Objective:To explore the effects of combination of epirubicin (EPI) and anti-CD47 antibody on therapy of breast cancer.Calreticulin ( CRT) and CD47 on DC-mediated phagocytosis.Methods: Breast cancer cells MCF-7 and MDA-MB-231 were treated with EPI , and expression of calreticulin ( CRT ) and CD47 on cell surface were detected by flow cytometry or immunofluorescence.DC were isolated from human peripheral blood , and cocultured with epirubicin-treated breast cancer cells in the present of anti-CD47 or anti-CRT antibody ,and the phagocytosis of DC was assessed.Results:Untreated breast cancer cells MCF-7 and MDA-MB-231 did not express CRT on the surface of cells ,but high level of CD47 was detected.After EPI treatment,CRT exposed on the cells surface,and the expression of CD47 was reduced.The results showed that EPI or anti-47 antibody alone increased DC-mediated phagocytosis ,and combination treatment marked enhanced this effects.Further more, in addition of anti-CRT antibody reduced the phagocytosis of DC.Conclusion:EPI could induce CRT exposure on the tumor cell surface ,and enhanced DC-mediated phagocytosis when combination with anti-CD47 antibody.The phagocytosis of DC on tumor cells were modulated by both ecto-CRT and CD47.This study provide a new effective strategy for the use of anti-CD47 antibody among the chemotherapy of breast cancer.

Objective To expolore the changes of coagulation index in newborns of different age and its clinical significance. Methods We studied 129 newborn infants without complication admitted to the neonatal department in an all-around hospital in Gnangzhou from January to December in 2005. These neonates were divided into two groups, including 63 cases of full-term infants and 66 cases of premature infants. Prothrombin time (PT), activated partial prothrombin time (APTT), Fibrinogen (Fg), thrombin time (TT), D-dimer (D-D) of these newborn infants were assayed on the first day, the third day and the tenth day. Results In the postnatal three periods of time, there was no difference in PT and D-dimer between two groups(P >0.05), but APTT and TT in premature infants were higher than that in full-term infants( P < 0.05), and Fg in premature infants were lower than that of full-term irfants(P<0.05). PT,APTT, TT,Ddimer were in decrease tendency and Fg increased as age increased( P < 0.05 ). Conclusion Geststional age and age had effect on coagulation index in newborn infants, and both can provide clinical references to clinical diagnosis and therapy.

Objective:To analyze the correlation and diagnostic value of serum homocysteine (Hcy), methionine (Met) and cysteine (Cys) in patients with chronic heart failure (CHF).Methods:One hundred and seventy-eight patients with acute decompensation CHF (CHF group) and 70 healthy persons (healthy control group) from October 2018 to September 2019 in Affiliated Zhongshan Hospital of Dalian University were continuously enrolled. In CHF group, heart failure with reduced ejection fraction (HFrEF) was in 53 cases, heart failure with mid-range ejection fraction (HFmrEF) was in 50 cases, and heart failure with preserved ejection fraction (HFpEF) was in 75 cases. Serum levels of Hcy, Met and Cys were detected by tandem mass spectrometry. Serum level of N-terminal brain natriuretic peptide precursor (NT-proBNP) was detected by electrochemical luminescence immunity. The left ventricular end-diastolic diameter (LVEDd), left ventricular end-systolic diameter (LVESd) and early diastolic peak blood flow velocity of mitral valve annulus/early diastolic peak velocity of mitral annulus (E/e′) were detected by echocardiography, then left ventricular eject fraction (LVEF) was calculated. Correlation was analyzed by Pearson correlation analysis. The receiver operator characteristic (ROC) curve was drawn, and the area under curve (AUC) was used to evaluate the efficacy of serum Hcy, Met, Cys, NT-proBNP and LVEF in the diagnosis of CHF.Results:The Hcy, Met, Cys, NT-proBNP, LVEDd and E/e′ in CHF group were significantly higher than those in healthy control group: (12.64 ± 5.02) μmol/L vs. (8.71 ± 3.47) μmol/L, (23.38 ± 5.75) μmol/L vs. (20.52 ± 4.18) μmol/L, (343.45 ± 44.49) μmol/L vs. (290.53 ± 48.38) μmol/L, (5 759.43 ± 3 806.22) pg/L vs. (40.24 ± 31.91) pg/L, (52.67 ± 12.27) mm vs. (46.41 ± 12.27) mm and (17.32 ± 5.61)% vs. (9.54 ± 2.64)%, the LVEF was significantly lower than that in healthy control group: (45.27 ± 4.93)% vs. (62.37 ± 5.41)%, and there were statistical differences ( P<0.01 or <0.05). The Hcy and Cys in patients with HFmrEF and HFrEF were significantly higher than those in patients with HFpEF: (16.29 ± 8.18) and (18.68 ± 8.99) μmol/L vs. (13.75 ± 6.48) μmol/L, (346.64 ± 51.85) and (361.40 ± 52.34) μmol/L vs. (329.35 ± 55.16) μmol/L, and there were statistical differences ( P<0.05); there were no statistical differences between patients with HFmrEF and patients with HFrEF ( P>0.05). The serum Met in patients with HFrEF was significantly higher than that in patients with HFpEF and HFmrEF: (28.74 ± 8.22) μmol/L vs. (24.76 ± 7.60) and (25.15 ± 6.96) μmol/L, and there was statistical difference ( P<0.05); there was no statistical difference between patients with HFpEF and patients with HFmrEF ( P>0.05). Pearson correlation analysis result showed that serum Hcy, Met and Cys were positively correlated with NT-proBNP ( r = 0.632, 0.206 and 0.455; P<0.01), positively correlated with E/e′( r = 0.463, 0.198 and 0.346; P<0.01), and negatively correlated with LVEF ( r = -0.491, -0.152 and -0.330; P<0.05 or <0.01). ROC curve analysis result showed that ROC the cut-off value for the diagnosis of CHF with serum NT-proBNP based on the maximum Youden index (0.994) was 120 pg/L, and AUC was 0.994 (95% CI was 0.997 to 1.000); the cut-off value for the diagnosis of CHF with serum Hcy based on the maximum Youden index (0.646) was 10.56 μmol/L, and AUC was 0.899 (95% CI 0.859 to 0.939); the cut-off value for the diagnosis of CHF with serum Met based on the maximum Youden index (0.218) was 25.58 μmol/L, and AUC was 0.637 (95% CI 0.563 to 0.711); the cut-off value for the diagnosis of CHF with serum Cys based on the maximum Youden index (0.391) was 298.05 μmol/L, and AUC was 0.765 (95% CI 0.700 to 0.830); the AUC of LVEF less than 0.5. Conclusions:Serum Hcy, Met and Cys levels in patient with CHF are significantly increased, which are positively correlated with NT-proBNP and E/e′, negatively correlated with LVEF. Moreover, serum Hcy has certain application value in the diagnosis of CHF.

OBJECTIVE: To investigate clinical application of head impulse test with video recording eye movements in the diagnosis of vertigo. METHOD: The video head impulse test(vHIT) was used to measure the eye saccades and velocity gain in 95 patients with vertigo which were divided into two groups, peripheral vertigo (47 cases) and central vertigo(48 cases); the characteristics of eye saccades and velocity gain of six semicircular canals in different patients with vertigo were analyzed, and were compared between the two groups. RESULT: The vHIT result in patients with peripheral vertigo: in 22 patients (23 affected ears) with Meniere's disease, 21 ears were abnormal (91. 3%); the vHIT results in 4 patients with vestibular schwannoma, 2 patients with vestibular neuritis, 5 patients with delayed endolymphatic hydrops, 6 patients with sudden hearing loss accompanied vertigo, and 8 patients with vestibular dysfunction, were abnormal with correct saccades and/or lower velocity gain of vHIT. The abnormal vHIT results were also found in 35 of 48 patients (72. 9%) with central vertigo, which including posterior cerebral circulation ischemia(7 patients), cerebral infarction/stroke(6 patients), and dizziness with vertigo(17 patients) and others(18 patients). Abnormal rate of vHIT in patients with peripheral vertigo was 95. 7% (45/47), which was significantly higher than that (72. 9%) in patients with central vertigo. CONCLUSION It is easy to perform the vHIT which without adverse reactions. We can record high-frequency characteristics of vestibular-ocular reflex among six semicircular canals through vHIT. The vHIT results which show the function of vestibular ocular reflex in different diseases with vertigo, can help discriminate peripheral vertigo from central vertigo, and it is a practical assessment method for vertigo.
Dizziness ; Endolymphatic Hydrops ; diagnosis ; Head Impulse Test ; Humans ; Meniere Disease ; diagnosis ; Neuroma, Acoustic ; diagnosis ; Reflex, Vestibulo-Ocular ; Saccades ; Semicircular Canals ; Vertigo ; diagnosis ; Vestibular Neuronitis ; diagnosis ; Video Recording

The nutritional status, serum protein, albumin, calcium, zinc, iron, SF, FEP, vitamin A, activity of RBC transketolase, and blood glutathione redu-ctase of 349 normal primigravidas, 30 healthy non-pregnant women and 42 toxemic gravidas were estimated longitudinally from the 1st trimester to delivery. It was noted that serum protein, albumin, Ca, Zn, and Fe decreased markedly in the course of pregnancy. The content of serum vitamin A showed no variation or decrease in the 3rd trimester in 1/3 of the pregnant women observed. Insufficiency of thiamine and riboflavin were noted in 16.7% and 47% of the normal pregnant women respectively. The adequate nutrients intakes in pregnancy were considered to be: Energy, +200 kcal/d; Protein, + 15g/d in the 2nd trimester and +25g/d in the 3rd trimester; Calcium 1000 mg/d in the 2nd trimester and 1500mg/d in the 3rd trimester; Zinc, 20mg/d; Iron 26 or 30 mg/d by supplementation if possible; vitaminA 1000 ?gRE/d; both thiamine and riboflavin 1.8 mg/d.

Objective:To investigate the risk factors for anterior circulation and posterior circulation symptomatic intracranial atherosclerotic stenosis (sICAS).Methods:The clinical data of patients admitted to Hebei General Hospital for ischemic stroke or transient ischemic attack (TIA) and diagnosed with sICAS by digital subtraction angiography from May 2019 to May 2020 were retrospectively included. The patients were divided into anterior circulation group and posterior circulation group according to the stenosis sites, and the distribution of sICAS and its risk factors were analyzed.Results:A total of 134 patients with sICAS were enrolled, including 82 males (61.2%) and 52 females (38.8%). Their age was 60.28±11.46 years; 115 (85.8%) had ischemic stroke and 19 (14.2%) had TIA. There were 92 patients (68.7%) in the anterior circulation group and 42 (31.3%) in the posterior circulation group. Body mass index (BMI), systolic and diastolic blood pressure levels, as well as the proportion of patients with hypertension, diabetes, smoking and drinking in the posterior circulation group were significantly higher than those in the anterior circulation group (all P<0.05). Multivariate logistic regression analysis showed that higher BMI (odds ratio [ OR] 1.191, 95% confidence interval [ CI] 1.029-1.379; P=0.019), hypertension ( OR 4.073, 95% CI 1.135-14.616; P=0.031) and diabetes ( OR 2.783, 95% CI 1.149-6.738; P=0.023) were independently correlated with the posterior circulation sICAS. Conclusions:Compared with anterior circulation, high BMI, hypertension and diabetes are the independent risk factors for posterior circulation sICAS.

We developed a novel portable and automated dissolution test analyzer for rapid and high precision in vitro dissolution testing of drugs.The analyzer consists of a flow-through-cell drug dissolution system,an automated sequential sampling system,a high-speed capillary electrophoresis (HSCE) system,and a data acquisition system.Combining the high-temporal resolution flow-gating sampling approach with HSCE,which has outstanding advantages of efficient separation and resolution,the analyzer can achieve rapid analysis and exhibits the ability in miniaturization for on-site assessment of different active pharmaceutical ingredients.To integrate the flow-through-cell dissolution system with HSCE,a specially designed flow-gating-injection (FGI) interface was employed.The performance of the analyzer was investigated by analyzing the dissolution of immediate-release drugs including single dose (amoxicillin dispersible tablets) and fixed dose combination (amoxicillin and clavulanate potassium) drug tablets with the high-temporal resolutions of 12 s and 20 s,respectively.The dissolution profiles of different active pharmaceutical ingredients could be simultaneously and automatically monitored with high repeatability and accuracy.The analyzer was successfully utilized for the pharmaceutical quality control and bio-relevant dissolution testing,as well as in vivo-in vitro correlation analysis.Our portable analyzer is miniaturized,convenient and of low-cost,and will provide a valuable tool for dissolution testing in pharmaceutical research and development.

Endovascular thrombectomy (EVT) has become an effective treatment for acute large vessel occlusive ischemic stroke. Because there are many common etiologies and pathogenesis between cerebral small vessel disease (CSVD) and large vessel disease, patients with large vessel occlusive ischemic stroke are often accompanied by imaging manifestations of CSVD. In recent years, with the wide application of EVT in the treatment of acute ischemic stroke, more and more studies have investigated the relationship between CSVD and the outcome of patients treated with EVT. This article reviews the relationship between various imaging phenotypes of CSVD and the outcome of acute ischemic stroke patients treated with EVT and its possible mechanism.

Objective:To analyze the research hotspots and development trend of the application of artificial intelligence to the field of anesthesia using bibliometrics, and to provide reference for further research.Methods:Based on the results of the literature search on artificial intelligence and anesthesia in the Web of Science database, Citespace5.5.R2 and VOSviewer1.6.16 softwares were used to draw the knowledge map of scientific research cooperation networks, keywords and citations and implement bibliometric analysis.Results:A total of 298 studies were included, and the number of publications and citation frequency in the early period were maintained at a very low level for a long time, and both showed an increasing trend year by year after 2017.These studies came from 45 countries/regions, among which the United States had the highest publications.Harvard University was the institution with the highest number of papers.The author with the highest publications was Matava Clyde, who worked at the Toronto Hospital for Sick Children.Research on the application of artificial intelligence to the field of anesthesia had mainly focused on artificial intelligence algorithms, event prediction, anesthesia control and pain management.Conclusions:The application of artificial intelligence to the field of anesthesia has gradually attracted the attention of the academic community in the past five years, and the number of publications and citation frequency have increased drastically.The academic achievements in this field in China still have a gap compared with the world advanced level, and more in-depth researches can be conducted in the future for the hot directions.

Objective:A comparative study of non-invasive hemodynamics and echocardiography in 139 cases of heart failure patients with preserved ejection fraction (HFpEF) at baseline and one year follow-up to explore its value on diagnosis, monitoring and prognosis in patients with HFpEF.Methods:The baseline and one year follow-up data of 139 patients with HFpEF in Affiliated Zhongshan Hospital of Dalian University patients who had been enrolled in the China PEACE 5P-HF from June 2016 to May 2018 were analyzed retrospectively. The general data were collected which contented age of the study subjects is (30 - 80) y, average age (64.0 ± 12.3) y, and 63.31% male, (88/139) and 36.69% female (51/139), 56.8% smokers (79/139). t-test way was used to analyze the baseline and one year follw-up data, The indexs included blood pressure (BP), estimated glomerular filtration rate (eGFR) and 6-munites walk test (6MWT). Non-invasive hemodynamic indicators included stroke volume (SV), ejection fractions (EF), cardiac index (CI), index of contratility (IC), pulmonary artery wedge pressure (PCWP), maximum angiectatic velocity(AMPC), left ventricular ejection time (LVET), left ventricular isovolumetric relaxation time (LVLVIVRT), pre-ejection period/left ventricular ejection fractions (PEP/LVET), left ventricular end diastolic pressure (LVEDP) and left cardiac work index (LCWI). Hemodynamic indicators included left ventricular end diastolic dimension(LVEDd), left ventricular end systolic dimension (LVEDs), interventricular septal thickness at diastole (IVSD), left ventricular ejection fractions (LVEF) and E/e′.Results:There was no significant difference between the baseline and one year follow-up data in SBP, DBP, NT-proBNP, eGFR, 6MWT ( P>0.05). There were significant increase in SV, EF, CI, IC in one year′ follow-up compared with that in baselinee [(73.39 ± 29.47) ml vs. (63.39 ± 30.08) ml, (64.87 ± 9.16)% vs. (61.81 ± 9.02)%, (3.06 ± 1.10) ml/(min·m 2) vs. (2.62 ± 1.06) ml/(min·m 2), (0.039 ± 0.037) L/s vs. (0.028 ± 0.015) L/s] ( P<0.05). PCWP in one year′ follow-up was significantly decreased compared with that in baselin [(9.21 ± 3.34) mmHg (1 mmHg = 0.133 kPa) vs. (9.87 ± 3.13) mmHg]( P<0.05), However, AMPC, LVE, LVLVIVRT, PEP/LVET, LVEDP, LCWI in baseline and one year′ follow-up showed no significant difference ( P>0.05). The Hemodynamic indicators in baseline and one year′s follow-up were as followed: LVEF in one year′ follow-up was significantly elevated compared with that in the baseline [(63.53 ± 8.39)% vs. (61.02 ± 7.16)%]; E/e′ in one year′s follow-up was significantly decresed compared with that in the baseline [12.89 ± 5.86 vs. 14.32 ± 6.61]( P<0.05); there were no significant differences in LVEDd, LVEDs and IVSD in baseline compared with those in one year′s followed-up ( P>0.05). Conclusions:Hemodynamic indicators including SV, EF, CI, IC and PCWP could be new reflections of early diagnosis, monitoring and prognosis on HFpEF. The combination of non-invasive hemodynamics and echocardiography on HFpEF can be more significant in reflecting the changes of myocardial remodeling and cardiac function.