Alleviation of isoproterenol-induced myocardial fibrosis in mice by autophagy regulated by Astragaloside Ⅳ through activating ROCK/JNK pathway / 药学实践杂志

Objective To investigate the effect and mechanism of astragaloside Ⅳ(AS-Ⅳ) activating ROCK/JNK to regulate autophagy in improving isoproterenol (ISO) induced myocardial fibrosis (MF) in mice. Methods The mice were randomly divided into control operation group (Control group), ISO induced myocardial fibrosis group (MF group), AS-Ⅳ treatment group (AS-Ⅳ group) and combination group of astragaloside IV and Y-33075 (ROCK inhibitor) (astragaloside IV+Y-33075 group). After repeated administration for 30 days. The serum levels of LDH, BNP, CTGF in each group were detected. The cardiac function was detected by ultrasound. Myocardial structure and tissue fibrosis degree in each group were detected by Sirius Red and Masson staining. Oxidative stress (ROS) levels in myocardial tissue of each group were detected by DHE staining and the expression of ROCK, JNK, Atg5, Beclin 1, and LC3 Ⅰ/Ⅱ in myocardial tissue were detected by Western blotting. Results Compared with AS-Ⅳ group, the EF value of AS-Ⅳ+Y-33075 group decreased and the degree of myocardial fibrosis increased (P<0.05). The serum level of LDH, BNP, CTGF increased and the level of ROS in myocardial tissue increased while the expression of ROCK, JNK, Atg5, Beclin 1, LC3 Ⅰ/Ⅱ decreased (P<0.05). Y-33075 could block the protective effect of AS-Ⅳ on myocardial injury induced by MF and inhibit the regulation of AS-Ⅳ on ROCK and JNK. Conclusion AS-Ⅳ could attenuate myocardial fibrosis in mice by activating ROCK/JNK signal and promoting autophagy.

A case-control study of minimally invasive transforaminal interbody fusion with the assistance of robot and traditional fluoroscopy in the treatment of single-space lumbar disc herniation / 中国骨伤

OBJECTIVE@#To compare the safety and nail placement accuracy of fluoroscopy-assisted and robot-assisted minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) in the treatment of single-space lumbar disc herniation.@*METHODS@#The clinical data of 52 patients with single-space lumbar disc herniation treated by MIS-TLIF from March 2019 to February 2020 were retrospectively analyzed. Among them, 24 patients were treated by robot-assisted MIS-TLIF(group A) and 28 patients were treated by fluoroscopy-assisted MIS-TLIF (group B). The intraoperative blood loss, operation time, intraoperative fluoroscopy times, preoperative and postoperative visual analogue scale(VAS), Japanese Orthopaedic Association(JOA) scores and operation-related complications were recorded in two groups. Gertzbein-Robbins grade according to CT scan was used to evaluate the nail placement after operation. Grade A and B were evaluated as satisfactory nail placement, and grade C, D, and E were evaluated as error placement. Babu's method was used to evaluate the screw's invasion to the superior articular process.@*RESULTS@#The operation time, intraoperative blood loss and intraoperative fluoroscopy times in group A were less than those in group B(P<0.05).VAS and JOA scores of all patients at the final follow-up were significantly improved compared with those before operation(P<0.05), but there was no statistically significant difference between the groups(P>0.05). There were 96 and 112 screws in group A and group B, respectively. Three days after operation, according to the Gertzbein-Robbins grade to evaluate the nail placement accuracy, there were 90 screws of grade A, 5 of grade B, 1 of grade C, no grade D and E in group A;there were 84 screws of grade A, 16 of grade B, 8 of grade C, 4 of grade D, no grade E in group B;the difference between two groups was statistically significant(Z=-3.709, P=0.000). The satisfactory rate of screw placement in group A was 98.96% (95/96), and that of group B was 89.29% (100/112), the difference between two groups was statistically significant (χ2=8.254, P=0.004). Three days after operation, the invasion of superior facet joints by pedicle screws was evaluated according to Babu's method, including 90 screws in grade 0, 4 in grade 1, 2 in grade 2, and 0 in grade 3 in group A;86 in grade 0, 12 in grade 1, 10 in grade 2 and 4 in grade 3 in group B, and the difference was statistically significant(Z=-3.433, P=0.001). There were no serious spinal cord, nerve and vascular injuries and other operation-related complications caused by screw implantation failure in both groups. All patients were followed up from 6 to 12(9.06±1.60) months. The neurological symptoms improved well after operation. During the follow-up period, there was no recurrence of symptoms, loosening or breakage of the internal fixation.@*CONCLUSION@#Compared with the traditional fluoroscopy-assisted MIS-TLIF, the spinal robot-assisted MIS-TLIF not only has more minimally invasive and safer, but also has higher accuracy in nail placement, lower incidence of upper articular process invasion, and more accurate decompression targets, which can be used for minimally invasive treatment of single-space lumbar disc herniation.

Association between preoperative hemoglobin amount and incidence of lower limb deep vein thrombosis following lower limb fracture / 中华创伤骨科杂志

Objective:To study the association between preoperative hemoglobin amount and incidence of lower limb deep vein thrombosis (DVT) in patients with lower limb fracture.Methods:A retrospective study was performed of the 2, 482 patients with lower limb fracture who had been treated at Department of Orthopaedics Trauma, Honghui Hospital Affiliated to Xi'an Jiaotong University from July 2014 to August 2019. They were 1, 174 males and 1, 308 females with an age of (60.6±19.3) years. Recorded were the patients' age, gender, injury time, hemoglobin amount, D-dimer measurement, combined medical conditions, time and results of ultrasound vein examination on both lower extremities. According to the ultrasound results, the patients were divided into a thrombosis group and a thrombosis-free group. The 2 groups were compared in hemoglobin amount. Logistic regression was used to analyze the relationship between preoperative hemoglobin amount and incidence of lower limb DVT. The patients were divided into 5 groups according to the quintile of hemoglobin amount; the incidences of thrombosis were compared between the 5 groups.Results:The total incidence of DVT in this cohort was 29.53%(733/2, 482). The hemoglobin amount in the thrombosis group was (116.57±19.24) g/L, significantly lower than that in the thrombosis-free group (124.76±19.79) g/L ( P<0.05). The preoperative hemoglobin amount was a risk factor for incidence of DVT after a lower limb fracture ( OR=0.985, 95% CI: 0.980 to 0.990, P<0.001). As the quintile level of hemoglobin increased, the incidence of DVT showed a downward trend. In comparison of the group with the highest DVT incidence (40.58%) and the group with the lowest DVT incidence (17.27%), the risk increased by 2.386 times (95% CI: 1.718 to 3.315). Conclusions:The preoperative hemoglobin amount can affect the DVT incidence after a lower limb fracture, and a low hemoglobin amount may more likely lead to lower limb DVT.

Incidence of deep venous thrombosis before hip arthroplasty and possible causes of postoperative thrombosis / 国际外科学杂志

Objective:To investigate the risk factors of deep venous thrombosis in patients before hip arthroplasty, and to explore the possible causes of postoperative thrombosis.Methods:The clinical data of 361 patients with hip arthroplasty treated in the Department of Orthopaedic Trauma of Xi′an Honghui Hospital from September 2015 to December 2019 were studied retrospectively, including 102 males and 259 females, aged 65 to 94 years, and the average age was 72.25 years old. All fracture patients were given subcutaneous injection of low molecular weight heparin calcium to prevent lower extremity thrombosis. The deep veins of both lower extremities were examined before and after operation. The general data of the two groups of patients were collected and recorded, including age, sex, whether complicated with medical diseases (essential hypertension, type 2 diabetes, coronary heart disease), serological indexes, time from injury to admission, and time from admission to operation. The software of SPSS 19.0 was used for statistical analysis.Results:The incidence of lower limb DVT, before operation was 29.92%, including 26 males (24.07%) and 82 females (75.93%). The results of multivariate logistic regression analysis showed that diabetes mellitus ( OR=2.127, 95% CI: 1.134-3.989, P=0.019), coronary heart disease ( OR=1.692, 95% CI: 1.056-2.713, P=0.029) and the time from injury to admission ( OR=1.677, 95% CI: 1.037-2.712, P=0.035) were independent risk factors for DVT in elderly patients undergoing hip arthroplasty. The incidence of lower limb DVT, after operation was 46.54%. After operation, proximal thrombus were occurred in 2 cases (1.19%), distal thrombus in 143 cases (85.12%), and mixed thrombus in 23 cases (13.69%). Postoperative thrombus was ipsilateral to the fracture limb in 84 cases (50.00%), thrombus was located in the healthy side of the fracture in 19 cases (11.31%), and DVT occurred in 65 cases (38.69%) in both lower limbs. Conclusions:Delayed admission longed than 48 hours, coronary heart disease and diabetes mellitus are the risk factors for the formation of DVT. The thrombus that existed before operation and did not disappear after operation accounted for 48.81% of the total incidence of postoperative thrombosis, and the new thrombus accounted for 51.19% of the total incidence of postoperative thrombosis. For the elderly patients with femoral neck fracture undergoing hip arthroplasty, ultrasonic examination of both lower limbs should be performed before and after operation to find the changes of thrombus in time and do a good job of prevention and treatment.

Therapeutic effect of propafenone and amiodarone on paroxysmal supraventricular tachycardia and their safety / 心血管康复医学杂志

Objective :To compare therapeutic effect of propafenone and amiodarone on paroxysmal supraventricular tachycardia (PSVT) and their safety .Methods : A total of 90 PSVT patients ,who were treated in our hospital from Jan 2013 to May 2018 ,were selected .Patients were randomly and equally divided into propafenone group and amio—darone group ,each group received corresponding medication based on routine treatment for 24h.Blood pressure , heart rate ,cardiac function indexes :LVEDV ,LVESV and LVEF before and after treatment ,cardioversion time , successful cardioversion rate within 60 min and incidence of adverse reactions during treatment were observed and compared between two groups .Results : There was no significant difference in successful cardioversion rate (propafenone group 91.11% vs.amiodarone group 93.33%, P＝1.000) between two groups .Compared with be—fore treatment ,on 24h after treatment ,there were significant reductions in blood pressure and heart rate in two groups , P＝0. 001 all ;but there was no significant difference between two groups before and after treatment , P＞0.05 all.Cardioversion time of propafenone group was significantly shorter than that of amiodarone group [ (12. 66 ± 2.06) min vs .(22. 80 ± 2.28 ) min ] , P＝ 0. 001 .Compared with propafenone group on 24h after treatment , there was significant rise in LVEF [ (63. 24 ± 3.67)% vs.(66. 83 ± 4.01)%] ,significant reductions in LVEDV [ (96.65 ± 5.24) ml vs.(92. 09 ± 4.37) ml] and LVESV [ (38.40 ± 2.87) ml vs.(30. 13 ± 7.34) ml] in amioda—rone group , P＝ 0. 001 all.Total incidence rate of adverse reactions in amiodarone group was significantly lower than that of propafenone group (8.89% vs.24. 44%) , P＝0. 048. Conclusion : Propafenone and amiodarone possess significant therapeutic effect on PSVT .Propafenone possesses shorter cardioversion time ,while amiodarone posses— ses less adverse reactions and improve cardiac function .Therefore ,medication should be selected properly according to patient′s specific condition in clinic .

Hypofibrinogenemia is a risk factor of poor prognosis of HELLP syndrome / 中华检验医学杂志

Objective Observing changes in thehaemostatic system to determinetheseverity and prognosis of HELLP syndrome. Methods 127 cases of HELLP syndrome diagnosed in Peking University Third Hospital were enrolled from August 2010 to August 2018. Maternal and fetaldemographic characters, postpartum complications,length of hospital stay,prothrombin time(PT),activated partial thromboplastin time (APTT), Fibrinogen(Fg) and D-Dimer(D-D) were collected. Results There was no statistical difference inparturient PT, APTT, D-D levels between maternals of HELLP syndrome with and without postpartum hemorrhage,which were [9.6 (9.0, 11.5)s vs 9.4 (8.9, 9.7)s, P=0.243], [30.2 (29.1, 38.3)s vs 29.8 (27.7, 31.8)s, P=0.151], and [0.80 (0.52, 4.52)μg/ml vs 0.91 (0.55, 2.48)μg/ml, P=0.923] respectively. There was a statistically significant difference obvious difference in parturient Fglevels between two groups [(2.94±1.48) g/L vs (3.61±1.00)g/L, P=0.022). The receiver operating characteristic curve(ROC) analysis showed that the AUC of fibrinogen level when estimating postpartum hemorrhage was 0.688(95％CI:0.600-0.767), cut-off value was 3.04 g/L, negative predictive value was 74.3％. There was a negative correlation between parturient Fg and days of hospital stay of HELLP syndrome maternal(r=-0.182, P=0.040). There was no statistical difference in parturient PT, APTT, Fg and D-D levels between the fetal survival group(n=93) and non-survival group (n=34), and between the distressed group (n=23) and he undistressed group(n=70) (P>0.05). Conclusions The low parturient Fg level may be a risk factor of maternal adverse clinical outcomes in HELLP syndrome. Maintaining the Fg at a stable level may reduce the incidence of HELLP syndrome adverse outcomes.

Circulating microsome proteins in the pathogenesis of preeclampsia / 中华检验医学杂志

Objective In this study, we aimed to detect the level of total circulating microparticles (MPs) in pregnant women with preeclampsia (PE) and analyze the proteome of MPs to explore their roles in the pathogenesis and progression of PE. Methods 98 pregnant women with PE, 54 healthy pregnant women, and 51 healthy non-pregnant women were enrolled from December 2016 to June 2018, whose MP levels were detected by flow cytometry and compared. Proteins extracted from the MPs were analyzed by high performance liquid chromatography mass spectrometry.Results The total MP level of the healthy pregnant group was significantly higher than thatof the non-pregnant group [159.87 (113.25, 218.18)/μl vs 94.10 (53.35, 140.23)/μl, P=0.004], but was not significantly different from that of the PE group. By proteomic profiling, 30 differential proteins were obtained between healthy pregnant women and healthy non-pregnant women, which were closely related to biological processes such as complements, coagulation cascades, angiogenesis and so on; 14 differential proteins were found between PE patients and healthy pregnant women, which were closely related to biological processes such as coagulation cascades, complements and inflammatory reactions, angiogenesis and so forth. Conclusions The level of circulating MPs may reflect the hypercoagulability of preeclampsia. In addition, circulating MPs may be involved in the pathogenesis of PE through various pathways by carrying different proteins, which indicates their potential value in the intervention of PE.

Analysis of thromboinflammatory response expression profile in pregnancy and preeclampsia / 临床检验杂志

Objective@#To explore the differences of thromboinflammatory response between healthy pregnancy and preeclampsia (PE) and provide potential strategies for diagnosis and prevention of PE. @*Methods@#The antibody microarray was prepared to detect plasma protein expression profile of non-pregnant women, healthy pregnant women and preeclampsia patients. The differentially expressed proteins were identified and analyzed. @*Results@#The levels of 37 proteins were significantly different between non-pregnant and healthy pregnant women, among which 16 proteins were increased, such as disintegrin, metalloproteinase domain-containing protein 12 and C-C motif chemokine 2, while 21 proteins were decreased, such as GM-CSF and apolipoprotein F. The levels of 27 proteins were significantly different between healthy pregnant women and preeclampsia patients, among which 16 proteins were increased, such as GM-CSF and VEGFR2 and 11 proteins were decreased, such as tumor necrosis factor-related apoptosis-inducing ligand and interferon Omega 1. Further analysis found that PE patients group presented more complicated changes compared with healthy pregnant women. PE group included more significantly increased proteins which involved in inflammation and immune responses and elevated levels of acute phase reaction, while the levels of more anti-inflammation cytokines decreased significantly. In the plasma of PE patients more proteins participating thrombosis and complement reaction increased significantly. Also, renin level was significantly dropped and VEGFR2 was elevated. @*Conclusion@#More serious inflammatory response, hypercoagulable status and imbalance of angiogenesis and anti-angiogenesis may exist in PE, which should be helpful for further improving potential strategies in diagnosis and prevention of PE.

Hemostatic function change during pregnancy of women with placental abruption and its application for predicting postpartum hemorrhage / 临床检验杂志

Objective@#To investigate whether the changes of hemostatic system in pregnant women with placental abruption are different from the pattern of the pregnant women without complications, and the tests of hemostatic function before labor are helpful for prediction and estimation of postpartum hemorrhage. @*Methods@#The pregnant women diagnosed with placental abruption who delivered at Peking University Third Hospital from December 1st, 2013 to December 1st, 2018 were enrolled. The normal pregnant women with matched age and gestational weeks and the women complicated with gestational diabetes mellitus (GDM) were also involved in our study as controls. Their medical records, pregnancy outcomes and all the results of hemostatic tests were completely collected and analysed. @*Results@#A total of 152 pregnant women with placental abruption, 268 normal pregnant women and 101 pregnant women with gestational diabetes mellitus were included. The hemostatic system in uncomplicated women and the women with GDM shared a similar course of changes, during which time PT, APTT and TT dropped, while Fib (fibrinogen), FDP and DD grew with increasing gestational weeks. However, in the women with placental abruption, Fib(g/L) presented downward trend in the second trimester and were significantly lower than the uncomplicated women at the same pregnancy period (4.11±0.17 vs 4.35±0.07, P=0.011). The Fib（g/L） levels in the women at delivery with placental abruption, whether complicated with GDM or not, showed significant difference between the women with and without postpartum hemorrhage (3.41±1.29 vs 4.30±0.94, P=0.001). According to the receiver operating charctistic curve, the area under the curve of Fib was 0.703 (95% confidence interval: 0.596-0.810) with cutoff value of 4.00 g/L and negative predictive value of 0.883. @*Conclusions@#The fibrinogen level in pregnant women with placental abruption did not increase with gestational weeks as it was in uncomplicated women and the women with GDM. Fib level at the time of delivery may contribute to predict the occurrence of postpartum hemorrhage in the women with placental abruption.

Effects of Tongxinluo Capsules combined with routine treatment on Fib and MPV levels in appropriate patients for CABG surgery / 中成药

AIM To investigate the effects of Tongxinluo Capsules (Ginseng Radix et Rhizoma,Hirudo,Scorpio,etc.) combined with routine treatment on fibrinogen (Fib) and mean platelet volume (MPV) levels in appropriate patients for coronary artery bypass graft (CABG) surgery.METHODS One hundred and six patients were randomly assigned into control group (n =50) for routine treatment and observation group (n =56) for combination therapy of Tongxinluo Capsules and routine treatment.Both groups had their Fib and MPV levels evaluated,and safety compared.RESULTS Thirty,ninety days after the treatment,the two groups reported less incidence of composite cardiovascular events (refractory angina pectoris,relapsing myocardial infarction or death) (P ＜ 0.01),and the observation group had an even more obviously reduced plasma Fib level (P ＜0.01).The significantly decreased after-treatment MPV levels in the two groups were observed (P ＜ 0.05),and a most distinct decrease extent was found in the observation group after 90 d (P ＜ 0.05).For the bleeding events,the incidence rates of the observation group and the control group were 5.4％ and 4.0％,respectively.CONCLUSION For appropriate candidates of CABG surgery,Tongxinluo Capsules shows its efficacy in dissolving thrombus and improving clinical symptoms without serious bleeding risk.

Application of 3D printing technology in modern medicine / 医疗卫生装备

The types of 3D printing rapid prototyping manufacturing technology were introduced,and the advantages and disadvantages of 3D printing technology and traditional printing technology were compared.Examples were taken to describe the problems and countermeasures of 3D printing technology in clinical medicine,and it's pointed out 3D printing technology may have of great significance for enhancing medical service,decreasing medical cost and promoting individualized medical service.

Application of 3D printing technology in modern medicine / 医疗卫生装备

The types of 3D printing rapid prototyping manufacturing technology were introduced,and the advantages and disadvantages of 3D printing technology and traditional printing technology were compared.Examples were taken to describe the problems and countermeasures of 3D printing technology in clinical medicine,and it's pointed out 3D printing technology may have of great significance for enhancing medical service,decreasing medical cost and promoting individualized medical service.

Application of 3D scanning system in medical education technology / 医疗卫生装备

Objective To investigate the application of 3D scanning system in medical education technology.Methods David 3D scanning system had its advantages,calibration technique,working flow and post-processing of scanning data described,and then introduced into medical education and underwent series of tests.Results David 3D scanning system gained high modeling speed,and spent only 2 h for actual specimen scanning,modeling as well as synchronized collection and mapping.The scanning accuracy reached industrial level.Conclusion David 3D scanning system gains advantages over the traditional 3D scanning technique,and facilitates medical digital modeling by transforming object information into digital signal.

Laboratory measurement of bleeding risk for patients receiving Dabigatran / 临床检验杂志

Objective To observe the correlation between conventional coagulation tests and Dabigatran concentration in order to find proper test method to predict the bleeding risk of patients receiving Dabigatran.Methods The clinical data of forty-nine non-valvular atrial fibrillation (NVAF) patients who took Dabigatran in Peking University Third Hospital from 2015 to 2017 were analyzed and the bleeding rates were calculated.The plasma samples from twenty healthy volunteers were collected and mixed up into normal pooled plasma (NPP).Different doses of active Dabigatran were mixed with NPP,making Dabigatran concentrations from 0 to 1 000 ng/mL.Prothrombin time (PT),activated partial thromboplastin time (APTT),thrombin time (TT),fibrinogen (Fib) and diluted Russell viper venom time (dRVVT) were determined.Fresh whole blood samples from three normal volunteers were collected and mixed with Dabigatran in the same way to perform thromboelastogram (TEG).Results The total bleeding rate of NVAF patients receiving Dabigatran was 28.6％,among which gastrointestinal bleeding accounts for the most.APTT,dRVVT,R time (R) and clot index (CI) showed a good linear correlation with Dabigatran concentration.The sensitivity of dRVVT was the best,followed by APTT.R and CI showed low sensitivity compared with APTT and dRVVT.Conclusion APTT and dRVVT should be good parameters for monitoring the bleeding risk of Dabigatran and helpful for physicians to choose proper point-in-time for withdrawal of Dabigatran and reduce bleeding events.

Expression of miR-140-5p and prediction of its target gene in human mesenchymal stem cells during adipogenic differentiation / 南方医科大学学报

<p><b>OBJECTIVE</b>To screen the differentially expressed miRNAs and their target genes in adipogenic differentiation of human bone marrow mesenchymal stem cells (hMSCs) to better understand the mechanism for regulating the balance between osteoblast and adipocyte differentiation.</p><p><b>METHODS</b>Cultured hMSCs were induced for adipogenic differentiation, and at 0, 7, 14, and 21 days of induction, the cells were examined for miRNA and mRNA expression profiles using miRNA chip and transcriptome sequencing (RNA-seq) techniques. Correlation analysis was carried out for the miRNAs and mRNAs of potential interest. The databases including TargetScan, PicTar and miRanda were used to predict the target genes of the differentially expressed miRNA.</p><p><b>RESULTS</b>The expression of miR-140-5p was down-regulated and leukemia inhibitory factor receptor (LIFR) expression increased progressively during adipogenic differentiation of hMSCs, showing a negative correlation between them. Target gene prediction using the 3 databases identified LIFR as the target gene of miR-140-5p.</p><p><b>CONCLUSION</b>miRNA-140-5p may play an important role by regulating its target gene LIFR during adipogenic differentiation of hMSCs.</p>

The impact of residual platelet activity and CYP2C19 polymorphism on the prognosis of acute coronary syndrome patients / 中华检验医学杂志

Objective To evaluate the correlation between RPA or the polymorphism of CYP 2C19 and the incidence of ischemic events and the influence on the clinical prognosis .Methods A case-control study was used.A total of 202 patients [male 66%,(63 ±11) years] with ACS on aspirin and clopidogrel treatment were recruited , whose RPA were measured by whole blood aggregometry ( WBA ) , and their CYP2C19 polymorphism were also tested .Their clinical ischemic events were recorded in the mean follow-up period of 16 months.The RPA cut-off values for antiplatelet low-responsiveness were defined by the receiver operator characteristic curve ( ROC); the relationships of clinical outcomes with RPA and CYP 2C19 were assessed by the Kaplan-Meier survival analysis.Results CYP2C19*2 (681G>A) present in 52.5% of recruited patients and*3 (636G>A) present in12.9%.RPA induced by adenosine diphosphate ( ADP) showed significant difference among CYP 2C19*2 or *3 heterozygotes, CYP2C19*2 or *3 homozygotes and noncarriers (χ2 =9.318, P=0.009);whereas, RPA induced by arachidonic acid (AA) (χ2 =2.441, P=0.295) and the incidence of ischemic events (χ2 =0.513, P=0.774) were not.During follow-up, 18 (9%) patients experienced clinical ischemic episodes , and their RPA were higher than patients without ischemic episodes [(8.6 ±4.8) Ωvs (5.2 ±3.7) Ω, P =0.013; (8.6 ±6.8) Ωvs (1.6 ±3.7) Ω, P <0.001].Moreover, employing 6.5 Ω(induced by ADP) and 2.5 Ω(induced by AA) as cutoff values,RPA showed optimal negative predictive values (97%, 96%) and poor positive predictive values (16%,29%).Survival analysis showed, statistically, patients with clopidogrel low-responsiveness had higher riskof ischemic episodes than patients with clopidogrel responsiveness (HR =2.86, χ2 =11.27,P =0.0008);however, patients with aspirin low responsiveness (HR =1.77, χ2 =1.74, P =0.19) or patients withCYP2C19*2 or *3 (HR =0.89, χ2 =0.12, P =0.73) did not.Conclusion Clopidogrel lowresponsiveness is associated with the occurrence of clinical ischemic events ; however, patients withCYP2C19 function reduced genetypes do not show higher risk of ischemic episodes though it presented slighlyhigher RPA.

Investigation on serum lipid levels of healthy adult population in Beijing / 中华检验医学杂志

Objective To investigate on the gender and age distribution characteristics of serum lipid levels among apparently healthy adult population in Beijing and analyse its related risk factors .Methods This is a prospective study.1 712 healthy individuals between 18 and 79 years old were recruited from medical examination center of Peking University Third Hospital .By strict exclusion criteria , 951 healthy individuals (429 males and 522 females) were included in our study.A calibrated automatic biochemical analyzer was used to measure TC, TG, HDL-C, LDL-C, ApoA1, ApoB concentrations in serum.Test results were stratified by gender , age, related risk factors, and statistically analysed.Two groups of normally disthibuted data were compared using t test;multiple groups of data were compared using variance analysis . Results Results for TC (t=4.013, P<0.050), HDL-C(t=9.162, P<0.05) and ApoA1( t=8.225, P<0.05) appear generally higher in women than in men .On the contrary, males had greater levels of TG (Z=3.119, P<0.05) compared to females.There was an obvious increasing trend in TC ( F=47.984, P<0.05), TG(Chi square =146.616, P<0.05), LDL-C(F=46.024, P <0.05), non-HDL-C(F =45.027, P<0.05) and ApoB levels(F=52.020, P<0.05), as well as peaked in the 60-69 age group, decreased in 70-70 years old.The population of beneath the bachelor-degree had greater levels of ApoB ( t=5.989, P<0.05), LDL-C(t=4.445, P<0.05), TC(t=2.885, P<0.05), non-HDL-C(t=4.332, P<0.05) and TG(Z=3.346, P<0.05) compared to the group of bachelor degree or above .Meanwhile, The levels of TC(t=8.273, P<0.05), HDL-C(t=3.346, P<0.05), LDL-C(t=5.768, P<0.05), non-HDL-C(t=7.213, P<0.05), ApoA1(t=3.683, P<0.05), ApoB(t=6.267, P<0.05), TG(Z=5.626, P<0.05) of the population lived in urban area were higher than rural areas .Interestingly, the concentration of ApoA1(t=3.238, P<0.05), HDL-C( t=6.011, P<0.05) and TC(t=2.712, P<0.05) were much higher in the population of mental worker than the manual worker .BMI and waistline positively correlated with serum TG(rs=0.379, 0.443, P<0.01), TC(rs =0.160, 0.176, P<0.01), LDL-C(rs =0.238, 0.263, P <0.01), ApoB (rs =0.326, 0.371, P <0.01) and non-HDL-C(rs =0.304, 0.336, P<0.01) respectively, but negatively correlated with HDL-C(rs =-0.358, -0.386, P<0.01) and ApoA1 ( rs =-0.203, -0.209, P <0.01 ) .Conclusions The study obtained the distribution of lipid levels among apparently healthy a dult population in Beijing .It may offer objective basis for clinical risk assessment of ASCVD , and guid the clinician to choose the optimal individualized treatment .

Quality assurance of clinical biochemistry testing:a mualti-center study based reference interval for clinical chemistry tests in the Chinese population / 中华检验医学杂志

Objective To verify and monitor the performance of accuracy, precision and comparability of 26 clinical biochemical analytes (29 methods) in the six centers involved in multi-centers reference intervals research, and to ensure the reliability of theirmeasurement results.Methods During the period of the systems evaluating, two levels of commercial quality control materials and fresh frozen human serum reference materials were applied to verify the performance of inter-laboratory precision and accuracy of analysis systems. During the period of samples testing, the commercial quality control materials were measured whenever samples were analysed, the fresh frozen serum reference materials were measured once a month.The coefficient of variations (CVs), bias and total errors were calculated to assess the precision, accuracy and comparability.Results Verification of precision and accuracy: ( 1 ) the ranges of CVs of 29 methods in the six laboratory laboratories were 0.4%-6.0%, the CVs of all 29 methods met the criterion . (2) The overall average bias of the analysis systems of 21 analytes (24 methods) ranged from -5.15%( ALT) to 4.46% ( Ur ) .Among 24 methods the overall average bias of TP, Glu-GOD, Ur, Cl, Ca exceeded the acceptable range.The quality assessment during the period of samples testing:(1) The overall average bias ranged from -1.95%(Ca) to 2.92%(Ur), median 1.26%, they all met the requirements of relevant standards.( 2 ) When commercial control materials were tested, the requirements of CVs were fulfilled for most methods in the six laboratories,and the CVs of TP, Alb, Cl, Ca exceeded the acceptable range.The overall average TE of all methods met the quality specification for the C-N controls material.For the C-P control material, only the overall average TE of TP (5.05%) exceeded thearceptable range while the other methods met the requirement in criterion.Conclusions The performance of precision and accuracy of the analysis systems used in the six laboratories passed the verification.During the period of sample testing, the performance of precision and accuracy of the most methods in the 6 laboratories met the requirements of quality specifications, and the overall performance was good.Because of the limitation of current technology the performance of some methods didn't fulfill the requirement of specifications, and need to be improved.

Qualitative analysis of chemical constituents in Si-Wu Decoction based on TCM component database / 药学学报

In order to clarify the chemical constituents of Si-Wu Decoction rapidly and holistically, we analyzed the ethanol extract of Si-Wu Decoction by UPLC/Q-TOF-MSE and UNIFI which based on traditional Chinese medicine database, the probable structures of 113 compounds were identified. The results show that this method can rapidly and effectively characterize the chemical compounds of Si-Wu Decoction and provide a new solution for identification of components from complex TCM extract.

Predictive factors for in-stent late loss and non-culprit coronary lesion progression in diabetic patients undergoing drug eluting stenting / 中国组织工程研究

BACKGROUND:Previous studies have suggested that the risks for coronary atherosclerotic plaque progression and in-stent restenosis are increased in patients with coronary heart disease combined with type 2 diabetes. OBJECTIVE:To explore the predictive factors for in-stent late loss and non-culprit coronary lesion progression in patients with type 2 diabetes mel itus. METHODS:A total of 399 stenting patients were enrol ed, including 179 diabetic patients and 220 non-diabetic patients. The clinical materials, angiography parameters and biochemical markers were col ected. The difference between the two groups was compared, and also we conducted subgroup analysis in the diabetic patients. Low-density lipoprotein cholesterol, hemoglobin A1c, fibrinogen and high-sensitivity C-reactive protein were detected at days 3, 120, 210 and 360 after stenting. RESULTS AND CONCLUSION:Compared with non-diabetic patients, the stent length (P=0.18) was longer and the stent diameter (P=0.002) was smal er in the diabetic patients. The minimal lumen diameters of post-procedure and fol ow-up angiography in the diabetic group were significantly decreased (P=0.001, P=0), and the diabetic patients also showed severe coronary artery stenosis instantly and within the fol ow-up after stenting (P=0.038, P=0.004). The fol ow-up angiography showed that the diabetic patients had more late loss and restenosis (P=0, P=0.097). Furthermore, in the subgroup analysis of diabetic patients, the levels of hemoglobin A1c, fibrinogen and high-sensitivity C-reactive protein were significantly increased in the patients with restenosis and non-culprit lesion progression. These findings indicate that diabetic patients appear to have the higher incidence of restenosis and non-culprit lesion progression. Moreover, hemoglobin A1c, fibrinogen and high-sensitivity C-reactive protein are effective predictors for in-stent late loss and non-culprit coronary lesion progression.