Objective:To investigate association of expression levels of serum long non-coding RNA(lncRNA)myo-cardial infarction-associated transcript(lncRNA MIAT)and microRNA-150-5p(miR-150-5p)with coronary artery plaque in patients with coronary heart disease(CHD).Methods:A total of 260 CHD patients admitted in Hebei Petro China Central Hospital between October 2016 and January 2022 were selected.According to coronary angiography(CAG)results,they were divided into stable angina pectoris(SAP)group(n=97)and acute coronary syndrome(ACS)group(n=163),another 97 patients who were excluded for CHD by CAG simultaneously were re-garded as control group.Expression levels of serum lncRNA MIAT and miR-150-5p were measured in all groups;CHD patients received intravascular ultrasound(IVUS)examination,and coronary artery plaque related indexes were compared between SAP group and UAP group.Pearson method was used to analyze the association of expres-sion levels of serum lncRNA MIAT and miR-150-5p with coronary artery plaque related indexes in ACS patients.Results:Compared with control group,SAP group and ACS group had significant higher serum lncRNA MIAT ex-pression level,and significant lower miR-150-5p expression level(P＜0.001 all);compared with SAP group,ACS group had significant higher lncRNA MIAT expression level,vascular remodeling index,necrosis core(NC)area,plaque eccentricity index,and significant lower miR-150-5p expression level and fibrous fat fraction(FF)area(P＜0.001 all).Pearson correlation analysis indicated that in ACS patients,serum lncRNA MIAT expression level was positively correlated with vascular remodeling index,NC area and plaque eccentricity index(r=0.537,0.484,0.392,P＜0.001 all),and inversely correlated with FF area(r=-0.496,P＜0.001);miR-150-5p ex-pression level was inversely correlated with vascular remodeling index,NC area and plaque eccentricity index(r=-0.403,-0.584,-0.546,P＜0.001 all),and positively correlated with FF area(r=0.388,P＜0.001).Conclu-sion:The expression levels of serum lncRNA MIAT and miR-150-5p are abnormal in CHD patients.Expression levels of serum lncRNA MIAT and miR-150-5p are related to coronary artery plaques in ACS patients,which has important significance for clinical diagnosis,prevention and treatment.

Objective:To compare the differences in the prevalence of mild micro-hepatic encephalopathy (MHE) among patients with cirrhosis by using the psychometric hepatic encephalopathy score (PHES) and the Stroop smartphone application (Encephal App) test.Methods:This prospective, multi-center, real-world study was initiated by the National Clinical Medical Research Center for Infectious Diseases and the Portal Hypertension Alliance and registered with International ClinicalTrials.gov (NCT05140837). 354 cases of cirrhosis were enrolled in 19 hospitals across the country. PHES (including digital connection tests A and B, digital symbol tests, trajectory drawing tests, and serial management tests) and the Stroop test were conducted in all of them. PHES was differentiated using standard diagnostic criteria established by the two studies in China and South Korea. The Stroop test was evaluated based on the criteria of the research and development team. The impact of different diagnostic standards or methods on the incidence of MHE in patients with cirrhosis was analyzed. Data between groups were differentiated using the t-test, Mann-Whitney U test, and χ2 test. A kappa test was used to compare the consistency between groups. Results:After PHES, the prevalence of MHE among 354 cases of cirrhosis was 78.53% and 15.25%, respectively, based on Chinese research standards and Korean research normal value standards. However, the prevalence of MHE was 56.78% based on the Stroop test, and the differences in pairwise comparisons among the three groups were statistically significant (kappa = -0.064, P < 0.001). Stratified analysis revealed that the MHE prevalence in three groups of patients with Child-Pugh classes A, B, and C was 74.14%, 83.33%, and 88.24%, respectively, according to the normal value standards of Chinese researchers, while the MHE prevalence rates in three groups of patients with Child-Pugh classes A, B, and C were 8.29%, 23.53%, and 38.24%, respectively, according to the normal value standards of Korean researchers. Furthermore, the prevalence rates of MHE in the three groups of patients with Child-Pugh grades A, B, and C were 52.68%, 58.82%, and 73.53%, respectively, according to the Stroop test standard. However, among the results of each diagnostic standard, the prevalence of MHE showed an increasing trend with an increasing Child-Pugh grade. Further comparison demonstrated that the scores obtained by the number connection test A and the number symbol test were consistent according to the normal value standards of the two studies in China and South Korea ( Z = -0.982, -1.702; P = 0.326, 0.089), while the other three sub-tests had significant differences ( P < 0.001). Conclusion:The prevalence rate of MHE in the cirrhotic population is high, but the prevalence of MHE obtained by using different diagnostic criteria or methods varies greatly. Therefore, in line with the current changes in demographics and disease spectrum, it is necessary to enroll a larger sample size of a healthy population as a control. Moreover, the establishment of more reliable diagnostic scoring criteria will serve as a basis for obtaining accurate MHE incidence and formulating diagnosis and treatment strategies in cirrhotic populations.

Objective:To investigate the diagnostic accuracy of serological indicators and evaluate the diagnostic value of a new established combined serological model on identifying the minimal hepatic encephalopathy (MHE) in patients with compensated cirrhosis.Methods:This prospective multicenter study enrolled 263 compensated cirrhotic patients from 23 hospitals in 15 provinces, autonomous regions and municipalities of China between October 2021 and August 2022. Clinical data and laboratory test results were collected, and the model for end-stage liver disease (MELD) score was calculated. Ammonia level was corrected to the upper limit of normal (AMM-ULN) by the baseline blood ammonia measurements/upper limit of the normal reference value. MHE was diagnosed by combined abnormal number connection test-A and abnormal digit symbol test as suggested by Guidelines on the management of hepatic encephalopathy in cirrhosis. The patients were randomly divided (7∶3) into training set ( n=185) and validation set ( n=78) based on caret package of R language. Logistic regression was used to establish a combined model of MHE diagnosis. The diagnostic performance was evaluated by the area under the curve (AUC) of receiver operating characteristic curve, Hosmer-Lemeshow test and calibration curve. The internal verification was carried out by the Bootstrap method ( n=200). AUC comparisons were achieved using the Delong test. Results:In the training set, prevalence of MHE was 37.8% (70/185). There were statistically significant differences in AMM-ULN, albumin, platelet, alkaline phosphatase, international normalized ratio, MELD score and education between non-MHE group and MHE group (all P<0.05). Multivariate Logistic regression analysis showed that AMM-ULN [odds ratio ( OR)=1.78, 95% confidence interval ( CI) 1.05-3.14, P=0.038] and MELD score ( OR=1.11, 95% CI 1.04-1.20, P=0.002) were independent risk factors for MHE, and the AUC for predicting MHE were 0.663, 0.625, respectively. Compared with the use of blood AMM-ULN and MELD score alone, the AUC of the combined model of AMM-ULN, MELD score and education exhibited better predictive performance in determining the presence of MHE was 0.755, the specificity and sensitivity was 85.2% and 55.7%, respectively. Hosmer-Lemeshow test and calibration curve showed that the model had good calibration ( P=0.733). The AUC for internal validation of the combined model for diagnosing MHE was 0.752. In the validation set, the AUC of the combined model for diagnosing MHE was 0.794, and Hosmer-Lemeshow test showed good calibration ( P=0.841). Conclusion:Use of the combined model including AMM-ULN, MELD score and education could improve the predictive efficiency of MHE among patients with compensated cirrhosis.

OBJECTIVE: To establish a new mechanical model of distal humerus in children with epiphysial cartilage, stimulate supracondylar humerus fracture and perform three dimensional finite elements, and study effect of pins numbers, pin tract, outlet height and pin configurations on stability of fixation. METHODS: Three dimensional computed tomography (CT) data of 6-year-old boy with distal humerus was downloaded from picture archiving and communications systems software (PACS), the data of picture was imported into Simpleware and SolidWorks 2016 software to establish distal humerus fracture in children contained ossific nucleus of the capitellum (ONC) and distal cartilage. Normal extense supracondylar humerus fracture model was established to stimulate configurations of crossed and lateral pinning fixation, 30 N was added on the direction of flexion extension and varus valgus, while 50 N was added on the direction of internal and external turning. Stability was analyzed by displacement degree of distal fracture. RESULTS: Among 2-pin configurations, 2-crossed pins were more stable against rotation forces which could resist rotation stress over 2 585 Nmm/ °, while low position through ONC of 2-divergent lateral pins were more stable, which could resist stress of 45 N /mm and 190 N /mm during the test of resistant strains and varus-valgus stress. The third pins was added into the more stable lateral 2-pins, the stability in all directions were increased obviously, and 3 crossed pins is the most stable, stress of flexion-extension, varus-valgus and internal-external turning were 198 N /mm, 395 N /mm and 6 251 Nmm/ °. CONCLUSION Two-divergent lateral pins could provide enough stability for supracondylar humerus fracture in children. In two-crossed pins, the upper border of MDJ could provide the best stability. Three-crossed pins could offer the best stability against both translation and rotation forces.
Biomechanical Phenomena ; Bone Wires ; Child ; Finite Element Analysis ; Fracture Fixation, Internal ; Humans ; Humerus ; Male