Objective To investigate the correlation between the prognosis and the early lactate clearance in patients with postcardiac surgery undergoing cardiopulmonary bypass.Methods The clinical data of 73 patients who underwent postcardiotomy undergoing cardiopulmonary bypass in SuBei Hospital of Jiangsu Provience,from March 2006 to February 2010,were prospectively collected and analyzed.The collection data including:( 1 ) Preoperative factors:including gender,age,diagnosis preoperative,NYHA grade,APACHE Ⅱ score and left ventricular end-diastolic diameter.(2) Operative factors:operation time,block aorta time.(3)Postoperation factors:hemorrhage volume,mechanical ventilation time,and factors of hemodynamics and oxygen metabolism at 6 hour postoperative:heart rate(HR),central venous pressure(CVP),pulmonary capilary wedged pressure( PCWP),cardiac output index( CI),arterial blood lactic acid,6 h lactate clearance,partial pressure of oxygen( PO2 ),mixed venous oxygen saturation ( SvO2 ),oxygen delivery index ( DO2I),oxygen consume index (VO2I),oxygen extraction ratio(O2ext).Patients were divided into survival group,control group,high level of lactate clearance group( lactate clearance rate ＞ 30％ ) and low level of lactate clearance group.Firstly,the data analyzed with process of single variable analysis and some parameters,which showed the significant difference,were sorted out from two groups.Then these parameters were put to the Logistic regression analysis.Consequently,the independent risk factors of death of postcardiac surgery could be found.Results The mortality in high lactate clearance group ( 4.55％ [ 2/44 ] ) was significantly less than the low lactate group (34.48％ [ 10/29] ) ( x2 =11.889,P ＜0.01 ).The single variable analysis had shown that there were significant difference on APACHE Ⅱ score ( [ 16.9 ± 2.9 ] vs [ 19.2 ± 2.6 ],t =2.537 ),left ventricular end-diastolic diameter( [ 53.9 ± 5.6 ] mm vs [ 63.8 ± 4.6 ] mm,t =5.847 ),block aorta time ( [ 101.2 ± 34.2 ] min vs [ 122.7 ±22.7 ] min,t =2.078 ),hemorrhage volume( [464.0 ± 158.8 ] ml vs [ 603.2 ± 159.5 ] ml,t =2.773 ),mechanical ventilation time( [ 22.6 ± 5.1 ] h vs [ 28.8 ± 5.2 ] h,t =3.857 ),arterial blood lactic acid ( [ 3.5 ±1.3 ] mmol/L vs [5.1 ± 1.5 ] mmol/L,t =3.912),lactate clearance ( [38.8 ± 17.4]％ vs [ 14.6 ±9.7]％,t =4.846),and SvO2( [69.1 ±4.2]％ vs [59.2 ±6.9]％,t =5.847) (P＜0.05 or P ＜0.001)between survival group and control group.Multiple regression analysis showed that lactate clearance and left ventricular enddiastolic diameter were the two independent risk factors of death,and the odds ratio(OR) were 7.773 (95％ CI 1.364-44.306,P ＜0.05) and 15.186(95％ CI 2.758-83.162,P ＜0.01).Conclusion Early lactate clearance rate can be used as an important indicator to evaluate the prognosis of patients with postcardiac surgery undergoing cardiopulmonary bypass.

Objective To explore the value of apolipoprotein B/A-1 ratio combined with carotid plaque nature examination in predicting the risk of patients with coronary heart disease.Methods A total of 250 patients with CHD were selected and divided into acute coronary syndrome group (ACS group,n=190) and stable angina pectoris group (SAP group,n=60).A total of 98 normal individuals by CAG were selected as control group.The carotid color ultrasound was performed for all the patients.The nature of carotid atherosclerostic plaque was estimated according to the acoustic characteristics of plaques.The ApoB and ApoA-1 contents as well as ApoB/A-1 ratio were detected and calculated,and correlations between indexes and risk factors were analyzed.Results There were no significant differences in levels of TC,TG,and LDL-C between the three groups (P>0.05).HDL-C level in the ACS group was significantly higher than that in the control group (P<0.05).ApoB and ApoB/A1 in the ACS group were significantly higher than those in the control group and ACS group (P<0.05).There was no significant difference in ApoA1 between the three groups (P>0.05).The total occurrence rates of plaques in ACS group and SAP group were significantly higher than the control group (P<0.05).The occurrence rate of carotid soft plaque in ACS group was significantly higher than SAP group and the control group (P<0.05).Conclusion Unstable plaques are able to detect by carotid ultrasound in CHD patients,and the ApoB level and ApoB/A-1 ratio increased abnormally,which indicates the severity of coronary artery lesions increases in CHD patients.

Objective To explore the value of apolipoprotein B/A-1 ratio combined with carotid plaque nature examination in predicting the risk of patients with coronary heart disease.Methods A total of 250 patients with CHD were selected and divided into acute coronary syndrome group (ACS group,n=190) and stable angina pectoris group (SAP group,n=60).A total of 98 normal individuals by CAG were selected as control group.The carotid color ultrasound was performed for all the patients.The nature of carotid atherosclerostic plaque was estimated according to the acoustic characteristics of plaques.The ApoB and ApoA-1 contents as well as ApoB/A-1 ratio were detected and calculated,and correlations between indexes and risk factors were analyzed.Results There were no significant differences in levels of TC,TG,and LDL-C between the three groups (P>0.05).HDL-C level in the ACS group was significantly higher than that in the control group (P<0.05).ApoB and ApoB/A1 in the ACS group were significantly higher than those in the control group and ACS group (P<0.05).There was no significant difference in ApoA1 between the three groups (P>0.05).The total occurrence rates of plaques in ACS group and SAP group were significantly higher than the control group (P<0.05).The occurrence rate of carotid soft plaque in ACS group was significantly higher than SAP group and the control group (P<0.05).Conclusion Unstable plaques are able to detect by carotid ultrasound in CHD patients,and the ApoB level and ApoB/A-1 ratio increased abnormally,which indicates the severity of coronary artery lesions increases in CHD patients.

Breaking the limitation of time and space, telemedicine has been applied to the clinical diagnosis and treatment of rare diseases.It establishes connections between doctors and patients, doctors and doctors, as well as patients and patients, building a new patient-centered medical service system.Finally, integrating telegenetics into the current system of rare diseases will provide all-round health protection for patients around the world.

Base editor (BE) is a gene-editing tool developed by combining the CRISPR/Cas system with an individual deaminase, enabling precise single-base substitution in DNA or RNA without generating a DNA double-strand break (DSB) or requiring donor DNA templates in living cells. Base editors offer more precise and secure genome-editing effects than other conventional artificial nuclease systems, such as CRISPR/Cas9, as the DSB induced by Cas9 will cause severe damage to the genome. Thus, base editors have important applications in the field of biomedicine, including gene function investigation, directed protein evolution, genetic lineage tracing, disease modeling, and gene therapy. Since the development of the two main base editors, cytosine base editors (CBEs) and adenine base editors (ABEs), scientists have developed more than 100 optimized base editors with improved editing efficiency, precision, specificity, targeting scope, and capacity to be delivered in vivo, greatly enhancing their application potential in biomedicine. Here, we review the recent development of base editors, summarize their applications in the biomedical field, and discuss future perspectives and challenges for therapeutic applications.
Humans ; Gene Editing ; CRISPR-Cas Systems ; Genetic Therapy ; DNA/genetics*