Objective    To explore coronary angiographic characteristics in patients with symptomatic recurrence after coronary artery bypass grafting (CABG). Methods    We performed a retrospective study of 997 patients with symptomatic recurrence after CABG in Beijing Anzhen Hospital from 2010 to 2020. There were 762 males and 235 females, with an average age of 62.41±8.70 years. Results    There was a high prevalence of risk factors like hypertension, diabetes and a history of smoking. Diseased arterial grafts accounted for 27.44% while saphenous vein graft 54.40%; 240 (24.07%) patients had all patent grafts. The main lesion characteristics of diseased grafts were chronic total occlusion lesions (79.57%). Most patients had more diseased native vessels after CABG than before. The type C coronary artery disease in native vessels relevant to ischemic area occurred in 674 (67.60%) patients; 525 (52.66%) patients with recurrent symptom after CABG had both diseased grafts and diseased native vessels. Conclusion     Graft status in patients with symptomatic recurrence after CABG is worse than we expected. The majority have newly developed lesions both in grafts and native vessels. Native vascular lesions will continue to progress after CABG.

Objective:To explore the perioperative effect of radial artery as a sequential graft in coronary artery bypass grafting(CABG).Methods:The clinical data and perioperative complications of 109 patients, who underwent radial artery(RA) or great saphenous vein(SVG) as a sequential graft during CABG from April 2020 to December 2020 in Beijing Anzhen Hospital, were analyzed, there were 86 males and 23 females, aged from 39 to 79 years, with an average of(61.1±8.0)years old. According to the graft materials, they were divided into the RA group(n=47) and SVG group(n=62).Results:There were no significant differences between the two groups in age, gender, comorbidities, echocardiographic results, transplant vascular indexes, coronary angiography results, and operation methods(on-pump or off-pump, use of left internal mammary artery, number and distribution of distal anastomoses)( P>0.05). There were also no significant difference between the two groups in ICU stay, postoperative hospital stay and drainage with 24 hours after CABG( P>0.05). The incidence of postoperative cerebrovascular events, postoperative infection and secondary thoracotomy in the RA group were higher than that in the SVG group. The incidence of myocardial infarction, postoperative ventricular arrhythmia and postoperative IABP assistance in the SVG were higher than that in the RA group, but the difference was not statistically significant( P>0.05). Conclusion:The application of radial artery as a sequential graft during CABG does not increase the risk of perioperative complications, and the patients recover smoothly.

Objective:To investigate the efficacy and safety of black tomato concentrated sauce in the treatment of benign prostatic hyperplasia(BPH) with lower urinary tract symptoms(LUTS).Methods:An open, randomized and controlled trial was conducted, and 150 BPH patients with LUTS were randomly assigned to three groups: experimental group(60 cases), placebo group (45 cases) and positive control group(45 cases) in the Department of Urology, Lanzhou University Second Hospital from December 2018 to September 2020.Inclusion criteria: age≥50 years old; first diagnosis of BPH, or interrupted medical treatment of BPH for more than 1 month; maximum urinary flow rate (Q max) <15ml/s; prostate volume (PV)≥20ml; IPSS≥8, QOL≥2. Exclusion criteria: lower urinary tract obstruction not caused by BPH, post-void residual urine volume(PVR) >250 ml; history of acute urinary retention in the last 3 months; prostate nodules and suspected prostate cancer were revealed by digital rectal examination and transrectal B-ultrasoundor; prostate-specific antigen (PSA)≥10 ng/ml; neurogenic bladder, perivous history of bladder, prostate, or urethra operations; suffering from serious heart, lung, liver, kidney and other diseases. The patients in the experimental group were orally treated with black tomato concentrated sauce(30 g/once, 3 times/day). The patients in the placebo group were orally administrated with placebo. In the positive control group, the patients with PV≤30ml were orally treated with tamsulosin(0.2mg/once, 1 time/day), the patients with PV>30ml were orally administrated with tamsulosin and finasteride(5 mg/once, 1 time/day). All enrolled patients were treated for 3 months. At the end of third month, the IPSS, QOL, PV, PVR, Q max, average urinary flow rate(Q ave), total PSA(tPSA), free PSA (fPSA), testosterone(TST) and the incidence of adverse reaction were assessed. Results:128 of 150 cases, including 52 cases in experimental group, 36 cases in placebo group and 40 cases in positive control group, completed the study, the rest was excluded due to not take medication regularly and fail to follow-up. There were no significant differences in baseline parameters among experimental group, placebo group and positive control group ( P>0.05) in age[(63.21±8.61) vs.(62.36±6.32) vs. (63.94±7.78)years old], body mass index[(23.74±3.17) vs. (23.94±3.09) vs. (24.26±2.91)kg/m 2], IPSS[(17.5±6.6) vs. (15.4±5.8) vs. (17.9±6.8)], QOL[4.0(3.0, 4.0) vs. 4.0(3.0, 4.5) vs. 4.0(3.0, 5.0)], Q max [(8.60±3.04) vs. (9.13±2.92) vs. (9.58±3.26) ml/s], Q ave[(4.39±1.69) vs. (4.66±1.76) vs. (4.88±1.60)ml/s], PV [32.00(25.55, 45.40)vs. 30.00(24.45, 38.35)vs. 34.80(27.65, 56.65)ml], PVR[23.50(8.25, 45.75) vs.5.50(0, 47.75) vs. 29.00(0, 84.00)ml], tPSA [1.53(0.89, 3.00) vs. 1.23(0.69, 1.98) vs. 2.23(0.90, 4.15)ng/ml], fPSA [0.37(0.28, 0.76) vs. 0.37(0.22, 0.52) vs. 0.54(0.30, 0.97) ng/ml] and TST[(443.64±156.32) vs. (493.97±176.16) vs. (450.89±135.08)ng/dl]. After 3 months of treatment, the IPSS in experimental group was(9.9±5.7), QOL score 2.0(2.0, 3.0), Q max(11.78±5.24)ml/s, Q ave(5.86±3.00)ml/s, tPSA 1.64(0.96, 3.32)ng/ml and TST (475.91±177.33)ng/dl, which were significantly different compared with pre-treatment( P<0.05). In positive control group, IPSS was (9.0±6.2), QOL 2.0(2.0, 3.0), Q max(11.73±4.50)ml/s, Q ave(6.11±2.53)ml/s, tPSA 1.57(0.80, 3.09)ng/ml, fPSA 0.37(0.24, 0.63)ng/ml and TST (526.11±126.88)ng/dl, which were statistically different compared with pre-treatment( P<0.01). However, there were no significant differences in all the above indexes in placebo control group compared with the baseline( P>0.05). The numerical changes of IPSS, QOL, Q maxand Q ave between experimental group and placebo group had statistically significant differences ( P<0.05). The changes of IPSS, QOL, Q max, Q ave, PV, tPSA, fPSA and TST between positive control group and placebo group had significant differences ( P<0.05). The changes of PV, tPSA and fPSA between positive control group and experimental group had statistically significant differences ( P<0.05). The incidence of adverse reactions was 5.77% (3/52, including 1 headache and 2 stomach discomfort) in experimental group, 5.56% (2/36, including 1 headache and 1 stomach discomfort) in placebo group, and 10.00%(4/40, including 1 dizzy, 1 nasal obstruction and 2 erectile dysfunction) in positive control group. And there was no statistical difference in the incidence of adverse reactions among three groups ( P>0.05). Conclusions:Black tomato concentrated sauce shows an excellent effect on patients with LUTS/BPH, and improves the quality of life with few adverse events.

In order to eliminate the influence of motion artifacts, high-frequency noise and baseline drift on photoplethysmographic (PPG), and to obtain the accurate value of heart rate in motion state, this paper proposed a de-noising method of PPG signal based on normalized least mean square (NLMS) adaptive filtering combining ensemble empirical mode decomposition(EEMD). Firstly, the PPG signal containing noise is passed through an adaptive filter with a 3-axis acceleration sensor as a reference signal to filter out motion artifacts. Secondly, the PPG signal is decomposed by EEMD to obtain a series of intrinsic modal function (IMF) according to the frequency from high to low. The threshold range of the signal is judged by the permutation entropy (PE) criterion, thereby filtering out the high frequency noise and the baseline drift. The experimental results show that the Pearson correlation coefficient between the calculated heart rate of PPG signal and the standard heart rate based on electrocardiogram (ECG) signal is 0.731 and the average absolute error percentage is 6.10% under different motion states, which indicates that the method can accurately calculate the heart rate in moving state and is beneficial to the physiological monitoring under the state of human motion.

Objective: To observe and study the influence of external drainage of lateral ventricle for continuous ventricular infusion and lumbar cistern drainage for the serum and cerebrospinal fluid on inflammatory mediators of patients with intracranial infection, in order to understand the clinical application value of the treatment methods. Methods: From June 2016 to May 2018, 56 patients with intracranial infection in the People's Hospital of Lianshui County were selected in the study and randomly divided into two groups according to the random allocation principle, with 28 cases in each group.The control group was treated with repeated lumbar intrathecal drug therapy, the observation group was treated with external drainage of lateral ventricle for continuous ventricular infusion and lumbar cistern drainage.The serum and cerebrospinal fluid inflammatory mediators of two groups before treatment and at the first and second week after treatment were compared. Results: The serum and cerebrospinal fluid inflammatory mediators of the two groups before treatment had no statistically significant differences(all P>0.05). The serum levels of IL-1β, IL-6 and IL-8 of the observation group at the first and second week after treatment were (2.27±0.28)μg/L, (9.25±0.89)μg/L, (11.15±1.35)μg/L and (1.65±0.20)μg/L, (7.04±0.81)μg/L, (8.42±0.79)μg/L, respectively, which were significantly lower than those of the control group [(4.63±0.38)μg/L, (11.92±1.35)μg/L, (14.28±1.75)μg/L and (3.20±0.29)μg/L, (9.41±1.02)μg/L, (11.32±1.47)μg/L] (t=26.456, 8.737, 7.493, 23.282, 9.628, 9.195, all P<0.01). Two weeks after treatment, the levels of IL-1, IL-6 and IL-8 in CSF of the observation group were (1.51±0.15)μg/L, (5.14±0.45)μg/L and (5.96±0.59)μg/L, respectively, which were significantly lower than those of the control group(t=12.876, 12.810, 14.272, all P<0.01). The levels of leukotriene B4(LTB4), substance P(SP) and nitric oxide(NO) in serum and cerebrospinal fluid of the two groups continued to decrease after treatment for one week and two weeks, and those in the observation group were lower than the control group(all P<0.05). Conclusion External drainage of lateral ventricle for continuous ventricular infusion and lumbar cistern drainage can significantly decrease the serum and cerebrospinal fluid inflammatory mediators of patients with intracranial infection, so the treatment method has high clinical application significance.

Objective To investigate the distribution of serum hepatitis B surface antigen (HBsAg) levels in patients with hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC).Methods A total of 226 cases of HBV-related HCC were collected from June 2009 to December 2013.Demographic characteristics of patients with different barcelona clinica liver cancer (BCLC) stages,the status of cirrhosis and HBsAg levels with different virological indicators were compared.HBsAg quantification was tested by chemiluminescence.The statistical analysis was conducted by t test,x2 test,Kruskal-Wallis H rank sum test and Mann-Whitney U rank sum test.Results A total of 226 cases were included with 201male patients and 25 female patients.HBsAg levels in HBV-related HCC patients with different ages were significantly different (x2=12.30,P =0.015),but with no statistical difference in those with different gender (Z=-0.35,P＞0.05).The HBsAg levels were not significantly different between patients with or without liver cirrhosis (Z =-0.80,P =0.419).HBsAg levels in liver cirrhosis cases with different liver function stages were not significant different (x2=2.15,P=0.341).HBsAg levels in HBeAg-positive group or HBV DNA positive group were significantly higher than those in HBeAg-negative group or HBV DNA negative group,respectively (Z =-3.67 and-4.80,respectively,both P＜0.01).The HBsAg levels in patients with different BCLC stages were not significantly different (x2 8.05,P =0.09).No significant differences were found in HBsAg levels between patients with or without portal vein violation,lymph node transfer or distant transfer (Z=-0.65,-0.03 and-1.24,respectively,all P＞ 0.05).The constituent ratios of patients with different HBsAg levels in different BCLC stages were statistically different (x2 =28.17,P-0.005).Conclusions There are no significant differences of HBsAg levels in patients with different BCLC stages,indicating that HBsAg may not be a contributor for disease progression after emergence of HCC.

The incidence rate of hepatocellular carcinoma (HCC) is increasing around the world and tends to decrease in East Asia and several regions in China;however, China still has higher incidence rate and mortality rate of HCC than most countries.Studies have shown that long-term antiviral therapy can inhibit HBV replication to a very low level or help patients with HCV infection achieve sustained virologic response, which can further reduce the incidence rate of virus-related HCC.New evidence suggests that compared with nucleos(t)ide analogues, PEG-IFNα has a better effect of secondary prevention.Studies also indicate that interferons play an important role in tertiary prevention of virus-related HCC.This article reviews the epidemiological studies on virus-related HCC in recent years and the role of antiviral therapy in second and tertiary prevention and points out that adequate and effective antiviral therapy is the basis for preventing the development and recurrence of HCC.

OBJECTIVETo use a rat model of nonalcoholic liver disease (NAFLD) to observe effects of the peroxisome proliferator-activated receptor-a (PPAR-a) agonist fenofibrate on hepatic steatosis in nonalcoholic fatty liver and to investigate the underlying mechanism.

METHODSSixty-six Sprague-Dawley rats were given adaptive feeding for 1 week and then randomly allocated into the following three groups: unmodeled control (group C,n =18), untreated NAFLD model (group M, n =24), and fenofibrate-treated NAFLD model (group F, n =24).Group C rats were given a normal diet, while group M and group F rats were given a high-fat diet. After model establishment, the group F rats were treated with fenofibrate (10 mg/kg/d, intraperitoneal) and the group C and group M rats were given sham-treatment with cosolvent (5 mL/kg/d, intraperitoneal). At the end of treatment weeks 4, 6 and 8, one-third of rats in each group were euthanized.Liver tissues were assessed by hematoxylin-eosin (HE) staining to determine level of steatosis and inflammaion activity, and by terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling to measure changes in hepatocyte apoptosis index. Changes in expression levels of the PPAR-a receptor and apoptosis factors (bcl-2, bax and caspase-3) were assessed by reverse transcription-PCR and immunohistochemistry.

RESULTSThe NAFLD modeled rats showed appropriate induction of hepatic steatosis, hepatic inflammation, and hepatocyte apoptosis. Compared to the group M rats, the group F rats showed lower expression of PPAR-and bcl-2 and higher expression of bax and caspase-3 at both the mRNA and protein level.

CONCLUSIONFenofibrate can ameliorate hepatic steatosis in an experimental rat model of NAFLD, and the mechanism may be associated with inhibition of hepatocyte apoptosis.

Animals ; Apoptosis ; Caspase 3 ; metabolism ; Diet, High-Fat ; Fenofibrate ; pharmacology ; Hepatocytes ; drug effects ; Non-alcoholic Fatty Liver Disease ; pathology ; Peroxisome Proliferator-Activated Receptors ; metabolism ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Rats ; Rats, Sprague-Dawley ; bcl-2-Associated X Protein ; metabolism

Objective T he present study aimed to optimize the established predictive models (REACH‐B scoring model) for hepatitis B virus (HBV)‐related hepatocellular carcinoma (HCC) . Methods The hepatitis B surface antigen (HBsAg) positive (> 6 months) patients who were firstly admitted in the Liver Center of First Affiliated Hospital ,Fujian Medical University between Oct 1st 2004 and May 1st 2014 were selected as the subjects and divided into two groups ,namely ,the case group (HCC group) and the control group (non‐HCC group) .Clinical data of all the subjects were retrospectively collected and analyzed .Receiver operating characteristic curves were used to evaluate the predictive values of the various models .Results To predict the development of HBV‐related HCC within 3 years ,a total of 627 patients (151 HCC cases and 476 non‐HCC controls) were enrolled .Area under curve (AUC) of HBV‐related HCC (REACH‐B) scoring model was 0 .78 (95% CI:0 .74-0 .82) ,with the sensitivity of 73 .00% and specificity of 78 .70% in predicting 3‐year risk of HCC occurrence .By combining alpha‐fetoprotein (AFP) and REACH‐B ,the R‐AFP scoring model was constructed .The AUC increased to 0 .80 (95% CI:0 .76 -0 .83 , Z= 2 .50 , P= 0 .01) ,with the sensitivity of 71 .03% and specificity of 79 .13% in predicting 3‐year HCC development .By combining AFP isoform 3 (AFP‐L3% ) and REACH‐B ,the R‐AFP‐L3% scoring model was constructed .The AUC further increased to 0 .83 (95% CI:0 .80-0 .87 ,Z=2 .45 ,P=0 .01) ,with the sensitivity of 75 .01% and specificity of 79 .32% in predicting 3‐year HCC development .To predict the development of HBV‐related HCC within 5 years ,a total of 159 (65 HCC cases and 94 non‐HCC controls) were enrolled .The AUC of REACH‐B scoring model was 0 .79 (95% CI:0 .72-0 .87) ,with the sensitivity of 73 .60% and specificity of 75 .43% .The R‐AFP scoring model had an AUC of 0 .84 (95% CI:0 .77-0 .90 ,Z=2 .70 ,P=0 .006) ,with the sensitivity of 83 .12%and specificity of 77 .89% .Conclusion Combination of AFP or AFP‐L3% may optimize the predictive values of REACH‐B scoring model in predicting 3‐year and 5‐years risks of developing HBV‐related HCC .

Hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) is a major public health problem in Southeast Asia. In recent years, researchers from Hong Kong and Taiwan have reported predictive models or risk calculators for HBV-associated HCC by studying its natural history, which, to some extent, predicts the possibility of HCC development. Generally, risk factors of each model involve age, sex, HBV DNA level, and liver cirrhosis. This article discusses the evolution and clinical significance of currently used predictive models for HBV-associated HCC and assesses the advantages and limits of risk calculators. Updated REACH-B model and LSM-HCC model show better negative predictive values and have better performance in predicting the outcomes of patients with chronic hepatitis B (CHB). These models can be applied to stratified screening of HCC and, meanwhile, become an assessment tool for the management of CHB patients.