High density lipoprotein ( HDL ) has been considered as an important mediator in favoring cardioprotective effects .However , recent studies revealed that HDL-C-raising therapeutics alone failed to reduce the risk of cardiovascular diseases , suggesting that the HDLfunctionalitymay be more critical for its cardioprotective properties than the simple HDL-C levels.microRNAs ( miRNAs) have been identified as the novel regulators of lipid metabolism and played essential roles in the key steps of reverse cholesterol transport, involving in HDL biogenesis , cellular cholesterol mobilization , hepatic HDL uptake and excretion.The intensive research on lipid metabolism-related miRNAs may provide further clarification on the molecular regulatory mechanisms for HDL-mediated reverse cholesterol transport and plasma HDL-C levels, advancing our knowledge on the effects of HDL in pathogenesis and progression of cardiovascular diseases.

Regular checking blood lipids may be served as the important approach for the risk assessment and prevention of the atherosclerotic cardiovascular disease (ASCVD). It has been emphasized by several dyslipidemia management guidelines that the low density lipoprotein cholesterol (LDL-C) was the primary intervention target for prevention of ASCVD risk. Recent studies have demonstrated that small dense low density lipoprotein (sdLDL) or sdLDL cholesterol (sdLDL-C) levels as the biomarker for the prediction and risk assessment of ASCVD may be more sensitive than LDL-C. The isolation and detection methods of sdLDL or sdLDL-C were developed from the traditional ultracentrifugation or gel electrophoresis to the efficient, fast, accurate automated processing system. The continuous advances and popularization in analytical techniques of LDL subcomponents provided new methods and ideas for their application in the risk assessment and prevention of ASCVD.

Objective To investigate FIB and D-D with GRACE risk score to predict the risk of acute coronary syndrome (ACS)during hospitalization.Methods Plasma FIB,D-D and GRACE risk score were measured in 90 patients with ACS and 23 healthy controls,the number of coronary artery lesions of ACS patients also was obtained.Results The results of FIB,D-D levels and GRACE risk score in ACS group were 2.77±0.79 g/L,1.67±2.13 mg/L,147.19±32.50,respective-ly.Compared to controls,FIB,D-D and GRACE risk score in ACS group were significantly increased (t=6.256,6.465, 10.317,all P<0.001).There were significant differences in plasma D-D and FIB levels in different risk stratification (F=18.475,9.426,all P<0.001).FIB (r=0.485,P<0.000 1)and D-D (r=0.357,P<0.000 6)levels were found positively related with GRACE risk score.Conclusion Pasma FIB ,D-D levels and GRACE risk score were increased in ACS group. FIB and D-D can be used as indicators to predict the risk stratification for ACS patients,and D-D was better than FIB.

Objective To investigate altered levels and clinical significance of serum miR-133a in patients with acute coronary syndrome ( ACS ) and stable coronary artery disease ( SCAD ) .Methods Retrospective study.Serum miR-133a levels were determined by TaqMan quantitative reverse-transcription PCR assay in 64 ACS, 62 SCAD patients who were admitted to Jinling Hospital from October 2011 to October 2012 and 70 normal controls who had contemporaneously visited Jinling Hospital for routine examination .The ACS and SCAD patients were diagnosed according to the European Society of Cardiology guidelines .Serum lipid/lipoprotein profiles , myonecrosis biomarkers and Gensini scores were also analyzed .The area under curve ( AUC) and 95%confidence interval ( CI) were calculated using ROC analyses .The odds ratio ( OR) and 95%CI were calculated using the multivariate logistic regression analyses .Results Compared with the controls [ΔCt:1.00 ±0.05], serum miR-133a levels were significantly increased in both ACS [ΔCt:2.34 ±0.24] (t=6.059, P<0.001) and SCAD [ΔCt:1.45 ±0.13] (t=3.265, P=0.001) patients.The miR-133a levels in ACS patients were significantly higher than in SCAD patients (t=3.133, P=0.002). Serum miR-133a were positively correlated with levels of creatine kinase MB ( CK-MB) ( r=0.402, P<0.001), cardiac troponin I (cTNI) (r=0.410, P=0.001) and Gensini scores (r=0.438, P<0.001). ROC curve analyses showed that the AUC of miR-133a for differentiating coronary artery disease (CAD) and controls was 0.717 (95%CI:0.645-0.788, P<0.001) and the AUC for differentiating ACS and SCAD was 0.667 (95% CI:0.573-0.761, P=0.001).Logistic regression analyses revealed that high miR-133a levels were closely associated with the presence of ACS ( OR=6.00, 95% CI:1.93 -18.67, P=0.002) and SCAD (OR=2.81, 95%CI:1.03-7.68, P=0.044), and also had statistical significance for differentiating ACS and SCAD (OR=2.13, 95% CI:1.20-3.78, P=0.010), after adjustment for the age, gender and serum lipid/lipoprotein levels.Conclusions Serum miR-133a levels were significantly elevated in CAD patients, and ACS patients exhibited the more significant increase .Serum miR-133a may be function as the potential biomarker for the disease assessment and judgement .

Objective To explore the characterization of the long-term survival patients through monitoring the lymphoeytes subgroup and cytokines level.Method The lymphocytes subgroups (T,B,and NK) and cytokines (IL-9,-17,-22) of patients and healthy groups were tested by using flow cytometry and ELISA.Results The levels of CD3+,CD4+,CD8+,CD8+ CD28+/CD8+ and IL-9 were gradually increased in the short-term group and long-term group as compared those in healthy group.The percentage of CD3 + cells and level of IL-9 were significantly lower in short-term group and long-term group than in healthy group (P＜0.05).The percentage of CD8+ cell was significantly lower in short-term group than in healthy group (P＜0.05).The ratio of CD8+ CD28+/CD8+ was significantly lower in short-term group than in longterm group and healthy group (P＜0.05).The percentage of B cells and NK cells,and IL-22 were gradually increased in the healthy group,shortterm group and long-term group.The percentage of B cells and NK cells was significamly higher in long-term group than in healthy group (P＜0.05).The level of IL-22 was significantly higher in longterm group than in short-term group and healthy group (P＜0.05).However,NKT lymnphocytes and IL-17 showed no statistically significant difference between long-term group and short-term group.Conclusion The ratio of T lymphocyte subgroups and the level of IL-9 were good biomarkers for evaluating the immune characterization of OLT patients; NK and B lymphocytes,and IL-22 may be associated with the long-term survival in patients after OLT.

Background and purpose: Primary liver cancer is the malignant tumor of liver cells or intrahepatic bile duct epithelium with familiar metastasis and postsurgical recurrence. The purpose of this study was to investigate the effects of miR-148a on the invasion and migration of hepatocellular carcinoma cells and the underlying mechanisms. Methods: The supernatant containing LV-miR-148a lentivirus particles was used to infect SMMC-7721 cells. The expression of miR-148a was determined by RT-PCR. Wound healing assay and transwell assay were performed to detect the effects of miR-148a on the invasion of hepatocellular carcinoma cells. Gelatin zymography assay was used to detect the effects of miR-148a on the enzyme activities of matrix metalloproteinase-2 (MMP-2) and matrix metalloproteinase-9 (MMP-9). The expression of MMP-2, MMP-9, E-cadherin and vimentin proteins was detected by Western blot assay. Results:RT-PCR showed the expression of miR-148a was upregulated in the infected SMMC-7721 cells. Transwell assay and wound healing assay showed ectopic expression of miR-148a suppressed cell migration and invasion abilities. miR-148a overexpression led to the decrease of the enzyme activities of MMP-2 and MMP-9 (P<0.05). Western blot assay showed that the protein expression of MMP-2, MMP-9 and vimentin proteins was signiifcantly decreased, the expression of E-cadherin had no changes. Conclusion:miR-148a is able to inhibit the migration and invasion of human SMMC-7721 cells in vitro, and the possible mechanisms may be related to decrease the enzyme activities of the MMP-2 and MMP-9 and the down regulation expression of MMP-2, MMP-9 and vimentin.

Exosomal microRNAs (miRNAs) from various cell sources in the cardiovascular system are involved in the regulation of diverse biological processes such as angiogenesis, myocardial remodeling, inflammation and plaque rupture, and may function as promising liquid biomarkers for atherosclerotic cardiovascular diseases (ASCVD). Expression analysis of exosomal miRNAs can be employed for monitoring ASCVD progression and evaluating treatment efficiency. This review focused on recent research advances regarding exosomal miRNAs in the field of ASCVD laboratory medicine, and summarized the future research trends and application prospects of circulating exosomal miRNAs in the field of ASCVD.

Objective:To compare the difference between serum lipoprotein(a) [Lp(a)] particle concentration and mass concentration in chronic kidney disease (CKD) patients and healthy controls, and to analyze the concentration distribution of the deviations between the two measurement methods.Methods:Serum Lp(a) particle concentration and mass concentration were respectively detected in 196 patients with CKD and 97 healthy controls from Eastern Theater General Hospital during June 2018 to December 2019. The upper limit of reference value for Lp(a) particle concentration was set as 75 nmol/L and the upper limit of reference value for mass concentration was set as 300 mg/L, the difference on the positive rates of Lp(a) particle concentration and mass concentration in each group were compared. According to the quartile of Lp(a) concentration in patients with CKD, the patients were divided into 4 groups, and the results derived from the two methods were compared among groups.Results:Serum Lp(a) particle concentration (25.7 [10.5, 75.4] nmol/L vs 19.2[8.1-50.2] nmol/L, P=0.021) and mass concentration (157[64, 432] mg/L vs 127[50-274] mg/L, P=0.023) were significantly higher in patients with CKD than those in healthy controls. The positive rate of Lp(a) particle concentration was significantly lower than that of mass concentration (25.0%[48/196] vs 37.2%[73/196], P=0.009) in CKD patients. The positive rate of Lp(a) particle concentration and mass concentration was similar in healthy controls (18.6%[18/97] vs 22.7%[22/97], P=0.478). The overestimation rate of Lp(a) mass concentration in CKD patients was significantly higher than that in healthy controls (12.8%[25/196] vs 4.1%[4/97], P=0.020). Lp(a) mass concentration of group Ⅲ in CKD patients was between 157.00-432.25 mg/L, the positive rate of Lp(a) particle concentration was significantly lower than that of mass concentration (4.1%[2/49] vs 49%[24/49], P<0.001), and the overestimation rate (44.9%[22/49]) of Lp(a) mass concentration in this group was also the highest (all P<0.001). According to the conversion factor provided by the reagent manual of Lp(a) particle concentration, the test results were converted into mass concentration. The actual mass concentration of Lp(a) in CKD patients grouped by quartile was significantly higher than that after Lp(a) particle concentration conversion (all P<0.05). Conclusions:The positive rate of serum Lp(a) particle concentration is significantly lower than that of mass concentration in CKD patients and the obvious overestimation deviation of Lp(a) mass concentration is observed in this analysis.

Objective To investigate serum complement 1q (C1q) levels in the patients with coronary artery disease (CAD),and evaluate its clinical values in predicting and discriminating acute coronary syndrome (ACS) and stable coronary artery disease (SCAD).Methods A total of 52 ACS patients,66 SCAD patients and 54 healthy controls were enrolled in this study.Their serum C1q and oxidized low-density lipoprotein (ox-LDL) levels were detected by an immune turbidimetric method and an enzyme linked immunosorbent assay,respectively.Their serum total cholesterol,triglyceride,high-density lipoprotein cholesterol and low-density lipoprotein cholesterol levels were also determined.Then,the Gensini scores in CAD patients were calculated,and the clinical values of Clq in predicting and discriminating ACS and SCAD were evaluated by stepwise multiple linear regression analysis and Logistic regression analysis.Results Serum C1q and ox-LDL levels in ACS (C1q:t =4.405,P＜0.001;ox-LDL:Z=5.941,P＜0.001) and SCAD (C1q:t =2.320,P=0.022;ox-LDL:Z =4.119,P ＜0.001) patients were significantly higher than those in healthy controls.Moreover,serum C1q (t =2.344,P =0.021) and ox-LDL (Z =2.166,P =0.030) levels in ACS patients were significantly higher than that in SCAD patients.Serum C1 q levels were positively correlated with serum ox-LDL (r =0.246,P =0.028) and TG (r =0.232,P =0.002) levels and Gensini scores (r =0.341,P =0.020) in ACS patients.The stepwise multiple regression analysis showed that serum ox-LDL levels were still independently correlated with serum C1 q levels in ACS patients (β =0.676,P =0.045,adjusted R2 =0.380) after adjusting for age,gender and other biochemical markers.The Logistic regression analysis showed that the increased serum C1q and ox-LDL levels were closely related to the occurrence of ACS (C1q:OR =1.05,95％ CI =1.03-1.08,P ＜ 0.001;ox-LDL:OR =1.18,95％ CI =1.08-1.29,P ＜0.001) and SCAD (C1q:OR =1.04,95％CI=1.01-1.06,P=0.003;ox-LDL:OR=I.11,95％CI=1.03-1.18,P=0.004),and that they could discriminate ACS and SCAD (C 1 q:OR =1.01,95 ％ CI =1.00-1.03,P =0.022;ox-LDL:OR =1.06,95 ％ CI =1.01-1.12,P =0.023).Conclusion Serum C1q levels increase significantly in CAD patients,and that of ACS patients is significantly higher than SCAD patients.In ACS patients,serum C1q levels are independently correlated with ox-LDL levels.Serum C1q levels may be served as a novel biomarker for the prediction and discrimination of ACS and SCAD.

Objective: To establish a prediction model for the distant metastasis of breast cancer based on qualitative magnetic reso-nance imaging (MRI) parameters. Methods: A retrospective analysis of 3,032 patients with breast MRI from January 2011 to Decem-ber 2016 in Tianjin Medical University Cancer Institute and Hospital was conducted. After the confirmation of invasive breast cancer, the subjects were divided in 2 groups: metastasis and metastasis-free. A total of 93 patients were included in the metastasis group, and 186 patients without the presence of distant metastasis in the metastasis-free group. We analyzed the correlation between breast cancer molecular subtypes and distant metastasis in the metastasis group. Univariate and Logistic regression analyses of qualitative MRI features were performed for the groups. Subsequently, we used the results to establish prediction models. Results: The results showed that hormone receptor-positive tumors (Luminal type) had a greater tendency to develop bone metastasis in the metastasis group. Triple-negative tumors showed a greater tendency to develop lung metastasis. Human epidermal growth factor receptor 2 gene overexpression cases were more likely to develop liver metastasis. The results of the univariate analysis showed that the type of le-sion, multifocality or multicentricity of the cancer, T1-weighted signal uniformity, T2-weighted signal uniformity, and tumor size were statistically different between the groups (P<0.05). The results of the logistic regression analysis showed that the type of lesion, multi-focality or multicentricity of the cancer, T2-weighted signal uniformity, and tumor size were independent predictors of distant metasta-sis. Based on select independent predictors, we established a prediction model for the distant visceral metastasis of breast cancer. The accuracy, area under the curve, sensitivity, and specificity of the model were 82.8%, 0.801, 85.7%, and 75.0%, respectively. Conclu-sions: The prediction model based on the clinical pathology and MRI features established in this study can predict the distant metasta-sis of breast cancer.