Clinical characteristics of patients with acute pulmonary embolism in high altitude area of Yunnan province in China / 中华心血管病杂志

Objective: To analyze the clinical features of patients with acute pulmonary embolism (APE) living in high altitude area of Yunnan province. Methods: This was a cross-sectional retrospective study. APE patients, hospitalized in our hospital between January 2017 and December 2019, were included. The selected patients were divided into low-risk group, medium-risk group and high-risk group according to risk stratification. The clinical data of patients, including demographic data, the main symptoms, risk factors of APE, heart rate and systolic blood pressure and laboratory testing results (D-dimer, cardiac troponin I (cTNI), N terminal B-type natriuretic peptide (NT-proBNP)) and echocardiography and electrocardiogram examination results, were obtained through the electronic medical record system. The clinical characteristics of selected patients were analyzed. Results: A total of 392 patients, aged (63.5±15.7) years, 224 males (57.14%), were included in this study and there were 59 low-risk, 304 medium-risk and 29 high-risk patients in this cohort. The main clinical manifestations were chest pain (157(40.05%)), dyspnea (107(27.30%)), hemoptysis (55(14.03%)), syncope as the first symptom (20(5.10%)), and only 6 cases (1.53%) presented with the typical "Virchow's triad". Most of the patients were accompanied by atypical chest tightness (223(56.89%)) and cough (208(53.06%)). The main risk factors were venous thrombosis of lower limbs (179(45.66%)), hypertension (138(35.20%)), surgery (63(16.07%)), and chronic obstructive pulmonary disease (COPD) (62(15.82%)). There were 57 cases (14.54%) of coronary heart disease, 57 cases (14.54%) of diabetes, 51 cases (13.01%) of cerebral infarction, 47 cases (12.00%) of advanced age, 15 cases (3.83%) of tumor, 7 cases (1.79%) of activity restriction, 6 cases (1.53%) of pregnancy and 4 cases (1.02%) of hormone use in this cohort. The proportion of lower extremity venous thrombosis was significantly higher in low-risk group than in medium-risk group (P<0.01), COPD was more common in high-risk and medium-risk groups than in low-risk group (P<0.01), hypertension was more common in high-risk group than in medium-and low-risk groups (P<0.01). The proportion of advanced age was significantly higher in medium-risk group than in low-risk group (P<0.01). There were no significant differences in RBC and hemoglobin level between low-, medium-and high-risk groups (P>0.05). The level of D-dimer was significantly higher in high-risk group than in medium-and low-risk groups (P<0.05). Levels of NT-proBNP and cTNI were significantly higher in high-risk group than in medium- and low-risk groups (P<0.05). Increased proportion of cTNI and NT-proBNP was significantly higher in high-risk group than in medium- and low-risk groups (P<0.05). There were 105 (26.79%) patients with pulmonary hypertension (PAH). The incidence of PAH was significantly higher in high-risk group than in low-risk group (P<0.01). There were 104 patients (26.53%) with right ventricular enlargement, and the incidence of right ventricular enlargement was significantly higher in high-risk group than in medium-and low-risk groups (P<0.01). Characteristic changes of electrocardiogram in patient with APE were T-wave inversion of limb leads (98(25.00%)), followed by SⅠQⅢTⅢ (83(21.17%)). Conclusions: The main clinical manifestations of APE in Yunnan high altitude area are chest pain and dyspnea, and syncope is the first symptom in some patients, but the typical "Virchow's triad" is rare. The most common risk factors are lower extremity venous thrombosis, hypertension, and COPD. Clinical symptoms, risk factors and laboratory examination results differ among patients with different risk stratification.

Tapping at acupoints along meridian combined with thunder-fire moxibustion for upper-limb hemiplegia after stroke / 中国针灸

OBJECTIVE@#To observe the effect of tapping at acupoints along meridian combined with thunder-fire moxibustion on upper-limb muscle strength and activities of daily living in patients with upper-limb hemiplegia after stroke.@*METHODS@#A total of 140 patients with upper-limb hemiplegia after stroke were randomly divided into a combination group (35 cases, 2 cases dropped off), an acupoint-tapping group (35 cases), a moxibustion group (35 cases, 2 cases dropped off) and a routine group (35 cases). The patients in the routine group were only treated with routine treatment and nursing. On the basis of the treatment in the routine group, the patients in the acupoint-tapping group were treated with tapping along the large intestine meridian of hand @*RESULTS@#Compared before treatment, body mass indexs of shoulder abduction, elbow extension, wrist flexion as well as BI scores in the four groups were significantly increased after treatment (@*CONCLUSION@#Tapping at acupoints along meridian combined with thunder-fire moxibustion could effectively improve the upper-limb muscle strength and activities of daily living in patients with upper-limb hemiplegia after stroke, and its effect is superior to simple tapping at acupoints along meridian or thunder-fire moxibustion.

Fibroblast growth factor 13 regulates apoptosis of A549 cells through the ROS/ Caspase-3 pathway / 中国肿瘤生物治疗杂志

@#目的：探讨成纤维细胞生长因子 13（fibroblast growth factor 13，FGF13）对非小细胞肺癌 A549 细胞活性氧（reactive oxygen species，ROS）的生成和凋亡的影响及其调控机制。方法：WB 法检测 FGF13 在人正常肺上皮细胞 BEAS-2B 和肺癌 A549、H460 细胞中的本底表达量。采用 FGF13 过表达载体转染 BEAS-2B 和 A549 细胞；设计两组靶向 FGF13 的 shRNA 序 列，构建慢病毒干扰载体，包装病毒后侵染 A549 细胞，采用 qPCR 和 WB 法检测干扰效果，DCFH-DA 探针结合荧光酶标仪分 析敲减 FGF13 对 A549 细胞内 ROS 水平的影响，MitoSOX 与 WB 法检测对线粒体 ROS 水平及烟酰胺腺嘌呤二核苷酸磷酸氧 化酶 4（nicotinamide adenine dinucleotide phosphate oxidase 4，NOX4）蛋白表达量的影响，Annexin V-FITC-PI 双染法检测对细胞 凋亡和 Caspase-3 及 Cleaved Caspase-3 蛋白表达的影响。结果：与 BEAS-2B 细胞相比，FGF13 蛋白在两种肺癌细胞中均高表 达（均 P<0.05）。成功构建 FGF13 过表达、低表达的 A549 细胞系。过表达 FGF13 后，BEAS-2B 和 A549 细胞内 ROS 水平显著 降低（P<0.05）；敲减 FGF13 表达后，A549 细胞内 ROS 水平显著升高（P<0.05）；然而过表达及干扰 FGF13 对 A549 细胞内线粒 体 ROS 水平无显著影响，但 NOX4 蛋白表达量显著下调（P<0.05）及显著上调（P<0.05）。FGF13 干扰后 A549 细胞凋亡率显著 升高（P<0.01），Caspase-3 及 Cleaved Caspase-3 蛋白表达量显著上调（P<0.05）。结论：FGF13 可能通过 NOX 家族途径调控 ROS 的生成，并通过 ROS/Caspase-3 通路调控 A549 细胞凋亡。

Prevalence of Congenital Heart Disease Amongst Schoolchildren in Southwest China

Objective: To investigate the prevalence and risk factors of congenital heart disease inYunnan, China which has diverse ethnic groups. Methods: This cross-sectional studyenrolled 244,023 children from 2010 to 2015. To diagnose CHD, a conventional physicalexamination was used to screen suspicious cases, which were further confirmed byechocardiography. Results: A total of 1695 children were diagnosed with CHD. Theestimated prevalence was 6.94%. Atrial septal defects were the most common cardiacabnormalities. A higher prevalence of CHD was observed with preterm birth, low birthweight, maternal age ≥35 years, and high-altitude regions. The prevalence also showeddifferences between diverse ethnic groups. Conclusion: The prevalence of CHD in Chinamay have ethnic differences.

The Application of the Technique in the Protection of PCI / 昆明医科大学学报

Objective To explore the treatment of percutaneous coronary intervention (PCI), and to comparatively study on the protection of side support by using the active and passive expansion technique.Method 78 patients with coronary artery disease were protected by using balloon technique, there were two groups: the active expansion group (n=41) and the side support balloon (n=37), the TIMI classification、myocardial perfusion rating (MBG), TIMI myocardial perfusion rating (TMP) and the incidence of marginal vascular interlayer were observed and analyzed. Results After the main support was put in, the proportion of patients with side branches of TIMI、 MBG and TMP was at level 3 and the proportion of patients with active balloon expansion was 93％, the margin expansion group was 84％, the difference was not statistically significant (P＞0.05); the incidence of intersecting vascular interlayer in active dilatation group was 24％, the margin expansion group was 8％, and there were statistical differences (P＜0.05). Conclusions Using the technique of holding balloon to protect the side branches, both the active expansion of the side support balloon and the expansion of the side support balloon can significantly reduce the risk of the main stent placement in the posterior branch of the blood vessel, however the incidence of side branch vascular interlayer was lower.

Estradiol promotes growth of decidua derived mesenchymal stem cells by inhibiting miR-16 via estrogen receptorα / 中国病理生理杂志

AIM:To study the effect of estradiol (E2) on the viability of mesenchymal stem cells (MSCs) de-rived from the decidua of the placenta by regulating the expression of microRNA-16 (miR-16).METHODS:The concen-tration of E2 in the peripheral blood of normal pregnant women and the patients with severe preeclampsia ( PE) was meas-ured.The effects of E2 at different concentrations on the viability of MSCs were analyzed .The effect of E2 at different con-centrations on the expression of miR-16 in the MSCs was detected , and which estrogen receptor ( ER) mediated the regula-tory effect of E2 on miR-16 expression was determined .RESULTS:The concentration of E2 in peripheral blood of the pa-tients with severe PE was significantly decreased (P<0.01).After treatment with E2 at 5, 10 and 100 nmol/L for 48 h, the viability of MSCs was increased (P<0.05).The expression level of miR-16 was down-regulated in the MSCs treated with E2 at 5, 10 and 100 nmol/L for 12 h.After treatment with E2 at 10 nmol/L for different time (0 h, 3 h, 6 h, 12 h and 24 h) , the expression level of miR-16 in the MSCs showed a clear time-dependent downward trend .E2 significantly promoted the viability of MSCs , and the cell viability was significantly reversed after miR-16 pretreatment.Pretreatment with estrogen receptor antagonists ICI 182780 and tamoxifen for 6 h attenuated the inhibitory effect of E 2 on miR-16 expres-sion.Only ERαagonist propyl pyrazole triol significantly inhibited the expression of miR-16 in MSCs but ERβagonist dia-rylpropionitrile did not .CONCLUSION:E2 promotes the growth of decidua-derived MSCs by inhibiting miR-16 via ERα.

Short-term outcomes of intravitreal injection of conbercept for diabetic macular edema and restoration of ellipsoid zone / 眼科新进展

Objective To evaluate the efficacy and safety of intravitreal injection of conbercept for diabetic macular edema (DME) and the changes of ellipsoid zone (EZ).Methods A retrospective study was conducted in 14 patients (16 eyes) and the clinical data were reviewed and analyzed.All the patients were administrated with conbercept intravitreally,and rechecked 1 month,2 months,3 months after injection including the best corrected visual acuity (BCVA) and optical coherence tomography (OCT).Then a comparison was performed in logMAR BCVA,central foveal thickness (CFT) and macular volume before treatment and 1 month,2 months and 3 months after conbercept injection,as well as the cross-sectional length of incomplete portion in EZ before treatment and 3 months after injection.Results The value of logMAR BCVA before treatment and 1 month,2 months and 3 months after conbercept injection was 0.79 ± 0.08,0.65 ± 0.07,0.56 ± 0.06 and 0.52 ± 0.06,respectively;the average CFT before treatment and 1 month,2 months and 3 months after treatment was (536.44 ±35.87) μm,(385.63 ± 22.60) μm,(336.13 ± 21.91) μm and (292.38 ± 22.54) μm accordingly;the macular volume before treatment and 1 month,2 months and 3 months after treatment was (11.27 ± 0.37) mm3,(10.21 ± 0.22) mm3,(9.69 ± 0.17) mm3 and (9.30 ±0.20) mm3,respectively,with statistically significance in palrwise comparison.Moreover,the cross-sectional length of disrupted EZ before treatment and 3 months after injection was (3116.69 ± 385.55) μm and (1784.88 ± 362.39) μm respectively,and there was statistically significant difference (P ＜ 0.05).Conclusion Intravitreal injection of conbercept to treat DME can alleviate macular edema and restore the disrupted ellipsoid zone.

Preliminary risk assessment on the dietary exposure of Cd in Yantai / 预防医学

Objective To analyze the cadmium level of main food,and to preliminarily assess the risk of dietary cadmium exposure among residents in Yantai.Methods A total of 925 samples of 10 kinds of food groups were collected from 14 counties (or districts)of Yantai.Cadmium contents in food were determined according to GB/T 5009.15—2003,and then the provisional tolerable monthly intake (PTMI)and the margins of safety(MOS)of cadmium were calculated by combining the concentration of cadmium in foods with food consumption data.Results The concentration of cadmium in 10 kinds of food groups was 26.47 μg/kg.The concentration of cadmium in sea foods was 92.48 μg/kg,and that was the highest among the 10 kinds of food groups.The concentration of cadmium in pluck,flour and vegetables were 47.35,33.25, 18.87 μg/kg respectively.Monthly dietary cadmium exposure quantity of flour,sea food,vegetable and rice was 295.70 μg,38.11 μg,32.09 μg and 10.87 μg,respectively.Flour as a most important contributor,contributed 76.09% of the total dietary cadmium exposure.Conclusion The average dietary cadmium exposure from the main food did not exceed the PTMI and the MOS was more than 1,so the level of dietary cadmium exposure is safe.However,based on the largest consumption of flour in Yantai and the high contribution rate of flour of dietary cadmium exposure,more attention should be paid to the possible cadmium contaminated wheat.

Retrospective analysis of patients with thrombocytopenia after patent ductus arteriosus interventional occlusion / 中华心血管病杂志

<p><b>OBJECTIVE</b>To explore the risk factors of patent ductus arteriosus (PDA) patients with thrombocytopenia after PDA interventional occlusion.</p><p><b>METHODS</b>Thrombocytopenia occurred in 14 out of 350 patients underwent PDA occlusion. Age, gender, body weight, PDA size, occluder size, mean pulmonary arterial pressure, the dose of heparin, the manufacturer of occluder, residual shunt after operation were analyzed. The recovery time of different grades of thrombocytopenia was observed.</p><p><b>RESULTS</b>Multivariate logistic regression showed that the PDA size (OR = 2.238, P < 0.05), the dose of heparin (OR = 3.247, P < 0.05), residual shunt after operation (OR = 1.912, P < 0.01) were the independent risk factors of thrombocytopenia after PDA occlusion. The recovery time of mild thrombocytopenia was (7 ± 2) days without treatment. The recovery time of moderate thrombocytopenia was (12 ± 4) days with glucocorticoids treatment. The recovery time of severe thrombocytopenia was (21 ± 7) days with platelet transfusion.</p><p><b>CONCLUSIONS</b>The occluder size, dose of heparin, residual shunt are the independent risk factors of thrombocytopenia after PDA interventional occlusion. Recover time of thrombocytopenia after PDA interventional occlusion is closely related to the severity of thrombocytopenia.</p>

Application of echocardiography in resynchronization treatment of heart failure patients / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To review the updated research progress about the application of echocardiography in resynchronization treatment of chronic heart failure patients.</p><p><b>DATA SOURCES</b>The data used in this review were from PubMed, published in English and using the key terms "heart failure", "echocardiography" and "cardiac resynchronization therapy".</p><p><b>STUDY SELECTION</b>Relevant articles were reviewed and selected to address the stated purpose.</p><p><b>RESULTS</b>Increasing numbers of studies have suggested the importance of echocardiography in resynchronization treatment of chronic heart failure patients. Echocardiography can evaluate atrioventricular, inter- and intra-ventricular mechanical dyssynchrony before cardiac resynchronization therapy (CRT), as a guidance to assess the optimal left ventricular (LV) pacing location, optimize the atrioventricular and interventricular delays and predict response to CRT.</p><p><b>CONCLUSIONS</b>Echocardiography is both non invasive and easily repeatable, and plays a crucial role in appraisal of heart synchronism, instruction of actuator placement, optimization of the device procedure, and prediction of the response to CRT.</p>

Regionspecific survival and differentiation of mouse embryonic stem cell-derived implants in the adult rat brain / 生理学报

Totipotent and regionally non-specified embryonic stem (ES) cells provide a powerful tool to understand mechanisms controlling stem cell differentiation in different regions of the adult brain. As the development capacity of ES cells in the adult brain is still largely unknown, we grafted small amounts of mouse ES (mES) cells into adult rat brains to explore the survival and differentiation of implanted mES cells in different rat brain regions. We transplanted the green fluorescent protein (GFP)-positive mES cells into the hippocampus, septal area, cortex and caudate nucleus in rat brains. Then the rats were sacrificed 5, 14 and 28 d later. Of all the brain regions, the survival rate of the transplanted cells and their progeny were the highest in the hippocampus and the lowest in the septal area (P<0.01). The grafted ES cells could differentiate into nestin-positive neural stem cells. Nestin-positive/GFP-positive cells were observed in all brain regions with the highest frequency of nestin-positive cells in the hippocampus and the lowest in the medial septal area (P<0.01). mES cells differentiated into end cells such as neurons and glial cells in all transplantation sites in recipient brains. In the hippocampus, the ES cells differentiated into neurons in large amounts. These results demonstrate that only some brain regions permit survival of mES cells and their progeny, and form instructive environments for neuronal differentiation of mES cells. Thus, because of region specific presence of microenvironmental cues and their environmental fields, the characteristics of the recipient tissue were considerably important in formulating cell replacement strategies for neural disorders.

The study on the immunogenicity of hESCs and the derived NSCs / 中华神经科杂志

Objective To study the immunogenicity of human embryonic stem cells(hESCs)and the derived neural stem cells(NSCs)in vitro.Methods The constitutive expression of human leucocyte antigen(HLA)Ⅰ and Ⅱ in hESCs and the NSCs derived from these hESCs were detected by flow cytometry (FCM), as well as the expression of HLA-Ⅰ,Ⅱin NSCs induced by 30 ng/ml recombination human interferon-?(IFN-?).Meanwhile, the NSCs before and after induction of IFN-? were co-cultured with peripheral blood lymphocyte obtained from healthy person.Lymphocyte proliferation standing for the immunoreactivity of NSCs was then investigated.Results The hESCs slightly expressed HLA-Ⅰ(6.18%) and hardly any HLA-Ⅱ before differentiation.However, the NSCs expressed more HLA-Ⅰ(23.56%)as well as HLA-Ⅱ(1.28%, 1.73%)than the hESCs did.Both HLA-Ⅰ(46.43%)and HLA-Ⅱ(8.73%, 10.57%)expressed by the NSCs after they were induced by IFN-? were up-regulated.Conclusions hESCs express certain level of HLA-Ⅰ molecules but do not constitutively express HLA-Ⅱ molecules.The derived NSCs express heavy HLA-Ⅰ and a little HLA-Ⅱ, when treated by IFN-? they can inducibly up- regulated both molecules.The NSCs derived from HESCs are of immunogenicity, which induce rejection aiming at HLA-Ⅰ molecules or even at HLA-Ⅱ molecules when the host is inflammative or under stress, which can result in a failure of cellular transplantation.

Differentiation of human embryonic stem cells into neural stem cells in vitro / 中华神经科杂志

Objective To explore a kind of simple and high efficient approach to differentiate human embryonic stem cells(hESCs)into neural stem cells(NSCs).Methods hESCs were cultured in bacterial culture dish filled with serum free medium to gain embryoid bodies.Then the mature embryoid bodies grew in the special medium including B27 and noggin by adherent culture to differentiate into NSCs. Results The hESCs kept floating in the bacterial culture dish and growing all the time and then formed mature embryoid bodies 7 to 10 days later.The embryoid bodies could be differentiated into highly pure (96.4%)nestin positive cells.And these cells were differentiated into all kinds of neural cells if cultured further.Conclusions This kind of method is less time-consuming,cheaper,and more efficient than those of the results in literatures reported.It affords very good source of seed cells for cell transplantation therapy in the future.