BACKGROUND: The available evidence regarding the benefits of percutaneous coronary intervention (PCI) on patients receiving dialysis with coronary artery disease (CAD) is limited and inconsistent. This study aimed to evaluate the association between PCI and clinical outcomes as compared with medical therapy alone in patients undergoing dialysis with CAD in China. METHODS: This multicenter, retrospective study was conducted in 30 tertiary medical centers across 12 provinces in China from January 2015 to June 2021 to include patients on dialysis with CAD. The primary outcome was major adverse cardiovascular events (MACE), defined as a composite of cardiovascular death, non-fatal myocardial infarction, and non-fatal stroke. Secondary outcomes included all-cause death, the individual components of MACE, and Bleeding Academic Research Consortium criteria types 2, 3, or 5 bleeding. Multivariable Cox proportional hazard models were used to assess the association between PCI and outcomes. Inverse probability of treatment weighting (IPTW) and propensity score matching (PSM) were performed to account for potential between-group differences. RESULTS: Of the 1146 patients on dialysis with significant CAD, 821 (71.6%) underwent PCI. After a median follow-up of 23.0 months, PCI was associated with a 43.0% significantly lower risk for MACE (33.9% [ n  = 278] vs . 43.7% [ n  = 142]; adjusted hazards ratio 0.57, 95% confidence interval 0.45-0.71), along with a slightly increased risk for bleeding outcomes that did not reach statistical significance (11.1% vs . 8.3%; adjusted hazards ratio 1.31, 95% confidence interval, 0.82-2.11). Furthermore, PCI was associated with a significant reduction in all-cause and cardiovascular mortalities. Subgroup analysis did not modify the association of PCI with patient outcomes. These primary findings were consistent across IPTW, PSM, and competing risk analyses. CONCLUSION This study indicated that PCI in patients on dialysis with CAD was significantly associated with lower MACE and mortality when comparing with those with medical therapy alone, albeit with a slightly increased risk for bleeding events that did not reach statistical significance.
Humans ; Percutaneous Coronary Intervention/methods* ; Male ; Female ; Coronary Artery Disease/drug therapy* ; Retrospective Studies ; Renal Dialysis/methods* ; Middle Aged ; Aged ; China ; Proportional Hazards Models ; Treatment Outcome

Objective:To evaluate the safety of early enteral nutrition (EEN) support in patients with severe intra-abdominal infection and intestinal fistulas.Methods:This was a retrospective cohort study. We collected relevant clinical data of 204 patients with severe intra-abdominal infection and intestinal fistulas who had been managed in the No. 1 Department of General Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University between 1 January 2017 and 1 January 2020. The patients were allocated to EEN or delayed enteral nutrition (DEN) groups depending on whether enteral nutrition had been instituted within 48 hours of admission to the intensive care unit. The primary outcome was 180-day mortality. Other outcomes included rates of intraperitoneal hemorrhage, septic shock, open abdominal cavity, bloodstream infection, mechanical ventilation, and continuous renal replacement therapy. Risk factors for mortality were analyzed by logistic regression.Results:There were no significant differences in hematological data or other baseline characteristics between the two groups at the time of admission to the intensive care unit (all P>0.05). However, septic shock (31.2% [15/48] vs. 15.4% [24/156], χ 2=4.99, P=0.025), continuous renal replacement therapy (27.1% [13/48] versus 9.0% [14/156], χ 2=8.96, P=0.003), and 180-day mortality (31.2% [15/48] vs. 7.7% [12/156], χ 2=15.75, P<0.001) were significantly more frequent in the EEN than the DEN group (all P<0.05). Multivariate regression analysis showed that older age (OR=1.082, 95%CI:1.027-1.139, P=0.003), worse Acute Physiology and Chronic Health Evaluation (APACHE) II scores (OR=1.189, 95%CI: 1.037-1.363, P=0.013), higher C-reactive protein (OR=1.013, 95%CI:1.004-1.023, P=0.007) and EEN (OR=8.844, 95%CI:1.809- 43.240, P=0.007) were independent risk factors for death in patients with severe intra-abdominal infection and intestinal fistulas. Conclusion:EEN may lead to adverse events and increase mortality in patients with both enterocutaneous fistulas and severe abdominal infection. EEN should be implemented with caution in such patients.

Objective:To evaluate the safety of early enteral nutrition (EEN) support in patients with severe intra-abdominal infection and intestinal fistulas.Methods:This was a retrospective cohort study. We collected relevant clinical data of 204 patients with severe intra-abdominal infection and intestinal fistulas who had been managed in the No. 1 Department of General Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University between 1 January 2017 and 1 January 2020. The patients were allocated to EEN or delayed enteral nutrition (DEN) groups depending on whether enteral nutrition had been instituted within 48 hours of admission to the intensive care unit. The primary outcome was 180-day mortality. Other outcomes included rates of intraperitoneal hemorrhage, septic shock, open abdominal cavity, bloodstream infection, mechanical ventilation, and continuous renal replacement therapy. Risk factors for mortality were analyzed by logistic regression.Results:There were no significant differences in hematological data or other baseline characteristics between the two groups at the time of admission to the intensive care unit (all P>0.05). However, septic shock (31.2% [15/48] vs. 15.4% [24/156], χ 2=4.99, P=0.025), continuous renal replacement therapy (27.1% [13/48] versus 9.0% [14/156], χ 2=8.96, P=0.003), and 180-day mortality (31.2% [15/48] vs. 7.7% [12/156], χ 2=15.75, P<0.001) were significantly more frequent in the EEN than the DEN group (all P<0.05). Multivariate regression analysis showed that older age (OR=1.082, 95%CI:1.027-1.139, P=0.003), worse Acute Physiology and Chronic Health Evaluation (APACHE) II scores (OR=1.189, 95%CI: 1.037-1.363, P=0.013), higher C-reactive protein (OR=1.013, 95%CI:1.004-1.023, P=0.007) and EEN (OR=8.844, 95%CI:1.809- 43.240, P=0.007) were independent risk factors for death in patients with severe intra-abdominal infection and intestinal fistulas. Conclusion:EEN may lead to adverse events and increase mortality in patients with both enterocutaneous fistulas and severe abdominal infection. EEN should be implemented with caution in such patients.

Objective:To investigate the diagnostic efficiency of the 2020 Chinese Thyroid Imaging Reporting and Data System (C-TIRADS) and the 2017 American College of Radiology Thyroid Imaging Reporting and Data System (ACR-TIRADS) in the diagnosis of benign and malignant thyroid nodules.Methods:A retrospective analysis of the two-dimensional ultrasound image results of 324 thyroid nodules in 289 patients with thyroid nodules and thyroid nodules were performed in the physical examination of the Health Management Department of the Guangdong Second Provincial General Hospital from January 2018 to January 2019. A superficial professional doctor with a senior professional title simultaneously uses the C-TIRADS and ACR-TIRADS methods to evaluate the above nodules. The results are all pathologically referenced for the χ2 test and the receiver operating characteristic curve is drawn. Results:The sensitivity of C-TIRADS in diagnosing benign and malignant thyroid nodules was 81.90%, specificity was 97.72%, accuracy was 92.59%, negative predictive value was 91.85%, positive predictive value was 84.51%; ACR-TIRADS diagnosis The sensitivity of benign and malignant thyroid nodules was 59.05%, specificity was 99.54%, accuracy was 86.42%, negative predictive value was 83.52%, and positive predictive value was 98.41%. The area under the ROC curve was 0.958 and 0.935( Z=2.31 P=0.021). Conclusion:C-TIRADS classification based on counting method is better than ACR-TIRADS classification based on sub-method in the diagnosis of thyroid nodules. It has better efficacy and is more suitable for the current status of diagnosis and treatment of thyroid nodules in China.

Objective:To investigate whether transplantation of gingival mesenchymal stem cells (GMSCs) can inhibit radiation-induced senescence of alveolar epithelial cells type Ⅱ (AECⅡ) and its role in the prevention of radiation-induced pulmonary fibrosis (RIPF).Methods:Mouse type Ⅱ alveolar epithelial cells (MLE12) were irradiated with 6 Gy X-rays and then co-cultured with GMSCs. The extent of cellular senescence of MLE12 cells was assessed by cell morphology, β-Gal staining, and senescence secretion-associated phenotype (SASP) assay. RIPF model was constructed by unilaterally irradiating the right chest of C57BL/6 mice with 17 Gy X-rays. GMSCs were transplanted 1 d after irradiation. At 180 d after irradiation, the pulmonary organ ratio, HE staining, and Masson staining were used to assess intra-pulmonary structure and interstitial collagen deposition in the lung. β-Gal immunohistochemistry and immunofluorescence co-localization with AECⅡ were measured to assess the degree of cellular senescence in the lung. The SASP expression changes in lung tissue were detected by qRT-PCR. The protein expressions in P53-P21 and P16 pathways were detected by Western blot assay. P21 expression in AECⅡ was detected by immunofluorescence co-localization assay.Results:GMSCs effectively inhibited radiation-induced senescence of MLE12 cells, reduced the ratio of radiation-elevated β-Gal positive cells by 11.8% ( t=6.72, P<0.05), and decreased the expressions of SASP (IL-6, IL-8, IL-1β) ( t=28.43, 28.43, 4.82, P<0.05). GMSCs transplantation improved the survival rate of irradiated mice, prevented radiation-induced alveolar structural collapse thickening and collagen deposition, reduced the number of senescent cells in the irradiated lung tissues by 23.9% ( t=21.83, P<0.05), and inhibited the expressions of SASP ( t=8.86, 20.63, P<0.05). GMSCs also inhibited the expression of P53-P21, P16-related proteins in MLE12 cells and lung tissues of mice after irradiation. Conclusions:GMSCs inhibit senescence-related P53-P21 and P16 pathways, prevent radiation-induced AECⅡ senescence, as well as the development of RIPF.

Spinal cord stimulation (SCS) is a promising technique for treating disorders of consciousness (DOCs). However, differences in the spatio-temporal responsiveness of the brain under varied SCS parameters remain unclear. In this pilot study, functional near-infrared spectroscopy was used to measure the hemodynamic responses of 10 DOC patients to different SCS frequencies (5 Hz, 10 Hz, 50 Hz, 70 Hz, and 100 Hz). In the prefrontal cortex, a key area in consciousness circuits, we found significantly increased hemodynamic responses at 70 Hz and 100 Hz, and significantly different hemodynamic responses between 50 Hz and 70 Hz/100 Hz. In addition, the functional connectivity between prefrontal and occipital areas was significantly improved with SCS at 70 Hz. These results demonstrated that SCS modulates the hemodynamic responses and long-range connectivity in a frequency-specific manner (with 70 Hz apparently better), perhaps by improving the cerebral blood volume and information transmission through the reticular formation-thalamus-cortex pathway.
Adolescent ; Adult ; Brain ; physiopathology ; Consciousness ; physiology ; Consciousness Disorders ; physiopathology ; therapy ; Female ; Hemodynamics ; physiology ; Humans ; Male ; Middle Aged ; Pilot Projects ; Spinal Cord ; physiopathology ; surgery ; Spinal Cord Stimulation ; methods ; Young Adult

Objective:To investigate the lipid-lowering effect and antioxidant activity of polysaccharide from Schisandra Chinensis (SCP)in the rats with non-alcoholic fatty liver disease (NAFLD)induced by high-fat diet,and to provide a theoretical basis for the development and utilization of Schisandra Chinensis.Methods: A total of 32 male Wistar rats were selected.Sixteen from the 32 rats were randomly selected and divided into normal control group (intragastrical administration of water,combined with normal diet,n = 8)and SCP group (intragastrical administration of 50 mg·kg-1 SCP,combined with normal diet,n=8).The remaining 16 rats were fed with high-fat diet for 4 weeks and the confirmed NAFLD rat models were set up.A total of 16 NAFLD rats were randomly divided into NAFLD group (intragastrical administration of water, combined with high-fat diet,n = 8 ) and NAFLD+SCP group (intragastrical administration of 50 mg·kg-1 SCP,combined with high-fat diet,n=8).After treated for 12 weeks,the body weights of all the rats were weighed and the liver index was calculated.The levels of total cholesterol (TC),triglyceride (TG),low density lipoprotein cholesterol (LDL-C),high density lipoprotein cholesterol (HDL-C),alanine aminotransferase (ALT)and aspartate aminotransferase (AST)in the serum of all the rats were determined.The levels of TC and TG in liver tissue of the rats were measured by enzymatic method. The malondialdehyde (MDA)levels and superoxide dismutase (SOD)activities in serum and liver tissue and the glutathione (GSH)levels in liver tissue of the rats were analyzed by TBA,xanthinoxidase and microscale enzyme methods,respectively. HE staining was used to observe the pathomorphology of liver tissue of the rats. Results:Compared with normal control group,the liver index of the rats in NAFLD group was increased (P <0.01);the levels of TC,TG,LDL-C,ALT and AST in serum of the rats were increased (P <0.01),the levels of TC and TG in liver tissue of the rats were increased (P <0.01),the MDA level was increased (P <0.01)and the SOD activity was decreased (P <0.01),and the GSH levels in liver tissue and serum were decreased (P <0.01). Compared with NAFLD group,the body weight and liver index,serum levels of TC,TG,LDL-C ,ALT and AST of the rats in NAFLD + SCP group were decreased (P < 0.05 ),the levels of TC and TG in liver tissue were decreased (P <0.01),the MDA level was decreased (P <0.01),the SOD activities in serum and liver tissue were increased (P < 0.01),and the level of GSH in liver tissue was increased (P < 0.01).The HE staining results showed that the structure of hepatic lobules of the rats in NAFLD group was disordered and showed significant hepatic steatosis,and the hepatic steatosis in hepatic lobules of the rats in NAFLD+SCP group was significantly reduced.Conclusion:SCP has a regulation effect in the NAFLD rats induced by high-fat diet,and its mechanism may be related to the anti-oxidative stress.

Objective:To study the effects of compound schisandra extracts (CSE) (schisandra,astragalus,acanthopanax,and rhodiola)on the exhaustive swimming time and the levels of blood urea nitrogen(BUN),serum lactic acid(LD),liver glycogen and muscle glycogene,superoxide dismutase(SOD)activity,and malonaldehyde(MDA) level in the mice and to charify its anti-fatigue effect and the mechanism.Methods:Eighty male ICR mice were randomly divided into blank control group,50 mg·kg-1 CSE group,100 mg·kg-1 CSE group,and 200 mg·kg-1CSE group;there were 20 mice in each group.The mice were administered orally for 30 d.Then 10 mice were randomly selected for exhaustive swimming test in each group and the exhaustive swimming time of the mice was recorded.The remaining 10 mice in each group were used for 90 min swimming,then all the mice were sacrificed and the blood and tissue samples were taken for the measurement of the levels of BUN,LD,liver glycogen and muscle glycogen,the SOD activity and MDA level;the total inhibitory rate of oxidation of CSE in vitro was determined by linoleic acid-ferric thiocyanate method.Results:Compared with blank control group,the exhaustive swimming time of the mice in 50,100,and 200 mg·kg-1 CSE groups were significantly increased (P<0.01);the levels of BUN and LD of the mice in 100 and 200 mg·kg-1 CSE groups were significantly decreased (P<0.05 or P<0.01);the levels of liver glycogen and muscle glycogen of the mice in 100 and 200 mg·kg-1 groups were significantly increased(P<0.05 or P<0.01);whereas the SOD activities were significantly increased and the levels of MDA were decreased(P<0.05 or P<0.01).Compared with 100 mg·kg-1 CSE group,the levels of serum BUN and LD of the mice in 200 mg·kg-1 CSE group were decreased (P<0.01),and the levels of liver glycogen and muscle glycogen were increased(P<0.05).The total inhibitory rate of oxidation of 5 g·L-1CSE was 76.94%.Conclusion:CSE has an anti-fatigue effect and the mechanism may be related to anti-oxidation effect.

Objective To prepare titanium dioxide (TiO2 ) nanoparticles with good near-infrared light and study the loading and release of doxorubicin. Methods The Sm doped TiO2 nanoparticles (Sm-TiO2 ) were synthesized using a modified solvothermal reaction and then observed with transmission electron microscope. The fluorescence spectrum, doxorubicin loading capacity and release profile were also determined. Results The obtained Sm-TiO2 nanoparticles with the length from 100-200 nm were fusiform and well dispersed. The emission wavelength was 640-670 nm. The drug loading capacity in water was 11. 5% . DOX in vitro was pH sensitive to release. Conclusion Sm-TiO2 nanoparticles have good near-infrared light, high drug loading capacity and controllable drug release are obtained and should be studied further more as a novel carrier.

OBJECTIVE: To explore the effects of 5-Aza-2'-deoxycitydine(5-Aza-dC) and trichostatin A (TSA) on the expression and methylation of CHFR in human laryngeal carcinoma cell line. METHOD: The mRNA expression and promoter hypermethylation and were detected by Realtime fluro-genetic quantitative PCR and methylation specific PCR in Hep-2 cell line, which were cultured in vitro and then treated with different concentrations of 5-Aza-dC and TSA. RESULT: Compared with the control team, 5-Aza-dC alone reactivated expression of the CHFR in Hep-2 cell line (1.75 +/- 0.21). TSA had no effect on gene expression (1.05 +/- 0.13). The combined treatment with 5-Aza-dC and TSA increased gene expression (2.15 +/- 0.18). The cell lines showed a characteristic DNA methylation status. 5-Aza-dC and combined 5-Aza-dC and TSA resulted in demethylation of CHFR. In contrast, TSA alone did not affect the DNA methylation status of CHFR. CONCLUSION Hypermethylation of CHFR gene promoter is a common event in the occurrence and development of laryngeal carcinoma. The promoter aberrant methylation of CHFR is a main cause for down-expression of CHFR. After either treatment with 5-Aza-dC alone or in combination with TSA, the expression of CHFR is up-regulated duo to the reversal methylation. It can be a new idea to the therapy of laryngeal carcinoma.
Azacitidine ; analogs & derivatives ; pharmacology ; Cell Cycle Proteins ; genetics ; metabolism ; DNA Methylation ; drug effects ; Decitabine ; Gene Expression ; drug effects ; Hep G2 Cells ; Humans ; Hydroxamic Acids ; pharmacology ; Laryngeal Neoplasms ; metabolism ; Methylation ; drug effects ; Neoplasm Proteins ; genetics ; metabolism ; Poly-ADP-Ribose Binding Proteins ; Promoter Regions, Genetic ; Ubiquitin-Protein Ligases