RA Group Research Articles

Test-Retest Reliability of Student-Administered Health-Related Fitness Tests in School Settings.

To examine the test-retest reliability of student-administered (SA) health-related fitness tests in school settings and to compare indices of reliability with those taken by trained research-assistants. Participants (n = 86; age: 13.43 [0.33]y) were divided into 2 groups, SA (n = 45, girls = 26) or research-assistant administered (RA; n = 41, girls = 21). The SA group had their measures taken by 8 students (age: 15.59 [0.56]y, girls = 4), and the RA group had their measures taken by 8 research-assistants (age: 21.21 [1.38], girls = 5). Tests were administered twice by both groups, 1 week apart. Tests included body mass index, handgrip strength, standing broad jump, isometric plank hold, 90° push-up, 4 × 10-m shuttle run, back-saver sit and reach, and blood pressure. Intraclass correlation coefficients for SA (≥.797) and RA (≥.866) groups were high, and the observed systematic error (Bland-Altman plot) between test 1 and test 2 was close to 0 for all tests. The coefficient of variation was less than 10% for all tests in the SA group, aside from the 90° push-up (24.3%). The SA group had a marginally lower combined mean coefficient of variation across all tests (6.5%) in comparison with the RA group (6.8%). This study demonstrates that, following familiarization training, SA health-related fitness tests in school-based physical education programs can be considered reliable.

Association between depression and rheumatoid arthritis: two longitudinal follow-up studies using a national sample cohort.

To investigate the bidirectional relation between RA and depression. Data from the Korean Health Insurance Review and Assessment Service - National Sample Cohort from 2002 to 2013 were analysed. Patients ≥20 years of age were included. Study I was conducted with 38087 depression patients and 152348 matched control participants. Study II was conducted with 7385 RA patients and 29540 matched control participants. Stratified Cox proportional hazards models were used to analyse the hazard ratios (HRs) for depression and RA (study I) and for RA and depression (study II). The data were adjusted by the Charlson comorbidity index; rheumatic disease was excluded. Subgroups were also analysed according to age and sex. A total of 0.7% (1260/38087) of the depression group and 0.6% (883/152348) of the control I group had RA (P = 0.02). The HR for RA in the depression group was not significantly higher than that in control I group. In study II, 5.5% (408/7385) of the RA group and 4.3% (1246/29540) of the control II group presented with depression (P < 0.001). The RA patients showed an adjusted depression HR that was 1.20 times higher (95% CI 1.07, 1.34; P = 0.002) than that of the control group. The >30-years-old and women subgroups of RA patients showed higher depression HRs than the control subgroups. RA increased the risk of depression; however, depression did not increase the risk of RA in the Korean adult population.

Impact of HFE gene Variants on Iron Overload, Overall Survival and Leukemia-Free Survival in Myelodysplastic Syndromes

Myelodysplastic syndromes (MDS) are myeloid neoplasms defined by peripheral cytopenia, dysplasia of myeloid cells and an increased risk to transform to secondary acute myeloid leukemia (AML). Although several laboratory and molecular risk factors and scoring systems have been established, little is known about genetic features contributing to disease evolution, AML development, and survival. Accumulating evidence suggests that iron metabolism and transfusion frequency are important prognostic determinants in MDS. It has also been described that patients with MDS frequently display HFE gene variants. However, little is known about the clinical impact of HFE variants. We examined the HFE status by restriction fragment length polymorphism (RFLP) analysis covering 2 common variants (H63D and C282Y) in 167 patients with MDS (observation-period: 1992-2019) and in 494 healthy Austrian controls. The median age of our MDS patients at diagnosis was 69 years (range 27-85 years) with a f:m ratio of 1:1.13. In the MDS cohort the international prognostic scoring systems, IPSS and IPSS-R, were applied, and in 94 patients a ´myeloid mutation´ screen was performed by next-generation sequencing (NGS). In all patients, serum ferritin levels were recorded at diagnosis and during follow up. Variant HFE species (H63D and/or C282Y) were detected in 63/167 patients with MDS (38.4%) and in 170/494 controls (34.4%). Median ferritin levels at diagnosis were slightly higher in HFE-mutated patients (409 mg/dL; range: 23-7415 mg/dL) compared to non-mutated patients (346.5 mg/dL; range: 10-5450 mg/dL) (p=0.62). During the first 2 years of transfusion therapy, HFE-mutated patients showed a slightly faster increase in serum ferritin levels compared to non-mutated patients. However, again, the difference was not significant, and patients with massive iron overload were found in both cohorts. When examining French-American-British (FAB) subgroups of MDS, the percentage of patients withHFE variants was higher in the group with refractory anemia, RA (22/53=41.5%) or RA with ring sideroblasts, RARS (17/39=43.9%) than in the group of RA with excess of blasts, RAEB (16/46=34.8%) or RAEB in transformation (5/17=29.4%). In CMML, 5/12 patients (41.7%) were found to carry a HFE variant. Clear differences were also observed between subgroups of MDS patients classified by World Health Organization (WHO) criteria. The prevalence of HFE mutations was 50.0% (13/26) in patients with ring sideroblasts (RS) and multilineage dysplasia (MDS-RS-MLD), 50.0% in MDS-MLD (6/12), 43% (7/18) in MDS with RS and single-lineage dysplasia (MDS-RS-SLD), 42.9% (12/28) in patients with excess of blasts-1 (MDS-EB1), 38.9% (7/18) in MDS-SLD, 21.4% (6/28) in MDS-EB2, and 20% (2/10) in MDS with isolated 5q-. When splitting patients according to the IPSS and IPSS-R, patients at highest risk were found to have a lower prevalence of HFE variants (IPSS high: 20%; IPSS-R very high: 15.4%) compared to other risk groups (IPSS low: 34.9%, int-1: 42.0%, int-2: 31.0%; and IPSS-R very low: 33.3%, low: 38.5%, int: 36.8%, high: 42.9%). Next, we examined correlations between HFE variants and somatic myeloid mutations in our MDS patients (n=94). No significant correlations were found when comparing expression of HFE variants with somatic mutations in ASXL1, ASXL1, SF3B1, SRSF2, TET2, DNMT3A, RUNX1, NRAS, TP53, IDH2 or EZH2 detected by NGS. Finally, we examined the HFE status in the context of clinical end points. In these studies, we found a clear difference in AML-free survival between HFE-mutated and non-mutated patients, although the difference did not reach statistical significance (p=0.089) (Figure 1A). No differences in overall survival (OS) were found when comparing patients with or without HFE variants (Figure 1B). In conclusion, the HFE variants H63D and C282Y are frequently detected in Austrian patients with MDS. These variants are more commonly detectable in low risk FAB patients and correlate roughly with higher ferritin levels at diagnosis and during transfusion therapy. In addition, HFE-mutated MDS patients have a slightly better AML-free survival. However, the correlation is weak. Therefore, we currently do not recommend screening for HFE gene variants at diagnosis in patients with MDS unless ferritin levels are excessively high or increase very rapidly during transfusion suggesting the possibility of a concomitant primary hemochromatosis. Disclosures Valent: Blueprint: Research Funding; Celgene: Honoraria; Deciphera: Honoraria, Research Funding; Pfizer: Honoraria; Novartis: Consultancy, Honoraria, Research Funding. Sperr:Novartis: Honoraria; Celgene: Consultancy, Honoraria.

Autologous Right Auricular Versus PTFE Cavopulmonary Lateral Tunnel: Influence of Surgical Technique on Arrhythmias.

To compare the incidence of arrhythmias and the overall survival at long-term follow-up of the right auricular baffle technique (RA) versus Gore-Tex® (GT) baffle as intra-atrial cavopulmonary lateral tunnel, as well as the Nakata index and tunnel dimensions on cardiac magnetic resonance. Data were retrospectively collected. Serial 24-hour Holter recordings and cardiac magnetic resonance findings of the two groups were compared. There was no significant difference in the estimated freedom from arrhythmias (87% at 10 years and 78% at 15 years vs 80% at 10 years and 70% at 15 years in RA and GT, respectively; P = .44) nor cumulative survival (86% at 10 years and 84% at 15 years vs 97% at 10 years and 81% at 15 years in RA and GT, respectively; P = .8). Also, no difference between the groups was observed in the Nakata index. The tunnel dimensions on cardiac magnetic resonance were significantly wider in the RA group. In reference to other potential risk indicators, using Cox proportional hazard regression analysis, only age (5 years or older at the time of total cavopulmonary connection) was associated with an increased risk for both arrhythmia and mortality. This study demonstrated that there was no difference in freedom from arrhythmias, Nakata index, or survival between the two groups. This study confirmed the growth potential of the right auricular tunnel. However, the growth of the tunnel did not influence the incidence of arrhythmias.

Effect of Rosmarinic Acid and Alcohol on Fat Graft Survival in Rat Model.

Autologous fat grafting is a common procedure performed for cosmetic and reconstructive purposes. Unpredictable graft survival is a major drawback, and a variety of improvements on technique such as using antioxidants have been reported to increase retention. The authors examined whether a natural rosemary plant extract known with antioxidant properties, rosmarinic acid, could improve the survival of the adipose tissue. Inguinal fat pads were harvested from 24 Sprague Dawley rats and implanted to the parascapular area. Rats were divided into three groups: rosmarinic acid and ethanol as solvent (RA), ethanol (E), and serum physiologic (C). These substances were administered intraperitoneally daily for 1week and once a week for 7weeks. Volume and weight measurements, blood specimens, weight and volume records, and histopathologic examinations were performed and analyzed. The RA group demonstrated lower TOS, TGF-beta, TNF-alpha, and MDA values compared to E and C groups. TGF-beta increase was statistically insignificant, but TOS, TNF-alpha, MDA decrease was found statistically significant. Weight and volume losses were lower in the RA and E groups compared to the C group. The difference between the RA and E groups in terms of weight and volume loss was statistically insignificant. Histopathologically fat necrosis, inflammation, and fibrosis were less in the RA group compared to the E and C groups (p < 0.05). Rosmarinic acid increased the fat graft volume retained and decreased cyst formation and abscess formation in the rat model. Further studies can be undertaken to investigate rosmarinic acid's local application as a tumescent and safety in humans. This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Polarity of para-disubstituted benzene derivatives: a correlation analysis of the substituent effect

The article is concerned with the influence of resonance donor substituents RD on the dipole moments μ of molecules 1,4-RDC6H4RA containing resonance acceptor groups RA (CF3, CN, COCH3, NO2 or COH) and grouped in five reaction (indicator) series. Generally, the μ values depend on the inductive, resonance, and polarizability effects of the substituents RD. Strengthening of the resonance acceptor properties of the RA groups leads to weaker conjugation between the substituents RD and the π-system.

Different effects of pravastatin on sFlt-1, PlGF and VEGF in different preeclampsia-like mouse models

Objective: To explore the pathways of preeclampsia by investigating different effects of pravastatin (Pra) on and soluble FMS tyrosine kinase-1 (sFlt-1), placental growth factor (PlGF) and vascular endothelial growth factor (VEGF) in different preeclampsia (PE)-like mouse models. Methods: C57BL/6J mice were randomly subcutaneously injected with N-nitro-L-arginine methyl ester (L-NAME) or intraperitoneally injected with lipopolysaccharide (LPS) as PE-like mouse model, saline as normal pregnancy control (Con) respectively, daily at gestational 7-18 days. Pra was given daily at gestational 8-18 days in each model group and the mice were divided into Pra (L-NAME+Pra, LPS+Pra, Con+Pra) and saline (L-NAME+NS, LPS+NS, Con+NS) groups. Liver,placental tissue and blood of pregnant mice were collected on the 18th day of pregnancy. The levels of VEGF, PlGF and sFlt-1 in the liver, placenta and serum of mice in each group were compared by western blot, ELISA and real-time fluorescence quantitative PCR (RT-PCR). Results: (1) ELISA: Serum VEGF (205.70±3.43, 154.60±2.31) and PlGF (131.5±3.75, 101.50±4.31) levels were significantly increased in L-NAME+Pra group compared with L-NAME+NS group (all P<0.05). Serum VEGF (202.30±4.90, 144.50±6.71) and PlGF (121.50±3.86, 95.41±4.08) levels were significantly higher in LPS+Pra group than those in LPS+NS group (all P<0.05). Serum sFlt-1 level in LPS+Pra group was significantly lower than that in LPS+NS group (3.01±0.50, 776.60±80.06), serum sFlt-1 level in L-NAME+Pra group was significantly lower than that in L-NAME+NS group (2.60±0.06, 583.70±9.83; all P<0.05). (2) Western blot: the expression levels of PlGF (1.344±0.118, 0.664±0.143) and VEGF (1.34±0.12, 0.66±0.14) in the liver of mice in the L-NAME+Pra group were significantly higher than those in the L-NAME+NS group (all P<0.05), but the expression levels of PlGF and VEGF in the placenta of L-NAME+Pra group were not significantly different from those of L-NAME+NS group (all P>0.05). The expression levels of PlGF and VEGF in placenta and liver of pregnant mice in LPS+Pra group were not significantly different from those in LPS+N group (all P>0.05). (3) RT-PCR: the mRNA expression of PlGF and VEGF in placenta and liver of L-NAME+Pra group were not significantly different from those in L-NAME+NS group (all P>0.05). The mRNA expression levels of PlGF and VEGF in placenta and liver of LPS+Pra group were not significantly different from those of LPS+NS group (all P>0.05). Conclusions: Pra has different regulatory effects on vascular endothelial function in different PE-like models. It reveals that different pathogenesis and pathways exist in different PE-like changes.

A preliminary study of a novel robotic system for pedicle screw fixation: A randomised controlled trial

Background and objectiveExisting orthopaedic robotic systems are almost restricted to provide guidance for trajectory direction. In the present study, a novel spinal robotic system with automatic drilling power was introduced. The aim of this study is to evaluate the feasibility and safety in pedicle screw ​insertion of posterior lumbar interbody fusion assisted by this novel robotic system. Methods and materialsA randomised controlled trial was conducted for 17 participants who were required posterior lumbar interbody fusion process. Seven (3 M/4 F) were randomly assigned to the robot-assisted group (RA group), and the other ten (4 M/6 F) were assigned to the conventional technique group (FH group). A novel robotic system was used in the RA group. All measurements were based on postoperative computed tomography (CT) data. Accuracy of screw insertion was determined using the Gertzbein and Robbins Scale. Precision was measured by the entry point deviation distance and the trajectory rotation. Other variables included operation time, radiation time, length of stay, and screw-related complications. ResultA total of 82 pedicle screws were placed in the 17 participants. In the RA group, 90.6% of screws placed were Grade A, and 9.4% were Grade B. In the FH group, 78.0% of screws were Grade A, 20.0% were Grade B, and 2.0% were Grade C. No statistical difference was found in the operation time, radiation time per case, and length of stay between both groups. The radiation time per screw is significantly lower in the RA group. No screw-related complications or revision occurred in the present study. ConclusionThe outcome of screw accuracy of this robotic system was comparable with that of experienced surgeons, and no screw-related complication was found in the RA group during hospitalisation. In addition, radiation time per screw in the robotic group was significantly lower than that in the conventional group, which shows the potential to reduce radiation exposure of pedicle screw fixation assisted by this robotic system. Translational potentialOur study shows that pedicle screw fixation assisted by “Orthbot” system is accurate and safe. It is concluded that this novel robotic system offers a new option for internal implantation in spine surgery.

Circulating Insulin-like Growth Factor-1 Levels in Patients with Rheumatoid Arthritis: A Meta-analysis.

Insulin-like growth factor-1 (IGF-1) levels have been investigated in rheumatoid arthritis (RA), however, produced inconsistent results. The purpose of this meta-analysis was to derive a more precise conclusion about serum/plasma IGF-1 levels in RA patients. PubMed, Embase and the Cochrane Library databases were searched up to December 2018 in English, and the studies comparing serum/plasma IGF-1 levels between RA group and healthy control group were what we are interested in. The Newcastle-Ottawa Scale (NOS) was used to assess the methodological quality of the included studies. The heterogeneity test was performed by the Cochrane Q statistic and I2 -statistic. The publication bias was evaluated by the funnel plot and Egger's test. The standard mean difference (SMD) with 95% confidence interval (CI) was calculated by the fixed-effects or random-effects model. A total of eleven articles with 334 cases and 261 controls were finally included. Compared with the healthy group, the RA group had lower circulating IGF-1 levels (pooled SMD= -0.936, 95% CI= -1.382 to -0.489, p<0.001). The subgroup analysis showed that RA patients from Asia (SMD= -0.645, 95% CI= -1.063 to -0.228, p= 0.002) and Europe (SMD= -1.131, 95% CI= -1.767 to -0.495, p<0.001) had lower circulating IGF-1 levels, no significant difference in plasma/serum IGF-1 levels was observed in RA patients from America. Sensitivity analysis indicated the stability and credibility of the overall effect sizes. Patients with RA have lower circulating IGF-1 level than healthy controls, particularly for patients from Asia and Europe. Further studies are necessary to elucidate the role of IGF-1 in the pathological process of RA.

Muscle stiffness in rheumatoid arthritis is not altered or associated with muscle weakness: A shear wave elastography study

Objectives: To investigate muscle stiffness and strength in rheumatoid arthritis patients compared to healthy controls.Methods: A sample of 80 RA patients from three discrete groups: 1 – newly diagnosed treatment-naïve RA (n = 29), 2 – active RA for at least 1 year (n = 18) and 3 – in remission RA for at least 1 year (n = 33), was compared to 40 healthy controls. Shear wave velocity (SWV) was measured using shear wave elastography as a surrogate for tissue stiffness in multiple muscles. All participants performed isometric grip strength, timed get-up-and-go test, 30-s chair stand test and isokinetic knee extension/flexion (60°/s). The difference in SWV amongst the groups was tested using one-way ANOVA, and the correlation between SWV and muscle strength results were calculated using Pearson’s coefficients.Results: The mean age ± SD was 61.2 ± 12.8 for RA patients and 61.5 ± 10.5 years for controls. SWV was not significantly different amongst the groups on all muscles (p > .05). In comparison to controls, the new and active RA groups showed a significantly lower isokinetic strength by –29% (p = .013) and –28% (p = .040), fewer chair stands by –28% (p = .001) and –44% (p < .001), longer walking times by –25% (p = .025) and –30% (p = .001), respectively, and weaker grip strength by –45% for both (p < .001). The muscle strength in the remission RA groups was not significantly lower, except in the isokinetic knee strength (–21%; p = .027). The correlations between SWE and the muscle assessment results were weak and insignificant (r < 0.30; p > .05).Conclusion: Significant muscle weakness was demonstrated in patients with RA disease. However, muscle stiffness was normal and not associated with muscle strength.

Effect of Gastric Acid Suppressants on Response to a Physical Activity Intervention and Major Mobility Disability in Older Adults: Results from the Lifestyle Interventions for Elders (LIFE) Study.

Proton pump inhibitors (PPIs) and histamine2 receptor antagonists (H2 RAs) are associated with pharmacologic effects that may be detrimental to mobility and response to physical activity. Mobility disability and injurious fall outcomes in PPI and H2 RA users were compared with nonusers in this secondary analysis of data from the Lifestyle Interventions for Elders (LIFE) study. Participants ages 70-89years were randomized to a physical activity (PA) or successful aging intervention and evaluated by medication use. Confounders included baseline demographic characteristics, physical function, cognitive function, sleep quality, and acid reflux symptoms that were adjusted via propensity score weighting. Outcomes were incident and persistent major mobility disability (MMD and pMMD) and injurious falls. Weighted proportional hazard models evaluated independent and interaction effects of PPIs and H2 RAs. No interaction was found between PPIs and H2 RAs and the PA intervention. Drug use associations were significant for H2 RAs (hazard ratio [HR] 1.74 [95% confidence interval [CI] 1.12-2.68]) and PPIs (HR 1.32 [95% CI 1.02-1.70]) compared with nonusers for pMMD. PPIs were associated with increased injurious falls compared with nonusers (HR 1.44 [95% CI 1.06-1.96]). Pooling of data from the H2 RA and PPI exposure groups showed a 26% increase in MMD (HR 1.26 [95% CI 1.07-1.48]), a 44% increase in pMMD (HR 1.44 [95% CI 1.16-1.77]), and a 48% increase in injurious falls (HR 1.48 [95% CI 1.15-1.91]) compared with nonusers. All direct comparisons between PPIs and H2 RAs were nonsignificant. Compared with nonusers, participants using either PPIs or H2 RAs had an increased risk of MMD, pMMD, and injurious falls. It is not known if these effects are related to the individual pharmacology of each medication, reduced acid secretion, or the underlying disease state. Further study is required to determine causality.

백·적하수오 담금주를 섭취한 흰쥐의 혈청과 뇌 조직의 과산화지질 수준 및 항산화 효소 활성 상태

This study was conducted to identify the effects of Cynanchi Wilfordii Radix and Polygoni Multiflori Radix liquors on lipid peroxidation and antioxidant activity in rats. Male Sprague-Dawley rats were placed on a liquid diet for six weeks. The rats were assigned to one of four experimental groups according to the following liquid diet types: a normal liquid diet (C), the soju liquid diet (A), a Cynanchi Wilfordii Radix liquor diet (WA) and a Polygoni Multiflori Radix liquor diet (RA). Except group C, alcohol contributed 12% of the total calories consumed by the rats. The results of MDA level and antioxidant activity of serum and brain tissue of rats were as follows. The serum and brain MDA levels of WA and RA groups could be lowered to the group C level. The nitric oxide (NO) level of the brain tissue of the RA group was lowest in all the groups. Serum superoxide dismutase (SOD) activity in the A and WA groups were significantly elevated. Serum catalase activity was significantly higher in the WA group than it was in groups C and A. Glutathione peroxidase (GSH-Px) activity in brain tissue was significantly elevated in the WA and RA groups relative to group A. Among all the experimental groups, the total serum antioxidant capacity in group A was lowest. This indicated the soju liquid diet led to oxidative damage in these rats. In contrast, the Cynanchi Wilfordii Radix and Polygoni Multiflori Radix liquor diets effectively inhibited lipid peroxidation and NO production.

Effect of N-Acetyltransferase 2 Genotype on the Pharmacokinetics of Hydralazine During Pregnancy.

Hydralazine, an antihypertensive agent used during pregnancy, undergoes N-acetylation primarily via N-acetyltransferase 2 (NAT2) to form 3-methyl-1,2,4-triazolo[3,4-a]phthalazine (MTP). To characterize the steady-state pharmacokinetics (PK) of hydralazine during pregnancy and evaluate the effects of NAT2 genotype on hydralazine and MTP PK during pregnancy, 12 pregnant subjects received oral hydralazine (5-25mg every 6 hours) in mid- (n=5) and/or late pregnancy (n=8). Serial blood samples were collected over 1 dosing interval, and steady-state noncompartmental PK parameters were estimated. Subjects were classified as either (rapid acetylators, n=6) or slow acetylators (SAs, n=6) based on NAT2 genotype. During pregnancy, when compared with the SA group, the RA group had faster weight-adjusted hydralazine apparent oral clearance (70.0±13.6 vs 20.1±6.9 L/h, P<.05), lower dose-normalized area under the concentration-time curve (AUC; 1.5±0.8 vs 5.9±3.7 ng·h/mL, P<.05), lower dose-normalized peak concentrations (0.77±0.51 vs 4.04±3.18 ng/mL, P<.05), and larger weight-adjusted apparent oral volume of distribution (302±112 vs 116±45 L/kg, P<.05). Furthermore, the MTP/hydralazine AUC ratio was ∼10-fold higher in the RA group (78±30 vs 8±3, P<.05) than in the SA group. No gestational age or dose-dependent effects were observed, possibly because of the small sample size. This study describes for the first time, the PK of oral hydralazine and its metabolite, MTP, during pregnancy, and confirmed that the PK of oral hydralazine is NAT2 genotype dependent during pregnancy.

Rho-associated protein kinase inhibitor induced morphological changes in type VI collagen in the human trabecular meshwork

AimsTo investigate morphological changes in type VI collagen in the human trabecular meshwork associated with the rho kinase inhibitor ripasudil.MethodsThis cross-sectional study evaluated the effects of ripasudil eye drop administration...

Total laparoscopic distal gastrectomy for gastric cancer: uncut Roux-en-Y anastomosis versus Billroth II anastomosis

Objective To compare the advantages and disadvantages between Uncut Roux-en-Y anastomosis and Billroth Ⅱ anastomosis in total laparoscopic distal gastrectomy (TLDG) for gastric cancer. Methods The clinical data of 132 patients with distal gastric cancer, who underwent TLDG with Uncut Roux-en-Y anastomosis or Billroth Ⅱ anastomosis in the Affiliated Hospital, Medical School of Ningbo University from February 2015 to December 2017, were retrospectively analyzed. There were 52 patients receiving TLDG with uncut Roux-en-Y anastomosis (RA group) and 80 patients receiving TLDG with Billroth Ⅱ anastomosis (BA group). Results Compared with BA group,the RA group had a longer operation time [(240.6±49.6) min vs. (202.2±36.4) min, F=2.356, P=0.000]and anastomosis time[(49.1±5.9) min vs. (47.3±4.2) min, F=4.45, P=0.043], more intraoperative blood loss[(128.9±130.0)ml vs. (79.2±62.5) ml, F=5.66, P=0.004]; and short times to first flatus[(2.7±0.8)d vs.(3.0±0.6) d, F=6.61,P=0.031],for liquid diet[(3.7±0.8) d vs.(4.0±0.6) d, F=7.35, P=0.022] and semifluid diet[(4.7±0.8)d vs. (5.0±0.6) d, F=6.43, P=0.013]. No perioperative death occurred in two groups; there were no significant differences in length of postoperative hospital stay [(9.4±4.2)d vs. (10.9±6.4) d, F=0.83, P=0.117]and the incidence of postoperative complication[5.8%(3/52) vs. 8.8%(7/80), χ2=0.40, P=0.527)]. Compared to BA group,alkaline reflex gastritis rate [3.8%(2/52) vs. 52.5%(42/80), χ2=40.04, P=0.000]and marginal ulcer rate were lower[0(0/52) vs. 11.3%(9/80), χ2=6.28,P=0.012]. There was no significant difference in dumping syndrome rate[0(0/52) vs. 3.8%(3/80), χ2=0.20, P=0.158] between two groups. Conclusion Uncut Roux-en-Y anastomosis can prevent alkaline reflex gastritis, marginal ulcer and Roux-en-Y stasis syndrome, it may be the preferable technique for reconstruction after total laparoscopic distal gastrectomy. Key words: Stomach neoplasms; Carcinoma; Laparoscopy; Gastrectomy; Anastomosis, Roux-en-Y

Correlation of myomir-206 and proinflammatory cytokines (IL-16 and IL-17) in patients with rheumatoid arthritis.

IntroductionRheumatoid arthritis (RA) is a persistent autoimmune disease in which the activity of proinflammatory cytokines and the imbalance, related to the inflammatory process, between elements of bone tissue remodeling such as osteoclasts and osteoblasts play a key role in development of erosions and bone destruction. MicroRNAs are important regulators of skeletal remodeling and are involved in RA pathogenesis. Myomir-206 (miR-206) is unrivalled among the myomirRs, where it is expressed in skeletal muscle and either absent or minimally expressed in other tissuesMaterial and methodsThis study was designed to analyze the miR-206 expression pattern in peripheral blood mononuclear cells (PBMCs) using quantitative real time polymerase chain reaction and its correlation with IL-16/IL-17 proinflammatory cytokines in two groups – 20 healthy individuals and 30 patients with RA.ResultsElevated expression of miR-206 was observed in RA patients compared with healthy controls (p < 0.001). A significant increase in both IL-17 and IL-16 serum levels was found in the RA group (p < 0.01 and p < 0.05; respectively) compared to the control group. miR-206 expression level and IL-17 production were directly positively correlated (r = 0.491; p < 0.01). ROC analysis of miR-206 showed a cutoff value of 2.7 with 70% sensitivity, 85% specificity, and the area under the curve was 0.802 (p < 0.001) with the 95% confidence interval from 0. 676 to 0.927ConclusionsTaken together, our results indicate the importance of miR-206 expression in patients with RA, as a potential new biomarker that affects bone loss/deformity and its collaborative role with proinflammatory cytokines such as IL-16 and IL-17 in RA bone metabolism. Particular interest should be given to further research to determine the contribution of expression of miR-206 in RA pathogenesis

Comparison of median nerve stiffness with and without rheumatoid arthritis by ultrasound real-time tissue elastography: A propensity score matching study

Objectives: This study aimed to compare median nerve stiffness measured by ultrasound real-time tissue elastography in patients with and without rheumatoid arthritis (RA and non-RA groups, respectively).Methods: Altogether, 402 hands of 201 RA group and 222 hands of 111 non-RA group were included in the study. Ultrasonography was performed to evaluate the circumference, cross‐sectional area (CSA) and strain ratio as an elasticity of the median nerve at the inlet level of the carpal tunnel and the proximal portion of the carpal tunnel inlet. Using propensity score matching, the difference between RA and non-RA group were analyzed.Results: After propensity score matching, 135 hands in 104 RA group and 70 non-RA group were finally analyzed. There were no significant differences in the circumference and CSA of the median nerve between the two groups. The strain ratio of the median nerve was significantly higher in RA group than in non-RA group only at the inlet of the carpal tunnel level.Conclusions: The nerve stiffness in patients with RA measured by ultrasound real-time tissue elastography was higher than without RA. Inflammatory condition of the flexor tendon and wrist joint in patients with RA may generate fibrotic changes in the median nerve.Trial registration: University Hospital Medical Information Network Clinical Trials Registry: UMIN000015314.

Duration‐dependent effects of IH‐stimulated Hif1a signaling on adult hippocampal neurogenesis

Intermittent hypoxia (IH), is a hallmark consequence of sleep apnea, a common untreated disorder associated with impaired neurological health. We have recently demonstrated that thirty days of IH impairs long term potentiation and reduced the proportion of neurons generated during adult neurogenesis. Hypoxia Inducible Factor 1a (HIF1a) is a transcription factor important to stem cell development that is regulated by the state of oxygenation. The objective of this on‐going study is to characterize how the duration of IH exposure influences the generation of adult‐born neurons and to determine the role of IH‐dependent HIF1a signaling in the generation of adult‐born neurons in the hippocampus. We hypothesize that IH has duration dependent influence over neurons generated through adult neurogenesis and involves HIF1a dependent signaling. We used a cre‐loxP transgenic strategy to birth label a discrete cohort of stem cells that experience room air for 30 days (control), 10 days of IH +20 days of recovery in room air (IH10+20RA), or 30 days of IH (IH30) in wild‐type reporter mice (Ai27) and in Ai27‐HIF1a+/flox mice. In wild‐type mice, exposure to IH10+20RA led to higher proportion of birth‐labelled neurons compared to the control (+19% ± 5%, n=6) while the proportion of neurons following IH30 decreased (−40% ± 10%, n=4). In Ai27‐HIF1a+/− mice, the proportion of birth‐labeled neurons was similar between control and IH10+20RA groups. However, following IH30 the proportion of birth‐labeled neurons was markedly decreased when compared to control in Ai27‐Hif1a+/− and to the IH30 wild‐type group. Dendritic complexity, as determined by Sholl analysis, was similar among labeled neurons in both wild‐type and Ai27‐HIF1a+/− groups suggesting that neither IH nor IH‐dependent HIF1a signaling influences dendritic complexity. These findings indicate that exposure duration is factor impacting how IH affects the generation of adult‐born neurons through a HIF1a signaling shaping how IH influences, associated with sleep apnea affects the generation of adult‐born neurons.Support or Funding InformationThis work was supported by NIH R01 NS10742101 (AJG).This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

RHEUMATOID ARTHRITIS;

Objectives: Objective of our study is to measure the concentration and role of Malondialdehydein determining the oxidative stress in rheumatoid arthritis patients in comparison with healthy individuals. Study Design: Cross sectional study. Setting: Department of physiology Gujranwala Medical College and Shalamar Medical College, Lahore. Period: From October 2016 to October 2017. Methodology: 180 patients of age 49 to 70 years of either gender. The approval for conducting experimental study was taken from ethical committee and consent information was taken from the patient on prescribed Performa. Data was analyzed on SPSS Version 23 related to study. Continuous variables were presented as mean and standard deviation like age and serum MDA concentration. Categorical variables were presented as numbers and percentages like gender. Post operative chi square test was applied and p- value less than or equal to 0.05 was considered as significant. Results: Total 180 person (n=180) of either genderwere included in this study. The study group was divided into two equal groups. Group A (RA group) consists of 90 patients (n=90) based on clinically and laboratory based criteria while group B (control group) consists of 90 (n=90) normal healthy individuals. The serum MDA levels in the RA patients were 3.97±1.03 nmoles/ml and it was 1.59±0.32 n moles/ml in control patients. The difference was statistically significant (t=20.87, p=0.001). Conclusion: The observations of our study showed statistically significant raised serum Malondialdehyde level as compared to control group which shows that raised serum MDA is an indicator of oxidative stress in rheumatoid arthritis patients.&#x0D;

Changes of Rheb gene and protein expression in preeclampsia-like mouse model treated with pravastatin

Objective: To explore whether pravastatin (Pra) inhibits mammalian target of rapamycin (mTOR) signal pathway by regulating Ras homolog enriched in brain (Rheb) protein through the comparison of gene and protein expression changes of Rheb in liver and placenta in preeclampsia (PE)-like mouse model treated with Pra. Methods: C57BL/6J pregnant mice were randomly divided into two groups. The PE group was established by injecting N-nitro-L-arginine methyl ester (L-NAME) daily at gestational 7-18 days, saline was injected as contol group (Con); then giving mice Pra (PE+Pra, Con+Pra group, n=8) or normal saline (PE+N, Con+N group, n=8) every day from the 8th gestational day of pregnancy. The maternal liver and placenta tissues were collected on the 18th day of pregnancy. Western blot, real-time quantitative PCR and immunohistochemistry were used to compare the levels of Rheb protein and mRNA expression in the liver and placenta. Results: (1)The results of western blot: there were no significant differences in Rheb protein expression between PE+N group (liver: 0.706±0.123; placenta: 0.866±0.128) and Con+N group (liver: 0.732±0.123; placenta: 0.909±0.097) , and the differences between PE+Pra group (liver: 0.669±0.134; placenta: 0.940±0.221) and PE+N group were not significant either in liver or in placenta (all P>0.05). (2) The results of real-time quantitative PCR: when PE+N group (liver: 1.026±0.480; placenta: 1.102±0.361) compared with Con+N group (liver: 1.058±0.389; placenta: 1.067±0.400) , PE+Pra group (liver: 0.735±0.356; placenta: 0.822±0.304) compared with PE+N group, there were no significant differences either in liver or in placenta (all P>0.05). (3) The results of immunohistochemistry: Rheb protein expression did not change significantly in maternal liver and placenta, there were no significant differences in protein expression levels between PE+N group and Con+N group, and between PE+Pra group and PE+N group (all P>0.05). Conclusion: The inhibition of Pra on mTOR signaling pathway in some PE-like model may be independent of the expression of Rheb gene and protein.