Objective To investigate the clinical significance of combined detection of serum cardiac troponin T (cTnT ) ,N-termi-nal pro-B-type natriuretic peptide(NT-proBNP) and myoglobin(Myo) in acute myocardial infarction diagnosis .Methods 440 pa-tients with main symptoms of acute chest pain were enrolled and divided into AMI group and non-AMI group ,and 220 healthy peo-ple were served as the control group .BECKMAN COULTER Access 2 automated chemiluminescent microparticle immunoassay analyzer was employed to detect their serum NT-proBNP ,cTnT and Myo concentrations .Results The serum concentrations of NT-proBNP ,cTnT and Myo of patients with AMI were (3 546 .12 ± 220 .95) pg/mL ,(0 .13 ± 0 .02)μg/L and (88 .12 ± 14 .27)μg/L , respectively ,which were significantly higher than those in non-AMI group and the control group(P<0 .05) .Areas under the curve (AUC) of receiver operator characteristic(ROC) of NT-proBNP ,cTnT and Myo detection were 0 .809 ,0 .851 and 0 .749 ,respec-tively ,and the ROC curve AUC of cTnT detection was markedly higher than that of Myo (P<0 .05) .The sensitivity ,specificity and diagnostic accuracy of combined detection of NT-proBNP ,cTnT and Myo were 0 .957 ,0 .950 and 0 .948 ,respectively ,which was significantly higher than those in combined detection of any two kinds of indicators (P<0 .05) .Conclusion Combined detection of serum NT-proBNP ,cTnT and Myo can improve the sensitivity ,specificity and diagnostic accuracy in AMI diagnosis .

Objective:To evaluate the effect of rhizome drynaria combined with tissue engineering cartilage on cartilage regeneration in experimental rabbits with cartilage defects.Methods:The hIGF-1 gene was transfected into MSCs by using the method of isola tion,purification and recombination of transgenic stem cells.The MSCs were transplanted into rabbit bone marrow mesenchymal stem cells (MSCs) in vitro.The cells were further amplified and mixed with acellular dermal matrix (ADM) to construct tissue engineered cartilage.Twenty-four New Zealand white rabbits,aged 6 months,were randomly divided into 4 groups (A,B,C and D).six rabbits in each group.Group A and C were transplanted with autologous cartilage.Group B and D were transplanted with modified cells.Group C and D group were fed with 40％ Drynaria Decoction,150ml/d for 4 weeks.Animals were sacrificed at 12 weeks postoperatively,and articular cartilage defects were isolated.Cartilage defect samples were embedded in paraffin blocks and stained with hematoxylin and eosin (H&E).Cartilage regeneration was evaluated by gross morphology,including sclerotic shape,color,contour and homogeneity.The quality of regenerated cartilage was assessed by histological scoring.Toluidine blue staining was used to evaluate the occurrence of chondrogenic glycosaminoglycans (GAG).Results:Compared with group B,the cartilage coverage,the color of new bone marrow,the edge of defect and the surface roughness of group C and D were significantly improved (P＜0.05);the cartilage surface score of regenerated cartilage was significantly improved P＜0.05).Groups C and D had better matrix,cell distribution and surface index than the other groups.And had a thick like hyaline cartilage tissue,with the normal glycosaminoglycan production.It is indicated that drynaria combined with tissue engineering cartilage can reduce cartilage defects by regenerating hyaline cartilage.Conclusion:Cartilage combined with drynariae can significantly improve the quality of cartilage defect repair in rabbit knee joint,and provide an important theoretical basis for clinical treatment of cartilage lesions.

Objective To investigate the expression of lipoprotein(a)and fibrinogen different genders of patients with coronary heart disease(CHD)and its clinical significance.Methods 1 500 patients with CHD in the hospital from January 2009 to December 2013 were selected as the observation group,including 954 males and 546 females.Contemporaneous 500 healthy people with physi-cal examination were selected as the control group,including 329 males and 171 females.The myocardial enzymes,serum lipid,blood coagulation function and various proteins were detected.Results Whether males or females,CK,CKMB,AST,LDH,α-HBDH, TC,TG,LDL-C,Fib,D-D,TT,FDP,LPa,cTnI,MYO and HCY in the observation group were significantly higher than those in the control group.HDL-C,APTT,INR and PT in the observation group were significantly lower than those in the control group.The differences were statistically significant(P <0.05 ).Conclusion Whether males or females,the different degrees of abnormal ex-pression of myocardial enzyme spectral indexes,blood lipid indexes,coagulation indexes,apolipoprotein,troponin,myoglobin and ho-mocysteine exist in the patients with CHD.Lipoprotein(a)and fibrinogen have high expression in the CHD patients,which can pro-vide the reliable scientific basis for diagnosis and treatment of the disease.

Objective: To analyze clinical characteristics and risk factors in patients with acute myocardial infarction (AMI) complicated with cardiac rupture (CR) and to explore the prevention and treatment strategy in clinical practice. Methods: A case control study was conducted in 2 groups: CR group, the patients with coronary angiography conifrmed AMI with CR,n=44 and Control group, the patients with simultaneous STEAMI and by 1:3 pair-matched ratio,n=132. Clinical information was compared between 2 groups and the relevant risk factors for predicting CR were studied by Logistic regression analysis. Results: Compared with Control group, CR group had the lower ratio of β-receptor blocker application (22.7% vs 81.4%),P<0.05. Univariate regression analysis indicated that lower body mass index, incipient MI, anterior MI, no-reperfusion therapy, delayed reperfusion therapy, lower blood pressure at admission, post-infarction angina, ventricular aneurysm, higher Gensini score, high blood levels of cretinine and BNP, low ejection fraction were the risk factors for CR occurrence in STEAMI patients, allP<0.05. Multivariate regression analysis presented that incipient MI (P<0.049, OR=7.462), post-infarction angina (P<0.000, OR=8.591), ventricular aneurysm (P<0.005, OR=4.617) and higher Gensini score (P<0.001, OR=2.788) were risk factors for CR occurrence in STEAMI patients. Conclusion: Incipient MI, post-infarction angina, ventricular aneurysm and higher Gensini score are the risk factors for CR occurrence in STEAMI patients.

Cytoplasmic male sterility is an important way to utilize wheat heterosis. The purpose of thisstudy was to identify cytoplasmic type of three wheat male sterile lines. Amplified fragment length polymorphism (AFLP) marker technique was used to analyze the wheat mitochondrial DNA. We isolated mitochondria by differential centrifugation and density gradient ultracentrifugation. The results show that the extracted mitochondrial DNA was pure. It was suitable for PCR and genetic analysis. We got 4 pairs of specific primers from 64 primers combinations. Primer E1/M7 amplified 3 specific fragments in ms(Kots)-90-110. Primer E4/M2 generated 2 specific fragments in ms(Ven)-90-110. Primer E7/M6 amplified 2 specific fragments in ms(S)-90-110. Primer E6/M4 produced 2 specific fragments in ms(Kots)-90-110. Four specific primers could be used to identify three cytoplasmic types of Aegilops kotschyi, Ae. ventricosa and Triticum spelta. It provided the molecular basis to further study the mechanism of wheat cytoplasmic male sterility.
Amplified Fragment Length Polymorphism Analysis ; methods ; Cytoplasm ; metabolism ; DNA, Mitochondrial ; genetics ; DNA, Plant ; genetics ; Gene Expression Profiling ; Genotype ; Plant Infertility ; genetics ; Triticum ; genetics

Objective:To explore the optimal local treatment pattern of supraclavicular lymph node in breast cancer patients with synchronous ipsilateral supraclavicular lymph node metastasis (sISLM).Methods:Clinical data of 128 breast cancer patients with sISLM admitted to the Fourth Hospital of Hebei Medical University from 2010 to 2015 were retrospectively analyzed. Among them, 68 cases were treated with supraclavicular lymph node dissection combined with radiotherapy, and 60 cases received radiotherapy alone. The locoregional recurrence-free survival (LRFS), distant metastasis-free survival (DMFS), progression-free survival (PFS) and overall survival (OS) were statistically compared between two groups.Results:Univariate analysis demonstrated that the 5-year LRFS, DMFS, PFS and OS did not significantly differ between two groups (all P>0.05). Multivariate analysis revealed that the local treatment pattern of supraclavicular lymph node was an independent prognostic factor for the 5-year DMFS, PFS and OS (all P<0.05). Subgroup analysis showed that when radiotherapy alone was performed, the 5-year OS of patients in the supraclavicular region radiation dose of>50 Gy group were significantly better than that in the 50 Gy group ( P=0.047). When supraclavicular lymph node dissection combined with radiotherapy was delivered, if the number of dissection was less than 10, the 5-year LRFS, DMFS, PFS, OS of patients in the>50 Gy group were all better than those in the 50 Gy group numerically without statistical significance (all P>0.05). If the number of dissection was ≥10, the 5-year LRFS, DMFS, PFS, OS in the 50 Gy group were better than those in the>50 Gy group numerically, whereas significant difference was only found in the 5-year DMFS ( P=0.028). Conclusions:Supraclavicular lymph node dissection combined with radiotherapy may be the optimal local treatment pattern for supraclavicular lymph node. When radiotherapy alone is performed, a radiation boost to the supraclavicular region may improve OS. When supraclavicular lymph node dissection combined with radiotherapy is performed, if the degree of dissection is low, a radiation boost to the supraclavicular region may bring clinical benefits. However, if the degree of dissection is high, a radiation boost to the supraclavicular region may not bring significant clinical benefits.

Objective: To investigate the expression pattern and clinical significance of long non-coding RNA deleted in lymphocytic leu-kemia 1 (DLEU1) in non-small cell lung cancer (NSCLC), and to further evaluate its effect on tumor metastasis. Methods: Paired cancer and adjacent tissues were obtained from 42 patients with NSCLC that underwent surgical resection of cancer in The Third Xiangya Hos-pital of Central South University from January 2008 to December 2012, at the Department of Cardiothoracic Surgery. The expression features of DLEU1 in NSCLC tissue were detected by real-time quantitative polymerase chain reaction assay. Statistical methods were used to analyze the relationship between the expression of DLEU1 and the clinicopathological features and the survival time of pa-tients with NSCLC. Effects of DLEU1 on migration and invasion of NSCLC cells were evaluated by in vitro wound healing and cell inva-sion assays, respectively. Western blot was performed to investigate the protein levels of E-cadherin, N-cadherin, and Vimentin, which are the biomarkers of epithelial to mesenchymal transition (EMT). Results: Of the 42 NSCLC samples, DLEU1 expression was up-regulat-ed in 35 samples (83.33%) and down-regulated in 7 samples (16.67%). The expression level of DLEU1 in NSCLC tissue was 2.11 times that in the adjacent tissues (P<0.05). The expression of DLEU1 in four NSCLC cell lines (A549, H1299, SPCA1, and H358) was higher than that in normal lung 16HBE epithelial cells, and of these, A549 cells had the highest DLEU1 expression (P<0.05). Highly expressed DLEU1 was positively correlated with lymph-node metastasis (P<0.05), but was not significantly associated with other parameters, in-cluding patient gender, age, smoking history, primary tumor size, histological grade, and the TNM stage. The survival time of patients with high DLEU1 expression was significantly shorter than that of patients with low DLEU1 expression (P<0.05). In vitro interference with DLEU1 expression significantly inhibited the migration and invasion of A549 and SPCA1 cells compared with that of the control group (P<0.05). Upon interference with DLEU1 expression , protein levels of E-cadherin increased, whereas those of N-cadherin and Vi-mentin decreased in A549 cells in comparison with the control group. Conclusions: The expression of DLEU1 is up-regulated in NSCLC tissues and cell lines, correlates with lymph-node metastasis and survival times in patients with NSCLC, and promotes tumor cell migra-tion and invasion by regulating EMT, suggesting that DLEU1 may be a potential therapeutic target for NSCLC.

Objective:To analyze the prognosis and influencing factors of patients with brain metastases from non-small cell lung cancer (NSCLC) treated with different doses of whole brain radiotherapy (WBRT).Methods:A total of 244 NSCLC patients with brain metastases who underwent WBRT in the Fourth Hospital of Hebei Medical University from 2013 to 2015 were analyzed retrospectively. According to different doses of WBRT (EQD 2Gy), they were divided into the 30-39 Gy group ( n= 104) and ≥40 Gy group ( n= 140). The intracranial progression-free survival (iPFS) and overall survival (OS) were compared betweentwo groups. According to the number of brain metastases, GPA score, KPS score, chemotherapy and targeted therapy, the prognosis of different doses of WBRT was further analyzed. Results:The median iPFS and OS of all patients were 6.9 months and 11.8 months, respectively. Univariate survival analysis: the 1-year iPFS and 1-year OS between two groups were 22.5% and 25.4%( P=0.430) and 41.1% and 46.4%( P=0.068), respectively. Multivariate survival analysis: different doses of WBRT were not associated with the improvement of iPFS and OS; independent factors influencing iPFS included local boost, gender, number of brain metastases, chemotherapy and targeted therapy; independent factors influencing OS included gender, number of brain metastases, chemotherapy and targeted therapy. Subgroup analysis: in patients with KPS≥90, the 1-year iPFS and OS of patients with WBRT ≥ 40 Gy were seemingly better than those of their counterparts with 30-39 Gy, but the difference was statistically significant only in OS ( P=0.047), the difference was not statistically significant in iPFS ( P=0.068); in patients with chemotherapy, the 1-year iPFS and OS of patients with WBRT≥40 Gy were better than those of their counterparts with 30-39 Gy ( P=0.017, P=0.012); in patients with targeted therapy, the 1-year iPFS and OS in the WBRT≥40 Gy group were better than those in the 30-39 Gy group ( P=0.012, P=0.045). Conclusions:The 30-39 Gy may be the appropriate dose of WBRT for NSCLC patients with brain metastases. WBRT≥40 Gy does not bring more benefits. WBRT≥40 Gy may benefit NSCLC patients with brain metastases with high KPS score or active systemic therapy.

Immunotherapy combined with targeted therapy can benefit the survival of patients with unresectable hepatocellular carcinoma. Atezolizumab combined with bevacizumab has achieved remarkable efficacy in patients with advanced hepatocellular carcinoma, but the efficacy of conversion therapy in patients with unresectable hepatocellular carcinoma still needs more evidences. The authors report the clinical efficacy of a case of unresectable hepatocellular carcinoma with hepatitis B virus related liver cirrhosis who was treated with immunotherapy plus targeted therapy combined with local treatment. Results show a good effect in patient without tumor recurrence after postoperative 9 months.

Objective:To analyze the clinical features of an outbreak of extensive drug resistant typhoid fever, and to provide experience for the diagnosis and treatment of drug resistant typhoid fever.Methods:Seven patients with confirmed diagnosis of extensive drug resistant typhoid fever who visited Beijing You′an Hospital, Capital Medical University, from January 27 to February 15, 2022 were included. The clinical characteristics, drug sensitivity tests, consultation and treatment history and prognosis of the patients were analyzed through descriptive study.Results:Of the seven extensive drug resistant typhoid fever patients, three were male and four were female, one of whom was pregnant (at 32-week gestation), aged (29.8±6.8) years, with a range of 22 to 42 years. There were seven cases with fever, and the course of fever ranged from six to 20 days. There were five cases with diarrhea and lack of typhoid-specific manifestations such as rose spot, apathetic facial expression and relatively slow pulse. Four cases were complicated with intestinal bleeding and six cases developed liver function injury. Six cases had loss or decrease in eosinophil ratio and two cases had decreased white blood cell count. The results of drug susceptibility tests showed that seven strains of Salmonella typhi were resistant to chloramphenicol, ampicillin, sulfamethoxazole-trimethoprim, quinolones, ceftriaxone, cefepime, ceftazidime, cefuroxime, and sensitive to carbapenem antibiotics, tigecycline and piperacillin/tazobactam. All seven cases had a history of antimicrobial use before admission. One case was administered with intravenous ceftizoxime for seven days after admission. After discharge, cefixime was administered orally for seven days. Six patients were given intravenous piperacillin sodium/tazobactam sodium for 14 days. All blood/fecal cultures were negative and the patients were cured and discharged. During the follow-up, one patient developed splenic abscess. All the seven patients were residents of the same apartment in Beijing City, and there were water cuts and turbid odors in the incubation period, which were considered as typhoid fever outbreak caused by waterborne transmission. Conclusions:With the use of antimicrobial agents, the typical clinical manifestations of typhoid fever are absent, and the drug resistance rates to quinolone and third-generation cephalosporins increase. Appropriate antimicrobial agents should be selected and the anti-infection course should be prolonged.