The predictive value of 18F-PSMA PET/CT-derived prostate specific membrane antigen expression parameters for the risk of metastasis in elderly prostate cancer patients / 中华老年医学杂志

Objective:To investigate the value of 18F-PSMA PET/CT-derived prostate specific membrane antigen(PSMA)expression parameters, including maximum standardize uptake value(SUV max), PSMA receptor expressing tumor volume(PSMA-TV), and total lesion PSMA receptor expression(TL-PSMA), in predicting the risk of metastasis in elderly prostate cancer patients aged 60 years and older. Methods:Clinical data of 39 patients with prostate cancer diagnosed in our hospital from January 2019 to May 2021 and imaging data of 18F-PSMA PET/CT before treatment were analyzed retrospectively.PSMA-TV and TL-PSMA of primary tumor tissue were calculated from PET/CT images with 40% of the SUV max as the threshold value.The influence of 18F-PSMA PET/CT on clinical TNM staging was evaluated.The Mann-Whitney U test was used to compare the differences in values of various indicators between the groups with or without metastasis, including the total prostate-specific antigen(tPSA)level, Gleason score and PSMA expression parameters.The correlation of PSMA expression parameters with tPSA and Gleason score was analyzed.The area under the receiver operating characteristic(ROC)curve(AUC)was used to determine the predictive ability of different indicators for the risk of prostate cancer metastasis, and multivariate logistic regression analysis was used to screen for independent predictors of prostate cancer metastasis. Results:The Gleason score of 39 prostate cancer patients(median age: 67 years, age range: 60-83 years)was 7.0(7.0, 8.0), and the median prostate specific antigen(PSA)level was 14.83(7.37, 30.93)μg/L.There were 11 cases(28.2%)with metastasis(the metastasis group), and 28 cases(71.8%)without metastasis(the non-metastasis group). Based on PET/CT, the clinical N and M stages of five patients(12.8%)were changed, but two cases(5.1%)with pelvic lymph node metastasis were missed.The median ages of the metastasis group and the non-metastasis group were 63(60-79)years and 69(60-83)years, respectively, and the difference was not statistically significant( P=0.115). The metastasis group and the non-metastasis group had tPSA levels at 54.0(9.9, 75.8)μg/L and 10.2(6.8, 22.8)μg/L, the SUV max at 29.1(16.8, 35.3)and 7.7(6.0, 13.6), the PSMA-TV at 41.5(22.4, 90.9)cm 3 and 6.8(3.6, 9.3)cm 3, TL-PSMA at 279(139.7, 996.4)and 25.5(15.9, 37.0), Gleason scores at 8.0(7.0, 8.0)and 7.0(7.0, 8.0), respectively.There were statistically significant differences in tPSA( Z=-2.528, P=0.011), SUV max( Z=-4.151, P<0.001), PSMA-TV( Z=-3.995, P<0.001)and TL-PSMA( Z=-4.213, P<0.001)between the two groups.SUV max( r=0.537, P<0.01), PSMA-TV( r=0.496, P<0.01)and TL-PSMA( r=0.508, P<0.01)were all positively correlated with tPSA.Furthermore, SUV max( r=0.547, P<0.01), PSMA-TV( r=0.412, P<0.01)and TL-PSMA( r=0.433, P<0.01)were also positively correlated with Gleason score.ROC curve analysis showed that the AUCs of SUV max, PSMA-TV, TL-PSMA and tPSA in predicting prostate cancer metastasis were 0.932, 0.916, 0.938 and 0.763, respectively.Multivariate Logistic regression analysis showed that SUV max( OR=1.203, 95% CI: 1.001-1.445, P=0.049)was an independent predictor of prostate cancer metastasis. Conclusions:These PSMA expression parameters of 18F-PSMA PET/CT have a good value in predicting the risk of metastasis in elderly prostate cancer patients, and SUV maxmay serve as a potential molecular imaging indicator to independently predict prostate cancer metastasis.

Clinical study on the efficacy of domestic Firebird2 TM rapamycin eluting stent and imported Endeavor Resolute stent / 中国综合临床

Objective:To compare the safety and efficacy of domestic Firebird2 TM rapamycin eluting stent and imported Endeavor Resolute stent in the treatment of coronary heart disease patients. Methods:The clinical data of 889 patients with coronary heart disease who underwent percutaneous coronary intervention (PCI) in Wuhan Asian heart hospital from 2010 to 2015 were analyzed retrospectively A case-control study was conducted. According to the type of stent used, 550 cases were divided into domestic Firebird 2TM group and 325 cases were divided into imported endeavor resolve group The incidence of major adverse cardiovascular events (MACE) was compared between the two groups. All patients was followed up for 1 year.Results:There was no significant difference in gender, age, body mass index, medical diseases, whether it was emergency PCI, previous PCI history, coronary artery bypass grafting history and left ventricular between the two groups (all P>0.05). The success rate of PCI in the two groups was 100%. The TIMI blood flow of target vessels in the two groups was grade 3. There was no stent unloading during the operation, and balloon pretreatment and post-treatment were performed. The results of one-year follow-up showed that there was no significant difference in the incidence of mace (3.1% (17/550) and 2.2%(7/325)) and the incidence of independent end points between domestic Firebird 2 TM group and endeavor group (all P>0.05); There was no significant difference in survival without mac between the two groups ( P>0.05). Conclusion:The domestic Firebird2 TM rapamycin eluting stent has the same clinical efficacy as the imported Endeavor Resolute drug eluting stent.

The correlation between metabolic parameters in (18)F-FDG PET-CT and solid and micropapillary histological subtypes in lung adenocarcinoma / 中华肿瘤杂志

Objective: Solid and micropapillary pattern are highly invasive histologic subtypes in lung adenocarcinoma and are associated with poor prognosis while the biopsy sample is not enough for the accurate histological diagnosis. This study aims to assess the correlation and predictive efficacy between metabolic parameters in (18)F-fluorodeoxy glucose positron emission tomography/computed tomography ((18)F-FDG PET-CT), including the maximum SUV (SUV(max)), metabolic tumor volume (MTV), total lesion glycolysis (TLG) and solid and micropapillary histological subtypes in lung adenocarcinoma. Methods: A total of 145 resected lung adenocarcinomas were included. The clinical data and preoperative (18)F-FDG PET-CT data were retrospectively analyzed. Mann-Whitney U test was used for the comparison of the metabolic parameters between solid and micropapillary subtype group and other subtypes group. Receiver operating characteristic (ROC) curve and areas under curve (AUC) were used for evaluating the prediction efficacy of metabolic parameters for solid or micropapillary patterns. Univariate and multivariate analyses were conducted to determine the prediction factors of the presence of solid or micropapillary subtypes. Results: Median SUV(max) and TLG in solid and papillary predominant subtypes group (15.07 and 34.98, respectively) were significantly higher than those in other subtypes predominant group (6.03 and 10.16, respectively, P<0.05). ROC curve revealed that SUV(max) and TLG had good efficacy for prediction of solid and micropapillary predominant subtypes [AUC=0.811(95% CI: 0.715~0.907) and 0.725(95% CI: 0.610~0.840), P<0.05]. Median SUV(max) and TLG in lung adenocarcinoma with the solid or micropapillary patterns (11.58 and 22.81, respectively) were significantly higher than those in tumors without solid and micropapillary patterns (4.27 and 6.33, respectively, P<0.05). ROC curve revealed that SUV(max) and TLG had good efficacy for predicting the presence of solid or micropapillary patterns [AUC=0.757(95% CI: 0.679~0.834) and 0.681(95% CI: 0.595~0.768), P<0.005]. Multivariate logistic analysis showed that the clinical stage (Stage Ⅲ-Ⅳ), SUV(max) ≥10.27 and TLG≥7.12 were the independent predictive factors of the presence of solid or micropapillary patterns (P<0.05). Conclusions: Preoperative SUV(max) and TLG of lung adenocarcinoma have good prediction efficacy for the presence of solid or micropapillary patterns, especially for the solid and micropapillary predominant subtypes and are independent factors of the presence of solid or micropapillary patterns.

Domestic and international research progress of edible and medicinal Arecae Semen / 中国中药杂志

Arecae Semen, as the first place among "Four South Medicines" in China, has great dual-use value of medicine and food. The research of Arecae Semen was mainly focused on the active ingredients and efficacy value, and its potential safety hazards were also concerned. Until now, there is still a lack of clear boundaries between medicine and food, resulting in its safety cannot be guaranteed. Therefore, it is of great significance to establish clear boundaries of medicine and food use and health risk assessment. In this paper, the differences of pretreatment and application methods of Arecae Semen were analyzed, and the research progress of Arecae Semen in chemical composition identification and toxicology research and safety evaluation were reviewed emphatically. Finally, the differences of quality control and safety evaluation of Arecae Semen in pharmacopoeias or standards were analyzed at home and abroad. It was expected to provide reference value for quality control, safety evaluation and international standardization research of Arecae Semen.

Appraisal of Guidelines for the Management of Blood Pressure in Patients with Diabetes Mellitus: The Consensuses, Controversies and Gaps

Background@#Currently available guidelines contain conflicting recommendations on the management of blood pressure (BP) in patients with diabetes mellitus (DM). Therefore, it is necessary to appraise the guidelines and summarize the agreements and differences among recommendations. @*Methods@#Four databases and the websites of guideline organizations were searched for guidelines regarding BP targets and thresholds for pharmacologic therapy in DM patients, and the included guidelines were appraised with the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument. @*Results@#In 6,498 records identified, 20 guidelines met our inclusion criteria with 64.0% AGREE II scores (interquartile range, 48.5% to 72.0%). The scores of the European and American guidelines were superior to those of the Asian guidelines (both adjusted P140 mm Hg (10 guidelines, 50%) and diastolic BP thresholds >90 mm Hg (nine guidelines, 45%). The tiny minority of the guidelines provided the relevant recommendations regarding the lower limit of official BP targets and the ambulatory BP monitoring (ABPM)/home BP monitoring (HBPM) targets and thresholds in DM patients. @*Conclusion@#The lower official BP targets (<130/80 mm Hg) in patients with DM are advocated by most of the guidelines, but they contain conflicting recommendations on the official BP thresholds. Moreover, the gaps regarding the lower limit of official BP targets and the ABPM/HBPM targets and thresholds need to be considered by future study.

Appraisal of Guidelines for the Management of Blood Pressure in Patients with Diabetes Mellitus: The Consensuses, Controversies and Gaps

Background@#Currently available guidelines contain conflicting recommendations on the management of blood pressure (BP) in patients with diabetes mellitus (DM). Therefore, it is necessary to appraise the guidelines and summarize the agreements and differences among recommendations. @*Methods@#Four databases and the websites of guideline organizations were searched for guidelines regarding BP targets and thresholds for pharmacologic therapy in DM patients, and the included guidelines were appraised with the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument. @*Results@#In 6,498 records identified, 20 guidelines met our inclusion criteria with 64.0% AGREE II scores (interquartile range, 48.5% to 72.0%). The scores of the European and American guidelines were superior to those of the Asian guidelines (both adjusted P140 mm Hg (10 guidelines, 50%) and diastolic BP thresholds >90 mm Hg (nine guidelines, 45%). The tiny minority of the guidelines provided the relevant recommendations regarding the lower limit of official BP targets and the ambulatory BP monitoring (ABPM)/home BP monitoring (HBPM) targets and thresholds in DM patients. @*Conclusion@#The lower official BP targets (<130/80 mm Hg) in patients with DM are advocated by most of the guidelines, but they contain conflicting recommendations on the official BP thresholds. Moreover, the gaps regarding the lower limit of official BP targets and the ABPM/HBPM targets and thresholds need to be considered by future study.

Analysis of fungal diversity on the surface of Armeniacae Semen Amarum using a DNA metabarcoding technique / 药学学报

Medicinal and edible Armeniacae Semen Amarum (ASA) is susceptible to fungal contamination because it is rich in oil and other nutrients. In this study, the fungal community diversity in ASA samples was analyzed based on a DNA metabarcoding technique to provide evidence for its safe use. Twelve batches of ASA samples samples from four medicinal material markets and three processing approaches were collected. Total DNA was extracted, the ITS2 sequences were amplified, and high-throughput sequencing was performed using the Illumina MiSeq PE300 platform. The results show that Ascomycota was the most dominant fungus in ASA samples. The predominant genus in sample SW1_P was Diutina, whereas the most predominant genus in the other samples was Aspergillus. Three harmful fungi were identified, namely, Aspergillus flavus, Wallemia sebi, and Rhizopus arrhizus. In addition, significant differences were observed in the relative abundance of Botryosphaeriales and Alternaria in ASA samples from different collection sites. Meanwhile, there were significant differences in the relative abundance of Hypocreales and Cladosporium in ASA samples from different processing approaches. In summary, the DNA metabarcoding technique can effectively clarify the fungal community diversity and quickly detect potential toxigenic fungi in ASA samples, thus providing a warning for mycotoxin contamination.

MCDB: A comprehensive curated mitotic catastrophe database for retrieval, protein sequence alignment, and target prediction

Mitotic catastrophe (MC) is a form of programmed cell death induced by mitotic process disorders, which is very important in tumor prevention, development, and drug resistance. Because rapidly increased data for MC is vigorously promoting the tumor-related biomedical and clinical study, it is urgent for us to develop a professional and comprehensive database to curate MC-related data. Mitotic Catastrophe Database (MCDB) consists of 1214 genes/proteins and 5014 compounds collected and organized from more than 8000 research articles. Also, MCDB defines the confidence level, classification criteria, and uniform naming rules for MC-related data, which greatly improves data reliability and retrieval convenience. Moreover, MCDB develops protein sequence alignment and target prediction functions. The former can be used to predict new potential MC-related genes and proteins, and the latter can facilitate the identification of potential target proteins of unknown MC-related compounds. In short, MCDB is such a proprietary, standard, and comprehensive database for MC-relate data that will facilitate the exploration of MC from chemists to biologists in the fields of medicinal chemistry, molecular biology, bioinformatics, oncology and so on. The MCDB is distributed on http://www.combio-lezhang.online/MCDB/index_html/.

The association between the frequency of prenatal care in childbearing aged women and risk of small for gestational age among neonatal twins in Shaanxi Province / 中华预防医学杂志

To explore the association between the frequency of prenatal care in childbearing aged women and risk of small for gestational age (SGA) among neonatal twins in Shaanxi Province. From July to December 2013, a total of 30 027 childbearing aged women, who were pregnant from January 2010 to November 2013 and had definite outcomes, were selected from 30 districts (counties) of Shaanxi Province by using the multi-stage random sampling method. The questionnaires with a face-to-face survey method were used to retrospectively collect demographic information, pregnancy history, lifestyle during pregnancy, disease history, nutritional supplements, and health care during pregnancy. Information on the gestational age and birth weight of the newborn were obtained by consulting the medical certificate of birth and were registered as twin A and twin B by birth order. Finally, 356 childbearing aged women and their twin babies with complete data were included in the analysis. A generalized estimation equation model was used to analyze the association between the frequency of prenatal care and the risk of SGA among neonatal twins. The age of childbearing aged women was (27.44±4.68) years old, of which 79.49% (283 women) were rural residents and 44.38% (158 women) had seven or more times prenatal care. The gestational age and birth weight were (37.64±2.51) weeks and (2 510±497) g, respectively. The prevalence of SGA was 51.40% (183/356) for twin A and 53.37% (190/356) for twin B, respectively. The prevalence of SGA was 44.30% (70/158) for twin A with seven or more times prenatal care and 42.41% (67/158) for twin B with seven or more times prenatal care, which was lower than that for twins with less than seven times prenatal care, respectively [57.07% (113/198) and 62.12% (123/198)] ( values were 0.017 and <0.001). The results of generalized estimation equation model suggested that compared to those with less than seven times prenatal care, after adjusting for parity, birth order, place of residence, maternal age, occupation, education, family wealth index, passive smoking, pregnancy-induced hypertension syndrome, folic acid, and iron supplement during perinatal period, and gender of the newborn, the (95) of risk of SGA among childbearing aged women with seven or more times prenatal care was 0.60 (0.40-0.91). Seven or more times prenatal care could reduce the risk of SGA among neonatal twins in Shanxi Province.

Evaluation and Early Diagnosis of Gastrointestinal Failure in Acute Pancreatitis / 中国医学科学院学报

To investigate the application of Acute Gastrointestinal Injury(AGI) grading in evaluating gastrointestinal failure in patients with acute pancreatitis(AP). In this retrospective observational study,patients presented with moderate severe AP and severe AP in our hospital from October 2013 to October 2016 were consecutively enrolled.Logistic regression analysis and receiver operating characteristic curve were used to explore and evaluate potential predictors of gastrointestinal failure. A total of 202 patients were included in this study,with 90 cases(44.6%) identified as gastrointestinal failure.Survival curve showed significantly increased risk of death in patients with gastrointestinal failure( < 0.05).Logistic regression analysis showed age(=1.06,95%:1.03-1.09,<0.001),complaint of stopping flatus and defecation(=7.02,95%:2.08-23.66,=0.002),increased counts of white blood cells in peripheral blood(=1.09,95%:1.02-1.17,=0.015),decreased level of serum albumin(=0.93,95%:0.86-1.00,=0.048),and increased level of serum creatinine at admission(=1.02,95%:1.01-1.04,=0.001) were the independent risk factors of gastrointestinal failure.The area under curves of Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) and Beside Index for Severity in Acute Pancreatitis (BISAP) scores in diagnosing gastrointestinal failure were 0.999 and 0.782,respectively. Gastrointestinal failure can remarkably increase the risk of death in patients with AP.Both APACHE Ⅱ and BISAP scores at admission are useful in diagnosing gastrointestinal failure in patients with AP.

Preparation of exosome-coated Bcl-2 siRNA and its inhibitory effect on the growth of pancreatic cancer cells / 药学学报

High expression of Bcl-2 is associated with the development of pancreatic cancer, and downregulation of Bcl-2 is an effective approach for the treatment of pancreatic malignancy. In the present study exosomes were isolated from the cultured medium of human embryonic kidney cells (HEK293) by ultracentrifugation and exosome-coated Bcl-2 siRNA (exosiBcl-2) was synthesized using electroporation. The results showed that the particle size of exosiBcl-2 was 67.3 ± 9.7 nm and the morphology of exosomes displayed a concave ring structure as determined by transmission electron microscopy (TEM). Western blot analysis indicated that exosomal proteins including CD9, CD81, CD63 and TSG101 were highly expressed. Confocal microscopy revealed that exosiBcl-2 was widely distributed in Miapaca-2 cells, and the transfection efficiency of exosiBcl-2 in Miapaca-2 was 77.2% as determined by flow cytometry. Treatment with exosiBcl-2 at a concentration of 100 nmol·L-1 resulted in an inhibitory effect on the growth of Miapaca-2 cells with an inhibition rate of 63%. ExosiBcl-2 treatment can downregulate Bcl-2 and upregulate Bax protein. This study provides evidence that exosiBcl-2 is able to inhibit the growth of pancreatic cancer cells and the nanoparticles have potential to be developed as a novel anticancer agent.

Effect of dexmedetomidine on quality of recovery from anesthesia in elderly patients undergoing electroconvulsive therapy with propofol anesthesia / 中华麻醉学杂志

Objective:To evaluate the effect of dexmedetomidine on the quality of recovery from anesthesia in elderly patients undergoing electroconvulsive therapy (ECT) with propofol anesthesia.Methods:Sixty patients of both sexes, aged>65 yr, weighing 45-80 kg, of American Society of Anesthesiologists physical status Ⅰor Ⅱ, scheduled for elective ECT with propofol anesthesia, were assigned into 2 groups ( n=30 each) using a random number table method: control group (group C) and dexmedetomidine group (group D). Dexmedetomidine was intravenously infused in a dose of 0.2 μg/kg (in normal saline 10 ml) over 10 min starting from onset of anesthesia induction in group D, while normal saline 10 ml was given instead in group C. Propofol 1.0-1.5 mg/kg was intravenously injected slowly.Succinylcholine 0.7 mg/kg was intravenously injected after the eyelash reflex disappeared, and oxygen was delivered via a mask to assist artificial ventilation.The mask was removed when the muscle twitching disappeared during depolarization, treatment was performed with an ETC apparatus, and electroencephalogram was monitored.The electrical stimulus intensity was set according to the age of the patient during ECT treatment, and the initial intensity was set at 0.5 times the age of the patient. When the postictal suppression index was less than 80%, a higher level of stimulus intensity was used in the next ECT treatment (the difference between adjacent intensity levels was 25.2 mc, which was 5% of the total stimulus intensity). After the end of ECT procedure, participants were manually ventilated with a mask, and the patients were transferred to postanesthesia care unit when the spontaneous breathing was completely restored.The time to recovery of spontaneous breathing and emergence time were recorded.The development of adverse cardiovascular events, nausea and vomiting, respiratory depression, headache, drowsiness, agitation and delirium during recovery from anesthesia was also recorded. Results:Compared with group C, the incidence of agitation, delirium, hypertension and tachycardia during recovery from anesthesia was significantly decreased, and no significant change was found in the other variables in group D ( P<0.05). Conclusion:Dexmedetomidine can improve the quality of recovery from anesthesia in elderly patients undergoing ECT under propofol anesthesia.

Value of 99Tc m-DMSA renal SPECT/CT imaging in the diagnosis of upper urinary tract infection in adults / 中华核医学与分子影像杂志

Objective:To explore the diagnostic value of 99Tc m-dimercaptosuccinic acid (DMSA) renal SPECT/CT imaging in adult upper urinary tract infection. Methods:From September 2017 to December 2019, 99Tc m-DMSA renal SPECT/CT imaging and clinical data of 109 patients (14 males, 95 females; age: 23-85(60.0±14.1) years) suspected of upper urinary tract infection from Beijing Hospital were retrospectively analyzed. Final clinical diagnosis was regarded as the diagnostic standard. The diagnostic efficacy of 99Tc m-DMSA renal SPECT/CT imaging was analyzed and compared with that of 99Tc m-DMSA renal SPECT imaging. The imaging features of SPECT/CT imaging in upper urinary tract infection were analyzed. The differences between the diagnostic methods were analyzed by using χ2 test or Fisher′s exact test. Results:Of 109 patients, 91 were diagnosed as upper urinary tract infection by 99Tc m-DMSA renal SPECT/CT imaging, with the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 100%(86/86), 78.26%(18/23), 94.51%(86/91), 18/18 and 95.41%(104/109), respectively. With the application of low-dose CT, the diagnostic specificity of SPECT/CT was significantly higher than that of SPECT (52.17% (12/23); P=0.014), and the causes of upper urinary tract infection were found in 5.81% (5/86) of patients with the help of CT. There were 10 (29.41%, 10/34) patients with chronic pyelonephritis had typical signs of renal scar on SPECT/CT imaging. Excluding the patients with typical renal scar, 11.54% (6/52) and 37.50% (9/24) of patients with acute and chronic pyelonephritis had decrease or defect focus≤2 ( χ2=6.987, P=0.008). Conclusions:99Tc m-DMSA renal SPECT/CT has good clinical value in the diagnosis of adult upper urinary tract infection. Compared with 99Tc m-DMSA renal SPECT, 99Tc m-DMSA renal SPECT/CT can effectively improve the diagnostic specificity and explore the causes of upper urinary tract infection such as urinary tract obstruction and stones.

Predictive value of phase analysis of gated myocardial perfusion imaging for major adverse cardiac events in patients with coronary artery disease / 中华核医学与分子影像杂志

Objective:To evaluate the value of phase analysis of gated myocardial perfusion imaging (GMPI) in predicting major adverse cardiac events (MACE) in patients with coronary atherosclerotic heart disease.Methods:Patients who underwent two-day rest-stress GMPI in the Department of Nuclear Medicine of Beijing Hospital from September 2012 to January 2014 were selected as observed subjects and analyzed retrospectively. The general clinical information, GMPI images and related parameters including phase standard deviation (PSD), phase histogram bandwidth (PBW), entropy, left ventricular ejection fraction (LVEF), summed stress score (SSS), peak ejection rate (PER), peak filling rate (PFR) were noted. Patients were followed up until the onset of MACE (cardiac death, nonfatal myocardial infarction, and late revascularization within 60 d after GMPI). χ2 test, independent-sample t test or Wilcoxon rank sum test were used to compare data between different groups. The independent risk factors of MACE were obtained by Cox proportional risk regression model. Kaplan-Meier survival curve analysis was used to analyze the cumulative survival rate without MACE. Results:A total of 505 patients (235 males, 270 females, median age: 73 years) were followed up successfully, with a median follow-up period of 55.6(52.0, 60.5) months. There were 54 cases (10.7%) with MACE: 6 patients with cardiac death, 27 patients with non-fatal myocardial infarction, and 21 patients with late revascularization. The incidence of hypertension and hyperlipidemia in patients with MACE was significantly higher than that in patients without MACE ( χ2 values: 4.126, 6.021, both P<0.05); LVEF, PFR and absolute value of PER of patients with MACE were significantly lower ( t/ z values: 6.261, 5.683, -4.246, all P<0.05), while SSS, PSD, PBW and entropy were significantly higher ( t/ z values: 5.024, 5.874, 7.119, -6.405, all P<0.05). Cox proportional risk regression model showed that abnormal PBW(>80°), abnormal entropy(>58 J·mol -1·K -1) and SSS≥12 were independent risk factors for MACE (odds ratio( OR) values: 2.795(95% CI: 1.259-6.201), 3.213(95% CI: 1.468-7.029), 3.640 (95% CI: 1.999-6.628), all P<0.05). The 5-year cumulative MACE-free survival rates of abnormal PSD group(>26.7°), abnormal PBW group and abnormal entropy group were 51.2%, 63.2% and 46.7%, which were significantly lower than those of normal PSD group (92.3%; χ2=77.768, P<0.05), normal PBW group (94.2%; χ2=77.741, P<0.05) and normal entropy group (92.8%; χ2=117.437, P<0.05). The 5-year cumulative MACE-free survival rate (31.7%) of patients with abnormal PBW and SSS≥12 was significantly lower than that of patients with normal PBW or patients with abnormal PBW and SSS<12 (80.1%-94.4%; χ2=185.4, P<0.01). The combination analysis of entropy and SSS showed similar results. Conclusions:PBW and entropy obtained by GMPI phase analysis are independent risk factors for predicting MACE in coronary artery disease. GMPI phase analysis is useful for coronary artery disease risk stratification.

Effect of HR-HPV positive,load and SCC-Ag positive on recurrence rate after radical resection for cervical cancer / 中国实用妇科与产科杂志

OBJECTIVE: To investigate the effect of HR-HPV positive,HR-HPV load and SCC-Ag positive on the recurrence of cervical cancer after radical resection.METHODS: The clinical data of cervical cancer patients who underwent radical resection of cervical cancer in People's Hospital of Zengcheng District from January 2010 to January2019 were retrospectively collected.The patients were followed up regularly,and the preoperative HR-HPV positive,loading,the amount of SCC-Ag expression were determined;the recurrence and metastasis of cervical cancer were analyzed,and the value of HR-HPV positive,HR-HPV loading and SCC-Ag in predicting the recurrence and metastasis of cervical cancer were analyzed.RESULTS: A total of 438 patients with cervical cancer were included.There was no significant difference in pathological type,or postoperative Meigs-Brunschwig pathological staging between the recurrence group(n=42)and the non-recurrence group(n=396)(P>0.05).The difference in the proportion of HRHPV positive(40/42 vs. 144/396),HR-HPV loading and SCC-Ag positive(34/42 vs. 64/396)was statistically significant between non-recurrence group and recurrence group(P0.05).Multivariate logistic regression analysis showed that distant metastasis,FIGO staging of cervical cancer,HR-HPV positive,and SCC-Ag were independent factors affecting cervical cancer recurrence(P<0.05).When predicting by individual indicator,the specificity and positive predictive value of HR-HPV positive for predicting cervical cancer recurrence were 99.18% and 95.23% at the highest,and the negative predictive value of HR-HPV was87.37% at the highest.When SCC-Ag was used to predict cervical cancer recurrence,the sensitivity was up to 33.33%.The sensitivity of combined prediction was 64.51%,the specificity was 99.46%,the positive predictive value was97.41%,and the negative predictive value was 94.44%.CONCLUSION: Distant metastasis,FIGO staging,HR-HPV positive,and SCC-Ag are independent factors affecting cervical cancer recurrence.The combination of HR-HPV positive,HR-HPV loading and SCC-Ag has certain value for predicting recurrence of cervical cancer,and the prediction value is the highest.

Effects of Vitamin D Receptor on Mucosal Barrier Proteins in Colon Cells under Hypoxic Environment / 中国医学科学院学报

To investigate the expressions of mucosal barrier proteins in colon cell line DLD-1 under hypoxic environment and its mechanism. Methods After DLD-1 cells were treated separately with hypoxia(l% O),vitamin D(100 nmol/L),or vitamin D plus hypoxia for 48 hours,the expressions of vitamin D receptor(VDR),tight junction proteins zonula occludens-1(ZO-1),occludin,Claudin-1,and adherent junction protein(E-cadherin)were determined by Western blot.Stable VDR knock-down(Sh-VDR)DLD-1 cell line and control DLD-1 cell line were established by lentivirus package technology and the protein expressions after hypoxia treatment were detected. Results Compared with control group,the expressions of occludin,Claudin-1,and VDR increased significantly after hypoxia treatment(all <0.001).In addition to the protein expressions of occludin,Claudin-1 and VDR,the expressions of ZO-1 and E-cadherin were also obviously higher in vitamin D plus hypoxia group than in single vitamin D treatment group(all <0.001).After hypoxia treatment,Sh-VDR cell line showed significantly decreased expressions of ZO-1(<0.001),occludin(<0.05),Claudin-1(<0.01)and E-cadherin(<0.001)when compared with untreated Sh-VDR cell line. Conclusion VDR acts as a regulator for the expressions of intestinal mucosal barrier proteins under hypoxia environment in DLD-1 colon cell line,indicating that VDR pathway may be another important protective mechanism for gut barrier in low-oxygen environment.

Value of pulmonary perfusion tomography/ low dose CT fusion imaging in the diagnosis of acute pul?monary embolism / 中华核医学与分子影像杂志

Objective To evaluate the diagnostic efficacy of the pulmonary perfusion tomography combined with low dose CT scan (Q SPECT/ CT) in detecting acute pulmonary embolism (PE) by compa-ring with pulmonary ventilation/ perfusion (V/ Q) SPECT imaging. Methods A total of 203 patients sus-pected with acute PE (88 males, 115 females, age range 19-94 years) from January 2013 to December 2015 were enrolled in this retrospective study. All patients underwent V/ Q SPECT and low dose CT scan. Final clinical diagnosis was regarded as the gold standard. The diagnostic consistency and diagnostic efficacy of Q SPECT/ CT were compared with those of V/ Q SPECT. χ2 test was used to compare the differences be-tween the two methods. Kappa analysis was used to analyze the agreement of them. Results The coinci-dence rate of Q SPECT/ CT and V/ Q SPECT was 94.09％(191/ 203), Kappa= 0.882, P<0.001. Among the 12 cases with inconsistent diagnosis, 9 were finally diagnosed as chronic obstructive pulmonary disease (COPD). The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of Q SPECT / CT in the diagnosis of PE were 95. 12％(78/ 82), 80.99％(98/ 121), 77.23％(78/ 101), 96.08％(98/ 102), 86. 70％ ( 176/ 203). The counterpart parameters of V/ Q SPECT were 95. 12％ ( 78/ 82), 90. 91％(110/ 121), 87.64％ (78/ 89), 96.49％ (110/ 114), 92.61％ (188/ 203). Compared with V/ Q SPECT, Q SPECT/ CT had the same sensitivity but lower specificity (χ2 = 4.928, P = 0.026). The positive predictive value, negative predictive value and accuracy of Q SPECT/ CT were lower than those of V/ Q SPECT, but there was no significant difference (χ2 values: 3.491, 0.000, 3.824, all P>0.05). Conclusion In the majority of patients with suspected acute PE, V/ Q SPECT scan can be replaced by Q SPECT/ CT, but it must be careful to select Q SPECT/ CT for patients with COPD history.

A review on factors influencing myopic progressioninchildrenafter orthokeratology / 国际眼科杂志(Guoji Yanke Zazhi)

With the increasingly higher prevalence of myopia in children, more and more attention has been paid on the prevention and control of childhood myopia. As a non-surgical method for correcting myopia and meanwhile slowing its progression, orthokeratology is now widely used around the world. Multiple clinical studies have revealed that orthokeratology is an effective and crucial way in controlling childhood myopic progression. However, the myopia controlling efficacy differs greatly among individuals. Many factors have been reported to have potential influences in the process of myopia control of orthokeratology in children and these factors were reviewed in this article.

A case of systemic lupus erythematosus in pregnancy complicated by pulmonary hypertension / 北京大学学报(医学版)

To investigate the pathophysiology, screening, diagnosis and treatment of the systemic lupus erythematosus (SLE) in pregnancy complicated with pulmonary hypertension. Retrospective analysis was made of one case of SLE in pregnancy complicated with pulmonary hypertension in Peking University Third Hospital. Literature was reviewed to investigate the pathophysiology, screening, diagnosis and treatment of the SLE in pregnancy complicated with pulmonary hypertension. SLE is an autoimmune mediated diffuse connective tissue disease characterized by immunological inflammation. The incidence of SLE combined with pulmonary hypertension was low, but the risk was high with pregnancy, with a high perinatal mortality rate. Pulmonary hypertension is the leading cause of the death in patients with pregnancy complicated with SLE. This patient was diagnosed with SLE six years before and was hospitalized for 29 weeks of menopause, with fatigue five months and chest congestion one month. Ultrasonic cardiogram showed severe pulmonary hypertension, with pulmonary arterial systolic pressure being 96 mmHg. After admission, multidisciplinary consultation was organized to draw up a diagnosis and treatment plan. The patient received the treatment of rest,oxygen,blood gas and pulmonary artery pressure monitoring. Considering perioperative pulmonary hypertension crisis likely to occur, pulmonary artery catheter was placed preoperatively. In general anesthesia, the cesarean was performedfter operation,the patient was transferred to the intensive care unit, with the treatment of expanding blood vessels, reducing pulmonary artery pressure,administering anticoagulation and preventing infection. Ten days after operation, the patient was discharged from hospital with smooth condition. Strengthening the management of SLE patients in pregnancy, early detection, and cooperation of multidisciplinary teams can help improve maternal and fetal outcomes. Termination of pregnancy should be offered to the patients with severe pulmonary hypertension. Right cardiac catheterization is the gold standard for diagnosing pulmonary hypertension. Some patients are diagnosed in later stage of pregnancy, regular antenatal examination, interdisciplinary co-operation, assessment of cardiac function, monitoring the condition of the pregnant woman and fetus and timely termination of pregnancy are needed. Epidural anesthesia is the appropriate choice for cesarean delivery.

Research progress on identification of Aspergillus fungi in traditional Chinese medicinal materials / 中草药

The issues of mycotoxin contamination in herbal materials have been frequently reported in recent years, which has attracted broad attention at home and abroad. Mycotoxins can trigger hepatotoxicity, nephrotoxicity, and other significant toxic effects, threatening the consumer health seriously. Aspergillus species are one of the main sources of fungal contamination in herbal materials. The rapid and accurate identification of Aspergillus species in herbal materials can provide early warning of mycotoxin contamination, which is of great significance for ensuring the efficacy and safety of herbal materials. In this study, the research progress on the classification and discrimination of Aspergillus species were systematically summarized. Moreover, the identification of Aspergillus species in herbal materials was also reviewed. Meanwhile, we explored the prospect of identifying Aspergillus species in Chinese herbal medicines using high-throughput sequencing.