Objective: To explore the relationships among social support, depression, anxiety and suicide ideation among middle school students in rural areas of south Sichuan Province so as to provide a scientific basis for promoting middle school students’ mental health and reducing suicide ideation. Methods: A sum of 2 217 students of grade 7 and 10 from 2 township middle schools in mountainous areas of Zizhong County, Sichuan Province, were investigated by means of typical sampling and cluster random sampling. Social Support Rating Scale (SSRS), Self-rating Scale for Depression (SDS), Self-rating Anxiety Scale (SAS) and Self-compiled adolescent health questionnaire were used to measure suicidal ideation, and structural equation model was used for statistical analysis. Results: The depression score of middle school students was (13.51±12.57), and the self-rating scale for Depression score of girls was (14.61±12.67), higher than that of boys (12.24±12.34). The SSRS score of Social Support Rating Scale of junior high school students was (35.49±5.88), which was higher than that of senior high school students (34.70±5.43), and the differences were of statistical significance(t=4.46, 2.67, P<0.05). The results of structural equation model showed that depression and anxiety directly affected suicidal ideation, and the standardized effects were respectively 0.11 (95%CI=0.06-0.16) and 0.09(95%CI=0.05-0.14). Depression and anxiety were the intermediate variables in the relationship between social support and suicidal ideation, and the mediating effects were respectively -0.46(95%CI=-0.51--0.41) and -0.21(95%CI=-0.27--0.16). Studying period could play a mediating role in the indirect effect made by social support on suicide ideation through anxiety. Conclusion Anxiety and depression have significant mediating effect on the relationship between social support and suicidal ideation among middle school students in rural areas of south Sichuan province. Anxiety and depression intervention are important measures to reduce suicide ideation among low social supporters.

Objective To study the effect of small doses of furosemide combined with brain natriuretic peptide for treatment of contrast -induced nephropathy.Methods A total of 180 patients of coronary an-giography or ( and ) percutaneous coronary intervention were recruited and divided into trial group ( n =90 ) and the control group ( n =90 ) . Patients in control group were given postoperative intravenous 20 mg of furosemide, patients in trial group were given the injection of furosemide combined with brain natriuretic peptide. Renal function indexes ( concentration of serum creatinine, serum creatinine clearance and glomerular filtration rate) after operation 48 h were observed, and the in-cidence of contrast-induced nephropathy was compared between the two groups.Results After surgery, serum creatinine concentration of control group was (82.01 ±15.12) μmol·L-1 , which significantly higher than that of the trial group of (73.92 ±16.79) μmol·L-1;serum creatinine clearance of control group was ( 86.84 ±22.11 ) mL·min-1 and glomerular filtration rate was ( 83.78 ±16.69 ) mL/( 1.73 m2·min ) , all lower than those of trial group of ( 96.83 ±24.51 ) mL·min -1 and (96.95 ±21.22) mL/(1.73 m2·min).The incidence of contrast-in-duced nephropathy in trial group was 5.56%, which significantly lower than that of control group ( 24.44%, P <0.05 ) .Conclusion For the treatment of contrast-induced nephropathy, small doses of furosemide combined with brain natriuretic peptide can effectively improve the patient' s kidney function and prevent the happening of the contrast-induced nephropathy.

OBJECTIVETo investigate the effects of losartan on left ventricular hypertrophy (LVH) and plasma transforming growth factor-beta1 (TGF-beta1) in elderly patients with essential hypertension (EH).

METHODSThe elderly patients with EH were divided into two groups, namely EH+LVH group and EH group according to the data of echocardiogram. The systolic and diastolic blood pressures of the patients were monitored. Plasma TGF-beta1 was measured before and after 6 months' treatment with losartan, and the relationship between TGF-beta1 and other index were analyzed.

RESULTSAfter 6 months' treatment, the blood pressure of EH+LVH group and EH group were significantly lowered (P<0.01). Significant improvement of IVSTd, LVPWd, E/A, and LVMI (P<0.01) and obvious reduction of plasma TGF-beta1 (P<0.01) occurred in EH+LVH group after 6 months' treatment. Correlation analyses indicated that the plasma TGF-beta1 level was positively correlated to LVMI (P<0.01).

CONCLUSIONLosartan can reversed LVH in elderly patients with EH partially by lowering plasma TGF-beta1 level.

Aged ; Antihypertensive Agents ; therapeutic use ; Female ; Humans ; Hypertension ; blood ; complications ; drug therapy ; Hypertrophy, Left Ventricular ; blood ; drug therapy ; etiology ; Losartan ; therapeutic use ; Male ; Middle Aged ; Transforming Growth Factor beta1 ; blood

INTRODUCTIONA meniscal deficient knee is at risk of early degenerative osteoarthritis. Allograft meniscal transplantation has been used to treat the meniscus deficiency to alleviate pain symptoms and to delay progression to arthritis. This case series aims to assess the postoperative outcomes of patients who have undergone meniscal allograft transplantation in our hospital.

MATERIALS AND METHODSThis is a prospective clinical review of prospectively collected data of our Meniscal Transplantation Programme from 2004 to 2007. Twelve meniscal allografts were implanted in 12 males with symptomatic knees, using arthroscopically assisted techniques. Preoperative and postoperative assessments were conducted using the Visual Analogue Scale (VAS), Tegner Activity Level Scale, Lysholm Knee Scoring Scale, and 2000 International Knee Documentation Committee (IKDC) scoring systems.

RESULTSThe mean age was 26.7 years with a mean follow-up of 17 months (range, 5 to 37). The VAS score for pain improved from 5.5 (3- 10) to 1.4 (0-2) [P <0.05], Tegner from 3 (2-5) to 5.9 (3-9) [P <0.05], Lysholm from 62.5 (27-88) to 88.6 (70-100) [P <0.05], IKDC Subjective Score from 50 (24-79) to 79.5 (56-95) [P <0.05]. Overall IKDC Knee Examination Grades revealed 10 nearly normal and 2 abnormal scores.

CONCLUSIONSThis is the first series of allograft meniscal transplantation from Southeast Asia. Patient outcome evaluation via VAS, Tegner Activity Level Scale, Lysholm Knee Scoring Scale and 2000 IKDC Knee Evaluation Form showed improvement in symptoms and knee function after implantation.

Adult ; Arthroscopy ; Humans ; Knee Injuries ; surgery ; Male ; Medical Audit ; Menisci, Tibial ; transplantation ; Middle Aged ; Pain Measurement ; Prospective Studies ; Tibial Meniscus Injuries ; Transplantation, Homologous ; Treatment Outcome

Subclavian artery (SCA) perforation is a rare complication while performing SCA intervention. In our present report, a 73-year-old female, with stenosis of the left SCA and situs inversus, presented with exercise-induced left arm weakness. The SCA stenosis was treated with direct stenting with a balloon-expansible Express LD 10×25 mm stent. However, it caused iatrogenic SCA perforation and hemothorax. The perforation was sealed by endovascular repair with operator-modified Endurant II graft stent, which complicated with occlusion of left common carotid artery. And, the carotid artery was rescued by another stent. The graft stent, which was originally designed for abdominal aortic aneurysm, can be modified to suitable length and take as a rescue stent of large vessel with iatrogenic perforation. Due to strong radial force of graft stent, preservation of large side branches should been watched out.
Aged ; Aortic Aneurysm, Abdominal ; Arm ; Carotid Arteries ; Carotid Artery, Common ; Constriction, Pathologic ; Female ; Hemothorax ; Humans ; Situs Inversus ; Stents* ; Subclavian Artery* ; Subclavian Steal Syndrome ; Transplants*

AIM:To investigate the role of prostaglandin E2receptor 2 agonist (EP2A) in proliferation and homing of human CD34 +cells. METHODS:Bone marrow fluid and peripheral blood containing stem cells were collected from healthy donors mobilized by granulocyte colony-stimulating factor in our department. Human CD34 +cells were isolated by the method of magnetic-activated cell sorting microbeads. Bone marrow mononuclear cells were isolated by Ficoll-Paque centrifugation,and the bone marrow mesenchymal stem cells(BMMSC) were cultured with L-DMEM. Human CD34 +cells and BMMSC were divided into 4 groups,and treated with PGE2(as positive control),DMSO(as negative control),EP2A and EP2A+prostaglandin E2receptor 2 antagonist (EP2AA),respectively. After exposed to the reagents,human CD34 +cell viability was measured by CCK-8 assay,the number of colonies was evaluated by colony-formation assay,the cell cycle distribution was analyzed by flow cytometry,and the protein expression of survivin,β-catenin and CXC chemokine receptor 4 (CXCR4) was detrmined by Western blot. Moreover, the concentration of stromal cell-derived factor-1α (SDF-1α) in the BMMSC was detected by ELISA. RESULTS:The cell viability and the colony number of human CD34 +cells in EP2A group were not higher than those in negative control group. Furthermore,the proportion of human CD34 +cells treated with EP2A in G2/M phase was not elevated compared with negative control group. The protein expression of survivin and β-cate-nin did not up-regulated in human CD34 +cells exposed to EP2A,but the protein expression of CXCR4 in human CD34 +cells and the concentration of SDF-1α in BMMSC were elevated. CONCLUSION:EP2A promotes human CD34 +cell homing in vitro but not proliferation.

Objective To explore the role of P-glycoprotein(P-gp)on cellular uptake and metabolism in the transmembrane transport of quercitrin.Methods Caco-2 cell monolayer and P-gp inhibitor Cyclosporin A(CysA)were used in the study.Quercitrin, quercetin,isorhamnetin and tamarixetin were determined by LC-MS to study cellular uptake and metabolism of quercitrin on Caco-2 cells.Results Uptake of quercitrin by Caco-2 cells:in different concentration groups of quercitrin coincubating with and without Cy?sA,intracellular accumulation presented the following characteristics:the amount of quercitrin first rose,reached the peak in 60 min and then declined to a steady-state in 120 min.And meanwhile there were significant differences between the two different processing groups incubating with and without CysA(P<0.05);quercetin was detected in all groups(3.0,9.0 and 27.0 mg/L).But in the higher concentration groups incubating with and without CysA,the intracellular quercetin presented a characteristics similar to its original glycosides and showed a significant difference(P<0.05),while the other groups showed no concentration-and time-dependence.At the same time,isorhamnetin and tamarixetin were detected in two higher concentration groups incubating with and without CysA, which showed the trend similar to the original glycosides but no significant difference was obtained between the two processing groups(P>0.05).Isorhamnetin and tamarixetin were not detected in the low and middle concentration groups.Transmembrane transport:on the basal lateral of all groups,the content of the quercitrin in 150 min incubation time showed a trend of continuous rise,and there was no significant difference between the two processing groups.Quercetin,isorhamnetin and tamarixetin were not detected.Conclu?sion Intact quercitrin could be absorbed into the Caco-2 cells and transported across the Caco-2 cell monolayer,and suffered a series of further metabolism in the Caco-2 cells and the basal side of Caco-2 cell monolayer,leading to different characteristics between intra?cellular accumulation and transmembrane transport.P-gp reduces the transmembrane transport of quercitrin by its efflux function,but did not involved in quercitrin metabolism.

Objective: To evaluate the efficacy of consolidation chemotherapy combined with allogeneic natural killer (NK) cell infusion in the treatment of low or intermediate-risk (LIR) acute myeloid leukemia (AML) . Methods: A cohort of 23 LIR AML patients at hematologic complete remission (CR) received NK cell transfusion combined with consolidation chemotherapy after 3 consolidation courses from January 2014 to June 2019 were reviewed. Control group cases were concurrent patients from Department of Hematology, and their gender, age, diagnosis, risk stratification of prognosis, CR and the number of courses of consolidate chemotherapy before NK cell transfusion were matched with LIR AML patients. Results: A total of 45 times of NK cells were injected into 23 LIR AML patients during 4 to 7 courses of chemotherapy. The median NK cell infusion quantity was 7.5 (6.6-8.6) ×10(9)/L, and the median survival rate of NK cells was 95.4% (93.9%-96.9%) . Among them, the median CD3(-)CD56(+) cell number was 5.0 (1.4-6.4) ×10(9)/L, accounting for 76.8% (30.8%-82.9%) ; The number of CD3(+) CD56(+) cells was 0.55 (0.24-1.74) ×10(9)/L, accounting for 8.8% (4.9%-20.9%) . Before NK cell infusion, the number of patients with positive MRD in the treatment and control groups were 9/23 (39.1%) and 19/46 (41.3%) (χ(2)=0.030, P=0.862) respectively. After NK infusion, There was no significant difference in terms of MRD that went from negative to positive between the treatment and the control groups (14.3% vs 22.2%, χ(2)=0.037, P=0.847) . In the treatment group, 66.7% (6/9) of the MRD were converted from positive to negative, which was significantly higher than that in the control group (10.5%, 2/19) (χ(2)=6.811, P=0.009) . Morphological recurrence occurred in 1 case of MRD negative in the treatment group and 2 cases of MRD positive in the control group. By the end of follow-up, the median follow-up was 35 (10-59) months, the number of patients with morphological recurrence in the treatment group was 30.4% (7/23) , which was significantly lower than that in the control group (50.2%, 24/46) (χ(2)=2.929, P=0.087) , although there was no statistically significant difference between the two groups. There was no significant difference on MRD-negative between the treatment and the control groups (43.5% vs 43.5%, χ(2)=1.045, P=0.307) . The 3-year leukemia-free survival was better in the treatment group [ (65.1±11.1) %] than that in the control group [ (50.0±7.4) %] (P=0.047) . The 3-year overall survival in the treatment and control groups were (78.1±10.2) % and (65.8±8.0) % (P=0.212) , respectively. Conclusion: The consolidation of chemotherapy combined with allogeneic NK cell infusion contributed to the further remission of patients with LMR AML and the reduction of long-term recurrence.
Consolidation Chemotherapy ; Hematopoietic Stem Cell Transplantation ; Humans ; Killer Cells, Natural ; Leukemia, Myeloid, Acute/therapy* ; Prognosis ; Remission Induction

Background/Aims: Real-world studies assessing the effectiveness and safety of sofosbuvir/velpatasvir (SOF/VEL) plus ribavirin (RBV) for Child-Pugh B/C hepatitis C virus (HCV)-related cirrhosis are limited. Methods: We included 107 patients with Child-Pugh B/C HCV-related cirrhosis receiving SOF/VEL plus RBV for 12 weeks in Taiwan. The sustained virologic response rates at off-treatment week 12 (SVR12) for the evaluable population (EP), modified EP, and per-protocol population (PP) were assessed. Thesafety profiles were reported. Results: The SVR12 rates in the EP, modified EP and PP were 89.7% (95% confidence interval [CI], 82.5–94.2%), 94.1% (95% CI, 87.8–97.3%), and 100% (95% CI, 96.2–100%). Number of patients who failed to achieve SVR12 were attributed to virologic failures. The SVR12 rates were comparable regardless of patient characteristics. One patient discontinued treatment because of adverse events (AEs). Twenty-four patients had serious AEs and six died, but none were related to SOF/VEL or RBV. Among the 96 patients achieving SVR12, 84.4% and 64.6% had improved Child-Pugh and model for endstage liver disease (MELD) scores. Multivariate analysis revealed that a baseline MELD score ≥15 was associated with an improved MELD score of ≥3 (odds ratio, 4.13; 95% CI, 1.16–14.71; P=0.02). Patients with chronic kidney disease (CKD) stage 1 had more significant estimated glomerular filtration rate declines than patients with CKD stage 2 (-0.42 mL/min/1.73 m2/month; P=0.01) or stage 3 (-0.56 mL/min/1.73 m2/month; P<0.001). Conclusions SOF/VEL plus RBV for 12 weeks is efficacious and well-tolerated for Child-Pugh B/C HCV-related cirrhosis.

Background/Aims: Real-world studies assessing the effectiveness and safety of sofosbuvir/velpatasvir (SOF/VEL) plus ribavirin (RBV) for Child-Pugh B/C hepatitis C virus (HCV)-related cirrhosis are limited. Methods: We included 107 patients with Child-Pugh B/C HCV-related cirrhosis receiving SOF/VEL plus RBV for 12 weeks in Taiwan. The sustained virologic response rates at off-treatment week 12 (SVR12) for the evaluable population (EP), modified EP, and per-protocol population (PP) were assessed. Thesafety profiles were reported. Results: The SVR12 rates in the EP, modified EP and PP were 89.7% (95% confidence interval [CI], 82.5–94.2%), 94.1% (95% CI, 87.8–97.3%), and 100% (95% CI, 96.2–100%). Number of patients who failed to achieve SVR12 were attributed to virologic failures. The SVR12 rates were comparable regardless of patient characteristics. One patient discontinued treatment because of adverse events (AEs). Twenty-four patients had serious AEs and six died, but none were related to SOF/VEL or RBV. Among the 96 patients achieving SVR12, 84.4% and 64.6% had improved Child-Pugh and model for endstage liver disease (MELD) scores. Multivariate analysis revealed that a baseline MELD score ≥15 was associated with an improved MELD score of ≥3 (odds ratio, 4.13; 95% CI, 1.16–14.71; P=0.02). Patients with chronic kidney disease (CKD) stage 1 had more significant estimated glomerular filtration rate declines than patients with CKD stage 2 (-0.42 mL/min/1.73 m2/month; P=0.01) or stage 3 (-0.56 mL/min/1.73 m2/month; P<0.001). Conclusions SOF/VEL plus RBV for 12 weeks is efficacious and well-tolerated for Child-Pugh B/C HCV-related cirrhosis.