Progressin Tumor-Associated Macrophages in the Treatment of Pancreatic Cancer / 中国医学科学院学报

Pancreatic cancer is one of the digestive system tumors with a high degree of malignancy,and most of the patients are diagnosed in advanced stages.Because of limited available therapies,the mortality of this disease remains high.Tumor-associated macrophages(TAM),the main immune cells in the tumor microenvironment,are involved in the regulation of the occurrence and development of pancreatic cancer.Specifically,TAM are involved in the proliferation,invasion,immune escape,and chemoresistance of pancreatic cancer cells,demonstrating potential in the targeted therapy of pancreatic cancer.In this paper,we summarize the TAM-based therapies including consuming TAM,reprogramming TAM,dynamic imaging of TAM with nanoprobes,and regulating the phagocytic ability of TAM for pancreatic cancer,aiming to provide a theoretical basis for developing new therapies for pancreatic cancer.

Progress in research of long-term protective efficacy of human papillomavirus vaccine / 中华流行病学杂志

The efficacy of HPV vaccine in preventing cervical cancer has been demonstrated in numerous clinical trials and clinical uses. The follow-up after clinical trials usually last for 5-6 years to evaluate the long-term efficacy, and a series of long-term follow-up studies have been conducted in some regions. The literature retrieval of HPV vaccine long term efficiency research both at home and abroad indicated that the protective efficacy of the vaccine against vaccine-type-related cervical intraepithelial neoplasia grade 2 and above is higher than 90%.

Chinese Medicine Plaster as A New Treatment for Surgical Site Infection in Patients with Cesarean Delivery: A Randomized, Double-Blind, Controlled Trial / 中国结合医学杂志

OBJECTIVE@#To evaluate the efficacy of Chinese plaster containing rhubarb and mirabilite on surgical site infection (SSI) in patients with cesarean delivery (CD) by performing a randomized controlled trial.@*METHODS@#This randomized controlled trial included 560 patients with CD due to fetal head descent enrolled at a tertiary teaching center between December 31, 2018 and October 31, 2021. Eligible patients were randomly assigned to a Chinese medicine (CM) group (280 cases) or a placebo group (280 cases) by a random number table, and were treated with CM plaster (made by rhubarb and mirabilite) or a placebo plaster, respectively. Both courses of treatment lasted from the day 1 of CD, followed day 2 until discharge. The primary outcome was the total number of patients with superficial, deep and organ/space SSI. The secondary outcome was duration of postoperative hospital stay, antibiotic intake, and unplanned readmission or reoperation due to SSI. All reported efficacy and safety outcomes were confirmed by a central adjudication committee that was unaware of the study-group assignments.@*RESULTS@#During the recovery process after CD, the rates of localized swelling, redness and heat were significantly lower in the CM group than in the placebo group [7.55% (20/265) vs. 17.21% (47/274), P<0.01]. The durution of postoperative antibiotic intake was shorter in the CM group than in the placebo group (P<0.01). The duration of postoperative hospital stay was significantly shorter in the CM group than in the placebo group (5.49 ± 2.68 days vs. 8.96 ± 2.35 days, P<0.01). The rate of postoperative C-reactive protein elevation (≽100 mg/L) was lower in the CM group than in the placebo group [27.6% (73/265) vs. 43.8% (120/274), P<0.01]. However, there was no difference in purulent drainage rate from incision and superficial opening of incision between the two groups. No intestinal reactions and skin allergies were found in the CM group.@*CONCLUSIONS@#CM plaster containing rhubarb and mirabilite had an effect on SSI. It is safe for mothers and imposes lower economic and mental burdens on patients undergoing CD. (Registration No. ChiCTR2100054626).

Feasibility and clinical benefits of the double-ProGlide technique for hemostasis after cryoballoon atrial fibrillation ablation with uninterrupted oral anticoagulants / 老年心脏病学杂志（英文版）

OBJECTIVE@#To access the efficacy and safety of the double-ProGlide technique for the femoral vein access-site closure in cryoballoon ablation with uninterrupted oral anticoagulants (OAC), and its impact on the electrophysiology laboratory time as well as hospital stay after the procedure in this observational study.@*METHODS@#Patients with atrial fibrillation undergoing cryoballoon ablation with uninterrupted OAC at Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China from May 2019 to May 2021 were enrolled in this study. From October 2020, double-ProGlide technique was consistently used for hemostasis (ProGlide group), and before that conventional manual compression was utilized (manual compression group). The occurrence of vascular and groin complications was accessed during the hospital stay and until the three-month follow-up.@*RESULTS@#A total of 140 participants (69.30% of male, mean age: 59.21 ± 10.29 years) were evaluated, 70 participants being in each group. Immediate hemostasis was achieved in all the patients with ProGlide closure. No major vascular complications were found in the ProGlide group while two major vascular complications were occurred in the manual compression group. The incidence of any groin complication was obviously higher in subjects with manual compression than patients with ProGlide devices (15.71% vs. 2.86%, P = 0.009). In addition, compared with the manual compression group, the ProGlide group was associated with significantly shorter total time in the electrophysiology laboratory [112.0 (93.3-128.8) min vs. 123.5 (107.3-158.3) min, P = 0.006], time from sheath removal until venous site hemostasis [3.8 (3.4-4.2) min vs. 8.0 (7.6-8.5) min, P < 0.001], bed rest time [8.0 (7.6-8.0) h vs. 14.1 (12.0-17.6) h, P < 0.001] and hospital stay after the procedure [13.8 (12.5-17.8) h vs. 38.0 (21.5-41.0) h, P < 0.001].@*CONCLUSIONS@#Utilization of the double-ProGlide technique for hemostasis after cryoballoon ablation with uninterrupted OAC is feasible and safe, which has the clinical benefit in reducing the total electrophysiology laboratory time and the hospital stay length after the procedure.

A food poisoning incident suspected to be caused by proteus in a city of Dehong Prefecture，Yunnan Province / 上海预防医学

Objective To Investigate the cause of a food poisoning incident in a city in Dehong Prefecture， determine the scope of the incident， and to formulate effective prevention and control measures. Methods Field epidemiology and case-control study methods were used to formulate case definition； carry out case search； find suspicious food combined with clinical manifestations， dining history and other information； and collect samples from the suspicious food， cases and environment for laboratory testing. Results A total of 160 cases were found and the incidence rate was 26.02% （160/615）. The main clinical manifestations were diarrhea， leukocytosis， vomiting， nausea and abdominal pain. The average incubation period was 10.89±5.09 h， with 2 h as the shortest and 28 h as the longest. The epidemiological curve suggested the point source exposure mode. The results of case-control study showed that eating roast pork with green shoots was an independent risk factor （OR=13.09， 95%CI： 3.26‒52.54）.16 samples were tested by the local CDC laboratory. Proteus mirabilis was detected in two the anal swabs of two patients He and Chen. Both proteus pani and proteus mirabilis were detected in anal swab of patient Zhou and Proteus pani was detected in roast meat. There was no detection of pathogenic bacteria in other samples. Conclusion Based on the field epidemiological investigation and laboratory test results， we conclude that the food poisoning incident is caused by suspected proteus bacteria. We suggest that the market supervision department should strengthen the supervision of local food hygiene； clarify the sampling rights， responsibilities and technical procedures when medical institutions treat patients with foodborne diseases； ensure finding the causes in time； and take effective prevention and control measures to avoid similar food poisoning events.

Orienting the superficial inferior epigastric artery (SIEA) pedicle in a stacked SIEA-deep inferior epigastric perforator free flap configuration for unilateral tertiary breast reconstruction

Superficial inferior epigastric artery (SIEA) flaps represent a useful option in autologous breast reconstruction. However, the short-fixed pedicle can limit flap inset options. We present a challenging flap inset successfully addressed by de-epithelialization, turnover, and counterintuitive rotation. A 47-year-old woman underwent left tertiary breast reconstruction with stacked free flaps using right deep inferior epigastric perforator and left SIEA vessels. Antegrade and retrograde anastomoses to the internal mammary (IM) vessels were preferred; additionally, the thoracodorsal vessels were unavailable due to previous latissimus dorsi breast reconstruction. Optimal shaping required repositioning of the lateral ends of the flaps superiorly, which would position the ipsilateral SIEA hemi-flap pedicle lateral to and out of reach of the IM vessels. This problem was overcome by turning the SIEA flap on its long axis, allowing the pedicle to sit medially with the lateral end of the flap positioned superiorly. The de-epithelialized SIEA flap dermis was in direct contact with the chest wall, enabling its fixation. This method of flap inset provides a valuable solution for medializing the SIEA pedicle while maintaining an aesthetically satisfactory orientation. This technique could be used in ipsilateral SIEA flap breast reconstructions that do not require a skin paddle, as with stacked flaps or following nipple-sparing mastectomy.

Identification of PD-1 small molecule inhibitors and validation in Panax ginseng / 药学学报

Tumor immune therapy has been remarkably successful in recent years and several kinds of PD-1/PD-L1 (programmed death-1/programmed death-ligand 1) antibody drugs have been approved by the FDA for treatment of advanced malignant neoplasms. However, as biomacromolecules these antibody drugs have certain drawbacks such as high cost, injection-only administration and immunogenicity; thus, we turned to small molecules that have lower immune risks and better modifiability. Considering the structural diversity of natural products, we chose to investigate the active components in Panax ginseng, a famous and highly valued traditional Chinese medicine. Nine compounds were separated and identified in this research using a HPLC-coupled MS system, and 3 PD-1 binding compounds were identified using the SPR method. The PD-1/PD-L1 inhibitory ability of ginsenoside Rg1, as a representative ginsenoside, was verified by cytopharmacological methods. This research provides a new method for the identification of immune blockade inhibitors in natural products.

Effects of different wavelengths of blue light on human retinal pigment epithelial cells / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate the effects of different wavelength of blue light on human retinal pigment epithelial(RPE)cells. <p>METHODS: ARPE-19 cells cultured <i>in vitro</i> were randomly divided into four groups, which were control group, 447nm blue light group, 456nm blue light group and 468nm blue light group. The cells in control group were cultured under normal conditions whereas the cells in blue light group were irradiated with different wavelengths of OLED blue light with the illumination intensity of 200Lux for 72h. Live/Dead staining assay, CCK-8 assay and real-time PCR were performed to compare the effects of different wavelengths of blue light on the morphology, cell viability, proliferation capacity, mRNA expression level of visual cycle biomarkers and inflammatory biomarkers of ARPE-19 cells, respectively.<p>RESULTS: After blue light irradiation, the abnormal morphology and the decrease of cell confluence of ARPE-19 cells were observed. Furthermore, with the decrease in the wavelength of blue light, the inhibition effect of blue light on RPE proliferation was enhanced, and the mRNA expression of the proliferation marker Ki-67 and visual cycle biomarkers LRAT, CRALBP, RDH and IRBP decreased. In addition, the mRNA expression levels of inflammatory factors MCP-1 and IL-6 in RPE cells were up-regulated with the decrease in the wavelength of blue light.<p>CONCLUSION: Our data demonstrated that blue light in different wavelengths exerted detrimental effects on RPE cells. The shorter the wavelength of blue light was, the more severe damage it caused on the RPE cells.

Effect of CASC2a on proliferation and migration of papillary thyroid carcinoma cells via NF-κB signaling pathway / 医学研究生学报

Objective There are few reports on the relationship between lncRNA cancer susceptibility candidate gene 2 (CASC2) and NF-κB signaling pathway in thyroid papillary carcinoma cells at home and abroad. This study aimed to investigate the effect of lncRNA CASC2a on the proliferation and migration of TPC-1 via NF-κB signaling pathway. Methods TPC-1 was selected and constructed into lncRNA CASC2a overexpression plasmids which were divided into plasmid group [transfection with overexpressed plasmid pcDNA3.1(+)-CASC2a], empty group [transfection with equal amount of pcDNA3.1 (+) empty plasmid], blank group (without any processing). The effect of overexpressed lncRNA CASC2a on the expression of CASC2a in each group of TPC-1 cells was examined. The cells of transfected plasmid group were randomly divided into transfection group [transfection with only overexpressed plasmid pcDNA3.1(+)-CASC2a], transfection + PMA group [transfection with overexpressed plasmid pcDNA3.1(+)- CASC2a + propylene glycol methyl ether acetate (PMA) stimulation], control group (without any processing), PMA group (only plus PMA stimulation). The effects of lncRNA CASC2a on cell proliferation and migration were verified by CCK-8 and cell scratch assays at 24, 48, 72 and 96 h. Western blot was used to detect the expression of p105/p50 and p65 in NF-κB signaling pathway. The expression of NF-κB signaling pathway-related antibody proteins p105/p50 and p65 was observed by NF-κB signaling pathway agonist PMA(propylene glycol methyl ether acetate). Results After transfection with overexpressed plasmid pcDNA3.1(+)-CASC2a, the expression of CASC2a in plasmid group was significantly higher than that in empty group (P<0.05). The cell proliferation ability (0.191±0.005) was significantly lower in transfection+PMA group than that in transfection group (0.217±0.013), PMA group (0.247±0.009), and control group (0.260±0.004), and the difference was statistically significant ( P<0.01), while the cell proliferation ability in transfection group was significantly lower than those in PMA group and control group (P<0.01). The cell migration ability of transfected + PMA group [(0.208±0.109)%] was lower than that of transfection group, PMA group, and control group [(1.775±0.061)%, (1.622±0.519)%, (2.927±0.136)%], while the cell migration ability of transfection group and PMA group was lower than that in control group (P<0.05). The relative expression of p105/p50 and p65 protein in plasmid group was significantly lower than that in blank group (P<0.05). The expression of p105/p50 and p65 protein in transfection+PMA group [(0.674±0.007), (0.713±0.014)] was significantly higher than that in transfection group [(0.581±0.003), (0.570±0.012)] (P<0.05). Conclusion lncRNA CASC2a may inhibit the proliferation and migration of thyroid papillary carcinoma cells through NF-κB signaling pathway.

Correlation analysis of chemokine CX3CL1 level and the prognosis of ST elevation myocardial infarction / 解放军医学杂志

Objective To investigate the correlation ofchemokine CX3CL1 and the major adverse cardiovascular events (MACCE) within 1 year in patients with ST elevation myocardial infarction (STEMI).Methods Five hundred patients with STEMI were continuously selected from the Department of Emergency,General Hospital of Shenyang Command,and 5ml venous blood was extracted at the time of admission.Plasma CX3CL1 levels were detected by ELISA.The median of CX3CL1 plasma concentration of all selected patients (2108.3pg/ml) was used to assign the patients to low expression group (＜2108.3pg/ml) and high expression group (≥ 2108.3pg/ml).The baseline information and the medical history of patients were recorded and followed up by telephone inquiry for 1 year.The endpoint events were defined as MACCE (including cardiac death,heart failure,nonfatal stroke and nonfatal myocardial infarction).Based on the MACCE in 1 year following up,patients were assigned into MACCE group and non-MACCE group.Multivariable Cox regression analysis was performed to analyze the correlation between CX3CL1 level and MACCE in STEMI patients.Results The plasma CX3CL1 level significantly increased in MACCE group compared with that in Non-MACCE group,the difference was statistically significant (P＜0.01).Kaplan-Meier and Cox regression analysis showed that the plasma concentration of CX3CL1 was independently associated with the occurrence of MACCE within 1 year (HR=1.124,95％CI:1.032-1.217,P=0.003).Conclusion Chemokine CX3CL1 concentration in plasma is positively correlated with the prognosis of patients with STEMI,and can be used in the prognosis assessment of STEMI patients.

The influence of bivalirudin in coronary blood flow during primary percutaneous coronary intervention for acute myocardial infarction / 中国介入心脏病学杂志

Objective To evaluate the efficacy of bivalirudin on reperfusion of coronary artery in patients with acute myocardial infarction undergoing percutaneous coronary intervention. Methods In our study, we evaluated 245 patients with acute myocardial infarction who underwent percutaneous coronary intervention between April 2012 to May 2015. Based on the therapy during operation, bivalirudin were used in 122 patients and heparin was used in 123 patients. Study outcomes included immediate TIMI(thrombolysis in myocardial infarction)flow and CTFC(Corrected TIMI Frame Count)by angiogrophy once the target lesion was opened rates of ,in-hospital thrombocytopenia, bleeding events myocardial infarction, repeat revascularization and the incidence of MACE(major adverse cardiac events)in 30 days and 1 year. Results The mean heart rate was higher in the bivalirudin group(P=0.034). There was no significant difference between the two groups in laboratory results or interventional data(P>0.05). After the target vessel was opened, the effect of bivalirudin on slow/no-reflow in primary PCI has no difference between heparin in terms of TIMI blood evaluation or CTFC (P>0.05). Hospitalization data analysis showed that bivalirudin was able to obtain a higher activated whole blood coagulation time(ACT)value(P<0.001)with lower decrease in the number of platelets. Follow-up data of 30 days and 1 year showed no difference in the incidence of MACE and net adverse clinical events(NACE)between the two groups(P>0.05). Conclusions Bivalirudin has well efficacy and safety in patients with acute myocardial infarction in patients with acute myocardial infarction undergoing PPCI without increasing the incidence of slow/no-reflow.

Risk factors for periprosthetic joint infection after hip or knee arthroplasty in Mainland of China: a meta-analysis / 中国组织工程研究

BACKGROUND: Periprosthetic joint infection (PJI) is a serious and catastrophic complication after hip or knee arthroplasty. With aging population increasing, more patients will undergo hip or knee arthroplasty. Studies have shown that the risk for PJI following arthroplasty is different in different populations. OBJECTIVE: To evaluate the risk factors for PJI after hip or knee arthroplasty in Mainland of China through a meta-analysis, thereby providing reference for the prevention and control of postoperative PJI. METHODS: A computer-based search of WanFang, CNKI, VIP, CBM, PubMed, Cochrane, Embase and Medline databases was performed and the literatures concerning the risk factors for PJI after hip or knee arthroplasty in Mainland of China published before September 2016 were collected by manual retrieval and retrospective approach. All the literatures were screened based on the inclusion and exclusion criteria, followed by data extraction and analyzed on RESULTS AND CONLUSION: (1) Finally 14 literatures were included, including 417 patients with PJI. (2) The results of the meta-analysis showed that the risk factors for PJI after hip or knee arthroplasty including the complication of diabetic mellitus, long-term use of steroids, long operation time (> 90 minutes), age (> 65 years), and history of hip or knee Stata 12.0 software. surgery. (3) To conclude, PJI after hip or knee arthroplasty is related to multiple factors, so physicians should pay attention to these factors to reduce the incidence of PJI.

Gene-gene interaction of GJB2, SOD2, and CAT on occupational noise-induced hearing loss in Chinese Han population / 生物医学与环境科学（英文）

The effects of genetic factors on the noise-induced hearing loss (NIHL) are still unclear. In the present study, eight single-nucleotide polymorphisms (SNPs) included rs1227049 and rs3802711 (CDH23), rs1695 (GSTP1), rs137852540 (GJB2), rs2289274 (PMCA2), rs4880 (SOD2), rs7943316, and rs769214 within CAT that might associated with NIHL were further validated in Chinese workers. The results showed that the carriers of the T allele (AT+TT) of rs7943316 and A allele (GA+AA) of rs769214, were significantly associated with an increased risk of NIHL compared to those with AA genotype (P<0.05) and GG genotype (P<0.05). Moreover, a significant three-locus model (P=0.0107) involving rs2016520, rs9794, and rs1805192 were observed that might associated with NIHL, with 53.95% of testing accuracy. Thus, our present study provided the evidence that GJB2, SOD2, and CAT genes might account for the NIHL development in independently and/or in an interactive manner.

Heart rate distribution and predictors of resting heart rate after initiation of beta-blocker treatment in patients with coronary artery disease: REsults of Sympathetic Evaluation And Research of China (RESEARCH) study / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The importance of heart rate as secondary prevention strategies for patients with coronary artery disease (CAD) is emphasized by multiple guidelines. However, limited information is available on the heart rate distribution and the change patterns of resting heart rate when initiating beta-blocker therapy among Chinese patients with CAD.</p><p><b>METHODS</b>The REsults of Sympathetic Evaluation And Research of China (RESEARCH) study is a multi-centre, prospective, observational study involving 147 centers in 23 cities across China. All eligible beta-blocker naive patients were prescribed with metroprolol succinate. Initial dosage and target heart rate were selected at the discretion of their physicians in charge according to their usual institutional practice. The heart rate distribution and the change patterns of resting heart rate after initiation of beta-blocker therapy were observed.</p><p><b>RESULTS</b>The majority of patients (63.6%) were prescribed with 47.5 mg metroprolol succinate. At baseline, there were only 17.4% of patients whose heart rate was less than 70 beats per minute, and the proportion reached 42.5% and 79.1%, one month and two months after initiation of beta-blockers, respectively. Multivariate linear regression analysis showed that baseline heart rate (B = 0.900, SE = 0.006, t = 141.787, P < 0.0001) and the dosage (B = -0.007, SE = 0.002, t = -3.242, P = 0.001) were independent predictors of resting heart rate 2 months after beta-blocker therapy.</p><p><b>CONCLUSIONS</b>Resting heart rate is not optimally controlled in a broadly representative cohort of Chinese outpatients with CAD even after initiation of β-blocker therapy, and baseline heart rate and the dosage of beta-blocker are both independent predictors of resting heart rate after β-blocker therapy.</p>

Application of slender narrow pedicle flap in facial skin cancer treatment / 中华整形外科杂志

<p><b>OBJECTIVE</b>To introduce the application of slender narrow pedicle flap in repairing facial tissue defects after skin carcinoma excision, and investigate its survival mechanism.</p><p><b>METHODS</b>The slender narrow pedicle iateral maxillocevical flap was designed with its pedicle including skin fascia or only the fascia located in front of auricle or behind of it, repaired 26 cases of facial defects, including 5 temporal skin basal cell carcinoma, 6 skin squamous cell carcinoma, and 1 facial skin malignant melanoma, 8 skin basal cell carcinoma, 5 skin squamous cell carcinoma, 1 skin mucinous carcinoma. In 26 cases, 24 cases their pedicles in front of the auricle, 2 cases behind of the auricle; 4 cases their pedicles only including fascia. The size of the flaps ranged from 3.0 cm x 2.5 cm to 10.0 cm x 8.0 cm. The width and length of the pedicle ranged 1.0-1.5 cm and 2-6 cm.</p><p><b>RESULTS</b>26 cases of the slender narrow pedicle flaps all survived and the results were satisfactory except 5 cases of distal congestion, then gradual recovery.</p><p><b>CONCLUSIONS</b>This slender narrow flap don't include any major blood vessel, without dissecting the blood vessels in operating. Due to its slender pedicle, the whole flap looks like "pingpang bat", the flap rotation is easy and its coverage area is very large, without cat ears. The postoperative appearance (color, texture, cosmetic aspect) is satisfactory. This slender narrow flap is an extraordinary new flap design and is ideal for the repair of the facial tissue defect after skin carcinoma excision.</p>

Assessment of early radial injury after transradial coronary intervention by high-resolution ultrasound biomicroscopy: innovative technology application / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Transradial coronary intervention (TRI) introduces injury to the radial artery (RA) which will affect repeat transradial coronary procedure and the quality as a bypass conduit. We sought to compare the early radial injury after TRI between first-TRI and repeat-TRI by ultrasound biomicroscopy (UBM).</p><p><b>METHODS</b>A total of 1116 patients who underwent the transradial coronary procedures were enrolled. The patients depending on whether for the first time to accept transradial coronary procedure were divided into first-TRI group and repeat-TRI group. The RA was examined by UBM before and one day after the procedure.</p><p><b>RESULTS</b>Compared with first-TRI group, the mean RA diameter of repeat-TRI one day after the procedure decreased significantly (P < 0.05). In first-TRI group, the mean RA diameter was (2.32 ± 0.53) and (1.93 ± 0.57) mm before procedure and one day after the procedure respectively (P < 0.05). In repeat-TRI group, the mean RA diameter was (2.37 ± 0.51) and (1.79 ± 0.54) mm before procedure and one day after the procedure, respectively (P < 0.01). Compared with first-TRI group, the mean RA diameter was reduced significantly in repeat-TRI group one day after the procedure (P < 0.05). The early radial injuries and intimal thickening were compared between first-TRI and repeat-TRI. The mean intima-media thickness of RA was (0.24 ± 0.13) mm and (0.59 ± 0.28) mm before procedure and one day after the procedure in first-TRI group. The mean intima-media thickness of RA was (0.29 ± 0.16) mm and (0.68 ± 0.32) mm before procedure and one day after the procedure in repeat-TRI group. Compared with first-TRI group, the mean intimal thickening was increased significantly in repeat-TRI group one day after the procedure (P < 0.05). Intimal dissection, stenosis and occlusion were all significantly greater in repeat-TRI RAs (P < 0.05). Linear regression analysis revealed that diameter, repeated TRI procedure and PCI procedure were the independent predictors of intimal thickening.</p><p><b>CONCLUSIONS</b>RA early injuries were greater in repeat-TRI patients than in first-TRI patients. We first use high-resolution UBM imaging to demonstrate the rate of radial injury and revealed that diameter, repeated TRI procedure and PCI procedure were the independent predictors of intimal thickening.</p>

Plasma neutrophil-gelatinase-associated lipocalin and cystatin C could early diagnose contrast-induced acute kidney injury in patients with renal insufficiency undergoing an elective percutaneous coronary intervention / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Contrast induced acute kidney injury (CIAKI) is an important complication in the use of iodinated contrast media (CM). Our study was to evaluate the neutrophil gelatinase-associated lipocalin (NGAL) and cystatin C for early diagnosis of CIAKI.</p><p><b>METHODS</b>The patients with established or suspected coronary artery disease (CAD) with the estimated glomerular filtration rate (eGFR) was more than 30 ml × min(-1) × 1.73 m(-2) and nor more than 90 ml × min(-1)× 1.73 m(-2) were continuously enrolled. The blood samples of the first 50 patients were obtained before and at 2, 4, 8, 24 and 48 hours after procedure to identify the time points at which the biomarkers reached peaks and at which the blood samples of the rest of patients were obtained. The plasma NGAL and cystatin C measure used enzyme-linked immunosorbent assay (ELISA) kit. The diagnostic characteristics of absolute and relative increasing NGAL and cystatin C for CIAKI were evaluated.</p><p><b>RESULTS</b>Total 311 patients were enrolled, among whom 39 (12.5%) developed CIAKI. Plasma NGAL increased at 2 hours and reached peak at 4 hours after procedure, while plasma cystatin C increased at 2 hours and reached peak at 24 hours after procedure. Thus, we determine rational point of time at 4 hours for NGAL and at 24 hours after procedure for cystatin C, respectively. The plasma NGAL at 4 hours after CM exposure showed largest area under curve (AUC) of 0.662 (95% confidence interval (CI): 0.565 - 0.758, P = 0.002) with 51.5% sensitivity and 80.6% of specificity. The relative increasing 25% of NGAL showed the best sensitivity and specificity of 0.872 and 0.808, respectively, with maximum Youden index of 0.680, while cystatin C with relative increasing more than 25% had 76.9% of sensitivity and 81.2% of specificity. Combined two biomarkers might get more than 90% of specificity.</p><p><b>CONCLUSIONS</b>Single measurement of NGAL or cystatin C had poor sensitivity and specificity; however, the relative increasing 25% of NGAL at 4 hours after CM exposure demonstrated higher diagnostic values for CIAKI. Combining relative increasing plasma NGAL with relative increasing plasma cystatin C might perform better for early diagnosis of CIAKI.</p>

Osteogenic potential of human calcitonin gene-related peptide alpha gene-modified bone marrow mesenchymal stem cells / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Most of the basic and clinical studies of osteonecrosis of the femoral head (ONFH) are restricted to bone tissues only, whereas various systems are involved in the onset and development of ONFH, including nervous system. Peptidergic nerve participates in the neuronal regulation of bone metabolism and anabolism, and plays key roles in the growth, repair and reconstruction of bone. Calcitonin gene-related peptide (CGRP), which is secreted by peptidergic nerve, is the main mediator of bone metabolism. It dramatically promotes the proliferation and osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs). Additionally, it enhances the osteoblast mass and the rate of osteoblast formation, and reduces the bone resorption by acting on osteoblasts and osteoclasts. Hence, we aimed to construct recombinant retrovirus vector pLNCX(2)-hCGRPα and to investigate the proliferation and osteogenic potential of hCGRPα-producing BMSCs (BMSCs/pLNCX(2)-hCGRPα) after virus infection.</p><p><b>METHODS</b>The constructed recombinant retrovirus vector pLNCX(2)-hCGRPα was transfected into PT67 packaging cells by lipofectamine 2000. Virus was collected for BMSCs infection. The mRNA and protein expression of hCGRPα was examined by reverse transcription polymerase chain reaction (RT-PCR) and Western blotting, respectively. The cell proliferation was determined by methyl thiazoleterazolium (MTT) assay. The osteogenic potential of BMSCs was evaluated by alkaline phosphatase (ALP) activity.</p><p><b>RESULTS</b>Both mRNA and protein expression of hCGRPα was detected in BMSCs/pLNCX(2)-hCGRPα cells. These cells exhibited significantly elevated proliferation and ALP value as compared with control BMSCs (P < 0.05).</p><p><b>CONCLUSION</b>BMSCs/pLNCX(2)-hCGRPα cells could stably express hCGRPα and showed promoted proliferation ability and osteogenic potential as compared with control BMSCs.</p>

Safety and efficacy of transulnar approach for coronary angiography and intervention / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Transradial approach, which is now widely used in coronary angiography and intervention, may be advantageous with respect to the femoral access due to the lower incidence of vascular complications. Transulnar approach has been proposed for elective procedures in patients not suitable for transradial approach. The objective of this study was to evaluate the safety and efficacy of the transulnar approach versus the transradial approach for coronary angiography and intervention.</p><p><b>METHODS</b>Two hundred and forty patients undergoing coronary angiography, followed or not by intervention, were randomized to transulnar (TUA) or transradial approach (TRA). Doppler ultrasound assessments of the forearm vessels were scheduled for all patients before procedures, 1 day and 30 days after procedures. The primary end point was access site vascular complications during hospitalization and 30 days follow-up. Major adverse cardiac events (MACE) as secondary end point was recorded till 30 days follow-up.</p><p><b>RESULTS</b>Successful puncture was achieved in 98.3% (118/120) of patients in the TUA group, and in 100% (120/120) of patients in the TRA group. Coronary angiographies were performed in 40 and 39 patients in TUA and TRA group. Intervention procedures were performed in 78 and 83 patients in TUA and TRA group, respectively. The incidence of artery stenosis 1 day and 30 days after procedures was 11.0% vs.12.3% and 5.1% vs. 6.6% in TUA and TRA group, respectively. Asymptomatic access site artery occlusion occurred in 5.1% vs.1.7% of patients 1 day and 30 days after transulnar angioplasty, and in 6.6% vs. 4.9% of patients 1 day and 30 days after transradial angioplasty. Minor bleeding was still observed at the moment of the ultrasound assessment in 5.9% and 5.7% of patients in TUA and TRA group, respectively (P = 0.949). No big forearm hematoma, and A-V fistula were observed in both groups. Freedom from MACE at 30 days follow-up was observed in all patients.</p><p><b>CONCLUSIONS</b>The transulnar approach is as safe and effective as the transradial approach for coronary angiography and intervention. It is an attractive opinion for experienced operators who are skilled in this technique, particularly in cases of anatomic variations of the radial artery, radial artery small-caliber or thin radial pulse.</p>

HCV infection in voluntary donors and its influence on recruitment of donors in Chongqing area / 中国实验血液学杂志

Blood donor recruitment models have changed from paid donors to employer-organized donors and to voluntary donors in China. Reports on the hepatitis C virus (HCV) infection among voluntary blood donors in China have been rarely found at present. The prevalence of anti-HCV and genotypes among the first-time voluntary blood donors was investigated in Chongqing area of China. A total of 13,620 serum samples were collected from the first-time voluntary blood donors in Chongqing, China. Anti-HCV antibody was tested by ELISA. The Core/E2 region of HCV RNA from HCV seropositive samples was amplified by RT-PCR for genotyping. The results indicated that the prevalence of anti-HCV averaged 0.49% (67/13,620), and the highest rate (0.86%) was obtained in the group aged 40 to 49. A higher prevalence was observed among the more educated donors, and metropolitan donors. The ratios of following genotypes 1b, 2a, 3a and 3b were 4 (18%), 5 (23%), 9 (41%) and 4 (18%) in all the 22 samples respectively. Genotype 3 (3a and 3b) was the predominant genotype. In conclusion, the prevalence of anti-HCV was low among the population of voluntary blood donors in Chonqing area. The genotyping results showed the possibility of presence of druggies among the voluntary blood donors. Therefore, more attention should be paid to exclude those high-risk persons from the volunteers.