Objective To explore the influence of enoxaparin on clinical events in complicated coronary lesions after percutaneous coronary intervention (PCI). Methods Totally 288 patients with complicated coronary lesions (type B2 and type C), who had no notable complications following PCI, were recruited in the present study. The patients were randomly assigned to receive either enoxaparin or not. Patients were assessed for major adverse cardiac events (MACEs) during hospitalization and at 1 and 12 months after PCI. Results There were no significant differences in the frequency of MACEs between the two groups during hospitalization (2.1% vs 1.4%, P>0.05), at 1 month (2.8% vs 2.8%, P>0.05) or 12 months post-PCI (5.5% vs 6.3%, P=0.780). The cumulative incidence rates of MACEs were not significantly different between the two groups (HR=0.875, 95%CI 0.337-2.273; P=0.79). The two groups had comparable rates of major bleeding (4.8% vs 2.8%,P=0.369), but that of the minor bleeding was significantly higher in the anticoagulation group (26.2% vs 16.1%, P=0.036). The average hospital stay in the anticoagulation group were significantly longer than that in the non-anticoagulation group ([6.04±1.64] d vs [5.43±1.54] d, P=0.001). Conclusion MACEs after PCI is not increased in patients with complicated coronary lesions receiving no anticoagulation compared with those receiving, with less minor bleeding and shorter hospital stay, suggesting that for the patients with complicated coronary lesions, routine anticoagulation therapy is not necessary after PCI without procedure complications.

Objective: To observe the clinical efficacy and eligibility of thumb-tack needle therapy based on meridian differentiation in treating cervical radiculopathy. Methods: A total of 70 patients with cervical radiculopathy were randomized into an observation group and a control group, with 35 cases in each group. Patients in the control group received thumb-tack needle based on conventional point selection, while those in the observation group received thumb-tack needle according to meridian differentiation. The visual analog scale (VAS) and clinical symptom scores in the two groups were compared before and after treatment, and the clinical efficacy of the two treatments was observed. Results: After treatment, the VAS score in both groups dropped significantly (both P<0.01), and the VAS score in the observation group was lower than that in the control group (P<0.01). The clinical symptoms score in both groups dropped significantly (all P<0.01), and the clinical symptoms score in the observation group was lower than that in the control group (P<0.01). The total effective rate in the observation group was higher than that in the control group (P<0.05). Conclusion: Thumb-tack needle therapy based on meridian differentiation can reduce pain score, improve clinical symptoms in patients with cervical radiculopathy, and produce more significant efficacy compared with conventional thumb-tack needle therapy.

Objective To explore the effect of PRKAG2 gene G100S mutation in cystathionine β-synthase (CBS) region on adenosine monophosphate-activated protein kinase (AMPK) activity in cardiomyocytes of mice. Methods A human PRKAG2 (G100S) transgenic mouse model was established. Four-week-old and 12-week-old transgenic mice, and 4-week-old and 12-week-old wildtype littermate were randomly selected from N4 generation mice (n＝6). The activity of AMPK in mouse cardiomyocytes was detected by phosphorylation assay kit. The difference of AMPK activity was compared between transgenic mice and wildtype littermate, and the changes of the activity of AMPK with the increase of age were observed in transgenic mice. Results The AMPK activities in cardiomyocytes of 4-week-old and 12-week-old transgenic mice were significantly lower than those of the wildtype littermate (0.042±0.013 vs 0.063±0.013, and 0.032±0.008 vs 0.062±0.018), and the differences were significant (P＝ 0.019, P＝0.004). There was no significant difference in the AMPK activity of cardiomyocytes between 4-week-old and 12-week-old transgenic mice (P＝0.135). Conclusion The PRKAG2 gene G100S mutation can cause a reduction of AMPK activity in cardiomyocytes of transgenic mice, and AMPK activity does not significantly increase or decrease with the growth of the transgenic mice.

OBJECTIVETo investigate the anti-HBV effect of fusion protein thymosin alpha1-interferon alpha (TA1-IFN) in vitro and to compare its effect with a combination of interferon alpha and thymosin alpha1.

METHODSAfter 2.2.15 cells were seeded for 24 hours, drugs of five serial concentrations (8000, 4000, 2000, 1000, 500 U/ml) were added to the wells, then the medium was changed every three days. After 2.2.15 cells were treated with drugs for 6 days, the medium was collected. The inhibitory rates on HBsAg and HBeAg were determined using Abbot kit, and the cytotoxicity of different drugs by means of MTT colorimetric assays was also observed.

RESULTSThe inhibitory rate of fusion protein on HBsAg, HBeAg was dose-dependent and reached the maximum at 8000 U/ml concentration. In the meantime, the inhibitory rates of fusion protein on HBsAg and HBeAg were 72.2% +/- 0.8% and 60.4% +/- 1.1% respectively, and the cell survival rate was 85.2% +/- 2.0%; In the corresponding concentration, the inhibitory rates of combination thymosin alpha 1 and interferon alpha on HBsAg and HBeAg were 40.0% +/- 0.7%, 34.5% +/- 3.2% respectively. The results showed significant statistical differences between them; cell survival rate 70.0% +/- 1.9%, and the difference of the results was also significant. Cytotoxicity of fusion protein was weaker than a combination of thymosin alpha 1 and interferon alpha.

CONCLUSIONFusion protein TA1-IFN exerted stronger anti-HBV effects in vitro. Its anti-HBV effects in vitro were stronger than the combination of thymosin alpha and interferon alpha, and its cytotoxicity was weaker than the combination of thymosin alpha and interferon alpha. Our studies provided important evidence for clinical research on TA1-IFN, and also brought new hope for hepatitis B therapy.

Antiviral Agents ; pharmacology ; Hepatitis B virus ; drug effects ; Humans ; Interferon-alpha ; biosynthesis ; genetics ; pharmacology ; Recombinant Fusion Proteins ; biosynthesis ; genetics ; pharmacology ; Thymosin ; biosynthesis ; genetics ; pharmacology

Objective To investigate the effect of early postoperative abnormal blood glucose on the short-term prognosis of non-small cell lung cancer(NSCLC),and to analyze the clinical characteristics and risk factors related to poor early prognosis.Methods A total of 897 patients with NSCLC who underwent thoracoscopic surgery in Huadong Hospital,Fudan University from Jan 2020 to Aug 2021 were divided into hyperglycemia(HG)group(>7.8 mmol/L)and normal blood glucose(NG)group(≤7.8 mmol/L and≥3.9 mmol/L)according to the early postoperative blood glucose values.Additionally,the patients were divided into higher blood glucose fluctuation group(≥4 mmol/L)and the group with lower blood glucose fluctuation(<4 mmol/L)basing on the fasting blood glucose.Using Logistic regression models,column line charts,ROC curves and other methods,we aimed to clarify the impact of early postoperative blood glucose abnormalities on short-term prognosis,explore clinical characteristics associated with poor short-term outcomes,identify other high-risk factors,and establish relevant risk prediction models.Results Compared with the NG group,the incidence of postoperative pneumonia,thromboembolism,ICU admission rate,total length of hospital stay and hospital cost were significantly higher in the HG group(P<0.05).Higher blood glucose fluctuation group had a greater risk of ICU admission(P=0.003).Logistic regression analysis showed that age,preoperative fasting glucose,white blood cell count and cytokeratin 19 fragment antigen 21-1(CYFRA21-1)were risk factors for postoperative hyperglycemia(P<0.05).Contrary to the effect of BMI,diabetes,male patients,higher blood glucose fluctuation,white blood cell count and age were the risk factors for postoperative adverse events(P<0.05).The AUC of the column line chart model was 0.661(95%CI:0.624-0.698),indicating good discriminative ability for predicting poor short-term prognosis postoperatively.Calibration curves also demonstrated good consistency between predicted and actual probabilities.Conclusion Early postoperative blood glucose fluctuations independently impact the short-term prognosis of thoracoscopic NSCLC patients.Blood glucose combined with gender,BMI,white blood cell count,age and diabetes history can serve as predictive factors for poor short-term prognosis postoperatively.Additionally,a column line chart constructed based on these factors may aid clinicians in early intervention for NSCLC patients with indications.

Objective: Retrospective analysis of the efficacy and influencing factors of bladder preservation integrated therapy for unresectable invasive bladder cancer confined to the pelvis was done, also including the bladder function preservation and adverse effects analysis. Methods: Sixty-nine patients with unresectable locally invasive bladder cancer who received radiotherapy-based combination therapy from March 1999 to December 2021 at our hospital were selected. Among them, 42 patients received concurrent chemoradiotherapy, 32 underwent neoadjuvant chemotherapyand 43 with transurethral resection of bladder tumors (TURBT) prior to radiotherapy. The late adverse effect of radiotherapy, preservation of bladder function, replase and metastasis and survival were followed-up. Cox proportional hazards models were applied for the multifactorial analysis. Results: The median age was 69 years. There were 63 cases (91.3%) of uroepithelial carcinoma, 64 of stage Ⅲ and 4 of stage Ⅳ. The median duration of follow-up was 76 months. There were 7 grade 2 late genito urinary toxicities, 2 grade 2 gastrointestinal toxicities, no grade 3 or higher adverse events occurred. All patients maintained normal bladder function, except for 8 cases who lost bladder function due to uncontrolled tumor in the bladder. Seventeen cases recurred locally. There were 11 cases in the concurrent chemoradiotherapy group with a local recurrence rate of 26.2% (11/42) and 6 cases in the non-concurrent chemoradiotherapy group with a local recurrence rate of 22.2% (6/27), and the difference in local recurrence rate between the two groups was not statistically significant (P=0.709). There were 23 cases of distant metastasis (including 2 cases of local recurrence with distant metastasis), including 10 cases in the concurrent chemoradiotherapy group with a distant metastasis rate of 23.8% (10/42) and 13 cases in the non-concurrent chemoradiotherapy group with a distant metastasis rate of 48.1% (13/27), and the distant metastasis rate in the non-concurrent chemoradiotherapy group was higher than that in the concurrent chemoradiotherapy group (P=0.036). The median 5-year overall survival (OS) time was 59 months and the OS rate was 47.8%. The 5-year progression-free survival (PFS) time was 20 months and the PFS rate was 34.4%. The 5-year OS rates of concurrent and non-concurrent chemoradiotherapy group were 62.9% and 27.6% (P<0.001), and 5-year PFS rates were 45.4% and 20.0%, respectively (P=0.022). The 5-year OS rates of with or without neoadjuvant chemotherapy were 78.4% and 30.1% (P=0.002), and the 5-year PFS rates were 49.1% and 25.1% (P=0.087), respectively. The 5-year OS rates with or without TURBT before radiotherapy were 45.5% and 51.9% (P=0.233) and the 5-year PFS rates were 30.8% and 39.9% (P=0.198), respectively. Multivariate Cox regression analysis results showed that the clinical stage (HR=0.422, 95% CI: 0.205-0.869) was independent prognostic factor for PFS of invasive bladder cancer. The multivariate analysis showed that clinical stages (HR=0.278, 95% CI: 0.114-0.678), concurrent chemoradiotherapy (HR=0.391, 95% CI: 0.165-0.930), neoadjuvant chemotherapy (HR=0.188, 95% CI: 0.058-0.611), and recurrences (HR=10.855, 95% CI: 3.655-32.638) were independent prognostic factors for OS of invasive bladder cancer. Conclusion: Unresectable localized invasive bladder cancer can achieve satisfactory long-term outcomes with bladder-preserving combination therapy based on radiotherapy, most patients can retain normal bladder function with acceptable late adverse effects and improved survival particularly evident in patients with early, concurrent chemoradiotherapy and neoadjuvant chemotherapy.
Humans ; Aged ; Treatment Outcome ; Retrospective Studies ; Combined Modality Therapy ; Chemoradiotherapy/methods* ; Urinary Bladder Neoplasms/radiotherapy* ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Neoplasm Staging