Objective To study the relation of epicardial adipose tissue (EAT) thickness with 1eftventricular remodeling and dysfunction in dilated cardiomyopathy (DCM) patients.Methods One hundred and twenty DCM patients who received treatment from Febuary 2012 to February 2016 were served as DCM group,and 76 healthy subjects undergoing physical examination were served as control group.Their left ventricular end-diastolic diameter (LVEDD),left ventricular end systolic diameter (LVESD),left ventricular end diastolic volume (LVESV),left ventricular end systolic volume (LVEDV),left ventricular end diastolic volume index (LVEDVI),left ventricular end systolic volume index (LVESVI),sphericity index (SI),leftventricular ejection fraction (LVEF),and EAT thickness were measured by routine cardiac ultrasonography and compared between two groups.Results The levels of LVESD,LVEDD,LVESV,LVEDV,LVESVI,LVEDVI and EAT thickness in DCM group were significantly higher,and the levels of LVEF,SIS and SID in DCM group were significantly lower (P＜0.05).The EAT thickness in DCM group with NYHA class Ⅱ,Ⅲ,Ⅳ was (8.1 ± 1.8),(7.8 ± 2.0),(7.9 ± 1.7) mm,and there was significant difference (F=1.973,P＞ 0.05) Linear correlation analysis showed that the EAT thickness was positively related with the LVESD,LVEDD,LVESV,LVEDV,LVEDVI,LVESVI,SISand SID (r =0.247,0.231,0.256,0.267,0.293,0.281,0.261,0.237,P＜0.05).There was no relationship between EAT thickness and LVEF (r =0.132,P＞ 0.05).Logistic multifactor regression analysis showed that EAT thickness was an independent risk factor for left ventricular remodeling in DCM patients (OR =0.793,95％CI:0.431-1.734,P =0.039).Conclusions The EAT thickness is significantly related with the left ventricular remodeling and can be used as an independent risk factor for predicting left ventricular remodeling in DCM patients.

Objective To explore the correlation of epicardial adipose tissue (EAT) volume with atrial fibrillation (AF) and its recurrence after radiofrequency ablation (RA).Methods Eighty-five AF patients (AF group) and 90 non-AF patients (control group) were chosen between January 2014 and May 2016.Their EAT volumes were measured by CT scanning.Patients in AF group after RA were followed up 6-18 months,and the recurrence of AF was recorded.The recurrence of AF within 3 months of RA was defined as blanking recurrence group (n =27) and non-blanking recurrence group (n =58),and that after 3 months of RA was defined as the 1 ong-term recurrence.Results The total EAT volume and left atrial EAT volume were significantly larger in blanking recurrence group than in non-blanking recurrence group [(118.71 ±28.94) cn3 vs (97.73 ±24.86)cm3,(29.98 ±8.09)cm3 vs (23.11 ±8.30)cm3,t =6.219,4.451,P ＜ 0.01].Multivariate logistic resgression analysis showed that total EAT volume and left atrial EAT volume were the independent risk factors for AF.All showed that total EAT volume and left atrial EAT volume were the independent risk factors for blanking recurrence.The incidence of long-term recurrence was significantly higher in blanking recurrence group [40.7％ (11/27)] than in non-blanking recurrence group [15.5 ％ (9/58)] (x2 =7.142,P ＜ 0.05).Conclusions The incidence of AF is higher in patients with a Iarger total EAT volume and a larger left atrial EAT volume and AF is easier to recur even though after RA.

To understand the higher medical clinical teaching base teachers'demand for the training of basic teaching skills,we use our self-made questionaire to make a survey on teachers of specialty and the result shows that the trachers of different age and different technical post title have different demand.We thus put forward some suggestions to enhance the clinical teaching base teachers'teaching level

Objective To study the effect of Tacrolimus on blood lipid after renal transplantation,and the relationship between C825T polymorphism in G protein beta 3 subunit (GNB3) gene and serum lipid levels.Method Eighty-one cases of recipients patients after renal transplantation were divided into two groups in terms of Tacrolimus concentration:normal blood concentration group (group A) and low blood concentration group (group B).The serum lipid levels at 1st,3rd,6th,and 12th month after renal transplantation were measured.Genotype was determined by the simple sequence-specific primer polymerase chain reaction (SSP-PCR).Result The percentage of patients with hypertriglyceride in group A was significantly higher than in group B during the one-year follow-up period.There was significant difference between the two groups in the serum triglyceride levels but no difference in the serum cholesterol levels.The 825C/T polymorphism in the GNB3 gene was not associated with hypertriglyceride in renal transplantations in Wenzhou.Conclusion The serum triglyceride levels in renal transplantations in Wenzhou was associated with the Tacrolimus concentration,and the incidence of hypertriglyceride is not associated with the 825C/T polymorphism in the GNB3 gene.

ObjectiveTo investigate the population with an advantage of clinical cure previously treated with nucleos(t)ide analogues (NAs), and to provide more methods for clinicians in pursuing the clinical cure of hepatitis B. MethodsA total of 42 chronic hepatitis B patients with low-level HBsAg who received NAs treatment in Hebi Third People’s Hospital from October 2017 to October 2019 were enrolled as subjects and divided into combination treatment group (group A) and NA monotherapy group (group B). The 22 subjects in group A were treated with NAs combined with PEG-IFN antiviral therapy for 48 weeks, and some patients withdrew from PEG-IFN after 24 weeks and continued to receive NA monotherapy, while the 20 subjects in group B received NA antiviral therapy alone. Both groups were observed till week 48, and the five makers for hepatitis B were measured to evaluate clinical outcome. The t-test was used for comparison of continuous data between two groups, and the Fisher’s exact test was used for comparison of categorical data between two groups; a multivariate logistic regression analysis was used to perform a multivariate analysis. ResultsCompared with group B at the 48-week treatment endpoint, group A had significantly higher HBsAg clearance rate (45.5% vs 0, P＜0.01) and HBsAg seroconversion rate (31.8% vs 0, P＜0.01). The population with HBsAg ＜1000 IU/ml, ＜500 IU/ml, ＜100 IU/ml, and ＜10 IU/ml had an HBsAg clearance rate of 52.6%, 61.5%, 66.7%, and 100%, respectively, and the population with an HBsAg level of 500-1000 IU/ml, 100-500 IU/ml, 10-100 IU/ml, and ＜10 IU/ml had an HBsAg clearance rate of 33.3%, 50%, 40%, and 100%, respectively. The 4 patients with baseline HBsAg ＜10 IU/ml (accounting for 18.2% in group A) achieved clinical cure at week 12 of combined treatment, and after observation to week 48, 2 patients had an anti-HBs level of ＞100 IU/ml and 2 had an anti-HBs level of ＞1000 IU/ml. The multivariate logistic regression analysis of HBsAg clearance showed that age at the initiation of combined treatment affected HBsAg clearance (odds ratio ［OR］=0.877, 95% confidence interval ［CI］: 0.781-0.985, P=0.026), and most of the patients with HBsAg clearance had an age of 36-49 (44.20±4.49) years; baseline HBsAg level also had an impact on HBsAg clearance (OR=0.996, 95% CI: 0.992-1.000, P=0.050). ConclusionThe addition of interferon therapy in chronic hepatitis B patients with low-level HBsAg previously treated with NAs can significantly improve the clinical cure rate. The younger the age and the lower the HBsAg level, the shorter the duration of combined treatment. Age and baseline HBsAg level are more important than the duration and type of NA medication.

Objective To explore the pathologic features and distribution characteristics of upper gastrointestinal submucosal tumors (SMT).Methods From January 2013 to December 2017,at Department of Gastroenterology of Taizhou Hospital Affiliated to Wenzhou Medical University,clinical data of 1 182 hospitalized patients with 1 237 upper gastrointestinal SMT who underwent endoscopic therapy and diagnosed by pathology and immunohistochemistry was retrospectively analyzed including the pathological types,tumor of locations,endoscopic findings,layer of origin and tumor size.Results There were 473 esophageal SMT,including 387(81.8％) leiomyomas,located in the mucosal muscularis or muscularis propria;and 59(12.5％)cysts located in the submucosa or mucosal muscularis.There were 138(29.2％) lesions,159(33.6％) lesions and 176(37.2％) lesions in the upper,middle and lower esophagus respectively,and the most common type was leiomyoma.A total of 723 tumors were gastric SMT,among them 284 (39.3％) lesions were gastrointestinal stromal tumors (GIST) and 273(37.8％) lesions were leiomyomas,and all located in the muscularis propria.A total of 69(9.5％) lesions located at cardia,the common types were leiomyoma (55 lesions,79.7％) and GIST (nine lesions,13.0％).A total of 239 (33.1％) lesions located at gastric fundus,the common types were GIST (152 lesions,63.6％) and leiomyoma (79 lesions,33.1％).A total of 280 (38.7％) lesions located at gastric body,the common types were leiomyoma (138 lesions,49.3％) and GIST (111 lesions,39.6％).A total of 127 (17.6％) lesions located at gastric antrum,the common types were heterotopic pancrease (71 lesions,55.9％) and lipoma (26 lesions,20.5％),and all were located in the submucosa,some involved the muscularis propria.There were six (0.8％) lesions at gastric angle,and two (0.3％) at gastrointestinal anastomosis.Forty-one lesions were duodenal SMT,among them 23(56.1％) located at duodenal bulb,the common types were cyst (10 lesions,43.5％),lipoma (five lesions,21.7％) and heterotopic pancrease (five lesions,21.7％).A total of 18(43.9％) lesions located at descending duodenum,the common types were lipoma (nine lesions,50.0％) and cyst (five lesions,27.8％),and all lesions located in the submucosa.Conclusions The most common type of SMT in the esophagus and cardia is leiomyoma,however the SMT in gastric fundus and body are mostly leiomyomas and GIST,while in gastric antrum,most SMT are heterotopic pancreases and lipomas.In duodenal bulb and descending duodenum,the common types of SMT are cyst and lipoma.

【Objective】 To evaluate the quality of platelet concentrates (PCs) prepared by traditional and modified buffy coat centrifugal canning methods, and to explore the effect of modified buffy coat centrifugal canning method on improving the quality of PCs. 【Methods】 The buffy coat centrifugal canning methods was divided into traditional group and modified group. In the traditional group, the buffy coat component bag and empty bag were directly combined layer by layer and vertically canned for light centrifugation. In the modified group, a foam spacer was added between the buffy coat component bag and the empty bag for light centrifugation layer by layer. The effects of the two groups of centrifugal canning methods on the preparation quality of PCs were observed. 【Results】 The platelet content in PCs prepared by the modified buffy coat centrifugal canning method was significantly higher than that in the traditional group, and the mixed amount of red blood cells was lower than that in the traditional group (P<0.05). Although there was no statistically significant difference in the qualified rate of platelet content between the two groups (P>0.05), the qualified rates of platelet content and mixed red blood cell in the modified group were higher than those in the traditional group (P<0.05). 【Conclusion】 The modified centrifugal canning method with buffy coat can improve the quality of PCs, which is convenient and cheap, and is worth popularizing.

BACKGROUND: We aim to explore the association between self-reported snoring and hypertension among adults aged 30-79 in Chongqing, China. METHODS: A total of 23,342 individuals aged 30-79 were included at baseline from August 2018 to January 2019, and the final sample size for the analysis was 22,423. Face-to-face interviews and physical examinations were conducted by trained investigators. Logistic regression was performed to study age-specific and gender-specific associations between snoring and hypertension. RESULTS: Frequent snoring was associated with the risk of hypertension for each age and gender group, and the frequency of snoring was positively correlated with the risk for hypertension. For the three age groups (< 45, 45-59, ≥ 60), compared with the non-snoring group, those who snore often had a 64.5%, 53.3%, and 24.5% increased risk of hypertension (< 45: OR = 1.65, 95%CI 1.34-2.02; 45-59: OR = 1.53, 95%CI 1.37-1.72; ≥ 60: OR = 1.25, 95%CI 1.09-1.42), respectively. For men and women, those who snore often had a 46.8% and 97.2% increased risk of hypertension, respectively, than the non-snoring group (men: OR = 1.47, 95%CI 1.33-1.63; women: OR = 1.97, 95%CI 1.75-2.23). CONCLUSIONS People who snore frequently should pay close attention to their blood pressure levels in order to achieve early prevention of hypertension, particularly for snorers who are female and aged under 45; importance should be attached to their blood pressure control.
Adult ; Aged ; China/epidemiology* ; Cross-Sectional Studies ; Female ; Humans ; Hypertension/etiology* ; Male ; Middle Aged ; Self Report ; Snoring/complications*

Aberrant activation of oncogenic signaling pathways in tumors can promote resistance to the antitumor immune response. However, single blockade of these pathways is usually ineffective because of the complex crosstalk and feedback among oncogenic signaling pathways. The enhanced toxicity of free small molecule inhibitor combinations is considered an insurmountable barrier to their clinical applications. To circumvent this issue, we rationally designed an effective tumor microenvironment-activatable prodrug nanomicelle (PNM) for cancer therapy. PNM was engineered by integrating the PI3K/mTOR inhibitor PF-04691502 (PF) and the broad spectrum CDK inhibitor flavopiridol (Flav) into a single nanoplatform, which showed tumor-specific accumulation, activation and deep penetration in response to the high glutathione (GSH) tumoral microenvironment. The codelivery of PF and Flav could trigger gasdermin E (GSDME)-based immunogenic pyroptosis of tumor cells to elicit a robust antitumor immune response. Furthermore, the combination of PNM-induced immunogenic pyroptosis with anti-programmed cell death-1 (αPD-1) immunotherapy further boosted the antitumor effect and prolonged the survival time of mice. Collectively, these results indicated that the pyroptosis-induced nanoplatform codelivery of PI3K/mTOR and CDK inhibitors can reprogram the immunosuppressive tumor microenvironment and efficiently improve checkpoint blockade cancer immunotherapy.