Valor Prognóstico dos Níveis Plasmáticos de NT-proBNP em Pacientes Hospitalizados com Mais de 80 Anos de Idade em um Hospital em Pequim, China / Prognostic Value of Plasma NT-proBNP levels in Hospitalized Patients Older than 80 Years of Age in a Hospital in Beijing, China

Resumo Fundamento Apesar das evidências crescentes de que o peptídeo natriurético N-terminal pró-cérebro (NT-proBNP) tem um valor prognóstico importante em adultos mais velhos, há dados limitados sobre seu valor preditivo prognóstico. Objetivos O objetivo deste estudo é avaliar o significado clínico do NT-proBNP em pacientes hospitalizados com mais de 80 anos de idade em Pequim, China. Métodos Este estudo prospectivo e observacional foi conduzido em 724 pacientes muito idosos em uma enfermaria geriátrica (idade ≥80 anos, variação, 80-100 anos, média, 86,6±3,0 anos). A análise de regressão linear multivariada foi utilizada para rastrear os fatores independentemente associados ao NT-proBNP, e o modelo de regressão de risco proporcional de Cox foi utilizado para rastrear as associações entre os níveis de NT-proBNP e os principais endpoints . Os principais endpoints avaliados foram mortes por todas as causas e ECAM. Valores de p <0,05 foram considerados estatisticamente significativos. Resultados As taxas de prevalência de doença cardíaca coronariana, hipertensão e diabetes mellitus foram 81,4%, 75,1% e 41,2%, respectivamente. O nível médio de NT-proBNP foi 770±818 pg/mL. Utilizando análises de regressão linear multivariada, foram encontradas correlações entre o NT-proBNP plasmático e índice de massa corporal, fibrilação atrial, taxa de filtração glomerular estimada, diâmetro do átrio esquerdo, fração de ejeção do ventrículo esquerdo, uso de betabloqueador, níveis de hemoglobina, albumina plasmática, triglicérides, creatinina sérica, e nitrogênio uréico no sangue. O risco de morte por todas as causas (HR, 1,63; IC 95%, 1,005-2,642; p = 0,04) e eventos cardiovasculares adversos maiores (ECAM; HR, 1,77; IC 95%, 1,289-3,531; p = 0,04) no grupo com o nível mais alto NT-proBNP foi significativamente maior do que no grupo com NT-proBNP mais baixo, de acordo com os modelos de regressão de Cox após o ajuste para vários fatores. Como esperado, os parâmetros da ecocardiografia ajustaram o valor prognóstico do NT-proBNP no modelo. Conclusões O NT-proBNP foi identificado como um preditor independente de morte por todas as causas e ECAM em pacientes hospitalizados com mais de 80 anos de idade.

Abstract Background Despite growing evidence that N-terminal pro-brain natriuretic peptide (NT-proBNP) has an important prognostic value in older adults, there is limited data on its prognostic predictive value. Objectives The aim of this study is to evaluate the clinical significance of NT-proBNP in hospitalized patients older than 80 years of age in Beijing, China. Methods This prospective, observational study was conducted in 724 very elderly patients in a geriatric ward (age ≥80 years, range, 80100 years, mean, 86.6 3.0 years). Multivariate linear regression analysis was used to screen for factors independently associated with NT-proBNP, and the Cox proportional hazard regression model was used to screen for relationships between NT-proBNP levels and major endpoints. The major endpoints assessed were all-cause death and MACEs. P values < 0.05 were considered statistically significant. Results The prevalence rates of coronary heart disease, hypertension, and diabetes mellitus were 81.4%, 75.1%, and 41.2%, respectively. The mean NT-proBNP level was 770 ± 818 pg/mL. Using multivariate linear regression analyses, correlations were found between plasma NT-proBNP and body mass index, atrial fibrillation, estimated glomerular filtration rate, left atrial diameter, left ventricular ejection fraction, use of betablocker, levels of hemoglobin, plasma albumin, triglycerides, serum creatinine, and blood urea nitrogen. The risk of all-cause death (HR, 1.63; 95% CI, 1.0052.642; P = 0.04) and major adverse cardiovascular events (MACE; HR, 1.77; 95% CI, 1.2893.531; P = 0.04) in the group with the highest NT-proBNP level was significantly higher than that in the group with the lowest level, according to Cox regression models after adjusting for multiple factors. As expected, echocardiography parameters adjusted the prognostic value of NT-proBNP in the model. Conclusions NT-proBNP was identified as an independent predictor of all-cause death and MACE in hospitalized patients older than 80 years of age.

Progress in the application of metal and metal oxide nanoparticles in the antibacterial modification of dental materials / 口腔疾病防治

@#The colonization of microorganisms planted on the surface of teeth and restoration materials is the main cause of oral disease and treatment failure. How to improve the antibacterial properties of dental materials is a hot topic in dentistry. Nano-sized antibacterial materials have attracted much attention. Among them, metal and metal oxide nanoparticles are prominent due to their strong and broad-spectrum antibacterial activity. Thus, in recent years, many studies have used metal and metal oxide nanoparticles to develop antimicrobial dental materials for resin restoration, root canal therapy, orthodontic treatment, and implant surface and removable denture repair and have found that the antibacterial properties of nano-sized materials are significantly enhanced. However, the mechanical properties and esthetic properties of the modified materials are affected, so it is still necessary to explore appropriate modification methods. In addition, most of the experiments are carried out in vitro, which cannot accurately simulate the oral environment. Therefore, the antibacterial effect, cytotoxicity and immune response of these materials in vivo still need further research and exploration. This paper reviewed the potential antibacterial mechanisms and the safety of those nanoparticles and their applications in dentistry.

Association between childhood neglect and the autonomic nerves disorder in students of sixth graders / 中国学校卫生

Objective@#To explore prevalence of childhood neglect and autonomic nervous function, and its association in sixth graders students in Harbin, and to provide clues to improve physical and mental health of children and adolescents.@*Methods@#Cluster sampling method was used to select 1 259 students from grade 6 in 5 schools in two districts of Harbin, and Childhood Trauma Questionnaire-Short Form (CTQ-SF) and TOHO University Medical Index (TMI) were filled in.@*Results@#The total rate of childhood neglect was 45.7%, of which the rate of emotional neglect and physical neglect were 18.8%, 40.8%. The rate of autonomic nerves disorder was 47.2%. The rate of autonomic nerves disorder in students suffered from neglect, emotional neglect, physical neglect are higher than those without any of neglect(χ2=50.52, 32.02, 43.61, P<0.01), and with the increase of the degree of neglect, the rate of autonomic nervous disorder were gradually increasing(χ2=47.99, 47.07, 49.24, P<0.01). After controlled for gender, neglect, emotional neglect, physical neglect were positively associated with autonomic nerves disorder(OR=1.53-2.34, P<0.05), and the odd ratio for autonomic nerves disorder among those with mild-to-moderate,moderate-to-severe and extremely servere neglect was 1.37, 1.83, 5.10 compared to those with none or mild neglect.@*Conclusion@#Childhood neglect is closely related to adolescent the autonomic nerves disorder in sixth graders students in Harbin. Moreover, the more serious the childhood neglect is, the higher the detection rate of autonomic nerves disorder is. In order to improve the physical and mental health of children and adolescents, it is necessary to pay attention to childhood neglect and early assessment of their autonomic function.

Application of a modified M-shaped flap in defect repair after resection of lower lip cancer / 口腔疾病防治

Objective@# To observe the clinical effect of the modified M-shaped flap for repairing defects following resection of lower lip cancer and to provide a reference for clinical application.@*Methods @#Fourteen cases using modified M-shaped flaps to repair lower lip cancer surgery defects were retrospectively analyzed. The postoperative follow-up patients’ flap survival, mouth opening, denture use, bilateral mouth angle symmetry, recurrence and survival were analyzed.@*Results @#Fourteen patients with lower lip cancer underwent reconstruction immediately after surgery, and the defect range after tumor resection was 30% to 50% of the lower lip. The continuity of the orbicularis oculi muscle is reconstructed by modified M-shaped flap to transfer bilateral residual lip tissue. The blood supply to the flap is stable. All patients’ flaps survived completely without complications, such as hemorrhage, infection or flap necrosis, and their lip movement and sensation recovered well. There were no obvious obstacles in opening and closing or pronunciation and dietary function, and the mean maximum opening was (3.06 ± 0.23) cm. Three patients used active dentures, which could be removed normally. All patients’mouths were preserved. Approximately 85.7% of patients (12/14) had bilateral symmetry of the bilateral mouth, the flaps matched the facial color, and the lower lip was naturally beautiful, as the scar was not obvious. After 6 months to 4 years of follow-up (mean 2 years and 6 months), no recurrence or death occurred.@*Conclusion @#The modified M-shaped valve design is simple and easy to operate. This method can be applied to 30% to 50% defect reconstructions of the lower lip to retain the corner of the mouth.

Over-expression of miR-204 suppresses proliferation and invasion of retinoblastoma cells and its possible mechanism / 中国肿瘤生物治疗杂志

@# Objective: To observe the effects of miR-204 on the proliferation and invasion of retinoblastoma (RB) cells and to explore the potential regulatory mechanism. Methods: The expression level of miR-204 in RB cell lines (Y79, SO-RB50, and HXO-Rb44) as well as in normal human retinal pigment epithelial cell line hTERT RPE-1 was detected using qRT-PCR. The Y79 cells were divided into two groups (negative control group and miR-204 group) by respectively transfecting Y79 cells with NC-mimics and miR-204 mimics using liposome transfection method. The effects of miR-204 on Y79 cell proliferation was detected with CCK-8 assay; while the effect of miR-204 on migration and invasion of Y79cellsweredeterminedbycellscratchassayandTranswellassay,respectively.Besides, thepotentialtargetgeneofmiR-204waspredictedbybioinformatics;and the influence of miR-204 on the expression of high mobility group AT-hook 2 gene (HMGA2) at both mRNA and protein levels was detected using qRT-PCR and Western blotting, respectively. Results: miR-204 expression in RB cell lines Y79, SO-RB50 and HXO-Rb44 was remarkably lower than that in normal human retinal pigment epithelial cell line hTERT RPE-1 (P<0.01). miR-204 expression in Y79 cells was markedly up-regulated after transfection with miR-204 mimics (P<0.01) along with significantly reduced cell proliferation, migration and invasion capacities (all P<0.01), and mRNA and protein expressions of HMGA2 were also outstandingly reduced (P<0.01). Conclusion: miR-204 is lowly expressed in RB cell lines; in addition, miR-204 over-expression can suppress RB cell proliferation, migration and invasion, the mechanism of which might be related to down-regulation of the expression of HMGA2.

Relationship between cytoplasmic phospholipase A2 and nuclear factor κB in one lung ventilation-induced lung injury in rabbits / 南方医科大学学报

<p><b>OBJECTIVE</b>To elucidate the mechanisms of up regulated expression of cytoplasmic phospholipase A2 (CPLA2) induced by one lung ventilation (OLV) by investigating the interactions between nuclear factor kappaB (NF-κB) and C-PLA2.</p><p><b>METHODS</b>Forty-eight healthy Japanese white rabbits were randomized into control group, solvent treatment group (group S), NF-κB inhibitor (PDTC)/solvent treatment group ( group PS), C-PLA2 inhibitor (AACOCF3)/solvent treatment group (group AS), OLV group (group O), solvent treatment plus OLV group (SO group), NFκB inhibitor (PDTC)/solvent treatment plus OLV group (group PSO) and CPLA2 inhibitor (AACOCF3)/solvent treatment plus OLV group (group ASO). ELISA was used to detect arachidonic acid (AA) content in the lung tissues, and NFκB and CPLA2 expressions were detected by Western blotting and quantitative PCR. Lung injuries were assessed based on the lung histological score, and the polymorphonuclear leukocyte count in the bronchial alveolar lavage fluid, myeloperoxidase (MPO) content in the lung tissues, and lung wet/dry weight (W/D) raito were determined.</p><p><b>RESULTS</b>Treatment of the rabbits with the solvent did not produce any adverse effects. OLV caused obvious lung injury in the rabbits and up regulated the expressions of CPLA2 and NFκB in the lung tissues (P<0.05). In rabbits without OLV, treatment with AACOCF3 or PDTC significantly down regulated both CPLA2 and NFκB expressions without affecting the other parameters. In rabbits with OLV, treatment with AACOCF3 or PDTC obviously lowered CPLA2 and NFκB expressions and lessened the OLV-induced lung injuries.</p><p><b>CONCLUSION</b>Both C-PLA2 and NF-κB play important roles and show interactions in OLV-induced lung injury in rabbits.</p>

Pathogenic role of leukotriene B4 in pulmonary microvascular endothelial cell hyper- permeability induced by one lung ventilation in rabbits / 南方医科大学学报

<p><b>OBJECTIVE</b>To elucidate the pathogenic role of leukotriene B4 (LTB4) in increased pulmonary microvascular endothelial cell permeability induced by one lung ventilation (OLV) in rabbits.</p><p><b>METHODS</b>Forty-eight healthy Japanese white rabbits were randomly divided into control group (group C), saline pretreatment group (group S), bestatin (a leukotriene A4 hydrolase (LTA4H) inhibitor) plus saline pretreatment group (group B), OLV group (group O), saline pretreatment plus OLV group (group SO) and bestatin plus saline pretreatment with OLV group (group BO). ELISA was used to detect LTB4 content in the lung tissues, and LTA4H and phospholipase Cεl (PLCEl) expressions were examined by Western blotting and quantitative PCR. The wet/dry weight (W/D) ratio of the lung, lung permeability index and the expressions of myosin light chain kinase (MLCK) protein and mRNA in the lung tissues were determined to evaluate the permeability of the pulmonary microvascular endothelial cells (PMVECs). The severities of lung injury were evaluated by lung histomorphological scores.</p><p><b>RESULTS</b>No significant differences were found among groups C, S and B except that LTA4H expressions was significantly lower in group B than in groups C and S (P<0.05). OLV significantly increased the expressions of LTA4H (P<0.05) and resulted in LTB4 overproduction in the lungs (P<0.05) accompanied by significantly enhanced PLCE1 expression and PMVEC permeability (P<0.05). Pretreatment with bestatin, significantly reduced the expression of LTA4H and LTB4 production (P<0.05) and down-regulated the expression of PLCE1 in the lungs of the rabbits receiving OLV (P<0.05).</p><p><b>CONCLUSION</b>Bestatin plays a protective role in OLV-induced rabbit lung injury by downregulating LTA4H to reduce the production of LTB4 in the lungs. LTB4 can increase PMVEC permeability by up-regulating PLCE1 expression in rabbits with OLV-induced lung injury.</p>

Analysis of factors influencing serum lipids of patients with chronic hepatitis B infection / 第二军医大学学报

Objective: To evaluate the different factors on serum lipids in chronic hepatitis B patients by multiple linear regression analysis. Methods: The liver function parameters, the renal function parameters and the serum glucose of 323 cases with viral B hepatitis and 39 healthy persons (as control group) were measured by automatic biochemical analyzer, the load of hepatitis B virus were measured by quantitative PCR analyzer and the plasma prothrombin activity (PTA) were detected with automatic coagulometer. Results: The serum lipids level were decreased with the deterioration of liver function in chronic hepatitis B patients, and there are statistical significant differences between the groups. It can be found that the serum lipids level of chronic hepatitis B patients were mostly affected by the plasma prothrombin activity and liver function, but the parameters of age; gender; serum glucose; hepatitis B viral load; renal function have minor or no effect on the serum lipids level of chronic hepatitis B patients by the analysis of multiple linear regression. And it can also be observed that In the many indicators, CHOL, TG mainly affected by the PTA, and HDL, LDL mainly affected by the ALB. Conclusion: It can be found that the serum lipids in chronic hepatitis B patients are mostly affected by the liver function by multiple linear regression analysis. And It has an important clinical value in judgment of patient's condition and estimatement of patient's prognosis by detect lipid levels in chronic hepatitis B patients.

The correlation of carotid plaque pathohistologic features and neurological symptoms: A meta-analysis of observational studies.

OBJECTIVE: To investigate the association between the pathological features of carotid plaque and ipsilateral symptoms of cerebral ischemia. MATERIALS AND METHODS: We sought to identify clinical observational studies comparing the incidence of pathological features between symptomatic and asymptomatic carotid plaques in terms of ulceration, thrombosis and intraplaque hemorrhage (IPH), published between 1996 and 2006. A search on, PubMed was supplemented by a review of bibliographies of relevant articles and lists of references in it. Odds ratios (OR) for the presence of each feature as a role in the pathogenesis of neurological events were calculated and combined by a meta-analysis. RESULTS: We integrated 16 clinical studies totaling 2839 plaques harvested at endarterectomy procedures. The reported incidence for each feature was highly variable. The methods in defining ulceration, thrombosis and IPH were very heterogeneous. The time intervals between the latest onset of ischemic symptoms and pathological examinations varied greatly. Overall, the incidence of ulcerated plaques in the symptomatic group were significantly higher than that in the asymptomatic group (study number, n=10; OR, 2.32; 95% CI, 1.90-2.83. A random-effect model was performed among studies regarding surface thrombosis because an apparent trend for heterogeneity was observed (n=6; OR, 1.57; 95% CI, 0.68-3.64). There was no difference with respect to IPH between the two groups (n=11; OR, 1.09; 95% CI, 0.91-1.32). CONCLUSIONS: Ulcerated carotid plaque is significantly correlated with the production of neurological events, whereas thrombosis fails to correlate with ischemic symptoms because of the presence of substantial heterogeneity. The association between IPH and clinical presentations is less clear.

TNF-alpha induced reversal of multidrug resistance in human hepatocellular carcinoma cells / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the reversal of multidrug resistance in the cell line HepG2/ADM induced by TNF-alpha.</p><p><b>METHODS</b>HepG2/ADM cells were incubated with different concentrations of TNF-alpha (100, 500 and 2500 U/ml) for 72 h. Real-time PCR was performed to compare the mRNA levels of MDR1 with PPAR-alpha in the different concentrations of TNF-alpha treated cells. The Annexin V assay was used to check cell apoptosis induced by 0.5 mg/L adriamycin. Rhodamine 123 efflux assay and MTT assay were used to study P-gp activity and drug resistance in each group, respectively.</p><p><b>RESULTS</b>TNF-alpha could induce down-regulation of MDR1 and up-regulation of PPAR-alpha. Meanwhile, it could enhance cell cytotoxicity and cell apoptosis induced by 0.5 mg/L adriamycin.</p><p><b>CONCLUSIONS</b>TNF-alpha could partially reverse the multidrug resistance of HepG2/ADM cells by down-regulating the expression of MDR1 and up-regulating the expression of PPAR-alpha.</p>

Expressions of ATP binding cassette transporter genes in rat hepatic oval cells / 中华肝脏病杂志

<p><b>OBJECTIVE</b>Liver regeneration occurs through hepatocytes after acute liver injury. However, severe liver injury activates bipotential oval cells from canals of Hering which can differentiate into hepatocytes and biliary epithelial cells. Most models of oval cell activation have employed potential carcinogens to inhibit hepatocyte replication in the face of a regenerative stimulus. Oval cells must be able to withstand the toxic milieu of the damaged liver. ATP binding cassette transporters are cytoprotective efflux pumps that may contribute to the protection of these cells. The aim of this study was to determine the ABC transporter expressions in hepatic oval cells.</p><p><b>METHODS</b>A rat model was established by feeding 2-acetylaminofluorene combined with partial hepatectomy to activate hepatic oval cells. Oval cells were isolated and purified using selective enzymatic digestion and density gradient centrifugation from the heterogeneous hepatic cell population. The expressions of ABC transporter gene, including MDR1, MRP1 and Bcrp1, in isolated hepatic oval cells and hepatocytes were measured by quantitative real-time reverse transcription-polymerase chain reaction and those in rat liver tissues were measured by immunohistochemistry.</p><p><b>RESULTS</b>Compared to those in the rat hepatocytes, mRNA expressions of the genes encoding MDR1, MRP1 and Bcrp1 were increased up to 9-, 1.5- and 13.8-folds in hepatic oval cells. Immunohistochemical staining of rat liver slides demonstrated that the expression of MDR1 proteins was found around periportal areas, and Bcrp1 protein was found located on cell membranes.</p><p><b>CONCLUSION</b>Hepatic oval cells express high levels of the ABC transporter gene that may have cytoprotective functions during severe hepatotoxicity.</p>

Expression of Twist gene in human hepatocellular carcinoma and its clinicopathological significance / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the expression and clinicopathological significance of transcription factor Twist in hepatocellular carcinoma (HCC), paraneoplastic and cirrhotic tissues.</p><p><b>METHOD</b>Immunohistochemistry was used to detect the expression of the Twist protein in 26 cases of HCC and paraneoplastic tissue and 10 cases of cirrhotic tissue. Meanwhile, the Twist mRNA and its protein were detected in 10 HCC tissues and 10 paraneoplastic tissues by RT-PCR and Western blot. And the expression differences and clinicopathological significances of the expression of Twist gene and its protein were analyzed.</p><p><b>RESULTS</b>The positive rates of the Twist protein in HCC, paraneoplastic and cirrhotic tissues were 84.6%, 19.2 % and 20.0 %, respectively. The positive rate of Twist in HCC was higher than that in paraneoplastic or cirrhosis tissues (P < 0.05). Compared with in paraneoplastic tissues, the mRNA and protein expression of Twist were up-regulated in HCC by 2.52 and 2.13 times, respectively.</p><p><b>CONCLUSION</b>Twist has an inappropriate expression in hepatocellular carcinoma and it may play an important role in the tumorigenesis and progression of HCC.</p>

Migration of dendritic cells in orthotopic rat liver transplantation / 中华器官移植杂志

Objective To investigate migration of dendritic cells(DC)in orthotopic rat liver transplantation models.Methods Allogeneic models(Wistar→SD,experimental group)and syngenic models(Wistar→Wistar,control group)of rat liver transplantation were established.Graft livers and host celiac lymph nodes(n=4)of each group were sampled respectively at day 3,5,and 7 after the transplantation.The acute rejection was graded according to liver histopathological changes.The dy- namic state of DC number within graft and lymph nodes was detected by means of immunohistochemi- cal staining and image analysis.T-cell active proliferative response in lymph nodes was also studied. Results The histological examination revealed that mild to severe rejection occurred on the post-opera- tive days 5 and 7.At day 3 after transplantation,the number of S-100~+ DC in allograft was signifi- cantly increased and reached the peak at day 5,then decreased gradually at day 7.A significant num- ber of S-100~+ cells was detected in the allogeneic host lymph nodes from day 3 after transplantation, and displayed a continuous increasing trend for next several days.Active proliferation of T cells in the lymph nodes was triggered as early as day 3 after transplantation.Conclusion Allogeneic liver trans- plantation induces the accelerated migration of DC within the allograft and host lymphoid nodes.DC delivers a strong and sustained stimulation among T cells in the lymphoid nodes where effector cells are predominantly sensitized and rejected the graft eventually.