Objective To explore the relationship among the severity of coronary disease, c-reaction protein (CRP) and mild renal dysfunction. Methods 64 patients underwent coronary angiography were divided into two groups according to their serum creatinine (cr) levels: normal renal function(cr

Objective To compare the complications of end colostomy and loop colostomy for preventive colostomy,then to evaluate which one is superior to the other.Methods Studies and relevant literatures comparing end colostomy with loop colostomy for defunctiong colostomy were searched by PubMed,Springer and Embase Library.The rates of complications were pooled and compared using a Meta analysis.The risk ratios were calculated with 95％ confidence intervals to evaluate the safety and efficacy of each teachnique.Results Six nonrandomized studies were included,with 1999 patients in total.The Meta-analysis of the non-randomied studies showed a lower risk of stoma retraction (RR:0.21,95％ CI:0.04 ～ 0.99,P =0.05) and stoma prolapse (RR:0.23,95 ％ CI:0.05 ～0.99,P =0.05) in the end colostomy group,but the higher risk of ischemia and necrosis (RR:5.08,95％ CI:1.94 ～ 13.22,P =0.05).No other statistically significant difference was observed for other complications.Conclusions Each type of defuncyioning stoma has its advantages and disadvantages.The study endorses end colostomy stoma over loop colostomy.However,there is not a strong evidence for the superiority of one colostomy over another for colostomy patients.So,large scale RCTs and high quality studies are needed.

Treatment of gynaeeological cancer frequently results in the loss of ovarian function and menopausal syndrome.The most effective treatment is hormone replacement therapy (HRT).According to the current studies,HRT does not increase the risk of recurrence or death in patients with early stage endometrial cancer and uterine leiomyosarcomas. The safety of HRT in ovarian cancer patients is inconclusive. Cervical squamous cell carcinoma, vaginal cancer and vulvar cancer are not contraindications for HRT. Estrogen replacement therapy (ERT) is contraindicated for low-grade endometrial stromal sarcomas. Therefore,after integrated risk assessment and discussion,patients with severe menopausal symptoms can be treated with HRT to improve the quality of life.

Objective To investigate the changes of serum procalcitonin (PCT), interleukin-6 (IL-6) and C reactive protein (CRP) in children with Henoch-Sch?nlein purpura (HSP) combined with surgical complications. Methods From January 2010 to June 2013, 48 children with HSP combined surgical complications were enrolled, the fasting venous blood were obtained in day 1, 3, 5 of admission and before discharge. Meanwhile, 30 healthy children were selected as control. Results Compared with the control group, the levels of serum PCT and IL-6 in day 1, 3, 5 of admission, and the levels of serum CRP in day 1, 3 of admission were higher in children with HSP combined with surgical complications (all P<0.01). The differences of levels of serum PCT, CRP and IL-6 in day 1, 3, 5 of admission and before discharge were statistically signiifcant between surgical group and non-surgical group. All these indicators showed a gradual downward trend. Compared with surgical group, the levels of serum PCT and IL-6 in day 3, 5 of admission and serum CRP in day 5 of admission were signiifcantly lower in non-surgical group (P<0.05). There were positive linear correlations between the level of serum PCT and IL-6, and between the level of PCT and CRP (r=0.48, 0.62, P<0.01). Conclusions The changes of serum PCT, IL-6 and CRP may be associated with the occurrence of surgical complications in children with HSP, monitor these indicators may help to assess the condition and to guide the treatment.

Objective:To evaluate clincal value of preoperative peripheral blood CD4/CD8 and neutrophil to lymphocyte ratio (NLR) in papillary thyroid carcinoma (PTC) coexisted with Hashimoto’s thyroiditis (HT) .Methods:Clinicopathological data of 202 patients diagnosed as PTC treated with operation from Jul.2016 to Jun.2019 were retrospectively analyzed. They were divided into Treatment Group including 94 PTC coexisted with HT and Control Group including 108 thyroid cancer according to the postoperateive pathology report. CD4+ and CD8+ subsets in peripheral blood were analyzed by flowcytometer and blood counts were measured before surgery.Results:There was no significant difference in gender, tumor size, number of lesions or lymph node metastasis between the two goups. In comparison with Control Group, median age was lower (39.5 vs 50.5, P=0.001) and CD4/CD8 raito (1.9731.973 Cvs 1.24141973 CD P=0.001) was higher in Treatment group. There was a higher proportion of bilateral lobe thyroidectomy in Treatment Group (40/94 vs 26/108, P=0.005) . A multivariate model analysis identified CD4/CD8 raito as independent risk factor for incidence of PTC coexisted with HT [ OR=0.035, 95% CI (0.009-0.093) , P=0.001]. The NLR level of thyroid cancer patients was correlated with lateral lymph node metastasis negatively (correlation coefficients=-0.286, P=0.045) . Conclusions:PTC might have some connection with HT mediated by body inmune status. Preoperative NLR level is correlated with lateral lymph node metastasis.

OBJECTIVETo investigate the effect of nuclear factor I-C (NFI-C) on platelet-derived growth factor (PDGF)-induced up-regulation of TGF-β receptor II (TβRII) in dermal fibroblasts.

METHODSA lentiviral vector containing NFI-C sequence (Lenti-GFP-NFI-C) was transfected into a human foreskin fibroblast cell line (HFF-1). Cultured HFF-1 cells, cells transfected with Lenti-GFP-NFI-C, and cells transfected with a negative virus were stimulated with PDGF-BB, and Western blotting and RT-qPCR were used to detect the expression levels of TβRII in the treated cells.

RESULTSPDGF treatment significantly increased the expression level of TβRII in HFF-1 cells (P<0.05). The cells transfected with Lenti-GFP-NFI-C expressed a significantly lower level of TβRII than non-transfected cells in response to PDGF stimulation (P<0.05), but the negative virus showed no such inhibitory effect (P>0.05). No significant difference was found in the expression level of TβRII protein between cells transfected with Lenti-GFP-NFI-C-transfection before PDGF stimulation and the blank control cells.

CONCLUSIONNFI-C can inhibit PDGF-induced up-regulation of TβRII and thus reduce the sensitivity of the dermal fibroblasts to TGF-β.

Cell Line ; Fibroblasts ; drug effects ; Genetic Vectors ; Humans ; Lentivirus ; NFI Transcription Factors ; genetics ; Platelet-Derived Growth Factor ; pharmacology ; Protein-Serine-Threonine Kinases ; metabolism ; Proto-Oncogene Proteins c-sis ; Receptors, Transforming Growth Factor beta ; metabolism ; Transfection ; Transforming Growth Factor beta ; pharmacology ; Up-Regulation

Objective To compare the treatment effect and study the efficacy of the elastic intramedullary nails for the treatment of primary aneurysmal bone cysts in limbs.Methods Twenty one children with primary aneurysmal bone cystsadmitted to and treated in Shanghai Children's Hospital from 2012 January to 2016 June were studied retrospectively.There were 18 males and 3 females,with overall age of 1-14 years old and median age of 5 years old.The lesions were mainly located in the femur,tibia,fibula and humerus.They were divided into 2 groups according to the treatment plan.The patients of the experimentgroup received curettage and bone grafts with high-speed burring and elastic intramedullary nail.The patients of the control group received curettage and bone grafts with high-speed burring.According to the imaging results (Neer grading) and MSTS functional evaluation,the curative effect of the children of the 2 groups were analyzed statistically.Results The cure children were followed up for more than 2 yearswith follow-up time range of 24-48 months (mean value of 32.29±8.22 months).Five patients had a recurrence,with mean postoperative recurrence time of 10±2.66 months.A total of 5 patients of the control group perceived curettage and bone grafts with high-speed burring and a total of 16 patients of the experimentgroup received curettage and bone grafts with high-speed burring andelastic intramedullary nail.According to the imaging results (Neer grading) and MSTS function evaluation,Neer grading was 3 cases for grade Ⅰ,0 case for grade Ⅱ,1 case for grade Ⅲ and 12 cases for grade Ⅳ in the experiment groups.That was 1 case for grade Ⅰ,1 case for grade Ⅱ,2 cases for grade Ⅲ and 1 case for grade Ⅳ in the control group.The ABC recurrence rate of experimental group (18.8％) was lower than matched group (40％),while there was no significant difference.We found that MSTS functional scores of experimental group was significantly higher than the matched group (28.88±2.22 vs 20.80± 10.38,t=3.058,P=0.006).According to postoperative MSTS functional evaluation,we found that even the patients in the study group with recurrencewere also able to participate in physical exercises,without further occurrence of pathological fracture and the postoperative life quality was greatly improved.Conclusion Curettage and bone grafts with high-speed burring andelastic intramedullary nail can significantly reduce the recurrence rate of primary aneurysmal bone cysts in the four limbs.Meanwhile the MSTS function evaluation of the recurrence cases in this group all achieve to a satisfactory level.The reason of recurrence may be correlated to patient age and the distance between the focus and epiphyseal plate.Therefore,an appropriate treatment protocol is helpful in reducing the relapse rate and improving the patients' postoperative living quality.

Objective:To explore the prognostic value of the serum concentration of human soluble stromelysin-2(sST2)combined with ultrasonic left ventricular diastolic function parameters for elderly patients with septic shock.Methods:This prospective study involved 150 elderly patients with septic shock admitted to the intensive care unit(ICU)of the First Hospital of Jiaxing between May 2019 and May 2022.Data on the following parameters were recorded on days 1, 3, 5, and 7 in the ICU: sST2 concentration, mitral early-diastolic inflow peak velocity(E), mitral late-diastolic inflow peak velocity(A), E/A ratio, early diastolic mitral annular velocity(e'), and E/e' ratio.According to the 28-day prognostic outcome obtained during follow-up, patients were divided into a survival group and a death group to compare differences in values of the above parameters between the two groups and at different time points.Logistic regression was used to analyze independent risk factors for 28-day mortality.The receiver operating characteristic(ROC)curve was used to analyze the predictive value for 28-day mortality, and further risk stratification was performed according to optimal cut-off values to compare differences in 28-day mortality under different risk stratification methods.The Kaplan-Meier survival curve was used to compare 28-day cumulative survival under different risk stratification methods and analyze the predictive value of the combination of the parameters for 28-day mortality.Results:On day 5 following ICU admission, e' was lower and E/e' and sST2 were higher in the death group than in the survival group.Univariate and multivariate Logistic regression analysis suggested that sST2(odds ratio: 1.010, P<0.001)was an independent risk factor for 28-day mortality in elderly patients with septic shock.sST2 had a sensitivity of 50.2%, a specificity of 79.1%, and an area under the curve of 0.660 for predicting 28-day mortality in patients with septic shock.The sST2 concentration was 89.3 μg/L on day 5 after ICU admission, which was the clinical cutoff point for predicting 28-day mortality.Based on the risk stratification of sST2 levels, the 28-day mortality rate was higher in the sST2>89.3 μg/L group than in the sST2≤89.3 μg/L group.Kaplan-Meier survival analysis showed that the 28-day cumulative survival rate was significantly lower in the sST2>89.3 μg/L group than in the sST2≤89.3 μg/L group(44.0% vs.66.7%, log-rank test: χ2=9.101, P=0.003).The receiver operating characteristic curve showed that the combination of sST2, e', and E/e' significantly improved the prediction efficiency of 28-day mortality in elderly patients with septic shock, with an area under the curve of 0.844, a sensitivity of 89.7%, and a specificity of 66.5%. Conclusions:sST2 is an independent risk factor for 28-day mortality in elderly patients with septic shock.When combined with e' and E/e', sST2 can more accurately evaluate the survival prognosis of these patients.

Objective To construct a regulatory network of competing endogenous RNA(ceRNA)with prognostic value for bladder urothelial carcinoma(BLCA),and analyze the relationship between key messenger RNA(mRNA)and immune function.Methods The UCSC Xena database was used to download mRNA expression data from 404 BLCA patients and 28 normal individuals and key mRNAs were screened by differential analysis.ENCORI database was utilized to search microRNAs(miRNAs)that bind to key mRNAs and all long non-coding RNAs(LncRNAs)that bind to miRNAs.The expression data of miRNA and LncRNA were downloaded from TCGA database,co-expression analysis was performed to identify key mRNA with all miRNAs and miRNA with all LncRNAs,and thus key miRNAs and LncRNAs were screened out.Survival analysis was conducted based on the differences in expression levels of these key mRNAs,miRNAs,and LncRNAs between tumor patients and normal individuals,and finally a ceRNA regulatory network was constructed.The correlation between key mRNAs and immune cells,immune checkpoints(CD274,PDCD1 and CTLA4),and immune cell marker genes(IG)was analyzed using the TIMER 2.0 database.Results A total of 22 key mRNAs were screened,with the most significant difference being proline 3-hydroxylase 4(P3H4).The expression of P3H4 in patients with BLCA was high,and survival time was shorter in patients with high expression.A sum of 33 miRNAs and 14 LncRNAs were screened using the key mRNAs as the central link.Through co-expression analysis and survival analysis,hsa-miR-151a-3p and MIR100 HG were identified as the key miRNA and key LncRNA with prognostic value.The differences in the above analysis results were statistically significant(all P＜0.05).Based on these findings,a ceRNA regulatory network consisting of 1 mRNA,1 miRNA,and 1 LncRNA was constructed.Immunoassay firstly revealed a significant positive correlation between double positive T cells and P3H4 expression in the tumor microenvironment of BLCA.Moreover,there were 3 types of immune cells(tumor-associated neutrophils,and tumor-associated macrophages,dendritic cells),3 immune checkpoints(CD274,PDCD1,CTLA4),and 15 IGs with significant correlation with P3H4.These differences were statistically significant(all P＜0.01).Conclusion This study could help to reveal the progression mechanism of BLCA.The constructed ceRNA network and immune analysis can offer new insights into potential biological targets and immunotherapy directions for the diagnosis,treatment,and prediction of BLCA patients.

OBJECTIVETo explore the effects of blocking two sites of TGF-β/Smads signaling on the formation of scar-related proteins in human skin fibroblasts.

METHODSTwo lentivirus vectors encoding soluble TGF-β receptor II (sTβRII) and mutant Smad 4-Smad 4ΔM4 were respectively transfected into human skin fibroblast cell line human foreskin fibroblast 1 (HFF-1) cells with the optimum multiplicity of infection (MOI) of 50. The protein expressions of sTβRII and Smad 4ΔM4 of the two types of transfected cells were determined by Western blotting so as to compare with those of the untransfected cells. The HFF-1 cells were divided into 6 groups as named below according to the random number table, with 6 dishes in each group, 1×10(4) cells per dish. Co-transfection group, transfected with the two previous lentivirus vectors, mixed with the ratio of 1:1 and MOI of 50, and then stimulated with 5 ng/mL TGF-β1 for 72 h; sTβRII group, transfected with lenti-sTβRII with MOI of 50, with the other treatment as above; Smad 4ΔM4 group, transfected with lenti-Smad 4ΔM4 with MOI of 50, with the other treatment as above; negative virus group, transfected with empty lentivirus vector, with the other treatment as above; positive control group, stimulated with 5 ng/mL TGF-β1 for 72 h; and blank control group, conventionally cultured without any other treatment. After stimulation, Western blotting and real-time fluorescent quantitative RT-PCR were respectively used to determine the protein and mRNA expressions of fibronectin in cells of each group. ELISA and Sircol collagen assay were respectively used to determine the protein expressions of connective tissue growth factor (CTGF) and total collagen in the cell culture supernate of each group. Data were processed with one-way analysis of variance and SNK-(q test).

RESULTS(1) HFF-1 cells transfected with lenti-sTβRII and HFF-1 cells transfected with lenti-Smad 4ΔM4 respectively expressed higher levels of sTβRII protein and Smad 4ΔM4 protein compared with those of untransfected cells, confirming that HFF-1 cells transfected with the two lentivirus vectors can efficiently express the target proteins. (2) There were statistically significant differences in the protein and mRNA expressions of fibronectin in cells of the 6 groups (with F values respectively 53.536 and 24.365, P values below 0.001). The protein and mRNA expressions of fibronectin in cells of positive control group (respectively 1.60 ± 0.18 and 1.99 ± 0.40) were similar with those of negative virus group (respectively 1.60 ± 0.15 and 1.94 ± 0.28, with q values respectively 0.091 and 0.419, P values above 0.05), and they were significantly higher than those of the rest 4 groups (with q values from 5.245 to 18.228, P values below 0.05). The protein and mRNA expressions of fibronectin in cells of co-transfection group (respectively 0.60 ± 0.05 and 0.70 ± 0.11) were significantly lower than those of sTβRII group (respectively 0.89 ± 0.13 and 1.24 ± 0.17) and Smad 4ΔM4 group (respectively 0.91 ± 0.14 and 1.28 ± 0.19, with q values from 3.964 to 4.294, P values below 0.05). (3) There were statistically significant differences in the protein expressions of CTGF and total collagen in the cell culture supernate of the 6 groups (with F values respectively 107.680 and 38.347, P values below 0.001). The protein expressions of CTGF and total collagen in the cell culture supernate of positive control group were similar with those of negative virus group (with q values respectively 1.106 and 0.491, P values above 0.05), and they were significantly higher than those of the rest 4 groups (with q values from 6.414 to 26.420, P values below 0.05). The protein expressions of CTGF and total collagen in the cell culture supernate of co-transfection group were significantly lower than those of sTβRII group and Smad 4ΔM4 group (with q values from 3.424 to 7.143, P values below 0.05).

CONCLUSIONSIn human skin fibroblasts, blockage of two sites of TGF-β/Smad signaling can reduce the expression of scar related proteins which are up-regulated by TGF-β1 to a greater extent than that of blocking one single site.

Cicatrix ; Connective Tissue Growth Factor ; Fibroblasts ; metabolism ; Genetic Vectors ; Humans ; Lentivirus ; genetics ; Protein-Serine-Threonine Kinases ; RNA, Messenger ; genetics ; Receptors, Transforming Growth Factor beta ; Signal Transduction ; drug effects ; Smad Proteins ; genetics ; metabolism ; Smad Proteins, Inhibitory ; genetics ; Transfection ; Transforming Growth Factor beta ; pharmacology ; Transforming Growth Factors