OBJECTIVETo clarify the role of waist circumference (WC) in estimating organ damage and assessing the prognosis in young and middle-aged patients with cardiovascular disease undergoing cardiac rehabilitation program (CRP).

METHODSWe recruited 147 young and middle-aged patients with cardiovascular disease to participate in the CRP for 4 or 5 weeks. The baseline clinical data and results of routine fasting blood test and ultrasonic cardiography were evaluated for these patients.

RESULTSWC had a linear correlation with the indices reflecting cardiac structure alteration (LVSd and LVPWd) of the patients after CRP but showed a negative correlation with their HDL-C levels. The fasting blood glucose (FBG) and serum uric acid (UA) levels showed a positive correlation with WC before CRP but not after CRP.

CONCLUSIONWC monitoring allows accurate assessment of organ damage in patients undergoing CRP after cardiovascular disease and has special value in evaluating the changes in cardiac structure and function.

Blood Glucose ; chemistry ; Body Mass Index ; Cardiovascular Diseases ; diagnosis ; physiopathology ; Humans ; Middle Aged ; Prognosis ; Uric Acid ; blood ; Waist Circumference

This study examined the effect of long-term administration of low-dose FTY720 on survival of murine cardiac allograft and the possible mechanism. Murine models of abdominal heterotopic heart transplantation were established. Low-dose FTY720 (0.3 mg/kg) was administrated to the animals 4 days before the transplantation of cardiac allografts until the occurrence of rejection or the observation terminals. The animals without FTY720 treatment and those with syngeneic cardiac grafts transplanted served as controls. The mean survival time (MST) of grafts, and T lymphocyte subsets in grafts, peripheral blood and lymphoid organs were measured by histopathological examination or flow cytometry, and compared among groups. The results showed that the MST of allografts in FTY720-treated mice was more than 40 days, significantly longer than that in the untreated group (MST=8 days, P<0.01). After the long-term administration of FTY720, the proportion of CD4(+) and CD8(+) lymphocytes in peripheral blood was diminished significantly, but the proportion of CD4(+) lymphocytes was increased in mesenteric lymph nodes (MLNs) and spleen. Immunofluorescence staining revealed that the infiltration of CD4(+) and CD8(+) lymphocytes in allografts was significantly inhibited after long-term administration of low-dose FTY720. It was concluded that low-dose long-term administration of FTY720 could promote T lymphocytes in lymphatic organs and decrease their infiltration in allografts, resulting in the inhibition of rejection and the long-term survival of allografts.

Objective:To analyze the cause of varicocele (VC) recurrence and investigate the efficacy of sub-inguinal microsurgical varicocelectomy (MV) for recurrent VC.Methods:All of 16 inpatients diagnosed as recurrent VC, in the Department of Andrology of the Affiliated Hospital of Qingdao University from 2015 April to 2019 April, were performed sub-inguinal MV. The age of the inpatients was 18-36 years old, median 27 years old.5 cases were originally performed retroperitoneal high ligation of spermatic vein and other 11 cases were originally performed laparoscopic varicocelectomy. During the review one to three years after the previous operation, all of 16 patients were diagnosed as VC recurrence. The complains of these patients during the review included male subfertility (10 cases) and scrotal pain (12 cases), in which 6 cases’ complains were male subfertility with scrotal pain. After admission, 13 patients were classified as Grade Ⅲ (left in 8 cases, bilateral in 5 cases) and 3 patients as Grade Ⅱ (all left). The median of their visual analogue scale (VAS) was 2.5. Color doppler flow imaging (CDFI) grading showed: Grade Ⅲ in 12 cases (left in 7 cases, bilateral in 5 cases), Grade Ⅱ in 4 cases (all left). Particularly, 12 of them were Graded as Ⅲ simultaneously accompanying with Nut-cracker Phenomenon (NCP). Preoperative tests showed that the average serum testosterone was (16.2±4.9)nmol/ml, the average sperm concentration was (11.8±3.9)×10 6/ml and the progressive motility rate (PR) was (24.4±4.2)%. All of the patients were performed sub-inguinal MV using general anesthesia and supine position. The spermatic cords were clearly exposed and padded up by inserting gauze strips under them. During the operation, the field was magnified 4-6 times with the microscope. Then all of the dilated external and internal spermatic veins were ligated, at the same time the internal spermatic artery and lymph vessels were well preserved. During these operations, 11 patients underwent left-side MV, while other 5 did bilateral MVs. During these MVs, we found twisted and dilated external and internal spermatic veins in all cases and well preserved the internal spermatic arteries and lymph vessels. The number of ligated left and right external spermatic veins were(2.1±0.6) and (1.4±0.5)respectively and the number of ligated left and right internal spermatic veins were (10.1±1.1) and (6.6±0.5) respectively. We also found out(1.3±0.5) internal spermatic arteries and (3.0±1.0)lymph-vessels on left side. On right side, there were (1.4±0.5) internal spermatic arteries and (2.6±0.5) lymph-vessels respectively. At last, we summarily analyzed the pre-operative and post-operative VAS, serum testosterone, CDFI and semen analysis data. Results:All of the 16 sub-inguinal MVs were successfully performed. All patients were reviewed comprehensively 6 months after MV. The reviewed results showed that the post-operative VAS was significantly reduced ( Z=-2.994, P<0.05), palpable scrotal vessels disappeared and Valsalva tests were negative. No obvious reflux of internal spermatic veins were detected by CDFI. Interestingly, the sperm concentration and motility were both significantly improved 6 months after MV ( P<0.05), while there was not remarkable increase of the serum testosterone after MV ( P>0.05). During the follow up, no testicular atrophy, hydrocele and other complications were found. Up to submission, five of the ten patients who presented for male subfertility have impregnated their wives. Conclusions:The most possible cause of VC recurrence could be the omission of the external and internal spermatic veins, particularly in the grade Ⅲ VC patients or VC accompanied with NCP. The sub-inguinal MV, which can discover more twisted spermatic veins and at the same time preserve the spermatic artery and lymph-vessels, shows better clinical efficacy than other procedures.

Objective:To investigate the clinical efficacy of tacrolimus combined with Jisheng Shenqi pills and Sijunzi decoction in treating spleen-kidney deficiency type lupus nephritis in patients. Methods:A randomized controlled study was conducted on 82 patients with spleen-kidney deficiency type lupus nephritis admitted to Weinan Central Hospital from January 2019 to December 2023. The patients were divided into a control group ( n = 41) and an observation group ( n = 41) using the coin flip method. The control group was treated with tacrolimus, while the observation group received Jisheng Shenqi pills and Sijunzi decoction in addition to the control group's treatment. All patients were treated for 2 months. The clinical efficacy, traditional Chinese medicine (TCM) syndrome scores, systemic lupus erythematosus disease activity index (SLE-DAI) scores, chronicity index (SLE-CI) scores, renal function (cystatin C, blood urea nitrogen, serum creatinine), high-sensitivity C-reactive protein, transforming growth factor β 1, procalcitonin, silent information regulator 4 (SIRT4) levels, and adverse reactions (gastrointestinal discomfort, dizziness, rash, liver function abnormalities) were compared between the two groups. Results:The total effective rate of clinical treatment in the observation group was significantly higher than that in the control group [95.12% (39/41)] vs. [80.49% (33/41), χ2 = 4.10, P < 0.05). After treatment, the TCM syndrome scores, SLE-DAI scores, and SLE-CI scores in the observation group were (4.24 ± 0.96) points, (9.04 ± 1.40) points, (1.22 ± 0.17) points, respectively, which were significantly lower than those in the control group [(8.13 ± 1.06) points, (12.78 ± 1.82) points, (1.37 ± 0.19) points, t = 17.41, 10.42, 3.76, all P < 0.05]. The levels of cystatin C, blood urea nitrogen, and serum creatinine in the observation group were (1.49 ± 0.42) mg/L, (5.20 ± 1.30) mmol/L, (93.27 ± 5.22) μmol/L, respectively, which were significantly lower than those in the control group [(2.16 ± 0.46) mg/L, (6.26 ± 1.27) mmol/L, (103.29 ± 5.07) μmol/L, t = 6.88, 3.73, 8.81, all P < 0.05]. The levels of high-sensitivity C-reactive protein, transforming growth factor β 1, and procalcitonin in the observation group were (3.24 ± 0.87) mg/L, (32.27 ± 6.57) μg/L, (14.11 ± 2.34) μg/L, respectively, which were significantly lower than those in the control group [(4.48 ± 0.81) mg/L, (40.34 ± 7.52) μg/L, (18.26 ± 2.79) μg/L, t = 6.67, 5.17, 7.29, all P < 0.05], while the level of SIRT4 was significantly higher in the observation group [(0.47 ± 0.06) mg/L] compared with the control group [(0.37 ± 0.04) mg/L, t = 8.87, P < 0.05]. The incidence of adverse reactions in the observation group [4.87% (2/41)] was slightly, but not significantly, lower than that in the control group [14.63% (6/41), χ2 = 2.21, P > =0.05]. Conclusion:Tacrolimus combined with Jisheng Shenqi pills and Sijunzi decoction in treating spleen-kidney deficiency type lupus nephritis can significantly improve clinical efficacy, reduce TCM syndrome scores, SLE-DAI scores, and SLE-CI scores, improve renal function, alleviate inflammation, and has good safety.

This study examined the effect of long-term administration of low-dose FTY720 on survival of murine cardiac allograft and the possible mechanism.Murine models of abdominal heterotopic heart transplantation were established.Low-dose FTY720 (0.3 mg/kg) was administrated to the animals 4 days before the transplantation of cardiac allografis until the occurrence of rejection or the observation terminals.The animals without FTY720 treatment and those with syngencic cardiac grafts transplanted served as controls.The mean survival time (MST) of grafts,and T lymphocyte subsets in gratis,peripheral blood and lymphoid organs were measured by histopathological examination or flow cytometry,and compared among groups.The results showed that the MST of allografts in FTY720-treated mice was more than 40 days,significantly longer than that in the untreated group (MST=8 days,P＜0.01).After the long-term administration of FTY720,the proportion of CD4+ and CD8+ lymphocytes in peripheral blood was diminished significantly,but the proportion ofCD4+ lymphocytes was increased in mesenteric lymph nodes (MLNs) and spleen.lmmunofluorescence staining revealcd that the infiltration of CD4+ and CD8+ lymphocytes in allografts was significantly inhibited after long-term administration of low-dose FTY720.It was concluded that low-dose long-term administration of FTY720 could promote T lymphocytes in lymphatic organs and decrease their infiltration in allografts,resulting in the inhibition of rejection and the long-term survival of allografts.

[Objective] To explore the causal relationship between the body mass index (BMI) and the risk of urinary tumors using two-sample Mendelian randomization. [Methods] BMI data in IEU public database genome association and date of kidney cancer, prostate cancer, prostate cancer, bladder cancer were screened and analy through the inverse variance weighting method, MR-Egger regression analysis, weighted median analysis of two-sample mondel randomization method to evaluate the causal relationship between constitution index and urinary tumor.Finally, a sensitivity analysis was used to assess the stability and reliability of the results. [Results] Genetically-predicted BMI is positively related to the risk of kidney cancer (OR: 1.442 5, 95%CI: 1.082 1-1.923 0, P=0.012 5), negatively related to the risk of prostate cancer (OR: 0.992 6, 95%CI: 0.988 7-0.996 5, P=0.000 2), and had no causal relationship with the risk of bladder cancer (OR: 1.000 3, 95%CI: 0.999 4-1.001 1, P=0.526 9). Sensitivity analysis and pleiotropy analyses showed that the results of this study were reliable and there was no heterogeneity. [Conclusion] Genetically-predicted BMI is a risk factor for renal cancer and a protective factor for prostate cancer.It is not associated with the risk of bladder cancer.This finding can provide reference for the potential risk of common urological tumors and the development of prevention strategies.

【Objective】 To construct a nomogram survival prediction model for patients with locally advanced renal cell carcinoma based on SEER database (n=7893), so as to provide reference for future prognosis study. 【Methods】 Case data were downloaded from the SEER database, and divided into the experimental group and validation group with a ratio of 7∶3 by simple randomization.The clinical information was analyzed, independent risk factors influencing prognosis were screened, and the overall survival (OS) and tumor-specific survival (CSS) were mapped.Model performance was evaluated using consistency index, area under the receiver operating characteristic curve (AUC), internal and external validation, and calibration curves. 【Results】 Patients’ age, tumor size, disease progression tpye, TNM stage, number of positive lymph nodes, marital status and pathological type were significantly correlated with OS and CSS (P<0.01).Based on the above predictors, the internal verification AUC of the 1-, 3- and 5- year OS nomogram model was 0.809, 0.721 and 0.715, respectively.The internal validation AUC of the nomogram model for 1-, 3- and 5- year CSS was 0.802, 0.745 and 0.735, respectively.The external validation AUC of the OS nomogram model was 0.792, 0.628 and 0.620 at 1, 3 and 5 years, respectively, and the external validation AUC of CSS was 0.943, 0.803 and 0.737 at 1.3 and 5 years, respectively, showing good model differentiation and accuracy. 【Conclusion】 The prediction performance of the nomogram model is good, and it can provide reference for individualized treatment.

【Objective】 A two-sample Mendelian randomization method was used to explore whether there is a causal relationship between the intake of alcohol, coffee, green tea and dairy products and the incidence of prostate cancer (PCa), in order to clarify the risk factors for the incidence of PCa and find a prevention pathway for PCa. 【Methods】 Data of alcohol, coffee, green tea, dairy products and prostate cancer were collected with genome-wide association study (GWAS).The causal relationship between their intake and the risk of PCa was analyzed with two-sample Mendelian randomization (2SMR).MR analysis was conducted with inverse-variance weighting (IVW).Sensitivity analysis was performed with weighted median, MR-Egger regression, Mendelian randomization pleiotropy residual sum and outlier (MR-PRESSO) tests. 【Results】 Coffee intake (OR: 0.994, 95%CI: 0.990-0.999, P=0.014) and green tea intake (OR: 0.999, 95%CI: 0.998-0.999, P=0.036) were negatively correlated with the risk of PCa.Alcohol intake (OR: 0.997, 95%CI: 0.990-1.004, P=0.392) and dairy intake (OR: 1.025, 95%CI: 0.983-1.069, P=0.256) were not associated with the risk of PCa.In weighted median, MR-Egger regression, and retention one method analyses, the results were robust without heterogeneity or pleiotropy. 【Conclusion】 There was a causal association between coffee intake and green tea intake and the onset of PCa, but no causal association between alcohol intake and dairy intake and PCa onset.