The impact of LDL-C/HDL-C ratio on severity of coronary artery disease and 2-year outcome in patients with premature coronary heart disease: results of a prospective, multicenter, observational cohort study / 中华心血管病杂志

Objective: To explore the relationship between low density lipoprotein cholesterol (LDL-C)/high density lipoprotein cholesterol (HDL-C) ratio with the severity of coronary artery disease and 2-yeat outcome in patients with premature coronary heart disease. Methods: This prospective, multicenter, observational cohort study is originated from the PROMISE study. Eighteen thousand seven hundred and one patients with coronary heart disease (CHD) were screened from January 2015 to May 2019. Three thousand eight hundred and sixty-one patients with premature CHD were enrolled in the current study. According to the median LDL-C/HDL-C ratio (2.4), the patients were divided into two groups: low LDL-C/HDL-C group (LDL-C/HDL-C≤2.4, n=1 867) and high LDL-C/HDL-C group (LDL-C/HDL-C>2.4, n=1 994). Baseline data and 2-year major adverse cardiovascular and cerebrovascular events (MACCE) were collected and analyzed in order to find the differences between premature CHD patients at different LDL-C/HDL-C levels, and explore the correlation between LDL-C/HDL-C ratio with the severity of coronary artery disease and MACCE. Results: The average age of the low LDL-C/HDL-C ratio group was (48.5±6.5) years, 1 154 patients were males (61.8%); the average age of high LDL-C/HDL-C ratio group was (46.5±6.8) years, 1 523 were males (76.4%). The number of target lesions, the number of coronary artery lesions, the preoperative SNYTAX score and the proportion of three-vessel coronary artery disease in the high LDL-C/HDL-C group were significantly higher than those in the low LDL-C/HDL-C group (1.04±0.74 vs. 0.97±0.80, P=0.002; 2.04±0.84 vs. 1.85±0.84, P<0.001; 13.81±8.87 vs. 11.70±8.05, P<0.001; 36.2% vs. 27.4%, respectively, P<0.001). Correlation analysis showed that there was a significant positive correlation between LDL-C/HDL-C ratio and preoperative SYNTAX score, the number of coronary artery lesions, the number of target lesions and whether it was a three-vessel coronary artery disease (all P<0.05). The 2-year follow-up results showed that the incidence of MACCE was significantly higher in the high LDL-C/HDL-C group than that in the low LDL-C/HDL-C group (6.9% vs. 9.1%, P=0.011). There was no significant difference in the incidence of all-cause death, cardiac death, myocardial infarction, stroke, revascularization and bleeding between the two groups. Cox multivariate regression analysis showed that the LDL-C/HDL-C ratio has no correlation with 2-year MACCE, death, myocardial infarction, revascularization, stroke and bleeding events above BARC2 in patients with premature CHD. Conclusion: High LDL-C/HDL-C ratio is positively correlated with the severity of coronary artery disease in patients with premature CHD. The incidence of MACCE of patients with high LDL-C/HDL-C ratio is significantly higher during 2 years follow-up; LDL-C/HDL-C ratio may be an indicator for evaluating the severity of coronary artery disease and long-term prognosis in patients with premature CHD.

Impact of prolonging dual antiplatelet therapy on long-term prognosis of elderly patients with coronary heart disease complicated with diabetes mellitus undergoing drug-eluting stent implantation / 中华心血管病杂志

Objective: To explore and compare the effect of standard or prolonged dual antiplatelet therapy (DAPT) on the long-term prognosis of elderly patients with coronary heart disease complicated with diabetes mellitus after drug-eluting stent (DES) implantation. Methods: Consecutive patients with diabetes mellitus, ≥65 years old, underwent DES implantation, and had no adverse events within 1 year after operation underwent percutaneous coronary intervention (PCI) from January to December 2013 in Fuwai Hospital were enrolled in this prospective cohort study. These patients were divided into three groups according to DAPT duration: standard DAPT duration group (11 ≤ DAPT duration≤ 13 months) and prolonged DAPT duration group (13<DAPT duration≤ 24 months; DAPT duration>24 months). All the patients were followed up at 1, 6 months, 1, 2 and 5 years in order to collect the incidence of major adverse cardiovascular and cerebrovascular events (MACCE), and type 2 to 5 bleeding events defined by the Federation of Bleeding Academic Research (BARC). MACCE were consisted of all cause death, myocardial infarction, target vessel revascularization or stroke. The incidence of clinical adverse events were compared among 3 different DAPT duration groups, and Cox regression model were used to analyze the effect of different DAPT duration on 5-year long-term prognosis. Results: A total of 1 562 patients were enrolled, aged (70.8±4.5) years, with 398 female (25.5%). There were 467 cases in standard DAPT duration group, 684 cases in 13<DAPT duration≤ 24 months group and 411 cases in DAPT duration>24 months group. The patients in standard DAPT duration group and the prolonged DAPT duration groups accounted for 29.9% (467/1 562) and 70.1% (1 095/1 562), respectively. The 5-year follow-up results showed that the incidence of all-cause death in 13<DAPT duration≤ 24 months group (4.8%(33/684) vs. 8.6%(40/467),P=0.011) and DAPT duration>24 month group(4.1%(17/411) vs. 8.6%(40/467),P=0.008) were significantly lower than in standard DAPT group. The incidence of myocardial infarction in 13<DAPT duration≤ 24 months group was lower than in standard DAPT duration group (1.9%(13/684) vs. 5.1%(24/467),P=0.002). The incidence of MACCE in 13<DAPT duration≤ 24 months group was the lowest (standard DAPT duration group, 13<DAPT duration≤ 24 months group and DAPT duration>24 month group were 19.3% (90/467), 12.3% (84/684), 20.2% (83/411), respectively, P<0.001). There was no significant difference in the incidence of stroke and bleeding events among the three groups (all P>0.05). Multivariate Cox analysis showed that compared with the standard DAPT group, prolonged DAPT to 13-24 months was negatively correlated with MACCE (HR=0.601, 95%CI 0.446-0.811, P=0.001), all-cause death (HR=0.568, 95%CI 0.357-0.903, P=0.017) and myocardial infarction (HR=0.353, 95%CI 0.179-0.695, P=0.003). DAPT>24 months was negatively correlated with all-cause death (HR=0.687, 95%CI 0.516-0.913, P=0.010) and positively correlated with revascularization (HR=1.404, 95%CI 1.116-1.765, P=0.004). There was no correlation between prolonged DAPT and bleeding events. Conclusions: For elderly patients with coronary heart disease complicated with diabetes mellitus underwent DES implantation, and had no MACCE and bleeding events within 1 year after operation, appropriately prolonging of the DAPT duration is related to the reduction of the risk of cardiovascular adverse events. Patients may benefit the most from the DAPT between 13 to 24 months. In addition, prolonging DAPT duration does not increase the incidence of bleeding events in this patient cohort.

Recurrent and Refractory Langerhans Cell Histiocytosis in Children Treated with the Combination of Cladribine and Cytarabine / 中国实验血液学杂志

OBJECTIVE@#To observe the efficacy and prognosis of cladribine (2-CdA) combined with cytarabine (Ara-C) regimen in the treatment of relapsed refractory Langerhans cell histiocytosis (LCH) in children.@*METHODS@#Nine patients with relapsed refractory LCH treated with the 2-CdA combined with Ara-C regimen in the Department of Hematology and Oncology of Wuhan Children's Hospital from July 2014 to February 2020 were retrospectively analyzed, and the efficacy and disease status were evaluated according to the Histiocyte Society Evaluation and Treatment Guidelines (2009) and the Disease Activity Score (DAS), the drug toxicity were evaluated according to the World Health Organization（WHO） grading criteria for chemotherapy. All patients were followed up for survival status and disease-related sequelae.@*RESULTS@#Before the treatment combining 2-CdA and Ara-C, 7 of 9 patients were evaluated as active disease worse (ADW), and 2 as active disease stable (ADS) with a median disease activity score of 8 (4-15). Of 9 patients, 6 cases achieved non active disease (NAD) and 3 achieved active disease better (ADB) with a median disease activity score of 0 (0 to 5) after 2-6 courses of therapy. All 9 patients experienced WHO grade IV hematologic toxicity and 3 patients had hepatobiliary adverse effects (WHO grade I～II) after treatment. The median follow-up time was 31(1 to 50) months with all 9 patients survived, 3 of the 9 patients experienced sequelae to the disease with 2 combined liver cirrhosis as well as cholestatic hepatitis and 1 with oral desmopressin acetate tablets for diabetes insipidus.@*CONCLUSION@#2-CdA combined with Ara-C is an effective regimen for the treatment of recurrent refractory LCH in children, and the main adverse effect is hematologic toxicity, which is mostly tolerated in children. Early treatment with this regimen may be considered for patients with multisystem LCH with risky organ involvement who have failed first-line therapy and for patients with relapse.

Clinical Analysis of Pediatric Acute Myeloid Leukemia with CCLG-AML 2015 Regimen / 中国实验血液学杂志

OBJECTIVE@#To analyze the clinical effects of CCLG-AML-2015 protocol on newly diagnosed children with acute myeloid leukemia (AML).@*METHODS@#The clinical data of 60 newly diagnosed AML children in the Department of Hematology and Oncology, Wuhan Children's Hospital from August 2015 to September 2019 were summarized, the effect of chemotherapy using the CCLG-AML-2015 regimen (hereinafter referred to as the 2015 regimen) were retrospectively analyzed. 42 children with AML treated by the AML-2006 regimen (hereinafter referred to as the 2006 regimen) from February 2010 to July 2015 were used as control group.@*RESULTS@#There were no statistical differences between the 2015 regimen group and the 2006 regimen group in sex, age at first diagnosis, and risk stratification (P>0.05). The complete remission rate of bone marrow cytology after induction of 1 course of chemotherapy (84.7% vs 73.1%, P=0.155), and minimal residual disease detection (MRD) negative (42.3% vs 41.4%, P=0.928) in the 2015 regimen group were not statistically different than those in the 2006 regimen group. The bone marrow cytology CR (98.1% vs 80.6%, P=0.004) and MRD negative (83.3% vs 52.8%, P=0.002) in the 2015 regimen group after 2 courses of induction were higher than those in the 2006 regimen group. The 5-year overall survival (OS) rate in the 2015 regimen group (62.3%±6.4% vs 20.6%±6.4%, P=0.001), the 5-year disease-free survival (EFS) rate (61.0%±6.4% vs 21.0% ±6.4% , P=0.001) were better than those in the 2006 regimen group. The 5-year OS and EFS of high-risk transplant patients in the 2015 regimen group were significantly better than those of high-risk non-transplant patients (OS: 86.6%±9.0% vs 26.7%±11.4%, P=0.000; EFS: 86.6%±9% vs 26.7%±11.4%, P=0.000).@*CONCLUSION@#The 2015 regimen can increase the CR rate after 2 courses of induction compared with the 2006 regimen. High-risk children receiving hematopoietic stem cell transplantation can significantly improve the prognosis.

The Relationship between Plasma sST2/Reg3α Levels and Acute Graft-Versus-Host Disease in Children After Allogeneic Hematopoietic Stem Cell Transplantation / 中国实验血液学杂志

OBJECTIVE@#To explore the relationship between plasma sST2/Reg3α levels and acute graft-versus-host disease (aGVHD) in children after allogeneic hematopoietic stem cell transplantation (allo-HSCT).@*METHODS@#The clinical data of 29 pediatric patients received allo-HSCT treatment in Department of Hematology and Oncology of Wuhan Children's Hospital from January 2019 to January 2020 were collected. Peripheral blood samples were collected at 14 and 28 day after allo-HSCT. The plasma concentrations of sST2 and Reg3α were detected by Luminex assay.@*RESULTS@#Among 29 patients there were 15 males and 14 females with a median age of 53 (29-117) months. After allo-HSCT, 18 patients developed grade 0-I aGVHD; while 11 patients developed grade II-IV aGVHD. These included skin aGVHD in 6 cases, gastrointestinal aGVHD (GI-aGVHD) in 3 cases and gastrointestinal/skin aGVHD in 5 cases. Plasma sST2 level in II-IV aGVHD group showed significantly higher than that in 0-I aGVHD group at 28 days after allo-HSCT [101.81 (73.94-150.77) ng/ml vs 48.97 (28.82-56.69) ng/ml, P=0.021]. Also, the plasma sST2 level was significantly higher in GI-aGVHD group than that in no-aGVHD group at 28 days after allo-HSCT [118.74 (87.00-243.36) ng/ml vs 48.97 (23.55-61.40) ng/ml, P=0.004]. Plasma sST2 level ≥65.34 ng/ml at 28 days after allo-HSCT showed a sensitivity of 85.7% and a specificity of 87.5% in predicting II-IV aGVHD. And the patients with a plasma sST2 level ≥65.34 ng/ml showed a significantly higher incidence of II-IV aGVHD than those with plasma sST2 level of < 65.34 ng/ml after allo-HSCT (P=0.021). There was no significant difference in plasma Reg3α level between the patients with II-IV aGVHD and the non-aGVHD ones.@*CONCLUSION@#The increasing plasma sST2 level after allo-HSCT in children indicates the development of II-IV aGVHD, so sST2 is promising as a biomarker for predicting II-IV aGVHD.

Analysis of the Outcome and Prognostic Factors of Cyclosporine A in Children with Non-severe Aplastic Anemia / 中国实验血液学杂志

OBJECTIVE@#To summarize the long-term efficacy of cyclosporine (CsA) in the treatment of non-severe aplastic anemia (NSAA) in children, and explore the early significant indicators.@*METHODS@#Data of 36 NSAA children in Department of Hematological Oncology, Wuhan Children's Hospital, Tongji Medical College of Huazhong University of Science and Technology from January 2013 to December 2017 were analyzed retrospectively. All the children received oral CsA immunosuppressive therapy, and CsA trough concentration was checked to maintain at the rage of 200-250 μg/L after 2 weeks. The evaluation time points were at 3, 6, 12, 18 and 24 months, and assessment items were peripheral white blood cell differential count and reticulocyte's percentage and count.@*RESULTS@#The 36 NSAA cases were composed of 16 males and 20 females, whose median age was 5.46 (2.92-7.99) years old, and median follow-up time was 28.00 (10.00-38.25) months. After taking oral CsA for 24 months, the number of cumulative effective cases was 21. There were 4 cases of complete remission (CR), 17 cases of partial remission (PR), and 15 cases of non-remission (NR). The total effective rate was 58.33%, and median effect-acting time of CsA was 3.0 (0.5-10.0) months. Compared with ineffective group, neutrophil (NEU) and red blood cell (RBC) of effective group (CR+PR) began to increase significantly at the 3rd month, and hemoglobin (Hb), platelet (PLT) and white blood cell (WBC) increase significantly at the 6th month after oral CsA administration (P<0.05). Except for 2 cases who received component transfusion within 3-12 months after taking oral CsA for 3 months in effective group, the others did not need.@*CONCLUSION@#The overall effective rate of oral CsA in children with NSAA was 58.33%. Stopping blood transfusion after the 3 months of treatment may be considered as a turning point for disease outcomes, and levels of NEU, RBC at the 3rd month and Hb, PLT, WBC at the 6th month as indicators for predicting disease prognosis.

Infection in Children with Acute Myeloid Leukemia in the Intensive Chemotherapy Period / 中国实验血液学杂志

OBJECTIVE@#To investigate the clinical characteristics of infection in children with acute myeloid leukemia (AML) after high intensive chemotherapy， so as to provide reference for prevention and control of infection.@*METHODS@#56 children diagnosed as acute myeloid leukemia in our hospital from January 2016 to August 2019 were enrolled and retrospectively analyzed, the infection rate, pathogens of disease and common location of infection during the induction and consolidation period were analyzed.@*RESULTS@#The total infection rate of the patients was 93.4%－96.4%, the average of serious infection rate was 16.0%(11.3%－19.6%), and the infection related mortality was 10.7%. Fever of unknown cause was the main reason of infection, while blood flow infections were the most common in severe infection, which were mainly caused by Gramnegative bacteria. The rate of fungal infection was 35.7% during chemotherapy.@*CONCLUSION@#Children with AML shows a high incidence of infection in each stage of chemotherapy. The serious illness caused by blood flow infection and take antifungal drugs to reduce the occurrence of fungal infection in AML patients should be paid attention.

Association of cardiovascular diseases with milk intake among general Chinese adults / 中华医学杂志(英文版)

BACKGROUND@#The association of milk intake with cardiovascular disease (CVD) and cause-specific mortality remained controversial and evidence among the Chinese population was limited. We aimed to study the relationship between milk intake and CVDs among general Chinese adults.@*METHODS@#A total of 104,957 participants received questionnaire survey. Results of physical examination such as anthropometric measurements and biochemical tests during 2007 to 2008, demographic data and their information on milk intake were collected through standardized questionnaires. Cox proportional hazard regression models were used to calculate hazard ratios (HRs) and their corresponding 95% confidence intervals (CIs) of CVD incidence, cause-specific mortality and all-cause mortality related to milk intake. Restricted cubic splines (RCSs) were applied to examine dose-response associations.@*RESULTS@#Among the 91,757 participants with a median follow-up period of 5.8 years, we documented 3877 CVD cases and 4091 all-cause deaths. Compared with participants who never consumed milk, the multivariate-adjusted HRs (95% CIs) of CVD incidence for 1 to 150 g/day, 151 to 299 g/day, and ≥300 g/day were 0.94 (0.86-1.03) (P > 0.05), 0.77 (0.66-0.89) (P < 0.05), and 0.59 (0.40-0.89) (P < 0.05), respectively; each 100 g increase of daily milk intake was associated with 11% lower risk of CVD incidence (HR, 0.89; 95% CI: 0.85-0.94; P < 0.001), and 11% lower risk of CVD mortality (HR, 0.89; 95% CI: 0.82-0.97; P = 0.008) after adjustment for age, sex, residential area, geographic region, education level, family history of CVD, smoking, alcohol drinking, physical activity level, body mass index, and healthy diet status (ideal or not). RCS analyses also showed a linear dose-response relationship with CVD (P for overall significance of the curve <0.001; P for non-linearity = 0.979; P for linearity <0.001) and stroke (P for overall significance of the curve = 0.010; P for non-linearity = 0.998; P for linearity = 0.002) incidence, and CVD mortality (P for overall significance of the curve = 0.045; P for non-linearity = 0.768; P for linearity = 0.014) within the current range of daily milk intake.@*CONCLUSIONS@#Daily milk intake was associated with lower risk of CVD incidence and mortality in a linear inverse relationship. The findings provide new evidence for dietary recommendations in CVD prevention among Chinese adults and people with similar dietary pattern in other countries.

Cardiovascular disease risk in diabetes patients aged 40 years old and above in China / 中华心血管病杂志

Objective: To evaluate the incidence of cardiovascular disease (CVD), ischemic and hemorrhagic cardiovascular events among Chinese diabetic patients aged 40 years and above with different CVD risk levels. Methods: This study enrolled participants aged 40 years and above in 15 provinces from a prospective cohort study, the China-PAR project (Prediction for Atherosclerotic Cardiovascular Disease Risk in China). Participants were categorized into two groups according to the presence or absence of diabetes at baseline. Individuals were further classified into low (0-4.9%), moderate (5%-9.9%) and high risk groups (≥10%), based on predicted ten-year CVD risk using the China-PAR equations. Two followed-up surveys were conducted between 2007 and 2015 to identify CVD events, which were defined as nonfatal acute myocardial infarction, or death due to coronary heart disease, or stroke. Ischemic cardiovascular events included nonfatal acute myocardial infarction, or death due to coronary heart disease, or ischemic stroke. Hemorrhagic cardiovascular events included subarachnoid hemorrhage and intracerebral hemorrhage. The incidences of CVD, ischemic and hemorrhagic cardiovascular events were compared in diabetes and non-diabetes population with different CVD risk levels. Results: This study included 89 209 participants aged 40 years and above, the average follow-up period was 8.5 years. The age was (54.8±9.4) years, and 36 794 (41.2%) were men, and 5 730 (6.4%) were diabetic patients. In diabetes patients aged 40 years and above, 53.7% (3 075/5 730) were at high risk of CVD. Age-and sex-adjusted incidence of CVD, ischemic and hemorrhagic cardiovascular events (1 066.93/100 000 person-years, 824.23/100 000 person-years, and 211.56/100 000 person-years) were significantly lower in diabetes patients than those in non-diabetes population with high CVD risk (1 773.73/100 000 person-years, 1 228.18/100 000 person-years, and 446.49/100 000 person-years) (all P<0.001). Among high CVD risk populations, incidence of ischemic events was significantly higher in diabetic patients than in non-diabetes population (1 638.47/100 000 person-years vs. 1 228.18/100 000 person-years, P<0.001), but incidence of hemorrhagic events tended to be lower in diabetic patients than in non-diabetes population (415.70/100 000 person-years vs. 446.49/100 000 person-years, P=0.635). Incidence of ischemic and hemorrhagic events were similar between diabetes patients and non-diabetes population at low or moderate CVD risk groups (all P>0.05). Conclusions: More than half of diabetes patients aged 40 years and above in China have high CVD risk. The incidence of CVD, ischemic and hemorrhagic cardiovascular events are different in diabetic patients with different CVD risk levels.

Effect of the Risk Factors for Treatment-Related Death in Children with Acute Lymphoblastic Leukemia / 中国实验血液学杂志

OBJECTIVE@#To explore the possible risk factors of death in children with acute lymphoblastic leukemia (ALL) after treatment.@*METHODS@#The clinical data of 31 children with newly diagnosed acute lymphoblastic leukemia and dead after treatment in the Hematology Oncology Department of Wuhan children's Hospital from January 1, 2016 to December 31, 2019 were retrospectively analyzed. Univariate factor analysis and multivariate Cox regression analysis were used to analyze the each indexes of ALL children, and the possible risk factors causes of death in ALL children after treatment were analyzed.@*RESULTS@#Among 230 newly diagnosed ALL children, 31 (13.4%) cases were dead. Among them, there were 12 male and 19 female. The mortality rates were 9%(12/133) for male and 19.5%(19/97) for female, which showed a significantly difference（P=0.02）； among the dead ALL children, 6 were less than 1 year old, 23 were 1-10 years old, and 2 was more than 10 years old. The mortality rates in different age groups were 46.1 % (6/13), 11.7%(23/195) and 9%(2/22), respectively, which showed a significantly difference（P=0.00）； the mortality rates of the ALL children in standard risk group, medium risk group and high risk group were 6.7% (4/59), 11.9% (13/10@*CONCLUSION@#The female, less than 1 year old at initial diagnosis, high risk ALL, WBC>50×10

Relationship of PTEN/PI3K/AKT Signaling Pathway Protein Expression with Apoptosis and Drug-resistance of Children's ALL Primary Cells Treated with Daunorubicin / 中国实验血液学杂志

OBJECTIVE@#To investigate the relationship of PTEN/PI3K/AKT signaling pathway protein expression with apoptosis and drug-resistance of children's ALL primary cells treated with daunorubicin (DNR).@*METHODS@#The bone marrow mononuclear cells in newly diagnosed and untreated B-ALL children were collected and cultured. After the treatment of primary-cultured cells with DNR of final concentration 0.5 mg/L for 24 h, the cell apoptosis rate was detected by using cell apoptosis assay kit; the samples were collected at the on test of culture and after drug treatment, then expression levels of PTEN, PI3K and AKT proteins were detected by Western blot, moreover the interindex correlation was analyzed.@*RESULTS@#After DNR treatment, the apoptosis rate in PTEN low expression group was lower than that in PTEN high expression group (P＜0.05), showing high positive correlation of the cell apoptosis rate with the expression of PTEN before DNR treatment; the cell apoptosis rate in PI3K and AKT low expression group was higher than that in PI3K and AKT high expression group (P＜0.01); however, the expression of PI3K and AKT proteins was down-regulated after treatment with DNR (P＜0.01).@*CONCLUSION@#The difference of PTEN expression is present in primary cells of B-ALL children, however the change of PTEN expression is not significant after DNR treatment, suggesting that the PTEN expression correlates with DNR-resistance. The DNR can induce the apoptosis of childrens B-ALL primary cells by down-regulating the expression of PI3K and AKT signaling pathway proteins.

Effect of long-chain non-coding RNA AP000344. 3 on the proliferation and invasion of human bladder cancer cells and its mechanism / 临床与实验病理学杂志

Purpose To investigate the effect of specific long-chain non-coding RNA AP000344. 3 on the proliferation and invasion of bladder cancer cells and its mechanism. Methods qRT-PCR was used to detect the expression of AP000344. 3 in bladder cancer cells and normal bladder epithelial cells. The cancer cells with the lowest expression rate were selected for subsequent experiments. The AP000344. 3 plasmid or the negative control plasmid was transferred into bladder cancer cells by Lipofectamine 2000, and the transfection efficiency of AP000344. 3 was detected by qRT-PCR. Cell proliferation activity was measured by MTT method,and cell invasion ability was detected by Transwell assay. Bioinformatics was used to predict downstream miRNA and downstream genes of AP000344. 3. qRT-PCR and Western blot were used to detect the expression of downstream genes. Results The expression of AP000344. 3 in bladder cancer cells was significantly lower than that in normal bladder epithelial cells (P < 0. 01) ,and the expression of AP000344. 3 was the lowest in BIU87 cells (P < 0. 01) . The expression of AP000344. 3 in BIU87 cells was up-regulated at 48 h after transfection with AP000344. 3 (P < 0. 01) . The proliferation activity of BIU87 cells was decreased (P < 0. 05) ,and the cell invasion ability was decreased (P < 0. 05) . AP000344. 3 can target and bind to miR-135a-5p,and miR-135a-5p to human chemokine-like factor superfamily member 3 (CMTM3) . After up-regulation of AP000344. 3,miR-135a-5p expression was down-regulated (P < 0. 01) ,and CMTM3 was up-regulated in mRNA and protein expression (P < 0. 01) . Conclusion AP000344. 3 is significantly down-regulated in bladder cancer cells,and up-regulation of AP000344. 3 can inhibit the proliferation and invasion of bladder cancer cells. The mechanism may be to inhibit the expression of miR-135a-5p and up-regulate the expression of CMTM3 protein,providing a theoretical basis for finding new therapeutic targets for bladder cancer.

Trends in Serum Total Cholesterol During 1998 to 2015 Among the Population-based Cohorts of China / 中国循环杂志

Objectives: To explore the trends of serum total cholesterol (TC) among Chinese adult cohorts from 1998 to 2015. Methods: The subjects of this study came from China Multicenter Collaborative Study of Cardiovascular Epidemiology and International Collaborative Study of Cardiovascular Disease in Asia. The baseline investigations were completed during 1998-2001, and the two follow-ups were conducted during 2007-2008 and 2013-2015, respectively. A total of 9 477 participants aged 35-74 years with complete serum TC data from three surveys were included in this study. Analysis on variance of data regarding repeated measurements were used to investigate the variation of serum TC in different subgroups. The serum TC levels were represented by mean (standard errors). Results: During 1998-2015, the mean level of serum TC of all participants significantly elevated from 4.81(0.01) mmol/L to 4.91(0.01) mmol/L, and to 4.98(0.01) mmol/L, growth rates of which were 2.08% and 3.53% in the first and second follow-up, respectively (Ptrend<0.001), especially for females. The fastest growth was noted in the group of young women aged 35-45 years over time, with a growth rate of 11.43%. No such a significant change in the male group during follow-up. The serum TC level and its growth rate in urban residents was significantly higher than those in rural residents. Conclusions: Longitudinal data demonstrated that the mean serum TC level among Chinese adults was continuously increased during 1998~2015. Prevention strategy for hypercholesterolemia should focus more on young women and urban residents.

2011 Status Survey for Physical Activity and Regular Exercise in Adult Residents of Beijing / 中国循环杂志

Objective: To explore the physical activity (PA) and regular exercise in adult residents of Beijing in order to provide the basis for guiding regular exercise and chronic disease prevention. Methods: A multi stage, random cluster investigation was conducted in 20242 residents from (18-79) years in Beijing area. Based on International physical activity questionnaire (IPAQ) published in USA (2000), the metabolic equivalent (MET) was calculated; according to the standard by General administration of sport of China, regular exercise rate was assessed. Weighting adjustment was conducted on the basis of 2010 Beijing population census data and sampling design. Results: 19584 participants with complete information were enrolled for final analyses. The median weekly MET of occupational PA, domesticity, transport-related PA and leisure exercise were (1918, 839, 922 and 928) MET-minute/week respectively. Female had the lower MET in occupational PA and leisure exercise than male (1436 vs 2156) MET-minute/week and (827 vs 944) MET-minute/week, both P<0.001. Elderly adults had the higher MET in leisure exercise than young and middle aged adults (1490 vs 718) MET-minute/week and (1490 vs 1162) MET-minute/week, both P<0.001. Regular exercise rate was only 31.5％ (95％ CI 30.7％-32.4％); multivariate analysis indicated that compared with male, female had the higher risk of insufficient regular exercise, OR=1.26 (95％ CI 1.14-1.40), compared with young adults, middle and elderly adults had the lower risk of insufficient regular exercise, OR=0.54 (95％ CI 0.50-0.59) and OR=0.46 (95％ CI 0.39-0.54). Compared to residents with education≤6 years, those with education at (7-12) years and with education>12 years had the lower risk of insufficient regular exercise, OR=0.66 (95％ CI 0.57-0.77) and OR=0.46 (95％ CI 0.39-0.54). Conclusion: Sampling residents in Beijing had insufficient leisure exercise with the low rate of regular exercise in 2011. Health policy and environment especially beneficial to female, youth and lower educated adults should be established to improve the healthy Beijing construction.

A new self-convertible inferior vena cava filter:in vivo experimental evaluation / 中国组织工程研究

BACKGROUND:An inferior vena cava filter is an effective tool to prevent fatal pulmonary embolism. The existing filters have some shortcomings that limit their clinical application. OBJECTIVE:To evaluate the feasibility and capture efficiency of a new self-convertible inferior vena cava filter (SCF)in vivo. METHODS:L-lactide and ε-caprolactone were fused and polymerized to act as a degradable deformable switch of the filter. Medical stainless steel wire as the metal structure of the filter was combined with the degradable deformable switch to make the SCF. Eight SCFs were implanted into the inferior vena cava of eight adult Beagle dogs. The inferior vena cava angiography was performed to evaluate the release process, morphology and location of the filter. Venous angiography was performed 2 weeks later to evaluate the morphology and location of the filter and inferior vena cava patency. Detection of pulmonary embolism or other complications was performed at autopsy. RESULTS AND CONCLUSION:Eight SCFs were successfully implanted and positioned accurately with no tilt, and they were converted successfully at 2 weeks after the implantation, as assessed by the venous angiography. One of the eight SCFs migrated to the orifice of the right atrium, and caused asymptomatic inferior vena cava obstruction. The remaining SCFs were normally positioned with no tilt and local lesion or obstruction after deformation. No marked filling defect in the trunk of the pulmonary artery was shown by the pulmonary artery angiography. The autopsy report revealed that the filter arm had been endothelialized, and the inferior vena cava that was in contact with the filter arm had no obvious stenosis. Mild intimal hyperplasia, less than 1 mm in thickness, was found in the bottom of the filter arm, but it did not cause a stenosis in the lumen. No vena cava perforation, retroperitoneal hemorrhage, and injury of the surrounding viscera were found. Overall, the design of the SCF is feasible.

A new self-convertible inferior vena cava filter:in vitro experimental evaluation / 中国组织工程研究

BACKGROUND: Inferior vena cava filter is an effective way to prevent fatal pulmonary embolism. The existing filters have some shortcomings that limit the clinical application. OBJECTIVE:To evaluate the feasibility and capture efficiency of a new self-convertible inferior vena cava filter(SCF)in vitro. METHODS: The biodegradable switch was constructed of a copolymer of ε-caprolactone and L-lactide (75%/25%, PCLA75). The biodegradable switch bound together with the apices of the convertible struts to make the self-convertible filter. The deformability and capture efficiency of the filter were tested in an in-vitro flow model with three different diameters (22, 25, 28 mm). A total of 15 filters were implanted both in the vertical and horizontal positions, and the tilt angle of the filter was tested after release. To accelerate switch degradation, a lipase perfusate was injected into the flow model and refreshed every 8 hours until conversion. RESULTS AND CONCLUSION: (1) All the filters were successfully implanted without tilting, both in the vertical and horizontal positions in the three different diameter models. (2) All the 15 SCFs were converted successfully without tilting, structural damage, and displacement. (3) The capture efficiency of the SCF had significant difference between the different diameter of the models, the size of the embolus and the position of the two models (P < 0.001). The mean capture efficiency was 82.5%, and the capture efficiency exhibited a downward trend with the increase of pipe diameter, the decrease of emboli size, and the position of pipeline changing from vertical to horizontal. All these results show that the SCF is feasible and highly efficient.

Effect of microRNA-448 inhibitor on the proliferation and migration of human prostate cancer cells / 临床与实验病理学杂志

Purpose To observe the effect of specific miR-448 inhibitor on the proliferation and migration of prostate cancer cells and its molecular mechanism. Methods Real-time fluo-rescent quantitative polymerase chain reaction ( qRT-PCR) was used to detect the expression of miR-448 in normal prostate epi-thelial cells and cancer cells. The cells with the highest expres-sion of miR-448 were selected for follow-up experiment. The miR-448 inhibitor or miR-NC was transferred into prostate canc-er cells using liposome transfection reagent. The expression of miR-448 and CMTM3 mRNA were detected by qRT-PCR. The expression of related proteins were detected by Western blotting. MTT assay was used to detect the cell proliferation activity. Tr-answell assay was used to detect the cell migration ability. Re-sults The expression of miR-448 in normal prostate epithelial cells was significantly lower than that in cancer cells ( P ＜0. 01), and the expression of miR-448 was the highest in DU- 145 cells ( P ＜0. 01). The expression of miR-448 in DU-145 cells was down-regulated 48 h after transfection with miR-448 in-hibitor (P＜0. 01). The expression of CMTM3 mRNA was up-regulated (P＜0. 01). The expression of CMTM3, E-cadherin and β-catenin proteins were up-regulated. The expression of N-cadherin and Snail proteins were down-regulated. Cell prolifera-tion was decreased (P＜0. 05). Cell migration ability decreased (P ＜ 0. 01 ). Conclusion miR-448 is highly expressed in prostate cancer cells. miR-448 inhibitor can down-regulate the expression of miR-448 in DU-145 cells, up-regulate the expres-sion of CMTM3 protein, inhibit the proliferation and migration of prostate cancer cells, which showing a potential function in mo-lecular therapy of prostate cancer.

Impact of Residual SYNTAX Score and Its Derived Indexes on Clinical Outcomes after Percutaneous Coronary Intervention: Data from a Large Single Center / 中华医学杂志(英文版)

<p><b>Background</b>Residual SYNTAX score (rSS) and its derived indexes including SYNTAX revascularization index (SRI) and clinical rSS had been developed to quantify and describe the extent of incomplete revascularization. This study was conducted to explore the utility of the three scores among real-world patients after percutaneous coronary intervention (PCI).</p><p><b>Methods</b>From January 2013 to December 2013, patients underwent PCI treatment at Fuwai Hospital were included. The primary endpoints were all-cause death and major adverse cardiovascular and cerebrovascular events. The secondary endpoints were myocardial infarction, revascularization, stroke, and stent thrombosis. Kaplan-Meier methodology was used to determine the outcomes. Cox multivariable regression was to test the associations between scores and all-cause mortality.</p><p><b>Results</b>A total of 10,344 patients were finally analyzed in this study. Kaplan-Meier survival analysis indicated that greater residual coronary lesions quantified by rSS and its derived indexes were associated with increased risk of adverse cardiovascular events. However, after multivariate analysis, only clinical rSS was an independent predictor of 2-year all-cause death (hazard ratio: 1.02, 95% confidence interval: 1.01-1.03, P < 0.01). By receiver operating characteristic (ROC) curve analysis, clinical rSS had superior predictability of 2-year all-cause death than rSS and SRI (area under ROC curve [AUC]: 0.59 vs. 0.56 vs. 0.56, all P < 0.01), whereas rSS was superior in predicting repeat revascularization than clinical rSS and SRI (AUC: 0.62 vs. 0.61 vs. 0.61; all P < 0.01). When comparing the predictive capability of rSS ≥8 with SRI <70%, their predictabilities were not significantly different.</p><p><b>Conclusions</b>This study indicates that all three indexes (rSS, clinical rSS, and SRI) are able to risk-stratify patients and predict 2-year outcomes after PCI. However, their prognostic capabilities are different.</p>

Evaluation of the Patterns of Non-Adherence to Anti-Platelet Regimens in Stented Patients Bleeding Score for Predicting the Long-term Out-of-hospital Bleeding Risk in Chinese Patients after Percutaneous Coronary Intervention / 中华医学杂志(英文版)

<p><b>Background</b>The Patterns of Non-Adherence to Anti-Platelet Regimens in Stented Patients (PARIS) bleeding score is a novel score for predicting the out-of-hospital bleeding risk after percutaneous coronary intervention (PCI). However, whether this score has the same value in non-European and American populations is unclear. This study aimed to assess the PARIS bleeding score's predictive value of bleeding in patients after PCI in the Chinese population.</p><p><b>Methods</b>We performed a prospective, observational study of 10,724 patients who underwent PCI from January to December 2013, in Fuwai Hospital, China. We defined the primary end point as major bleeding (MB) according to Bleeding Academic Research Consortium definition criteria including Type 2, 3, or 5. The predictive value of the PARIS bleeding score was assessed with the area under the receiver operating characteristic (AUROC) curve.</p><p><b>Results</b>Of 9782 patients, 245 (2.50%) MB events occurred during the 2 years of follow-up. The PARIS bleeding score was significantly higher in the MB group than that of non-MB group (4.00 [3.00, 5.00] vs. 3.00 [2.00, 5.00], Z = 3.71, P < 0.001). According to risk stratification of the PARIS bleeding score, the bleeding risk in the intermediate- and high-risk groups was 1.50 times (hazard ratio [HR]: 1.50; 95% confidence interval [CI]: 1.160-1.950; P = 0.002) and 2.27 times higher (HR: 2.27; 95% CI: 1.320-3.900; P = 0.003) than that in the low-risk group. The PARIS bleeding score showed a moderate predictive value for MB in the overall population (AUROC: 0.568, 95% CI: 0.532-0.605; P < 0.001) and acute coronary syndrome (ACS) subgroup (AUROC: 0.578, 95% CI: 0.530-0.626; P = 0.001) and tended to be predictive in the non-ACS subgroup (AUROC: 0.556, 95% CI: 0.501-0.611; P = 0.054).</p><p><b>Conclusion</b>The PARIS bleeding score shows good clinical value for risk stratification and has a significant, but relatively limited, prognostic value for out-of-hospital bleeding in the Chinese population after PCI.</p>

Validation of Predictive Value of Patterns of Nonadherence to Antiplatelet Regimen in Stented Patients Thrombotic Risk Score in Chinese Population Undergoing Percutaneous Coronary Intervention: A Prospective Observational Study / 中华医学杂志(英文版)

Background@#The patterns of nonadherence to antiplatelet regimen in stented patients (PARIS) thrombotic risk score are a novel score for predicting the risk of coronary thrombotic events (CTEs) after percutaneous coronary intervention (PCI) with drug-eluting stents. However, the prognostic value of this score has not been fully evaluated in non-Euro-American PCI populations.@*Methods@#We performed a prospective, observational study of 10,724 patients who underwent PCI in Fuwai hospital, China and evaluated the PARIS thrombotic risk score's predictive value of CTEs in the PCI population. The area under the receiver operating characteristic curve (AUROC) was used to assess the predictive value of the PARIS score for CTE.@*Results@#Among 9782 patients without in-hospital events, a total of 95 CTEs occurred during the 2-year follow-up. The PARIS score was significantly higher in patients with CTEs (3.38 ± 2.04) compared with patients without events (2.53 ± 1.70, P < 0.001). According to the risk stratification of the PARIS thrombotic score, the risk of CTEs in the high-risk group was 3.14 times higher than that in the low-risk group (hazard ratio [HR], 3.14; 95% confidence interval [CI], 1.92-5.13; P < 0.001). However, the risk of CTEs in the intermediate-risk and low-risk groups was not significant (HR, 1.39; 95% CI, [0.86-2.24]; P = 0.184). The PARIS score showed prognostic value in evaluating CTEs in the overall population (AUROC, 0.621; 95% CI, 0.561-0.681), the acute coronary syndrome (ACS) population (AUROC, 0.617; 95% CI, 0.534-0.700; P = 0.003), and the non-ACS population (AUROC, 0.647; 95% CI, 0.558-0.736; P = 0.001).@*Conclusions@#In a real-world Chinese population, the PARIS thrombotic risk score shows a modest prognostic value for CTEs in patients after PCI. This score also has a predictive value for CTEs in the ACS and non-ACS subgroup populations.