Objective:To investigate the correlation between heart rate recovery at 1 min after exercise (HRR 1) and long-term prognosis in patients with acute myocardial infarction treated by percutaneous coronary intervention (PCI). Methods:The clinical data of 117 acute myocardial infarction patients who successfully underwent PCI in Qingdao Starr Heart Hospital from May 2014 to May 2017 were retrospectively analyzed. The patients were performed cardiopulmonary exercising test within 30 d after PCI, the peak heart rate (HR peak), resting heart rate, peak oxygen uptake (VO 2peak) were detected, and the HRR 1, heart rate reserve and oxygen pulse were calculated. The correlation between HRR 1 and cardiopulmonary exercise related indexes was analyzed. The incidence of major adverse cardiovascular events (MACE) was recorded 3 years after PCI. The risk factors affecting the prognosis in patients with acute myocardial infarction were analyzed by Cox regression. Results:Among 117 patients, HRR 1 didn′t decrease in 74 cases (non-reduced group), and HRR 1 decreased in 43 cases (reduced group). The proportion of Killip heart function grade Ⅱ to Ⅲ, proportion of triple coronary artery lesions, Gensini score, resting heart rate and oxygen pulse in reduced group were significantly higher than those in non-reduced group: 90.7% (39/43) vs. 70.3% (52/74), 53.5% (23/43) vs. 17.6% (13/74), (81.46 ± 21.55) scores vs. (58.06 ± 17.52) scores, (81.48 ± 11.17) times/min vs. (69.06 ± 10.10) times/min and (13.13 ± 2.93) times/min vs. (9.19 ± 3.06) times/min, the VO 2peak, HR peak, HRR 1 and heart rate reserve were significantly lower than those in non-reduced group: (20.19 ± 9.39) ml/(kg·min) vs. (26.38 ± 9.40) ml/(kg·min), (124.98 ± 22.79) times/min vs. (149.47 ± 22.88) times/min, (16.63 ± 5.92) times/min vs. (27.24 ± 10.21) times/min and (55.51 ± 10.29) times/min vs. (69.07 ± 12.27) times/min, and there were statistical differences ( P<0.01). Correlation analysis results showed that HRR 1 was positively correlated with heart rate reserve, HR peak, VO 2peak ( r = 0.793, 0.835 and 0.800; P<0.01), and negatively correlated with resting heart rate ( r = -0.748, P<0.01); but there was no correlation between HRR 1 and oxygen pulse ( P>0.05). Twenty-one patients did not complete 3 years′ follow-up, with 8 cases in reduced group and 13 cases in non-reduced group. The incidence of MACE in reduced group was significantly higher than that in non-reduced group: 62.9% (22/35) vs. 13.1% (8/61), and there was statistical difference ( χ2 = 12.546, P<0.01). Multivariate Cox regression analysis result showed that the number of coronary artery lesions and HRR 1 were independent risk factors affecting the prognosis in patients with acute myocardial infarction ( HR = 3.124 and 0.248, 95% CI 1.044 to 9.342 and 0.080 to 0.771, P<0.05). Conclusions:The reduction of HRR 1 is related to the exercise cardiopulmonary index in patients with acute myocardial infarction, which can be used as one of the important predictors of long-term prognosis of patients.

Background and purpose: Tumor vasculature is increasingly recognized as a target for cancer therapy. In recent years, a fusion protein consisting of the extra cellular domain of tissue factor (truncated tissue factor, tTF) was fused to the antibody selectively binding to tumor vasculature. Antibody-truncated tissue factor(Ab-tTF) fusion protein specifically induced thrombotic occlusion of tumor vessels resulting in tumor growth retardation or regression in some types of solid tumors. However, there were still some disadvantages in the above approach. We constructed and expressed that the (RGD)_3-tTF fusion protein with peptides arginine-glycine-aspartic acid (GRGDSP, abbr. RGD)as the carrier of tTF to explore whether it bad the capability of targeting to tumor vasculature in the colonic carcinoma model. Methods: The (RGD)_3-tTF fusion gene consisting of the tTF was fused to three series-wound peptides RGD. The (RGD)_3-tTF construct was expressed in Escherichia coil BL21(DE_3). The fusion protein was purified through Nickel affinity chromatography column. The activity of inducing blood coagulation was detected by clotting assay and coagulation factor X (FX) activation assay. The specific binding to integrins α_vβ_3 was analyzed by indirect enzyme linked immunosorbent assay (ELISA). All these were compared with the fusion protein RGD-tTE Colonic nude mice models were randomly divided into 3 groups (1 nude mice per group).Tumors were stained by the (RGD)_3-tTE RGD-tTF fusion protein and tTF which were labeled with Fluorescein Isothiocyanate(FITC). The location of the (RGD)_3-tTF fusion protein in the colonic carcinoma bearing nude mice tissue was analyzed by immunofluorescence assay. Results: The (RGD)_3-tTF fusion protein retained tissue factor thrombogenic activities. With increasing concentration, the clotting time was shortened correspondingly. Under the conditions of Ca~(2+), the clotting time was 9.96±0.56 min when the concentration was 6 μmol/L(P<0.01). The (RGD)_3-tTF fusion protein could activise F X above 6 μmol/L concentration, which was similar to RGD-tTF fusion (F=0.147, P>0.05). The ability of the (RGD)_3-tTF fusion protein binding specifically to integrins α_vβ_3 was stronger than that of the RGD-tTF fusion protein in the same concentration (F=164.81, P<0.01), which was apparently indicated by the A_(405nm) 1.25 and 0.95 when the concentration was 0.24 μmol/L. Immunofluorescence assay showed that the (RGD)_3-tTF fusion protein was assembling in the tumor vasculature of the colonic carcinoma bearing nude mice. Conclusion: The (RGD)_3-tTF fusion protein which retained tissue factor thrombogenic activities could bind specifically and efficiently to tumor vasculature in the colonic carcinoma bearing mice through binding to the tumor marker integrins α_vβ_3. It might be a promising foundation for further studies on the colon cancer molecular targeted therapy with tTF as an effective factor.

BACKGROUND: Syringomyelia is a progressive chronic disease that leads to nerve pain, sensory dissociation, and dyskinesia. Symptoms often do not improve after surgery. Stem cells have been widely explored for the treatment of nervous system diseases due to their immunoregulatory and neural replacement abilities. METHODS: In this study, we used a rat model of syringomyelia characterized by focal dilatation of the central canal to explore an effective transplantation scheme and evaluate the effect of mesenchymal stem cells and induced neural stem cells for the treatment of syringomyelia. RESULTS: The results showed that cell transplantation could not only promote syrinx shrinkage but also stimulate the proliferation of ependymal cells, and the effect of this result was related to the transplantation location. These reactions appeared only when the cells were transplanted into the cavity. Additionally, we discovered that cell transplantation transformed activated microglia into the M2 phenotype. IGF1-expressing M2 microglia may play a significant role in the repair of nerve pain. CONCLUSION Cell transplantation can promote cavity shrinkage and regulate the local inflammatory environment.Moreover, the proliferation of ependymal cells may indicate the activation of endogenous stem cells, which is important for the regeneration and repair of spinal cord injury.

Objective: Adenosquamous carcinoma of lung is an uncommon subtype with more aggressive behavior and poor prognosis than adenocarcinoma and squamous cell carcinoma. This study was aimed to investigate the clinicopathological characteristics and prognostic factors of lung adenosquamous carcinoma. Methods: The pathological features and follow-up data of 133 patients were collected and the prognostic factors of these patients were retrospectively analyzed. Results: Among the 133 patients, 81 cases (60.9%) smoked. Among the 62 patients whose percentage of histological components were identified, 45 cases had >50% adenocarcinoma components, and 17 cases had >50% squamous cell carcinoma components. 55 patients had lymph node metastasis at the first visit. All patients accepted at least one test of tumor driven gene mutation, and the results showed that the mutation rate of EGFR was 50.8% (67/132), the mutation rate of K-ras was 8.6% (11/128), the ALK-positive rate was 4.2% (2/48). The gender, smoking status, and the proportion of pathological components were the main influence factors of EGFR mutation status. The median overall survival was 28 months, the rates of 1-year, 3-year, and 5-year survival were 72.9%, 23.3%, and 9.0%, respectively. EGFR tyrosine kinase inhibitors (TKIs) treatment was an independent risk factor for prognose of these patients (P=0.024). Conclusions Lung adenosquamous carcinoma is a rare subtype with high malignancy and poor prognosis. Early diagnosis and driven-mutation-based individualized therapy may improve the survival of patients with lung adenosquamous carcinoma.