Objective:To explore the related risk factors for systemic embolism (SE) in patients aged≥75 years with non-valvular atrial fibrillation (NVAF).Methods:A case-control study. NVAF patients aged≥75 years who were hospitalized at the First Affiliated Hospital of Xinjiang Medical University from October 2018 to October 2020 were divided into no SE ( n=1 127) and SE ( n=433) groups according to the occurrence of SE after NVAF. Multivariate logistic regression was used to analyze SE-related factors in patients with NVAF without anticoagulation treatment. Results:In the multivariate model, the following factors were associated with an increased risk of SE in patients with NVAF: history of AF≥5 years [odds ratio ( OR)=2.75, 95% confidence interval ( CI) 1.98-3.82, P<0.01], lipoprotein(a)>300 g/L ( OR=2.07, 95% CI 1.50-2.84, P<0.01), apolipoprotein (Apo)B>1.2 g/L ( OR=1.91, 95% CI 1.25-2.93, P=0.003), left ventricular ejection fraction (LVEF) of 30%-49% ( OR=2.45, 95% CI 1.63-3.69, P<0.01), left atrial diameter>40 mm ( OR=1.54, 95% CI 1.16-2.07, P=0.003), and CHA 2DS 2-VASc score≥3 ( OR=15.14, 95% CI 2.05-112.13, P=0.01). ApoAI>1.6 g/L was negatively correlated with the occurrence of SE ( OR=0.28, 95% CI 0.15-0.51, P<0.01). Conclusions:History of AF≥5 years, lipoprotein(a)>300 g/L, elevated ApoB, left atrial diameter>40 mm, LVEF of 30%-49%, and CHA 2DS 2-VASC score≥3 are independent risk factors for SE whereas ApoAI>1.6 g/L is a protective factor against SE in patients with NVAF.

Objective:To investigate the effect of miRNA-1-3p (miR-1-3p) on expression of myocyte enhancer factor 2A (MEF2A) and the biological function of osteosarcoma cells.Methods:The tumor tissues and adjacent normal tissues of 20 patients with osteosarcoma who were clinically diagnosed in Shanxi Provincial Cancer Hospital from January 2019 to January 2020 were collected, and the expression of miR-1-3p in the samples was detected by real-time fluorescent quantitative polymerase chain reaction (qRT-PCR). The expression of miR-1-3p in osteosarcoma cell lines U2-OS, SAOS-2, MG63, SW1353 and human normal osteoblast cell line hFOB1.19 was detected by qRT-PCR, then the cell line with the lowest expression of miR-1-3p was selected for follow-up experiments. An overexpression miR-1-3p vector was constructed (miR-1-3p mimcs). The miR-1-3p overexpression group was transfected with miR-1-3p mimcs, and the control group was transfected with empty vector (miR-1-3p nc). CCK-8 method was used to detect the proliferation activity of cells; flow cytometry was used to detect the changes of cell apoptosis and cell cycle. miRwalk database was used to predict the miR-1-3p target gene, and the target gene was verified by dual-luciferase reporter gene assay; Western blot was used to detect the expression of MEF2A protein in cells of each group.Results:Compared with adjacent tissues, the expression of miR-1-3p in osteosarcoma tissues was down-regulated (0.31±0.14 vs. 0.62±0.21), and the difference was statistically significant ( t = 5.31, P<0.01). The expression of miR-1-3p in U2-OS cells was the lowest; compared with the control group, the proliferation activity of U2-OS cells was inhibited in miR-1-3p overexpression group (48 h absorbance value 0.56±0.01 vs. 0.77±0.03, t = 2.77, P<0.01; 72 h absorbance value 0.87±0.02 vs. 1.40±0.03, t = 2.93, P<0.01); G 1/S cell cycle arrest increased [G 1 phase (38.24±0.55)% vs. (32.11±0.80)%, t = 9.27, P = 0.01; S phase (61.24±0.90)% vs. (67.78±0.83)%, t = 7.52, P = 0.02]; early apoptotic rate increased [(11.20±0.12)% vs. (1.50±0.12)%, t = 2.91, P<0.05], miRwalk database predicted that the miR-1-3p target gene was MEF2A. The result of dual-luciferase reporter gene assay showed that miR-1-3p bound to MEF2A 3'UTR, and the luciferase activity of U2-OS cells in miR-1-3p overexpression group was lower than that in the control group (renilla luciferase/firefly luciferase activity ratio 0.53±0.06 vs. 1.00±0.04, t = 4.04, P < 0.05). Western blot showed that the expression of MEF2A protein in U2-OS cells of miR-1-3p overexpression group was lower than that of the control group (protein relative expression 0.41±0.14 vs. 0.77±0.12, t = 3.93, P < 0.05). Conclusions:The low expression of miR-1-3p may be associated with the proliferation, apoptosis and cycle changes of osteosarcoma cells. miR-1-3p can negatively regulate the expression of MEF2A protein and regulate the occurrence and development of osteosarcoma.

BK polyomavirus-associated nephropathy (BKPyVAN) is a common cause of allograft failure. However, differentiation between BKPyVAN and type I T cell-mediated rejection (TCMR) is challenging when simian virus 40 (SV40) staining is negative, because of the similarities in histopathology. This study investigated whether donor-derived cell-free DNA (ddcfDNA) can be used to differentiate BKPyVAN. Target region capture sequencing was applied to detect the ddcfDNAs of 12 recipients with stable graft function, 22 with type I TCMR, 21 with proven BKPyVAN, and 5 with possible PyVAN. We found that urinary ddcfDNA levels were upregulated in recipients with graft injury, whereas plasma ddcfDNA levels were comparable for all groups. The median urinary concentrations and fractions of ddcfDNA in proven BKPyVAN recipients were significantly higher than those in type I TCMR recipients (10.4 vs. 6.1 ng/mL,

Objective To study the correlation between serum miRNA-21 (miR-21) level and chemosensitivity and prognosis of osteosarcoma patients. Methods A total of 68 osteosarcoma patients who were treated in Shanxi Provincial Cancer Hospital from August 2016 to August 2017 were selected. All patients received routine chemotherapy after admission. They were followed up for one year. According to the effectiveness of chemotherapy, they were divided into effective group (52 cases) and ineffective group (16 cases). The general clinicopathological characteristics of the two groups were recorded. Univariate logistic regression model was used to analyze the serum miR-21 level and chemosensitivity in osteosarcoma patients. The prognostic efficacy of serum miR-21 was evaluated by receiver operating characteristic (ROC) curve. Results The serum miR-21 expression in the effective group was higher than that in the ineffective group (6.6 ±0.7 vs. 5.2 ±0.7), and the tumor metastasis rate in the effective group was lower than that in the ineffective group [33.9％ (18/52) vs. 37.5％ (6/16)], and the differences between the two groups were statistically significant (both P< 0.05). There were no significant differences in gender, age, body mass index (BMI), tumor location, size of tumors and TNM stage between the two groups (all P>0.05). Univariate logistic regression model showed that serum miR-21 and metastasis were the factors affecting chemosensitivity (both P<0.05). ROC curve showed that the area under the curve (AUC) of using serum miR-21 to predict the prognosis of osteosarcoma patients was 0.774. Youden index indicated that the best cut-off points of serum miR-21 and chemosensitivity for predicting the prognosis of osteosarcoma patients was 6.25. Conclusion Serum miR-21 level in osteosarcoma patients is significantly correlated with chemosensitivity and prognosis, and it can be used as an effective index to predict the effect of chemotherapy and prognosis of patients with osteosarcoma.

Objective To compare the flow cytometry versus test tube method in detecting antibody titer in ABO blood type,and try to establish a standard method using flow cytometry to provide insight in ABO incompatible kidney transplantation and therapeutics.Methods The ABO blood type titers of anti-IgM-A/B and anti-IgG-A/B in 30 serum samples from renal allograft recipients were measured by flow cytometry.The results were compared with those determined by test tube method.Results The titers by cytometry significantly higher than those by test tube method (P＜0.05).Conclusion The sensitivity of flow cytometry is significantly higher than test tube method,and flow cytometry can precisely monitor the ABO blood titers in renal allograft recipients,which can provide better medical advice in clinical treatment and therapeutics.

Objective To investigate the antimicrobial resistance of Streptococcus pneumoniae strains isolated from multiple medical institutions across Hebei Province in 2015.Methods The bacterial data were collected from 53 member hospitals of Hebei Antimicrobial Resistance Investigation Net (HEBARIN) according to the unified surveillance program in Hebei province.WHONET 5.6 was used to review,analyze and summarize the surveillance data.The results were interpreted according to CLSI guideline 2014.Results A total of 2 408 strains of S.pneumoniae were included in this analysis.S.pneumoniae was the third most frequently isolated gram positive bacteria.More than 95％ of these S.pneumoniae strains were susceptible to vancomycin and moxifloxacin.However,96.4％,89.3％ and 67.4％ of these strains were resistant to erythromycin,clindamycin,and trimethoprim-sulfamethoxazole,respectively.The antimicrobial susceptibility profile was similar between the strains isolated from adults and those isolates from children.Conclusions The antimicrobial resistance profile ofS.pneumoniae isolates in Hebei Province is generally consistent with the nation-wide data,except higher resistance level to a few antimicrobial agents.We should be alert to and control the emergence of resistant S.pneumoniae.

Objective To analyze the metabolic profile in serum between normal and orthotopic xenograft nude mice burdened with three human pancreatic cancer cell lines,which were differentiated differently.Methods Human pancreatic cancer lines SW1990,BxPC-3 and Panc-1 were subcutaneously injected into the nude mice,respectively.When the tumor volume reached 1.0 cm3,the nude mice were euthanized and the tumor tissues were removed and implanted to the pancreas to establish the orthotopic xenograft mice model.The serum from three orthotopic xenograft tumor nude mice and the normal controls were collected and then analyzed by 1H nuclear magnetic resonance spectroscopy.Results The three orthotopic xenograft nude mice models were successfully established.In SW1990,BxPC-3 and Panc-1 group,the orthotopic xenograft tumor formation rate was 79％ (11/14),93％ (13/14) and 86％ (12/14),while the mortality was 7％ (1/14),0 and 7％ (1/14),respectively.Compared with control group,the content of metabolites in the serum of orthotopic xenograft tumor nude mice was increased including creatine,alanine,glutamine,1-methylhistidine,isoleucine,lactate,phenylalanine,tryptophan and valine,but the glycerolphosphocholine (GPC) and glucose levels were reduced.As the tumors progressed to be more malignant,the content of valine and isoleucine tended to increase.Conclusions The establishment of the orthotopic implantation tumor nude mice model was stable and reliable with high tumor formation rate.Obvious metabolic differences of glucose,lipid and amino acids were observed between normal and human pancreatic cancer tumor burdening nude mice models.The common metabolic features identified in all three nude mice models burdened with human pancreatic cancer could be used as the potential markers for diagnosing human pancreatic cancer.

Objective To investigate the clinical value of serum metabonomic profile of pancreatic cancer using nuclear magnetic resonance (NMR)-based metabonomics.Methods The retrospective case-control study was adopted.The clinical data of 23 patients with pancreatic cancer (PC group) and 16 healthy volunteers (control group) who were admitted to the Fujian Medical University Union Hospital between December 2013 and December 2014 were collected.The serum of the 2 groups was measured by 1H NMR spectroscopy.Multivariate statistical analyses were performed to identify the characteristic metabolites in the 2 groups,including principal component analysis (PCA),partial least squares discriminant analysis (PLS-DA) and orthogonal partial least squares discriminant analysis (OPLS-DA).Observation indicators included:(1) multivariate statistical analysis of serum metabonomic profile,results of PCA,PLS-DA and OPLS-DA,(2) screening of metabolites.Measurement data with normal distribution were presented as x ± s.The comparison between groups was evaluated with the t test.The count data were analyzed using the chi-square test.Results (1) The multivariate statistical analysis of serum metabonomic profile:results of PCA showed that expression rates of principal component 1 (PC1) and principal component 2 (PC2) to original data were 54.9％ and 23.5％,with both cumulative contribution rate of 78.4％.Results of PLS-DA showed that the separative trend between PC group and control group was appeared,and variance of X and Y matrixes and predictive value were 0.254,0.816 and 0.385.Results of OPLS-DA showed that the differences of samples between the 2 groups were further increased,and differential metabolites were screened according to the distinction of scores between the 2 groups,value of R2X,R2Y and Q2 was 0.254,0.816 and 0.433.(2) Screening of metabolites:35 serum metabolites were detected in the 2 groups.Compared with the control group,levels of 3-hydroxybuyarate,citrate,formate,glutamate,isoleucine,methionine and phenylalanine in the PC group were elevated (r =0.524,0.511,0.656,0.566,0.503,0.498,0.648,P ＜0.05),and levels of 3-methylhistidine,alanine,glutamine,LDL and VLDL in the PC group were decreased (r =-0.607,-0.508,-0.560,-0.568,-0.559,P ＜ 0.05).Conclusions Compared with healthy controls,several amino acids,citrate and lipoproteins demonstrate the metabolic differences in the serum of patients with pancreatic cancer.NMR based metabonomic profile technology can distinguish the difference of serum metabolites between patients with pancreatic cancer and healthy controls.NMR based metabonomic technology may be a promising method for the diagnosis of pancreatic cancer.

Objective To explore the clinical effect of the open and laparoscopic surgery in the treatment of ectopic pregnancy to retain the clinical efficacy of reproductive function analysis. Methods Four hundred and fifty-six patients with ectopic pregnancy were selected as our subjects. Two hundred and eleven cases were served as laparotomy group( open),and 245 cases were laparoscopic group( laparoscopic). The data of intraoperative blood loss,operative time,postoperative anal exhaust time,average hospital stay,tubal patency rate,intrauterine pregnancy rate and again repeat ectopic pregnancy rate were recorded. Results Patients in two groups were successfully completed surgery. The operative time,intraoperative blood loss,postoperative anal exhaust time,average hospitalization time were(55. 1 ± 13. 5)min,(63. 5 ± 18. 3)ml,(25. 7 ± 5. 6)h,(6. 1 ± 2. 0)d respectively in laparotomy group,and(41. 3 ± 15. 5)min,(41. 1 ± 13. 3)ml,(13. 5 ± 5. 1)h,(3. 6 ± 1. 4)d respectively in laparoscopic group,and the differences were significant( t =2. 045,2. 263,3. 131, 3. 152,P﹤0. 05). The tubal patency rate,intrauterine pregnancy,ectopic pregnancy rate in laparotomy group were 81. 0%( 171/211 ),59. 7%( 126/211 ) and 26. 5%( 56/211 ) respectively,and 75. 5%( 185/245 ), 53. 5%( 131/245 ) and 22. 9%( 56/245 ) respectively in laparoscopic group,and the differences were not significant(χ2 =2. 254,2. 130,1. 242;P ﹥0. 05 ). Conclusion Laparoscopic surgery in the treatment of ectopic pregnancy is superior to laparotomy in terms of small trauma,less bleeding,faster recovery,shorter hospitalization time,and postoperative tubal patency rate.

Objective To compare the effect of pancreatic duct stent internal versus external drainage in the prevention of postoperative complications after pancreaticoduodenectomy through the method of Meta analysis.Methods PubMed,Embase and the Cochrane Library,were searched for randomized controlled trials (RCTs) concerning pancreatic duct stent in the prevention of postoperative complications after pancreaticoduodenectomy.All these databases were searched from their establishment to March 31,2015.The data was reviewed and extracted by two investigators independently.Then,the Cochrane network RevMan 5.3 software was used for statistic analysis.Results As a result,this meta analysis has got 3 RCTs,including 362 participants.The outcomes in our study design were classified as major and minor one.The former was the outcomes of the major postoperative complications,like postoperative pancreatic fistula and delayed gastric emptying.The minor outcome were postoperative morbidity,mortality and intestinal obstruction.The results of meta analysis were:(1) Postoperative total pancreatic fistula rate (A/B/C):three studies showed a statistic difference between the internal and external drainage groups (OR =0.59,95％CI:0.36-0.97,P =0.04).(2) Postoperative pancreatic fistula rate (B/C):three studies showed a statistic difference between the internal and external drainage groups (OR =0.44,95％ CI:0.20-0.97,P =0.04).(3) Postoperative incidence rate of delayed gastric emptying:three studies showed a certain statistic difference between the internal and external drainage groups (OR =0.42,95 ％ CI:0.23-0.79,P =0.007).(4) Post-operative incidence rate of total mortality:three studies showed no certain statistic difference between the internal and external drainage groups (OR =0.81,95 ％ CI:0.23-2.86,P =0.74).(5) As for the postoperative incidence rate of total complications and intestinal obstruction,the heterogeneity was bigger than 50％.So we made an analysis of the cause of heterogeneity.We deduced that it may be caused by the different and complicated perioperative management.Then,we used the random effect model rather than the fixed effect model to make a quantitative analysis.No statistical difference was found eventually in both this two marks.Conclusions By comparing the outcomes in both internal and external drainage groups,we found pancreatic duct stent external drainage could effectively decrease the incidence rate of postoperative pancreatic fistula rate and delayed gastric emptying.But when the limit studies and sample size considered,this conclusion still need to be certificated with more high-quality clinical research.