Analysis on the efficacy and safety of fibrinolytic therapy in patients with acute ST-segment elevation myocardial infarction during the COVID-19 epidemic / 中华心血管病杂志

Objective: To evaluate the efficacy and safety of fibrinolysis strategy in patients with acute ST-segment elevation myocardial infarction (STEMI) during the COVID-19 epidemic, and to provide reference value for optimization of fibrinolytic process on the premise of prevention and control of COVID-19 transmission, including self-protection of medical staff. Methods: The efficacy and safety of fibrinolysis were retrospectively analyzed in 7 patients with acute STEM, who hospitalized from February 29, 2020 to April 3, 2020 in the Department of Cardiology, Wuhan Union Hospital of Tongji Medical College, Huazhong University of Science and Technology. To optimize the fibrinolytic process on the premise of prevention and control of COVID-19 transmission, including self-protection of medical staff, a full-time medical team in charge of fibrinolysis under third-grade protection was established. The acute STEMI patients were treated immediately in a fixed and isolated area in emergency department before receiving green channel fibrinolysis. Blood samples for complete blood count, COVID-19 antibody test and nasopharyngeal swab samples for COVID-19 nucleic acid test were made before fibrinolysis, while the chest CT examination was accomplished after fibrinolysis. By comparing differences of time from the first electrocardiogram (ECG) to fibrinolysis before and after the improvement of fibrinolytic process, the effect of optimization of the fibrinolytic process was evaluated. Results: In the present study, seven patients with acute STEMI received fibrinolysis therapy, 6 of them achieved reperfusion and no bleeding was observed in all of the patients. Five out of the 7 patients were hospitalized after fibrinolysis, and the hospitalization days were 19.6 days on average. By following up to April 14, 2020, none of the 7 patients died. The first 2 patients were treated according to the routine medical procedure and the time from the first ECG to fibrinolysis were 201 and 106 minutes, respectively. After the optimization of the fibrinolytic process, the time from the first ECG to fibrinolysis of the last 5 patients were 42, 46, 51, 43 and 54 minutes, respectively，which was significantly shorter than that before optimization. Conclusions: During the COVID-19 epidemic, fibrinolysis in patients with acute STEMI is safe, effective and easy to implement. Therefore, it is recommended as the top priority for the patients with acute STEMI with indications for fibrinolysis. On the premise of prevention and control of COVID-19 transmission, including self-protection of medical staff, the duration of myocardial ischemia can be shortened by optimization of the fibrinolytic process.

Induction of Endoplasmic Reticulum Stress by Cadmium and Its Regulation on Nrf2 Signaling Pathway in Kidneys of Rats / 生物医学与环境科学（英文）

OBJECTIVE@#This study was conducted to investigate the regulation of endoplasmic reticulum stress on Nrf2 signaling pathway in the kidneys of rats.@*METHODS@#Rats were divided into twelve groups of six animals each. Some groups were pre-administered with bacitracin or tauroursodeoxycholic acid (TUDCA), and all of them were treated with 5-20 μmol/kg cadmium (Cd) for 48 h. The oxidative stress levels were analyzed using kits. The mRNA and protein expression levels of endoplasmic reticulum stress-related factors and Nrf2 signaling pathway-related factors were determined using RT-PCR and western blot.@*RESULTS@#Cd exposure resulted in oxidative stress in the kidneys of rats and upregulated the expression of endoplasmic reticulum stress (ERS)-related factors and Nrf2 signaling pathway-related factors, especially at doses of 10 and 20 μmol/kg Cd, and the expression changes were particularly obvious. Moreover, after pretreatment with bacitracin, Cd upregulated the expression of ERS-related factors to a certain extent and, at higher doses, increased the mRNA expression of Nrf2. After pretreatment with TUDCA, Cd reduced the level of ERS to a certain extent; however, at these doses, there were no significant changes in the expression of Nrf2.@*CONCLUSION@#Cadmium can result in ERS and oxidative stress in the kidneys of rats, activate Nrf2, and upregulate the transcriptional expression of phase II detoxification enzymes under these experimental conditions. ERS has a positive regulation effect on Nrf2 signaling pathway but has little effect on the negative regulation of Nrf2 signaling pathway in cadmium toxicity.

Dosimetric comparison of static intensity-modulated radiation therapy and volumetric modulated arc therapy in lymphoma patients received mediastinal radiation / 国际肿瘤学杂志

Objective To compare target dosimetric distribution and normal tissue radiation between different static intensity-modulated radiation therapy (IMRT)plans and volumetric modulated arc therapy (VMAT),and to identify the best IMRT plan for lymphoma patients needed mediastinal radiation. Methods A total of 11 patients with lymphoma who received first course radiotherapy in the mediastinal region after che-motherapy in Cancer Hospital & Shenzhen Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College from March 2017 to January 2019 were included in the study. There were 8 males and 3 fe-males,2 patients were in Ann Arbor stage Ⅰ-Ⅱ,and 9 cases in Ⅲ-Ⅳ stage. There were 6 patients with Hodgkin lymphoma (HL)and 5 patients with non-Hodgkin lymphoma (NHL). Patients with HL and NHL were given prescript doses of 36 Gy and 50 Gy,respectively. Three plans were designed for each patient:static 5F-IMRT,7F-IMRT and VMAT plan. The target dosimetric distribution,normal tissue radiation dose,and effi-ciency of each plan were evaluated. Results The mean conformity index (CI)and homogeneity index (HI) values of plan target volume (PTV)in 5F-IMRT,7F-IMRT,VMAT plan were 0. 64 ± 0. 06,0. 67 ± 0. 05, 0. 76 ± 0. 04 (F = 17. 045,P < 0. 001)and 1. 07 ± 0. 01,1. 07 ± 0. 01,1. 09 ± 0. 01 (F = 9. 258,P =0. 001),respectively. VMAT showed significantly better CI than two static IMRT plans (both P < 0. 001),but worse HI (both P < 0. 001). The lungs low dose irradiation volume (V (V 5 )and high dose irradiation volume 30 )in 5F-IMRT,7F-IMRT,VMAT plan were (43. 98 ± 7. 77)％,(42. 71 ± 4. 98)％,(55. 92 ± 8. 16)％(F = 8. 281,P = 0. 001)and (8. 19 ± 2. 97)％,(8. 25 ± 2. 87)％,(7. 53 ± 3. 16)％ (F = 0. 140,P =0. 870),respectively. The volume of low dose irradiation in lungs of VMAT plan was significantly higher than 5F-IMRT and 7F-IMRT plans (both P < 0. 001),while high dose volume was no significant difference. The left and right breast low dose irradiation volume (V 4 )in 5F-IMRT,7F-IMRT and VMAT plan were (24. 29 ± 8. 14)％,(23. 87 ± 7. 70)％,(80. 17 ± 22. 92)％ (F = 14. 505,P = 0. 005)and (22. 12 ± 13. 28)％, (21. 13 ± 13. 01)％,(81. 77 ± 20. 76)％ (F = 13. 938,P = 0. 006),respectively. VMAT showed signifi-cantly higher breast low dose irradiation volume than static IMRT plan (both P < 0. 05). The number of monitor units and treatment time in 5F-IMRT,7F-IMRT,VMAT plan were (1622 ± 281)MU,(1729 ± 286)MU, (411 ± 75)MU (F = 105. 277,P < 0. 001)and (6. 79 ± 0. 93)min,(7. 42 ± 0. 95)min,(4. 98 ± 0. 00)min (F = 29. 545,P < 0. 001),respectively. VMAT showed significantly less monitor units than static IMRT (both P < 0. 001)and shorter treatment time (both P < 0. 001). Conclusion For lymphoma patients who have the indication of mediastinal radiotherapy,VMAT is highly efficient and has no definite dose advan-tage,the static 5F-IMRT or 7F-IMRT plan has good conformal and uniform target area,and some organs at risk exposure is even lower.

Effect of DNA single strand breaks and 8-OHd G production on cadmium-induced toxicity on human embryonic kidney epithelial cells / 中国职业医学

OBJECTIVE: To explore the effects of cadmium chloride( CdCl_2) on DNA single strand breaks and the production of 8-hydroxy-2'-deoxyguanosine( 8-OHdG) in human embryonic kidney epithelial cells( HEK cells). METHODS: HEK cells in logarithm growth phase were divided into 5 groups and incubated with the different concentrations of CdCl_2( 0. 0,2. 5,5. 0,10. 0 and 20. 0 μmol/L) for 24,48 and 72 hours in vitro. After harvesting the cells,DNA single strand breaks was tested by single cell gel electrophoresis,and the level of 8-OHdG was measured using the enzyme linked immunosorbent assay. RESULTS: The Olive tail moment was statistically significant in the main effect of CdCl_2 exposed HEK cells( P < 0. 01). Among them,when HEK cells were exposed to 5. 0 μmol / L of CdCl_2,the Olive tail moment began to have a statistical significant increasing trend compared with the 0. 0 μmol / L group( P < 0. 05); when CdCl_2 concentration was 2. 5-10. 0 μmol / L,the Olive tail moment lengthened with the increasing dose of cadmium exposure,showing a doseeffect relationship( P < 0. 05). The tail DNA% was statistically significant in the interaction between exposure treatment and exposure time in HEK cells( P < 0. 01). Among them,when CdCl_2 concentration was at 2. 5-10. 0 μmol / L at 24 hours time point and 5. 0-20. 0 μmol / L at 48 hours time point,the tail DNA% raised with the increasing dose of cadmium exposure,showing a dose-effect relationship( P < 0. 05). The tail DNA% at 3 time points of 24,48 and 72 hours after exposure to 20. 0 μmol / L of CdCl_2 in HEK cells increased with the increasing time of cadmium exposure,showing a timeeffect relationship( P < 0. 05). The level of 8-OHdG had statistical significance in the main effect of CdCl_2 exposure treatment in HEK cells( P < 0. 05). Among them,the level of 8-OHdG was first significantly increased only after exposure to 10. 0 μmol / L CdCl_2 compared with the 0. 0 μmol / L group( P < 0. 05). After treatment with Ca Cl2,there was no doseeffect relationship and time-effect relationship found between the cadmium chloride exposure and tail length as well as the tail / head length ratio and 8-OHdG level. CONCLUSION: To a certain extent,CdCl_2 exposure may cause both DNA single strand breaks and 8-OHdG production in HEK cells. Compared with 8-OHdG,the DNA single strand breaks show more significant change with a lower dose of cadmium treatment,which may be related to its higher sensitivity to cadmium toxicity than 8-OHdG.

Comparison of indirect immunofluorescence assay and ELISA for detecting antinuclear antibodies and anti-double-stranded DNA antibodies / 南方医科大学学报

<p><b>OBJECTIVE</b>To compare indirect immunofluorescence assay (IIFA) and enzyme-linked immunosorbent assay (ELISA) for detecting antinuclear antibodies (ANA) and anti-double-stranded DNA antibodies (anti-dsDNA).</p><p><b>METHODS</b>A total of 125 serum samples were obtained from patients with established or suspected autoimmune disease, and 82 samples were used for ANA detection and 57 for anti-dsDNA detection using both IIFA and ELISA. Fourteen samples were examined for both ANA and anti-dsDNA. In cases where discrepancy occurred in the results by the two methods, extractable nuclear antigens were detected using immunoblotting.</p><p><b>RESULTS</b>The positivity rate of ANA detected by IIFA and ELISA was significantly different (87.8% and 73.17%, respectively, P<0.01), but the positivity rate of anti-dsDNA was similar between IIFA and ELISA (77.19% and 71.93%, respectively, P>0.05). The percent agreement between the two testing methods with different cutoff values of ANA and anti-dsDNA showed significant differences (P<0.01), and for some uncommon patterns, the percent agreement of the two methods was lowered in ANA detection but remained unchanged for anti-dsDNA with different ANA patterns. High percent agreements of the two methods were obtained with the cutoff ANA titer of 1:100 and the cutoff anti-dsDNA value of weak positivity, but they demonstrated a significant difference in testing low-titer ANA and anti-dsDNA.</p><p><b>CONCLUSION</b>IIFA is more sensitive than ELISA in detecting the total ANA and anti-dsDNA. ELISA prescreening combined with IIFA can obtain the information of the nuclear pattern and allow the observation of the titer alterations. The combination of two or more testing methods can greatly enhance the accuracy of the results.</p>

Cyto-genotoxicity induced by cigarette smoke condensates in human peripheral blood lymphocytes in vitro / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To investigate the cyto-genotoxicity of cigarette smoke condensates (CSCs) in human peripheral blood lymphocytes with different assays in vitro.</p><p><b>METHODS</b>Human lymphocytes were exposed to particle matter of cigarette smoke combined with or without S9 mixtures at doses of 25, 50, 75, 100 and 125 microg/ml for 3 h. The cytotoxicity induced by CSCs was detected by CCK-8 assay. The DNA damage, DNA repair (repair time: 30, 60, 90, 120 and 240 min, respectively) and the somatic cell mutations induced by 75 microg/ml CSCs were measured by comet assay, hprt gene and TCR gene mutation tests, respectively.</p><p><b>RESULTS</b>CCK-8 assay indicated that the cell viability decreased with CSCs doses. At the doses of 100, 125 microg/ml, the cell viability of CSCs +S9 group was significantly higher than that of CSCs -S9 group (P < 0.05, P < 0.01). In comet assay, DNA damage significantly increased in a dose-dependent manner, as compared with controls (P < 0.01). Moreover, there was significant difference between -S9 group and +S9 group (P < 0.05, P < 0.01). The Mf-TCR at each dose group was significantly higher than that of controls (P < 0.05, P < 0.01). The Mf-hprt at high-dose groups were significantly higher than that of controls (P < 0.01), and significant difference of Mf-TCR and Mf-hprt at high doses of CSCs between -S9 group and +S9 group (P < 0.05, P < 0.01). The DNA damage induced by CSCs +S9 or CSCs -S9 could be repaired, but DNA repair speed was different between -S9 group and +S9 group (P < 0.05, P < 0.01).</p><p><b>CONCLUSION</b>CSCs may induce cyto-genotoxicity in human peripheral blood lymphocytes in vitro, but S9 mix could reduce the toxicity of CSCs and impact DNA repair speed.</p>

Response of lymphocytes to radiation in untreated breast cancer patients as detected with three different genetic assays / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To detect the response of lymphocytes to radiation in untreated breast cancer patients with three different genetic assays.</p><p><b>METHODS</b>Blood samples were collected from 25 untreated patients and 25 controls. Each blood sample was divided into two parts: one was irradiated by 3-Gy X-ray (irradiated sample), the other was not irradiated (non-irradiated sample). The radiosensitivity of lymphocytes was assessed by comet assay, cytokinesis-block micronucleus (CBMN) assay and 6-TG-resistant cells scored (TG) assay.</p><p><b>RESULTS</b>The baseline values of micronucleated cell frequency (MCF) and micronucleus frequency (MNF) in the patients were significantly higher than those in the controls (P < 0.01), and 3-Gy X-ray induced genetic damage to lymphocytes in the patients increased significantly as compared with that in the controls as detected with the three genetic assays (P < 0.01). The proportion of radiosensitive cases in the patient group was 48% for the mean tail length (MTL), 40% for the mean tail moment (MTM), 40% for MCF, 44% for MNF, and 48% for mutation frequencies of the hprt gene (Mfs-hprt), respectively, whereas the proportion of radiosensitive cases in the control group was only 8% for all the parameters.</p><p><b>CONCLUSION</b>The difference in the lymphocyte radiosensitivity between the breast cancer patients and the controls is significant. Moreover, there are wide individual variations in lymphocyte radiosensitivity of patients with breast cancer. In some cases, the radiosensitivity of the same patient may be different as detected with the different assays. It is suggested that multiple assays should be used to assess the radiosensitivity of patients with breast cancer before therapy.</p>

Mutagenic, carcinogenic and teratogenic effects induced by radiofrequency electromagnetic field of mobile phone / 浙江大学学报·医学版

The extensive use of mobile phones causes increasing public concern on health effects of exposure to radiofrequency (RF) electromagnetic fields. Conflicting results are found in publications on the mutagenic, carcinogenic and teratogenic effects of RF electromagnetic fields. The overwhelming findings do not support the assumption that RF exposure may induce mutagenic, carcinogenic or teratogenic effects. However, health effects from low level RF exposure need to be further studied.

Early treatment for the unstable fracture of the thoracolumbar / 中国骨伤

<p><b>OBJECTIVE</b>To research the efficacy and feasibility for unstable fracture of thoracolumbar with AF spine internal fixation device.</p><p><b>METHODS</b>Thirty-two patients with unstable fractures of T11-L3 were treated with AF spine internal fixation device and autograft between vertebral lamina vertebral body transverse process from January 2002 to June 2006. There were 21 female and 11 male, aging from 58 to 72 years with a mean of 62 years. All these patients were examined with x-ray and CT preoperative and postoperative respectively. They were followed-up thirteen months averagely, observing the stability of spinal column, bone grafting fusion, the height of vertebra and recovery of anterior bone fragment herniation.</p><p><b>RESULTS</b>All these AF spine internal fixation devices treated for the unstable fractures of thoracolumbar had not removed because of internal fixation failure or pain. Fracture healing and grafting fusion appeared after operation three months averagely. X-rays revealed post-protrusion angle were recovered from 22 degrees to 8.5 degrees, the heights of anterior were recovered from 50% to 86%, the angle of posterior were recovered from 94% to 98%. The postoperative CT scan showed that six cases with herniation to canal gained a completely recoveries.</p><p><b>CONCLUSION</b>AF spine internal fixation device used in early stage for unstable fracture of thoracolumbar is a simple and effective method. It has advantages such as providing early substantial fixation, maintaining a well three column stability. Bone grafting is a key factor in this operative technique.</p>

A novel autoantibody in patients with primary hypertension: antibody against L-type Ca2+ channel / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Recently, it has been proposed that the autoantibodies against various cardiovascular receptors play a role in the pathogenesis of primary hypertension. In this study, we aimed to identify whether or not there are autoantibodies against cardiovascular L-type Ca2+ channels in patients with primary hypertension.</p><p><b>METHODS</b>A peptide corresponding to the sequence 2-16 of the alpha1c-subunit of L-type Ca2+ channel was used as an antigen to screen the autoantibodies from 90 patients with primary hypertension and 45 healthy controls by an enzyme-linked immunosorbent assay (ELISA). The clinical data of 90 hypertensive patients were compared between patients with and without these autoantibodies.</p><p><b>RESULTS</b>Serum from 3 (6.7%) of the 45 healthy controls, 33 (36.7%) of 90 hypertensives showed positive responses in ELISA (P < 0.01). The prevalence of such autoantibodies in two subgroups of hypertensives with coronary heart disease (9/21, 57.14%, P < 0.05) and left ventricular diastolic dysfunction (28/63, 44.4%, P < 0.05) was higher than in those without the corresponding complications. And the patients with such autoantibodies had lower E/A than patients without such autoantibodies (0.803 +/- 0.191 vs. 1.004 +/- 0.322, P = 0.002).</p><p><b>CONCLUSION</b>There are autoantibodies against vascular L-type Ca2+ channels in patients with primary hypertension.</p>

Genetic effects of workers occupationally exposed to mercury using three genetic end-points / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To investigating genetic effects of workers occupationally exposed to mercury (Hg).</p><p><b>METHODS</b>The peripheral lymphocytes from 20 workers exposed to mercury and 20 controls were measured with micronucleus test, comet assay, hrpt gene mutation test and TCR gene mutation test.</p><p><b>RESULTS</b>The mean micronuclei rate(MNR) and mean micronucleated cells rate(MCR) in 20 workers were (5.90 +/- 0.91) per thousand and (5.30 +/- 0.81) per thousand, respectively while MNR and MCR in controls were (1.50 +/- 0.47) per thousand and (1.30 +/- 0.31) per thousand respectively, The difference of MNR and MCR between workers and controls was very significant (P < 0.01). The mean tail length (MTL) of workers and controls were (3.16 +/- 0.31) and (0.99 +/- 0.07) microm, respectively. The mean tail moment (MTM) of workers and controls were 1.63 +/- 0.22 and 0.39 +/- 0.03, respectively, There was a significant difference in MTL and MTM between workers and controls(P < 0.01). When the average mutation frequencies (Mfs-hprt) of hprt and (Mfs-TCR) of TCR of workers were compared with those of controls, there were not significant difference (P > 0.05).</p><p><b>CONCLUSION</b>The results of the investigation indicated that the adverse genetic effects in workers occupationally exposed to mercury could be detected.</p>

Effect of tumor necrosis factor-it on the expression of ATP binding cassette transporter A1 in THP-1 macrophage foam ceils / 中华老年医学杂志

Objective To investigate the influence of tumor necrosis factor-?(TNF-?) on ATP binding cassette transporter A1(ABCA1)in THP-1 macrophage foam cells, and the intervention effect of nuclear factor-?B(NF-?B) inhibitor TPCK on the TNF-?, so as to determine the role of TNF-?/ NF-?B in cellular cholesterol efflux. Methods Foam cells were transformed from THP1 cells. The correlation of cellular cholesterol efflux from foam cells with different concentrations and time stimulated by TNF-? were estimated. Subsequently foam cells were treated with TNF-? at satulated concentration(10.0 ng/ml ), TPCK(10?mol/L),or TPCK(10?mol/L) pretreated for 60 min before TNF-? stimulation. ABCA1 gene expression was analyzed by RT-PCR. ABCA1 protein level was detected by Western blot. Results TNF-? decreased cellular cholesterol efflux of foam cells in concentration-and time-dependent manner. 10 ng/ml of TNF-? down-regulated the levels of both ABCA1 mRNA and protein expressions in time-dependent manner. TPCK was observed to efficiently block the suppressive effect of TNF-? on ABCA1. Conclusions TNF-? decreases cellular cholesterol efflux mainly through the down-regulation of ABCA1. TPCK, an inhibitor of NF-?B activation, is observed to partly block the suppressive effect of TNF-? on ABCA1, suggesting a mechanism involving NF-?B signal transduction. TNF-?/NF-?B might play a critical role in the progression of atherosclerosis by decreasing cellular cholesterol efflux from foam cells.