Objective:To investigate the use of apolipoprotein B (ApoB) diagnostic algorithm for hyperlipidemia typing combined with whole exome sequencing in the precise diagnosis of familial hyperlipidemia.Methods:A retrospective observational study was conducted by collecting clinical information on all patients who attended our hospital, and had their lipid levels tested from January 2023 to May 2024, including 440 patients with low-density lipoprotein cholesterol (LDL-C)>4.10 mmol/L. Family history, current lipid levels, medication use, and comorbidities were collected by telephone follow-ups. Among them, 10 patients had a family history of hyperlipidemia. Peripheral venous blood samples were collected from patients with a family history of hyperlipidemia, and whole exome sequencing was performed.Results:According to the Fredrickson typing of WHO, 10 patients (P1 to P10) could be categorized into two groups, of which only type Ⅱa could be excluded in 6 cases, and the typing could not be determined in 4 cases. The ApoB diagnostic algorithm of hyperlipidemia typing could classify patients P1 and P2 as type Ⅱa, patients P3 to P7, P9 and P10 as type Ⅱb, and patient P8 as type Ⅴ, respectively. Whole exome sequencing detected mutations in LDLR, PCSK9, C5AR2, KIF12, ALMS1, ABCG5, COL4A3, and MTTP genes.Conclusion:The ApoB diagnostic algorithm for hyperlipidemia can be used for accurate typing of hyperlipidemia, and ApoB could be recommended as a routine lipid testing parameter. The ApoB diagnostic algorithm for hyperlipidemia combined with whole exome sequencing could be used for the accurate typing of patients with familial hyperlipidemia and defining the underlying gene mutations.

Objective:To investigate the use of apolipoprotein B (ApoB) diagnostic algorithm for hyperlipidemia typing combined with whole exome sequencing in the precise diagnosis of familial hyperlipidemia.Methods:A retrospective observational study was conducted by collecting clinical information on all patients who attended our hospital, and had their lipid levels tested from January 2023 to May 2024, including 440 patients with low-density lipoprotein cholesterol (LDL-C)>4.10 mmol/L. Family history, current lipid levels, medication use, and comorbidities were collected by telephone follow-ups. Among them, 10 patients had a family history of hyperlipidemia. Peripheral venous blood samples were collected from patients with a family history of hyperlipidemia, and whole exome sequencing was performed.Results:According to the Fredrickson typing of WHO, 10 patients (P1 to P10) could be categorized into two groups, of which only type Ⅱa could be excluded in 6 cases, and the typing could not be determined in 4 cases. The ApoB diagnostic algorithm of hyperlipidemia typing could classify patients P1 and P2 as type Ⅱa, patients P3 to P7, P9 and P10 as type Ⅱb, and patient P8 as type Ⅴ, respectively. Whole exome sequencing detected mutations in LDLR, PCSK9, C5AR2, KIF12, ALMS1, ABCG5, COL4A3, and MTTP genes.Conclusion:The ApoB diagnostic algorithm for hyperlipidemia can be used for accurate typing of hyperlipidemia, and ApoB could be recommended as a routine lipid testing parameter. The ApoB diagnostic algorithm for hyperlipidemia combined with whole exome sequencing could be used for the accurate typing of patients with familial hyperlipidemia and defining the underlying gene mutations.

Coronary heart disease (CHD) is a kind of cardiovascular diseases originated from atherosclerosis (AS), and chronic inflammation is one of the pathological characteristics. The peripheral blood leukocytes, especially mononuclear cells, play an important role in the AS processes. Recently, in a series of Epigenome-Wide Association Studies (EWAS), multiple DNA differential methylation sites in peripheral blood cells were found to be statistically associated with CHD, which suggested that these DNA differential methylation sites might serve as new risk factors for CHD. The recognition of the variant of DNA methylation as a common epigenetic nucleic acid modification in the occurrence and development of CHD, is ongoing. DNA methylation has the potential to become warning biomarkers, which might provide new ideas and evidences for mechanistic studies of CHD.

Objective:To investigate the relationship between the polymorphisms of two SNP loci (rs901823 and rs3736228) in the low density lipoprotein receptor-associated protein 5 (LRP5) gene and glucocorticoids-induced osteoporosis (GIOP) in children.Methods:87 children with GIOP who were treated in Beijing Aiyuhua Women’s and Children’s Hospital and Beijing Children’s Hospital affiliated to Capital Medical University from Jan. 2015 to Dec. 2020 were selected as the research objects, and 100 children with normal bone mass who were treated with corticosteroids in this hospital during the same period were enrolled as the control group. Capillary electrophoresis and fragment analysis (SNaPshot) technology were used to genotype SNP sites rs901823 (T>C) and rs3736228 (C>T) ; Quantitative real-time fluorescence quantitative polymerase chain reaction detection method was employed to determine the relative mRNA of LPR5 gene The amount of expression.Results:For the rs901823 locus of the LRP5 gene, the TT, TC, and CC genotype distribution differences between the GIOP group and the control group were statistically significant ( χ2=14.176, P=0.001) . Compared with the TT genotype, carriers of the TC and CC genotypes had a higher risk of GIOP, with OR values of 3.022 (1.189-6.387) and 5.483 (1.452-20.883) ; For academic significance, OR values were 3.412 (1.795-6.587) and 4.352 (1.215-15.982) . For the rs3736228 locus, the distribution of CC, CT, TT genotypes between the GIOP group and the control group was significantly different ( χ2=9.597, P=0.008) . Compared with CC carriers, CT genotype carriers had a significantly increased risk of GIOP, with an OR value of 5.125 (1.721-16.241) . The result of a dominant model was statistically significant, with an OR value of 4.165 (1.335-14.652) , while for TT there was no statistically significant difference between the carrier and the CC genotype ( P=0.512) , and the results of the recessive model also showed no significant statistical significance ( P=0.887) . There was a statistically significant difference in the frequency distribution of T and C alleles at rs901823 between the GIOP group and the control group ( χ2=17.298, P<0.001) , and the difference in the frequency distribution of C and T alleles at rs3736228 was also statistically significant ( χ2=9.356, P=0.002) . The relative expression level of LRP5 gene mRNA in children with GIOP was 1.34±0.26, which was significantly lower than the expression level of LRP5 gene mRNA in children in the control group of 3.06±0.42 ( t=8.248, P<0.001) . Among children with GIOP, the relative expression of LRP5 gene mRNA in patients with rs901823 locus TT, TC, and CC genotypes was statistically significant ( P<0.001) ; the differences in rs901823 locus CC, CT, TT genotype patients were significant. Pairwise comparison of the relative expression of LRP5 gene mRNA showed that there was no significant difference between the TT group and the CT group ( P>0.05) , but the expression of the CC group was significantly higher than that of the CT group and the TT group ( P<0.05) . Conclusion:The rs901823 and rs3736228 polymorphisms of LRP5 gene are correlated with the occurrence of GIOP and can be used as genetic markers for predicting GIOP in children.

Objective To study the analgesic efficacy and safety of the disposable postoperative local analgesia system and patient-controlled intravenous analgesia pump system following conventional thoracotomy.Methods Eighty patients who received con-ventional thoracotomy in our hospital from June, 2013 to June, 2014 were enrolled for the study.The patients were randomly divided in-to the experimental group ( the disposable postoperative local analgesia system group) and the control group ( the patient-controlled in-travenous analgesia pump system group) , each consisting of 40 patents.Postoperative analgesic efficacy ( visual analogue scores and Prince-Henry scores) , pethidine cumulative dosages and the incidence of adverse drug reactions were compared between the 2 groups. Results (1) Severity of pain:there was no difference in the VAS scores at h 12, 24 and 48 after surgery, when comparisons were made between the 2 groups.However, the Prince-Henry scores of the experimental group(3.82 ±0.64,2.66 ±0.45,1.89 ±0.24) were lower than those of the control group(3.71 ±0.77,2.74 ±0.55,1.94 ±0.51).(2) The cumulative dosages of pethidine:the cu-mulative dosage of the experimental group(2.39 ±0.34,1.48 ±0.18,0.92 ±0.11) was lower than that of the control group(3.14 ± 0.42,2.74 ±0.33,1.58 ±0.21), there were statistical difference ushen comparisons were made between them(P<0.05).(3) Rates of atelectasis and respiratory failure, nausea, vomiting, dizziness and drowsiness of the experimental group were lower than those of the control group.Conclusion As compared with the patient-controlled intravenous analgesia pump, the disposable postoperative local an-algesia system could achieve more ideal dynamic analgesic effects, reduce the dosage of opioid drugs and the rate of adverse drug reac-tions.More importantly, it was a safer and more effective analgesic method.

Objective The goal of this report was to evaluate the applicability of the da Vinci S surgical system in thoracic surgery.Methods The da Vinci S surgical system consists of a console, a patient cart, and a vision system.The patient cart loading with 3 robot arms and 1 central endoscope arm connects the console which commands the movements of the arm tips.The robot arm tips are introduced via small chest wall ports and attached to the arms of the robot.The surgeon, sitting at the console, manipulates highly sensitive sensors that transfer the surgeon's movements to the arm tips.The so called EndoWrist'technology offers up , down, left, right, and twist, seven degrees of movements, thus exceeding the capacity of a surgeon's hand in open surgery.17 intrathoracic lesion cases, including 12 Myasthenia Gravis, 1 diaphragm hernia, 2 esophageal cancer, 1 pulmonary cancer , 1 pneumothorax, were evaluated for clinical application of the da Vinci S surgical system.Results Out of 17 surgical procedures, 14 procedures were done using the robot from beginning to the end, including 12 thymectomies, 1 diaphragm hernia repair, 1 pulmonary bleb dissection.Only gastric mobilizations, the abdominal part procedures were done using the da Vinci S system, and the thoracic part procedures were done through small incision thoracotomy in 2 cases with esophageal cancer.One resection of left upper lobectomy had to be converted due to surgical problem.The postoperative courses were uneventful.Conclusion The da Vinci operating robot can do nearly all kinds of thoracic operations.Advanced general thoracic procedures can be performed safely and effectively with the da Vinci S robot allowing precise dissection.This benefit becomes evident most elegantly in thymectomies.The robot operation procedures can be done by the doctors with open and assisted thoracopic surgery experiences and other personnels getting trained in a short period of time, but case selection and preparing emergency thoracotomy at any time is needed to ensure the patient safety.

BACKGROUNDTo observe the CT appearance and pathological changes of VX2 tumor in rabbit lung after radio-frequency ablation.

METHODSAfter VX2 tumor tissue suspension was injected into the lungs, the transplanted lung cancer models were established in 36 New Zealand white rabbits. Twenty-eight rabbits were treated with radio-frequency ablation, and another 8 rabbits without any treatment as control. The CT appearances and pathological changes were observed in different time intervals after the treatment in 14 rabbits out of experimental group. The survival periods of the rabbits were recorded in the rest 14 rabbits of experimental group and the control group respectively.

RESULTSCoagulative necrosis and cell apoptosis appeared in the tumor tissues after the ablation, and inflammatory cells were found in the lung tissues around the areas of ablation. Wadding shadows appeared in CT images after the treatment and disappeared with the inflammation vanished, but the tumor shadows ceased to increase. In the experimental group, tumor tissues were almost necrosed in the target areas of 21 rabbits, however, peripheral residual nests of histologically viable tumor were found in the target areas of the other 7 rabbits. The survival periods of rabbits in the experimental group and the control group were 38 days±3.4 days days and 26 days±2.8 days respectively (P < 0.05).

CONCLUSIONSRadio-frequency ablation may be an effective method in the treatment of lung cancer.

Objective Three soluble materials were used as carrier of recombinant human bone morphogenetic protein-2(rhBMP-2) in order to seek suitable slow-release carrier of rhBMP-2,which induced neogenetic cartilage in canine tracheal autografting segment.Methods 32 mongrel dogs were randomly and equally divided into 4 groups.A five-ring cervical tracheal segment was harvested as the autograft.The materials including dextran,polyvinyl pyrrolidone(PVP) and collagen were respectively combined with equal rhBMP-2 and then injected into the soft tissues between cartilaginous rings of autografts.In addition,without carrier group was used as controls.Then the autografts were heterotopically transplanted into greater omentum.The animals were sacrificed at postoperative 4 weeks,and the postmortem specimens were examined grossly and histologically.Results Cartilage rings of the grafts were partly absorbed in all four groups.New cartilage was induced in the rhBMP-2 injected area in the groups in which PVP or collagen was used as carrier,and more new cartilage was observed in the collagen group.Conclusions PVP and collagen could be sustained as release carriers for rhBMP-2 in tracheal autograft.Collagen is more effective as a carrier than other vehicles and it could enhance the ability of rhBMP-2 inducing cartilage regeneration in tracheal transplantation.