Objective To study the characteristics of clustering of cardiovascular risk factors in patients less than 50 years-old of premature stable coronary heart disease(PSCHD)complicated with nonalcoholic fatty liver(NAFL).Methods One hundred and six patients with documented PSCHD were recruited into this study and their clinical data,including biochemical parameters,high-sensitivity C-reactive protein(hsCRP),white blood cell(WBC)count,ete.,were analyzed based on whether they had NAFL by B-type ultrasound scanning and their homeostasis model assessment ratio(Homa-IR)by the criteria for metabolic syndrome formulated by the International Diabetes Federation.Results Thirty-two (30.1percent)of 106 patients of PSCHD complicated with NAFL,and 74(69.9 percent)without NAFL. As compared to patients without NAFL,patients with NAFL had higher fasting blood glucose(FBS),serum level of insulin(INS),total cholesterol(TC),triglyceride(TG),serum activity of alanine aminotransferase(ALT),hsCRP,WBC count,body mass index(BMI),Homa-IR,and higher proportion of those with abnormal blood glucose,hypertension.metabolic syndrome(MS)and carotid atherosclerosis (CA)(P＜0.05),respectively.Bi-variate correlation analysis revealed that hsCRP positively correlated to BMI,TG,ALT and Homa IR(r=0.420,P=0.000;r=0.200,P=0.040;r=0.218,P=0.048:and r=0.546,P=0.000,respectively)and inversely correlated with serum level of high-density lipoprotein cholesterol(HDL-C)(r=-0.220,P=0.023).WBC count positively correlated with FBS(r=0.211,P=0.030).BMI,hsCRP,ALT,and proportions of hypertension,diabetes,MS,NAFL and CA in patients with Homa-IR above median were significantly higher than those in patients with that below median ( P＜0.05,respectively).Conclusions More risk faetors for chronic inflammatory reaction,cardiovascular disease and insulin resistance were clustered more obviously in patients of PSCHD complicated with NAFL.

Objective: To analyze the long-term prognosis of re-operation in patients with functional tricuspid regurgitation (FTR) after left sided valve replacement (LSVR) and hence evaluate the optimal timing of mentioned re-operation. Methods: A total of 59 FTR patients who had re-operation after their prior LSVR in our hospital from 1999-01 to 2013-01 were analyzed. The clinical information and post-operative follow-up results were recorded in all patients. Results: There were 5/59 (8.5%) patients died in peri-operative period and the overall post-operative mortality was 11.9% (7/59). The follow-up data of 54 survivors were available for the mean time of 51.1 (21-188) months. There were 19/54 (35.2%) patients suffered from MACE and 30 (55.6%) were beneifted by improved cardiac function. Uni-variable analysis indicated that pre-operative NYHA class IV (P=0.008), pre-operative right ventricular (RV) dysfunction (P=0.037), concomitant left-sided redo-operation (P=0.017) and TVR operation (P=0.002) were associated with all cause mortality of tricuspid re-operation. Multi-variable Cox regression analysis showed that pre-operative RV dysfunction was the only independent risk factor of long term MACE-free accumulating survival rate (HR=3.0, 95% CI 1.11-8.2,P=0.031); while TVR operation (HR=12.8, 95% CI 1.53-107.02,P=0.019) and pre-operative NYHA class IV (HR=5.3, 95% CI 1.20-24.51,P=0.032) were the independent risk factors for long-term mortality in patients after tricuspid re-operation. Conclusion: Patients with compensatory RV function showed better long term prognosis after secondary tricuspid operation. Aggressive re-operation before the occurrence of right ventricular dysfunction could be beneficial for relevant patients.

Objective To study the clinical efficacy of platelet-rich plasma (PRP) in the treatment of knee osteoarthritis (KOA) and evaluate whether the age,body mass index and grade of KOA are associated with the treatment outcomes.Methods Using the prospective,randomized,controlled study,100 KOA patients hospitalized between December 2013 and November 2014 were enrolled.Twentyeight patients were men and 72 were women.Mean age was 58 years (range,35-85 years).Degenerative arthritis occurred in 68 patients and traumatic arthritis in 32 patients.Kellgren-Lawrence (K-L) score was grade Ⅱ in 35 patients,grade Ⅱ in 46 and grade Ⅲ in 19.The patients were assigned to receive hyaluronic acid (HA) (HA group,n =50) and PRP (PRP group,n =50) by an intraarticular route once weekly for 3 weeks,according to the random number table.Between-group differences were insignificant in age,gender,body mass index (BMI) and K-L grade.Western Ontario and McMaster Universities Arthritis Index (WOMAC),visual analog scale (VAS) and cartilage lesions score (CaLs) were used for clinical and MRI evaluations.At follow-up evaluation,the effective rate was defined at least 36％ improvement from the baseline WOMAC score.Results All patients were followed up for 6 months.The effective rate in PRP group was 84％ versus 68％ in HA group after the last treatment (P ＞0.05),and was 60％ versus 36％ in HA group at the final follow-up (P ＜ 0.05).WOMAC score in both groups had significant improvement after operation,while VAS improved only in PRP group (P ＜ 0.01).In PRP group patients with K-L grade I had better VAS and WOMAC scores than those with grade Ⅱ (P ＜0.05),and patients with grade Ⅱ had better WOAMC score than those with grade Ⅲ (P ＜ 0.05).MRI findings showed seven patients in PRP group had similar CaLs before and after operation (P ＞ 0.05),and the area of abnormal signal in subchondral bone and the depth of cartilage lesion gradually decreased in one of them.Follow-up study showed the outcomes had negative correlation with age and K-L grade (P ＜0.05),but no certain correlation with BMI in PRP group (P ＞ 0.05).Clinical effects in both groups were decreased over time.Conclusions Intraarticular injection of PRP benefits to pain relief,decreased inflammation and tissue repair,and has much better outcome in patients with younger age and lower K-L grade.However,BMI is not associated with the outcome.

Objective • To investigate the value of percutaneous oxygen saturation measurement combined with echocardiography remote consultation in the screening and referral of neonatal critical congenital heart disease (CCHD) in remote areas. Methods • The live newborns who were born between 2014 and 2016 in Chongming District of Shanghai were taken as the objects of study, the percutaneous oxygen saturation was measured at 24-48 h after birth. The data were classified according to congenital heart disease segmental diagnosis standard in the mean time, and the echocardiography was preliminary diagnosed after the remote consultation through WeChat platform. Results • A total of 4 450 live newborns were screened, 11 cases were positive, 6 cases were preliminary diagnosed as CCHD by the echocardiography remote consultation, and 1 case of negative screening was later diagnosed as pulmonary atresia with ventricular septal defect by echocardiography. The sensitivity of percutaneous oxygen saturation screening for CCHD was 85.71%, the specificity was 99.89%, the false positive rate was 0.11%, the false negative rate was 14.29%, and the area under the ROC curve was 0.928. Conclusion • CCHD can be screened out effectively by percutaneous oxygen saturation combined with the WeChat platform, and it can be preliminary diagnosed by the echocardiography remote consultation, which can provide timely referral and avoid unnecessary referral. This screening model is simple and practical. It has practical value in remote areas where are lack of professional medical technicians for the diagnosis and treatment of congenital heart disease.

Objective: To describe the patients situation and correlation Health Empowerment ability and the quality of life of patients with coronary heart disease. Methods: A Random sampling from December 2016 to August 2017 was preformed. The patients with coronary heart disease were recruited and assessed for socio-demographic, medical data with self-made general information questionnaire, the scales of Chinese version of Patient perception of empowerment scale (PPES) and the MOS item short from health survey (SF-36). Results: The patients with coronary heart disease Healthy empowerment cognition score was (45.17±5.72) and the Healthy empowerment cognition was positively correlated with Quality of life (r=0.109-0.371, P<0.05). Conclusion The Healthy empowerment cognition and Quality of life of mild-to- moderate generally in patients with coronary heart disease. It is suggested that improving the healthy empowerment ability of patients with coronary heart disease can indirectly improve the quality of life of the patients.

In 2013, the World Health Organization reported the first case of human infection with a new influenza A (H7N9) virus in China. This has caused damage and panic within certain areas in China. Therefore, analysis of this virus with bioinformatics technology is very necessary. Neuraminidase (NA) is one of the most important antigens of the influenza virus and an important target for anti-flu drugs. In this study, the nucleotide and protein sequences of NA gene of A/H7N9 influenza viruses were retrieved from the NCBI database, and MEGA 5.0 software was employed to construct a phylogenetic tree based on the nucleotide coding sequence; BioEdit software was used to align the nucleotide and protein sequences of NA and calculate the homologies of nucleotides and amino acids and then to analyze the important mutation sites of NA gene. The results demonstrated that the spread of influenza virus H7N9 showed certain geographical and temporal relations. The H7N9 virus isolated from China in 2013 belonged to Euroasiatic serotype, and its NA stalk region hadobvious variation, which may be one of the reasons that this virus infects human. These analyses may be very helpful for understanding the evolutionary relationship and mutation trend of A/H7N9 influenza viruses.
Databases, Genetic ; Evolution, Molecular ; Humans ; Influenza A Virus, H7N9 Subtype ; enzymology ; genetics ; Mutation ; Neuraminidase ; chemistry ; genetics ; Phylogeny ; Sequence Analysis

Osteoclasts are multinucleated giant cell, which derived from mononuclear myeloid hematopoietic stem cells with the function of bone absorption. Osteoclasts plays a key role in bone metabolism, therefore the body is very strict to regulation of osteoclastogenesis. Mobilization and differentiation of osteoclast maturation is a complex and sophisticated multi-level regulatory processes. In the relevant regulatory mechanisms, OPG/RANKL/RANK system plays a pivotal role in the process of osteoclast differentiation and maturation. Recent studies revealed that immune cells and osteoclasts were closely connect with each other in the field of bone metabolism, also provide a new therapeutic target for the treatment of bone diseases. The apoptosis of osteoclasts in bone metabolism have been payed more attention,while its mechanism is still not clear, which need further research.
Animals ; Cell Differentiation ; Gene Expression Regulation ; Humans ; Osteoclasts ; cytology ; metabolism ; Osteoprotegerin ; genetics ; metabolism ; RANK Ligand ; metabolism ; Receptor Activator of Nuclear Factor-kappa B ; genetics ; metabolism

Objective To observe the influence of circadian rhythm disruptions on exercise capability in rats. Methods A total of 30 spontaneously hypertensive rats (SHR) and age and weight matched homologous normal blood pressure WKY rats were randomly divided into normal circadian rhythm group (control group), twelve hours cir-cadian rhythm disruption group (observation group 1), six hours circadian rhythm disruption group (observation group 2). Each group included ten SHR rats and WKY rats, changing the light/dark time to construct circadian rhythm disruption model. Exercise endurance, blood pressure and heart rate after exhaustion were measured be-fore and one, two and three months after modeling. Results The interaction of time and circadian rhythm was significant on the exhaustion time of SHR rats (F=2.409, P=0.047). After three months of modeling, the exhaustion time of the control group was more than that of the obser-vation groups 1 and 2 (F=4.290, P=0.032). The interaction of time and circadian rhythm was not significant on the exhaustion time of WKY rats (F=0.717, P=0.638), there was no significant difference in the exhaustion time among groups (P>0.05). For SHR rats, after three months of modeling, the systolic pressure, diastolic pressure and mean arterial pressure after exhaustion of the observation group 1 were higher than those of the control group and the observation group 2 (P<0.05), the heart rate of the observation groups 1 and 2 was higher than that of the control group (P<0.05). But there was no significant difference in the systolic pressure, diastolic pressure, average arterial pressure and heart rate of WKY rats among groups (P>0.05). Conclusion Circadian rhythm disruptions can reduce the exercise endurance of SHR rats, which may be related to the cardiovascular function impairment.

OBJECTIVETo investigate the effect of c-kit mutation on the prognosis of gastrointestinal stromal tumors.

METHODSA search of studies in PubMed and MedLine (from 1999 to 2008) was performed to assess the effect of c-kit mutation on the prognosis of gastrointestinal stromal tumors. The articles were retrieved with the entries of "gastrointestinal stromal tumors", "imatinib", "c-kit" and "mutation". A meta-analysis was performed to assess the data included.

RESULTSA total of 15 articles were collected in this analysis. No significant differences was found in incidence of mitoses (> 5/50 HPF) between the patients with wild type c-kit (wild type group) and the ones with mutated c-kit (mutation group) (P = 0.710); tumor recurrence and metastasis rate after surgery was significant higher in the mutation group than that in wild type group (P = 0.010); as for imatinib response with different c-kit mutation types, the results showed the incidence of clinical response (complete response + partial response) was significantly higher in mutation group than that in wild type group (P = 0.009), but the imatinib resistance rate was lower in mutation group (P = 0.000); three studies provided data for imatinib resistance with c-kit second mutations, the results showed the second mutations mainly focus on exon 13, 14, 17.

CONCLUSIONSC-kit mutation is related closely with the incidence of recurrence and metastasis in GIST after surgery. The mutations of c-kit influences the therapeutic effects of imatinib.

Antineoplastic Agents ; therapeutic use ; Benzamides ; Case-Control Studies ; Gastrointestinal Stromal Tumors ; drug therapy ; genetics ; Humans ; Imatinib Mesylate ; Mutation ; Piperazines ; therapeutic use ; Prognosis ; Proto-Oncogene Proteins c-kit ; genetics ; Pyrimidines ; therapeutic use

BACKGROUNDTranscatheter aortic valve implantation (TAVI) has emerged as the treatment choice for non-operable patients with severe symptomatic aortic stenosis (AS) and may be a good alternative to surgery for those at very high or prohibitive surgical risk. We performed a meta-analysis to evaluate the comparative benefits of TAVI versus surgical aortic valve replacement (SAVR) in patients with severe AS.

METHODSA comprehensive literature search of PubMed, Embase, ScienceDirect and Cochrane Central Register of Controlled trials was performed, and randomized trials as well as cohort studies with propensity score analysis were included.

RESULTSOne randomized trial (n = 699) and six retrospective cohort studies (n = 781) were selected for meta-analysis. Mortality at 30-day and 1-year follow-up was comparable between TAVI and SAVR. Despite similar incidences of stroke, myocardial infarction, re-operation for bleeding, and renal failure requiring dialysis, TAVI was associated with a lower occurrence rate of new-onset atrial fibrillation (OR 0.51, 95%CI 0.33 - 0.78) and shorter procedural time (mean difference -67.50 minutes, 95%CI -87.20 to -47.81 minutes). Post-operative aortic regurgitation and permanent pacemaker implantation were more common in patients after TAVI than in those with SAVR (OR 5.53, 95%CI 3.41 - 8.97; OR 1.71, 95%CI 1.02 - 2.84, respectively).

CONCLUSIONIn patients with severe symptomatic AS, TAVI and SAVR did not differ with respect to short- and mid-term survival, but the incidence of permanent pacemaker implantation and post-procedural aortic regurgitation remain relatively high after TAVI.

Aortic Valve Stenosis ; surgery ; therapy ; Heart Valve Prosthesis ; Humans