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Objective:To assess the characteristics and correlation of motor development in preterm infants of different gestational weeks by using the Test of Infant Motor Performance (TIMP) method, and to develop better individualized early interventions based on TIMP test results.Methods:A prospective study involving 43 full-term healthy infants and 77 preterm followed up in 3201 Hospital from June 2019 to July 2021 was conducted.Preterm infants were divided into the early preterm group (39 cases) and late preterm group (38 cases) according to their gestational age at birth.TIMP assessment was performed at the gestational age of 40 weeks and the corrected age of 16 weeks after birth.Similarly, the full-term healthy infants were assessed by TIMP at the postnatal age of 16 weeks.The differences between groups were investigated using ANOVA or Mann- Whitney rank sum test.Correlations were analyzed by the Pearson correlation method. Results:There were no significant difference in TIMP scores between early and late preterm infants at the gestational age of 40 weeks [(65.74±6.52) scores vs.(66.96±8.51) scores] and the corrected age of 16 weeks [(101±10) scores vs.(104±8) scores] (all P>0.05). TIMP scores in the full-term healthy group at the corrected age of 16 weeks [(108±10) scores] differed significantly from those of early and late preterm infants ( P<0.05). Compared with full-term infants, early and late preterm infants had lower TIMP scores in observation, supine position, and supine turning (all P<0.05), but a higher TIMP score in standing position ( P<0.05). For both early and late preterm infants, TIMP scores at the gestational age of 40 weeks were significantly positively correlated with those at the corrected age of 16 weeks ( r=0.565, 0.302, all P<0.01). Conclusions:There were significant differences in motor development between preterm infants of different gestational ages and term infants, which had guiding significance for early intervention.English version TIMP could play a positive role in promoting individualized follow-up and early intervention of preterm infants in China.
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Pulmonary hypertension(PH)is commonly seen in preterm infants with bronchopulmonary dysplasia(BPD)and is significantly associated with increased mortality.The pathophysiological basis of PH is pulmonary vascular dysplasia or remodeling, and airways hyperresponsiveness.At present, management of BPD-PH should be comprehensive supportive therapy and focus on targeted pharmacotherapies, including various pulmonary vasodilators with different vasoactive mechanisms, such as phosphodiesterase inhibitors, endothelin receptor antagonists and prostaglandins analogs.However, although expert consensus recommends targeted pulmonary arterial hypertension therapy, high-quality clinical studies on the safety and efficacy of these drugs are few.Pulmonary vascular remodeling inhibitors and stem cell therapy have enormous potential to reduce pulmonary hypertension and further research and more data are needed.
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Objective:To summarize the clinical characteristics of neonatal cerebral infarction and its risk factors, so as to provide a reference for clinical diagnosis and early prevention of the disease.Methods:This study retrospectively analyzed the demographic data, clinical manifestations and brain imaging features of neonates with cerebral infarction ( n=45) admitted to the Department of Neonatal Critical Care Medicine of the Affiliated Children's Hospital of Xi'an Jiaotong University from June 2012 to July 2020. Ninety newborns without cerebrovascular disease matched for date of birth and gestational age were selected as the control. Two independent sample t-test, rank-sum test, Chi-square or corrected Chi-square test were used for univariate analysis and binary logistic regression were applied for analyzing the risk factors for neonatal cerebral infarction. Results:A total of 45 infants with clinically diagnosed neonatal cerebral infarction were enrolled, including eight small for gestational age and three macrosomia infants. The median age at disease onset was 1 d (1-2 d). There were 71% (32/45) presenting with convulsions as the first symptom, 4% (2/45) admitted with apnea and respiratory distress as the chief complaints, respectively,11% (5/45) having poor response and 9% (4/45) showing no obvious clinical manifestations. Cranial MRI and magnetic resonance angiography identified left hemisphere lesion in 25 cases (56%), right hemisphere lesion in 16 (36%) and both in four (9%). Thalamus and basal ganglia were involved in 11 cases. The lesions were supplied by middle cerebral artery [38% (17/45)], anterior cerebral artery ( n=1), posterior cerebral artery ( n=4), anterior and middle cerebral arteries ( n=4), middle and posterior cerebral arteries ( n=16), or anterior, middle and posterior cerebral arteries ( n=3). Univariate analysis showed that the proportions of small for gestational age [18% (8/45) vs 6% (5/90), χ 2=5.15], cesarean section after failure of trial of labor [18% (8/45) vs 1% (1/90), χ 2=10.85], meconium stained amniotic fluid [33% (15/45) vs 9% (8/90), χ 2=12.68], fetal distress [20% (9/45) vs 3% (3/90), χ 2=8.34] and neonatal asphyxia [16% (7/45) vs 2% (2/90), χ 2=6.56] were all higher in the infarcted infants than those in the control (all P<0.05). Binary logistic regression analysis revealed that small for gestational age ( OR=3.981, 95% CI: 1.075-14.742, P=0.039), cesarean section after failure of trial of labor ( OR=17.959, 95% CI: 2.032-158.698, P=0.009) and fetal distress ( OR=5.756, 95% CI: 1.129-29.331, P=0.035) were independent risk factors for neonatal cerebral infarction. Conclusions:Most neonates with cerebral infarction would have convulsions initially, while some are asymptomatic. Middle cerebral arteries are often involved in the lesion. The risk of this disease may be increased in small for gestational age infants, cesarean section after failure of trial of labor and fetal distressed cases.
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Objective:To explore the potential mechanism of Jiajian Xuezheng Decotion in infiltrative gastric cancer by network pharmacology and proteomics.Methods:The Traditional Chinese Medicine Systems Pharmacology Database (TCMSP) database was used to find the compounds and their targets of Jiajianxuezhengtang, and the targets of invasive gastric cancer were determined by high performance liquid chromatography with tandem mass spectrometry (HPLC-MS/MS). The predicted target gene of Jiajian Xuezheng Decotion and the target protein data of infiltrative gastric cancer were analyzed by Venny to obtain the target gene. The target gene set was analyzed by Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment by the David. The protein interaction network diagram (PPI) was obtained by the String method, displaying the prescription-drug-compound-gene network in Cytoscape software.Results:69 active ingredients and 215 drug targets were screened from Jiajian Xuezheng Decotion; 660 proteins were significantly up-expressed in infiltrative gastric cancer, and 10 drug targets and gene targets were the common targets. There were 10 protein nodes in the PPI network, of which 3 core nodes were CASP3, BCL2L1 and STAT1. The 11 KEGG pathways were significantly enriched such as include PI3K-Akt signaling pathway, p53 signaling pathway, proteoglycan in cancer, apoptosis, Jak-STAT signaling pathway and other pathways.Conclusions:Jiajian Xuezheng Decotion plays an anti-infiltrative gastric cancer effect possibly regulated apoptosis through PI3K-Akt signaling pathway, p53 signaling pathway and Jak-STAT signaling pathway. This study provides a theoretical basis for further research on the mechanism of Jiajian Xuezheng Decotion in the treatment of invasive gastric cancer.
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Objective:To investigate the correlation between migraine and overall burden of cerebral small vessel disease (CSVD).Methods:Migraine patients who visited the headache clinic of Jiangyin People's Hospital from January 2021 to October 2021 were selected as the case group, and healthy people who had no previous primary headache of any type and matched age and sex in the same period were selected as the control group. Various CSVD phenotypes, including vasogenic lacuna, white matter hyperintensities (WMHs), cerebral microbleeds (CMBs) and enlarged perivascular space (EPVS) were detected by the multimodal MRI, and the overall burden score of CSVD was calculated. The detection rates of CSVD and its phenotypes and the overall burden of CSVD were compared between the case group and the control group. The subjects with CSVD were divided into mild group, moderate group and severe group according to the overall burden score of CSVD. The independent influencing factors of the overall burden of CSVD were identified by the ordinal multi-classification logistic regression model. Results:A total of 109 migraine patients and 100 healthy controls were enrolled. The detection rate of CSVD (65.13% vs. 46.00%; P=0.005) and the proportion of patients with severe CSVD overall burden (24.77% vs. 10.00%; P=0.005) in the case group were significantly higher than those in the control group. In terms of specific CSVD phenotypes, the detection rates of WMHs (48.62% vs. 33.00%; P=0.022) and CMBs (35.80% vs. 19.00%; P=0.007) in the case group were significantly higher than those in the control group, while there were no significant differences in vasogenic lacuna and moderate to severe EPVS. Univariate analysis showed that the overall burden of CSVD was significantly associated with age, migraine, hypertension, baseline diastolic blood pressure, low-density lipoprotein cholesterol (LDL-C) and glycosylated hemoglobin (all P<0.05). Multivariate logistic analysis showed that age (odds ratio [ OR] 3.731, 95% confidence interval [ CI] 1.051-1.217; P=0.001), migraine ( OR 2.812, 95% CI 1.045-5.124; P=0.012), hypertension ( OR 2.112, 95% CI 1.525-4.021; P=0.032), and LDL-C ( OR 2.512, 95% CI 1.541-4.312; P=0.023) were independently associated with the overall burden of CSVD. Conclusions:The detection rate of CSVD in migraine patients is higher than that in the general population, especially WMHs and CMBs. Migraine is independently associated with the overall burden of CSVD.
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Objective:To evaluate the value of contrast-enhanced ultrasound (CEUS) in the diagnosis and differential diagnosis of bladder urothelial carcinoma(BUC).Methods:A comparative analysis of 138 patients with bladder lesions (123 cases of BUC and 15 cases of other benign lesions) who were hospitalized in Union Hospital, Fujian Medical University from January 2019 to May 2021 were confirmed by pathology. All patients underwent two-dimensional ultrasound, color Doppler ultrasound, CEUS examination, the time intensity curve (TIC) of the region of interest(ROI) before operation was drawn, the ultrasound examination results with the pathological diagnosis results were compared and its diagnostic efficiency was analyzed.Results:Among the 138 cases of bladder lesions, 98 cases were single lesions and 40 cases were multiple lesions. In all single lesions, 95 cases were found by two-dimensional ultrasound and 3 cases were missed, while in all multiple lesions, 24 cases were found by two-dimensional ultrasound and 16 cases were missed, but all cases could be shown by CEUS. The sensitivity of CEUS to multiple bladder lesions was higher than that of two-dimensional ultrasound ( P<0.05). Besides, the differences between BUC and benign lesions in color blood flow distribution intensity and CEUS performance were significant (both P<0.05). Malignant lesions were mostly "less- to -rich" blood flow signals, and benign lesions were mainly "less- to- no" blood flow signals.In addition, in the CEUS examination, 83.7% (103/123) of BUC were high enhancement, and only 33.3% (5/15) of benign lesions were high enhancement. The diagnostic accuracy, specificity and negative predictive value of CEUS(89.9%, 46.7%, 53.8%) were higher than that of two-dimensional ultrasound(67.4%, 13.3%, 13.3%). The area under the curve, the rising slope and the peak intensity of BUC were all higher than those of benign lesions, and the differences were significant(all P<0.05), but none of them was independent risk factor for BUC ( P>0.05). Conclusions:CEUS can significantly improve the diagnostic sensitivity of bladder multiple lesions and help to improve the diagnostic accuracy of BUC, while the area under the curve, the rising slope and the peak intensity of TIC were not the independent risk factors for BUC.
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Objective:A clinical prediction model was constructed based on the related factors affecting neonatal early-onset sepsis (EOS).Methods:A retrospective study was conducted. The patients with EOS amditted to the neonatal intensive care unit of Children′s Hospital Affiliated to Xi′an Jiaotong University from April 2015 to April 2020 were enrolled. The demographic data and the clinical indicators within 8 hours after admission were collected. The death 7 days after admission was taken as the end event. The differences of various indexes between the survival group and the death group were compared. After univariate analysis of the indexes that may have an impact on the prognosis, binary logistic regression analysis was performed; The predictive model was established for the factors that may affect the prognosis; the predictive value of the relevant models was analyzed by recevier operating characteristic (ROC) curve, and the model was verified by independent clinical medical records.Results:A total of 139 children were enrolled, and 41 died within 7 days, with a fatality rate of 29.50%. Compared with the survival group, the dead group had higher white blood cells (WBC), serum procalcitonin (PCT), lactic acid (Lac), creatinine (Scr), D-dimer and Paediatric Risk of Mortality (PRISM) score {WBC(×10 9/L): 24.15[4.36, 29.36] vs 21.21[19.14, 28.36], PCT: (67.32±40.36)ng/L vs (37.76±25.11)ng/L, Lac: (8.69±6.17)mmol/L vs (2.34±1.11)mmol/L, Scr: (239.99±68.46)μmol/L vs (65.31±34.34)μmol/L, D-dimer(mg/L): 5.21[2.06, 21.49] vs 0.34[0.26, 0.45], PRISM Ⅲ: (19.52±6.25)s vs (10.63±2.05)s, all P<0.05}, and lower fibrinogen (Fib), platelet count (PLT) and hemoglobin concentration (Hb) [Fib: (1.48±1.19)g/L vs (2.44±0.83)g/L, PLT: (154±58)×10 9/L vs (189±29)×10 9/L, Hb: (169±49)g/L vs (182±52)g/L, all P<0.05]. The incidence of placental/umbilical cord lesions, amniotic fluid pollution, asphyxia, premature delivery, premature rupture of membranes, positive etiology and maternal infection in the death group were higher than those in the survival group, while the gestational age and weight were lower than those in the survival group (all P<0.05); Binary logistic regression analysis showed that Lac, PCT and premature rupture of membranes were independent risk factors for the prognosis of EOS [odds ratio ( OR) and 95% confidence interval (95% CI): Lac was 1.23(1.00-2.05), PCT was 1.05(1.03-1.85), premature rupture of membranes was 2.59(1.89-3.32), all P<0.05]; ROC curve analysis showed that the area under the curve (AUC) of the prediction model was 0.967; the predicted sensitivity was 88.70%; and the specificity was 78.20% respectively. Conclusions:PCT, Lac and premature rupture of membranes are independent risk factors affecting the prognosis of EOS. The clinical prognosis prediction model constructed by combining PLT, gestational age and weight has good prediction efficiency.
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OBJECTIVE To study the protective effects o f valproic acid on cardiac and cerebral injury in rats subjected to severe scalding combined with seawater immersion injury with delayed fluid replacement. METHODS The rats were divided into scalding+delayed fluid replacement group （group S ），scalding+seawater immersion+delayed fluid replacement group （group SS ）， scalding+seawater immersion+valproic acid+delayed fluid replacement group （group SSV ）according to random number table ，with 60 rats in each group. All groups were subjected to 35％total body surface area third-degree full-thickness scalding with boiled water. Group SS and group SSV were immersed in artificial ；seawater（30 min）immediately after scalding ，and group SSV was subcutaneously injected with valproic acid 300 mg/kg immediately after out of water. Sodium lactate Ringer ’s 0314-2279277。E-mail：125467374@qq.com injection was injected intravenously within 30 minutes according to 1/2 Parkland formula at 2 h after scalding in each group for delayed fluid replacement. The death time of rats was recorded ，and the average survival time and 24 h survival rate of rats in each group were calculat ed. Mean arterial pressure （MAP），heart rate （HR），respiration rate （RR），rectal temperature （RT），arterial blood pH ，arterial partial pressure of oxygen （PaO2），arterial blood partial pressure of carbon dioxide （PaCO2），HCO3－，creatine kinase MB isoenzyme （CK-MB）and neuron specific enolase （NSE）were detected before scalding ，at 0，2，5 h after scalding. The pathological changes of cardiac and cerebral tissue were observed. RESULTS The 24 h survival rate of group SS （55％）was significantly lower than that of group S （90％）， while that of group SSV （75％）was increased significantly ，compared with group SS （P＜0.05）. Compared with group S ，the levels of MAP ，RT，HR，pH，PaO2 and HCO 3－ in group SS were significantly lowered ，while the levels of CK-MB and NSE were increased significantly at 0，2，5 h after scalding ；the levels of PaCO 2 were increased significantly at 2，5 h after scalding ， while the levels of RR were decreased significantly at 0，2 h after scalding （P＜0.05）. Compared with group SS ，the levels of MAP，RT，HR，pH，PaO2 and HCO 3－ in group SSV were significantly increased ，while the levels of PaCO 2，CK-MB and NSE were decreased significantly at 2，5 h after scalding ；the level of RR was increased significantly at 2 h after scalding （P＜0.05）. At 2，5 h after scalding ，cardiac and cerebral injury of rats in group SS were aggravated significantly than that in group S ；cardiac and cerebral injury of rats in group SSV were relieved significantly than that in group SS. CONCLUSIONS After severe scalding combined seawater immersion injury ，hypodermic injection of sodium valproate could protect cardiac and cerebral function of rats ， improve vital signs and blood gas index ，prolong survival time and improve survival rate in rats.
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Objective:To explore the expression and clinical significance of IL-1β and IL-1β receptor antagonist(IL-1ra)in persistent pulmonary hypertension of the newborn(PPHN)secondary to sepsis.Methods:The newborns with sepsis were enrolled in the Department of Neonatal Intensive Care Unit(NICU)of Xi′an Children′s Hospital from January 2018 to November 2020.The newborns with sepsis were divided into two groups: the newborns without PPHN( n=108)were the control group and the newborns with PPHN( n=44)were the experimental group.Clinical data, laboratory examination and bedside echocardiography of all the newborns were collected to analyze the differences between the two groups.The expression levels of IL-1β and IL-1ra in neonatal plasma of the two groups were detected by enzym-linked immunosorbination(ELISA), and their roles in neonatal sepsis with PPHN were further analyzed.The risk factors of neonatal sepsis with PPHN were analyzed by multivariate Logistic regression, and the early prediction value of the risk factors for neonatal sepsis with PPHN were evaluated by the receiver operating characteristic(ROC)curve. Results:There were no significant differences in gestational age[(39.11±0.55)w vs(38.85±0.72)w], birth weight[(3.30±0.49)kg vs(3.24±0.55)kg]and proportions of males[60(55.6%)vs 30(68.2%)]between the two groups( P>0.05). The right ventricular diameter[(9.57±0.35)mm], pulmonary artery pressure[(51.36±5.91)mmHg]and the level of N-terminal brain natriuretic peptide(NT-proBNP)[(25436.83±12343.18)ng/L)]significantly increased in the experimental group than those in the control group[(8.77±0.41)mm, (31.24±5.11)mmHg, (11267.09±4405.48)ng/L, respectively, P<0.05]. Before treatment, the expression levels of plasma IL-1β[(31.24±5.25)ng/L]and IL-1ra[(41.94±10.13)ng/L]in the experimental group were significantly higher than those in the control group[(18.27±4.47)ng/L, (21.47±8.76)ng/L, respectively, P<0.05]. The expression levels of plasma IL-1β[(10.46±3.17)ng/L]and IL-1ra[(10.58±2.94)ng/L]in the experimental group after treatment were significantly lower than those before treatment[(31.24±5.25)ng/L, (41.94±10.13)ng/L , respectively, P<0.05]. Multivariate Logistic regression analysis showed that IL-1β and NT-proBNP were the independent risk factors for neonatal sepsis with PPHN( P<0.05). ROC curve analysis showed that IL-1β and NT-proBNP had the good predictive value for the occurrence of neonatal sepsis with PPHN( P<0.05). IL-1β combined with NT-proBNP has the better predictive value for neonatal sepsis with PPHN. Conclusion:IL-1β combined with NT-proBNP have the high predictive value for PPHN of the newborns secondary to sepsis.
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Objective:To evaluate the diagnostic value of coronary angiography-based fractional flow reserve(caFFR)versus a wire-based fractional flow reserve(FFR)in elderly patients with stable ischemic heart disease.Methods:A total of 168 patients(186 vessels)who underwent a pressure wire(PW)-based FFR measurement from Jan.2015 to Dec.2019 in Beijing hospital were enrolled and analyzed retrospectively.Coronary angiography images and matched steady-state aortic pressure of patients were sent to the core laboratory for caFFR measurement under the blind method.All patients were divided into the non-elderly group(<65 years, n=93)and the elderly group(≥65 years, n=75). The diagnostic value of caFFR was evaluated by using the wire-based FFR cut-off value of ≤0.80 as the reference standard.The correlation and consistency of caFFR and wire-based FFR were analyzed, and compared between the non-elderly and elderly groups.Results:The caFFR had a good correlation and consistency with wire-based FFR in the elderly group( r=0.796, P<0.01). In non-aged versus elderly groups, diagnostic accuracy of caFFR was 91.9% versus 93.1%, diagnostic sensitivity of caFFR was 91.8% vs.93.2%, diagnostic specificity of caFFR was 92.3% vs.93.0%, all P>0.05.The area under the receiver-operating characteristic curve of caFFR had no significant difference between the non-elderly and elderly patients(0.964 vs.0.972, Z=0.00823, 95% CI: -0.037-0.052, P>0.05). Conclusions:The caFFR has a good diagnostic correlation and consistency with wire-based FFR in the elderly group, and caFFR's diagnostic performance in the elderly is similar to that in the non-elderly patients.
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【Objective】 To investigate the complaints of blood quality in Changsha, in order to continuously improve blood quality management. 【Methods】 The Handling Forms of Blood Quality Complaints of our center during 2014~2019, and the blood units issued, corresponded to the occurrence period of complaints, were collected from the SHINOW 9.0 system, and the overall blood supply and complaints of blood quality, including various components, were classified and analyzed by SPSS19.0. 【Results】 1 865 466 bags of blood were delivered from 2014 to 2019 in Changsha, coming down 435 complaints with 435 bags of blood involved, and the total ratio of blood quality complaints rated at 0.23‰(435/1 865 466), of which red blood cell complaint accounted for 45.06%(196/435), with a rise from 30.23%(26/86) in 2014 to 49.49%(49/99) in 2019. Meanwhile, the cryoprecipitate complaint increased from 10.47%(9/86) to 20.20%(20/99). The complaints were mainly broken blood bags 29.89%(130/435), positive serological testing results(irregular antibody screening+ or direct anti globulin test+ ) 34.48%(150/435), floccule or precipitates 18.39%(80/435), clot 5.52%(24/435), lipemia 3.45%(15/435), and blood type variant(ABO subgroups and variants of RhD) 2.07%(9/435). The complaints were different in blood components, each with a particular tilt as follows: positive serological testing results in red blood cell [72.45%(142/186)], broken blood bags in plasma [83.74%(103/123)], floccule or precipitates in platelet [54.17%(13/24)] and cryoprecipitate [64.13%(59/92)] . 【Conclusion】 Broken blood bags of plasma, floccule or precipitates of cryoprecipitate, and positive serological testing results of red blood cell were the main complaints of blood quality in Changsha. Blood banks should strengthen quality control, handle quality complains cautiously and strengthen community with hospitals before transfusion to improve blood satisfaction in clinical, and save blood resources.
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Objective:To observe the effects of microRNA-21 (miR-21) on cell invasion, migration and apoptosis of pancreatic cancer PANC1 cells, and explore the potential molecular mechanism.Methods:Recombinant plasmids carrying miR-21 or small interfering RNA targeting miR-21 were constructed. Using blank plasmid as the control, the recombinant plasmids were transfected with human pancreatic cancer PANC1 cells by liposome method, respectively to establish blank group, miR-21 overexpression group (overexpression group) and miR-21 silence group (silence group) PANC1 cell lines. Cell proliferation, apoptosis, invasion and metastasis were detected by MTT method, flow cytometry, transwell chamber and wound scratch test, respectively. ELISA and Western blot were used to measure the protein expression of programmed cell death factor 4(PDCD4), gene of phosphate and tension homology deleted on chromsome ten (PTEN), vascular endothelial growth factor (VEGF), survivin, matrix metalloproteinase 2 (MMP-2) and MMP-9.Results:After 24 h cell culture, the cell proliferation rate of blank group, overexpression group and silence group was (20.72±5.62)%, (28.46±6.12)% and (14.05±3.36 )%; cell apoptosis rate was (5.89±0.26)%, (4.62±0.19)% and (8.66±2.55)%; the number of transmembrane cells was (212.4±32.5), (508.8±50.7) and (50.9±10.6) per 200 times visual field; the area covered by migrated cells was (75.6±12.1), (118.8±20.2) and (48.8±9.5)mm 2 per 200 times visual field; the expression of PDCD4 was 0.85±0.22, 0.72±0.10 and 1.36±0.41; the expression of PTEN was 0.85±0.21, 0.28±0.09 and 1.36±0.45; the expression of VEGF was 0.79±0.24, 1.15±0.31 and 0.46±0.10; the expression of survivin was 1.02±0.33, 1.51±0.42 and 0.52±0.12; the expression of MMP-2 was 1.12±0.22, 1.86±0.52 and 0.56±0.18; the expression of MMP-9 was 1.06±0.15, 1.78±0.48 and 0.49±0.12. All the differences among the three groups were statistically significant (all P<0.05). Compared with blank group, the cell apoptosis rate, PDCD4 and PTEN expression were increased, while cell proliferation, invasion and migration, and the protein expression of VEGF, survivin, MMP-2 and MMP-9 were all decreased; the changes in silence group was totally contrary to those in overexpression group. All the differences among the three groups were statistically significant (all P<0.05). Conclusions:miR-21 silencing can inhibit the proliferation, migration and invasion of PANC1 cells and promote apoptosis, and the mechanism was possibly associated with the upregulation of PDCD4 and PTEN protein expression.
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OBJECTIVE@#To explore the genetic basis for a fetus with autosomal recessive polycystic kidney disease (ARPKD).@*METHODS@#Fetal tissue and peripheral blood samples were respectively obtained from the abortus and the couple. Following extraction of genomic DNA, genetic testing was carried out.@*RESULTS@#The fetus was found to carry compound heterozygous variants of the PKHD1 gene, namely c.5336A>T (p.N1779I) and c.9455delA (p.N3152Tfs*10), which were respectively inherited from the husband and wife.@*CONCLUSION@#The c.5336A>T and c.9455delA variants of the PKHD1 gene probably account for the ARPKD in the fetus. Above results have enabled genetic counseling and prenatal diagnosis for the couple.
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OBJECTIVE: To investigate the effect of short-term rehabilitation therapy based on exercise on lung function in coal workers' with pneumoconiosis(CWP). METHODS: A total of 74 CWP patients were divided into control group(32) and treatment group(42) by random number table method. The control group received routine treatment only. The treatment group underwent 6 months of exercise-based rehabilitation treatment on the basis of routine treatment. The lung function was assessed in two groups to evaluate the treatment efficacy. RESULTS: Before rehabilitation treatment, the vital capacity(VC) and forced vital capacity(FVC) of patients in the treatment group were lower than that in the control group(P<0.05). But there was no significant difference in forced expiratory volume in first second(FEV_(1.0)) and FEV_(1.0)% between the two groups(P>0.05). After treatment, VC and FVC in the treatment group were higher than that before treatment in the same group(P<0.05). However, there was no significant difference in the four lung function indexes before and after treatment in the control group(P>0.05). The difference of VC and FVC before and after treatment in the treatment group was higher than those in the control group(P<0.01). However, there was no significant difference in FEV_(1.0 )and FEV_(1.0)% between the two groups before and after treatment(P>0.05). CONCLUSION: Exercise-based short-term rehabilitation therapy can improve lung ventilation of CWP patients.
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Objective@#To explore the role of targeted ultrasound contrast agent in the evaluation of angiogenesis in papillary thyroid carcinoma (PTC) in nude mice by constructing platelet derived growth factor receptor α (PDGFRα)-targeted ultrasound contrast agents, and to explore the effect of platelet derived growth factor (PDGF) on angiogenesis in PTC.@*Methods@#PDGFRα-targeted ultrasound contrast agents were constructed through biotin-avidin linkage, and blank micro-bubbles were served as control group. After the siRNA-PDGF BCPAP cell line was established, well prepared BCPAP cells or siRNA-PDGF-BCPAP cells were injected subcutaneously into the back of male BABL/C nude mice. The growth of the tumors was observed closely. All tumors of the normal group and the siRNA-PDGF group were examined by PDGFRα-targeted ultrasound contrast agents or blank micro-bubbles, and the dynamic images were analyzed quantitatively by QontraXt software.All mice were sacrificed after ultrasonography. Microvessels density (MVD) in the tumors was counted by CD31 staining and the expressions of vascular endothelial growth factor(VEGF) and PDGF were detected by Western Blot.@*Results@#PTCs in nude mice were enhanced well by PDGFRα-targeted ultrasound contrast agent or blank micro-bubbles. The peak of tumors in siRNA-PDGF group was significantly lower than that in the normal group [(43.085±13.244)% vs (57.428±10.952)%, P=0.004]; MVD of the siRNA-PDGF group was significantly less than that of the normal group [(23.200±6.017)strips/view vs (35.000±8.456)strips/view, P=0.012]. The protein expression of PDGF and VEGF in siRNA-PDGF group were significantly lower than those in the normal group, respectively (0.142±0.058 vs 0.269±0.102, P=0.002; 0.096±0.036 vs 0.158±0.072, P=0.016).@*Conclusions@#PDGF plays an important role in angiogenesis of PTC, it maybe a new ultrasound molecular imaging method for monitoring tumor angiogenesis.
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Objective To analyze the safety and efficacy of coronary rotational atherectomy in elderly patients with coronary heart disease.Methods A total of 107 consecutive patients with coronary artery disease receiving rotational atherectomy from January 2012 to December 2016 were retrospectively analyzed.Patients were divided into an ≥75 years group(n=44)and a ＜75 years group (n=63).We compared the characteristics of rotational atherectomy,peri-procedural complications,instant procedure success rates and 1-year cardiovascular events,including angina,re-infarction,hospitalization due to heart failure,repeat revascularization and cardiac death.Results There was no significant difference in the target coronary vessel,reference vessel diameter,maximal diameter of the burr and ratio of maximal diameter of the burr to reference vessel diameter between the two groups(all P＞0.05).Compared with ＜75 years patients,more ≥75 years patients used 2 burrs(10 cases or 22.7％ vs.4 cases or 6.3％,P =0.013),while there was no significant difference in terms of burr size,rotational time,maximal rotational speed,pre-and post-dilation pressure between the two groups (all P＞0.05).The incidence of peri-procedural complications had no significant difference between the ≥75 years group and the ＜75 years group(8 cases or 18.2％ vs.13 cases or 20.6％,P =0.753).One case of burr entrapment occurred in each group with successful retrieval.The procedure success rate was 96.8％(61 cases)in the ＜75 years group and 100％ in the ≥75 years group(P=0.640).No acute or sub-acute stent thrombosis or urgent coronary artery bypass graft occurred in the two groups during hospitalization.No cardiac death occurred in either group.Conclusions Coronary rotational atherectomy is effective and safe in elderly patients with coronary disease with a high instant procedure success rate.
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Objective To investigate the prevalence and risk factors for atherosclerotic renal artery stenosis (ARAS) in elderly patients with refractory hypertension.Methods Two hundred and eight elderly patients with a mean age of (68.3±4.9)years (53.8％ in men) diagnosed with refractory hypertension were recruited in this retrospective study from January 2010 to January 2017 in Beijing hospital.Fifty of the 208 patients with ultrasonography-suspected renal artery stenosis received renal arteriography and 39 were confirmed as renal artery stenosis.Renal artery stenosis was defined when stenosis located in at least one of renal arteries and only if the stenosis equal or over 50％.The prevalence of ARAS was calculated.Besides,univariate and final multivariate Logistic regression analyses were conducted to detect independent risk factors for development of ARAS.Results Thirty-nine of 208 patients (18.8％) were confirmatively diagnosed as ARAS.Although univariate Logistic regression showed that diabetes,coronary heart disease,renal insufficiency,and peripheral artery disease (P=0.034,0.040,0.022,and 0.030) might be risk factors for ARAS,a multivariate regression analysis demonstrated that only the peripheral artery disease (OR=3.218,P＜0.01) and renal insufficiency (OR=3.827,P＜0.01) were independent risk factors for ARAS.Conclusions Renal angiography should routinely be performed in refractory hypertension patients with renal insufficiency or peripheral artery disease to identify ARAS in time.
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Objective To evaluate the clinical impact of percutaneous coronary intervention (PCI)on prognosis in elderly patients(≥70 years old)with coronary artery chronic total occlusion (CTO). Methods A total of 445 consecutive patients with a angiography-confirmed CTO lesions registered from January 2011 to December 2013 were divided into the elderly group(≥70 years)and the non-elderly group(< 70 years).The primary endpoints measured were defined as the composite outcomes of hospitalization due to angina,re-infarction,heart failure,repeat re-vascularization,and cardiac death at 36 months follow-up. Results The elderly group included 200 patients(44.9%) and the non-elderly group included 245 patients(55.1%).During the follow-up,the proportions of coronary lesion were significantly higher in the elderly group with left main(LM)disease(45, 22.5%),three-vessel disease(166,83.0%)and J-CTO score≥2(64,32.0%)than in the non-elderly group with diseases of LM,three-vessel,and J-CTO score ≥ 2〔(34,13.9%);(180,73.5%);(57, 23.3%),respectively〕(χ2 =5.607,5.782,4.243;P=0.018,0.016,0.039).T he ratio of the patients undergoing PCI-reperfusion therapy of CTO was higher in non-elderly group(109/275,39.6%)than in elderly group(53/222,23.9%)(χ2 =13.891,P<0.001),while CTO PCI success rate was similar between the two groups(38 patients,71.7% vs.90 patients,82.6%,χ2 = 2.541,P= 0.111).The elderly group versus non-elderly group showed that the 3-year cardiac mortality rate was 12.5%(25 patients)versus 3.3%(8 patients)(χ2 =13.677,P<0.011),and the incidence rate of 3-year primary endpoint was 31.5%(63 patients)versus 22.9%(56 patients)(χ2 =4.199,P=0.040).Among the elderly group,patients without CTOs re-vascularized by PCI had a greater tendency toward higher risk of hospitalization due to angina,re-infarction,heart failure,or repeat re-vascularization than patients with CTOs re-vascularized by PCI(34/149,22.8% vs.3/33,9.1%,χ2 =3.143,P=0.076),while they had comparable incidence of 3-year cardiac death(19/149,12.8% vs.5/33,15.2%,χ2 = 0.007,P=0.933).Multivariate analysis revealed that after adjusting for baseline and procedure differences,LM combined with three vessel disease(OR= 3.804,95% CI:1.274 to 11.356,P= 0.017)remained an independent predictor for 3-year cardiac mortality in elderly patients with CTOs. Conclusions Elderly patients with CTO have mostly a serious coronary artery disease and a poor prognosis.Although CTO is re-vascularized by PCI,long-term clinical outcome seems not more to be improved in elderly patients with CTOs.LM combined with three-vessel disease might be an independent predictor for 3-year cardiac mortality in elderly CTO patients.
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Objective To investigate the clinical effect of thoracoscopic lobectomy in the treatment of elderly patients with non -small cell lung cancer .Methods 120 elderly patients with non -small cell lung cancer were selected as study objects ,and they were randomly divided into study group ( 60 cases ) and control group ( 60 cases ) according to the digital table .The control group was treated with traditional thoracic lobectomy .The study group was treated with thoracoscopic lobectomy .The surgical related indicators , postoperative pain , cardiopulmonary function , postoperative complications and clinical efficacy were compared between the two groups .Results The blood loss of the study group was (138.44 ±41.53)mL,which was less than (327.83 ±54.61)mL of the control group,and the postoperative drainage was (1290.28 ±129.37)mL in the study group,which was less than (1643.19 ±231.27)mL in the control group.The operation time and hospitalization time of the study group were (145.72 ±19.65) min, (7.43 ±1.59)d,respectively,which were shorter than (243.26 ±50.38)min,(10.35 ±2.34)d of the control group (t=21.383,10.316,13.972,7.995,all P<0.05).1,3,7 days after surgery,the VAS scores of the study group were significantly lower than those of the control group [(7.57 ±1.63) vs.(8.76 ±2.06),(5.46 ±0.82) vs.(6.68 ± 1.53),(2.51 ±0.41) vs.(4.94 icant difference in cardiopulmonary function between the two groups before treatment ( t =0.207,0.287,1.112, 0.137,all P>0.05).After treatment,the heart rate(HR) and the carbon monoxide diffusion (DLCO) of the study group were significantly lower than those of the control group [(83.27 ±12.85)times/min vs.(95.38 ±15.6)times/min,(67.49 ±6.84)％vs.(71.43 ±5.91)％],the FEV1 and mean ventilation volume(MVV) of the study group were significantly higher than those of the control group [(1.67 ±0.25)L vs.(1.42 ±0.10)L,(74.34 ±0.56)％vs.(63.25 ±0.51)％],and the differences were statistically significant (t=4.636,3.376,7.192,113.413,all P<0.05).The incidence rate of postoperative complications in the study group was lower than that in the control group (1.67％vs.11.67％,χ2 =4.821,P<0.05).There was no statistically significant difference between the two groups in median survival time(19.24 months vs.19.49 months,u=0.571,P>0.05).There was no statistically significant difference in the disease free survival rate between the two groups (P>0.05).Conclusion Thoracoscopic lobectomy has less effect on cardiopulmonary function in elderly patients with non -small cell lung cancer .The short -term curative effect is better than traditional thoracic lobectomy ,but the long-term curative effect is similar .
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Objective To investigate the effect of fatty acid binding protein 4(FABP4)DNA methylation on abnormal lipid metabolism in placental trophoblastic dyslipidemia. Methods Human placental trophoblast cell line(HTR-8)was treated with L-NAME of 100 μmol/L for 48 h. The lipid content in placental trophoblasts was detected by chemical enzyme-colorimetry. The FABP4 DNA methylation level in placenta trophoblasts was detected by nested-touch down methylation specific PCR (NT-MSP). the mRNA and protein expression of DNMT1 and FABP4 were detected by qRT-PCR and Western Blot,respectively,in trophoblast cells. Results The lipid content in trophoblasts significantly increased as compared with the control(P < 0.05). Expression of FABP4 mRNA and protein increased(P < 0.05),while FABP4 methylation level and expression of DNMT1 significantly decreased (P<0.05)after treatment with L-NAME. Conclusions FABP4 DNA methylation is involved in the regulation of lipid metabolism in placental trophoblastic cells of hypertensive disorder complicating pregnancy.