[Progress in the application of alveolar organoids in common lung diseases].

Organoids are tissue cultures formed by culturing cells in three-dimensional environments that simulate the physiological or pathological conditions of the human body. The cultivation of organoids is used to study the temporal and spatial transformation of cells during the development of tissues or organs, to investigate changes in cellular functions and inter-communications caused by various risk factors, and to discover potential therapeutic targets. This article provided an overview of the cultivation and identification methods of alveolar organoids, as well as the research progress in their application to common respiratory diseases such as pulmonary fibrosis, chronic obstructive pulmonary disease, viral pneumonia, and so on. The limitations and future applications of alveolar organoids are also analyzed and discussed.

Nomogram to predict haemorrhagic transformation after stroke thrombolysis: a combined brain imaging and clinical study.

AIM: To construct a novel nomogram by integrating computed tomography perfusion (CTP) and clinical parameters for individualised prediction of haemorrhagic transformation (HT) in intravenous thrombolysis (IVT)-treated acute ischaemic stroke (AIS) patients. METHODS: Anterior circulation AIS patients who underwent IVT at a single centre from January 2018 to June 2020 were reviewed retrospectively. The CTP parameters of two regions of interest (ROI), the entire perfusion lesion areas, and the infract core areas, were assessed. HT was documented by follow-up CT 24 ± 2 h after IVT. Multivariable logistic regression was conducted by including clinical variables and CTP parameters to identify the independent predictors of HT. A nomogram was developed based on the independent predictors. The discriminative value and calibration of the nomogram were tested by concordance indexes (C-indexes) and calibration plots. Internal validation was performed using fivefold cross-validation. RESULTS: The nomogram was generated using the complete data from 341 patients. Seven variables were included in the final nomogram, including: the relative cerebral blood volume (rCBV), permeability surface (PS), and relative PS (rPS) in infract core areas, the relative time to maximum (rTmax) and rPS in entire perfusion lesion areas, the National Institutes of Health Stroke Scale (NIHSS), and atrial fibrillation (AF). The C-indexes were 0.815 and 0.817 for the nomogram and internal validation. The calibration plots showed excellent agreement. CONCLUSION: This is the first study establishing a nomogram based on CTP and clinical parameters to predict HT after stroke thrombolysis.

[A case report of TAFRO syndrome].

The study is to improve clinicians' understanding of TAFRO syndrome, to explore the diagnosis and treatment of TAFRO syndrome and to identify TAFRO syndrome in the early stage. The clinical manifestations, laboratory examination results, imaging manifestations, diagnosis and treatment of TAFRO syndrome were reported, and the literature of TAFRO syndrome was reviewed. The main clinical manifestations of the female were intermittent vaginal bleeding, fever, depressive edema of both legs, red blood cell and thrombocytopenia, and renal function deterioration. The results showed that leukocytes increased, anemia, thrombocytopenia and severe renal dysfunction were found; With fever, C-reactive protein and procalcitonin increased significantly, bone penetration suggested that granulocyte proliferation was active, and megakaryocytes were seen. But anti-infection treatment was ineffective; CT suggested that there was a high uptake of multiple fluorodeoxyglucose (FDG) in many parts of the body; The lymph node biopsy was considered to be in accordance with the transparent vascular type of Castleman disease; Renal biopsy was used to return thrombotic microvascular disease with subacute renal tubulointerstitial nephropathy. In terms of treatment, the clinical condition of the patients was improved after methylprednisolone (60 mg, once a day), the temperature was normal, and the effusion in the serous cavity was better than before. The blood transfusion and platelet support therapy were intermittently given. Hemoglobin and platelets were increased in sex, and the urine volume increased to 1 000 mL/day. However, the platelet dropped at a later time, after 1 month of treatment with topizumab, the clinical condition of the patients was further improved. At present, the blood pigment and platelets returned to normal and had been separated from dialysis. TAFRO syndrome is a special subtype of idiopathic multicentric Castleman disease, and it is a group of systemic inflammatory diseases with its own characteristics. Its clinical manifestations and diagnosis and treatment are unique compared with other idiopathic multicentric Castleman diseases. For the enlargement of lymph nodes of unknown reasons, it is suggested to improve the lymph node biopsy actively. Renal insufficiency is an important part of TAFRO syndrome. Renal biopsy is of great significance to study the pathogenesis of TAFRO syndrome and to judge the prognosis of patients. The clinical diagnosis of the disease requires comprehensive clinical manifestations and the results of various examinations. Early diagnosis and early treatment of the disease can often achieve good clinical effect.

[Relationship between marked hyperferritinemia and hemophagocytic lymphohistiocytosis].

OBJECTIVE: To investigate the relationship between marked hyperferritinemia (MHF) and hemophagocytic lymphohistiocytosis(HLH). METHODS: The clinical data of 123 patients with MHF admitted to Peking University People's Hospital from January 2017 to September 2018 were collected, including demographics, baseline characteristics, signs and symptoms, blood routine, blood biochemistry, coagulation function parameters, such as prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (Fib), d-dimer (D-D), fibrin degradation product (FDP), blood ferritin, natural killer (NK) cell activity, soluble interleukin (IL)-2 receptor and bone marrow examination. According to the diagnosis of HLH, the patients were divided into HLH group and non HLH group. The patients were divided into death group and survival group according to the 3-month follow-up results. The groups were compared and statistically analyzed. RESULTS: In the 123 patients with MHF, the average age was (44.2±17.4) years with a male/female ratio of 1.3 ∶1. The most common causes were hematolo-gic malignancies, rheumatologic and inflammatory disorders, iron overload, and HLH. HLH was enriched as the ferritin increased, and the HLH ratios were 28.8%, 40.0%, 54.5%, 50.0%, 50.0% in ferritin value of 10 000-19 999, 20 000-29 999, 30 000-39 999, 40 000-49 999 µg/L, more than 50 000 µg/L respectively. There were 46 cases of HLH, among which 15 cases were secondary to malignancies, 14 cases secondary to rheumatologic disorders, 2 cases secondary to infection, and 15 cases with no clear precipitating cause. There were significant differences between the HLH group and non-HLH group in hepatomegaly, splenomegaly, lymphadenectasis, albumin (ALB), fibrinogen(Fib), P < 0.05, and no significant differences in age, gender, fever, disturbance of consciousness, ferritin level on presentation, maximum ferritin level, cytopenia in 2 or more cell lines, alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL), direct bilirubin (DBIL), triglyceride (TG), coagulation parameters (PT, APTT, D-D, FDP, exception of Fib), and mortality rate (P > 0.05). There were significant differences between the death group and survival group in disturbance of consciousness, platelet count, PT, TBIL, and DBIL (P < 0.05), but no significant differences in age, gender, fever, hepatomegaly, splenomegaly, lymphadenectasis, ferritin level on presentation, maximum ferritin level, neutrophils, hemoglobin, ALT, AST, ALB, TG, coagulation parameters (Fib, APTT, D-D, FDP, exception of PT) and the HLH ratio (P > 0.05). CONCLUSION: HLH was enriched as the ferritin increased, but marked hyperferritinemia was not specific for HLH in adults.

[Utility of the type 3 portable monitor for the diagnosis of sleep disordered breathing in patients with stable heart failure].

Objective: To evaluate the utility of a type 3 portable monitor (PM) at home for the diagnosis of sleep disordered breathing (SDB) in patients with stable congestive heart failure (CHF). Methods: Seventy-six consecutive patients with CHF (61 males, 15 females, mean±standard deviation age (57.0±16.9) years) were enrolled from the sleep center of Peking university People's Hospital during January 2016 to January 2019, and underwent overnight, unattended home sleep apnea testing (HSAT) with a portable monitor followed by an overnight simultaneous polysomnogram (PSG) with in-laboratory portable monitor (in-lab PM) recording within one week. The consistency of apnea hypopnea index (AHI), obstructive sleep apnea index (OAI), central sleep apnea index (CAI) between HSAT and PSG as well as the in-lab PM and PSG were analyzed by Bland-Altman plot; the sensitivity and specificity of PM for the diagnosis of SDB in patients with CHF were evaluated. Results: The number of patients included in the final analysis were 65 in HSAT, 63 in in-lab PM and 65 in PSG. AHI [M(Q1,Q3)] was 26.1 (10.9,40.1) events/h by HSAT, 27.9 (11.3,43.2) events/h by in-lab PM, both were not different from AHI 29.0 (10.2,45.0) events/h by PSG (P>0.05). The AHI, OAI and CAI assessed by HSAT correlated significantly with those by PSG (r=0.892, 0.903, 0.831, P<0.05). Bland-Altman analysis of AHI, OAI, CAI by PSG versus HSAT showed a mean difference of 3.1 events/h, 0.8 events/h, 1.2 events/h; limits of consistency were -15.2 to 21.4 events/h, -9.7 to 11.3 events/h, -10.9 to 13.2 events/h, respectively. Based on a threshold of AHI ≥5 events/h, HSAT had 94.6% sensitivity, 75% specificity, compared to PSG. For detecting Cheyne-Stokes respiration (CSR), a sensitivity of 96.4%,a specificity of 97.2% were achieved, compared to PSG. Conclusion: Type 3 PM can be used to diagnose SDB in patients with CHF.

[Clinical analysis of 61 patients with thrombotic thrombocytopenic purpura].

OBJECTIVE: To analyze and summarize the clinical features, diagnosis, treatment and prognosis of 61 patients with thrombotic thrombocytopenic purpura (TTP), so as to improve the ability of diagnosis and treatment. METHODS: The clinical data of 61 TTP patients admitted to Peking University People's Hospital from January 2004 to March 2019 were retrospectively analyzed, and the clinical manifestations, blood routine, hemolysis indicators, and von Willebrand factor lyase (von Willebrand factor-cleaving protease, vWF-CP, also known as ADAMTS13) of these patients were observed. According to the outcome at the time of discharge, they were divided into survival group and death group, and the differences in clinical characteristics, neutrophil to lymphocyte ratio (NLR) and plasma exchange between the two groups were compared. The PLASMIC scores were calculated and compared with ADAMTS13 to determine the accuracy of the PLASMIC score in predicting ADAMTS13. RESULTS: Among the 61 TTP patients, 22 were males and 39 were females, with an average age of (48±17) years. In the study, 48 cases had pentalogy, only 9 had triad, and the remaining 4 had no neuropsychiatric symptoms. Twenty-seven cases (44.3%) died and 34 cases (55.7%) survived. Among the 61 TTP patients, the platelet count was (12.9±9.5)×109/L, the hemoglobin (66.5±20.7) g/L, the percentage of erythrocyte fragments 3% (2%, 7%), and the plasma free hemoglobin increased to 360 (200, 457) mg /L, and the lactate dehydrogenase 1 508 (811, 2 133.8) U/L. The blood clotting was basically normal. The ADAMTS13 value of 30 patients was 49.0 (40.8, 61.3) µg/L, the ADAMTS activity of 10 patients was < 5%, and the remaining 21 patients were not checked. The PLASMIC score was 6-7 in 58 cases, 5 in 2 cases, and 4 in 1 case. The PLASMIC score predicted the decreased activity or the reduction of ADAMTS with a sensitivity as high as 97.5%. The NLR in the death group was higher than that in the survival group, but the difference was not statistically significant (P>0.05). The total amount and frequency of plasma exchange (PEX) in the death group were significantly less than those in the survival group, and the difference was statistically significant (P < 0.05). There was no significant difference in the treatment of glucocorticoids and human immunoglobulin between the two groups (P>0.05). CONCLUSION: PEX can significantly improve the survival rate of TTP patients. PLASMIC score can easily and quickly predict the possibility of ADAMTS13 activity reduction, which is beneficial to the early diagnosis of TTP and PEX treatment. NLR can reflect the systemic inflammatory process, but its significance in TTP needs further study.

[A report of six TAFRO syndrome: clinical characteristics, diagnosis and treatment analysis].

Objective: To explore the clinical characteristics, treatment and prognosis of TAFRO syndrome. Methods: All patients diagnosed as Castleman disease in Peking University People's Hospital between December 2011 and April 2019 were included.Among them,6 patients were diagnosed as TAFRO syndrome. Medical records were studied;the clinical manifestation, laboratory test, pathology, treatment and prognosis were analyzed. Recent related literatures were reviewed. Results: The average age of six TAFRO syndrome patients (5 males)was 41.5 years(range, 27-59 years). The patients presented as acute or subacute onset, manifested as fever, thrombocytopenia, polyserositis including pleural effusion and ascites, organomegaly, anasarca, and renal insuffciency. One patient was accompanied by hemophagocyticsyndrome, one patient was accompanied by hypothyroidism, six patients' serum IL-6 was elevated, four patients had received the test of serum VEGF and results were all elevated, six patients' HIV antibody were negative,four patients had received HHV-8 DNA test and results were all negative. For pathology, threewere plasma cell type, twowere mixed type andonewashyaline vascular type. Renal biopsies were performed in 2 patients, showing that renal thrombotic microangiopathyassociated with subacute tubulointerstitial nephritis and secondary capillary proliferative glomerulonephritis. CHOP chemotherapy wereused in 2 patients, glucocorticoid was used in 1 patient, and glucocorticoid combined with Rituximab or Tocilizumab were used in 3 patients. Among them, one patient died because of disease progression after 5 years, other five patientsare still stable. Conclusion: TAFRO syndrome is a rare disease, early recognition and appropriate treatment may improvethe prognosis.

[Accuracy analysis of robotic assistant needle placement for trigeminal gasserian ganglion].

OBJECTIVE: To evaluate the accuracy and feasibility of a custom robot system guided by optical navigation for needle puncture on trigeminal gasserian ganglion. METHODS: A synthetic human skull model was used, with plasticine placed around the skull base to imitate the human soft tissue. Cone beam CT (CBCT) scanning was performed before the operation. With image data transferred to the graphical user interface of the computer workstation, the oval foramen was selected as the target and the "skin entry point" was also determined by the surgeon on the surgical planning software. Thus the needle trajectory was eventually planned. The skull model was fixed firmly to the trial table with a head clamp and relative size of the trial table was the same as a standard operating table. Following point-based registration, the data were sent to the robot control unit. Only after the surgeon's confirmation, the needle was automatically inserted into the intended target by the robot guided by optical navigation. When the procedure was completed, the instantaneous data of the needle tip orientation acquired by navigation system was sent back to the computer workstation for accuracy verification by calculating the geometric distance between the needle tip and the planning target after matrix transformation. Subsequently, after the needle had been released, CBCT scanning was also acquired to make image fusion of the preoperative skull and the postoperative skull. The data of the needle tip orientation was acquired on the postoperative image and the accuracy was re-verified by calculating the geometric distance between the needle tip and the planning target after matrix transformation. IBM SPSS Statistics 20 was used for statistical analysis and the paired t-test was used to compare the differences in the accuracy measured by the intraoperative navigation and postoperative image fusion. RESULTS: All 20 interventions were successfully located in oval foramen at the first needle insertion. The mean deviation of the needle tip was (0.56±0.07) mm (measured by the navigation system) and (1.49±0.14) mm (measured by the image fusion), respectively (P<0.001). CONCLUSION: The experimental results show the robot system is efficient and reliable. The navigation accuracy is one of the most significant factors in robotic procedures.

Ventilation strategy and anesthesia management in patients with severe tracheal stenosis undergoing urgent tracheal stenting.

BACKGROUND: Stenting of airway stenosis is a common procedure in specialized centers. The aim of this study was to summarize our clinical experience in ventilation strategy and anesthesia management of patients undergoing urgent tracheal stenting. METHODS: Clinical data of 22 patients with severe tracheal stenosis who underwent urgent endoscopic placement of a tracheal stent during a 2-year period were retrospectively reviewed. The efficacy and safety of different ventilation strategies and veno-arterial extracorporeal membrane oxygenation (ECMO), individualized based on the cause and location of tracheal narrowing, were evaluated. RESULTS: Sufficient ventilation was successfully established in all patients; ECMO was used in five patients with stenosis in the mid-trachea who were unable to tolerate conventional intubation; a laryngeal mask airway (LMA) was used in five patients with post-intubation tracheal stenosis; a cuffed tracheal tube was used in eight patients with lower tracheal stenosis; and low-frequency jet ventilation in rigid bronchoscopy was used in four patients with mid- or lower tracheal stenosis. Tracheal stents were successfully placed and there were significant improvements in dyspnea. There were significant increases in the partial pressure of carbon dioxide in patients ventilated with the LMA and cuffed tracheal tube. There was no hypoxia during the operative period. CONCLUSION: Establishment of effective airway ventilation in patients with severe tracheal stenosis should be based on the cause, location, and severity of tracheal narrowing. Veno- arterial ECMO may be considered in patients with severe stenosis, if they are judged unable to tolerate conventional ventilation or jet ventilation.

[Evaluation of strain indexes and prognosis of patients with cardiac amyloidosis with preserved LVEF by three-dimensional speckle tracking imaging].

Objective: To evaluate the patients with Cardiac amyloidosis (CA) and Hypertrophic cardiomyopathy (HCM) by using the strain indexes of three-dimensional speckle tracking imaging(3D-STI) technique, and to evaluate the prognosis. Methods: A total of 32 patients with pathologically confirmed cardiac amyloidosis and 34 patients with hypertrophic cardiomyopathy and 16 normal controls were enrolled from the First Affiliated Hospital of Zhejiang University College of Medicine from June, 2013 to January, 2018.The color Doppler echocardiography and three-dimensional speckle tracking echocardiography were used to measure strain indexes of each group, and the Logistic regression equation was used to analyze the index differences.The cut-off values were analyzed using the Receiver Operating Characteristic (ROC), and Kaplan-Meier and Cox were used for survival regression analysis. Results: The globe radial strain (GRS) (16%±7% vs 23%±9%), left ventricular wall peak time difference (PSD) (52 ms±17 ms vs 77 ms±25 ms), Sokolow-Lyon index (20 mm±6 mm vs 34 mm±14 mm) were significantly different between cardiac amyloidosis group and hypertrophic cardiomyopathy group by 3D-STI, which had high sensitivity and specificity by Logistic regression analysis.The area under the ROC curve of GRS was 0.725, PSD was 0.812, Sokolow-Lyon index was 0.832.In addition, the area strain and atrial septal thickness were significant prognostic factors according to survival regression analysis. Conclusions: For the differential diagnosis of cardiac amyloidosis with preserved LVEF, unlike echocardiographic parameters, the 3D-STI strain indicators could be used to differentiate cardiac amyloidosis from hypertrophic cardiomyopathy, reflecting obvious diagnostic advantages.When combined with area strain and atrial septal thickness, 3D-STI strain indicators could be used to predict the survival prognosis, which are important in clinical practice.

Sensitive and rapid detection of Pectobacterium atrosepticum by targeting the gyrB gene using a real-time loop-mediated isothermal amplification assay.

UNLABELLED: This study reports the development of a real-time, loop-mediated isothermal amplification (RealAmp) assay for the detection of Pectobacterium atrosepticum (P. atrosepticum). A phylogenetic tree was constructed based on the gyrB gene of P. atrosepticum and related species. Pectobacterium atrosepticum from different sources can be clustered in the same branch with 100% support rate. The RealAmp primers targeting the gyrB gene of P. atrosepticum worked most efficiently at 61·0°C. Compared with 55 related bacterial strains, the eight P. atrosepticum strains displayed positive reaction in the RealAmp assay. The melting temperature (Tm) of P. atrosepticum amplified products was about 85·0°C. The detection limit of the RealAmp assay for the detection of P. atrosepticum in pure culture was approx. 3 CFU reaction(-1) . The detection limit of the RealAmp assay for the detection of P. atrosepticum in artificially contaminated samples was 22 CFU reaction(-1) . The detection rate of the RealAmp assay for the detection of potato tubers was 28·5-32·0% higher than that of the conventional PCR. In summary, a specific, sensitive and rapid RealAmp assay based on the gyrB gene of P. atrosepticum, which can be easily performed and real-time monitored, was established. SIGNIFICANCE AND IMPACT OF THE STUDY: Potato blackleg caused by Pectobacterium atrosepticum (P. atrosepticum) which is mainly transmitted through the seed potato leads to the decline in potato production. To reduce yield loss, rapid detection of P. atrosepticum in seed potato remains essential. Based on the gyrB gene of P. atrosepticum, species-specific primers were designed. A real-time, loop-mediated isothermal amplification (RealAmp) assay was established for the detection of P. atrosepticum. The RealAmp assay is a specific, rapid and sensitive method for P. atrosepticum detection. Therefore, it provides an effective diagnosis of potato blackleg in both the growing and stored potato.

Translocation breakpoints of chromosome 4 in male carriers: clinical features and implications for genetic counseling.

Cytogenetic analysis remains a powerful and cost-effective technology, and has wide applicability in genetic counseling for infertile males. Chromosomal rearrangements are thought to be one of the major genetic factors that influence male infertility. Some carriers with balanced reciprocal translocation have been identified as having oligozoospermia or azoospermia, and there is an association between balanced translocation and recurrent abortion. Researchers have reported the involvement of chromosome 4 translocations in male factor infertility and recurrent miscarriages. A translocation breakpoint might interrupt the structure of an important gene, and it is associated with reproductive failure. However, the clinical characteristics of the breakpoints in chromosome 4 translocations have not been studied. Here, we report the breakpoints in chromosome 4 translocation and the clinical features presented in carriers to enable informed genetic counseling of these patients. Of 82 patients with balanced reciprocal translocations, 14 were carriers of the chromosome 4 translocation: four presented with pregestational infertility (clinical manifestations: oligozoospermia, severe oligozoospermia, or azoospermia), whereas 10 presented with gestational infertility (able to conceive but with a tendency to miscarry). The breakpoint at 4q12 was associated with pregestational infertility, whereas the breakpoints at 4q13, 4q21, 4q25, and 4q32 were associated with gestational infertility. However, the breakpoint at 4q35 was associated with both pregestational and gestational infertility. Chromosome 4 translocation carriers with pregestational or gestational infertility should be counseled on chromosomal breakpoints and the different technologies available to assist reproduction.

Chromosome 7 translocation breakpoints in male carriers: clinical features and implications for genetic counseling.

Balanced reciprocal translocations are associated with reproductive failure. Some reciprocal translocation carriers exhibit azoospermia or oligozoospermia, and an association exists between these chromosomal abnormalities and recurrent abortion. Previous reports have indicated the involvement of chromosome 7 translocations in male infertility and recurrent miscarriage. A translocation breakpoint can occur within an important gene, interrupting its structure and leading to male infertility. However, clinical characteristics resulting from chromosome 7 translocation breakpoints have not been studied. Here, we report such breakpoints and their associated clinical features, to enable informed genetic counseling of carriers. Balanced reciprocal translocations were found in 1.57% of the tested patients. Among these 82 individuals, 14 (17.07%) carried a chromosome 7 translocation, of which, five presented with pregestational infertility and clinical manifestations of oligozoospermia or necrospermia, while nine presented with gestational infertility (i.e., were able to conceive, but often resulting in miscarriage). Breakpoints at 7q31 and 7q36 were associated with pregestational infertility, whereas those at 7p10, 7q21.2, 7q22, and 7q32 were connected to gestational infertility. However, the breakpoint at 7p15 was associated with both. Chromosome 7 translocation carriers with pregestational or gestational infertility should be counseled on chromosomal breakpoints and the various molecular technologies available for assisted reproduction.

[Analysis of related factors on effects of uterine artery embolization in the treatment of dysmenorrhea of adenomyosis and the construction and validation of prediction model].

Objective: To investigate the related factors on effects of uterine artery embolization(UAE)in the treatment of dysmenorrhea in patients with adenomyosis, and to construct and validate the efficacy prediction model. Methods: A total of 127 cases of adenomyosis patients with symptoms of dysmenorrhea in Guangzhou No.1 People's Hospital and Nanfang Hospital of Southern Medical University from June 1999 to December 2009 were reviewed. The evaluation standard was to improve the degree of dysmenorrhea, the related factors of efficacy were analysed. Combined with artificial neural network theory, the effect prediction model was constructed, and the effectiveness of the model was evaluated using receiver operating characteristic(ROC)curve, and the effectiveness of the cut-off point was calculated. The model was validated by 68 cases of patients with adenomyosis in the Nanfang Hospital from January 2010 to November 2014. Results: (1)In 127 cases of dysmenorrhea patients, UAE treatment was effective in 98 cases, effective rate was 77.2%(98/127).(2)Age was an independent predictor of effective UAE treatment(HR= 1.129, P=0.026); in the range of this study, the greater the age, the higher the UAE treatment efficiency.(3)The developing situation of ovary branches of uterine artery was an independent predictor of effective UAE treatment(HR=0.460, P=0.020), the efficiency of patients whose intraoperative bilateral uterine artery ovarian branch did not develop was 89.7%(35/39), the efficiency of patients whose unilateral uterine artery ovarian branch was developing was 84.1%(37/44)and the efficiency of patients whose bilateral uterine artery ovarian branch were developing was 59.1%(26/44).(4)Blood supply of adenomyosisis was an independent predictor of effective UAE treatment(HR=0.313, P=0.001). Type Ⅰ(bilateral predominated)patients, efficiency was 93.5%(43/46); type Ⅱ(bilateral balanced)patients, efficiency was 78.0%(39/50); type Ⅲ(unilateral predominated)patients, efficiency was 51.6%(16/31).(5)UAE for the treatment of adenomyosis efficacy of artificial neural network prediction model was constructed, the model's area under the ROC curve was 0.808, the optimal cut-off point was 0.669 13. Actual verification of the model, sensitivity was 96.5%, specificity was 81.8%, positive predictive value was 96.5% and negative predictive value was 81.8%, the total accuracy was 94.1%. Conclusions: (1)Age, the developing situation of ovary branches and blood supply of adenomyosis are the independent predictors of effective UAE treatment.(2)The artificial neural network prediction model is satisfied with the accuracy and the accuracy of prediction.

Lack of association between the aryl hydrocarbon receptor rs2066853 polymorphism and breast cancer: A meta-analysis on Ahr polymorphism and breast cancer.

Published data regarding the association between aryl hydrocarbon receptor (Ahr) rs2066853 polymorphism and the risk of breast cancer shows conflicting results. We performed a meta-analysis on 2999 patients and 3050 controls from three related case-control studies to estimate the association between Ahr rs2066853 polymorphism and the risk of breast cancer. The protocol was approved by the Institutional Animal Care and Use Committee (IACUC) at the University of Florida (America NIH Publication No. 86-231985 Revision). According to the three eligible populations, the odds ratios (ORs), 95% confidence intervals (CIs) on the risk of breast cancer for the genotypes GA vs GG, AA vs GG, and A vs G were 1.06 (0.81-1.40), 0.96 (0.81-1.13), and 1.02 (0.85-1.22), respectively. The OR (95%CI) for GA + AA vs GG was 1.05 (0.80-1.37). Furthermore, after multi-variates adjustment, the ORs (95%CIs) were 1.05 (0.80-1.38) for GA vs GG, and 0.92 (0.76-1.10) for AA vs GG. This meta-analysis suggests that Ahr (rs2066853) polymorphism would not modify the risk of breast cancer. However, further research should be conducted to provide more evidence.

Clinical significance and levels of blood brain natriuretic peptides in patients with persistent atrial fibrillation before and after catheter ablation.

The aim of this study was to observe levels of blood brain natriuretic peptides (BNPs) in patients with persistent atrial fibril-lation (AF) before and after catheter ablation. Thirty-six patients with persistent AF (28 successful surgeries and eight recurrent cases) and 36 healthy controls with normal sinus rhythm were recruited for this study. BNP levels in the AF and control groups were measured before and after catheter ablation. BNP levels before surgery were significantly higher in the persistent AF group than in the control group (P < 0.01). The successful surgery group had distinctly lower BNP levels before ablation than the recurrent group (P < 0.01). In the recurrent group, BNP levels 2 h after ablation were significantly lower than those be-fore ablation (P < 0.01); these levels increased after AF recurrence (P < 0.01) and were comparable with those before ablation (P < 0.01). Logistic regression analysis indicated that the BNP level was an inde-pendent factor for and predictor of AF recurrence (P < 0.01). The BNP level in patients with persistent AF is clinically important in predicting and evaluating AF recurrence after ablation.

Association between a single nucleotide polymorphism of the XRCC1 gene and hepatocellular carcinoma susceptibility in the Chinese Han population.

The human X-ray repair cross-complementing protein 1 (XRCC1) gene is a potentially gene determining hepatocellular carcinoma (HCC) susceptibility. The purpose of this study was to evaluate the association between XRCC1 and susceptibility to HCC. The association of XRCC1 polymorphisms with HCC susceptibility was investigated in 460 HCC patients and 463 controls using the created restriction site-polymerase chain reaction method. Our results indicate that the c.1471G>A variant could be detected and that the allele and genotype frequencies were statistically different between cases and controls. The AA genotype was strongly associated with increased HCC susceptibility as compared with the GG wild genotype (OR = 2.214, 95%CI = 1.493-3.283, χ(2) = 15.97, P < 0.0001). In addition, significantly increased HCC susceptibility was also found in a dominant and recessive model (P < 0.01). The allele A could contribute to HCC susceptibility compared with the G allele (OR = 1.480, 95%CI = 1.224-1.789, χ(2) = 16.44, P = 0.0001). Results from this study indicate that the XRCC1 c.1471G>A polymorphism is associated with HCC susceptibility in the Chinese Han population. Future studies on larger populations are essential to confirm this association.

Regulatory functions of docosahexaenoic acid on ion channels in rat ventricular myocytes.

OBJECTIVE: The aim of this study was to study the regulatory functions of docosahexaenoic acid (DHA) on resting potential (RP), action potential duration (APD), delayed rectifier potassium current (Ik), and inwardly rectifier potassium current (Ik1) in rat ventricular myocytes, and analyze the related anti-arrhythmia mechanism. MATERIALS AND METHODS: Rat ventricular myocytes were isolated by enzyme digestion method. RP, APD, Ik and Ik1 in individual ventricular myocytes were recorded by patch-clamp technique with whole-cell configuration. Effects of DHA with various concentrations (0, 20, 40, 60, 80, 100 and 120 mmol/L, respectively) on RP, AP, Ik and Ik1 were investigated. RESULTS: There was no statistical difference of RP with different DHA concentrations (p > 0.05, n = 20), and the 25%, 50% and 90% of APD (APD25, APD50, and APD90) were gradually prolonged with increase of DHA concentration, respectively (p < 0.05, n = 20). IK gradually blocked and the I-V curve was downward shifted, according to increase of DHA concentration (p < 0.05, n = 20). The DHA half effect concentration (EC50) was 47.52 ± 2.32 µmol/L. With increasing DHA concentration, the steady-state inactivation curve shifted to left, and the recovery curve shifted to right. DHA had no significant effect on IK1 (p > 0.05, n = 20). CONCLUSIONS: DHA has regulatory functions on RP, APD, Ik and Ik1 in rat ventricular myocytes, which may be one of the related antiarrhythmic mechanisms.

[Five-year immunity persistence following immunization with haemophilus influenzae type b conjugate vaccine].

Objective: To evaluate the immunity persistence five years later after immunization with Haemophilus influenzae type b (Hib) conjugate vaccine in healthy infants/children aged 3 months to 5 years in China. Methods: The children were subjects who completed the whole-schedule immunization in the phase Ⅲ clinical trial in Lianshui county of Jiangsu povince was selected for the collection of blood samples at 5 years after vaccination from November to December, 2019. The enzyme-linked immunosorbent assay (ELISA) was used to detect Hib polyribosyl-ribitol-phosphate antibody (anti-Hib-PRP), and the long-term/short-term protection rate, geometric mean concentration (GMC) and geometric mean concentration increase fold (GMFI) of serum anti-Hib-PRP were calculated. Results: A total of 580 children were enrolled in this study, of which 158, 207 and 215 belonged to 3-5 month age group, 6-11 month age group and 1-5 year age group, respectively. The short-term (≥0.15 µg/ml)/long-term (≥1.0 µg/ml) protection rates of serum anti-PRP in the three groups after immunization were 89.24%, 90.34% and 98.60%, respectively; the GMC were 3.95 µg/ml, 3.11 µg/ml and 10.01 µg/ml respectively, and the GMFI were 29.04, 11.01 and 3.26 respectively. Conclusions: Hib conjugate vaccine can still have good immunogenicity after 5 years of primary immunization in healthy infants/children aged 3 months to 5 years in China.

Clinical characteristics and microbiology of nosocomial enterococcal bloodstream infections in a tertiary-level hospital: a retrospective study, 2007-2019.

BACKGROUND: Enterococci are important pathogens causing nosocomial bloodstream infections (BSIs) and cannot be treated with appropriate timely empirical antibiotics due to their natural resistance to many kinds of antibiotics. AIM: To analyse the clinical characteristics and microbiological features of nosocomial bloodstream infections caused by enterococci. METHODS: The clinical characteristics and microbiological features of nosocomial enterococcal BSI patients in Xiamen University Zhongshan Hospital were examined in a case-controlled retrospective study. All patient information was collected through an electronic surveillance system. FINDINGS: A total of 199 cases were identified as nosocomial enterococcal BSIs over a period of 13 years. The incidence of BSIs fluctuated from 0.21% to 0.81%. In the distribution of wards, enterococcal BSIs in hepatobiliary surgery ranked first. Intra-abdominal diseases (odds ratio: 3.36; 95% confidence interval: 2.15-5.27; P < 0.001), chemotherapy history (4.37; 2.06-9.25; P < 0.001), and urinary catheterization (2.34; 1.52-3.61; P < 0.001) were risk factors for nosocomial enterococcal BSI acquisition. Vancomycin-resistant enterococci and linezolid-insensitive enterococci strains were not found. CONCLUSION: Patients with a history of intra-abdominal disease, chemotherapy and urinary catheterization are at higher risk of nosocomial enterococcal bloodstream infections. The enterococcus strains were still sensitive to commonly used antibiotics.