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@#Objective To explore the value of preoperative detection of soluble fragments of cytokeratin-19 (CYFRA21-1), carcinoembryonic antigen (CEA), and postoperative detection of nuclear proliferation associated antigen Ki67 in prognostic evaluation of non-small cell lung cancer patients. Methods The clinicopathological data and follow-up results of patients with non-small cell lung cancer treated in the Department of Thoracic Surgery of the First Affiliated Hospital of Xiamen University in 2017 were collected. CYFRA21-1>3.39 ng/mL was defined as positive, and CEA>5 ng/mL was defined as positive. The receiver operating characteristic curve (ROC curve) of Ki67 expression level was drawn. The maximum area under the curve (AUC) was the cutoff value of Ki67 expression level, and the Ki67 expression level greater than its cutoff value was defined as positive. Cox regression analysis was used to determine the independent risk factors for poor prognosis in patients with non-small cell lung cancer. Results Finally 248 patients were collected, including 125 males and 123 females, with a median age of 61 years (ranging from 30 to 81 years) at the time of surgery. Univariate analysis showed that positive CYFRA21-1, high expression of Ki67, positive CEA, age≥60 years at operation, distant metastasis, lymph node metastasis, maximum tumor diameter>3 cm, and TNM stage Ⅲ were associated with poor prognosis in patients with non-small cell lung cancer. When combined detection of preoperative tumor markers and postoperative Ki67, the prognosis of all negative patients was the best, and that of all positive patients was the worst. Cox regression analysis showed that positive CEA+positive CYFRA21-1+high expression of Ki67 was an independent risk factor for poor prognosis in patients with non-small cell lung cancer (P<0.05). Conclusion The combined detection of preoperative serum CYFRA21-1, CEA, and postoperative Ki67 has important value in evaluating the prognosis of non-small cell lung cancer patients.
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Objective:To validate the feasibility of the gamma analysis method in the study of prescription dose conversion between logistic nanodosimetry model (LNDM) and microdosimetric kinetic model (MKM) basing on the Chinese self-developed model LNDM by applying clinical experiences of National Institute of Radiological Science (NIRS).Methods:Physical dose distributions derived from the MKM- and LNDM-based carbon ion treatment plans were compared via the method of gamma analysis under the open-source treatment planning platform matRad. In this way, the prescribed dose conversion factor between the MKM- and LNDM-based treatment plans was obtained. Using water phantoms, the influence of geometric shape, size, depth of target volume (TV), prescribed dose and field setting on the conversion factor was investigated comprehensively. Moreover, preliminary verification of the acquired conversion factor was conducted on the C-shape model and a case of liver cancer patient.Results:The conversion factor depended on the field setting rather than the TV shape. Under the condition of single field, the conversion factor was positively correlated with the size and depth of TV, and the prescribed dose. Moreover, the conversion factor was successfully verified using the C-shape model and the patient with liver cancer, where the gamma passing rates (2%/2 mm) of the physical dose distribution generated by the MKM and LNDM treatment plans were 92.79% and 91.19%, respectively.Conclusions:The conversion factors (f=D LNDM/D MKM) obtained in this study might provide guidance for the prescribed dose setting during the carbon ion treatment planning based on the LNDM. Besides, the gamma analysis method could be used for the study of the prescribed dose conversion between different models.
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ObjectiveThe type 2C protein phosphatases （PP2C） are involved in numerous plant signal transduction pathways. They mainly participate in plant stress response and regulate second metabolites biosynthesis via negatively regulating MAPK signaling pathway. Herein，we were to identify and analyze PP2C （CsPP2C） gene family from hemp genome，in hope of providing comprehensive insights for studying CsPP2C function during the development of hemp. MethodMolecular Evolutionary Genetics Analysis （MAGA）-X was used to construct phylogenetic tree. Expert Protein Analysis System （ExPASy），WoLF PSORT，Multiple EM for Motif Elicitation （MEME），Batch Conserved Domain Search （Batch-CD-Search），PlantCare，and TBtools were used，respectively，to predict CsPP2C physicochemical properties，subcellular localization，conserved motifs，protein structure，cis-element in promoter and collinearity with Arabidopsis PP2C. Cannabis sativa transcriptome and Real-time polymerase chain reaction（Real-time PCR） were used to analyze and verify gene expressions，respectively. ResultFifty-two CsPP2C with conserved domains were identified from the entire genome of hemp，encoding proteins ranging from 244 to 1 089 aa in length and with molecular weights ranging from 26.76 to 122.53 kDa. Those genes were mainly distributed in the nucleus，cytoplasm and chloroplast. The 47 CsPP2C were divided into 10 subfamilies，and the remaining 5 were not clustered. Seven pairs of homologous genes between hemp and Arabidopsis thaliana were identified according to collinear analysis. The light-responsive elements and abscisic acid elements are most abundant in the prediction. The gene expression heat map showed varied expression pattern of CsPP2C in different tissues. Real-time PCR results of three CsPP2C were consistent with transcriptome data. Moreover，alternative splicing analysis showed that some CsPP2C had alternative-splicing genes during evolution. ConclusionWe predicted and analyzed CsPP2C gene family in genomic scale and showed that CsPP2C are involved in many biological processes，whereby provides foundation for CsPP2C functional study.
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ObjectiveThe type 2C protein phosphatases （PP2C） are involved in numerous plant signal transduction pathways. They mainly participate in plant stress response and regulate second metabolites biosynthesis via negatively regulating MAPK signaling pathway. Herein，we were to identify and analyze PP2C （CsPP2C） gene family from hemp genome，in hope of providing comprehensive insights for studying CsPP2C function during the development of hemp. MethodMolecular Evolutionary Genetics Analysis （MAGA）-X was used to construct phylogenetic tree. Expert Protein Analysis System （ExPASy），WoLF PSORT，Multiple EM for Motif Elicitation （MEME），Batch Conserved Domain Search （Batch-CD-Search），PlantCare，and TBtools were used，respectively，to predict CsPP2C physicochemical properties，subcellular localization，conserved motifs，protein structure，cis-element in promoter and collinearity with Arabidopsis PP2C. Cannabis sativa transcriptome and Real-time polymerase chain reaction（Real-time PCR） were used to analyze and verify gene expressions，respectively. ResultFifty-two CsPP2C with conserved domains were identified from the entire genome of hemp，encoding proteins ranging from 244 to 1 089 aa in length and with molecular weights ranging from 26.76 to 122.53 kDa. Those genes were mainly distributed in the nucleus，cytoplasm and chloroplast. The 47 CsPP2C were divided into 10 subfamilies，and the remaining 5 were not clustered. Seven pairs of homologous genes between hemp and Arabidopsis thaliana were identified according to collinear analysis. The light-responsive elements and abscisic acid elements are most abundant in the prediction. The gene expression heat map showed varied expression pattern of CsPP2C in different tissues. Real-time PCR results of three CsPP2C were consistent with transcriptome data. Moreover，alternative splicing analysis showed that some CsPP2C had alternative-splicing genes during evolution. ConclusionWe predicted and analyzed CsPP2C gene family in genomic scale and showed that CsPP2C are involved in many biological processes，whereby provides foundation for CsPP2C functional study.
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@#Objective To evaluate the effectiveness and safety of a central venous catheter for thoracic drainage after video-assisted thoracoscopic lobectomy compared with a conventional chest tube. Methods This study collected 200 patients with lung cancer who underwent thoracoscopic lobectomy and systematic hilar and mediastinal lymph node dissection between January 2018 and September 2019 in our hospital. The patients were randomly divided into two groups, including a group A (left with 28F chest tubes postoperatively) and a group B (left with 12G central venous catheters postoperatively). Patients in both groups were left with 2 chest tubes after upper lobectomy and 1 chest tube after middle or lower lobectomy. Duration and total volume of drainage, length of hospital stay, maximum visual analogue scale score and so forth were compared between the two groups. Results Finally, 151 patients were included for analysis. There were 73 patients in the group A, including 26 males and 47 females, with an average age of 55.38±9.95 years, and 78 patients in the group B, including 37 males and 41 females, with an average age of 59.86±10.18 years. No statistical difference was found between the two groups in drainage volume on postoperative day 2, and proportion of prolonged air leaks, hemothorax, chylothorax or drain reinsertion (all P>0.05). There was a statistical difference in drainage volume on postoperative day 1 [200.0 (120.0, 280.0) mL vs. 57.5 (10.0, 157.5) mL, P=0.000], postoperative day 3 [155.0 (100.0, 210.0) mL vs. 150.0 (80.0, 215.0) mL, P=0.023], total volume of drainage [890.0 (597.5, 1 530.0) mL vs. 512.5 (302.5, 786.3) mL, P=0.000], maximum pain score (2.29±0.72 points vs. 2.09±0.51 points, P=0.013) and length of hospital stay [7 (7, 9) d vs. 5 (4, 7) d, P=0.000]. Conclusion Compared with conventional chest tubes, central venous catheters for chest drainage in patients with lung cancer after thoracoscopic lobectomy shortens the length of hospital stay and reduces postoperative pain.
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Objective:To explore the correlation between body mass index(BMI)and coronary flow reserve(CFR)in patients with chest pain and no obstructive coronary artery disease(NOCA).Methods:This study was a single-center retrospective cross-sectional study. Sixty-six patients with chest pain and NOCA on coronary angiography who underwent PET/CT quantitative myocardial blood flow measurements at TEDA International Cardiovascular Hospital were retrospectively analyzed from August 2018 to October 2019. Pearson correlation analysis and linear regression analysis were used to explore the correlation between BMI and CFR. Patients were divided into 2 groups according to CFR: coronary microvascular dysfunction(CMD)group(CFR<2.5)and control group(CFR≥2.5). Logistic regression analysis was applied to analyze the association of BMI with CMD.Results:The proportions of female, obesity, and overweight plus obesity in CMD group were higher than those in control group( P<0.05). The levels of BMI and low density lipoprotein-cholesterol(LDL-C)were higher in CMD group compared with control group( P<0.05). Pearson correlation analysis showed that CFR was linearly correlated with BMI( r=-0.45, P<0.01), which still existed after adjusted by confounding factors using linear regression model( r=-0.371, P<0.01). Logistic regression analysis showed that BMI was dependently associated with CMD after adjusted by gender, age, hypertension, diabetic mellitus, and LDL-C. The OR value of CMD was 4.46(95% CI 1.47-13.55, P<0.01)with BMI increased by 5 kg/m 2. Conclusion:In patients with chest pain and NOCA, higher BMI is an independent risk factor of CMD.
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Objective:To diagnose female coronary microvascular diseases (CMVD) without obstructive coronary artery disease through coronary flow reserve (CFR) measured with PET/CT imaging, and further analyze its related risk factors of quantitative parameters and clinical characteristics.Methods:From September 2017 to August 2019, a total of 75 female patients (age: 25-77 years) with clinically suspected CMVD from TEDA International Cardiovascular Hospital were retrospectively analyzed. All patients had negative results of coronary angiography (CAG) or coronary CT angiography (CCTA) and underwent 13N-NH 3·H 2O PET/CT dynamic quantitative imaging. Left ventricle (LV) coronary flow reserve (LV-CFR) value of 2.5 for critical value was divided into CMVD group and non-CMVD group. Clinical characteristics and quantitative parameters including rest LV-myocardial blood flow (MBF) and stress LV-MBF were respectively analyzed and compared between groups. Independent-sample t test, Mann-Whitney U test and Pearson correlation analysis were used to analyze the data. Results:Of 75 patients, 51 cases (68%) were diagnosed with CMVD and 24 cases (32%) with non-CMVD. Body mass index (BMI) of the CMVD group was higher than that of the non-CMVD group ((26.93±3.52) vs (23.83±3.42) kg/m 2, t=3.63, P=0.001), and LV-CFR was negatively correlated with BMI ( r=-0.341, P=0.003). The LV-CFR of the overweight group (BMI≥24 kg/m 2) was lower than that of non-overweight group (BMI<24 kg/m 2) (2.18±0.47 vs 2.54±0.55, t=-2.89, P=0.005). The rest LV-MBF in the CMVD group (0.74(0.65, 0.84) ml·min -1·g -1) was higher than that in the non-CMVD group (0.66(0.58, 0.75) ml·min -1·g -1; U=417.5, P=0.027), and the stress LV-MBF and LV-CFR was lower than that in the non-CMVD group ((1.53±0.35) vs (1.96±0.45) ml·min -1·g -1, 2.07(1.71, 2.34) vs 2.86(2.61, 2.95); t=-4.54, U=0, both P<0.001). In the hypertensive group, the CMVD sub-group had higher rest LV-MBF than the non-CMVD sub-group ((0.77±0.16) vs (0.65±0.13) ml·min -1·g -1; t=2.26, P<0.05), but lower stress LV-MBF ((1.49±0.34) vs (1.85±0.40) ml·min -1·g -1; t=-3.07, P<0.05) and LV-CFR(1.99(1.64, 2.23) vs 2.85(2.55, 2.95); U=0, P<0.05] than the non-CMVD sub-group. In the non-hypertensive group, stress LV-MBF and LV-CFR of the CMVD sub-group were lower than those of the non-CMVD sub-group (1.53(1.36, 1.97) vs 1.94(1.76, 2.16) ml·min -1·g -1, 2.35(1.94, 2.43) vs 2.87(2.65, 3.09); U values: 43.5 and 0, both P<0.05). LV-CFR of CMVD subgroup in hypertensive group was lower than that of CMVD subgroup in non-hypertensive group ( U=164.0, P=0.028). Conclusions:BMI is negatively correlated with LV-CFR in CMVD. The decrease of stress LV-MBF and the increase of rest LV-MBF in CMVD lead to the decrease of LV-CFR. Hypertension is one of the important influence factors for MBF and CFR.
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Objective:To observe the changes of blood cell count, and levels of hormone, glucose, and electrolytes at adrenocorticotrophic hormone (ACTH) and thyrotropic hormone (TSH) axes in patients with traumatic brain injury (TBI) at early stage, and explore the correlations among these indicators.Methods:Prospective selection of 93 patients with TBI (TBI group), admitted to our hospital from March 2018 to July 2019, and 18 health subjects accepted physical examination (control group) during the same period was performed. TBI patients were divided into mild, moderate, and severe subgroups according to Glasgow coma scale (GCS) scores at admission. The changes of blood cell count, and levels of hormone, glucose, and electrolytes of these TBI patients and the control subjects were detected on the 2 nd, 8 th, and 15 th d of TBI. Results:(1) The cortisol (COR) level in TBI group was significantly higher than that in control group on the 2 nd and 8 th d of TBI (P<0.05); COR level in TBI group was decreased on the 2 nd, 8 th, and 15 th d of TBI, successively. TSH level in the TBI group was significantly lower than that in control group on the 2 nd d of TBI; TSH level in patients from the TBI group on the 8 th and 15 th d of TBI was significantly higher than that on the 2 nd d of TBI (P<0.05). Triiodothyronine (T3) level in the control group, and mild, moderate, and severe TBI subgroups decreased successively on the 2 nd d of TBI; and T3 level in TBI group was significantly lower than that in the control group on the 8 th and 15 th d of TBI; T3 level in the TBI group on the 15 th d of TBI was significantly higher than that on the 2 nd and 8 th d of TBI (P<0.05). Tetraiodothyronine (T4) level in the control group, and mild, moderate, and severe TBI subgroups decreased successively on the 2 nd d of TBI; and T4 level in the control group was significantly higher than that in the mild and severe TBI subgroups on the 8 th d of TBI(P<0.05); patients in the severe TBI subgroup had increased T4 level successively on the 2 nd, 8 th, and 15 th d of TBI. Free triiodinated thyroxine (FT3) level in the control group, and mild, moderate and severe TBI subgroups decreased successively on the 2 nd d of TBI; and FT3 level in the TBI group was significantly lower than that in the control group on the 8 th and 15 th d of TBI; FT3 level in TBI group on the 15 th d of TBI was significantly higher than that on the 2 nd and 8 th d of TBI (P<0.05). Free tetraiodothyronine (FT4) level in the control group and moderate TBI subgroup was significantly higher than that in the mild and severe TBI subgroups on the 2 nd and 8 th d of TBI (P<0.05). (2) The white blood cell (WBC) count of the TBI group was significantly higher than that of the control group on the 2 nd d of TBI (P<0.05); the WBC count in the moderate TBI subgroup, severe TBI subgroup, mild TBI subgroup and control group decreased, successively, on the 8 th d of TBI; the WBC count in the severe TBI subgroup, mild TBI subgroup, moderate TBI subgroup and control group decreased, successively, on the 15 th d of TBI; the WBC count in the patients of mild TBI subgroup on the 8 th and 15 th d of TBI was significantly lower than that on the 2 nd d of TBI, and that in patients of moderate and severe TBI subgroups on the 15 th d of TBI was significantly lower than that on the 2 nd and 8 th d of TBI (P<0.05). The red blood cell (RBC) count in the mild, moderate, and severe TBI subgroups, and control group were increased, successively, on the 2 nd, 8 th, and 15 th d of TBI. The platelet (PLT) count in the TBI group was significantly lower than that in the control group on the 2 nd d of TBI, and the PLT count in the mild and moderate TBI subgroups, and control group was significantly lower than that in the severe TBI subgroup on the 15 th d of TBI (P<0.05); the PLT count in the TBI group increased successively on the 2 nd, 8 th, and 15 th d of TBI. The blood glucose level in the control group, and mild, moderate and severe TBI subgroups increased, successively, on the 2 nd d of TBI, and the blood glucose in the severe TBI subgroup was statistically higher than that in the control group on the 8 th d of TBI; the blood glucose level in the TBI subgroup decreased, successively, on the 2 nd, 8 th, and 15 th d of TBI. Potassium level in the mild, moderate and severe TBI subgroups was significantly higher than that in the control group on the 15 th d of TBI; significantly higher potassium level on the 8 th and 15 th d of TBI was noted than that on the 2 nd d of TBI in patients from the moderate and severe TBI subgroups (P<0.05). The sodium content in the severe TBI subgroup was significantly higher than that in the mild and moderate TBI subgroups and control group on the 2 nd d of TBI; the sodium content in the severe TBI subgroup was statistically lower than that in the control group on the 15 th d of TBI (P<0.05). In patients from the severe TBI group, the sodium and chlorine contents on the 8 th and 15 th d of TBI were significantly lower than those on the 2 nd d of TBI. The blood calcium content in the moderate TBI subgroup and control group was significantly higher than that in the mild and severe TBI subgroups on the 2 nd d of TBI, and the calcium content in the severe TBI subgroup was significantly lower than that in the control group on the 15 th d of TBI; calcium content in the mild and severe TBI subgroups on the 8 th and 15 th d of TBI was significantly higher than that on the 2 nd d of TBI ( P<0.05). (3) In TBI patients, WBC count and blood glucose level were positively correlated with COR, and negatively correlated with TSH, T3 and FT3 levels ( P<0.05). RBC count was negatively correlated with TSH level, and positively correlated with FT4 level ( P<0.05). PLT count was negatively correlated with COR and positively correlated with ACTH, TSH, T3, T4 and FT3 levels ( P<0.05). Potassium was positively correlated with TSH, T3, T4, FT3 levels, and negatively correlated with COR ( P<0.05). Sodium was negatively correlated with TSH, T4, FT3 and FT4 levels, and positively correlated with COR ( P<0.05). Chlorine was negatively correlated with COR, TSH, T4, FT3 and FT4 levels ( P<0.05). Calcium was positively correlated with T3, T4, FT3 and FT4 levels ( P<0.05). Conclusions:The more severe the injury of TBI patients, the more significant the decline of T3, FT3, and FT4 levels and RBC count, and the more significant the increase of WBC count and glucose level. Most of them gradually returns to normal within one-2 weeks of injury. It is recommended to evaluate ACTH axis and TSH axis functions when blood cell count, glucose, and electrolytes are abnormal after TBI.
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Objective To evaluate the diagnostic value of coronary flow reserve (CFR) on 13 N-NH3 ·H2 O PET/ CT imaging for patients with suspected coronary microvascular disease (CMVD). Meth-ods From September 2017 to September 2018, 54 clinical suspected CMVD patients (22 males, 32 fe-males; age: 25-77 years) in TEDA International Cardiovascular Hospital were retrospectively analyzed. All patients underwent 13N-NH3·H2O PET/ CT imaging to measure left ventricle CFR (LV-CFR), and were divided into CMVD group (LV-CFR<2.5) and non-CMVD group (LV-CFR≥2.5). Semi-quantitative parameters of PET/ CT myocardial perfusion imaging (MPI), including summed stress score (SSS), summed rest score (SRS), summed difference score (SDS) and transient ischemic dilation (TID), as well as left ventricular function parameters, such as rest and stress imaging left ventricular ejection fraction (LVEF), end-diastolic volume (EDV), and end-systolic volume (ESV) were compared between two groups. Besides, rest and stress LV-myocardial blood flow (MBF) and CFR distribution of the CMVD group in the region of three coro-nary arteries was also analyzed and compared. Independent-sample t test, Mann-Whitney U test and Pearson cor-relation analysis were used to analyze the data. Results Rest LV-MBF of CMVD group was higher than that of non-CMVD group ((0.74±0.16) vs (0. 63±0.09) ml·g-1 ·min-1 ) and stress LV-MBF was lower ((1.52± 0. 36) vs (1.89±0.22) ml·g-1 ·min-1; t values: 2.925, -4.503, both P<0.05). There was no signifi-cant difference between the two groups in other semi-quantitative parameters ( t values: from - 1. 430 to 1. 400, U values: 286.0-338.5, all P>0.05). Positive correlations were found in CFR among left anterior descending (LAD), left circumflex (LCX) and right coronary artery (RCA) (r values: 0.798-0.836, all P<0.01). Conclusion CFR measured with PET/ CT imaging is better than semi-quantitative parameters in MPI, which provides noninvasive and objective diagnosis and evaluation information for patients without ob-vious epicardial coronary artery stenosis and suspected with CMVD.
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Objective To investigate the risk factors,mechanism and treatment strategies of expanding regional brain injury (traumatic intracerebral contusion or hematoma) in patients with acute traumatic epidural hematoma (ATEDH) after surgical evacuation.Methods Fifty-nine patients with ATEDH,admired to and accepted surgical evacuation in our hospital from February 2013 to September 2018,were chosen in this study;their clinical data and CT imaging data were retrospectively analyzed.The volume ofintracranial hematoma was measured by 3D Slicer software.According to the progress of local brain injury revealed by first CT examination after surgical evacuation,patients with ATEDH were divided into progressive group and non-progressive group.Risk factors of patients with expanding regional brain injury after surgery were analyzed by univariate and multivariate Logistic regression analyses.Results After surgery,22 showed expanding regional brain injury,accounting for 37.29％:9 occurred expanding intracerebral hematoma,and 2 of them died after conservative treatment;two had both expanding intracerebral contusion and hematoma;11 expanding intracerebral contusion patients developed into hematoma,and three of them occurred delayed intracerebral hematoma adjacent to the area of ATEDH,and two underwent secondary craniotomy with good recovery.As compared with patients from the non-progressive group,progressive group had significantly higher percentages of patients with preoperative hyperglycemia (＞9.1 mmol/L),patients with preoperative abnormal coagulation and patients accepted decompressive craniectomy (P＜0.05).Multivariate Logistic regression analysis revealed that preoperative abnormal coagulation was an independent risk factor for expanding intracerebral contusion or hematoma after surgery (OR=6.498,95％CI:1.076-39.253,P=0.041).Conclusion Expanding regional brain injury has high morbidity in patients with ATEDH after surgery evacuation;preoperative abnormal coagulation is an independent risk factor for its occurrence.
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Objective@#To evaluate the diagnostic value of coronary flow reserve (CFR) on 13N-NH3·H2O PET/CT imaging for patients with suspected coronary microvascular disease (CMVD).@*Methods@#From September 2017 to September 2018, 54 clinical suspected CMVD patients (22 males, 32 females; age: 25-77 years) in TEDA International Cardiovascular Hospital were retrospectively analyzed. All patients underwent 13N-NH3·H2O PET/CT imaging to measure left ventricle CFR (LV-CFR), and were divided into CMVD group (LV-CFR<2.5) and non-CMVD group (LV-CFR≥2.5). Semi-quantitative parameters of PET/CT myocardial perfusion imaging (MPI), including summed stress score (SSS), summed rest score (SRS), summed difference score (SDS) and transient ischemic dilation (TID), as well as left ventricular function parameters, such as rest and stress imaging left ventricular ejection fraction (LVEF), end-diastolic volume (EDV), and end-systolic volume (ESV) were compared between two groups. Besides, rest and stress LV-myocardial blood flow (MBF) and CFR distribution of the CMVD group in the region of three coronary arteries was also analyzed and compared. Independent-sample t test, Mann-Whitney U test and Pearson correlation analysis were used to analyze the data.@*Results@#Rest LV-MBF of CMVD group was higher than that of non-CMVD group ((0.74±0.16) vs (0.63±0.09) ml·g-1·min-1) and stress LV-MBF was lower ((1.52±0.36) vs (1.89±0.22) ml·g-1·min-1; t values: 2.925, -4.503, both P<0.05). There was no significant difference between the two groups in other semi-quantitative parameters (t values: from -1.430 to 1.400, U values: 286.0-338.5, all P>0.05). Positive correlations were found in CFR among left anterior descending (LAD), left circumflex (LCX) and right coronary artery (RCA) (r values: 0.798-0.836, all P<0.01).@*Conclusion@#CFR measured with PET/CT imaging is better than semi-quantitative parameters in MPI, which provides noninvasive and objective diagnosis and evaluation information for patients without obvious epicardial coronary artery stenosis and suspected with CMVD.
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Objective To investigate the toxicity of urban PM2.5 in Guangzhou on PC-12 cells.Methods PM2.5 was collected in Guangzhou city.PC-12 cells were cultured in vitro and divided into several groups,including the control group,PM2.5 groups with different concentrations and NAC pretreated group (pretreaed with 10 μmol/mL NAC followed with 100 μg/mL PM2.5 exposure).Cells were incubated with indicated stimulator for 24 h,then cell viability was checked with cell counting Kit-8 assay,the level of intracellular ROS was labeled using H2DCFDA fluorescence probe,cell apoptosis was measured by the flow cytometry and the expression of apoptosis-related proteins,including Cytochrome C,Caspase 9,Caspase 3 and PARP,were detected by Western Blot assay.Results PM2.5 has a strong toxicity on PC-12 cells when its concentration is over 25 μg/mL.After exposure for 24 h,the cell viability was markedly decreased.The results of flow cytometry and Western blot assay showed that PM2.5 enhanced the apoptosis of PC-12 cells with the upregulatios of Cytochrome C,Caspase 9,Caspase 3 and PARP.Pretreatment with NAC could significantly diminish PM2.5-induced PC-12 cell toxicity,decreased ROS generation and apoptosis of PC-12 cells,with the down regulations of apoptosis-related proteins.Conclusion PM2.5 can cause apoptosis of PC-12 cells by inducing oxidative stress,upregulating the Cytochrome C expression and activating Caspase9/3,which may be one of the mechanisms underlying PM2.5-induced neurotoxicity.
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Objective To observe the effects ofYiqi Shuxin Pills on the coronary flow reserve (CFR) of patients with acute coronary syndrome (ACS) in the coronary angiography (CAG); To discuss its relevant mechanism of action.Methods Totally 101 patients with ACS were divided into control group (49 cases) and treatment group (52 cases). Patients in the treatment group were treated with western therapy andYiqi Shuxin Pills, while patients in the control group were treated with western therapy only. After treated for 6 months, CAG was reviewed to compare the CFR in both groups before and after the treatment. The blood-stasis syndrome and qi-deficiency syndrome scores and the level of NO, ET-1, hs-CRP, sVCAM-1, P-selectin in blood of both groups before and after the treatment were observed.Results The blood-stasis syndrome and qi-deficiency syndrome scores in the treatment group were significantly lower than those in the control group (P<0.01); The levels of ET-1, hs-CRP, sVCAM-1, P-selectin were obviously reduced and NO obviously increased in treatment group than those of control group (P<0.05). The CFR in the treatment group was significantly better than that of control group, with statistical significance (P<0.05). ConclusionYiqi Shuxin Pills can improve the state of blood-stasis syndrome and qi-deficiency syndrome, improve vascular endothelial function, relieve inflammatory reaction, lower the expression of platelet, stabilize atherosclerotic plaque of coronary artery, and then improve the CFR of ACS patients in CAG.
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<p><b>OBJECTIVE</b>To assess the impact of transfection with recombinant adenovirus vector-mediated Klotho gene on myocardial remodeling in a rat model of heart failure (HF) by intraperitoneal injection of isoproterenol.</p><p><b>METHODS</b>Rats were divided into 5 groups by table of exponential random numbers: normal control group, HF group, saline-control HF group, recombinant adenovirus vector transfection group (Ad.EGFP group, 2 × 10¹⁰ pfu, 0.5 ml/rat), pDC316-CMV-EGFP-rKlotho transfection group (Ad.Klotho group, n=5 each). Left ventricular ejection fraction (LVEF) was obtained by echocardiography, hemodynamic parameters obtained by multi-channel physiological recorder, myocardial tissue underwent pathohistological examination. Additionally, the green fluorescin expression was observed on frozen heart section. Myocardial fibrosis correlated gene expression including Klotho gene, collagen I and III was detected by real time-PCR. Moreover, plasma levels of B-type natriuretic peptide (BNP) were measured with ELISA.</p><p><b>RESULTS</b>Compared to saline control HF group, LVEF, LVSP and ±dp/dtmax were significantly increased, myocardial fibrosis and myocardial remodeling were significantly attenuated in the Ad. Klotho group and there was green fluorescin distribution in myocardial tissues of Ad. Klotho group. Klotho expression was down-regulated and collagen I and III expression was upregulated in HF rats compared to normal control group (all P<0.05) and these changes could be significantly reversed in Ad. Klotho group (all P<0.05). Plasma BNP level was also significantly lower in Ad. Klotho group than in HF group (P<0.05).</p><p><b>CONCLUSIONS</b>Klotho gene transfection could improve cardiac function and attenuate cardiac remodeling and reducing myocardial fibrosis.</p>
الموضوعات
Animals , Rats , Adenoviridae , Disease Models, Animal , Echocardiography , Gene Expression , Genetic Vectors , Glucuronidase , Heart Failure , Hemodynamics , Isoproterenol , Myocardium , Natriuretic Peptide, Brain , Transfection , Ventricular Function, Leftالملخص
Purpose To observe the characteristics of coronary artery lesion in patients with unstable angina pectoris (UAP) and stable angina pectoris (SAP) using virtual histology intravascular ultrasound (IVUS-VH).Materials and Methods A total of 199 patients with angina pectoris were enrolled and divided into SAP group (101 cases) and UAP group (98 cases) according to clinical symptoms, ECG and myocardial enzyme level. All the patients underwent coronary angiography to determine the criminals vessels, grayscale intravascular ultrasound was used to measure and compare the external elastic membrane area (EEMA), lumen cross-sectional area (lumen CSA), plaque area (PA), plaque burden (PB), remodeling index (RI), plaque eccentricity index (EI) of the criminals vessels. IVUS-VH method was used to measure and compare the area and percentage of calcified tissue,fibrous tissue, lipid tissue and necrotic tissue in the plague components of the criminals vessels between the two groups.Results There was no significant difference (t=1.392,-0.345, 1.921, 0.378 and 0.857,P>0.05) of EEMA, lumen CSA, PA, EI and RI measured at the location with smallest lumen area between the two groups. Necrotic core area and percentage of lesion composition in UAP group was significantly higher than that in SAP group (t=2.361,P0.05) between the two groups on the area of fiber, lipid and calcification. On the distribution of plaque components, fibrous plaque area percentage of UAP group was lower than that in SAP group (t=-2.418, P0.05) between the two groups on lipid and calcification area.Conclusion Necrotic core area and percentage of plaque composition in the UAP group is larger than the other group. Criminals lesions are more unstable and more easily to be complicated with acute cardiovascular events.
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Objective To study the feasibility and clinical effect of trans umbilical single incision laparoscopic right hemicolectomy for right hemicolon carcinoma.Methods The clinical data of 35 patients with right hemicolon carcinoma were retrospectively analyzed,the 15 cases were received the trans umbilical single incision laparoscopic right hemicolectomy (single incision group) and 20 cases were received laparotomy right hemicolectomy (laparotomy group).The clinical indexes were compared between the 2 groups.Results The length of incision,intraoperative bleeding volume,passage of gas by anus time,feeding time,hospitalized time in single incision group were significantly better than those in laparotomy group [(5.5 ± 0.6) cm vs.(17.6 ± 2.2) cm,(84.0 ± 31.1) ml vs.(155.5 ± 43.1) ml,(2.00 ± 0.76) d vs.(3.75 ± 0.63) d,(5.3 ± 0.6) d vs.(6.5 ± 0.6) d,(9.3 ± 1.4) d vs.(13.5 ± 1.5) d],the operation time in single incision group was significantly longer than that in laparotomy group [(238.4 ± 19.3) min vs.(165.3 ± 25.8) min],there were statistical differences (P ＜ 0.05).There was no statistical difference in number of incision lymph node between the 2 groups (P ＞ 0.05).Postoperative complication in single incision group occurred in 2 cases,postoperative complication in laparotomy group occurred in 3 cases,there was no statistical difference (P ＞0.05).The follow-up time was 1-55 months,the median follow-up time was 28 months,local recurrence and distant metastasis were found in 2 cases in single incision group,and 4 cases was found in laparotomy group,there was no statistical difference (P ＞ 0.05).Conclusions Single incision laparoscopic right hemicolectomy for right hemicolon carcinoma is safe and feasible,which has the advantages of minimal trauma,aesthetic outlook,less bleeding,quick recovery and short hospitalization time,etc.It can be developed in the hospital which has some basis of laparoscopic surgery.
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Objective To investigate the effect of Shanzha Xiaozhi Capslue on stability of atherosclerosis plaques in patient with metabolic syndrome (MS) and carotid atherosclerosis (CAS). Methods Totally 106 patients with MS and CAS were randomly divided into 2 groups with 55 cases in the treatment group and 51 cases in the control group. The control group improved the way of life and control of relevant risk factors, while the treatment group was treated with Shanzha Xiaozhi Capslue additionally for 6 months. The occurrence of major adverse cardiovascular and cerebrovascular events of the two groups was compared. The intima-media thickness, plaques grade of carotid artery and the changes of Hs-CRP, Hcy, insulin resistance were measured before and after the treatment. Results After treatment, the occurrence of major adverse cardiovascular and cerebrovascular events in the treatment group reduced significantly compared with the control group (P=0.047). The intima-media thickness and plaques grade of carotid artery in the treatment group decreased significantly compared with the control group (P<0.05), and the serum levels of Hs-CRP, Hcy, insulin resistance were decreased significantly compared with the control group (P<0.01). Conclusion Shanzha Xiaozhi Capslue can decrease the intima-media thickness and plaques score of carotid artery, stabilize atherosclerotic plaque, thus reduce the occurrence of major adverse cardiovascular and cerebrovascular events of patients with MS and CAS.
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Objective To investigate the effect of Shanzha Xiaozhi capslue on intima-media thickness(IMT) and plaques score of carotid artery in patients with non-acute phase coronary heart disease and traditional Chinese medicine(TCM)syndrome of phlegm and blood stasis. Methods A prospective study was conducted to carry out a research on 102 patients with non-acute phase coronary heart disease and TCM syndrome of phlegm and blood stasis. They were randomly divided into two groups:a control group(50 cases)treated with conventional western medicine alone and a observation group(52 cases)which was treated by both conventional western medicine and Shanzha Xiaozhi capslue(the main TCM ingredients:Shanzha,Dahuang)0.7 g,3 times a day,the therapeutic course being 6 months in both groups. The cardiocerebral vascular incidences of the two groups were observed,in the mean time,the carotid artery IMT and plagues score were registered,the scores of phlegm stagnation syndrome and blood-stasis syndrome were measured,adverse reaction was observed and compared in both groups before and after treatment. Results After treatment,the occurrence of major adverse acute cardiovascular and cerebrovascular events in observation group were reduced significantly compared with those in the control group(5.77%vs. 20.00%,P<0.05). The IMT and plaques score of carotid artery and the scores of phlegm stagnation syndrome and blood-stasis syndrome were all decreased obviously compared to those before treatment,and the effect was more remarkable in the treatment group〔IMT of carotid artery(mm):0.80±0.13 vs. 0.95±0.12,the plaques score:1.35±0.65 vs. 1.75±0.88, phlegm syndrome score:20.98±6.42 vs. 35.55±9.22,blood-stasis syndrome score:23.23±5.12 vs. 28.95±6.38, P<0.05 or P<0.01〕. Abdominal pain appeared in 2 patients of observation group without other adverse reactions. Conclusion Shanzha Xiaozhi capsule can stabilize atherosclerotic plaque and reduce the occurrence of acute adverse cardiocerebral vascular events in patients with non-acute phase coronary heart disease and phlegm and blood stasis syndrome possibly by removing phlegm and blood stasis to decrease the IMT and plaques score of carotid artery.
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ObjectiveTo evaluate the trauma care effect and the value of trauma and injury severity score (TRISS) in prediction of the mortality by using TRISS to calculate the survival probability of trauma patients in five hospitals from Zhejiang province in 2009.MethodsA retrospective study was done on trauma patients (study group) firstly admitted to Emergency Department of five hospitals from Zhejiang province in 2009.The relevant information was collected,including demographic data,trauma types and injury causes.The TRISS score was obtained through calculating injury severity score (ISS) and revised trauma score (RTS) on admission into emergency department.With the major trauma outcome study (MTOS) as control group,M value,standardized Ws value and 95％ confidence interval (CI) were calculated to compare actual survival rate and anticipation survival rate.ResultsA total of 2 193 patients at mean age of 44.39 years were enrolled in the study,including 1 661 male patients (75.74％).Traffic accident injury was the most common,followed by fall injury.The mortality rate according to TRISS was 13.22％,but the actual mortality rate was 9.75％.For all the patients,M =0.80 indicated that the injury severity of the study group was significantly different from that of the control group.At the same time,Ws =2.15,95％ CI for Ws:1.54-2.77 showed that the actual survival rate of the study group was significantly higher than that of the control group.Besides,the survival rate of trauma patients in the affiliated hospitals and three hospitals at class A grade was significantly higher fian that of the control group,but there was no significant difference between three hospitals at class B grade and control group. ConclusionsTRISS overestimates the mortality of the study group,which is probably associated with the rapid development of traumatology and the old coefficients of TRISS.Setting up local trauma database and renewing coefficients of TRISS may improve the ability of TRISS in predicting mortality of the trauma patients.
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Objective To explore risk factors in the mortality of casualties and to find a way to improve trauma emergency service. Method The possible factors likely related to the mortality of casualties were taken into account based on each stage of trauma emergency so as to find the independent risk factors by using univariate and multivariate analyses. Results A total of 3 659 casualties were enrolled in this study.Of them, 226 casualties died and the mortality rate was 6.18%. Following factors were related to mortality after univariate analysis: age, cause of trauma, injury severity score, Glasgow come scale come on the scene, professional emergency treatment on the scene, intubation in the ambulance, debridement and hemostasis in the ambulance, low blood pressure at admission, closed drainage of pleural cavity, emergency operation, CVP monitoring in ICU and mechanical ventilation in ICU. After multivariate analysis, six factors were independently related to the mortality of casualties as follows: Glasgow coma scale, injury severity score, mechanical ventilation, blood pressure at admission, age and professional emergency treatment on the scene. Conclusions It has a great significance to investigate the risk factors of mortality for casualties. Severity of trauma and age were independently associated with the outcomes of trauma. Besides, improving prehospital care and stabilizing the trauma patients in early phase can further decrease the mortality.