Objective:To analyze the correlation of serum lipoprotein-associated phospholipase A2(Lp-PLA2)and nucleotide-binding oligomerization domain-like receptor protein 3(NLRP3)levels with the severity of coronary heart disease in elderly patients.Methods:Clinical data of 200 elderly patients with coronary heart disease in the hospital from January 2017 to July 2019 were retrospectively collected.Data of 80 healthy elderly patients undergoing regular physical examinations in our hospital during the same period were collected and used as the healthy control group.All patients received laboratory tests using relevant parameters and coronary angiography on admission, with complete records of examination results for analysis.Based on SYNTAX scores from angiography of coronary artery lesions, all 200 elderly patients with coronary heart disease were further divided into a low-risk lesion subgroup, an intermediate-risk lesion subgroup and a high-risk lesion subgroup.The correlation of serum Lp-PLA2 and NLRP3 levels with the severity of coronary lesions was analyzed in elderly patients with coronary heart disease.Results:The mean SYNTAX score was 27.6±10.1.There were 60 cases with low-risk lesions, 68 cases with intermediate-risk lesions and 72 cases with high-risk lesions, accounting for 30.0%, 34.0% and 36.0%, respectively.The control group had the lowest serum levels of Lp-PLA2 and NLRP3, followed by the low-risk lesion, intermediate-risk lesion and high-risk lesion subgroups( F=305.026, 9.173 and 582.029, all P<0.001). Bivariate Pearson correlation analysis showed that serum levels of Lp-PLA2 and NLRP3 were positively correlated to the Syntax score in elderly patients with coronary heart disease( r=0.545 and 0.689, all P<0.001). Conclusions:Serum levels of Lp-PLA2 and NLRP3 are correlated to the severity of coronary artery disease in elderly patients with coronary heart disease.Overexpression of these two markers may indicate growing severity of coronary artery disease.Testing for serum Lp-PLA2 and NLRP3 levels in elderly patients with coronary heart disease can be considered to evaluate coronary lesions and treatment options in the future.

AIM: To investigate the effects of prenatal stress (PS) on neurons and neuronal ultrastructure of hippocampus in offspring rats, and to explore the role of the overproduction of oxidants. METHODS: One month male offspring rats were obtained to observe the neuronal number, neuronal ultrastructure and the number of nNOS -positive cell in hippocampus. RESULTS: The neuronal number of CA1 and CA4 subregions in late gestation stress (LS) offspring decreases significantly. The neuronal ultrastructure of CA1 subregion in MS (stress in 7-13 days of gestation) and LS offspring appeared bulgy mitochondria, unclear membrane and irregular electron density. Lipofuscin pigments increased; The number of nNOS-positive cell in CA1, CA2, CA3 subregions and DG of MS group and the whole hippocampus of LS group increased significantly. CONCLUSION: PS damaged the neurons and neuronal ultrastructure of hippocampus of offspring rats. The damages were associated with the overproduction of oxidants.

Objective To evaluate hepatic segment vascular occlusion technology in precise resection of liver segment.Methods Sixty-seven cases of liver cancer patients who underwent precision liver segment resection from August 2007 to May 2012 in Qilu Hospital were analyszed retrospectively.There were 51 male patients and 16 female patients,age ranging from 45 to 66 yrs.Results All operations were performed successfully.All cases were with single tumor,the diameter ranged from 2 cm to 6 cm.Resection of segment Ⅲ was performed in 22 cases,segment Ⅳ in 10 cases and segment Ⅵ in 35 cases.Operation time was 50-120 minutes,and the average time was 73 minutes.Blood loss was 50-200 ml,averaging 86 ml.No patient needed blood transfusion.Postoperative incisional liquefaction was found in 6 cases which were cured with interference in time.There was no bile leakage,hemorrhage,celiac infection and complications such as liver failure.The average hospital stay was 7.8 days.No rccurrence was found during 3 months follow-up.Conclusions Hepatic segment vascular occlusion technology was safe and feasible in precise resection of liver segment in liver cancer patients.It effectively controlled blood loss and reduced liver damage.

Objective To study the relationship between the severity of diastolic heart failure(DHF)and bone mineral density in the elderly. Methods Totally 80 elderly patients aged over 80 years who were tested as normal for cardiac diastolic function by Doppler tissue imaging(DTI) were selected and divided into four groups by the e/a ratio,i.e.,the normal group(n=18),the DHF 1 group(0.8≤e/a<1,n=25),the DHF 2 group (0.6≤e/a<0.8,n=22),and the DHF 3 group(e/a<0.6,n=15). And the other 20 healthy people by physical examination were set as the normal control group.All subjects underwent bone mineral density(BMD)measurement(including femoral neck,total femoral hip and lumbar vertebra 1?4) by dual energy X?ray absorptiometry. Results Bone mineral density(BMD)was significantly decreased(P<0.05)in DHF groups(DHF 1,DHF 2,and DHF 3). Bone mineral density significantly decreased along with the severity of DHF. Bone mineral density was positively correlated with the e/a ratio in the elderly with DHF(r=0.75,P<0.01). Conclusion The severity of diastolic heart failure is closely related to bone mineral density in the elderly. The severity of diastolic heart failure could predict osteoporosis.

Objective To study the effect of annexin A1 on cardiac function,tumor necrosis factorα(TNF?α),and interleukin 1β(IL?1β)in diabetic rats. Methods Twenty?four SD rats were randomly divided into normal control and diabetic groups. The type 2 diabetes model was in?duced with a high?glucose and high?fat diet and administration of low?dose streptozotocin.Left ventricular end?diastolic volume(LVEDV),left ven?tricular end?systolic volume(LVESV),peak velocity of early diastolic mitral?to?late diastolic peak velocity(e/a)ratio,left ventricular ejection frac?tion(LVEF),and stroke volume(SV)were measured by using color Doppler ultrasonography at the end of week 8. The expression levels of TNF?αand IL?1βin blood were measured by using enzyme?linked immunosorbent assay,and the expression level of annexin A1 in blood was measured at weeks 0,4,and 8 by using real?time polymerase chain reaction. Results Compared with the normal control group,the diabetic group had de?creased LVEDV,e/a,and SV(P<0.05).The annexin A1 expression level in the diabetic group decreased significantly after 8 weeks(P<0.01). The TNF?αand IL?1βlevels in the diabetic group were significantly higher than those in the normal control group(P<0.05)and increased signifi?cantly after 8 weeks(P<0.01). Annexin A1 level correlated with the TNF?αand IL?1βlevels in the diabetic group(P<0.01). Conclusion Annexin A1 expression shows an anti?inflammatory effect that improved the cardiac function of diabetic rats.

Objective To study the mechanism of RING finger protein 34 ( RNF34 ) involved in innate immunity . Methods Recombinant PCR was used and transient expression of the plasmid was achieved in HEK 293T cells.The cells were stimulated with Sendai virus ( SeV) or N-RIG-Ⅰfor the indicated time while luciferase activity was observed using the dual-luciferase reporter assay kit .Results We constructed the plasmid pcDNA 3-Flag-RNF34 and its three mutations .The study found that when stimulated by SeV , RNF34 could inhibit the activity of NF-κB and IFN-βmore significantly than RNF34-ΔFYVE, RNF34-ΔCID and RNF34-ΔRING.We also found that RNF 34 and its three mutants had similar inhibitory effect when the activation of NF-κB and IFN-βwas stimulated by the N-RIG-Ⅰ.Conclusion RNF34 negatively regulates innate immunity by acting on the RIG-Ⅰ-MAVS signaling pathway .

Objective:To examine potential predisposing risk factors for coronary heart disease(CHD)in elderly patients and the correlation between serum uric acid levels and the predisposing risk factors in elderly patients with CHD.Methods:Clinical data of 200 elderly inpatients with CHD(CHD group)and 150 elderly outpatients without CHD(control group)at our hospital from January 2017 to January 2019 were retrospectively analyzed.Peripheral venous blood was collected from patients immediately after admission, and serum uric acid levels were measured.Baseline information of patients was recorded.Potential predisposing risk factors of CHD were identified by single-factor and multiple-factor analysis, and serum uric acid levels were compared against predisposing risk factors.The correlation between serum uric acid levels and predisposing risk factors in elderly patients with CHD was analyzed.Results:According to preliminary single-factor analysis, smoking, diabetes mellitus, low high-density lipoprotein cholesterol(HDL-C)hypolipidemia, family history of CHD and glomerular filtration rate seemed to be predisposing risk factors for elderly patients with CHD( χ2=6.739, 15.655, 6.331, 9.615, 23.279, P<0.05). Multiple-factor analysis showed that smoking, diabetes mellitus, low HDL-C hypolipidemia, family history of CHD and glomerular filtration rate were predisposing risk factors for elderly patients with CHD( OR=1.777, 2.381, 1.883, 1.967, 3.205, all P<0.05). Serum uric acid levels in elderly CHD patients with smoking, diabetes mellitus, low HDL-C hypolipidemia, family history of CHD or glomerular filtration rate<100 ml/min were higher than in patients without any of those conditions, and the difference was statistically significant( t=8.017, 5.907, 8.509, 7.164, 13.839, P<0.001). Spearman correlation analysis showed that serum uric acid levels were positively correlated with risk factors such as smoking, diabetes mellitus, and family history of CHD in elderly patients with CHD( r=0.409, 0.422, 0.422, all P<0.001), and were negatively correlated with low HDL-C hypolipidemia and glomerular filtration rate( r=-0.428 and -0.481, all P<0.001). Conclusions:High level serum uric acid is closely related to many CHD risk factors such as smoking and diabetes mellitus and may be an independent risk factor for the onset of CHD.

Objective:To investigate the value of CD64 index and C-reactive protein (CRP)/albumin (Alb) ratio (CRP/Alb) in predicting infection after modified radical mastectomy for breast cancer.Methods:The clinical data of 203 breast cancer patients who underwent modified radical mastectomy from January 2018 to August 2021 in Anhui No.2 Provincial People's Hospital were retrospectively analyzed. All cases were divided into infection group (40 cases) and non-infection group (163 cases) according to whether they were infected at the 1st month after operation. On the 1st day after operation, the serum CD64 index was measured by using flow cytometry, the serum CRP and Alb levels were measured by using immunoturbidimetry, and the CRP/Alb was calculated. The values of CD64 index and CRP/Alb in the diagnosis of infection after modified radical mastectomy for breast cancer were evaluated by using receiver operating characteristic (ROC) curve. The factors influencing infection after modified radical mastectomy for breast cancer were explored by using multivariate logistic regression.Results:The levels of CD64 index, CRP, CRP/Alb in the infection group were higher than those in the non-infection group [5.7±1.1 vs. 1.5±0.3, t = 32.05, P < 0.001; (78±13) mg/L vs. (11±3) mg/L, t = 39.26, P <0.001; 3.09±0.42 vs. 0.36±0.02, t = 57.48, P < 0.001], and the level of Alb in the infection group was lower than that in the non-infection group [(25±3) g/L vs. (32±4) g/L, t = 8.37, P < 0.001]. There were statistically significant differences in the catheterization time, CD64 index and CRP/Alb between the infection group and non-infection group (all P < 0.05); multivariate logistic regression showed that catheterization time >9 d, CD64 index >42.65 and CRP/Alb >1.25 were risk influencing factors of infection after modified radical mastectomy for breast cancer (all P < 0.001). The ROC curve results showed that the area under the curve, sensitivity, and specificity of CD64 index in the diagnosis of infection after modified radical mastectomy for breast cancer were 0.804, 89.5% and 85.4%, the CRP were 0.712, 70.6% and 76.5%, the Alb were 0.766, 72.4% and 75.4%, and the CRP/Alb ratio were 0.856, 88.0% and 90.5%. Conclusions:The CD64 index and CRP/Alb have certain values in the prediction of infection after modified radical mastectomy for breast cancer.

The incidence rate of inflammatory bowel disease(IBD)in China is in a rapid rise period in recent years,and the course of the disease is repeated and prolonged.The risk of IBD combined with thromboembolism is significantly increased,and it is one of the important reasons for poor prognosis in IBD patients.However,the pathological and physiological mechanisms of thromboembolism have not been fully understood and have not received sufficient attention from clinical physicians.This article aims to provide a systematic review of the risks and mechanisms of thromboembolism in IBD,and to summarize the progress in its prevention and treatment strategies,in order to be helpful for the prevention and treatment of thromboembolism in IBD patients.

Objective:To evaluate the efficacy and safety of lenvatinib combined with camrelizumab as the second-line treatment for advanced intrahepatic cholangiocarcinoma (ICC).Methods:The clinical data of patients with advanced ICC undergoing the second-line treatment of lenvatinib combined with camrelizumab in the Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University from June 2021 to June 2022 were screened and analyzed. A total of 12 patients were enrolled, including seven males and five females, aged (67.5±8.6) years. Response evaluation criteria in solid tumor 1.1 was used to evaluate the efficacy of treatment. The safety assessment adopts the Adverse Event Evaluation Standard 5.0. Kaplan-Meier method was conducted to plot survival curves.Results:Among the 12 patients (after 1-7 cycles of immune and targeted therapy), three achieved partial response, four achieved stable disease, and five were defined as progression disease. Adverse events of different degrees occurred in seven cases, among which three patients had adverse events of grade ≥ 3: one with hypertension, which was managed after antihypertensive and symptomatic treatment; one with elevated serum total bilirubin, which was improved after reducing the dose of lenvatinib; one with liver dysfunction, which was considered as immune-related liver toxicity and alleviated after discontinuing camrelizumab. The 1-month, 3-month, and 6-month survival rates and progression-free survival rates of the patients were 100.0%, 91.7%, 66.7%, and 83.3%, 41.7%, and 25.0%, respectively. The median overall survival of patients was 14.7 months (95% CI: 9.2-21.2) and the median time to progression was 8.0 months (95% CI: 4.1-11.9). Conclusion:Combination of lenvatinib and camrelizumab could bring survival benefits with controllable adverse events as the second-line treatment of patients with advanced ICC.