Objective Glycosylated hemoglobin A1c (HbA1c) has become one of key components in new American Diabetes Association (ADA) diagnostic criteria for pre-diabetes and diabetes,which is not included in the World Health Organization (WHO) 1999 criteria.Thus,we aimed to compare the two criteria in diagnosis of pre-diabetes and diabetes in patients with non-acute coronary syndrome (non-ACS) in Chinese.Methods Non-ACS patients who had undergone elective coronary angiography (CAG) in Peking Union Medical College Hospital without previously known diabetes were enrolled consecutively from October 2013 to April 2014.Fasting plasma glucose (FPG),2-hour plasma glucose after a 75 g oral glucose load (2hPG) and HbA1c levels before CAG were measured.Both WHO and new ADA criteria were applied for pre-diabetes and diabetes screening.Results One hundred and thirty-nine patients were included,aged (61.9 ± 10.1) years and 88(63.3％) were men among them.According to WHO 1999 criteria,34 patients (24.4％) were normal glucose regulation,57 (41.0％) pre-diabetes (including one impaired fasting glucose and 56 impaired glucose tolerance),and 48 (34.5％) newly diagnosed diabetes mellitus.ADA criteria identified 12 more patients with pre-diabetes and eight more with diabetes than WHO criteria.Compared with those diagnosed by both criteria,the proportion of women was higher in diabetic patients diagnosed with HbA1c alone.They also had lower hemoglobin [(124.88 ± 17.74) g/L vs (140.15 ± 15.17) g/L,P =0.013] and higher fibrinogen levels [(3.47 ± 0.41) g/L vs (3.02 ± 0.68) g/L,P =0.024] than those diagnosed by both criteria.Conclusion Compared with WHO 1999,new ADA criteria with HbA1c assessment are able to identify more previously unknown pre-diabetes and diabetes patients.Measurement of HbA1c might be needed to carry out routinely for screening patients with glucose metabolism abnormalities before elective CAG.

65 mm Hg and CVP between 10-14 cm H2O. In control group no AHHD was performed. Blood samples and urine specimens were obtained before anesthesia (T1), at the end of operation (T2 ) and 72 h after operation (T3 ) for determination of blood and urinary creatinine (BCr, UCr) , blood sodium (BNa) , urinary sodium (UNa), blood urea nitrogen (BUN) , urinary ?1-microglobulin (?1-MG), urinary albumin, urinary immuno-globulin G, creatinine clearance (CCr), and fractional sodium clearance (FENa) . Results BUN, urinary albumin, urinary immuno-globulin G, CCr and FENa were normal during the study in both groups. Urinary concentration of ?1-MG was significantly increased at T2 as compared with the baseline value before anesthesia (T, ) and declined at T3 but was still significantly higher than that at T1 . There was no significant difference between the two groups in terms of the parameters mentioned above. Conclusion AHHD with 6% HES (200/0.5) has no detrimental effects on renal function in patients with normal function.

Objective To investigate the effects of miR-135a on HOXA10 expression,proliferation and apoptosis of SKOV3 cells.Methods (1) Through computer-aided algorithms,the predicted target gene of miR-135a (HOXA10)were determined.(2) miR-135a mimics,miR-135a inhibitor and negative control were transfected into SKOV3 cells,respectively.Reverse transcription (RT)-PCR,western blot analysis were used to examine the expression levels of HOXA10 at different times (24,48 and 72 hours).(3) A luciferase reporter assay was used to confirm the direct regulation between miR-135a and HOXA10.(4) SKOV3 cells proliferation at different times (24,48 and 72 hours) was detected by methyl thiazolyl tetrazolium(MTT) assay [quantified by absorbance(A)].Western blot was used to examine the expression of apoptosis-associated protein bcl-2,bax and caspase-3 in SKOV3 cells after 48 hours transfection.Results (1) HOXA10 was predicted to be the target gene of miR-135a by computer-aided algorithms.(2) RT-PCR shown that HOXA10 mRNA levels were decreased over time (24,48 and 72 hours) after miR-135a mimics transfectionin SKOV3 cells (0.94 ±0.04 vs 0.78 ±0.03 vs 0.70 ±0.03,P ＜0.05).While,the expression of HOXA10 mRNA was increased over time after miR-135a inhibitor transfection (1.14 ± 0.05 vs 1.16 ±0.03 vs 2.60 ±0.08,P ＜0.05).After transfected with miR-135a mimics or miR-135a inhibitor over 48 and 72 hours,the HOXA10 expression levels in SKOV3 cells were significantly lower or higher than each control group,respectively (all P ＜ 0.01).Western blot analysis of HOXA10 expression in SKOV3 cells confirmed the results of RT-PCR detected.(3) After cotransfection of miR-135a plasmid and pMIR-REPORT luciferase plasmid containing HOXA10,luciferase reporter assays showed that the luciferase activity reduced by 67.8％ (P ＜0.01).(4) MTT showed that SKOV3 cells growth after miR-135a mimics transfection for 48 and 72 hours were significantly lower than those in control group (0.38 ± 0.03 vs 0.52 ± 0.05,0.67 ±0.05 vs 0.75 ± 0.06 ; respectively,all P ＜ 0.05).While,SKOV3 cells transfected with miR-135a inhibitor for 72 hours grew significantly faster than that in control group (0.95 ± 0.05 vs 0.75 ± 0.06,P ＜ 0.01).After miR-135a mimics transfection,the level of bcl-2 protein was significantly lower than that in control group (0.28 ±0.06 vs 0.76 ±0.09,P ＜0.01).The activity of caspase-3 was significantly higher than that in control group (115.0 ± 2.4 vs 95.4 ± 2.1,P ＜ 0.01).While,there was no statistical difference of bax expression (P =0.142).However,after miR-135a inhibitor transfection,the expression level of bcl-2 protein was significantly higher than that in control group (0.92 ± 0.03 vs 0.76 ± 0.09,P =0.037) and the activity of caspase-3 was significantly lower than that in control group (59.5 ± 4.1 vs 95.4 ± 2.1,P ＜ 0.01).There was also no statistical difference of bax expression (P =0.066).Conclusion miR-135a may play an important role in cell proliferation and apoptosis of ovarian cancer cells by regulating HOXA10 and its downstream pathways.

Objective To explore the relationship between the four different molecular subtypes of locally advanced breast cancer(LABC) and the clinical effect of neoadjuvant chemotherapy containing docetaxel and anthracyclines on breast cancer. Methods The record of 68 patients with LABC who were treated with the therapeutic scheme was reviewed. Breast cancer molecules were diagnosed by core needle biopsy through IHC and were divided into four subtypes. After 3 to 5 courses of treatment, the relationship of molecular subtype and clinical effects was analyzed. Results Univariate analysis showed that absence of estrogen receptor (ER) expression and size of tumor (≤5cm) were predictive factors for clinical complete response (cCR) (P<0.05).Over expression of HER-2 and molecular subtypes were predictive for pathologic complete response (pCR) (P<0.05). pCR rate of HER2+/ER- subtype in this therapeutic scheme was, higher than that of other subtypes and pCR rate of Luminal A subtype was the lowest. Multivariate analysis showed that molecular subtypes cant be the predictive factors for this therapeutic scheme (P>0.05) and only HER-2 (P<0.05) was the independent variable in predicting pCR for this therapeutic scheme. Conclusion Molecular subtypes can not independently predict pCR for neoadjuvant chemotherapy regimen containing docetaxel and anthracyclines.

OBJECTIVETo explore an ideal surgical method for nipple hypertrophy correction.

METHODSFrom July 2008 to June 2011, 44 nipple reductions were performed for 22 women (44 sides) by using the modified Z-shaped incision technique. The incision consists of two circles, one quadrangle and one triangle located on the top, body and base of the nipple. The nipple's height was decreased and the nipple diameter and base area were reduced. Bilateral nipples were designed symmetrically.

RESULTS22 cases(44 sides) were treated with primary healing. The mean diameter of the nipple was reduced to (9.8 +/- 1.6) mm from (17.6 +/- 3.4) mm, the average height from (18.8 +/- 3.6) mm to (8.2 +/- 1.4) mm, with the patient supine. All the patients were followed up for 14 months to 4 years with satisfactory results. No nipple necrosis, infection and numb happened. 20 patients completed the self-designed survey scale 1 year after operation, of which 4 cases achieved normal lactation, and the remaining patients didn't have childbirth and breastfeeding yet.

CONCLUSIONSThe modified Z-shaped incision technique could reduce the height, diameter, and most importantly, reduce the basal shape of all types of hypertrophic nipple to create a desired new cylindrical nipple without affection of nipple sensation and function.

Adolescent ; Adult ; Female ; Humans ; Hypertrophy ; Mammaplasty ; methods ; Nipples ; pathology ; surgery ; Treatment Outcome ; Young Adult

Background and purpose:Neuropilin-1 (NRP1), a vascular endothelial growth factor (VEGF) receptor, plays an important role in tumor angiogenesis and tumor cell migration. The purpose of this study was to de-termine the correlation between NRP1 expression and sensitivity to ifrst-line platinum-based chemotherapy in patients with advanced non-small cell lung cancer (NSCLC), and between NRP1 expression and survival.Methods:NRP1 ex-pression in tumor tissues of 104 advanced NSCLC patients treated with ifrst-line platinum-based regimen was detected by immunohistochemisty.A chi-square test and logistic regression model were used to analyze the relationship between NRP1 expression and the chemotherapy response rate. Kaplan-Meier and Cox proportional hazard regression models were used to analyze the effect of NRP1 expression on patient survival.Results:Among the 104 patients, 56 (53.8%) had high expression of NRP1. High expression of NRP1 was not related to age, gender, histological type, degree of differentiation, performance status, and chemotherapy regimen. The chemotherapy response rate was significantly higher in patients with low NRP1 expression than in patients with high expression (43.8% vs23.2%,P=0.026). The low NRP1 expression was signiifcantly associated with longer progression-free survival (4.6 monthsvs3.0 months, P=0.001 for log-rank test,χ2=11.273) and overall survival (11.5 monthsvs9.2 months,P=0.000 for log-rank test,χ2=14.392) as compared with high NRP1 expression. Multivariate analysis showed that high expression of NRP1 was an independent predictor for the chemotherapy response rate and overall survival in patients with advanced NSCLC.Conclusion:NRP1 expression is associated with response rate and survival in advanced NSCLC patients treated with ifrst-line plati-num-based chemotherapy. NRP1 expression may be a potential biomarker for predicting chemosensitivity and prognosis in patients with advanced NSCLC.

Objective To analyze the risk factors of pulmonary hypertension in patients with systemic lupus erythematosus (SLE-PH).Methods Echo data of 598 SLE patients were collected,clinical characteristics of 107 suspected SLE-PH (PASP ≥40 mmHg,estimated by Echo) and 64 suspected moderate to severe PH (PASP ≥50 mmHg) were retrospectively analyzed.T-test,x2-test and Logisticregression were used for statistical analysis.Results Out of 598 patients 70.7％(423 patients) had abnormal Echo findings,and pericardial effusion in 45.5％(272 cases),valvular insufficiency in 31.3％(187 cases),suspected PH in 17.9％(107 cases),left ventricular enlargement in 5.9％(35 cases),left ventricular hypertrophy in 4.3％(26cases).In addition 1.7％ had mitral valve prolapse,1.5％ had mitral valve vegetation,and right ventricular enlargement in 6.5％(39 cases),LVEF＜50％ in 6.0％(36 cases),right ventricular systolic dysfunction in 2.2％(13 cases).Logistic regression analysis showed Raynaud's phenomenon (OR=3.205,95％CI:1.911-5.375,P=0.000),thrombocytopenia (OR=1.680,95％CI:1.049-2.689,P=0.031),hyperuricemia (OR=3.643,95％CI:2.154-6.164,P=0.000),and anti-U1RNP antibody positivity (OR=1.777,95％CI:1.099-2.874,P=0.019)were independent risk factors for suspected SLE-PH,fever (OR=0.576,P=0.029)and rash (OR=0.558,P=0.017) were independent protective factors for suspected SLE-PH.SLE duration (OR=1.145,95％CI:1.016-1.290,P=0.026) and Raynaud's phenomenon (OR=3.371,95％CI:1.126-10.086,P=0.030)were independent risk factors for suspected moderate to severe PH,nephritic syndrome (OR=0.042,P=0.009) was the in dependent protective factor for suspected moderate to severe PH.Conclusion Cardiac involvement is common in SLE patients.Screening for PH should be considered in SLE patients with thrombocytopenia,hyperuricemia,anti-U1RNP antibody positivity,particularly with Raynaud's phenomenon.

Objective Amyotrophic lateral sclerosis(ALS)is a progressive paralytic disorder resulting from the degeneration of upper and lower motor neurons.Sporadic ALS(SALS)accounm for majority of patients.ALS is a kind of complex disorder.There were several single nucleotide polymorphism (SNP)reported to be associated with SALS in recently published genome-wide association(GWA)study,but there are few data from Asia ALS population and no report focus on SNP which may associated with SALS of Chinese origin.Our study is to screen and add the SNPs related to the risks of SALs in Chinese.Methods Eighty-six individuals with SALS and 94 matched controls were recruited for our study and genomic DNA from blood samples was extracted.Genotypes were determined by a matrix assisted laser desorption/ionization time of flisht mass spectrometry based approach followed by association analysis. Results Individual genotype data for 8 SNPs,rs6700125,rs10260404, rs1942239,rs2279812,rs2405657,rs558889,rs6922711 and rs935 1470 in Chinese population showed no significant association with sporadic ALS.Combining genotype data from published GWA,rs1942239 gained in strength of allelic association(P value decreased to 9.07×10-5 from 1.48×10-4),and rs558889 deviated Hardy-Weinberg equilibrium at ALS case group which may be associated with susceptibility.Conclusions SNP rs1942239 and rs558889 may contribute to susceptibility of sporadic ALS in Chinese patient.The larger sample studies are warranted to confirm the association.

Objective:To explore the establishment and application of ovarian cancer organoids.Methods:Fresh ovarian tumor tissues, obtaining from patients underwent surgery in the First Affiliated Hospital of Nanjing Medical University between October 2021 and March 2022, were collected, enzymatic degraded, digested, and embedded into matrigel to establish organoids. A total of 32 ovarian cancer samples were collected. Hematoxylin eosin (HE) staining and immunofluorescence (IF) procedure were used to verify the morphological structure of organoids and their expression of molecular markers. 3D cyto-live or dead assay was used to detecte the live or dead cells in organoids. Carboplatin with a concentration ranging from 5 to 80 μmol/L (5, 10, 20, 40, 80 μmol/L) was added to organoids to calculate the 50% inhibitory concentration (IC 50) in different organoids. Results:(1) Organoids from a total of 32 patients were established, of which 18 cases could be passaged stably in the long term in vitro, while 14 could be passaged in the short time. The average amplification time of long-term passage in vitro was over 3 months, and the longest reached 9 months. (2) In HE staining, significant nuclei atypia and local micropapillary structures were observed in organoids. IF staining revealed that ovarian cancer organoids expressed molecular markers similar to primary tumor tissues, such as Pan cytokeratin (Pan-CK), p53, paired box gene 8 (PAX8), and Wilms tumor gene 1 (WT1). (3) In 3D cyto-live or dead assay, a large number of apoptotic cells were observed inside and around the organoids after added carboplatin. The sensitivity to carboplatin varied in 18 organoids could amplify in the long term, with an average IC 50 of (29.5±15.8) μmol/L. Moreover, IC 50 values of 4 organoids derived from patients received neoadjuvant chemotherapy were much higher than the 14 organoids which did not received neoadjuvant chemotherapy [(48.7±11.3) μmol/L vs (24.0±12.1) μmol/L; t=3.429, P=0.022]. Conclusions:Organoids recapitulate ovarian cancers in vitro and could be stably passaged. Organoids derived from patients received neoadjuvant chemotherapy have higher resistance to carboplatin.

OBJECTIVETo observe the prevalence and related risk factors of arterial stiffness measured by brachial-ankle pulse wave velocity (baPWV) in patients with systemic lupus erythematosus (SLE).

METHODSThe study population included 135 patients currently enrolled in the Chinese SLE Treatment and Research group registry (CSTAR). All traditional cardiovascular risk factors and SLE-related disease factors were collected on the day of the baPWV examination.

RESULTS(1)Significant differences were observed in age (P < 0.000) , family history of cardiovascular disease (P = 0.003), mean blood pressure (P = 0.000) and hemoglobin A1c (P = 0.023) between SLE patients with normal and abnormal arterial stiffness. In addition, SLE patients with abnormal arterial stiffness had lower creatinine clearance rates [85.9 (65.5-108.8) ml/min vs. 106.4 (86.8-124.6) ml/min, P = 0.011], longer disease and hydroxychloroquine duration (P = 0.002 and P = 0.022, respectively), and higher proportion of intravenous cyclophosphamide use (OR = 3.04, 95%CI:1.230-7.514, P = 0.013) as compared to patients with normal arterial stiffness. (2)After adjustment of all confounding factors, age (OR = 4.56, 95%CI: 1.863-11.133, P = 0.001), mean blood pressure (OR = 1.12, 95%CI: 1.055-1.196, P = 0.000) , disease duration (OR = 1.12, 95%CI: 1.050-1.367, P = 0.007) and the proportion of intravenous cyclophosphamide use (OR = 2.86, 95%CI: 1.364-5.979, P = 0.005) remained as independent risk factors for abnormal arterial stiffness in SLE patients.

CONCLUSIONBoth traditional cardiovascular risk factors and SLE-related factors are associated with the risk of increased arterial stiffness.

Ankle ; Ankle Brachial Index ; Asian Continental Ancestry Group ; Blood Flow Velocity ; Cardiovascular Diseases ; Humans ; Incidence ; Lupus Erythematosus, Systemic ; complications ; Prevalence ; Pulsatile Flow ; Pulse Wave Analysis ; Risk Factors ; Vascular Stiffness