Impact of adjuvant chemotherapy on prognosis in intrahepatic cholangiocarcinoma patients underwent radical resection / 中华外科杂志

Objectives: To investigate the clinical value of adjuvant chemotherapy(ACT) in patients with intrahepatic cholangiocarcinoma(ICC) who underwent radical resection and to explore the optimal population that can benefit from ACT. Methods: A retrospective cohort study method was adopted. The clinical and pathological data of 685 patients with ICC who underwent curative intent resection in 10 Chinese hepatobiliary surgery centers from January 2010 to December 2018 were collected;There were 355 males and 330 females. The age(M(IQR)) was 58(14) years (range: 22 to 83 years). Propensity score matching(PSM) was applied to balance the differences between the adjuvant and non-adjuvant chemotherapy groups. Log-rank test was used to compare the prognosis of the two groups of patients. A Bayesian network recurrence-free survival(RFS) prediction model was constructed using the median RFS time (14 months) as the target variable, and the importance of the relevant prognostic factors was ranked according to the multistate Birnbaum importance calculation. A survival prognostic prediction table was established to analyze the population benefiting from adjuvant chemotherapy. Results: Among 685 patients,214 received ACT and 471 did not receive ACT. A total of 124 pairs of patients were included after PSM, and patients in the ACT group had better overall survival (OS) and RFS than those in the non-ACT group(OS: 32.2 months vs. 18.0 months,P=0.003;RFS:18.0 months vs. 10.0 months,P=0.001). The area under the curve of the Bayesian network RFS prediction model was 0.7124. The results of the prognostic factors in order of importance were microvascular invasion (0.158 2),perineural invasion (0.158 2),N stage (0.155 8),T stage (0.120 9), hepatic envelope invasion (0.090 3),adjuvant chemotherapy (0.072 1), tumor location (0.057 5), age (0.042 3), pathological differentiation (0.034 0), sex (0.029 3), alpha-fetoprotein (0.028 9) and preoperative jaundice (0.008 5). A survival prediction table based on the variables with importance greater than 0.1 (microvascular invasion,perineural invasion,N stage,T staging) and ACT showed that all patients benefited from ACT (increase in the probability of RFS≥14 months from 2.21% to 7.68%), with a more significant increase in the probability of RFS≥14 months after ACT in early-stage patients. Conclusion: ACT after radical resection in patients with ICC significantly prolongs the OS and RFS of patients, and the benefit of ACT is greater in early patients.

Analysis of the current status and related factors of oral nutritional supplements intake among 18-79 years old in Beijing in 2017 / 中华流行病学杂志

Objective: To understand the current status of taking nutrient supplements for residents aged 18 to 79 years old in Beijing and its related factors. Methods: Data were gathered from the 2017 Beijing Non-communicable and Chronic Disease Surveillance Program. Multiple classified cluster sampling method was used, and participants aged 18-79 were sampled from 16 districts. The questionnaire included chronic diseases and related risk factors, health knowledge, and oral nutritional supplements within 12 months. Multivariate logistic regression models were established to analyze associated factors that affect the intake of nutrient supplements. Results: The weighted prevalence of supplements use was 13.1% among 12 696 subjects within the past 12 months. The proportions of multivitamins (4.7%), B vitamins (4.5%), and folic acid (3.2%) were higher. The prevalence of supplement use of young people (18-39 years old) and the elderly (60-79 years old) was higher than middle-aged people (40-59 years old) (χ2=54.09, P<0.001). Except for the age group of 70-79 years old, the consumption rate of women was significantly higher than that of men (P<0.05). After adjusting age and sex, among patients with hypertension, diabetes, or dyslipidemia, the control rates of blood pressure, glucose and lipids of patients who take nutrient supplements were higher than those who do not (P<0.05). And participants who took nutrient supplements had a more heightened awareness rate of health knowledge, such as the hazards of smoking and second-hand smoke, and recommended amount of salt per day (P<0.001). The multi-factor logistic analysis found that nutrient supplement-related factors include women, old age, higher education level, living in urban, insufficient physical activity, sleeping problems, active physical examination, blood pressure control among patients, and health knowledge (P<0.05). Conclusions: The factors of nutrient supplements use were related to sex, age, education level, health status, and health literacy. We should pay attention to key populations and guide them to establish the correct concept of taking nutrient supplements.

Spatio-temporal trend of female breast cancer mortality in Shandong Province from 1970 to 2013 / 中华预防医学杂志

The mortality of female breast cancer in Shandong Province has increased since the 1970. The differential decomposition analysis found that the slight decline in the crude mortality of breast cancer among women was entirely due to non-demographic factors during the 1970-1990, and the significant increase in the crude mortality was due to a combination of demographic and non-demographic factors since the 1990. The contribution rate of demographic factor has gradually increased from 53.5% in 2004-2005 to 59.5% in 2011-2013, while that of non-demographic factor has decreased from 46.5% to 40.5%. The women aged 45-64 years old were the major population of female breast cancer deaths, accounting for 40%-60% of total breast cancer deaths in different times, and then the mortality in female aged 55-64 years old increased rapidly, with increases of 52.12%, 115.19% and 29.01% in 2011-2013 over the 1970-1974, 1990-1992 and 2004-2005, respectively (Z=-7.342,P<0.001). Compared with 1970-1974, the age-standardized mortality rate of rural women increased by 41.86% in 2011-2013 (Z=-17.933, P<0.001), and that of urban women increased by 18.62% in 2011-2013 (Z=-25.642, P<0.001). The age-standardized mortality rate of breast cancer in urban women was higher than that in rural women in different times (all P<0.05). The spatial scan analysis found that eastern Shandong Province was found to be a sustained high-risk area for death, and other high-risk areas were transferred from north to southwest of Shandong between 1970 and 2013.

Investigation on knowledge, attitude and behavior of salt reduction in adults of Beijing in 2017 / 中华预防医学杂志

Objective: To explore the knowledge, attitude and behavior of salt reduction in adults of Beijing in 2017. Methods: Based on the monitoring data of chronic diseases and corresponding risk factors in adults of Beijing in 2017, the indicators of salt reduction knowledge, attitude and behavior of 13 240 participants aged 18-79 years old were analyzed. The awareness rate, attitude support rate and behavior rate were calculated by complex weighting method, and compared among different age groups, genders, residential areas, and history of hypertension. The proportion of people taking various salt reduction measures to the total number of people was compared. Results: The awareness rate of recommended daily salt intake, the awareness of hypertension caused or aggravated by more salt intake, the attitude support rate and behavior rate of adults were 31.77%, 88.56%, 90.27% and 53.86%, respectively. After weighted adjustment, the awareness rate of recommended daily salt intake was 31.08%, which increased with age (χ2trend=431.56, P<0.001) and education level (χ2trend=95.44, P<0.001). The awareness rate of women was higher than that of men (χ²=118.89, P<0.001), and the awareness rate of population in urban areas was higher than that of population in suburban areas (χ²=34.09, P=0.001). The awareness rate of hypertension caused or aggravated by eating more salt was 86.73%. The support rate of salt reduction attitude was 90.45%. The rate of salt-reducing behavior was 54.05%. Among different salt reduction measures, reducing salt when cooking was the most common measure (52.41%), while the least common one (35.22%) was using low sodium salt. Logistic regression model analysis showed that the gender, age, education level, self-reported history of hypertension, awareness of salt recommendation, awareness of hypertension caused or aggravated by eating more salt, and salt reduction attitude were significantly associated with salt reduction behavior. Conclusion: In 2017, adults in Beijing have a basic understanding of the impact of high-salt diet on health and support salt reduction, but the rate of salt reduction behavior is still relatively low. There are obvious gender and age differences, and the salt reduction measure is simple. Targeted measures should be taken to promote the formation of salt reduction behavior.

Health risk assessment of arsenic exposure in rural drinking water in Tongzhou District, Beijing Municipality / 预防医学

Objective@#To investigate the level of arsenic exposure in rural drinking water and to assess the health risk caused by exposure to arsenic in Tongzhou District, Beijing Municipality in 2019, so as to provide insights into improving the quality of rural drinking water.@*Methods@#Water samples were collected from self-provided wells in 196 villages of 7 townships in Tongzhou District from April to June, 2019, and the arsenic levels were measured in drinking water according to Standard examination methods for drinking water-Metal parameters (GB/T 5750.6-2006). The carcinogenic and non-carcinogenic risks of arsenic were evaluated in drinking water using the environmental risk assessment model recommended by the United States Environmental Protection Agency (EPA).@*Results@#Totally 520 water samples were collected, and the median arsenic concentration was 0.001 2-0.050 0 mg/L. There were 67 water samples with arsenic levels exceeding the defined standard level (12.88%), and the proportions of arsenic levels exceeding the defined standard level were 57.69%, 17.24%, 12.20%, 6.52% and 1.31% in Songzhuang, Huoxian, Lucheng, Zhangjiawan and Yongdedian townships, and the arsenic levels did not exceed the defined standard level in Majuqiao or Taihu townships. The carcinogenic risk of arsenic was 3.135 7×10-4/a in drinking water, which exceeded the maximum acceptable risk, and the carcinogenic risk of arsenic all exceeded the maximum acceptable risk, with the highest value seen in Songzhuang Township (9.648 2×10-4/a). A high carcinogenic risk of arsenic was seen in men at ages of 60 to 80 years (3.012 8×10-4/a) and in women at ages of 80 years and older (2.949 0×10-4/a). The non-carcinogenic risk of arsenic was 0.696 8 in drinking water, indicating a low risk, and were 1.009 5 and 2.144 1 in Huoxian and Songzhuang townships, indicating a high risk. In addition, a high non-carcinogenic risk of arsenic was seen in men at ages of 60 to 80 years (0.669 5) and in women at ages of 80 years and older (0.655 3).@*Conclusion@#There was a high proportion of arsenic levels exceeding the defined standard level in rural drinking water in Tongzhou District, 2019, and there was a health risk, notably with the highest carcinogenic risk seen in residents at ages of 60 years and older. Effective interventions are needed to reduce arsenic levels in drinking water.

Experimental investigation of early assessment of corpora cavernosa fibrosis with two-dimensional shear wave elastography / 亚洲男科学杂志(英文版)

This study explored the usefulness of two-dimensional shear wave elastography (2D-SWE) in the early assessment of corpora cavernosa fibrosis (CCF). New Zealand male rabbits were randomly assigned to an experimental group or a control group. Recombinant human transforming growth factor beta 1 (TGF-β1) was injected into the dorsal penis tissue of rabbits in the experimental group. Conventional ultrasound and 2D-SWE examinations were performed before and 20 days after injection. Penile histological analysis was performed by hematoxylin-eosin staining, sirius red staining, and immunohistochemistry. Measurement of 2D-SWE examination results was performed using shear wave elastography quantitative measurement (SWQ). Histological analysis outcomes were the proportion of smooth muscle cells (SMCs), collagen fibers (CFs), collagen type I (Col I), and collagen type III (Col III), as well as the SMCs/CFs ratio, measured by sirius red staining. Other histological analysis outcomes were the positive area proportion (PAP) of TGF-β1 (PAPT), fibronectin (PAPF), and Col III (PAPC), measured by immunohistochemistry. After recombinant human TGF-β1 injection, SWQ was higher in the experimental group than that in the control group (P < 0.001); however, there were no differences in conventional ultrasound results. There were significant differences in histological outcomes between the two groups (all P < 0.05). These results indicated that 2D-SWE was superior for identifying early histological changes in CCF.

Paeoniflorin regulates gut microbiota and bile acids metabolism in colitis mice / 药学学报

The current study was designed to evaluate the modulatory effects of paeoniflorin on the dysregulated gut microbiota as well as the disturbed fecal bile acids (BAs) in colitis mice. After approved by Xi'an Jiaotong University Ethics Committees (Approval No. XJTU2019-679), the animals were randomly distributed into the control (Con), colitis, low dose paeoniflorin (PF-L, 25 mg·kg-1·d-1), high dose paeoniflorin (PF-H, 50 mg·kg-1·d-1) and 5-aminosalicylic acid (5-ASA, 50 mg·kg-1·d-1) groups. Colitis was induced by administering 3% (w/v) DSS in drinking water for 7 days. Paeoniflorin and 5-ASA were dissolved in water and administered to the appropriate groups by oral gavage over the 7-day period. The mice were monitored daily, and the disease activity index (DAI) comprising of body weight loss, stool consistency and gross blood was measured. The pathological changes of colon were evaluated by HE staining; the levels of inflammatory cytokines in colonic tissue were determined by ELISA; the gut permeability was measured by FITC-dextran. Microbiota analysis based on 16S rDNA and targeted metabolomics for BAs were used to evaluate the composition of gut microbiota and fecal BAs pool. The results showed that administration of paeoniflorin markedly alleviated the inflammatory response and intestinal barrier dysfunction in DSS-induced colitis. Importantly, these ameliorative effects of paeoniflorin were accompanied by the improvements of disturbed composition of gut microbiota and the dysmetabolism of bile acids in feces. Finally, we performed Spearman's correlation analysis between the fecal BAs and gut microbiota genera, and found that Lactobacillus has a strong positive correlation with DCA and LCA which were reported to confer the beneficial effects of maintaining intestinal homeostasis. Taken together, paeoniflorin might improve the intestinal homeostasis in colitis mice via modulating gut microbiota and fecal BAs metabolism.

Observation on the functional characteristics of multidrug-resistant Mycobacterium tuberculosis-infected macrophage model / 中华微生物学和免疫学杂志

Objective:To observe the characteristics of the phagocytosis and bactericidal function of multidrug-resistant Mycobacterium tuberculosis(MDR- Mtb)-infected macrophage model, and the changes of the immune response and metabolic function in the process of phagocytosis and bactericidal function, aiming to provide reference for studying the role and mechanism of macrophages in the occurrence and development of multidrug-resistant tuberculosis(MDR-TB). Methods:We established MDR- Mtb and H37Rv-infected macrophage models, and used the colony-forming unit (CFU), Magnetic Luminex ? Assay and Cholesterol Assay kit to observe the effects on phagocytosis and bactericidal function, the secretion of Th1(IL-12/23 p40, IL-27 and TNF-α) and Th2 cytokines (IL-6 and IL-10) and cholesterol metabolism. The data were analyzed by SPSS25.0 software. The data were expressed as Mean± SD and analyzed by t test or F test. P<0.05 was considered statistically significant. Results:(1) After MDR- Mtb-infected macrophages, the intracellular CFU gradually increased and reached the highest at 24 h, while the extracellular CFU gradually decreased and reached the lowest at 24 h. The intracellular CFU at 48 h was lower than that at 24 h, while the extracellular CFU was higher than that at 24 h ( P<0.05). Both intracellular and extracellular CFU at 48 h were close to those at 4 h ( P>0.05). The intracellular CFU was lower than the H37Rv group at 8-48 h, while the extracellular CFU was higher than the H37Rv group ( P<0.05). (2) The level of IL-12/23 p40, IL-27, TNF-α, IL-6 and IL-10 of MDR-TB group were higher than those of blank group ( P<0.05), but the level of TNF-α and IL-6 at 24 h and 48 h were higher than that at 4 h ( P<0.05). IL-12/23 p40 and TNF-α at 48 h and IL-6 at 24 h were lower than those of the H37Rv group, while IL-27 at 48 h was higher than that of the H37Rv group ( P<0.05). (3) The levels of cholesterol of MDR-TB group at 24 h and 48 h were lower than those of 4 h and blank group ( P<0.05), but the level of cholesterol was similar to the H37Rv group at any time ( P>0.05). (4) TNF-α reached the highest when the intracellular CFU reached the highest at 24 h, and IL-6 reached the highest when the intracellular CFU decreased at 48 h. With the decreasing of cholesterol expression, the intracellular CFU increased and then decreased. Conclusions:MDR- Mtb could induce the phagocytosis and bactericidal function of macrophages, increase the expression of Th1 and Th2 cytokines and promote the utilization and consumption of cholesterol, but this function was weaker than that of H37Rv strain.

Current situation of mother-infant-dyads at their first visit to breastfeeding counseling clinic / 中华围产医学杂志

Objective:To analyze the current situation of the mothers and infants at their first visit to the breastfeeding counseling clinic, and provide a reference for promoting breastfeeding in infancy.Methods:Clinical data of 581 mother-infant-dyads visiting the breastfeeding counseling clinic of Nanjing Maternal and Child Health Hospital from January 2019 to December 2019 were collected and analyzed retrospectively, including the general information of the dyads, and the subjective and actual reasons for visits. According to the age of infants coming to the clinics, they are divided into the younger group (60 d and below, n=316), middle-aged group (61-120 d, n=178), and older group (121 d and above, n=87). Differences in exclusive breastfeeding rate and reasons for visits between different groups were analyzed by analysis of variance, Kruskal-Wallis rank sum test, Chi-square test, or Fisher's exact test. Results:The age of the 581 infants at the first visit were mainly at 30-34, 41-45 and 90-94 d, which accounted for 9.3%( n=54), 25.3%( n=147), and 9.0%( n=52), respectively. The total exclusive breastfeeding rate was 71.8%( n=417) at visit, and there were significant differences among the younger, middle-aged and older group [67.7%(214/316), 79.8%(142/178), 70.1%(61/87), χ 2=14.294, P=0.006), and between the younger and middle-aged group in the pairwise comparison. The most common subjective reason for visiting was slow weight gain ( n=249, 42.9%), followed by worrying about insufficient milk ( n=142, 24.4%) and feeding difficulties ( n=132, 22.7%). Whereas the top three practical reasons for visiting included infant's inability to latch on or sucking ( n=165, 28.4%), lack of breastfeeding knowledge ( n=149, 25.6%) and inappropriate maternal feeding skills ( n=140, 24.1%). The younger group faced more problems regarding latching on or sucking [39.6%(125/316] and mother's feeding skills[25.9%(82/316)], while the lack of breastfeeding knowledge mainly occurred in the older group[48.3%(42/87)]. The coincidence rates between the subjective and actual reasons for slow weight gain, worrying of insufficient milk, and feeding difficulties were only 1.2%( n=3), 6.3%( n=11), and 21.2%( n=28). Conclusions:Breastfeeding- related problems exist in infants of different ages below one year old. There is a big knowledge gap between the subjective reasons for medical visits and the actual problems that interfere with breastfeeding. Therefore, individualized breastfeeding guidance for infants of different ages is recommended in children's health clinics.

The effect of weight loss on endothelial function and cerebrovascular risk factors in obese and overweight people / 中华健康管理学杂志

Objective:To explore the effect of weight loss on endothelial function and cerebrovascular risk factors in obese and overweight people.Methods:A total of 127 obese or overweight subjects received 6-month body weight management. Subjects who lost 3 kg or more than 5% of their body weight prior to the 6-month intervention were defined as achievement group. Endothelial function (FMD) and other cerebrovascular risk factors were measured before and after intensified lifestyle management.Results:The achievement group comprised 57 (44.9%) cases and the non-achievement group 70 (55.1%) cases. After 6-month intervention, FMD (6.98±2.88% vs 7.90±2.96%, P<0.05) and HDL-C increased in the achievement group. Significant decreases were observed in the achievement group in BMI, SBP, DBP, FPG, TC, LDL-C, TG and uric acid. However, only DBP and FPG decreased in the non-achievement group. Conclusion:Weight loss can reverse endothelial dysfunction and metabolic dysfunction. Decrease of body fat ratio contributes to the improvement of endothelial function.

Psoriasis-related Signaling Pathways Regulated by Traditional Chinese Medicine： A Review / 中国实验方剂学杂志

As an inflammatory skin disease with a gradually increasing prevalence，psoriasis has negatively impacted the quality of life of patients and has attracted widespread attention from the medical community. The pathogenesis of psoriasis can be affected by a variety of genetic，environmental， and immune factors，and cytokine-driven epidermal proliferation，abnormal differentiation，inflammation， and neovascularization contribute to the pathogenesis，involving the interaction between immune and skin cells. However， some pathogenesis is still a blind spot for research，which brings great challenges to clinical treatment. Therefore， the identification of effective targets for psoriasis is critical in the research on psoriasis. Signaling pathways， another hotpot in the research on psoriasis， play an important cellular transduction role in the pathological mechanism of psoriasis and serve as key transduction factors regulating the immune and inflammatory responses to psoriasis. With the in-depth research in the field of network pharmacology and molecular biology， single Chinese medicine and Chinese medicinal compound can exert a therapeutic role by regulating multiple signaling pathways related to psoriasis. In recent years，traditional Chinese medicine （TCM） has achieved good clinical efficacy in the prevention and treatment of psoriasis，such as relieving pruritus，decreasing the area of skin lesions，improving anxiety， and preventing complications， which confirms the credibility of TCM in the understanding and treatment of psoriasis. Despite the rich theoretical and clinical research on the prevention and treatment of psoriasis，studies on the regulation of psoriasis-related signaling pathways and mechanisms of action by TCM are rarely reported. Therefore，the present study reviewed the available research in recent years and introduced the following six major signaling pathways related to psoriasis which are regulated by TCM： Janus kinase（JAK）/signal transducer and activator of transcription（STAT） signaling pathway，mitogen-activated protein kinase（MAPK） signaling pathway，phosphatidylinositol-3-kinases（PI3K）/protein kinase B（Akt） signaling pathway，nuclear transcription factor-κB（NF-κB） signaling pathway，Wnt signaling pathway， and Notch signaling pathway.

Effect of Intervention with Traditional Chinese Medicine on Th17/Treg Balance in Psoriasis： A Review / 中国实验方剂学杂志

Psoriasis is an autoimmune disease presented in the context of inflammation， and it mainly results from proliferation and differentiation defects of keratinocytes and abnormal immune response. However， some cellular and molecular mechanisms remain unclear. Although a variety of drugs and physiotherapies are applicable to this disease， they can only be utilized for a short-term period considering their transient effect， high cost， and serious adverse reactions. It is difficult to achieve satisfactory long-term results in the treatment of psoriasis. With the development of network pharmacology and molecular biology and the modernization of traditional Chinese medicine （TCM）， the multi-component and multi-target characteristics of TCM have become prominent， promoting the in-depth research on TCM by doctors and scholars. Nevertheless， there is no detailed summarization on the mechanisms of TCM in interfering with T helper 17 （Th17）/regulatory T （Treg） cell balance to prevent and treat psoriasis. After reviewing the recent literature data， this paper has found that Chinese herbal monomers， active ingredients， and compounds obviously regulate the Th17/Treg axis in psoriasis. Th17 cells have a pro-inflammatory effect， while Treg cells are responsible for maintaining peripheral tolerance. They function in a mutually exclusive manner， and maintaining the Th17/Treg balance helps to effectively reduce inflammatory reaction and regulate immune homeostasis. As revealed by a series of clinical and experimental studies carried out based on the Th17/Treg axis in psoriasis， reducing the percentage of Th17 cells，increasing the percentage of Treg cells，and regulating the levels of related cytokines and transcription factors are conducive to alleviating inflammation and regaining immune homeostasis，which has provided new ideas for further elucidating the pathological mechanism of psoriasis and alternative plans for developing new treatments against psoriasis.

Clinical prediction model of moderate and severe obstructive sleep apnea hypopnea in snoring patients / 中国医师进修杂志

Objective:To establish a simple and efficient clinical prediction model of moderate and severe obstructive sleep apnea hypopnea (OSAHS) in snoring patients based on the clinical data and morphological measurement data in order to increase the early diagnosis and then early intervention of OSAHS. The prediction model is evaluated by external validation.Methods:A total of 299 subjects from January 2015 to December 2018 were selected to perform polysomngraphy (PSG) in Yangpu Hospital, Tongji University School of Medicine. According to the PSG results, they were divided into moderate and severe OSAHS groups (143 cases) and control groups (156 cases). Clinical complications data and morphological measurement data were collected. The regression equation and ROC curve were established according to the Logistic regression method. Then, another 110 subjects from January 2019 to October 2019 were chosen as verified data group, and used to verify the accuracy of the prediction model. The data of 110 subjects were put into the equation according to risk factors and assignment. The ROC curve was drawn and the area under the curve was calculated. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value were calculated.Results:The predicted equation was: y = -10.707 86+0.589 60 × sex+ 0.141 61 × BMI+ 1.281 62 × tonsil size degree+ 1.807 43 × modified Mallampati degree′tongue position. The AUC of the ROC curve of prediction model in training set was 0.851(95% CI 0.807-0.895), the sensitivity was 83.9%, the specificity was 79.5%, and the cut-off value was 0.634.The AUC of the ROC curve in validation set was 0.827(95% CI 0.751-0.904) with a sensitivity of 73.3% and a specificity of 86.0%, and an accuracy of 79.1%. Its positive predictive value was 5.238, and negative predictive value was 0.310. Conclusions:The predictive model constructed by the combination of clinically accessible data (sex) and morphological measurement (BMI, tonsil size degree, modifiedMallampatidegree) has a relatively high predictive efficiency for screening snoring patients with moderate and severe OSAHS. The predictive model is proved with good forecast accuracy by the external verification method.

Overexpression of LncRNA ITGB2-AS1 Predicts Adverse Prognosis in Acute Myeloid Leukemia / 中国实验血液学杂志

OBJECTIVE@#LncRNA ITGB2-AS1 has been found to play important roles in the occurrence and development of human solid tumors. However, its role in hematological diseases, especially acute myeloid leukemia (AML), remains unclear. The aim of this study was to identify the expression pattern of ITGB2-AS1 in AML patients and to further explore its clinical significance.@*METHODS@#ITGB2-AS1 expression was analyzed in public datasets (including TCGA and GSE63270) and further validated in a cohort of 109 AML patients by real-time quantitative PCR (RT-qPCR).@*RESULTS@#The level of ITGB2-AS1 was up-regulated among two independent cohorts (TCGA, P<0.05; GSE63270, P<0.05), which was confirmed by the data from 109 AML patients enrolled in this study (P<0.05). Clinically, high ITGB2-AS1 expression was associated with older age (P=0.023) and lower complete remission (CR) rate (P=0.005). Multivariate analysis identified that high ITGB2-AS1 expression was an independent prognostic factor not only for CR rate (P=0.027) but also for overall survival (OS) time (P=0.011), and ITGB2-AS1 was positively correlated with ITGB2 expression in both TCGA (r=0.74, P<0.001) and clinical data detected in this study (r=0.881, P<0.001). High ITGB2 expression was also associated with older age (P=0.02) and lower CR rate (P=0.020). Moreover, high ITGB2 expression predicted worse OS (P=0.028).@*CONCLUSION@#ITGB2-AS1 is overexpressed in AML and predicts poor prognosis in AML patients.

Effects of SLCO1B1 521 T>C and APOE gene polymorphisms on lipid-lowering efficacy and adverse reactions of atorvastatin / 药学实践杂志

Objective To study the effect of SLCO1B1 521 T>C and APOE gene polymorphisms on the clinical efficacy and safety of atorvastatin in ischemic stroke patients with dyslipidemia. Methods 210 cases of ischemic stroke with dyslipidemia were enrolled from April 2018 to December 2018 to determine SLCO1B1 521 T>C and APOE gene polymorphisms. Patients received atorvastatin 20 mg/d orally. TC, TG, HDL-C, LDL-C levels were measured to evaluate the efficacy 3 months pre-and post- treatment. TBil, ALT, AST, CK levels were assayed with following up adverse reactions to evaluate safety. Results SLCO1B1 521 T>C genotype distribution was TT79.05%, TC19.05%, CC1.90%. E2, E3, E4 allele frequencies of APOE genes were 14.28%, 67.62%, 18.10%. Each genotype conforms to the law of Hardy-Weinberg balance. After three months of medication, there were significant differences in TC, TG, LDL-C, HDL-C changes in patients with different APOE genotypes. No obvious abnormality was found in safety index. The incidence of myalgia in SLCO1B1521 T>C mutant group was significantly higher than that in the wild group (P<0.01). Conclusion Lipid regulation of atorvastatin was affected by APOE gene polymorphism. SLCO1B1521 T>C may be associated with myalgia, the adverse reaction of atorvastatin. The detection of SLCO1B1 and APOE genotyping is helpful for individualized treatment of blood lipids and provides basis for rational use of statins in patients for drug therapy management.

The optimal reference genes for miRNA quantitative analysis in cerebrospinal fluid of patients with tuberculous meningitis / 中华检验医学杂志

Objective:To explore the feasibility of U6 and Cel-miR-39 as reference genes for quantitative detection of microRNA (miRNA) in cerebrospinal fluid (CSF) of tuberculous meningitis (TBM), and validate the difference of miRNAs between tuberculous and viral meningitis (VM).Methods:The remaining CSF specimens after routine examination were collected in Beijing Chest Hospital of Capital Medical University. A total of 36 TBM and 34 VM patients were enrolled based on the information in the medical records. Total RNA were extracted from the CSF samples, and Taqman based real-time quantitative PCR (RT-CR) analysis were performed to determine the concentration of the miRNAs in CSF. GeNorm, NormFinder and Bestkeeper software were used for stability analysis of the two reference genes. 2 -ΔCt method was used to determine the relative gene expression. Accordance of repeated tests was analyzed by Pearson correlation test. Continuous variables were compared by the t-test. Results:Among the 70 samples, the average cycle threshold (Ct) value of U6 was 30.40±3.30, while the average Ct value of Cel-miR-39 was 21.49±0.70. The expression level of Cel-miR-39 was higher than that of U6. Correlation analysis showed good accordance of the repeated tests among the reference genes and target genes analysis in the randomly selected 10 samples ( r>0.931, P<0.001). Based on the analyses results of the three software, including GeNorm, NormFinder and Bestkeeper, Cel-miR-39 presented better stability in RT-PCR analysis and was more suitable as a reference gene for miRNA quantitative determination in CSF sample of TBM patients. The relative expression levels of the three target miRNAs were calculated using Cel-miR-39 as the reference gene, and miR-126-3p (1.13±0.41 vs 3.34±0.82, t=2.452, P=0.016), miR-130a-3p (0.56±0.10 vs 2.59±0.70, t=2.960, P=0.004) and miR-151a-3p (0.64±0.25 vs 2.11±0.33, t=3.536, P<0.001) were showed significant lower expression levels in CSF in TBM group than that in VM group. Conclusions:Cel-miR-39 can be used as a reference gene for quantitative detection of miRNAs in CSF of TBM patients. Significant differences were detected in expression level of miR-126-3p, miR-130a-3p and miR-151a-3p between TBM and VM group.

Progress in the study of age-related macular degeneration and lipid / 中华眼底病杂志

The etiology and pathogenesis of age-related macular degeneration (AMD) are unclear and difficult fot treatment. Some genetic research evidences in recent years have shown that the relationship between lipid metabolism-related gene polymorphism and AMD is statistically significant; it has also been found that blood lipid levels are related to AMD, and lipid-lowering drugs may have the effect of delaying the development of AMD in clinically. Abnormal lipid metabolism may play an important role in the occurrence and development of AMD. Clarifying the role of lipid metabolism in the occurrence and development of diseases will help reveal the pathogenesis of diseases and promote early diagnosis, monitoring and prevention of diseases, and provide an entry point for treatment.

Prevalence of decreased estimated glomerular filtration and risk factors among middle-aged and elderly residents in Beijing / 中华全科医师杂志

Objective:To investigate the prevalence of estimated glomerular filtration (eGFR) and risk factors among middle-aged and elderly residents in Beijing.Methods:In August-December of 2017, 6 549 residents aged 45-79 years old were randomly selected in the study by stratified multi-stage cluster sampling method. The investigation was performed by questionnaire, physical examination and laboratory tests. The contents of questionnaire included the demographic characteristic and prevalence of chronic disease. Blood pressure was tested. Fasting venous blood was collected to test the level of total cholesterol (TC), high density lipoprotein cholesterol (HLDL), low density lipoprotein cholesterol (LDL), triglyceride (TG), fasting blood-glucose (FBG), blood creatinine (Cr) and serum uric acid (UA). The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation was used to estimate GFR(eGFR). The decreased GFR was defined as eGFR less than 60 ml/min per 1.73 m 2. The statistical software SPSS 20.0 was used for analysis. The general linear model, test of independence of rows and columns, logistic regression for complex samples were generalized. The weighted mean and weighted rate were analyzed. Results:The average level of eGFR was (100.51±0.54) ml/min per 1.73 m 2. The rate of decreased GFR was 1.28%, and it showed a higher rate in subjects aged 70-79 years-old, living in urban area, with history of cardiovascular disease, hypertension, diabetes mellitus, hyperuricemia (4.53%, 1.57%, 2.90%, 2.27%, 2.12% and 4.62%; F=30.827, 10.588, 11.466, 34.693, 6.788,51.643, all P<0.05) . Logistic regression analysis of complex sampling showed that 70-79 years old ( OR=4.435, 95 %CI:2.402-8.191), living in urban area ( OR=3.145, 95 %CI: 1.540-6.420), hypertension ( OR=4.663, 95 %CI:2.177-9.988), hyperuricemia ( OR=6.751, 95 %CI:3.363-13.553) were associated with decreased GFR (all P<0.05). Conclusion:The prevalence of the decreased eGFR among middle-aged and elderly residents in Beijing is higher than the average level in the eastern part of China. Hypertension, hyperuricemia, the old age and living in urban are risk factors of decreased GFR.

Establishment of osimertinib-resistant non-small cell lung cancer cell line and preliminary study of drug resistance mechanism / 中国医师杂志

Objective:To establish osimertinib-resistant non-small cell lung cancer (NSCLC) cell line and explore its drug resistance mechanism.Methods:The human NSCLC cell line H1975 was used as the research object, and low-concentration osimertinib was used to continuously select secondary drug-resistant cell lines. Osimertinib drug sensitivity of cells was detected by MTS method. Cell proliferation was detected by live cell workstations. Flow cytometry was used to detect cell cycle and apoptosis. Protein mass spectrometry was used to construct differentially expressed protein profiles between parental and drug-resistant cells and some resistance-related proteins were validated by real time fluorescence quantitative polymerase chain reaction (qRT-PCR) and Western blot.Results:Secondary drug-resistant H1975/OSI cell line were successfully established. Compared with the parental cells, the resistance index of H1975/OSI cells increased by 27.25 times ( P<0.01), the cell proliferation ability decreased but the apoptosis resistance increased ( P=0.01), and no new drug-resistance related gene mutation in H1975/OSI cells. Meanwhile, the differential protein expression profiles of H1975 and H1975/OSI cells were built, and 307 upregulated proteins and 295 down-regulated proteins were found in resistant cells. When fibroblast specific protein-1 (FSP1) gene with expression up-regulation was diturbed in H1975/OSI cells, the cell IC50 value of osimertinib decreased 3.51 times ( P=0.02) , and when FSP1 was overexpressed in the H1975 cells, the IC50 value of osimertinib increased by 3.75 times ( P<0.01). Conclusions:We successfully established human NSCLC osimitinib-resistant cell line H1975/OSI. Protein differential expression profiles between H1975 and H1975/OSI was constructed successfully. It was found that FSP1 was involved in mediating the resistance of H1975/OSI to osimertinib.

Effect of left atrioventricular interphase on cardiac function after dual-chamber pacemaker implantation in patients with high-degree atrioventricular block / 中国医师进修杂志

Objective:To study the effect of left atrioventricular interphase (LAVI) via esophageal electrocardiogram on cardiac function after dual-chamber pacemaker implantation in patients with high-degree atrioventricular block.Methods:Using a prospective approach, 40 patients with high-degree atrioventricular block who would undergo dual-chamber pacemaker implantation from January 2017 to March 2018 in Department of Cardiovascular Medicine, Dalian Municipal Central Hospital Affiliated of Dalian Medical University were enrolled. All patients accepted esophageal electrocardiogram tests at 3 months after the implantation, to exam the interatrial conduction time (IACT) of sinus rhythm and pacing rhythm, and interventricular conduction time (IVCT). Then based on the outcome of the echocardiography test, the optimal atrioventricular delay (AVD) of the pacemaker of each patient was determined while the LAVI differed from 100 ms to 150 ms. The left ventricular ejection fraction (LVEF), peak speed of blood flow velocity in early mitral orifice diastole (E), E peak deceleration time (EDT), peak speed of early mitral annular diastolic movement (e′), isovolumic relaxation time (IVRT) and left atrial volume (LAV) were tested by echocardiogram before implantation, before AVD adjustment at 3 months after implantation, after AVD adjustment at 3 months after implantation, and 6, 12, and 18 months after implantation. Then, the left atrial volume index (LAV/body surface area) and E/e′ were calculated.Results:Among the 40 patients, the IACT of sinus rhythm was (55.55 ± 10.33) ms, the IACT of pacing rhythm was (93.95 ± 12.77) ms, and the mean IVCT was (63.20 ± 17.84) ms; the optimal LAVI was 110 to 150 (132.00 ± 10.43) ms, and notably, the optimal LAVI between 120 and 140 ms was 82.5% (33/40). The LVEF, EDT, IVRT, left atrial volume index and E/e′ from before AVD adjustment of 3 months after implantation to follow-up endpoint (18 months after implantation) were significantly improved compared with those before implantation, and there were statistical differences ( P<0.01); the EDT and IVRT after AVD adjustment at 3 months after implantation were significantly improved than those before AVD adjustment at 3 months after implantation: (142.15 ± 35.58) ms vs. (125.94 ± 31.13) ms and (119.52 ± 22.15) ms vs. (133.92 ± 23.87) ms, and there were statistical differences ( P<0.05); the IVRT and left atrial volume index 18 months after implantation were significantly improved compared with those before AVD adjustment at 3 months after implantation: (122.07 ± 16.99) ms vs. (133.92 ± 23.87) and 32.94 ± 3.22 vs. 35.43 ± 5.76, and there were statistical differences ( P<0.05). Conclusions:Optimizing the LAVI after dual-chamber pacemaker implantation via esophageal electrocardiogram can improve the long-term prognosis of patients with high-degree atrioventricular block.