Short-term effects of dapagliflozin on non-diabetic patients with severe aortic stenosis after tran-scatheter aortic valve replacement / 新乡医学院学报

Objective To investigate the short-term efficacy of dapagliflozin in the treatment of non-diabetic patients with severe aortic stenosis after transcatheter aortic valve replacement(TAVR).Methods A total of 84 non-diabetic patients with severe aortic stenosis after TAVR who were admitted to Zhengzhou Cardiovascular Hospital from March 2019 to September 2022 were selected as research subjects.According to the postoperative treatment,the patients were divided into control group and observation group,with 42 patients in each group.Patients in both groups underwent TAVR.The patients in the control group were given routine treatments such as antiplatelet drugs,cardiac remodeling improvement drugs,and diuretics after TAVR;patients in the observation group were given dapagliflozin 10 mg daily for 6 months in addition to treatment in the control group.The left ventricular ejection fraction(LVEF),left ventricular end-systolic diameter(LVESD),left ventricular end-diastolic diameter(LVEDD),aortic valve peak gradient(AVPG)and aortic valve peak velocity(AVPV)of patients in the two groups were measured by using an ultrasound diagnostic instrument before surgery,3 days and 6 months after TAVR;before surgery and 6 months after the TAVR,low-density lipoprotein cholesterol(LDL-C)in serum of patients in the two groups was detected by direct measurement method,lipoprotein a[Lp(a)]level in serum was detected by latex agglutination reaction method,hypersensitive C-reactive protein(hs-CRP)level in serum was detected by rate scattering turbidimetry;the levels of N-terminal pro B-type natriuretic peptide(NT-proBNP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)and interleukin-1 β(IL-1 β)in serum were detected by using enzyme-linked immunosorbent assay;the glycated hemoglobin level of patients in the two groups was measured by ion exchange chromatography.Results There was no statistically significant difference in LVEF,LVESD and LVEDD of patients in the two groups before and 3 days after surgery(P＞0.05);after 3 days of surgery,the AVPG and AVPV of patients in the two groups were significantly lower than those before surgery(P＜0.05).Six months after surgery,the LVEF of patients in the two groups was significantly higher than that before and 3 days after surgery,while LVESD,LVEDD,AVPG and AVPV were significantly lower than those before and 3 days after surgery(P＜0.05).There was no statistically significant difference in LVEF,LVESD,LVEDD,AVPG and AVPV between the control group and the observation group before and 3 days after surgery(P＞0.05).After 6 months of surgery,the LVEF of patients in the observation group was significantly higher than that in the control group,while LVESD and LVEDD were significantly lower than those in the control group(P＜0.05);there was no statistically significant difference in AVPG and AVPV of patients between the observation group and control group(P＞0.05).Before surgery,there was no statistically significant difference in body mass index(BMI),LDL-C and Lp(a)of patients between the two groups(P＞0.05).Six months after surgery,the BMI,LDL-C and Lp(a)of patients in the two groups were significantly lower than those before surgery,and the BMI,LDL-C and Lp(a)of patients in the observation group were significantly lower than those in the control group(P＜0.05).Before surgery,there was no statistically significant difference in the hs-CRP,NT-proBNP,IL-6,TNF-α and IL-1 β of patients between the two groups(P＞0.05);six months after surgery,the hs-CRP,NT-proBNP,IL-6,TNF-α and IL-1 β of patients in the two groups were significantly lower than those before surgery,and the hs-CRP,NT-proBNP,IL-6,TNF-α and IL-lβ of patients in the observation group were significantly lower than those in the control group(P＜0.05).There was no statistically significant difference in glycated hemoglobin of patients between the two groups before and six months after surgery(P＞0.05),and no statistically significant difference in glycated hemoglobin of patients in the two groups six months after surgery compared with that before surgery(P＞0.05).Conclusion Dapagliflozin can effectively improve cardiac structural remodeling,regulate lipid metabolism,reduce the expression of inflammatory factors and promote the recovery of heart function in non-diabetic patients with severe aortic stenosis after TAVR.

Isolation of Endophytic Fungi from Angelica sinensis and Evaluation of Their Secondary Metabolite Activities / 中国中医药信息杂志

Objective To isolate endophytic fungi from Angelica sinensis and evaluate the bioactivity of their secondary metabolites.Methods Angelica sinensis and rhizosphere soil were utilized as materials.The tissue homogenization method was employed with six diverse culture media to isolate endophytic fungi.The antibacterial activity of secondary metabolites was gauged using a 96-well plate assay,while UV spectrophotometry was used to evaluate the inhibitory activity of four enzymes.Results A total of 153 fungal strains were isolated and purified from Angelica sinensis roots,stems,leaves,and soil.The samples exhibited specific inhibitory activities against adenosine deaminase(ADA),β-lactamase,xanthine oxidase(XO),and tyrosinase(TYR),with rates of 45.83%,52.78%,51.39%and 55.56%,respectively.Furthermore,1.39%of the samples displayed wide-ranging inhibitory effects against four indicator bacteria.Strain 6B also showcased the lowest inhibitory concentration values of 62.5 and 7.81 μg/mL against Escherichia coli ATCC25922 and ATCC35218,respectively,signifying its potential research significance.Conclusion Angelica sinensis has abundant endophytic fungal resources and is a good source for discovering active compounds,demonstrating certain research value.

A new method for evaluating lung volume: AI-3D reconstruction.

Objective: This study aims to explore the clinical application of an AI-3D reconstruction system in measuring lung volume and analyze its practical value in donor-recipient size matching in lung transplantation. Methods: The study retrospectively collected data from 75 subjects who underwent a plethysmography examination and lung CT at the First Hospital of Jilin University. General data and information related to lung function, and imaging results were collected. The correlation between actual total lung volume (aTLV), predicted total lung volume (pTLV), and artificial intelligence three-dimensional reconstruction CT lung volume (AI-3DCTVol) was analyzed for the overall, male, and female groups. The correlation coefficient and the absolute error percentage with pTLV and AI-3DCTVol were obtained. Results: In the overall, male, and female groups, there were statistical differences (p <0.05) between the pTLV formula and AI-3D reconstruction compared to the plethysmography examination value. The ICC between pTLV and aTLV for all study participants was 0.788 (95% CI: 0.515-0.893), p <0.001. Additionally, the ICC value between AI-3D reconstruction and aTLV was 0.792 (95% CI: 0.681-0.866), p <0.001. For male study participants, the ICC between pTLV and aTLV was 0.330 (95% CI: 0.032-0.617), p = 0.006. Similarly, the ICC value between AI-3D reconstruction and aTLV was 0.413 (95% CI: 0.089-0.662), p = 0.007. In the case of female research subjects, the ICC between pTLV and aTLV was 0.279 (95% CI: 0.001-0.523), p = 0.012. Further, the ICC value between AI-3D reconstruction and aTLV was 0.615 (95% CI: 0.561-0.870), p <0.001. Conclusion: The AI-3D reconstruction, as a convenient method, has significant potential for application in lung transplantation.

Diagnostic performance of IVUS-FFR analysis based on generative adversarial network and bifurcation fractal law for assessing myocardial ischemia.

Background: IVUS-based virtual FFR (IVUS-FFR) can provide additional functional assessment information to IVUS imaging for the diagnosis of coronary stenosis. IVUS image segmentation and side branch blood flow can affect the accuracy of virtual FFR. The purpose of this study was to evaluate the diagnostic performance of an IVUS-FFR analysis based on generative adversarial networks and bifurcation fractal law, using invasive FFR as a reference. Method: In this study, a total of 108 vessels were retrospectively collected from 87 patients who underwent IVUS and invasive FFR. IVUS-FFR was performed by analysts who were blinded to invasive FFR. We evaluated the diagnostic performance and computation time of IVUS-FFR, and compared it with that of the FFR-branch (considering side branch blood flow by manually extending the side branch from the bifurcation ostia). We also compared the effects of three bifurcation fractal laws on the accuracy of IVUS-FFR. Result: The diagnostic accuracy, sensitivity, and specificity for IVUS-FFR to identify invasive FFR ≤ 0.80 were 90.7% (95% CI, 83.6-95.5), 89.7% (95% CI, 78.8-96.1), 92.0% (95% CI, 80.8-97.8), respectively. A good correlation and agreement between IVUS-FFR and invasive FFR were observed. And the average computation time of IVUS-FFR was shorter than that of FFR-branch. In addition to this, we also observe that the HK model is the most accurate among the three bifurcation fractal laws. Conclusion: Our proposed IVUS-FFR analysis correlates and agrees well with invasive FFR and shows good diagnostic performance. Compared with FFR-branch, IVUS-FFR has the same level of diagnostic performance with significantly lower computation time.

Rat and mouse bone marrow mesenchymal stem cells can spontaneously express troponin T.

PURPOSE: This study aims to investigate whether the bone marrow mesenchymal stem cells (BMSCs) of rat and mice can spontaneously express troponin T (cTnT) in vitro. METHODS: The BMSCs of rats and mice were cultured in vitro. The expression of cTnT in the BMSCs of rats and mice was detected by immunofluorescence, immunohistochemistry, and Western blot. The detection of cTnT and α-sarcomeric actin coexpression on the surface of BMSCs was determined using immunofluorescence and qRT-PCR. RESULTS: In rats and mice, cTnT expression was detected in a portion of BMSCs. The positive rates of cTnT in rats and mice were approximately 10-52 % and 27-60 %, respectively. According to the results of the Western blot analysis, the gray values of cTnT in rats and mice were 0.64 ± 0.02 and 1.08 ± 0.03, respectively. Additionally, the surface of BMSCs can express cTnT and α-sarcomeric actin, which is a marker for striated muscle. CONCLUSION: The BMSCs of rats and mice can spontaneously express cTnT and automatically differentiate striated muscles in vitro.

Effects of Fretting Stimulation Amplitude on Bone Growth and Micro-Injury at the Interface Between Bone Tissues and TitaniuBead Coating / 医用生物力学

Objective To improve the performance of artificial joint at biological fixed interface by frettingmechanical stimulation. Methods Taking the bonding sample of active rat bone tissues and inactive titanium bead coating as the research object, by using the self-developed fretting mechanical stimulation test device, the effects of mechanical stimulation with different tangential fretting amplitudes on growth promotion and micro-injury of bone tissues at fixed interface were explored, and the mechanism of growth promotion and micro-injury of bonetissues on the surface of titanium bead coating under fretting stimulation was revealed. Results The mechanical stimulation group with 40 μm fretting amplitude showed the maximum interface bonding force between bone tissues and titanium bead coating. The tangential fraction force-displacement curves changed from elliptic shape to linear shape, and the bonding interface was in adhesion area, which was difficult to become loose. The bone tissues had the most complete structure, and the number of tissue cells adhering and growing on the surface of titanium bead coating was the largest, as well as the distribution range was the widest. With the increase of fretting amplitude, the promoting effect of fretting stimulation on bone growth weakened, the bonding strength between bone tissues and titanium bead coating interface gradually decreased, the internal cavity area increased, the number and proliferation activity of tissue cells decreased to varying degrees as well. Conclusions Fretting stimulation with different amplitudes can promote the growth of bone tissue and cause micro-injury at the same time, and the optimal fretting amplitude is 40 μm.

Comparison of clinical features and outcomes of different chorionic twins with selective intrauterine growth restriction / 安徽医科大学学报

Objective @#To delineate the similarities and differences among general characteristics and maternal⁃fetal outcomes in patients with selective intrauterine growth restriction( sIUGR) in monochorionic and dichorionic twin , and to compare the disparate patient types with dichorionic twin sIUGR , with an intent to furnish vital insights for clinical diagnosis and prognostic assessment. @*Methods @#Clinical data were collected from 89 patients with twin pregnancies diagnosed with sIUGR. Statistical analyses used the t ⁃test , rank⁃sum test , and chi⁃square test.@*Results@#Pregnant women with dichorionic twins often leverage multiple assisted reproductive technologies. The maternal outcome for dichorionic twins were significantly later than that for monochorionic twins. Furthermore , the incidence of gestational diabetes mellitus was higher in dichorionic twins compared to monochorionic twins. In terms of fetal outcomes , the proportion of normal neonates with Apgar scores ≥8 , body mass , and the incidence of type I sIUGR in dichorionic twin pregnancieswere significantly higher than those in monochorionic twin pregnancies. Conversely , occurrences of umbilical cord sail attachment and a smaller placental share were significantly higher in monochorionic twins. In assessing variations in sIUGR typologies among dichorionic twins , one case of intrauterine death was happened in a pregnancy with type Ⅱ/ Ⅲ sIUGR typology , but none in type I. Pregnancies with type I sIUGR typology had a significantly higher proportion of large and small fetuses with Apgar scores ≥8 and better birth quality of smaller fetuses. @*Conclusions @#Compared to monochorionic twin pregnancies , there are superior maternal and fetal prognosis for dichorionic twin pregnancies with sIUGR . Clinical management should , therefore , prioritize greater attention to monochorionic twin pregnancies. In addition , this study discovers more complex outcomes in type Ⅱ/ Ⅲ pregnancies among dichorionic twins , a subject area currently lacking sufficient domestic research , thereby underlining the need for meticulous monitoring and prompt intervention.

Application of prenatal bacterial artificial chromosome-on-beads identification/isolation technology in the diagnosis of chromosomal aneuploidy and microdeletion/microduplication syndrome / 中华检验医学杂志

Objective:To explore the indication of bacterial artificial chromosome-on-beads identification/separation technology in prenatal diagnosis and its application value.Methods:The inclusion criteria were as follows: age ≥35 years, high risk/critical risk of serological prenatal screening, high risk of non-invasive gene testing (NIPT), abnormal ultrasonic indexes or adverse pregnancy history. From April 2016 to December 2020, 3579 amniotic fluid samples collected from pregnant women with singletons were detected by bacterial artificial chromosome-on-beads identification/separation technique (BoBs) and G-banding karyotype analysis simultaneously. The aneuploid abnormality/microdeletion/microdeletion samples detected by karyotype analysis or BoBs were verified by fluorescence in situ hybridization (FISH)/SNP array as needed.Results:(1) The percentage of samples with indications of advanced maternal age, high risk of NIPT and high risk of serological screening was 89.44%(3 201/3 579), the detection rate of aneuploidy was 96.19%(202/210), and the detection rate of microdeletion/microduplication was 87.5%(28/32),the total abnormal detection rate was 95.04% (230/242). The samples with abnormal ultrasonic indexes, adverse pregnancy history and critical risk indications of serological screening in the second trimester accounted for 10.66%, and the abnormality of aneuploidy and micro-duplication/micro-deletion was 4.96%. (2) 198 common chromosome aneuploidies (13/18/21/X/Y) were detected by BoBs, and 12 cases with chimeras ≥20% were found, which were consistent with karyotype results. Two copies of 21-trisomy, three copies of X/Y, seven copies of 2, 7, 8, 9, 10, 20, mar karyotype chimerism, eight copies of arm inversion and five copies of translocation outside the detection range of probes were detected by karyotype analysis. The sensitivity, specificity and false negative rate of BoBs detection for five aneuploidies were 94.6%(210/222), 100% and 5.4%(12/222), respectively. BoBs and karyotype analysis detected 32 and 9 cases of microdeletions/microduplications respectively. Compared with single karyotype analysis, the combined application of G-banding karyotype analysis and BoBs can detect an additional 9.4% (23/244)positive samples.Conclusion:The samples with elder age, high risk of NIPT, and high risk of serological screening are more suitable as indications for the application of BoBs in prenatal diagnosis.

Effect of dendritic cells on immune function regulated by programmed cell death-1/programmed cell death-ligand 1 in sepsis / 中华危重病急救医学

Objective:To study the effect of programmed cell death-1/programmed cell death-ligand 1 (PD-1/PD-L1) regulating dendritic cells (DC) on the immune status of sepsis, and analyze the effect of PD-1/PD-L1 on prognosis.Methods:Twenty-five patients with sepsis in the intensive care unit (ICU) of the Affiliated Hospital of Zunyi Medical University from October 2018 to September 2019 were collected and followed up for 28 days. According to the 28-day survival of patients, patients were divided into survival group and death group. Among them, 10 cases were in the survival group and 15 cases were in the death group. Simultaneously, 20 healthy subjects in our hospital during the same period served as the healthy control group. Peripheral blood of patients with sepsis was taken within 24 hours after diagnosis, and the healthy control group was taken at the time of enrollment. Flow cytometry was used to detect the proportion of CD4 +T and CD8 +T cells, the ratio of T cell subsets (CD4/CD8), the expression of PD-1 on CD4 +T and CD8 +T cells, and the expression of PD-L1 and CD86 in DC. Enzyme linked immunosorbent assay (ELISA) was used to detect the levels of interleukin-10 (IL-10) and tumor necrosis factor-α(TNF-α) in serum. Spearman correlation analysis was used to analyze the correlation between CD11c +PD-L1 and CD4 +PD-1, CD8 +PD-1, TNF-α, DC, CD11c +CD86, T cell subpopulation ratio, CD4 +T cells, CD8 +T cells, and IL-10. Binary Logistic regression was used to analyze the risk factors affecting the death of patients with sepsis, and receiver operator characteristic curve (ROC curve) was drawn to evaluate the predictive value of independent risk factors on the prognosis of patients. Results:The scores of acute physiology and chronic health evaluationⅡ (APACHEⅡ) and sequential organ failure assessment (SOFA) in the death group were higher than that in the survival group (APACHEⅡ score: 27.0±7.3 vs. 17.0±3.9, SOFA score: 15.1±4.1 vs. 10.7±2.7, both P < 0.05). The ratio of T cell subsets in the survival group and the death group was less than 1, the death group was lower than that in the survival group (CD4/CD8: 0.54±0.15 vs. 0.79±0.09, P < 0.05), and the ratio of T cell subsets in the healthy control group was greater than 1. Compared with healthy control group, the levels of CD4 +T cells, CD8 +T cells, CD11c +DC, CD11c +CD86, IL-10 and TNF-α in survival group and death group were significantly decreased, the level of CD4 +PD-1, CD8 +PD-1, CD11c +PD-L1 were significantly increased, and the changes in the above indicators in the death group were significant compared with the survival group [CD4 +T cells: 0.14±0.07 vs. 0.22±0.08, CD8 +T cells: 0.24±0.07 vs. 0.28±0.10, CD11c +DC: 0.84±0.14 vs. 0.93±0.03, CD11c +CD86: (58.83±20.77)% vs. (78.24±9.39)%, IL-10 (ng/L): 34.22±13.98 vs. 18.49±5.55, TNF-α(ng/L): 95.30±29.33 vs. 67.00±20.16, CD4 +PD-1: (39.58±10.08)% vs. (27.03±6.35)%, CD8 +PD-1: (38.77±11.91)% vs. (29.15±8.37)%, CD11c +PD-L1: (21.13±11.54)% vs. (12.11± 8.34)%, all P < 0.05]. Spearman correlation analysis showed that CD11c +PD-L1 was positively correlated with CD4 +PD-1, CD8 +PD-1, and IL-10 ( r values were 0.748, 0.713, 0.898, all P < 0.05), while was negatively correlated with DC, CD11c +CD86, T cell subpopulation ratio, CD4 +T cells, CD8 +T cells, and TNF-α( r values were -0.587, -0.906, -0.840, -0.706, -0.513, -0.820, all P < 0.05). Multivariate binary Logistic regression analysis showed that CD4 +T PD-1 was an independent risk factor for the prognosis of sepsis patients [odds ratio ( OR) = 1.463, 95% confidence interval (95% CI) = 1.032-2.074, P = 0.033]. ROC curve analysis showed that CD4 +TPD-1 had certain predictive value for the prognosis of patients with sepsis [area under ROC curve (AUC) = 0.857, 95% CI was 0.709-1.000, P < 0.01). When the best predictive value was 34.48%, the sensitivity, specificity, and accuracy were 66.7%, 90.0%, and 85.7% respectively. Conclusions:Up-regulation of PD-1/PD-L1 in peripheral blood could inhibit the activation and proliferation of DC, affect the activation of T cells, and induce immunosuppressive state. PD-1/PD-L1 can reflect the immune status of patients with sepsis. The expression of PD-1 on CD4 +T cells may have important significance for the evaluation of prognosis.

Research progress of microRNAs in cardiovascular diseases / 中国综合临床

Objective@#MicroRNAs (miRNAs) are endogenous short stranded RNAs with a length of about 22 NT, which are highly conserved and have no coding function.Mature miRNAs play a role by specifically binding to the 3′untranslated region of the target gene, degrading the mRNA of the gene or hindering its translation at the post transcriptional level, so as to negatively regulate the expression of the target gene and play a biological role.In recent years, the research of miRNAs in cardiovascular diseases is increasingly in-depth.A large number of evidences show that miRNAs play a role in the pathogenesis of many cardiovascular diseases, and will become a potential marker and new treatment target for the diagnosis and prognosis evaluation of cardiovascular diseases.

Research progress of microRNAs in cardiovascular diseases / 中国综合临床

Objective:MicroRNAs (miRNAs) are endogenous short stranded RNAs with a length of about 22 NT, which are highly conserved and have no coding function.Mature miRNAs play a role by specifically binding to the 3′untranslated region of the target gene, degrading the mRNA of the gene or hindering its translation at the post transcriptional level, so as to negatively regulate the expression of the target gene and play a biological role.In recent years, the research of miRNAs in cardiovascular diseases is increasingly in-depth.A large number of evidences show that miRNAs play a role in the pathogenesis of many cardiovascular diseases, and will become a potential marker and new treatment target for the diagnosis and prognosis evaluation of cardiovascular diseases.

The clinical value of serum Mir-208a in early differential diagnosis of acute coronary syndrome / 中华老年医学杂志

Objective:To investigate the clinical value of serum miR-208a in early differential diagnosis of acute coronary syndrome(ACS).Methods:One hundred ACS patients admitted to our department from January 2016 to January 2018 were randomly divided into the non-ST elevation myocardial infarction(NSTEMI)group(n=50)and the unstable angina(UA)group(n=50). Fifty healthy people during the same period were included as the control group(control). Serum levels of miR-208a, cardiac troponin-T(cTnT)and creatine kinase MB isoenzyme(CK-MB)were detected immediately, 4 h, 12 h and 24 h after admission and compared among the three groups of NSTEMI, UA and control.Receiver operating characteristic(ROC)curve was used to analyze the early diagnostic value of above serum indexes in NSTEMI and UA group, and the correlations of miR-208a level with cTnT and CK-MB were analyzed.Results:Serum miR-208a and cTnT levels had significant differences( P<0.05), while serum CK-MB level had no significant difference( P>0.05)among the NSTEMI and UA groups immediately after admission and the control group in the fasting state.There were significant differences in serum miR-208a, cTnT and CK-MB levels between NSTEMI group and UA group at different time points( P<0.05). After further multiple comparisons, the results showed that serum miR-208a and cTnT levels had statistical differences( P<0.05)and serum CK-MB level had no difference( P>0.05)between the NSTEMI group and the UA group immediately after admission.The above three biochemical indexes showed statistically significant differences between the NSTEMI group and the UA group at 4 h, 12 h and 24 h after admission( P<0.05). ROC curve analysis showed that miR-208a had a high diagnostic value in ACS(AUC>0.9, P=0.004), and the best diagnostic cut-off point was 9.278.The cTnT had a medium diagnostic value in ACS(0.7<AUC<0.9, P=0.013), and the diagnostic cut-off point was 5.147 μg/L.CK-MB had a low diagnostic value in ACS(0.5<AUC<0.7, P=0.031), and the diagnostic cut-off point was 82.716 u/l.Serum miR-208a level was positively correlated with cTnT level in ACS patients( P<0.05), and there was no correlation between serum miR-208a level and CK-MB level( P>0.05). Conclusions:Serum miR-208a has a higher value in early diagnosis of ACS than cTnT and CK-MB, and it has a better differentiation ability of NSTEMI than UA.

Study on the repairation of intestinal mucosal barrier by infliximab in patients with Crohn′s disease / 中华消化杂志

Objective:To explore the role of infliximab (IFX) in the repairation of intestinal mucosal barrier in Crohn′s disease (CD).Methods:From January 2018 to October 2019, in Shanghai Tenth People′s Hospital, 382 CD patients were selected. All the patients were treated with IFX. And 103 individuals who underwent colonoscopy were selected as healthy control group. The general clinical data, fasting blood samples and intestinal mucosa tissue samples of CD patients and healthy controls were collected. The body mass index (BMI), hemoglobin, albumin, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and relative inflammation factors, including tumor necrosis factor (TNF)-α, interferon (IFN)-γ, interleukin (IL)-1, IL-2, IL-6, IL-8, IL-10 and IL-17A, and their mRNA expression levels were detected. Crohn′s disease activity index (CDAI) and simplified endoscopic score for Crohn′s disease (SES-CD) were used to evaluate the disease activity of CD patients. The expression levels of occudin, claudin-1, zonula occluden-1 (ZO-1) and junctional adhesion molecule-A (JAM-A) were measured by Western blotting. The intestinal mucosal epithelial cells were observed by transmission electron microscope. T test was used for statistical analysis. Results:Before treatment, BMI, and hemoglobin and albumin levels of CD patients were all lower than those of healthy control group ((18.3±1.8) kg/m 2 vs. (20.2±1.2) kg/m 2, (95.3±8.4) g/L vs. (129.2±5.7) g/L, (33.2±5.4) g/L vs. (50.3±3.2) g/L), and the differences were statistically significant ( t=3.457, 5.342 and 2.674, all P<0.05). After treatment the BMI and hemoglobin levels of CD patients were higher than those before treatment ((19.5±2.1) kg/m 2 vs. (18.3±1.8) kg/m 2, (117.2±10.3) g/L vs. (95.3±8.4) g/L), and the CRP level, CDAI score and SES-CD score were lower than those before treatment ((16.3±2.3) mg/L vs. (47.2±9.3) mg/L, 113.2±12.5 vs. 245.2±23.5, 5.0±2.1 vs. 10.0±4.3), and the differences were statistically significant ( t=2.090, 2.339, 2.432, 6.345 and 5.234, all P<0.05). The expression levels of TNF-α, IFN-γ, IL-2, IL-6, IL-8, IL-17A and their mRNA levels of healthy control group were lower than those of CD patients before treatment ((1.1±0.4) ng/L vs.(158.2±38.3) ng/L, (3.2±0.8) ng/L vs. (28.3±13.4) ng/L, (2.7±1.3) ng/L vs. (3.3±2.4) ng/L, (5.2±0.3) ng/L vs. (16.3±7.4) ng/L, (16.3±6.3) ng/L vs. (18.9±10.2) ng/L, (10.5±2.3) ng/L vs. (38.5±11.2) ng/L; 1.00±0.00 vs. 4.68±0.34, 7.83±0.32, 1.25±0.46, 8.36±0.44, 2.01±0.89 and 6.83±0.53, respectively), and the differences were statistically significant ( t=2.345, 6.456, 3.008, 4.009, 7.045, 10.223, 8.345, 11.235, 1.114, 12.334, 5.304 and 5.678, all P<0.05). After treatment the TNF-α, IFN-γ, IL-2, IL-6, IL-8, IL-17A expression levels and their mRNA levels of CD patients were lower than those before treatment ((106.4±29.9) ng/L vs. (158.2±38.3) ng/L, (25.7±10.8) ng/L vs. (28.3±13.4) ng/L, (2.9±1.7) ng/L vs. (3.3±2.4) ng/L, (15.4±4.2) ng/L vs. (16.3±7.4) ng/L, (17.2±8.7) ng/L vs. (18.9±10.2) ng/L, (29.9±12.7) ng/L vs. (38.5±11.2) ng/L, 2.45±0.21 vs. 4.68±0.34, 3.75±0.18 vs. 7.83±0.32, 1.09±0.22 vs. 1.25±0.46, 3.78±0.21 vs. 8.36±0.44, 1.67±0.33 vs. 2.01±0.89, 2.96±0.11 vs. 6.83±0.53), and the differences were statistically significant ( t=9.345, 2.456, 2.334, 2.090, 3.009, 8.345, 4.567, 6.445, 2.046, 7.774, 3.008 and 8.867, all P<0.05). The results of Western blotting showed that the expression levels of occudin, claudin-1, ZO-1 and JAM-A in the intestinal mucosa of CD patients before treatment were lower than those of the healthy control group (0.21±0.03 vs. 1.00±0.02, 0.17±0.07 vs. 1.00±0.01, 0.16±0.06 vs. 1.00±0.04, 0.26±0.08 vs. 1.03±0.04). After treatment the expression levels of occudin, claudin-1, ZO-1 and JAM- A mRNA in the intestinal mucosa of CD patients were higher than those before treatment (0.77±0.08 vs. 0.21±0.03, 0.69±0.08 vs. 0.17±0.07, 0.78±0.09 vs. 0.16 ±0.06, 0.72±0.07 vs. 0.26±0.08), and the differences were statistically significant ( t=4.567, 6.346, 5.557, 8.456, 9.678, 8.671, 10.456 and 7.456, all P<0.05). Conclusions:IFX can effectively relieve the disease activity and improve the nutritional status of CD patients. IFX maintains the expression of intestinal epithelial tight junction protein by reducing inflammatory response, and repairs the intestinal mucosal barrier of CD patients.

Correlation between myeloperoxidase levels and adverse cardiac events in patients undergoing coronary stent implantation / 中华老年医学杂志

Objective To investigate the correlation between myeloperoxidase(MPO)levels and adverse cardiac events in patients undergoing coronary stent implantation.Methods A total of 76 patients undergoing coronary stent implantation from January 2015 to June 2016 in the cardiac surgery department of our hospital were enrolled in this study.Serum levels of MPO,high sensitivity C-reactive protein(hs-CRP),and interleukin 6 (IL-6)were detected by enzyme-linked immunosorbent assays(ELISA).After a one-year follow-up,the receiver operating characteristic(ROC)curve was used to determine the predictive value of the difference in MPO before and after the operation(△MPO)on the long-term prognosis of patients after coronary stent implantation.The correlations of △MPO with the traditional risk factors for coronary heart disease and adverse cardiac events were analyzed using multi factor Logistic regression analysis.Results Serum levels of MPO,hs-CRP and IL 6 increased in patients after coronary stent implantation,compared with those before treatment (P ＜ 0.05).The results of ROC curve analysis showed that the area under the curve(AUC)value of serum △MPO was 0.786,the 95 ％ confidence interval was 0.471～ 1.000 and the predictive value of serum △MPO for adverse cardiac events was significant(P ＜0.05).There was a significant correlation between △MPO and age,and the incidence of adverse cardiac events increased with increased △MPO levels.Logistic regression analysis showed that serum △MPO levels could preliminarily diagnose the cardiovascular risk after coronary stent implantation and independently predict the occurrence of adverse cardiac events.Conclusions MPO levels in peripheral blood are notably elevated in patients after coronary stent implantation when compared with pre-treatment levels.Serum △MPO levels can preliminarily diagnose adverse cardiac events after coronary stent implantation and can be used as a marker to predict adverse cardiac events.

Factors influencing the outcomes of the traditional Chinese medicine percutaneous release treatment for the stenosal tendosynovitis / 国际中医中药杂志

Objective The aim of this study is to analyze the factors influencing the outcomes of the traditional Chinese medicine (TCM) percutaneous release treatment for the stenosal tendosynovitis. Methods A total of 119 eligible participants, from outpatient of Dongzhimen Hospital during June, 2014 to April, 2017, were included into the study. The participants received TCM percutaneous release treatment, and were followed-up and assessed outcomes at 27 w. Responders were defined as participants with normal movement in week 27 compared with the baseline period. The NRS assessment in both groups was described, and the baseline characteristics of participants potentially related to cure response were mainly analyzed using Logistic regression analysis. Results Cure group and non-cure group were determined according to the cure response. And the outcomes of pain relief along the timeframe showed the feasibility of criteria of cure response. The uni-factor Logistic regression analysis showed that the factors age,course of disease,interventions and pain severity were significantly different between the cure and non-cure groups,and the multi-factor Logistic regression confirmed the four factors influenced the cure response of the TCM percutaneous release treatment for the stenosal tendosynovitis. The cutting knife was 5.85 fold than the traditional needling knife at increasing the cure response (OR=5.853,95% CI 1.853-18.485;P=0.003).All the factors that age equal to or older than 60 years(OR=6.170, 95% CI 1.890-20.141; P=0.003), course of disease more than six months (OR=4.696, 95% CI 1.371-16.085;P=0.014)and pain severity from 6 to 7(OR=5.184,95% CI 1.416-18.975;P=0.013)were negatively associated with clinical response. Conclusions The patients with increasing age, long course of disease and distinct pain severity may be less likely to respond to the TCM percutaneous release treatment. These findings contribute to guiding clinical practice in terms of pretreatment patient selection. Further research is needed to confirm the association.

Rs17042171 at chromosome 4q25 is associated with atrial fibrillation in the Chinese Han population from the central plains / 中南大学学报(医学版)

Objective:To determine the correlations of single nucleotide polymorphisms (SNPs) with atrial fibrillation (AF) in the Chinese Han population from the central plains.Methods:A total of 168 hospitalized patients,including 56 AF and 112 controls,were recruited in this case-control study.The clinical data were obtained from the medical records.All 5 SNPs,rs337711 in KCNN2,rs11264280 near KCNN3,rs17042171 near PITX2,rs6771157 and rs6795970 in SCN10A,were genotyped using amplification refractory mutation system-polymerase chain reaction or direct sequencing.The x2 test was used to compare categorical variables and preliminarily examine correlations between the genotype frequencies and AF.Subsequently,a logistic regression model was constructed to determine the associations between the SNPs and AF based on the above screened results.Odds ratios (ORs) and 95％ confidence interval (CI) were calculated to assess the strength of the correlations.Moreover,we downloaded the genotype data from the HapMap Project for linkage disequilibrium analysis ofrs17042171.Results:AF patients were likely to be of older age and longer left atrial diameter and had more coronary artery disease and higher hypertension compared with the control group (P＜0.05).Among the 5 SNPs,the frequency distribution of genotype AA for rs17042171 was significantly different between the AF and control groups (P＜0.05).After adjusting for several covariates,there was still a high risk ratio in patients with the AA genotype compared with the AC+CC genotype (OR:5.591,95％CI 2.176 to 14.365,P-B＜0.008).Similarly,stratification analysis on the AA genotype demonstrated significant differences between rs17042171 and persistent AF.However,there were not significant correlations between AF and the control groups for the other 4 SNPs (P＜0.05).Conclusion:Rs17042171,near PITX2 on chromosome 4q25,is associated with AF susceptibility in the Chinese Han population from the central plains,suggesting that this SNP can provide a new strategy for clinical diagnosis in AF patients.

Varied therapeutic effects of Human Amniotic Mesenchymal Stem Cell Transplantation with Different Transplantation Methods for Spinal Cord Injury Therapy in Rats / 实用医学杂志

Objective To compare the therapeutic effects of orthotopic injection and tail vein injection of human amniotic mesenchymal stem cells(hAMSCs)on histological restoration and neurological functions of rats with spinal cord injury. Methods Transected spinal cord injury model in rats was established by transplanting DAPI prelabelled hAMSCs one week after injury.BBB scores were used to evaluate the hindlimb movement of rats. The histological patterns.and morphology of medullary sheath of spinal cord were observed. Results BBB scores in the orthotopic injection group and tail vein injection group were increased gradually from one to six week after hAM-SCs transplantation and reached 6.5 ± 0.5 and 7.12 ± 1.61 respectively 6 weeks after cell transplantation,higher than that of the control group(both P < 0.01). However,there was no statistical significance between the two groups.Histological results indicated that the repair of injured tissue in the orthotopic injection group and tail vein injection group were both better than that in the control group,and there were more vesica and loosened layers forming in the injured spinal cord of rats in the PBS control group as compared with the orthotopic and tail vein transplantation group. Conclusion hAMSCs transplantation through tail vein injection could promote histological restoration and neurological regeneration of rats with spinal cord injury,which has the similar therapeutic effects with hAMSCs orthotopic transplantation.

Value of KRAS mutation predicting prognosis of patients with colorectal liver-only metastasis after hepatectomy / 中华消化外科杂志

Objective To explore the value of KRAS mutation predicting prognosis of patients with colorectal liver-only metastasis after hepatectomy.Methods The retrospective case-control study was conducted.The clinicopathological data of 79 patients with colorectal liver-only metastasis who underwent hepatectomy in the Sun Yat-sen University Cancer Center between October 2010 and October 2016 were collected.KRAS mutation in colorectal cancer tissue was detected by fluorescent quantitative polymerase chain reaction (PCR) and laser flight mass spectrometer.Observation indicators:(1) KRAS mutation;(2) relationship between KRAS mutation and clinicopathological factors of patients with colorectal liver-only metastasis;(3) follow-up and survival situations.Follow-up using outpatient examination and telephone interview was performed to detect recurrence-free survival and overall survival up to June 30,2017.The relationship between KRAS mutation and clinicopathological factors of patients with colorectal liver-only metastasis was analyzed by the chi-square test or Fisher exact probability.The survival curve and time were respectively drawn and calculated by the Kaplan-Meier method,and COX regression model was used for survival analysis.Results (1) KRAS mutation:79 patients received KRAS gene detection of surgical tumor tissues,including 54 in wide-type mutation and 25 in mutant-type mutation.Of 25 patients in mutant-type mutation,mutation at codon 12 of KRAS exon 2 was in 21 patients,and GGT＞GAT (G12D),GGT＞GTT (G12V),GGT＞TGT (G12C),GGT＞GCT (G12A) and GGT＞CGT (G12R) of mutation types were respectively detected in 13,4,2,1 and 1 patients;mutation at codon 13 of KRAS exon 2 was in 3 patients,with a mutation type of GGC＞GAC (G13D);mutation at codon 61 of KRAS exon 3 was in 1 patient,with a mutation type of CAA＞CAT (Q61H).(2) Relationship between KRAS mutation and clinicopathological factors of patients with colorectal liver-only metastasis:primary tumor located in right and left hemicolon were detected in 11,14 patients with mutant-type mutation and 7,47 patients with wide-type mutation,respectively,with a statistically significant difference (x2=9.357,P＜0.05).(3) Follow-up and survival situations:79 patients were followed up for 2.0-71.0 months,with a median time of 29.0 months.Median recurrence-free survival time and median overall survival time were respectively 11.3 months,43.5 months in patients with mutant-type mutation and 9.9 months,44.3 months in patients with wide-type mutation,respectively,with no statistically significant difference in recurrence-free and overall survivals [hazard ratio (HR)=1.255,1.108,95％ confidence interval (CI):0.741-2.126,0.521-2.355,P＞0.05].Further analysis:of patients with low clinical risk score (CRS) of Memorial Sloan Caitlin Cancer Center (MSKCC),median recurrence-free survival time was 11.3 months in 17 patients with mutant-type mutation and 23.5 months in 26 patients with wide-type mutation,with a statistically significant difference in recurrence-free survival of patients (HR=2.082,95％CI:1.006-4.307,P＜0.05).The median overall survival time was 44.6 months in 17 patients with mutant-type mutation and 49.0 months in 26 patients with wide-type mutation,with no statistically significant difference in overall survival of patients (HR =1.165,95％CI:0.413-3.282,P＞0.05).Of patients with high CRS of MSKCC,median recurrence-free survival time and median overall survival time were respectively 5.6 months,28.7 months in 7 patients with mutant-type mutation and 4.5 months,36.7 months in 24 patients with wide-type mutation,with no statistically significant difference in recurrence-free and overall survivals (HR=0.402,1.197,95％CI:0.284-1.656,0.371-3.866,P＞0.05).Conclusions KRAS mutation is often detected in patients with right colon cancer.Recurrence-free survival time is obviously reduced in patients with KRAS mutation and low CRS of MSKCC.

The effects of early neck isometrics exercise on neck discomfort in patients underwent cerebellopontine angle surgeries / 中华护理杂志

Objective To evaluate the effects of early neck isometrics exercise on relieving neck discomfort in patients after cerebellopontine angle surgeries.Methods The non-synchronous control study was conducted.The control group(40 patients recruited from March to June,2017) received routine nursing,while the intervention group (40 patients recruited from July to November,2017) performed early neck isometrics exercise in addition to routine nursing.Neck discomfort degree,neck rotation range,and Barthel score were measured and compared between two groups on Day 1,Day 3,Day 5,and Day 7 after surgeries.Results The intervention group had a high level of participation and no adverse events occurred.Neck discomfort degree of the intervention group was significantly lower than that of the control group on Day 1,Day 3,and Day 5(P＜0.05).Neck rotation range of the intervention group was improved on Day 1 and Day 3 compared with the control group(P＜0.05).Barthel score of the intervention group on Day 3,Day 5 and Day 7 was significantly better than that of the control group(P＜0.05).Conclusion Early neck isometrics exercise in patients underwent cerebellopontine angle surgeries is safe and feasible,which can alleviate discomfort of neck,and improve patients' early postoperative experience and quality of life.

Expression and identification of recombinant chimeric CARDS of Mycoplasma pneumoniae / 中国人兽共患病学报

We expressed multi-epitope chimeric protein of CARDS toxin protein of Mycoplasma pneumonia (Mp) in prokaryotic cells,and purified and investigated its immunoreactivity.A recombinant multi-epitope chimeric gene including ten critical epitopes was connected by linker and cloned into prokaryotic expression vector pET-28a(+),and transformed into E.coli BL21(DE3) cells for expression under induction of IPTG.The antigenicity of expressed recombinant protein was identified with 6 × His monoclonal antibody and human positive serum by Western blot.The recombinant expression vector pET-CARDS was constructed and the about 30 kDa recombinant chimeric protein expressed in BL21(DE3) successfully.Western blot analysis showed that it can react respectively with 6 × His monoclonal antibodies and human positive serum.This study showed that the chimeric CARDS protein has an obvious immunoreactivity and a potential to be a new antigen for the diagnosis of Mp infection.