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Objective To construct a nomogram prediction model for major adverse cardiovascular events(MACE)within 1 year after percutaneous coronary intervention(PCI)in elderly patients with acute coronary syndrome(ACS).Methods A retrospective analysis was conducted on 551 patients with diagnosed ACS and undergoing PCI in Department of Cardiovascular Medicine of Air Force Medical Center from 1 January 2020 to 1 April 2022.According to the occurrence of MACE during 1 year of follow-up,they were classified into MACE group(n=176)and non-MACE group(n=375).Risk factors for the occurrence of MACE in elderly ACS patients within 1 year after PCI were analysed using univariate and multivariate logistic regression,a nomogram prediction model was constructed,and the predictive power of the model was assessed using the area under the ROC curve(AUC).Results The MACE group had significantly higher Gensini score,systemic immune-inflammation index,and GRACE score,but obviously lower prognostic nutritional index than the non-MACE group(P<0.01).Multivariate logistic regression analysis showed that recent smoking(OR=2.222,95%CI:1.361-3.628,P=0.010),hyperlipidaemia(OR=1.881,95%CI:1.145-3.089,P=0.013),prognostic nutritional index(OR=4.645,95%CI:2.788-7.739,P=0.001),LVEF(OR=5.177,95%CI:3.160-8.483,P=0.001),systemic immune-inflammation index(OR=5.396,95%CI:3.179-9.159,P=0.001),and preoperative di-agnosis of non-STEMI(OR=2.829,95%CI:1.356-5.901,P=0.006)or STEMI(OR=3.451,95%CI:1.596-7.463,P=0.002)were independent influencing factors for occurrence of MACE after PCI in elderly ACS patients.ROC curve analysis showed that the AUC value of the nomo-gram model for predicting MACE within 1 year after PCI in elderly ACS patients was 0.888.Con-clusion Our developed nomogram model is simple and practical,and can effectively predict the occurrence of MACE within 1 year after PCI in elderly ACS patients.And external validation should be carried out to ensure its generality.
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OBJECTIVE@#To study the association of the level of advanced oxidation protein products (AOPPs) in seminal plasma with teratospermia and the outcome parameters of fertilization (IVF).@*METHODS@#We conducted a cross-sectional study among 272 male patients receiving assisted reproduction treatment in the Center for Reproductive Medicine of our hospital between October, 2018 and March, 2019. The levels of seminal AOPPs and reactive oxygen species (ROS), demographic data, sperm parameters and IVF outcome parameters were analyzed for all the patients. According to the percentage of sperms with normal morphology, the patients were divided before IVF into teratozoospermia group and normal sperm morphology group, and those in teratozoospermia group were further divided into 3 subgroups with mild, moderate and severe teratozoospermia. The patients were also divided on the day oocyte retrieval into 2 groups with fertilizing rates lower (group Ⅰ) and higher (group Ⅱ) than the median rate.@*RESULTS@#We found a significant negative correlation of seminal AOPP level before treatment with the percentage of normal sperm morphology (=0.003) and seminal ROS level (=0.013). The seminal levels of AOPPs (= 0.027) and ROS (=0.036) were significantly elevated in patients with teratospermia, and seminal AOPP level was significantly higher in severe teratospermia group than in mild (=0.019) and moderate (=0.015) teratospermia groups. The seminal levels of AOPPs (=0.003) and ROS (=0.017) on the day of oocyte retrieval were negatively correlated with the fertilization rate in IVF cycles, and the levels of AOPPs (=0.049) and ROS (=0.036) were significantly higher in group Ⅰ than in group Ⅱ.@*CONCLUSIONS@#An elevated level of seminal AOPPs may indicate an increased risk of severe teratospermia and a lower fertilization rate in IVF.
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Humans , Male , Advanced Oxidation Protein Products , Cross-Sectional Studies , Fertilization in Vitro , Semen , Spermatozoa , TeratozoospermiaABSTRACT
OBJECTIVE@#To explore the impact of dietary sodium-intake on residual renal function in patients undergoing peritoneal dialysis (PD).@*METHODS@#Thirty-three patients on PD with stable dialysis were regularly followed up for 12 months. The daily sodium intake of the patients was calculated based on the 3-day dietary record. Based on the mean daily sodium intake, the patients enrolled were divided into low-salt group (sodium intake≤3.0 g/day, 19 patients) and high-salt group (sodium intake>3.0 g/day, 14 patients). The baseline data of the patients were recorded, and the indicators of residual renal function and peritoneal function were regularly tested. The patients were followed-up at 3-month intervals, and their urine volume, peritoneal ultrafiltration volume and other clinical indicators were recorded and the biochemical indexes were detected to evaluate the changes in the residual renal function and peritoneal function.@*RESULTS@#There was a positive correlation between the total sodium excretion and dietary sodium intake in these patients (=0.536, =0.0013), and sodium excretion by dialysis was positively correlated with their sodium intake (=0.901, =0.000). Regression analysis suggested that the total sodium excretion was correlated with dietary sodium intake (β=0.416, 95% : 0.170-0.666; < 0.0018); sodium excretion by dialysis was associated with dietary sodium intake (β=0.489, 95% : 0.395-0.582; < 0.001). The residual renal function was reduced by 17.48±11.22 L /(w·1.73 m) in the low-salt group, as compared to 30.20±18.30 L /(w·1.73 m) in the high-salt group (=0.032). The reduction in the residual renal function was correlated with sodium intake in the PD patients (=0.409, =0.018). Multivariate regression analysis showed that sodium intake was an independent factor contributing to the reduction of residual renal function (β=14.646, 95% CI 7.426-21.866, < 0.001).@*CONCLUSIONS@#Sodium excretion by PD in patients with continuous ambulatory PD is positively correlated with their dietary sodium intake, which contribute to the decrease of residual renal function. A high dietary sodium intake may accelerate the reduction of residual renal function in these patients.
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Humans , Kidney , Peritoneal Dialysis , Prospective Studies , Sodium, DietaryABSTRACT
BACKGROUND:The cardiomyocytes obtained by traditional culture methods exhibit poor purity and viability, cells grow in clusters, the connection between cells is less, and most of cells beat separately. OBJECTIVE: To obtain high-purity cardiomyocytes presenting with a sheet-like growth by modified culture method. METHODS: Myocardial tissues were digested using 0.1% trypsin at 4℃ overnight, and then digested repeatedly through the addition of type Ⅱ collagenase, and finally were isolated and purified by differential adhesion method combined with chemical inhibitors. The morphology of cardiomyocytes was observed under inverted phase contrast microscope. The purity of cardiomyocytes was identified by cardic troponin T antibody after cultured for 48 hours. The beating frequency of cardiomyocytes was recorded every two days for 10 consecutive days. RESULTS AND CONCLUSION:The cardiomyocytes adhered within 24 hours of culture, distributed in clusters at 72 hours and grew in sheets at 5-7 days of culture. The survival rate of cardiomyocytes was 96% and the purity identified by immunofluorescence was over 97%. There was no significant difference in the beating frequency at different time. These results suggest that the high-purity and high-viability cardiomyocytes are obtained by the modified culture method, which is an effective method for culturing neonatal cardiomyocytes.
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Objective To explore the role of phospholipase A2 receptor 1 (PLA2R1) in the diagnosis,differential diagnosis and evaluation of idiopathic membranous nephropathy (IMN) in adult patients.Methods A total of 242 renal disease patients diagnosed by renal biopsy from March 2015 to January 2016 were enrolled,consisting of 90 IMN,20 secondary membranous nephropathy (SMN),82 IgA nephropathy (IgAN),30 minimal changed disease (MCD),16 focal segmental glomerulosclerosis (FSGS) and 4 membranoproliferative glomerulonephritis (MPGN).Their clinical data including age,sex,serum creatinine (Scr),serum albumin and 24 h urinary protein were collected.Serum PLA2R1 was measured by enzyme linked immunosorbent assay.PLA2R and IgG subclasses in glomeruli were detected by indirect immunofluorescence assay.The positive rate of serum PLA2R1 among those groups and its correlation with clinical-pathological parameters were analyzed.Results Compared with IMN patients,SMN,MCD and FSGS patients were younger (all P < 0.01); IgAN patients were younger and had higher serum albumin and lower 24 h proteinuria (all P < 0.001); MPGN patients had higher Scr (all P < 0.01).The positive rate of serum PLA2R1 was 75.6% in IMN patients,while it was 0.0% in non-IMN patients.The distribution between serum PLA2R1 and pathological diagnosis had difference (P < 0.001),their positive coincidence rate was 100%,negative coincidence rate was 87.4%,total coincidence rate was 90.9% and their consistency was well (Kappa=0.795,P < 0.001).Among IgG subtype comparisons between IMN patients and SMN patients in the glomeruli,only moderate or more positive IgG4 had statistical differences (82.2% vs 5.0%,P < 0.001); the positive rate of glomerular PLA2R1 was 41.1% in IMN patients,higher than 10.0% in SMN patients (P=0.009); positive PLA2R1 with moderate or more positive IgG4 in glomeruli in IMN patients was more than that in SMN patients (40.0% vs 0.0%,P < 0.001),which could improve the diagnostic specificity of IMN.In IMN patients serum PLA2R1 and glomerular PLA2R1 had statistical differences (P<0.001).Spearman rank correlation analysis showed that serum PLA2R1 of IMN patients positively correlated with 24 h proteinuria (r=0.315,P=0.002),negatively correlated with serum albumin (r=-0.228,P=0.030) and didn't correlate with Scr (r=0.199,P=0.059).Conclusions Serum PLA2R can be used as the specific indicator for diagnosis,differential diagnosis of IMN and to reflect the severity of IMN in patients.
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Objective To investigate the correlation between serum level of gamma-glutamyl transferase (GGT) and coronary heart disease (CHD) in military pilots. Methods Sixty male military pilots hospitalized in Airforce General Hospital having coronary angiography examination(CAG) from March 2005 to May 2015 were involved then were divided into CHD group (n = 24) and control group (n = 36) according to the results of coronary angiography (CAG). The patients with CHD were divided into low score group (Gensini score ≤ 20) and high score group (Gensini score > 20) according to Gensini score. Results There were significant increase of the level of TG, GGT and decrease of the level of HDL-C in CHD group than those in control group(P 0.05); logistic regression analysis showed that serum GGT was an independent risk factor of CHD in military pilots (OR = 1.168, P < 0.01). Conclusion Serum GGT is associated with CHD in military pilots and is the independent risk factor of CHD in the pilots.
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Objective:To prepare the polyclonal antibodies against advanced oxidation protein products (AOPP),and to provide an effective agent for research on the pathogenesis of AOPP and assess exactly the relationship between AOPP and relative diseases.Methods:AOPP-rabbit serum albumin (AOPP-RSA) was prepared by treating RSA with hypochloric acid.The rabbit anti-AOPP-RSA polyclonal antibodies were generated and purified by affinity chromatography. The titers and the specificity of the antibodies were measured by ELISA.The plasma AOPP and the localization of AOPP in nephridial tissues of some patients with chronic kidney disease (CKD) were determined using rabbit anti-AOPP-RSA.Results:Titers of the antibodies were 10-6.Purified antibodies reacted specifically with oxidized albumin from different genus,but could not react with normal albumin and glycosylated albumin.The high level of AOPP in plasma from CKD patients was confirmed by Western blot.The antibodies could be used to immunostain AOPP deposition in different regions of kidney tissues from both CKD patients and CKD rat models.Conclusion:We successfully generate rabbit anti-AOPP polyclonal antibodies with high titers and striking specificity.The presence of plasma AOPP and localizations of AOPP in kidney tissues of CKD patients can be demonstrated using the antibodies.The development of anti-AOPP polyclonal antibodies may provide a new tool to explore the pathogensis of AOPP and assess exactly the relationship between AOPP and relative diseases.
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Objective To explore the diameter change of the extrahepatic bile duct before and after laparoscopic cholecystectomy (LC). Methods From Jan. 2006 to Dec. 2007, 113 patients including chronic gallstone cholecystitis (n=55), inactive cholecystolithiasis (n=46) and gallbladder polyps (n=12) were collected and treated by LC. The diameters of their extrahepatic bile ducts were measured by B ultrasonography before operation, 3 months and 6 months after operation. These data were collected and analyzed retrospectively. Results The diameters of the extrahepatic bile ducts of all patients before LC, 3 months and 6 months after LC were (5?2) mm, (8?2) mm and (6?2) mm respectively. And in chronic gallstone cholecystitis patients they were (5?2) mm, (9?2) mm and (6?2) mm respectively, in inactive gallstone cholelithiasis patients they were (5?2) mm, (8?2) mm and (6?2) mm respectively, and in gallbladder polyps ones they were (5?2) mm, (7?2) mm and (5?2) mm respectively. Conclusion The change of the extrahepatic bile duct diameter after LC is a dynamic process. It is enlarged on the third month after operation than before operation. In the sixth month after operation marked retraction occurs, and compared with before operation, it shows no obvious statistic significance.
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Objective To observe whether bone marrow mesenchymal stem cells (MSCs) can promote the repair of IgA nephropathy and to explore its possible mechanism. Methods Sprague-Dawley rats were randomly divided into three groups which were MSCs injection group, normal saline(NS) infusion group and healthy control group. IgA nephropathy model was established by the improving method with BSA +SEB +CCl4 in former two groups. MSCs of SD rats were continuously cultured in vitro and identified with specific surface antigens by flow cytometry and osteogenic and adipogenic differentiation. MSCs were labeled with bromodeoxyuridine (BrdU) in vitro before transplanted. At 1st and 4th week after MSCs injection, the changes of body weight, urine protein, renal function, histopathology and IgA immunofluorescence were observed. MCP-1, TGF-β1 in urine were detected by ELISA. The expression of MCP-1, TGF-β1 in kidney were examined by RT-PCR. The cytokines and BrdU labeled MSCs were detected by immunohistochemistry to observe the disposition in kidney. Results At the end of the first week of MSCs transplantation, MSCs group urine protein (36.86±4.78) mg/24 h, serum creatinine (53.50±6.28) μmol/L, and the NS group urine protein (66.98±5.86) mg/24 h, serum creatinine (82.50±8.36) μmol/L, the differences between two groups were significant (P<0.05). At the same time, the content of MCP-1, TGF-β1 in urine and expression in renal tissue of MSCs group were obviously less than those of NS group (P <0.05). At the end of the 4th week, the body weight, histopatholngy, IgA immunofluorescence of MSCs group were remarkably improved as compared with those of NS group. The content of MCP-1, TGF-β1 in urine and expression in renal tissue, and renal pathological change in MSCs group had no significant differences as compared with those of healthy control group. As the time passed, the disposition of BrdU-labeled MSCs in kidney was taper. Conclusions MSCs injection contributes to renal repair in rat IgA nephropathy. The mechanism may partly depend on adjusting the excretion of cytokines in renal microenvironment and/or other functions rather than completely depend on their differentiation to renal cells.
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Objective To observe the changes in plasma C type natriuretic peptide(CNP) and C reaction protein(CRP) levels and the preventive effect of exogenous CNP on vascular stenosis in a diabetic rabbit model after femoral artery injury.Methods After setting up an animal model of diabetes,the rabbits were divided into the control group(n=8),artery injury group(n=8) and CNP treatment group(n=8).Enzyme-linked immunosorbent assay was used in determination of plasma CRP and CNP concentration.Histological changes in the femoral artery wall were evaluated by HE staining to determine the degree of stenosis.Results The post operative CRP concentration of the artery injury group compared with CNP treatment group was 13.81?4.30 ?g/mL vs 8.43?0.61 ?g/mL(P