Objective To evaluate the diagnostic value of adenosine load-resting gated myocardial perfusion imaging for three-vessel disease in coronary artery disease(CAD)patients using coronary angiography as the gold standard.Methods A retrospective study was conducted,including 318 patients diagnosed with CAD who underwent coronary angiography at Yanan Hospital Affiliated to Kunming Medical University from January 2021 to December 2022.Based on the results of coronary angiography,the 318 CAD patients were divided into a three-vessel disease group(n=166)and a non-three-vessel disease group(single and double vessel disease group,n=152).All the subjects underwent adenosine stress-resting GMPI within two weeks.Adenosine stress-resting GMPI myocardial perfusion parameters(SSS,SRS,SDS),cardiac function parameters(LVEF,LVEDV,LVSV)and left ventricular mechanical contraction synchronization parameters(PSD,PHB)were collected.The diagnostic value of adenosine stress-resting gated myocardial perfusion imaging for three-vessel disease in CAD was explored.Results Among the perfusion parameters,SSS had the highest AUC of 0.781,while sLVEF had the highest AUC of 0.748 among cardiac function parameters,and sPHB had the highest AUC of 0.724 among synchrony parameters.The AUCs of combined parameters were all higher than those of perfusion parameters,cardiac function parameters,and synchrony parameters(P＜0.05).The changes in Δ LVESV and Δ LVEF between the three-vessel disease group and the non-three vessel disease group showed statistical significance(P＜0.05).Conclusion The perfusion,cardiac function and synchronization parameters of adenosine stress-resting gated myocardial perfusion imaging have high diagnostic value for three-vessel coronary heart disease,and the combined detection of the three parameters provides even greater diagnostic value for three-vessel coronary heart disease.

Objective:To explore the utility of adenosine stress-rest gated myocardial perfusion imaging (G-MPI) in evaluation of left ventricular (LV) myocardial perfusion, heart function, and synchronization in patients with multivessel coronary artery disease after coronary artery bypass grafting (CABG).Methods:Fifty-five patients (42 males, 13 females, age (59.3±9.0) years) with multivessel coronary artery disease who underwent CABG surgery in Yan′an Hospital Affiliated to Kunming Medical University between January 2021 and June 2023 were retrospectively collected. All of them underwent G-MPI (one-day method) one week before and six months after CABG. Paired t-test or Wilcoxon signed rank test was used to compare LV myocardial perfusion parameters including summed stress score (SSS), summed rest score (SRS), and summed different score (SDS) before and after CABG, as well as cardiac function parameters (LV ejection fraction (EF), LV end-diastolic volume (EDV), LV end-systolic volume (ESV), stroke volume (SV), peak filling rate (PFR)), and LV mechanical contraction synchronization parameters such as phase histogram bandwidth (PHB) and phase standard deviation (PSD). Differences of the changes of parameters after CABG compared to baseline (Δ) between adenosine stress imaging and rest imaging were also compared by Wilcoxon signed rank test. The relationships between rest LVEF, rest PFR and myocardial perfusion parameters were analyzed by Spearman rank correlation analysis. Results:After CABG, the SSS, SRS, and SDS were significantly lower than those before surgery (6(3, 12) vs 16(9, 23), 1(0, 9) vs 4(1, 15), 3(1, 5) vs 8(6, 12); z values: 6.37, 4.84, 6.24, all P<0.001); postoperative rest/stress LVEF(60%(49%, 67%), 58%(48%, 68%)) and PFR (3.67(3.12, 4.28), 3.23(2.77, 4.43) EDV/s) significantly increased compared with preoperative values (51%(33%, 62%), 53%(27%, 61%); 2.76(2.08, 3.52), 2.83(1.86, 3.62) EDV/s; z values: 3.23-5.58, all P<0.01); postoperative rest/stress LVEDV and LVESV were significantly lower than those before surgery ( t values: 6.40, 5.27; z values: 5.33, 5.40; all P<0.001); rest/stress PHB (45°(35°, 70°), 53°(44°, 113°)) and PSD (14.7°(10.9°, 27.3°), 20.0°(14.6°, 33.8°)) were significantly lower than those before surgery (60°(45°, 131°), 83°(58°, 198°), 20.4°(16.0°, 49.1°), 27.2°(19.6°, 60.4°); z values: 4.19-4.81, all P<0.001). The ΔSSS was greater than the ΔSRS, and the ΔPFR was greater in rest imaging than that in stress imaging ( z values: 6.24, 2.77, both P<0.05). Rest LVEF, PFR were negatively correlated with SSS and SRS ( rs values: from -0.741 to -0.431, all P<0.05). Conclusion:The LV myocardial perfusion, function, and mechanical contraction synchronicity information obtained from adenosine stress-rest G-MPI can be used to evaluate the recovery after CABG, which may help to better identify patients who may have adverse cardiac events.

Objective:To investigate the clinicopathological features of fumarate hydratase (FH) deficiency uterine leiomyoma.Methods:The data of 38 patients with FH deficiency uterine leiomyoma were screened and analyzed. The expressions of FH, S-(2-succino)-cysteine (2SC), desmin, p16, p53, CD 10 and cell proliferation associated nuclear antigen (Ki-67) proteins were detected by immunohistochemistry, and their clinicopathological features were analyzed retrospectively. Results:(1) Clinical features: the median age of the patients was (42.5±7.4) years old. Twenty-one cases (55%) of them were myomas found in physical examination, and the median maximum diameter of the tumor was 6.0 cm (range: 5.0-7.5 cm); myomectomy was performed in 23 cases (61%), total hysterectomy with or without bilateral appendages in 15 cases (39%); laparoscopic surgery in 27 cases (71%), open surgery in 11 cases (29%); none of the patients had renal cell carcinoma. (2) Histological features: atypical nuclear cells were distributed locally or diffusely, eosinophilic nucleoli and intranuclear inclusion bodies could be seen, glass like globules could be seen in the cytoplasm, nuclear division was 0-4/10 high power field (HPF), and antler like blood vessels and pulmonary edema-like changes could be seen in the stroma. Among 38 patients with FH deficiency uterine leiomyoma, FH was negative in 37 cases (97%), and positive in 1 case (3%); 2SC, desmin, p16, p53, CD 10 and Ki-67 showed focal positive expression in 38 cases (100%), including 35 cases (92%) with Ki-67 index<10% and 3 cases (8%) with Ki-67 index ≥10%. (3) Follow-up: 4 cases (11%) recurred, and there was no death. There were significant differences in age, family history, distribution of atypical nuclei and mitosis number between recurrent group and non-recurrent group (all P<0.05). Conclusions:FH deficiency uterine leiomyoma is a rare tumor, which needs pathological examination,immunohistochemical examination and clinical history. Patients younger than 43 years old, with family history, histologically atypical diffuse nuclear distribution and mitotic number ≥3/10 HPF should be alert to the risk of recurrence.

Objective:To investigate the infection rate in close contacts of COVID-19 patients before and after the last negative nucleic acid test, evaluate the effect of dynamic nucleic acid test in determining the infectivity of COVID-19 patients.Methods:Dynamic nucleic acid test results of COVID-19 cases were collected in a retrospective cohort study. COVID-19 cases with negative nucleic acid test results before their first positive nucleic acid tests were selected as study subjects. Close contacts of the index cases and the secondary close contacts were kept isolation for medical observation to assess their risk of infection.Results:This study included 89 confirmed cases from two local COVID-19 epidemics in Ningbo. A total of 5 609 close contacts were surveyed, the overall infection rate was 0.20%. No close contacts of the COVID-19 cases before the last negative nucleic acid test were infected, and the infection rate in the close contacts of the COVID-19 cases after the last negative nucleic acid test was 1.33%, all of these close contacts lived together with the index cases. No secondary close contacts were infected.Conclusion:COVID-19 patient becomes infectious after the last nucleic acid is negative, and has no infectivity before the last nucleic acid negative.

Objective To explore the expression of circ_0006692 in NSCLC and its relation with clinicopathological characteristics and related mechanism. Methods We collected 50 pairs of NSCLC tissues and adjacent tissues. The expression of circ_0006692 was detected by qRT-PCR and its relation with clinicopathological features was analyzed. We constructed lung cancer A549 cell line with circ_0006692 overexpression and knockdown. Cell proliferation, migration and invasion were detected by MTS, colony forming, wound healing and Transwell invasion assays. qRT-PCR and Western blot were used to detect the effect of circ_0006692 expression change on EMT-related gene expression. Results The expression of circ_0006692 in NSCLC was significantly higher than that in adjacent tissues (P < 0.05). The expression level of circ_0006692 was closely related to tumor size, TNM stage and pulmonary membrane invasion (P < 0.05). circ_0006692 knockdown inhibited cell proliferation, invasion and metastasis, while its overexpression promoted cell proliferation, invasion and metastasis. circ_0006692 knockdown inhibited the expression of EMT-related genes CDH2 and MMP7 in A549 cells and promoted the expression of CDH1. Conclusion The upregulated expression of circ_0006692 in NSCLC is closely related to tumor size, TNM stage and pulmonary membrane invasion. circ_0006692 expression could regulate the proliferation, invasion, metastasis and EMT progression of lung cancer A549 cells.

Objective:To find out the key factors that affect the clinical outcome of euploid single blastocyst transfer.Methods:This retrospective study included 956 patients' clinical data of frozen euploid single blastocyst transfer cycles for preimplantation genetic testing (PGT) in Shanghai Ji Ai Genetics and IVF Institute from January 2014 to January 2018. According to the outcome of transplantation, the patients were divided into pregnancy group ( n=509) and non-pregnancy group ( n=447), and the clinical data between the two groups were compared to screen out the key factors affecting the pregnancy rate of transplantation; at the same time, the pregnancy group was further divided into live birth subgroup and miscarriage subgroup, and the clinical data between the two subgroups were compared and the significant factors affecting the abortion were screened by logistic regression. Results:The endometrial thickness of pregnancy group was significantly thicker than that of non-pregnancy group [9(8,10) mm vs. 8(8,10) mm] ( P=0.006); the clinical pregnancy rate and the live birth rate of blastocyst with good quality were significantly higher than those with poor quality (59.2% vs. 46.3%, 50.2% vs. 37.7%) ( P=0.001). In addition, compared with miscarriage subgroup, blastocyst development time was a risk factor of abortion, and the OR value was 0.536 (95% CI=0.309-0.929). Conclusion:In the frozen embryo transfer cycles of single euploid blastocyst, the thicker endometrium, the faster development and the higher score of blastocyst are the key factors for the success of the implantation. In the process of maintaining the late pregnancy, the faster development of blastocyst (D5) has a higher live birth rate and a lower miscarriage rate.

Objective:To find out the key factors that affect the clinical outcome of euploid single blastocyst transfer.Methods:This retrospective study included 956 patients' clinical data of frozen euploid single blastocyst transfer cycles for preimplantation genetic testing (PGT) in Shanghai Ji Ai Genetics and IVF Institute from January 2014 to January 2018. According to the outcome of transplantation, the patients were divided into pregnancy group ( n=509) and non-pregnancy group ( n=447), and the clinical data between the two groups were compared to screen out the key factors affecting the pregnancy rate of transplantation; at the same time, the pregnancy group was further divided into live birth subgroup and miscarriage subgroup, and the clinical data between the two subgroups were compared and the significant factors affecting the abortion were screened by logistic regression. Results:The endometrial thickness of pregnancy group was significantly thicker than that of non-pregnancy group [9(8,10) mm vs. 8(8,10) mm] ( P=0.006); the clinical pregnancy rate and the live birth rate of blastocyst with good quality were significantly higher than those with poor quality (59.2% vs. 46.3%, 50.2% vs. 37.7%) ( P=0.001). In addition, compared with miscarriage subgroup, blastocyst development time was a risk factor of abortion, and the OR value was 0.536 (95% CI=0.309-0.929). Conclusion:In the frozen embryo transfer cycles of single euploid blastocyst, the thicker endometrium, the faster development and the higher score of blastocyst are the key factors for the success of the implantation. In the process of maintaining the late pregnancy, the faster development of blastocyst (D5) has a higher live birth rate and a lower miscarriage rate.

Objective To explore the effect of different levels of iodine excess on morphological changes of mouse thyroid follicle and pancreatic acinar cells.Methods Sixty female mice (BALB/c) were selected and their body weight were 18-22 g.The mice were divided into 6 groups according to body weight via the random number table method,10 mice in each group.Potassium iodate was added to drinking water in exposure groups with iodine contents of 300,600,1 200,2 400,and 4 800 μg/L,while normal group (control) was given normal levels of iodine (5 μg/L) tap water.After feeding for one month,the thyroid and pancreas of the mice were harvested,and the morphology of thyroid follicle and pancreatic acinar cells were observed through light microscope and ultrastructural changes of pancreas were observed through electron microscope.Results After one month of feeding,mice in the high iodine drinking water groups,starting from the 1 200 μg/L group,thyroid follicular cavity gradually enlarged and cells became flat;swollen and vacuolar-like deformation were observed in the mouse pancreas acinar cells under light microscope.Under the electron microscope,the ultrastructure of pancreatic acinar cells changed significantly starting from the 600 μg/L group,the number of zymogens decreased,organelle degeneration and necrosis,and endoplasmic reticulum expanded.Conclusion Iodine excess can cause damage to pancreatic acinar cells in mice.

Objective: To investigate the expression of long non-coding RNA (lncRNA) SNHG8 in EB virus related gastric cancer and their correlation prognosis. Methods: The expression of SNHG8 in 93 gastric cancers and 93 cancer-free controls, matched by age and sex, were determined by real-time PCR. EB virus expression was detected by EBER in situ hybridization. Results: Forty-one gastric cancers were EB virus associated. For all gastric cancers, SNHG8 expression was 14 times higher (P=0.001) than that in non-cancer controls; in the EB virus related gastric cancers, SNHG8 expression was increased 25 times (P<0.05) over EB virus negative gastric cancers. SNHG8 expression level was also significantly associated with TNM staging (P<0.05). Conclusions SNHG8 may act as a proto-oncogene, participating in gastric carcinogenesis.EB virus infection of gastric mucosa may promote SNHG8 expression.

BACKGROUND:Tranexamic acid is a synthetic anti-fibrinolytic drug, and can effectively control blood loss after total knee arthroplasty through vein. OBJECTIVE:To evaluate the effectiveness and safety of tranexamic acid in reducing blood loss after primary unilateral total knee arthroplasty. METHODS:From 2014 to 2015, 100 patients from the Department of Lower Limb, Sichuan Orthopaedic Hospital underwent primary unilateral total knee arthroplasty, and randomly divided into test group which used tranexamic acid and control group which used tranexamic acid, with 50 cases in each group. 1 g tranexamic acid was infused into the vein at 10 minutes before total knee arthroplasty in the test group, but tranexamic acid was not given in the control group. RESULTS AND CONCLUSION:The amount of total blood loss, postoperative wound drainage in 24 hours, and the amount of blood transfusion were significantly less in the test group than in the control group (P < 0.05). No significant differences in intraoperative blood loss and the number of patients receiving blood transfusion were found between the test and control groups. No significant difference in preoperative hemoglobin levels was detected before surgery, but hemoglobin levels were decreased after surgery between the two groups. Postoperative hemoglobin levels were apparently higher in the test group than in the control group after surgery. At 24 hours after surgery, no significant difference in coagulation was detectable between the two groups. At 6 days, double lower limb vein color Doppler ultrasound examination did not reveal deep vein thrombosis in both groups. These findings verify that treatment with tranexamic acid in the vein before primary unilateral total knee arthroplasty can evidently diminish the amount of perioperative blood loss and blood transfusion, reduce the risk and cost of blood transfusion, which is good for rehabilitation and does not increase the risk of deep vein thrombosis.