Consensus ; Critical Illness ; Humans ; Serum Albumin ; Serum Albumin, Human

BACKGROUND: Drug-coated balloons (DCBs) have emerged as potential alternatives to drug-eluting stents in specific lesion subsets for de novo coronary lesions. Quantitative flow ratio (QFR) is a method based on the three-dimensional quantitative coronary angiography and contrast flow velocity during coronary angiography (CAG), obviating the need for an invasive fractional flow reserve procedural. This study aimed to assess the serial angiographic changes of de novo lesions post-DCB therapy and further explore the cut-off values of lesion and vessel QFR, which predict vessel restenosis (diameter stenosis [DS] ≥50%) at mid-term follow-up. METHODS: The data of patients who underwent DCB therapy between January 2014 and December 2019 from the multicenter hospital were retrospectively collected for QFR analysis. From their QFR performances, which were analyzed by CAG images at follow-up, we divided them into two groups: group A, showing target vessel DS ≥50%, and group B, showing target vessel DS <50%. The median follow-up time was 287 days in group A and 227 days in group B. We compared the clinical characteristics, parameters during DCB therapy, and QFR performances, which were analyzed by CAG images between the two groups, in need to explore the cut-off value of lesion/vessel QFR which can predict vessel restenosis. Student's t test was used for the comparison of normally distributed continuous data, Mann-Whitney U test for the comparison of non-normally distributed continuous data, and receiver operating characteristic (ROC) curves for the evaluation of QFR performance which can predict vessel restenosis (DS ≥50%) at mid-term follow-up using the area under the curve (AUC). RESULTS: A total of 112 patients with 112 target vessels were enrolled in this study. Group A had 41 patients, while group B had 71. Vessel QFR and lesion QFR were lower in group A than in group B post-DCB therapy, and the cut-off values of lesion QFR and vessel QFR in the ROC analysis to predict target vessel DS ≥50% post-DCB therapy were 0.905 (AUC, 0.741 [95% confidence interval, CI: 0.645, 0.837]; sensitivity, 0.817; specificity, 0.561; P < 0.001) and 0.890 (AUC, 0.796 [95% CI: 0.709, 0.882]; sensitivity, 0.746; specificity, 0.780; P < 0.001). CONCLUSIONS The cut-off values of lesion QFR and vessel QFR can assist in predicting the angiographic changes post-DCB therapy. When lesion/vessel QFR values are <0.905/0.890 post-DCB therapy, a higher risk of vessel restenosis is potentially predicted at follow-up.
Constriction, Pathologic ; Coronary Angiography ; Coronary Artery Disease/therapy* ; Coronary Restenosis ; Follow-Up Studies ; Fractional Flow Reserve, Myocardial ; Humans ; Pharmaceutical Preparations ; Predictive Value of Tests ; Retrospective Studies ; Treatment Outcome

Analgesia ; methods ; Betacoronavirus ; Conscious Sedation ; methods ; Consensus ; Coronavirus Infections ; complications ; Humans ; Pandemics ; Pneumonia, Viral ; complications

Asian Continental Ancestry Group/genetics* ; Charcot-Marie-Tooth Disease/genetics* ; China ; Genetic Profile ; Humans ; Pedigree

Background: Rapid visual acuity (VA) decline was a common complaint in patients with sellar/suprasellar germinoma. In our hospital, 3.4 Gy/2f of emergency irradiation was applied to save patient VA and enable subsequent chemoradiotherapy. This study aimed to investigate the efficacy of emergency irradiation with 3.4 Gy/2f in patients with sellar/suprasellar germinoma who had rapid VA decline. Methods: From January 2014 to December 2017, 33 patients with sellar/suprasellar germinoma who complained of VA decline within 3 months received 3.4 Gy/2f of emergency irradiation in Beijing Tiantan Hospital. The best-corrected VA (BCVA) and mean deviation (MD) were measured. Correlations between visual function change and clinical factors, including age at diagnosis, duration of VA decline, extent of tumor regression, serum level of tumor markers, were analyzed. Results: Among 33 patients with sellar/suprasellar germinoma, the median diameter and volume of sellar/suprasellar lesions were 32 mm (range: 5–55 mm) and 12.9 cm³ (range 0.6–58.5 cm³), respectively. Data on pre- and post-emergency-irradiation BCVA were obtained in 32 patients. For the right eyes, BCVA was improved in 23 patients (71.9%), unchanged in 7 (21.9%), and worsened in 2 (6.2%); and for the left eyes, these numbers were 27 (84.4%), 4 (12.5%), and 1 (3.1%), respectively. In terms of the logarithm of the minimum angle of resolution (logarithm of the minimum angle of resolution = Log (1/BCVA) score, the improvement was significant in both eyes (P < 0.001). In terms of MD, six patients had paired data and the improvement was marginal in the right eyes (P = 0.068) and significant in the left eyes (P = 0.043). However, no clinical factor was found to have correlation with visual function improvement. Conclusion In sellar/suprasellar germinoma patients with VA decline, 3.4 Gy/2f of emergency irradiation was effective in improving visual function.

OBJECTIVETo examine the influence of vascular endothelial growth factors (VEGF) in controlling the growth of an experimental osteosarcoma in mice by performing retrovirus-mediated sFlt-1 gene modification.

METHODSFrom March to October 2010 human osteosarcoma G-292 cells were in vitro infected with retroviral vectors encoding soluble Flt-1 or LacZ gene before transplanted into proximal tibiae of immune deficient SCID mice to establish experimental orthotopic osteosarcoma. Daily observation and biweekly microCT were performed to monitor tumor development and progression till sacrifice at 8 weeks after tumor cell inoculation for histological and molecular analyses.

RESULTSSuccessful transgene expression was confirmed in the culture media of sFlt-1 transduced G-292 cells using ELISA, and with positive X-gal staining of the LacZ transduced cells. Noteworthy tumors were grown in all mice on the tibiae receiving G-292 cell inoculation, with clear detection on microCT images starting 2 weeks after inoculation. Over the time period, tumors derived from sFlt-1 transduced G-292 cells were distinctively smaller in size compared to the ones from wide-type G-292 and G-292-LacZ cells. Histology showed typical osteosarcoma characteristics including severe cellular pleomorphism, bone erosions, and neo-vascularization. Real-time polymerase chain reaction indicated significantly higher sFlt-1 expression in sFlt-1 transduced groups than the wild-type G-292 or LacZ treated groups. Strong expression of oncogenes c-myc and c-fos were also obvious, along with the expression of VEGF in the primary tumor tissue.

CONCLUSIONRetrovirus-mediated sFLT-1 gene modification decelerates the osteosarcoma tumor growth in this murine model.

Animals ; Bone Neoplasms ; genetics ; metabolism ; pathology ; Cell Line, Tumor ; Female ; Genetic Vectors ; Humans ; Lac Operon ; Mice ; Mice, SCID ; Neovascularization, Pathologic ; metabolism ; pathology ; Osteosarcoma ; genetics ; metabolism ; pathology ; Retroviridae ; genetics ; Transgenes ; Vascular Endothelial Growth Factor A ; metabolism ; Vascular Endothelial Growth Factor Receptor-1 ; metabolism

This report aims to investigate the dynamical changes of HBcAg18-27 epitope specific cytotoxic T lymphocytes(CTL), alanine aminotransferase (ALT), HBV DNA and HBsAg in peripheral blood of acute hepatitis B patients, and to explore the roles of HBcAg18-27-specific CTLs in virus clearance and liver injury. Acute hepatitis B (AHB) and chronic hepatitis B (CHB) patients were divided into two groups according to results of HLA-A0201. Patients with positive HLA-A0201 were classified into HBcAg-specific CTL group and those with negative HLA-A0201 were referred as control group. The specific CTLs were stained with HLA-A0201 limited HBcAg18-27 epitope MHC-Pentamer and the frequencies of CTLs, T, B, NK and NKT cells were detected by flow cytometry (FCM). The serum ALT, HBV DNA and HBsAg were examined using speed analysis, quantitative PCR and abbott chemiluminescent technology. The frequencies of HBcAg18-27-specific CTLs in AHB patients were higher in the early three weeks as compared to the late three weeks. The apex time of HBV-specific CTL frequencies lagged behind those of HBV DNA, HBsAg and ALT. The loss of HBsAg in patients with high frequencies of HBV-specific CTL was earlier than that in patients with low frequencies (t = 2.018, P value is less than 0.05). In the second week the peak frequencies of CD3+CD8+ cells overlapped with that of HBcAg18-27-specific CTLs and with a positive correlation between (r = 0.420, P value is less than 0.05). During the early stages of AHB, the frequencies of NK and NKT cells were found significantly lower than that of control group and CHB group and the levels were back to normal after recovery. Moreover, a negative correlation existed between the frequencies of NK cells and the dynamic changes of HBcAg18-27-specific CTLs (r = -0.435, P value is less than 0.01) in AHB group. The frequencies of HBcAg18-27-specific CTLs were significantly higher as compared to CHB group in the first three weeks (z = -3.258, -4.04, and -3.259, P value is less than 0.01). The early loss of HBsAg was closely related to the high frequencies of HBcAg18-27 specific CTLs in AHB patients. HBcAg-specific CTL frequencies in peripheral blood could be used to predict clinical outcome after HBV infection. The frequencies of CD8+ T cells can reflect the changes of frequencies of HBcAg-specific CTL during acute HBV infection.
Adolescent ; Adult ; Case-Control Studies ; Female ; HLA-A2 Antigen ; immunology ; Hepatitis B ; immunology ; Hepatitis B Core Antigens ; blood ; immunology ; Humans ; Killer Cells, Natural ; immunology ; Lymphocyte Count ; Male ; Middle Aged ; T-Lymphocytes, Cytotoxic ; cytology ; immunology ; Young Adult

Background There are no noticeable symptoms in early stages of diabetic retinopathy(DR)and the detection of presymptomatic DR remains challenging. Therefore, data on the prevalence and progress of DR will help in prevention and treatment programs in China. Objective This study was to survey the prevalence and risk factors of diabetic retinopathy( DR ) in a population aged 40 years or older in the Shunyi district of Beijing city.Methods A cross-sectional study was designed. Cluster sampling was used to randomly select 4167 (91.6%)individuals aged ≥40 years in 24 clusters in the Shunyi district of Beijing city in China. The Questionnaire data,including general information, living habits, present history, past history, family history, education level etc., were obtained from each subjects. The height, body weight and blood pressure were examined, and slit-lamp examination, direct ophthalmoscopy,indirect ophthalmoscopy and nonmydriatic fundus photography were performed during the study duration. Diabetic mellitus (DM)was diagnosed and graded according to the criteria of Early Treatment Diabetic Retinopathy Study Research Group(ETDRS). The associated factors with DR were analyzed byx2 test,trend x2 test,and multivariate Logistic regression analysis. This protocol was approved by the Ethic Committee of Peking University. Informed consent was obtained from each individual prior to the survey. Results A total of 4167 ( 91.6% )individuals were examined from the 4549 samples with a response rate of 86. 4%. This study showed a prevalence of 29. 2% for DR, 5.4% for sight-threatening diabetic retinopathy ( STDR), and 1.3% for prolifrative retinopathy (PDR) in type 2 DM subjects. Of the type 2 DM subjects,0. 4% (4/445)had social blindness( VA＜0. 1 ) ,and 6. 3% (28/445) presented with visual impairment (VA ＜ 0. 3 )in bilateral eyes. Univariate Logistic regression analysis indicated that insulin therapy ( P = 0.011 ) and lower body mass index ( BMI, kg/m2 ) ( P = 0. 022 ) appeared to be significantly associated with DR, and the multivariate Logistic regression analysis demonstrated that longer duration of diabetes( P＜ 0. 01 ) , increased fasting glucose ( P ＜ 0.01 ) and lower education level ( P = 0. 031 ) were significant independent predictors of DR. Conclusion The prevalence of DR is lower among diabetic Chinese aged ≥ 40 years than those of matched population in Western countries. Lower BMI and insulin therapy were the significantly associated factors of DR, and a longer duration of disease and higher fasting glucose level are independent risk factors of DR. Education attainment is important for the DM patients as a protective factor of DR.

Background Visual impairment influent the life quality of patient and bring about the economical burden to their families and society.Epidemiology survey of the prevalence and main causes of visual impairment is the basis of the prevention of blindness.Objective The goal of this survey was to investigate the visual impairment in the subjects aged 40 years or older living in Shunyi district and assist in the design of intervention programs.Methods A cross-sectional survey was performed in this study.Cluster sampling was used to randomly select 4549 individuals aged ≥40 years in Shunyi district,and visual impairment was evaluated based on WHO criteria and analyzed based on the 10-year interval groups.The questionnaire,best corrected visual acuity (BCVA)and comprehensive eye examination were provided for eligible residents.To evaluate the independentassociation of significant sociodemographic variables with visual impairment,a regression model was constructed including age,sex and education level.This study was approved by the Ethic Committee of Peking University Medical Department.Written informed consent was signed by each subject before any medial survey.Results A total of 4167 subjects participated in this survey with the response rate of 91.6％.The age of the subjects ranged from 40-94 years(mean:56.61±11.10 years).The numbers of visual impairment was 161 with the prevalence 3.9％.Trend x2 test showed that the number and percentage of visual impairment were elevated as the increase of age,showing a significantly difference among different age groups(x2 =159.487,P＜0.01).The prevalence rate of visual impairment in 70 and older group was 15 times more than that of 60-69-year-old group(OR =0.114,95％ CI:0.056-0.234).No significant difference was found between gender and prevalence of visual impairment(OR =0.901,95％ CI:0.627 -1.295).The prevalence rate of visual impairment in illiterate group was 5.5 fold more than that of educated group (OR =2.743,95％ CI:1.830-4.111).Conclusions Ageing and low education degree are the important factors of visual impairment.Education attainment is an independent protective factor of visual impairment.

OBJECTIVESTo access the prevalence of HIV infection and the associated factors among urban MSM in China.

METHODSParticipants were recruited using respondent driven sampling and snowball sampling method in Beijing, Harbin, Zhengzhou and Chengdu city. A face-to-face questionnaire was administrated to collect relevant demographic and ethological data; 5 ml venous blood sample was taken from each subject to measure HIV antibody in serum (samples were first screened by colloidal gold, latex chromatographic and double-antigen sandwich ELISA method, positive samples were further confirmed by immunoblotting method). The characteristics of HIV infection was described and the risk factors were analyzed.

RESULTSA total of 1864 MSM were recruited and the prevalence of HIV was 6.7% (125/1864). It was 9.5% (24/252) among MSM older than 39 years and it was 1.9% (2/105) among those less than 20 years old. The prevalence was 8.4% (31/371) among MSM with junior level education and was 4.8% (41/858) among those with college level education. It was 10.3% (35/340) among MSM with sexual partner old than him for over 10 years while it was 5.0% (58/1168) among those having sexual partner within 10 years older. The prevalence of HIV infection was 8.9% (61/695) among MSM with unprotected receptive anal sex and it was 5.5% (64/1169) among those without unprotected receptive anal sex. The risk factors independently associated with HIV infection included being older than 39 years (OR = 6.5, 95%CI: 1.5 - 28.7), with junior or lower level education (OR = 1.8, 95%CI: 1.2 - 2.7), having sexual partner older than himself for over 10 years (OR = 2.1, 95%CI: 1.3 - 3.3) and having unprotected receptive anal intercourse (OR = 1.6, 95%CI: 1.1 - 2.4).

CONCLUSIONMSM had a high rate of HIV infection. Older age, lower level education, having older sexual partner and unprotected receptive anal intercourse were related to HIV infection.

Adult ; China ; epidemiology ; HIV Infections ; epidemiology ; Homosexuality, Male ; Humans ; Male ; Prevalence ; Risk Factors ; Surveys and Questionnaires ; Young Adult