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Objective:To explore the risk of hip fracture, changes of composite indices of femoral neck strength and its influential factors in non-low-weight postmenopausal women with type 2 diabetes mellitus(T2DM).Methods:A total of 626 non-low-weight postmenopausal women were selected and divided into type 2 diabetes group, pre-diabetic group, and non-diabetic group according to the diagnostic criteria of the American Diabetes Association in 2010. Each participant completed the questionnaire, physical examination, laboratory examination, and Dual-energy X-ray absorptiometry(DXA) examination.Results:Hip fracture rate in T2DM group was significantly higher than that in non-diabetic group(3.4% vs 0.7%, P<0.05), while no significant difference was observed between pre-diabetic group and non-diabetic group(1.1% vs 0.7%, P>0.05). Bone mineral density(BMD) of lumbar spine 1-4, femoral neck, and total hip was comparable between T2DM group and non-diabetic group or pre-diabetic group and non-diabetic group, respectively( P>0.05). The composite indices of femoral neck strength in T2DM group was significantly lower than that in non-diabetic group( P<0.05), but there was no significant difference between pre-diabetic group and non-diabetic group( P>0.05). Regression analysis showed that age and body mass index were the main influential factors of the femoral neck bone mineral density and the composite indices of femoral neck strength( P<0.05). Conclusion:The composite indices of femoral neck strength could be used as one of the markers to evaluate the risk of hip fracture in type 2 diabetic patients.
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Objective:To evaluate the influence factors of the peak time in computed tomography (CT) portal venography.Methods:Twenty-eight patients who underwent CT perfusion (CTP) examination in Minhang Hospital Affiliated to Fudan University from October 2020 to December 2021 were retrospectively collected. The CT enhancement time-density curves of the main portal vein trunk and abdominal aorta were obtained at the cross section of the left and right branches of portal vein. The peak time of portal vein and abdominal aorta, the enhanced CT attenuation of the liver and spleen parenchyma enhancement at the peak value of portal vein were measured. Pearson correlation and regression analysis were performed.Results:The peak time of abdominal aorta was (16.39±2.68)s, and portal vein was (27.12±4.65)s. The enhanced CT attenuation of liver and spleen parenchyma were (84.64±20.21)HU and (142.28±25.15)HU, respectively. The peak time of portal vein was positively correlated with the peak time of abdominal aorta ( r=0.825, P<0.001), and there was no statistical correlation with the enhanced CT values of liver and spleen. Multiple linear regression analysis showed that the peak time of abdominal aorta was an independent factor affecting the peak time of portal vein ( b=1.326, t=5.874, P<0.001). The regression equation was the peak time of portal vein=4.185+ 1.451× the peak time of abdominal aorta. The peak time of portal vein in cirrhosis group was (27.78±4.48)s, and that in noncirrhosis group was (26.8±4.81)s, with no significant difference between the two groups ( P=0.614). Conclusions:There was a linear correlation between the peak time of portal vein and the abdominal aorta, and the results could be helpful to optimize the setting of delay time before CT portal venography.
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Objective:To compare the influence of single and staged percutaneous coronary intervention (PCI) on long-term prognosis in patients with multi-vessel coronary artery disease.Methods:Using prospective research methods, 1 832 patients with multi-vessel coronary artery disease from January to December 2013 in Fuwai Hospital, Chinese Academy of Medical Sciences were selected. According to the time of PCI, the patients were divided into single PCI group (1 218 cases) and staged PCI group (614 cases). The patients were followed up for 2 years, the primary endpoint was major cardiovascular and cerebrovascular event (MACCE), including target vessel-related myocardial infarction (TV-MI), target vessel-related revascularization (TVR), cardiogenic death and stroke, and the secondary endpoint was stent thrombosis. The propensity score matching (PSM) was applied to balance the discrepancies between 2 groups, and the baseline and follow-up data were compared. The Kaplan-Meier survival curves were drawn to evaluate the survival rates events; multifactor Cox proportional risk regression was used to analyze whether staged PCI was an independent risk factor for the endpoint events.Results:The in-hospital stay, duration of procedure and synergy between percutaneous coronary intervention with taxus and cardiac surgery (SYNTAX) score in single PCI group were significantly lower than those in staged PCI group: (5.54±3.09) d vs. (9.50±4.06) d, (43.12±28.55) min vs. (79.54±44.35) min, (14.04±7.63) scores vs. (18.51±7.79) scores, and there were statistical differences ( P<0.01); there were no statistical difference in complete revascularization rate and SYNTAX score after PCI between 2 groups ( P>0.05). Based on 2-year follow-up, the incidences of TV-MI and stent thrombosis in staged PCI group were significantly higher than those in single PCI group: 2.1% (13/614) vs. 0.5% (6/1 218) and 2.0% (12/614) vs. 0.4% (5/1 218), and there were statistical differences ( P<0.01). Kaplan-Meier survival curves analysis results showed that the event-free survival rates of TV-MI and stent thrombosis in single PCI group were better than those in staged PCI group (99.5% vs. 97.9% and 99.6% vs. 98.0%, P<0.01). Multifactor Cox proportional risk regression analysis results showed that staged PCI was an independent risk factor for stent thrombosis ( HR = 3.91, 95% CI 1.25 to 12.18, P = 0.019). After PSM, the incidences of TV-MI and stent thrombosis in staged PCI group were significantly higher than those in single PCI group: 2.1% (13/614) vs. 0.7% (4/614) and 2.0% (12/614) vs. 0.5% (3/614), and there were statistical differences ( P<0.05); Kaplan-Meier survival curve analysis results showed that the event-free survival rates of TV-MI and stent thrombosis in single PCI group were significantly higher than those in staged PCI group: (99.3% vs. 97.9% and 99.5% vs. 98.0%, P<0.05); multifactor Cox proportional risk regression analysis results showed that staged PCI was not an independent risk factor of stent thrombosis ( HR = 2.29, 95% CI 0.58 to 9.00, P = 0.234). Both before and after PSM, there were no evidences for interaction between the type of angina pectoris and staged PCI ( P>0.05). Conclusions:Although a seemingly increase exists in the incidence of TV-MI and stent thrombosis in the staged PCI group, staged PCI is an independent risk factor neither for MACCE and its components, nor for stent thrombosis. In addition single PCI reduces the in-hospital days and duration of PCI procedure, which may be a relatively reasonable approach to clinical practice.
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To evaluate the impact of the depth of lipohypertrophy on glycemic control in diabetic patients, 498 diabetic patients were recruited from July 2017 to July 2020 in the First Affiliated Hospital of Nanjing Medical University. Their demographic and clinical data were collected. Lipohypertrophy was assessed with ultrasound. 85.1%(424/498) of patients had lipohypertrophy. The average depth of lipohypertrophy was(5.62±2.49) mm. Compared with HbA 1C≤7%, patients with HbA 1C>7% had significantly higher proportion of lipohypertrophy with depth >5 mm(69.7% vs 81.3%, P<0.05). After adjusting potential confounders, the level of HbA 1C in patients with the depth of lipohypertrophy>5 mm was still significantly higher than those with the depth of lipohypertrophy≤5 mm( OR=1.716, 95% CI 1.104-2.668, P<0.05). The depth of lipohypertrophy may be an independent risk factor for suboptimal HbA 1C. However, prospective studies are still needed to confirm.
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Objective:To investigate the value of radiomics based on unenhanced CT texture analysis in predicting the WHO/International Society of Urological Pathology (ISUP) grading of clear cell renal cell carcinoma (ccRCC).Methods:Postoperative pathology-confirmed ccRCC subjects ( n=90) who received CT scanning and had a definite pathological grading in Cancer Hospital of the University of Chinese Academy of Sciences were collected retrospectively from December 2016 to May 2019. The cases were randomly divided into training group ( n=63) and test group ( n=27) as a ratio of 7∶3. All cases were classified into low grade (grades Ⅰ and Ⅱ, n=57) and high grade (grades Ⅲ and Ⅳ, n=37) according to the new pathological grading (WHO/ISUP grading, version 2016) of renal carcinoma. 3D-ROI segmentation was performed on unenhanced CT images and 93 texture features were extracted. The least absolute shrinkage and selection operator (LASSO) regression was used to reduct dimension of texture parameters and then the radiomics score (Rad-score) was established. The logistic regression was used to develop the prediction model with the pathological grading as the gold standard. The ROC curve and calibration curve were used to evaluate the predictive performance of the model, and the area under the curve (AUC), accuracy, sensitivity and specificity were calculated. The Hosmer-Lemeshow test was used to evaluate calibration degree of the model. Results:The 10 non-zero coefficient texture features were screened out through dimension reduction steps. The Rad-score was formed according to the linear combination of these ten features and corresponding coefficients, and then the prediction model was developed. The AUC of the model in training group was 0.933 (95%CI 0.862-1.000), the sensitivity was 92.3%, the specificity was 89.2%, and the model accuracy was 90.5%. The calibration curve showed the good calibration ( P=0.257). The AUC value in test group was 0.875 (95%CI 0.734-1.000), the sensitivity, specificity and accuracy were 72.7%, 87.5% and 81.5%. The calibration curve showed the good calibration ( P=0.125). Conclusion:The radiomics prediction model based on unenhanced CT texture analysis have application potential for the evaluation of WHO/ISUP grading of ccRCC.
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OBJECTIVE：To study the effects of different amounts of Euphorbiae Semen fatty oil in self-assembly micelles on intestinal absorption of 4 kinds of euphorbia （euphorbia L 1，L2，L3，L8）in rats. METHODS ：The self-assembled micelle solution containing 4 kinds of euphorbia was prepared by adding 4 kinds of euphorbia （40 mg/L）in excess ，using the fatty oil of Euphorbia Semen（0.2，0.4，1，4 g/L）and sodium deoxycholate as carriers. Totally 60 rats were collected to establish in-situ one-way intestinal perfusion model. Different intestinal segments （duodenum，jejunum，ileum，colon）were perfused with drug-containing intestinal perfusion fluid according to different dosage of Euphorbiae Semen fatty oil. HPLC method was adopted to determine the contents of 4 kinds of euphorbia in the intestinal perfusate before and after perfusion. The absorption rate constant （Ka）and apparent absorption coefficient （Peff）of 4 kinds of euphorbia in different intestinal segments were calculated. The ileum segment with better absorption was selected as the object to investigate and calculate the ac cumulative absorption of 4 kinds of euphorbia. RESULTS：The self-assembled micelles formed by different concentrations of fatty oil of Euphorbiae Semen could significantly increase the absorption of 4 kinds of euphorbia in different intestinal segments to different extents. When the dosage of Euphorbiae Semen fatty oil was 0.4 g/L，the intestinal absorption effect of 4 kinds of euphorbia were all the best ；the Peff was significantly increased，compared with no fat oil group （P＜0.05 or P＜ . According to the order of Ka and Peff of each intestinal ： segment in different fatty oil dosage groups ，the absorption 0531-89628590。E-mail：1310394709@qq.com effect of 4 kinds of euphorbia in each intestinal segment was the best in jejunum and the worst in colon. Compared with no fatty oil group ，when the amount of Euphorbiae Semen fatty oil w as 0.2-4 g/L，accumulative amount of 4 kinds of euphorbia in the ileum of rats increased significantly （P＜0.05 or P＜0.01）， and the highest in 0.4 g/L Euphorbiae Semen fatty oil group. CONCLUSIONS ：The self-assembly micelle s composed of Euphorbiae Semen fatty oil and deoxycholate can increase the absorption of euphorbia L 1，L2，L3，L8 in each intestinal segment to different extent，and the jejunum is the main absorption segment.
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Age-related macular degeneration (AMD) is one of the leading causes of blindness for the elderly over 50, characterized by loss of central vision irreversibly.The mechanism of AMD is not clear.In recent years, researchers have screened a variety of AMD-related genes ( CFH, ARMS2, HTRA1, etc.) and single nucleotide polymorphisms (SNPs) through genome-wide association study (GWAS). By testing these specific loci in high-risk populations, we can predict the risk of AMD, the subtypes, how AMD would develop, and how patients would react to treatment.There are few breakthroughs in the pathogenesis of the disease.Gene therapy focuses on anti-vascular endothelial growth factor (VEGF), complement pathway inhibition and RNA interference, by expressing functional proteins through transfection of adeno-associated virus vectors, but the safety and efficacy remains to be further evaluated.
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Retinal vein occlusion (RVO) is one of the most common diseases severely threatening visual acuity.There is not a complete consensus on the clinical treatment strategies and schemes,and no guideline or consensus has been published in China.The publication of the latest international guidelines has provided more comprehensive and clear suggestions and advices for treatment and management strategies for RVO.Reading and understanding those guidelines could provide references for clinical practice,and offer help for standard diagnosis and treatment.
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Retinal vein occlusion (RVO) is one of the most common diseases severely threatening visual acuity.There is not a complete consensus on the clinical treatment strategies and schemes, and no guideline or consensus has been published in China.The publication of the latest international guidelines has provided more comprehensive and clear suggestions and advices for treatment and management strategies for RVO.Reading and understanding those guidelines could provide references for clinical practice, and offer help for standard diagnosis and treatment.
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@#This study aimed to investigate the antitumor efficacy of a single-chain variable fragment JZC00 combined with 2-deoxyglucose(2-DG)on murine non-small lung cancer cell and breast cancer cell models. JZC00 was expressed by E. coli and identified using SDS-PAGE and Western blot. The combination inhibited the proliferation of LLC and 4T1 cells. The concentration of glucose and lactic acid in the medium were determined by glucose and lactate kit, respectively, then calculated the tumor cell glucose uptake inhibition rate and lactate release inhibition rate. In vivo, the tumor volume and tumor weight were analyzed after 15-day treatment. The results showed that the molecular weight of JZC00 expressed was correct, and it could inhibit the proliferation of tumor cells in vitro. JZC00 and 2-DG could inhibit the glycolysis of tumor cells, respectively, and JZC00 combined with 2-DG could inhibit glycolysis synergistically. When hypoxic microenvironment was induced in vitro, the inhibition of glycolysis by JZC00 treatment decreased. However, it was reversed with the addition of 2-DG. The in vivo models the combination showed a significantly improved tumor suppressive effect compared with JZC00 treated group, suggesting that 2-DG could improve the anti-tumor effect of anti-angiogenic antibodies and its combination has the potentialial value in the treatment of solid tumors.
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Objective@#To observe the safety and impact of short-term anticoagulant therapy on prognosis after selective percutaneous coronary intervention (PCI) in patients with coronary artery disease.@*Methods@#From January 2013 to December 2013, 9 769 consecutive patients underwent selective PCI in Fuwai Hospital were retrospectively included in this study. Patients were divided into two groups, including non-post-PCI anticoagulant therapy group and low-dose and short-time post-PCI anticoagulant therapy group (enoxaparin 0.4 ml/12 h or fondaparinux 2.5 mg/day by subcutaneous injection for 2-3 days after PCI). All patients were evaluated at 30 days, 180 days and 12 months for major adverse coronary and cerebral events (MACCE) including all-cause death, myocardial infarction, revascularization and stroke as well as in-stent thrombosis and bleeding events. Data from 1 755 pairs of patients were analysis after propensity score matching. The clinical outcomes were compared between groups by using Kaplan-Meier survival analysis before and after propensity score matching. Multivariable Cox analysis was used to define the impact and determinants of post-PCI anticoagulation on clinical outcomes.@*Results@#one thousand seven hundred and fifty-five (18.0%) patients didn′t receive post-PCI anticoagulation and 8 014 (82.0%) patients received post-PCI anticoagulation, 5 666 (58.0%) patients received enoxaparin and 2 348 (24.0%) patients received fondaparinux. Patients were younger and incidence of female patients was less, incidence of renal dysfunction and acute coronary syndrome were higher in low-dose and short-time post-PCI anticoagulant therapy group than in non-post-PCI anticoagulation group (all P<0.05). Similarly, patients with post-PCI anticoagulation were associated with more left main coronary artery lesion and branch lesion (P<0.05). Post-PCI anticoagulation patients were associated with less trans-femoral process, more drug-eluting stents implantation and less simple balloon dilatation (all P<0.05). Nine thousand seven hundred and seventeen (99.5%) patients completed 2 years follow up. Post-PCI anticoagulation patients had significantly lower 30-day all-cause death (0.05% (4 cases) vs. 0.46% (8 cases), P<0.001) and stroke (0 vs. 0.11% (2 cases), P=0.003), lower 180-day all-cause death (0.17% (14 cases) vs. 0.57% (10 cases), P=0.002), revascularization (2.07% (166 cases) vs. 3.71% (65 cases), P<0.001) and MACCE (3.49% (280 cases) vs. 5.47% (96 cases), P<0.001), lower 2-year revascularization (7.61% (610 cases) vs. 12.84% (225 cases), P<0.001) and MACCE (10.92 (875 cases) vs. 16.01% (281 cases), P<0.001). Multivariable Cox regression analysis showed that post-PCI anticoagulant therapy was an independent protective factor of 30-day (HR=0.17, 95%CI 0.05-0.62, P=0.007), 180-day all-cause death (HR=0.37, 95%CI 0.16-0.87, P=0.023) and MACCE (HR=0.74, 95%CI 0.58-0.94, P=0.013), 2-year MACCE (HR=0.71, 95%CI 0.62-0.81, P<0.001). After propensity score matching, post-PCI anticoagulation therapy remained as an independent protective factor of 30-day all-cause death (HR=0.11, 95%CI 0.01-0.92, P=0.042) and 2-year MACCE (HR=0.81, 95%CI 0.68-0.96, P=0.015).@*Conclusions@#Low-dose and short-time post-PCI anticoagulant therapy may decrease 30-day all-cause death, 180-day all-cause death and MACCE and 2-year MACCE, and meanwhile this option does not increase bleeding risk in patients underwent selective PCI.
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Objective@#To investigate the mechanism of chemokine-like factor superfamily member (CMTM) 5 on the proliferation of multiple myeloma cells.@*Methods@#RT-qPCR method was used to detect the expression and correlation of CMTM5, caspase3 and caspase9 in U266 after decitabine demethylation treatment; U266 transfected with pcDNA3.1 plasmid overexpressed CMTM5, then cell proliferation activity was detected by CCK-8 assay.@*Results@#Compared with the control group, the low-dose demethylation treatment increased mRNA expression of CMTM5, caspase3, and caspase9 in U266, and showed a time-dependent (P<0.01). The up-trend of CMTM5, caspase3, and caspase9 in the high-demethylation drug treatment group was more significant and also showed time-dependent (P<0.001); There was a significant positive correlation between CMTM5 and caspase3 (r=0.937) and caspase9 (r=0.945) in each group (P<0.001). After transfection of U266 with the pcDNA3.1-CMTM5 plasmid, overexpression of CMTM5 inhibited the cell proliferation activity compared with the control and pcDNA3.1-vector group.@*Conclusion@#Decitabine has a reductive effect on the low level of CMTM5 in U266 cells, and its recovery level is significantly positively correlated with caspase 3 and caspase9. Re-expression of CMTM5 inhibits the proliferative activity of U266.
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PURPOSE: Although the effect of lysosome-associated protein transmembrane 4 beta (LAPTM4B) on the proliferation, migration, and invasion of breast cancer (BC) cells has already been studied, its specific role in BC progression is still elusive. Here, we evaluated the effect of different levels of LAPTM4B expression on the proliferation, invasion, adhesion, and tumor formation abilities of BC cells in vitro, as well as on breast tumor progression in vivo. METHODS: We investigated the influence of LAPTM4B expression on MCF-7 cell proliferation, invasion, adhesion, and tube formation abilities in vitro through its overexpression or knockdown and on breast tumor progression in vivo. RESULTS: Cell growth curves and colony formation assays showed that LAPTM4B promoted the proliferation of breast tumor cells. Cell cycle analysis results revealed that LAPTM4B promoted the entry of cells from the G1 into the S phase. Transwell invasion and cell extracellular matrix adhesion assays showed that LAPTM4B overexpression increased the invasion and adhesion capabilities of MCF-7 cells. More branches were observed in MCF-7 cells overexpressing LAPTM4B under an electron microscope. In comparison with LAPTM4B overexpression, LAPTM4B knockdown decreased the expression of vascular endothelial growth factor-A and significantly inhibited the vasculogenic tube formation ability of tumors. These results were also verified with western blot analysis. CONCLUSION: LAPTM4B promoted the proliferation of MCF-7 cells through the downregulation of p21 (WAF1/CIP1) and caspase-3, and induced cell invasion, adhesion, and angiogenesis through the upregulation of hypoxia-inducible factor 1 alpha, matrix metalloproteinase 2 (MMP2), and MMP9 expression. This specific role deems LAPTM4B as a potential therapeutic target for BC treatment.
Subject(s)
Blotting, Western , Breast Neoplasms , Breast , Caspase 3 , Cell Cycle , Disease Progression , Down-Regulation , Extracellular Matrix , Hypoxia-Inducible Factor 1 , In Vitro Techniques , Matrix Metalloproteinase 2 , MCF-7 Cells , S Phase , Up-Regulation , Vascular Endothelial Growth Factor AABSTRACT
Objective@#Patients with acute coronary syndrome due to multivessel disease (MVD) were at the highest risk of adverse cardiovascular events. Neutrophil to lymphocyte ratio (NLR) was proposed as a marker of cardiovascular risk. Present study evaluated the independent predictive value of NLR for acute myocardial infarction (AMI) patients with MVD.@*Methods@#AMI patients with MVD (n=1 433) underwent percutaneous coronary intervention (PCI) between January 2013 and December 2013 were followed up for 2 years. Patients were divided into 2 sub-groups based on an optimal cut off value of NLR to predict 2-year all-cause mortality. The primary endpoint was all-cause death. The secondary endpoint was long-term major adverse cardiovascular and cerebrovascular events (MACCE).@*Results@#By receiver operating characteristics curve analysis, the optimal cut-off value of admission NLR to predict 2-year all-cause mortality was 3.39 (area under the curve 0.765, sensitivity 71%, specificity 73%). The high NLR group(n=396) had higher prevalence of prior myocardial infarction, prior PCI and intra-aortic balloon pump use (IABP)(P<0.01). Compared to the low NLR group (n=1 037), patients in the high NLR group were older, had higher level of neutrophil count and high-sensitivity C-reactive protein (hs-CRP) (P<0.001), but lower level of lymphocyte count, estimated glomerular filtration rate (eGFR) and ejection fraction (P<0.001). During the follow-up period, rate of long-term all-cause death was significantly higher in the high NLR group than in the low NLR group (5.1% (20/396) vs. 0.8% (8/1 037), P<0.001). Cardiac death (4.0% (16/396) vs. 0.7% (7/1 037), P<0.001) and MACCE (21.7% (86/396) vs. 12.6% (131/1 037), P<0.001) were also significantly higher in the high NLR group than in the low NLR group. Multivariate Cox analysis showed that NLR ≥ 3.39 was determined as an independent predictor of 2-year all-cause mortality (HR=3.23, 95%CI 1.38-7.54, P=0.007) and MACCE (HR=1.58, 95%CI 1.19-2.10, P=0.002) in this patient cohort after adjusting for other risk factors. Correlation analysis showed that the NLR was positively correlated with hs-CRP levels (r=0.241, P<0.001).@*Conclusion@#Our study demonstrates that admission NLR ≥ 3.39 is an independent predictor of long term all cause death and MACCE in AMI patients with MVD post PCI.
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Objective@#To investigate the impact of coronary lesion calcification on the long-term outcome of patients with coronary heart disease after percutaneous coronary intervention.@*Methods@#In this prospective observational study, a total of 10 119 consecutive patients with coronary heart disease undergoing percutaneous coronary intervention from January 1 to December 31, 2 103 in our hospital were enrolled. The patients were divided into non/mild calcification group (8 268 cases) and moderate/severe calcification group (1 851 cases) according to the angiographic results. The primary endpoint was one-year major adverse cardiovascular events (MACE), including all-cause death, myocardial infarction, and target vessel revascularization.@*Results@#The patients were (58.3±10.3) years old, and there were 2 355 females (23.3%). Compared with non/mild calcification group, patients in the moderate/severe calcification group were older ((60.0±10.6) years vs. (57.9±10.2) years, P<0.01), and had higher proportion of female (25.4% (470/1 851) vs. 22.8% (1 885/8 268), P=0.02), debates (33.9% (628/1 851) vs. 29.0% (2 399/8 268), P<0.01), hypertension (68.0% (1 259/1 851) vs. 63.7% (5 264/8 268), P<0.01), coronary artery bypass grafting (4.6% (85/1 851) vs. 3.2% (268/8 268), P<0.01), stroke (12.6% (233/1 851) vs. 10.4% (861/8 268), P=0.01), and renal dysfunction (6.2% (115/1 851) vs. 3.7% (303/8 268), P<0.01). Compared with non/mild calcification group, patients in themoderate/severe calcification group experienced longer procedure time (37 (24, 61) min vs. 27 (17,40) min, P<0.01) and stent length was longer (32 (23,48) mm vs. 27 (18,38) mm, P<0.01), and percent of rotational atherectomy was higher (2.56%(57/2 229) vs. 0.03% (3/11 930), P<0.01). One-year follow-up results showed that MACE (7.5% (139/1 846) vs. 4.9% (402/8 243), P<0.01), all-cause death (1.0% (19/1 846) vs. 0.6% (49/8 243), P=0.04), myocardial infarction (2.2% (41/1 846) vs. 1.4% (114/8 243), P=0.01), and target vessel revascularization (5.0% (92/1 846) vs. 3.2% (266/8 243), P<0.01) were all significantly higher in moderate/severe calcification group than in non/mild group. Multivariate Cox regression analysis showed that moderate/severe calcification was an independent predictor of MACE at one-year after the procedure (HR=1.41, 95%CI 1.16-1.72, P<0.01).@*Conclusion@#Moderate/severe calcification in coronary lesion is an independent predictor of long-term poor prognosis in coronary heart disease patients undergoing percutaneous coronary intervention.
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Objective@#To clarify the effect of TRAF2 in the biological behavior of gastric cancer and explore the mechanism.@*Methods@#TRAF2 stably depleted AGS cell was established. Cell growth was monitored by x-CELLigence system. Cell proliferation was detected using cell viability assay. The apoptosis and cell cycle were detected by flow cytometry. The difference of migration and invasion abilities were measured by real-time xCELLigence system and Transwell. The expression and activity of NF-κB signaling pathway were measured by western blot and TransAM assay. The expression of TRAF2 in gastric cancer tissue and its clinical significance were detected by immunohistochemistry.@*Results@#The cell index of AGS-siTRAF2 cells was significantly lower than that of AGS-sictrl cells at 8 h. In the cell viability assay, the A values of AGS-siTRAF2 cells were 51 296.00±2 631.06, 68 389.25±6 703.21 and 65 559.50±6 339.22 at 24 h, 48 h and 72 h. The values of the viability of AGS-siTRAF2 cells were significantly lower than those of AGS-sictrl cells (P<0.001). The results of flow cytometry showed that the apoptosis rates of AGS-siTRAF2 cells were (1.42±0.07)%, (2.98±0.11)% and (1.56±0.03)% at 24 h, 48 h and 72 h, respectively, which were significantly higher than those of AGS-sictrl cells (all P<0.05). The distribution of S phase in AGS-siTRAF2 cells was (23.57±1.12)%, while that in the AGS-sictrl cells was (19.49±1.19)%. The difference was statistically significant (P=0.012). AGS-siTRAF2 cells migrated much slower than AGS-sictrl cells from 3 h and the number of migrated AGS-sictrl cells was 121.7±6.7 while that of AGS-siTRAF2 cells was 84.0±6.6 (P=0.002). The cell index of AGS-siTRAF2 cells was less than that of AGS-sictrl cells from 3 h. In Transwell assay, the number of invaded AGS-sictrl cells was 109.3±3.1 after 24 h of culture, significantly higher than 79.0±6.2 of AGS-siTRAF2 cells (P=0.002). Western blot analysis showed that the expression levels of RelA, RelB, p50 and p52 in AGS-siTRAF2 cells were significantly lower than those in AGS-sictrl cells. The activities of RelA, RelB, p50 and p52 in AGS-siTRAF2 cells were 0.01±0.00, 0.01±0.01, 0.92±0.01 and 0.53±0.03, respectively, significantly lower than those of AGS-sictrl cells (all P<0.001). High TRAF2 expression (TRAF2-high) was found in 53.0% of GC samples, while TRAF2-high was only observed in 38.0% of the paired adjacent tissues (P=0.033). The expression of TRAF2 was significantly higher in the tubular adenocarcinoma, poor differentiation advanced T, advanced N, and clinical staging (P<0.05). The median survival time were 17 months and 78 months in the TRAF2 high-expression and low-expression groups, respectively, and the difference was statistically significant (P=0.010).@*Conclusions@#Depletion of TRAF2 inhibits the AGS cell growth, migration and invasion. The expression of TRAF2 is increased in gastric tumor tissue. The expression of TRAF2 is associated with the prognosis of gastric cancer.
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Objective@#To compare the clinical characteristics and long-term prognosis between male and female patients with premature coronary artery disease (PCAD) post coronary intervention, and analyse the risk factors of major adverse cardio-cerebrovascular events (MACCE) and bleeding events.@*Methods@#This was a prospective single-center observational study. From January 2013 to December 2013, 4 744 patients diagnosed as PCAD and treated with percutaneous coronary intervention (PCI) in Fuwai Hospital were enrolled. The general clinical data, laboratory results and interventional treatment data of all patients were collected, and patients were followed up for 2 years after PCI and the incidence of events including MACCE and bleeding was analyzed. The baseline data and clinical events of PCAD patients of different genders were compared. Survival curves were estimated by Kaplan-Meier method. Univariate and multivariate Cox regression were used to analyze whether gender was an influencing factor of different clinical events of PCAD patients within 2 years after PCI, and other relevant influencing factors of MACCE and bleeding events.@*Results@#Among the 4 744 PCAD patients included, there were 3 390 (71.5%) male aged (47.0±5.4) years old and 1 354 (28.5%) female aged (57.0±5.8) years old. Compared with female patients, male patients had higher body mass index, higher proportion of hyperlipidemia, smoking, myocardial infarction, previous PCI, preoperative estimated glomerular filtration rate, ST-segment elevation myocardial infarction, radial artery approach, intravenous ultrasound use and chronic occlusive lesions (all P<0.05). Age, left ventricular ejection fraction, prevalence of hypertension, diabetes mellitus, past stroke history, non-ST-segment elevation acute coronary syndrome (NSTE-ACS) and the use of calcium channel blockers were lower in male patients than in female patients (all P<0.05). The 2-year follow-up results showed that the incidence of BARC type 1 hemorrhage was significantly higher in female patients than in male patients (6.9%(92/1 343) vs. 3.7%(126/3 378), P<0.001); however, the incidence of MACCE, all-cause death, cardiac death, recurrent myocardial infarction, revascularization (target vessel revascularization and target lesion revascularization), stent thrombosis, stroke and BARC type 2-5 hemorrhage were similar between the two groups (all P>0.05). Multivariate Cox regression analysis showed that gender was an independent risk factor for BARC type 1 bleeding in PCAD patients (HR=2.180, 95%CI 1.392-3.416, P<0.001), but it was not an independent risk factor for MACCE and BARC type 2-5 bleeding(all P>0.05). Hyperlipidemia, preoperative SYNTAX score, multivessel lesions and NSTE-ACS were the independent risk factors for MACCE in PCAD patients with PCI (the HRs(95%CI) were 1.289(1.052-1.580), 1.030(1.019-1.042), 1.758(1.365-2.264), 1.264(1.040-1.537), respectively); gender (HR=1.579, 95%CI 1.085-2.297, P=0.017), hyperlipidemia (HR=1.305, 95%CI 1.005-1.695, P=0.046), anticoagulant drugs including low molecular weight heparin (HR=1.321, 95%CI 1.002-1.741, P=0.048) or sulfonate(HR=1.659, 95%CI 1.198-2.298, P=0.002) were the independent risk factors for bleeding events.@*Conclusions@#There are differences in clinical and coronary artery lesion characteristics between different genders in patients with PCAD. The incidence of minor bleeding is significantly higher in female PCAD patients than in male PCAD patients. Hyperlipidemia, preoperative SYNTAX score, multivessel lesions and NSTE-ACS are the independent risk factors for MACCE, and gender, hyperlipidemia, anticoagulant drugs including low molecular weight heparin or sulfonate are the independent risk factors for bleeding events in patients with PCAD.
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Objective The application of flash glucose monitoring ( FGM) in type 1 diabetes could diminish the frequency of hypoglycaemia, however, how FGM improving the glycaemic control target (e.g. HbA1C) is waited to be investigated. Methods Seventy type 1 diabetic patients were recruited from December 2017 to July 2018 in the First Affiliated Hospital of Nanjing Medical University. Their demographic data, use of FGM and HbA1C level were collected. Results We observed that type 1 diabetic patients wearing the FGM showed lower insulin dose [(0.562± 0.059)U/kg vs (0.772±0.049)U/kg, P=0.008)], shorter diabetic duration[2.0(0.8-6.0) vs 6.0(2.5-10), P=0.013], lower HbA1C value [6.8％(6.2％-7.7％) vs 8.0％(6.9％-9.4％), P=0.001]. Nevertheless, after adjusting the potential confounders, the level of HbA1C in patients wearing FGM was significantly lower than those without FGM. Moreover, it was independent of other factors, such as the dose of insulin and the insulin delivery method. Conclusion Type 1 diabetic patients wearing FGM had lower HbA1C value but it needs further follow-up to confirm the improvement of glycaemic control in type 1 diabetes with the use of FGM.
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Objective To evaluate the effect of transversus abdominis plane (TAP) block on postoperative cognitive function in elderly patients undergoing laparoscopic surgery under general anesthesia.Methods Forty-eight male patients undergoing laparoscopic tension-free repair of inguinal hernia under general anesthesia,aged 65-75 yr,of American Society of Anesthesiologists physical status Ⅱ or Ⅲ,with body mass index of 20-28 kg/m2,were divided into 2 groups (n =24 each) using a random number table method:TAP block combined with general anesthesia group (group TG) and general anesthesia group (group G).Anesthesia was induced with midazolam,cisatracurium besylate,sufentanil and etomidate,and the patients were mechanically ventilated after laryngeal mask airway insertion.TAP block was performed through the anterior superior iliac spine approach,and 0.25％ ropivacaine 30 ml was injected in group TG.Anesthesia was maintained by target-controlled infusion of propofol and remifentanil and muscle relaxation by intravenously injecting cisatracurium.The occurrence of cerebral regional oxygen saturation (rSO2) and low rSO2 events (rSO2 ＜60％) was recorded at 1 min before anesthesia induction (T0),5 min after inserting the laryngeal mask airway (T1),at skin incision (T2),30 min after skin incision (T3),and at the end of surgery (T4).The consumption of propofol and remifentanil was recorded during surgery.Montreal Cognitive Assessment (MoCA) was used to evaluate the cognitive function of patients at 1 day before surgery and 7 days after surgery,and the development of postoperative cognitive dysfunction (POCD,MoCA scores＜ 26) was recorded.Results Compared with group G,the intraoperative consumption of propofol and remifentanil was significantly reduced,rSO2 was increased at T2~,and the incidence of low rSO2 events was decreased,MoCA scores were increased at 7 days after surgery,and the incidence of POCD was decreased in group TG (P＜0.05).Conclusion TAP block can reduce the incidence of POCD in elderly patients undergoing laparoscopic surgery under general anesthesia.
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Objective To investigate the clinicopathological features of undifferentiated pancreatic carcinoma with osteoclast-like giant cells (UOC).Methods Clinical and pathological data of 6 patients with UOC admitted in Navy Medical University affiliated Changhai Hospital from April 2011 to December 2017 were retrospectively analyzed.The expressions of Cam5.2,EMA,CD68,vimentin,lysozyme,E-cad,C-erbB-2,p53,MUC1,MLH1,MSH2,MSH6,Osteoponin and Ki-67 were detected by immunohistochemistry,and Kras gene mutations was measured by fluorescence quantitative PCR method.Results There were two main types of UOC cells.One type was oval or spindle mononuclear tumor cells,and the other was osteoclast-like giant cells scattered among mononuclear cells.Immunohistochemical staining results showed that the epithelial markers like CAM5.2,EMA,E-cad,MLH1,MSH2,MSH6 and Ki-67 of the components of ductal adenocarcinoma in 6 UOC patients were all positively expressed,and the mesenchymal markers like vimentin,CD68,lysozyme and tumor-related markers like Her-2,p53 and MUC1 were all negatively expressed.Vimentin,CD68,lysozyme and Osteoponin were positively expressed in osteoclast-like giant cells,but epithelial markers like Cam5.2,EMA,E-cad,MLH1,MSH2 and MSH6 were negatively expressed.6 UOC patients all had K-ras codon 12 mutation,and the mutant type was GGT ＞ TGT,GGT ＞ GTT,GGT ＞ GCT,and no codon 13 mutation was observed.Conclusions Osteoclast-like giant cells may be reactive multinucleated giant cells rather than neoplastic components.