[Safety and efficacy of acute stent implantation during endovascular treatment for patients with emergent large vessel occlusion due to intracranial atherosclerotic stenosis].

Objective: To investigate the efficacy and safety of acute stent implantation during endovascular treatment for patients with emergent large vessel occlusion due to intracranial atherosclerotic stenosis. Methods: A retrospective analysis was carried out on 46 patients with emergent large vessel occlusion due to intracranial atherosclerotic stenosis who received endovascular treatment at the Strategic Support Force Medical Center from January 2015 to August 2022. Twenty-seven patients underwent balloon angioplasty alone and 19 patients underwent acute stent implantation. The baseline characteristics, modified thrombolysis in cerebral infarction (mTICI) score of the responsible vessels, modified Rankin scale (mRS) score 90 days after operation, incidence of symptomatic intracranial hemorrhage and mortality of the two groups were evaluated. Results: The proportion of effective recanalization of the offending vessels (mTICI≥2b) in the acute stenting group was slightly higher than that in the balloon angioplasty group (16/19 vs. 81.5%), but the difference was not statistically significant (P>0.05). Besides, there was no significant difference in the median of mRS between the acute stenting group [3.0(0, 4.0)] and the balloon angioplasty group [4.0(1.0, 5.0)] 90 days after operation (P>0.05). In terms of safety, the incidence of symptomatic intracranial hemorrhage and mortality were comparable between the two groups (P>0.05). Conclusions: The effect of acute stent implantation during endovascular treatment for patients with emergent large vessel occlusion due to intracranial atherosclerotic stenosis is not inferior to that of balloon angioplasty, and it does not increase the risk of intracranial bleeding complications.

Screening and validation for core genes in osteoarthritic cartilage based on weighted gene co-expression network analysis.

OBJECTIVE: Osteoarthritis (OA) has the highest disability rate among chronic diseases. The burden on patients and public health care resources is increasingly evident due to increasing obesity rates and aging populations. So, there is still a lack of early diagnosis and treatment for OA. MATERIALS AND METHODS: A total of three OA cartilage tissue datasets (GSE1919, GSE32317, and GSE5235) were obtained from the Gene Expression Omnibus (GEO) database. Screening of differentially expressed genes and WGCNA of overlapping genes were performed using the R language package. Functional and immune infiltration analyses of overlapping genes were also carried out while hub genes were screened through LASSO regression analysis method and ROC curve. Finally, experimental validation was carried out through PCR and Western Blot analysis of rat cartilage. RESULTS: A total of 149 differentially expressed genes were screened, and they were mainly enriched in the cytokine-cytokine receptor interaction, rheumatoid arthritis, and interleukin (IL-17) signaling pathways. Four co-expression modules were obtained, of which the blue module was the most substantial morbidity associated with OA. Thirteen overlapping genes were identified based on significant module network topology analysis and differential genes, upon which their validation through LASSO regression analysis method and ROC curve was performed. From these, five signature genes were determined, before three potential core genes were finally identified after confirmation using the validation set. CONCLUSIONS: ATF3, FOSL2, and GADD45B may be hub genes to the osteochondropathy, and they are expected to be new biomarkers and drug targets in OA research.

[Safety and efficacy of intra-arterial tirofiban infusion in patients with acute cardiogenic cerebral embolism undergoing endovascular reperfusion therapy].

Objective: To evaluate the safety and efficacy of intra-arterial tirofiban infusion during endovascular reperfusion therapy in patients with acute cardiogenic cerebral embolism. Methods: Clinical data of 72 patients with acute cardiogenic cerebral embolism caused by large artery occlusion were retrospectively analyzed in Department of Neurology, Strategic Support Force Medical Center from August 2015 to August 2020.Among those, 52 patients were treated with intra-arterial tirofiban, the other 20 patients were treated with control medication. The baseline characteristics, modified thrombolysis in cerebral infarction (mTICI) score of responsible vessels, modified Rankin scale (mRS) score 90 days after operation, incidence of symptomatic intracranial hemorrhage and mortality were evaluated and compared in two groups. Results: The proportion of effective recanalization of the offending vessels (mTICI≥2b) in tirofiban group was higher than that in control group (92.3% vs. 75.0%), but the difference was not statistically significant (P=0.104). At 90 days after operation, the rate of patients with good prognosis (mRS≤2) in tirofiban group (61.5%) was significantly higher than that in control group (35.0%) (P<0.05). The incidence of symptomatic intracranial hemorrhage and mortality were comparable between the two groups (P>0.05). Conclusion: Intra-arterial tirofiban infusion in patients with acute cardiogenic cerebral embolism is effective and feasible, which improves the prognosis without increasing the risk of intracranial bleeding complications.

[Advances in the study of the role of adenosine 2A receptor in liver injury].

Adenosine, as an endogenous purine nucleoside, is widely distributed in various tissues and organs of the body. It binds to adenosine receptors to regulate a variety of important biological processes. Adenosine 2A receptors have a close relationship with the occurrence and development of various clinical diseases. This article reviews the research progress of adenosine 2A receptors in non-alcoholic fatty liver disease, acute immune hepatitis, liver ischemia-reperfusion injury, liver fibrosis, etc., in order to provide new research strategies for the prevention and treatment of these diseases.

[Characteristics of lymph node metastasis and evaluating the efficacy of endoscopic submucosal dissection in early gastric cancer].

OBJECTIVE: To investigate the correlation between clinicopathological features and lymph node metastasis, and to evaluate the feasibility and efficacy of endoscopic submucosal dissection (ESD) in early gastric cancer (EGC) by comparing with surgery treatment. METHODS: The clinicopathological data of 320 patients with EGC who were treated in Peking University First Hospital between January 2010 and December 2017 were retrospectively reviewed, in which there were 198 cases of surgical procedure and 122 cases of ESD. Characteristics of lymph node metastasis in EGC were analyzed, and lymph node metastasis of EGC with ESD absolute and expanded indications were summarized. The long-term efficacy of ESD and surgical treatment of EGC were compared to evaluate the rationality of absolute and expanded indications of ESD. RESULTS: Lymph node metastasis was detected in 22 (11.1%) of 198 patients. Univariate analysis showed a positive relationship between tumor size (χ2=5.525, P=0.019), depth of invasion(χ2=8.235, P=0.004), histological type (χ2=6.323, P=0.012), lymphovascular invasion (χ2=12.273, P < 0.001) and lymph node metastasis in EGC. Multivariate analysis revealed that depth of invasion(Wald=7.575, P=0.006) and histological type (Wald=6.317, P=0.012) were independent relative factors of lymph node metastasis in EGC. The lymph node metastasis rates of the patients with absolute and expanded ESD indications were both 0%. The 5-year survival rates of the patients who met ESD absolute indication receiving surgery treatment and ESD were 97.6% and 97.9% respectively, and the difference between the two groups was not statistically significant(χ2=0.014, P=0.907).The 5-year survival rates of the patients who met ESD expanded indication receiving surgery treatment and ESD were 96.5% and 91.7% respectively, the difference between the two groups was not statistically significant(χ2=1.061, P=0.303). CONCLUSION: Lymph node metastasis in EGC is mainly correlated with depth of invasion and histological type. Our data indicate that ESD procedure for EGC is comparable to surgery in terms of long-term efficacy in both absolute and expanded indications. However, some studies of a large sample size are still needed for more confirmation.

MiR-647 promotes proliferation and migration of ox-LDL-treated vascular smooth muscle cells through regulating PTEN/PI3K/AKT pathway.

OBJECTIVE: Aberrant microRNAs (miRNAs) play vital roles in various human diseases, including atherosclerosis (AS). MiR-647 expression was highly elevated in AS samples. Therefore, this study aimed at exploring the role and mechanism of miR-647 on AS progression. PATIENTS AND METHODS: Human aorta vascular smooth muscle cells (HA-VSMCs) were treated with oxidized modified low-density lipoprotein (ox-LDL) to establish the AS model in vitro. The qRT-PCR assay was used to detect the expression of miR-647 and PTEN mRNA. The levels of PTEN protein, PI3K, AKT, p-PI3K, and p-AKT were measured using Western blot. Cell proliferation and migration were determined by Cell Counting Kit-8 (CCK-8) assay and transwell assay, respectively. The target of miR-647 was verified using the dual-luciferase reporter assay. RESULTS: Our data supported that miR-647 was upregulated and PTEN was downregulated in the serum of AS patients and ox-LDL-treated HA-VSMCs. The proliferation and migration of ox-LDL-treated HA-VSMCs were promoted by miR-647 overexpression or PTEN knockdown, while they were suppressed following miR-647 depletion or high PTEN expression. Moreover, PTEN was a direct target of miR-647. PTEN antagonized miR-647-mediated regulatory effects on cell proliferation and migration. Additionally, the PI3K/AKT signaling pathway was involved in miR-647/PTEN-mediated regulation in ox-LDL-treated HA-VSMCs. CONCLUSIONS: MiR-647 promoted the proliferation and migration of ox-LDL-treated HA-VSMCs at least partly by targeting the PTEN/PI3K/AKT pathway. Targeting miR-647 may be a promising method for AS treatment.

[Microbiome analysis of diabetic foot osteomyelitis by metagenome sequencing technology].

Objective: To analyze the microbiome of diabetic foot osteomyelitis (DFO) by means of metagenome sequencing and provide evidence for identification of pathogenic bacteria in DFO. Methods: A total of 5 patients (3 males and 2 females) with DFO hospitalized at the Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University were enrolled and infected bone specimens were obtained between September 2016 and April 2017. The mean age was (55.8±9.5) years. Metagenome sequencing was performed to explore the characteristics of microbiome, and compared with the results of 16S rRNA sequencing. Results: The results of metagenome sequencing showed that DFO contained diverse microorganism. Totally, 22 dominant species were obtained, Klebsiella pneumoniae (69.66%) was the most abundant, followed by Veillonella parvula (36.93%) and Prevotella intermedia (34.19%). Compared with the 16S rRNA sequencing, metagenome sequencing could obtain more species information on the basis of fewer samples. At the genus level, both sequencing techniques suggested the most dominant pathogen in DFO was anaerobe. All bone specimens had polymicrobial communities. Conclusions: More microecological diversity and abundance of DFO can be found by using metagenome sequencing. At the species level, more bacteria, even bacterial strains can be identified by metagenome sequencing. At the genus level, the most abundant bacteria is anaerobe, however, at the species level, it is facultative anaerobe.

[Clinical short-term and long-term efficacy of endoscopic submucosal dissection in the treatment of early low rectal cancer and precancerous lesions].

Objective: To evaluate the short-term and long-term efficacy of endoscopic submucosal dissection (ESD) in the treatment of early low rectal cancer and precancerous lesions. Methods: Inclusion criteria: (1) Distance from the lower margin of tumor to the anal was ≤ 5 cm. (2) Early low rectal cancers were any size rectal epithelial tumors with infiltration depth limited to the mucosa and submucosa, which were diagnosed by postoperative pathology as high-grade intraepithelial neoplasia or adenocarcinoma of the rectum with infiltration depth of intramucosal or submucosal cancer (M or SM stage). (3) Precancerous lesions included adenoma and low-grade intraepithelial neoplasia of the rectum. (4) Patients received ESD treatment. Patients with tumor invasion depth over submucosa by pathology were excluded. From January 2008 to January 2018, 63 patients meeting the above criteria in Peking University First Hospital were enrolled in this descriptive cohort study. The disease characteristics, clinical manifestations, pathological types, treatment time, hospitalization time, en bloc resection rate (resection of the whole lesion), complete resection rate (both the horizontal and vertical incision margins were negative), postoperative complications and follow-up results were analyzed. Cummulative survival rate was calculated by Kaplan-Meier. Results: The diameter of the lesion was (29.0±23.4) mm and the distance from the lesion to the anus was (2.7±1.8) cm. The median operation time was 45.0 (range, 10.0 to 360.0) minutes, the median hospitalization time was 3.0 (range, 2.0 to 12.0) days, en bloc resection rate was 100%, complete resection rate was 96.8% (61/63), and 1 case (1.6%) had postoperative bleeding. The follow-up rate was 87.3% (55/63) and the median follow-up time was 57.9 (range, 15.6 to 121.1) months. No local recurrence was found during the follow-up period and the 5-year survival rate was 100%. Conclusion: Short- and long-term efficacy of ESD are quite good in the treatment of patients with early low rectal cancer and precancerous lesions.

LncRNA SNHG8 promotes the development and chemo-resistance of pancreatic adenocarcinoma.

OBJECTIVE: The aim of this study was to investigate the role of small nucleolar RNA host gene 8 (SNHG8) in the pathogenesis of pancreatic adenocarcinoma and to explore the possible underlying mechanism. PATIENTS AND METHODS: SNHG8 expression in 40 pairs of pancreatic adenocarcinoma tissues and para-cancerous tissues, as well as 10 normal pancreas tissues was detected by quantitative Real Time-Polymerase Chain Reaction (qRT-PCR). Survival analysis was conducted to explore the correlation between SNHG8 expression and the prognosis of pancreatic adenocarcinoma patients. After the transfection of SNHG8 siRNA into pancreatic adenocarcinoma cells, the proliferation and cell cycle were detected by cell counting kit-8 (CCK-8) assay and flow cytometry, respectively. Meanwhile, cell apoptosis was detected by flow cytometry and Western blot. The regulatory effect of SNHG8 on the chemo-sensitivity of pancreatic adenocarcinoma cells was assessed by CCK-8 assay. RESULTS: The expression of SNHG8 in pancreatic adenocarcinoma tissues was significantly higher than that of para-cancerous tissues and normal pancreatic tissues. Pancreatic adenocarcinoma patients with higher expression of SHNG8 presented shorter overall survival than those with lower expression. Meanwhile, SNHG8 expression was correlated with tumor stage and differentiation level, whereas not correlated with age, sex, tumor location and lymph node metastasis of pancreatic adenocarcinoma patients. In vitro results showed that SNHG8 knockdown significantly decreased the proliferative ability, prolonged G0/G1 phase and increased the apoptosis of Hs766T and PANC-1 cells. Western blot results elucidated that SNHG8 knockdown remarkably downregulated the protein expression levels of cleaved caspase-3 and cleaved PARP in Hs766T and PANC-1 cells. In addition, SNHG8 significantly decreased the chemo-sensitivity of pancreatic adenocarcinoma cells. CONCLUSIONS: SNHG8 is highly expressed in pancreatic adenocarcinoma tissues and is negatively correlated with its prognosis. Moreover, SNHG8 promotes cell proliferation and cell cycle, whereas inhibits cell apoptosis and reduces the chemo-sensitivity of pancreatic adenocarcinoma cells.

Investigation for TGF-ß1 expression in type 2 diabetes and protective effects of TGF-ß1 on osteoblasts under high glucose environment.

OBJECTIVE: The occurrence rate of delayed fracture healing in diabetes mellitus patients is high. Transforming growth factor ß1 (TGF-ß1) is an important regulatory factor in bone tissue repair and regeneration. However, TGF-ß1 expression and its function in diabetic patient fracture have not been fully elucidated. PATIENTS AND METHODS: Type 2 diabetes fracture patients (T2DM group), fracture patients without diabetes (non-T2DM group), and healthy volunteers (Control group) were selected for the research. TGF-ß1 expression in peripheral blood was detected by using enzyme-linked immunosorbent assay (ELISA). Osteoblast cell line, MG-63 cells, were randomly divided into Control, high glucose group, and TGF-ß1 group. TGF-ß1 expression was evaluated by using Real Time-PCR (RT-PCR). Cell proliferation was evaluated by using 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2-H-tetrazolium bromide (MTT) assay. Cell apoptosis activity was determined with caspase-3 activity and flow cytometry assay. The effect of TGF-ß1 on NF-κB was detected by using Western blot. RESULTS: TGF-ß1 was significantly reduced in patients of T2DM and non-T2DM groups compared with Control (p<0.05), while it was lower in T2DM group (p<0.05). TGF-ß1 expression was declined, cell proliferation was inhibited, caspase-3 activity was enhanced, cell apoptosis was elevated, and NF-κB expression was reduced in MG-63 cells of high glucose group compared to Control group (p<0.05). TGF-ß1 significantly promoted cell proliferation, suppressed caspase-3 activity, alleviated cell apoptosis, and elevated NF-κB expression in MG-63 cells compared with high glucose group (p<0.05). CONCLUSIONS: TGF-ß1 decreased in diabetes fracture patients. Up-regulation of TGF-ß1 regulates cell apoptosis and caspase-3 activity, and it facilitates osteoblasts proliferation.

[Development of Markov models for economics evaluation of strategies on hepatitis B vaccination and population-based antiviral treatment in China].

Objective: To construct the Markov models to reflect the reality of prevention and treatment interventions against hepatitis B virus (HBV) infection, simulate the natural history of HBV infection in different age groups and provide evidence for the economics evaluations of hepatitis B vaccination and population-based antiviral treatment in China. Methods: According to the theory and techniques of Markov chain, the Markov models of Chinese HBV epidemic were developed based on the national data and related literature both at home and abroad, including the settings of Markov model states, allowable transitions and initial and transition probabilities. The model construction, operation and verification were conducted by using software TreeAge Pro 2015. Results: Several types of Markov models were constructed to describe the disease progression of HBV infection in neonatal period, perinatal period or adulthood, the progression of chronic hepatitis B after antiviral therapy, hepatitis B prevention and control in adults, chronic hepatitis B antiviral treatment and the natural progression of chronic hepatitis B in general population. The model for the newborn was fundamental which included ten states, i.e. susceptiblity to HBV, HBsAg clearance, immune tolerance, immune clearance, low replication, HBeAg negative CHB, compensated cirrhosis, decompensated cirrhosis, hepatocellular carcinoma (HCC) and death. The susceptible state to HBV was excluded in the perinatal period model, and the immune tolerance state was excluded in the adulthood model. The model for general population only included two states, survive and death. Among the 5 types of models, there were 9 initial states assigned with initial probabilities, and 27 states for transition probabilities. The results of model verifications showed that the probability curves were basically consistent with the situation of HBV epidemic in China. Conclusion: The Markov models developed can be used in economics evaluation of hepatitis B vaccination and treatment for the elimination of HBV infection in China though the structures and parameters in the model have uncertainty with dynamic natures.

[Cost-effectiveness and affordability of strategy for preventing mother-to-child transmission of hepatitis B in China].

Objective: To evaluate the cost effectiveness of nationwide prevention of mother to child transmission (PMTCT) strategy for hepatitis B, and estimate the willing to pay and budget impacts on the PMTCT. Methods: The decision analytic Markov model for the PMTCT was constructed and a birth cohort of Chinese infants born in 2013 was used to calculate the cost-effectiveness of the PMTCT among them compared with those receiving no intervention. The parameters in the model were obtained from literatures of national surveys or Meta-analysis. The costs, cases of HBV-related diseases and quality-adjusted life-years (QALYs) were obtained from the societal and payer perspectives, respectively. The incremental cost-effectiveness ratio (ICER) was used as measures of strategy optimization. One-way and probability sensitivity analysis were performed to explore the uncertainty of the primary results. In addition, cost-effectiveness acceptability curve and cost-effectiveness affordability curves were drawn to illustrate the cost effectiveness threshold and financial budget of the PMTCT strategy. Results: The lifetime cost for PMTCT strategy was 4 063.5 yuan (RMB) per carrier, which was 37 829.7 yuan (RMB) lower compared with those receiving no intervention. Due to the strategy, a total of 24.516 1 QALYs per person would be gained, which was higher than that in those receiving no intervention. From societal perspective, the ICER was -59 136.6 yuan (RMB) per additional QALYs gained, indicating that the PMTCT is cost effective. The results were reliable indicated by one-way, multi-way and probability sensitivity analyses. By the CEAC, the willing to pay was much lower than the cost-effectiveness threshold. From the affordability curve of the PMTCT strategy, the annual budget ranged from 590.4 million yuan (RMB) to 688.8 million yuan (RMB), which was lower than the financial ability. Based on the results of cost-effectiveness affordability curves, the higher annual budget was determined, the higher probability of affordability for the PMTCT would be obtained under the same willing to pay state. Only when the annual budget reaches 688.8 million yuan (RMB), the goal of PMTCT would be fully realized. Conclusions: The PMTCT strategy in China was cost effective, and the cost is not beyond the financial budget needed and the willing to pay. The strategy, which is consistent with the global hepatitis B elimination efforts, should be conducted widely in China.

[Cost-effectiveness of community-based treatment of chronic hepatitis B in China].

Objective: Since eliminating hepatitis B in China would need considerable public health resources, the economics problem of the strategy of community-based antiviral treatment for chronic hepatitis B (CHB) has become an important issue. The cost-effectiveness and affordability of the strategy were evaluated in this study. Methods: According to the advocacy on eliminating hepatitis B by WHO and the comprehensive protocol of community based prevention of major infectious diseases and the guideline for CHB prevention and treatment in China, the decision analytic Markov model was constructed with the parameters from national surveys or Meta-analysis. A cohort population aged 20-59 years was used as study subjects. The strategy of CHB antiviral treatment was compared with the strategies of hepatitis B vaccination and non-intervention, respectively. The costs and disability-adjusted life years (QALYs) of the strategies were calculated from the societal and payer perspectives. The incremental cost-effectiveness ratio (ICER) and the cost-effectiveness ratio (CER) were calculated for the comparison of the strategies. One-way and probability sensitivity analysis were performed for uncertainty of the results. And the cost-effectiveness and affordability curves were introduced to estimate the budget impact on the strategies. Results: In the Chinese aged 20-59 years, the ICER of CHB antiviral treatment was 37 598.6 yuan (RMB) per QALYs and the ICERs were smaller in the low age groups, indicating that the antiviral treatment strategy is cost-effective and low age groups should be the priority population. The ICER of hepatitis B vaccination was -64 000.0 yuan (RMB) per QALYs, indicating that hepatitis B vaccination is cost saving. The CER of CHB antiviral treatment ranged from 731.8 to 1 813.3 yuan (RMB) per QALYs compared with hepatitis B vaccination, and the CER of CHB antiviral treatment was higher than that of hepatitis B vaccination in all age groups, indicating that hepatitis B vaccination would be more cost-effective than CHB antiviral treatment. The price of antiviral drug, entercavir, can influence the cost effectiveness of CHB antiviral treatment. If the price of entercavir declined half, CHB antiviral treatment would be cost-saving. The probability sensitivity analysis showed that people's willing to pay for CHB antiviral treatment should not be ignored, although the results of economics evaluation of CHB antiviral treatment were reliable. The results of affordability analysis indicated that the antiviral treatment strategy could not be implemented with the budget lower than 30 million yuan (RMB), the probability of implementing the strategy was 42.6% if the budget reaches 127 million yuan (RMB), and only when the budget reaches 269 million yuan (RMB), the goal of CHB antiviral treatment strategy can be fully realized. Conclusions: Although the strategy of CHB antiviral treatment as prevention in Chinese aged 20-59 years is cost-effective, it is not an appropriate public health measure due to the high cost. The cost effectiveness would be higher by conducting hepatitis B vaccination and then antiviral treatment in susceptible population.

[Recombinant human tumor necrosis factor receptor type â ¡-IgG Fc fusion protein for treatment of occupational medicamentosa-like dermatitis induced by trichloroethylene].

Objective: To investigate the efficacy and safety of the recombinant human tumor necrosis factor receptor Ⅱ-IgG Fc fusion protein (rhTNFR: Fc, etanercept) for the treatment of occupational medicamentosa-like dermatitis induced by trichloroethylene (OMLDT) . Methods: In September 2011 to February 2016, 12 patients with OMLDT were treated with etanercept 25 mg, subcutaneous injection, twice per week, doubling of first dose. The course of treatment was 6 weeks. The drug eruption area and severity index (DASI) score, the proportion of patients achieving a 50%, 75% and 90% reduction in DASI (DASI50, DASI75, DASI90) and the serum level of TNF-α were used to assess the efficacy at different times. Adverse reactions were also recorded and evaluated. The results were statistically analyzed by nonparametric Friedman test and repetitive measurement ANOVA using the software SPSS19.0. Results: After 4 weeks treatment, the DASI score decreased form 56.33±7.02 to 0.50±0.91 (P<0.01) . The DASI50, DASI75 and DASI90 were all increased to 12 (100%) . The serum level of TNF-α decreased form (43.74±41.62) pg/ml to (3.03±0.47) pg/ml (P<0.01) . Statistically significant difference was observed from the above indexes. There were no adverse reactions in clinical application. Conclusion: Recombinant human tumor necrosis factor receptor Ⅱ-IgG Fc fusion protein may be a safe and effective drug in the treatment of OMLDT.

The expression and significance of IL-6, IFN-γ, SM22α, and MMP-2 in rat model of aortic dissection.

OBJECTIVE: To examine the expression of interleukin-6 (IL-6), interferon-γ (IFN-γ), smooth muscle 22α (SM22α), and matrix metalloproteinase-2 (MMP-2) and their possible roles in aortic dissections (AD). MATERIALS AND METHODS: Male SD rats (3 weeks) were induced for AD using 0.25% ß-aminopropionitrile (BAPN) treatment for 6 weeks and were subsequently divided into the model I (with AD) and model II (no AD). Aorta was separated and observed, while TUNEL staining observed apoptosis of aortic vascular smooth muscle cells. Immunohistochemistry (IHC) staining measured the positive expression of IL-6, IFN-γ and MMP-2 in aorta tissues, followed by Western blotting for protein expressions of IL-6, IFN-γ, SM22α, MMP-2, and signal transduction factors phosphorylated c-Jun N-terminal kinase (p-JNK) and p-c-Jun. RESULTS: Under an 80% rate of AD formation in model rats, those with AD had significantly higher aorta diameter and apoptosis of aortic vascular smooth muscle cells compared to those without AD or control rats (p<0.05). Elastic fiber gap of model I group was increased, accompanied with elastin fiber breakage and disarrangement. Model rats had significantly higher IL-6, IFN-γ, MMP-2, p-JNK, and p-c-Jun expression than control ones, and lower SM22α expression. No significant difference has been found for these parameters between model I and model II subgroups (p>0.05). There were significantly positive correlations between IL-6 versus MMP-2, IL-6 versus p-JNK, IFN-γ versus MMP-2, IFN-γ versus p-c-Jun in the model I group (p<0.05). CONCLUSIONS: IL-6, IFN-γ, and MMP-2 expressed highly in AD. During AD formation, IL-6 and IFN-γ may enhance MMP-2 expression and increase extracellular matrix degradation of aorta vascular wall via JNK signal pathway. The apoptosis and phenotype transformation of vascular smooth muscle cells is likewise correlated with AD formation.

Descriptive epidemiology of deployment-related medical conditions and shipboard training-related injuries in a Chinese Navy population.

OBJECTIVES: To investigate the deployment-related medical conditions and shipboard tactical training-related injuries in a Chinese Navy population. STUDY DESIGN: A retrospective study with the Chinese Navy was conducted. METHODS: The medical records of 1543 Navy crewmembers from 2011 to 2015 were collected. The distribution and incidence rate (IR) of different types of medical conditions were provided and compared between the Aden Gulf deployment and nondeployment periods. The occurrence of military training-related injuries in crewmembers receiving 12-week shipboard tactical training was compared with that of 956 marines and 4371 recruits receiving combat and physical training, respectively. The anatomic locations and types of training-related injury were analyzed. RESULTS: Compared with the nondeployment period, the percentages of the following injuries were significantly higher during deployment: injuries and certain other consequences of external causes (16.97% vs 7.76%), diseases of the musculoskeletal system and connective tissue (15.40% vs 10.34%) and mental and behavioral disorders (11.23% vs 3.45%); however, respiratory system diseases had a lower percentage (19.84% vs 28.35%). Far seas deployment significantly increased the IRs of acute upper respiratory infection, skin and eye infection, sprains and low back pain as well as aphthous ulcer, insomnia, and seasickness (P < 0.05, 0.01 or 0.001). Shipboard training induced higher IRs of injuries to the upper extremities, spine and back and head and face than physical training and a higher incidence of head and face injury than combat training (P < 0.05 or 0.001). Physical training had higher IRs of overuse injuries than shipboard and combat training (P < 0.001). The IR of fracture was higher during combat and physical training than shipboard training (P < 0.01 and 0.001). CONCLUSIONS: The Chinese Navy has experienced novel health issues in crewmembers in recent years. Corresponding countermeasures should be taken to address deployment-related medical conditions and shipboard training-related injuries in the future.

[Effects of prenatal maternal seizure on hippocampal damage and cognitive deficits in offspring rats].

Objective: To observe hippocampal damage and cognitive impairment of offspring exposed to prenatal maternal seizure induced by amygdala kindling, and to explore the underlying mechanism by the detection of pathological changes of placenta. Method: Adult female SD rats were randomly divided into three groups: control group(8 rats), kindling group(12 rats) and sham group(8 rats). All the rats were allowed to mate after one week's fully kindling. The pregnant rats in kindling group received electric stimulation every 48 h. Dams were allowed to deliver naturally. Effects of maternal seizure on the number of offspring, the survival rate and body weight of pups were observed. HE staining was used to visualize histopathological changes of placenta. Morris water maze test was used to assess the cognitive function and Nissal's staining to detect hippocampal morphology of the offspring. One-way ANOVA analysis and χ2 test were used. Result: Compared with the sham group (95%(78/82)) and the control group (95%(82/86)), the survival rate of pups in kindling group(81%(66/82))was much lower (χ2=13.817, P=0.001). There were no significant differences in the number of pups per litter and pups birth-weight between kindling group and sham group or control group(F=0.312 and 0.257, P=0.736 and 0.776). HE staining showed that placental tissues from control and sham groups were normal whereas the histologic abnormalities of placentas from kindling group were characterized by thickening of the villus vascular walls, luminal stenosis, trophoblasts hyperplasia, abnormalities of trophoblasts with nuclear pyknosis and karyorrhexis and accumulation of inflammatory lymphocytes in labyrinthine zone. Nissl staining showed that neurons in hippocampus of P0(0 d after birth) and P84(84 d after birth) offspring from control and sham groups were normal, but neuronal damages were obvious in hippocampus of P0 and P84 offspring from kindling groups, and the damages in P0 pups were severe with a marked loss of neuron, shrinkage of cells and nuclear pyknosis and karyorrhexis. In the Morris water maze, compared with the sham group ((29±8), (19±9), (10±4)s) and the control group ((25±6), (17±5), (14±4)s) rats in the kindling group ((36±8), (29±8), (30±11)s) exhibited significantly longer escape latency from the 3rd, 4th, and 5th days (F=6.276, 7.518, 18.422, P=0.030, 0.003, 0.000), significant less time in the target quadrant ((27±8) vs.(58±11)and(68±13)s, F=35.993, P=0.000) and reduced number of crossing the platform ((4.4±1.7) vs. (7.2±1.6) and (8.5±1.3)times, F=18.377, P=0.000). In addition, there was no significant difference between control and sham groups(P all >0.05). Conclusion: The prenatal maternal seizures induced significant pathological damages to hippocampus and cognitive impairment of offspring. Hypoxia-ischemia of placenta might play an important role in this process.

[Cost-effectiveness and cost-benefit analysis on strategy for preventing mother-to-child transmission of hepatitis B virus].

OBJECTIVE: Through cost-benefit analysis (CBA), cost-effectiveness analysis (CEA) and quantitative optimization analysis to understand the economic benefit and outcomes of strategy regarding preventing mother-to-child transmission (PMTCT) on hepatitis B virus. METHODS: Based on the principle of Hepatitis B immunization decision analytic-Markov model, strategies on PMTCT and universal vaccination were compared. Related parameters of Shenzhen were introduced to the model, a birth cohort was set up as the study population in 2013. The net present value (NPV), benefit-cost ratio (BCR), incremental cost-effectiveness ratio (ICER) were calculated and the differences between CBA and CEA were compared. RESULTS: A decision tree was built as the decision analysis model for hepatitis B immunization. Three kinds of Markov models were used to simulate the outcomes after the implementation of vaccination program. The PMTCT strategy of Shenzhen showed a net-gain as 38 097.51 Yuan/per person in 2013, with BCR as 14.37. The universal vaccination strategy showed a net-gain as 37 083.03 Yuan/per person, with BCR as 12.07. Data showed that the PMTCT strategy was better than the universal vaccination one and would end with gaining more economic benefit. When comparing with the universal vaccination program, the PMTCT strategy would save 85 100.00 Yuan more on QALY gains for every person. The PMTCT strategy seemed more cost-effective compared with the one under universal vaccination program. In the CBA and CEA hepatitis B immunization programs, the immunization coverage rate and costs of hepatitis B related diseases were the most important influencing factors. Outcomes of joint-changes of all the parameters in CEA showed that PMTCT strategy was a more cost-effective. CONCLUSIONS: The PMTCT strategy gained more economic benefit and effects on health. However, the cost of PMTCT strategy was more than the universal vaccination program, thus it is important to pay attention to the process of PMTCT strategy and the universal vaccination program. CBA seemed suitable for strategy optimization while CEA was better for strategy evaluation. Hopefully, programs as combination of the above said two methods would facilitate the process of economic evaluation.

Environmental exposure and risk of uterine leiomyoma: an epidemiologic survey.

AIM: The present study was undertaken to explore the relationship between environmental exposure and risk of uterine leiomyoma in women using an epidemiologic survey. SUBJECTS AND METHODS: We conducted a case-control survey of premenopausal Han women aged 30-50 years in Nanjing. The subjects included 600 patients with uterine leiomyoma confirmed at the Affiliated Zhongda Hospital of Southeast University between February 2010 and June 2012 and 600 patients with non-uterine leiomyoma or healthy volunteers who presented to the above mentioned hospital for physical examination during the same period. We entered the results into a database and explored the relationship between risk factors and prevalence of uterine leiomyoma using univariate or multivariate non-conditional logistic regression analysis. RESULTS: The results showed that patients aged 40-45 years had a high prevalence of uterine leiomyoma. The prevalence of uterine leiomyoma in subjects with an education beyond high school was higher than in those with a high school education or less. Exposure to plastic products (odds ratio [OR]: 1.481; 95% confidence interval [CI]: 1.046-2.097); exposure to cosmetics and other chemicals (OR: 1.954; 95% CI: 1.479-2.582); and consumption of soybean milk (OR: 2.518; 95% CI: 1.894-3.347), food additives, sweeteners, and preserved food (OR: 3.166, 95% CI: 2.247-4.461) had a significant effect on the occurrence of uterine leiomyoma (p < 0.05). CONCLUSIONS: Exposure to plastic products, cosmetics, and other chemicals as well as intake of soybean milk, food additives, sweetener, and preserved foods may be risk factors for uterine leiomyoma.

Octreotide is the favorable alternative for cisplatin resistance reversal of ovarian cancer in vitro and in nude mice in vivo.

This study aimed to observe the effects of octreotide (OCT) on cisplatin resistance reversal of cancer cells in vitro and in nude mice in vivo. MTT method and flow cytometry were used to investigate the effect of cisplatin, OCT or the combination of these two compounds on the proliferation and apoptosis of SKOV3-DDP cells. The size and weight of xenograft tumors from the nude mice model were measured. Real-time PCR was used to detect the mRNA expression of SSTR2, MDR1, MRP2, GST-pi and EGFR in SKOV3/DDP cells following the different treatment. At the concentration of 2.5-20 g/ml, OCT significantly reduced IC50 (p < 0.05) and promoted apoptosis (p < 0.05) of SKOV3-DDP cells' response to cisplatin. Unchanged expression was found in SSTR2 on the SKOV3/DDP cell in vitro after OCT treatment, but increased expression in vivo (p < 0.05). OCT increased GST-pi expression (p < 0.05) and reduced MRP2 and EGFR expression (p < 0.05) in a dose-dependent manner. The similar results were obtained in mice in vivo experiment, except the reduced expression of GST-pi. It is suggested that OCT could inhibit ovarian cancer proliferation and promote apoptosis, via the cell surface SSTR2, and reverse cisplatin resistance through inhibition of MRP2, EGFR, and even GST-pi expressions.