Association of greenness exposure with waist circumference and central obesity in Chinese adults aged 65 years and over / 中华预防医学杂志

Objective: To examine the association of greenness exposure with waist circumference (WC) and central obesity in older adults in China. Methods: Based on the cross-sectional data from the Chinese Longitudinal Healthy Longevity Survey in 2017-2018, 14 056 participants aged 65 years and over were included. Demographic characteristics, lifestyle, WC, and other information were collected through a questionnaire and physical examination. Based on the satellite monitoring data of moderate-resolution imaging spectroradiometer (MODIS) provided by NASA, the annual mean of normalized difference vegetation index (NDVI) within a radius of 1 000 meters was obtained as the measurement value of greenness exposure. Multivariate linear regression model, multivariate logistic regression model, and restricted cubic splines (RCS) model were used to analyze the association and dose-response relationship between greenness exposure and WC and central obesity in older adults in China. Results: A total of 14 056 participants were enrolled with a median age of 84.0 years [IQR: 75.0-94.0 years]. About 45.0% (6 330) of them were male and 48.6% (5 853) were illiterate. There were 10 964 (78.0%) participants from rural. The mean of WC was (84.4±10.8) cm. Central obesity accounted for 60.2% (8 465), and the NDVI range was (-0.06, 0.78). After adjusting for confounding factors, the multivariate linear regression model showed that the change value of WC in the urban group [β (95%CI):-0.49 (-0.93, -0.06)] was smaller than that in the rural [-0.78 (-0.98, -0.58)] for every 0.1 unit increase in NDVI (Pinteraction=0.022). Compared with the Q1 group in NDVI, WC of Q2 and Q3 groups in rural decreased, and the β (95%CI) values were-1.74 (-2.5, -0.98) and-2.78 (-3.55, -2.00), respectively. The multivariate logistic regression model showed that after adjusting for confounding factors, the risk of central obesity decreased for urban and rural older adults with an increase of 0.1 unit in NDVI, and the OR (95%CI) values were 0.87 (0.80, 0.95) and 0.86 (0.82, 0.89), respectively (Pinteraction=0.284). Compared with the Q1 group in NDVI, the risk of central obesity in the Q2 and Q3 groups in rural was lower, and the OR (95%CI) values were 0.68 (0.58, 0.80) and 0.57 (0.49, 0.68), respectively. The results of the multivariate regression model with RCS showed that there was a non-linear association of NDVI with WC (Pnonlinear=0.006) and central obesity (Pnonlinear=0.025). Conclusion: Greenness exposure is negatively associated with WC and central obesity in older adults in China.

A prospective study on the safety and efficacy of excimer laser coronary angioplasty for the treatment of degenerated great saphenous vein graft / 中华心血管病杂志

Objective: To explore the safety and efficacy of excimer laser coronary angioplasty (ELCA) for the treatment of degenerated great saphenous vein graft (SVG). Methods: This is a single-center, prospective, single-arm study. Patients, who were admitted to the Geriatric Cardiovascular Center of Beijing Anzhen Hospital from January 2022 to June 2022, were consecutively enrolled. Inclusion criteria were recurrent chest pain after coronary artery bypass surgery (CABG), and coronary angiography confirmed that the SVG stenosis was more than 70% but not completely occluded, and interventional treatment for SVG lesions was planned. Before balloon dilation and stent placement, ELCA was used to pretreat the lesions. Optical coherence tomography (OCT) examination was performed and postoperative index of microcirculation resistance (IMR) were assessed after stent implantation. The technique success rate and operation success rate were calculated. The technique success was defined as the successful passage of the ELCA system through the lesion. Operation success was defined as the successful placement of a stent at the lesion. The primary evaluation index of the study was IMR immediately after PCI. Secondary evaluation indexes included thrombolysis in myocardial infarction (TIMI) flow grade, corrected TIMI frame count (cTFC), minimal stent area and stent expansion measured by OCT after PCI, and procedural complications (Ⅳa myocardial infarction, no reflow, perforation). Results: A total of 19 patients aged (66.0±5.6) years were enrolled, including 18 males (94.7%). The age of SVG was 8 (6, 11) years. The length of the lesions was greater than 20 mm, and they were all SVG body lesions. The median stenosis degree was 95% (80%, 99%), and the length of the implanted stent was (41.7±16.3)mm. The operation time was 119 (101, 166) minutes, and the cumulative dose was 2 089 (1 378, 3 011)mGy. The diameter of the laser catheter was 1.4 mm, the maximum energy was 60 mJ, and the maximum frequency was 40 Hz. The technique success and the operation success rate were both 100% (19/19). The IMR after stent implantation was 29.22±5.95. The TIMI flow grade of patients after ELCA and stent implantation was significantly improved (all P>0.05), and the TIMI flow grade of all patients after stent implantation was Grade Ⅲ. The cTFC decreased significantly after ELCA (33.2±7.8) and after stent placement (22.8±7.1) than preoperative level (49.7±13.0) (both P<0.001). The minimum stent area was (5.53±1.36)mm2, and the stent expansion rate was (90.0±4.3)%. Perforation, no reflow, type Ⅳa myocardial infarction and other complications were not observed. However, postoperative high-sensitivity troponin level was significantly increased ((67.937±33.839)ng/L vs. (5.316±3.105)ng/L, P<0.001). Conclusion: ELCA is safe and effective in the treatment of SVG lesions and could improve microcirculation and ensure full expansion of stent.

Clinical observation of Qiliqiangxin capsule combined with recombinant human brain natriuretic peptide in patients with acute heart failure / 中华内科杂志

Objective: To observe the clinical effect of Qiliqiangxin capsule combined with recombinant human brain natriuretic peptide in acute left heart failure patients 7 days after onset as well as the effects of plasma MDA and ET-1. Methods: In total, 240 hospitalized patients with acute left heart failure from October 2017 to May 2021 were selected from the Department of Emergency and Critical Care Center of Beijing Anzhen Hospital, Capital Medical University and the Department of Cardiology of the Jilin Provincial People's Hospital. They were randomly divided into routine treatment group and combined treatment group, with 120 cases in each group. The routine treatment group was treated with vasodilation, diuresis, cardiotonic and recombinant human brain natriuretic peptide. The combined treatment group was treated with Qiliqiangxin capsules based on the routine treatment group. One week later, the changes in clinical efficacy, ejection fraction, left ventricular commoid diameter, and plasma BNP, MDA, and ET-1 were compared between the two groups before and after treatment. SPSS 11.5 statistical software was used. The measurement data was expressed in x¯±s, the independent sample t-test was used for comparison between groups, and the paired t-test was used for comparison before and after treatment within groups. Counting data was expressed as case (%), and the rank sum test was used for inter-group comparison. Result: In terms of clinical efficacy, the total effective rate of the combined treatment group was significantly higher than that of the conventional treatment group, and the difference was statistically significant (P<0.05). Compared with the routine treatment group, the left ventricular ejection fraction in the combined treatment group was significantly increased (P<0.05). The levels of plasma BNP, MDA and ET-1 were significantly decreased (P<0.05). Conclusion: Qiliqiangxin capsule combined with rhBNP treatment can effectively improve the clinical symptoms of acute heart failure, as well as reduce the lipid peroxidation product MDA content and endothetin ET-1 level in blood. The clinical application value of the Qiliqiangxin capsule needs to be further confirmed by further trials.

Association of greenness, nitrogen dioxide with the prevalence of hypertension among the elderly over 65 years old in China / 中华预防医学杂志

Objective: To investigate the association of mixed exposure to greenness and nitrogen dioxide(NO2) and hypertension among the older adults aged 65 years and over in China. Methods: The study subjects were from the Chinese Longitudinal Healthy Longevity Survey from 2017 to 2018. A total of 15 423 older adults aged 65 years and over meeting the criteria were finally included in the study. A questionnaire survey was used to collect information on demographic characteristics, lifestyle habits and self-reported prevalence of hypertension. Blood pressure values were obtained through physical examination. The level of normalized difference vegetation index(NDVI) was measured by the Medium-resolution Imaging Spectral Radiator(MODIS) of the National Aeronautics and Space Administration(NASA). The concentration of NO2 was from China's surface air pollutant data set. Meteorological data was from NASA MERRA-2. The exposure to NDVI and NO2 for each study subject was calculated based on the area within a 1 km radius around their residence. The association between mixed exposure of NDVI and NO2 as well as their interaction and hypertension in older adults was analyzed by using the multivariate logistic regression model. The restrictive cubic spline(RCS) function was used to explore the exposure-response relationship between greenness and NO2 and the risk of hypertension in study subjects. Results: The mean age of 15 423 older adults were (85.6±11.6). Women accounted for 56.3%(8 685/15 423) and 55.6%(8 578/15 423) lived in urban areas. The mean time of residence was (60.9±28.5) years. 59.8% of participants were with hypertension. The mean NDVI level was 0.41±0.13, and the mean NO2 concentration was (32.18±10.36) μg/cm3. The results of multivariate logistic regression analysis showed that NDVI was inversely and linearly associated with the hypertension in older adults, with the OR(95%CI) value of 0.959(0.928-0.992). Compared with the T1 group of NDVI, the risk of hypertension was lower in the T3 group, with the OR(95%CI) value of 0.852(0.769-0.944), and the trend test was statistically significant(P<0.05). Compared with the T1 group of NO2, the risk of hypertension was higher in the T2 and T3 groups, with OR(95%CI) values of 1.160(1.055-1.275) and 1.244(1.111-1.393), and the trend test was statistically significant (P<0.05). The result of the RCS showed that NDVI was inversely and linearly associated with hypertension in older adults. NO2 was nonlinearly associated with hypertension in older adults. The interaction analysis showed that NDVI and NO2 had a negative multiplicative interaction on the risk of hypertension, with OR(95%CI) value of 0.995(0.992-0.997). Conclusion: Exposure to greenness and NO2 are associated with hypertension in older adults.

Construction and application of remote consultation system for epidemic prevention and control in Henan province / 中华医院管理杂志

The present pandemic prevention and control of 2019 novel coronavirus diseases(COVID-19) is still severe in China and abroad, which is however witnessing a dimensional application and success of the information technology.For example, the remote consultation system of epidemic prevention and control had played a key role in Henan province in its fight against COVID-19. The architecture of the system was composed of software and hardware architecture, data exchange technology, security system design, and data collection specifications. By the end of September 2021, the audio and video systems of 147 designated hospitals for patients of COVID-19 had been constructed, and 98 of which had achieved clinical data sharing and interaction. The remote consultation system effectively guaranteed the real-time sharing of case data, saved diagnosis costs and treatment time, laying a solid foundation for the pandemic prevention and control of COVID-19.

Inhibitory Effect of Duanteng Yimu Decoction on Pannus Formation in Mice with Collagen-induced Arthritis Based on VEGF Pathway / 中国实验方剂学杂志

Objective:To investigate the mechanism of Duanteng Yimu decoction （DTYM） in the inhibition of pannus formation in collagen-induced arthritis （CIA） mice. Method:Twenty-four SPF-grade DBA/1 male mice were randomly divided into the following four groups： a blank group （NC group）， a model group （CIA group）， a methotrexate group （MTX group）， and a DTYM group， with six mice in each group. The mice， except for those in the NC group， were modeled. From the second immunization， the medium， MTX （1 mg·kg^-1）， and DTYM （15.4 g·kg^-1） were administered at an equal volume by gavage for 35 days. Mice were observed for general condition and the arthritis index. The knee and ankle joints were scanned by microcomputed tomography （micro CT）. Hematoxylin-eosin （HE） and safranin O/fast green staining were performed to observe pathological changes. Immunohistochemistry was performed to detect the expression of platelet/endothelial cell adhesion molecule-1 （CD31）， vascular endothelial growth factor-<italic>α</italic> （VEGF-<italic>α</italic>）， vascular endothelial growth factor receptor 2 （VEGFR2）， and phosphorylated（p）-VEGFR2. Result:Compared with the NC group， the CIA group showed red and swollen ankle joints， increased arthritis index scores （<italic>P</italic><0.05， <italic>P</italic><0.01）， manifest injury in the knee and ankle joints， reduced cartilage thickness， elevated Micro CT bone destruction scores of knee and ankle joints （<italic>P</italic><0.01）， and up-regulated absorbance values of synovial CD31， VEGF-<italic>α</italic>， VEGFR2， and p-VEGFR2 （<italic>P</italic><0.01）. Compared with the CIA group， the DTYM group showed relieved ankle joint redness and swelling， reduced arthritis index scores of mice three weeks after administration （<italic>P</italic><0.05， <italic>P</italic><0.01）， intact joint surfaces of the knee and ankle joints， thickened cartilage， declining Micro CT bone destruction scores in both the knee and ankle joints （<italic>P</italic><0.05， <italic>P</italic><0.01）， and lowered absorbance values of CD31， VEGF-<italic>α</italic>， VEGFR2， and p-VEGFR2 in the synovium （<italic>P</italic><0.01）. Conclusion:DTYM can inhibit the pannus formation in CIA mice presumedly by regulating the VEGF pathway.

Mechanism of Duanteng Yimu Decoction on Human Umbilical Vein Endothelial Cell Model / 中国实验方剂学杂志

Objective:To explore the effect of Duanteng Yimu decoction （DTYM） on the activation of the human umbilical vein endothelial cell （HUVEC） model and the effect on related activated proteins and vascular endothelial growth factor （VEGF） signaling pathway. Method:After DTYM （200， 400 g·mL^-1） treatment of HUVEC induced by VEGF and tumor necrosis factor-<italic>α</italic> （TNF-<italic>α</italic>）， cell proliferation， migration， and tubulogenesis were detected by cell counting kit-8 （CCK-8） assay， 5-ethynyl-2'-deoxyuridine （EdU） assay， transwell migration assay， phalloidin staining， and matrix gel card method. The mRNA expression of adhesion factors， including E-selectin， intercellular adhesion molecule-1 （ICAM-1）， and vascular cell adhesion molecule-1 （VCAM-1） was detected by real-time fluorescence quantitative polymerase chain reaction （Real-time PCR）. The expression of von Willebrand factor （VWF）， platelet-endothelial cell adhesion molecule-31 （CD31）， angiogenic factor cysteine-rich-61 （CYR61）， angiopoietin-1 （ANG-1）， VEGF， and VEGF receptor-2 （VEGFR2） was detected by Western blot. Immunofluorescence was used to determine CD31 expression. Result:Compared with the normal group， the model group showed potentiated proliferation， migration， and tubulogenesis of HUVEC （<italic>P</italic><0.05， <italic>P</italic><0.01）， elevated mRNA expression of E-selectin， ICAM-1， and VCAM-1 （<italic>P</italic><0.01）， up-regulated protein expression of VWF， CD31， ANG-1， CYR61， VEGF-<italic>α</italic>， and phospho （p）-VEGFR2 （<italic>P</italic><0.05，<italic> P</italic><0.01）， and increased CD31 immunofluorescence intensity （<italic>P</italic><0.01）. Compared with the model group， the DTYM groups displayed blunted proliferation， migration， and tubulogenesis of HUVEC （<italic>P</italic><0.05，<italic> P</italic><0.01）， decreased mRNA expression of E-selectin， ICAM-1， and VCAM-1 （<italic>P</italic><0.05， <italic>P</italic><0.01）， down-regulated protein expression of VWF， CD31， ANG-1， CYR61， VEGF-<italic>α</italic>， and p-VEGFR2 （<italic>P</italic><0.05， <italic>P</italic><0.01）， and weakened CD31 immunofluorescence intensity （<italic>P</italic><0.01）. Conclusion:DTYM inhibits HUVEC proliferation， migration， adhesion， and tubulogenesis， which is associated with the regulation of CD31， VWF， CYR61， and ANG-1 expression in HUVEC and the VEGF signaling pathway.

Retrospective analysis of sentinel lymph node biopsy using methylene blue dye for early breast cancer / 中华医学杂志(英文版)

BACKGROUND@#Methylene blue is the most commonly used tracer for sentinel lymph node (SLN) biopsy (SLNB) in China. This study aimed to investigate the feasibility of clinical application of SLNB using methylene blue dye (MBD) for early breast cancer and the prognosis of patients with different SLN and non-SLN statuses.@*METHODS@#We retrospectively analyzed the clinicopathological data of patients with early breast cancer treated at the Peking University First Hospital between 2013 and 2018. We calculated the SLN identification rate (IR) in SLNB with MBD and the false-negative rate (FNR), and analyzed the prognosis of patients with different SLN and non-SLN statuses using Kaplan-Meier curves.@*RESULTS@#Between January 2013 and December 2018, 1603 patients with early breast cancer underwent SLNB with MBD. The SLN IR was 95.8% (1536/1603). Two SLNs (median) were detected per patient. There were significant differences in FNR between patients with SLN micrometastasis and macrometastasis (19.0% vs. 4.5%, χ2 = 12.771, P < 0.001). Chi-square test showed that there were significant differences in SLN successful detection rates among patients with different vascular tumor embolism status (96.3% vs. 90.8%, χ2 = 9.013, P = 0.003) and tumor (T) stages (96.6% vs. 94.1%, χ2 = 5.189, P = 0.023). Multivariate analysis showed that vascular tumor embolism was the only independent factor for SLN successful detection (odds ratio: 0.440, 95% confidence interval: 0.224-0.862, P = 0.017). Survival analysis showed a significant difference in disease-free survival (DFS) between patients with non-SLN metastasis and patients without non-SLN metastasis (P = 0.006).@*CONCLUSION@#Our single-center data show that, as a commonly used tracer in SLNB in China, MBD has an acceptable SLN IR and a low FNR in frozen sections. This finding is consistent with reports of dual tracer-guided SLNB. Positive SLNs with non-SLN metastasis are associated with DFS.

Preparation and in vitro imaging of a magnetic heating phasetransition multimodal ultrasound contrast agent / 中华超声影像学杂志

Objective:To prepare a novel magnetic heating phasetransition nanoparticle contrast agent (PFH-HIONS), and to study its performance on enhancing photoacoustic imaging, magnetic resonance imaging and ultrasound imaging after phasetransition by magnetic-thermo in vitro. Methods:Firstly, the superparamagnetic nano hollow iron spheres (HIONS) were prepared by a one-pot solvothermal method, and then the phasetransition liquid perfluorocarbon (PFH) was loaded on the HIONS by vacuum adsorption to obtain PFH-HIONS. After characterization of the nanoparticles, photoacoustic imaging, magnetic resonance imaging and ultrasound imaging after phasetransition with magnetic-thermo were performed in vitro, and the results were analyzed by a software.Results:PFH-HIONS was successfully prepared with uniform particle size of (537.3±24.8)nm. PFH-HIONS could apparently enhance photoacoustic imaging and magnetic resonance imaging in vitro. In an alternating magnetic field, it could significantly increase the temperature, which promotes phasetransion of the PFH to produce microbubbles, thereby enhancing ultrasound imaging. Furthermore, as the concentration increased, the imaging intensity was enhanced, and the differences in imaging intensity between different concentration groups were statistically significant ( P<0.05). Conclusions:The PFH-HIONS can enhance the multimodal imaging including ultrasound, photoacoustic and magnetic resonance, and it also has obvious magnetic heating performance. It provides a new and efficient research platform for theranostics based on molecular imaging, therefore it has promising application prospects.

Preparation and in vitro imaging of a magnetic heating phasetransition multimodal ultrasound contrast agent / 中华超声影像学杂志

Objective@#To prepare a novel magnetic heating phasetransition nanoparticle contrast agent (PFH-HIONS), and to study its performance on enhancing photoacoustic imaging, magnetic resonance imaging and ultrasound imaging after phasetransition by magnetic-thermo in vitro.@*Methods@#Firstly, the superparamagnetic nano hollow iron spheres (HIONS) were prepared by a one-pot solvothermal method, and then the phasetransition liquid perfluorocarbon (PFH) was loaded on the HIONS by vacuum adsorption to obtain PFH-HIONS. After characterization of the nanoparticles, photoacoustic imaging, magnetic resonance imaging and ultrasound imaging after phasetransition with magnetic-thermo were performed in vitro, and the results were analyzed by a software.@*Results@#PFH-HIONS was successfully prepared with uniform particle size of (537.3±24.8)nm. PFH-HIONS could apparently enhance photoacoustic imaging and magnetic resonance imaging in vitro. In an alternating magnetic field, it could significantly increase the temperature, which promotes phasetransion of the PFH to produce microbubbles, thereby enhancing ultrasound imaging. Furthermore, as the concentration increased, the imaging intensity was enhanced, and the differences in imaging intensity between different concentration groups were statistically significant (P<0.05).@*Conclusions@#The PFH-HIONS can enhance the multimodal imaging including ultrasound, photoacoustic and magnetic resonance, and it also has obvious magnetic heating performance. It provides a new and efficient research platform for theranostics based on molecular imaging, therefore it has promising application prospects.

Induction of thoracic aortic dissection: a mini-review of β-aminopropionitrile-related mouse models / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Thoracic aortic dissection (TAD) is one of the most lethal aortic diseases due to its acute onset, rapid progress, and high rate of aortic rupture. The pathogenesis of TAD is not completely understood. In this mini-review, we introduce three emerging experimental mouse TAD models using β-aminopropionitrile (BAPN) alone, BAPN for a prolonged duration (four weeks) and then with added infusion of angiotensin II (AngII), or co-administration of BAPN and AngII chronically. We aim to provide insights into appropriate application of these three mouse models, thereby enhancing the understanding of the molecular mechanisms of TAD.

Prevalence of depression and its influencing factors among middle school students in Liaoning Province / 中国学校卫生

Objective@#To investigate the prevalence of depression of middle school students in Liaoning Province in 2019 and analyze its influencing factors, to provide corresponding strategies and measures for depression prevention and control.@*Methods@#By using the method of multi-stage stratified random cluster sampling, the 32 909 students of grade 1-3 of junior middle school, senior high school and vocational high school were selected from 14 cities in Liaoning province, and were investigated with Center for Epidermiologic Studies Depression Scale (CES-D) psychological scale.@*Results@#The depression score of middle school students in Liaoning Province was (12.66±9.53), and the incidence of depression was 19.5%. Analysis of variance and multiple regression analysis showed that the main factors influencing the occurrence of depression were grade, bullying on campus, internet addiction, being beaten and scolded by parents, drinking, gender, Leave of absence from school, smoking, serious injury and economic classification (P<0.05).@*Conclusion@#Depression of middle school students in Liaoning Province is not optimistic. Effective prevention and control measures should be developed and implemented to the occurrence of adverse factors, so as to reduce the occurrence of depression symptoms.

Effect of Whole Body Vibration on Abilities of Lower Extremities for Stroke Patients / 中国康复理论与实践

Objective:To explore the effect of whole body vibration (WBV) on lower extremities loading, balance and walking for stroke patients based on weight-bearing training. Methods:In 2017, 70 stroke inpatients were randomly divided into control group (n = 35) and experimental group (n = 35). They all accepted routine rehabilitation and weight-bearing training, while the experimental group accepted WBV in addition, for six weeks. They were assessed with weight-bearing time, gait length and speed, Berg Balance Scale (BBS) and Functional Ambulation Category (FAC) before and after treatment. Results:The weight-bearing time, gait length and speed, and the scores of BBS and FAC improved after treatment in both groups (t > 8.835, P < 0.001), and improved more in the experimental group than in the control group (F > 19.644, P < 0.001). Conclusion:WBV may further improve the abilities of lower extremities for stroke patients.

Risk factors and prognoses analysis of new-onset atrial fibrillation in patients with acute myocardial infarction / 中华内科杂志

Objective To explore the risk factors and prognoses of new-onset atrial fibrillation (NOAF) in patients with acute myocardial infarction (AMI).Methods A total of 468 patients with AMI were admitted into Beijing Anzhen Hospital for emergency pereutaneous coronary intervention (PCI).According to the NOAF occurred during hospitalization,the patients were divided into two groups:the NOAF (n=37) group and the non-NOAF (n=431) group.Parameters including general clinical conditions,coronary lesions,echocardiography,biochemical markers,C-reactive protein (CRP),N-terminal pro-brain natriuretic peptide (NT-pro-BNP),and myocardial markers were collected.In-hospital mortality and incidence of in-hospital main adverse cardiovascular and cerebrovascular events (MACCE) were compared between the two groups.Logistic multivariate regression analyses were performed for the association between the risk factors and NOAF.Results The incidence of NOAF was 7.9％ in AMI patients undergoing emergency PCI.There were no significant differences in door-to-balloon time,weight,platelet counts,baseline serum creatinine (SCr),postoperative SCr,triglyceride,total cholesterol,low density lipoprotein cholesterol,high density lipoprotein cholesterol,uric acid,glycosylated hemoglobin A1c,preoperative medication,number of lesions,thrombus aspiration,location of myocardial infarction,and history of hypertension,diabetes,peripheral vascular disease and old myocardial infarction between the two groups.The percentage of women was in the NOAF group (32.4％ vs.16.7％,P＜0.05) and subjects in this group were significantly elder than those in the non-NOAF groups [(66±10) years vs.(571±11) years,P＜0.001].Moreover,the levels of no-reflow rate (40.5％ vs.12.6％,P＜0.001),CRP [25.2 (15.43,29.97)mg/L vs.5.21 (2.33,16.98) mg/L,P＜0.001],white blood cell counts [(11.19±3.44)× 109 vs.(9.91 ±3.23)× 109,p=0.022],NT-pro-BNP [(652.6± 108.8) ng/L vs.(258.3±105.9) ng/L,P＜0.001],and troponin I (TnI) [20.41(1.78,87.89) μg/L vs.7.72(1.29,36.39) μg/L,P=0.006] were significantly higher in the NOAF group than in the non-NOAF group,while left ventricular ejection fraction [(47.70± 7.34)％ vs.(53.35 ± 8.05)％,P＜0.001],and hemoglobin [137.0(125.5,146.0) g/L vs.144.0(133.0,156.0) g/L,P=0.042] were significantly lower in the NOAF group than the non-NOAF group.Patients in the NOAF group had significantly longer hospital stay than those in the non-NOAF group [(8.7± 5.6) d vs.(6.0± 2.3) d,P=0.007].The in-hospital mortality (8.1％ vs 1.4％ P=0.004) and the incidence of in-hospital MACCE (37.8％ vs.7.7％,P＜0.001) in the NOAF group were significantly higher than those in the non-NOAF group.Logistic multivariate regression analyses showed that age (HR 1.083,95％CI 1.028-1.141,P=0.003),CRP (HR 1.116,95％CI 1.049-1.187,P=0.001),NT-pro-BNP (HR 1.463,95％CI 1.001-4.064,P=0.001) and no-reflow (HR 4.388,95％CI 1.006-19.144,P=0.049) were independent predictors of NOAF after AMI.Conclusions Age,elevated levels of CRP,NT-pro-BNP,and the absence of no-reflow are risk factors for incident NOAF in patients with AMI in hospital.

Effects of Niaoduqing Particles () on Delaying Progression of Renal Dysfunction: A Post-trial, Open-Label, Follow-up Study / 中国结合医学杂志

OBJECTIVE@#To follow up the participants of the randomized clinical trial "Efficacy and Safety of Niaoduqing Particles () for Delaying Moderate-to-Severe Renal Dysfunction", and assess the long-term effects of Niaoduqing Particles on delaying the progression of renal dysfunction.@*METHODS@#Participants, who had previously been randomly assigned to receive Niaoduqing Particles or placebo for 24 weeks (146 cases in each group), were invited to follow-up and all were administered Niaoduqing Particles 5 g thrice daily and 10 g before bedtime for 24 weeks. The primary endpoints were changes in baseline serum creatinine (Scr) and estimated glomerular filtration rate (eGFR) after completion of the open-label treatment period.@*RESULTS@#After the double-blind period, the median (interquartile range) changes in Scr were 1.1 (-13.0-24.1) and 11.7 (-2.6-42.9) μmol/L for the Niaoduqing Particle and placebo groups, respectively (P=0.008), and the median changes in eGFRs were-0.2 (-4.3-2.7) and-2.21 (-5.7-0.8) mL•min•1.73 m, respectively (P=0.016). There were significant differences in the double-blind period changes in renal function between groups. After the open-label period, the median changes in Scr were 9.0 (-10.0-41.9) and 17.5 (-6.0-50.0) μmol/L for the Niaoduqing Particle and placebo groups according to baseline grouping, respectively (P=0.214), and the median changes in eGFRs were-2.3 (-6.4-1.9) and-3.7 (-7.5-1.1) mL•min•1.73 m, respectively (P=0.134). There were no statistical differences in the open-label period changes in renal function between groups. The eGFR reduction of participants who accepted Niaoduqing Particle treatment for 48 weeks was projected to 2.5 mL•min•1.73 m per year.@*CONCLUSION@#Niaoduqing Particles appear to have long-term efficacy for patients with moderate-to-severe renal dysfunction. Although there was no statistical difference, the early use of Niaoduqing Paticles seems to ameliorate the worsening of renal function. (Trial registration No. ChiCTR-TRC-12002448).

Research of the Consistency between Pathology and the Single and Combined Diagnosis of Negative Breast Cancer by Ultrasonography and Mammography / 医学研究杂志

Objective To study the consistency between pathology and the single and combined diagnosis of negative breast cancer by ultrasonography and mammography.Methods 90 clinical case data of patients with palpable negative breast tumors and mammography revealed small calcifications were retrospective analyzed.All patients were received the high frequency ultrasound.The value of two methods and combined diagnosis in the diagnosis of breast cancer with palpation negative were compared,which the pathological biopsy was the gold standard.Results The pathological showed that there were 58 cases of benign tumors,32 cases of malignant tumors,10 cases of stage 0,18 cases of stage Ⅰ,4 cases of stage Ⅱ.The high frequency ultrasonography was consistent with pathological(Kappa =0.641).The AUC of diagnosiing the breast cancer was 0.775.The molybdenum target radiography was consistent with pathological (Kappa =0.725),and the AUC was 0.830.The high frequency ultrasonography combined with molybdenum target radiography was highly consistent with pathological(Kappa =0.879),and the AUC was 0.934.The accuracy of combined diagnosis was higher than that of high frequency ultrasound (P ＜ 0.05) and molybdenum target radiography(P ＞ 0.05).Conclusion The high frequency ultrasonography and molybdenum target radiography have advantages in the diagnosis of palpable negative breast cancer.The joint diagnosis helps to achieve complementary strengths,has high consistency with pathology,and help to improve the diagnostic accuracy.

The preliminary report of a registration clinical trial of proton and heavy ion irradiation / 中华肿瘤杂志

Objective@#To verify the safety and efficacy of IONTRIS particle therapy system (IONTRIS) in clinical implementation.@*Methods@#Between 6.2014 and 8.2014, a total of 35 patients were enrolled into this trial: 31 males and 4 females with a median age of 69 yrs (range 39-80). Ten patients had locally recurrent head and neck tumors after surgery, 4 cases with thoracic malignancies, 1 case with hepatocellular carcinoma, 1 case with retroperitoneal sarcoma, and 19 cases with non-metastatic prostate carcinomas. Phantom dose verification was mandatory for each field before the start of radiation.@*Results@#Twenty-two patients received carbon ion and 13 had proton irradiation. With a median follow-up time of 1 year, all patients were alive. Among the 16 patients with head and neck, thoracic, and abdominal/pelvic tumors, 2, 1, 12, and 1 cases developed complete response, partial response, stable disease, or disease progression, respectively. Progression-free survival rate was 93.8% (15/16). Among the 19 patients with prostate cancer, biological-recurrence free survival was 100%. Particle therapy was well tolerated in all 35 patients. Twenty-five patients (71.4%) experienced 33 grade 1 acute adverse effects, which subsided at 1 year follow-up. Six (17.1%) patients developed grade 1 late adverse effects. No significant change in ECOG or body weight was observed.@*Conclusions@#IONTRIS is safe and effective for clinical use. However, long term follow-up is needed to observe the late toxicity and long term result.

The value of multi-modal guiding in transrectal ultrasound-guided prostate targeted biopsies in the biopsy naive patients / 中华泌尿外科杂志

Objective To estimate the value of multi-modal guiding in transrectal ultrasound-guided prostate targeted biopsies (TB) in the biopsy naive patients.Methods From June 2016 to December 2017,178 patients with suspicious prostate cancer were retrospectively evaluated.The age of patients was 54-87 years(median 70 yesrs).Serum PSA level before biopsy was 1.5-95.0 ng/ml (median 13.2 ng/ml),in which 70 cases with PSA ＜ 10 ng/ml,58 cases 10-20 ng/ml,and 50 cases ＞ 20 ng/ml.All patients underwent transrectal ultrasound (TRUS),real-time tissue elastography (RTE) and contrast-enhanced ultrasonography(CEUS).All positive sites on imaging undergoing two-core TB and 10 core-systematic biopsy (SB).The detection rates and positive rates of biopsy for any cancer (PCa) and clinically significant prostate cancer (CsPCa) were compared between TB and SB.Pathological findings of each biopsy core was analyzed for Gleason grade and the single-core length of prostate cancer.Results The total detection rate for PCa was 48.8％ (87/178).The diagnostic accuracy of PCa did not significantly differ between TB 35.5％ (63/178) and SB 42.8％ (76/178) groups.There was no significant difference between the proportion of CsPCa in TB group and SB group [80％ (50/63) vs.66％ (50/76),P =0.21].TB had an obvious higher single-core positive rate for prostate cancer 60.6％ (449/740) and an obvious higher singlecore positive rate for high-risk prostate cancer [10.3％ (76/740)] than SB [29.7％ (530/1 780) and 5.5 ％ (98/1 780)],with statistically signficant difference (P ＜ 0.001,P =0.002).TB also had a higher single-core length of prostate cancer than SB [6.80 (0.20-15.00) mm vs.5.50 (0.06-18.00) mm,P ＜0.05].Conclusions This study revealed a similar rate of prostate cancer detection between multi-modal guiding in transrectal ultrasound-guided prostate targeted biopsies (TB) and 10 core-systematic biopsy (SB).TB maybe tend to detect higher proportion of high-risk PCa.

Clinical features and drug resistance in children with Salmonella infection / 中国当代儿科杂志

OBJECTIVE@#To study the clinical features and drug resistance in children with Salmonella infection.@*METHODS@#A total of 163 children with positive fecal cultures for Salmonella who were hospitalized between 2013 and 2017 were enrolled. A retrospective analysis was performed for their data on clinical features, distribution of Salmonella serotypes, and drug sensitivity test results.@*RESULTS@#Among the 163 children with Salmonella infection, 79 (48.5%) were aged ≤1 year. Main clinical manifestations included fever and diarrhea. Of all the children, 121 (74.2%) reached a body temperature of above 39°C, 52 (31.9%) had diarrhea more than 10 times a day, and 56 (34.4%) had respiratory infection. Salmonella infection often occurred in summer and autumn. Of all the children, 131 (80.4%) had the infection in May to October. Salmonella typhimurium was observed in 100 children (61.3%) and Salmonella enteritidis was observed 15 children (9.2%). All serotypes of Salmonella had a drug resistance rate of >20% to cefotaxime, as well as high sensitivities to β-lactamase inhibitors (amoxicillin/clavulanic acid and piperacillin/tazobactam). There were no strains resistant to carbapenems including imipenem.@*CONCLUSIONS@#Infants aged ≤1 year are susceptible to Salmonella infection in summer and autumn, and the most common serotype is Salmonella typhimurium. Main clinical manifestations are fever and diarrhea in children with Salmonella infection, and most children also have respiratory infection. Salmonella has an increased rate of drug resistance to third-generation cephalosporins. In clinical treatment, antimicrobial drugs should be used according to the results of drug sensitivity test.