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 establish a mouse model of aorta dissection (AD) by β-aminopropionitrile (BAPN) in drinking water + subcutaneously pumped angiotensin II (Ang II) infusion.Methods Forty 3-week-old C57B1/6J male mice were randomly divided into two groups.All animals received 0.1 g/kg/d BAPN in drinking water for 4 weeks.Then the BAPN drinking + saline infusion group and BAPN drinking + Ang II infusion group received continuous saline or Ang II (1,000 ng/kg/min) infusion, respectively, via subcutaneous osmotic minipump for 72 hour.The mice were restricted in a noninvasive computerized tail-cuff system and their arterial systolic blood pressure and heart rate were monitored.Autopsy was performed if a mouse died during the experiment.At the end of the experiment, mice were sacrificed by injection with an overdose of sodium pentobarbital and the aortas were harvested.The formation of aortic false lumen was observed by pathology using hematoxylin-eosin staining.Results The overall incidence of AD in the BAPN drinking administration +Ang II infusion group was 95%, whereas the incidence of AD in the BAPN drinking administration +saline infusion group was only 5%.The mortality from dissecting aneurysm rupture was 24% in the BAPN drinking administration +Ang II infusion group during the experiment.Pathological examination of the aortic cross-sections clearly showed the formation of blood-filled false lumens induced by Ang II.Conclusions A mouse model with high incidence of aortic dissection is successfully established.

The present study determined the thyroid hormone interference of tetrabromobisphenol A (TBBPA) in Sprague-Dawley (SD) rats, and the derived-reference dose (RfD) of different endpoint effects on mammals based on experimental results and data collection. Based on repeated exposure toxicity tests on mammals and extensive research, the present study used BMDS240 Software to derive a benchmark dose, and analyzed the accuracy and uncertainty, and similarity with other studies. Test results on triiodothyronine (T3), thyroxine (T4), and thyroid stimulating hormone (TSH) demonstrated that all the indicators presented a non-monotonous dose-effect relationship clearly, except TSH in male rats exposed to 0-1000 mg/kg BW per day. Therefore, RfDs were derived from different critical effects. In summary, RfD for mammals in the present study was found to be 0.6 mg/kg per day.
Animals ; Dose-Response Relationship, Drug ; Female ; Male ; Polybrominated Biphenyls ; toxicity ; Rats ; Rats, Sprague-Dawley ; Thyroid Hormones ; metabolism ; Thyrotropin ; metabolism ; Thyroxine ; metabolism ; Triiodothyronine ; metabolism

Objective: To explore the application value on combined examination of blood levels of growth differentiation factor-15 (GDF-15) and NT-pro B-type natriuretic peptide (NT-proBNP) in patients after successful cardiopulmonary resuscitation (CPR) for their recent prognosis.
Methods: A total of 102 patients with sudden cardiac arrest and successful CPR in our hospital were enrolled. Blood levels of GDF-15 were examined at immediately, 12 h and 24-48 h after CPR respectively. According to GDF-15 levels, the patients were divided into 3 groups: Group A, the patients with GDF-15<1200 ng/L at all-time points,n=31; Group B, GDF-15 level consistently increasing and GDF-15>1200 ng/L at all-time points,n=35; Group C, GDF-15 level consistently increasing at 12 h and 24-48 h after CPR, while it was lower at 24-48 h than 12 h after CPR,n=36. Blood levels of NT-proBNP and left ventricular ejection fraction (LVEF) were also examined. The patients were followed-up for 6 months for post-CPR death.
Results: Blood levels of GDF-15 and NT-proBNP were related, NT-proBNP level was changing with GDF-15 varying. GDF-15 and NT-proBNP level was negatively related to LVEF (r=-0.530,P<0.001), the patients with GDF-15>1800 ng/L and NT-proBNP>400 pg/ml had the higher mortality than those had the lower levels of GDF-15 and NT-proBNP,P<0.05. Survival analysis presented that 6 months survival rate in Group B was lower than Group A and Group C,P<0.05; survival rate was similar between Group A and Group C,P>0.05.
Conclusion: Combined examination for blood levels of GDF-15 and NT-proBNP may better predict the recent prognosis in patients who received CPR.

Objective: To explore the relationship between plasma level of B-type natriuretic peptide (BNP) and short term prognosis in patients of sudden cardiac arrest with successful cardiopulmonary resuscitation (CPR). Methods:A total of 60 relevant patients were divided into 3 groups based on their plasma levels of BNP. Group A, the patients with plasma level of BNP < 200 pg/ml at immediately, 3 hours and 12-24 hours after CPR,n=16. Group B, the patients with consistently increased BNP and at 3 hours, 12-24 hours after CPR and the BNP level > 200 pg/ml , n=22. Group C, the patients with obviously increased BNP at 3 hours after CPR, while at 12-24 hours after CPR, BNP level decreased to lower than 3 hours level,n=22. All patients were followed-up for 6 months to compare the mortality incidence among different groups. Results: There was no patient died in Group A, the mortality incidence in Group B was 11 and in Group C was 3. The 6 months survival rate in Group A was higher than that in Group B (χ2 = 11.337,P=0.001), the survival rates were similar between Group A and Group C (χ2 = 2.330,P=0.127), and the survival rate in Group B was lower than that in Group C (χ2=7.435,P= 0.006). Conclusion: Consistently increased plasma level of BNP may imply heart failure in patients of sudden cardiac arrest with successful CPR, those patients could have poor short term prognosis. It is critical to improve the cardiac function and increase the important organ infusion to make better recent clinical prognosis.

Nowadays, tumor is one of the most challenging human health diseases, which oblige human tirelessly to studied for the tumor.Gene therapy is a promising treatment in oncotherapies. Suicide gene therapy is the most widely researched among gene therapies. At the same time, bystander effect take important role in the mechanism of suicide gene therapy. Therefore, more researchers devote themselves to studyinghow enhance the bystander effect in order to improve the effect of suicide gene therapy. This article reviewed in short how to augment bystander effect of suicide gene therapy against cancer.

Objective To assess the value of real-time myocardial contrast echocardiography (RTMCE) and intermittent triggered myocardial contrast echocardiography (ITMCE) in the detection of myocardial no-reflow phenomenon after reperfusion in acute myocardial infarction on mini-swine models. Methods Thirty close-chest mini-swines were used to create acute myocardial infarction and reperfusion model through interventional method. RTMCE and ITMCE were performed at baseline, 2 h after occlusion of left anterior descending coronary artery and 3 h after reperfusion. The myocardial perfusion defects after occlusion was measured as risk area (RA) and that after reperfusion was measured as no-reflow area (NRA). NRA/RA was calculated and compared with pathological findings. Results The whole study protocol was successfully performed in 27 mini-swines. NRA/RA obtained from RTMCE, ITMCE and pathological staining was (47.94±21.29)%, (38.20±21.04)% and (30.07±14.62)% , respectively. NRA/RA had no significant difference by ITMCE and pathological staining (P=0.124), RTMCE and ITMCE (P=0.071). The correlation coefficient of RTMCE and staining was 0.700 (P<0.001), ITMCE and staining was 0.765 (P<0.001), RTMCE and ITMCE was 0.897 (P<0.001). The sensitivity, specificity and accuracy in the detection of myocardial no-reflow was 100%, 58.33% and 79.17% for RTMCE, 91.67%, 73.33% and 81.48% for ITMCE. Conclusion Both RTMCE and ITMCE could be used as noninvasive methods to reveal the myocardial perfusion and quantitatively detect myocardial no-reflow after reperfusion therapy.

Objective To investigate the significance of Akt in the pathogenesis of psoriasis.Methods Tissue specimens were obtained from involved and uninvolved skin of 30 patients with progressive psoriasis vulgaris and normal skin of 20 human controls.Immunohistochemistry.immunobloting and kinase activity assay were performed to detect the expressions of Akt and phosphorylated Akt as well as Akt activities in these specimens.Immunostaining intensity Was assessed by optical density detection and the results of immunobiot and activity assay by grey scanning.Statistical analyses were performed by variance analysis and student's t test.Results As immunohistochemistry revealed.there was no significant difierence in Akt protein expression among normal epidermis,psoriatic epidermis and uninvolved epidermis(F=0.611,P＞0.05):the level of phosphorylated Akt in psoriatic epidermis was significantly higher than that in normal epidermis and psoriatic uninvolved epidermis(F=19.081.P＜0.01).while no significant difierence was observed between normal epidermis and psoriatic uninvolved epidermis (t=0.624.P＞0.05).Immunoblot showed a significant difierence in phosphorylated Akt(t=237.75.P＜0.01)but not in Akt(t=1.378,P＞0.05)between psoriatic involved epidermis and normal epidermis.In comparison with normal epidermis,the activity of Akt in psoriatic involved epidermis was increased significantly(t=138.44 1.P＜0.0 1).Conclusion The overproliferation of psoriatic keratinocytcs may be associated with increased activation of Akt.

Objective To investigate the relationship of the expression of phosphatidylinositol-3-kinase(PI3K)subunits,P85 and P110 to the pathogenesis of psoriasis.Methods Immunohistochemical staining for P85 and P110 was performed in the tissue specimens from patients with psoriasis(n=30),chronic dermatitis(n=20),seborrheic keratosis(n=20),squamous cell carcinoma(n=20),basal cell carcinoma(n=30)and normal human controls(n=10).The absorbance of immunostained tissue was quantified with image analysis system (Q550CW,Leica,Manheim,Germany).Statistical analysis was carried out by ANOVA,Results Among these groups,a significant difference was observed in the expression level of P110 in the epidermis(F=35.64,P＜0.01),as well as in that of P85(F=59.98,P＜0.01)and P110(F=323.23,P＜0.01)in the lymphocytes infiltrating the lesion.Increased expression of P110 was found in the epidermis of psoriatic lesions compared with the lesions in the other disorders,whereas no significant difference was noticed among the other disorders.In the case of P85 and P110 expression in the lesion-infiltrating lymphocytes infiltrating the lesion,psoriasis and squamous cell carcinoma significantly differed from the other disorders,while no difference was observed between psoriasis and squamous cell carcinoma (P＞0.05).Conclusions The high expression of P110 might be closely correlated to the hyperproliferation of keratinocytes;but filrther study is needed to clarify the relationship of increased expression of P85 and P110 to the activation and proliferation of lymphocytes in psoriatic lesions.