The evaluation of blood compatibility of biomaterials is crucial for ensuring the clinical safety of implantable medical devices. To address the limitations of traditional testing methods in real-time monitoring and electrical property analysis, this study developed a portable electrical impedance tomography (EIT) system. The system uses a 16-electrode design, operates within a frequency range of 1 to 500 kHz, achieves a signal to noise ratio (SNR) of 69.54 dB at 50 kHz, and has a data collection speed of 20 frames per second. Experimental results show that the EIT system developed in this study is highly consistent with a microplate reader ( R ²=0.97) in detecting the hemolytic behavior of industrial-grade titanium (TA3) and titanium alloy-titanium 6 aluminum 4 vanadium (TC4) in anticoagulated bovine blood. Additionally, with the support of a multimodal image fusion Gauss-Newton one-step iterative algorithm, the system can accurately locate and monitor in real-time the dynamic changes in blood permeation and coagulation caused by TC4 in vivo. In conclusion, the EIT system developed in this study provides a new and effective method for evaluating the blood compatibility of biomaterials.
Electric Impedance ; Animals ; Tomography/instrumentation* ; Biocompatible Materials ; Materials Testing/instrumentation* ; Cattle ; Titanium ; Alloys ; Prostheses and Implants

Purpose To explore the influence of thrombolysis therapy before percutaneous coronary intervention(PCI)on long-term left ventricular global and regional function in ST segment elevation myocardial infarction(STEMI)patients by cardiac magnetic resonance(CMR).Materials and Methods A retrospective analysis was conducted on 67 STEMI patients who were enrolled in a prospective study from November 2021 to August 2022 in the First Affiliated Hospital with Nanjing Medical University,the First People's Hospital of Lianyungang,the Affiliated Hospital of Jiangnan University,Changzhou No.2 People's Hospital and Huai'an Second People's Hospital and underwent CMR examination one year later.STEMI patients were divided into thrombolysis group and non-thrombolysis group according to whether a single half-dose of 5 mg recombinant staphylokinase(r-SAK)was given within two hours before the first medical contact and PCI.Based on CMR cine images,the traditional left ventricular function,global and segmental functional parameters were measured,and the differences between the two groups were compared.According to the degree of late gadolinium enhancement involvement,myocardial segments were divided into the following four types:transmural infarcted segments,non-transmural infarcted segments,locally infarcted segments,and non-infarcted segments.The parameters of the two groups were compared across these different segments.Results At the patient level,the cardiac index,left ventricular wall thickening and left ventricular wall motion in r-SAK thrombolysis group were higher than those in non-thrombolysis group(t/Z=-2.426,-4.307,-2.735,all P<0.05).At the segment level,compared with non-thrombolysis group,patients received r-SAK before primary PCI showed greater segmental radial strain in non-transmural infarcted segments(Z=-2.117,P=0.034);larger segmental wall motion in locally infarcted segments(Z=-2.235,P=0.025),and better segmental circumference strain in the non-infarcted segments(Z=-3.869,P<0.001).Conclusion The thrombolytic therapy before PCI in STEMI patients retain better long-term left ventricular global and regional function evaluating by CMR.

Purpose To explore the influence of thrombolysis therapy before percutaneous coronary intervention(PCI)on long-term left ventricular global and regional function in ST segment elevation myocardial infarction(STEMI)patients by cardiac magnetic resonance(CMR).Materials and Methods A retrospective analysis was conducted on 67 STEMI patients who were enrolled in a prospective study from November 2021 to August 2022 in the First Affiliated Hospital with Nanjing Medical University,the First People's Hospital of Lianyungang,the Affiliated Hospital of Jiangnan University,Changzhou No.2 People's Hospital and Huai'an Second People's Hospital and underwent CMR examination one year later.STEMI patients were divided into thrombolysis group and non-thrombolysis group according to whether a single half-dose of 5 mg recombinant staphylokinase(r-SAK)was given within two hours before the first medical contact and PCI.Based on CMR cine images,the traditional left ventricular function,global and segmental functional parameters were measured,and the differences between the two groups were compared.According to the degree of late gadolinium enhancement involvement,myocardial segments were divided into the following four types:transmural infarcted segments,non-transmural infarcted segments,locally infarcted segments,and non-infarcted segments.The parameters of the two groups were compared across these different segments.Results At the patient level,the cardiac index,left ventricular wall thickening and left ventricular wall motion in r-SAK thrombolysis group were higher than those in non-thrombolysis group(t/Z=-2.426,-4.307,-2.735,all P<0.05).At the segment level,compared with non-thrombolysis group,patients received r-SAK before primary PCI showed greater segmental radial strain in non-transmural infarcted segments(Z=-2.117,P=0.034);larger segmental wall motion in locally infarcted segments(Z=-2.235,P=0.025),and better segmental circumference strain in the non-infarcted segments(Z=-3.869,P<0.001).Conclusion The thrombolytic therapy before PCI in STEMI patients retain better long-term left ventricular global and regional function evaluating by CMR.

Objective:To investigate the effects of β-glucan combined with agonistic anti-CD40 monoclonal antibody (5C11) on the immune functions of dendritic cells (DCs) and the possible molecular mechanism.Methods:Mononuclear cells were separated from fresh concentrated white cells (granulocytes) of healthy subjects using Ficoll density gradient centrifugation, and induced by GM-CSF and IL-4 to differentiate into immature DCs. Following various stimulation (5C11 alone, β-glucan alone, 5C11 combined with β-glucan), flow cytometry was used to detect the expression of CD40, CD80, CD83, CD86 and MHC-Ⅱ molecule HLA-DR on the surface of DCs. ELISA was used to detect the secretion of cytokines including IL-12, IL-6, TNF-α and IL-10. Western blot was used to detect the phosphorylation of proteins related to MAPK signaling pathway.Results:Flow cytometry suggested that β-glucan significantly induced the expression of co-stimulatory molecule CD40 on the surface of DCs ( P<0.05). After the DCs were co-stimulated with β-glucan and 5C11, CD80, CD83 and CD86 expression were further significantly increased, and a strong synergistic effect on CD83 expression, a key marker of DC maturation, was observed ( P<0.01). ELISA showed that β-glucan combined with 5C11 could significantly promote the secretion of cytokines such as IL-12, IL-6 and TNF-α by DCs, and have a synergistic effect on the secretion of IL-12, a critical cytokine in regulating DC functions ( P<0.01). Western blot indicated that the phosphorylation of p38 MAPK and p44/42 MAPK in DCs was increased significantly after combined treatment, and the phosphorylation started earlier and lasted longer compared to that in DCs stimulated with 5C11 or β-glucan alone ( P<0.01). Conclusions:This study suggested that β-glucan combined with 5C11 had a synergistic effect on promoting the maturation and improving the immune functions of DCs, providing a new strategy for the preparation of anti-tumor DC vaccines.

Objective:To investigate the effect of pressurization on the recovery of exercise-induced fatigue in rats in plateau environment.Methods:A total of 24 rats in natural environment were transported from altitude of 1 520 m to 2 260 m, then randomly divided into three groups: group A (quiet control group), group B (natural recovery group), and group C (pressurized recovery group), with 8 rats in each group. After the exercise fatigue model training on the running platform every day, the rats in the group B recovered naturally, while the rats in the group C had a 1-hour-recovery in a pressurized cabin of 0.2 MPa for 6 days. On the day 7, the rats in the group B and the group C exercised to exhaustion, and then were killed 24 hours later for sampling. The exercise time of exhaustion was recorded; gastrocnemius HIF-1α, lung iNOS, myocardial CaMKⅡ, and BNP protein expressions, and serum SOD, TAOC, GSH-Px and CAT, ROS, MDA concentration were determined; the morphological chages of myocardium after HE staining, and gastrocnemius were observed.Results:(1) The exhaustive exercise time of the group B (99.00±69.37 min) was lower than that of group C (126.14±59.09 min). (2)The expression level of HIF-1α protein in skeletal muscle was 0.220±0.170 in the group A, 0.070±0.003 in the group B, and 0.360±0.140 in the group C. The expression level of the group C was significantly higher than that in the group B ( P<0.05). The expression level of CaMKⅡ protein in myocardium was 1.18±0.17 in the group A, 1.07±0.13 in the group B, and 1.40±0.22 in the group C. There were no statistical difference between each group. The expression level of BNP protein in myocardium was 0.29±0.05 in the group A, 0.29±0.08 in the group B, 0.53±0.01 in the group C. There were significant differences comparing the group C with the group A and the group B respectively ( P<0.01). The expression level of iNOS in lung was 0.130±0.002 in the group A, 0.450±0.004 in the group B, and 0.360±0.005 in the group C. It was significantly lower in the group A than those in the group C and the group B ( P<0.01). (3) Compared with the group A, the serum SOD ( P<0.05) and GSH-Px decreased, ROS and MDA increased in the group B ( P<0.05). Compared with the group B, the serum SOD ( P<0.05), GSH-Px and TAOC increased, ROS and MDA decreased in the group C ( P<0.05). (4) Under light microscope, muscle fiber in the group B showed atrophy, thinning, rupture, increase of cell gap, and local lytic necrosis; while muscle fiber in the group C showed shrinking gap, decreased rupture, and relieved cell infiltration. Conclusion:In the plateau and hypoxia environment, the application of pressurization to the rats in exercise-induced fatigue can prolong the exhaustive exercise time, alleviate the morphological changes of muscle fibers in myocardium and skeletal muscles, e. g. thinning, rupture, and increase of cell gap, enhance the expressions of HIF-1α, CaMKⅡand BNP in gastrocnemius muscle, increase the levels of serum SOD, GSH Px, and TAOC, reduce the levels of serum ROS and MDA, and contribute to sports fatigue recovery.

Objective:To investigate the effect of pressurization on the recovery of exercise-induced fatigue in rats in plateau environment.Methods:A total of 24 rats in natural environment were transported from altitude of 1 520 m to 2 260 m, then randomly divided into three groups: group A (quiet control group), group B (natural recovery group), and group C (pressurized recovery group), with 8 rats in each group. After the exercise fatigue model training on the running platform every day, the rats in the group B recovered naturally, while the rats in the group C had a 1-hour-recovery in a pressurized cabin of 0.2 MPa for 6 days. On the day 7, the rats in the group B and the group C exercised to exhaustion, and then were killed 24 hours later for sampling. The exercise time of exhaustion was recorded; gastrocnemius HIF-1α, lung iNOS, myocardial CaMKⅡ, and BNP protein expressions, and serum SOD, TAOC, GSH-Px and CAT, ROS, MDA concentration were determined; the morphological chages of myocardium after HE staining, and gastrocnemius were observed.Results:(1) The exhaustive exercise time of the group B (99.00±69.37 min) was lower than that of group C (126.14±59.09 min). (2)The expression level of HIF-1α protein in skeletal muscle was 0.220±0.170 in the group A, 0.070±0.003 in the group B, and 0.360±0.140 in the group C. The expression level of the group C was significantly higher than that in the group B ( P<0.05). The expression level of CaMKⅡ protein in myocardium was 1.18±0.17 in the group A, 1.07±0.13 in the group B, and 1.40±0.22 in the group C. There were no statistical difference between each group. The expression level of BNP protein in myocardium was 0.29±0.05 in the group A, 0.29±0.08 in the group B, 0.53±0.01 in the group C. There were significant differences comparing the group C with the group A and the group B respectively ( P<0.01). The expression level of iNOS in lung was 0.130±0.002 in the group A, 0.450±0.004 in the group B, and 0.360±0.005 in the group C. It was significantly lower in the group A than those in the group C and the group B ( P<0.01). (3) Compared with the group A, the serum SOD ( P<0.05) and GSH-Px decreased, ROS and MDA increased in the group B ( P<0.05). Compared with the group B, the serum SOD ( P<0.05), GSH-Px and TAOC increased, ROS and MDA decreased in the group C ( P<0.05). (4) Under light microscope, muscle fiber in the group B showed atrophy, thinning, rupture, increase of cell gap, and local lytic necrosis; while muscle fiber in the group C showed shrinking gap, decreased rupture, and relieved cell infiltration. Conclusion:In the plateau and hypoxia environment, the application of pressurization to the rats in exercise-induced fatigue can prolong the exhaustive exercise time, alleviate the morphological changes of muscle fibers in myocardium and skeletal muscles, e. g. thinning, rupture, and increase of cell gap, enhance the expressions of HIF-1α, CaMKⅡand BNP in gastrocnemius muscle, increase the levels of serum SOD, GSH Px, and TAOC, reduce the levels of serum ROS and MDA, and contribute to sports fatigue recovery.

Objective: To determine the clinical benefits of internal mammary sentinel lymph node biopsy (IM-SLNB) acquired by breast cancer patients with clinically positive axillary lymph node (ALN), and further optimize the IM-SLNB indications. Methods: All primary breast cancer patients with clinically positive ALN from February 2014 to September 2017 were prospectively recruited in this study. IM-SLNB was performed under the guidance of the modified injection technique. The success rate and visualization rate of IM-SLNB, metastatic rate of internal mammary sentinel lymph node (IMSLN) and its related factors were analyzed, and the clinical benefits were accessed according to the current guidelines. Results: Among 126 patients, all of 94 patients (74.6%) who showed internal mammary drainage successfully underwent IM-SLNB. The incidence of internal mammary artery bleeding and pleural lesion were 4.3%(4/94) and 9.6%(9/94), respectively. The metastatic rate of IMSLN was 38.3% (36/94), which was significantly associated with the number of positive ALN (P<0.001) and tumor size (P=0.024). The lymph node staging of 94 patients who underwent IM-SLNB was more accurate. Among them, 36 cases with positive IMSLN underwent internal mammary radiotherapy (IMRT), while the other 58 cases with negative IMSLN avoided radiotherapy. Conclusions IM-SLNB should be routinely performed in patients with positive ALN. IM-SLNB can provide more accurate staging and guide tailored IMRT to benefit more breast cancer patients.

Objective: To analyze the clinical characteristics of recurrent thrombosis in patients with polycythemia vera (PV) and essential thrombocythemia (ET) to probe the risk factors for recurrent thrombosis in patients with ET and PV. Methods: The clinical data of 104 ET and PV patients with thrombosis in Beijing Anzhen Hospital from February 2001 to November 2016 were retrospectively analyzed. Thrombosis reoccurred in 38 patients. Statistical analyses were performed by multivariate logistic regression for risk factors of recurrent thrombosis in ET and PV patients. Results: Recurrent thrombosis occurred in 36.5% of patients with ET/PV, the total incidence rate in ET and PV patients was 9.8% patient-years, 12.3% patient-years and 5.7% patient-years in ET and PV respectively. There were a total of 56 re-thrombotic events, and 42.1% of events occurred within 1 year after the first thrombosis. The arterial re-thrombosis was 97.4% (most of acute coronary syndrome, ACS), and venous events was 2.6%. The most common cases of re-thrombosis were ACS in ET patients (18 cases, 64.3%), and cerebral infarction in PV patients (7 cases, 70.0%). The number of PV patients with 2 times or more re-thrombotic events was significantly higher than that of ET patients (9 cases, 90.0% vs 7 cases, 25.0%). The proportion of the patients with WBC>12.5×10⁹/L or Hct>45%, and thrombosis history or splenomegaly and high risk thrombotic events were higher than those with a single thrombus (52.6% vs 31.8%; 50.0% vs 30.0%; 86.8% vs 13.6%; 84.2% vs 33.3%; 52.6% vs 15.2%; 94.7% vs 53.0%; P values were 0.036,0.046, <0.001, <0.001, <0.001 and <0.001, respectively). Logistic regression analysis showed that thrombosis history (OR=13.697, P=0.025), splenomegaly (OR=13.301, P=0.034) and high risk stratification of thrombotic events (OR=44.618, P=0.025) were independent risk factors for recurrent thrombotic events. Conclusions ET and PV patients had a higher risk of re-thrombosis. The incidence of re-thrombosis in ET was higher than in PV, ACS was more common cases of re-thrombotic events; but PV patients were more susceptible to multiple re-thromboses than ET ones, also with more cerebral infarction. Previous thrombus history, splenomegaly and high risk stratification of thrombotic events were independent risk predictors for re-thrombosis of ET and PV patients.

Objective To determine the clinical benefits of internal mammary sentinel lymph node biopsy (IM?SLNB) acquired by breast cancer patients with clinically positive axillary lymph node ( ALN), and further optimize the IM?SLNB indications. Methods All primary breast cancer patients with clinically positive ALN from February 2014 to September 2017 were prospectively recruited in this study.IM?SLNB was performed under the guidance of the modified injection technique. The success rate and visualization rate of IM?SLNB, metastatic rate of internal mammary sentinel lymph node ( IMSLN) and its related factors were analyzed, and the clinical benefits were accessed according to the current guidelines. Results Among 126 patients, all of 94 patients ( 74.6%) who showed internal mammary drainage successfully underwent IM?SLNB. The incidence of internal mammary artery bleeding and pleural lesion were 4.3%( 4／94) and 9.6%(9／94), respectively. The metastatic rate of IMSLN was 38.3%( 36／94), which was significantly associated with the number of positive ALN (P＜0.001) and tumor size (P＝0.024).The lymph node staging of 94 patients who underwent IM?SLNB was more accurate. Among them, 36 cases with positive IMSLN underwent internal mammary radiotherapy (IMRT), while the other 58 cases with negative IMSLN avoided radiotherapy. Conclusions IM?SLNB should be routinely performed in patients with positive ALN. IM?SLNB can provide more accurate staging and guide tailored IMRT to benefit more breast cancer patients.

Objective: To evaluate the efficacy of consolidation chemotherapy combined with allogeneic natural killer (NK) cell infusion in the treatment of low or intermediate-risk (LIR) acute myeloid leukemia (AML) . Methods: A cohort of 23 LIR AML patients at hematologic complete remission (CR) received NK cell transfusion combined with consolidation chemotherapy after 3 consolidation courses from January 2014 to June 2019 were reviewed. Control group cases were concurrent patients from Department of Hematology, and their gender, age, diagnosis, risk stratification of prognosis, CR and the number of courses of consolidate chemotherapy before NK cell transfusion were matched with LIR AML patients. Results: A total of 45 times of NK cells were injected into 23 LIR AML patients during 4 to 7 courses of chemotherapy. The median NK cell infusion quantity was 7.5 (6.6-8.6) ×10(9)/L, and the median survival rate of NK cells was 95.4% (93.9%-96.9%) . Among them, the median CD3(-)CD56(+) cell number was 5.0 (1.4-6.4) ×10(9)/L, accounting for 76.8% (30.8%-82.9%) ; The number of CD3(+) CD56(+) cells was 0.55 (0.24-1.74) ×10(9)/L, accounting for 8.8% (4.9%-20.9%) . Before NK cell infusion, the number of patients with positive MRD in the treatment and control groups were 9/23 (39.1%) and 19/46 (41.3%) (χ(2)=0.030, P=0.862) respectively. After NK infusion, There was no significant difference in terms of MRD that went from negative to positive between the treatment and the control groups (14.3% vs 22.2%, χ(2)=0.037, P=0.847) . In the treatment group, 66.7% (6/9) of the MRD were converted from positive to negative, which was significantly higher than that in the control group (10.5%, 2/19) (χ(2)=6.811, P=0.009) . Morphological recurrence occurred in 1 case of MRD negative in the treatment group and 2 cases of MRD positive in the control group. By the end of follow-up, the median follow-up was 35 (10-59) months, the number of patients with morphological recurrence in the treatment group was 30.4% (7/23) , which was significantly lower than that in the control group (50.2%, 24/46) (χ(2)=2.929, P=0.087) , although there was no statistically significant difference between the two groups. There was no significant difference on MRD-negative between the treatment and the control groups (43.5% vs 43.5%, χ(2)=1.045, P=0.307) . The 3-year leukemia-free survival was better in the treatment group [ (65.1±11.1) %] than that in the control group [ (50.0±7.4) %] (P=0.047) . The 3-year overall survival in the treatment and control groups were (78.1±10.2) % and (65.8±8.0) % (P=0.212) , respectively. Conclusion: The consolidation of chemotherapy combined with allogeneic NK cell infusion contributed to the further remission of patients with LMR AML and the reduction of long-term recurrence.
Consolidation Chemotherapy ; Hematopoietic Stem Cell Transplantation ; Humans ; Killer Cells, Natural ; Leukemia, Myeloid, Acute/therapy* ; Prognosis ; Remission Induction