Coronary Artery Fistula and Severe Coronary Artery Stenosis: A Case Report and an Insight for Potential Pathogenesis of Coronary Artery Atherosclerosis.

Coronary artery fistulae (CAF) are a rare anomaly characterized by abnormal connections between a coronary artery and a cardiac chamber or a great vessel, with most patients remaining asymptomatic. Despite being predisposed to severe complications like heart failure, patients with CAF infrequently experience severe stenosis in the coronary artery. This study delineates a case involving a 46-year-old male presenting with a fistula bridging the right coronary artery (RCA) and right atrium (RA), manifesting a pronounced 99% stenosis at the right extremity of the coronary artery proximal to the fistula. Concurrently, the individual exhibits six conventional risk factors: age over 40, male gender, hypertension, diabetes, smoking, and hypertriglyceridemia. Following pharmaceutical intervention, the patient was discharged and subjected to extended follow-up. This case highlights the dual processes of "accelerating damage" and "retarding renewal" in the progression of atherosclerosis. Factors such as shear stress, smoking, and hypertension are posited to expedite endothelial cell damage, while aging and diabetes may impede the renewal and repair of these cells. Together with the concept of secondary atherosclerotic plaque healing, this case prompts the introduction of a "Double Endothelial Healings" hypothesis, proposing a potential pathogenetic mechanism for coronary artery atherosclerosis.

Cost-Effectiveness Analysis of Hp and New Gastric Cancer Screening Scoring System for Screening and Prevention of Gastric Cancer.

Gastric cancer is one of the most common gastrointestinal cancers. Early diagnosis can improve the 5-year survival rate. This study aimed to evaluate the cost-effectiveness of Helicobacter pylori (Hp) and a new gastric cancer screening scoring system (NGCS) in areas with a high incidence of gastric cancer. A decision-analytic Markov model was constructed based on the theory and method of cost-effectiveness analysis, which included three decisions: no screening, Hp screening, and NGCS screening. The uncertainty of each parameter in the model was determined using a one-way sensitivity analysis and probability sensitivity analysis. The results of the cost-effectiveness analysis revealed that the application of the NGCS had the highest cost-effectiveness, while the one-way sensitivity analysis revealed that the probability of intestinal metaplasia progression to dysplasia had the most significant effect on the incremental cost-effectiveness ratio. The probability sensitivity analysis concluded that the result of the NGCS having the highest cost-effectiveness was stable. Although the application of the NGCS will require upfront screening costs, it can significantly improve the detection rate of early gastric cancer and save the consequent long-term healthcare costs. It is practicable and can be popularized in China.

Chemerin/CMKLR1 ameliorates nonalcoholic steatohepatitis by promoting autophagy and alleviating oxidative stress through the JAK2-STAT3 pathway.

Nonalcoholic steatohepatitis (NASH) is a global public health challenge. Overwhelmed oxidative stress and impaired autophagy play an important role in the progression of NASH. Chemerin is an adipokine that has attracted much attention in inflammation and metabolic diseases. This study aimed to examine the effects of chemerin in NASH and its association with oxidative stress and autophagy. In this study, chemerin was found to significantly ameliorate high-fat diet (HFD) induced NASH, marked by decreased serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), interleukin (IL)-1ß, IL-6, and tumor necrosis factor-α (TNF-α), decreased insulin resistance (IR) and leptin resistance (LR), and improved liver lesions. Besides, chemerin prevented enhanced oxidative stress in NASH mice by regulating the antioxidant defense system (MDA downregulation and upregulation of superoxide dismutase (SOD)). Moreover, chemerin contributed to the alleviation of NASH through autophagy activation (p62 downregulation, and upregulation of beclin-1 and LC3). Furthermore, these effects were related to increased phosphorylation of JAK2-STAT3 stimulated by chemerin, which could be inhibited by the CMKLR1 specific inhibitor α-NETA. In conclusion, excess chemerin highly probably ameliorated NASH by alleviating oxidative stress and promoting autophagy, the mechanism responsible for this process was related, at least in part, to the increased phosphorylation of JAK2-STAT3 stimulated by chemerin/CMKLR1. Rh-chemerin may represent promising therapeutic targets in the treatment of NASH.

GC-PROM: validation of a patient-reported outcomes measure for Chinese patients with gastric cancer.

BACKGROUND: There is increasing recognition that PROs are important in the estimation of the burden of long-term survival among patients with gastric cancer. The study aimed to develop a disease-specific instrument to assess patient-reported outcomes for Chinese patients with gastric cancer. METHOD: Following the FDA's draft guidance for patient-reported outcome, conceptual framework and item pool were defined based on relevant existing work. A draft scale was formed after revising some items based on feedback from experts and Chinese patients with gastric cancer. The pre-survey and formal survey were conducted in eight different hospitals in Shanxi Province, and two item-selection process based on classical test theory and item response theory. Finally, the patient-reported outcomes measure for Chinese patients with gastric cancer (GC-PROM) was validated in terms of reliability, validity, and feasibility. The minimal clinically important difference was determined by distribution-based method. RESULTS: The final GC-PROM consisted of 38 items, 13 subdomains, and 4 domains. Reliability was verified by Cronbach's alpha coefficient for four domains and 13 subdomains respectively. The validity results showed that the multidimensional scale fulfilled expectations. In the formal survey, the completion rate was 96.16%, and the average filling time was less than half an hour. The values of the minimal clinically important difference were 4.14, 3.41, 3.37, and 3.28 in the four domains. CONCLUSIONS: The GC-PROM had good reliability, validity, and feasibility and thus can be considered an effective clinical evaluation instrument for Chinese patients with gastric cancer.

MiR-223-3p promotes the proliferation, invasion and migration of colon cancer cells by negative regulating PRDM1.

Colon cancer is one of the most common malignancies worldwide, while the molecular mechanism remains largely unknown. miR-223-3p plays an important role in cancer development. Here, we found that miR-223-3p was up-regulated in 30 cases of colon cancer tissues as compared with their adjacent normal tissues. Lentivirus-mediated miR-223-3p over-expression promoted the proliferation, colony formation, migration and invasion of colon cancer cells. Inverse results were observed in miR-223-3p knockdown cells. Epithelial-mesenchymal transition (EMT) was regulated by miR-223-3p. In addition, cell apoptosis was suppressed and enhanced by miR-223-3p over-expression and knockdown, respectively. We further identified PRDM1, a tumor suppressor, was the target of miR-223-3p using microarray and luciferase assay. Our findings suggested that miR-223-3p acts as an oncogenic microRNA in colon cancer through regulating EMT and PRDM1.

Research on the mechanical properties of a glass fiber reinforced polymer-steel combined truss structure.

An assembled plane truss structure used for vehicle loading is designed and manufactured. In the truss, the glass fiber reinforced polymer (GFRP) tube and the steel joint are connected by a new technology featuring a pretightened tooth connection. The detailed description for the rod and node design is introduced in this paper, and a typical truss panel is fabricated. Under natural conditions, the short-term load test and long-term mechanical performance test for one year are performed to analyze its performance and conduct a comparative analysis for a reasonable FEM model. The study shows that the design and fabrication for the node of an assembled truss panel are convenient, safe, and reliable; because of the creep control design of the rods, not only does the short-term structural stiffness meet the design requirement but also the long-term creep deformation tends towards stability. In addition, no significant change is found in the elastic modules, so this structure can be applied in actual engineering. Although the safety factor for the strength of the composite rods is very large, it has a lightweight advantage over the steel truss for the low density of GFRP. In the FEM model, simplifying the node as a hinge connection relatively conforms to the actual status.

Conditioned medium from chondrocyte/scaffold constructs induced chondrogenic differentiation of bone marrow stromal cells.

For the application of bone marrow stromal cells (BMSCs) in cartilage tissue engineering, it is imperative to develop efficient strategies for their chondrogenic differentiation. In this study, the conditioned media derived from chondrocyte/scaffold constructs were used to direct chondrogenic differentiation of BMSCs. The porcine articular chondrocytes were seeded on the PGA/PLA scaffolds to form chondrocyte/scaffold constructs and were cultured to form engineered cartilage in vitro. The culture media were collected as conditioned media and used for chondrogenic induction of BMSC pellets (experimental group, Exp.). The chondrocyte pellets and BMSC pellets were cultured routinely as positive control (PC) and negative control (NC), respectively. After 4 weeks, the wet weight and GAG content in Exp. group and PC group were significantly higher than that in NC group. Histological and immunohistochemical analysis showed that cartilaginous tissue was formed with typical cartilage lacuna structure and positive staining of collagen Type II (Col II) in the peripheral area of the BMSC pellets in Exp. group. Gene expression of Sox9, Col II, and COMP in Exp. group and PC group were significantly higher than that in NC group. The growth factors in the conditioned media derived from human costal chondrocytes-scaffold constructs were tested by protein microassay. The conditioned media contained low levels of TGF-ß1,2,3, IGF-1 and high levels of IGF-2, FGF-4, and IGFBP4,6, and so forth. The soluble factors derived from the engineered cartilage can induce chondrogenic differentiation of BMSCs independently. Many cytokines may function in chondrogenesis in a coordinated way.

[Progress of methods of inducing bone marrow mesenchymal stem cells into chondrocytes in vitro].

OBJECTIVE: To review the research progress of the current methods of inducing bone marrow mesenchymal stem cells (BMSCs) to chondrogenic differentiation in vitro so as to provide references for researches in cartilage tissue engineering. METHODS: Various methods of inducing BMSCs differentiation into the chondrogenic lineage in vitro in recent years were extensively reviewed and analyzed. RESULTS: Adding exogenous growth factors is still the mainly method of inducing BMSCs differentiation into the chondrogenic lineage; among the members, transforming growth factor beta (TGF-beta) family is recognized as the most important chondrogenic induction factor. Other important inducing factors include various chemical factors, physical factors, transgenic methods, and the microenvironmental induction. But the problems of low inducing efficiency and unstable inducing effects still exist. CONCLUSION: The progress of chondrogenic induction of BMSCs promotes its utilization in cartilage tissue engineering. Further researches are needed for establishing more efficient, simpler, and safer inducing methods.

Determination of trace elements in residual oil by high-resolution inductively coupled plasma mass spectrometry.

An analytical method using high-resolution inductively coupled plasma mass spectrometry (HR-ICP-MS) for rapid simultaneous determination of 20 elements, including Na, Mg, Al, Ca, Ti, V, Mn, Fe, Co, Ni, Cu, Zn, Ga, As, Mo, Cd, Sn, Sb, Ba, and Pb elements, in residual oil was described. The sample was dissolved in HNO(3) by microwave digestion, and then the above 20 elements in the solution were analyzed directly by HR-ICP-MS. Most of the spectral interferences could be avoided by measuring in the high-resolution mode. The matrix effect caused by the sample-digesting solution and corrected by Sc, Rh, and Bi as the internal standard elements was studied in detail. The optimum condition of the determination was also tested and discussed. The result showed that the detection limits of the method were in the range of 0.014 to 11.6 microg L(-1); the relative standard deviation was less than 3.8% and recoveries in the samples were in the range of 88.4% to 108.0%. This method can be used to determine the trace elements in residual oil with the features of accurate, rapid, and convenient determination.

A missense mutation in the CHRM2 gene is associated with familial dilated cardiomyopathy.

Circulating autoantibodies against the M2-muscarinic acetylcholine receptor (CHRM2) have been detected in patients with dilated cardiomyopathy (DCM). However, it has yet to be determined whether the pathogenesis of familial DCM may be linked to the genetic variability of the CHRM2 gene. The coding regions of the CHRM2 gene were examined by direct DNA sequencing. Plasma concentrations of autoantibodies against CHRM2 were determined by ELISA in 7 unrelated DCM families. Linkage analysis demonstrated cosegregation of the microsatellite markers, D7S509 and D7S495 that flank the CHRM2 gene, with the familial form of DCM. A novel missense mutation (C722G) replacing cysteine with tryptophane (Cys176Trp) was identified in the CHRM2 gene in all affected members but was absent in unaffected members. Additionally, 139 sporadic DCM patients and 450 normal volunteers were screened for the same mutation, but none were identified. Among the 12 affected members with familial DCM, 5 patients had died suddenly and 7 experienced ventricular arrhythmia, atrioventricular conduction block, and heart failure. All mutation carriers were positive for autoantibodies against CHRM2. Survival analysis disclosed that prognosis in patients who were mutation carriers with familial DCM was poorer than that seen in patients who were noncarriers with sporadic DCM ((P<0.05). We have identified a novel missense mutation (C722G) in the CHRM2 gene associated with familial DCM. We also show that this variant correlates with the presence of autoantibodies against CHRM2. Patients with C722G mutation have more progressive disease, characterized by sudden death, arrhythmia, and heart failure.

[Soil enzyme activities of limestone degraded ecosystem at its different restoration phases].

The study showed that there was no distinct descending of enzyme activities along the soil profile of limestone degraded ecosystem, which were enhanced with progressive succession, and varied with vegetation characteristics, soil types, and soil enzyme properties. On the whole, soil enzyme activities enhanced in order of herb < Cupressuss funebris high forest< shrubbery, and under the same vegetation, limestone Cupressuss funebris high forest had higher soil enzyme activities than purple psammophytia. There was no significant correlation between soil enzyme activities and soil pH, while significant correlation was found between soil moisture content, soil total nitrogen content and soil enzyme activities, indicating that soil water and nutrient contents were the key factors of ecological restoration in this region. Different soil enzymes in the same vegetation-soil system as well as the same enzyme in the same soil type but at different restoration phases had different activities, so did for the same type vegetation but different soil type.