Objective To investigate early and differential diagnosis of Alzheimer disease and vascular dementia (VD)using FDG-PET scan. Methods Clinical data was collected from AD,VD and normal control(NC). 18F-2-fluo-ro-deoxy-D-glucose(18F-FDG)PET scan was conducted to detect the cerebral FDG metabolism. The average standard uptake value (SUV) of cerebral regions was expressed as semiquantitative index relative to ipsilateral cerebellum. Re-sults There were no differences in age and the mean total scores of the mini mental status examination (MMSE) between patients with VD and those with AD.The AD group showed that the SUV was significantly decreased in the right frontal, parietal,temporal lobe,hippocampus,temporo-parietal junction,and bilateral posterior cingulate cortex compared to the VD and in the bilateral posterior cingulate cortex,temporo-parietal junction,frontal and temporal lobe comparing to the NC(P≤0.01). SUV was significantly increased in the right parietal,posterior cingulate cortex and hippocampus whereas was significantly decreased in the left frontal lobe,temporo-parietal junction and thalamus in the VD compared with NC group(P≤0.01). Conclusion AD patients have typical features of 18F-FDG PET which may be helpful for the diagnosis of AD in the early stage.

Objective To evaluate the safety, performability and long-term clinical efficacy of stenting angioplasty for treating symptomatic internal carotid artery (ICA) stenosis in the origin part in elderly patients. Methods Stenting angioplasty was performed on 29 patients with symptomatic ICA stenosis in the origin part. Results 29 stents were placed in 29 patients. Operations were performed 100%successfully. After an average 24 months of follow-up visits, restenoses were detected in 2cases reexamined by DSA 6 months after stenting, both presented with less than 50% stenoses. 1 case was found not regularly taking statins and antiplatelet drugs after stenting, severe restenosis occurred 6 months later, stent implantation performed again, no recurrence of transient ischemic attack (TIA) was noted during 2 years′follow-up visit. Cerebral ischemic strokes occurred in 2 cases , and both of them had balloon dilatation after stenting. 1 case was completely recovered after treatment and 1 was left with weakness in right extremities, unabling to walk. No cases of posterior circulation ischemia, death and myocardial infarction were detected. Conclusions Stenting angioplasty can be performed in treating symptomatic internal carotid artery stenosis in elderly patients. It showed a relatively good mid-long-term clinical effects and can be a secondary prevention option.

OBJECTIVETo construct a lectin-like oxidized low-density lipoprotein receptor (LOX-1) RNA interference (RNAi) lentivirus and explore the role of LOX-1 in H(2)O(2)-induced apoptosis of rat myocardial cells.

METHODSLOX-1 shRNA sequence was synthesized and cloned into pLentiLox3.7 (pLL3.7) lentiviral vector to construct the lentiviral vector pLL3.7-LOX1. The lentiviral vectors (pLL3.7 and pLL3.7-LOX1) and the packaging vectors dR8.9 and VSVG were co-transfected into 293FT cells for packaging the lentivirus. H9C2 myocardial cells were infected by the lentiviruses to observe the inhibitory rate of LOX-1 on H(2)O(2)-induced apoptosis of H9C2 cells by RT-PCR, CCK-8, and Hochest33258 staining.

RESULTSDouble restriction enzyme digestion and DNA sequencing confirmed correct insertion of the sequence. Suppression of LOX-1 by the lentivirus attenuated H(2)O(2)-induced cell viability reduction and apoptosis in the myocardial cells (P<0.01).

CONCLUSIONLOX-1 activation may play an important role in H(2)O(2)-induced apoptosis of rat myocardial cells.

Animals ; Apoptosis ; physiology ; Cells, Cultured ; Genetic Vectors ; genetics ; Hydrogen Peroxide ; Lentivirus ; genetics ; Myocytes, Cardiac ; cytology ; Oxidative Stress ; RNA Interference ; RNA, Small Interfering ; genetics ; Rats ; Scavenger Receptors, Class E ; genetics

Objectives:To evaluate the preoperative prediction methods of osteotomy angle of thoracolumbar kyphosis in ankylosing spondylitis(AS)patients,and to analyze their clinical values in reconstruction of spinopelvic sagittal alignment.Methods:22 AS patients with thoracolumbar kyphosis,who underwent single segment pedicle subtraction osteotomy(PSO)from January 2015 to January 2022 in the First Affiliated Hospital of Xinjiang Medical University,were retrospectively reviewed.There were 17 males and 5 females with a mean age of 44.3±7.4 years(range,29-56 years).Preoperative and postoperative spinopelvic parameters were measured on X-ray lateral radiographs,osteotomy angles were predicted with different methods,full balance integated index(FBI),spine femoral angle(SFA),hilus pulmonis-hip axis(HP-HA),center of both acoustic meati-hip axis(CAM-HA),and Surgimap method.And theoretical spinopelvic parameters and theoretical os-teotomy angle were calculated according to pelvic incidence(PI).The differences between preoperative,final follow-up and theoretical spinopelvic parameters,and between the predictive,actual and theoretical osteotomy angles,were compared.Results:The osteotomy sites of the 22 cases included 4 in L1,10 in L2 and 8 in L3.All the patients achieved ideal imaging and surgical results.The differences in pelvic tilt(PT),sacral slope(SS),lumbar lordosis(LL),thoracic kyphosis(TK),thoracolumbar kyphosis(TLK),global kyphosis(GK),and sagittal vertical axis(SVA)between final follow-up and preoperation were statistically significant(P＜0.05).The osteotomy angles predicted with FBI,SFA,HP-HA,CAM-HA,and Surgimap methods were 50.5°±12.1°,52.0°±11.3°,53.9°±8.1°,51.3°±5.8°,and 43.2°±9.2°,respectively,with statistically significant differences(F=2.342,P=0.046).The theoretical osteotomy angle required by simulated osteotomy to restore the ideal spinopelvic sagittal alignment was 51.2°±8.1°,which wasn't statistically different from the osteotomy angles predicted with FBI,SFA,HP-HA or CAM-HA methods(P＞0.05).The actual osteotomy angle during the operation was 41.1°±5.4°,which was statistically different from the osteotomy angles predicted with FBI,SFA,HP-HA and CAM-HA methods(P＜0.05),but not statistically different with the angle predicted with Surgimap method(P＞0.05).Conclusions:The osteotomy angles predicted with FBI,SFA,HP-HA,and CAM-HA methods are similar with the theoretical osteotomy angle,while different from the actual osteotomy angle to some extent;The osteotomy angle predicted with Surgimap method is similar with the actual osteotomy angle.

Objective To analyze the clinical efficacy of percutaneous endoscopic decompression for adjacent segment diseases after lumbar fusion surgery.Methods A total of 26 patients with adjacent segment diseases after lumbar fusion surgery undergoing percutaneous endoscopy decompression in our hospital from January 2020 to June 2022 were retrospectively analyzed.The patients were operated through transforaminal approach in 11 cases and translaminar approach in 15 cases.There were 21 cases of unilateral decompression and 5 cases bilateral decompression.The clinical efficacy were evaluated by using the Visual Analogue Scale(VAS),Oswestry Disability Index(ODI),Japanese Orthopedic Association(JOA)scores,and modified MacNab criteria.Results All the operations were completed successfully without serious complications.The operative time was(85.4±21.7)min,the blood loss was(19.8±5.9)ml,and the number of intraoperative fluoroscopy was(7.7±2.4)times.The VAS scores of lower limb pain were significantly decreased immediately after operation(P=0.000).The patients were followed up for 10-24 months postoperatively,with an average of(16.0±3.7)months.At 3 months after operation and at the last follow-up,the VAS scores and ODI were significantly reduced compared to before surgery(F=105.444,P=0.000;F=852.714,P=0.000),while the JOA scores were significantly increased(F=256.222,P=0.000).At the last follow-up,the efficacy was excellent in 18 cases(69.2％),good in 5 cases(19.2％),and fair in 3 cases(11.5％),with an overall excellent and good rate of 88.5％(23/26).Conclusion Percutaneous endoscopic treatment of adjacent segment diseases after lumbar fusion can achieve good clinical efficacy.

OBJECTIVETo construct the recombinant HCV-1b replicon by replacing NS5A region using serum samples from patients with chronic hepatitis C (CHC) in South China and explore the biological characteristics of NS5A protein in response to antiviral therapy.

METHODSThe on-off plasmid containing the cutting sites of the restriction endonucleases MIu I and Bcl I was designed based on the backbone of robust HCV 1b replicon. The full-length fragments of HCV NS5A were amplified from different CHC patients by RT-PCR and cloned into pMD-18 vector, followed by sequence analysis of amino acid mutation of ISDR, PKRBD, V3 and IRRDR within the NS5A region. If the amplicon obtained contained no MIu I or Bcl I cutting sites, the NS5A fragment was re-amplified using primers containing the cutting sites and inserted into the replicon for replacement.

RESULTSThe full-length fragments of NS5A were obtained successfully from CHC patients. The core region of ISDR-V3 of NS5A was replaced in the HCV replicon plasmid and showed correct sequences. The amino acid mutations of ISDR and PKRBD within NS5A were more frequent in patients with sustained viral response (SVR) than those without SVR. A high variability in the amino acid sequence was observed in both IRRDR and V3 regions.

CONCLUSIONThe plug-in type recombinant HCV replicon for replacement of NS5A region in the virus from CHC patients has been successfully constructed, which provides a basis for further investigation of the biological characteristics of NS5A protein, the mechanisms of interferon-resistance, and antiviral therapy of difficult-to-treat CHC.

Amino Acid Sequence ; Antiviral Agents ; administration & dosage ; pharmacology ; Drug Resistance ; genetics ; Genetic Variation ; Genotype ; Hepacivirus ; genetics ; Hepatitis C, Chronic ; drug therapy ; virology ; Humans ; Interferons ; administration & dosage ; pharmacology ; Molecular Sequence Data ; Recombination, Genetic ; Replicon ; genetics ; Sequence Analysis ; Viral Nonstructural Proteins ; genetics

Objective:To investigate the relationship of delayed cardiac tamponade (CT) after left atrial appendage closure (LAAC) in atrial fibrillation (AF) patients and implanted occluders and adjacent anatomical structures.Methods:This study was a retrospective study. Thirteen AF patients with LAAC complicated with delayed CT and with concurrent emergency pericardiocentesis drainage in Zhoupu Hospital, Shanghai University of Medicine & Health Sciences from August 2016 to June 2021 were selected. The follow-up time was (16±12) months. The clinical data of these patients were retrospectively analyzed, including the relationship between the left atrial appendage and pulmonary artery, vein anatomy by left atrium computed tomography angiography (CTA) before and after LAAC.Results:Thirteen patients with delayed CT were treated by pericardiocentesis and drainage after LAAC and aged (72.1±8.3) years, and 7 patients were male, Six patients received cryoablation simultaneously. The classification types of left atrial appendage included cauliflower and chicken wing types were 8 and 5 respectively. The seal plate diameter of the lobe-and-disc devices was (29.5±2.8)mm; 10 patients had cardiac CTA reviewed. The occluder was attached to pulmonary artery in 8 patients, attached to left superior pulmonary vein only in one patient, and attached to pulmonary artery and left superior pulmonary vein in one patient. The prognosis was good except one patient who died 2 days after LAAC.Conclusions:Delayed CT after LACC is closely related to the location of left atrial appendage adjacent to pulmonary artery and left superior pulmonary vein, and is related to larger occluder and anchor hook.

Objective:To investigate the clinical characteristics and prognosis of coronavirus disease 2019 (COVID-19) patients with Omicron variant combined with atrial fibrillation (AF).Methods:From March 23, 2022 to May 15, 2022, 2 675 aged ≥ 50 years old COVID-19 patients with AF were admitted to Zhoupu Hospital, the designated hospital for COVID-19 in Shanghai. Patients were divided into mild symptoms group, normal group, and serious/critical group according to the symptoms. The clinical data, imaging examination and laboratory results and prognosis of the three group patients were compared.Results:The median age of 2 675 COVID-19 patients was 69.0 (60.0, 81.0) years old, the incidence of AF was 5.05% (135/2 675), the age range of AF patients were from 55 to 101 years old, with a median age of 84.0 (74.0, 89.0), and the number of mild symptoms, normal, serious/critical patients were 68, 30, 37, respectively, including 9 of serious and 28 of critical patients. In the serious/critical patients, aged 55-75 years old accounted for 43.2%, the rate of 2019 novel coronavirus vaccination was 32.4%. The identified new-onset AF was the highest among the three groups, but the rate of persistent AF was the highest in the mild symptoms group (58.8%). The severe/critical group complicated with fever (29.7%), hepatic insufficiency (13.5%), renal insufficiency (46.0%), type 2 diabetes (46.0%), and heart failure were higher in NYHA classification [compared with the mild symptoms and normal group (score): 1.8±1.1 vs. 1.1±0.8, 1.2±0.7, respectively, all P < 0.05]. In term of laboratory examinations, C-reactive protein (CRP), alanine aminotransferase (ALT), and aspartate aminotransferase (AST) levels were significantly higher in serious/critical patients compared to the mild symptoms and normal groups [CRP (mg/L): 27.2 (6.0, 60.8) vs. 7.6 (3.1, 19.3), 12.8 (4.9, 26.3), ALT (U/L): 31.3±15.4 vs. 15.4±9.3, 19.3±11.7, AST (U/L): 78.0±21.7 vs. 34.7±15.6, 38.1±24.4, all P < 0.05]. The hemoglobin (Hb) and albumin (ALB) levels were significantly lower than those in the mild symptoms and normal groups [Hb (g/L): 105.3±22.5 vs. 125.8±25.4, 123.0±20.4, ALB (g/L): 33.7±6.0 vs. 39.0±5.5 and 39.6±13.1, all P < 0.05]. In addition, MB isoenzyme of creatine kinase (CK-MB) was significantly higher in the serious/critical group than that in the mild symptoms group [μg/L: 2.5 (1.5, 3.4) vs. 2.2 (1.2, 2.8), P < 0.05]. In terms of the treatment, the percentage of antiplatelet agents and low-molecular heparin ratio compared among the three groups were statistically significant, with the serious/critical group using the lowest percentage of antiplatelet agents (27.0%) and a higher percentage of low-molecular heparin usage than that in mild symptoms group [81.1% (30/37) vs. 51.5% (35/68), P < 0.05]. In terms of prognosis, the mortality of patients with AF was 18.5% (25/135), all of whom were critical ill, including 32.0% (8/25) with cerebral embolism, pulmonary embolism and cerebral hemorrhage. Among them, 40.0% (10/25) died of multiple organ failure (40.0% combined with gastrointestinal hemorrhage), 20.0% (5/25) died of heart failure, and 12.0% (3/25) died of respiratory failure; while there were no death cases recorded in the mild symptoms, normal group and 9 serious patients. Conclusions:The serious/critical patients infected with COVID-19 Omicron variant with AF, have a worse prognosis and high mortality. Multiple organ failure, heart failure, sudden cardiac death, respiratory failure and embolic disease are the major causes of death.

Objective:To investigate the effects of educational level on smoking cessation in patients with moderate to severe tobacco dependence, explore effective individualized smoking cessation methods, and increase smoking cessation rate.Methods:A total of 480 patients with moderate to severe tobacco dependence who were willing to quit smoking and received treatment in the Department of Respiratory and Critical Care Medicine, Shengli Oilfield Central Hospital from January to December 2020 were included in this study. They were divided into four groups ( n = 120/group) according to their educational level: group A (elementary school and below), group B (junior high school and senior high school), group C (technical secondary school or college), and group D (university and above). All patients were randomly assigned to undergo "5A" intervention alone or "5A" intervention combined with varenicline intervention (combined intervention). Patients' awareness of the health risks of tobacco smoking was compared among the four groups. The smoking cessation rate measured at different time points was compared between different intervention strategies. Results:The scores of health risk of tobacco smoking in groups D, C, B, and A were (806.5 ± 35.7) points, (710.8 ± 26.2) points, (643.6 ± 43.4) points, and (512.4 ± 30.1) points, respectively. Patients with high education levels had high awareness of the health risk of tobacco smoking ( F = 1 543.26, P < 0.001). At 1, 3, and 6 months, the smoking cessation rate of combined intervention was higher than that of "5A" intervention alone in each group (group A: χ2 = 3.85, 4.23, 4.10, group B: χ2 = 4.30, 4.09, 4.60, group C: χ2 = 6.81, 4.30, 4.03, group D: χ2 = 6.71, 6.51, 4.73, all P < 0.05). The smoking cessation rate after 6 months of "5A" intervention alone or combined intervention in group D was 60.0% and 78.3% respectively, which were significantly higher than 41.7% and 60.0% in group C, 23.3% and 41.7% in group B, and 20.0% and 36.7% in group A ( χ2 = 26.59, 26.12, both P < 0.001). At different time points, the smoking cessation rates of the "5A" intervention alone in group D were significantly higher than those of combined intervention in groups A and B ( χ2 = 9.25, 25.04, 7.29, all P < 0.05). Conclusion:Awareness of the health risks of tobacco smoking is related to a patient's educational level, and affects smoking cessation. Individualized smoking cessation interventions based on a patient's educational level can increase the rate of smoking cessation.

Objective The family reconstruction method was used to establish paternity index algorithm for uncle-nephew relationships between two full sibling uncles and one nephew.Methods According to Mendelian genetic law,the family of two known full-sib uncles and one nephew were reconstructed according to the relationship between uncle and nephew,and the test hypothesis was established between two full sibling uncles and one nephew as the uncle-nephew relationship and unrelated individuals,and the paternity index of the uncle-nephew relationship between two full sibling uncles and one nephew was calculated by using Excel.Results Among the 99 genotypic combinations between two full sibling uncles and one nephew,91 of which were consistent with the genetic rules of uncle-nephew relationships,while 8 of which were not.a stepwise mutation model was introduced in the situations that do not conform to the genetic laws of uncle-nephew relationships.The paternity index of uncle-nephew relationship between two full sibling uncles and one nephew can be calculated using Excel.Conclusion The uncle-nephew testing involved by two full sibling uncles makes use of the role of the assistant,and the paternity index of the obtained uncle-nephew relationship is higher than that between two known full-siblings alone and their nephew,which has a good practical value in helping the appraiser to draw a clear appraisal opinion.