Diagnosis Significance of the Levels of Cytokines IL-6, IL-10 and CXCL-13 in Cerebrospinal Fluid for Central Nervous System Infiltration of Lymphoma / 中国实验血液学杂志

OBJECTIVE@#To evaluate the diagnostic value of the expression levels of cytokines interleukin-6(IL-6), interleukin-10 (IL-10) and chemokine （C-X-C motif） ligand-13 (CXCL-13) in cerebrospinal fluid (CSF) for central nervous system infiltration of lymphoma.@*METHODS@#Forty patients diagnosed as lymphoma or acute lymphoblastic leukemia in General Hospital of Northern Theater Command from July 2020 to July 2021 were collected and recorded their CSF indexes, including pressure, protein, Pandy test, nucleated cell count, glucose and chlorine content in CSF. The levels of cytokines IL-6, IL-10 and CXCL-13 were detected by Enzyme-linked immunosorbent assay.@*RESULTS@#The patients were divided into CNSI (central nervous system infiltration) group and non-CNSI group, the average levels of IL-6, IL-10, CXCL-13 and IL-10/IL-6 ratio in CNSI group were higher than those in non-CNS group, but the difference of IL-10/IL-6 ratio between the two groups was statistically significant (P<0.05). Then the patients were divided into protein elevated(n=14) group and protein normal group(n=26), the levels of IL-6 ［ (5.78±2.69) pg/ ml］ and CXCL-13 ［(0.83±0.59) pg/ml］ in protein elevated group were significantly higher than those in the protein normal group ［IL-6: (2.41±1.16) pg/ml; CXCL-13: (0.38±0.18) pg/ml］ (P<0.05). Further analysis of the expression levels of the cytokines in non-CNSI group (n=32), IL-6, IL-10, CXCL-13 level and IL-10/IL-6 ratio in the protein elevated group (n=12) were higher than those in the protein normal group (n=20), but the difference was not statistically significant.@*CONCLUSION@#The levels of IL-6, IL-10 and CXCL-13 in CSF of lymphoma patients with CNS infiltration were higher than those in non-CNS infiltration group, and those in patients with protein elevated group are higher than those in the protein normal group.

Clinical characteristics and surgical outcomes of school-age pediatric monocular retinal detachment / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To evaluate the underlying aetiology and clinical characteristics of retinal detachment(RD)in school-age pediatric monocular RD.METHODS:Patients with RD and contralateral blind(monocular RD)aged 7-14 years, from November 2015 to May 2021 in our hospital were retrospectively reviewed. Demographic characteristics and etiology of RD, clinical type, surgical modality, type of intraocular tamponade, pre-and postoperative visual and anatomical outcomes were recorded and evaluated.RESULTS: There were 27 children(27 eyes)with monocular RD at least 6mo follow-up. The average age at presentation was 10.63±2.30 years. Familial exudative vitreoretinopathy(FEVR)(11/27, 41%), postoperative congenital glaucoma(6/27, 22%)and Stickler syndrome(3/27, 11%)were main underlying etiologies. Among them, rhegmatogenous retinal detachment(RRD)comprised 78%(21/27)of the patients, of which 81% patients(17/21)had proliferative vitreoretinopathy(PVR)C3 or worse. Pars plana vitrectomy(PPV)was done in 85%(23/27)of the patients, of which 83%(19/23)received silicone oil tamponade. Best corrected visual acuity(BCVA, LogMAR)worse than 1.7 was seen in 78%(21/27)of the patients at final visit, and 82%(22/27)had reattached retina, but 41%(11/27)of the patients remained status of silicone oil tamponade at last visit.CONCLUSION:School-age pediatric monocular RD is often associated with underlying congenital or hereditary conditions, and often presented with severe RD and severe PVR reaction which needed vitrectomy combined with silicon oil tamponade, and with poor visual and anatomical short-term prognosis.

Report of two imported COVID-19 cases in mid-term pregnancy / 上海预防医学

Objective:To study the clinical characteristics of imported coronavirus disease 2019 （COVID-19） cases in pregnancy. Methods:Two imported COVID-19 cases in pregnancy admitted to Shanghai public health clinical center from March 2020 to April 2020 were retrospectively analyzed. Results:The two COVID-19 patients were in the second trimester of pregnancy， and were imported cases： case 1 came from the United States and was asymptomatic； case 2 came from Russia， and had fever， sore throat， cough and expectoration， and taste and smell loss. Laboratory testing on admission suggested that the albumin decreased in case 1. In case 2， lymphocyte count and percentage decreased， C-reactive protein and procalcitonin increased， albumin decreased， serum troponin increased， while the electrocardiogram was normal. Chest CT scans of the two cases were abnormal. They were administered with intensive care and nutritional support. Case 2 was treated with cefaclor tablets for 5 days. Case 1 and case 2 were hospitalized for 14 days and 12 days， respectively. They were discharged until twice nasopharyngeal swabs and fecal specimen tested negative for the novel coronavirus nucleic acid. Conclusion:The treatment for the patients with normal type of COVID-19 in the second trimester of pregnancy is aimed to strengthen the monitoring during pregnancy， which needs nutritional and psychological intervention. However， follow-up of pregnancy outcome is warranted .

Long-term outcomes of percutaneous coronary intervention for in-stent chronic total occlusion / 中华医学杂志(英文版)

BACKGROUND@#The development of the technique has improved the success rate of percutaneous coronary intervention (PCI) for in-stent chronic total occlusion (IS-CTO). However, long-term outcomes remain unclear. The present study sought to investigate long-term outcomes of PCI for IS-CTO.@*METHODS@#A total of 474 IS-CTO patients were enrolled at two cardiac centers from 2015 to 2018 retrospectively. These patients were allocated into either successful or failed IS-CTO PCI groups. The primary endpoint (major adverse cardiac events [MACE]) consisted of recurrent angina pectoris (RAP), target-vessel myocardial infarction (MI), heart failure, cardiac death, or ischemia-driven target-vessel revascularization (TVR) at follow-up. Multivariable Cox regression analysis was used to investigate the association between treatment appropriateness and clinical outcomes.@*RESULTS@#A total of 367 patients were successfully treated with IS-CTO PCI while 107 patients had failed recanalization. After a median follow-up of 30 months (interquartile range: 17-42 months), no significant difference was observed between the two groups for the following parameters: cardiac death (successful PCI vs. failed PCI: 0.9% vs. 2.7%; adjusted hazard ratio [HR]: 1.442; 95% confidence interval [CI]: 0.21-9.887; P = 0.709), RAP (successful PCI vs. failed PCI: 40.8% vs. 40.0%; adjusted HR: 1.025; 95% CI: 0.683-1.538; P = 0.905), heart failure (successful PCI vs. failed PCI: 6.1% vs. 2.7%; adjusted HR: 0.281; 95% CI: 0.065-1.206; P = 0.088), target-vessel related MI (successful PCI vs. failed PCI: 1.5% vs. 2.7%; adjusted HR: 1.150; 95% CI: 0.221-5.995; P = 0.868), MACE (successful PCI vs. failed PCI: 44.2% vs. 45.3%; adjusted HR: 1.052; 95% CI: 0.717-1.543; P = 0.797). More patients were free of angina in the successful IS-CTO PCI group compared with failed PCI in the first (80.4% vs. 60%, P 18 months of dual antiplatelet therapy (DAPT) was an independent predictor of decreased risk of TVR (HR: 2.682; 95% CI: 1.295-5.578; P = 0.008) or MACE (without TVR) (HR: 1.898; 95% CI: 1.036-3.479; P = 0.038) in successful IS-CTO PCI.@*CONCLUSIONS@#After a median follow-up of 30 months, the successful IS-CTO PCI group had MACE similar to that of the failed PCI group. However, the successful IS-CTO PCI group had improved angina symptoms and were free from requiring coronary artery bypass grafting in the first or second years. To decrease MACE, DAPT was found to be essential and recommended for at least 18 months for IS-CTO PCI.

Protective effect of thymosin β4 in ocular surface diseases / 国际眼科杂志(Guoji Yanke Zazhi)

@#Thymosin is a kind of protein that is widely distributed in many tissues. It has many biological activities. Thymosin is divided into three subtypes: thymosin α, thymosin β and thymosin γ. Thymosin β4(Tβ4)is the most widely distributed in normal human body. A large number of studies have confirmed that Tβ4 has the functions of anti-inflammatory, anti-apoptosis and promoting proliferation. Ocular surface diseases are mostly related to ocular surface injury and inflammation. Therefore, promoting wound repair and healing and anti-inflammatory are the key to the treatment of ocular surface diseases. The present review mainly introduces the distribution, structure, synthesis of Tβ4 and its protective effect on ocular surface.

Prognostic impact of PCI in patients with chronic total occlusion on non-infarct-related artery in acute STEMI with cardiogenic shock / 中国实用内科杂志

Chronic total occlusion(CTO) located at a non infarct-related artery in patients with acute ST-segment–elevation myocardial infarction is linked to attack of cardiogenic shock and increased mortality.It has been demonstrated that direct PCI of infarct-related artery(IRA) in STEMI patients with multi-vessel lesions will restore the blood flow of IRA and improve prognosis of cardiogenic shock. But how to deal with non-target CTO lesions? Whether successful CTO PCI will reduce cardiovascular events, cardiovascular mortality and heart failure remains a research hotspot.

Clinical assessment of 25G micro-incision vitrectomy for treatment of intraocular foreign bodies / 眼科新进展

Objective To investigate the clinical efficacy of 25G minimally invasive vitrectomy for the removal of foreign bodies in the posterior segment of the ball.Methods The clinical data of 21 patients (21 eyes) with intraocular foreign bodies who underwent 25G minimally invasive vitrectomy combined with intrabulbar foreign body removal were retrospectively analyzed,including magnetic foreign bodies in 17 patients and non-magnetic foreign bodies in 4 patients.All the patients had cataract and vitreous hemorrhage,with 3 patients (3 eyes) suffering secondary endophthalmitis,and 12 patients (12 eyes) suffering secondary retinal detachment.Cataract extraction,retinal reattachment and silicone oil tamponade were combined according to different conditions,and the complications and surgical outcomes were analyzed for 6-month followup.Results All patients received preoperative examinations,immediately following implementation of 25G minimally invasive vitrectomy and intrabulbar foreign body removal procedures.The removal rate of foreign bodies in phase Ⅰ was 100％.All the endophthalmitis and retinal detachment were cured before operation.The turbid lens was removed during operation from the corneal incision in 20 patients (20 eyes),and from a scleral incision in 1 patient after cataract extraction.A total of 19 eyes had better postoperative visual acuity than preoperative vision,14 eyes underwent phase Ⅱ intraocular lens implantation,and silicone oil was retained in 2 eyes.No postoperative complications related to minimally invasive surgery occurred.Conclusion 25G minimally invasive vitrectomy has good clinical outcomes in the removal of intraocular foreign bodies in the posterior segment of the eye,with minimal surgical trauma,rapid visual function recovery,and fewer complications,but great attention should be paid to its indications.

Change of Inflammatory Factors in Patients with Acute Coronary Syndrome / 中华医学杂志(英文版)

<p><b>Background</b>Acute coronary syndrome (ACS) is closely related to unstable plaques and secondary thrombosis. The inflammatory cells in plaques and their inflammatory products may be the cause for plaque instability and ruptures. The study aimed to disclose the changes of inflammatory factors including serum intracellular adhesion molecule-1 (ICAM-1), chitinase-3-like protein 1 (YKL-40), and lipoprotein-associated phospholipase A2 (Lp-PLA2) in patients with ACS and its clinical significance.</p><p><b>Methods</b>A total of 120 patients with coronary heart disease (CHD) were categorized into 2 groups: 69 with ACS and 51 with stable angina pectoris (SAP); 20 patients with chest pain and normal angiography served as a control group. The 120 patients with CHD were categorized into single-vessel disease group, double-vessel disease group, and three-vessel disease group based on the number of coronary artery stenosis. The severity of coronary artery stenosis was quantified based on coronary angiography using Gensini score. They were further divided into mild CHD group with its Gensini score <26 (n = 36), moderate CHD group with its Gensini score being 26-54 (n = 48) and severe CHD group with its Gensini score >54 (n = 36). Serum levels of ICAM-1, YKL-40, and Lp-PLA2 of different groups were determined by enzyme-linked immunosorbent assay. Correlation between ICAM-1, YKL-40, Lp-PLA2, and Gensini score was analyzed.</p><p><b>Results</b>The levels of serum inflammatory factors ICAM-1, YKL-40, and Lp-PLA2 were significantly higher in the ACS group than those in control group and SAP group (all P < 0.05); and compared with control group, no significant difference was observed in terms of the serum ICAM-1, YKL-40, and Lp-PLA2 levels in the SAP group (P > 0.05).The levels of serum ICAM-1, YKL-40, and Lp-PLA2 were not significantly different among control group, single-vessel disease group, double-vessel disease group, and three-vessel disease group (all P > 0.05). The levels of serum ICAM-1, YKL-40, and Lp-PLA2 were not significantly different among control group, mild CHD group (Gensini score <26), moderate CHD group (Gensini score 26-54), and severe CHD group (Gensini score >54) (all P > 0.05). Nonparametric Spearman correlation analysis showed that the levels of serum ICAM-1, YKL-40, and Lp-PLA2 were not correlated with the Gensini score in CHD patients (r = 0.093, r = -0.149, and r = -0.085, all P > 0.05; respectively).</p><p><b>Conclusions</b>The serum levels of ICAM-1, YKL-40, and Lp-PLA2 were correlated with different clinical types of CHD, but not well correlated the severity and extent of artery stenosis, suggesting that ICAM-1, YKL-40, and Lp-PLA2 might be involved in occurrence of instability of atherosclerotic plaque, and might reflect the severity of CHD mostly through reflecting the plaque stability.</p>

Protection Effect of Exogenous Fibroblast Growth Factor 21 on the Kidney Injury in Vascular Calcification Rats / 中华医学杂志(英文版)

<p><b>Background</b>Chronic kidney disease (CKD) is closely related to the cardiovascular events in vascular calcification (VC). However, little has known about the characteristics of kidney injury caused by VC. Fibroblast growth factor 21 (FGF21) is an endocrine factor, which takes part in various metabolic actions with the potential to alleviate metabolic disorder diseases. Even FGF21 has been regarded as a biomarker in CKD, the role of FGF21 in CKD remains unclear. Therefore, in this study, we evaluate the FGF21 on the kidney injury in VC rats.</p><p><b>Methods</b>The male Sprague-Dawley rats were divided into three groups: (1) control group, (2) Vitamin D3 plus nicotine (VDN)-induced VC group, (3) FGF21-treated VDN group. After 4 weeks, the rats were killed and the blood was collected for serum creatinine, urea nitrogen, calcium, and phosphate measurement. Moreover, the renal tissues were homogenized for alkaline phosphatases (ALPs) activity and calcium content. The levels of FGF21 protein were measured by radioimmunoassay. The levels of β-Klotho and FGF receptor 1 (FGFR1) protein were measured by enzyme-linked immunosorbent assay (ELISA). The structural damage and calcifications in aortas were stained by Alizarin-red S. Moreover, the structure of kidney was observed by hematoxylin and eosin staining.</p><p><b>Results</b>The renal function impairment caused by VDN modeling was ameliorated by FGF21 treatment, inhibited the elevated serum creatinine and urea level by 20.5% (34.750 ± 4.334 μmol/L vs. 27.630 ± 2.387 μmol/L) and 4.0% (7.038 ± 0.590 mmol/L vs. 6.763 ± 0.374 mmol/L; P < 0.01), respectively, together with the structural damages of glomerular atrophy and renal interstitial fibrosis. FGF21 treatment downregulated the ALP activity, calcium content in the kidney of VC rats by 42.1% (P < 0.01) and 11.7% (P < 0.05) as well as ameliorated the aortic injury and calcification as compared with VDN treatment alone group, indicating an ameliorative effect on VC. ELISA assays showed that the expression of β-Klotho, a component of FGF21 receptor system, was increased in VDN-treated VC rats by 37.4% (6.588 ± 0.957 pg/mg vs. 9.054 ± 0.963 pg/mg; P < 0.01), indicating an FGF21-resistant state. Moreover, FGF21 treatment downregulated the level of β-Klotho in renal tissue by 16.7% (9.054 ± 0.963 pg/mg vs. 7.544 ± 1.362 pg/mg; P < 0.05). However, the level of FGFR1, the receptor of FGF21, kept unchanged under VDN and VDN plus FGF21 administration (0.191 ± 0.0376 ng/mg vs. 0.189 ± 0.032 ng/mg vs. 0.181 ± 0.034 ng/mg; P > 0.05).</p><p><b>Conclusions</b>In the present study, FGF21 was observed to ameliorate the kidney injury in VDN-induced VC rats. FGF21 might be a potential therapeutic factor in CKD by cutting off the vicious circle between VC and kidney injury.</p>

Evaluation of risk factors for sudden cardiac death after revascularization in patients with coronary heart disease and heart failure / 中国介入心脏病学杂志

Objective To explore the risk factors for sudden cardiac death(SCD)after revascularization in patients with coronary heart disease and heart failure.Methods This study was a retrospective analysis of 1683 patients with coronary heart disease whose left veatricalar ejection fraction(LVEF)≤40％within 30 days before revascularization.Patients were categorized into 2 groups according their clinical outcome as with or without SCD.Their clinical,angiographic and echocardiographic characteristics were reviewed and compared.The average follow-up time was 1803 days.Results There were total 59 SCD cases.The Cox regression analysis revealed that tricuspid regurgitation(HR 2.217,95％CI 1.285-3.827,P=0.004),lef t main with triple-vessel disease(HR 3.089,95％CI 1.310-7.283,P=0.010),uric acid levels(HR 1.003,95％CI 1.001-1.005,P=0.006)were independent risk factors of SCD.Conclusions The risk of sudden cardiac death after revascularization in coronary artery disease patients with heart failure were significantly higher in patients with tricuspid regurgitation,left main with triple-vessel disease and high uric acid levels.

Effect of different doses of enoxaparin combined with ticagrelor on clinical events in patients with non-ST-elevation acute coronary syndrome and complex coronary artery lesions after percutaneous coronary intervention / 中国介入心脏病学杂志

Objective To explore the safety and efficacy of different doses of enoxaparin combined with ticagrelor after percutaneous coronary intervention (PCI) in patients with non-ST elevation-acute coronary syndrome (NSTE-ACS) and complex coronary artery lesions and try to find out the best combination dose of enoxaparin. Methods A total of 345 NSTE-ACS patients with complex coronary artery lesions that had undergone percutaneous coronary intervention were recruited in Beijing Anzhen Hospital affi liated to Capital University from March 2015 to October 2016. All patients were treated with aspirin and ticagrelor during the trial and randomly assigned to three groups: no enoxaparin anticoagulation therapy (non-anticoagulation group), half dose of enoxaparin anticoagulation therapy (0.5 mg / kg, half-anticoagulation group) and full dose of enoxaparin anticoagulation therapy (1 mg / kg) (total-anticoagulation group).The primary endpoints were bleeding events during hospitalization and at 12 months after PCI and the secondary endpoints were major adverse cardiac and cerebrovascular events (MACCEs) during hospitalization and at 1, 3 and 12 months after PCI. Results (1) The primary endpoints: The incidences of total bleeding events in patients treated with full dose of enoxaparin were signifi cantly higher than those in the non-anticoagulation group(29.5%vs.13.6%,P=0.005)and the two groups had comparable rates of major bleeding(1.9%vs. 0,P>0.05),but minor bleeding rates were higher in the total-anticoagulation group(27.6% vs.13.6%, P=0.012).There were no significant differences in the incidence of major and minor bleeding events between the half-anticoagulation and the non-anticoagulation groups during hospitalization (all P>0.05). Trend test showed that the incidence of total bleeding and minor bleeding were increased with the increase of the dose of enoxaparin after PCI, and there was a linear correlation between bleeding events and dose of enoxaparin (total bleeding: trend for P=0.005; minor bleeding: trend for P=0.011). (2) The secondary endpoints: there was no signifi cant diff erence in the incidence of perioperative myocardial injury and MACCE at 1 month, 3 months and 12 months post-PCI between three groups (P>0.05).Conclusions For NSTE-ACS patients with complex coronary lesions, the combination of ticagrelor and enoxaparin after PCI did not bring additional benefi ts. Subcutaneous application of full dose of enoxaparin may increase patients' bleeding risk after PCI, while reduced dose of enoxaparin is relatively safe. These results suggest that routine anticoagulation therapy after PCI is not necessary for patients with NSTE-ACS and complex coronary lesions who were treated with ticagrelor. Reduced dose of enoxaparin could be applied subcutaneously post PCI after fully assessing the ischemia and bleeding risk of patients if it is necessary.

Safety and efficacy of the second generation biodegradable polymer Cobalt-Chromium sirolimus-eluting stent (EXCEL 2) stent in diabetic patients:A Subgroup analysis of the CREDIT Ⅱ and CREDIT Ⅲ trials / 中国介入心脏病学杂志

Objective To invesgate the safety and efficacy of the second generation biodegradable polymer Cobalt-Chromium sirolimus-eluting stent (EXCEL2) stent in diabetic patients by a subgroup analysis of of the CREDITⅡand CREDIT Ⅲ trials. Methods All patients who were implanted with the EXCEL2 stent were enrolled in the CREDITⅡand CREDIT Ⅲ trials. The primary endpoint was target lesion failure at 24-month, defi ned as a composite of cardiac death, target vessel myocardial infarction (TV-MI) and target lesion revascularization(TLR). The secondary endpoint was endpoints including all-cause death, all myocardial infarction (MI) or any revascularization.Results A total of 828 patients were included from the patients who were implanted with the EXCEL2 stent in the CREDIT II and CREDIT Ⅲ trials. 24-month follow-up rate was 99.5%. There was no significant difference in the primary endpoint (P>0.05) and event rates of the secondary endpoints(P>0.05) between the diabetic and non-diabetic group, which included all-cause death[diabetics (2.5%)vs.non-diabetics(1.4%),P>0.05],myocardial infarction(MI)(7.5% vs.5.0%,P>0.05),all from of revascularization(5.0% vs.3.9%,P>0.05),and stent thrombosis(0.6% vs.0.4%,P>0.05).Conclusions EXCEL 2 stent met the objective performance goal on effcacy and safety, which can reduce make stent restenosis, target vessel revascularization ,with 160 diabetic cases among them, and stent thrombosis in diabetic patients.

Relationship between two blood stasis syndromes and inflammatory factors in patients with acute coronary syndrome / 中国结合医学杂志

<p><b>OBJECTIVE</b>To investigate the relationship between inflammatory factors and two Chinese medicine (CM) syndrome types of qi stagnation and blood stasis (QSBS) and qi deficiency and blood stasis (QDBS) in patients with acute coronary syndrome (ACS).</p><p><b>METHODS</b>Sixty subjects with ACS, whose pathogenesis changes belongs to qi disturbance blood stasis syndrome, were divided into 2 groups: 30 in the QSBS group and 30 in the QDBS group. The comparative analysis on them was carried out through comparing general information, coronary angiography and inflammatory factors including intracellular adhesion molecule-1 (ICAM-1), chitinase-3-like protein 1 (YKL-40) and lipoprotein-associated phospholipase A2 (Lp-PLA2).</p><p><b>RESULTS</b>Compared with the QSBS group, Lp-PLA2 and YKL-40 levels in the QDBS group showed no-significant difference (P>0.05); ICAM-1 was significantly higher in the QDBS group than in the QSBS group in the pathological processes of qi disturbance and blood stasis syndrome of ACS (P<0.05).</p><p><b>CONCLUSIONS</b>Inflammatory factor ICAM-1 may be an objective basis for syndrome typing of QSBS and QDBS, which provides a research direction for standardization research of CM syndrome types.</p>

Randomized Comparison of the Crush Versus the Culotte Stenting for Coronary Artery Bifurcation Lesions / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The crush and the culotte stenting were both reported to be effective for complex bifurcation lesion treatment. However, their comparative performance remains elusive.</p><p><b>METHODS</b>A total of 300 patients with coronary bifurcation lesions were randomly assigned to crush (n = 150) and culotte (n = 150) treatment. The primary endpoint was the occurrence of major adverse cardiac events (MACEs) at 12 months including cardiac death, myocardial infarction, stent thrombosis, and target vessel revascularization. Index lesion restenosis at 12 months was a secondary endpoint. The surface integrals of time-averaged wall shear stress at bifurcation sites were also be quantified.</p><p><b>RESULTS</b>There were no significant differences in MACE rates between the two groups at 12-month follow-up: Crush 6.7%, culotte 5.3% (P = 0.48). The rates of index lesion restenosis were 12.7% versus 6.0% (P = 0.047) in the crush and the culotte groups, respectively. At 12-month follow-up, the surface integrals of time-averaged wall shear stress at bifurcation sites in the crush group were significantly lower than the culotte group ([5.01 ± 0.95] × 10-4 Newton and [6.08 ± 1.16] × 10-4 Newton, respectively; P = 0.003).</p><p><b>CONCLUSIONS</b>Both the crush and the culotte bifurcation stenting techniques showed satisfying clinical and angiographic results at 12-month follow-up. Bifurcation lesions treated with the culotte technique tended to have lower restenosis rates and more favorable flow patterns.</p>

Analysis of Renal Artery Stenosis in Patients with Heart Failure: A RASHEF Study / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Previous data are controversial about the association of renal artery stenosis (RAS) with clinical outcome in patients with heart failure. Definition of RAS in previous studies might not be appropriate. By definition of RAS with renal duplex sonography, we investigated the association of RAS with clinical outcome in patients with heart failure.</p><p><b>METHODS</b>In this retrospective study, we identified 164 patients with heart failure (New York Heart Association classification ≥II; left ventricular ejection fraction <50%) who had received renal duplex sonography during hospital stay. RAS was defined as renal-aortic ratio ≥3.5 or a peak systolic velocity ≥200 cm/s (or both), or occlusion of the renal artery. Categorical data of patients were compared using the Chi-square test or Fisher's exact test. Cox proportional hazards regression modeling technique was used to investigate the prognostic significance of possible predictors.</p><p><b>RESULTS</b>Finally, 143 patients were enrolled. Median follow-up time was 32 months (1-53 months). Twenty-two patients were diagnosed as RAS by renal duplex sonography, including 13 unilateral RAS (3 left RAS, 10 right RAS) and 9 bilateral RAS. There were more all-cause mortality and cardiovascular death in patients with RAS than patients without RAS. By multivariate analysis, RAS was a significant predictor for all-cause death and cardiovascular death (hazard ratio [HR] = 4.155, 95% confidence interval [CI]: 1.546-11.164, P = 0.005; and HR = 3.483, 95% CI: 1.200-10.104, P = 0.022, respectively). As for composite endpoint events, including death, nonfatal myocardial infarction, ischemic stroke or intracranial hemorrhage, rehospitalization for cardiac failure, and renal replacement therapy, only angiotensin-converting enzyme inhibitor or angiotensin-receptor blocker was significant predictor. RAS was not a significant predictor for composite endpoint events.</p><p><b>CONCLUSIONS</b>Our data suggested that RAS is associated with a poorer clinical outcome in patients with heart failure.</p>

Predictive Ability of the SYNergy Between Percutaneous Coronary Intervention with TAXus and Cardiac Surgery Score II for Long-term Mortality in Patients with Three-vessel Coronary Artery Disease Undergoing Percutaneous Coronary Intervention Treated with Second-generation Drug-eluting Stents / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The SYNergy between percutaneous coronary intervention with TAXus and cardiac surgery Score II (SS-II) can well predict 4-year mortality in patients with complex coronary artery disease (CAD), and guide decision-making between coronary artery bypass graft surgery and percutaneous coronary intervention (PCI). However, there is lack of data regarding the utility of the SS-II in patients with three-vessel CAD undergoing PCI treated with second-generation drug-eluting stents (DES). The purpose of the present study was to evaluate the ability of the SS-II to predict long-term mortality in patients with three-vessel CAD undergoing PCI with second-generation DES.</p><p><b>METHODS</b>Totally, 573 consecutive patients with de novo three-vessel CAD who underwent PCI with second-generation DES were retrospectively studied. According to the tertiles of the SS-II, the patients were divided into three groups: The lowest SS-II tertile (SS-II ≤20), intermediate SS-II tertile (SS-II of 21-31), and the highest SS-II tertile (SS-II ≥32). The survival curves of the different groups were estimated by the Kaplan-Meier method. Univariate and multivariate Cox proportional hazard regression analyses were performed to evaluate the relationship between the SS-II and 5-year mortality. The performance of the SS-II with respect to predicting the rate of mortality was studied by calculating the area under the receiver operator characteristic (ROC) curve. The predictive ability of the SS-II for 5-year mortality was evaluated and compared with the SS alone.</p><p><b>RESULTS</b>The overall SS-II was 27.6 ± 9.0. Among patients in the lowest, intermediate and the highest SS-II tertiles, the 5-year rates of mortality were 1.6%, 3.2%, and 8.6%, respectively (P = 0.003); the cardiac mortality rates were 0.5%, 1.9%, and 5.2%, respectively (P = 0.014). By multivariable analysis, adjusting for the potential confounders, the SS-II was an independent predictor of 5-year mortality (hazard ratio: 2.45, 95% confidence interval: 1.38-4.36; P = 0.002). The SS-II demonstrated a higher predictive accuracy for 5-year mortality compared with the SS alone (the area under the ROC curve was 0.705 and 0.598, respectively).</p><p><b>CONCLUSION</b>The SS-II is an independent predictor of 5-year mortality in patients with three-vessel CAD undergoing PCI treated with second-generation DES, and demonstrates a superior predictive ability over the SS alone.</p>

α-GalCer reduces Acute Graft-versus-Host Disease by Altering Donor T Cells Migration / 中国实验血液学杂志

<p><b>OBJECTIVE</b>This study was aimed to explore the new mechanism of α-Galactosyleramide (α-GalCer), a synthetic glycolipid, and a well-known activator of natural killer T cells (NKT) for improving acute graft-versus-host disease(aGVHD).</p><p><b>METHODS</b>Murine allogeneic bone marrow transplantation (allo-BMT) model was established. Recipient mice were injected intraperitoneally with α-GalCer immediately after allo-BMT, whereas mice from the vehicle groups received the diluent (DMSO) only. The severity degree of aGVHD was estimated by survival, aGVHD clinical score and pathology. The mechanism of aGVHD reduced by α-GalCer was explored by detecting T cells migration in vivo and in vitro.</p><p><b>RESULTS</b>Mice in α-GalCer group survived longer than in control group, and their clinical and pathological status of aGVHD were lighter. α-GalCer reduced aGVHD by altering donors T cell migration.</p><p><b>CONCLUSION</b>After allo-BMT α-GalCer reduces aGVHD by altering donor T cells migration.</p>

Blockade of Autophagy Aggravates Endoplasmic Reticulum Stress and Improves Paclitaxel Cytotoxicity in Human Cervical Cancer Cells / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: Autophagy is one of the ways to degrade unfolded proteins after endoplasmic reticulum (ER) stress. The purpose of this study is to determine whether a blockade of autophagy leads to aggravated endoplasmic reticulum stress, which then induces cells apoptosis in HeLa cells treated with paclitaxel. MATERIALS AND METHODS: Autophagy activation and the proapoptotic effects were characterized using monodansylcadaverine labeling and Hoechest staining, respectively. A Western blot analysis was used to detect the expression of apoptotic and autophagy-related genes. A flow cytometry was used to assess the cell apoptosis ratio. RESULTS: Paclitaxel exposure induced the aggregation of autophagosomes in the cytoplasms of cervical cancer HeLa cells. The expression of Beclin 1 and LC3 II were upregulated, but p62 was downregulated, which suggests that autophagy was promoted by paclitaxel. On the other hand, the expression of GRP78 obviously increased, suggesting that ER stress was induced after paclitaxel treatment. The cell proliferation assay indicated that a knockdown of Beclin 1 sensitized HeLa cells to paclitaxel. Furthermore, paclitaxel-mediated apoptotic cell death was further potentiated by the pretreatment with autophagy inhibitor chloroquine or small interfering RNA against Beclin 1. These results suggest that an induction of autophagy by paclitaxel may induce cell survival rather than cell death in HeLa cells; moreover, inhibition of autophagy led to an aggravated ER stress and an induction of downstream apoptosis. CONCLUSION: Our results reveal autophagy induced by paclitaxel conferred protection of tumor cells against apoptosis, and blockade of autophagy subsequently aggravated ER stress, enhancing the apoptosis associated with paclitaxel treatment in HeLa cells.

Analysis of full-length gene sequence of rabies vaccine virus aG strain / 病毒学报

To sequence and analyze the full-length gene sequence of rabies vaccine virus aG strain. The full-length gene sequence of aG strain was amplified by RT-PCR by 8 fragments,each PCR product was cloned into vector pGEM-T respectively, sequenced and assemblied; The 5' leader sequence was sequenced with method of 5' RACE. The homology between aG and other rabies vaccine virus was analyzed by using DNAstar and Mega4. 0 software. aG strain was 11 925nt(GenBank accession number: JN234411) in length and belonged to the genotype I . The Bioinformatics revealed that the homology showed disparation form different rabies vaccine virus. the full-length gene sequence of rabies vaccine virus aG strain provided a support for perfecting the standard for quality control of virus strains for production of rabies vaccine for human use in China.

Clinical and pathological analysis of 41 cases of acute leukemia combined with intracranial hemorrhage / 中国实验血液学杂志

This study was aimed to summarize the clinical and pathological features of patients with acute leukemia combined with intracranial hemorrhage. The clinical and pathological data of 41 adult patients diagnosed as acute leukemia in our hospital from 1953 to 1990 year were analyzed retrospectively. The results showed that there were 35 cases of AML, 6 cases of ALL; 9 cases in clinical hematologic remission, 32 cases in non-remission, 3 cases of AL with hypertension, 2 cases of AL with diabetes, 4 cases of AL with sepsis, 19 cases with WBC ≥ 100×10(9)/L; the pathologic examination showed 4 cases of AL accompanied with disseminated intravascular coagulation, 10 cases with prothrombin time INR ≥ 1.5, 26 cases with multifocal intracranial hemorrhage, 7 cases with single intracranial hemorrhage, 8 cases with diffused spotting intracranial hemorrhage; the examination also showed that 84 hemorrhage foci were found in 41 cases of AL, among them 46 foci located under cerebral cortex, 23 foci in cerebellum, 6 in basal ganglia, 5 foci in pons, 2 foci in thalamus, 2 foci in spinal cord. It is concluded that the intracranial hemorrhage is a major cause resulting in death of AL patients which should be think highly, and the diagnosis and treatment should be conducted through comprehensive analysis.