Objective: To study the diagnostic characteristics of cardiac amyloidosis (CA) by non-invasive electrocardiography (ECG) in relevant patients. Methods: We retrospectively analyzed 60 CA patients diagnosed in our hospital from 2008-08 to 2013-12 for their clinical and ECG characteristics. Results: There were 48 male and 12 female patients with the ratio of 4: 1. The ifrst time diagnosis rate was low and the average age for conifrmed diagnosis was at (54. 5±14. 2) years.①There were 32 (53. 3%) cases combining heart failure, 12 (20%) with pleural effusion, 20 (33. 3%) with atrial arrhythmia, 8 (13. 3%)with ventricular arrhythmia, 4 (6. 7%)with sino-atrial block, 15 (25%)with atrio-ventricular block, 4 (6. 7%) with left bundle branch block (LBBB), 5 (8. 3%)with RBBB and 8 (13. 3%)with intra-ventricular block.②There were 32 (53. 3%) cases with low voltage on limb leads, 52 (86. 7%) with pseudo-infarct pattern, 48 (60%) with ST-T abnormality and 30 (50%) combining low voltage on limb leads with pseudo-infarct pattern.③The patients combining pleural effusion and with pseudo-infarct pattern had the increased ratio of low voltage on limb leads, while there were still 22 (45. 8%) cases without pleural effusion had low voltage on limb leads.④ ECG characteristics for 60 CA patients were as follows: QRS duration (104±26) ms, QT interval (404±34) ms, QTc (462±35) ms; the R wave of avR 0. 17 mV, QRS wave 0.30 mV; the R wave of limb leads and V1-3 were all<0.5mV, the S wave of V1-3 were 0. 62mV, 1. 61mV, 1. 56mV; the R/S ratio of V1-3 were 0. 19, 0. 12, 0. 20 respectively. Conclusion: CA patients had the highest incidence of pseudo-infarct pattern; meanwhile, combining with low voltage on limb leads, pseudo-infarct with long Q or S wave and ST-T abnormality but normal QRS duration was helpful for differential diagnosis of CA in clinical practice.

Objective To investigate the effects of 10 mg and 20 mg atorvastatin and 10 mg rosuvastatin on inflammatory factors in patients with acute coronary syndrome (ACS).Methods 66 patients with ACS were randomly divided into three groups:the 10 mg atorvastatin group,the 20 mg atorvastatin group and the 10 mg rosuvastatin group(n=22 for each group).The levels of blood lipids,serum matrix metalloproteinases-9 (MMP-9)and plasminogen activator inhibitor-1 (PAI-1)were measured before and after two-week treatment.19 patients with normal coronary angiography were assigned to the control group.Results The concentration of serum MMP-9 and PAI-1 was higher significantly in patients with ACS than those in control subjects(P＜0.05 or P＜0.01).After two weeks'treatment,the serum MMP-9 and PAI-1 levels were lowered significantly (P＜0.01),which were much better in groups of 20mg atorvastatin and of 10mg rosuvastatin than those in group of 10mg atorvastatin (P＜0.05 or P＜0.01 ).No relationship was observed between the levels of above inflammatory markers and serum hpids levels(P＞0.05).Conclusion 10 mg Rosuvastatin can greatly reduce the serum level of MMP-9 and PAI-1 as compared to 10 mg atorvastatin in patients with ACS ,equivalent to the effect of 20 mg atorvastatin,suggesting that the anti-inflammatory effect is independent of lipid-lowering action.

BACKGROUNDNeoadjuvant chemotheropy can improve the survival rate of patients with stage III non-small cell lung cancer (NSCLC), whose chemotherapy is valid. The value of P53 expression in stage III NSCLC has not been reported. This study is to investigate the value of P53 expression on neoadjuvant chemotherapy sensitivity and prognosis in stage III NSCLC and to investigate the relationship between P53 expression and the result from thoracic CT examination.

METHODSBy immunohistochemical technique, the expression of P53 in 51 patients with stage III NSCLC who received neoadjuvant chemotherapy was determined in contrast with 49 patients with stage III NSCLC without neoadjuvant chemotherapy. Every patient who received neoadjuvant chemotherapy was examined by thoracic CT before and after neoadjuvant chemotherapy.

RESULTS(1) There was no significant difference in the positive rate of P53 and the median survival time between neoadjuvant group and control group (48.98% vs 49.02% and 18 months vs 19 months). In neoadjuvant chemotherapy group, the median survival time was significantly different between P53 positive patients and P53 negative ones (13 months vs 31 months). (2) The expression of P53 was related to the neoadjuvant chemotherapeutic response by the results from thoracic CT examination (r=0.537, P < 0.01).

CONCLUSIONS(1)Detection of P53 expression might be helpful to predict the effect of neoadjuvant chemotherapy. (2)The expression of P53 and the neoadjuvant chemotherapeutic results from thoracic CT examination are correlated.

Using a modified TAIL-PCR technique, the 5' -flanking region of the X gene in wheat was successfully isolated. Two novel modifications of the TAIL-PCR were introduced here: using a battery of random 10-mers as the short arbitrary primers instead of three degenerate 16-mers; using 29 degrees C instead of 44 degrees C as the annealing temperature for the low-stringency cycle; increasing five high-stringency cycles and reducing five low-stringency cycles; and using single primers for the third round of product identification. Isolated 5' -flanking region was fused to the GUS gene, and tested for expression in Arabidopsis plants. Histochemical analysis of the transgenic plants showed the report gene was driven by isolated 5'-flanking region. Modified TAIL-PCR technique could isolate rapidly the promoter of any gene from organisms with large genomes.
Base Sequence ; Genes, Plant ; genetics ; Molecular Sequence Data ; Polymerase Chain Reaction ; methods ; Promoter Regions, Genetic ; genetics ; Triticum ; genetics ; metabolism

Objective To investigate the characteristics of clinical and cardiovascular magnetic resonance imaging(CMR) of arrhythmogenic cardiomyopathy with left ventricular(ALVC) involvement. Methods Ten cases of arrhythmogenic cardiomyopathy with left ventricular involvement and sixteen randomly chosen cases of arrhythmogenic cardiomyopathy with right ventricular (ARVC) involvement were enrolled in this study. Clinical symptoms, cardiac electrophysiological changes as well as the cardiac morpharage, ventricular functions and delayed enhancement of myocardium assessed by CMR were compared between the two groups. The size of heart chambers, global ventricular functions and the fat/fibrosis infiltration were evaluated by turbo fast spin echo, ture FISP cine and delayed enhancement. These were statistically analyzed by independent samples t test, respectively.Results There was no significant difference in age and gender between two groups. All the patients in two groups presented non-specific clinical manifestations with no significant differences (P>0.05) except for short of breath(P=0.034). The end-diastolic diameter of left ventricular, left ventricular end-diastolic volume index, left and right ejection fraction in ALVC and ARVC group were (64.2±7.7), (49.2±5.9) mm(t=5.551,P<0.001), (113.9±24.0), (69.2± 30.0) ml/m2(t=3.962, P<0.001), (38.5±3.1)%, (56.0±8.4)%(t=-6.733,P<0.001), (42.0±5.5)%, (18.0±7.3)%(t=8.817, P<0.001) respectively. An medium of 11 and 14 segments of fat or fat/fibrosis were found in intramural wall of the LV myocardiumin patients with ALVC,while only 0 segment(all P<0.001)was found in patients with ARVC.Conclusions The clinical manifestations of arrhythmogenic cardiomyopathy with left ventricular involvement was similar to ARVC, however, with regarding to cardiac morphological, functional and myocardial lesions, these two diseases have different characteristics in CMR features.“one-stop-shop”MRI examination has high value in the diagnosis of arrhythmogenic cardiomyopathy with Left ventricular involvement.

Objective To understand the knowledge,attitude and behavior on health hazards of haze and secondhand smoke exposure among middle school students in Beijing,and provide us with guidance to carry out effective health education for middle school students.Methods A total of 1 294 students were selected randomly using stratified cluster sampling method;1 085 valid questionnaires were recovered.Among them,739 were junior high school students and 346 were senior high school students.The questionnaire included questions on middle school students' knowledge on haze and secondhand smoke exposure,their attitudes towards the judgement of severity of haze and secondhand smoke exposure and their utilization of protective measures when they are exposed to haze or secondhand smoke.Pearson's chi-squared test was performed to assess differences in knowledge,attitude and behavior between junior middle school students and senior high school students,boys and girls.Results Middle-school students' awareness rate on "the haze and exposure to secondhand smoke may cause respiratory disease" was the highest,which was 93.55％ and 95.76％ respectively.The awareness rate of the fact that haze,secondhand smoke exposure can cause cardiovascular disease was 38.99％ and 55.85％ respectively;while the rate of their awareness on the haze and exposure to secondhand smoke can lead to cancer was the lowest,which was 54.10％ and 69.95％ respectively.The differences was significant in the awareness rate of the fact that respiratory disease,cardio-cerebrovascular disease and cancer can be caused by the haze (x2=732.539,P＜0.05),likewise the differences were significant in the awareness rate of the above three kinds of diseases can be caused by secondhand smoke exposure (x2=460.291,P＜0.05).In the comparison between the severity of haze and smoking hazards,35.94％ of students believe that haze hazards is heavier than tobacco;48.02％ of the students think that the dangers of smoking is greater than haze;16.04％ of the students cannot determine the extent of damage of the haze and smoke.The proportion of students who think smoking was more harmful than haze was higher in junior high school group than in senior high school group.The two groups had a significant difference in the understanding of the severity comparison between haze and smoking (x2=13.014,P＜0.05).The differences between boys and girls in the view of the severity comparison between haze and smoking are also statistically significant,more boys believed smoking was more harmful than haze (x2=9.650,P＜0.05).In the aspect of protection from haze and secondhand smoke exposure,86.36％ of the students would like to protect themselves from haze,while 55.94％ of the students would take measures to prevent the secondhand smoke exposure initiatively,the junior high school students performed better than the senior high school students in this two aspects(x2=17.125,P＜0.05;x2=45.785,P＜0.05).Conclusion While middle school students have a certain understanding of the impact of haze and secondhand smoke exposure on health hazards,their understanding is limited.They have not paid enough attention to the harm of secondhand smoke exposure and their awareness of active refusal to secondhand smoke exposure needs to be improved.Schools should strengthen the health education for students and educate them not only to stay away from haze but also should be far away from secondhand smoke exposure.

Objective To explore the expression of liver fatty acid binding protein (L-FABP) in tissues of hilar cholangiocarcinoma and the relationship between expression of L-FABP and clinicopathological factors and prognosis of the patients.Methods The retrospective case-control study was conducted.The clinicopathological data of 132 patients with hilar cholangiocarcinoma who were admitted to the Navy General Hospital between January 2003 and January 2013 were collected.The expression of L-FABP in tumor tissues and adjacent tissues of hilar cholangiocarcinoma and normal bile duct tissues were respectively detected by immunohistochemistry.Observation indicators:(1) expression of L-FABP by immunohistochemistry;(2) relationship between clinicopathological factors of patients and expression of L-FABP in tumor tissues;(3) follow-up and survival situations;(4) prognostic analysis of patients after radical resection of hilar cholangiocarcinoma.Follow-up using outpatient examination and telephone interview was performed to detect postoperative overall survival time up to June 2017.Count data were described as percentage and compared using the chi-square test.The survival time was calculated by the Kaplan-Meier method.Measurement data with skewed distribution were described as M (range).The univariate analysis and multivariate analysis were respectively done using the nonparametric test and COX regression model.Results (1) Expression of L-FABP by immunohistochemistry:the positive expressions of L-FABP were located in the cytoplasm.The low,moderate and high expression rates of L-FABP in tumor tissues were respectively 11.36％ (15/132),71.97％ (95/132) and 16.67％ (22/132),and positive-staining cells showed platy and / or diffuse distribution;the low,moderate and high expression rates of L-FABP in adjacent tissues of hilar cholangiocarcinoma were respectively 77.27％ (102/132),7.58％ (10/132) and 15.15％ (20/132),and positive-staining cells showed scattered or platy distribution,with a weaker staining intensity compared with tumor tissues;there was no positive expression in normal bile duct tissues.There was a statistically significant difference in expressions of L-FABP among tumor tissues and adjacent tissues of hilar cholangiocarcinoma and normal bile duct tissues (x2=5.423,P ＜ 0.05).(2) Relationship between clinicopathological factors of patients and expression of L-FABP in tumor tissues:cases with low,moderate and high expressions of L-FABP in tumor tissues were respectively 10,30,5 in 45 patients with tumor diameter ＜ 3 cm and 4,29,9 in 42 patients with 3 cm ≤ tumor diameter ≤ 5 cm and 1,36,8 in 45 patients with tumor diameter ＞ 5 cm,with a statistically significant difference (x2 =10.171,P＜ 0.05).(3) Follow-up and survival situations:132 patients were followed up for 5-90 months,with a median time of 33 months.During the followup,postoperative overall median survival time of 132 patients was 31 months.(4) Prognostic analysis of patients after radical resection of hilar cholangiocarcinoma:results of univariate analysis showed that tumor differentiation,lymph node metastasis and expressions of L-FABP in tumor tissues were related factors affecting prognosis of patients after radical resection of hilar cholangiocarcinoma (Z =1.845,3.156,1.243,P＜0.05).Results of multivariate analysis showed that tumor differentiation,lymph node metastasis and expressions of L-FABP in tumor tissues were independent factors affecting prognosis of patients after radical resection of hilar cholangiocarcinoma (odds ratio =0.431,1.806,3.692,95％ confidence interval:0.292-0.693,0.974-2.973,1.875-11.364,P＜0.05).Conclusions The high expression of L-FABP in tumor tissues is significantly correlated with the tumor diameter.Tumor differentiation,lymph node metastasis and expressions of L-FABP in tumor tissues are independent factors affecting prognosis of patients after radical resection of hilar cholangiocarcinoma.

OBJECTIVETo investigate the predictive value of cardiac magnetic resonance (CMR) on outcome of patients with hypertrophic obstructive cardiomyopathy (HOCM) undergoing percutaneous transluminal septal myocardial ablation (PTSMA).

METHODSA total of 38 consecutive HOCM patients underwent CMR imaging before PTSMA in Fuwai hospital From March 2010 to September 2012 were included in this retrospective study. The efficacy was defined as >30 mmHg (1 mmHg = 0.133 kPa) reduction of echocardiography derived left ventricular outflow tract gradient (LVOTG) at 6 months post operation. The relationship between CMR imaging derived parameters and effect of PTSMA was analyzed. Receiver operating curve (ROC) was applied to assess the predicting effectiveness of related CMR parameters.

RESULTSThe effective rate of PTSMA was 65.8% (25/38). The thickness of basal anterior wall (r = 0.505, P = 0.001), basal anteroseptal wall (0.500, P = 0.001) and the sum of the two segments (r = 0.656, P < 0.001) was positively correlated to the post-procedure reduction of LVOTG. The area under the ROC curve of the thickness of basal anterior wall, basal anteroseptal wall and the sum of the two segments was 0.806, 0.675 and 0.834, respectively. The sensitivity was 84.6% and specificity was 84.0% to predict the efficacy of PTSMA using the sum of left ventricular basal anterior wall and basal anteroseptal wall thickness 49.6 mm as cut-off value.

CONCLUSIONSLVOTG reduction post PTSMA positively correlates to pre-procedure left ventricular basal anterior wall, basal anteroseptal wall and the total thickness of these two segments in patients with HOCM. The total thickness of these two segments is a superior parameter for predicting efficacy of PTSMA in HOCM patients.

Cardiac Surgical Procedures ; Cardiomyopathy, Hypertrophic ; diagnosis ; therapy ; Echocardiography ; Heart Septum ; Heart Ventricles ; Humans ; Magnetic Resonance Spectroscopy ; Predictive Value of Tests ; Prognosis ; Retrospective Studies ; Sensitivity and Specificity

Objective:To Explore the diagnosis, treatment and prognosis of FH-deficient renal cell carcinoma (FH-deficient RCC) with tumor thrombus, and share surgical experience.Methods:From August 2019 to October 2022, 6 cases of FH-deficient RCC with tumor thrombus were diagnosed and treated in our center, including 4 males and 2 females. The patients were aged 22 to 57 years, with 2 cases younger than 40 years, icluding 5 cases on the left and 1 case on the right. The median maximum diameter of the tumor is 8 (4.8, 14.0) cm. Operations were performed after complete examination (enhanced CT and other related examinations). One case underwent open surgery and palliative resection of the left kidney was performed because of severe adhesion of the inferior vena cava. Among the remaining 5 cases, 1 case underwent retroperitoneal laparoscopic right radical nephrectomy with inferior vena cava thrombectomy, 1 case underwent transabdominal laparoscopic left radical nephrectomy with inferior vena cava thrombectomy, and 3 cases underwent robot assisted laparoscopic left radical nephrectomy with inferior vena cava thrombectomy.Results:The median surgical time was 293 (185, 366) min, with blockage of the vena cava for 13 min and 28 min in 2 of 6 cases, respectively. The pathological report of renal tumor and tumor thrombus was FH-deficient renal carcinoma. The pathological features were as follows: the gross section of the specimen was gray yellow solid, often accompanied by necrosis, and the cystic cavity could be seen locally. Microscopically, the tumor extensively involved the renal parenchyma, with papillary, cribriform and tubular cystic structures. Immunohistochemistry showed FH (-), 2SC (+ ). The median postoperative hospital stay was 8 (4, 15) days. The median follow-up time was 13 (4, 27) months. One patient undergoing palliative resection of the left kidney underwent targeted therapy and radiotherapy after surgery (died 15 months after surgery due to gastrointestinal perforation). During the follow-up process, 4 cases experienced metastasis and received systematic treatment, with 1 death 27 months after surgery. Uterine leiomyomas were found in the remaining 1 case during follow-up.Conclusions:FH-deficient RCC with tumor thrombus is very rare. This disease is highly invasive, difficult to be diagnosed preoperatively and poor clinically prognostic. Operation combined with systemic therapy is an effective way to treat FH-deficient RCC with tumor thrombus.

Objective:Induced pluripotent stem cells (iPSCs) cell lines were established using peripheral blood mononuclear cells (PBMCs) from a patient suffering from neonatal respiratory distress syndrome (NRDS) who carried Adenosine triphosphate-binding cassette transporter A3 ( ABCA3) compound heterozygous mutations. Methods:Cell experimental research.Peripheral venous blood was collected and PBMCs were isolated and cultured in vitro. PBMCs were transfected with non-integrated Sendai vector carrying reprogramming factors.The chromosome karyotypes of the established iPSCs were analyzed.Immunofluorescence and flow cytometry were used to detect pluripotency markers of stem cells and verify their differentiation potential.Sanger sequencing was performed to analyze gene mutations.In addition, short tandem repeat (STR) analysis was performed, polymerase chain reaction(PCR) and agarose gel electrophoresis were used to detect virus residual. Results:Karyotype analysis of established iPSCs cell lines showed normal diploid 46, XY karyotype.Immunofluorescence showed positive staining of stem cell pluripotency markers OCT4, SSEA4, Nanog and Sox2.Flow cytometry was used to detected stem cell pluripotency markers and showed expression of TRA-1-60, SSEA-4 and OCT4.After differentiation into all three germ layers, immunofluorescence was performed to detect ectoderm (Pax-6), mesoderm (Brachyury) and endoderm alpha-fetoprotein markers, and the results showed positive staining, which confirmed that the iPSCs had the potential to differentiate.Sanger sequencing showed c. 3997_3998del and c. 3137C>T compound heterozygous mutations.STR analysis showed they originate from PBMCs, and no Sendai virus residual was detected by PCR and agarose gel electrophoresis.Conclusions:In this study, PBMCs from patient carrying ABCA3 compound heterozygous mutations was used to establish iPSCs cell lines.The research lays a foundation for the study of pathogenesis, therapeutic drug screening and cell therapy of NRDS caused by ABCA3 gene mutations.