Aim To explore the effect of age on myocardial remodeling after percutaneous coronary intervention(PCI)in patients with acute anterior myocardial infarction.Methods This study was a cross-sectional study analyzing clinical data of regular follow-up at 1,3,6 and 12 months after PCI for acute anterior myocardial infarction.According to the age of the patients,they were divided into a low age group(＜65 years old)and a high age group(≥65 years old).The differences in baseline data,biochemical indexes,coronary angiography,inflammatory factor levels,and cardiac ultrasound indexes between the two groups were analyzed,and the correlation analysis between age and inflammatory factors and the multivariate linear regression analysis of diastolic function were performed.Results A to-tal of 87 patients with acute anterior myocardial infarction were selected,aged(62±13)years,including 67 males(77.0％),43 in the low age group and 44 in the high age group.Compared with the low age group,the levels of inflam-matory factors such as C-reactive protein,interleukin-1β(IL-1β),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)increased in the high age group,while ultrasound indicators such as mitral valve annulus septal e',mitral valve flow velocity E/A,and mitral valve annulus sidewall e'decreased(P＜0.05).Older age was an independent risk factor for a decrease in mitral valve flow velocity E/A,mitral valve annulus sidewall e'and mitral valve annulus septal e'in patients with acute anterior myocardial infarction 6 months after PCI(P＜0.05).Conclusion Age is an independent risk factor for reduced diastolic function after PCI in acute anterior myocardial infarction,inflammatory factor such as IL-1β,IL-6 and TNF-α may play a role in the impaired diastolic function after PCI in age-related acute anterior myocardial infarction.

Aim To apply coronary angiography derived index of microcirculatory resistance(caIMR)to evaluate the effect of coronary microcirculation perfusion on myocardial remodeling after interventional therapy in patients with acute anterior ST segment elevation myocardial infarction(STEMI).Methods This was a cross-sectional study.The analysis was performed among the patients who were hospitalized for acute anterior STEMI in the First Department of the Second Affiliated Hospital of Dalian Medical University from January 2021 to July 2022 and received percutaneous coro-nary intervention(PCI)with regtelar follow-up visits.The patients were divided into low caIMR(L-caIMR)group,me-dium caIMR(M-caIMR)group and high caIMR(H-caIMR)group according to the results of caIMR.The results of ech-ocardiography at perioperative period,1 month,3 months,6 months and 1 year were analyzed and compared,including left atrial diameter(LAD),left ventricular end-diastolic diameter(LVEDD),interventricular septum thickness(IVST),mitral orifice flow velocity E/A,mitral annular septum e'and mitral annular wall e',etc.The difference of interleukin-1β(IL-1β),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)and other inflammatory factors in peripheral blood of the three groups were also compared.Results A total of 75 patients diagnosed with acute anterior STEMI were recrui-ted,including 55 males.The L-caIMR group,M-caIMR group,and H-caIMR group had 26,26 and 23 cases,respec-tively.Compared with the L-caIMR group,the LAD and IVST in the M-caIMR group and the H-caIMR group exhibited an increasing tendency one month after PCI,and the increase in the H-caIMR group was more significant than that in the M-caIMR group(P＜0.05).The ejection fraction in the H-caIMR group was notably lower than that in the L-caIMR group and the M-caIMR group at 1 and 3 months after PCI(P＜0.05).Compared with the L-caIMR group,the mitral flow velocity E/A at 6 months after PCI,and the e'at the septal side and the lateral wall of the mitral annulus at 1,3,and 6 months after PCI were significantly reduced in the M-caIMR and H-caIMR groups(P＜0.05).Compared with the L-caIMR group,the levels of IL-1β,IL-6,and TNF-α showed an increasing trend in the M-caIMR group and the H-caIMR group,and the increase was greater in the H-caIMR group than that in the M-caIMR group(P＜0.05).Multivariate anal-ysis revealed that caIMR was a factor influencing the levels of IL-1 β and IL-6(P＜0.05).Conclusion CMD may be involved in the process of myocardial remodeling in patients with acute anterior STEMI after PCI,in which inflammation plays a role.

Objectives:To assess the effectiveness of transcatheter aortic valve replacement (TAVR) on electrocardiographic remodeling in patients with severe aortic stenosis (AS), and identify its influencing factors.Methods:A cohort study was conducted on patients with a confirmed diagnosis of severe AS who successfully underwent TAVR at the Second Affiliated Hospital of Dalian Medical University between June 2018 and March 2023. Data, including standard 15-lead electrocardiograms and echocardiograms, were collected before the operation, 1 week after the operation, and 3 months after the operation. The average degree of ST-segment depression in the lateral wall leads of the electrocardiograms, and the amplitude of the T-wave were measured and calculated. The changes of electrocardiograms indexes were observed, and Spearman correlation analysis was used to explore the correlation between each index of electrocardiograms and each index of echocardiography. Multiple linear regression analysis was used to determine the influencing factors of the improvement of electrocardiographic remodeling in patients with severe AS after TAVR.Results:A total of 33 patients with severe AS, aged (73±9) years, were included in the study. Among them there were 15 (45%) males. The degree of ST-segment depression, supra-aortic flow velocity, peak transaortic pressure, and mean transaortic pressure exhibited significant improvement at 1 week post-TAVR (all P<0.05). Similarly, significant improvements in T-wave hypoplasia or inversion, left ventricular mass, and left ventricular mass index were observed at 3 months post-TAVR (all P<0.05). The degree of ST-segment depression was found to be correlated with supra-aortic flow velocity, peak transaortic pressure, and mean transaortic pressure (all P<0.05). Additionally, a correlation was observed between T-wave amplitude and left ventricular mass, left ventricular mass index, left ventricular end-diastolic internal diameter, and left ventricular ejection fraction (all P<0.05). Multiple linear regression analysis revealed that supra-aortic flow velocity was an independent influencing factor of the level of ST-segment depression ( β=-0.156, P=0.007), while left ventricular mass index was identified as an independent influencing factor of T-wave amplitude ( β=-2.007, P=0.001). Conclusion:The improvement in electrocardiographic remodeling could be observed after TAVR in patients with severe AS, which may be due to enhanced cardiac perfusion and regression of left ventricular hypertrophy subsequent to aortic valve opening.

Aim To apply coronary angiography derived index of microcirculatory resistance(caIMR)to evaluate the effect of coronary microcirculation perfusion on myocardial remodeling after interventional therapy in patients with acute anterior ST segment elevation myocardial infarction(STEMI).Methods This was a cross-sectional study.The analysis was performed among the patients who were hospitalized for acute anterior STEMI in the First Department of the Second Affiliated Hospital of Dalian Medical University from January 2021 to July 2022 and received percutaneous coro-nary intervention(PCI)with regtelar follow-up visits.The patients were divided into low caIMR(L-caIMR)group,me-dium caIMR(M-caIMR)group and high caIMR(H-caIMR)group according to the results of caIMR.The results of ech-ocardiography at perioperative period,1 month,3 months,6 months and 1 year were analyzed and compared,including left atrial diameter(LAD),left ventricular end-diastolic diameter(LVEDD),interventricular septum thickness(IVST),mitral orifice flow velocity E/A,mitral annular septum e'and mitral annular wall e',etc.The difference of interleukin-1β(IL-1β),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)and other inflammatory factors in peripheral blood of the three groups were also compared.Results A total of 75 patients diagnosed with acute anterior STEMI were recrui-ted,including 55 males.The L-caIMR group,M-caIMR group,and H-caIMR group had 26,26 and 23 cases,respec-tively.Compared with the L-caIMR group,the LAD and IVST in the M-caIMR group and the H-caIMR group exhibited an increasing tendency one month after PCI,and the increase in the H-caIMR group was more significant than that in the M-caIMR group(P＜0.05).The ejection fraction in the H-caIMR group was notably lower than that in the L-caIMR group and the M-caIMR group at 1 and 3 months after PCI(P＜0.05).Compared with the L-caIMR group,the mitral flow velocity E/A at 6 months after PCI,and the e'at the septal side and the lateral wall of the mitral annulus at 1,3,and 6 months after PCI were significantly reduced in the M-caIMR and H-caIMR groups(P＜0.05).Compared with the L-caIMR group,the levels of IL-1β,IL-6,and TNF-α showed an increasing trend in the M-caIMR group and the H-caIMR group,and the increase was greater in the H-caIMR group than that in the M-caIMR group(P＜0.05).Multivariate anal-ysis revealed that caIMR was a factor influencing the levels of IL-1 β and IL-6(P＜0.05).Conclusion CMD may be involved in the process of myocardial remodeling in patients with acute anterior STEMI after PCI,in which inflammation plays a role.

Aim To explore the effect of age on myocardial remodeling after percutaneous coronary intervention(PCI)in patients with acute anterior myocardial infarction.Methods This study was a cross-sectional study analyzing clinical data of regular follow-up at 1,3,6 and 12 months after PCI for acute anterior myocardial infarction.According to the age of the patients,they were divided into a low age group(＜65 years old)and a high age group(≥65 years old).The differences in baseline data,biochemical indexes,coronary angiography,inflammatory factor levels,and cardiac ultrasound indexes between the two groups were analyzed,and the correlation analysis between age and inflammatory factors and the multivariate linear regression analysis of diastolic function were performed.Results A to-tal of 87 patients with acute anterior myocardial infarction were selected,aged(62±13)years,including 67 males(77.0％),43 in the low age group and 44 in the high age group.Compared with the low age group,the levels of inflam-matory factors such as C-reactive protein,interleukin-1β(IL-1β),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)increased in the high age group,while ultrasound indicators such as mitral valve annulus septal e',mitral valve flow velocity E/A,and mitral valve annulus sidewall e'decreased(P＜0.05).Older age was an independent risk factor for a decrease in mitral valve flow velocity E/A,mitral valve annulus sidewall e'and mitral valve annulus septal e'in patients with acute anterior myocardial infarction 6 months after PCI(P＜0.05).Conclusion Age is an independent risk factor for reduced diastolic function after PCI in acute anterior myocardial infarction,inflammatory factor such as IL-1β,IL-6 and TNF-α may play a role in the impaired diastolic function after PCI in age-related acute anterior myocardial infarction.

Objectives:To assess the effectiveness of transcatheter aortic valve replacement (TAVR) on electrocardiographic remodeling in patients with severe aortic stenosis (AS), and identify its influencing factors.Methods:A cohort study was conducted on patients with a confirmed diagnosis of severe AS who successfully underwent TAVR at the Second Affiliated Hospital of Dalian Medical University between June 2018 and March 2023. Data, including standard 15-lead electrocardiograms and echocardiograms, were collected before the operation, 1 week after the operation, and 3 months after the operation. The average degree of ST-segment depression in the lateral wall leads of the electrocardiograms, and the amplitude of the T-wave were measured and calculated. The changes of electrocardiograms indexes were observed, and Spearman correlation analysis was used to explore the correlation between each index of electrocardiograms and each index of echocardiography. Multiple linear regression analysis was used to determine the influencing factors of the improvement of electrocardiographic remodeling in patients with severe AS after TAVR.Results:A total of 33 patients with severe AS, aged (73±9) years, were included in the study. Among them there were 15 (45%) males. The degree of ST-segment depression, supra-aortic flow velocity, peak transaortic pressure, and mean transaortic pressure exhibited significant improvement at 1 week post-TAVR (all P<0.05). Similarly, significant improvements in T-wave hypoplasia or inversion, left ventricular mass, and left ventricular mass index were observed at 3 months post-TAVR (all P<0.05). The degree of ST-segment depression was found to be correlated with supra-aortic flow velocity, peak transaortic pressure, and mean transaortic pressure (all P<0.05). Additionally, a correlation was observed between T-wave amplitude and left ventricular mass, left ventricular mass index, left ventricular end-diastolic internal diameter, and left ventricular ejection fraction (all P<0.05). Multiple linear regression analysis revealed that supra-aortic flow velocity was an independent influencing factor of the level of ST-segment depression ( β=-0.156, P=0.007), while left ventricular mass index was identified as an independent influencing factor of T-wave amplitude ( β=-2.007, P=0.001). Conclusion:The improvement in electrocardiographic remodeling could be observed after TAVR in patients with severe AS, which may be due to enhanced cardiac perfusion and regression of left ventricular hypertrophy subsequent to aortic valve opening.

Objective:To analyze the correlation of cyclin-dependent kinase 4 (CDK4) and breast cancer resistance protein (BCRP) expression with pathological features and prognosis of breast cancer.Methods:From Jan. 2020 to Jun. 2021, 132 breast cancer patients admitted to our hospital were chosen. The surgically removed breast cancer tissues and adjacent tissues of all patients were collected, and the expressions of CDK4 and BCRP were detected by immunohistochemical staining. Clinical data of all patients were collected, and the correlation among CDK4, BCRP expression and pathological features, prognosis was analyzed.Results:The positive expression rates of CDK4 and BCRP in breast cancer tissues were higher than those in adjacent tissues ( P <0.05) ; The positive expression rate of CDK4 and BCRP was associated with differentiation degree, TNM stage and lymph node metastasis (all P <0.05) ; Kaplan-Meier analysis showed that the cumulative survival rate of CDK4 and BCRP negative expression group was higher than that of positive expression group ( P <0.05) ; Differentiation degree, TNM stage, lymph node metastasis, CDK4 expression and BCRP expression were independent prognostic factors for overall survival of breast cancer patients (all P <0.05) . Conclusions:CDK4 and BCRP have high positive expression rates in breast cancer tissues, and their expression is related to pathological features, with certain value in evaluating the prognosis of breast cancer patients.

Objective To evaluate the expression of serum vascular endothelial growth factor ( VEGF ) on recurrence and/or metastasis following surgery in patients with differentiated thyroid carcinoma,and to ana1yze the relationship between serum VEGF and serum thyroglobulin levels.Methods The serum samples were obtained from 25 patients with pulmonary metastasis, 43 cases with locoregional recurrence, 30 cases without recurrence and/or metastasis and 30 normal subjects were selected as control.The levels of serum VEGF were analyzed by enzyme-linked immunosorbent assay( ELISA) ,the levels of serum thyroglobulin were analyzed by chemiluminescence method. Results The level of serum VEGF[(864.3 ±200.3)ng/L] in patients with pulmonary metastasis were significantly higher than that in patients with locoregional recurrence[(393.3 ±96.3)ng/L],without recurrence and /or metasta-sis[(276.6 ±47.7)ng/L] and normal subjects[(268.6 ±36.9)ng/L](t=11.04,14.34,14.66,all P<0.05), while there was no significant difference of serum VEGF level between without recurrence and /or metastasis and normal subjects (t=0.73,P>0.05).It showed linear correlation between serum VEGF and thyroglobulin levels on recurrence and/or metastasis following surgery in patients with differentiated thyroid carcinoma ( r=0.902 2, P<0.001) .Conclusion The serum VEGF level was significantly elevated in patients with locoregional recurrence and pulmonary metastases, the serum VEGF can be used as a auxiliary index to predict recurrence and /or metastasis following surgery in patients with differentiated thyroid carcinoma.

Objective To know the distribution of pathogenic bacteria in the hospital ,and to provide scientific evidence for con‐trolling hospital infection and clinical medication .Methods Samples of the hospitalized patients and the data of bacteria culture and isolation in the hospital were collected and statistically analysed retrospectively from January 2011 to December 2013 .Bacterial iden‐tification and drug sensitivity test were carried out by using VITEK 2 Compact automated bacterial identification and drug sensitive system .The clinical distribution and drug resistance characteristics of the strains were analyzed by using WHONET5 .4 and SPSS17 .0 software .Results In the hospital ,71 929 specimens were received from 2011 to 2013 totally ,the detection rate of patho‐genic bacteria was 18 .5% .Sputum(62 .8% ) ,secretions and pus(11 .3% ) ,blood(10 .3% ) were the top three types of specimens which had larger positive numbers .Gram negative bacteria are the main kind of pathogenic bacteria in the hospital ,accounting for 73 .3% .Gram positive bacteria accounted for 25 .0% .E .coli(21 .1% ) ,Pseudomonas aeruginosa(14 .8% ) ,Acinetobacter baumannii (12 .5% ) ,Klebsiella pneumoniae (12 .2% ) and Staphylococcus aureus(11 .04% ) were the top five pathogenic bacteria .The drug resistance of the isolates were as follows .Gram‐negative bacteria showed resistance of different extents to broad‐spectrum penicil‐lins ,quinolones ,cephalosporins except for the 4th generationsand and aminoglycosides .Over 80% Staphylococcus aureus showed re‐sistance to penicillin ,erythromycin and clindamycin ,but the rate to Oxacillin were decreasing year by year .Enterobacteria were still most sensitive to carbapenems with a sensitive rate over 98 .6% .However ,the emergence of Carbapenem‐resistent enterobacteria from 2011 to 2013 was worthy of clinical attention .Conclusion The type of positive specimens were mainly sputum .Gram negative bacteria are the main pathogenic bacteria ,and have obvious multi-drug resistance .E .Coli is the superiority strains ,fungal infection rate are increasing year by year .Doctors and hospital infection controlling department should pay attention to the monitoring of bac‐terial resistance and improve the rational use of antimicrobial drugs .

Purpose To exp1ore the c1inicopatho1ogica1 features,diagnosis and differentia1 diagnosis of mu1ti1ocu1ar cystic rena1 ce11 carcinoma( MCRCC). Methods 18 cases of MCRCC were reported by microscopy,immunohistochemistry,differentia1 diagnosis and were fo11owed-up. Results A11 patients were adu1ts inc1uding twe1ve ma1es and six fema1es who aged from 26 to 68 years(mean 55. 6 years). Imaging studies revea1ed a po1ycystic mass,with c1ear boundary. Gross1y,the cut surface of the tumors had more cysts of va-rying sizes,containing serous or b1oody f1uid. Microscopica11y,the cyst wa11s of tumors were often covered with a few simp1e c1ear ce11s,stratified epithe1ium or devoid of epithe1ium. The septa contained aggregates of epithe1ia1 ce11s with transparent cytop1asm which showed gradeⅠ nuc1ear features,these characteristics were diagnostic c1ues of MCRCC. Immunohistochemica11y the c1ear ce11 was positive for CD10,vimentin,EMA and Ki-67 showed 1ow pro1iferative activity. 18 case were fo11owed up,mean fo11ow-up 43 months, no case recurred or with metastasis. Conclusion MCRCC is a rare histo1ogica1 subtype of rena1 ce11 carcinoma with more favorab1e prognosis. It shou1d be distinguished from cystic change of c1ear ce11 rena1 carcinoma and cysts of kidney 1esion.