OBJECTIVETo compare the angiogenesis in unstable and stable plaques and to investigate the potential role of neovessels in creating vulnerable sites for atherosclerotic plaques.

METHODSSpecimens of coronary arteries were obtained from 52 autopsy cases with acute coronary syndromes. Plaque morphology was studied by use of stained slides. 922 tissue blocks of late-stage lesions were classified into two groups: (1) unstable plaque (n = 153), the plaque was characterized by a large extracellular lipid core (more than 40% of the plaque area); (2) stable plaque (n = 769), lipid core less than 40% of the plaque area. Forty blocks were selected randomly from each group and serial sections were stained immunohistochemically with a polyclonal antibody against F VIII RAg. Computer-aided planimeter was used for quantitative analysis.

RESULTSIn unstable plaques, the occurrence of neovessels was more frequent and the neovessel density (number/mm(2)) was significantly increased as compared to that of stable plaques (frequency: 80.4% vs 66.6%, P < 0.01; shoulder: 22.16 +/- 19.96 vs 10.04 +/- 11.52, base: 21.68 +/- 20.44 vs 9.68 +/- 11.52, fibrous cap: 3.80 +/- 5.32 vs 1.48 +/- 2.28, P < 0.05). Most neovessels were located in the shoulder region and at the base of plaques.

CONCLUSIONSThese findings suggest that neovessels in coronary atherosclerotic plaques are closely associated with the decreased stabilization of the plaques.

Aged ; Aged, 80 and over ; Coronary Artery Disease ; pathology ; Coronary Vessels ; pathology ; Female ; Humans ; Male ; Neovascularization, Pathologic ; pathology

Objective To analyze the clinical application status and existing problems of TCM "preventive treatment of diseases"; To propose corresponding countermeasures. Methods Contrast observation literature about application of TCM "preventive treatment of diseases" in CNKI, Wanfang Database and VIP from 1stJanuary of 2013 to 31stDecember of 2017 was retrieved by computers. Prevention and treatment of people, intervention methods, evaluation criteria, frequency of use, etc. in the literature were analyzed. Results Totally 203 articles were included, involving 37 104 cases. The prevention and treatment of diseases were mostly caused by common chronic diseases and their complications. The prevention and treatment of "the undiseased" involved sub-healthy (28.08%) and healthy (2.46%) people. Intervention methods included medicine treatment, TCM treatment, health management, diet, sports rehabilitation, psychological rehabilitation, etc., and medicine treatment was the main method. The evaluation criteria mostly adopted disease efficacy evaluation criteria. The constituent indicators mainly included syndrome symptom indicators, biological indicators, scale evaluation indicators, and outcome indicators. The most common were syndrome/symptoms/signs (77.66%). Conclusion The clinical application of TCM "preventive treatment of diseases"is widely used. At present, problems, such as few research reports on healthy people, diverse intervention methods but lack of evidence-based evidence, evaluation indicators the same as disease evaluation index system, and lagging effect evaluation standard still exist.

Objective To characterize the current status of operating room nurse' s burn-out, explore the relationship between the nurse burnout and job stress sources. Methods Applying cross section survey to do the descriptive study, choosing 445 operating room nurses were investigated by questionnaires, including MBI-HSS, and work pressure-source questionnaire (SSRS). Results Among the three burnout inventories,operating room nurses' high fatigue including emotional exhaustion which occupied 43.6％, depersonalization tendency which occupied 31.7％, low level of efficacy which occupied 54.6％. Compared with North American norm (33％ for high fatigue), there was just depersonalization tendency which similar to North American norm,while the emotional exhaustion and low level of efficacy were highly above the norm; The top three factors which leading to the job stress were worrying about mistakes and accidents( 3.32 ± 0. 69), large work amount( 3.18 ±0.76), and social position ( 3. 12 ± 0.87). Conclusions The operating room nurse working pressure was generated from job burn-out, further influence nursing work quality and work efficiency.

OBJECTIVE: The objective of this study was to evaluate the effect of overexpression of epidermal growth factor receptor (EGFR) on the expression of epithelial cell markers (E-cadherin and alpha-catenin) and mesenchymal cell markers (N-cadherin and vimentin) in endometrial carcinoma. METHODS: The expression of all 4 markers was evaluated in EGFR overexpressing Ishikawa cells, control Ishikawa cells, and KLE cells using reverse transcription polymerase chain reaction (RT-PCR) and Western blotting. The expression of these 4 markers was also determined in cancerous tissues of patients with endometrial carcinoma using immunohistochemical staining. RESULTS: Ishikawa cells transfected with EGFR showed decreased expression of E-cadherin and alpha-catenin and increased expression of N-cadherin and vimentin compared with control Ishikawa cells (p<0.01 for all). The expression of N-cadherin and vimentin was higher and the expression of E-cadherin and alpha-catenin was lower in stage II-III than stage I and in grade II-III than grade I endometrial carcinoma tissue (p<0.01 for all). CONCLUSION: Decreased expression of epithelial markers (E-cadherin and alpha-catenin) and increased expression of mesenchymal markers (N-cadherin and vimentin) were observed in human endometrial carcinoma tissue. These findings correlate with high EGFR expression in cultured endometrial carcinoma cells.
alpha Catenin ; Blotting, Western ; Cadherins ; Endometrial Neoplasms* ; Epidermal Growth Factor* ; Epithelial Cells ; Epithelial-Mesenchymal Transition ; Female ; Humans ; Polymerase Chain Reaction ; Receptor, Epidermal Growth Factor* ; Reverse Transcription ; Vimentin

This study was aimed to explore whether multiple common gene mutations of leukemia synergistically involved in acute promyelocytic leukemia (APL) pathogenesis, and to investigate their relevance to clinical features, cytogenetics and molecular risk stratification. 84 specimens of admitted de novo APL patients from February 2005 to October 2010 were collected, the gene mutations of bone marrow mononuclear cells and clinical features of mutation-positive patients were analyzed by genomic DNA-PCR. The results indicated that the prevalence of mutations was 60.7% (51/84), in which the mutations with the highest incidence were found as FLT3-ITD, reaching 27.4% (23/84). Next, there were 12 cases WT1 mutation, 9 for FLT3-TKD, 7 for TET2, 5 for N-RAS, 4 for ASXL1, 2 for EZH2 mutation and 1 positive case in MLL-PTD, IDH1 and CBL mutation respectively. No mutation was found in other JAK1, DNMT3, c-Kit, NPM1, IDH2, RUNX1 and JAK2 (V617F) common leukemia-related genes. Combined analysis with clinical data demonstrated that the patients with FLT3-ITD mutation displayed higher white blood cell counts, while the patients with N-RAS mutation showed lower platelet counts. Overall survival of these patients was obviously shorten as compared with patients with wild-type. This difference between mutant and wild-type of all above mentioned cases was statistically significant (P < 0.05). The difference between APL with simple t (15;17) and additional abnormal karyotype was not statistically significant. It is concluded that the FLT3-ITD mutation is recurrent genetic change in APL, and together with N-RAS mutation indicates poor prognosis. Additional abnormal karyotype does not associate with prognosis of APL.
Adolescent ; Adult ; Aged ; Child ; DNA Mutational Analysis ; DNA-Binding Proteins ; genetics ; Enhancer of Zeste Homolog 2 Protein ; Female ; Genes, ras ; Humans ; Leukemia, Promyelocytic, Acute ; genetics ; Male ; Middle Aged ; Mutation ; Nuclear Proteins ; genetics ; Polycomb Repressive Complex 2 ; genetics ; Prognosis ; Proto-Oncogene Proteins ; genetics ; Proto-Oncogene Proteins c-kit ; genetics ; Repressor Proteins ; genetics ; Tandem Repeat Sequences ; Young Adult ; fms-Like Tyrosine Kinase 3 ; genetics

OBJECTIVETo study the effect of tetrandrine (Tet) in combination with droloxifen (DRL) on the expression of nuclear factor kappa B (NF-kappaB) in K562 and K562/A02 cell lines and its reversal mechanism.

METHODSThe activation of NF-kappaB in K562 and K562/A02 cell lines and the effect of Tet or DRL alone or in combination on NF-kappaB protein expression were determined with immunocytochemistry and Western blotting respectively.

RESULTS(1) K562/A02 cells displayed higher level of NF-kappaB protein expression than K562 cells. (2) The application of Tet or DRL alone or in combination had no effect on NF-kappaB expression in K562 cells at 6 h and 12 h (P > 0.05). (3) Tet and DRL alone or in combination could significantly down-regulate NF-kappaB protein expression in nuclei of K562/A02 cells. The effect was more significant in combination than either alone. This effect was more significant at 12 h than at 6 h.

CONCLUSIONS(1) Activation of NF-kappaB may be involved in the mechanism of MDR of K562/A02 cell line. (2)Inhibition of NF-kappaB activation may be involved in the reversal of multidrug resistance in K562/A02 cells by Tet and DRL.

Benzylisoquinolines ; pharmacology ; Drug Resistance, Multiple ; Humans ; K562 Cells ; NF-kappa B ; metabolism ; Tamoxifen ; analogs & derivatives ; pharmacology

Objective:Analyze the characteristics of nervous system (NS)complications after hematopoietic stem cell transplantation(HSCT ) ,and evaluate risk factors in order to reduce its occurrence ,provide better diagnosis and treatment and improve the prognosis of the patients .Methods:The clinical outcomes of the patients who developed NS complications after HSCT were collected in our hospital from August 2012 to August 2015 ,and retrospective analysis was used .Results:A total of 87 patients with NS complications after HSCT include central nervous system complications was 71 .3% (62/87 ) and peripheral nerve complications was 28 .7% (25/87) . The types of primary disease included acute lymphoblastic leukemia (ALL)34 .5% (30/87) ,acute myelogenous leukemia (AML)23 .0% (20/87) ,chronic myelogenous leukemia (CML )12 .6%(11/87) ,other types of leukemia by 9 .2% (8/87) ,aplastic anemia 13 .8% (12/87) ,myelodysplastic syndrome 6 .9% (6/87);HLA matched 19 cases (21 .8% ) ,HLA mismatched 53 cases (60 .9% ) ,unrelated donors 15 cases (17 .2% ) ,central nervous system complication rate was 16 .1% ,69 .4% and 14 .5% , respectively ;peripheral nerve complication rate was 36 .0% , 40 .0% and 24 .0% respectively (χ2 =6 .682 ,P=0 .034) .The incidences of NS complications were 26 .4% (23/87) in children and 73 .6% (64/87)in adults respectively ,and there was no significant difference in the types of NS complications (P=0 .435) . The cases accompanied with GVHD or infection respectively account for 69 .0% (60/87) and 59 .8% (52/87) ,and there were significant difference in the incidences of types of NS complications (P< 0 .05) .The onset time of 87 patients with nervous system complications or peripheral nerve complications was 1‐726 days (median 49 days) and 20‐694 days (median 80 days) , respectively .The overall mortality rate was 33 .3% (29/87) ,with central nervous system complications was 93 .1% (27/29) , with peripheral nerve complications was 6 .9% (2/29 , P< 0 .05) .Conclusions :The patients with central nervous system complications have higher incidence , higher mortality ,and shorter onset time than the patients with peripheral nerve complications ,and related with HLA types ,GVHD and infection risk factors .

Background:Transcranial alternating current stimulation (tACS) offers a new approach for adult patients with major depressive disorder (MDD).The study is to evaluate the efficacy and safety of tACS treating MDD.Methods:This is an 8-week,double-blind,randomized,placebo-controlled study.Ninety-two drug-naive patients with MDD aged 18 to 65 years will receive 20 daily 40-min,77.5-Hz,15-mA sessions of active or sham tACS targeting the forehead and both mastoid areas on weekdays for 4 consecutive weeks (week 4),following a 4-week observation period (week 8).The primary outcome is the remission rate defined as the 17-item Hamilton depression rating scale (HDRS-17) score ≤7 at week 8.Secondary outcomes are the rates of response at weeks 4 and 8 and rate of remission at week 4 based on HDRS-17,the proportion of participants having improvement in the clinical global impression-improvement,the change in HDRS-17 score (range,0-52,with higher scores indicating more depression) over the study,and variations of brain imaging and neurocognition from baseline to week 4.Safety will be assessed by vital signs at weeks 4 and 8,and adverse events will be collected during the entire study.Discussion:The tACS applied in this trial may have treatment effects on MDD with minimal side effects.

BACKGROUNDData on the epidemiology of hypertension in Chinese non-dialysis chronic kidney disease (CKD) patients are limited. The aim of the present study was to investigate the prevalence, awareness, treatment, and control of hypertension in the non-dialysis CKD patients through a nationwide, multicenter study in China.

METHODSThe survey was performed in 61 tertiary hospitals in 31 provinces, municipalities, and autonomous regions in China (except Hong Kong, Macao, and Taiwan). Trained physicians collected demographic and clinical data and measured blood pressure (BP) using a standardized protocol. Hypertension was defined as systolic BP ≥ 140 mmHg and/or diastolic BP ≥ 90 mmHg, and/or use of antihypertensive medications. BP < 140/90 mmHg and < 130/80 mmHg were used as the 2 thresholds of hypertension control. In multivariate logistic regression with adjustment for sex and age, we analyzed the association between CKD stages and uncontrolled hypertension in non-dialysis CKD patients.

RESULTSThe analysis included 8927 non-dialysis CKD patients. The prevalence, awareness, and treatment of hypertension in non-dialysis CKD patients were 67.3%, 85.8%, and 81.0%, respectively. Of hypertensive CKD patients, 33.1% and 14.1% had controlled BP to < 140/90 mmHg and < 130/80 mmHg, respectively. With successive CKD stages, the prevalence of hypertension in non-dialysis CKD patients increased, but the control of hypertension decreased (P < 0.001). When the threshold of BP < 130/80 mmHg was considered, the risk of uncontrolled hypertension in CKD 2, 3a, 3b, 4, and 5 stages increased 1.3, 1.4, 1.4, 2.5, and 4.0 times compared with CKD 1 stage, respectively (P < 0.05). Using the threshold of < 140/90 mmHg, the risk of uncontrolled hypertension increased in advanced stages (P < 0.05).

CONCLUSIONSThe prevalence of hypertension Chinese non-dialysis CKD patients was high, and the hypertension control was suboptimal. With successive CKD stages, the risk of uncontrolled hypertension increased.

Adult ; Aged ; Awareness ; Female ; Humans ; Hypertension ; complications ; epidemiology ; therapy ; Male ; Middle Aged ; Prevalence ; Renal Insufficiency, Chronic ; complications

OBJECTIVE: To explore the application value of next generation sequencing (NGS) in preimplantation genetic diagnosis of α/β complex thalassemia couple. METHODS: The coding regions of α-globin genes (HBA1, HBA2) and β-globin gene (HBB) were selected as the target regions. The high-density and closely linked single nucleotide polymorphism (SNP) sites were selected as the genetic linkage markers in the upstream and downstream 2M regions of the gene. After NGS, the effective SNP sites were selected to construct the haplotype of the couple, and the risk chromosome of the mutation carried by the couple was determined. The NGS technology was used to sequence the variations of HBA1, HBA2 and HBB directly and construct haplotype linkage analysis for preimplantation genetic diagnosis. RESULTS: Direct sequencing and haplotype linkage analysis of HBA1, HBA2 and HBB showed that two of the six blastocysts were α/β complex thalassemia, one was β-thalassemia heterozygote, two were α-thalassemias heterozygotes, and one was intermediate α-thalassemia. A well-developed embryo underwent preimplantation genetic diagnosis was implanted into the mother's uterus, and a healthy infant was born at term. CONCLUSION Preimplantation genetic diagnosis can be carried out by NGS technology in α/β complex thalassemia couples, and abortion caused by aneuploid embryo selection can be avoided.
Female ; High-Throughput Nucleotide Sequencing ; Humans ; Mutation ; Pregnancy ; Preimplantation Diagnosis ; alpha-Thalassemia ; beta-Globins/genetics* ; beta-Thalassemia/genetics*