Objective:To establish a risk prediction model for prolonged mechanical ventilation in adult heart transplant recipients.Methods:This study used structured language to query hospital electronic medical record systems. From January 2004 to December 2021, 957 adult recipients undergoing cardiac transplantation at Fuwai Hospital of the Chinese Academy of Medical Sciences were selected as the study subject using a convenience sampling. This study collected basic information, past history, preoperative blood creatinine, preoperative total bilirubin, preoperative ventilation assistance, and intraoperative donor heart cold ischemia time. The enrolled patients were divided into a training group ( n=717) and a validation group ( n=240) in a ratio of 3∶1. Based on the training group data, a risk prediction model was constructed using two-way stepwise Logistic regression. The prediction performance of the model was evaluated using the area under the receiver operating characteristic (ROC) curve, sensitivity and specificity based on the validation group data. Results:A total of 957 adult heart transplant recipients were included, and 18.39% (176/957) of them experienced prolonged mechanical ventilation (>24 hours) after surgery. Based on the model established by the training group data, 7 independent risk factors for prolonged mechanical ventilation after surgery were clarified, including age ≥ 60 years old ( OR=1.820), history of blood transfusion ( OR=5.237), previous cardiac surgery ( OR=2.826), preoperative total bilirubin≥ 34.2 μmol/L ( OR=1.861), preoperative ventilator assistance ( OR=9.421), preoperative intra-aortic balloon pump assistance ( OR=1.826), intraoperative donor heart cold ischemia time≥ 360 min ( OR=2.093) ( P<0.05). The area under the curve of the model was 0.676 (95% confidence interval was 0.581 to 0.770), with a sensitivity of 0.500, and a specificity of 0.796. Conclusions:Based on the data of adult heart transplant recipients from a single center, this study established a relatively simple and objective risk prediction model that can predict the prolonged mechanical ventilation in adult heart transplant recipients, and has good clinical value.

Inflammation-associated proteinase functions are key determinants of inflammatory stromal tissues deconstruction. As a specialized inflammatory pathological process, dental internal resorption (IR) includes both soft and hard tissues deconstruction within the dentin-pulp complex, which has been one of the main reasons for inflammatory tooth loss. Mechanisms of inflammatory matrix degradation and tissue resorption in IR are largely unclear. In this study, we used a combination of Cre-loxP reporter, flow cytometry, cell transplantation, and enzyme activities assay to mechanistically investigate the role of regenerative cells, odontoblasts (ODs), in inflammatory mineral resorption and matrices degradation. We report that inflamed ODs have strong capabilities of matrix degradation and tissue resorption. Traditionally, ODs are regarded as hard-tissue regenerative cells; however, our data unexpectedly present ODs as a crucial population that participates in IR-associated tissue deconstruction. Specifically, we uncovered that nuclear factor-kappa b (NF-κB) signaling orchestrated Tumor necrosis factor α (TNF-α)-induced matrix metalloproteinases (Mmps) and Cathepsin K (Ctsk) functions in ODs to enhance matrix degradation and tissue resorption. Furthermore, TNF-α increases Rankl/Opg ratio in ODs via NF-κB signaling by impairing Opg expression but increasing Rankl level, which utterly makes ODs cell line 17IIA11 (A11) become Trap⁺ and Ctsk⁺ multinucleated cells to perform resorptive actions. Blocking of NF-κB signaling significantly rescues matrix degradation and resorptive functions of inflamed ODs via repressing vital inflammatory proteinases Mmps and Ctsk. Utterly, via utilizing NF-κB specific small molecule inhibitors we satisfactorily attenuated inflammatory ODs-associated human dental IR in vivo. Our data reveal the underlying mechanisms of inflammatory matrix degradation and resorption via proteinase activities in IR-related pathological conditions.
Humans ; Matrix Metalloproteinases/metabolism* ; Minerals/metabolism* ; NF-kappa B/metabolism* ; Odontoblasts/metabolism* ; Osteoclasts/metabolism* ; RANK Ligand/metabolism* ; Tumor Necrosis Factor-alpha/metabolism*

Objective To investigate the mechanism involving the apoptosis of BGC-823 strain induced by miRNA-143. Methods Fluorometry and Western blot were used to detect Bcl-2 mRNA and the protein contents in the gastric cancer strain ( BGC-823)and normal gastric mucosa strain (GES-1).We verified the binding site by a Lnciferase reporter method .MiRNA-143-mimics, in-hibitor and NC were chemically synthesized .Bcl-2 protein levels were measured by Western blotting 48 hours after transiently transfect-ed with either miRNA-143 mimics, inhibitors, or negative control miRNAs into BGC-823 cells.Apoptosis assays were employed to eval-uate cell apoptosis in BGC-823 strain, and miRNA-143 expression levels in BGC-823 were measured by quantitative PCR ( qPCR) sim-ultaneously at different time points after transfection .Results The study successfully predicted and verified the putative miRNA-143 binding site in the 3′UTR of human Bcl-2 gene.Bcl-2 level in BGC-823 cells was significantly increased and miRNA-143 level was de-creased, as compared with that of GES-1 cells, and significant differences could be noted , when comparisons were made between the groups(P<0.01).Research results indicated that miRNA-143-mimics/miRNA-143-inhibitor and the wild type luciferase reporter gene co-transfection significantly reduced and induced the activity of luciferase .Forty-eight hours after transfection , statistical significance could be noticed, when the co-transfection group was compared with the single transfection group (P<0.05).The transfection of miR-NA-143-mimics and miRNA-143-inhibitors had no significant effects on the activity of mutant luciferase reporter gene .Statistical signifi-cance could be seen, when the co-transfection group was compared with the single transfection group (P<0.05).Furthermore, the transfection of miRNA-143-mimics and miRNA-143-inhibitor could significantly inhibit or enhance the expression of Bcl-2 protein, and statistical significance could be found , when it was compared with the control group (P<0.05).miRNA-143-mimics and miRNA-143-inhibitor transfected cells could induce changes in miRNA-143 level.Forty-eight hours after transfection , miRNA-143 level in the miR-NA-143-mimics transfected cells was obviously elevated , while that in the miRNA-143-inhibitor was significantly reduced , and statisti-cal significance could also be noted , when it was compared with the control group (P<0.05).There were no significant differences in miRNA-143 levels, when the negative control group was compared with the transfected control group (P<0.05).Results of apoptosis detection indicated that the elevated expression level of miRNA-143 could significantly induce apoptosis of BGC-823, and statistical sig-nificance could be seen, when the gene intervention group was compared with the transfected control group (P<0.05).Conclusion Through the inhibition of Bcl-2 gene expression, miRNA-143 could induce the apoptosis of the gastric cancer BGC-823 strain.

Objective To assess the relationship between lactate clearance and prognosis of patients with multiple organ dysfunction syndrome following resuscitation.Methods Data of 42 eligible patients with multiple organ dysfunction syndrome after resuscitation admitted from January 2009 to December 2011 were collected for retrospective analysis.The patients included were adult patients who survived more 24 hours after CPR for cardiac arrest with subsequent multi-organ failure.Exclusion criteria were traumatic heart arrest and the end-stage diseases.All the patients were divided into survival group and death group on the 3rd day and the 7th day after restoration of spontaneous circulation.The differences in the age,gender,mean arterial pressure,oxygenation index (PaO2/FiO2),APACHE Ⅱ score,white blood cell count (WBC),initial lactate level and 6h lactate clearance rate between the two groups were compared by using the Mann-Whitney U-tests and logistic regression analysis.Results Of 42 patients,the mean age was (59.57±14.68) years and mean APACHE Ⅱ score was (26.79 ±7.77),and 23 (54.8％) patients survived until the 3rd day and 14 (33.3％) patients survived to the 7th day after restoration of spontaneous circulation (ROSC).Univariate analysis showed that APACHE Ⅱ score in death group was significantly higher and 6 h lactate clearance was significantly lower than those in survival group (P ＜ 0.05) on the 3rd day and the 7th day after ROSC,and other biomarkers were not significantly different between the two groups.The results from logistic regression analysis showed that there were statistically significant difference in APACHE Ⅱ score (RR =2.143,P =0.028) and 6-h lactate clearance (RR =0.887,P =0.040) between survival group and death group on the 7th day after ROSC,although no significant differences in APACHE Ⅱ score and 6 h lactate clearance were found between the two groups on the 3rd day after ROSC.Conlusions Post-cardiac arrest patients with low lactate clearance in the early stage after ROSC have a poor prognosis.Lactate clearance may be an independent predictor of mortality in post-cardiac arrest patients in the recovery phase.

Objective To set up a real-time quantitative PCR approach for detection and quantification for bcr-abl transcripts in CML patients,and detect minimal residual disease (MRD) in CML by real-time quantitative PCR (RQ-PCR)and evaluate the significance of MRD detection.Methods The ber-abl.fusion gene expression in 80 patients with CML was analyzed by RQ-PCR. The patients were divided into three groups according to the different treatment, allogeneic hematopoietic stem cell transplantation group,imatinib group and hydroxyurea group. The change of bcr-abl fusion gene was monitored in CML patients before and after treatment.Results The average of RQ-PCR detection on newly diagnosed patients with CML in chronic phase was 6847.67 copies / 104 cells,the accelerated phase was 306 176.08 copies / 104 cells,and the average results were 944.33, 2.37, 0.29, 0 copies / 104 cells after allogeneic hematopoietic stem cell transplantation one month,6 months,12 months or 24 months respectively.The average of RQ-PCR detection after use imatinib mesylate 3 months was 3720.23 copies / 104 cells and not be detected after one year. The average was 7290.11 and 3143.24 copies / 104 cells after hydroxyurea treatment 0 and 9 months respectively.The difference in first two groups was not significant (t=1.74,P=0.17), but the difference between the third group and the first two groups was significant (t=3.74,P=0.01.t=2.97,P=0.02). The upregulation of bcr-abl transcript levels could be detected when disease progression. The transcripts level in accelerated phase was significantly higher than that in chronic phase. Conclusion RQ-PCR can be used to detect the MRD,monitor the treatment outcome,predict disease recurrence and give early intervention.

ObjectiveTo explore the genetic abnormalities of multiple myeloma (MM)patients by fluorescence in situ hybridization (FISH).MethodsWith the application of FISH,sequence specific DNA probes (IGH,DI3S319/p53 and 1q21/RB1) were applied to detect 14q32 rearrangement,del(13q14),del (17p13)and gain of lq21.Forty-four MM patients were enrolled in this study.ResultsThirty-two cases (72.7 ％) detected by FISH had genetic abnormality in 44 cases,lq21 amplification was observed in 11 cases (25.0 ％),while RB1 deletion in 17 cases (38.6 ％),D13S319 deletion in 16 cases (36.4 ％),p53 deletion in 6 cases(13.6 ％)and 14q32 translocation in 19 cases(43.2 ％).The patients with one abnormality was detected in 10 cases(22.7 ％),two abnormalities in 11 cases(25.0 ％),three abnormalities in 8 cases (18.2 ％),4 abnormalities in 3 cases(6.8 ％).28 were found to undergo split-phase by conventional cytogenetic in 44 patients.The patients with genetic abnormalities detected by conventional G-banding was 2 cases (7.14 ％),the difference with that in FISH was significant (P ＜0.05).Genetic abnormalities compared with clinical parameters showed that β2-MG in IGH gene abnormal patients were significantly higher than those without such abnormalities (P ＜0.05).Patients with bone marrow plasma cells of lq21 amplification were higher than those with normal karotypes(P ＜0.05),CRE was significantly higher among lq21 amplification and p53 deletion patients (P ＜0.05),CRP was significantly higher among p53 deletion patients (P ＜0.05).No significant difference was oberserved in relationship of the chromosome aberration and age,the chromosome aberration and stage.ConclusionThe most common genetic abnormalities in MM is IGH rearrangement and absence of RB1 and D13S319,followed by lq21 amplification,the least is p53 deletion.FISH is a rapid and sensitive technique to refine chromosome aberrations in MM.The specific detection for genomic features of MM is proved to be correlative with its clinicopathologic characteristics and the prognosis.

Multiple myeloma (MM) is a malignancy of the plasma cells, characterized by complex karyotype and chromosome instability. These cytogenetic changes are important prognostic indicators in MM patients. Fluorescence in situ hybridization (FISH) can analyze a large number of interphase cells without metaphase. It is simple, reproducible, highly sensitive and specific. It has more prominent advantages in the research of MM without informative metaphase. FISH can detect microdeletions in genetic loci that are closely related to disease prognosis, therefore significantly improves the abnormal clone detection rate. FISH provides a theoretical foundation for the diagnosis, clinical classification and prognosis prediction, and can guide the personalized therapy of MM.