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Background: The aim of this multicentre cohort study was to compare the long-term oncological outcomes of robotic gastrectomy (RG) and laparoscopic gastrectomy (LG) for patients with gastric cancer., Methods: Patients with gastric cancer who underwent radical gastrectomy by robotic or laparoscopic approaches from 1 March 2010 to 31 December 2018 at 10 high-volume centres in China were selected from institutional databases. Patients receiving RG were matched 1 : 1 by propensity score with patients undergoing LG. The primary outcome was 3-year disease-free survival. Secondary outcomes were overall survival and disease recurrence., Results: Some 2055 patients who underwent RG and 4309 patients who had LG were included. The propensity score-matched cohort comprised 2026 RGs and 2026 LGs. Median follow-up was 41 (i.q.r. 39-58) months for the RG group and 39 (38-56) months for the LG group. The 3-year disease-free survival rates were 80.8% in the RG group and 79.5% in the LG group (log rank P = 0.240; HR 0.92, 95% c.i. 0.80 to 1.06; P = 0.242). Three-year OS rates were 83.9 and 81.8% respectively (log rank P = 0.068; HR 0.87, 0.75 to 1.01; P = 0.068) and the cumulative incidence of recurrence over 3 years was 19.3% versus 20.8% (HR 0.95, 0.88 to 1.03; P = 0.219), with no difference between groups., Conclusion: RG and LG in patients with gastric cancer are associated with comparable disease-free and overall survival., (© The Author(s) 2024. Published by Oxford University Press on behalf of BJS Foundation Ltd. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

The process of generating type I/II collagen scaffolds is fraught with bubble formation, which can interfere with the three-dimensional structure of the scaffold. Herein, we applied low-temperature vacuum freeze-drying to remove mixed air bubbles under negative pressure. Type I and II rubber sponges were acid-solubilized via acid lysis and enzymolysis. Thereafter, vacuum negative pressure was applied to remove bubbles, and the cover glass press method was applied to shape the type I/II original scaffold. Vacuum negative pressure was applied for a second time to remove any residual bubbles. Subsequent application of carbamide/N-hydroxysuccinimide cross-linked the scaffold. The traditional method was used as the control group. The structure and number of residual bubbles and pore sizes of the two scaffolds were compared. Based on the relationship between the pressure and the number of residual bubbles, a curve was created, and the time of ice formation was calculated. The bubble content of the experimental group was significantly lower than that of the control group (P < 0.05). The pore diameter of the type I/II collagen scaffold was higher in the experimental group than in the control group. The time of icing effect of type I and II collagen solution was 136.54 ± 5.26 and 144.40 ± 6.45 s, respectively. The experimental scaffold had a more regular structure with actively proliferating chondrocytes that possessed adherent pseudopodia. The findings indicated that the vacuum negative pressure method did not affect the physical or chemical properties of collagen, and these scaffolds exhibited good biocompatibility with chondrocytes., (© 2022. The Author(s), under exclusive licence to Springer Nature B.V.)

Objective: A large-scale multicenter retrospective cohort study was conducted to compare the short- and long-term outcomes of robotic gastrectomy (RG) and laparoscopic gastrectomy (LG) for gastric cancer., Summary of Background Data: RG is being increasingly used worldwide, but data from large-scale multicenter studies on the short- and long-term oncologic outcomes of RG versus LG are limited. The potential benefits of RG compared with LG for gastric cancer remain controversial., Methods: Data from eligible patients who underwent RG or LG for gastric cancer of 11 experienced surgeons from 7 centers in China between March 2010 and October 2019 were collected. The RG group was matched 1:1 with the LG group by using propensity score matching. The primary outcome was postoperative complications., Results: After propensity score matching, a well-balanced cohort of 3552 patients was included for further analysis. The occurrence of overall complications (12.6% vs 15.2%, P = 0.023) was lower in the RG group than in the LG group. RG was associated with less blood loss (126.8 vs 142.5 mL, P < 0.001) and more retrieved lymph nodes in total (32.5 vs 30.7, P < 0.001) and in suprapancreatic areas (13.3 vs 11.6, P < 0.001).The long-term oncological outcomes were comparable between the two groups., Conclusions: The results of this multicenter study demonstrate that RG is a safe and effective treatment for gastric cancer when performed by experienced surgeons, although longer operation time and higher costs are still concerns about RG. This study provides evidence suggesting that RG may represent an alternative surgical treatment to LG., Competing Interests: Conflict of interest Disclosures: The authors declare that they have no conflict of interest., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

Objective: To compare the clinical efficacy of performing simple plate fixation with that using a plate combined with fracture end fixation to investigate the necessity of fracture end fixation outside the plate in cases of oblique fracture of the middle clavicle., Methods: This was a retrospective follow-up study of patients with middle clavicle oblique fractures (Robinson types 2A1 and 2A2) between 2015 and 2020. Patients were divided into two groups according to their treatment options: the simple plate fixation (SPF) group (n = 79; 43 men and 36 women; average age, 46.37 ± 14.54 years) and the plate combined with fracture local fixation (PLFP) group (n = 81; 36 men and 45 women; average age, 48.42 ± 12.55 years). Intraoperative blood loss, operation time, postoperative fracture healing time, postoperative shoulder function score (Constant-Murley and disabilities of the arm, shoulder, and hand [DASH] scores), clinical complications, and postoperative subjective satisfaction were compared between the two groups., Results: One hundred sixty patients with a sufficient follow-up period were included in the final analysis: 79 in the SPF group (follow-up time: 16.24 ± 3.94 months) and 81 in the PLFP group (follow-up time: 16.15 ± 3.43 months). Age, sex, body mass index, follow-up duration, fracture classification, and cause of injury were not significantly different between the two groups. There was no significant difference in blood loss, Constant-Murley and DASH scores, follow-up period, and postoperative subjective satisfaction between the two groups (P > 0.05). The fracture healing time was shorter in the PLFP group than in the SPF group (4.41 ± 0.99 vs. 4.87 ± 1.60 months, P < 0.05), but the operation duration was longer in the PLFP group than in the SPF group (65.48 ± 16.48 min, P < 0.05). There were seven (complication rate, 8.86%) and five (complication rate, 6.17%) cases that had complications in the SPF and PLFP groups, respectively. There was no significant difference in the complication rates between the two groups (P > 0.05)., Conclusion: Although the healing time was shorter in the PLFP group than in the SPF group, the clinical efficiency of the two methods in the treatment of oblique fracture of the middle clavicle was similar., (© 2022 The Authors. Orthopaedic Surgery published by Tianjin Hospital and John Wiley & Sons Australia, Ltd.)

Introduction: Both side-by-side (SBS) and stent-in-stent (SIS) bilateral stenting have been used for patients with malignant hilar biliary obstruction (MHBO). However, it is unclear which technique is better., Aim: This meta-analysis is conducted to investigate the clinical efficacy and safety of SBS and SIS bilateral stenting for patients with MHBO., Material and Methods: Relevant studies were searched in PubMed, Embase, Cochrane Library, Wanfang, VIP, and CINK databases. The timeline for the searches was from the establishment of the database to September 2021. The relative outcomes are pooled., Results: A total of 7 studies fulfilled the inclusion criteria and entered into this meta-analysis. The pooled technical success rate was significant higher in the SIS group than that in the SBS group (p = 0.04). The pooled early complication rate was significantly lower in the SIS group than in the SBS group (p = 0.04). The pooled stent re-obstruction rate was significantly lower in the SBS group than in the SIS group (p = 0.04). The pooled stent patency duration was significantly longer in the SBS group than in the SIS group (p = 0.01). The pooled functional success rates (p = 0.79), total complication rates (p = 0.34), and overall survival duration (p = 0.27) were comparable between 2 groups. Egger test did not show any publication bias., Conclusions: When comparing the SBS and SIS bilateral stenting for patients with MHBO, although SIS technique may have the superiorities of technical success and early complication rates, the longer stent patency was achieved by the SBS technique., Competing Interests: The authors declare no conflict of interest., (Copyright: © 2022 Fundacja Videochirurgii.)

Intervertebral disc (IVD) degeneration, which is common among elderly individuals, mainly manifests as low back pain and is caused by structural deterioration of the nucleus pulposus (NP) due to physiological mechanical stress. NP mesenchymal stem cells (NPMSCs) around the IVD endplate have multidirectional differentiation potential and can be used for tissue repair. To define favorable conditions for NPMSC proliferation and differentiation into chondroid cells for NP repair, the present study simulated periodic mechanical stress (PMS) of the NP under physiological conditions using MSC chondrogenic differentiation medium and recombinant human BMP-2 (rhBMP-2). rhBMP-2 effectively promoted NPMSC proliferation and differentiation. To clarify the mechanism of action of rhBMP-2, integrin alpha 1 (ITG A1) and BMP-2 were inhibited. PMS regulated the BMP-2/Smad1/RUNX2 pathway through ITG A1 and promoted NPMSC proliferation and differentiation. During tissue-engineered NP construction, PMS can effectively reduce osteogenic differentiation and promote extracellular matrix protein synthesis to enhance structural NP recovery., Competing Interests: The authors declare no competing interests., (© 2022 The Author(s).)

Objective: Diabetic foot ulcers (DFUs) are one of the most serious diabetic consequences, leading to amputations. Various therapies have been used to treat DFUs; however, a combination of negative pressure suction, artificial skin and autogenous skin implantation have never been investigated. This study aimed to evaluate the effectiveness of a novel three-step therapy protocol using negative pressure wound therapy (NPWT), artificial skin and autogenous skin implantation in patients with DFUs., Method: At a single tertiary university hospital between 2015 and 2018, the three-step therapy protocol was applied to patients with DFUs and its safety and efficacy was investigated., Results: A total of 21 patients took part in the study. The majority of the patients were female (62%), with a mean age of 65 years and a mean body mass index of 21kg/m 2 . A third (n=7) of operative sites experienced minor complications, with two requiring re-operation. At a median follow up of 24 months, the average time of complete wound healing was 46 days, and the wound healing rate was 71%. The first-stage wound healing rate was 90%. All patients had achieved remission without any further recurrence of disease., Conclusion: This comprehensive surgical technique for managing DFUs achieved a high local cure rate, minimal functional morbidity, and acceptable wound complication rates. The three-step therapy protocol has the potential to promote the healing process of DFUs, which is expected to serve as a new method for the treatment and cure of DFUs.

Objective: During laparoscopic pelvic operational procedure for obese patients with rectal cancer, the large amount of fat in the abdominal cavity often impairs the exposure of the surgical field, resulting in technical difficulty. In contrast, robotic surgery has the advantages of being more minimally invasive, precise, and flexible. This study compared the clinical efficacy of robotic and laparoscopic radical resection of rectal cancer for overweight and obese patients. Methods: A retrospective cohort study was conducted. Clinical data of 173 patients with rectal cancer and a body mass index (BMI) ≥ 25 kg/m(2) who received robotic or laparoscopic radical rectal resection at the First Affiliated Hospital of Nanchang University from January 2015 to February 2019 were retrospectively collected. Of 173 patients, 90 underwent robotic surgery and 83 underwent laparoscopic surgery. The intraoperative parameters, postoperative short-term and follow-up status were analyzed and compared between the two groups. The follow-up ended in December 2019. Results: Of 173 patients, 103 were male and 70 were female with a median age of 62 (range 29 to 86) years. The average BMI was (27.2±1.6) kg/m(2) in the robotic group and (27.3±1.5) kg/m(2) in the laparoscopic group. No significant differences in baseline data were observed between two groups (all P >0.05). As compared to the laparoscopic group, the robotic group had less intraoperative blood loss [(73.0±46.8) ml vs. (120.9±59.9) ml, t =-5.881, P <0.001] and higher postoperative hospitalization expense [(61±15) thousand yuan vs (52±13) thousand yuan, t =3.468, P =0.026]. The conversion rate in the robotic group was 1.1% (1/90), which was lower than 6.0% (5/83) in the laparoscopic group, but the difference was not statistically significant ( P =0.106). There were no statistically significant differences between the two groups in operative time, number of intraoperative blood transfusion, number of harvested lymph nodes, time to the first flatus, postoperative hospital stay and morbidity of total postoperative complications (all P >0.05). Five (6.0%) patients in the laparoscopic group developed urinary dysfunction, while no case in the robotic group developed postoperative urinary dysfunction ( P =0.024). The 173 patients were followed up for 8-59 months, with a median follow-up of 36 months. The 3-year overall survival rate of robotic group and laparoscopic group was 89.8% and 86.6%, respectively without significant difference between the two groups ( P =0.638). The 3-year disease-free survival rate of the robotic group and the laparoscopic group was 85.6% and 81.5%, respectively without significant difference as well ( P =0.638). Conclusions: Robotic radical surgery is safe and feasible for overweight and obese patients with rectal cancer. Compared with laparoscopic radical surgery, it has advantages of clear vision of surgical exposure, less intraoperative blood loss, less pelvic autonomic nerve damage, and operation in a narrow space.

Objective: To investigate the effect of partial facetectomy on lumbar stability using percutaneous endoscopy., Methods: Five male adult volunteers with no history of lumbar disease participated in the study. Based on computed tomography data, a three-dimensional model of the L3-S1 segment was created using the Mimics l5.0 and Ansys 13.0 software. The use of an 8.5-mm-diameter ring saw was simulated to cut through 5 different needle insertion points (IPs) commonly used in the clinic on the left-side facet joint (FJ) of L5 to perform facetectomy. The first to third IPs were on the apex of the superior FJ, the midpoint of the ventral side of the superior FJ, and the lowest point of the ventral side of the superior FJ. The fourth and fifth IPs represented the positions of the second and third IPs (8.5 mm/2) after the radius of the ring saw was translated to the dorsal side of the superior FJ. Physiologic load was applied to the human models. The pressure on the left and right FJ of the L5 vertebra, the pressure on the L4-5 intervertebral disc, and the range of motion of the lumbar spine were recorded when normal flexion and extension and lateral flexion and rotation of the lumbar spine model after facetectomy were simulated., Results: Compared with the intact group, the second IP, maximum pressure on the L4-5 intervertebral disc after facetectomy was not significantly different under any condition (P > 0.05). The maximum pressure on the left FJ of L5 showed significant differences during right rotation of the lumbar spine (P < 0.05). The pressure on the right FJ of L5 was significantly different during left rotation of the lumbar spine (P < 0.05). The range of motion of the lumbar spine was not significantly different under any condition (P > 0.05)., Conclusions: The second IP at the midpoint of the ventral side of the superior FJ showed minimal effect on lumbar spine biomechanics compared with all the other IPs during percutaneous transforaminal facetectomy. Thus, it can be considered as the most suitable IP for facetectomy., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Objective: To compare the short- and long-term outcomes of robot-assisted and laparoscopic radical resection for mid-low rectal cancer. Methods: A prospective randomized controlled trial was conducted. A total of 130 patients with mid-low rectal cancer (inclusion criteria: age > 18 or ≤80 years old; pathological diagnosis of rectal adenocarcinoma by colonoscopy; distance from tumor to the anal verge ≤12 cm; no distant metastasis; cT1-3N0-1 or ycT1-3 after neoadjuvant radiotherapy and chemotherapy; suitable for laparoscopic and robotic surgery) at the Department of Colorectal Surgery of the First Affiliated Hospital of Nanchang University from October 2016 to September 2018 were prospectively enrolled. According to computer-generated random number method, patients were randomly divided into the robot group ( n =66) and laparoscopy group ( n =64), and underwent robot-assisted surgery or laparoscopic surgery respectively. Clinicopathological data of all the patients were collected and analyzed. The demographic parameters, short- and long-term outcomes were compared between two groups. Results: One patient in robot group whose postoperative sample was diagnosed as rectal adenoma by pathology was excluded. There were no statistically significant differences in age, sex, BMI, ASA classification, distance from tumor to the anal verge, serum CEA level, CA199 level between two groups (all P >0.05). Operations were successfully performed in all the patients without conversion to open operation. Robotic surgery was found to be associated with less intraoperative blood loss than laparoscopic surgery [(73.4±49.7) ml vs. (119.1±65.7) ml, t =-4.461, P <0.001], while there were no statistically significant differences in surgical procedures, operation time, time to first flatus, time to first liquid intake, time to removal of catheter or postoperative hospital stay between two groups (all P >0.05). Besides, there was no significant difference in the morbidity of postoperative complication between two groups [10.8% (7/65) vs. 12.5 (8/64), χ(2)=4.342, P =0.720]. The median number of harvested lymph node in the robot group and the laparoscopy group was 15.7±6.2 and 13.8±6.1 ( t =1.724, P =0.087). There were no significant differences between two groups in tumor sample length, distance between proximal and distal resection margin, integrity grade of TME specimen, number of positive lymph nodes, postoperative pathological stage and tumor differentiation (all P >0.05). The distal resection margin of samples in two groups was all negative. One case in the robot group was found to have positive circumferential resection margin. The median follow up was 24 (9 to 31) months. In the robot group and the laparoscopy group, the 2-year overall survival rate was 95.4% and 90.6% respectively; the 2-year disease-free survival rate was 90.8% and 85.9% respectively, whose differences were not significant (both P >0.05). Conclusion: Robot-assisted radical resection for mid-low rectal cancer can achieve similar short-term and long-term outcomes of laparoscopic resection, while robot-assisted surgery can decrease blood loss during operation, leading to more precise practice in minimally invasive surgery.

Background: Reports in the field of robotic surgery for rectal cancer are increasing year by year. However, most of these studies enroll patients at a relatively early stage and have small sample sizes. In fact, studies only on patients with locally advanced rectal cancer (LARC) and with relatively large sample sizes are lacking., Aim: To investigate whether the short-term outcomes differed between robotic-assisted proctectomy (RAP) and laparoscopic-assisted proctectomy (LAP) for LARC., Methods: The clinicopathological data of patients with LARC who underwent robotic- or laparoscopic-assisted radical surgery between January 2015 and October 2019 were collected retrospectively. To reduce patient selection bias, we used the clinical baseline characteristics of the two groups of patients as covariates for propensity-score matching (PSM) analysis. Short-term outcomes were compared between the two groups., Results: The clinical features were well matched in the PSM cohort. Compared with the LAP group, the RAP group had less intraoperative blood loss, lower volume of pelvic cavity drainage, less time to remove the pelvic drainage tube and urinary catheter, longer distal resection margin and lower rates of conversion ( P < 0.05). However, the time to recover bowel function, the harvested lymph nodes, the postoperative length of hospital stay, and the rate of unplanned readmission within 30 days postoperatively showed no difference between the two groups ( P > 0.05). The rates of total complications and all individual complications were similar between the RAP and LAP groups ( P > 0.05)., Conclusion: This retrospective study indicated that RAP is a safe and feasible method for LARC with better short-term outcomes than LAP, but we have to admit that the clinically significant of part of indicators are relatively small in the practical situation., Competing Interests: Conflict-of-interest statement: The authors have no conflicts of interest to declare., (©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.)

Objective: To explore the short-term clinical efficacy of robotic radical resection for high rectal cancer with transvaginal specimen extraction. Methods: A cohort study was carried out. The clinical data of consecutive patients with high rectal cancer who underwent robotic radical resection at the Department of General Surgery of The First Affiliated Hospital of Nanchang University from June 2017 to January 2018 were retrospectively analyzed. Inclusion criteria: (1) preoperative diagnosis of rectal cancer, and distance from tumor to anal margin≥10 cm undercolonoscopy; (2) T1-3 assessed by preoperative imaging examination, and no distant metastasis; (3) female, age≥50 years old, body mass index ≤ 30 kg/m(2); (4) without radiotherapy and chemotherapy before surgery; (5) implementation of robotic radical surgery for high rectal cancer. Fourteen female patients undergoing transvaginal removal of specimen without abdominal incision were included in the no incision group with age of (62.2±9.3) years old and distance from tumor to anal verge of (12.5±0.9) cm. As the match of 1:2, 28 simultaneous patients of high rectal cancer undergoing traditional robotic surgery (surgery interval <8 months) were enrolled to the control group, with age of (60.6±12.8) years old and distance from tumor to anal verge of (11.3±3.8) cm. Short-term efficacy and safty were compared between two groups. Follow-up ended in September 2018. Results: There was no significant difference in baseline data between the two groups (all P >0.05). Compared with the control group, the no incision group had longer operation time [(149.6±15.6) minutes vs. (130.9±12.9) minutes, t =-4.135, P <0.001], shorter time to postoperative flatus [(40.9 ±2.6) hours vs. (51.9±2.9) hours, t =12.049, P <0.001], lower pain score on the operation day and the first day after surgery (using Changhaipainstick) [(3.1±0.4) points vs. (4.6±0.7) points, t =7.458, P <0.001; (2.5±0.3) points vs. (3.3±0.5) points, t =6.142, P <0.001], shorter time to ground activity [(15.6±2.0) hours vs. (24.3±2.5) hours, t =11.102, P =0.030], and shorter postoperative hospital stay [(6.1±0.8) days vs. (7.2±1.3) days, t =2.806, P =0.008], whose differences were statistically significant. There were no significant differences in intraoperative blood loss, proportion of postoperative analgesia patients, and complication within 30 days after surgery (all P >0.05). In the no incision group and the control group,the tumor size was (3.1±0.4) cm and (3.6±0.9) cm, the proximal margin distance was (9.1±1.5) cm and (9.8±1.5) cm, the distal margin distance was (4.3±0.4) cm and (4.5±0.4) cm, the number of harvested lymph node was 15.8±2.4 and 15.2 ± 2.5, and the number of positive lymph node was 0.6±1.3 and 1.1±2.4, respectively, whose differences were not statistically significant (all P >0.05). The mean followed-up period was 10 months (7-14 months) in the no incision group, and 14 months (10-18 months) in the control group. No local recurrence and distant metastasis were found in both groups. Conclusion: Robotic radical resection for high rectal cancer with transvaginal specimen extraction is safe and feasible with advantages of rapid postoperative recovery, less postoperative pain and short hospital stay.

Objective: To investigate the specific role of miR-23 in atrial fibrillation (AF) progression and explore the possible underlying mechanism., Patients and Methods: Right atrial appendage (RAA) tissues were collected from 30 patients with AF and 30 patients with sinus rhythm (SR), respectively. The expression level of miR-23 was detected by quantitative Real time-polymerase chain reaction (qRT-PCR). Moreover, cell counting kit-8 and flow cytometry were performed to detect the proliferation and cell apoptosis of AC16 cells after transfection with miR-23 inhibitor and mimics. Furthermore, luciferase reporter gene assay and RNA immunoprecipitation assay were performed to uncover the possible underlying mechanism., Results: In the present study, the expression level of miR-23 in RAA tissues of AF patients was significantly higher than that of SR patients. After knockdown of miR-23 in AC16 cells, the proliferation was inhibited and cell apoptosis was induced. However, overexpression of miR-23 significantly promoted cell growth and suppressed cell apoptosis. Further experiments revealed that transforming growth factor-b1 (TGF-β1) was a direct target of miR-23. In addition, TGF-β1 expression was positively correlated with miR-23 expression in AF tissues., Conclusions: Our findings indicated that miR-23 could promote the progression of AF via promoting TGF-β1, which might serve as a new direction for interpreting the mechanism of AF development.

Objective: The aim of this study was to explore the role of long non-coding RNA (lncRNA) TCL6 in preeclampsia (PE) development and to investigate its underlying mechanism., Patients and Methods: The expression of TCL6 in 42 placental tissues of PE pregnancies and normal pregnancies was detected by quantitative Real Time-Polymerase Chain Reaction (qRT-PCR). Receiver Operating Characteristic (ROC) curve was applied to explore the relationship between TCL6 expression, urine protein level, blood pressure and neonatal weight of PE pregnancies. The proliferation and cell cycle of trophoblast cells after TCL6 knockdown were detected by cell counting kit-8 (CCK-8) assay and flow cytometry, respectively. Moreover, the specific role of TCL6 in cell cycle was detected by Western blot., Results: TCL6 was highly expressed in 42 placental tissues of PE pregnancies when compared with that of normal pregnancies. PE pregnancies with lower expression level of TCL6 exhibited significantly lower urinary protein level, as well as systolic and diastolic blood pressure than those with higher level. Besides, neonatal weight was significantly higher in PE pregnancies with lower expression level of TCL6. Meanwhile, downregulation of TCL6 resulted in remarkably increased proliferation and cell cycle of trophoblast cells. In addition, Western blot results indicated that TCL6 knockdown significantly upregulated CDK2 and downregulated PTEN in trophoblast cells., Conclusions: TCL6 was highly expressed in placental tissues of PE patients. Overexpression of lncRNA TCL6 inhibited the proliferation of trophoblast cells and promoted PE development via targeting PTEN.

Solvothermal reaction of 3,5-di(pyridin-4-yl) benzoic acid (HDPB) with Co(II) leads to a novel metal-organic framework, [Co 2 O(DPB) 2 (DMF) 2 ]· xS (1), which represents a rare reo-type net with trigonal prismatic cobalt dimer, [Co 2 O(CO 2 ) 2 N 4 ], as building blocks to construct a 3D framework containing three different types of nanoscale M 12 L 12 and M 24 L 12 polyhedron cages. More interestingly, under the same condition, the assembly of 4-methyl-3,5-di(pyridin-4-yl) benzoic acid (HMDPB) with Co(II) facilitates the formation of a cationic framework, [Co 2 (MDPB) 3 (DMF)](NO 3 )· xS (2), with cobalt dimer, [Co 2 (CO 2 ) 3 N 4 ], as building blocks. Complex 2 represents the first example of a zeolite-like network with 48-nuclear SOD cage. The significant effect of subtle modification of ligand on the overall MOFs is discussed. Moreover, the gas adsorption studies reveal that 1 exhibits permanent porosity and selective CO 2 uptake. Variable-temperature magnetic susceptibility measurements show that both 1 and 2 exhibit antiferromagnetic behavior.

Testicular cell apoptosis is associated with impaired spermatogenesis. It has been reported that Asiatic acid (AA) may suppress apoptosis. However, little is known about the effect of AA on high-fat diet (HFD)-induced impairment of spermatogenesis. The aim of the present study was to determine whether AA protects against HFD-induced impairment of spermatogenesis. Sprague-Dawley rats were randomly divided into three groups: Control group, HFD group and AA (50 mg/kg) + HFD group. Rats fed an HFD were orally administered with AA (50 mg/kg) daily for 12 weeks, and blood samples, testis and epididymis were harvested for further analysis. Sex hormones were detected and hematoxylin and eosin staining was performed to examine the morphological changes of the testis. Semen samples were collected to evaluate sperm quality and apoptosis was determined. The results indicate that AA treatment significantly increased testis weight, testis/body weight, spermatogonia, Leydig cells and Sertoli cells in the testis of obese mice (P<0.05). AA treatment also attenuated HFD-induced histological change. AA treatment prevented HFD-induced decrease of sex hormones and the quality of semen samples (P<0.05). Furthermore, HFD-induced apoptosis was significantly attenuated by AA treatment (P<0.05). In conclusion, the results suggest that AA is able to ameliorate HFD-induced impaired spermatogenesis via inhibiting apoptosis in Sprague-Dawley rats. AA may have therapeutic value in the treatment of obesity-related impairment of spermatogenesis.

BACKGROUND To observe and demonstrate therapeutic effects and side effects of two selective COX-2 inhibitors, imrecoxib and celecoxib, on patients with axial spondyloarthritis (axSpA) and observe the correlation between imaging scores and serum DKK-1 levels. MATERIAL AND METHODS Sixty patients with axSpA were randomly assigned to receive 200 mg imrecoxib or 200 mg celecoxib twice daily. Fifty-one patients who completed follow-up were included in the study. At baseline, week 4, and week 12, the clinical parameters, inflammatory markers (ESR, CRP), and adverse reactions were recorded. Serum DKK-1 levels were investigated by enzyme-linked immunosorbent assay. Radiographic scores were calculated by sacroiliac joint SPARCC (Spondyloarthritis Research Consortium of Canada) score method at baseline serum DKK-1 levels and week 12. RESULTS Patients in the imrecoxib group (n=25) and patients in the celecoxib group (n=26) were improved at week 4. At week 12, all clinical parameters and inflammatory markers were improved in the two groups and the differences was not statistically significant. Serum DKK-1 levels were decreased and the differences were not statistically significant. Serum DKK-1 levels in patients in the imrecoxib group at baseline were negatively correlated with all study parameters, while those in the celecoxib group had correlations with BASFI (r=-0.048, p=0.027) and Schober test (r=0.437, p=0.048), without any correlation with other clinical parameters or inflammatory markers. CONCLUSIONS Patients experienced significant improvement in disease activity, functional parameters, and inflammatory markers when treated with selective COX-2 inhibitors for 12 weeks, and the efficacy of imrecoxib was not inferior to celecoxib. Selective COX-2 inhibitors imrecoxib and celecoxib had no obvious effects on serum DKK-1 levels.

To determine the expression of mTOR, Becline-1, LC3 and p62 in the peripheral blood mononuclear cells (PBMCs) of systemic lupus erythematosus (SLE) and assess their relationship with disease activity and immunologic features. The expression of mTOR, Becline-1, LC3 and p62 was detected by RT-PCR in 81 SLE subjects and 86 age- and sex-matched healthy controls. Data regarding demographics and clinical parameters were collected. Disease activity of SLE was evaluated according to the SLE Disease Activity Index (SLEDAI) score. Independent sample t-test was used to analyze the expression of mTOR, Becline-1, LC3, and p62 in the two groups. Pearson's or Spearman's correlation was performed to analyze their relationship with disease activity and immunologic features. The mean levels of Becline-1, LC3 and p62 mRNA were significantly higher in SLE patients than the controls (9.96×10 -4 vs 7.38×10 -4 for Becline-1 with P <0.001; 4.04×10 -5 vs 2.62×10 -5 for LC3 with P <0.001; 9.51×10 -4 vs 7.59×10 -4 for p62 with P =0.008). However, the levels of mTOR mRNA in SLE patients were not significantly different from that in controls. Correlation analysis showed that Becline-1, LC3 and p62 mRNA levels correlated positively with SLEDAI, IgG and ds-DNA, negatively with C3. Our results suggested that autophagosomes formation were activated and their degradation were blocked in SLE. Moreover, the maintenance of autophagy balance can improve disease activity and immune disorders in SLE patients.

Objective: We aimed to investigate the prevalence of vitamin D deficiency in Chinese lupus patients and to assess the association between vitamin D levels and disease severity., Methods: Serum levels of 25OHD3 in 121 patients with systemic lupus erythematosus (SLE) and 150 healthy controls were measured by electrochemiluminescence immunoassay. Data regarding demographics and clinical parameters were collected. Disease activity of SLE was evaluated according to the SLE Disease Activity Index (SLEDAI) score and irreversible organ damage by the Systemic Lupus International Collaborating Clinic/American College of Rheumatology, SLICC/ACR Damage Index (SDI). The multivariate logistic regression model was used to investigate the association between the degree of vitamin D deficiency and SLEDAI or SDI scores., Results: The prevalence of vitamin D insufficiency (25OHD3 <30 ng/ml) and severe deficiency (25OHD3 <10 ng/ml) in SLE patients was 62.81% and 34.71%, respectively. Logistic regression analysis indicated that the cut-off point of 25OHD3 concentration was 10 ng/ml where its level was correlated with increased SLEDAI (OR 6.420, p = 0.006), but not with the SDI. In addition, hydroxychloroquine treatment lowered the SLEDAI increased by the severe 25OHD3 deficiency (OR 0.280, p = 0.008). Moreover, long disease duration (OR 1.014, p = 0.008) predicted moderate to severe organ damage., Conclusions: Vitamin D deficiency is highly prevalent in patients with SLE. Severe deficiency increases the risk for moderate to severe disease activity, but not for organ damage., (© The Author(s) 2016.)

This study aimed to explore the protective effects of Angelica sinensis polysaccharide (ASP) on rat chondrocyte injury induced by hydrogen peroxide (H2O2). Rat chondrocytes were cultured and treated with different concentrations of ASP alone or in combination with H2O2, and they were measured with cell viability, apoptosis, release of inflammatory cytokines, such as interleukin-1beta (IL-1β) and tumor necrosis factor-alpha (TNF-α), activity of superoxide dismutase (SOD), and catalase (CAT), and levels of malondialdehyde (MDA) production, respectively. In addition, quantitative real-time reverse transcription polymerase chain reaction was used to estimate the relative expression levels of osteoarthritis (OA)-associated genes, such as collagen type II (Col2a1), aggrecan, SOX9, matrix metalloproteinase (MMP)-1, -3, and -9, as well as tissue inhibitor of matrix metalloproteinase (TIMP)-1, respectively. Results indicated that ASP protected chondrocytes from H2O2-induced oxidative stress and subsequent cell injury through its antioxidant, antiapoptotic and anti-inflammatory effects in vitro. Our study suggests that ASP could become a therapeutic supplementation for the treatment of OA., (Copyright © 2016 Elsevier B.V. All rights reserved.)

We aimed to determine the prevalence of hypovitaminosis D in patients with autoimmune rheumatic diseases (ARDs) in China and its association with demographic characteristics of the patients. We recruited 384 patients in this cross-sectional study including 121 cases of systemic lupus erythematosus (SLE), 131 rheumatoid arthritis (RA), 102 spondyloarthritis (SpA) and 30 other ARDs. For each patient, demographic information was collected and serum concentration of 25OHD3 was measured by electrochemiluminescence immunoassay (ECLIA). The multivariate logistic regression model was used to investigate the association between vitamin D deficiency and patient characteristics. The mean serum vitamin D level of the 384 patients was 18.91 (8.12) ng/mL, and the median age was 37.33 (12.01) yrs. Among these patients, 222 (57.81%) and 127 (33.07%) were found to be vitamin D deficiency and insufficiency, respectively. From the disease perspective, the percentages of insufficiency and deficiency were as follow: 97.52% and 84.30% in SLE, 87.02% and 48.85% in RA, 88.24% and 40.20% in SpA, 90.89% and 57.81% in other ARDs patients. The causative factors for vitamin D deficiency included SLE per se (OR 12.54, P < 0.001) and high body mass index (BMI) (OR 1.88, P < 0.001). However, the seniors were less likely to have vitamin D deficiency (OR 0.95, P = 0.005). No correlation was disclosed between vitamin D deficiency and gender or disease duration. Hypovitaminosis D is highly prevalent among autoimmune rheumatic diseases population in China. The SLE per se and the obesity are the risk factors for vitamin D deficiency. Clinicians are advised to supplement vitamin D in these patients.

Objective: To get scientific basis for further health education through the research of the road construction workers' KBP before and after the interventions of highway AIDS prevention project., Methods: Multi-stage random sampling method was employeed to select workers of 8 sites from 14 sites along highway to investigate their AIDS knowledge, belief and performance (KBP) before and after highway AIDS prevention project., Results: Over 90% of the investigated workers had ever heard about AIDS, and the non-skilled workers of lower educational level improved more after intervention. The correct answer rate of the three transmitting ways of AIDS of drivers which is the focused group of highway before and after intervention had the obvious statistical significance (P<0.05), and the other group's correct answer rates also had improved after intervention. Most people's understanding of preventing AIDS through correct use of condoms when having sex had a statistically significant difference(P<0.05) after prevention. The rates of using condoms of foremen and skilled workers when having sex with commercial sex worker/casual partner increased after intervention., Conclusions: The health education of HIV among the road construction workers is effective and further health education of HIV prevention should be carried out among the road construction workers to improve their knowledge and awareness of avoiding the high-risk behaviors., (Copyright © 2013 Hainan Medical College. Published by Elsevier B.V. All rights reserved.)

The aim of the present study was to investigate the clinical effects of lamina replantation with ARCH plate fixation on patients with thoracic and lumbar intraspinal tumors, following laminectomy. Thirteen patients with thoracic and lumbar intraspinal tumors underwent total lamina replantation with ARCH plate fixation and repair of the supraspinous ligaments, following laminectomy and tumor enucleation. To investigate the clinical effect of lamina replantation with ARCH plate fixation, pre- and postoperative visual analog scale (VAS), and Oswestry Disability Index (ODI) scores were determined, and pre- and postoperative X-ray and magnetic resonance imaging (MRI) examinations were conducted. Computed tomography (CT) examinations were also included in the follow-up. No complications were observed pre- or postoperatively. The VAS and ODI results 2 weeks following surgery and at the final follow-up examination demonstrated a significant improvement compared with the corresponding preoperative results. The X-ray examination results indicated a satisfactory internal fixation location, without any characteristics of a fracture, lumbar scoliosis, kyphosis or instability. Following the surgery, the CT and MRI examination results demonstrated that healing of the lamina bone and repair of the supraspinous ligament had occurred without tumor recurrence or spinal epidural scar recompression. Two of the 13 cases were lost to follow-up. The results indicated that in patients with thoracic and lumbar intraspinal tumors, lamina replantation with ARCH plate fixation following total laminectomy is effective and provides thoracolumbar stability. Furthermore, this has been identified to be an effective technique for preventing intraspinal scar proliferation.

Our objective was to determine metabolic syndrome (MS) prevalence in Chinese patients with systemic lupus erythematosus (SLE) and to investigate the conditions that contribute to its development. 116 patients with SLE classified according to the American College of Rheumatology (ACR) classification criteria, and 115 controls were enrolled. MS was defined by the joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity (IDF/NHLBI/AHA/WHF/IAS/IASO). SLE features and treatment of SLE were assessed. Fasting insulin and cortisol levels of 30 newly diagnosed, untreated patients and 33 age and sex-matched controls were detected. MS prevalence was 34.2% in patients with SLE and 14.8% in controls (p=0.002). Lupus patients with MS had less frequency of hydroxychloroquine (HCQ) intake (16.0% vs 45.8%; p=0.012). Untreated patients with SLE had higher levels of fasting insulin (10.92 ± 13.53 vs 5.48 ± 5.43 uU/mL, p<0.001) and plasma cortisol at 16:00 (257.22 ± 177.98 vs 139.84 ± 63.46 nmol/L, p=0.001), but lower plasma cortisol at 08:00 (195.51 ± 149.84 vs 278.95 ± 136.27 nmol/L, p=0.024). Comparisons regarding steroid therapy, levels of insulin and cortisol were not statistically significant between patients with MS and without MS. The Chinese patients with SLE presented a higher MS prevalence and fasting insulin than controls. MS was not associated with the steroid therapy and plasma cortisol. HCQ use proved to be protective against MS. The circadian rhythm of cortisol may differ in patients with SLE.

The present study aimed to evaluate the early effects of interspinous spacers on lumbar degenerative disease. The clinical outcomes of 23 patients with lumbar degenerative disease, treated using interspinous spacer implantation alone or combined with posterior lumbar fusion, were retrospectively studied and assessed with a visual analogue scale (VAS) and the Oswestry Disability Index (ODI). Pre-operative and post-operative interspinous distance, disc space height, foraminal width and height and segmental lordosis were determined. The early effects and complications associated with the interspinous spacers were recorded. The surgical procedures performed with the in-space treatment were easy and minimally invasive. The VAS scores and ODI were improved post-operatively compared with pre-operatively. Significant changes in the interspinous distance, disc space height, foraminal width and height and segmental lordosis were noted. In-space treatment for degenerative lumbar disease is easy and safe, with good early effects. The in-space system provides an alternative treatment for lumbar degenerative disease.

Objective: To investigate the incidence and correlative factors of metabolic syndrome (MS) in patients with systemic lupus erythematosus (SLE)., Methods: A total of 116 SLE patients and 115 controls were enrolled into the study. The incidence of MS, SLE disease activity index (SLEDAI) of patients with SLE combined with MS (MS-SLE) and patients without MS (n-MS-SLE), lupus characteristics, cumulative glucocorticoids, administration dose of glucocorticoids and hydroxychloroquine were compared between SLE group and the control group., Results: The incidence of MS of SLE group was obviously higher than that of the control (34.48% vs 14.78%, P < 0.05). The ratios of patients with lower HDL-C, higher TG and higher blood pressure in SLE group (50.86%, 56.03%, 46.55%) were higher than those in the controls (34.78%, 16.52%, 20.00%, all P < 0.05). MS-SLE group had significantly higher mean waist circumference, BMI, systolic blood pressure and diastolic blood pressure and lower HDL-C than n-MS-SLE group (all P < 0.05). No significant difference was found regarding duration of disease, renal involvement, ESR, C-reactive protein,high-sensitivity C-reactive protein, SLEDAI, cumulative and current glucocorticoids use in MS-SLE group and n-MS-SLE group. The ratio of patients taking hydroxychloroquine in n-MS-SLE group was higher than that of MS-SLE group (46.05% vs 15.00%, P < 0.05)., Conclusions: Patients with SLE has a higher incidence rate of MS. Hydroxychloroquine may reduce their MS incidence.

N-doped NaTaO(3) compounds (NaTaO(3-)(x)N(x)) with nano-cubic morphology were successfully synthesized by one-step hydrothermal method and Methyl Orange (MO) was used as a model dye to evaluate their photocatalytic efficiency under visible-light irradiation. The as-prepared NaTaO(3-)(x)N(x) samples were characterized by various techniques, such as X-ray diffraction (XRD), X-ray photoelectron spectroscopy (XPS), scanning electron microscopy (SEM) and UV-vis diffuse reflectance spectra and GC-MS. The results indicate that NaTaO(3-)(x)N(x) displays a pure perovskite structure when the synthesis temperature is higher than 180°C. Moreover, as observed by SEM images, the particles of resultant NaTaO(3-)(x)N(x) show cubic morphology with the edge length of 200-500nm, which can be easily removed by filtration after photocatalytic reaction. Doping of N increases the photocatalytic activity of NaTaO(3), and NaTaO(2.953)N(0.047) shows the highest visible-light photocatalytic activity for the degradation of MO. Based on the experiment results, a possible mechanism of the photocatalysis over NaTaO(3-)(x)N(x) and the photodegradation pathway of MO were proposed., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

Purpose: Denosumab, a fully human monoclonal antibody to RANKL, suppresses bone resorption. This study evaluated the effects of denosumab in i.v. bisphosphonate (IV BP)-naïve patients with breast cancer-related bone metastases., Experimental Design: Eligible women (n = 255), stratified by type of antineoplastic therapy, were randomized to 1 of 5 blinded denosumab cohorts or an open-label IV BP cohort. Denosumab was administered s.c. every 4 weeks (30, 120, or 180 mg) or every 12 weeks (60 or 180 mg) through 21 weeks. Final efficacy results for up to 25 weeks are reported, including percentage change from baseline in urine N-telopeptide corrected for creatinine (uNTx/Cr) and incidence of skeletal-related events (SRE). Safety results are reported through the end of follow-up (up to 57 weeks)., Results: At week 13 and 25, the median percent changes in uNTx/creatinine (Cr) among patients with measurable uNTx were -73% and -75% for the pooled denosumab groups and -79% and -71% for the IV BP group. Among patients with > or =1 postbaseline measurement of uNTx at week 25, 52% (109 of 208) of denosumab-treated patients and 46% (19 of 41) of IV BP-treated patients achieved >65% uNTx/Cr reduction. On-study SREs occurred in 12% (26 of 211) of denosumab-treated patients and 16% (7 of 43) of IV BP-treated patients. Overall rates of adverse events were 95% in denosumab and IV BP groups. No denosumab-related serious or fatal adverse events occurred., Conclusions: In IV BP-naïve breast cancer patients with bone metastases, denosumab suppresses bone turnover and seems to reduce SRE risk similarly to IV BPs, with a safety profile consistent with an advanced cancer population receiving systemic therapy.

Objective: To study in the linkage between eotaxin-3 gene polymorphisms and allergic asthma susceptivity, blood plasma IgE or peripheral blood eosinophil in adult population of Han nationality from Hubei province of China., Methods: Polymerase chain reaction (PCR), single strand conformation polymorphism (SSCP), tetra-primer PCR technique and restriction analysis were applied to identify the single nucleotide polymorphism., Results: The allele frequency of eotaxin-3 +2497 G, total levels of plasma IgE and peripheral blood eosinophil counts revealed the significant difference between control and allergic asthma group, that the P value was 0.011, 0.021 or 0.029 respectively. The allele frequency of eotaxin-3 +77 T and total levels of plasma IgE showed to have no significant difference between control and allergic asthma group, that the P value was 0.824 and 0.473 respectively. However, the peripheral blood eosinophil counts was significantly different between control and allergic asthma group, and the P value was 0.044., Conclusion: Single nucleotide polymorphism of eotaxin-3 +2497 is associated with the asthma susceptibility, peripheral eosinophil counts and total levels of plasma IgE in adult population from Hubei province, and polymorphism of +77 is associated with peripheral eosinophil counts.

Objective: To select short tandem repeats(STR) from X chromosome., Methods: STR is a universal genetic marker that has changeable polymorphism and stable heredity in human genome. It is a specific DNA segment composed of 2-6 base pairs as its core sequence. It is an ideal DNA marker used in linkage analysis and gene mapping. In this study, 8 short tandem repeats were selected from two genomic clones on X chromosome by using BCM Search Launcher. Primers amplifying the STR loci were designed by using Primer 3.0 according to the unique sequence flanking the STRs. Polymorphisms of the short tandem repeats in Chinese population were evaluated by PCR amplification and PAGE., Results: Five of these STRs were polymorphic. Chi-square test indicated that the distribution of genotypes agreed with Hardy-Weinberg equilibrium (P>0.05)., Conclusion: Five polymorphic short tandem repeats have been identified on chromosome X and will be useful for linkage analysis and gene mapping.

Objective: Smith-Fineman-Myers syndrome (SFMS) is an X-linked mental retardation syndrome. The authors had ascertained a large Chinese family with SFMS from Shandong and had mapped the disease locus to an interval of 19.8 Mb on Xq25 flanked by markers DXS8064 and DXS8050. Further investigation suggested that SFMS exhibited locus heterogeneity. In this study for facilitating the identification of the gene responsible for SFMS, the additional markers were analyzed to narrow down the candidate region, and four candidate genes (GPC3, MST4,GPCR2 and GLUD2) were chosen and screened for disease-causing mutation., Methods: PCR and denaturing polyacrylamide gel electrophoresis were used to genotype 13 new polymorphic markers distributed within the candidate region. Mutation detection was accomplished by sequencing the exons and intron-exon junctions of the candidate genes., Results: By analyzing 13 additional polymorphic markers, SFMS candidate region can be reduced to an interval of 10.18 Mb bounded by XSTR3 and XSTR4, and no disease-causing mutation was identified in the coding regions of four candidate genes., Conclusion: GPCR2 GPC3, MST4 and GLUD2 were excluded as pathogenic genes for SFMS. The refined SFMS locus will assist in the identification and characterization of other candidate genes for SFMS.

The study is to determine the genomic structure and the role of SMARCA1 (SWI/SNF-related, matrix-associated, actin-dependent regulator of chromatin, subfamily A, member1, SMARCA1) in the etiology of Smith-Fineman-Myers syndrome (SFMS). By comparing the cDNA sequence of SMARCA1 with the genomic sequences, genomic structure of SMARCA1 was determined, and conformed by amplifying and sequencing the sequences of exons and splicing junction. The results show that the genomic sequence of SMARCA1 gene exceeds 71.7 kb in length, and contains 24 exons and 23 introns. All the exon/intron boundaries follow the GT-AG rule and are in good agreement with the exon/intron consensus sequence. The characterization of genomic structure of SMARCA1 gene allows us to detect disease-causing mutation within the gene and further study its biological function. The open reading frame of SMARCA1 was detected for mutation by PCR amplification and direct sequencing in affected males from SFMS family in Shandong China. The disease in SFMS family from Shandong is not caused by the mutation within open reading frame of SMARCA1 gene.

Aim: To investigate the antiepileptic effect of dizocilpine (MK-801) on amygdala kindling models in rats and the effects of its combination with general antiepileptic drugs., Methods: To establish amygdala kindling models in rats and observe the effect of dizocilpine on kindling models and its combination with general antiepileptic drugs (phenobarbital, valproate and nicardipine) at ineffective dose. The influence of dizocilpine on convulsions induced by semicarbazide (SCZ) in mice were also observed., Results: Dizocilpine (0.1-0.25 mg.kg-1, i.p.) was shown to dose-dependently inhibit amygdala kindled seizure, shorten the after discharge duration (ADD) and reduce the Racine's stage (P < 0.01). The combination of dizocilpine with phenobarbital, valproate, nicardipine at ineffective dose shortened ADD or reduced Racine's stages (P < 0.01). Dizocilpine (0.1-0.25 mg.kg-1, i.p.) significantly prolonged the latency and reduced the rate of convulsions and death in mice., Conclusion: Dizocilpine inhibits the seizure of the amygdala kindling and improve the antiepileptic activity of phenobarbital, valproate and nicardipine, indicating that these combination may provide a new approach for treating epilepsy.

Objective: To evaluate the role of homozygosity mapping in the fine mapping of the genes responsible for the rare autosomal recessive diseases., Methods: Polymerase chain reaction-single sequence length polymorphism was used to genotype the family members from 8 families with osteoporosis-pseudoglioma syndrome(OPS) for 14 polymorphic loci within candidate region. The OPS candidate region was narrowed by searching for homozygous region in affected., Results: The OPS candidate region was narrowed to a 1 cM interval between D11S1296 and D11S4136., Conclusion: Homozygosity mapping is a powerful method for mapping and narrowing the candidate region of the genes responsible for the rare autosomal recessive diseases.