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Objective To investigate the role of chemokine ligand 19 (CCL19) and protein kinase-B (AKT) signaling pathway in lung cancer development. Methods The human lung adenocarcinoma cell line, A549 cells, in logarithmic growth phase were randomly divided into five groups： blank control group, solvent control group, CCL19 treatment group, AKT inhibition group, and antibody neutralization group. The blank control group received no treatment. The other four groups were treated with dimethyl sulfoxide, CCL19, MK-2206 (AKT inhibitor), and a combination of CCL19 and MK-2206, respectively. Cell viability was assessed using the CCK-8 assay, while cell migration and invasion capabilities were evaluated using the cell scratch and transwell assays. The relative expression levels of Pan-AKT, p-AKT (Ser473), p-AKT (Thr308), E-cadherin (E-cad), N-cadherin (N-cad), and Snail proteins in A549 cells were detected using Western blotting. Lung cancer tissue samples from 60 patients with non-small cell lung cancer (NSCLC) were collected, and the expression of CCL19 and matrix metalloproteinase 9 (MMP9) proteins in the specimens was examined using immunohistochemistry. Results The survival rate of A549 cells in the AKT inhibition group and antibody neutralization group was lower than that in blank control group, solvent control group, and CCL19 treatment group (all P<0.05). The cell scratch assay result showed that the cell migration rate of the CCL19 treatment group was higher at 36.0 and 48.0 hours than those of the blank control group, solvent control group, AKT inhibition group, and neutralizing antibody group (all P<0.05). The Transwell assay result showed that the invasion amount of A549 cells in the AKT inhibition group was less than that in the CCL19 treatment group (P<0.05). Compared with the blank control group, the relative expression of E-cad protein in the CCL19 treatment group decreased, while the relative expression of p-AKT (Ser473), p-AKT (Thr308), N-cad and Snail proteins increased (all P<0.05). The relative expression of p-AKT (Ser473), p-AKT (Thr308), N-cad, and Snail proteins in A549 cells decreased (all P<0.05), and relative expression of E-cad protein increased (all P<0.05) in the AKT inhibition group and antibody neutralization group compared with the blank control group, solvent control group, and CCL19 treatment group. There was no significant difference in the expression of CCL19 and MMP9 in lung cancer tissues of NSCLC patients in Xuanwei City, Gejiu City, and other regions (all P>0.05). The expression of CCL19 and MMP9 in NSCLC patients with lymph node metastasis was higher than in patients without lymph node metastasis (all P<0.01). Conclusion CCL19 can promote the invasion and metastasis of lung cancer cells and induce epithelial-mesenchymal transition. Its expression level is related to lymph node metastasis in NSCLC patients. The AKT signaling pathway may be an important mechanism underlying lung cancer development.
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Background@#Femoral neck fractures (FNFs) comprise a large proportion of osteoporotic fractures in Asia. However, the full range of prognostic variables that affect prognosis remains unclear. Here, we aimed to determine whether the severity of bone defects at the fracture site and other variables impact the prognosis of displaced FNFs. @*Methods@#We evaluated the incidence of FNF internal fixation failures at regular intervals after surgery in data collected retrospectively. Digital Imaging and Communications in Medicine (DICOM) magnetic resonance imaging data of the displaced FNFs of 204 patients (> 20 years old; mean age, 52.3 years; men, 55.4%) who underwent internal fixation were used to construct threedimensional (3D) virtual models of the femoral neck region. We calculated the position and volume of bone defect (VBD) using our independently developed algorithm and Mimics software. Each participant was followed up for at least 24 months; complications were noted and correlated with VBD and demographic and clinical variables. @*Results@#On the basis of VBD values calculated from virtual reduction models, 57 patients were categorized as having a mild defect, 100 as having a moderate defect, and 47 as having a severe defect. Age (p = 0.046) and VBD (p < 0.001) were significantly correlated with internal fixation failure. Multivariate analysis revealed that severe bone defects were associated with internal fixation failure (adjusted odds ratio [aOR], 23.073; 95% confidence interval [CI], 2.791–190.732) and complications (aOR, 8.945; 95% CI, 1.829–43.749). In patients with a severe defect, bone grafting was inversely associated with internal fixation failure (aOR, 0.022; 95% CI, 0.002–0.268) and complications (aOR, 0.023; 95% CI, 0.002–0.299). @*Conclusions@#Bone defect severity was associated with internal fixation failure and other complications. For young adults with large VBDs, bone grafting of the defect can reduce the risk of internal fixation failure. These results provide useful new quantitative information for precisely classifying displaced FNFs and guiding subsequent optimal treatments.
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Objective:To observe and analyze the morphological characteristic of bone marrow and peripheral blood in patients diagnosed with de novo acute leukemia.Methods:From October 1, 2015 to December 31, 2021, 1151 patients aged 47 (26, 62) years, consisting of 602 males and 549 females with newly diagnosed acute leukemia in the Department of Hematology, Affiliated Hospital of Xuzhou Medical University, were collected to preform the morphological analysis in bone marrow and peripheral blood smears. Based on the comprehensive diagnosis results of morphology, immunology, cytogenetics, and molecular biology, comparison between acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL), AML with RUNX1-RUNXITI gene, AML with CBFβ/MYH11 gene, acute promyelocytic leukemia (APL) with PML/RARA gene, AML with NPM1 gene, the rest of the AML, Ph+ALL and Ph-ALL were performed by Chi-square test along with analysis of the differences in the ratio of wood bundle cells, pseudo-Chediak-Higashi (PCH) inclusions, cytoplasmic small particles, nuclear notches, leukemia cells with cup-like changes (cup cells); as well as the differences in the micromeganuclei, early immature granulocytes, plasma cells, high eosinophils and other accompanying cells and the distribution of "grape-like" aggregation. Finally, the morphological characteristics of acute leukemia cells, the appearance and arrangement of accompanying cells were summarized.Results:Between AML and ALL, there were statistically significant differences in cytoplasmic Auer bodies[(45.5%, 0%), χ 2=211.400, P<0.01], PCH inclusion bodies[(28.9%, 0%), χ 2=114.100, P<0.01], cytoplasmic fine particles[(20.7%, 2.9%), χ 2=53.798, P<0.01], nuclear notches[(0.7%, 6.1%), χ 2=30.906, P<0.01], and goblet cells[(4.9%, 0.3%), χ 2=13.495, P<0.01], micromegakaryus [(22.4%, 0.3%), χ 2=80.398, P<0.01], plasma cells[(87.6%, 10.6%), χ 2=604.241, P<0.01], hyperacidophils[(15.3%, 1.0%), χ 2=46.116, P<0.01] showed significant differences in the "grape-like" aggregation distribution. In AML with RUNX1-RUNXITI gene, the changes of vacuoles and PCH inclusion bodies are more obvious; in AML with CBFβ/MYH11 gene, the increase of hypereosinophils is more obvious; in APL with PML/RARA gene, the increase of woodbundle is more obvious. The morphology of nuclei chromatin, nucleolus, and vacuoles were also different among the groups. Comparison between Ph+ALL and Ph-ALL showed that Ph+ALL was more prone to develop early immature granulocytes and plasma cells (all P<0.05). Conclusion:There are significant differences between AML and ALL in the characteristics of leukemia cells, the regularity of accompanying cells, and the aggregation and distribution patterns. The subtypes of AML with specific genetic abnormalities have their own characteristics in the appearance of vacuoles, PCH inclusions, hypereosinophils, woodbundle cells, and goblet cells. Ph+ALL is more prone to present early immature granulocytes and plasma cells.
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Objective:To explore the scope, mode, anticoagulation mode and complications of blood purification in children with acute and critical illness.Methods:A total of 377 times of treatment of 102 children treated with blood purification in PICU at the First Affiliated Hospital of Xinxiang Medical College from January 2018 to December 2020 were retrospectively analyzed.Results:Among 102 critically ill children treated with blood purification, acute and chronic renal failure ranked the first in terms of disease distribution, with 23 cases in total, followed by 16 cases of severe viral encephalitis (meningoencephalitis), 11 cases of septic shock, seven cases of acute poisoning, five cases of severe allergic purpura, five cases of necrotic encephalopathy.In terms of clinical prognosis, 51(50.0%) cases were cured, 29(28.4%) cases were improved, 10(9.8%) cases died, and 12 cases abandoned treatment.In 2019, the blood purification application frequency was the highest, with a total of 47 cases, which was higher than those in 2018 and 2020( P<0.05). Continuous veno-venous hemofiltration was used in the largest number of children, with a total of 56 cases.There was a statistically significant difference in the application ratio of this mode during 3 years ( P<0.05), while there was no statistically significant difference in the application ratio of other modes.In terms of the selection of anticoagulation methods, the proportions of systemic anticoagulation and extracorporeal anticoagulation had significantly difference among different years( P<0.05), and the application of extracorporeal anticoagulation had increased year by year.There was no statistically significant difference in the proportion of patients without anticoagulants.The incidence of complications of blood purification was the highest in 2019, with catheter related thrombus in the majority (30 person-times), followed by hypothermia, catheter filter coagulation, hematoma formation, catheter related infection, hypotension, heparin-induced thrombocytopenia, etc.There was statistically significant difference in the total complications among different years( P<0.05). Conclusion:Blood purification is widely used in children with acute and critical illness, with a variety of diseases.The most commonly used mode is continuous veno-venous hemofiltration and in vitro anticoagulation.Catheter-related thrombosis is the most common complication.
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Objective:To investigate the physicochemical and biological properties of different magnesium modified calcium phosphate bone cements.Methods:The different magnesium modified calcium phosphate bone cements were divided into magnesium citrate, magnesium lactate, magnesium malate, magnesium phosphate and magnesium glycinate groups, each of which was added with different magnesium agents in the proportion of 0%, 1%, 3% and 5% of the total weight of calcium phosphate bone cements. The initial and final setting time, injectability, anti-collapse performance and compressive strength of different magnesium modified calcium phosphate bone cements were tested. Furthermore, the screened bone cement extracts were used to culture with third generation osteoblasts. Bioactivity assays were performed using the Cell Proliferation and Toxicity Assay Kit (CCK-8). Alkaline phosphatase (ALP) staining and Alizarin Red S (ARS) staining were performed on osteoblasts to observe the osteogenic activity of magnesium malate modified calcium phosphate bone cements.Results:The addition of different proportions of different magnesium agents led to the shortening of the initial and final setting time of modified calcium phosphate bone cements. Moreover, the final setting time of 5% magnesium malate modified calcium phosphate bone cements was the shortest (<40 minutes), which was significantly shorter compared with other magnesium agents in the same proportion (all P<0.05). With the addition of different magnesium agents in different proportions, the injectability of bone cements was gradually increased, and the injectability of 5% magnesium malate calcium phosphate bone cements reached the highest for (87.3±1.9)%, which was significantly increased compared with other magnesium agents in the same proportion (all P<0.05). The anti-collapse performance of bone cements was decreased with the addition of different magnesium agents in different proportions. Magnesium citrate, magnesium phosphate and magnesium glycinate modified calcium phosphate bone cements could not resist the flushing of deionized water. In particular, magnesium malate modified calcium phosphate bone cements had the best anti-collapse performance, with the maximum weight loss rate for only (9.8±2.3)% after 30 minutes of deionized water flushing, which was better than the rest of the groups (all P<0.05). The compressive strength of magnesium lactate and magnesium phosphate modified calcium phosphate bone cements showed a decrease compared with original calcium phosphate bone cements, while the compressive strength of magnesium citrate and magnesium malate modified calcium phosphate bone cements was significantly increased compared with original calcium phosphate bone cements, of which 3% magnesium malate modified calcium phosphate bone cements had the greatest compressive strength of (6.2±0.2)MPa, significantly higher than the rest of the groups (all P<0.05). The sieve test yielded magnesium malate modified calcium phosphate bone cement, which had a weight loss of (27.0±0.9)% at 35 days in vitro. The release of magnesium ions was increased with increasing magnesium malate dose in the in vitro environment of magnesium malate modified calcium phosphate bone cements in different ratios. A stable magnesium ion release was achieved within 35 days.Also, the pro-proliferative and osteogenic effects of modified calcium phosphate bone cements on osteoblasts were more obvious with increase of magnesium malate dose. For 5% magnesium malate modified calcium phosphate bone cements, the cell number, ALP staining area ratio and calcium nodule area ratio were significantly increased compared with the groups in the proportion of 0% and 1% magnesium malate (all P<0.05). Conclusions:Among magnesium citrate, magnesium lactate, magnesium malate, magnesium phosphate and magnesium glycinate modified calcium phosphate bone cements, magnesium malate modified calcium phosphate bone cements have relatively suitable setting time, excellent anti-collapse performance and mechanical strength. Meanwhile, 5% magnesium malate modified calcium phosphate bone cements have better biological activity among different ratios of magnesium malate modified calcium phosphate bone cements, suggesting a potential value for clinical application.
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Objective:To investigate the effect of Asarinin on the survival time of transplanted heart after allogeneic heterotopic heart transplantation and to further verify the anti-immune rejection effect of Asarinin in spleen and peripheral blood.Methods:Using 64 Wistar rats as donors, 64 SD rats as recipients to establish the allogeneic heterotopic heart transplantation model in rats.After successful transplantation, 64 rats were use simple randomization divided into control group, cyclosporine A(CsA) group, Asarinin group and half CsA + half Asarinin group with 16 rats in each group.CsA group was given 5 mg/kg by gavage; Asarinin group was given 25 mg/kg; half dose group was given CsA 2.5 mg/kg+ Asarinin 12.5 mg/kg and the control group was given the same volume of normal saline by gavage.After administration for 1 week, half of them were used to observe the survival time.The other half of the rats were fully anesthetized with chloral hydrate, spleen and peripheral blood were taken.Half of the spleen was taken to observe the slices under the microscope.The other half of spleen was used RT-PCR to detect the relative expression of IFN-γ and IL-4.The expression of co-stimulatory molecules CD80, CD86 and CD40 in peripheral blood were detected by flow cytometry.Results:Survival time of transplanted heart was control group (8.4±0.9), CsA group (30.5±8.3), Asarinin group (16.5±4.3) and half-dose group (26.1±5.2) days.Compared with control group, survival time of heart transplantation became prolonged in all groups and the difference was statistically significant ( P<0.05). HE staining of splenic tissue showed that, as compared with control group, the injury of each group was alleviated.The relative expression of IFN-γ in spleen was control group (1.055±0.083), CsA group (0.396±0.038), Asarinin group (0.833±0.094) and half-dose group (0.862±0.104). The last three groups were lower than control group and the difference was statistically significant ( P<0.05). The relative expression of IL-4 in spleen was control group (1.429±0.234), CsA group (3.808±0.729), Asarinin group (2.209±0.306) and half-dose group (2.323±0.321). The last three groups all spiked as compared with control group and the difference was statistically significant ( P<0.05). The expressions of CD80, CD86 and CD40 in peripheral blood were control group (98.21±0.54), (85.78±0.89) and (96.36±0.66), CsA group (89.26±0.36), (56.86±2.32) and (88.11±1.61), Asarinin group (94.19±0.47), (79.01±1.12) and (87.86±1.67) and half-dose group (94.87±0.74), (80.81±0.98) and (89.71±0.97) respectively.The last three groups were lower than control group and the difference was statistically significant ( P<0.05). Conclusions:Asarinin can prolong the survival time of transplanted heart after allogeneic heterotopic heart transplantation in rats, inhibit the immune injury of spleen after allogeneic heterotopic heart transplantation in rats, decrease IFN-γ in spleen, increase IL-4 in spleen and inhibit the expression of peripheral blood costimulatory molecules CD80, CD86 and CD40.
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With the development of global economy, the dramatically increased production of polyethylene terephthalate (PET) plastics has led to a remarkably increased amount of plastic waste. PET waste can be treated by landfill, incineration, or biodegradation. While landfilling and incineration may cause secondary pollution, biodegradation has since received increased attentions due to its environmental friendliness. Recent studies have indicated that the carbohydrate binding module (CBM) can effectively enhance the binding of PET degrading enzymes to PET, and consequently increasing PET degradation rate. Here we constructed a fusion protein BaCBM2-Tfuc containing the BaCBM2 from Bacillus anthraci and the cutinase Tfuc from Thermobifida fusca, by megaprimer PCR of whole plasmids (MEGAWHOP). Notabaly, the PET film degradation efficiency (at 60 ℃) of BaCBM2-Tfuc was 2.8 times that of Tfuc. This study may provide technical support for constructing fusion proteins capable of efficiently degrading PET.
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Carbohydrates , Carboxylic Ester Hydrolases , Polyethylene Terephthalates , ThermobifidaABSTRACT
Objective:To explore the technical feasibility of CT feature tracking (CT-FT) technique in evaluating left ventricular myocardial strain and evaluate the change of myocardial strain in patients with coronary heart disease.Methods:Eighty-one patients with coronary heart disease (lesion group) and 33 patients with normal coronary artery (control group) matched with age and sex were collected retrospectively from the Second Affiliated Hospital of Nanchang University from April 2019 to October 2020. The lesion group was first divided into single vessel stenosis group (42 cases) and multi vessel stenosis group (39 cases) according to the number of coronary artery stenosis branches, and the global myocardial strains of the left ventricle between the groups were analyzed. Lesion site included the left anterior descending branch (LAD), right coronary artery (RCA) and left circumflex branch (LCX), respectively. According to the degree of vascular stenosis, the lesion groups were divided into normal group, mild stenosis group, moderate stenosis group and severe stenosis group. The segmental myocardial strains of the branch segment of LAD, RCA or LCX were analyzed between groups. All CCTA examinations were performed with retrospective electrocardiogram gating. CVI 42 cardiac postprocessing software was used to obtain myocardial strain parameters, including global peak longitudinal strain (GPLS), global peak circumferential strain (GPCS), global peak radial strain (GPRS), and the segmental myocardial strains of the branch segment of LAD, RCA or LCX. The segmental myocardial strains included the peak longitudinal strain (PLS), peak circumferential strain (PCS) and peak radial strain (PRS). One way ANOVA or Kruskal Wallis H test were used for multi group analysis. Results:With the increased number of coronary artery stenosis branches, the absolute value of GPLS gradually decreased. The GPLS of the control group, single vessel stenosis group and multi vessel stenosis group were -14.1%±2.7%, -11.5%±2.3% and -8.8%±2.0%, respectively. The difference of GPLS between the 3 groups or any 2 groups was statistically significant (all P<0.001). The absolute values of GPRS and GPRS in multi vessel stenosis group were significantly lower than those in control group and single vessel stenosis group (all P<0.001). There was no significant difference in GPRS or GPRS between single vessel stenosis group and control group ( P=0.083, 0.118). And there were significant differences in the segmental myocardial strains of the branch segment of LAD, RCA or LCX among 3 groups ( P<0.001). In severe stenosis group, the absolute values of PRS, PCS and PLS in LAD, RCA or LCX were significantly lower than those in moderate stenosis group, mild stenosis group and normal group (all P<0.05). In the moderate stenosis group, the absolute value of PLS in each branch segment was lower than that of the mild stenosis and normal group (all P<0.05), and there was no significant difference in any 2 other myocardial strain parameters of each branch (all P>0.05). Conclusions:CT-FT technique was feasible to evaluate left ventricular myocardial function. With the increased number or degree of coronary artery stenosis, the global and segmental myocardial strain parameters of left ventricle gradually decreased, and the longitudinal strain was more sensitive.
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A case of primary amoebic meningoencephalitis (PAM) treated in the First Affiliated Hospital of Xinxiang Medical University in March 6, 2022 was reported.The proband was a 14-year-old boy, who was admitted to the hospital because of " fever, headache and vomiting for 2 days" . Metagenomic next-generation sequencing (mNGS) was consequently conducted to examine the pathogens in cerebrospinal fluid.Naegleria infection was detected, so the child was diagnosed with PAM.The disease developed rapidly, and the patient died 29 hours after admission.In the paper, a total of 13 studies were reviewed, and 15 children with PAM were reported.Of the reported cases, only 1 case survived, 14 cases died.PAM had a low incidence, a dangerous condition, and high mortality.Most cases were diagnosed by autopsy or pathogen diagnosis in cerebrospinal fluid.This case is confirmed by mNGS of pathogens, and it is rarely reported at home and abroad.
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OBJECTIVE To provide emp irical evidence for relevant decision makers in China to formulate and improve policies related to children ’s medicine use . METHODS Based on the purchase data （Jul. 2016-Jun. 2019）of 18 tertiary children ’s hospitals，the availability of medicines included in the 7th edition of WHO Model List of Essential Medicines for Children （WHO EMLc）and their influential factors were investigated according to standard medicine investigation method recommended by the WHO and Health Action International . RESULTS A totally 189 active ingredients listed in the 7th edition of WHO EMLc were available at 18 tertiary children ’s hospitals in China ，which referred to 229 medicines. The availability of Budesonide inhalation suspension，oral rehydration salt ，Immunoglobulin for injection and Water for injection was 100%. In each quarter from Jul . 2016 to Jun . 2019，the availability of more than half of the medicines exceeded 50%，and the availability of the medicines remained basically stable in each quarter . The overall availability of cardiovascular system medicines and blood system medicines was the highest，while that of antiparasitic medicines and dermatology medicines was lower . There were 28 medicines（12.2%）that were not approved for use in children in China ，the use of which were off -label. The medicines which had been approved for children and which were included in national essential medicine list had a significantly higher availability （P＜0.05）. CONCLUSIONS The availability of essential medicines for children is generally better at tertiary children ’s hospitals in China . But the use of some essential medicines in children are off -label. In order to ensure the safety and the availability of essential medicines for children ，it is suggested to introduce China ’s essential medicines list for children ，to promote clinical trials in children for commonly used medicines，and to updete the drug manual in time .
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The formation of most proteins consists of two steps: the synthesis of precursor proteins and the synthesis of functional proteins. In these processes, propeptides play important roles in assisting protein folding or inhibiting its activity. As an important polypeptide chain coded by a gene sequence in lipase gene, propeptide usually functions as an intramolecular chaperone, assisting enzyme molecule folding. Meanwhile, some specific sites on propeptide such as glycosylated sites, have important effect on the activity, stability in extreme environment, methanol resistance and the substrate specificity of the lipase. Studying the mechanism of propeptide-mediated protein folding, as well as the influence of propeptide on lipases, will allow to regulate lipase by alternating the propeptide folding behavior and in turn pave new ways for protein engineering research.
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Lipase/metabolism , Molecular Chaperones/metabolism , Protein Folding , Protein Precursors , Substrate SpecificityABSTRACT
Objective:To explore the effect of calcium phosphate cement（CPC）scaffold loaded with emodin（EMO）on osteogenic activity of osteoblasts.Methods:The bone cement scaffold was prepared by mixing EMO powder and CPC powder（ratio 1∶9），adding citric acid and then was poured into polytetrafluoroethylene mold（EMO-CPC group）. A dose of 0.36 g CPC powder was mixed with citric acid and injected into the polytetrafluoroethylene mold（CPC group）. General morphology，setting time（initial setting time and final setting time），injection rate and compressive strength of stents were compared between the two groups. Primary osteoblasts were extracted and co-cultured with two sets of scaffolds. After co-culture for 3 days，their characterization was observed by scanning electron microscopy. Live/dead cell staining and 3-（4,5-dimethylthiazole-2）-2,5-diphenyltetrazolium bromide（MTT）colorimetric method were used to detect cell viability，toxicity and proliferation activity of scaffolds. Two sets of scaffolds were stained with immunofluorescence for osteopontin（OPN），and protein expression was observed under an inverted fluorescence microscope. After co-culture for 7 days，tetrazolium nitro blue/5-bromo-4-chloro- 3-indolyl-phosphate（NBT/BCIP）staining method was used for alkaline phosphatase（ALP）staining. After co-culture for 14 days，two sets of scaffolds were stained with Alizarin Red to detect their osteogenic activity.Results:Two sets of stents showed relatively smooth and flat topography under the scanning electron microscope. There were no significant differences in initial setting time，final setting time，injection rate and compressive strength of stents between two groups（ P > 0.05）. After co-culture for 3 days，the osteoblast clusters were adhered to the surface of the EMO-CPC scaffold，with good shape. Viable cell rate reached（98.2 ± 0.1）% in EMO-CPC group and（90.2% ± 0.1）% in CPC group（ P <0.05）. Cell proliferation activity in EMO-CPC group was stronger than that in CPC group（ P < 0.05）. OPN-specific staining showed that EMO-CPC group had stronger OPN protein fluorescence expression compared to CPC group. After co-culture for 7 days，expression of ALP in EMO-CPC group was higher than that in CPC group. After co-culture for 14 days，staining intensity of Alizarin Red in EMO-CPC group was more significant than that in CPC group. Conclusions:The EMO-CPC scaffold can provide a suitable environment for the growth of osteoblasts for it has better biocompatibility，cell proliferation and osteogenic activity than the CPC scaffold.
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Objective:To explore the clinical characteristics, treatment and prognosis of primary cardiac tumors in infants and children.Methods:The clinical information for 21 patients with primary cardiac tumor in the Department of Pediatric Cardiology, Beijing Anzhen Hospital Affiliated to Capital Medical University from May 2010 to August 2018 were analyzed retrospectively.Their median age was 7 months (gestational age 26 weeks-15 years old, and 6 cases were found in fetal phase) and 10 cases of them were male, 11 cases were girl.The clinical features, treatment methods and prognosis were summarized.Results:Among the 21 patients, 8 cases had an atypical heart murmur, 2 cases with chest tightness and chest pain, 2 cases with congestive heart failure, 1 case with dizziness and amaurosis, 1 case with cerebral artery embolism, 1 case with higher inflammatory index, and 9 cases were asymptomatic.Totally, 13 cases underwent surgical resection.All of them were confirmed as benign tumors, including 4 cases of rhabdomyoma, 3 cases of myxoma, 3 cases of fibroma and 2 cases of inflammatory myofibroblastic tumor (IMT) and 1 case of teratomas.There was no death during perioperative period.Follow-ups were performed from 3 months to 7 years, and 3 cases had recu-rrence (2 cases with myxomas and 1 cases with IMT). There were 8 cases without treatment, of which 7 cases were clinically diagnosed as transverse leiomyoma.During the follow-up, 3 cases disappeared, 1 case became small, 2 cases had no obvious change, and 1 case was lost to follow-up.One case was considered to be malignant tumor, and died within half a year.Conclusions:Primary cardiac tumors in children are mostly benign, especially transverse leiomyoma, and their clinical manifestations are diverse.Pathological examination is the golden standard for diagnosis.Surgical treatment is a radical method for most cardiac tumors, some benign tumors can be treated with drug adjuvant therapy, while the prognosis is poor for malignant cardiac tumor patients.
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Shengmai Yin (SMY) is a Chinese herbal decoction that effectively alleviates the side effects of radio-therapy in various cancers and helps achieve radiotherapy's clinical efficacy.In this study,we explored the interaction mechanism among SMY,DNA methylation,and nasopharyngeal carcinoma (NPC).We identified differences in DNA methylation levels in NPC CNE-2 cells and its radioresistant cells (CNE-2R)using the methylated DNA immunoprecipitation array and found that CNE-2R cells showed genome-wide changes in methylation status towards a state of hypomethylation.SMY may restore its original DNA methylation status,and thus,enhance radiosensitivity.Furthermore,we confirmed that the dif-ferential gene Tenascin-C (TNC) was overexpressed in CNE-2R cells and that SMY downregulated TNC expression.This downregulation of TNC inhibited NPC cell radiation resistance,migration,and invasion.Furthermore,we found that TNC was hypomethylated in CNE-2R cells and partially restored to a hypermethylated state after SMY intervention.DNA methyltransferases 3a may be the key protein in DNA methylation of TNC.
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Objective:To investigate the correlation between specific expression of serum micro ribonucleic acid (miRNA) and dilated cardiomyopathy (DCM) in children.Methods:Sixteen children diagnosed with DCM in Pediatric Heart Center of Beijing Anzhen Hospital from November 2013 to March 2016 were enrolled in the DCM group.Meanwhile, 12 age- and gender-matched healthy children who underwent medical examinations at the same time in the same hospital were selected as the healthy control group.Their serum was collected and miRNA sequencing was performed.The sample size was expanded at the later stage (the DCM group included 30 cases, and the healthy control group included 16 cases). The real-time fluorescence quantitative polymerase chain reaction (qRT-PCR) verification experiment was conducted on 11 miRNAs with statistically significant sequencing results.Results:Serum miRNA sequencing showed that 172 miRNAs were up-regulated but no miRNAs were down-regulated in the DCM group, compared with the healthy control group (fold change>2, P<0.001). Top 11 significantly up-regulated miRNAs were verified by qRT-PCR, and it was found that 8 of the 11 miRNAs (let-7f, let-7g, miR142-5p, miR143-3p, miR26a, miR27a-3p, miR27b-3p, and miR126-3p) in the DCM group were significantly up-regulated (all P<0.05). In the receiver operating characteristic (ROC) curves of DCM patients, the area under the curves of serum miR142-5p, miR143-3p, miR27b-3p, and miR126-3p were 0.983, 0.992, 0.915 and 0.950, respectively, which were statistically significantly different from those of the healthy control group (all P<0.05). Conclusions:Four serum miRNAs (miR-142-5p, miR-126-3p, miR-143-3p and miR-27b-3p) can distinguish children with DCM from healthy children.Circulating miRNAs are effective in screening DCM children.
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Objective:To investigate the clinical manifestations and pathological features of adult celiac disease in Xinjiang Uygur Autonomous Region.Methods:From January 2016 to December 2019, the clinical data of 943 patients with gastrointestinal symptoms such as chronic diarrhea, abdominal pain, abdominal distension and visited the People′s Hospital of Xinjiang Uygur Autonomous Region were collected. All patients tested for serum anti-tissue transglutaminase antibody inmunoglobulin A (tTG-IgA). And patients with positive serum tTG-IgA underwent gastroscopy and colonoscopy examination. To observe whether duodenal and ileal mucosal villi atrophy and histopathological examination was performed. Body mass index (BMI), hemoglobin, serum calcium, serum albumin level were compared between patients with and without celiac disease. T test and chi-square test were used for statistical analysis. Results:Serum tTG-IgA was positive in 30 patients, and 28 cases were finally diagnosed as celiac disease. The detection rate of celiac disease of Kazakh patients was higher than that of Uygur and Han patients (17.3%, 9/52 vs. 3.2%, 12/375 and 1.4%, 6/427), the detection rate of celiac disease of Uygur was higher than that of Han, and the differences were statistically significant ( χ2=7.65, 5.42 and 5.98, all P<0.05). The main clinical manifestations of 28 patients with celiac disease were weight loss or marasmus (71.4%, 20/28), iron deficiency anemia (67.9%, 19/28), persistent fatigue (57.1%, 16/28) and chronic diarrhea (53.6%, 15/28). The serum tTG-IgA level of patients with celiac disease was higher than that of patients without celiac disease ((131.97±64.58) CU vs. (7.58±1.92) CU), while the levels of BMI, hemoglobin, serum calcium and serum albumin were all lower than those of patients without celiac disease ((15.4±2.9) kg/m 2 vs. (23.8±3.4) kg/m 2, (110±28) g/L vs. (138±12) g/L, (1.70±0.20) mmol/L vs. (2.52±0.15) mmol/L, and (31.5±11.6) g/L vs. (48.2±7.3) g/L, respectively), and the differences were statistically significant ( t=2.473, 2.521, 2.641, 2.734 and 2.512, all P<0.05). Under gastroscopy all patients with celiac disease had atrophy of duodenal mucosal villi, which mainly appeared as nodular mucosal atrophy, grooves and fissure like changes, and villous atrophy was confirmed by histopathology. Conclusions:The detection rates of celiac disease in Kazakh and Uyghur in Xinjiang Uygur Antonomous Region are significantly higher than that of Han nationality. Celiac disease screening has a certain clinical significance.
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Objective@#To summarize the clinical and electrophysiological characteristics of children with Wolff-Parkinson-White syndrome or ventricular pre-excitation.@*Methods@#One hundred and seventy-nine consecutive children with Wolff-Parkinson-White syndrome or ventricular pre-excitation who were hospitalized at Beijing Anzhen Hospital Affiliated to Capital Medical University and planned to accept radiofrequency ablations were selected.Electrocardiogram and echocardiography were completed and detailed clinical data were collected before ablations.Anterograde refractory period of accessory pathways (ERPAPA) and retrograde ventriculoatrial conduction were measured during electrophysiology studies.The clinical and electrophysiological characteristics of these children were analyzed.@*Results@#The ratio of left-sided to right-sided accessory pathways was 1.001.93(61 cases vs.118 cases). Six out of 61 patients with left-sided accessory pathways were verified by electrophysiology study.There was no statistical difference of P-R interval and QRS duration between patients with right-sided and left-sided accessory pathways(all P>0.05). Twelve patients were combined with congenital heart diseases.Fourteen patients with right-sided accessory pathways were of ventricular pre-excitation induced dilated cardiomyopathy.ERPAPA was measured successfully in 110 patients, ERPAPA less than 250 ms accounted for 32.7%(36/110 cases). Six children with two pathways were recognized.Antidromic atrioventricular reentrant tachycardia was induced in 3 children.One child had slow conduction pathway localized in right-sided septum.@*Conclusions@#Right-sided overt accessory pathways are more common in children with Wolff-Parkinson-White syndrome or ventricular pre-excitation.Organic heart diseases are not uncommon.Besides congenital heart disease, a small proportion of patients with right overt accessory pathways may develop ventricular pre-excitatory induced dilated cardiomyopathy resulting from ventricular wall dyskinesia.Most of the decremental retrograde ventriculoatrial conduction is the characteristic of ventricular muscles rather than the accessory pathways in nature.Two pathways are not uncommon in children with Wolff-Parkinson-White syndrome or ventricular pre-excitation.Before finishing radiofrequency ablation, the anterograde and retrograde function of the accessory pathway should be evaluated in detail again because it is easy to neglect the existence of another accessory pathway.
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Aiming at comparing the pre-operative and post-operative gait characteristics and therefore establishing post-operative rehabilitation guidance for patients with end-stage knee osteoarthritis (KOA) merged with varus deformity, this study captured the level walking and sit-to-stand trials of 9 patients with 3-dimensional motion analysis system and after which musculoskeletal multi-body dynamic analysis was conducted. The study indicated that the average range of motion (ROM) of the proposed-surgical knee was 24.4°-57.6° and that of the non-surgical knee was 22.5°-71.5°. The knee ROM of control group during level walking was 7.2°-62.4°. When the unilateral KOA patients stood up from chair to complete the sit-to-stand movement, the ground reaction forces (GRFs) symmetry was 0.72-0.85, which means that the non-surgical limb bear the majority of body weight. The GRFs of the bilateral KOA patients were smallest during the sit-to-stand movement. The strategy that the non-surgical limb dominates in loading bearing taken by the unilateral KOA patients to cover most post-operative daily activities could increase the risk of KOA among non-surgical side joints as a result of long-term excessive loading-bearing. The study, on kinematics and biomechanical characteristics of patients with KOA merged with varus deformity, could help to understand the pathogenesis of KOA merged with varus deformity from the perspective of biomechanics and to provide strong clinic guidance for the pre-operative evaluation, prevention and post-operative recovery for patients.
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Objective@#To explore the relationship between coronary tortuosity and coronary microvascular disease (CMVD).@*Methods@#Patients with typical angina symptoms and without serious coronary artery stenosis by coronary angiography were enrolled from June 2014 to December 2016, and CMVD was diagnosed by single photon emission tomography (SPECT). According to the SPECT results, patients were divided to the CMVD group and non-CMVD group. The baseline clinical characteristics, results of coronary angiography were compared between the two groups. The logistic analysis was used to analyze the relationship between coronary tortuosity and CMVD.@*Result@#A total of 117 cases were enrolled, with 69 cases in the CMVD group and 48 cases in the non-CMVD group. No differences were found in gender distribution, age, hypertension, lipid abnormality, hyperuricemia and uses of statins between the two groups (all P>0.05). Incidence of diabetes (78.26%(54/69) vs. 35.42% (17/48) , P<0.05), hs-CRP ((4.29±2.15)mmol/L vs. (2.63±1.20)mmol/L, P<0.001), LDL-C ((2.98±0.96)mmol/L vs. (2.52±0.83)mmol/L, P=0.008) and homocysteine ((13.7±5.61)mmol/L vs. (11.5±4.38)mmol/L, P=0.025) levels were higher in the CMVD group than in the non-CMVD group. The data derived from echocardiographic examination were similar between the two groups. The Corrected TIMI frame counts were higher in the CMVD group than in non-CMVD group (LAD: 31.56±4.92 vs. 27.31±3.75, LCX: 29.47±4.18 vs. 26.62±3.19, RCA: 29.09±5.05 vs. 26.24±3.28, all P<0.001). The incidences of coronary atherosclerosis (76.81% (53/69) vs. 27.08% (13/48) , P<0.001) and coronary tortuosity ( (60.87% (42/69) vs. 33.33% (16/48) , P=0.035) were also higher in the CMVD group than in non-CMVD group. Logistic analysis found that coronary tortuosity (OR=6.111, 95%CI 2.707-13.794, P<0.001), diabetes (OR=6.565, 95%CI 2.883-14.948, P<0.001) and coronary atherosclerosis (OR=8.918, 95%CI 3.822-20.808, P<0.001) were independent risk factors of CMVD.@*Conclusion@#Coronary tortuosity, diabetes and coronary atherosclerosis are related to CMVD in this patient cohort.
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Objective@#By comparing the clinical characteristics of patulous Eustachian tube with habitual nasal extraction and those of non-Eustachian tube abnormalities, we aimed to investigate the relationship between patulous Eustachian tube and acquired cholesteatoma of middle ear.@*Methods@#A total of 218 patients in Affiliated Hospital of Qingdao University from November 2011 to November 2016 who underwent surgical treatment and with complete data of acquired cholesteatoma of middle ear were enrolled. The patients were divided into two groups: patulous Eustachian tube with habitual nasal extraction and non-Patulous Eustachian tube. Their ages of onset , sides, characteristics of acoustic immitance, clinical manifestations, prognosis and complications were compared. The statistical analysis was carried out with SPSS 19.0 software.@*Results@#Among the 218 cases of acquired cholesteatoma of the middle ear, 22 cases were diagnosed as patulous Eustachian tube with habitual nasal extraction [with average age of (35.7±7.5) years]; 196 cases were diagnosed as non-patulous Eustachian tube [with average age of (47.8±20.1) years]. The average age of the patulous Eustachian tube with habitual nasal extraction was significantly lower than that of the non-patulous Eustachian tube group (t=4.25, P<0.01). Ratio of bilateral middle ear cholesteatoma in patulous Eustachian tube [68.2%(15/22)] was significantly higher than that of the non-patulous Eustachian tube group [18.9%(37/196)] (χ2=26.47, P<0.01).@*Conclusions@#Some acquired cholesteatoma patients are associated with the patulous Eustachian tube with habitual nasal extraction. The patients have a lower age, and are susceptible for bilateral middle ear cholesteatoma.