ABSTRACT
Objective:To investigate the effect of electroporation-mediated local gene therapy on the expression of Wnt3a and β-catenin in callus of distraction gap during mandibular distraction osteogenesis of rabbits.Methods:The experiments were conducted in the laboratory of the Affiliated Friendship Plastic Surgery Hospital of Nanjing Medical University from September 2019 to December 2019. Forty eight New-Zealand rabbits were randomly divided into control group (group A), gene therapy group (group B) and normal saline group (group C), with 16 rabbits in each group. After bilateral mandible osteotomy and distractors were implanted, the distractors were activated at a speed of 0.8 mm/d on 4th day, postoperatively, and lasted for 7 days, followed by consolidation period. Group A distracted only, group B was subject to local injection of recombinant plasmid pIRES-hBMP2-hVEGF165 in the distraction gap and electroporation stimulation at the beginning of activation distractors; and group C local injection of the same dose of normal saline in the distraction gap and electroporation stimulation at the beginning of activation distractors. Four animals in each group were sacrificed on the day at the end of distraction, 7th, 14th, 28th days of consolidation period, respectively. The callus in the distraction gap was taken for immunohistochemical staining and RT-PCR to detect the expression of Wnt3a and β-catenin, and image analysis was performed. SPSS 22.0 statistical software was used for data analysis.Results:Immunohistochemical staining showed that Wnt3a and β-catenin were mainly located in the cytoplasm and nuclei of fibroblasts, chondrocytes and osteoblasts in callus tissue. Immunohistochemistry and RT-PCR showed that the expression of Wnt3a and β-catenin reached a peak at the end of distraction. With the disappearance of distraction tension, the expression of Wnt3a and β-catenin gradually decreased. After gene therapy intervention, the expression of Wnt3a and β-catenin was significantly increased, and the expression of Wnt3a and β-catenin in group B was the highest at each time point, with statistically significant difference compared with groups A and C ( F=96.3, P<0.01). Conclusions:Gene therapy promotes the expression of Wnt3a and β-catenin in the callus of distraction gap, regulating the balance of the bone reconstruction system and thus promoting the formation of new bone in the distraction gap.
ABSTRACT
Objective:To evaluate the clinical effects of the dissection of the implant pockets with ultrasonic scalpel or traditional electroscalpel through the axillary approach under endoscopic assistant.Methods:A total of 125 female patients with an average of 32.5 years, ranged from 21 to 44 years, underwent endoscopic-assisted transaxillary breast augmentation in the Department of Plastic Surgery, the Affiliated Friendship Plastic Surgery Hospital of Nanjing Medical University, from January 2019 to December 2020, were analyzed retrospectively. The implant pockets were dissected with ultrasonic scalpel (ultrasonic scalpel group) in 64 patients or with traditional electroscalpel (electroscalpel group) in 61 patients. The operation time, operation speed, postoperative drainage, drainage tube removal time and hospital stay of the two groups were compared and analyzed statistically.Results:Compared with the electroscalpel group, the average operation time of the ultrasonic scalpel group 75(71-90) min was significantly shorter than that of the electroscalpel group 105(80-135) min ( t=4.10, P<0.001), the operation speed (3.27±0.44 ml/min) was faster than that of the electroscalpel group (2.52±0.72 ml/min) ( t=4.71, P<0.001), the postoperative drainage 130.5(98.8-193.3) ml was significantly less than that of the electroscalpel group 281.75(145.5-328.3) ml ( t=2.21, P<0.05), and the drainage tube removal time 3 (3-4) d and hospital stay 3 (3-4) d were remarkablely shorter than that of the electroscalpel group 4 (3-4) d, 5 (4-6) d ( t=3.58; t=4.06, P<0.05). Conclusions:The application of ultrasonic scalpel in endoscopic-assisted transaxillary breast augmentation is safe and reliable. In addtion to improving the surgical efficiency, ultrasonic scalpel can reduce blood loss, shorten the time of hospital stay and reduce complications, which is worthy of further promotion in clinical application.
ABSTRACT
Objective:To investigate the effect of eyebrow arch augmentation with personalized polyether ether ketone (PEEK) implant assisted by endoscope.Methods:From January 2019 to August 2021, 9 patients with low and flat eyebrow arch requiring eyebrow arch augmentation were treated in the plastic surgery department of the Friendship Plastic Surgery Hospital Affiliated to Nanjing Medical University. The cranial and maxillofacial CT scanning data were obtained before operation, the eyebrow arch elevation range and height were designed according to the patient's requirements, and personalized peek implants were manufactured. During the operation, a small temporal hairline incision was used to accurately separate the implantation cavity of individualized peek implants under the periosteum of the eyebrow arch implantation area with the aid of endoscope. Personalized PEEK implants were implanted under endoscope to make them fully fit with the eyebrow arch bone and fixed with titanium nails. Photos were taken and analyzed before and after operation.Results:All patients were followed up for 3 months to 2 years. Their facial expressions were normal, and there were no motor nerve injury, rejection and iatrogenic infection. The patients were satisfied with the postoperative effect. Compared with before operation, the low level of orbital bone in eyebrow area was improved, and the facial contour was three-dimensional and harmonious.Conclusions:The eyebrow arch augmentation with individualized peek implant assisted by endoscope is safe and effective. It can greatly reshape the upper contour of the face, deepen the upper eyelid fossa and improve the convex eye phenomenon, so as to achieve the cosmetic effect of enhancing the three-dimensional sense of the eyebrow orbital area, which is worthy of clinical application.
ABSTRACT
Objective:To construct the targeting evaluation method of traditional Chinese medicine （TCM） preparations based on supramolecular Qi chromatography theory， and to study the liver targeting effect of Bupleuri Radix on Pien Tze Huang. Method:The molecular connectivity index （MCI） was used to analyze the characteristics of imprinted template and liver targeting tendency of TCM mainly attributed to liver meridian and components of Pien Tze Huang， and combined with target dynamics and total statistical moment principle， aimed at the independent action characteristics of multi-component imprinted template of TCM， a method for evaluating the targeting of TCM preparations was established. Hepatoma rats in Pien Tze Huang group， Bupleuri Radix<italic> </italic>group， Pien Tze Huang+Bupleuri Radix group and blank group were tested and verified. Result:After the average value of MCI of TCM mainly attributed to liver meridian was deducted， the MCI similarity between Pien Tze Huang group and Bupleuri Radix group was 0.376 8， Pien Tze Huang+Bupleuri Radix group and Bupleuri Radix group was 0.988 2， so it was predicted that Bupleuri Radix could enhance the liver targeting of Pien Tze Huang. A system for evaluating the targeting of TCM compounds was established， including relative total uptake efficiency （RUE<sub>T</sub>）， relative total concentration （RC<sub>T</sub>）， relative imprinted tendency （RIT<sub>T</sub>） and relative imprinted variance （RIV<sub>T</sub>）. The RUE<sub>T</sub> and RC<sub>T</sub> of liver were the highest in all tissues （RUE<sub>T</sub>=1.88>1，RC<sub>T</sub><italic>=</italic>2.30>1）， and the corresponding values of other tissues were all <1， indicating that Pien Tze Huang combined with Bupleuri Radix could increase its distribution in liver and enhance liver targeting. Except for plasma， the RIT<sub>T</sub> and RIV<sub>T</sub> of other tissues fluctuated around 1.0， indicating that targeted modification did not change imprinted tendency of Pien Tze Huang and had no significant effect on the types of components. Conclusion:Under the guidance of supramolecular Qi chromatography theory， a targeting evaluation parameter system can be established to characterize the multi-component imprinted effect of TCM preparations by MCI and total statistical moment parameters， so as to realize the evaluation of targeting of TCM preparations. The addition of Bupleuri Radix can increase the liver targeting of Pien Tze Huang.
ABSTRACT
Sepsis， a common critical disease in the intensive care unit（ICU）， features high morbidity and mortality. At present， it is mainly tackled with western medicine， which may trigger a series of problems like antibiotic resistance， adverse hormonal reactions， and high cost after a long-term use. Therefore， exploring new efficient， safe， and cheap drugs and treatment modes has become the focus of our research at this stage. By virtue of unique advantages including "the concept of holism and individualized treatment based on syndrome differentiation"， Chinese medicine has accumulated quite rich experience in the prevention and treatment of sepsis. In recent years， research on the regulation of Chinese medicine on nuclear transcription factor-κB（NF-κB） signaling pathway in sepsis has kept emerging. On this basis， this paper reviewed the etiology and pathogenesis of sepsis， syndrome differentiation and treatment， NF-κB signaling pathway， and its intervention with Chinese medicine. It has been found that some single Chinese herbs and their extracts， Chinese herbal compounds， and Chinese herbal injections effectively inhibit the expression of such inflammatory factors as NF-κB-mediated tumor necrosis factor-α（TNF-α）， interleukin-1（IL-1）， and IL-6 as well as the related proteins， reduce the systemic inflammatory response and organ injury， and improve the prognosis by regulating the activation of NF-κB signaling pathway and the immune function of macrophages. However， due to the limitations of objective conditions， some studies also have the problems of fuzzy pro-inflammatory anti-inflammatory balance mechanism， unclear pharmacokinetics and low drug safety evaluation， which need to be further studied and explored in order to provide a new theoretical basis and diagnosis and treatment thinking for the treatment of sepsis with traditional Chinese medicine.
ABSTRACT
Objective:To design a toilet assistant device according with an ergonomics based on the natural sit-to-stand transition motion trajectory, to improve the safety and comfort for the older adults. Methods:The sit-to-stand transition motion trajectory was obtained at different speeds using Inertial Measurement Unit from twelve healthy subjects. The finite element contrastive pressures on toilet seat at 0°, 10°, 20°, 30°, 40° sitting inclination angles were compared from this trajectory to the other research trajectory, as well as the balance analysis after standing. A total of 20 healthy subjects experienced the toilet assistant device and reported their satisfaction. Results:At four angles of inclination, the average pressure of this trajectory was less than that of the other research; while the vertical projection of center of mass was within the range of center of pressure, satisfying the balance condition. Most of the subjects were satisfactory to the toilet assistant device. Conclusion:A new sit-to-stand transition motion trajectory has been obtained. A toilet assistant device based on the motion trajectory has been designed, which is comfortable and steady.
ABSTRACT
Objective:To evaluate the effects of slow breathing training on hypertension. Methods:Articles about slow breathing training for hypertension were retrieved from CNKI, Wangfang Data, PubMed and Web of Science, until March, 2021. The authors, publishing time, subjects, interventions and courses, and outcome indexes and conclusion were extracted. Results:There were 924 articles returned, and 35 included, which published mainly from 2009 to 2020. The subjects were patients with hypertension, and the outcome index was blood pressure. Conclusion:Slow breathing training may work for hypertension, which associates to baroreflex sensitivity, heart rate variability, sympathetic nerve activity and cardiopulmonary diastolic receptors.
ABSTRACT
Objective:To investigate the clinical outcomes of personalized polyetheretherketone (PEEK) implant in the correction of nasolabial fold depression.Methods:A total of 30 patients with nasolabial fold depression (5 males, 25 females, aged 26 to 52 years, mean 36.3 years) admitted to the Affiliated Friendship Plastic Hospital of Nanjing Medical University who want to undergo nasolabial fold augmentation from January 2019 to January 2021. All patients underwent CBCT scan and three-dimensional simulation, the personalized PEEK implant was designed and produced with CAD/CAM technique, the personalized PEEK was implanted during the operation. The patients were followed up for 3-12 months, and the wrinkle score and satisfaction were compared before operation and 3 months and 6 months after operation.Results:The depressions of nasolabial fold were significantly improved in all patients, and there were no complications such as hematoma and infection after operation. During the follow-up, there was no implant displacement or exposure, and the effect was stable and lasting. The scores of wrinkles at 3 months after operation (2.30±0.47) and 6 months after operation (2.17±0.38) were significantly lower than those before operation (4.03±0.67), and the scores of satisfaction were significantly higher than those before operation ( P<0.05). The scores of satisfaction at 3 months after operation (3.97±0.56) and 6 months after operation (4.23±0.57) were significantly higher than those before operation (1.70±0.60). The difference was statistically significant ( P<0.05). Conclusions:3D printing personalized PEEK prosthesis is effective in correcting nasolabial fold depression, and it is safe and stable, so it is recommended for clinical application.
ABSTRACT
Objective:To investigate the inhibitory effect of small interfering RNA-Yes-associated protein 1 (siRNA-YAP1) on epithelial-mesenchymal transition (EMT) in human lens epithelial cells (LECs) induced by transforming growth factor-β 2 (TGF-β 2). Methods:Human LECs line (HLEB-3) was cultured and divided into normal control group and TGF-β 2 induced group.The cells in the normal control group were treated with serum-free low-glucose medium for 24 hours, and the cells in the TGF-β 2 induced group were treated with additional 10 ng/ml TGF-β 2 for 24 hours.The cultured HLEB-3 cells were divided into siRNA empty vector group, siRNA-YAP1 transfection group, siRNA empty vector+ TGF-β 2 group and siRNA-YAP1+ TGF-β 2 group, and the cells were transfected with plasmid including siRNA empty vector or siRNA-YAP1 sequence according to grouping.The relative expression levels of YAP1 mRNA and protein in various groups were detected and compared by quantitative real-time polymerase chain reaction (PCR), immunofluorescence and Western blot assay, respectively.The relative expression levels of EMT marker proteins (E-cadherin and Vimentin proteins) in various groups were detected by immunofluorescence and Western blot assay. Results:Compared with the normal control group, the expression level of E-cadherin protein was decreased (1.180±0.118 vs.0.830±0.104) and the Vimentin protein was increased (0.797±0.110 vs.1.240±0.110) in the TGF-β 2 induced group, with significant differences between the two groups ( t=3.857, P=0.018; t=-4.933, P=0.008).The relative expression levels of YAP1 mRNA and protein in the TGF-β 2 induced group were significantly increased in comparison with the normal control group (2.200±0.193 vs.1.136±0.123; 1.203±0.121 vs.0.967±0.025), with significant differences between the two groups ( t=-9.288, P<0.01; t=-3.329, P=0.029).Compared with the siRNA empty vector group, the expression levels of YAP1 mRNA and protein in the siRNA-YAP1 transfection group were significantly reduced (both at P<0.01).Compared with the siRNA empty vector+ TGF-β 2 group, the relative expression level of E-cadherin protein was significantly enhanced and the expression level of Vimentin protein was significantly reduced in the siRNA-YAP1+ TGF-β 2 group (both at P<0.01). Conclusions:YAP1 participates in the TGF-β 2 induced EMT in human LECs, and siRNA-YAP1 can suppress the EMT process.
ABSTRACT
Human genetic prion diseases (gPrDs) are directly associated with mutations and insertions in the PRNP (Prion Protein) gene. We collected and analyzed the data of 218 Chinese gPrD patients identified between Jan 2006 and June 2020. Nineteen different subtypes were identified and gPrDs accounted for 10.9% of all diagnosed PrDs within the same period. Some subtypes of gPrDs showed a degree of geographic association. The age at onset of Chinese gPrDs peaked in the 50-59 year group. Gerstmann-Sträussler-Scheinker syndrome (GSS) and fatal familial insomnia (FFI) cases usually displayed clinical symptoms earlier than genetic Creutzfeldt-Jakob disease (gCJD) patients with point mutations. A family history was more frequently recalled in P105L GSS and D178N FFI patients than T188K and E200K patients. None of the E196A gCJD patients reported a family history. The gCJD cases with point mutations always developed clinical manifestations typical of sporadic CJD (sCJD). EEG examination was not sensitive for gPrDs. sCJD-associated abnormalities on MRI were found in high proportions of GSS and gCJD patients. CSF 14-3-3 positivity was frequently detected in gCJD patients. Increased CSF tau was found in more than half of FFI and T188K gCJD cases, and an even higher proportion of E196A and E200K gCJD patients. 63.6% of P105L GSS cases showed a positive reaction in cerebrospinal fluid RT-QuIC. GSS and FFI cases had longer durations than most subtypes of gCJD. This is one of the largest studies of gPrDs in East Asians, and the illness profile of Chinese gPrDs is clearly distinct. Extremely high proportions of T188K and E196A occur among Chinese gPrDs; these mutations are rarely reported in Caucasians and Japanese.
Subject(s)
Humans , 14-3-3 Proteins/cerebrospinal fluid , China , Creutzfeldt-Jakob Syndrome/genetics , Mutation/genetics , Prion Diseases/genetics , Prion Proteins/genetics , Prions/genetics , tau Proteins/cerebrospinal fluidABSTRACT
Objective:To seek a minimally invasive method for costal cartilage harvest by using two different costal cartilage harvest techniques in rhinoplasty and to compare their influence on donor site pain.Methods:Fourty-three female patients who underwent costal cartilage harvest for rhinoplasty from Dec. 2016 to Dec. 2017 were randomly divided into two groups. We harvested the right side seventh costal cartilage in both groups. In control group, we harvested a full thickness segment of costal cartilage in each patient, whereas we harvested a split thickness segment of costal cartilage by preserving the superior strip in experimental group. Donor site pain was evaluated via visual analogue scale (VAS) 6 h, 24 h, 48 h and 72 h after surgery.Results:The VAS scores (mean±standard deviation) at different time points in the control group were (5.515±1.085), (5.250±1.302), (5.315±1.117) and (4.895±1.042). And in the experimental group, they were (2.665±0.713), (2.261±0.642), (1.609±0.398) and (1.383±0.514), respectively. The VAS scores at different time points were significantly higher in the control group than that in the experimental group ( P<0.05). Conclusions:The superior strip preserved costal cartilage harvest technique significantly reduces postoperative donor site pain.
ABSTRACT
Objective:To observe the effect of needle-embedding therapy (press needle) combined with transcutaneous electrical nerve stimulation on pain and motor function in patients with nonspecific neck pain. Methods:From July, 2016 to September, 2017, 80 patients with nonspecific neck pain were randomly divided into control group and treatment group, with 40 cases in each group. The treatment group was treated with press needle combined with transcutaneous electrical nerve stimulation, while the control group was treated with transcutaneous electrical nerve stimulation only, seven times per week for two weeks. They were assessed with Visual Analogue Scale (VAS), Neck Disability Index (NDI), neck range of motion and neck muscle average electromyography (EMG) before treatment, at the end of treatment, and one-month and six-month followup. Results:All 80 patients completed the treatment and follow-up. After treatment, the scores of VAS and NDI decreased in both groups (t >1.731, P < 0.05), and were lower in the treatment group than in the control group (t > 0.236, P < 0.05); the neck range of motion increased in both groups (P < 0.05), and no difference was found between two groups (P > 0.05); the average EMG value of the neck muscles decreased in both groups (P < 0.05), and were less in the treatment group than in the control group (P < 0.05). Conclusion:The press needle combined with transcutaneous electrical nerve stimulation was more effective on nonspecific neck pain than transcutaneous electrical nerve stimulation only, and no adverse reaction was observed during the treatment.
ABSTRACT
@#In this paper, a novel and simple RP-HPLC method for the determination of related substances of tiopronin for injection was described. The RP-HPLC analysis was performed on a C18 column, with acetonitrile-0. 1% phosphoric acid(8 ∶92), mobile phase in isocratic mode at a rate of 1. 0 mL/min. The photodiode array detector was set at 210 nm. Seven related substances were detected and the structures were characterized by mass spectrometry. The method showed great suitability, specificity and excellent linearity over the concentration range of 0. 3 to 50 μg/mL(r≥0. 999), and the limits of detection and quantitation were found to be 0. 10 and 0. 31 μg/mL, respectively. The accuracy of the method determined by the entire mean recovery ranged from 98. 7% to 103. 7%. The intra-and inter-day precision was satisfactory(RSD≤4. 4%)and robust(RSD≤6. 4%). And this method was successfully applied for the determination of related substances of tiopronin for injection, which revealed the retention of sulfhydryl compounds and glycine analogues on the RP-HPLC and the effect of the pH value of the mobile phase on the chromatographic behavior of the analytes.
ABSTRACT
Objective@#To understand the epidemic trend of tobacco use among junior middle school students in Shunyi District of Beijing in recent 5 years, and to provide scientific basis for formulating adolescent tobacco control strategies and intervention measures.@*Methods@#The two stage sampling method was used to survey 3 junior middle school schools randomly selected from Shunyi District, Beijing, in November 2013, December 2015 and November 2017. The number of students surveyed each year was 1 520, 1 404 and 1 467 respectively.@*Results@#A total of 4 500 questionnaires were distributed and 4 391 questionnaires were valid, with an effective rate of 97.6%. The current smoking rate and the attempting smoking rate in Shunyi District junior high school students increased substantially, the difference was statistically significant(χ2=9.15, 11.54, P<0.01). The exposure rate of second-hand smoke among junior high school students in Shunyi District is increasing year by year. The current smoking rate and the attempting smoking rate of second-hand smoke at home and in public places were higher than those of non-exposed ones. The differences in the current smoking rates of junior high school students (χ2=25.86, 37.61, P<0.01) and the attempting smoking rate (χ2=49.51, 63-86, P<0.01) were statistically significant. The influence of Shunyi District junior high school students through different tobacco information access channels on the current smoking rate of junior high school students increased year by year. Different tobacco information access channels have significant difference in the influence of the junior middle school students’ attempting smoking rate(P<0.05).@*Conclusion@#The overall tobacco use of junior high school students in Shunyi District of Beijing is increasing by year. The exposure of second-hand smoke is not optimistic, and the supervision of tobacco information acquisition channels is urgent to be strengthened.
ABSTRACT
<p><b>OBJECTIVE</b>To obtain stable primary cultures of human malignant meningioma cells and establish an intracranial in-situ tumor model in nude mice.</p><p><b>METHODS</b>Ten surgical specimens of highly suspected malignant meningioma were obtained with postoperative pathological confirmation. Primary malignant meningioma cells were cultured from the tissues using a modified method and passaged. After identification with cell immunofluorescence, the cultured cells were inoculated into the right parietal lobe of 6 nude mice using stereotaxic apparatus and also transplanted subcutaneously in another 6 nude mice. The nude mice were executed after 6 weeks, and HE staining and immunohistochmistry were used to detect tumor growth and the invasion of the adjacent brain tissues.</p><p><b>RESULTS</b>The primary malignant meningioma cells were cultured successfully, and postoperative pathology reported anaplastic malignant meningioma. Cell immunofluorescence revealed positivity for vimentin and EMA in the cells, which showed a S-shaped growth curve in culture. Flow cytometry revealed a cell percentage in the Q3 area of (95.99∓2.58)%. Six weeks after transplantation, tumor nodules occurred in the subcutaneous tumor group, and the nude mice bearing the in situ tumor showed obvious body weight loss. The xenografts in both groups contained a mean of (36∓5.35)% cells expressing Ki-67, and the intracranial in situ tumor showed obvious invasion of the adjacent peripheral brain tissues.</p><p><b>CONCLUSION</b>We obtained stable primary cultures of malignant meningioma cells and successfully established a nude mouse model bearing in situ human malignant meningioma.</p>
ABSTRACT
Objective@#To evaluate the anthracyclines-induced cardiotoxicity in patients with early-stage breast cancer.@*Methods@#This retrospective study analyzed data of 64 patients (aged from 36 to 59 years old) with early-stage breast cancer after surgery. Patients were divided into ACT group (n=21), FAC group (n=19) and EC group (n=24). The NCI CTC 4.0 scores was used to evaluate the side effects at the time of 2 weeks, 4 weeks and 6 weeks after chemotherapy. Meanwhile, the level of cTnT, the incidence of abnormal electrocardiogram (ECG) and left ventricular ejection fraction (LVEF) were used to evaluate the anthracyclines-induced cardiotoxicity, the follow-up observation points were as follows: at the acute cardiotoxicity (time A), subacute cardiotoxicity (time B), 24 months after chemotherapy (time C), 36 months after chemotherapy (time D), 48 months after chemotherapy (time E), 60 months after chemotherapy (time F). The 3-years and 5-years overall survival and progress free disease survival among three groups were compared.@*Results@#The ages, clinical stage, the size of tumor, axillary lymph node positivity and Eastern Cooperative Oncology Group Scores were similar among three groups (P>0.05); the incidence of side effects level 4 was 0. The levels of cTnT in the three groups were significantly lower than those at the baseline and time points C, D, E and F (all P<0.05), and the levels of cTnT were significantly higher in EC group than in FAC and ACT group at the time points B, C, D, E and F (P<0.05); however, the incidence of abnormal ECG and LVEF was similar among the 3 groups (P>0.05). The 5-year overall survival was 95.2% (20/21) ,100% (19/19) and 95.8% (23/24) in ACT group, FAC group and EC group, respectively; 5-year progress free disease survival was 95.2% (20/21) ,94.7% (18/19) and 91.7% (22/24) in ACT group, FAC group and EC group, respectively (P>0.05) .@*Conclusions@#Patients with early-stage breast cancer after surgery could tolerate the anthracyclines-induced cardiotoxicity. Three chemotherapy schemes of ACT, FAC and EC, especially the EC protocol, could affect the myocardial damage. However, outcome is comparable among patients treated with above chemotherapy schemes in this patient cohort.
ABSTRACT
Objective To investigate the relationship of galectin-3 (Gal-3)and matrix metalloproteinase-9 (MMP-9)with in-stent restenosis (ISR).Methods We consecutively recruited 434 patients who had undergone successful drug eluting stent (DES)implantation.Then we divided them into ISR group (n=41)and NO-ISR group (n=393)according to the results of coronary angiography review.Independent risk factors for ISR were found out by multivariate analysis and the two groups were matched for these factors except for Gal-3 and MMP-9 .After elim-ination of the influence of confounders,serum Gal-3 and MMP-9 were compared between the groups and their rela-tions with the severity of ISR were analyzed.Patients were grouped based on Gal-3 and MMP-9 concentrations and major adverse cardiac events (MACEs)were compared between the two groups.Results After elimination of the influence of confounders,the results showed that serum levels of Gal-3 and MMP-9 were significantly higher in ISR group than in NO-ISR group (P＜0.001).Serum levels of Gal-3 and MMP-9 increased with the increased grade of classification.Serum levels of Gal-3 and MMP-9 were obviously higher in classes Ⅲ and Ⅳ ISR than in class Ⅰ (P＜0.05).Patients with higher levels of Gal-3 and MMP-9 had a higher incidence of MACEs (P＜0.01).ISR group had a higher incidence of MACEs than NO-ISR group (P＜0.05).Conclusion Serum levels of Gal-3 and MMP-9 are correlated with ISR and its severity,and they are independent risk factors for ISR.The rate of MACEs during follow-up period was increased with the increased levels of Gal-3 and MMP-9 .
ABSTRACT
Objective To investigate the predictive values of platelet to lymphocyte ratio (PLR) and neutrophil to lymphocyte ratio (NLR)before percutaneous coronary intervention (PCI)and a reexamination of coronary angiography (CAG)on the development of in-stent restenosis (ISR)in patients implanted with coronary drug eluting stent (DES).Methods For this study we enrolled 123 patients who had undergone successful drug eluting stent implantation (SI)and a further CAG reexamination.Another 45 patients with non-coronary heart disease (NC)served as controls.PLR and NLR were measured before DES implantation or CAG and compared between the groups.Patients in SI group were further divided into two subgroups based on the results of CAG reexamination:ISR group and no-ISR group.Hematologic data were reexamined before further CAG and compared between the subgroups.Receiver operator characteristic curve (ROC)was drawn to evaluate the predictive values of PLR and NLR for ISR.Results PLR and NLR before PCI or a further CAG were significantly higher in ISR group (34 patients)than in non-ISR group (89 patients,P＜0.05).Before PCI,the best cutoff value of PLR in screening restenosis was 107.20;the sensitivity and the specificity were 64.7% and 65.2%.The best cutoff value of NLR in screening restenosis was 2.72; the sensitivity and the specificity were 61.8% and 70.8%. Before CAG reexamination,the best cutoff value of PLR in screening restenosis was 160.08;the sensitivity and the specificity were 26.5% and 97.8%.The best cutoff value of NLR in screening restenosis was 2.08;the sensitivity and the specificity were 73.5% and 56.2%.Conclusion Both PLR and NLR before PCI or CAG reexamination can be predictors of ISR in patients implanted with DES.
ABSTRACT
Objective To analyze the association of atherogenic index of plasma (AIP)and serum bilirubin with coronary in-stent restenosis after drug-eluting stent implantation.Methods For this research we recruited 268 patients who had undergone successful drug-eluting coronary stent implantation and then received coronary angiography.Both ends (from the edge of the supporting frame≤5 mm)or the vessel's diameter stenosis ≥50% were used as the definition of restenosis.According to the results of coronary angiography,the subjects were divided into restenosis group (42 cases)and non-restenosis group (226 cases).The total bilirubin,direct bilirubin,indirect bilirubin and AIP in the two groups were compared to explore the correlation of AIP and serum bilirubin with in-stent restenosis.Results AIP in restenosis group was significantly higher than that in non-restenosis group (P＜0.05).The level of total bilirubin was significantly lower in the former group than in the latter one (P＜0.05). Conclusion AIP is a risk factor for restenosis,and serum total bilirubin is a protective factor for coronary stent restenosis.
ABSTRACT
Objective To investigate the relationship between ischemia-modified albumin (IMA) and coronary artery stenosis in patients without myocardial infarction.Methods For this study we consecutively enrolled 345 patients who received coronary angiography (CAG).According to the results,the subjects were divided into coronary stenosis group (232 cases)and control group (113 cases)to investigate the the relationship of IMA and IMA/albumin (IMAr)with coronary stenosis.Results ① The levels of IMA and IMAr in coronary stenosis group were higher than those in control group (P＜0.001).② The IMA and IMAr were higher in single-branch and multi-branch lesion groups than in control group (P＜0.05),whereas there was no significant difference between single-branch lesion group and multi-branch lesion group (P＞0.05).③ In receiver operating characteristics curve analysis,the sensitivity of IMA and IMAr was 64.4% and 78.0%,respectively (AUC:0.653,0.705,P＜0.001)in predicting coronary stenosis.④ Multivariate logistic regression analysis showed that IMAr was an independent risk factor for coronary stenosis in patients without myocardial infarction (OR=73.05,P＜0.001).Conclusion IMA and IMAr are closely correlated with coronary stenosis and have a value in predicting coronary artery stenosis in patients without myocardial infarction.