Effect and Mechanism of RBM8A on Proliferation, Migration and Apoptosis of Human Endometrial Cancer HEC-1A Cells / 肿瘤防治研究

Objective To investigate the effect of silenced RBM8A gene on the biological behavior (proliferation, migration, and apoptosis) of human endometrial cancer HEC-1A cells and its possible mechanism. Methods The hairpin shRNA targeted by the RBM8A gene was designed, and the best shRNA silencing fragment was screened. The recombinant lentiviral interference vector carrying the target gene was constructed and used to infect HEC-1A cells. Cells with stable knockdown of RBM8A gene were screened by puromycin as the experimental group (shRBM8A), while the shRNA of nonsense sequence was designed as the control group (shControl). CCK-8 method was used to detect cell proliferation, and flow cytometry was used to detect cell apoptosis. Transwell assay was used to detect cell migration and invasion. Western blot was used to analyze the expression of apoptosis-related proteins and EMT signal transduction pathway related proteins. Results In comparison with the shControl group, after RBM8A knockdown, HEC-1A cell proliferation was reduced, apoptosis was increased, migration and invasion ability were significantly inhibited (P < 0.05), the expression of apoptosis-related proteins cleaved caspase 9 and caspase 3 increased, EMT-related protein E-cadherin expression increased, and Vimentin expression decreased. Conclusion RBM8A gene silencing can inhibit the proliferation, migration, and invasion and promote the apoptosis of endometrial cancer cells. The inhibition of EMT signal transduction pathway may be its mechanism.

Effect of Doxycycline on Intrinsic Apoptosis of Myeloma Cell Line H929 and Its Mechanism / 中国实验血液学杂志

OBJECTIVE@#To investigate the mechanism of the in vitro toxicity of doxycycline to myeloma cell line H929 and also the possible pathway involved its toxicity.@*METHODS@#Myeloma cell line H929 was treated with DOX, MEK inhibitor U0126 or RAS agonist ML-098, either alone or in combination. Then, the expression of p-MEK, caspase-3, caspase-9 and c-Jun in H929 were used to detected by Western blot; the cells proliferation and apoptosis were detected by CCK-8 assay and flow cytometry, respectively.@*RESULTS@#DOX significantly increased the levels of cleaved caspase-3 and caspase-9, and down-regulated the level of p-MEK in H929 (P<0.05). MEK antagonist U0126 significantly increased the levels of cleaved caspase-3 and caspase-9, and down-regulated the level of p-MEK (P<0.05). After Dox combined with ML-098 treatment of H929 cells, the apoptosis rate of H929 cells was lower than that of DOX alone treatment group(P<0.05). Compared with DOX alone treatment group, the expressions of p-MEK and p-ERK1/2 in DOX+ML-098 combined treatment group were increased, and the levels of cleaved caspase-3,9 in H929 cells were decreased (P<0.05). The levels of c-Jun mRNA and protein increased in H929 when treated by DOX alone (P<0.05).@*CONCLUSION@#DOX can induce apoptosis of H929 via intrinsic apoptosis pathway, and MEK/ERK pathway and c-Jun possibly play a role in this process.

The relationships among atherogenic index of plasma and inflammatory adipocytokines with the severity of coronary artery calcification in coronary artery disease / 中国医师杂志

Objective:The aims of the study were to investigate the relationship among atherogenic index of plasma (AIP) and inflammatory adipocytokines with the severity of coronary artery calcification (CAC) score in coronary artery disease (CAD). And then we analyzed the diagnostic value of the new markers on CAC.Methods:A total of 241 patients with CAD diagnosed by coronary CT angiography (CTA) and coronary angiography in Baoding First Central Hospital from June 2019 to June 2020 were retrospectively enrolled. According to the presence of calcification in coronary CTA, they were divided into CAC group ( n=63) and non-CAC group ( n=178). The clinical data of the patients were collected, and the levels of serum inflammatory factors were measured by enzyme-linked immunosorbent assay (ELISA). The correlation between CAC score and AIP and inflammatory cytokines was analyzed. The diagnostic value of AIP and inflammatory factors in the formation of CAC in patients with CAD. Results:The levels of AIP, serum osteoprotegerin (OPG) and oligomeric matrix protein (COMP) in CAC group were higher than those in non-CAC group, while the levels of serum fibroblast growth factor 21 (FGF21) were lower than those in non-CAC group, with statistically significant difference (all P<0.01). Correlation analysis showed that CAC score of CAD patients was positively correlated with AIP, OPG and COMP ( r=0.581, 0.451, 0.326, P<0.05), and negatively correlated with FGF21 ( r=-0.294, P<0.05). Receiver operating characteristic (ROC) curve analysis showed that AIP, OPG, COMP and FGF21 had diagnostic value for CAC in CAD patients (all P<0.05). AIP>0.387, OPG>5.150 ng/ml, FGF21>136.35 pg/ml, COMP>733.16 ng/ml were independent factors affecting the formation of CAC (all P<0.05). Conclusions:The increase of AIP and the change of inflammatory factors can be used as markers for the diagnosis of CAC formation in CAD patients.

Accuracy of photogrammetry and conventional impression techniques for complete-arch implant rehabilitation: an in vitro comparative study / 中华口腔医学杂志

Objective: To compare the accuracy of photogrammetry and conventional impression techniques for complete-arch implant rehabilitation. Methods: An edentulous maxillary stone cast containing 8 screw-retained implant abutment replicas was derived from a 74-year-old male patient who visited the Department of Dental Implant Center, Capital Medical University School of Stomatology in September 2019. The stone cast was copied through the open-tray splinted impression, and the copied cast was used as the master cast for this study. The abutment-level impressions of master cast were made by photogrammetry (PG) and the conventional impression technique (CNV) by one attending doctor. Group PG: after which scan bodies were connected to each implant replica, a photogrammetry system was used to obtain digital impressions of the master cast (n=10); Group CNV: conventional open-tray splinted impression technique was performed to fabricate conventional definitive casts (n=10). After connecting the scan bodies onto each implant replicas, the master cast and the 10 definitive casts from group CNV were digitized with a laboratory reference scanner. All data of group PG, group CNV and mater cast were saved as ".stl" files. For all test scans and reference scan, the three-dimensional information of scan bodies were converted to implant abutment replicas using a computer aided design software (Exocad). The data of the group PG and the group CNV were respectively registered with the reference data (trueness analysis) and pairwise within group (precision analysis) for accuracy evaluation in a three-dimensional analysis software (Geomagic Control X). Results: The trueness and precision of group PG [(17.33±0.34) and (2.50±0.79) μm ] were significantly statistically better than those of group CNV [(24.30±4.16) and (26.12±4.54) μm] respectively (t=-5.29 and -34.35, P<0.001). Conclusions: For complete-arch implant abutment-level impression, photogrammetry produces significantly better accuracy than conventional impression technique.

Pathogenesis of Secondary Pulmonary Tuberculosis and Role of Cord Factor in Secondary Infection / 中国医学科学院学报

The primary and secondary tuberculosis features two completely different pathogenesis.At present,the pathogenesis of primary tuberculosis has been clear,whereas that of secondary tuberculosis remains unclear.In order to decipher the mechanism of secondary infection of

Apatinib Combined with Local Irradiation Leads to Systemic TumorControl via Reversal of Immunosuppressive Tumor Microenvironmentin Lung Cancer / Journal of the Korean Cancer Association, 대한암학회지

Purpose@#This study aimed to investigate the potential systemic antitumor effects of stereotactic ablativeradiotherapy (SABR) and apatinib (a novel vascular endothelial growth factor receptor2 inhibitor) via reversing the immunosuppressive tumor microenvironment for lung carcinoma. @*Materials and Methods@#Lewis lung cancer cells were injected into C57BL/6 mice in the left hindlimb (primary tumor;irradiated) and in the right flank (secondary tumor; nonirradiated). When both tumors grewto the touchable size, mice were randomly divided into eight treatment groups. These groupsreceived normal saline or three distinct doses of apatinib (50 mg/kg, 150 mg/kg, and 200mg/kg) daily for 7 days, in combination with a single dose of 15 Gy radiotherapy or not tothe primary tumor. The further tumor growth/regression of mice were followed andobserved. @*Results@#For the single 15 Gy modality, tumor growth delay could only be observed at the primarytumor. When combining SABR and apatinib 200 mg/kg, significant retardation of both primaryand secondary tumor growth could be observed, indicated an abscopal effect wasinduced. Mechanism analysis suggested that programmed death-ligand 1 expressionincreased with SABR was counteract by additional apatinib therapy. Furthermore, whenapatinib was combined with SABR, the composition of immune cells could be changed.More importantly, this two-pronged approach evoked tumor antigen–specific immune responsesand the mice were resistant to another tumor rechallenge, finally, long-term survivalwas improved. @*Conclusion@#Our results suggested that the tumor microenvironment could be managed with apatinib,which was effective in eliciting an abscopal effect induced by SABR.

Effects and Predictive Factors of Immunosuppressive Therapy Combined with Umbilical Cord Blood Infusion in Patients with Severe Aplastic Anemia

PURPOSE: To investigate the efficacy and safety of umbilical cord blood (UCB) infusion (UCBI) plus immunosuppressive therapy (IST) treatment in comparison to IST treatment, as well as predictive factors for clinical responses, in severe aplastic anemia (SAA) patients. MATERIALS AND METHODS: Totally, 93 patients with SAA were enrolled in this cohort study. In the IST group, rabbit antithymocyte globulin (r-ATG) combined with cyclosporine A (CsA) was administered, while in the IST+UBCI group, r-ATG, CsA, and UCB were used. RESULTS: After 6 months of treatment, UCBI+IST achieved a higher complete response (CR) rate (p=0.002) and an elevated overall response rate (ORR) (p=0.004), compared to IST. Regarding hematopoietic recovery at month 6, platelet responses in the UCBI+IST group were better than those in the IST group (p=0.002), and UCBI+IST treatment facilitated increasing trends in absolute neutrophil count (ANC) response (p=0.056). Kaplan-Meier curves illuminated UCBI+IST achieved faster ANC response (p < 0.001) and platelet response (p < 0.001), compared with IST therapy. There was no difference in overall survival (OS) between the two groups (p=0.620). Furthermore, logistic regression analysis demonstrated that UCBI+IST was an independent predicting factor for both CR (p=0.001) and ORR (p < 0.001), compared to IST; meanwhile, very severe aplastic anemia (VSAA) and ANC could predict clinical responses as well. However, Cox proportional hazard regression indicated that VSAA (p=0.003), but not UCBI+IST, affected OS. Safety profiles showed that UCBI+IST therapy did not elevate adverse events, compared with IST treatment. CONCLUSION: UCBI+IST achieved better clinical responses and hematopoietic recovery than IST, and was well tolerated in SAA patients.

Shufeng Huoxue Formula suppresses proliferation and regulates melanin metabolism in murine B16 melanoma cells in vitro through autophagy pathway / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the role of autophagy in the regulatory effect of Shufeng Huoxue Fumula (SFHXF) on the proliferation and melanin metabolism in cultured murine B16 melanoma cells.</p><p><b>METHODS</b>B16 cells were treated with solutions containing 0.12, 0.25, 0.49, 0.98, or 1.96 mg/mL SFHXF preparations, rapamycin (an autophagy inducer), or rapamycin+SFHXF. The changes in the proliferation of B16 cells were assessed using MTT assay, and tyrosinase activity and melanin content in the cells were determined. The expressions of autophagy-related proteins P62, p-mTOR, LC3B, and beclin 1 in the cells were detected using Western blotting.</p><p><b>RESULT</b>Compared with the blank control cells, treatments with SFHXF both in the presence and in the absence of rapamycin concentration-dependently inhibited the cell proliferation (P<0.05) and obviously increased tyrosinase activity and melanogenesis in B16 cells (P<0.05); 0.98 mg/mL SFHLF, rapamycin+0.98 mg/mL SFHXF, and 50 nmol/L rapamycin all significantly up-regulated the expressions of LC3B-II and beclin 1 and down-regulated the expressions of P62 and p-mTOR in the cells.</p><p><b>CONCLUSION</b>SFHXF can regulate melanin metabolism and enhance tyrosinase activity and melanogenesis through the autophagy pathway to inhibit the proliferation of B16 cells in vitro.</p>

Evaluation of the clinical effects of implant-supported overdenture with ball or Locator attachment / 实用口腔医学杂志

Objective:To evaluate the clinical effects of ball attachment and Locator attachment for implant-supported overdenture.Methods:67 cases with edentulous jaw were treated with 150 Straumann and Bego implants and implant-supported overdentures using ball attachments Locator attachments,respectively.All cases were followed up regularly,biological and mechanical complications were observed,the patient satisfaction after restoration was compared between groups.Statistical analysis was performed using SPSS 17.0 software.Results:Follow-up was completed in 58 cases,25 with ball attachment,26 with Locator attachment and 7 with ball changed by Locator.Biological complications comparison showed that the incidence of gingival hyperplasia in the ball group was higher than that in the Locator group(P ＜ 0.05).There was no statistical difference of mechanical complications between the 2 groups (P ＞ 0.05),but the incidence of all kinds of mechanical complications in the Locator group was less than those in the ball group,the average repair frequency of the ball and Locator group was 1.9 times and 0.9 times respectively.Patients'satisfaction on chewing and retention was higher in the Locator attachment group than that in the ball attachment group(P ＜ 0.05).No statistical difference was found in patients' satisfaction between genders (P＞0.05),and no correlation of satisfaction was found with patients' age and follow-up time.Conclusion:The clinical effects of implant-supported overdenture using the Locator attachment is superior to that using the ball attachment.

Serological and molecular analysis of a case with para-Bombay phenotype caused by a h(nt328G to A) mutation / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To explore the serological characteristics and molecular basis for an individual with para-Bombay phenotype.</p><p><b>METHODS</b>Blood type of the proband was determined with routine serological methods. Exons 6 and 7 of the ABO gene and coding regions of the FUT1 and FUT2 genes were amplified by PCR and sequenced.</p><p><b>RESULTS</b>The para-Bombay phenotype was confirmed to be of Ah-secretion type. The genotype of the individual was determined as A102/O01. Position 328 of the FUT1 gene was mutated from A to G, resulting in replacement of Alanine (Ala) at position 110 by Threonine (Thr).</p><p><b>CONCLUSION</b>The G to A mutation of nt328 of the FUT1 gene probably underlies the para-Bombay phenotype in this individual.</p>

The impact of repeated app1ication of contrast media on rena1 function within a short period of time ;in different occasions / 中国介入心脏病学杂志

Objective To discuss the impact of repeated contrast media exposure on renal function in patients who received coronary angiography ( CAG) or percutaneous coronary intervention ( PCI) within 1 week after CTA of coronary ateries. Methods A total of 258 patients who received CAG or PCI after coronary CTA were divided into the study group ( n=132, patients had CAG/PCI within 1 week after CTA) and the control group ( n=126, patients had CAG/PCI 1-2 weeks after CTA). Serum creatinine, cystatin C and estimated GFR were tested before and on day 1, 2 and 3 after procedures. The occurance of contrast-induced nephropathy ( CIN ) was recorded. Resu1ts The baseline clinical characteristics of the patients between the two groups had no significant difference. Preoperative and postoperative serum creatinine, cystatin C and eGFR values on day 1, 2 and 3 had no significant difference between the two groups (all P﹥0. 05). There was no significant difference in the incidence of CIN between two groups (5. 3% in the study group vs. 4. 8% in the control group, P﹥0. 05 ) . Conc1usions It is safe and feasible for patients with eGFR≥60 ml/( min?1. 73 m2 ) to undergo CAG or PCI within 1 week after coronary CTA.

Clinical Efficacy of Folic Acid Intervene in Hyper-homocysteinemia Patients Combining Coronary Artery Disease and Heart Failure / 中国循环杂志

Objective: To observe clinical efficacy of oral folic acid (FA) intervene in hyper-homocysteinemia (HHcy) patients combining coronary artery disease (CAD) and heart failure (HF), to study the effect of blood level of Hcy on cardiac function. Methods: A total of 126 relevant patients with blood level of Hcy>15 μmol/L were randomly divided into 2 groups:Routine group, the patients received anti-platelet therapy, statins, beta-blockers, diuretics, angiotensin converting enzyme inhibitor (ACEI) or angiotensin II receptor antagonist and FA group, in addition to above mentioned therapies, the patients also received FA 5 mg/day. n=63 in each group and all patients were treated for 3 months. Fasting blood levels of Hcy, BNP and left ventricular end diastolic diameter (LVEDD), left ventricular ejection fraction (LVEF), 6-minute walk test (6MWT) were compared between 2 groups at pre- and 3 months post-treatment. Results: ① Based on NYHA classification, the patients with cardiac function at II, III, IV had accordingly increased blood levels of Hcy, BNP and LVEDD, while decreased LVEF and 6MWT, all P<0.05. ② Blood levels of Hcy were positively related to BNP (r=0.733, P<0.001) and LVEDD (r=0.511, P<0.001), negatively related to LVEF (r=-0.382, P<0.001) and 6MWT (r=-0.410, P<0.001). ③ With 3 months treatment, FA group and Routine group showed decreased Hcy level as (8.43 ± 1.87) μmol/L vs (3.29 ±1.68) μmol/L and BNP (891.84 ± 456.10) pg/ml vs (682.24 ± 463.79) pg/ml, reduced LVEDD (4.33 ± 1.231) mm vs (2.06 ± 1.73) mm, while elevated LVEF (6.59 ± 2.28) % vs (2.52 ± 2.37) % and 6MWT (142.97 ± 55.15) m vs (86.35 ± 59.06) m, all P<0.05. Conclusion: Increased blood level of Hcy is risky for HF occurrence, FA may treat HHcy and further improve the cardiac structure and function in HF patients.

An analysis of clinical features of celiac disease patients in different ethnic / 中华内科杂志

Objective To summarize the clinical features of different racial patients with celiac disease (CD) and analyze the disease prevalence,diagnosis and treatment in Chinese population.Methods All the patients were diagnosed as CD and enrolled in Beijing United Family Hospital between January 2005 and July 2015.Clinical data including nationality,age,symptoms,endoscopic and pathological findings,outcome were collected and compared in patients from different countries.Results A total of 87 patients were enrolled including 63 Caucasians,18 Asian patients and 6 Middle East patients.The peak age of disease onset was 40-60 years old.Patients with typical symptoms such as chronic diarrhea and weight loss only accounted for 20.7％ (18/87) and 9.2％ (8/87) respectively.Some patients presented with nonspecific symptoms such as abdominal pain and bloating [32.2％ (28/87)],even constipation [5.7％ (5/87)].13.8％ (12/87) patients were previously diagnosed as irritable bowel syndrome.The incidence of abdominal pain,bloating,diarrhea and constipation between Asians and Caucasians had no statistical significance (P ＞ 0.05);but the proportions of weight loss,growth retardation,iron deficiency anemia and dermatitis herpetiformis in Asian group were significantly higher than that in Caucasian group (P ＜ 0.05).IgA type of anti-gliadin antibody (AGA),endomysium antibody (EMA) and tissue transglutaminase antibody (tTGA) were dominant autoimmune antibodies in patients with CD,which accounted for 58.6％ (51/87),44.8％ (39/87) and 36.8％ (32/87) respectively.The endoscopy showed that the lesion of CD was mainly located in small intestine,with reducing severity from the proximal to the distal small intestine.The lesions of duodenal bulb and descending duodenum appeared more significant in Asian group.Accordingly pathological intestinal atrophy and the degree of intraepithelial lymphocytosis were more severe in Asian patients.All 87 cases took the gluten-free diet (GFD).Eighty-one cases received serological follow up and 8 with endoscopic intestinal biopsy.The celiac disease antibodies in 47 patients turned negative from 6-9 months after GFD treatment,while 34 patients turned negative from 12-18 months after GFD.All patients reported disease remission to some extent.After 1 year GFD treatment,the pathology of endoscopic intestinal biopsy in 8 patients showed significant improvement of villous atrophy and lymphocyte infiltration.Conclusions CD patients with typical clinical manifestations are not the majority.Serological celiac disease antibodies (AGA,EMA and tTGA) have a high diagnostic value.GFD treatment is effective on majority of celiac patients.Clinical manifestations,endoscopy,intestinal pathology,and response to GFD in Chinese patients are not the same as Caucasians.Clinicians need to pay attention to the differential diagnosis.

Serological Characteristics and Family Survey of 3 Cases of H-deficient Blood Group / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To investigate the serological characteristics and the genetic status of the family of H-deficient blood group in Jining area of Shandong province in China.</p><p><b>METHODS</b>ABO, H, and Lewis blood groups in 3 probands were screened out by the serological method, and saliva testing was performed on all the individuals. The presence of weak A or B on the RBC was confirmed by using the adsorption-elution procedure.</p><p><b>RESULTS</b>Three cases of H-deficient blood group were identified to be para-Bombay blood group (secretor), out of 3 cases, 2 cases were Bh, 1 case was Ah, and anti-H or anti-HI antibody was detected in their serum.</p><p><b>CONCLUSION</b>Three cases of H-deficerent blood group are para-Bombay phenotype, among them one proband's parents have been confirmed to be consanguineous relationship.</p>

Analysis of risk factors of no reflow phenomenon on post-percutaneous coronary intervention in patients with acute myocardial infarction / 中国综合临床

Objective To explore the risk factors of no reflow phenomenon on post-percutaneous coronary intervention(PCI) in patients with acute myocardial infarction (AMI).Methods The clinical data of 268 patients with AMI who performed emergency PCI were collected and divided into normal group(normal flow) and no-reflow group (no flow).The risk factors of predicting the occurrence of no reflow phenomenon were screened by univariate and multivariate analysis.Results Thirty-two cases (11.9％) of 268 patients had flow occurrence and 236 cases(88.1％) were with no flow occurrence.There were significantly statistical differences between the two groups in terms of angina pectoris history before infarction,white blood cell count (WBC),history of oral of stains,administration of 600 mg of plavix before the operation,creatinine kinase,MB isoenzyme (CK-MB),C-reactive protein (CRP),Low density lipoprotein(LDL),time of coronary artery perfusion,numbers of balloons used during PCI and Killip ≥ grade 2 (all P ＜ 0.05).The multivariate logistic regression model analysis displayed that Killip ≥ grade 2 (odds ratio (OR) =1.237,95％ confidence interval (95％ CI) 1.049 -2.264,P=0.021),history of oral of stains(OR=2.355,95％CI 1.547-3.438,P＜0.001),WBC ≥ 12× 109/L (OR =4.139,95％ CI 2.273-8.451,P＜0.001),no administration of 600 mg of plavix before the procedure (OR =2.645,95％CI 1.628-5.246,P＞0.005) and no angina pectoris history before infarction(OR=1.413,95％CI 1.150-2.426,P＜0.001) were independent risk factors regarding of causing no reflow phenomenon.Conclusion The factors including Killip ≥ grade 2,history of oral of stains,WBC ≥ 12× 109/L,no administration of 600 mg of plavix before theoperation and no angina pectoris history before infarction were independent risk factors in terms of causing no reflow phenomenon.

Thrombelastography and conventional coagulation test for monitoring the perioperative coagulation state after joint arthroplasty / 中国组织工程研究

BACKGROUND:There is a general consensus that patients undergoing joint arthroplasty surgery wil be in hypercoagulable state and easily to induce deep vein thrombosis. Thromboelastography is a new kind of method to monitor blood coagulation state, but not widely used in orthopaedics. No final conclusion has yet been reached on whether we can guide the clinical prevention of deep vein thrombosis and medication through using thromboelastography to monitor perioperative coagulation state of patients treated with joint arthroplasty. OBJECTIVE:To investigate the correlation between thromboelastography and routine coagulation functional tests, and evaluate the clinical application value of thromboelastography in monitoring the perioperative coagulation state of patients treated with joint arthroplasty. METHODS:A total of 204 patients who treated with joint arthroplasty at First Affiliated Hospital of Soochow University from November 2014 to August 2015 were retrospectively analyzed. The thromboelastography, routine coagulation, platelet and other data before and after the replacement were respectively col ected. The correlative analysis was conducted between the thromboelastography result and the results of conventional coagulation test, that is, routine coagulation and platelet count. RESULTS AND CONCLUSION:In total knee arthroplasty group, activated partial thromboplastin time and reaction time showed good consistency (φ=0.713, Kappa value=0.647);Prothrombin time had moderate correlation and general consistency with reaction time (φ=0.392, Kappa value=0.362);Coagulation time and fibrinogen had moderate correlation and consistency (φ=0.392, Kappa value=0.488);Aggregates formation rate (αangle) and fibrinogen had moderate correlation and consistency;the remaining parameters had poor correlation and consistency. In total hip arthroplasty group, there was a weak correlation and consistency between the reaction time, activated partial thromboplastin time and prothrombin time;the other correlations were poor. However, there was a higher proportion of consistent clotting trend between some parameters of thrombelastography and routine coagulation. In total hip arthroplasty group, the consistent proportion of coagulation time and fibrinogen accounted for 67.6%;the consistent proportion of aggregates formation rate (αangle) and fibrinogen accounted for 78.3%. These results suggest that thromboelastography and routine coagulation tests have some correlations and consistency. Thromboelastography parameters have more consistent tendency on the data. Thrombelastography can serve as an auxiliary mean to monitor coagulation state of perioperative joint arthroplasty.

Effect of spirolactone on cardiac function and serum brain natriuretic peptide in patients with chronic heart failure / 中国综合临床

Objective To investigate the effect of spirolactone on cardiac function and serum brain natriuretic peptide in patients with chronic heart failure( CHF). Methods Eighty-four patients with CHF were randomly divided into control group( n=42 )and observation group( n=42 ). The patients in the control group were given conventional therapy,while in the observation group were given spirolactone( 20 mg/times,2 times/day)based on treatment of the control group for six months. The clinical effects and left ventricular end diastolic diameter( LVEDd ),left ventricular ejection fraction( LVEF ) and serum brain natriuretic peptide( BNP ) of pretherapy and post-treatment between the two groups were recorded and compared. Results The total effective rate of observation group was 95. 2%(40/42),obviously higher than that of control group(80. 9%(34/42),χ2=6. 468,P=0. 028). The levels of LVEDd and BNP in two groups after treatment were(57. 8 ± 6. 2)mm and (62. 4 ± 7. 8)mm,(364. 4 ± 32. 8)ng/L and(457. 4 ± 43. 2)ng/L,significantly lower than those at before treatment((64. 6 ± 7. 4)mm and(64. 8 ± 7. 6)mm,(867. 8 ± 78. 5)ng/L and(864. 4 ± 74. 8)ng/L),while LVEF in two groups after treatment were( 49. 8 ± 5. 4 )% and( 42. 6 ± 4. 6 )%,significantly higher than those before treatment((35. 2 ± 3. 9)% and(35. 4 ± 3. 5)%),and the differences were significant(t = -3. 264, 4. 626,-5. 373,-3. 932,5. 438,-6. 548;P﹤0. 05). Moreover the changes in observation group were obvious than those in control group in terms of LVEDd,BNP and LVEF( t = -3. 425,3. 644,-2. 846;P ﹤0. 05 ) . Conclusion Spironolactone can effectively decrease the serum brain natriuretic peptide levels,improve the cardiac function in patients with chronic heart failure,and it is worthy of popularization and application.

Safety and feasibility of transulnar versus transradial artery approach for coronary catheterization in non-selective patients / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Transradial approach catheterization is now widely used in coronary angiography and angioplasty. The ulnar artery, which is one of the two terminal branches of the brachial artery, may be a potential approach for cardiac catheterization. The aim of this study was to evaluate the safety and feasibility of a transulnar approach for coronary catheterization in non-selective patients.</p><p><b>METHODS</b>A total of 535 consecutive patients were randomly assigned to transulnar approach (TUA) group (n = 271) or transradial approach (TRA) group (n = 264) upon arrival at the catheterization laboratory. Allen's test and inverse Allen's test were not routinely performed. Ultrasound-Doppler assessment of the forearm artery was performed before the procedure, two days after the procedure, and 30 days after the procedure. The primary endpoints of study were the rate of successful artery cannulation and the access-site related complications. The secondary endpoints included the number of needle punctures, total time for the procedure, and major adverse cardiac events (MACE).</p><p><b>RESULTS</b>Successful puncture of the objective artery was obtained in 91.5% of the patients in the TUA group, and 95.1% of the patients in the TRA group (P > 0.05). There was no significant difference in hematoma complications between the two groups (7.7% vs. 4.2%, P = 0.100). A motor abnormality of the hand was observed in one patient in the TUA group. There were no arteriovenous fistula or pseudoaneurysm observed in our study. Three (1.1%) patients in the TUA group and 8 (3.0%) patients in the TRA group had occlusion of the access artery (P = 0.137), but none of the patients had symptoms or signs of hand ischemia. There were no significant differences in MACE between the two groups during follow-up.</p><p><b>CONCLUSION</b>The transulnar approach is an effective and safe technique for coronary catheterization in non-selective patients.</p>

Gut flora and gut-derived endotoxin in minimal hepatic encephalopathy / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To investigate the relationship of gut flora and gut-derived endotoxin with minimal hepatic encephalopathy (MHE).</p><p><b>METHODS</b>Patients with hepatitis B virus-related liver cirrhosis (HBV-LC) were screened for MHE using the number connect test-A (NCT-A) and digital symbol test (DST) and divided into the following groups: HBV-LC with (+) MHE (n = 26) and HBV-liver cirrhosis without (-) MHE (n = 25); in addition, one healthy immediate family member of each patient in the HBV-LC + MHE group was enrolled as a control. Each participant provided fecal and blood samples. PCR amplification and 454 pyrosequencing were used to detect bacterial 16S rRNA in feces. Turbidimetric Limulus amebocyte lysate assay was used to detect level of endotoxin in serum. The significance of inter-group differences was assessed by one-way ANOVA or Student's t-test.</p><p><b>RESULTS</b>The three groups showed different distributions of gut flora. The differences in the microbial communities' members and distributions were related to disease or health status, but not to the patient's genetic makeup or diet. In particular, the HBV-LC + MHE patients showed significantly lower amounts of different bacterial species and abundance of these species than the other two (non-MHE) groups (P less than 0.05). The healthy control family members had a richer diversity of gut flora than their counterparts with HBV-LC + MHE (P less than 0.05). The HBV-LV + MHE patients also had higher serum levels of endotoxin.</p><p><b>CONCLUSION</b>Development of minimal hepatic encephalopathy in patients with HBV-LC may be related to a gut flora disorder or higher levels of endotoxin in serum.</p>

Electrocardiographically triggered CT angiography of the whole aorta and coronary arteries with high-pitch dual-source CT / 中华放射学杂志

Objective To investigate the feasibility of comprehensive assessment of the whole aorta and coronary arteries (CA) simultaneously with high-pitch 128-slice dual-source CT ECG-gated FLASH protocol.Methods A total of 48 consecutive patients with suspected aortic diseases underwent CTA examination of the whole aorta and CA using a ECG-gated FLASH CT protocol (pitch =3.2) without heart rate (HR) control.Aorta,aortic valves and CA were shown with different post-processing modalities.The image quality of the aorta,aortic valves and CA was evaluated and compared according to HR (low HR group ≤ 65 bpm,high HR group ＞ 65 bpm).The scan time,effective dose and contrast medium volume were recorded.Inter-observer differences were calculated by Kappa test.Differences between groups were analyzed by Mann-Whitney test with count data and variance test with measurement data.Results All examinations were completed successfully.The image quality was acceptable in the aorta,aortic valve (100％,48/48) and CA (94.0％,551/586).Percentage of diagnostic quality images was slightly higher in low HR group (94.7％,232/245,93.5％,319/341,Z =-2.504,P ＜ 0.05).Inter-reader reproducibility was 95.8％ (46/48) in the aorta and aortic valve,96.6％ (566/586) in CA,yielded good agreement (Kappa =0.81 and 0.89).The mean attenuation of aorta and CA were higher than 300 HU,especially in low HR group (357.0-446.0) HU.Except proximal segment of right CA,the CNR of whole aorta and coronary arteries were significantly higher in the low HR group (24.5-29.0) than that in the high HR group (20.0-23.1,P ＜0.05).SNR of the whole aorta was higher in the low HR group (13.7-17.9) than the high HR group (11.5-13.9,P ＜ 0.05).The mean scan time was (1.56 ± 0.08) s,effective dose was (4.12 ± 1.23) mSv (2.77-6.77 mSv),and contrast medium volume was (72.8 ± 2.1) ml.Conclusions CT angiography of whole aorta and coronary arteries could be performed simultaueously within 2 seconds with CT ECG-gated FLASH protocol.The images were of diagnostic quality for aortic and CA disease with low dose of radiation and contrast media.However,high HR could decrease the image quality of CA.