Objective To analyze the clinical efficacy of valve surgeries for infective endocarditis and the affecting factors, and compare the early- and long-term postoperative outcomes of different surgery approaches. Methods The patients with infective endocarditis who underwent valve replacement/valvuloplasty in our hospital from 2010 to 2022 were retrospectively collected. The clinical data of the patients were analyzed. Results A total of 343 patients were enrolled, including 197 patients with mechanical valve replacement, 62 patients with bioprosthetic valve replacement, and 84 patients with valvuloplasty. There were 238 males and 105 females with an average age of (44.2±14.8) years. Single-valve endocarditis was present in 200 (58.3%) patients, and multivalve involvement was present in 143 (41.7%) patients. Sixty (17.5%) patients had suffered thrombosis before surgery, including cerebral embolisms in 32 patients. The mean follow-up time was (60.6±43.8) months. Early mortality within one month after the surgery occurred in 17 (5.0%) patients, while later mortality occurred in 19 (5.5%) patients. Eight (2.3%) patients underwent postoperative dialysis, 13 (3.8%) patients suffered postoperative stroke, 6 patients underwent reoperation, and 3 patients suffered recurrence of infective endocarditis. Smoking (P=0.002), preoperative embolisms (P=0.001), duration of surgery (P=0.001), and postoperative dialysis (P=0.001) were risk factors for early mortality, and left ventricular ejection fraction ≥60% (P=0.022) was protective factor for early mortality. New York Heart Association classification Ⅲ-Ⅳ (P=0.010) and ≥3 valve procedures (P=0.028) were risk factors for late mortality. The rate of composite endpoint events was significantly lower in the valvuloplasty group than that in the valve replacement group. Conclusion For patients with infective endocarditis, smoking and preoperative embolisms are associated with high postoperative mortality, multiple-valve surgery is associated with a poorer prognosis, and valvuloplasty has advantages over valve replacement and should be attempted in the surgical management of patients with infective endocarditis.

OBJECTIVES: To investigate the role of long noncoding RNA (lncRNA) HClnc1 in regulating proliferation, invasion, and migration of hepatocellular carcinoma (HCC) cells and the regulatory mechanism. METHODS: HClnc1 expression levels in liver cancer tissues were analyzed using data from the TCGA database. BrdU incorporation, plate cloning, and transwell assays were employed to examine the effects of HClnc1 silencing/overexpression and/or ODC1 silencing on proliferation, invasion, and migration of liver cancer cells. The effects of HClnc1 silencing on ODC1 protein and mRNA expression in the liver cancer cells were analyzed using qRT-PCR and Western blotting. The activity of ODC1 promoter was analyzed using a dual luciferase reporter gene assay. Pull-down experiment, mass spectrometry analysis, and chromatin immunoprecipitation (ChIP) assay were used for identification of HClnc1-binding proteins and their interactions. Protein interactions with the ODC1 promoter region and their binding efficiencies were investigated using RNA interference and ChIP analysis. RESULTS: HClnc1 was significantly overexpressed in HCC tissues. In liver cancer cells, HClnc1 silencing significantly inhibited cell proliferation, invasion, and migration, while HClnc1 overexpression promoted these behaviors. ODC1 silencing also suppressed malignant behaviors of liver cancer cells, and counteracted the effects of HClnc1 overexpression. Interference of HClnc1 obviously inhibited ODC1 promoter activity. RBBP5 and KAT2B proteins were identified to bind simultaneously with HClnc1. HClnc1 overexpression upregulated ODC1 protein expression, while interference of RBBP5 or KAT2B downregulated ODC1 protein expression and blocked HClnc1-induced upregulation of ODC1 protein. Both RBBP5 and KAT2B could directly bind to ODC1 promoter region; knocking out KAT2B or RBBP5 reduced the binding efficiency, while knocking out HClnc1 reduced the binding of both RBBP5 and KAT2B to ODC1 promoter region. CONCLUSIONS By targeting the RBBP5/KAT2B epigenetic modification complex, HClnc1 increases ODC1 promoter activity to enhance ODC1 transcription and promote the proliferation and migration of liver cancer cells.
Humans ; Cell Proliferation ; RNA, Long Noncoding/genetics* ; Cell Movement ; Liver Neoplasms/metabolism* ; Cell Line, Tumor ; Carcinoma, Hepatocellular/genetics* ; Promoter Regions, Genetic ; Gene Expression Regulation, Neoplastic

Objective To compare the perioperative renal function changes in patients undergoing heart transplantation (HT) and left ventricular assist device (LVAD) implantation. Methods Patients with end-stage heart failure who underwent surgical treatment at Beijing Anzhen Hospital, Capital Medical University from January 2019 to April 2024 were included. According to the surgical method, patients were divided into a HT group and a LVAD group, and the estimated glomerular filtration rate (eGFR) of patients before surgery and postoperative 1, 7, 30, 60 days was compared between the two groups. The patients with preoperative renal dysfunction were subdivided into subgroups for comparison of eGFR changes before surgery and 30 days after surgery between the two groups. Results A total of 112 patients were enrolled. There were 78 patients in the HT group, including 61 males and 17 females, aged (44.42±18.51) years. There were 34 patients in the LVAD group, including 30 males and 4 females, aged (54.94±11.37) years. Compared with the HT group, the average age of patients in the LVAD group was greater (P<0.001), body mass index was higher (P=0.008), preoperative eGFR was lower (P=0.009), and the proportions of smokers (P=0.017), alcohol drinkers (P=0.041), and diabetes mellitus (P=0.028) patients were higher. Among patients with preoperative renal dysfunction [eGFR<90 mL/(min·1.73 m2)], compared with the HT group, the postoperative eGFR of the LVAD group was significantly higher than that of the HT group, and it was significantly increased compared with that before surgery; the postoperative eGFR of the HT group was comparable to that before surgery, and more than half of the patients had a lower eGFR than before surgery. Among patients with preoperative renal dysfunction, 11 patients in the HT group received continuous renal replacement therapy, and 8 died early; 2 patients in the LVAD group received continuous renal replacement therapy, and 1 died early. Conclusion For end-stage heart failure patients with combined renal dysfunction, compared with HT, LVAD implantation enables patients to obtain better renal function benefits.

In China, more than half of heart failure patients are ischemic heart failure patients. And a large proportion of left ventricular assist device implantation patients are also ischemic heart failure patients. However, left ventricular assist device implantation in ischemic heart failure patients is facing with problems such as patient screening, coronary artery disease, small left ventricle, mitral insufficiency, and ventricular aneurysm. There are only a few retrospective studies with small sample sizes abroad trying to provide solutions to these problems. While there is a lack of systematic understanding of this issue in China. Therefore, we provide an overview of the application and progress of left ventricular assist devices in ischemic heart failure patients, aiming to help clinicians have a comprehensive understanding of this issue and provide some guidance.

Osteosarcoma, a highly malignant tumor originating from bone tissue, is characterized by a high mortality along with a poor prognosis. The heterogeneity of the tumor microenvironment plays a pivotal role in its development and prognosis. Single-cell sequencing technology emerges as a crucial tool in elucidating this heterogeneity by delineating the functional characteristics and gene expression patterns of tumor cells, immune cells, and stromal cells within osteosarcoma tissues. This technology enables the depiction of the intricate interaction network between these cells. Utilizing the high-resolution advantage of single-cell sequencing, novel cell subtypes such as SPP1 (+) macrophages, C1QC (+) macrophages, and CLEC11A (+) B cells have been identified in osteosarcoma tissues, contributing to tumor growth and invasion within the tumor microenvironment. Identification of osteosarcoma stem cell subpopulations suggests that SERPINA1_CSCL1, FUS_CSCL2, and SPP1_CSCL3 populations may serve as the origin of osteosarcoma cells. Moreover, single-cell sequencing has revealed that mregDCs promote immune escape and tumor progression by selectively expressing CCR7, CCL17, CCL19, and CCL22 factors, thereby recruiting Treg cells. Additionally, this technology aids in the development of personalized chemotherapy regimens by pinpointing potential drug resistance targets in osteosarcoma, leading to the establishment of a drug resistance risk score model. In terms of disease prognosis, single-cell sequencing has identified immune infiltration-associated genes in osteosarcoma (e.g., EPHX2, FDPS, GBP1, MMD, ZYX), facilitating the construction of a prognostic analysis model for osteosarcoma patients, thus aiding in prognostic prediction.

ObjectiveTo investigate the regulatory effects of Xuanfu Daizhetang on a mouse model of allergic asthma induced by ovalbumin （OVA）. MethodSixty female BALB/c mice （6-8 weeks old， SPF） were randomly divided into groups. Ten mice were assigned to the normal group and given 0.2 mL of saline， while the remaining groups received intraperitoneal injections of Al（OH）₃ at 5 g·L^-1 and OVA at 1 g·L^-1. The mice were divided into normal group （10 mL·kg^-1 saline）， OVA model group （10 mL·kg^-1 saline）， dexamethasone group （OVA+DEX， 1 mg·kg^-1）， OVA+ low-dose Xuanfu Daizhetang group （OVA+XL， 7.065 g·kg^-1）， OVA+ medium-dose Xuanfu Daizhetang group （OVA+XM， 14.13 g·kg^-1）， and OVA+ high-dose Xuanfu Daizhetang group （OVA+XH， 28.26 g·kg^-1）. An OVA-induced asthma model was established in mice. Hematoxylin-eosin （HE） and periodic acid-Schiff （PAS） staining methods were used to observe bronchial tissue pathological changes. Enzyme-linked immunosorbent assay （ELISA） was performed to measure the levels of immunoglobulin E （IgE）， interleukin-4 （IL-4）， IL-5， IL-13， IL-17A， and γ interferon （IFN-γ） in bronchoalveolar lavage fluid. Western blot was used to detect the phosphorylation of extracellular signal-regulated kinase （ERK）， p38 mitogen-activated protein kinase （MAPK）， and c-Jun N-terminal kinase （JNK） proteins in lung tissue. ResultCompared with the normal group， the OVA model group showed increased inflammatory cell infiltration in mouse alveoli， elevated levels of IL-4， IL-5， IL-13， IL-17A， IFN-γ in bronchoalveolar lavage fluid， and IgE in serum （P<0.05， P<0.01）， and promoted phosphorylation of MAPK signaling pathway-related proteins. Compared with the model group， the OVA+XL， OVA+XM， and OVA+XH groups showed reduced inflammatory cell infiltration in mouse alveoli， decreased levels of IL-4， IL-5， IL-13， IL-17A， IFN-γ in bronchoalveolar lavage fluid， and IgE in serum （P<0.05， P<0.01）， and inhibited phosphorylation of MAPK signaling pathway-related proteins. ConclusionThe results of this study suggest that Xuanfu Daizhetang has potential anti-allergic asthma activity， providing a theoretical basis for its future clinical application.

Objective:To evaluate the quality of information about bronchial asthma in Chinese Internet Site.Methods:According to the traffic ranking of Alexa website, three Chinese keywords of “bronchial asthma”, “asthma” and “asthma treatment” were searched in two most common Chinese search engines: Baidu and Sohu, and the information quality was evaluated by DISCERN tool. The completeness and accuracy of the information were evaluated according to the “2019 Global Strategy For Asthma Management And Prevention”.Results:A total of 25 websites were obtained. The DISCERN evaluation showed that none of the evaluations had an average score of more than 3.40 points. More than 50% of the information on the websites was incomplete or incorrect, and 4% of the websites contained incorrect information. The website content scores were graded, and the grading results were: excellent 12%, good 40%, fair 36%, poor 12%. The website was evaluated according to the attributes of the owner. Professional websites had better accuracy and comprehensive websites had better comprehensiveness. Pearson correlation analysis showed that the content score was positively correlated with the reliability score, detail score, and total score in DISCERN score ( r=0.58, 0.63, 0.61, all P<0.001). Conclusion:The quality of asthma information on Chinese Internet Site is generally poor.

Objective To explore the effects of tutor psychological counseling on adaptation in freshmen of university. Methods From September 2015 to September 2016, we selected 212 five-year undergraduate freshmen majored in clinical medicine from two classes of 2015 in Hubei University of Medicine as subjects by convenience sampling. Students of class 1 of clinical medicine were set as the experimental group (n=105). Students of class 2 of clinical medicine were set as the control group (n=107). Students of control group were taught according to conventional methods. Otherwise, students of the experimental group accepted targeted psychological counseling by instructors assisted by tutor. All of the students were evaluated with the China College Student Adjustment Scale (CCSAS) when they enrolled and one year after they enrolled. Results After implementing psychological counseling, the scores of 7 dimensions of CCSAS including interpersonal relationship, learning adaptation, campus adaptation, occupational selection, emotion, self-adaptation, satisfaction of students of the experimental group were (35.87±4.528), (45.10±7.682), (29.21±4.243), (33.02±4.290), (29.84±5.000), (29.07±5.432), (18.75±3.419) higher than those [(33.66±5.234), (37.91±8.280), (25.84±4.685), (28.79±3.683), (27.13±4.535), (25.21±4.455), (17.15±3.618)]of the control group with significant differences (t=-3.275, -6.559, -5.422, -7.698, -4.131, -5.650, -3.314; P<0.01). Conclusions Tutor psychological counseling improves the adaptation of freshmen of university. It is worth to be used widely.

Objective:To observe the impact of rehabilitation training,acupuncture-moxibustion combined with Danshen Chuanxiongqin acupoint injection on the patients with shoulder-hand syndrome (SHS) after cerebral infarction (CI).Methods:82 patients with SHS after CI from March 2014 to March 2016 in our hospital were randomly divided into the group A and the group B (n=41).Patients in the group A received comprehensive drug therapy,acupuncture and rehabilitation training,the group B was given Danshen Chuanxiongqin acupoint injection therapy based on the group A.Before and after treatment,the upper limb movement function score (FMA),digital pain score (NRS),the degree of swelling in the shoulder joint,shoulder joint of motion (ROM),and neural function defect scale (CNFDS),daily life activities ability (MBI) and quality of life scores (WHOQOL) of patients in two groups were compared and analyzed.Results:After treatment,the scores of NRS,shoulder swelling,upper extremity CNFDS were significantly higher than those before treatment,the ROM,while the upper extremity FMA,MBI and WHOQOL of both groups were significantly decreased (P＜0.05),these index improved more significantly in group A than those of group B (P＜0.05).Conclusion:Rehabilitation training,acupuncture-moxibustion combined with Danshen Chuanxiongqin acupoint injection was more effective in the treatment of SHS after cerebral infarction than rehabilitation training and acupuncture-moxibustion.

Objective To analyze the CT characteristics of chronic schistosomiasis liver disease,in order to improve the accuracy of CT diagnosis for the disease.Methods We analyzed the CT features of 125 cases of clinical pathology diagnosis of chronic schistosomiasis liver and of 50 normal control group,and measured the hepatic lobe lines and spleen index.Results (1) Schistosoma calcification:In 125 cases,there were 120 patients with varying degrees of liver calcification,in which 76 cases of intrahepatic or subcapsularlinear calcification,44 cases of reticular or map-like calcification,33 cases of calcification portal system,15 cases of spleen calcification,85 cases of intestinal wall calcification;(2) Morphological changes of the liver and spleen:The transverse diameter of the left hepatic lobe,caudate lobe,and caudate lobe-right lobe ratio were larger in patients with chronic schistosomiasis than controls,the transverse diameter of the right hepatic lobe were smaller and there were statistically difference (P＜0.001).There were 82 cases of expanded gallbladder fossa in chronic schistosomiasis.Splenic index in patients with chronic schistosomiasis and had no obvious difference in the control group (P＞0.05);(3) Schistosomiasis liver's complications:there were 43 cases of cholecystitis and cholelithiasis,11 cases of liver cancer,5 cases of colon cancer,3 cases of bladder cancer.Conclusion Intrahepatic calcification and the left hepatic lobe and caudate lobe enlargement are CT signs of chronic schistosomiasis,which is often merged with many complications.