Objective To explore the HEART risk score in predicting 30-day major adverse cardiovascu-lar events (MACE)for the patients presenting to Emergency Department (ED) with acute chest pain. Methods Patients presented in our ED with acute chest pain were enrolled from January,2016 to April,2016. All cause MACE of each patient were followed up at 30 days by Health insurance information management System and call . Results Total 209 patients were enrolled(mean age 65.28 ± 16.85 years;52.63%male). The age,hypertension, ratio of ACS,SpO2,in-patient number HEART score in MACE subject were significantly higher than that in non MACE patients(P<0.05). The blood pressure at admission of MACE patients was significantly decrease than that in non MACE patients(P<0.05). The MACE within 30 days was 5.74%. The respective areas under the curve (AUC)for 30-day MACE(95% CI)was 0.908(0.846 ~ 0.974). The percent of patients with 30-day MACE with HEART scores between 0% and 3,4 ~ 6,and 7 ~ 10 was 0%,2.5%,and 27%,respectively. Conclusion HEART score can be simple,rapid and accurate prediction of emergency department of patients with acute chest pain within 30 days of MACE,effective elimination of low-risk patients with MACE,it plays a very important role for disease assessment and diagnosis and treatment process in emergency department.

Objective To evaluate the diagnostic performance of a point-of-care testing for sensitive cardiac troponin Ⅰ (POCT-cTnI) in early diagnosis of chest pain patients who had a high pretest probability of acute myocardial infarction (AMI).Methods Total of 127 patients with new-onset chest pain at the emergency department were enrolled.Blood samples were drawn for the routine blood test,and determined POCT-cTnI and central laboratory testing for high sensitive cardiac troponin T (CLT-hscTnT) at admission,three and then at six hours after admission.All patients were divided into AMI group and non-AMI group according to the final diagnosis,which was adjudicated independently by two physicians who reviewed all available medical records for the 90-day follow-up period,and they were unaware of the results of the investigational assays of cardiac troponins.The receiver operating characteristic (ROC) curves were constructed to assess and compare the diagnostic performance of AMI of two cardiac troponin assays.The comparison of areas under the ROC curves (AUC) was performed by DeLong test,and the sensitivity,specificity,negative predictive values (NPV) and positive predictive values (PPV) for the target markers were calculated by applying a maker-specific cutoff value.Results The final diagnosis of AMI was made in 40 of 127 patients (31.5 ％).The diagnostic accuracy of the two assays oBtained at presentation,as quantified by AUC,was no statistically differences (AUC for POCT-cTnⅠ,0.901,95％ CI,0.901 to 0.947;and for CLT-hscTnT,0.907,95％ CI,0.842 to 0.951;Z =0.235,P =0.745).The AUC for POCT-cTnI at 3 hours after admission was significantly higher than that on admission (0.931 vs.0.858;Z =-2.038,P =0.042),while there was on further improvement at 6 hours after admission (0.931 vs.0.949;Z =-1.435,P =0.151).With use of POCT-cTnI (cutoff value 0.023 ng/mL,which was the 99th percentile upper reference limit) on adimission,the clinical sensitivity was 77.5％,and the specificity was 94.2％.A single sample of POCT-cTnI at 3 hours after admission improved the diagnostic accuracy,with a sensitivity of 96.4％,a specificity of 92.0％,and a NPV of 98.6％,a PPV of 81.8％.While,with use of CLT-hscTnT (cutoff value 0.014 ng/mL,was the 99th percentile upper reference limit) at 3 hours after admission,the NPV reached to 100％.Conclusions The use of a POCT-cTnI assay in chest pain patients can identify and exclude the AMI rapidly and exactly at three hours after admission,and the diagnostic performance is equivalent to CLT-hscTnT.

Objective To investigate the impact of micro ribonucleic acid -214 (miR-214) on the proliferation of hepatocellular carcinoma (HCC) and its mechanism. Methods MHCC97L cells were respectively transfected using miR-214 mimics and negative control mimics to establish M214 group, negative control (NC214) group. And untransfected control (Ctrl) group was established. The contents of miR-214 of MHCC97L cells in three groups were detected by fluorescence quantitative polymerase chain reaction (PCR). Cell counting kit (CCK)-8 assay was used to define the cell proliferation inhibition rate. Plate cloning formation assay was used to define the cell clonality. Cell apoptosis rate was detected by flow cytometery. The expressions of protein c-myc, Bax and B-cell lymphoma (Bcl)-2 were detected by Western blot assay. The comparison of three groups was conducted using one way analysis of variance and pairwise comparison using LSD-t test. Results The miR-214 content of MHCC97L cells in M214 group was (2 536±7) times of that in Ctrl group, where significant difference was observed (LSD-t=58.75, P<0.05). The cell proliferation inhibition rates were (15.33±0.62) %, (24.07±0.75) %, (41.02±0.91) % at the 24, 48, 72 h in M214 group, and significant difference was observed compared with that in Ctrl group (LSD-t =14.64, 19.87, 31.86; P<0.05). The clone formation quantity was (5.3±0.7) /well in M214 group, which was significantly lower compared with that in Ctrl group [(37.1±1.0)/well] (LSD-t =-12.51, P<0.05). The cell apoptosis rate was (42.1±3.2)% in M214 group, which was significantly higher compared with that in Ctrl group [(7.0±0.7) % ] (LSD-t=35.66, P<0.05). In M214 group, the expressions of protein c-myc, Bcl-2 decreased and Bax increased. Conclusion The miR-214 can inhibit the proliferation of human HCC cells through down-regulating the protein c-myc expression and Bcl-2/Bax ratio.

ObjectiveTo investigate the role of protein kinase C-epsilon (PKCε) gene silenced by small interfering ribonucleic acid (siRNA) in inhibiting the development of cholangiocellular carcinoma and its mechanism.MethodsHuman cholangiocellular carcinoma QBC939 cells were respectively transfected using PKCε-siRNA and negative control (NC)-siRNA to establish PKC group and NC group. And untransfected control (CTRL) group was established. Cell counting kit (CCK)-8 assay was used to define the cell proliferation inhibition rate. Cell apoptosis rate was detected by flow cytometery. The expressions of protein PKCε and survivin were detected by Western blot. The comparison of three groups was conducted using one way analysis of variance and pairwise comparison using LSD-t test.ResultsThe cell proliferation inhibition rates at 24, 48, 72 h [(7.52±0.33)%, (15.28±0.20)%, (37.12±0.45)% ] increased gradually in PKC group, where significant difference was observed compared with those in CTRL group (LSD-t=15.37, 27.12, 35.05;P<0.05). The cell apoptosis rate was (56.9±6.1)% in PKC group, which was significantly higher compared with that in CTRL group [(12.5±1.3) % ] (LSD-t=28.55,P<0.05). The expressions of protein PKCε and survivin decreased in PKC group compared with those in NC group and CTRL group.ConclusionPKCε gene silenced by siRNA may inhibit the development of cholangiocellular carcinoma through down-regulating the expression of protein survivin and promoting cell apoptosis.

Objective To investigate the impact of purinergic receptors P2Y12 gene inhibited by small interference RNA (siRNA) on the angiogenesis of hepatocellular carcinoma (HCC). Methods Human HCC cell line MHCC97H was infected using P2Y12-siRNA lentiviral expression vector and empty negative control vector to establish siRNA group and control group. The expression of P2Y12 protein in two groups was detected by Western blot assay. angiogenesis assay was used to deifne the angiogenesis potential of HCC cell. The microvessel density (MVD) of nude mice subcutaneous tumors was observed. The experimental data between two groups were compared using t test. Results The average relative expression of P2Y12 protein were 0.07±0.01 and 0.26±0.02 respectively in siRNA group and control group. The expression of P2Y12 protein in siRNA group decreased significantly compared with that in control group (t=-35.64, P<0.05). No continuous closed small tubular structure was observed in the human umbilical vein endothelial cell (HUVEC) stimulated by the supernatant of siRNA group, while large number of closed tubules was observed in the HUVEC stimulated by the supernatant of control group. A few microvessels of nude mice subcutaneous tumors were observed in siRNA group. The MVD was 5±1, which was signiifcantly lower than that in control group (23±6) (t=-17.01, P<0.05). Conclusion Purinergic receptors P2Y12 gene inhibited by siRNA can suppress the angiogenesis of HCC.

Objective:To describe the treatment of the first carpometacarpal arthritis in Eaton Ⅱ, Ⅲ combining the hemi excision of trapezium with tendon ball and evaluate its clinical efficacy.Methods:Data of patients with the first carpometacarpal arthritis who were treated by hemi excision of trapezium and tamponade of the tendon ball from March 2013 to October 2018 were retrospectively analyzed. Twelve patients were all females with an average age of 55±2.8 years (range, 48-61 years). There were 3 cases of left thumbs and 9 cases of right. The study was only researched with primary osteoarthritis patients, preoperative imaging Eaton stages, including 8 cases inⅡstage, 4 cases in Ⅲ stage. Postoperative X-ray examination was performed, and the subsidence rate of the first metacarpal bone was evaluated according to height of arthroplasty. Preoperative and postoperative pain was evaluated according to visual analogue scales (VAS) score and DASH score. Preoperative and postoperative finger movement was evaluated according to the changes in preoperative and postoperative grip and pinch force.Results:The average follow-up period was 12±4.8 months (range, 6-17 months). The mean score of VAS after operation was 1.2±1.0 which was lower than 6.3±1.5 before operation ( t=13.4, P=0.0001); DASH score after operation was 26.2±9.6 which was lower than 48.9±13.0 before operation ( t=5.7, P=0.0001); Grip force after operation was 25.5±6.8 kg which was higher than 15.0±2.9 kg before operation ( t=7.3, P=0.0001); Pinch force after operation was 3.2±0.8 kg which was higher than 2.1±0.4 kg before operation ( t=3.6, P=0.0045), and all of these four above data has statistic difference. At the latest postoperative follow-up, the height index of arthroplasty was 0.299±0.022, and there was no significant change ( F=1.337, P=0.276) when compared with 0.306±0.021 before surgery and 0.313±0.024 after surgery. After the operation, 2 patients presented with incision redness and swelling and exudation. It was considered that local hematoma in the intra-articular operation could not be completely absorbed. After several dressing changes, the redness and swelling subsided and the exudation was controlled. Conclusion:Preserving the proximal joint surface of trapezium and tamponading tendon ball, could reduce the subsidence rate of the first metacarpal bone and alleviate the pain of the first carpometacarpal joint, thus may effectively improve the joint function. It has a significant effect on the treatment of Eaton Ⅱ,Ⅲ stage of the first carpometacarpal arthritis.

BACKGROUND: Idiopathic scoliosis (IS) affects patients' quality of life, yet there have been few reports of its morphology and epidemiological study in the southeast region of China. The aim of this study is to access the curve characteristics, prevalence, and factors associated with IS in Chaozhou city. METHODS: A cross-sectional study was performed in 2018, in which scoliosis screening was conducted among 5497 primary school students in Chaozhou city. Then, a case-control study based on the screening involving 2547 children was followed for the exploration of the associated factors. The questionnaires covering demographic characteristics, postural habits, cognition and self-sensation of scoliosis, and physical conditions were addressed for the investigation. ORs with 95%CIs were calculated based on logistic regression analysis to evaluate the factors associated with scoliosis. RESULTS: The prevalence of IS among primary school students was 6.15% in Chaozhou city, with 4.04% for males and 8.71% for females. The average Cobb angle was 15° (range 8 to 37°). Multiple logistic regression analysis suggested that female (OR=2.45), BMI (OR=0.67), having myopia (OR=1.49), self-sensation of scoliosis with symptoms (OR=5.52), insufficient sleep time (OR=2.65, 3.33), and less exercise time (OR=7.09, 7.29) were significantly associated with IS. CONCLUSIONS The prevalence of IS among primary school students in Chaozhou was at an average level, and it was significantly higher in females than in males. Lower body mass, having myopia, insufficient sleep time, and lower physical activity were associated with IS.
Case-Control Studies ; Child ; China/epidemiology* ; Cross-Sectional Studies ; Epidemiologic Studies ; Female ; Humans ; Male ; Myopia/complications* ; Risk Factors ; Schools ; Scoliosis/physiopathology* ; Students