Analysis of breast cancer screening among rural women in Qinba area / 肿瘤研究与临床

Objective:To analyze the results of the free breast cancer screening project for rural women in Qinba area, and to investigate intervention measures for the improvement of screening rate.Methods:The data of 5 974 rural women aged 35 to 64 years old with breast cancer in Qinba area during two cancer screening in 3201 Hospital Affiliated to Xi'an Jiaotong University College of Medicine and Nanjiang County Women and Children Hospital between August 2021 and March 2022 were retrospectively analyzed. The characteristics of the screened population, the results of breast ultrasonography, mammography and pathological examination were statistically analyzed.The differences in the positive rates of breast ultrasonography and breast ultrasonography supplemented with mammography in the clinical screening of breast cancer among different age groups were compared.Results:The highest participation rate was found in those aged 45 to 49 years old, accounting for 29.56% (1 766/5 974); the lowest participation rate was those aged 60 to 64 years old, accounting for 3.65% (218/5 974). According to breast ultrasonography screening, 976 (16.34%) cases were suspected positive, 282 (4.72%) cases were positive; 84 (1.41%) were screened for mammography, 18 (21.43%) cases were suspected positive and 6 (7.14%) cases were positive; and the detection rate of breast cancer was 66.96/ 100 000 (4/5 974). There were statistically significant differences in the positive rate of clinical breast cancer screening by breast ultrasonography and breast ultrasonography supplemented with mammography among different age groups (all P < 0.05). Conclusions:Breast cancer screening in Qinba area has achieved some good results. The screening mode of physical examination combined with breast ultrasound supplemented with mammography is suitable for this area, but the compliance of the population is poor. The scientific awareness of breast cancer in rural women should be improved.

Short-term medication of dapagliflozin exacerbates CCl4 induced acute liver injury / 西安交通大学学报(医学版)

【Objective】 To investigate the role and mechanism of dapagliflozin (Dapa), a sodium glucose co-transporter 2 inhibitor, in acute liver injury. 【Methods】 Eight-week-old C57BL6/J mice were given a single intraperitoneal injection of CCl4 to induce acute liver injury. The mice were preventively given 5 mg/kg Dapa by gavage 24 h and 2 h before CCl4 injection, while those in the control group were given an equal volume of solvent gavage. After 24 h, the mice were anesthetized and sacrificed. H&E staining, plasma biochemistry, RT-qPCR, and Western blotting were used to detect the severity of liver injury and the expressions of macrophage-related genes. 【Results】 In the CCl4 group, hepatic infiltration of inflammatory cells increased, and liver and renal functions significantly deteriorated, which was further aggravated by Dapa. CCl4 could promote the expressions of M1 macrophages and fibrosis-related genes in the liver, but reduce those of M2 and antioxidant-related genes, and the latter was further inhibited by Dapa. In addition, the protein expression of arginase 1 decreased and that of SGLT2 increased after Dapa intervention, while NF-κB pathway did not change significantly, suggesting that Dapa might directly affect the energy metabolism homeostasis in the liver and aggravate acute liver injury induced by CCl4. 【Conclusion】 Dapa can exacerbate hepatic and renal damage in acute stage of liver injury, inhibit macrophages M2 polarization, and aggravate oxidative stress and inflammatory injury induced by CCl4.

Clinical characteristics and mechanism of COVID-19 vaccine-related myocarditis / 西安交通大学学报(医学版)

【Objective】 To investigate the clinical characteristics and potential mechanism of coronavirus disease 2019 （COVID-19） vaccine-related myocarditis. 【Methods】 We made a systematic literature retrieval based on PubMed to search for all reports on COVID-19 vaccine-related myocarditis published by August 31， 2021. A total of 29 reports involving 71 patients with myocarditis were enrolled after screening. The patients’ demographic data， vaccination， clinical manifestations， biochemical and imaging results， treatments， and outcomes were extracted and summarized. The patients were divided into prior COVID （n=12） and non-prior COVID （n=59） according to their previous medical history. 【Results】 COVID vaccine-related myocarditis was more common in men （91.5%） and after the second dose of mRNA vaccine （81.7%）. The average time to onset was 3 （1， 25） days， and the main symptoms included chest pain （94.4%）， fever （45.1%）， myalgia （26.8%）， and shortness of breath （16.9%）. Abnormal troponin level was present in almost all the patients， with a common elevation of C-reactive protein. Non-steroidal anti-inflammatory drugs and colchicine were widely used in clinical treatment， and the symptoms of one-fifth of the patients were relieved after symptomatic therapy， with 1 to 2 weeks’ length of hospital stay. However， the risk of vaccine-related myocarditis was significantly increased in patients with previous COVID-19 infection， which was more common after the first dose of vaccine （58.3%） other than the second dose. And the clinical symptoms and outcomes were somewhat different from those without COVID-19 infection previously. 【Conclusion】 Myocarditis is one of the serious adverse events related to COVID-19 vaccine， with an overall relatively low incidence， mild clinical severity， and favorable prognosis. Vaccine-related myocarditis may be a combined result of primed immune system and individual susceptibility after infection with COVID-19.

Correlation of platelet/albumin ratio, platelet/hemoglobin ratio and C-reactive protein/albumin ratio with diabetes in a population-based study / 西安交通大学学报(医学版)

【Objective】 To investigate the association of platelet/albumin ratio （PAR）， platelet/hemoglobin （PHR） and C-reactive protein/albumin （CAR） with diabetes mellitus. 【Methods】 Based on the data of China Health and Nutrition Survey （CHNS2009）， with gender and age matched by their ID， a total of 8 258 individuals with serological test results were finally included and were divided into diabetes group and control group according to the fasting blood glucose and HbA1c， and then the blood lipid and blood cell changes， PAR， PHR and CAR differences between groups were compared， and the correlation analysis of diabetes was performed. 【Results】 Compared with those in the control group， serum uric acid， total cholesterol， triacylglycerol and low-density lipoprotein cholesterol （LDL-C） were significantly increased in diabetes group， while high-density lipoprotein cholesterol （HDL-C） was significantly decreased. Besides， there was no significant difference in PAR or PHR between the two groups， while CAR was significantly increased in diabetes （0.48±0.18 vs. 0.08±0.23， P<0.001）， and was positively correlated with the levels of fasting glucose （r=0.181 8， P<0.001）， HbA1c （r=0.186 6， P<0.001）， and HOMA-IR （r=0.188 1， P=0.003）. However， CAR was not an independent risk factor for diabetes. In addition， increased red blood cell count （B=1.324， 95% CI： 1.182-1.483， P<0.001） and leukocytes count （B=1.230， 95% CI： 1.166-1.298， P<0.001） may be independent risk factors for the incidence of diabetes. 【Conclusion】 CAR is correlated with diabetes mellitus， but it is not an independent risk factor. Dyslipidemia， elevated leukocytes and red blood cell counts may be independent risk factors for diabetes， but further study is needed.

Network pharmacology explores the potential mechanism of Salvia miltiorrhiza in the treatment of coronary heart disease complicated with depression or anxiety disorder / 西安交通大学学报(医学版)

【Objective】 To explore the potential mechanism of Salvia miltiorrhiza and its active monomers in patients with coronary heart disease （CHD） complicated with depression or anxiety disorder based on network pharmacology. 【Methods】 We collected the clinical data of 147 patients with CHD admitted to our hospital from March to April 2021 and investigated biochemical examination， drug treatment and the use of Chinese herbal compound. The downstream targets of active monomers of Salvia miltiorrhiza were screened based on TCMSP， PubChem and SwissTargetPrediction databases， and depression or anxiety-related genes were mining in OMIM， GeneCards and TTD databases. Protein-protein interaction network and GO and KEGG gene enrichment analyses were performed by matching Chinese herbal compound with disease targets. Chinese herbal compound-target-disease network was built by Cytoscape. 【Results】 Shuxuening （44.9%）， Salviae miltiorrhiza （27.9%）， and Sofren injection （21.8%） were the most commonly used Chinese herbal or injections in the clinical treatment of CHD， and there was no difference in the frequency of use between genders. Network pharmacology showed that the active components of Salvia miltiorrhiza might act on neuroactive ligand-receptor binding， 5-hydroxytryptamine synapses and dopaminergic synapses and participate in the regulation of neurotransmitter transport， dopamine and catecholamine metabolism and stress response. Target-disease network analysis showed that many active components of Salvia miltiorrhiza interacted with catechol-O-methyltransferase， monoamine oxidase， 5-hydroxytryptamine receptor and opioid receptor， which may be the potential targets of Salvia miltiorrhiza in improving depression and anxiety. 【Conclusion】 Salvia miltiorrhiza is involved in the regulation of neurotransmitters and synaptic activities， thus making it a potential drug for the clinical treatment of CHD complicated with depression and anxiety disorder.

Correlation between serum trace elements and blood pressure in healthy people and patients with hypertension / 西安交通大学学报(医学版)

【Objective】 To explore the correlation between serum trace elements and systolic and diastolic blood pressure in healthy population and patients with hypertension. 【Methods】 The health examination data of the subjects from our hospital from September 2018 to May 2021 were selected. They consisted of 3430 healthy people with no history of chronic diseases and 216 patients with hypertension previously diagnosed. We measured the levels of serum zinc， iron， calcium， magnesium， lead， copper and cadmium and analyzed their correlation with systolic blood pressure （SBP） and diastolic blood pressure （DBP）. 【Results】 The incidence of low zinc （9.5%） and hypomagnesemia （1.8%） was relatively low， while hypomagnesemia （27.8%） was relatively common in the healthy population. Logistic regression analysis showed that age， BMI and serum albumin were associated with increased SBP and DBP. Fasting blood glucose （OR=1.095， 95% CI： 1.007-1.191） and blood lead （OR=1.006， 95% CI： 1.000-1.012） were risk factors for SBP. Serum total cholesterol （OR=1.244， 95% CI： 1.095-1.412）， serum iron （OR=1.275， 95% CI： 1.114-1.460） and blood lead （OR=1.010， 95% CI： 1.004-1.015） were risk factors， while serum magnesium （OR=0.488， 95% CI： 0.266-0.894） acted as a protective factor for DBP. After adjusting for age， gender， BMI， waist-hip ratio， and smoking history， there was no significant difference in serum trace element levels between the hypertension and healthy control groups. 【Conclusion】 SBP is correlated with serum lead， while DBP is positively correlated with serum iron and lead， but negatively correlated with serum magnesium in normal healthy population. There was no significant difference in serum trace element content between hypertensive patients and healthy control group， but the conclusion still needs to be further verified.

Magnesium citrate inhibits hyperphosphorus-induced VSMCs calcification through activating calcium-sensitive receptor / 西安交通大学学报(医学版)

【Objective】 To investigate the inhibitory effect of magnesium citrate （MgCit） on hyperphosphorus-induced VSMCs calcification and its mechanisms. 【Methods】 VSMCs were divided into the following groups： normal control group， high-phosphorus group， low-dose MgCit group， high-dose MgCit group and high-dose MgCit+NPS2143 （calcium-sensitive receptor inhibitor） group. Alizarin red staining was used for semi-quantitative analysis of VSMCs calcification and the calcium content in VSMCs was detected by the commercial kit. The osteogenic transdifferentiation parameters including alkaline phosphatase （ALP） activity， as well as mRNA and protein levels of smooth muscle 22α （SM22α）， runt-related transcription factor 2 （RUNX2） and bone morphogenetic protein 2 （BMP2）， were detected in each group. 【Results】 Compared with those in the control group， the calcium content of VSMCs in the model group was increased， ALP activity， and the mRNA and protein expressions of RUNX2 and BMP2 were increased， and the mRNA expression of SM22α was decreased （P<0.05）. MgCit could reduce VSMCs calcification， decrease ALP activity， decrease mRNA and protein levels of RUNX2 and BMP2， and increase mRNA levels of SM22α induced by high-phosphorous （P<0.05）. The above effects of MgCit were reduced when NPS2143 was administered simultaneously （P<0.05）. 【Conclusion】 MgCit can reduce VSMCs calcification and osteogenic transdifferentiation induced by high phosphorus through activating of CaSR.

Association of normal weight obesity with carotid atherosclerosis and peripheral arterial stiffness / 西安交通大学学报(医学版)

【Objective】 To investigate the association of normal weight obesity （NWO） with carotid atherosclerosis （CAS） and peripheral arterial stiffness （PAS） in persons received physical examination. 【Methods】 A total of 1 894 people with normal BMI （18.5-23.9 kg/m2） were consecutively enrolled for this study. All these people had completed body fat measurement， carotid artery ultrasound examination and peripheral arterial stiffness detection. Then they were divided into control group， CAS group， PAS group， and CAS + PAS group according to the test results mentioned above. Clinical data were compared between different groups to assess the baseline situation. Besides， Multivariate Logistic regression analysis was performed to determine independent risk factors for atherosclerosis. 【Results】 The proportion of NWO in CAS group， PAS group， and CAS + PAS group was significantly higher than that in normal group （P<0.05）. Univariate analysis results showed that NWO was correlated with greater risks of both CAS and PAS （P<0.05）. However， multiple factors analysis suggested that NWO was not associated with PAS， but with CAS （OR=1.286， 95% CI： 1.032-1.603， P<0.05）. 【Conclusion】 NWO is closely related to the occurrence of CAS and may be an independent risk factor for CAS. Attention should be paid to the body fat mass of the NWO population. Early intervention is needed to prevent the occurrence of CAS in these people.

Correlation of the intake of major macronutrients with serum lipid and uric acid / 西安交通大学学报(医学版)

【Objective】 To explore the correlation of the intake of different nutrients with the levels of serum lipids and uric acid. 【Methods】 Based on the data of China Health and Nutrition Survey （CHNS2009）， a total of 1 343 individuals were finally included by ID matching with demographic data， serological tests and dietary nutrition results. We compared serum lipids and uric acid levels between groups of different nutrients intake （group Q1-Q4） and conducted the correlation analysis. 【Results】 The total cholesterol （TC）， triglyceride （TG）， and low-density lipoprotein （LDL-C） in the men were significantly higher than those in the women， while high-density lipoprotein （HDL-C） was significantly lower in the men. The average intakes of daily energy， carbohydrate， fat and protein were significantly higher in the males than in the females. Intergroup comparisons and correlation analyses showed that total energy and protein intakes were positively correlated with TG （r=0.070 9，P=0.008 4；r=0.051 7，P=0.012 3）， while fat intake was positively correlated with TC （r=0.086 1，P=0.001 4）. The blood uric acid level was positively correlated with the intake of fat and protein （r=0.127 3，P<0.001；r=0.138 0，P<0.001）. The results of subgroup analysis of the males were consistent with those of the whole population. However， there was a significantly negative correlation between carbohydrate intake and blood uric acid level in the females （r=-0.107 9，P＝0.002 2）. Multiple linear regression analysis showed that TC， TG and uric acid were correlated with gender， age and intake of different nutrients. 【Conclusion】 The levels of blood uric acid and lipids are significantly higher in men than in women. Different types of dyslipidemia and hyperuricemia are related to different nutrient intakes in different genders and ages.

Investigation and analysis of negative emotion among university students during home quarantine of COVID-19 / 西安交通大学学报(医学版)

【Objective】 To investigate the negative emotions among university students during home quarantine under the epidemic of coronavirus disease 2019 (COVID-19) so as to provide scientific basis for psychological counseling. 【Methods】 We conducted an online questionnaire survey to collect 405 undergraduates’ and postgraduates’ DASS-21 scale scores and responses to epidemic prevention knowledge, and analyzed the university students’ negative emotions during the epidemic and influencing factors. 【Results】 Of the 405 students surveyed, 178 individuals (44.0%) had depression, 171(42.2%) felt anxious, and 119(29.4%) felt stressed. Individuals in the DASS21+ group spent much time on entertainment on the cell phone daily than those in the DASS21- group (P<0.001), and the degree of impact by COVID-19 on daily life was significantly higher (P<0.001). Correlation analysis showed that entertainment time on the cell phone, the severity of COVID-19, and the impact of the epidemic were positively related to DASS-21 scores, with correlation coefficients of 0.231, 0.143 and 0.259, respectively (all P<0.01). Binary logistic regression analysis found that mobile entertainment time for over 5 hours per day (OR=3.370, 95% CI: 1.369-8.294, P=0.008) was a risk factor for negative emotions during quarantine at home. 【Conclusion】 During quarantine at home in the epidemic of COVID-19, nearly half of university students are prone to breed negative emotions, like depression, anxiety or stress, which may be related to long-term mobile phone entertainment.

Inhibition of EZH2 expression is associated with the proliferation, apoptosis and migration of SW620 colorectal cancer cells in vitro.

Epigenetic changes have been recently recognized as important in many human cancers. Enhancer of zeste homologue 2 (EZH2) gene has shown overexpression in various human cancers, consistent with a straightforward role of EZH2 as an oncogene, but its function in carcinogenesis is partly contradictory. The role of EZH2 in development of human colorectal cancer (CRC) has not yet been clarified. In present study, we observed up-regulation of EZH2 expression in tumor tissues from CRC patients. The expression of EZH2 in CRC cell lines is consistent with the trend in cancer tissues using RT-PCR. We showed that TNM stage and lymph node metastasis in CRC patients are significantly correlated with EZH2 expression levels. EZH2 level of transcription and protein was inhibited by small interfering RNA (siRNA). More importantly, EZH2-siRNA inhibited the proliferation and migration of SW620 cells while promoting their apoptosis, and inducing G0/G1 cell cycle arrest of CRC cells. Collectively, our results suggest that up-regulated EZH2 expression may contribute to the progression of the patients with CRC. A comprehensive study of epigenetic mechanisms and the relevance of EZH2 in CRC is important for fully understanding this disease and as a basis for developing new treatment options in patients with CRC.

Relationship between ischemia-modified albumin and coronary stenosis / 西安交通大学学报(医学版)

Objective To investigate the relationship between ischemia-modified albumin (IMA) and coronary artery stenosis in patients without myocardial infarction.Methods For this study we consecutively enrolled 345 patients who received coronary angiography (CAG).According to the results,the subjects were divided into coronary stenosis group (232 cases)and control group (113 cases)to investigate the the relationship of IMA and IMA/albumin (IMAr)with coronary stenosis.Results ① The levels of IMA and IMAr in coronary stenosis group were higher than those in control group (P＜0.001).② The IMA and IMAr were higher in single-branch and multi-branch lesion groups than in control group (P＜0.05),whereas there was no significant difference between single-branch lesion group and multi-branch lesion group (P＞0.05).③ In receiver operating characteristics curve analysis,the sensitivity of IMA and IMAr was 64.4% and 78.0%,respectively (AUC:0.653,0.705,P＜0.001)in predicting coronary stenosis.④ Multivariate logistic regression analysis showed that IMAr was an independent risk factor for coronary stenosis in patients without myocardial infarction (OR=73.05,P＜0.001).Conclusion IMA and IMAr are closely correlated with coronary stenosis and have a value in predicting coronary artery stenosis in patients without myocardial infarction.

Correlation between the degree of coronary artery stenosis and endothelial dysfunction in patients with coronary heart disease and subclinical hypothyroidism / 西安交通大学学报(医学版)

Objective To study the correlation between coronary artery stenosis and endothelial dysfunction in patients with coronary heart disease and subclinical hypothyroidism.Methods According to the results of coronary angiography and thyroid function,the patients were divided into coronary heart disease with subclinical hypothyroidism (group A,n=71),coronary heart disease without subclinical hypothyroidism (group B,n=73), and normal coronary angiography (control group,n=59).The degree of coronary artery stenosis was evaluated by Gensini integral method.Fasting blood was taken to measure nitric oxide (NO),high sensitivity C reactive protein (hs-CRP),and endothelin (ET)to evaluate endothelial dysfunction.Results TC,TG,LDL-c,FT3,TSH,hs-CRP,ET and Gensini score were higher in Group A than in Group B and control group (P＜0.05).The level of NO in Group A and Group B were lower than that in control group (P＜0 .0 5).Multivariate Logistic regression analysis showed that age,TSH,ET and NO were independent risk factors for coronary heart disease.ET and NO levels in patients with coronary heart disease combined with subclinical hypothyroidism were correlated with Gensini scores (r=0.431,r=-0.383,P＜0.001).Conclusion Subclinical hypothyroidism may cause endothelial dysfunction in patients with coronary heart disease,which may increase cardiovascular risk in these patients.

Therapy approaches in treatment of recurrent ischemic angina with internal mammary artery bridge after coronary artery bypass grafting / 西安交通大学学报(医学版)

Objective To investigate the clinical therapeutic methods and their curative effects in recurrent ischemic angina for internal mammary artery resterosis after coronary artery bypass grafting (CABG).Methods We enrolled the patients who had recurrence of ischemic angina for restenosis of internal mammary artery graft after CABG as research subjects in the Affiliated Hospital of Yan'an University from January 2014 to January 2016.The 42 patients were divided into three groups according to the different treatment approaches for recurrence of ischemic angina:Group A (n=22)who received internal mammary artery interventional therapy;Group B (n=12)who received coronary artery bypass grafting treatment;and Group C (n=8)who received left subclavian artery proximal stent treatment.Then we compared the clinical therapeutic effects in the three groups.Results The success rate in Group C was 100%,which was the highest in the three groups,and the post-operative restenosis rate was 0.The hospitalization time was significantly shorter in Group A than in Group B (P＜0.05).However,the two groups did not significantly differ in mortality,success rate or restenosis rate (P＞0.05).Conclusion We should select the appropriate treatment according to the patient's specific situation for recurrent ischemic angina. Endovascular treatment has evident therapeutic effects,rapid postoperative recovery,and lower treatment risk, making it the preferred treatment when possible.

Association of low levels of free thyroxin within normal range with the severity of coronary artery disease and carotid atherosclerosis / 西安交通大学学报(医学版)

Objective To investigate the association of low level of free thyroxin (FT4)within normal range with the severity of coronary artery disease (CAD)and carotid atherosclerosis.Methods We enrolled 312 consecutive patients who underwent coronary angiography (CAG)and divided them into CAD group (196 cases)and non-CAD group (116 cases)according to CAG results.We calculated Gensini score and divided CAD group into≤10 Gensini score group (n=65),10-30 Gensini score group (n=67)and ＞30 Gensini score group (n=64).Thyroid hormone level,carotid intima-media thickness (CIMT)and other clinical data were measured and compared between the groups,and the correlation analysis was used to find the relationship of FT4 level with Gensini score.By taking CIMT reference value of 0.9 mm as the standard,we divided the patients into thickened IMT group (IMT≥0.9 mm)and normal IMT group (IMT＜0.9 mm).Results The level of FT4 was significantly lower in CAD group and subgroups than in non-CAD group (P＜0.05).The level of FT4 was negatively correlated with Gensini score (P＜0.05).The levels of FT4 and TT4 were significantly lower in thickened CIMT group than in normal CIMT group (P＜0.05).Conclusion Low level of FT4 within normal range is significantly related to the severity of CAD,and low level of FT4 can be used as an independent risk factor for the severity of CAD.Low levels of FT4 and TT4 are significantly related to carotid atherosclerosis.