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Occlusion of the superficial femoral artery is a frequently encountered pathology in peripheral vascular disease. In patients with chronic lower limb ischaemia in a lesion of crural arteries the results of femoropopliteal bypass grafting are unsatisfactory, therefore, the deep femoral artery becomes the decisive collateral pathway for perfusion of the lower extremity. PATIENTS AND METHODS: The study included a total of 166 patients presenting with TASC II B, C and D type lesions of the femoropopliteal segment after profundoplasty, who were subdivided into 3 groups depending on the stage of chronic lower limb ischaemia: Group 1 - 95 patients with stage II B, Group 2 - 56 patients with stage III, and Group 3 - 15 patients with stage IV. RESULTS: Five years after profundoplasty in Group 1 amputation was avoided in 90 patients (94.7%) in Group 2 - in 47 patients (83.9%), where p=0.028. During 14 months in Group 3 due to unsatisfactory distal bed 15 patients (100%) were subjected to amputation of the operated lower limb at various levels. The binary logistic regression analysis of the diameter of the deep femoral artery (p=0.045, OR=0.139) and the state of the distal arterial bed (p=0.02, OR=9.341) demonstrated that the diameter of the artery directly influenced the outcome of profundoplasty within up to 5 years. CONCLUSION: Profundoplasty is an effective operation from the point of view of clinical and haemodynamic outcomes for patients presenting with occlusion of the superficial femoral artery and stenosis of the deep femoral artery with stage IIB and III chronic lower limb ischaemia. The diameter of the deep femoral artery and the condition of the arterial bed are the factors influencing the results of profundoplasty within up to 5 years.
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Isquemia , Doenças Vasculares Periféricas , Procedimentos Cirúrgicos Vasculares , Artéria Femoral , Humanos , Isquemia/cirurgia , Extremidade Inferior/irrigação sanguínea , Doenças Vasculares Periféricas/cirurgia , Artéria Poplítea , Resultado do Tratamento , Grau de Desobstrução VascularRESUMO
PURPOSE: To investigate the value of the iodine concentration (IC) measured by dual-layer detector spectral CT (DLDSCT) in evaluating the factors related to the treatment scheme and survival prognosis of patients with glioma. METHODS: From 2018 to 2019, we prospectively collected the data of 99 patients with glioma. The degree of CT enhancement and the IC of low grade gliomas (LGGs, II), high grade gliomas (HGGs, III and IV), grade II and III gliomas, were compared. The predictive performance of the degree of CT enhancement and IC was examined via receiver operating characteristic (ROC) analysis. The correlations between IC and Ki-67 labeling index, isocitrate dehydrogenase (IDH) mutation, chromosome 1p/19q deletion status of the tumor were examined. RESULTS: Both IC and the degree of CT enhancement of patients with HGG were significantly higher than those of patients with LGG (p < 0.001; χ2 =41.707, pâ¯<⯠0.001); IC had large area under the ROC curve for diagnostic HGG (0.931; 95 % CI: 0.882-0.979; pâ¯<⯠0.001). The IC in the grade III gliomas was significantly higher than that in grade II gliomas (p < 0.001); IC had a large area under the ROC curve for diagnostic grade III gliomas (0.865; 95 % CI: 0.779-0.952; pâ¯<⯠0.001). There was a significant positive correlation between IC and Ki-67 LI (râ¯=â¯0.679; p < 0.001). CONCLUSIONS: The DLDSCT technology can be used as a supplementary method to provide more information for preoperative grading of the gliomas and the prognosis assessment of the patients.
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Neoplasias Encefálicas , Glioma , Neoplasias Encefálicas/diagnóstico por imagem , Glioma/diagnóstico por imagem , Glioma/cirurgia , Humanos , Isocitrato Desidrogenase/genética , Mutação , Gradação de Tumores , Tomografia Computadorizada por Raios XRESUMO
Existing studies have underscored the pivotal role of N-acetyltransferase 10 (NAT10) in various cancers. However, the outcomes of protein-protein interactions between NAT10 and its protein partners in head and neck squamous cell carcinoma (HNSCC) remain unexplored. In this study, we identified a significant upregulation of RNA-binding protein with serine-rich domain 1 (RNPS1) in HNSCC, where RNPS1 inhibits the ubiquitination degradation of NAT10 by E3 ubiquitin ligase, zinc finger SWIM domain-containing protein 6 (ZSWIM6), through direct protein interaction, thereby promoting high NAT10 expression in HNSCC. This upregulated NAT10 stability mediates the enhancement of specific tRNA ac4C modifications, subsequently boosting the translation process of genes involved in pathways such as IL-6 signaling, IL-8 signaling, and PTEN signaling that play roles in regulating HNSCC malignant progression, ultimately influencing the survival and prognosis of HNSCC patients. Additionally, we pioneered the development of TRMC-seq, leading to the discovery of novel tRNA-ac4C modification sites, thereby providing a potent sequencing tool for tRNA-ac4C research. Our findings expand the repertoire of tRNA ac4C modifications and identify a role of tRNA ac4C in the regulation of mRNA translation in HNSCC.
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Humanos , Proteínas de Ligação a DNA , Neoplasias de Cabeça e Pescoço/genética , Acetiltransferases N-Terminal , RNA de Transferência , Serina , Transdução de Sinais , Carcinoma de Células Escamosas de Cabeça e PescoçoRESUMO
Objective To observe the imaging findings of embryonal tumor with multilayered rosettes(ETMR).Methods MRI(n=8)and CT(n=6)data of 8 children with pathologically confirmed ETMR were retrospectively reviewed,and the imaging findings were analyzed.Results ETMR present as masses with the maximum diameter of 32-96 mm and clear edges in all 8 cases,located supratentorially in 5 and infratentorially in 3 cases.The supratentorial ETMR were giant cystic solid masses,while the infratentorial ETMR had relatively small volumes.No peritumoral edema was noticed.Cystic solid masses were observed in 6 cases,and the cystic portion presented as low T1WI and high T2WI signals at the edge of the masses.After administration of contrast agents,mild focal uneven enhancement in the solid portion was found in 5 cases,while 1 case was not found enhancement.Among the above 6 cases,the intratumoral bleeding and empty blood vessel shadows within the masses were observed each in 5 cases,while adjacent dura mater invasion was noticed in 3 cases.Two ETMR present as solid masses with focal nodular uneven enhancement,and the enhanced area corresponded to the low signal area on apparent diffusion coefficient(ADC)image,among them,increased choline(Cho)/creatine(Cr)and decreased N-acetyl aspartate(NAA)was found in 1 case.Limited diffusion on diffusion weighted imaging(DWI)were detected in all 8 cases.Among 6 cases who underwent CT scanning,patchy or punctate calcification,corresponding to the low signal area on MRI were detected in 4 cases.Conclusion ETMR mostly present as supratentorial large solid cystic masses with clear edges,and the cystic portion often located at the edge of masses,with characteristic vascular flow voids often accompanied by intratumoral bleeding and some with calcifications but without peritumoral edema,which showed significantly limited diffusion on DWI and weakly inhomogeneous enhancement of the solid part.
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Authenticity verification is a very important aspect of medical device registration quality management system verification of medical device. How to verify the authenticity of samples is a problem worth discussing. This study analyzes the methods of authenticity verification from the aspects of product retention sample, registration inspection report, traceability of records, hardware facilities and equipment. In order to provide reference for relevant supervisors and inspectors in the verification of registration quality management system.
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Methyltransferase like 13 (METTL13), a kind of methyltransferase, is implicated in protein binding and synthesis. The upregulation of METTL13 has been reported in a variety of tumors. However, little was known about its potential function in head and neck squamous cell carcinoma (HNSCC) so far. In this study, we found that METTL13 was significantly upregulated in HNSCC at both mRNA and protein level. Increased METTL13 was negatively associated with clinical prognosis. And METTL13 markedly affected HNSCC cellular phenotypes in vivo and vitro. Further mechanism study revealed that METTL13 could regulate EMT signaling pathway by mediating enhancing translation efficiency of Snail, the key transcription factor in EMT, hence regulating the progression of EMT. Furthermore, Snail was verified to mediate METTL13-induced HNSCC cell malignant phenotypes. Altogether, our study had revealed the oncogenic role of METTL13 in HNSCC, and provided a potential therapeutic strategy.
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Humanos , Neoplasias de Cabeça e Pescoço , Carcinoma de Células Escamosas de Cabeça e Pescoço/genéticaRESUMO
Objective:To investigate the effect of pre-stroke dependence and pre-stroke combined dementia on the outcome of 3 months after stroke in patients aged more than 65 years.Methods:This study was a retrospective cohort study. A total of 966 patients with acute stroke were enrolled in the Department of Neurology, the First Affiliated Hospital of China Medical University from March 2015 to March 2018, including 168 patients diagnosed with dementia before acute stroke for the dementia group, and the remaining 798 people were treated as the non-dementia group. The demographic differences between the two groups at admission were compared. With the death and independence as the dependent variable within 3 months after the diagnosis of acute stroke, the independent risk of admission and the presence of dementia were used as covariates to make a COX proportional hazard assessment.Results:There was significant difference in the number of medications, consistently taken with warfarin, pre-stroke independence, admission status between the dementia group and the non-dementia group ( U=3.42, χ2=4.52, 8.96, 8.76, P<0.01). There was no significant difference in the number of deaths between the two groups during admission ( χ2=0.96, P>0.05). There was significant difference in the number of deaths within 3 months after discharge and dependence within 3 months after stroke between the two groups ( χ2=5.69, 6.94, P < 0.01). Patients with pre-stroke dementia died during hospitalization and died within 3 months after discharge, the risk of moderate-to-severe dependence within 3 months after discharge was 1.00, 1.32, 2.56 compared with those who were completely independent before admission; mild dependence before admission patients who died before the stroke were completely dead during hospitalization and died within 3 months after discharge, the risk of moderate-to-severe dependence within 3 months after discharge was 1.42, 1.86, 2.73, respectively. Patients who were moderately dependent before admission were more likely to die from hospitalization than those who were completely independent before stroke, the risk of death within 3 months after discharge was 1.68, 2.42, respectively. Patients who were heavily dependent before admission were more likely to die from hospitalization than those who were completely independent before stroke, the risk of death within 3 months after discharge was 1.89, 3.24, respectively. Conclusions:Pre-stroke dementia and activity disorder lead to a high risk of death and high disability within 3 months after stroke.
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Objective@#To investigate the effect of pre-stroke dependence and pre-stroke combined dementia on the outcome of 3 months after stroke in patients aged more than 65 years.@*Methods@#This study was a retrospective cohort study. A total of 966 patients with acute stroke were enrolled in the Department of Neurology, the First Affiliated Hospital of China Medical University from March 2015 to March 2018, including 168 patients diagnosed with dementia before acute stroke for the dementia group, and the remaining 798 people were treated as the non-dementia group. The demographic differences between the two groups at admission were compared. With the death and independence as the dependent variable within 3 months after the diagnosis of acute stroke, the independent risk of admission and the presence of dementia were used as covariates to make a COX proportional hazard assessment.@*Results@#There was significant difference in the number of medications, consistently taken with warfarin, pre-stroke independence, admission status between the dementia group and the non-dementia group (U=3.42, χ2=4.52, 8.96, 8.76, P<0.01). There was no significant difference in the number of deaths between the two groups during admission (χ2=0.96, P>0.05). There was significant difference in the number of deaths within 3 months after discharge and dependence within 3 months after stroke between the two groups (χ2=5.69, 6.94, P < 0.01). Patients with pre-stroke dementia died during hospitalization and died within 3 months after discharge, the risk of moderate-to-severe dependence within 3 months after discharge was 1.00, 1.32, 2.56 compared with those who were completely independent before admission; mild dependence before admission patients who died before the stroke were completely dead during hospitalization and died within 3 months after discharge, the risk of moderate-to-severe dependence within 3 months after discharge was 1.42, 1.86, 2.73, respectively. Patients who were moderately dependent before admission were more likely to die from hospitalization than those who were completely independent before stroke, the risk of death within 3 months after discharge was 1.68, 2.42, respectively. Patients who were heavily dependent before admission were more likely to die from hospitalization than those who were completely independent before stroke, the risk of death within 3 months after discharge was 1.89, 3.24, respectively.@*Conclusions@#Pre-stroke dementia and activity disorder lead to a high risk of death and high disability within 3 months after stroke.
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Objective:To investigate the risk factors of elderly, sports cognitive risk syndrome falling, repeated falls and fractures after falls.Methods:A total of 3 552 people were enrolled in the Department of Neurology, the First Affiliated Hospital of China Medical University from April 2015 to April 2016. The demographics of each selected individual were recorded. The selected individuals were assessed by MMSE for the presence of Subjective Cognitive Complaint (SCC), and the pace was used to assess whether there was slow walking and whether there was MCR (SCC + slow walking). All individuals were divided into MCR group and non-MCR group according to the evaluation results. The non-MCR group was subdivided into SCC subgroup, slow speed walking subgroup and healthy subgroup. Baseline variables were compared between the two groups, and demographics between subgroups, subgroups, and MCR groups were compared. Follow-up was followed every 4 months for a total of 2 years. The number of people who fell during the follow-up period, repeated falls, and fractures were recorded. With all demographics and SCC, walking at a slower pace, MCR was an independent variable, with a fall during follow-up, repeated falls and post-fall fractures as dependent variables, and a COX proportional hazard regression model of independent and dependent variables.Results:The proportions of the MCR group in higher education, depression, the use of crutches were 10.2% (36/352), 22.4% (79/352), 44.9% (158/352), the BMI, number of medications in the MCR group were (27.0 ± 4.3) kg/m 2, (6.8±3.2), the proportions of non-MCR group in higher education, depression, using crutches ratio were 22.9% (732/3 200), 12.8% (409/3 200), 22.8% (729 /3 200), the BMI, number of medications of non-MCR group were (24.8 ± 3.8) kg/m 2, (5.2 ± 3.1), the two groups showed statistical significant difference( χ2 values were 29.93, 3.45, 24.98, t values were 12.34, 82.71, P<0.05). The proportions of higher education, depression and crutches were 18.9% (289/1531), 13.2% (202 /1531) and 22.5% (344/1531) in SCC subgroup. The difference between MCR group and SCC subgroup was statistically significant ( χ2 values were 14.99, 19.28, 73.56, P<0.05). The higher education level of the slow walking group was 16.6% (34/205), which was significantly different from that of the MCR group ( χ2 value was 4.77, P<0.05). The proportions of higher education level, arthritis, depression and crutches in the healthy subgroup were 27.9% (409/1 464), 12.9 (190/1 464), 11.2% (164/1 464) and 19.7% (288/1 464), while that in the SCC subgroup were 18.9% (289/1 531), 16.2 (248/1 531), 13.2% (202/1 531) and 22.5% (344/1 531), and that in the slow walking subgroup were 16.6% (34/205), 21.5% (44/205), 20.9 (43/205) and 47.3% (97/205). There were significant differences among the three subgroups ( χ2 values were 13.08-78.28, P<0.05). BMI and number of drugs in healthy subgroups were (23.4±4.4) kg/m 2 and (4.7±2.8) , SCC group was (25.2±4.3) kg/m 2 and (5.1±2.9) kinds, and slow walking subgroup were (25.1±3.8) kg/m 2 and (6.7±3.1) kinds. The differences among the three subgroups were statistically significant ( t values were 2.68,7.21, P<0.05). The risks of falling, repeated falling and fracture after falling in MCR patients were 1.22, 1.47 and 2.54 ( P<0.05). Conclusions:Age, MCR is a high risk factor for falls in the elderly, repeated falls and fractures after falls. In clinical care, MCR needs to be evaluated and attention should be payed to the elderly.
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Objective To observe the fat particles survival situations in autologous transplantation under different conditions of low temperature.Methods Three sample groups of adult Wistar rats were injected with fresh autologous fat particles,which were stored under 80 ℃ for two months and under-196 ℃ for two months respectively,and the volume,parallel histological detection,glucose transport measurement,MTT experiments and other data were compared and analyzed one month and two months after the transplantation.Results One month after transplantation,graft survival rate was higher in Group injected fresh autologous fat particles than that of Group injected autologous fat particles stored under-80 ℃ and Group injected autologous fat particles stored under -196 ℃ (P<0.05);Two months after transplantation,the differences among three groups had no statistical significance.Before the transplantation,the activity of autologous fat particles stored in -80 ℃ and-196 ℃ were 68.7% and 62.5% of fresh autologous fat particles,respectively,two months after cryopreservation.One month after the transplantation,we found that the activities of autologous fat particles were higher in fresh group than that of-196 ℃ and-80 ℃,There was no significant difference between the groups stored in-196 ℃ and-80 ℃.Two months after the transplantation,the activities of autologous fat particles were higher in fresh group than that of-196 ℃ and -80 ℃.Before transplantation,the particles of fat histology showed no significant difference among three groups.One month after transplantation,fat vacuoles and distinct inflammatory infiltration were observed in all three groups,with the group stored in-80 ℃ as the most serious affected.Two months after transplantation,fresh fat particles and Group stored in-196 ℃ showed large quantity of tightly packed intact fat cells,scattered around the central area in fat vacuoles,while Group stored in -80 ℃ still had a large quantity of fat vacuoles,but the fat vacuoles were obviously fused.Conclusions The fat stored at-80 ℃ and-196 ℃ could meet the needs of clinical use in the short time.The fat stored at-196 ℃ shows the best activity.The fat particles stored at-196 ℃ could be used to establish better blood circulation.The heaviest inflammatory reaction occurs in the graft zone one month after fat transplantation and the decrease of transplanted particle activity is the most obvious.
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With roles of blocking cell proliferation, cyclin-dependent protein kinase (CDK) 4/6 inhi-bitors are effective and safe complementary therapies for hormone receptor-positive breast cancer. CDK4/6 inhibitors combined with endocrine therapy significantly improve the prognosis of patients with advanced or metastatic breast cancer, especially those with endocrine resistance. Indications for CDK4/6 inhibitors are also expected to broaden into early-stage breast cancer. However, mechanisms of resistance of CDK4/6 inhibitors remain elusive.
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With roles of blocking cell proliferation,cyclin-dependent protein kinase (CDK)4 / 6 inhi-bitors are effective and safe complementary therapies for hormone receptor-positive breast cancer. CDK4 / 6 inhibitors combined with endocrine therapy significantly improve the prognosis of patients with advanced or metastatic breast cancer,especially those with endocrine resistance. Indications for CDK4 / 6 inhibitors are also expected to broaden into early-stage breast cancer. However,mechanisms of resistance of CDK4 / 6 inhibitors remain elusive.
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Objective@#To analyze the treatment efficacy in the vertically impacted maxillary central incisors using cone-beam CT (CBCT) and explore the treatment timing and the influence of orthodontic traction on the root development and alveolar bone height in the mixed dentition.@*Methods@#Twenty-two patients with vertically impacted maxillary central incisor who were admitted to the Department of Orthodontics, Stomatological Hospital affiliated to Nanjing Medical University from December 2012 to December 2017 were selected [12 males and 10 females, (9.2±0.9) years]. Based on the dental age, patients were classified as early treatment group (teeth ranging from a third to two thirds of root formation, n=12) and late treatment group (teeth with nearly or fully complete root formation, n=10). The contralateral maxillary central incisor was used as the control. Three-dimensional reconstruction of CBCT before treatment, after treatment and one year after treatment was carried out to measure root length, tooth surface area, tooth volume, labial and lingual apical alveolar bone thickness, the loss of labial alveolar bone height and intraosseous root ratio. The clinical crown length was measured in the mouth. The difference values of the measurement variables between the impacted teeth and the control teeth were calculated and analyzed(measurement values of impacted teeth were subtracted from control values).@*Results@#The values of root length difference beween the impacted teeth and the control teeth in the early and late treatment group were (1.58±1.56) mm and (2.57±1.00) mm, respectively after the treatment and the values were significantly less than those corresponding values before treatment [(3.47±1.40) and (3.36±0.79) mm] (P<0.05). After the treatment, the values of the surface area and volume difference between the impacted teeth and the control teeth in the early treatment group [(0±34) mm2 and (-10±44) mm3] were significantly less than those corresponding values before treatment [(38±31) mm2 and (55±70) mm3] (P<0.05). The value differences of any measurement variables between the early and late treatment group were not significantly different after the treatment (P>0.05). The root length and intraosseous root ratio of the impacted teeth after the treatment in the early and late treatment group were significantly less than those of the control teeth after the treatment (P<0.05). The clinical crown length, the loss of labial alveolar bone height of the impacted teeth after the treatment were significantly larger than those of the control teeth after the treatment (P<0.05).@*Conclusions@#Orthodontic traction promoted the root growth and development of the vertically impacted maxillary central incisors. However, the root length and alveolar bone height still cannot reach the normal level after treatment. Treatment timing had no effect on root development and alveolar bone height of vertically impacted maxillary central incisors in mixed dentition.
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Objective The internationalization of modern scientific research and its high degree of complexity have showed the importance of scientific research cooperation.How to promote cooperation more effectively is an important research topic.Methods This article analyzes the research cooperation of Institute of Hematology & Blood Diseases Hospital Chinese Academy of Medical Sciences during the past 12 years.Results Scientific research cooperation is a big trigger for the output of papers,especially high-level output,international and native institutions' cross-cooperation can be used as an important way for expanding scientific research cooperation and provides a reference for decision-making.Conclusions Strengthen the awareness of cooperation,increasing scientific research funding,establishing common and hot research directions and constructing highlevel platform can expand scientific research cooperation.
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Teicoplanin is a glycopeptide antibiotic for treatment of gram-positive bacterial infections in children, especially for methicillin-resistant staphylococcus aureus infection.The body clearance of teicoplanin differs between child and adult.This article explores the suitable testing indicators based on the clinical medication guide and the latest research progress , as well as the pharmacokinetic and pharmacodynamics of teicoplanin , to provide information for individualized dosage regime of teicoplanin in children.
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Objective To investigate whether elevated parathyroid hormone (PTH) levels could induce endothelial - to - mesenchymal transition (EndMT) and adipocyte transition in endothelial cells (ECs), and to determine the possible underlying mechanism. Methods (1) A rat model of secondary hyperparathyroidism and chronic kidney disease (CKD) was established. The adiposity in bone marrow was detected by oil red O staining. Immunofluorescence staining was performed to detect the expression and localization of cluster of differentiation 31 (CD31) and fibroblast-specific protein 1 (FSP1). (2) The human umbilical vein ECs were cultured in vitro. Western blotting was performed to detect protein expressions of EndMT-related markers CD31, FSP1 and α-smooth muscle actin (α-SMA) in interference groups with different PTH concentrations (0, 10-11, 10-9, 10-7 mol/L PTH for 48 h) and times (0, 12, 24, 48 h, 10-7 mol/L PTH), as well as the expression of β-catenin in interference groups with different PTH concentrations. The localizations of CD31, FSP1 and β - catenin were observed by cell immunofluorescence. Protein expressions of adipocytes markers peroxisome proliferator - activated receptor-γ (PPAR-γ) and CCAAT/enhancer binding protein-α (C/EBP-α) by Western blotting and the degree of adipogenesis by oil red O staining were detected after transformed ECs were cultured in adipogenic culture medium for one week. Small interfering RNA (siRNA) was performed to silenceβ - catenin expression. ECs were divided into control siRNA group, β - catenin siRNA group, PTH +control siRNA group and PTH+β-catenin siRNA group. Protein expressions of CD31, FSP1 and PPAR-γby Western blotting and the degree of adipogenesis by oil red O staining were determined. Results (1) In vivo, compared with the control, CKD rats had increased adipocytes in bone marrow (P<0.05), and the co-expression of CD31 and FSP1 in bone marrow ECs. (2) In vitro, PTH significantly inhibited the expression of endothelial marker CD31 and increased the expressions of mesenchymal markers FSP1 and α-SMA in concentration-and time-dependent manners. These indexes in 10-7 mol/L PTH group and 0 mol/L PTH group, in 48 h group and 0 h group showed statistical differences (all P<0.05). In PTH group ECs with 10-7 mol/L PTH for 48 h showed FSP1 accumulation in the cytoplasm and reduced expressions of CD31, and ECs had higher expressions of PPAR-γ and C/EBP-α as well as the degree of adipogenesis than those in control group (all P<0.05). Furthermore, PTH enhanced the nuclearβ-catenin protein levels in ECs in concentration-dependent. The expressions of β-catenin in 10-7 mol/L PTH group and 0 mol/L PTH group showed statistical differences (P<0.05). β - catenin expressed in the cytoplasm in control group, while it enter into the nucleus in PTH group. Compared with those in PTH+control siRNA group, the expressions of CD31 and PPAR-γ as well as the degree of adipogenesis decreased in PTH+β-catenin siRNA group (all P<0.05), while the expression of FSP1 increased (P<0.05). Conclusions PTH induces ECs - to - adipocytes transition by the canonical Wnt/β - catenin signaling pathway, which might account for bone loss in CKD. Silenced β - catenin expression can inhibit PTH-induced EndMT and adipogenesis.
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Objective@#Previous cross-sectional studies suggested that elevated levels of total cholesterol content of erythrocyte membrane (CEM) could significantly increase the risk of acute coronary syndrome (ACS). The purpose of the present study was to assess the predictive value of baseline CEM levels for the risk of clinical endpoint events in patients with ACS through prospective follow-up studies.@*Methods@#This study is a prospective follow-up study, which consisted of 859 patients with first ACS (698 patients with unstable angina pectoris and 161 patients with acute myocardial infarction), diagnosed and hospitalized in the First and Second Affiliated Hospital of Anhui Medical University. The routine blood lipid levels and CEM were measured. Patients were divided into two groups according to the median of baseline CEM: CEM≤131.56 μg/mg group (n=430) and CEM>131.56 μg/mg group (n=429). Patients were followed up at 6 months interval. The clinical endpoints were nonfatal myocardial infarction, nonfatal stroke, all-cause mortality, all-cause mortality, heart failure requiring hospitalization, and coronary artery revascularization. Kaplan-Meier curve analysis and Cox proportional hazard model were used to analyze the impact of elevated CEM on the occurrence of clinical end-point events. HR values and 95%CI of each variable were obtained. Cox regression analysis of all-cause mortality was performed according to whether patients had risk factors for coronary heart disease (hypertension, diabetes, smoking and elevated LDL-C) and whether they were treated with PCI.@*Results@#The follow-up time was 1 640 (1 380, 2 189) days. Cox analysis after adjustment showed that an elevated baseline of CEM (>131.56 μg/mg) was associated with an increased risk of all-cause mortality (HR=1.690, 95%CI 1.041-2.742, P=0.034), but had no significant predictive effect on the other clinical endpoints. Subgroup analysis showed that elevated baseline CEM levels in ACS patients with LDL-C>1.8 mmol/L (HR=1.687, 95%CI 1.026-2.774, P=0.039), receiving in-hospital PCI (HR=2.365, 95%CI 1.054-5.307, P=0.037), or male (HR=1.794, 95%CI 1.010-3.186, P=0.046) were associated with an increased risk of all-cause mortality.@*Conclusion@#The results showed that elevated CEM levels can increase the risk of all-cause mortality in ACS patients.
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Objective@#To evaluate the cost-utility of different immunization strategies for rabies in China, and to provide a reference for determining the optimal immunization strategy.@*Methods@#The system dynamics model was used to simulate the epidemic of canine rabies and a decision tree model was conducted to analysis different immune strategies. Relevant probabilities were obtained through literature search and on-site investigation. Sensitivity analysis was used to explore the important influenced factors.@*Results@#At baseline, from a social perspective, 70% vaccination of dogs was the optimal strategy compared to current vaccination strategy (43% vaccination in dogs, human category-Ⅱ exposure vaccination/category-Ⅲ exposure vaccination combined with RIG). The total cost was 14 084 354 CNY, and the total utility value was 22 078 616.23 QALYs, and the incremental cost-utility ratio was-62 148 147 CNY/QALY; if human vaccination was considered, 55% vaccination of dogs combined with strategy one was the optimal strategy, its incremental cost-utility ratio was-444 620 557 CNY/QALY. The probability that an injured dog carries rabies virus was the most sensitive parameter. When it was greater than 0.005 03, strategy four was the optimal strategy. When it was less than 82/100 000, strategy one was the optimal strategy; when it was between 82/100 000 and 120/100 000, strategy two was the optimal strategy; when it was between 120/100 000 and 503/100 000, strategy two was the optimal strategy.@*Conclusion@#It was conducive to increase the vaccination coverage of canine for the prevention and control of rabies.
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Influenza virus , the causative agent of influenza , has characteristics of fast transmission and strong infectivity, posing a major threat to public health .Currently, with widely use of the first-line antiviral neuraminidase inhibitors , drug-resistant strains have appeared and brought difficulties to the precaution and treatment of influenza .This article reviews influenza virus structural characteristics , drug-resistance mechanisms , resistance situation and detection methods of drug-resistant virus strains , aiming to provide a reference for future research on influenza virus drug-resistance and clinical medication .