Purpose To explore the predictive value of myocardial perfusion in assessing myocardial systolic function recovery after primary percutaneous coronary intervention (PPCI),in order to improve poor prognosis by early detection of myocardial no-reflow.Materials and Methods Forty nine patients with acute myocardial infarction (AMI) who had received PPCI were chosen as subjects.All the patients underwent two-dimensional strain (2DS) images and resting real-time myocardial contrast echocardiography (MCE) within one week after surgery,and 2DS measurement was repeated after three months.2DS imaging was used to acquire longitudinal peak systolic strain (LPSS) at all myocardial segments.Based on the graphs of LPSS,left ventricular myocardium was divided into normal contractile function myocardium (red) and impaired contractile function myocardium (light red,blue).According to the myocardial perfusion scores (MPS) qualitatively assessed by MCE visual interpretation,the myocardia with impaired systolic function were categorized into three groups with different perfusion level.The changes of LPSS within one week and three months after surgery (△ LPSS) among the three groups were analyzed.The correlation between MPS and LPSS within one week and three months after PPCI was also analyzed respectively.Results The △ LPSS increased significantly among the three groups with the improvement of myocardial perfusion level [(-5.78±6.23)％ vs.(-4.37±6.60)％ vs.(-1.21 ±4.77)％,all P＜0.05].The MPS measured one week after PPCI was both positively correlated with the LPSS detected within one week after surgery and that after three months (r=0.47,0.58,P＜0.001).The consistence of myocardial perfusion scores given by two evaluators was good (Kappa=0.785,P＜0.05).Conclusion The level of myocardial perfusion after PPCI in patients with AMI is closely related to regional myocardial systolic function,and the improvement of myocardial perfusion can forecast the recovery of regional systolic function.

Objective To evaluated the value of myocardial perfusion before delayed percutaneous coronary intervention (PCI) for predicting the recovery of systolic function of patients with acute myocardial infarction (AMI).Methods A total of 64 patients with AMI receiving delayed PCI treatment in the First People's Hospital of Foshan from January 2014 to June 2015 were selected.One day prior to delayed PCI,all of the patients underwent two dimensional strain to measure the longitudinal peak systolic strain (LPSS) of each left ventricular segment and the global longitudinal strain (GLS) of the left ventricle.The myocardial perfusion score (MPS) and the perfusion score index (PSI) were measured by myocardial contrast echocardiography (MCE).Left ventricular myocardial perfusions were classified as good,reduced,or absent.The two dimensional strain measurements were again conducted at 6 months after the delayed PCI to assess LPSS and GLS.The change of GLS and LPSS between one day prior to delayed PCI and six months after delayed PCI was assessed by paired t-test.The differences of LPSS among good,reduced,or absent myocardial perfusion groups were analyzed by one-way ANOVA.LSD-t test was used to compare in pairs of groups that had different values.The correlations between PSI and GLS,MPS and LPSS were assessed by Spearman's rank-correlation test.Results The GLS of all patients were higher at six months after delayed PCI than at one day prior to delayed PCI [(-15.39±7.80)％ vs (-12.44±8.38)％,t=14.398,P ＜ 0.001].The LPSS of myocardial perfusion in good,reduced and absent groups at one day prior to delayed PCI were (-2.64±5.60)％,(-6.19±6.87)％ and (-12.07±5.86)％,respectively.The LPSS of myocardial perfusion in good,reduced and absent groups at six months after delayed PCI were (-2.97 ± 4.93)％,(-11.38± 7.26)％ and (-15.82 ± 5.97)％,respectively.The myocardial LPSS of left ventricular segment with good or reduced perfusion was significantly higher at six months after delayed PCI (t=13.013,10.821,both P ＜ 0.001),but the LPSS of left ventricular segment with absent perfusion was similar to that of pre-PCI.Whether at one day prior to delayed PCI or six months after delayed PCI,there were significant differences in LPSS parameters among the three groups (at one day prior to delayed PCI,myocardial perfusion absent vs reduced or good,t=4.201 and 11.771,both P ＜ 0.001;myocardial perfusion reduced vs good,t=12.561,P ＜ 0.001;at six months after delayed PCI,myocardial perfusion absent vs reduced or good,t=9.714 and 15.646,both P ＜ 0.001;myocardial perfusion reduced vs good,t=9.254,P ＜ 0.001).The LPSS both at one day prior to delayed PCI and six months after delayed PCI in myocardial perfusion good group ＞ those of myocardial perfusion reduced group ＞ those of myocardial perfusion absent group.PSI was positively correlated with GLS at both one day prior to delayed PCI and six months after delayed PCI (r=0.69,0.72,both P ＜ 0.001).MPS was positively correlated with LPSS at both one day prior to delayed PCI and six months after delayed PCI (r=0.49 and 0.45,both P ＜ 0.001).Conclusion Myocardial perfusion before delayed PCI,monitored by MCE,is correlated well with myocardial systolic function,and may be used to predict the recovery of myocardial systolic function after delayed PCI.

Objective To comprehensively evaluate the clinical efficacy,safety and economic benefits of atorvastatin and fluvastatin in regulating dyslipidemia.Methods The clinical randomized controlled trials (RCTs) for comparing clinical efficacy of atorvastatin and fluvastatin on regulating dyslipidemia were retrieved from databases,including Cochrane Library,PubMed,Medline,Embase,Wiley,Springer,CNKI,Wanfang and VIP,till June 2016.Data were evaluated by two reviewers independently according to the Jadad standard.The changes of low density lipoprotein cholesterol (LDL-C),high density lipoprotein cholesterol (HDL-C),total cholesterol (TC) and triglyceride (TG) before and after treatment were extracted to perform Meta-analysis by using RevMan5.0 software.The economic evaluation was carried out,as well.Results A total of 7 RCTs were included,including 684 cases of patients treated with fluvastatin and 2 208 cases of patients treated with atorvastatin.The patients were spitted into two subgroups according to the same or different maximum dose of atorvastatin and fluvastatin.The results indicated that the effects of atorvastatin on down-regulating LDL-C,TC and TG levels were significantly better than those of fluvastatin,the differences were statistically significant (Z=23.63、23.32、5.50,P＜0.000 01).No significant difference was found in regulating HDL-C level between atorvastatin and fluvastatin.Conclusion Compared with fluvastatin,atorvastatin is more effective to regulate levels of LDL-C,TC and TG,but there is no significant difference in up-regulating HDL-C level.Additionally,application of atorvastatin is more economicallv effective.

Objective:To evaluate left ventricular systolic function and myocardial perfusion in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI) by left ventricular pressure-strain loop (PSL).Methods:From August 2020 to December 2020, 47 patients with AMI admitted to the Intensive Care Unit of Cardiovascular Department of the First People′s Hospital of Foshan and treated with PCI were selected. Myocardial contrast echocardiography (MCE) and conventional echocardiography were performed within 72 hours after operation (T1 phase) and conventional echocardiography was repeated 3 months later (T2 phase). Myocardial perfusion scores (MPS) of left ventricular segments were obtained by MCE and the overall myocardial perfusion score index (PSI) was calculated. According to PSI, the patients were divided into good perfusion group and poor perfusion group. Conventional ultrasonic parameters and two-dimensional global longitudinal strain (2D-GLS) were collected. Left ventricular PSL analyzed in off-line EchoPAC software was used to evaluate the left ventricular myocardial work index, including global work index (GWI), global constructive work (GCW), global waste work (GWW), global work efficiency (GWE). The differences of parameters between patients with different perfusion levels and the change of parameters with time at the same perfusion level were compared. ROC curves were used to analyze the diagnostic values of strain parameters and myocardial work parameters in patients with hypoperfusion.Results:There were no significant differences in conventional ultrasound parameters between groups in T1 and T2 phases (all P>0.05), while there were significant differences in 2D-GLS and myocardial work parameters (except GWI in T2 phase) (all P<0.05). The absolute values of 2D-GLS and myocardial work parameters (except GWW ) were higher than those in T1 phase (all P<0.05). There was no significant difference in GWW ( P>0.05), but it decreased in good perfusion group while increased in poor perfusion group over time. ROC curve analysis showed that 2D-GLS, GWI, GCW and GWE had high area under the curve. Conclusions:Left ventricular PSL provides a new sensitive method for the evaluation of cardiac function in patients with AMI after PCI, and is expected to become a new index for the preliminary evaluation of microcirculation.

Objective:To study the risk factors of intra-abdominal infection after hepatectomy in patients with primary liver neoplasms.Methods:The clinical data of patients with primary liver neoplasms who underwent hepatectomy at the Department of Hepatobiliary Surgery, Mengchao Hepatobiliary Hospital of Fujian Medical University from January 2019 to December 2021 were retrospectively analyzed. Of 1 229 patients who were enrolled, 48 patients developed postoperative abdominal infection. There were 45 males and 3 females, with age of 58.0 (45.0, 66.0) years old in the infected group. Forth-eight patients without postoperative abdominal infection were selected based on the random number formula to be allocated to the uninfected group to include 44 males and 4 females with age of 58.5 (48.5, 64.8) years old. The general data, preoperative and postoperative laboratory test results, types of liver neoplasms and hepatectomy, pathogenic infective microorganisms and their drug sensitivity tests were collected. Univariate analysis was used to analyze the related factors of intra-abdominal infection after hepatectomy, and significant factors were included in logistic multivariate regression analysis.Results:Of 24 pathogenic strains which were detected in the 143 samples of abdominal infection, the positive rate of culture was 16.78%(24/143). Multivariate logistic regression analysis showed that prealbumin <180 mg/L ( OR=3.757, 95% CI: 1.117-12.634), intraoperative blood transfusion ( OR=6.363, 95% CI: 1.301-31.113) and the time of drainage tube placement ≥7 d ( OR=31.098, 95% CI: 6.906~140.029) were independent risk factors of intra-abdominal infection after hepatectomy. Conclusion:Prealbumin <180 mg/L, intraoperative blood transfusion and the time of drainage tube placement ≥7 d were independent risk factors of intra-abdominal infection after hepatectomy for primary liver neoplasms.

OX40 is a costimulatory receptor that is expressed primarily on activated CD4⁺, CD8⁺, and regulatory T cells. The ligation of OX40 to its sole ligand OX40L potentiates T cell expansion, differentiation, and activation and also promotes dendritic cells to mature to enhance their cytokine production. Therefore, the use of agonistic anti-OX40 antibodies for cancer immunotherapy has gained great interest. However, most of the agonistic anti-OX40 antibodies in the clinic are OX40L-competitive and show limited efficacy. Here, we discovered that BGB-A445, a non-ligand-competitive agonistic anti-OX40 antibody currently under clinical investigation, induced optimal T cell activation without impairing dendritic cell function. In addition, BGB-A445 dose-dependently and significantly depleted regulatory T cells in vitro and in vivo via antibody-dependent cellular cytotoxicity. In the MC38 syngeneic model established in humanized OX40 knock-in mice, BGB-A445 demonstrated robust and dose-dependent antitumor efficacy, whereas the ligand-competitive anti-OX40 antibody showed antitumor efficacy characterized by a hook effect. Furthermore, BGB-A445 demonstrated a strong combination antitumor effect with an anti-PD-1 antibody. Taken together, our findings show that BGB-A445, which does not block OX40-OX40L interaction in contrast to clinical-stage anti-OX40 antibodies, shows superior immune-stimulating effects and antitumor efficacy and thus warrants further clinical investigation.
Mice ; Animals ; Receptors, Tumor Necrosis Factor/physiology* ; Receptors, OX40 ; Membrane Glycoproteins ; Ligands ; Antibodies, Monoclonal/pharmacology* ; Antineoplastic Agents/pharmacology*

Acidosis, regardless of hypoxia involvement, is recognized as a chronic and harsh tumor microenvironment (TME) that educates malignant cells to thrive and metastasize. Although overwhelming evidence supports an acidic environment as a driver or ubiquitous hallmark of cancer progression, the unrevealed core mechanisms underlying the direct effect of acidification on tumorigenesis have hindered the discovery of novel therapeutic targets and clinical therapy. Here, chemical-induced and transgenic mouse models for colon, liver and lung cancer were established, respectively. miR-7 and TGF-β2 expressions were examined in clinical tissues (n = 184). RNA-seq, miRNA-seq, proteomics, biosynthesis analyses and functional studies were performed to validate the mechanisms involved in the acidic TME-induced lung cancer metastasis. Our data show that lung cancer is sensitive to the increased acidification of TME, and acidic TME-induced lung cancer metastasis via inhibition of miR-7-5p. TGF-β2 is a direct target of miR-7-5p. The reduced expression of miR-7-5p subsequently increases the expression of TGF-β2 which enhances the metastatic potential of the lung cancer. Indeed, overexpression of miR-7-5p reduces the acidic pH-enhanced lung cancer metastasis. Furthermore, the human lung tumor samples also show a reduced miR-7-5p expression but an elevated level of activated TGF-β2; the expressions of both miR-7-5p and TGF-β2 are correlated with patients' survival. We are the first to identify the role of the miR-7/TGF-β2 axis in acidic pH-enhanced lung cancer metastasis. Our study not only delineates how acidification directly affects tumorigenesis, but also suggests miR-7 is a novel reliable biomarker for acidic TME and a novel therapeutic target for non-small cell lung cancer (NSCLC) treatment. Our study opens an avenue to explore the pH-sensitive subcellular components as novel therapeutic targets for cancer treatment.