.Cross-sectional study.One hundred elite athletes, at competition levels ranging from regional to international, in aerobic gymnastics, swimming, sports dancing, badminton and soccer, were assessed for proprioceptive acuity at the ankle, knee, spine, shoulder, and finger joints. An active movement extent discrimination test was conducted at each joint, to measure ability to discriminate small differences in movements made to physical stops.Multiple regression analysis showed that 30% of the variance in the sport competition level an athlete achieved could be accounted for by an equation that included: ankle movement discrimination score, years of sport-specific training, and shoulder and spinal movement discrimination scores (p0.001). Mean proprioceptive acuity score over these three predictor joints was significantly correlated with sport competition level achieved (r=0.48, p0.001), highlighting the importance of proprioceptive ability in underpinning elite sports performance. Years of sport-specific training correlated with an athlete's sport competition level achieved (r=0.29, p=0.004), however, proprioceptive acuity was not correlated with years of sport-specific training, whether averaged over joints or considered singly for each joint tested (all r≤0.13, p≥0.217).Proprioceptive acuity is significantly associated with the performance level achieved by sports elites. The amount of improvement in proprioceptive acuity associated with sport-specific training may be constrained by biologically determined factors.

Quantitative assessments of handedness and footedness are often required in studies of human cognition and behaviour, yet no reliable Chinese versions of commonly used handedness and footedness questionnaires are available. Accordingly, the objective of the present study was to translate the Edinburgh Handedness Inventory (EHI) and the Waterloo Footedness Questionnaire-Revised (WFQ-R) into Mandarin Chinese and to evaluate the reliability and validity of these translated versions in healthy Chinese people. In the first stage of the study, Chinese versions of the EHI and WFQ-R were produced from a process of translation, back translation and examination, with necessary cultural adaptations. The second stage involved determining the reliability and validity of the translated EHI and WFQ-R for the Chinese population. One hundred and ten Chinese participants were tested online, and the results showed that the Cronbach's alpha coefficient of internal consistency was 0.877 for the translated EHI and 0.855 for the translated WFQ-R. Another 170 Chinese participants were tested and re-tested after a 30-day interval. The intra-class correlation coefficients showed high reliability, 0.898 for the translated EHI and 0.869 for the translated WFQ-R. This preliminary validation study found the translated versions to be reliable and valid tools for assessing handedness and footedness in this population.

Studies have revealed that miR-103a-3p contributes to tumor growth in several human cancers, and high miR-103a-3p expression is associated with poor prognosis in advanced gastric cancer (GC) patients. Moreover, bioinformatics analysis has shown that miR-103a-3p is upregulated in The Cancer Genome Atlas (TCGA) stomach cancer cohort. These results suggest that miR-103a-3p may function as an oncogene in GC. The present study aimed to investigate the role of miR-103a-3p in human GC. miR-103a-3p expression levels were increased in 33 clinical GC specimens compared with adjacent nontumor stomach tissues. Gain- and loss-of-function studies were performed to identify the correlation between miR-103a-3p and tumorigenesis in human GC. Inhibiting miR-103a-3p suppressed GC cell proliferation and blocked the S-G2/M transition in MKN-45/SGC-7901 cells, whereas miR-103a-3p overexpression improved GC cell proliferation and promoted the S-G2/M transition in vitro. Bioinformatics and dual-luciferase reporter assays confirmed that ATF7 is a direct target of miR-103a-3p. Analysis of the TCGA stomach cancer cohort further revealed that miR-103a-3p expression was inversely correlated with ATF7 expression. Notably, silencing ATF7 showed similar cellular and molecular effects as miR-103a-3p overexpression, namely, increased GC cell proliferation, improved CDK2 expression and decreased P27 expression. ATF7 overexpression eliminated the effects of miR-103a-3p expression. These findings indicate that miR-103a-3p promotes the proliferation of GC cell by targeting and suppressing ATF7 in vitro.

Methyl-CpG binding protein 2 (MeCP2) has recently been characterized as an oncogene frequently amplified in several types of cancer. However, its precise role in gastric cancer (GC) and the molecular mechanism of MeCP2 regulation are still largely unknown. Here we report that MeCP2 is highly expressed in primary GC tissues and the expression level is correlated with the clinicopathologic features of GC. In our experiments, knockdown of MeCP2 inhibited tumor growth. Molecular mechanism of MeCP2 regulation was investigated using an integrated approach with combination of microarray analysis and chromatin immunoprecipitation sequencing (ChIP-Seq). The results suggest that MeCP2 binds to the methylated CpG islands of FOXF1 and MYOD1 promoters and inhibits their expression at the transcription level. Furthermore, we show that MeCP2 promotes GC cell proliferation via FOXF1-mediated Wnt5a/β-Catenin signaling pathway and suppresses apoptosis through MYOD1-mediated Caspase-3 signaling pathway. Due to its high expression level in GC and its critical function in driving GC progression, MeCP2 represents a promising therapeutic target for GC treatment., Highlights • MeCP2 inhibits FOXF1 and MYOD1 transcription by binding to their promoter regions. • MeCP2 promotes GC cell proliferation via FOXF1-mediated Wnt/β-Catenin signaling pathway. • MeCP2 suppresses GC cell apoptosis through MYOD1-mediated Caspase-3 signaling pathway. Gastric cancer is the fourth most common malignant cancer and the third most frequent cause of cancer-related deaths worldwide. The molecular mechanism underlying gastric carcinogenesis and progression is still unknown. Methyl-CpG binding protein 2 (MeCP2) has recently been characterized as an oncogene frequently amplified in several types of cancer. However, its precise role and the molecular mechanism of MeCP2 regulation in gastric cancer are largely unknown. Our results show that MeCP2 promotes gastric cancer cell proliferation via FOXF1-mediated Wnt5a/β-Catenin signaling pathway and suppresses cell apoptosis through MYOD1-mediated Caspase-3 signaling pathway. MeCP2 represents a promising therapeutic target for gastric cancer treatment.

It has been proposed that asymmetry between the upper limbs in the utilization of proprioceptive feedback arises from functional differences in the roles of the preferred and non-preferred hands during bimanual tasks. The present study investigated unimanual and bimanual proprioceptive performance in right- and left-handed young adults with an active finger pinch movement discrimination task. With visual information removed, participants were required to make absolute judgments about the extent of pinch movements made to physical stops, either by one hand, or by both hands concurrently, with the sequence of presented movement extents varied randomly. Discrimination accuracy scores were derived from participants’ responses using non-parametric signal detection analysis. Consistent with previous findings, a non-dominant hand/hemisphere superiority effect was observed, where the non-dominant hands of right- and left-handed individuals performed overall significantly better than their dominant hands. For all participants, bimanual movement discrimination scores were significantly lower than scores obtained in the unimanual task. However, the magnitude of the performance reduction, from the unimanual to the bimanual task, was significantly greater for left-handed individuals. The effect whereby bimanual proprioception was disproportionately affected in left-handed individuals could be due to enhanced neural communication between hemispheres in left-handed individuals leading to less distinctive separation of information obtained from the two hands in the cerebral cortex.

Uromodulin (UMOD) genetic variants cause familial juvenile hyperuricemic nephropathy, characterized by hyperuricemia, decreased renal excretion of UMOD and uric acid; such findings suggest a role for UMOD in the regulation of plasma uric acid. We screened common variants across the UMOD locus in two populations, one from a community-based Chinese population, the other from California twins and siblings. Transcriptional activity of promoter variants was estimated in luciferase reporter plasmids transfected into HEK293 cells and mlMCD3 cells. By variance components in twin pairs, uric acid concentration and excretion were heritable traits. In the primary population from Beijing, we identified that carriers of haplotype GCC displayed higher plasma uric acid, and 3 UMOD promoter variants associated with plasma uric acid. UMOD promoter variants displayed reciprocal effects on urine uric acid excretion and plasma uric acid concentration, suggesting a primary effect on renal tubular handling of urate. These UMOD genetic marker-on-trait associations for uric acid were replicated in an independent American population sample. Site-directed mutagenesis at trait-associated UMOD promoter variants altered promoter activity in transfected luciferase reporter plasmids. These results suggest that UMOD promoter variants seem to initiate a cascade of transcriptional and biochemical changes influencing UMOD secretion, eventuating in elevation of plasma uric acid.

This study tested whether proprioceptive discrimination of movement is a global, general ability, or an attribute that is specific to the joint tested. 40 right-handed, healthy, young adults (19 men, 21 women; M age = 20.4 yr., SD = 1.7) volunteered. A battery of versions of the Active Movement Extent Discrimination Apparatus (AMEDA) were employed to generate the stimuli for movements of different extents at the ankle, knee, spine, shoulder, and finger; discrimination accuracy scores were derived from participants' responses. No significant correlations were found between the discrimination scores from the five sites (all rs ≤ .21, all ps ≥ .20). This finding extends a previous report of non-significantly correlated proprioception test scores at two lower limb sites, and the findings taken together suggest that rather than proprioception being a global, general ability, sensitivity to the proprioception that underlies movement control is site-specific.

Objectives To explore the effects of kinesiology taping (KT) and athletic taping (AT) on ankle proprioception when tested in functional, full weight-bearing stance. Design Cross-sectional study. Methods Twenty-four healthy university students participated. Proprioception was measured using the Active Movement Extent Discrimination Apparatus (AMEDA). The three testing conditions: no-taping, KT, AT, and foot tested were randomly assigned. Perceived comfort, support and proprioceptive performance under two taping conditions were recorded. Results Proprioceptive discrimination scores with 95% CIs for no-taping, KT and AT were 0.81 (0.79–0.84), 0.81 (0.79–0.83), and 0.79 (0.77–0.81). Repeated measures ANOVA showed neither any significant difference associated with taping compared with no-taping (p = 0.30), nor any difference between KT and AT (p = 0.19). The group was then divided, according to their no-taping scores, into two sub-groups: with scores below the no-taping mean (n = 13), and above the mean (n = 11). ANOVA revealed a significant interaction (p = 0.008) indicating that above-average no-taping performers proprioception scores were worse when taped, whereas below-average performers improved. For both KT and AT, only ratings of perceived comfort when taped were significantly associated with actual proprioceptive performance (both r > 0.44, p ≤ 0.03). Other perception ratings (support and performance) were significantly inter-correlated (both r > 0.42, p 0.31). Conclusions Taping of the foot and ankle may amplify sensory input in a way that enhances proprioception of poor performers but produces an input overload that impairs proprioception in those who originally performed well when no-taping. Screening of ankle proprioception may identify those who would benefit most from taping.

Background Xinjiang is a multi-ethnic region of China. Many large population based cross-sectional studies have shown that Uygur, the largest ethnic group in the Xinjiang, had a higher incidence rate of metabolic syndrome (MetS) than other ethnic groups living in Xinjiang region, but the pathological mechanism is not yet clear. Insulin resistance plays a critical role in the pathogenesis of MetS. Resistin is an adipocyte- and monocyte-derived cytokine that represents a link between obesity, insulin resistance, and type 2 diabetes. The aim of this study is to examine the relationship between serum resistin levels and metabolic syndrome parameters in Uygur and Han in Xinjiang. Methods Subjects came from a population based cross-sectional study, a total of 465 subjects were selected for the study. Blood resistin, fasting blood sugar (FBS), fasting insulin (FINS), total cholesterol (TC), low-density lipoprotein-cholesterol (LDL-C), high-density lipoprotein-cholesterol (HDL-C), triglycerides (TG), waist circumference (WC), body mass index (BMI), systolic blood pressures (SBP), diastolic blood pressures (DBP), and the homeostasis model assessment-estimated insulin resistance (HOMA-IR) indices were measured. Dietary intake data were obtained by food frequency questionnaire method. The International Diabetes Federation (IDF) criteria were adopted to define metabolic syndrome. Results The MetS group has higher metabolic parameters of FPG, TG, TC, DBP, SBP, WC, BMI, LDL-C, and low HDL-C than the non-MetS group, Uygurs have higher FPG and WC than Hans, and Hans have higher TC, TG, and FINS than Uygurs, even after adjusting for age, gender, and BMI, indicating ethnic differences in MetS-related parameters. There was no significant difference in serum resistin levels between the MetS and non-MetS group, as well as between the Uygur and the Han ethnic groups, but a significant positive correlation was found between serum resistin levels with FIN, HOMA, and diet fat. Conclusions In our study, we did not observe significant differences in serum resitin levels between the MetS and non-MetS group, regardless of ethnicity. However, serum resistin was positively associated with insulin resistance markers, suggesting that resistin may be an independent determinant for insulin resistance, or indirectly contribute to the development of MetS. Therefore the role of resistin in MetS warrants further investigation.

Hypertension is an important risk factor for chronic kidney disease. The kidney, in turn, has an important role in the regulation of blood pressure (BP). On the basis of a genome-wide association study, single-nucleotide polymorphisms in the uromodulin (UMOD) promoter region had been considered to influence both renal sodium reabsorption and BP. In this study, we asked whether common variants across the UMOD gene influence BP in a community-based Chinese cohort. We screened seven common variants across the UMOD locus in a community-based population from Beijing, including 1000 individuals with 48% males and an average age of 63.7±9.0 years. The urinary UMOD concentration was measured by enzyme-linked immunosorbent assay. We then analyzed the association of common variants of UMOD with BP. The UMOD promoter common variant rs13333226 G/A is associated with diastolic BP (DBP), and G allele carriers have higher DBP compared with A/A homozygotes (P=0.035). The variant rs6497476 C/T predicted the DBP level, with C homozygotes having a higher DBP compared with CT heterozygotes and T homozygotes (P=0.025). Urinary UMOD excretion was correlated with urinary sodium excretion (R=0.239, P=0.656*10(-13)). We determined that common variants of UMOD are associated with DBP level in a community-based Chinese cohort.

Krüppel-like factor 17 (KLF17), a new member of the Krüppel-like factors (KLFs), has been reported to be a negative regulator of epithelial-mesenchymal transition (EMT) and metastasis in breast cancer. However, the biological role and clinical significance of KLF17 in lung adenocarcinoma has been less clear. In the present study, we showed that KLF17 expression was decreased in lung adenocarcinoma. Reduced expression of KLF17 was correlated significantly with a short survival time in patients with lung adenocarcinoma (P0.0001). Moreover, KLF17 expression was an independent prognostic indicator for patients with lung adenocarcinoma. KLF17 expression level was correlated with the tumor stage (P=0.016) and tumor size (P=0.001) in lung adenocarcinoma. Overexpression of KLF17 inhibited cell growth in A549 and PC-9 cell lines. In conclusion, it is possible that KLF17 inhibits tumor growth in lung adenocarcinoma. The reduced expression of KLF17 is a valuable prognostic indicator for patients with lung adenocarcinoma, and KLF17 could be a novel target for treatment of lung adenocarcinoma.

The antisaccade task, where eye movements are made away from a target, has been used to investigate the flexibility of cognitive control of behavior. Antisaccades usually have longer saccade latencies than prosaccades, the so-called antisaccade cost. Recent studies have shown that this antisaccade cost can be modulated by event probability. This may mean that the antisaccade cost can be reduced, or even reversed, if the probability of surrounding events favors the execution of antisaccades. The probabilities of prosaccades and antisaccades were systematically manipulated by changing the proportion of a certain type of trial in an interleaved pro/antisaccades task. We aimed to disentangle the intertwined relationship between trial type probabilities and the antisaccade cost with the ultimate goal of elucidating how probabilities of trial types modulate human flexible behaviors, as well as the characteristics of such modulation effects. To this end, we examined whether implicit trial type probability can influence saccade latencies and also manipulated the difficulty of cue discriminability to see how effects of trial type probability would change when the demand on visual perceptual analysis was high or low. A mixed-effects model was applied to the analysis to dissect the factors contributing to the modulation effects of trial type probabilities. Our results suggest that the trial type probability is one robust determinant of antisaccade cost. These findings highlight the importance of implicit probability in the flexibility of cognitive control of behavior.

Predictability in the visual environment provides a powerful cue for efficient processing of scenes and objects. Recently, studies have suggested that the directionality and magnitude of saccade curvature can be informative as to how the visual system processes predictive information. The present study investigated the role of the right posterior parietal cortex (rPPC) in shaping saccade curvatures in the context of predictive and non‐predictive visual cues. We used an orienting paradigm that incorporated manipulation of target location predictability and delivered transcranial magnetic stimulation (TMS) over rPPC. Participants were presented with either an informative or uninformative cue to upcoming target locations. Our results showed that rPPC TMS generally increased saccade latency and saccade error rates. Intriguingly, rPPC TMS increased curvatures away from the distractor only when the target location was unpredictable and decreased saccadic errors towards the distractor. These effects on curvature and accuracy were not present when the target location was predictable. These results dissociate the strong contingency between saccade latency and saccade curvature and also indicate that rPPC plays an important role in allocating and suppressing attention to distractors when the target demands visual disambiguation. Furthermore, the present study suggests that, like the frontal eye fields, rPPC is critically involved in determining saccade curvature and the generation of saccadic behaviors under conditions of differing target predictability. Hum Brain Mapp, 2011. © 2011 Wiley‐Liss, Inc.

Background: Lipoprotein glomerulopathy (LPG) is a unique disease characterized by thrombus-like lipoprotein deposition in glomeruli and an increased serum apolipoprotein E level (ApoE protein or APOE gene). Several APOE mutations contribute to the occurring of LPG. Methods: We confirmed LPG in 7 individuals by renal biopsy, and investigated families of 2 patients with urinalysis, serum creatinine and serum lipid examination. Exons of APOE of all individuals as well as their relatives were amplified and sequenced directly. Results: Two types of APOE mutations were identified in the 7 patients and their relatives. APOE Maebashi (Arg142-Leu144→0) heterozygotes were found in 5 individuals who were from 4 different families. APOE Kyoto (Arg25-Cys) was confirmed heterogeneous in another 2 individuals. Both mutations present incomplete penetrance. Conclusion: Our research indicates that APOE Maebashi (Arg142-Leu144→0) is a common mutation in Chinese LPG. However, not all carriers of the 2 mutations have LPG, although hyperlipidemia and high serum ApoE level are tested. There are likely other reasons, such as a local mechanism in the glomeruli, which participated in the renal injury.

// Kaishun Hu 1,* , Dan Liao 1,* , Wenjing Wu 1,* , An-Jia Han 2 , Hui-Juan Shi 2 , Fen Wang 2 , Xin Wang 1 ,Li Zhong 1 , Tingmei Duan 1 , Yuanzhong Wu 1 , Jingying Cao 1 , Jianjun Tang 1 , Yi Sang 1 , Li Wang 1 , Xiaobin Lv 1 , Shuangbing Xu 1 , Ru-Hua Zhang 1 , Wu-Guo Deng 1 , Sheng-Ping Li 1 , Yi-Xin Zeng 1 , and Tiebang Kang 1 1 State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, China, ; 2 Department of Pathology, First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China; * These authors contributed equally to the work Correspondence: Tiebang Kang, email: // Keywords : APC/C, BRD7, Cancer Target Received : January 15, 2014 Accepted : March 19, 2014 Published : March 21, 2014 Abstract Osteosarcoma is the most common primary malignant bone tumor in childhood and adolescence and has a propensity for local invasion and early lung metastasis. However, the current therapies often result in chemoresistance, and a therapeutic target is not available in the clinic for osteosarcoma. Here, we report that BRD7 forms a complex with the anaphase-promoting complex/cyclosome (APC/C) and is degraded by APC/C cdh1 and APC/C cdc20 during the cell cycle. Moreover, BRD7 is a tumor suppressor in osteosarcoma, and the BRD7 mutant resistant to degradation by APC/C is more efficient than the wild-type protein at suppressing proliferation, colony formation, and tumor growth of osteosarcoma in vitro and in vivo . The combination of proTAME, an inhibitor of APC/C, with chemotherapeutic drugs efficiently targets osteosarcoma in vitro . Furthermore, there is a strong inverse correlation of protein levels between BRD7 and Cdh1 or Cdc20, and lower BRD7 expression is an indicator for poor prognosis in patients with osteosarcoma. Collectively, our results indicate that targeting the APC/C-BRD7 pathway may be a novel strategy for treating osteosarcoma.

Objective: The sensitivity of pinch movement discrimination between the thumb and index finger was assessed with and without elastic resistance. Background: Researchers have examined the effect of elastic resistance on control of single upper-limb movements; however, no one has explored how elastic resistance affects proprioceptive acuity when using two digits simultaneously in a coordinated movement. Method: For this study, 16 right-handed, healthy young adults undertook an active finger pinch movement discrimination test for the right and left hands, with and without elastic resistance. We manipulated pinch movement distance by varying the size of the object that created the physical stop to end the pinch action. Results: Adding elastic resistance from a spring to the thumb–index finger pinch task did not affect accuracy of pinch discrimination measured as either the just noticeable difference, F(1, 15) = 1.78, p = .20, or area under the curve, F(1, 15) = 0.07, p = .80. Conclusion: Having elastic resistance to generate lever return in pincers, tweezers, and surgical equipment or in virtual instruments is unlikely to affect pinch movement discrimination. Application: Elastic resistance did not affect finger pinch discrimination in the present study, suggesting that return tension on equipment lever arms has a practical but not perceptual function. An active finger pinch movement discrimination task, with or without elastic resistance, could be used for hand proprioceptive training and as a screening tool to identify those with aptitude or decrements in fine finger movement control.

To evaluate the clinical efficacy of acellular tissue engineering dermal matrix (ATDM) in repairing wounds of skin graft donor site.Sixty patients with burn or chronic wounds hospitalized from January 2011 to April 2012 received autologous skin grafting. One wound [with size larger than 55 cm(2), and thickness of (0.33 ± 0.03) mm] out of multiple skin graft donor sites of every patient was selected, and it was divided into two parts in accordance with self-control principle. A part of wound close to the wound edge with diameter of 5 cm was taken as trial area (treated with ATDM), and the remaining wound was taken as control area (treated with vaseline gauze) according to the random number table. Blood and urine routine, liver and kidney function, and levels of IgG and IgM in blood of patients were measured one day before operation and on the 1st day after wound healing. Vital signs of patients were recorded on the operation day and the wound healing day. Gross condition of the wounds was observed during dressing change. Wound healing time was recorded. The healed wound was observed histologically. Data were processed with Log rank test or t test.Leucocyte count was lowered on the 1st day after wound healing [(7.1 ± 1.2)×10(9)/L] as compared with that one day before operation [(10.1 ± 1.5)×10(9)/L, t = -12.10, P0.01]. The differences were not statistically significant in red blood cell count, haemoglobin level, platelet count, urine routine, levels of indexes of liver and kidney function, levels of IgG and IgM in blood between one day before operation and the 1st day after wound healing, or in vital signs (including body temperature, pulse, respiration, systolic pressure, and diastolic pressure) between the operation day and the wound healing day (with t values from -1.43 to 1.88, P values all above 0.05). No adverse effects such as abnormal exudation, itching, redness and swelling, and exanthema were observed in the wound. The median wound healing time in trial area was 12 d (95% confidence interval: 11 - 13 d), which was significantly shorter than that in control area [17 d (95% confidence interval: 16 - 18 d), χ(2) = 24.9, P0.01]. The healed wound of trial area was closer to the normal skin than that of control area in the shape and distribution of Fb and vascular endothelial cell, and the shape of the basilar membrane and the epidermal layer.ATDM can accelerate healing of wound of skin graft donor site, and no adverse reactions were observed.

This article analyzed the medical records of a patient with 90% TBSA unhealed wound accompanied with wound sepsis 50 days post burn (PBD) and to discuss the ideal strategies of treatment for such patients in such condition. This was a 24-year-old male patient suffering from flame burn with 95% TBSA wound and severe inhalation injury. Meek skin grafting with autologous scalp was performed once to the thoracic and abdominal regions; intermingled skin grafting of autologous scalp microskin and large sheet of allograft was performed twice to the limbs within PBD 31. The patient was transferred to our hospital on PBD 50 with 90% TBSA wound unhealed, leaving a vast amount of necrotic tissue and allografts. Furthermore, he was complicated by sepsis, pulmonary infection, and gastric ulcer. Debridement and allogenic skin grafting were performed on the first day after hospitalization. When the condition of wounds was improved, transplantation of a large sheet of allogenic skin with inlaid small pieces of autologous skin, intermingled skin grafting of autologous and allogenic skin, and small pieces of autologous skin grafting were performed. Because of the shortage of donor area, the exposed wounds were temporarily covered with allogeneic skin. Epidermal growth factor was used to promote the healing of autologous skin donor site and deep partial-thickness burn wound. Autologous skin grafting was performed whenever source of healthy skin was available. Systemic use of effective antibiotics, nutritional support and therapy, and other comprehensive measures also contributed to the success of treatment of this patient suffering from wound sepsis. The patient was cured and discharged on PBD 145.

Prostate cancer (PC) is the most prevalent strain of cancer in men, but it is often slow-acting or undetected. Common diagnostic tools for PC include prostate biopsy and consequent analysis by the Gleason scoring of the tissue samples, as well as tests for the presence and levels of prostate-specific antigens. Common treatments for androgen-dependent PC include prostatectomy or irradiation, which can be invasive and significantly lower the patient's quality of life. Alternative treatments exist, such as androgen ablation therapy, which, though effective, causes relapse into androgen-independent PC, which is far more invasive and likely to metastasize to other parts of the body. MicroRNAs (miRNA) are short nucleotide sequences (between 19 and 25 nucleotides long) that bind to various targeted messenger RNA (mRNA) sequences post-transcriptionally through complementary binding and control gene expression, often through silencing or leading to the degradation of targeted mRNA. Studies have shown that miRNAs are expressed abnormally in various cancers, suggesting that they play a pivotal role in cancer development and progression. Some miRNAs are oncogenes that incite cancerous growth, while others are involved in tumor suppression and cell cycle controls. MiRNA expression also differs in various types of cancers. Studies of PC-specific miRNAs show potential for their utilization in the prevention, diagnosis, and treatment of PC to more effectively target tumor growth and provide patients with better therapeutic options.

The present study was carried out to investigate the protective effects of tempol on renal function and the underlying mechanism in streptozotocin-induced diabetic rats. The diabetic rats were randomly divided into the model group (without tempol) and tempol group (1 mM tempol in drinking water for 6 weeks). Nondiabetic rats were served as the Control group. The mRNA expression of canonical transient receptor potential 6 (TRPC6), transforming growth factor (TGF)-β1, and type IV collagen (Col IV) were examined. The malondialdehyde (MDA) level, activities of superoxide dismutase (SOD), and glutathione peroxidase (GSH-Px) in renal tissues were measured to assess redox status in kidneys. We found that tempol significantly reduced 24-h urine output and urine albuminuria excretion in the diabetic rats. Compared with the model group, the concentration of MDA was significantly lower in the tempol group. In addition, diabetes decreased activities of SOD and GSH-Px and these responses were prevented by tempol treatment. Moreover, in diabetic rats, the mRNA expression levels of TGF-β1 and Col IV were upregulated. TRPC6 mRNA expression level was down-regulated in diabetic kidneys. However, all of these diabetic effects were significantly suppressed by tempol treatment. These results suggest that chronic treatment of diabetic rats with tempol can protect kidneys, possibly by reducing expression of TGF-β1, Col IV, and upregulating TRPC6 expression level. Keywords:: diabetic nephropathy, tempol, transient receptor potential 6 (TRPC6), transforming growth factor-β1, collagen IV

To establish a method of enzyme-linked immunosorbent assay (ELISA) to measure urinary uromodulin and explore the urinary uromudulin level in IgA nephropathy.The rabbit anti-human uromodulin polyclonal antibodies were coated on plates to capture uromodulin and the mouse anti-human uromodulin monoclonal antibody was used as detecting antibody to set up ELISA procedure. The precision and repeatability of this ELISA method were evaluated, and then this method was compared with the commercialized Tamm-Horsfall Glycoprotein ELISA Kit by examining urinary uromodulin levels in 55 individuals. Finally, the urinary uromodulin level in 166 IgA nephropathy patients were detected as well as 48 normal controls with this established method.The detecting range of uromodulin was 0.78-12.5 μg/L by this method. The coefficient of variation within-run was 7.5%, and between-run of coefficient of variation was 7.9%. Correlation of this method and comercialized kit was good (r=0.615, P0.001). The urinary uromodulin/urinary creatinine ratio in IgA nephropathy was significantly lower than that in normal controls.The established ELISA method is sensitive and repeatable, and can be used in further studies.

Vascular anomalies are common and multidisciplinary involved diseases. The greatest impediment to their treatment in the past was their confusing terminology and clinical heterogeneities. This hospital-based retrospective study assessed some clinical characteristics, diagnosis, therapies and outcomes of patients with vascular anomalies in southeast China.A total of 592 vascular anomalies patients (patients with intracranial tissues or viscera involved were excluded), admitted to the First Affiliated Hospital of Sun Yat-sen University from January 2006 to September 2009, were enrolled in the study. Data for clinical characteristics, diagnosis, therapies and outcomes were collected and analyzed.Of the 592 patients, the male:female ratios in the vascular tumor group (n = 187) and the vascular malformation group (n = 405) were 1:1.49 and 1:1.06 respectively, with no significant difference between them. The mean onset age of the vascular tumor group was significantly younger than that of the vascular malformation group (p0.001). The head and neck were the most commonly (31.4%) involved areas in vascular anomalies. A total of 23.8% of the patients with vascular anomalies had definite symptoms caused by the vascular lesions. In the vascular tumor group, 94.1% of them were infantile hemangiomas. Venous malformation was the most common (41.0%) subtype of vascular malformations. Surgical therapy was undertaken in 94.2% of the patients with vascular anomalies. Of the 519 patients available for the 16 - 58 month follow-up, 322 patients (62.0%) were cured, 108 patients (20.8%) were markedly improved, 57 patients (11.0%) were partially improved, and 32 patients (6.2%) were uncured.Vascular anomalies are clinically heterogeneous. While the outcome is generally favorable, further effort should be made to determine the appropriate terminology and management.

To investigate the contribution of latent membrane protein (LMP)1 to nasopharyngeal carcinogenesis via Wnt/β-catenin signal pathway.The recombinant plasmid pHA2-LMP1 was constructed; immunofluorescence staining, Dual-Luciferase Reporter Assay, Western blot and immunohistochemistry staining were used to study the effect of LMP1 on the transcriptional activity and expression of β-catenin.(1) Abnormal expression of β-catenin was obtained in 38 cases (50.7%, 38/75), LMP1 expression was obtained in 38 cases (50.7%, 38/75). There was significantly positive correlation between LMP1 expression and abnormal expression of β-catenin in nasopharyngeal carcinoma tissue (P = 0.008). (2) The expression of β-catenin in nuclei of NPC cell line CNE1 and CNE2 transfected with pHA2-LMP1 plasmid dramatically increased, and the expression was remarkable in poorly-differentiated NPC cell line CNE2 than that of well-differentiated CNE1 cells. (3) LMP1 expression dramatically increased the transcriptional activity of β-catenin in CNE1 and CNE2 cells transfected with pHA2-LMP1 and was in a time-dependent. The transcriptional activity of β-catenin was higher in poorly-defferentiated cell line CNE2 than that of well-differentiated NPC cell line CNE1. (4) LMP1 expression did not affect the total protein expression level of β-catenin in both CNE1 and CNE2 cell lines.EB virus-encoded LMP1 may be involved in the pathogenesis of NPC via β-catenin signal pathway.

By reviewing 3725 lymphomas diagnosed in our institution from 1999 to 2010, we found eight cases (0.21%) of primary lymphoma in soft tissue with comprehensive histologic and immunohistochemical studies. Of the eight cases of primary lymphoma in soft tissue, two patients were male and six were female. The mean age was 54.8 years with range from 23 to 76 years. The greatest diameter of tumor ranged from 1.3 to 20 cm with an average diameter of 7.5 cm. Six cases were diffuse large B-cell lymphoma (DLBCL), subclassified as three DLBCL non-germinal center B-cell phenotype, one DLBCL germinal center B-cell phenotype, and two (Epstein-Barr Virus) EBV-positive DLBCL of the elderly; one case was anaplastic large cell lymphoma, ALK-positive; and one case was peripheral T cell lymphoma, not otherwise specified. Follow-up was available for four patients. One patient who refused further therapy died of the disease at 2 months after diagnosis. The other three patients with follow-up were alive without recurrence and metastatic disease at 9, 36, and 48 months, respectively, after excisional biopsy combined with appropriate chemotherapy and/or radiation therapy.

AIM: To study the clinicopathological features of gastric glomus tumor and review the related Chinese literature published in 1990-2010. METHODS: A case of gastric glomus tumor was reported. Clinicopathological findings in 56 cases of gastric glomus tumor were analyzed. RESULTS: Gastric glomus tumor was far more common in women than in men with a female to male ratio of 1.6:1. The median age of the patients was 45 years (range 28-79 years). The patients often complained of epigastric pain and bloody stool. The tumor was located in antrum of the stomach. The greatest diameter of the tumor was 0.8-11cm. Histologically, the tumor was comprised of nests of glomus cells surrounding the capillaries. Glomus cells were small, uniform and round. Vimentin, smooth muscle actin and actin were expressed in the tumor. Other markers, including S-100 protein, CD34, CD117, desmin, CD56, synaptophysin, chromogranin A, neuron specific enolase and cytokeratin were all negative. CONCLUSION: Gastric glomus tumor is a rare benign mesenchymal neoplasm. Its diagnosis depends on pathologic examination. Differential diagnosis includes gastrointestinal stromal tumor, paraganglioma and carcinoid tumor.