Objective To investigate the necessity of preoperative use of prophylactic antibiotics in percutaneous transluminal angioplasty (PTA) of lower extremity. Methods A total of 86 patients with arteriosclerosis obliterans of lower extremity (101 invalid lower extremities in total) were enrolled in this study. The patients were prospectively and randomly divided into study group (n=41, 51 limbs) and control group (n=45, 50 limbs). The patients in the study group received intravenously prophylactic antibiotics two hours before PTA, while no antibiotic was employed for the patients in the control group. The improvement of symptoms and the occurrence of infection after PTA in the two groups were compared. Results After PTA, fever was seen in 27 patients, including 12 patients of the study group (29.3%) and 15 patients of the control group (33.3%). Elevation of neutrophil count (>70%) was observed in 6 patients (14.7%) of the study group and in 7 patients (15.6%) of the control group, but the difference between the two groups was not statistically significant (P>0.05). Septicemia occurred in one patient in each group, both were aged patients with diabetes. The post-treatment infection rate in the study group and in the control group was 1.96% and 2.00%respectively, the difference between the two groups was not significant (P>0.05). Conclusion There is no significant correlation between the use of prophylactic antibiotics and the infections after PTA of lower extremity. Therefore, the clinical value of using prophylactic antibiotics for patients with high risk of infection needs to be verified by further randomized controlled trials.

Although adenocarcinomas of the prostate are relatively indolent, some patients with advanced adenocarcinomas show recurrence of treatment-induced neuroendocrine prostate cancer, which is highly aggressive and lethal. Detailed biological features of treatment-induced neuroendocrine prostate cancer have not been characterized owing to limited biopsies/resections and the lack of a cellular model. In this study, we used a unique cellular model (LNCaP/NE1.8) to investigate the potential role of cancer stem cells in treatment-induced neuroendocrine prostate cancer with acquired resistance to hormonal therapy and chemotherapy. We also studied the role of cancer stem cells in enhancing invasion in treatment-induced neuroendocrine prostate cancer cells that recurred after long-term androgen-ablation treatment. Using an in vitro system mimicking clinical androgen-ablation, our results showed that the neuroendocrine-like subclone NE1.8 cells were enriched with cancer stem cells. Compared to parental prostate adenocarcinoma LNCaP cells, NE1.8 cells are more resistant to androgen deprivation therapy and chemotherapeutic agents and show increased cancer cell invasiveness. Results from this study also suggest a potential epigenetic therapeutic strategy using suberoylanilide hydroxamic acid, a histone deacetylase inhibitor, as a chemotherapeutic agent for therapy-resistant treatment-induced neuroendocrine prostate cancer cells to minimize the risk of prostate cancer recurrence and metastasis.

OBJECTIVETo investigate the possible effect of MicroRNA-214 (miR-214) on migration of umbilical cord blood CD34hematopoietic stem/progenitor cells induced by BM-MSC.

METHODSAfter transfection of the inhibitor or mimic of miR-214, the cultured supernatant of BM-MSC were collected respectively. The expression of miR-214 in BM-MSC was detected by real time quantitative PCR, the effect of supernatant on CD34cell migration was evaluated by chemotaxis assays. The levels of chemokine(SDF-1) secreted by BM-MSC in the supernatant were detected by ELISA.

RESULTSThe cultured supernatant of BM-MSC could promote the migration of CD34cells. Compared with the group without transfection or negative control(NC) group, the transfection with miR-214 mimic could promote the migration of CD34cells (P<0.01), while the migration rate in miR-214 inhibitor groups decreased significantly (P<0.01). Further study found that the concentration of SDF-1 was not changed notably in all groups (P>0.05), as compared with the control group.

CONCLUSIONmiR-214 signalings may indirectly increase the migration of CD34hematopoietic stem/progenitor cells by modulating BM-MSC functions, which may not significantly correlate with the chemokine SDF-1 secreted by BM-MSC.

BackgroundThe influence of different right ventricular lead locations on ventricular arrhythmias (VTA) in patients with a cardiac resynchronization therapy (CRT) is not clear. This study aimed to evaluate the influence on VTA in patients with a CRT when right ventricular lead was positioned at the right ventricular middle septum (RVMS) and the right ventricular apical (RVA).

MethodsA total of 352 patients implanted with a CRT-defibrillator (CRT-D) between May 2012 and July 2016 in the Department of Cardiology of Anhui Provincial Hospital were included. Two-year clinical and pacemaker follow-up data were collected to evaluate the influence of the right ventricular lead location on VTA. Patients were divided into the RVMS group (n = 155) and the RVA group (n = 197) based on the right ventricular lead position. The VTA were compared between these two groups using a Kaplan-Meier curve and Cox multivariate analysis.

ResultsWhen the left ventricular lead location was not considered, RVMS and RVA locations did not affect VTA. However, the subgroup analysis results showed that when the left ventricular lead was positioned at the anterolateral cardiac vein (ALCV), the RVMS group had an increased risk of ventricular arrhythmias and appropriate defibrillation (hazard ratio [HR] = 3.29, P = 0.01 and HR = 4.33, P < 0.01, respectively); when the left ventricular lead was at the posterolateral cardiac vein (PLCV), these risks in the RVMS group decreased (HR = 0.45, P = 0.02 and HR = 0.33, P < 0.01, respectively), and when the left ventricular lead was at the lateral cardiac vein, there was no difference between the two groups. In regard to inappropriate defibrillation, there was no significant difference among all these groups.

ConclusionsWhen the left ventricular lead was positioned at ALCV or PLCV, the right ventricular lead location was associated with VTA and appropriate defibrillation after CRT. Greater distances between leads not only improved cardiac function but also may reduce the risk of VTA.

Objective: To investigate the relationship between PET/CT metabolic parameters and pathological features and prognosis in esophageal squamous cell carcinoma (ESCC) patients with intramural gastric metastasis (IGM). Methods: Totally 86 cases of ESCC IGM patients treated in Anhui Provincial Hospital Affiliated to Anhui Medical University from January 2008 to December 2014 were selected for this study. The patients received the imaging examination by positron emission tomography and computed tomography (PET/CT). The metabolic parameters including maximum standard uptake value (SUVmax), metabolic tumor volume (MTV), PET tumor length (PTL) and mean standard uptake value (SUVmean) were examined to calculate the total lesion glycolysis (TLG). The survival of the patients during 5-year follow-up was recorded, and the relationship between metabolic parameters and clinical pathological features and prognosis was analyzed. Results: SUVmax and SUVmean of IGM patients were related to the diameter of the primary tumor (all P<0.05); MTV was associated with the tumor diameter, lymph node metastasis, and TNM staging (all P<0.05); TLG was associated with the tumor diameter, lymph node metastasis, TNM stage, and tissue differentiation (all P<0.05). During the 5-year follow-up, 6 patients were lost to follow-up, 36 patients died and 44 patients survived; SUVmax, MTV, TLG, PTL, SUVmean, and TNM staging were predictors for patients’prognosis (all P<0.05); MTV, TLG, PTL, SUVmean, and TNM staging were risk factors for prognosis (all P< 0.05). Conclusion: The metabolic parameters including SUVmax, MTV, TLG, PTL and SUVmean in ESCC patients with IGM are related to the pathological characteristics of patients; moreover, MTV, TLG, PTL, SUVmean and TNM staging are risk factors for prognosis; so, PET/CT examination has certain clinical value for the prognosis assessment in ESCC patients with IGM.

Objective: To sequence the ATP7B gene in patients with Wilson's disease (WD) and to analyze the relationship between the mutations and WD. Methods: The genomic DNA was obtained from the oral mucosal cells of 67 clinically diagnosed WD patients; PCR was used to amplify all the exons 5' end→ 3' end of ATP7B gene. And the PCR products were subjected to DNA direct sequencing for mutations. Results: We found that the ATP7B gene mutation rate was 77.61% (52/67) in WD patients. Of these patients, 16 had homozygote mutations (including 12 patients with Arg778Leu and 4 with Arg919Gly), 5 had complex mutations, and 31 had simple hetrozygote mutations. Five types of the ATP7B gene complex mutations were rarely reported in China. Conclusion: We have identified 5 complex mutations of ATP7Bgene, which might be related to the development and progression of WD and deserves further study.

AIM: To analyze changes in objective visual quality before and after femtosecond laser in situ keratomileusis(FS-LASIK)and smart pulse technology-assisted transepithelial photorefractive keratectomy(SMART).

METHODS: Prospective study. We collected 50 cases(100 eyes)treated with FS-LASIK(FS-LASIK group)and another 50 cases(100 eyes)treated with SMART(SMART group)from the Ophthalmology Department of our hospital between October 2018 and December 2018 using Optical Quality Analysis System(OQAS)to measure objective scatter index(OSI), modulation transfer function cut off frequency(MTF cut off), strehl ratio(SR)before and after surgery.

RESULTS: In the FS-LASIK and SMART groups, the OSI values were higher in the 1 and 3mo after surgery, whereas the MTF cut off and SR were lower in the 1 and 3mo after surgery(P<0.05). There was no statistical difference between the two groups in the objective visual quality index before and after 1mo(P>0.05). However, after 3mo, the OSI value of the FS-LASIK group was higher than the SMART group(0.88±0.28 vs 0.70±0.27, P<0.001), whereas the SR was lower than SMART group(0.21±0.05 vs 0.24±0.05, P=0.002).

CONCLUSION: Both FS-LASIK and SMART caused an increase in the intraocular scattering index and a decrease in objective visual quality. However, the visual quality of the SMART group was generally better than that of the FS-LASIK group, and long-term visual quality was more dominant.

AIM: To investigate the effects of serum 25-hydroxyvitamin D (25(OH)D) on the blood glucose and islet β-cells function in the elderly with type 2 diabetes (T2DM). METHODS: Fifty-eight elderly patients with type 2 diabetes were recruited from June 2019 to January 2020, and all the patients were divided into three groups according to levels of serum 25(OH)D. Age, body mass index (BMI) and the levels of fasting blood glucose (FBG), hemoglobin A1c (HbA1c) were analyzed. Steamed bread meal test was performed in all patients, and the levels of blood glucose and C-peptide were compared among the three groups at the time points of 0, 30, 60, 120 and 180 min to investigate the effect of serum 25(OH)D on the islet β-cells function.RESULTS: Compared with the elderly T2DM patients with sufficient 25(OH)D, the HbA1c increased significantly in the elderly T2DM patients with deficiency of 25(OH)D (P<0.05). The levels of blood glucose were increased at the time points of 120 min and 180 min, while the levels of C-peptide at the time point of 60 min and 120 min, C peptide index and AUCCP180 in elder T2DM patients decreased significantly (P<0.05). Pearson correlation analysis showed that serum was negatively correlated with HbA1c, and positively correlated with the C peptide and C peptide index and AUCCP180 (P<0.05). And stepwise multiple regression analysis indicated that C peptide was a factor influencing 25(OH)D levels. CONCLUSION: Elderly T2DM patients with deficiency of 25(OH)D are more likely to suffer with severe dysfunction of islet β-cells.

OBJECTIVETo investigate the effect of microRNA-99a-5p (miR-99a-5p) on differentiation ability of human bone marrow mesenchymal stem cells (BM-MSC).

METHODSBM-MSC was cultured and then transfected with miR-99a-5p mimics or inhibitors. The transfection efficiency was detected by real-time quantitative PCR. The effects of miR-99a-5p on the adipogenic and osteogenic differentiation ability of BM-MSC were detected by differentiation experiment.

RESULTSAs compared with the negative control group, the expression of miR-99a-5p was significantly up-regulated after transfection with miR-99a-5p mimics(P<0.001), the expression of miR-99a-5p was down-regulated after transfection with miR-99a-5p inhibitor (P<0.001). In osteogenic differentiation experiments, the miR-99a-5p overexpression could promote the osteogenic differentiation, while the downregulation of miR-99a-5p expression inhibited the osteogenic differentiation. The same results were obtained by semi-quantitative detection through spectrophotometry. In the adipogenic differentiation test, transfection of miR-99a-5p mimics or inhibitors had no significant effect on the adipogenic differentiation of BM-MSC.

CONCLUSIONOverexpression of miR-99a-5p can promote the osteogenic differentiation of BM-MSC, but no significant effects are observed in the adipogenic differentiation.

Aim To investigate the effect of quercetin on the osteogenic ability of human dental pulp mesenchymal stromal cells (hDPSCs) in vitro and in vivo. Methods hDPSCs were obtained from the pulp tissues of premolar, and the characteristic surface antigens were identified by flow cytometry. Cell Counting Kit-8 (CCK-8) assay was used to test the cytotoxicity of quercetin. Alkaline phosphatase (A L P) and alizarin red staining were used to detect the osteogenic ability of cells in vitro. The expression of osteogenic genes was detected by qPCR. Four round calvarial bone defects with a diameter of 8 mm were created in 10 male New Zealand rabbits, and they were differentiated and randomized into four groups. Group A, hDPSCs cultured on Bio-Oss