Objective To investigate the risk factors for postpartum cardiac events in pregnant women with heart diseases and to provide prenatal counseling for them.Methods A retrospective analysis was made in cases of pregnant women with heart diseases admitted to the surgical intensive care unit (SICU) of Anzhen Hospital from May 2004 to May 2012.Data were used to identify univariate and multivariate predictors for postpartum cardiac events.Results A total of 190 patients (≥ 20 weeks gestation) were enrolled in the study with 134 (70.5％) of congenital heart disease,30 (15.8％) of rheumatic heart disease,10 (5.3％) of cardiomyopathy,2 (1.1％) of peripartum cardiomyopathy and 14(7.4％) of hypertensive heart disease.Postpartum cardiac events were observed in 42 cases with the incidence of 22.1％.A total of 7 cases resulted in death with the mortality rate of 3.7％.Among them,5 cases were dead of circulatory collapse and pulmonary hypertensive crisis postpartum,while the other 2 cases with secondary pulmonary infection were died of respiratory and circulatory collapse.The baseline parameters of New York Heart Academy(NYHA) ＞ 1,left ventricular ejection fraction (LVEF) ＜ 50％,use of cardiac drugs and pulmonary artery hypertension(PAH) ＞ 80 mm Hg(1 mm Hg =0.133 kPa) were the independent predictors for postpartum cardiac events by univariate and multivariate logistic regression analysis.Conclusions The incidence of postpartum cardiac events is high in pregnant women with heart diseases.Pulmonary artery hypertension and heart failure are the main causes of death.

Inflammatory bowel disease(IBD)is a group of chronic non-specific intestinal inflammatory diseases with unclear etiology.Its pathogenesis may be related to the intestinal immune imbalance caused by the interaction of multiple factors such as environment,genetics and intestinal microecology.Macrophages,as an important component of the immune system,can maintain a balance between pro-inflammatory and anti-in-flammatory responses in the intestine.Macrophages can be divided into two polarization types:classical activa-tion(Ml)and alternative activation(M2)according to the different phenotypes and cytokines secreted by macrophages.The polarization of macrophages plays a key role in the subside of intestinal inflammation and the healing of mucosa.In the intestinal immune system of IBD,the imbalance between pro-inflammatory and anti-inflammatory factors caused by macrophage polarization imbalance can lead to sustained progression of intestinal mucosal inflammation and impairment of barrier function,playing a key role in IBD.The changes in macrophage polarization levels may affect the therapeutic effect of IBD.Therefore,targeting macrophage po-larization may be an important target for the treatment of IBD.This article summarizes the role of intestinal macrophage polarization in IBD and the impact of regulating macrophage polarization in IBD treatment to pro-vide reference for studying the new treatment methods for IBD.

Objective: To explore sarcoplasmic reticulum ryanodine receptor2 (RyR 2) expression and calcium releasing function in chronic heart failure (CHF) rabbits and to study the impact of long term valsartan treatment in relevant animals. Methods: HF model was established by volume overloading with pressure overloading in experimental rabbits. 27 rabbits were divided into 3 groups: Sham group, HF group and HF+valsartan group. n=9 in each group and the animals were treated for 7 weeks. Left ventricular structure, hemodynamic parameters, expression and functional changes of myocardiocyte sarcoplasmic reticulum RyR 2 were observed and compared among different groups. Results: Compared with Sham group, HF group had increased left ventricular mess index (LVMI), left ventricular end diastolic pressure (LVEDP) and decreased left ventricular shortening fraction, LVEF, all P<0.05. Compared with HF group, HF+valsartan group showed decreased LVMI, LVEDP and increased left ventricular shortening fraction, LVEF, all P<0.05. Sarcoplasmic reticulum RyR 2 expression and calcium releasing function were lower in HF group than Sham group, P<0.05; while they were both higher in HF+valsartan group than HF group, P<0.05. Conclusion: Long term application of valsartan could improve the cardiac function which might be related to increased myocardial sarcoplasmic reticulum RyR 2 expression and calcium releasing function in experimental CHF rabbits.

Host genetic, environmental and viral factors are classified as three categories that determine clinical outcomes of hepatitis B virus (HBV) infection. The objective of this study was to detect the associations between polymorphisms rs346473 and rs346482 in Rho GTPase-activating protein 24 (ARHGAP24) gene and disease progression of HBV infection in Han Chinese population. These two SNPs were found by our DNA pooling using Affymetrix Genome-Wide Human Mapping SNP6.0 Array in HBV carriers, and verified by using TaqMan 7900HT Sequence Detection System with 758 progressed HBV carriers versus 300 asymptomatic HBV carriers (AsC) in a discovery phase and 971 progressed HBV carriers versus 328 AsC in a replication phase. Multivariable logistic regression revealed that individuals with genotype TT at variant rs346473 displayed remarkable correlations with disease progression of HBV infection both in the discovery phase (OR, 2.693; 95% CI, 1.928-3.760; P=6.2×10(-9); additive model) and the replication phase (OR, 1.490; 95% CI, 1.104-2.012; P=9.0×10(-3); additive model). These two SNPs were in strong linkage disequilibrium with D'=0.99 and r (2)=0.951, and haplotype TT disclosed an increased susceptibility to HBV progression (OR, 1.980; 95% CI, 1.538-2.545; P=8.1×10(-8)). These findings suggest that polymorphism rs346473 in the ARHGAP24 gene might be a part of the genetic variants underlying the susceptibility of HBV carriers to disease progression.

Objective:To investigate the effect of stroke center on the treatment time and short-term prognosis in patients with ultra-early acute cerebral infarction (ACI) within 6 h treated with intravenous thrombolysis.Methods:The clinical data of 113 patients with ultra-early ACI treated with intravenous thrombolysis from July 2017 to July 2019 in Chaoyang City Central Hospital, Liaoning Province were retrospectively analyzed. Among them, 40 patients who received intravenous thrombolysis before the establishment of the stroke center (from July 2017 to July 2018) were enrolled as control group, and 73 patients who received intravenous thrombolysis after the establishment of the stroke center (from August 2018 to July 2019) were as study group. The treatment time nodes were recorded, including the time of onset, time of ACI initial diagnosis, time of completing blood collection and index reporting, time of completing CT examination and diagnosis, time of informed consent and time of onset of intravenous thrombolysis. The short-term prognosis indexes were recorded, including the mortality rate, effective rate of intravenous thrombolysis, improvement rate of neurological deficit at discharge and length of stay.Results:The time of ACI initial diagnosis, time of informed consent and time of onset of intravenous thrombolysis in study group were significantly shorter than those in control group: (5.16 ± 1.97) min vs. (10.23 ± 7.80) min, (36.26 ± 21.89) min vs. (56.23 ± 40.97) min and (85.12 ± 35.46) min vs. (126.28 ± 50.14) min, and there were statistical differences ( P<0.01); there were no statistical difference in the time of onset, time of completing blood collection and index reporting and time of completing CT examination and diagnosis between 2 groups ( P>0.05). The mortality rate in study group was significantly lower than that in control group: 1.4% (1/73) vs. 12.5% (5/40), the effective rate of intravenous thrombolysis and improvement rate of neurological deficit at discharge were significantly higher than those in control group: 84.9% (62/73) vs. 67.5% (27/40) and 76.7% (56/73) vs. 55.0% (22/40), and there were statistical differences ( P<0.05); there was no statistical difference in length of stay between 2 groups ( P>0.05). Conclusions:The establishment of standard stroke center can shorten the treatment time and improve the prognosis of patients with ultra-early ACI.

Objective:To investigate the correlation of excessive platelet (Plt) recovery at the first time of achieving morphologic complete remission (CR) after induction chemotherapy with minimal residual disease (MRD) and the clinical features of acute myeloid leukemia (AML).Methods:The clinical data of newly-treated 57 AML patients (except for acute promyelocytic leukemia) who achieved CR after induction chemotherapy in Jinjiang People's Hospital from January 2016 to December 2021 were retrospectively analyzed. A total of 57 newly diagnosed adult AML patients were divided into excessive Plt recovery group (Plt recovery>350×10 9/L) and normal Plt recovery group [Plt recovery: (100-350)×10 9/L] according to the Plt recovery. Meanwhile, the MRD was analyzed by using multiparameter flow cytometry (MFC) in patients achieving CR after receiving 1 course of standard treatment regimen or 1-2 courses of demethylation drugs combined with pre-conditioning regimen. The clinical features and negative rate of MRD between the two groups were compared. Results:Among 57 CR patients, 31 (54.4%) patients had CR with excessive Plt recovery and MFC-MRD negative rate was 67.7% (21/31); 26 (45.6%) had CR with normal Plt recovery and MFC-MRD negative rate was 38.5% (10/26); and the difference in the proportion of MRD negative patients between the both groups was statistically significant ( χ2 = 4.89, P = 0.027). There were no statistically differences in the proportions of patients with different gender, age, WBC at initial diagnosis, Plt, chemotherapy regimen and risk degree classification between the two groups (all P > 0.05). Conclusions:In AML patients, excessive Plt recovery at the first time of achieving morphologic CR after induction chemotherapy is associated with negative MRD, which has a certain value in the judgement of therapeutic effect.

Objective To establish a rat model of glucocorticoid-induced osteoporosis(GIOP)and to explore the interventional effect of the Chinese medicine Fufang Zhenzhu Tiaozhi(FTZ)capsules on regulation of mitogen-activated protein kinase kinase kinase 2(MEKK2)-Wnt coupling and inhibiting β-catenin ubiquitination, and to investigate the effect of FTZ on the bone mineral density and cell osteogenic ability. Methods SPF male rats were randomly divided into normal control group,methylprednisolone group(model group),methylprednisolone + saline group(blank control group) and methylprednisolone + FTZ group(experimental group). The proximal femoral cancellous bone was examined by mi-cro-CT and histopathology,and assessment of expressions of Wnt3a,MEKK2,and β-catenin proteins. Bone mesenchymal stem cells(BMSCs were isolated and treated with serum containing FTZ,stained by alkaline phosphatase and alizarin red. The expressions of osteogenic differentiation-related genes ALP,Runx2 and OCN,the expressions of MEKK2 and β-catenin proteins,and the transcription level of β-catenin/TCF were determined. Results 1)The micro-CT imaging showed that compared with the control group, the BV/TV, Tb.Th and Tb/N expressions were significntly decreased, and Tb/sp in-creased in the experimental group(P<0.05). Region of interest(ROI)three-dimensional reconstruction of trabecular bone in the experimental group showed improvement of bone trabeculae and local bone repair. 2)The pathology using he-matoxylin and eosin staining showed that in the experimental group,the bone trabecular density was higher than that of the model group,and observed a better trabecula morphology. 3)The Wnt3a,MEKK2 and β-catenin expressions in the exper-imental group were significantly increased compared with the model model(P<0.05). 4)After treated with FTZ and BMP2,the result of alkaline phosphatase and alizarin red staining indicated an enhanced osteogenic response(P<0.05) in the GIOP rat models. 5)After treatment with seum containing FTZ,The BMSCs isolated from the GIOP rats enhanced the transcriptional activity of β-catenin/TCF/LEF(P<0.05)and promoted the expression of β-catenin and MEKK2 pro-teins(P<0.05). Conclusions FTZ can ameliorate GIOP by regulating the MEKK2-Wnt coupling and inhibiting the β-catenin ubiquitination,and improve the bone microstructure.

Objective:To investigate the value of amino acid metabolomics in evaluating chemotherapeutic response of patients with ad-vanced breast cancer, the changes in the levels of 32 amino acids in the circulating serum of patients before (baseline) and after the first cycle (prognosis) of chemotherapy were tested. Methods:Seventy-three advanced breast cancer patients with local recurrence and distant metastasis admitted at the Liaoning Cancer Hospital from March 2015 to October 2016 were enrolled. Peripheral blood samples (2 mL) were collected before and after the first cycles of chemotherapy from each patient. Thirty-two amino acids in the se-rum were tested using the ultra-performance liquid chromatography-tandem mass spectrometry (LC-MS/MS). Patients were catego-rized into the improvement or deterioration groups, based on the first imaging test after 2-4 cycles of chemotherapy. The changes in amino acids levels were analyzed in different prognosis groups. Results:The levels of the 32 amino acids ranged 3-180000 pmol/L. Compared to their baseline levels, both glycine and L-glutamine increased in the improvement group, but decreased in the deteriora-tion group. Sarcosine was significantly reduced in the improvement group, while differences in its levels were not obvious in the deteri-oration group. L-threonine, taurine, iminodiacetic acid, and L-glutamic acid were increased in both groups. Conclusion:Changes in the serum levels of glycine, sarcosine, and the other amino acids before and after the first cycles of chemotherapy can predict chemothera-peutic response in patients with advanced breast cancer. Amino acid metabolomics may become a potential biomarker for predicting the efficacy of chemotherapy earlier than that of imaging tests, and thereby help improve therapeutic strategies for advanced breast cancer.

Objective: To explore the changes of protein expression and activity of calcium/calmodulin-dependent protein kinase-II (CaMK-II) in myocardium nucleus and sarcoplasmic reticulum in experimental rabbits with heart failure (HF).
Methods: A total of 16 rabbits were divided into 2 groups: Sham group and HF group, the HF model was established by volume overload plus pressure overload.n=8 in each group and all animals were treated for 7 weeks. Left ventricular structure, hemodynamic parameters and protein expression and activity of CaMK-II in myocardium nucleus and sarcoplasmic reticulum were examined and compared between 2 groups.
Results: Compared with Sham group, HF group presented increased left ventricular mass index (LVMI) (1.32 ± 0.06) g/kg vs (3.61 ± 0.09) g/kg, LVEDP (-1.50 ± 0.50) mmHg vs (23.00 ± 2.37) mmHg, allP<0.05; while decreased left ventricular shorten fraction (37.83 ± 3.58) % vs (17.38 ± 3.13) % and LVEF (71.92 ± 4.56) % vs (38.50 ± 6.07) %, allP<0.05. The protein expression and activity of CaMK-II were both higher in HF group than Sham group, allP<0.05.
Conclusion: Increased protein expression and activity of CaMK-II in myocardium nucleus and sarcoplasmic reticulum might be one of the mechanisms for HF occurrence in experimental rabbits.

Purpose: There is no optimal prognostic model for T-cell lymphoblastic lymphoma (T-LBL). Here, we discussed the predictive value of total metabolic tumor volume (TMTV) and total lesion glycolysis (TLG) measured on 18F-fluorodeoxyglucose positron emission tomography–computed tomography (PET-CT) in T-LBL. Materials and Methods: Thirty-seven treatment naïve T-LBL patients with PET-CT scans were enrolled. TMTV was obtained using the 41% maximum standardized uptake value (SUVmax) threshold method, and TLG was measured as metabolic tumor volume multiplied by the mean SUV. Progression-free survival (PFS) and overall survival (OS) were analyzed by Kaplan-Meier curves and compared by the log-rank test. Results: The optimal cutoff values for SUVmax, TMTV, and TLG were 12.7, 302 cm3, and 890, respectively. A high SUVmax, TMTV, and TLG indicated a shorten PFS and OS. On multivariable analysis, TMTV ≥ 302 cm3, and central nervous system (CNS) involvement predicted inferior PFS, while high SUVmax, TLG and CNS involvement were associated with worse OS. Subsequently, we generated a risk model comprising high SUVmax, TMTV or TLG and CNS involvement, which stratified the population into three risk groups, which had significantly different median PFS of not reached, 14 months, and 7 months for low-risk group, mediate-risk group, and high-risk group, respectively (p < 0.001). Median OS were not reached, 27 months, and 13 months, respectively (p < 0.001). Conclusion Baseline SUVmax, TMTV, and TLG measured on PET-CT are strong predictors of worse outcome in T-LBL. A risk model integrating these three parameters with CNS involvement identifies patients at high risk of disease progression.