[Research Progress in Diagnostic Reference Levels in Interventional Radiology].

During interventional procedures,subjects are exposed to direct and scattered X-rays.Establishing diagnostic reference levels is an ideal way to optimize the radiation dose and reduce radiation hazard.In recent years,diagnostic reference levels in interventional radiology have been established in different countries.However,because of the too many indicators for characterizing the radiation dose,the indicators used to establish diagnostic reference levels vary in different countries.The research achievements in this field remain to be reviewed.We carried out a retrospective analysis of the definition,establishment method,application,and main factors influencing the dose difference of the diagnostic reference level,aiming to provide a basis for establishing the diagnostic reference level for interventional procedures in China.

Tear inflammation related indexes after cataract surgery in elderly patients with type 2 diabetes mellitus.

BACKGROUND: Quantitative studies on the changes in inflammation-related content in tears, especially the effect of diabetes, are lacking. In this study, we measured the preoperative and postoperative tear inflammatory mediator levels in cataract patients, focusing on the expression of inflammatory factors in postoperative cataracts in the diabetic, and investigated the effect of drugs on the control of postoperative inflammation. AIM: To study the expression of inflammatory factors in elderly people with type 2 diabetes after cataract surgery. METHODS: Patients with a mean age of 70.3 ± 6.3 years were divided into group A (composed of elderly patients with cataracts and type 2 diabetes, n = 20 eyes) and group B (patients with age-related cataract, n = 20 eyes). Their tears were collected before each operation and on days 1 and 3, and weeks 1, 2, 3, and 4 post-surgery. Saline (150 µL) was dropped into the conjunctival sac of the surgical eye, followed by oculogyration in four directions. The fluid in the conjunctival sac was extracted using a sterile syringe and stored in Eppendorf tubes at -80 °C until measurement. The expression levels of matrix metalloproteinase-2 (MMP-2), MMP-9, tissue inhibitor of metalloproteinase-1 (TIMP-1), TIMP-2, interleukin-6 (IL-6), and IL-20 in tear fluid were measured using enzyme-linked immunosorbent assays. RESULTS: The postoperative expression levels of MMP-2, MMP-9, TIMP-2, IL-6, and IL-20 in group A were significantly higher than those in group B, whereas the concentration of TIMP-1 in group A remained lower than that in group B. The levels of MMP-2 and IL-6 in both groups continuously increased until the peak in the first postoperative week, and then gradually decreased over the next three weeks. Ultimately, MMP-2 declined to a lower level than that preoperatively at week 4, but IL-6 decreased to the same level as that preoperatively. The level of MMP-9 peaked in the first two weeks postoperative and then returned to the same level as 1-day post-operation. The concentration of TIMP-1 post-operation remained constant at a lower level than before surgery, and TIMP-2 Levels remained stable in both groups. IL-20 content started to increase in the third week after surgery. CONCLUSION: Inflammatory factor levels in tears fluctuated before and post-operation, which indicated more severe postoperative inflammation in the first two weeks.

Analysis of Bacterial Biofilm Formation in Patients with Malignancy Undergoing Double J Stent Indwelling and Its Influencing Factors.

OBJECTIVE: To analyze the bacterial biofilm (BF) formation in patients with malignancy undergoing double J stent indwelling and its influencing factors. METHODS: A total of 167 patients with malignant tumors who received double J stent indwelling in the hospital from January 2018 to January 2021 were included in the study. The urine and double J stent samples were collected for bacterial identification and observed for BF formation on the surface of the urinary catheter under a scanning electron microscope (SEM). Univariate and multivariate logistic regression analyses were used to analyze the influencing factors of BF. RESULTS: The BF formation rate was 34.73% (58/167). The BF formation rate of positive specimens cultured in urine and double J stent was significantly higher than that of negative ones (P<0.05). Staphylococcus was the main BF bacteria in double J stent and urine culture specimens, followed by Enterococcus, Pseudomonas, Enterobacter, and Acinetobacter. Compared with the non-BF group, the number of viable bacteria in the double J stent and urine and the catheterization time in the BF group rose markedly (P<0.05). Advanced age, chemotherapy, anemia, indwelling time ≥90d, and urinary tract infection were risk factors for BF formation in patients with malignancy undergoing double J stent indwelling (P<0.05). CONCLUSION: There is a high rate of BF formation in patients with malignancy undergoing double J stent indwelling, with Staphylococcus as the dominant species. Treatment requires enhanced urinary catheter management and nutritional status to inhibit BF formation and lower the rate of urinary catheter-related infections.

Screening the Influence of Biomarkers for Metabolic Syndrome in Occupational Population Based on the Lasso Algorithm.

Aim: Metabolic syndrome (MS) screening is essential for the early detection of the occupational population. This study aimed to screen out biomarkers related to MS and establish a risk assessment and prediction model for the routine physical examination of an occupational population. Methods: The least absolute shrinkage and selection operator (Lasso) regression algorithm of machine learning was used to screen biomarkers related to MS. Then, the accuracy of the logistic regression model was further verified based on the Lasso regression algorithm. The areas under the receiving operating characteristic curves were used to evaluate the selection accuracy of biomarkers in identifying MS subjects with risk. The screened biomarkers were used to establish a logistic regression model and calculate the odds ratio (OR) of the corresponding biomarkers. A nomogram risk prediction model was established based on the selected biomarkers, and the consistency index (C-index) and calibration curve were derived. Results: A total of 2,844 occupational workers were included, and 10 biomarkers related to MS were screened. The number of non-MS cases was 2,189 and that of MS was 655. The area under the curve (AUC) value for non-Lasso and Lasso logistic regression was 0.652 and 0.907, respectively. The established risk assessment model revealed that the main risk biomarkers were absolute basophil count (OR: 3.38, CI:1.05-6.85), platelet packed volume (OR: 2.63, CI:2.31-3.79), leukocyte count (OR: 2.01, CI:1.79-2.19), red blood cell count (OR: 1.99, CI:1.80-2.71), and alanine aminotransferase level (OR: 1.53, CI:1.12-1.98). Furthermore, favorable results with C-indexes (0.840) and calibration curves closer to ideal curves indicated the accurate predictive ability of this nomogram. Conclusions: The risk assessment model based on the Lasso logistic regression algorithm helped identify MS with high accuracy in physically examining an occupational population.

A comparative research on obesity hypertension by the comparisons and associations between waist circumference, body mass index with systolic and diastolic blood pressure, and the clinical laboratory data between four special Chinese adult groups.

BACKGROUND: The obesity-hypertension pathogenesis is complex. From the phenotype to molecular mechanism, there is a long way to clarify the mechanism. To explore the association between obesity and hypertension, we correlate the phenotypes such as the waist circumference (WC), body mass index (BMI), systolic blood pressure (SB), and diastolic blood pressure (DB) with the clinical laboratory data between four specific Chinese adult physical examination groups (newly diagnosed untreated just-obesity group, newly diagnosed untreated obesity-hypertension group, newly diagnosed untreated just-hypertension group, and normal healthy group), and the results may show something. OBJECTIVE: To explore the mechanisms from obesity to hypertension by analyzing the correlations and differences between WC, BMI, SB, DB, and other clinical laboratory data indices in four specific Chinese adult physical examination groups. METHODS: This cross-sectional study was conducted from September 2012 to July 2014, and 153 adult subjects, 34 women and 119 men, from 21 to 69 years, were taken from four characteristic Chinese adult physical examination groups (newly diagnosed untreated just-obesity group, newly diagnosed untreated obesity-hypertension group, newly diagnosed untreated just-hypertension group, and normal healthy group). The study was approved by the ethics committee of Hangzhou Center for Disease Control and Prevention. WC, BMI, SB, DB, and other clinical laboratory data were collected and analyzed by SPSS. RESULTS: Serum levels of albumin (ALB)，alanine aminotransferase (ALT), low density lipoprotein cholesterol (LDLC), triglyceride (TG), high density lipoprotein cholesterol (HDLC), alkaline phosphatase (ALP), uric acid (Ua), and TC/HDLC (odds ratio) were statistically significantly different between the four groups. WC statistically significantly positively correlated with BMI, ALT, Ua, and serum levels of glucose (GLU), and TC/HDLC, and negatively with ALB, HDLC, and serum levels of conjugated bilirubin (CB). BMI was statistically significantly positively related to ALT, Ua, LDLC, WC, and TC/HDLC, and negatively to ALB, HDLC, and CB. DB statistically significantly positively correlated with ALP, BMI, and WC. SB was statistically significantly positively related to LDLC, GLU, serum levels of fructosamine (FA), serum levels of the total protein (TC), BMI, and WC. CONCLUSION: The negative body effects of obesity are comprehensive. Obesity may lead to hypertension through multiple ways by different percents. GGT, serum levels of gamma glutamyltransferase; ALB, serum levels of albumin; ALT, serum levels of alanine aminotransferase; LDLC, serum levels of low density lipoprotein cholesterol; TG, serum levels of triglyceride; HDLC, serum levels of high density lipoprotein cholesterol; FA, serum levels of fructosamine; S.C.R, serum levels of creatinine; IB, serum levels of indirect bilirubin; ALP, serum levels of alkaline phosphatase; CB, serum levels of conjugated bilirubin; UREA, Urea; Ua, serum levels of uric acid; GLU, serum levels of glucose; TC, serum levels of the total cholesterol; TB, serum levels of the total bilirubin; TP, serum levels of the total protein; TC/HDLC, TC/HDLC ratio.

A regulatory circuit involving miR-143 and DNMT3a mediates vascular smooth muscle cell proliferation induced by homocysteine.

Accumulating evidence has suggested that homocysteine (Hcy) is an independent risk factor for atherosclerosis (AS). Hcy can promote vascular smooth muscle cell (VSMC) proliferation, which is pivotal in the pathogenesis and progression of AS. The aim of the present study was to investigate the epigenetic regulatory mechanism of microRNA (miR)­143­mediated VSMCs proliferation induced by Hcy. The results of a 3­(4,5­dimethylthiazol­2­yl)­2,5­diphe­nyltetrazolium bromide assay revealed that VSMC proliferation was increased by 1.39­fold following treatment with 100 mM Hcy, compared with the control group. The levels of miR­143 were markedly downregulated in the Hcy group, compared with the control group, as determined using reverse transcription­quantitative polymerase chain reaction analysis. In addition, the level of miR­143 methylation was increased markedly in the VSMCs treated with Hcy, compared with the control, and was reduced following transfection with DNA methyltransferase (DNMT)3a small interfering RNA, determined using methylation­specific­PCR. The activities of DNMT3a luciferase were also altered accordingly in VSMCs transfected with pre­miR­143 and miR­143 inhibitor, respectively. In addition, the expression of miR­143 was observed to be inversely correlated with the mRNA and protein expression of DNMT3 in the VSMCs. Taken together, these findings suggest that DNMT3a is a direct target of miR­143, and that the upregulation of DNMT3 is responsible for the hypermethylation of miR­143 in Hcy-induced VSMC proliferation.

[The effect of miR-124 on homocysteine-induced atherosclerosis via promoter region DNA methylation in ApoE(-/-) mice].

The aim of the present study is to explore the role of miR-124 and its promoter region DNA methylation in homocysteine (Hcy)-induced atherosclerosis. ApoE(-/-) mice were fed with hypermethionine diet for 16 weeks to duplicate hyperhomocysteinemia model. Meanwhile, a normal control group (C57BL/6J mice fed with normal diet, N-control) and a model control group (ApoE(-/-) mice fed with normal diet, A-control) were set. The degree of atherosclerosis was observed by HE and oil red O staining. Automatic biochemical analyzer was used to detect the serum levels of Hcy. Foam cell model was duplicated and oil red O staining was used to confirm whether the model was successfully established. And foam cells were stimulated with 0, 50, 100, 200, 500 µmol/L Hcy and 50 µmol/L Hcy + 10 µmol/L AZC respectively. Real-time quantitative PCR (RT-qPCR) was used to detect the expressions of miR-124 in mice aorta and foam cells; Nested landing methylation specific PCR (nMS-PCR) was used to detect the levels of miR-124 promoter DNA methylation in mice aorta and foam cells. Meanwhile, the effects of DNA methylation inhibitor AZC on miR-124 expression were observed at the cellular level. The effect of miR-124 promoter DNA methylation status on lipid accumulation in foam cells was observed by oil red O staining. The results showed that compared with model control group, the serum levels of Hcy in high methionine group were significantly increased (P < 0.01) and developed aortic atherosclerotic plaque, the expression of miR-124 was markedly decreased (P < 0.01), while the levels of miR-124 promoter DNA methylation were significantly increased (P < 0.01). Given different levels of Hcy, the expression of miR-124 in foam cells was decreased, while the levels of miR-124 promoter DNA methylation were increased in a dose-dependent manner (P < 0.05, P < 0.01). AZC reversed the results of mentioned indices as above markedly (P < 0.05). Downregulation of miR-124 may play a role in Hcy-induced atherosclerosis and its promoter DNA methylation status may be an important mechanism in this process.

Aberrant DNA methylation of the PDGF gene in homocysteine­mediated VSMC proliferation and its underlying mechanism.

It is well established that homocysteine (Hcy) is an independent risk factor for atherosclerosis (AS), which is characterized by vascular smooth muscle cell (VSMC) proliferation. However, the molecular mechanism underlying AS in VSMCs is yet to be elucidated. The aim of this study was to investigate the potential involvement of aberrant DNA methylation of the platelet­derived growth factor (PDGF) gene in Hcy­mediated VSMC proliferation and its underlying mechanism. Cultured human VSMCs were treated with varying concentrations of Hcy. VSMC proliferation, PDGF mRNA and protein expression and PDGF promoter demethylation showed a dose­dependent increase with Hcy concentration, suggesting an association among them. Cell cycle analysis revealed a decreased proportion of VSMCs in G0/G1 and an increased proportion in S phase, indicating that VSMC proliferation was increased under Hcy treatment. Furthermore, S­adenosylhomocysteine (SAH) levels were observed to increase and those of S­adenosylmethionine (SAM) were observed to decrease. The consequent decrease in the ratio of SAM/SAH may partially explain the hypomethylation of PDGF with Hcy treatment. Folate treatment exhibited an antagonistic effect against Hcy­induced VSMC proliferation, aberrant PDGF methylation and PDGF expression. These data suggest that Hcy may stimulate VSMC proliferation through the PDGF signaling pathway by affecting the epigenetic regulation of PDGF through the demethylation of its promoter region. These findings may provide novel insight into the molecular association between aberrant PDGF gene demethylation and the proliferation of VSMCs in Hcy­associated AS.

[Fruit and vegetable consumption and related influencing factors among urban junior students in Hangzhou].

OBJECTIVE: To explore the fruit and vegetable (FV) consumption and related influencing factors among urban junior students in Hangzhou. METHODS: In a cross-sectional study, a self-administered questionnaire was used to assess the frequency and amount of FV consumption as well as related socio-demographic characteristics. Logistic regression method was applied to study other factors related to the amount of vegetables consumption ≥ 21 servings and fruit consumption ≥ 14 servings per week. RESULTS: Among 3724 junior students included in this study, 54.7% of them consumed FV daily, 23.6% consumed vegetables ≥ 21 servings and fruit ≥ 14 servings per week (equaled to vegetables ≥ 3 servings and fruit ≥ 2 servings every day). The level of FV intake was high in girls, mother with higher education, and higher family socioeconomic status (SES). After controlling 5 socio-demographic factors, data on the consumption of daily vegetables ≥ 21 servings and fruit ≥ 14 servings weekly, were positively associated with daily physical activity (PA) ≥ 60 min (OR = 1.667, 95%CI: 1.216 - 2.203), encouragement on FV intake daily by family (OR = 1.881, 95%CI: 1.498 - 2.363), positive familial attitude on the daily intake of FV (OR = 1.275, 95%CI: 1.025 - 1.586), preparation FV 3 - 6 days per week (OR = 1.691, 95%CI: 1.310 - 2.183) or daily (OR = 2.944, 95%CI: 2.348 - 3.690), family consumption of FV with children/3-6 days per week (OR = 1.392, 95%CI: 1.056 - 1.835) or on the daily base (OR = 2.817, 95%CI: 2.217 - 3.580), breakfast usually made at home (OR = 1.364, 95%CI: 1.158 - 1.607), offering FV course at school last year (OR = 1.238, 95%CI:1.035 - 1.480) and awareness on the benefit of FV (OR = 3.150, 95%CI: 1.121 - 8.856) etc. respectively. CONCLUSION: Socio-demographic characteristics, daily PA, dietary pattern at home, education and awareness on the benefits of FV on health etc. were all related to the FV intake among junior students in Hangzhou.

[Relations between attitude and practice of smoking and the training program regarding tobacco control among community medical staff members in Hangzhou, Zhejiang province].

OBJECTIVE: To investigate the relations between training and both the attitude and practice on smoking control among community medical staff members in Hangzhou, Zhejiang province. METHODS: Three representative districts including Xiacheng, Gongshu and Westlake were chosen from Hangzhou city. Questionnaire survey was applied to collect information from the related community medical staff members. The survey mainly contained three aspects: knowledge, attitude and practice regarding smoking control involved in the community medical activities. Availability and application of the resources on smoking cessation were also studied. Logistic regression analysis was applied to explore the factors associated with the smoking control training programs. Differences of rates between groups were assessed with chi-square statistics. Wilcoxon rank sum test was used to study the relationships among knowledge, attitude and practice related to smoking control programs, targeted to the community medical staff members. RESULTS: Eight hundred forty-six community medical workers were involved. Sixty-five percent of the community medical staff members had learned related knowledge on smoking control. Proportion of the community medical staff who had taken lessons on smoking control with 3-10 working years was 1.77 times more than the ones with experience less than two years (OR = 1.77, 95% CI: 1.25-2.51). Eighty-eight point seven percent of the medical staff who had received smoking control training programs were identified with the consciousness that they should advise the patients to quit smoking, comparing to the proportion 81.60% (Z=-2.87, P=0.00) in the control group. In terms of the practice regarding smoking control, data showed that 21.62% of the medical staff who had received smoking control training programs would provide 'how to quit smoking' to more than 90% of the smoking patients, while the proportion in the control group was 10.65% (Z = -5.68, P = 0.00). The use of drugs, traditional Chinese medicine therapy and the smoking cessation hotline rate were all less than 30%. CONCLUSION: The training programs being used on smoking control seemed useful in improving the consciousness and practice towards the smoking control programs during their medical activities among the community medical staff members.