[Correlation between serum growth differentiation factor 11 level and severity of coronary artery disease in patients with acute myocardial infarction].

Objective: To investigate the correlation between serum growth differentiation factor 11 (GDF11) level and coronary artery lesions in patients with ST-segment elevation myocardial infarction (STEMI), and the predictive efficacy of nomogram risk prediction model based on GDF11 combined with traditional risk factors on the occurrence of STEMI. Methods: This study was a retrospective cross-sectional study. Patients hospitalized in the Department of Cardiology of the 904th Hospital of Joint Logistic Support Force of People's Liberation Army of China from 2016 to 2018 were selected and divided into control group and STEMI group. The demographic data, blood lipid level, laboratory indicators of blood and GDF11 level were collected. Logistic regression analysis screened out independent correlated factors for the occurrence of STEMI. Spearman correlation analysis clarified the correlation of each indicator with the SYNTAX or Gensini scores. A nomogram risk prediction model for the risk of STEMI occurrence and the receiver operating characteristic curve was used to compare the prediction efficiency of each model. Results: A total of 367 patients were enrolled, divided into control group (n=172) and STEMI group (n=195), age (66.5±11.8), male 222 (60.49%). The serum GDF11 level of STEMI group was significantly lower than that of the control group (36.20 (16.60, 70.75) µg/L vs. 85.00 (53.93, 117.10) µg/L, P<0.001). The results of multivariate logistic regression analysis showed serum GDF11(OR=0.98, 95%CI: 0.97-0.99) and traditional independent risk factors such as smoking, diabetes, C-reactive protein, homocysteine, lipoprotein (a) and apolipoprotein A1/B were independent correlate factors for the occurrence of STEMI (P<0.05). Spearman correlation analysis showed that serum GDF11 was negatively correlated with SYNTAX score and Gensini score (P<0.05). The nomogram model constructed by serum GDF11 combined with traditional independent risk factors (AUC=0.85, 95%CI: 0.81-0.89) had better predictive value for the occurrence of STEMI than the traditional nomogram model constructed by independent risk factors(AUC=0.80, 95%CI:0.75-0.84) or serum GDF11 (AUC=0.76, 95%CI: 0.72-0.81), all P<0.01. Conclusions: Serum GDF11 is an independent correlate factor in the occurrence of STEMI and is negatively correlated with the severity of coronary artery lesions in patients with STEMI. The nomogram model constructed based on GDF11 combined with traditional risk factors can be a good predictor for the occurrence of STEMI.

[Prevalence and risk factors of aortic valve calcification among the elderly residents of Wuxi city, Jiangsu province].

Objective: To evaluate the prevalence and risk factors of aortic valve calcification among the elderly (≥65 years old) resident of Wuxi city, Jiangsu province. Methods: The household registration population aged ≥65 years old in Wuxi city was selected as the research subject by stratified sampling method from August 2017 to December 2018. Echocardiography was performed to assess the aortic valve calcification, and the participants were divided into calcification group and non-calcification group. Multivariate logistic regression analysis was used to explore the related risk factors of aortic valve calcification. Results: The age of the respondents was (73.6±7.1) years old, of which 48.8% (461 cases) were males.The prevalence rate of aortic valve calcification was 22.0% (208/944) in the elderly (≥ 65 years old) residents in Wuxi city. The prevalence rate in 65-69 years old, 70-74 years old, 75-79 years old, 80-84 years old and ≥85 years old was 16.7% (58/347),16.7% (41/245),16.2% (26/161),23.3% (24/103), and 67.0% (59/88),respectively. There were significant differences in age, weight, abdominal circumference, hip circumference, high-salt diets, exercise, hypertension, hyperlipidemia, diabetes, coronary heart disease, cerebrovascular disease, and carotid atherosclerosis between the non-calcified group (736 cases) and the calcified group (208 cases) (P<0.01 or 0.05).Multivariate logistic regression analysis showed that age (OR=1.077, 95%CI 1.053-1.101, P<0.001), diabetes mellitus (OR=1.697, 95%CI 1.174-2.453, P=0.005), and coronary heart disease (OR=1.964, 95%CI 1.378-2.799, P<0.001) were the risk factors of aortic valve calcification. Conclusions: The prevalence of aortic valve calcification in the elderly (≥65 years old) residents in Wuxi city of Jiangsu province increases with aging. Age, diabetes mellitus and coronary heart disease are the risk factors of aortic valve calcification in this population cohort.

[Upregulated Notch1 expression promotes bone morphogenetic protein-2/4 expression of calcified human heart valve interstitial cells].

OBJECTIVE: To observe the protein expression of Notch1 in the cultured calcified human heart valve interstitial cells (hVICs) in vitro and related mechanisms. METHODS: hVICs were divided into two groups: control hVICs were cultured in conventional media for 14 days and calcified hVICs were cultured with calcification inducers: ß-glycerophosphate (500 µl), ascorbic acid (200 µl), dexamethasone(100 µl) for 7 days. The calcified hVICs were further divided into calcified hVICs group and inhibited calcified hVICs by adding specific Notch1 inhibitor DAPT (50 µmol/L(4 µl/hole))groups and cultured for another 7 days. Inflammatory response of all groups were induced by lipopolysaccharide (LPS) for 8 to 12 hours. Western blot was used to detect the protein expression of Notch1, phosphorylation nuclear transcription factor κB (p-NF-κB), bone morphogenetic protein-2/4(BMP-2/4). ELISA was applied to detect the content of BMP-2 secretion of the groups. Von Kossa staining was used to observe of cellular calcification. RESULTS: (1)Von Kossa staining is positive in the induced calcification group, the expression of Notch1, p-NF-κB, BMP-2 and BMP-4 is significantly higher in the induced calcification group than in the control group (all P<0.05). The expression of BMP-2 is significantly higher in the induced calcification group than in control group ((88.23±3.28) pg/ml vs. (25.41±3.68) pg/ml, P=0.02). (2) After treatment with DAPT, the calcification and the expression of Notch1, p-NF-κB, BMP-2 and BMP-4 were significantly decreased compared to calcification group (all P<0.05). The expression of BMP-2 is (26.74±4.62) pg/ml in the calcification inhibition group and (80.41±2.96) pg/ml in calcified control group (P=0.02). CONCLUSIONS: Upregulated Notch 1 expression promotes BMP-2/4 secretion in LPS stimulated hVICs, and contributes to osteogenic changes in hVICs. Inhibiting Notch1 can decrease the BMP-2/4 secretion and calcification in hVICs, which may serve as a novel therapeutic option for treating calcific valve disease.

Comparison of effects of devascularization versus shunt on patients with portal hypertension: a meta-analysis.

OBJECTIVE: To systematically evaluate the effectiveness of devascularization and shunt on patients with portal hypertension. METHODS: Relevant studies compared devascularization and shunt for the treatment of portal hypertension were identified searching the PubMed, Embase, Elsevier, CNKI (China National Knowledge Infrastructure) database and Cochrane Trial Register searches until December 2013. Data of interest for devascularization and shunt including postoperative recurrent bleeding, postoperative hepatic encephalopathy,ascites, operative mortality rate, and long term survival rate were subjected to meta-analysis. RESULTS: Eleven studies were included in the study, the results of the meta-analysis showed that all eleven clinical studies demonstrated a significantly higher postoperative recurrent bleeding rate with devascularization group than with shunt group (Odds Ratio =2.14, 95% CI =(1.42, 3.21), P = 0.0003),the rate of hepatic encephalopathy in the devascularization group was significantly lower compared with the shunt group (Odds Ratio =0.56, 95% CI =(0.38, 0.82), P = 0.003); Our meta-analysis of three clinical studies revealed that the reduction of ascites in the devascularization group was significantly less than the shunt groups (Odds Ratio =0.48, 95% CI =(0.26, 0.89), P = 0.02), the operative mortality rate was not significantly different between the devascularization group than for shunt group (Odds Ratio =1.54, 95% CI = (0.91,2.63), P = 0.11). And the long-term survival rate was not significantly different between the devascularization and shunt groups (Odds=1.13, ratio, 95% CI =(0.64, 1.99), P = 0.68). CONCLUSIONS: Devascularization and shunt have different advantages and disadvantages respectively which reflected in postoperative complications and long term survival rate.

Neurofibromatosis type-1 with retroperitoneal stromal tumour: one case report.

BACKGROUND: Neurofibromatosis with gastrointestinal stromal tumours have been reported several times, while neurofibromatosis with retroperitoneal stromal tumours are very rare. CASE DESCRIPTION: We report the case of a 44-year-old man with a long history of neurofibromatosis. He complained of severe constipation and left leg pain. The patient's examination showed prominent peripheral cutaneous neurofibromas mainly in the belly and limbs, especially a huge mass in his abdomen, no less than ten café-au-lait spots, four Lisch nodules of the iris. Computed tomography and magnetic resonance imaging revealed a round and lobular mass in the retroperitoneal space. It was a well-circumscribed, hypervascular mass with cystic necrosis. A surgical resection was performed, and pathology and immunohistochemistry findings were consistent with stromal tumour. The c-kit gene and platelet-derived growth factor receptor-α gene mutations are not observed in the specimen. CONCLUSIONS: Neurofibromatosis with retroperitoneal stromal tumour is very rare, and radiological, pathological and immunohistochemical examination may identify it. Surgical resection may be the unique method of cure for it.

Erythrocyte trans-fatty acids, type 2 diabetes and cardiovascular risk factors in middle-aged and older Chinese individuals.

AIMS/HYPOTHESIS: Few data are available about intakes and food sources of trans-fatty acids (TFAs) or their associations with cardiometabolic outcomes in Asian people who consume a prudent diet but are experiencing rapid nutritional transitions. We aimed to investigate the relationships between TFA biomarkers and type 2 diabetes and cardiovascular risk factors in Chinese individuals. METHODS: Erythrocyte fatty acids were measured by gas chromatography among 3,107 men and women (50-70 years) recruited from urban and rural areas in Beijing and Shanghai, China. RESULTS: Total trans-18:1 and two trans-18:2 isomers were detected and accounted for 0.37% of the total fatty acids in the erythrocytes. Concentrations of TFAs were higher in women than men, and in urban than rural residents. Of the TFAs, trans-18:1, but not trans-18:2, showed a modest association with dairy consumption (ß = 0.27), but not with other foods. After adjustment for BMI, social-demographic, lifestyle and dietary factors and other TFAs, erythrocyte trans-18:1 was shown to be associated with a lower risk of type 2 diabetes (OR comparing extreme [first and fourth] quartiles 0.68, 95% CI 0.48, 0.97, p(trend) = 0.02), as well as 20-50% lower odds of central obesity, dyslipidaemia, hyperglycaemia, insulin resistance and chronic inflammation. In contrast, trans-18:2 fatty acids were positively associated with high triacylglycerol (p(trend) < 0.001) and LDL-cholesterol (p(trend) = 0.03) levels, but not with diabetes and other cardiometabolic risk factors. CONCLUSIONS/INTERPRETATION: Among middle-aged and older Chinese individuals with overall low erythrocyte TFAs levels, trans-18:1 might serve as a marker of dairy intake. Higher trans-18:1 levels were associated with a lower risk of type 2 diabetes, whereas higher trans-18:2 levels were associated with dyslipidaemia.

Sex-Specific Associations of Dietary Iron Intake with Brain Iron Deposition on Imaging and Incident Dementia: A Prospective Cohort Study.

OBJECTIVES: The study aimed to evaluate the association of dietary iron intake with incident dementia and brain iron deposition. DESIGN/SETTING/PARTICIPANTS: We included dementia-free participants from the UK Biobank who completed at least one 24-hour dietary recall at study baseline (2009-2012) and were followed up to 2021. Incident dementia was determined through linkage to medical records and death registries. Brain MRI was conducted in a subgroup of participants since 2014, with T2* measurements being used as indicators of brain iron deposition. MEASUREMENTS: Cox proportional hazard models were used to assess the associations of high (top quintile) and low (bottom quintile) versus medium (quintile 2 to 4) level of dietary iron intake with incident dementia, respectively. Linear regression was applied to assess the relations between dietary iron intake and brain T2* measurements. RESULTS: During follow-up (mean = 9.5 years), a total of 1,454 participants (650 women and 804 men) developed dementia among 191,694 participants (55.0% female; mean age, 56.2 years). When adjusted for sociodemographic, lifestyle, and other dietary factors, participants with low dietary iron intake (< 10.05 mg/day) had a significantly higher dementia risk (hazard ratio [HR], 1.50, 95% confidence interval [CI], 1.19-1.89), while the relation for high intake (> 16.92 mg/day) was non-significant (HR, 1.16, 95% CI, 0.92-1.46). A significant gender difference (P-interaction < 0.001) was observed, with a U-shaped association in male participants (HR for low vs. medium, 1.56, 95% CI, 1.14-2.13; HR for high vs. medium, 1.39, 95% CI, 1.03 - 1.88; P-nonlinearity < 0.001) and no significant association in females, regardless of their menopause status. In general, dietary iron intake was not related to T2* measurements of iron deposition in most brain regions. CONCLUSION: Our findings suggested a U-shape relationship between dietary iron intake and risk of dementia among males, but not females.

Artificial neural networks predict the incidence of portosplenomesenteric venous thrombosis in patients with acute pancreatitis.

Essentials Predicting the occurrence of portosplenomesenteric vein thrombosis (PSMVT) is difficult. We studied 72 patients with acute pancreatitis. Artificial neural networks modeling was more accurate than logistic regression in predicting PSMVT. Additional predictive factors may be incorporated into artificial neural networks. SUMMARY: Objective To construct and validate artificial neural networks (ANNs) for predicting the occurrence of portosplenomesenteric venous thrombosis (PSMVT) and compare the predictive ability of the ANNs with that of logistic regression. Methods The ANNs and logistic regression modeling were constructed using simple clinical and laboratory data of 72 acute pancreatitis (AP) patients. The ANNs and logistic modeling were first trained on 48 randomly chosen patients and validated on the remaining 24 patients. The accuracy and the performance characteristics were compared between these two approaches by SPSS17.0 software. Results The training set and validation set did not differ on any of the 11 variables. After training, the back propagation network training error converged to 1 × 10-20 , and it retained excellent pattern recognition ability. When the ANNs model was applied to the validation set, it revealed a sensitivity of 80%, specificity of 85.7%, a positive predictive value of 77.6% and negative predictive value of 90.7%. The accuracy was 83.3%. Differences could be found between ANNs modeling and logistic regression modeling in these parameters (10.0% [95% CI, -14.3 to 34.3%], 14.3% [95% CI, -8.6 to 37.2%], 15.7% [95% CI, -9.9 to 41.3%], 11.8% [95% CI, -8.2 to 31.8%], 22.6% [95% CI, -1.9 to 47.1%], respectively). When ANNs modeling was used to identify PSMVT, the area under receiver operating characteristic curve was 0.849 (95% CI, 0.807-0.901), which demonstrated better overall properties than logistic regression modeling (AUC = 0.716) (95% CI, 0.679-0.761). Conclusions ANNs modeling was a more accurate tool than logistic regression in predicting the occurrence of PSMVT following AP. More clinical factors or biomarkers may be incorporated into ANNs modeling to improve its predictive ability.

Effective treatment of early endobronchial cancer with regional administration of liposome-p53 complexes.

BACKGROUND: Lung cancer originates in a diffusely damaged bronchial epithelium as a result of sequential and cumulative genetic alterations. We investigated the feasibility of in vivo gene replacement in endobronchial precancerous and cancerous cells by a regionally administered nonviral delivery system. METHODS: After evaluating the in vitro transfection efficiency and cytotoxicity of a variety of cationic liposome-p53 formulations, a specific formulation, DP3-p53, was selected for further in vitro and in vivo evaluation. The ability of DP3-p53 to introduce the p53 gene in the normal bronchial epithelium was studied in transgenic mice that lack the p53 gene. The therapeutic effect of DP3-p53 administered intratracheally was studied in two nude mouse models of endobronchial human lung cancer by use of H358 (p53-null) and H322 (p53-mutant) cells. RESULTS: DP3-p53 was able to effectively introduce and express the p53 gene and induce G1 arrest and apoptosis in H358 cells in vitro and to introduce and transcribe the p53 gene in the bronchial epithelium of transgenic mice that lack the p53 gene in vivo. In therapeutic experiments using groups of four or five mice each, administration of five intratracheal doses of DP3-p53 (2 microg or 8 microg DNA per dose) on days 4, 8, 12, 16, and 20 after intratracheal tumor inoculation significantly inhibited lung tumor formation and prolonged by approximately twofold the survival of mice bearing H358 or H322 endobronchial tumor cells in contrast to the survival among untreated mice and mice treated with the DP3-empty vector (P = .007 [two-sided logrank test] for mice bearing H358 cells and P = .008 [two-sided logrank test] for those bearing H322 cells). CONCLUSIONS/IMPLICATIONS: Liposome-based p53 delivery through the airways is a potentially effective strategy for the treatment of early endobronchial cancer. These results have important implications for the gene therapy and prevention of human lung cancer.

Expression of inducible nitric oxide synthase in mast cells contributes to the regulation of inflammatory cytokines in irritable bowel syndrome with diarrhea.

BACKGROUND: Nitric oxide (NO) and mast cells (MCs) are possibly involved in the development of irritable bowel syndrome (IBS), but details on their role and interactions still remain undetermined. We aimed to investigate the expression of inducible NO synthase (iNOS) in MCs of the colon of IBS with diarrhea (IBS-D), and elucidated a potential role of NO in the differential regulation of cytokines in MCs. METHODS: Colonic mucosal biopsies of 19 IBS-D patients and 16 healthy controls were collected. The expression of tryptase and iNOS was investigated by immunohistochemistry, Western blotting, and real-time PCR. Effects of NO on the expression of cytokines in rat bone marrow MCs (BMMCs) were examined using a cytokine array by NG-nitro-l-arginine methyl ester (L-NAME) treatment. KEY RESULTS: Immunohistochemistry for tryptase revealed an increase in number of MCs with extensive iNOS expression in the colonic mucosa of IBS-D. Tryptase, iNOS and interleukin (IL)-1ß mRNA and protein levels were upregulated in IBS-D compared with healthy controls. Specifically, a positive correlation between tryptase and iNOS protein expression was observed in the colon of IBS-D (r = 0.667, p < 0.05). Supernatant from IBS-D increased iNOS expression in BMMCs. Antibody array showed that agrin, beta-nerve growth factor, fractalkine, granulocyte-macrophage colony-stimulating factor, IL-1ß, IL-1R6, IL-13, leptin, tumor necrosis factor alpha were suppressed, and cytokine-induced neutrophil chemoattractant (CINC)-1, CINC-2α, CINC-3, monocyte chemotactic protein-1, matrix metalloproteinase-8 were strongly produced in L-NAME treated BMMCs, comparable to levels in the control group. CONCLUSIONS & INFERENCES: Our findings provide new evidence that NO is able to regulate many cytokines in MCs that may be involved in the development of IBS.

Development of cationic liposome formulations for intratracheal gene therapy of early lung cancer.

Regional (intratracheal or aerosol) delivery of cationic liposome-DNA complexes for gene therapy of lung disease offers distinct advantages over systemic (intravenous) administration. However, optimal formulations for early lung cancer treatment have not been established. Therefore, we investigated >50 different liposome and micelle formulations for factors that may affect their transcription efficiency and tested the ideal formulations in an in vivo mouse model. Our data showed that cationic liposomes were generally more effective at transfecting genes than were micelles of the same lipid composition, thus suggesting a role for the bilayer structure in facilitating transfection. In addition, the transfection efficiency of liposome-delivered genes was highly dependent upon the lipid composition, lipid/DNA ratio, particle size of the liposome-DNA complex, and cell lines used. By optimizing these factors in vitro and in vivo, we developed a novel liposome formulation (DP3) suitable for intratracheal administration. Using G67 liposome as control, we found that DP3 was more effective than G67 in vitro and as effective as G67 at both preventing lung tumor growth and prolonging survival in our lung cancer mouse model. We observed a positive correlation between the in vitro p53 function and the in vivo antitumoral activities of liposome-p53 formulations, which had not been reported previously in studies of an intravenous liposome gene delivery system. This correlation may facilitate the development and optimization of a liposome-p53 formulation for aerosol use in lung cancer patients.

[Folk medicine of the Qiang nationality].

Based on a two-year investigation of folk medicine of the Qiang Nationality, systematic studies have been made on its formation and development, specific methods of physical therapy and experiences and features of clinical application.

[Comparison between Cistanche deserticola Y. C. Ma and C, tubulosa (Shenk) Wight on some pharmacological actions].

The weights of seminal vesicle and prostate gland of castrated young rats were significantly increased by administration of alcohol soluble extract from the decoction of Cintanche deserticola, C. tubulosa and soaked C. deserticola. The phagocytic function of intra-abdominal macrophage in mice was activated by the decoction of C. deserticola and C. tubulosa.

[Kidney reinforcing and yang supporting action of cistanche deserticola Y. C. Ma before and after preparation].

The weights of seminal vesicle and prostate gland of castrated young rats were significantly increased by administration of alcoholsoluble extract from decoction of Cistanche deserticola. The weights of testes, seminal vesicle and prostate gland in mice and rats were also increased by the extract. The phagocytic function of intra-abdominal macrophage in mice was activated by decoction of Cistanche deserticola. The results showed no statistical differences between crude and prepared drugs. The maximum oral tolerance for mouse was 40 g/kg.

[Comparison between actions of shiquandabu pills and shiquandabu liquor on immunological parameters in mice].

The comparison shows that both Shiquandabu pills and Shiquandabu liquor are efficacious in strengthening the immunological functions of mice. No significant difference has been found between the two forms of preparation. There exists a good dose-efficacy relationship for the pills in immunological functions.

[Effects of guifu dihuang pills extract on rabbit IgG accelerated mouse nephritis induced by nephrotoxic serum].

The effects of Guifu Dihuang Pills extract were observed in rabbit IgG accelerated mouse nephritis model induced by nephrotoxic serum. The results showed that this preparation could increase serum albumin, reduce urine protein, serum urea nitrogen and total cholesterol in serum, and improve the histological lesions in kidneys. The effects of Guifu Dihuang Pills extract in dosages of 0.3g/kg and 1.2g/kg were similar to those of cyclophosphamide 0.015g/kg.

[Prophylactic effect of systemic ceftazidime on bacterial translocation in scalded rats].

In this study, we evaluated the prophylactic effect of Ceftazidime on bacterial translocation (BT) of Pseudomonas aeruginosa in scalded rat by qualitative and quantitative bacterial cultures of blood, organs and mesenteric lymph nodes (MLN). Ceftazidi-me was administered systemically at 3 h, 6 h and 12 h post injury respectively. The dynamic changes in levels of Ceftazidime in blood and organ tissues were also determined. The results showed that effective levels of Ceftazidime in blood, liver and mucosa of the small intestine were rapidly reached and maintained for more than 4 h, but no drug was found in MLN. The prophylactic effect on BT was significant when systemic administration started at 3 h post injury (P < 0.001) and 6 h post injury (P < 0.05). Although the incidence of BT was unchanged (P > 0.05) when systemic administration started at 12 h, the number of organisms present in livers and kidneys, except MLN, was dramatically reduced (P < 0.01).

[The pharmacokinetics of ceftazidime in the burned patients].

Pharmacokinetic studies were carried out following systemic administration of ceftazidime in ten burn patients (TBSA 30%-60% and with full-thickness burn) and six healthy volunteers. Dynamic ceftazidime concentrations in blood, urine and blister fluid were analysed by HPLC. The results showed that the burned patients, especially during their shock phase, some pharmacokinetics parameters differed from that of normal volunteers, in that the volume of distribution (0.45 +/- 0.06 L/kg vs. 0.23 +/- 0.05 L/kg) and non-renal clearance of drug (30.54 +/- 21.97ml.min-1 vs. 11.08 +/- 4.91 ml.min-1) increased, but the elimination of half-life was prolonged. The result indicated that it was not necessary to increase the dosage of ceftazidime in extensive burns in the early period. Burn blister fluid concentrations were higher than MIC. Ranging from 1.004-21.62 micrograms/ml, indicating that systemic ceftazidime could penetrate second-degree burn tissue in the early postburn stage.