Atypical manifestations of acute coronary syndrome - throat discomfort: a multi-center observational study.

To present the clinical characteristics and the misdiagnosis rate of acute coronary syndrome manifested primarily as throat discomfort, we conducted a multicentric and retrospective study in the cardiology and otorhinolaryngology departments. Records of patients with primary complaint of throat discomfort, absence of chest pain at onset, and an ultimate diagnosis of acute coronary syndrome, as well as patients with pharyngitis (as controls) were collected from May 2015 to April 2016. The patients' main manifestations were compared. Logistic regression results showed that chest tightness, dyspnea, perspiring, and exertional throat symptoms were significantly associated with acute coronary syndrome, with odds ratios of 8.3 (95% CI 2.2-31.5), 10.9 (95% CI 1.8-66.9), 25.4 (95% CI 3.6-179.9), and 81.2 (95% CI 13.0-506.7). A total of 25 (56.82%) out of 44 acute coronary syndrome patients, who were first admitted to the otorhinolaryngology department, were misdiagnosed, with a 12% (3/25) mortality rate. Throat discomfort can be the principal manifestation of acute coronary syndrome. Such patients exhibit high misdiagnosis and mortality rates. Exertional throat symptoms, chest tightness, perspiring, and dyspnea were important indicators of acute coronary syndrome in patients whose main complaint was throat discomfort. The awareness of this condition will result in prompt diagnosis and reduce morbidity and mortality.

A Computational Model of Working Memory Based on Spike-Timing-Dependent Plasticity.

Working memory is closely involved in various cognitive activities, but its neural mechanism is still under exploration. The mainstream view has long been that persistent activity is the neural basis of working memory, but recent experiments have observed that activity-silent memory can also be correctly recalled. The underlying mechanism of activity-silent memory is considered to be an alternative scheme that rejects the theory of persistent activity. We propose a working memory model based on spike-timing-dependent plasticity (STDP). Different from models based on spike-rate coding, our model adopts temporal patterns of action potentials to represent information, so it can flexibly encode new memory representation. The model can work in both persistent and silent states, i.e., it is compatible with both of these seemingly conflicting neural mechanisms. We conducted a simulation experiment, and the results are similar to the real experimental results, which suggests that our model is plausible in biology.

Mixtures of Tea and Citrus maxima (pomelo) Alleviate Lipid Deposition in HepG2 Cells Through the AMPK/ACC Signaling Pathway.

Tea and citrus maxima are natural, medicinal homologous plants, typically used for making beverages, which have anticancer, antiobesity, and antioxidation properties. Green tea, yellow tea, and black tea were combined with citrus maxima to obtain green tea and Citrus maxima (GTCM), yellow tea and Citrus maxima (YTCM), and black tea and Citrus maxima (BTCM). The biochemical components of these mixtures were analyzed, and their possible effects and mechanisms on relieving liver lipid deposition were explored. The tea polyphenols, free amino acids, phenolamine ratio, and caffeine were comparable in YTCM and GTCM, being significantly higher than those in BTCM. In addition, the content of esterified catechins, nonesterified catechins, and total catechins in YTCM was significantly higher than those in GTCM and BTCM. All three mixtures of Citrus maxima tea significantly reduced lipid deposition in HepG2 cells, with GTCM and YTCM being slightly more effective than BTCM. Regarding the possible mechanism, Western blot analysis revealed that the three Citrus maxima tea mixtures could activate the AMPK/ACC signaling pathway, upregulate the expression of p-AMPK, p-ACC, and CPT-1 proteins, and downregulate the expression of SREBP1c and fatty acid synthase proteins to inhibit fat synthesis, thereby relieving lipid deposition in liver cells. In conclusion, as a novel and healthy beverage, Citrus maxima tea has the potential to alleviate liver lipid deposition, and further could be responsible for obesity treatment.

Fetal bovine serum inhibits neomycin-induced apoptosis of hair cell-like HEI-OC-1 cells by maintaining mitochondrial function.

Aging and exposure to noise or ototoxic drugs are major causes of hair cell death leading to human hearing loss, and many agents have been developed to protect hair cells from apoptosis. Fetal bovine serum (FBS) is a fundamental ingredient in the culture medium of hair cell-like House Ear Institute Organ of Corti 1 (HEI-OC-1) cells, but there have been no reports about the function of FBS in HEI-OC-1 cell apoptosis. In this study, we found that FBS deprivation alone significantly increased HEI-OC-1 cell apoptosis in the absence of neomycin exposure and that the presence of FBS significantly inhibited HEI-OC-1 cell apoptosis after neomycin exposure compared to FBS-deprived cells. Further, we found that the protective effect of FBS was dose dependent and more effective than the growth factors B27, N2, EGF, bFGF, IGF-1, and heparan sulfate. We also found that FBS deprivation significantly disrupted the expression level of mitochondrial proteins, increased pro-apoptotic gene expression, decreased the mitochondrial membrane potential, and increased reactive oxygen species accumulation in HEI-OC-1 cells after neomycin exposure. These findings indicate that FBS is involved in maintaining the level of mitochondrial proteins, maintaining the balance of oxidant gene expression, and preventing the accumulation of ROS, and thus FBS maintains normal mitochondrial function and inhibits apoptosis in HEI-OC-1 cells after neomycin exposure.

The miR-383-LDHA axis regulates cell proliferation, invasion and glycolysis in hepatocellular cancer.

OBJECTIVES: To explore the correlation between expression patterns and functions of miR-383 and LDHA in hepatocellular cancer (HCC). MATERIALS AND METHODS: We detected the expression of miR-383 and LDHA in 30 HCC tissues and their matched adjacent normal tissues using qRT-PCR. Then we performed MTT assay, foci formation assay, transwell migration assay, glucose uptake assay and lactate production assay to explore the function of miR-383 in cell proliferation, invasion and glycolysis in HCC cell lines. Luciferase reporter assay was used to explore whether LDHA was a target gene of miR-383. Western blot and qRT-PCR were used to further confirm LDHA was targeted by miR-383. Then the above functional experiments were repeated to see whether the function of LDHA could be inhibited by miR-383. RESULTS: The results of qRT-PCR showed that miR-383 was down-regulated in HCC tissues compared with their matched adjacent normal tissues. Functional experiments showed that overexpression of miR-383 significantly suppressed cell proliferation, invasion and glycolysis. Luciferase reporter assay showed LDHA was a target gene of miR-383 and expression of LDHA was inversely correlated with that of miR-383 in HCC. Besides, increased cell proliferation, invasion and glycolysis triggered by LDHA could be inhibited by overexpression of miR-383 in HCC cell lines. CONCLUSION: Our study proved that miR-383 is down-regulated in HCC and acts as a tumor suppressor through targeting LDHA. Targeting the miR-383-LDHA axis might be a promising strategy in HCC treatment.

Pretreatment neutrophil-to-lymphocyte ratio in peripheral blood was associated with pulmonary tuberculosis retreatment.

INTRODUCTION: The neutrophil-to-lymphocyte ratio (NLR) is a readily available biomarker associated with recurrence and survival in various diseases. The objective of this study was to investigate the relationship between NLR and pulmonary tuberculosis (PTB) retreatment. MATERIAL AND METHODS: This was a case-control study that included 306 newly diagnosed cases of PTB in the clinical database of the Infectious Hospital of Wuxi from December 2009 to December 2011. Of the 306 patients, a total of 68 cases were followed up with TB retreatment. The remaining 238 PTB patients who completed anti-TB treatment and were cured without retreatment were selected as controls. RESULTS: According to the ROC curve, the best cut-off value of NLR was 2.53, with a sensitivity of 70.6% and a specificity of 45.4%. The NLR ≥ 2.53 before anti-TB treatment was associated with PTB retreatment (OR = 1.994, 95% CI: 1.116-3.564; adjusted OR (AOR) = 2.409, 95% CI: 1.212-4.788). The retreatment rates with NLR ≥ 2.53 and NLR < 2.53 were 27.1% and 15.5%, respectively, with a significant difference (log-rank test; p = 0.010). Additionally, cavitation on chest X-ray (OR = 2.922, 95% CI: 1.654-5.411; AOR = 2.482, 95% CI: 1.230-5.007), history of smoking (OR = 2.202, 95% CI: 1.158-3.493; AOR = 2.321, 95% CI: 1.135-4.745) and age ≥ 60 (OR = 3.828, 95% CI: 1.626-9.015; AOR = 2.931, 95% CI: 1.122-7.653) were also associated with PTB retreatment. CONCLUSIONS: NLR ≥ 2.53 is predictive of PTB retreatment. Otherwise, initial cavitation on chest X-ray, history of smoking, and age of ≥ 60 are also risk factors for PTB retreatment.

[The evaluation of nasal ventilatioan in patients with obstructive sleep apnea-hypopnea syndrome after nasal cavity ventilation expansion techniques by using acoustic rhinometry].

OBJECTIVE: To evaluate nasal ventilation in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) after nasal cavity ventilation expansion techniques by using acoustic rhinometry. METHOD: Thirty-eight patients with mild OSAHS and 17 patients with moderate OSAHS who were diagnosis by PSG were selected. The acoustic rhinometry and rhinomanometry were used to assess the nasal cavity volumes (NCV), nasal airway resistance (NR), nasal minimal cross-section area (NMCA) and distance of nasal minimal cross-section area from nostril (DCAN) before and after the surgery (6 month later). RESULT: The state of mild OSAHS group in NCV, NMCA and NR: before surgery (2.41 ± 1.33) cm³, (0.37 ± 0.39) cm², (2.07 ± 1.48) cmH2O/(L · min), after surgery (2.53 ± 1.54) cm³, (0.45 ± 0.34) cm², (1.69 ± 1.03) cmH2O/(L · min), has significant difference (P < 0.05). The state of moderate OSAHS group in NCV, NMCA and NR: before surgery (2.03 ± 1.54)cm³, (0.29 ± 0.39) cm², (3.47 ± 2.56) cmH2O/(L · min), after surgery (2.31 ± 1.47) cm³, (0.39 ± 0.33) cm², (1.89 ± 1.03)cmH2O/(L · min), also has significant difference (P < 0.05), while DCAN in two group had no difference (P > 0.05). CONCLUSION: There was an objective evaluation of nasal ventilation in OSAHS patients after surgery by using acoustic rhinometry.

The value of initial cavitation to predict re-treatment with pulmonary tuberculosis.

OBJECTIVE: Pulmonary cavitation is the classic hallmark of pulmonary tuberculosis (PTB) and is the site of very high mycobacterial burden associated with antimycobacterial drug resistance and treatment failure. The objective of this study was to investigate the relationship between re-treatment PTB and initial pulmonary cavitation coordinated with other clinical factors. METHODS: We conducted a case-control study of 291 newly diagnosed cases of pulmonary TB in The Infectious Hospital of Wuxi from Dec 2009 to Dec 2011 with complete follow-up information until December 31st of 2014. 68 patients were followed-up with PTB re-treatment; the rest of the PTB patients (n = 223) had completed anti-TB treatment, and cured without re-treatment were selected as controls. RESULTS: The univariate analysis [hazard ratio (HR) 1.885, 95 % CI 1.170-3.035, P = 0.009] and the multivariable analysis (HR 2.242, 95 % CI 1.294-3.882, P = 0.004) demonstrated that the initial pulmonary cavitation was a prognostic predictor for TB re-treatment. Additionally, the re-treatment rates in PTB patients with cavitation and no-cavitation were 27.1 and 15.5 %, respectively, with significant difference (log-rank test; P = 0.010). Other factors, age of ≥60 and history of smoking, were also prognostic variables. CONCLUSION: Initial pulmonary cavitation of chest X-ray was a significant predictor for PTB re-treatment.

[The evaluation of nasal ventilation in allergic rhinitis patients after nasal provocation].

OBJECTIVE: To evaluate nasal ventilation in allergic rhinitis patients after nasal provocation with acoustic rhinometry. METHOD: Twenty AR cases were selected. Each one was assessed for the nasal cavity volumes (NCV), nasal airway resistance (NR), nasal minimal cross-section area (NMCA) and distance of nasal minimal cross-section area from nostril (DCAN) by using acoustic rhinometry before and after nasal provocation 1 hour and 6 hours later. The results were statistically analyzed. RESULT: After nasal provocation 1 hour 1 later, NCV and NR had a significant difference compared with before nasal provocation(P<0. 05), but NMCA and DCAN had no difference (P > 0.05). After 6 hours later, NCV, NR, NMCA and DCAN had a significant difference compared with before nasal provocation (P < 0.05). NCV,NR,DCAN had a significant difference between 1 hour later and 6 hours later after provocation (P < 0.05), while NMCA had no difference (P > 0.05). CONCLUSION: The nasal ventilation in allergic rhinitis after nasal provocation had declined over time.

Ratio of monocytes to lymphocytes in peripheral blood in patients diagnosed with active tuberculosis.

OBJECTIVE: The ratio of monocytes to lymphocytes in peripheral blood could reflect an individual's immunity to Mycobacterium tuberculosis. The objective of this study was to evaluate the relationship between ratio of monocytes to lymphocytes and clinical status of patients with active tuberculosis. METHODS: This was a retrospective review of data collected from the clinical database of The Fifth People's Hospital of Wuxi, Medical College of Jiangnan University. A total of 419 patients who had newly diagnosed active tuberculosis and 108 cases from 419 patients with tuberculosis therapy either near completion or completed were selected. Controls were 327 healthy donors. RESULTS: Median ratio of monocytes to lymphocytes was 0.36 (IQR, 0.22-0.54) in patients before treatment, and 0.16 (IQR, 0.12-0.20) in controls (p<0.001). Ratio of monocytes to lymphocytes <9% or >25% was significant predictors for active tuberculosis (OR=114.73, 95% CI, 39.80-330.71; OR=89.81, 95% CI, 53.18-151.68, respectively). After treatment, the median ratio of monocytes to lymphocytes recovered to be nearly normal. Compared to other patients, patients with extrapulmonary tuberculosis and of age >60 years were more likely to have extreme ratio of monocytes to lymphocytes (AOR=2.57, 95% CI, 1.08-6.09; AOR=4.36, 95% CI, 1.43-13.29, respectively). CONCLUSIONS: Ratio of monocytes to lymphocytes <9% or >25% is predictive of active tuberculosis.

[Serum adiponectin levels in patients with obstructive sleep apnea-hypopnea syndrome].

OBJECTIVE: To explore the changes of serum adiponectin levels in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS). METHODS: Polysomnography was performed in 71 obese OSAHS patients (obese OSAHS group), 21 OSAHS patients without obesity (non-obese OSAHS group), 26 obese controls (obese group) and 22 normal healthy adults (control group). In both the obese OSAHS group and obese group, the body mass index (BMI) was higher than 25 and there was no significant difference in BMI. Serum adiponectin levels were measured by radioimmunoassay. RESULTS: The serum adiponectin level in the control group [(8.9 +/- 0.6) mg/L] was significantly higher than those in the obese group [(7.1 +/- 1.3) mg/L, P < 0.05], the non-obese OSAHS group [(5.4 +/- 0.6) mg/L, P < 0.01] and the obese OSAHS group [(5.0 +/- 1.0) mg/L, P < 0.01] respectively. The serum adiponectin level was significantly lower in both the obese OSAHS group and the non-obese OSAHS group (all P < 0.05). The serum adiponectin levels between the obese OSAHS group and the non-obese OSAHS group showed no statistical difference (P > 0.05). In the obese OSAHS patients and the obese patients serum adiponectin levels were negatively correlated with AHI (r = -0.78, P < 0.01), BMI (r = -0.21, P < 0.05), waist circumference (r = -0.36, P < 0.01), and neck circumference (r = -0.42, P < 0.01), but positively correlated with minimal pulse oxygen saturation (r = 0.48, P < 0.01). CONCLUSIONS: Serum adiponectin levels were significantly lower in OSAHS patients than in the normal control and the obese patients. In addition to increased waist and neck circumferences, OSAHS may contribute to the decreased serum adiponectin level.

[Culture and induced multilineage differentiation of mesenchymal stem cells derived from human nasal mucosa].

OBJECTIVE: To establish an in vitro method to culture mesenchymal stem cells(MSCs) derived from human nasal mucosa, and explore their stemness and differentiation potential. METHOD: Based on the observation of distribution of MSCs in human nasal mucosa, we cultured and proliferated MSCs in vitro and identified the expression of stem cell markers on them including Nestin, CD133, Vimentin and Sa114 with immunofluorescence. The MSCs were induced to differentiate to osteoblasts with medium containing dexamethasone, ascorbic acid and beta sodium glycerophosphate, and to neurons with Neurobasal medium containing B27, ATRA and TSA. Histochemistry and immunofluorescence were applied to evaluate the differentiation. RESULT: The nestin and vimentin immunofluorescence-positive MSCs existed extensively in human nasal mucosa. While the MSCs were cultured in the osteogenic-inducing medium, activities of alkaline phosphatase were increased significantly, and bone nodules were found on the surface of the osteoblasts by alizarin red staining. After the induction by neural-inducing medium, the MSCs adopted neuron like appearance with many slim protrusions interconnected as a network. The induced cells expressed neural markers NF-200 and BM88 strongly. CONCLUSION: The MSCs derived from human nasal mucosa are multipotent stem cells and can be utilized as seed cells to repair bone or neural injury.

Ratio of monocytes to lymphocytes in peripheral blood in patients diagnosed with active tuberculosis

Objective: The ratio of monocytes to lymphocytes in peripheral blood could reflect an indi- vidual's immunity to Mycobacterium tuberculosis. The objective of this study was to evaluate the relationship between ratio of monocytes to lymphocytes and clinical status of patients with active tuberculosis. Methods: This was a retrospective review of data collected from the clinical database of The Fifth People's Hospital of Wuxi, Medical College of Jiangnan University. A total of 419 patients who had newly diagnosed active tuberculosis and 108 cases from 419 patients with tuberculosis therapy either near completion or completed were selected. Controls were 327 healthy donors. Results: Median ratio of monocytes to lymphocytes was 0.36 (IQR, 0.22-0.54) in patients before treatment, and 0.16 (IQR, 0.12-0.20) in controls (p < 0.001). Ratio of monocytes to lymphocytes <9% or >25% was significant predictors for active tuberculosis (OR = 114.73, 95% CI, 39.80-330.71; OR = 89.81, 95% CI, 53.18-151.68, respectively). After treatment, the median ratio of monocytes to lymphocytes recovered to be nearly normal. Compared to other patients, patients with extrapulmonary tuberculosis and of age >60 years were more likely to have extreme ratio of monocytes to lymphocytes (AOR = 2.57, 95% CI, 1.08-6.09; AOR = 4.36, 95% CI, 1.43-13.29, respectively). Conclusions: Ratio of monocytes to lymphocytes <9% or >25% is predictive of active tuberculosis. .

[The therapeutic effects of basic fibroblast growth factor injected into tympanic cavity on sensorineural deafness].

OBJECTIVE: To evaluate the therapeutic effects of basic fibroblast factor (bFGF) ototopically injected into tympanic cavity on sensorineural deafness. METHOD: 40 cases (50 ears) suffering from sensorineural deafness have been treated with bFGF,which was injected into tympanic cavity from 1998 to 1999. The hearing threshold of post-therapy was compaired with that of pre-therapy. RESULT: The total therapeutic effective rate of bFGF on the deafness was 96%. The hearing threshold of post-therapy was much lower than that of pre-therapy in average. CONCLUSION: The bFGF could improve the hearing of sensorineural deafness patients. The method of ototopically injecting bFGF to tympanic cavity was safe and applicable.