Background: With the increasing need for high-quality exercise interventions in China, relatively little is known about issues and challenges related to recruitment of older Chinese adults into exercise-based disease ...Background: With the increasing need for high-quality exercise interventions in China, relatively little is known about issues and challenges related to recruitment of older Chinese adults into exercise-based disease prevention interventions. This study aims to describe the recruitment process and outcomes of 2 exercise interventions conducted in Shanghai, China.Methods: Recruitment information was ascertained from 2 community-based randomized controlled trials for 2 exercise interventions, the first designed to improve health outcomes for older women with knee osteoarthritis and the second to study changes in cognitive function in adults with mild cognitive impairment. Results were summarized in terms of recruitment sources, number screened, screening-to-enrollment ratios, and costs.Results: Recruitment was primarily achieved through working with local residential divisions(i.e., neighborhood associations and residential committees). Both studies achieved their planned target number of older adults(45 and 46, respectively) within a 1-year time frame, with a screening-to-randomized ratio of 5:1 and demonstrated excellent retention rates(range 87%–93%) at 6 months. The recruitment cost for the 2studies averaged RMB 189(about USD 30) per initial recruit and RMB 738(about USD 119) per participant randomized. Some major issues encountered during the recruitment process included(1) the use of community neighborhoods to support the conduct of the projects,(2) access to participants, and(3) feasibility.Conclusion: Analysis of the 2 randomized controlled trials has provided valuable insights into the recruitment process and identified resources that can help better planning and recruitment for future interventions. Recommendations aimed at increasing the success of future recruitment efforts are provided.展开更多
Osteoarthritis(OA)is a common degenerative disease worldwide and new therapeutics that target inflammation and the crosstalk between immunocytes and chondrocytes are being developed to prevent and treat OA.These attem...Osteoarthritis(OA)is a common degenerative disease worldwide and new therapeutics that target inflammation and the crosstalk between immunocytes and chondrocytes are being developed to prevent and treat OA.These attempts involve repolarizing pro-inflammatory M1 macrophages into the anti-inflammatory M2 phenotype in synovium.In this study,we found that phosphoglycerate mutase 5(PGAM5)significantly increased in macrophages in OA synovium compared to controls based on histology of human samples and single-cell RNA sequencing results of mice models.To address the role of PGAM5 in macrophages in OA,we found conditional knockout of PGAM5 in macrophages greatly alleviated OA symptoms and promoted anabolic metabolism of chondrocytes in vitro and in vivo.Mechanistically,we found that PGAM5 enhanced M1 polarization via AKT-mTOR/p38/ERK pathways,whereas inhibited M2 polarization via STAT6-PPARγpathway in murine bone marrow-derived macrophages.Furthermore,we found that PGAM5 directly dephosphorylated Dishevelled Segment Polarity Protein 2(DVL2)which resulted in the inhibition ofβ-catenin and repolarization of M2 macrophages into M1 macrophages.Conditional knockout of both PGAM5 andβ-catenin in macrophages significantly exacerbated osteoarthritis compared to PGAM5-deficient mice.Motivated by these findings,we successfully designed mannose modified fluoropolymers combined with siPGAM5 to inhibit PGAM5 specifically in synovial macrophages via intra-articular injection,which possessed desired targeting abilities of synovial macrophages and greatly attenuated murine osteoarthritis.Collectively,these findings defined a key role for PGAM5 in orchestrating macrophage polarization and provides insights into novel macrophage-targeted strategy for treating OA.展开更多
AIM To assess disease-specific circulating micro RNAs(mi RNAs) in non-alcoholic steatohepatitis(NASH) patients.METHODS A total of 111 biopsy-proven non-alcoholic fatty liver disease(NAFLD) or chronic hepatitis B(CHB) ...AIM To assess disease-specific circulating micro RNAs(mi RNAs) in non-alcoholic steatohepatitis(NASH) patients.METHODS A total of 111 biopsy-proven non-alcoholic fatty liver disease(NAFLD) or chronic hepatitis B(CHB) patients and healthy controls from China's Mainland were enrolled to measure their serum levels of mi R-122,-125 b,-146 b,-16,-21,-192,-27 b and-34 a. The correlations between serum mi RNAs and histological features of NAFLD were determined. The diagnostic value of mi RNA in NASH and significant fibrosis was analyzed and compared with that of cytokeratin-18(CK-18), fibrosis-4(FIB-4), and aspartate aminotransferase to platelet ratio index(APRI), respectively.RESULTS Circulating mi R-122,-16,-192 and-34 a showed differential expression levels between NAFLD and CHB patients, and mi R-34 a had an approximately 2-fold increase in NAFLD samples compared with that of CHB samples(P < 0.01). Serum mi R-122,-192 and-34a levels were correlated with steatosis(R = 0.302, 0.323 and 0.470, respectively, P < 0.05) and inflammatory activity(R = 0.445, 0.447 and 0.517, respectively, P < 0.01); only serum mi R-16 levels were associated with fibrosis(R = 0.350, P < 0.05) in patients with NAFLD. The diagnostic value of mi R-34 a for NASH(area under the receiver operating characteristic, 0.811, 95%CI: 0.670-0.953) was superior to that of alanine aminotransferase, CK-18, FIB-4 and APRI in NAFLD, but mi R-16 showed a limited performance in the diagnosis of significant fibrosis in NASH.CONCLUSION Circulating mi R-34 a may serve as a disease-specific noninvasive biomarker for the diagnosis of NASH.展开更多
AIM: To compare the follow-up outcomes of ileosigmoidal anastomosis(ISA) and caecorectal anastomosis(CRA) in patients with slow transit constipation(STC) with or without melanosis coli(MC).METHODS: We collected the cl...AIM: To compare the follow-up outcomes of ileosigmoidal anastomosis(ISA) and caecorectal anastomosis(CRA) in patients with slow transit constipation(STC) with or without melanosis coli(MC).METHODS: We collected the clinical data of 48 STC patients with or without MC from May 2002 to May 2007.Twenty-six patients underwent CRA(14 with MC) and 22 cases received ISA(14 with MC).A 3-year postoperative follow-up was conducted.RESULTS: CRA improved the quality of life [evaluated by the gastrointestinal quality of life index(GIQLI)] in patients without MC,but was inferior to ISA in stool frequency and Wexner and GIQLI scores for MC patients.In the CRA group,patients with MC suffered worse outcomes than those without MC.CONCLUSION: CRA is more suitable for STC patients without MC; however,for STC patients with MC,ISA is a better choice.展开更多
AIM To investigate the distribution and function of interstitialcells of Cajal(ICCs) and platelet-derived growth factor receptor-α positive(PDGFRα+) cells in the proximal and distal colon.METHODS The comparison of c...AIM To investigate the distribution and function of interstitialcells of Cajal(ICCs) and platelet-derived growth factor receptor-α positive(PDGFRα+) cells in the proximal and distal colon.METHODS The comparison of colonic transit in the proximal and distal ends was performed by colonic migrating motor complexes(CMMCs). The tension of the colonic smooth muscle was examined by smooth muscle spontaneous contractile experiments with both ends of the smooth muscle strip tied with a silk thread. Intracellular recordings were used to assess electrical field stimulation(EFS)-induced inhibitory junction potentials(IJP) on the colonic smooth muscle. Western blot analysis was used to examine the expression levels of ICCs and PDGFRα in the colonic smooth muscle.RESULTS Treatment with NG-nitro-L-arginine methyl ester hydrochloride(L-NAME) significantly increased the CMMC frequency and spontaneous contractions, especially in the proximal colon, while treatment with MRS2500 increased only distal CMMC activity and smooth muscle contractions. Both CMMCs and spontaneous contractions were markedly inhibited by NPPB, especially in the proximal colon. Accordingly, CyPPA sharply inhibited the distal contraction of both CMMCs and spontaneous contractions. Additionally, the amplitude of stimulationinduced nitric oxide(NO)/ICC-dependent slow IJPs(sIJPs) by intracellular recordings from the smooth muscles in the proximal colon was larger than that in the distal colon, while the amplitude of electric field stimulationinduced purinergic/PDGFRα-dependent fast IJPs(fIJPs) in the distal colon was larger than that in the proximal colon. Consistently, protein expression levels of c-Kit and anoctamin-1(ANO1) in the proximal colon were much higher, while protein expression levels of PDGFRα and small conductance calcium-activated potassium channel 3(SK3) in the distal colon were much higher.CONCLUSION The ICCs are mainly distributed in the proximal colon and there are more PDGFRα+ cells are in the distal colon, which generates a pressure gradient between the two ends of the colon to propel the feces to the anus.展开更多
AIM: To demonstrate that caudate lobectomy is a valid treatment in cases of hepatocellular carcinoma(HCC) rupture in the caudate lobe based on our experience with the largest case series reported to date.METHODS: A re...AIM: To demonstrate that caudate lobectomy is a valid treatment in cases of hepatocellular carcinoma(HCC) rupture in the caudate lobe based on our experience with the largest case series reported to date.METHODS: A retrospective study of eight patients presenting with spontaneous rupture and hemorrhage of HCC in the caudate lobe was conducted.Two patients underwent ineffective transarterial embolization preoperatively.Caudate lobectomy was performed in all eight patients.Bilateral approach was taken in seven cases for isolated complete caudate lobectomy.Left-sided approach was employed in one case for isolated partial caudate lobectomy.Transarterial chemoembolization was performed postoperatively in all patients.RESULTS: Caudate lobectomy was successfully completed in all eight cases.The median time delay from the diagnosis to operation was 5 d(range: 0.25-9).Median operating time was 200 min(range: 120-310) with a median blood loss of 900 m L(range: 300-1500).Five patient remained in long-term follow-up,with one patient becoming lost to followup at 3 years and two patients currently alive at 7 and 19 mo.One patient required reoperation due to recurrence.Gamma knife intervention was performed for brain metastasis in another case.Two patients survived for 10 and 84 mo postoperatively,ultimately succumbing to multiple organ metastases.CONCLUSION: Caudate lobectomy is the salvage choice for HCC rupture in the caudate lobe.Local anatomy and physiologic features of the disease render caudate lobectomy a technically difficult operation.Postponement of surgical intervention is thus recommended while the rupture remains hemodynamically stable until an experienced surgeon becomes available.Prognosis is confounded by numerous factors,but long-term survival can be expected in the majority of cases.展开更多
Dear Editor,I am Dr.Zhao PQ,from the Department of Ophthalmology,Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai,China.I write to present a case report of tissue plasminogen ac...Dear Editor,I am Dr.Zhao PQ,from the Department of Ophthalmology,Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai,China.I write to present a case report of tissue plasminogen activator(tP A)-assisted vitrectomy in the early treatment of acute massive展开更多
Dear Editor,Iam Dr.Tian Tian,from the Department of Ophthalmology,Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai,China.I write to present a rare case report of a delayed diagn...Dear Editor,Iam Dr.Tian Tian,from the Department of Ophthalmology,Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai,China.I write to present a rare case report of a delayed diagnosis of unsuspected retinoblastoma(RB)in an in vitro fertilisation(IVF)infant with retinopathy of prematurity.The simultaneous presentation of RB and prematurity of retinopathy(ROP)in an IVF infant is very rare.The relationship between RB and IVF is still indeterminate and mechanisms that lead to ocular or systemic展开更多
Retinopathy of prematurity(ROP)is a proliferative disorder of the developing retina in premature and low birth weight infants.Recently,the role of vascular endothelial growth factor(VEGF)in the pathophysiology of ROP ...Retinopathy of prematurity(ROP)is a proliferative disorder of the developing retina in premature and low birth weight infants.Recently,the role of vascular endothelial growth factor(VEGF)in the pathophysiology of ROP has been well studied and anti-VEGF drugs have been used in phase 2 to treat ROP patients in many ways.At first,ophthalmologists began to give intravitreal bevacizumab(IVB)or ranibizumab off-label to treat ROP as a salvage treatment after failure in laser photocoagulation or in combination with laser as an adjuvant treatment for patients had media opacity or rigid pupil.Now anti-VEGF drugs are also used as monotherapy in type I ROP or perioperative use in stage 4/5 ROP.Questions remain regarding long-term safety,dose,timing,visual outcomes and long-term effects,including systemically.展开更多
AIM:To compare central macular thickness(CMT) measurements obtained by two spectral-domain optical coherence tomography(SD-OCT) exams,and to evaluate measurement reproducibility and agreement between these two exams,a...AIM:To compare central macular thickness(CMT) measurements obtained by two spectral-domain optical coherence tomography(SD-OCT) exams,and to evaluate measurement reproducibility and agreement between these two exams,and to investigate the relationship between CMT and possible influencing factors such as age,sex,eye(OD/OS),and operators in elderly non-mydriatic eyes.· METHODS:Seventy-two normal subjects were included.Every subject underwent CMT measurement twice using one of two SD-OCT(OSE-2000,Moptim,Shenzhen,China & 3-D OCT-1000,Topcon,Tokyo,Japan) instruments respectively where we randomly chose one eye in each patient for the test;these exams were performed by two operators over an hour period with a brief rest between sessions.Comparison of the OSE-2000 and 3-D OCT-1000 CMT measurements was based on paired-t test.The mean difference between the CMT measurements was calculated.General linear model analyzed the relationships among eye(OD/OS),operator,sex,and CMT values using age as co-variant.All tests were considered statistically significant at P <0.05.The main outcome measures included CMT.· RESULTS:When evaluated with general linear model analysis,CMT measurements were found to have high reproducibility across the two instruments between the two operators for the OSE-2000 single line scan and 3-D OCT-1000 macular scans(P =0.731;P =0.443).There was statistically significant difference in CMT values between the two instruments(P <0.001) and the mean difference was-46.83μm at 95% confidence limits(-49.15,-44.51).Age was positively correlated with CMT(beta coefficient =0.516,P = 0.001;beta coefficient=0.453,P =0.009) and sex was correlated with CMT from the OSE-2000(P =0.021) but not with the 3-D OCT-1000(P =0.056).According to the actual thickness measurements,the CMT of the male was thicker than the female's but there was no statistical difference.There was interaction between sex and eye in OSE-2000 and not in 3-D OCT-1000(P =0.02;P =0.374).No significant correlation was found between CMT and the influencing factor of eye in both of the instruments(P =0.884;P =0.492).· CONCLUSION:Reproducibility of CMT measurement using the two SD-OCTs is excellent in normal eyes according to the operator factor analysis.OSE-2000 has a different posterior retinal boundary of CMT measurement,which results in the CMT value differences,compared with the 3-D OCT-1000.Age is positively correlated with CMT measurement while sex is correlated with CMT in the OSE-2000 but not in the 3-D OCT-1000 and eye(OD/OS) had no correlation with CMT values.Mydriatic drops may not be necessary for CMT measurement using high scan rate SD-OCT in normal eyes in dark room.展开更多
BACKGROUND Solitary fibrous tumors are rare neoplasms of mesenchymal origin. They are often of low malignant potential and rarely metastasize. They frequently arise from the pleura and can occur at any soft tissue sit...BACKGROUND Solitary fibrous tumors are rare neoplasms of mesenchymal origin. They are often of low malignant potential and rarely metastasize. They frequently arise from the pleura and can occur at any soft tissue site in the body. However, these tumors rarely develop in the mesentery, peritoneal cavity or peritoneum.CASE SUMMARY We report on a scarce case of solitary fibrous tumor of the rectal mesentery showing sarcomatosis about 4 years after previous tumor resection. This 69-yearold male had no clinical symptoms but was transferred to our hospital because of a suspected tumor recurrence from follow-up abdominal computed tomography.Tumor markers(CEA, CA 19-9 and CA 125) were within the normal range. Open laparotomy showed sarcomatosis, and pathology confirmed its mesenchymal origin and diagnosis as the solitary fibrous tumor. Our case may be the second recurrent mesentery solitary fibrous tumor reported to date, and the only one with progression to sarcomatosis. There has been no evidence of recurrence in follow-up at the 28 th mo after extensive intra-operative peritoneal lavage and cytoreductive surgery.CONCLUSION Although there are few risk factors of cancer recurrence in this patient, careful long-term followup after cytoreductive surgery is necessary.展开更多
Dear editor,I am Dr.Jie Peng,from the Department of Ophthalmology,Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai,China.I write to present a case report of a novel in-frame del...Dear editor,I am Dr.Jie Peng,from the Department of Ophthalmology,Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai,China.I write to present a case report of a novel in-frame deletion mutation c.177179del TAC of neurofibromatosis type 1 in a Chinese boy with bilateral blindness.Neurofibromatosis type 1（NF1;OMIM#162200）,an autosomal dominant disease,is caused by mutations in the NF1gene.The incidence of this disease is around 1 in展开更多
Background Respiratory syncytial virus(RSV)is the leading global cause of respiratory infections and is responsible for about 3 million hospitalizations and more than 100,000 deaths annually in children younger than 5...Background Respiratory syncytial virus(RSV)is the leading global cause of respiratory infections and is responsible for about 3 million hospitalizations and more than 100,000 deaths annually in children younger than 5 years,representing a major global healthcare burden.There is a great unmet need for new agents and universal strategies to prevent RSV infections in early life.A multidisciplinary consensus development group comprising experts in epidemiology,infectious diseases,respiratory medicine,and methodology aims to develop the current consensus to address clinical issues of RSV infections in children.Data sources The evidence searches and reviews were conducted using electronic databases,including PubMed,Embase,Web of Science,and the Cochrane Library,using variations in terms for"respiratory syncytial virus","RSV","lower respiratory tract infection","bronchiolitis","acute","viral pneumonia","neonatal","infant""children",and"pediatric".Results Evidence-based recommendations regarding diagnosis,treatment,and prevention were proposed with a high degree of consensus.Although supportive care remains the cornerstone for the management of RSV infections,new monoclonal antibodies,vaccines,drug therapies,and viral surveillance techniques are being rolled out.Conclusions This consensus,based on international and national scientific evidence,reinforces the current recommendations and integrates the recent advances for optimal care and prevention of RSV infections.Further improvements in the management of RSV infections will require generating the highest quality of evidence through rigorously designed studies that possess little bias and sufficient capacity to identify clinically meaningful end points.展开更多
Cancer-associated fibroblasts(CAFs) are important components of various types of tumors,including gastric cancer(GC).During tumorigenesis and progression,CAFs play critical roles in tumor invasion and metastasis via a...Cancer-associated fibroblasts(CAFs) are important components of various types of tumors,including gastric cancer(GC).During tumorigenesis and progression,CAFs play critical roles in tumor invasion and metastasis via a series of functions including extracellular matrix deposition,angiogenesis,metabolism reprogramming and chemoresistance.However,the mechanism of the interaction between gastric cancer cells and CAFs remains largely unknown.Micro RNAs(mi RNAs) are a class of non-coding small RNA molecules,and their expression in CAFs not only regulates the expression of a number of target genes but also plays an essential role in the communication between tumor cells and CAFs.In this review,we provide an overview of recent studies on CAF mi RNAs in GC and the relevant signaling pathways in gastrointestinal tumors.Focusing the attention on these signaling pathways may help us better understand their role in tumor invasion and metastasis and identify new molecular targets for therapeutic strategies.展开更多
AIM:To report a simple approach to actively remove high viscosity silicone oil through a 23-gauge cannula via pars plana.METHODS:Forty-eight eyes of 48 patients underwent silicone oil(5700 centistokes) removal(SOR) we...AIM:To report a simple approach to actively remove high viscosity silicone oil through a 23-gauge cannula via pars plana.METHODS:Forty-eight eyes of 48 patients underwent silicone oil(5700 centistokes) removal(SOR) were enrolled.A section of blood transfusion set was prepared to connect a standard 23-gauge cannula and vitrectomy machine.Silicone oil was removed with suction of500-mm Hg vacuum through the cannula.Main outcome measures were SOR duration,number of sutured sites,intraocular pressure(IOP),best-corrected visual acuity(BCVA),and complications.RESULTS:Silicone oil was successfully removed in all cases.The mean SOR time was 5.70±0.85 min.Nine eyes(18.75%) needed suture partial sclerotomies.No intraoperative complications were noted.Transient hypotony(≤8 mm Hg) was seen in 3 eyes(6.25%) on postoperative day 1,but all resolved within 1wk.Retinal reattachment was achieved in all cases and no other postoperative complications were noted during 3-month following-up.BCVA at the final visit improved or stabilized in all patients comparing to the preoperative level.CONCLUSION:Active removal of high viscosity silicone oil through a 23-gauge instrument cannula jointed with blood transfusion set is a practical and reliable technique when considering two sides of efficacy and safety.展开更多
AIM: To identify the contribution of CDKAL1 to the development of diabetic retinopathy(DR) in Chinese population.·METHODS: A case-control study was performed to investigate the genetic association between DR and ...AIM: To identify the contribution of CDKAL1 to the development of diabetic retinopathy(DR) in Chinese population.·METHODS: A case-control study was performed to investigate the genetic association between DR and polymorphic variants of CDKAL1 in Chinese Han population with type 2 diabetes mellitus(T2DM). A welldefined population with T2 DM, consisting of 475 controls and 105 DR patients, was recruited. All subjects were genotyped for the genetic variant(rs10946398) of CDKAL1. Genotyping was performed by i PLEX technology. The association between rs10946398 and T2 DM was assessed by univariate and multivariate logistic regression(MLR) analysis.· RESULTS: There were significant differences in C allele frequencies of rs10946398(CDKAL1) between control and DR groups(45.06% versus 55.00%, P <0.05).The rs10946398 of CDKAL1 was found to be associated with the increased risk of DR among patients with diabetes.·CONCLUSION: Our findings suggest that rs10946398 of CDKAL1 is independently associated with DR in a Chinese Han population.展开更多
Patient’s information The patient is a 56-year-old man who visited our hospital for "repeated epigastric pain for more than two months." Physical examination showed nearly pale appearance; abdomen was soft ...Patient’s information The patient is a 56-year-old man who visited our hospital for "repeated epigastric pain for more than two months." Physical examination showed nearly pale appearance; abdomen was soft and no mass palpable; left supraclavicular lymph node (-); and digital rectal examination (-).展开更多
A three dimensional Fricke-(PVA-glutaraldehyde)-xylenol orange (FPGX) hydrogel dosimeter was prepared by chemical crosslinking method.Dose determination was performed by measuring the absorbance change of the dosimete...A three dimensional Fricke-(PVA-glutaraldehyde)-xylenol orange (FPGX) hydrogel dosimeter was prepared by chemical crosslinking method.Dose determination was performed by measuring the absorbance change of the dosimeter before and after irradiation using UV-Vis spectrophotometer at 585 nm.The dose response of the FPGX hydrogel dosimeter related to absorbance change was linear,when it was irradiated by X-ray in the range of 0~2 Gy.The stability of the dosimeter before and after irradiation was evaluated by studying the change of absorbance with time.展开更多
Objective:To compare the effects of different conservative managements on patients with adolescent idiopathic scoliosis (AIS). Method:One hundred and four AIS patients were recruited for this study. The patients were ...Objective:To compare the effects of different conservative managements on patients with adolescent idiopathic scoliosis (AIS). Method:One hundred and four AIS patients were recruited for this study. The patients were divided into 3 groups:exercise (E group), brace (B group) and combined rehabilitation treatment (brace treatment combined with exercise, CR group). Radiological parameter were used to assess AIS patients before and after treatment. The Chinese version of scoliosis research society-22(SRS-22) patient questionnaires were filled out by patients after treatment. The SRS-22 scores were compared among management groups. Result:The maximal Cobb angles were smaller in E group than in B group or CR group both before and af- ter treatment. The maximal Cobb angles were significantly smaller after treatment than before treatment in B group and CR group. Function/activity was better in E group than in B group or CR group. Self-image/appear- ance and satisfaction with management were better in E group and CR group than in B group. There was no significant difference among treatment groups in pain and mental health. Conclusion:Both brace and combined rehabilitation treatment can reduce the spinal curve of AIS patients. Both exercise and combined rehabilitation treatment have positive influence on self-image/appearance and satis- faction with management. We support preference of combined rehabilitation treatment above brace treatment.展开更多
基金supported by the Shanghai City Committee of Science and Technology Key Project (No. 12490503200)the National Natural Science Foundation of China (No. 81572213, No. 11372194)
文摘Background: With the increasing need for high-quality exercise interventions in China, relatively little is known about issues and challenges related to recruitment of older Chinese adults into exercise-based disease prevention interventions. This study aims to describe the recruitment process and outcomes of 2 exercise interventions conducted in Shanghai, China.Methods: Recruitment information was ascertained from 2 community-based randomized controlled trials for 2 exercise interventions, the first designed to improve health outcomes for older women with knee osteoarthritis and the second to study changes in cognitive function in adults with mild cognitive impairment. Results were summarized in terms of recruitment sources, number screened, screening-to-enrollment ratios, and costs.Results: Recruitment was primarily achieved through working with local residential divisions(i.e., neighborhood associations and residential committees). Both studies achieved their planned target number of older adults(45 and 46, respectively) within a 1-year time frame, with a screening-to-randomized ratio of 5:1 and demonstrated excellent retention rates(range 87%–93%) at 6 months. The recruitment cost for the 2studies averaged RMB 189(about USD 30) per initial recruit and RMB 738(about USD 119) per participant randomized. Some major issues encountered during the recruitment process included(1) the use of community neighborhoods to support the conduct of the projects,(2) access to participants, and(3) feasibility.Conclusion: Analysis of the 2 randomized controlled trials has provided valuable insights into the recruitment process and identified resources that can help better planning and recruitment for future interventions. Recommendations aimed at increasing the success of future recruitment efforts are provided.
基金This work was supported by grants from National Natural Science Foundation of China(81830078,82071868,32370892)Science and Technology Commission of Shanghai Municipality(23141901200)+2 种基金Health Commission of Shanghai Municipality(2022JC029)Biomaterials and Regenerative Medicine Institute Cooperative Research Project,Shanghai Jiaotong University School of Medicine(2022LHA11)Shanghai Key Laboratory of Orthopedic Implant(No.KFKT202206).
文摘Osteoarthritis(OA)is a common degenerative disease worldwide and new therapeutics that target inflammation and the crosstalk between immunocytes and chondrocytes are being developed to prevent and treat OA.These attempts involve repolarizing pro-inflammatory M1 macrophages into the anti-inflammatory M2 phenotype in synovium.In this study,we found that phosphoglycerate mutase 5(PGAM5)significantly increased in macrophages in OA synovium compared to controls based on histology of human samples and single-cell RNA sequencing results of mice models.To address the role of PGAM5 in macrophages in OA,we found conditional knockout of PGAM5 in macrophages greatly alleviated OA symptoms and promoted anabolic metabolism of chondrocytes in vitro and in vivo.Mechanistically,we found that PGAM5 enhanced M1 polarization via AKT-mTOR/p38/ERK pathways,whereas inhibited M2 polarization via STAT6-PPARγpathway in murine bone marrow-derived macrophages.Furthermore,we found that PGAM5 directly dephosphorylated Dishevelled Segment Polarity Protein 2(DVL2)which resulted in the inhibition ofβ-catenin and repolarization of M2 macrophages into M1 macrophages.Conditional knockout of both PGAM5 andβ-catenin in macrophages significantly exacerbated osteoarthritis compared to PGAM5-deficient mice.Motivated by these findings,we successfully designed mannose modified fluoropolymers combined with siPGAM5 to inhibit PGAM5 specifically in synovial macrophages via intra-articular injection,which possessed desired targeting abilities of synovial macrophages and greatly attenuated murine osteoarthritis.Collectively,these findings defined a key role for PGAM5 in orchestrating macrophage polarization and provides insights into novel macrophage-targeted strategy for treating OA.
基金Supported by grants from the State Key Development Program for Basic Research of China,No.2012CB517501National Natural Science Foundation of China,No.81270491 and No.81470840+1 种基金Hundred Talents Program of the Shanghai Board of Health,No.XBR2011007Program of the Shanghai Committee of Science and Technology,No.10411956300
文摘AIM To assess disease-specific circulating micro RNAs(mi RNAs) in non-alcoholic steatohepatitis(NASH) patients.METHODS A total of 111 biopsy-proven non-alcoholic fatty liver disease(NAFLD) or chronic hepatitis B(CHB) patients and healthy controls from China's Mainland were enrolled to measure their serum levels of mi R-122,-125 b,-146 b,-16,-21,-192,-27 b and-34 a. The correlations between serum mi RNAs and histological features of NAFLD were determined. The diagnostic value of mi RNA in NASH and significant fibrosis was analyzed and compared with that of cytokeratin-18(CK-18), fibrosis-4(FIB-4), and aspartate aminotransferase to platelet ratio index(APRI), respectively.RESULTS Circulating mi R-122,-16,-192 and-34 a showed differential expression levels between NAFLD and CHB patients, and mi R-34 a had an approximately 2-fold increase in NAFLD samples compared with that of CHB samples(P < 0.01). Serum mi R-122,-192 and-34a levels were correlated with steatosis(R = 0.302, 0.323 and 0.470, respectively, P < 0.05) and inflammatory activity(R = 0.445, 0.447 and 0.517, respectively, P < 0.01); only serum mi R-16 levels were associated with fibrosis(R = 0.350, P < 0.05) in patients with NAFLD. The diagnostic value of mi R-34 a for NASH(area under the receiver operating characteristic, 0.811, 95%CI: 0.670-0.953) was superior to that of alanine aminotransferase, CK-18, FIB-4 and APRI in NAFLD, but mi R-16 showed a limited performance in the diagnosis of significant fibrosis in NASH.CONCLUSION Circulating mi R-34 a may serve as a disease-specific noninvasive biomarker for the diagnosis of NASH.
文摘AIM: To compare the follow-up outcomes of ileosigmoidal anastomosis(ISA) and caecorectal anastomosis(CRA) in patients with slow transit constipation(STC) with or without melanosis coli(MC).METHODS: We collected the clinical data of 48 STC patients with or without MC from May 2002 to May 2007.Twenty-six patients underwent CRA(14 with MC) and 22 cases received ISA(14 with MC).A 3-year postoperative follow-up was conducted.RESULTS: CRA improved the quality of life [evaluated by the gastrointestinal quality of life index(GIQLI)] in patients without MC,but was inferior to ISA in stool frequency and Wexner and GIQLI scores for MC patients.In the CRA group,patients with MC suffered worse outcomes than those without MC.CONCLUSION: CRA is more suitable for STC patients without MC; however,for STC patients with MC,ISA is a better choice.
基金Supported by The National Natural Science Foundation of China,No.31671192 and No.31571180Foundation of Xin Hua Hospital,No.JZPI201708
文摘AIM To investigate the distribution and function of interstitialcells of Cajal(ICCs) and platelet-derived growth factor receptor-α positive(PDGFRα+) cells in the proximal and distal colon.METHODS The comparison of colonic transit in the proximal and distal ends was performed by colonic migrating motor complexes(CMMCs). The tension of the colonic smooth muscle was examined by smooth muscle spontaneous contractile experiments with both ends of the smooth muscle strip tied with a silk thread. Intracellular recordings were used to assess electrical field stimulation(EFS)-induced inhibitory junction potentials(IJP) on the colonic smooth muscle. Western blot analysis was used to examine the expression levels of ICCs and PDGFRα in the colonic smooth muscle.RESULTS Treatment with NG-nitro-L-arginine methyl ester hydrochloride(L-NAME) significantly increased the CMMC frequency and spontaneous contractions, especially in the proximal colon, while treatment with MRS2500 increased only distal CMMC activity and smooth muscle contractions. Both CMMCs and spontaneous contractions were markedly inhibited by NPPB, especially in the proximal colon. Accordingly, CyPPA sharply inhibited the distal contraction of both CMMCs and spontaneous contractions. Additionally, the amplitude of stimulationinduced nitric oxide(NO)/ICC-dependent slow IJPs(sIJPs) by intracellular recordings from the smooth muscles in the proximal colon was larger than that in the distal colon, while the amplitude of electric field stimulationinduced purinergic/PDGFRα-dependent fast IJPs(fIJPs) in the distal colon was larger than that in the proximal colon. Consistently, protein expression levels of c-Kit and anoctamin-1(ANO1) in the proximal colon were much higher, while protein expression levels of PDGFRα and small conductance calcium-activated potassium channel 3(SK3) in the distal colon were much higher.CONCLUSION The ICCs are mainly distributed in the proximal colon and there are more PDGFRα+ cells are in the distal colon, which generates a pressure gradient between the two ends of the colon to propel the feces to the anus.
文摘AIM: To demonstrate that caudate lobectomy is a valid treatment in cases of hepatocellular carcinoma(HCC) rupture in the caudate lobe based on our experience with the largest case series reported to date.METHODS: A retrospective study of eight patients presenting with spontaneous rupture and hemorrhage of HCC in the caudate lobe was conducted.Two patients underwent ineffective transarterial embolization preoperatively.Caudate lobectomy was performed in all eight patients.Bilateral approach was taken in seven cases for isolated complete caudate lobectomy.Left-sided approach was employed in one case for isolated partial caudate lobectomy.Transarterial chemoembolization was performed postoperatively in all patients.RESULTS: Caudate lobectomy was successfully completed in all eight cases.The median time delay from the diagnosis to operation was 5 d(range: 0.25-9).Median operating time was 200 min(range: 120-310) with a median blood loss of 900 m L(range: 300-1500).Five patient remained in long-term follow-up,with one patient becoming lost to followup at 3 years and two patients currently alive at 7 and 19 mo.One patient required reoperation due to recurrence.Gamma knife intervention was performed for brain metastasis in another case.Two patients survived for 10 and 84 mo postoperatively,ultimately succumbing to multiple organ metastases.CONCLUSION: Caudate lobectomy is the salvage choice for HCC rupture in the caudate lobe.Local anatomy and physiologic features of the disease render caudate lobectomy a technically difficult operation.Postponement of surgical intervention is thus recommended while the rupture remains hemodynamically stable until an experienced surgeon becomes available.Prognosis is confounded by numerous factors,but long-term survival can be expected in the majority of cases.
基金Supported by the National Natural Science Foundation of China(No.81500725No.81770963+1 种基金No.81470642)Shanghai Science and Technology Committee(No.15XD1502800)
文摘Dear Editor,I am Dr.Zhao PQ,from the Department of Ophthalmology,Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai,China.I write to present a case report of tissue plasminogen activator(tP A)-assisted vitrectomy in the early treatment of acute massive
文摘Dear Editor,Iam Dr.Tian Tian,from the Department of Ophthalmology,Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai,China.I write to present a rare case report of a delayed diagnosis of unsuspected retinoblastoma(RB)in an in vitro fertilisation(IVF)infant with retinopathy of prematurity.The simultaneous presentation of RB and prematurity of retinopathy(ROP)in an IVF infant is very rare.The relationship between RB and IVF is still indeterminate and mechanisms that lead to ocular or systemic
文摘Retinopathy of prematurity(ROP)is a proliferative disorder of the developing retina in premature and low birth weight infants.Recently,the role of vascular endothelial growth factor(VEGF)in the pathophysiology of ROP has been well studied and anti-VEGF drugs have been used in phase 2 to treat ROP patients in many ways.At first,ophthalmologists began to give intravitreal bevacizumab(IVB)or ranibizumab off-label to treat ROP as a salvage treatment after failure in laser photocoagulation or in combination with laser as an adjuvant treatment for patients had media opacity or rigid pupil.Now anti-VEGF drugs are also used as monotherapy in type I ROP or perioperative use in stage 4/5 ROP.Questions remain regarding long-term safety,dose,timing,visual outcomes and long-term effects,including systemically.
文摘AIM:To compare central macular thickness(CMT) measurements obtained by two spectral-domain optical coherence tomography(SD-OCT) exams,and to evaluate measurement reproducibility and agreement between these two exams,and to investigate the relationship between CMT and possible influencing factors such as age,sex,eye(OD/OS),and operators in elderly non-mydriatic eyes.· METHODS:Seventy-two normal subjects were included.Every subject underwent CMT measurement twice using one of two SD-OCT(OSE-2000,Moptim,Shenzhen,China & 3-D OCT-1000,Topcon,Tokyo,Japan) instruments respectively where we randomly chose one eye in each patient for the test;these exams were performed by two operators over an hour period with a brief rest between sessions.Comparison of the OSE-2000 and 3-D OCT-1000 CMT measurements was based on paired-t test.The mean difference between the CMT measurements was calculated.General linear model analyzed the relationships among eye(OD/OS),operator,sex,and CMT values using age as co-variant.All tests were considered statistically significant at P <0.05.The main outcome measures included CMT.· RESULTS:When evaluated with general linear model analysis,CMT measurements were found to have high reproducibility across the two instruments between the two operators for the OSE-2000 single line scan and 3-D OCT-1000 macular scans(P =0.731;P =0.443).There was statistically significant difference in CMT values between the two instruments(P <0.001) and the mean difference was-46.83μm at 95% confidence limits(-49.15,-44.51).Age was positively correlated with CMT(beta coefficient =0.516,P = 0.001;beta coefficient=0.453,P =0.009) and sex was correlated with CMT from the OSE-2000(P =0.021) but not with the 3-D OCT-1000(P =0.056).According to the actual thickness measurements,the CMT of the male was thicker than the female's but there was no statistical difference.There was interaction between sex and eye in OSE-2000 and not in 3-D OCT-1000(P =0.02;P =0.374).No significant correlation was found between CMT and the influencing factor of eye in both of the instruments(P =0.884;P =0.492).· CONCLUSION:Reproducibility of CMT measurement using the two SD-OCTs is excellent in normal eyes according to the operator factor analysis.OSE-2000 has a different posterior retinal boundary of CMT measurement,which results in the CMT value differences,compared with the 3-D OCT-1000.Age is positively correlated with CMT measurement while sex is correlated with CMT in the OSE-2000 but not in the 3-D OCT-1000 and eye(OD/OS) had no correlation with CMT values.Mydriatic drops may not be necessary for CMT measurement using high scan rate SD-OCT in normal eyes in dark room.
文摘BACKGROUND Solitary fibrous tumors are rare neoplasms of mesenchymal origin. They are often of low malignant potential and rarely metastasize. They frequently arise from the pleura and can occur at any soft tissue site in the body. However, these tumors rarely develop in the mesentery, peritoneal cavity or peritoneum.CASE SUMMARY We report on a scarce case of solitary fibrous tumor of the rectal mesentery showing sarcomatosis about 4 years after previous tumor resection. This 69-yearold male had no clinical symptoms but was transferred to our hospital because of a suspected tumor recurrence from follow-up abdominal computed tomography.Tumor markers(CEA, CA 19-9 and CA 125) were within the normal range. Open laparotomy showed sarcomatosis, and pathology confirmed its mesenchymal origin and diagnosis as the solitary fibrous tumor. Our case may be the second recurrent mesentery solitary fibrous tumor reported to date, and the only one with progression to sarcomatosis. There has been no evidence of recurrence in follow-up at the 28 th mo after extensive intra-operative peritoneal lavage and cytoreductive surgery.CONCLUSION Although there are few risk factors of cancer recurrence in this patient, careful long-term followup after cytoreductive surgery is necessary.
文摘Dear editor,I am Dr.Jie Peng,from the Department of Ophthalmology,Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai,China.I write to present a case report of a novel in-frame deletion mutation c.177179del TAC of neurofibromatosis type 1 in a Chinese boy with bilateral blindness.Neurofibromatosis type 1（NF1;OMIM#162200）,an autosomal dominant disease,is caused by mutations in the NF1gene.The incidence of this disease is around 1 in
文摘Background Respiratory syncytial virus(RSV)is the leading global cause of respiratory infections and is responsible for about 3 million hospitalizations and more than 100,000 deaths annually in children younger than 5 years,representing a major global healthcare burden.There is a great unmet need for new agents and universal strategies to prevent RSV infections in early life.A multidisciplinary consensus development group comprising experts in epidemiology,infectious diseases,respiratory medicine,and methodology aims to develop the current consensus to address clinical issues of RSV infections in children.Data sources The evidence searches and reviews were conducted using electronic databases,including PubMed,Embase,Web of Science,and the Cochrane Library,using variations in terms for"respiratory syncytial virus","RSV","lower respiratory tract infection","bronchiolitis","acute","viral pneumonia","neonatal","infant""children",and"pediatric".Results Evidence-based recommendations regarding diagnosis,treatment,and prevention were proposed with a high degree of consensus.Although supportive care remains the cornerstone for the management of RSV infections,new monoclonal antibodies,vaccines,drug therapies,and viral surveillance techniques are being rolled out.Conclusions This consensus,based on international and national scientific evidence,reinforces the current recommendations and integrates the recent advances for optimal care and prevention of RSV infections.Further improvements in the management of RSV infections will require generating the highest quality of evidence through rigorously designed studies that possess little bias and sufficient capacity to identify clinically meaningful end points.
文摘Cancer-associated fibroblasts(CAFs) are important components of various types of tumors,including gastric cancer(GC).During tumorigenesis and progression,CAFs play critical roles in tumor invasion and metastasis via a series of functions including extracellular matrix deposition,angiogenesis,metabolism reprogramming and chemoresistance.However,the mechanism of the interaction between gastric cancer cells and CAFs remains largely unknown.Micro RNAs(mi RNAs) are a class of non-coding small RNA molecules,and their expression in CAFs not only regulates the expression of a number of target genes but also plays an essential role in the communication between tumor cells and CAFs.In this review,we provide an overview of recent studies on CAF mi RNAs in GC and the relevant signaling pathways in gastrointestinal tumors.Focusing the attention on these signaling pathways may help us better understand their role in tumor invasion and metastasis and identify new molecular targets for therapeutic strategies.
基金Supported by the National Nature Science Foundation(No.81473295)Science Technology project of Zhejiang Province(No.2014C33260)Wenzhou Science and Technology Bureau(No.Y20140142)
文摘AIM:To report a simple approach to actively remove high viscosity silicone oil through a 23-gauge cannula via pars plana.METHODS:Forty-eight eyes of 48 patients underwent silicone oil(5700 centistokes) removal(SOR) were enrolled.A section of blood transfusion set was prepared to connect a standard 23-gauge cannula and vitrectomy machine.Silicone oil was removed with suction of500-mm Hg vacuum through the cannula.Main outcome measures were SOR duration,number of sutured sites,intraocular pressure(IOP),best-corrected visual acuity(BCVA),and complications.RESULTS:Silicone oil was successfully removed in all cases.The mean SOR time was 5.70±0.85 min.Nine eyes(18.75%) needed suture partial sclerotomies.No intraoperative complications were noted.Transient hypotony(≤8 mm Hg) was seen in 3 eyes(6.25%) on postoperative day 1,but all resolved within 1wk.Retinal reattachment was achieved in all cases and no other postoperative complications were noted during 3-month following-up.BCVA at the final visit improved or stabilized in all patients comparing to the preoperative level.CONCLUSION:Active removal of high viscosity silicone oil through a 23-gauge instrument cannula jointed with blood transfusion set is a practical and reliable technique when considering two sides of efficacy and safety.
基金Supported by National Natural Science Foundation of China(No.81270903)Science and Technology Commission of Shanghai Municipality(No.13140901600)
文摘AIM: To identify the contribution of CDKAL1 to the development of diabetic retinopathy(DR) in Chinese population.·METHODS: A case-control study was performed to investigate the genetic association between DR and polymorphic variants of CDKAL1 in Chinese Han population with type 2 diabetes mellitus(T2DM). A welldefined population with T2 DM, consisting of 475 controls and 105 DR patients, was recruited. All subjects were genotyped for the genetic variant(rs10946398) of CDKAL1. Genotyping was performed by i PLEX technology. The association between rs10946398 and T2 DM was assessed by univariate and multivariate logistic regression(MLR) analysis.· RESULTS: There were significant differences in C allele frequencies of rs10946398(CDKAL1) between control and DR groups(45.06% versus 55.00%, P <0.05).The rs10946398 of CDKAL1 was found to be associated with the increased risk of DR among patients with diabetes.·CONCLUSION: Our findings suggest that rs10946398 of CDKAL1 is independently associated with DR in a Chinese Han population.
文摘Patient’s information The patient is a 56-year-old man who visited our hospital for "repeated epigastric pain for more than two months." Physical examination showed nearly pale appearance; abdomen was soft and no mass palpable; left supraclavicular lymph node (-); and digital rectal examination (-).
基金Supported by Shanghai Municipal Science & Technology Commission (08cj1410200)Shanghai Leading Academic Discipline Project (No. S30109)
文摘A three dimensional Fricke-(PVA-glutaraldehyde)-xylenol orange (FPGX) hydrogel dosimeter was prepared by chemical crosslinking method.Dose determination was performed by measuring the absorbance change of the dosimeter before and after irradiation using UV-Vis spectrophotometer at 585 nm.The dose response of the FPGX hydrogel dosimeter related to absorbance change was linear,when it was irradiated by X-ray in the range of 0~2 Gy.The stability of the dosimeter before and after irradiation was evaluated by studying the change of absorbance with time.
基金supported by the Science and Technology Committee of Shanghai Gran(t114119a2700)
文摘Objective:To compare the effects of different conservative managements on patients with adolescent idiopathic scoliosis (AIS). Method:One hundred and four AIS patients were recruited for this study. The patients were divided into 3 groups:exercise (E group), brace (B group) and combined rehabilitation treatment (brace treatment combined with exercise, CR group). Radiological parameter were used to assess AIS patients before and after treatment. The Chinese version of scoliosis research society-22(SRS-22) patient questionnaires were filled out by patients after treatment. The SRS-22 scores were compared among management groups. Result:The maximal Cobb angles were smaller in E group than in B group or CR group both before and af- ter treatment. The maximal Cobb angles were significantly smaller after treatment than before treatment in B group and CR group. Function/activity was better in E group than in B group or CR group. Self-image/appear- ance and satisfaction with management were better in E group and CR group than in B group. There was no significant difference among treatment groups in pain and mental health. Conclusion:Both brace and combined rehabilitation treatment can reduce the spinal curve of AIS patients. Both exercise and combined rehabilitation treatment have positive influence on self-image/appearance and satis- faction with management. We support preference of combined rehabilitation treatment above brace treatment.
