Objective To study the correlation between normal level of thyroid hormone and gensini coronary scor-ing system. Methods Coronary heart disease patient who were treated with Cardio-angiography (CAG) (n=231) were divid-ed into 4 groups based on gensini coronary score. All the patients were examined with indexes include total triiodothyronine (TT3), total thyronine(TT4), free thyronine(FT4), free triiodothyronine (FT3), thyroid stimulating hormone (TSH). And correla-tion between thyroid hormone level and gensini coronary scoring system was studied by Spearman correlation analysis and Multiple regression analysis. Results No significant difference was found in the levels of TT3, TT4, FT4, Cholesterol(CHO) and Triglyceride(TG) between the all 4 groups (P>0.05). FT3 and HDL-C decreased with the increase of extent of coronary artery lesions(P<0.01), and AGE and LDL-C raised with the coronary artery lesions extent (P<0.05). Gensini coronary scoring system was linearly negatively correlated with FT3, HDL-C and positively correlated with age and LDL-C. Age, FT3,HDL-C,LDL-C was independently correlated to Gensini score. Conclusion The lower level of FT3 is an indepen-dent risk factor for CHD.

Mantle cell lymphoma (MCL),as a kind of highly aggressive non-Hodgkin's lymphoma,is characterized by malignant B cell infiltration of lymph node,gastrointestinal tract and bone marrow.Patients suffering from MCL are prone to drug resistance or progression of disease.The 55th ASH annual meeting about MCL explored all aspects.In preclinical research aspects:new mutations including ATM,POT1 and tumor microenvironment further improved the pathogenesis mechanism of MCL.In prognostic indicators,minimal residual disease detected by molecular techniques and whole genome methylation analysis provided new tools for monitoring MCL prognosis and curative effect to guide further risk stratification and individual treatment.Exploration of high effective and low toxic side effective treatment strategies for elderly MCL patients has become a major focus of the meeting.Chemoimmunotherapy including Lenalidomide,bendamustine,rituximab and autologous stem cell transplantation provide more options for the treatment of elderly MCL patients.Novel drugs such as ibrutinib,ABT-199 and MLN8237 have shown encouraging results in preclinical trials which provide new hope for MCL patients.

Objective: To analyze the risk factors of high-risk pregnancy, the change factor conversion rate and pregnancy outcomes, summarize the experience of high-risk pregnancy management, make it rationalized and standardized, improve the health of pregnant women and perinatal children, and guarantee the safety of mother and baby. Methods: The 6 472 pregnant women who were admitted to the hospital from January 2016 to March 2017 were screened for high-risk factors according to the relevant management methods and implementation rules of high-risk pregnancies, and systematic management of high-risk pregnant women was conducted. Results: Among 6 472 pregnant women, 1 610 pregnant women were high-risk pregnancies, and the incidence rate was 24.88%. Three or more high-risk factors accounted for 163 cases (10.12%), two high risk factors accounted for 391 (24.29%) , one risk factors accounted for 1056 cases (65.59%). The top five risk factors were abortion history, age, gestationathe or mild pre-eclampsia, preterm prematurity, and premature rupture of fetal membranes at more than 34 weeks. Among pregnant women with high risk, 249 cases (11.29%) were between 19 and 25 years old; 441 cases (18.27%) of 26-30 years old; 536 cases (36.49%) of 31-34 years old; 384 cases (100.00%) of the 35-year old. The incidence of high-risk pregnancy was closely related to age, and the incidence of high-risk pregnancy was 100% in patients over 35 years old, with the increase of age. The risk factors of hypertension, preterm birth, endocrine disease and prenatal hemorrhage could be change normal rates were 32.77% (58/177), 83.21% (109/131), 46.88% (45/96) and 83.13% (69/83) respectively. The age group with the highest cesarean section rate was ≥35 years old. The c-section rate gradually decreased with age. The age group with the highest vaginal assist rate was 31-34 years old high-risk pregnant women without obviously differences between groups; the highest perinatal mortality rate was ≥35 years old (P <0.05). The risk of eclampsia, puerperal infection and postpartum hemorrhage was significantly higher in maternal ≥35 years old than in other age groups (P <0.05). Conclusions There are many influencing factors of high risk pregnancy, screening, identification and management of the influence factors, attention to health education, to promote the hospital management and community management cooperation, strengthen the management of high-risk pregnancies, helps to reduce the risk of maternal severe adverse pregnancy outcomes, and improve maternal and infant prognosis.

Objective To study the characteristics of Chinese ischemic stroke subclassification (CISS) in relation with migration to different climatic zones in autumn and winter.Methods Ninety-six subjects who travelled from northeast China,northwest China and north China to Hainan Province from September 2012 to February 2017 and were admitted to our hospital due to cerebral infarction occurred within 3 weeks after they arrived at Hainan were included in this study.Their demographic data,risk factors for cerebrovascular disease,laboratory blood test and imaging parameters were recorded.The patients were classified according to their medical history,auxiliary examination findings and CISS.The recorded data were statistically analyzed.Results CISS showed that penetrating artery disease,large artery atherosclerosis,cardiogenic stroke,and undetermined etiology accounted for 50.0％,38.5％,4.2％,7.3％ respectively.Hypertension (70.8 ％) and abnormal glucose metabolism (61.5％) were the major risk factors for cerebral in farction.Conclusion The incidence of penetrating artery disease is the highest,followed by that of large artery atherosclerosis in cerebral infarction patients.Alert to cerebral infarction should thus be stressed for those with hypertension and abnormal glucose metabolism who are going to travel in autumn and winter.

Objective To systematically assess whether cilostazol can delay the progression or decrease the carotid intima-media thickness (clMT).Methods Papers on the effect of cilostazol on cIMT in randomized controlled trials and cohort studies were retrieved from a number of foreign and domestic databases.The data were analyzed by Review Manager 5.3.Results Six randomized controlled trials and two cohort studies were included in this study.A total of 1107 patients were divided into cilostazol therapy group (n=533) and control group (n=574).Meta-analysis showed that cilostazol therapy for 6 months,12 months,≥24 months could reduce the maximum cIMT with a mean difference of-0.04 mm (95％CI:-0.05--0.03,P=0.000),a mean difference of -0.04 mm (95％CI:-0.05--0.03,P=0.000) and a mean difference of-0.08 mm (95％CI:-0.11-0.05,P =0.000) respectively.Conclusion Cilostazol therapy for 6 months,12 months,24 months or more than 24 months can reduce the maximum cIMT,which is needed to be confirmed by studies with a large sample of clinical data.

Differentiated cells can be reprogrammed into pluripotent stem cells, known as "induced pluripotent stem cells" (iPSCs), through the overexpression of defined transcription factors. The creation of iPSC lines has opened new avenues for patient-specific cell replacement therapies for regenerative medicine. However, the clinical utilization of iPSCs is largely impeded by two limitations. The first limitation is the low efficiency of iPSCs generation from differentiated cells. The second limitation is that many iPSC lines are not authentically pluripotent, as many cell lines inefficiently differentiate into differentiated cell types when they are tested for their ability to complement embryonic development. Thus, the "quality" of iPSCs must be increased if they are to be differentiated into specialized cell types for cell replacement therapies. Overcoming these two limitations is paramount to facilitate the widespread employment of iPSCs for therapeutic purposes. Here, we summarize recent progress made in strategies enabling the efficient production of high-quality iPSCs, including choice of reprogramming factors, choice of target cell type, and strategies to improve iPSC quality.
Animals ; Cell Differentiation ; Cellular Reprogramming ; Humans ; Induced Pluripotent Stem Cells ; cytology ; metabolism ; MicroRNAs ; metabolism ; Regenerative Medicine ; Signal Transduction ; Transcription Factors ; metabolism

Objective:To investigate the clinical effect of four-layer reposition of skin flap, musculocutaneous flap, orbital septum flap, and orbitum septum fat flap via lower eyelid margin approach, combined with periorbital fixed-point suspension of the midfacial soft tissue, to reconstruct the aesthetic structure of lower eyelid subunits.Methods:The clinical data of patients admitted to the Department of Beauty and Plastic Surgery of Zhejiang Rongjun Hospital for midface rejuvenation via lower eyelid margin approach surgery from June 2019 to August 2021 were retrospectively analyzed. The layer above the orbital septal, maxillary space, and zygomatic space were dissected to form a musculocutaneous flap. The septal fat flap was released and fixed, then the orbital septum flap was dissected and to make a net-like fixation in horizontal and vertical arrangement around the orbit. The mid and lateral suspension points and suspension tissues were determined and marked by pushing up the facial soft tissues in the sitting position, followed by fixation. Then, the abondant part of the musculocutaneous flap and the lower eyelid margin skin were trimmed to form a flap. Post-operative follow-up was performed by patient self-assessment (very satisfied, satisfied, dissatisfied, very dissatisfied). One attending plastic surgeon who was not involved in the surgery evaluated the results of the reconstruction of the aesthetic structures of the lower lid subunits, including laughing hill, lower eyelid fold, inferior sulcus of the lower tarsal plate, and eyelid-cheek junction based on global aesthetic improvement scale (IGAIS) (-1 to 3, the higher the score the more significant the improvement).Results:A total of 96 patients were included, including 7 males and 89 females, aged 38-83 years, with an average age of 53 years. In all patients, the swelling subsided 1 week after surgery, with no complication such as hematoma, lower eyelid retraction, blepharon separation, lower eyelid ectropion, etc. There was no malar lateral soft tissue accumulation and suspension point sunken deformity. 6-12 months postoperative follow-up showed that all patients had expected benefit outcomes in the reconstruction of laughing hill, lower eyelid fold, and inferior sulcus of lower tarsal plate. Yet, fat bulgings at the eyelid-cheek junction were moderately visible in 2 cases, and it is slightly visible in 3 cases. The rest of the patients had good curvilinear continuity in the eyelid-cheek junction area. Patient self-assessment showed that 76 were very satisfied, 16 were satisfied, and 4 were dissatisfied. IGAIS score showed 96 patients scored 2.43±0.35, with 76 scored 3, 16 scored 2 and 4 scored 1.Conclusion:Four-layer reposition of skin flap, musculocutaneous flap, orbital septum flap, and orbital septum fat flap via lower eyelid margin approach, combined with periorbital fixed-point suspension of the midfacial soft tissue can effectively reconstruct the aesthetic structure of the lower eyelid subunits, including the laughing hill, lower eyelid fold, inferior sulcus of inferior tarsal plate and eyelid-cheek junction.

Objective:To investigate the clinical effect of four-layer reposition of skin flap, musculocutaneous flap, orbital septum flap, and orbitum septum fat flap via lower eyelid margin approach, combined with periorbital fixed-point suspension of the midfacial soft tissue, to reconstruct the aesthetic structure of lower eyelid subunits.Methods:The clinical data of patients admitted to the Department of Beauty and Plastic Surgery of Zhejiang Rongjun Hospital for midface rejuvenation via lower eyelid margin approach surgery from June 2019 to August 2021 were retrospectively analyzed. The layer above the orbital septal, maxillary space, and zygomatic space were dissected to form a musculocutaneous flap. The septal fat flap was released and fixed, then the orbital septum flap was dissected and to make a net-like fixation in horizontal and vertical arrangement around the orbit. The mid and lateral suspension points and suspension tissues were determined and marked by pushing up the facial soft tissues in the sitting position, followed by fixation. Then, the abondant part of the musculocutaneous flap and the lower eyelid margin skin were trimmed to form a flap. Post-operative follow-up was performed by patient self-assessment (very satisfied, satisfied, dissatisfied, very dissatisfied). One attending plastic surgeon who was not involved in the surgery evaluated the results of the reconstruction of the aesthetic structures of the lower lid subunits, including laughing hill, lower eyelid fold, inferior sulcus of the lower tarsal plate, and eyelid-cheek junction based on global aesthetic improvement scale (IGAIS) (-1 to 3, the higher the score the more significant the improvement).Results:A total of 96 patients were included, including 7 males and 89 females, aged 38-83 years, with an average age of 53 years. In all patients, the swelling subsided 1 week after surgery, with no complication such as hematoma, lower eyelid retraction, blepharon separation, lower eyelid ectropion, etc. There was no malar lateral soft tissue accumulation and suspension point sunken deformity. 6-12 months postoperative follow-up showed that all patients had expected benefit outcomes in the reconstruction of laughing hill, lower eyelid fold, and inferior sulcus of lower tarsal plate. Yet, fat bulgings at the eyelid-cheek junction were moderately visible in 2 cases, and it is slightly visible in 3 cases. The rest of the patients had good curvilinear continuity in the eyelid-cheek junction area. Patient self-assessment showed that 76 were very satisfied, 16 were satisfied, and 4 were dissatisfied. IGAIS score showed 96 patients scored 2.43±0.35, with 76 scored 3, 16 scored 2 and 4 scored 1.Conclusion:Four-layer reposition of skin flap, musculocutaneous flap, orbital septum flap, and orbital septum fat flap via lower eyelid margin approach, combined with periorbital fixed-point suspension of the midfacial soft tissue can effectively reconstruct the aesthetic structure of the lower eyelid subunits, including the laughing hill, lower eyelid fold, inferior sulcus of inferior tarsal plate and eyelid-cheek junction.

Objective:To explore the clinical features, etiologies and outcomes of unknown origin fever after simultaneous pancreas-kidney transplantation(SPK).Methods:From March 2015 to January 2020, clinical data were retrospectively reviewed for 120 SPK recipients.According to the definite evidence of fever, such as microbial culture, imaging findings or rejection, they were divided into three groups of free-fever(FF, n=41)and defined-fever(DF, n=47)and fever of unknown origin(FUO, n=32). The differences in general clinical features, surgical complications, laboratory tests and prognoses were compared.Logistic regression was employed for analyzing the risk factors of FUO and Kapla-Meier for survival analysis.And P<0.05 was deemed as statistically significant. Results:Multivariate analysis revealed that preoperative diabetic gastroenteropathy was an independent risk factor for unexplained fever.Significant differences existed between FUO and DF groups in leucocyte count[6.50(5.13, 7.36)vs.10.36(6.11, 12.97)×10 9/L], C-reactive protein(CRP)[11.75(6.25, 16.85)vs.35.00(16.30, 75.00)μg/ml], procalcitonin[0.13(0.06, 0.18)vs.0.19(0.11, 1.05)ng/ml]( P<0.001, P<0.001, P=0.025). As compared with DF group, 19 recipients in FUO group only received 1-2 antibiotics and there was a shorter course of treatment[13(40.6%)vs.32(68.1%), P=0.016]. For 6(18.7%)recipients after a diagnosis of FUO, clinical outcome was achieved with only NSAIDs.Length of stay was(48.72±19.51)days in FUO group versus(57.36±27.46)days in DF group and the difference was statistically significant( P<0.001). Hospitalization expenses of two groups were 253 463.25 and 334 605.96 yuan respectively and the difference was also statistically significant( P=0.002). Conclusions:Diabetic gastroenteropathy is an independent risk factor for early FUO after SPK transplantation.Inflammatory markers of leukocytes, CRP and procalcitonin in FUO patients are significantly lower than DF group.And these clinical features can help diagnose FUO in an early stage.