Objective: To explore the relationship between erythrocyte sedimentation rate (ESR) and myocardial infarction (MI) occurrence in patients with rheumatoid arthritis (RA) combining coronary artery disease (CAD).
Methods: A total of 106 consecutive patients with RA combining CAD were studied. There were 46 male and 60 female patients and divided into 2 groups:RA with MI group, n=46 and RA without MI group, n=60. The base line condition was compared between 2 groups, and multivariate regression analysis was conducted to explore the risk factors for MI occurrence in relevant patients.
Results: Compared with RA without MI group, RA with MI group had the lower level of cholesterol and higher levels of inlfammatory indexes of ESR, high sensitivity C-reactive protein (hs-CRP) and CRP, P<0.05. The base line condition was similar between 2 group, P>0.05. Multivariate regression analysis indicated that ESR was the independent risk factor of MI occurrence, OR=1.024, 95%CI 1.024 (1.007-1.043), P=0.007.
Conclusion: ESR was independently related to MI occurrence in patients with RA combining CAD.

Objective To explore the role of infection control in preventing infections in pregnancy-at-term(PAT)parturients with cervical incompetence. Method The strategies of infection control for 80 PAT parturients with cervical incompetence were enforced,including enhanced disinfection of hands,wards,cunnus,intensified care to skin,limited examinations of anus and pubes and prevention of complications. Results All the parturients and their babies were well and safe with one exception,who developed with infection but were cured and discharged by anti-infection managements,complement of energy and increase of nutrition intake. Conclusion Infection control may prevent the infections in PAT parturients with cervical incompetence,enhance the perinatal quality and ensure the safety of mothers and babies.

Objective:To analyze the association between thrombocytopenia and clinical manifestations in patients with antiphospholipid syndrome (APS), and the significance of adding thrombocytopenia to the classification criteria of APS.Methods:One hundred and sixty one APS patients admitted to Peking University People's Hospital from January 2003 to August 2017 were retrospectively analyzed. Clinical and laboratory data were compared between patients with and without thrombocytopenia. Chi-square test, Fisher's exact test and t test were used for statistical analysis. Results:Among 161 APS patients, 48 patients (29.8%) were primary APS and 113 patients (70.2%) were secondary APS. Ninety-one patients (56.5%) experienced thrombocytopenia, while 62 patients (38.5%) had thrombocytopenia as the initial symptom. Among primary APS patients, compared with patients without thrombocytopenia, the prevalence of thrombosis was significantly lower in patients with thrombocytopenia (40.0% vs 69.6%, χ2=4.218, P=0.040), especially venous thrombosis (20.0% vs 47.8%, χ2=4.174, P=0.041). Among secondary APS patients, compared with patients without thrombocyt-openia, the prevalence of thrombosis, arterial thrombosis (21.2% vs 42.6%, χ2=5.944, P=0.015) and venous thrombosis (22.7% vs 51.1%, χ2=9.753, P=0.002) was significantly lower in patients with thrombocytopenia (43.9% vs 80.9%, χ2=15.496, P<0.01). As for laboratory findings, primary APS patients with thrombocytopenia showed a higher proportion of positive aCL findings (80.0% vs 52.2%, χ2=4.174, P=0.041), while secondary APS patients with thrombocytopenia experienced more leukopenia (25.8% vs 10.6%, χ2=4.002, P=0.045), lower complement C3 levels (78.7% vs 44.4%, χ2=13.205, P<0.01) and complement C4 levels (74.6% vs 46.7%, χ2=8.485, P=0.004). The proportion of patients fulfilling 1988, 1989, 1999 and 2006 APS classification criteria in our cohort was 88.2%, 87.0%, 64.0% and 70.8%, respectively. Inclusion of thrombocytopenia into 2006 criteria improved the proportion to 96.3%. Conclusion:The prevalence of thrombosis in APS patients with thrombocytopenia is significantly low. Thrombocytopenia is an important clinical manifestation of APS which can improve the diagnostic accuracy of APS.

Objective To compare the influence of postoperative pelvic floor function after different surgical procedures of hysterectomy. Methods A total of 260 patients who underwent hysterectomy in Renmin hospital of Wuhan University from January 2012 to January 2014 were enrolled in the study, and divided into 5 groups by different surgical procedures, which were total abdominal hysterectomy (A-TH;46 cases), total laparoscopic hysterectomy (L-TH;59 cases), total vaginal hysterectomy (V-TH;42 cases), abdominal intrafascial hysterectomy (A-CISH;78 cases), laparoscopic intrafascial hysterectomy (L-CISH;35 cases). Pelvic examination, pelvic organ prolapse quantitation (POP-Q), test of pelvic muscle strength, pelvic floor distress inventory-short form 20 (PFDI-20) and the female sexual function index (FSFI) questionnaire were measured after 6 months and 12 months. Results The differences of pelvic organ prolapse incidence after 6 months, A-TH and A-CISH [7%(3/46) versus 3%(2/78)], A-TH and L-CISH [7%(3/46) versus 3% (1/35)] were statistically significance (all P＜0.05).POP-Q grade after 6 months between A-TH and A-CISH was statistically different in degree (P＜0.05). The differences of incidence of abnormal pelvic floor muscle fatigue after 6 months of A-TH and A-CISH [59% (27/46) versus 29% (23/78)], A-TH and L-CISH [59%(27/46) versus 26%(9/35)] were statistically significant (all P＜0.05), after 12 months the difference of L-TH and A-CISH [61% (36/59) versus 29%(23/78)] was statistically different (P＜0.05). The differences of incidence of abnormal pelvic floor muscle strength after 6 months of L-TH and A-CISH [53%(31/59) verus 24%(19/78)], V-TH and A-CISH [60%(25/42) verus 24%(19/78)], V-TH and L-CISH [60%(25/42) verus 23%(8/35)] were statistically significant (all P＜0.05);after 12 months the difference of V-TH and A-CISH [57% (24/42) versus 26% (20/78)] was statistically significant (P＜0.05). Stress urinary incontinence, abnormal bowel movements after 6 months and 12 months were no significant difference between groups (all P＞0.05), PFDI-20 total score was not statistically significant (P＞0.05). FSFI total score after 6 months and 12 months in A-TH and A-CISH, L-TH and A-CISH, A-CISH and L-CISH were statistically significant (all P＜0.05). Conclusion The influences of different surgical procedures to pelvic floor function are no statistical difference; as to the surgical resection of hysterectomy, intrafascia hysterectomy compared with extrafascia hysterectomy, the former is more helpful to the protection of the structure and function of the pelvic floor.

Objective To explore the interaction and compatibility optimization of esketamine combined with oxycodone in postoperative analgesia after cesarean section.Methods A total of 138 postpartum women who received cesarean section in Zhejiang Provincial Hospital of Chinese Medicine from April 2021 to October 2022 were selected as the study subjects.The initial compatibility concentration of target-controll infusion of esketamine and oxycodone was selected,and the pain disappearance time(TLOP)of patients after anesthesia,who visual analogue scale(VAS)scores＜3 was observed.The target-controlled infusion concentrations of esketamine and oxycodone were adjusted according to bispectral index(BIS),mean arterial pressure(MAP)and heart rate(HR)during operation,and BIS 42-65,MAP＞60 mmHg and HR＞50 times/min were maintained.The pain recovery time(TROP)from esketamine and oxycodone infusion to VAS score＞3 was recorded.The median effective dose(ED50)of each group of drugs at BIS50 was calculated by point-slope method.The pharmacodynamic interaction of esketamine and oxycodone in postoperative analgesia after cesarean section was analyzed by response surface model,and the optimal compatible concentration range was calculated.Results When the BIS value was 50,ED50 of esketamine combined with oxycodone deviated from the addition line without statistical significance(P＞0.05).The compound drug effect(compound point SP)fell to the left of the addition line,indicating that the analgesic effect of the two drugs was synergistic.The response surface model showed that esketamine and oxycodone had a significant synergistic effect on the body motor response and circulation response during postoperative analgesia in patients undergoing cesarean section.The optimal compatible concentration range was as follows:when the concentration of oxycodone was 2 mg/mL,0.38-0.80 mg/kg esketamine was used;when the concentration of oxycodone was 3 mg/mL,0.30-0.70 mg/kg esketamine was used;when the concentration of oxycodone was 4 mg/mL,0.23-0.46 mg/kg esketamine was used;when the concentration of oxycodone was 5 mg/mL,0.18-0.37 mg/kg esketamine was used;when the concentration of oxycodone was 6 mg/mL,0.20 mg/kg esketamine was used.Conclusion The target-controlled infusion of esketamine and oxycodone target controlled infusion has a synergistic effect in postoperative analgesia after cesarean section.The combination of different pharmacodynamic responses creates the optimal dosage range of esketamine and oxycodone,which can provide patients with good analgesia effect and fewer adverse reactions within the optimal concentration range.

Alcoholic liver disease is a common chronic liver disease. Inflammatory pathways in the immune microenvironment of the liver play important roles in the development and progression of alcoholic liver disease, providing potential targets for therapeutic interventions. This review focused on the pathophysiology of alcoholic liver disease, changes in the immune microenvironment including immune cells and inflammatory mediators, and advances in targeted therapy.

PURPOSE: Cathepsin K is a potent collagenase implicated in human and animal atherosclerosis-based vascular remodeling. This study examined the hypothesis that serum CatK is associated with the prevalence of coronary artery disease (CAD). MATERIALS AND METHODS: Between January 2011 and December 2012, 256 consecutive subjects were enrolled from among patients who underwent coronary angiography and percutaneous coronary intervention treatment. A total of 129 age-matched subjects served as controls. RESULTS: The subjects' serum cathepsin K and high sensitive C-reactive protein (hs-CRP) and high-density lipoprotein cholesterol were measured. The patients with CAD had significantly higher serum cathepsin K levels compared to the controls (130.8+/-25.5 ng/mL vs. 86.9+/-25.5 ng/mL, p<0.001), and the patients with acute coronary syndrome had significantly higher serum cathepsin K levels compared to those with stable angina pectoris (137.1+/-26.9 ng/mL vs. 102.6+/-12.9 ng/mL, p<0.001). A linear regression analysis showed that overall, the cathepsin K levels were inversely correlated with the high-density lipoprotein levels (r=-0.29, p<0.01) and positively with hs-CRP levels (r=0.32, p<0.01). Multiple logistic regression analyses shows that cathepsin K levels were independent predictors of CAD (odds ratio, 1.76; 95% confidence interval, 1.12 to 1.56; p<0.01). CONCLUSION: These data indicated that elevated levels of cathepsin K are closely associated with the presence of CAD and that circulating cathepsin K serves a useful biomarker for CAD.
Aged ; Biological Markers/blood ; C-Reactive Protein/metabolism ; Cathepsin K/*blood ; Coronary Artery Disease/*blood/metabolism ; Female ; Humans ; Male ; Middle Aged

PURPOSE: Cathepsin K is a potent collagenase implicated in human and animal atherosclerosis-based vascular remodeling. This study examined the hypothesis that serum CatK is associated with the prevalence of coronary artery disease (CAD). MATERIALS AND METHODS: Between January 2011 and December 2012, 256 consecutive subjects were enrolled from among patients who underwent coronary angiography and percutaneous coronary intervention treatment. A total of 129 age-matched subjects served as controls. RESULTS: The subjects' serum cathepsin K and high sensitive C-reactive protein (hs-CRP) and high-density lipoprotein cholesterol were measured. The patients with CAD had significantly higher serum cathepsin K levels compared to the controls (130.8+/-25.5 ng/mL vs. 86.9+/-25.5 ng/mL, p<0.001), and the patients with acute coronary syndrome had significantly higher serum cathepsin K levels compared to those with stable angina pectoris (137.1+/-26.9 ng/mL vs. 102.6+/-12.9 ng/mL, p<0.001). A linear regression analysis showed that overall, the cathepsin K levels were inversely correlated with the high-density lipoprotein levels (r=-0.29, p<0.01) and positively with hs-CRP levels (r=0.32, p<0.01). Multiple logistic regression analyses shows that cathepsin K levels were independent predictors of CAD (odds ratio, 1.76; 95% confidence interval, 1.12 to 1.56; p<0.01). CONCLUSION: These data indicated that elevated levels of cathepsin K are closely associated with the presence of CAD and that circulating cathepsin K serves a useful biomarker for CAD.
Aged ; Biological Markers/blood ; C-Reactive Protein/metabolism ; Cathepsin K/*blood ; Coronary Artery Disease/*blood/metabolism ; Female ; Humans ; Male ; Middle Aged

Objective:To investigate the influence of COX-2 expression in hepatocellular carcinoma (HCC) on the infiltration and immune response of conventional type 1 dendritic cells (cDC1).Methods:Clinicopathological data from 111 HCC patients undergoing radical hepatectomy at Peking University People's Hospital from Jan 2016 to Jun 2017 were retrospectively analyzed. Immunofluorescence staining was employed to evaluate the cDC1 infiltration and COX-2 expression in tumor tissues. Patients were divided into two groups based on cDC1 infiltration: cDC1 enrichment and cDC1 depletion, and the correlation between COX-2 expression and cDC1 infiltration was analyzed. Single-cell sequencing of HCC tumor tissues was used to further investigate the correlation between PTGS2, the encoding gene of COX-2, and cDC1 infiltration. Hematopoietic stem cells (HSC) were utilized for in vitro generation of cDC1. HSC-derived cDC1s were sorted by FACS and cocultured with HCC cell line SNU423. Celecoxib, a selective COX-2 inhibitor, was used to suppress the COX-2 expression in HCC cell line SNU423. The functions of cDC1 were explored by FITC-dextran uptake assay, flow cytometry, and Luminex multiplex cytokine assay. Results:COX-2 expression was significantly higher in the cDC1 depletion group ( n=73) compared to the cDC1 enrichment group ( n=38) ( P=0.004 2). Patients with higher PTGS2 expression had significantly lower proportion of cDC1. Increased cDC1 infiltration in the HCC tumor microenvironment correlated with improved patient overall survival rates ( P=0.037) and disease-free survival rates ( P=0.048). Results from FITC-dextran uptake assay, flow cytometry, and Luminex assay indicated that cDC1 co-cultured with HCC showed significantly reduced antigen uptake function, co-stimulatory molecule expression, and cytokine secretion, but partially abrogated with celecoxib treatment. Conclusions:The intratumoral infiltration of cDC1 is positively correlated with favorable prognosis in HCC patients. Elevated COX-2 expression in HCC impedes the intratumoral accumulation of cDC1 and compromises their immune response capabilities. COX-2 inhibitors hold promise for enhancing cDC1 function in HCC.

PURPOSE: Several studies have compared the effects of coronary stenting and coronary-artery bypass grafting (CABG) on left main coronary artery (LMCA) disease. However, there are limited data on the long-term outcomes of these two interventions in diabetic patients. MATERIALS AND METHODS: We evaluated 56 patients with LMCA stenosis who underwent drug-eluting stent (DES) implantation and 116 patients who underwent CABG in a single hospital in China between January 2004 and December 2006. We compared long-term major adverse cardiac events (death; a "serious outcome" composite of death, myocardial infarction, or stroke; and target-vessel revascularization). RESULTS: In-hospital (30-day) mortality was 0% for the DES group and 3.4% for the CABG group (p=0.31). There was no difference between the two groups in terms of risk of death [hazard ratio for stenting group, 0.49; 95% confidence interval (CI), 0.13-1.63; p=0.55] or risk of serious outcome (hazard ratio for DES group, 1.11; 95% CI, 0.39-1.45; p=0.47). The target-vessel revascularization rate was higher in the DES group than in the CABG group (hazard ratio, 3.67; 95% CI, 1.24-11.06; p=0.018). CONCLUSION: In this cohort of diabetic patients with LMCA stenosis, there was no difference in composite endpoints between patients receiving DESs and those undergoing CABG. However, stenting was associated with higher rates of target-vessel revascularization than CABG. DES implantation in diabetic patients with LMCA disease was found to be at least as safe as CABG.
Angioplasty, Balloon, Coronary/*methods ; Coronary Stenosis/*therapy ; Diabetes Mellitus ; *Drug-Eluting Stents ; Female ; Humans ; Male ; Middle Aged ; Treatment Outcome