Objective:To investigate the relationship between serum myosin-like BCL2 interacting protein (Beclin-1), tissue non-specific alkaline phosphatase (TNAP) and arrhythmia in patients with hypertension and chronic heart failure (CHF).Methods:A total of 121 patients with hypertension and CHF who experienced arrhythmia and 121 patients with hypertension and CHF who did not experience arrhythmia and were admitted to Xi'an Traditional Chinese Medicine Brain Disease Hospital from April 2022 to April 2024 were included as the study subjects, and were assigned into the occurrence group and the non occurrence group, respectively. Enzyme-linked immunosorbent assay (ELISA) method was applied to detect the expression levels of Beclin-1 and TNAP in the serum of patients with hypertension and CHF. Pearson method was applied to analyze the correlation between Beclin-1, TNAP levels and mean heart rate, New York Heart Association functional class (NYHA), left ventricular ejection fraction (LVEF), dynamic stiffness index (AASI), and N-terminal pro-brain natriuretic peptide (NT-proBNP) in patients with hypertension complicated with CHF arrhythmia. Multivariate logistic regression was applied to analyze the influencing factors of arrhythmia in patients with hypertension and CHF. Receiver operating characteristic (ROC) curve was applied to evaluate the diagnostic value of serum Beclin-1 and TNAP levels for arrhythmia in patients with hypertension and CHF.Results:The expression level of Beclin-1 in the serum of the occurrence group was lower than that of the non-occurrence group: (4.18 ± 1.12) μg/L vs. (5.26 ± 0.69) μg/L, while the TNAP level was higher than that of the non-occurrence group: (6.31 ± 1.32) μg/L vs. (5.27 ± 1.24) μg/L, and the differences were statistically significant ( P<0.05). In patients with hypertension combined with CHF and arrhythmia, Beclin-1 was negatively correlated with average heart rate, NYHA classification, AASI and NT-proBNP, and positively correlated with LVEF ( P<0.05), while TNAP was positively correlated with average heart rate, NYHA classification, AASI and NT-proBNP, and negatively correlated with LVEF ( P<0.05). Mean heart rate, NYHA classification, AASI, NT-proBNP and TNAP were risk factors for arrhythmia in patients with hypertension and CHF, while LVEF and Beclin-1 were protective factors for arrhythmia in patients with hypertension and CHF ( P<0.05). The AUC of Beclin-1 and TNAP in diagnosing arrhythmia in patients with hypertension and CHF was 0.813 and 0.818, respectively. When the AUC of their combined diagnosis increased to 0.904, the AUC of their combined diagnosis for arrhythmia in patients with hypertension and CHF was better than that of Beclin-1 ( Z = 2.583, P<0.05) and TNAP ( Z = 2.559, P<0.05). Conclusions:Beclin-1 is downregulated and TNAP is upregulated in the serum of patients with hypertension complicated with CHF and arrhythmia. The combination of the two has a high value in diagnosing arrhythmia in patients with hypertension and CHF.

Objective:To investigate the value of tumor and adipose tissue metabolic parameters from baseline 18F-FDG PET/CT in predicting the efficacy and prognosis of immunotherapy in patients with advanced nasopharyngeal carcinoma (NPC). Methods:From February 2019 to February 2022, 112 patients (91 males, 21 females, age 21-73 years) with advanced NPC who were treated with programmed death-1 (PD-1) inhibitors at Sun Yat-Sen University Cancer Center were retrospectively included. All patients underwent baseline PET/CT examination. Tumor and adipose tissue metabolic parameters were measured and calculated. Patients were divided into clinical benefit and non-clinical benefit groups, and Mann-Whitney U test or χ2 test was used to assess the differences between groups. Prognostic analysis of progression-free survival (PFS) was performed using multivariate Cox proportional hazards regression model and a prognostic stratification system was constructed. Results:Of the 112 patients, 85 were in the clinical benefit group and 27 were in the non-clinical benefit group. In non-clinical benefit group and clinical benefit group, the metabolic tumor volume (MTV) of primary tumor (PT-MTV) were 47.7(7.7, 81.2) and 14.0(5.7, 27.1)cm 3, total lesion glycolysis (TLG) of primary tumor (PT-TLG) were 228.9(27.4, 492.8) and 72.7(20.4, 165.5)g, whole-body MTV (WB-MTV) were 94.2(45.9, 215.4) and 61.3(31.6, 104.3)cm 3, whole-body TLG (WB-TLG) were 605.5(214.1, 1 402.5) and 319.2(172.4, 632.8)g, SUV max of visceral adipose tissue (SUV max-VAT) were 0.77(0.55, 0.91) and 0.62(0.48, 0.76), respectively ( Z values: from -2.72 to -1.96, all P<0.05). The proportion of patients with lung metastasis in non-clinical benefit group was higher than that in clinical benefit group (44.4%(12/27) vs 23.5%(20/85); χ2=4.39, P=0.036). PT-MTV (hazard ratio ( HR)=2.807, 95% CI: 1.540-5.118, P=0.001) and the presence of lung metastases ( HR=1.691, 95% CI: 1.012-2.823, P=0.045) were independent predictive factors for PFS in multivariate analysis. The prognostic prediction model based on the two predictive factors was able to significantly differentiate the prognosis in patients. Conclusions:Baseline tumor metabolic parameters and SUV max-VAT are associated with the efficacy of immunotherapy in patients with advanced NPC. PT-MTV and lung metastasis can independently predict PFS. The constructed prediction model can stratify patients′ prognosis.

Objective:To investigate the value of tumor and adipose tissue metabolic parameters from baseline 18F-FDG PET/CT in predicting the efficacy and prognosis of immunotherapy in patients with advanced nasopharyngeal carcinoma (NPC). Methods:From February 2019 to February 2022, 112 patients (91 males, 21 females, age 21-73 years) with advanced NPC who were treated with programmed death-1 (PD-1) inhibitors at Sun Yat-Sen University Cancer Center were retrospectively included. All patients underwent baseline PET/CT examination. Tumor and adipose tissue metabolic parameters were measured and calculated. Patients were divided into clinical benefit and non-clinical benefit groups, and Mann-Whitney U test or χ2 test was used to assess the differences between groups. Prognostic analysis of progression-free survival (PFS) was performed using multivariate Cox proportional hazards regression model and a prognostic stratification system was constructed. Results:Of the 112 patients, 85 were in the clinical benefit group and 27 were in the non-clinical benefit group. In non-clinical benefit group and clinical benefit group, the metabolic tumor volume (MTV) of primary tumor (PT-MTV) were 47.7(7.7, 81.2) and 14.0(5.7, 27.1)cm 3, total lesion glycolysis (TLG) of primary tumor (PT-TLG) were 228.9(27.4, 492.8) and 72.7(20.4, 165.5)g, whole-body MTV (WB-MTV) were 94.2(45.9, 215.4) and 61.3(31.6, 104.3)cm 3, whole-body TLG (WB-TLG) were 605.5(214.1, 1 402.5) and 319.2(172.4, 632.8)g, SUV max of visceral adipose tissue (SUV max-VAT) were 0.77(0.55, 0.91) and 0.62(0.48, 0.76), respectively ( Z values: from -2.72 to -1.96, all P<0.05). The proportion of patients with lung metastasis in non-clinical benefit group was higher than that in clinical benefit group (44.4%(12/27) vs 23.5%(20/85); χ2=4.39, P=0.036). PT-MTV (hazard ratio ( HR)=2.807, 95% CI: 1.540-5.118, P=0.001) and the presence of lung metastases ( HR=1.691, 95% CI: 1.012-2.823, P=0.045) were independent predictive factors for PFS in multivariate analysis. The prognostic prediction model based on the two predictive factors was able to significantly differentiate the prognosis in patients. Conclusions:Baseline tumor metabolic parameters and SUV max-VAT are associated with the efficacy of immunotherapy in patients with advanced NPC. PT-MTV and lung metastasis can independently predict PFS. The constructed prediction model can stratify patients′ prognosis.

Objective:To investigate the relationship between serum myosin-like BCL2 interacting protein (Beclin-1), tissue non-specific alkaline phosphatase (TNAP) and arrhythmia in patients with hypertension and chronic heart failure (CHF).Methods:A total of 121 patients with hypertension and CHF who experienced arrhythmia and 121 patients with hypertension and CHF who did not experience arrhythmia and were admitted to Xi'an Traditional Chinese Medicine Brain Disease Hospital from April 2022 to April 2024 were included as the study subjects, and were assigned into the occurrence group and the non occurrence group, respectively. Enzyme-linked immunosorbent assay (ELISA) method was applied to detect the expression levels of Beclin-1 and TNAP in the serum of patients with hypertension and CHF. Pearson method was applied to analyze the correlation between Beclin-1, TNAP levels and mean heart rate, New York Heart Association functional class (NYHA), left ventricular ejection fraction (LVEF), dynamic stiffness index (AASI), and N-terminal pro-brain natriuretic peptide (NT-proBNP) in patients with hypertension complicated with CHF arrhythmia. Multivariate logistic regression was applied to analyze the influencing factors of arrhythmia in patients with hypertension and CHF. Receiver operating characteristic (ROC) curve was applied to evaluate the diagnostic value of serum Beclin-1 and TNAP levels for arrhythmia in patients with hypertension and CHF.Results:The expression level of Beclin-1 in the serum of the occurrence group was lower than that of the non-occurrence group: (4.18 ± 1.12) μg/L vs. (5.26 ± 0.69) μg/L, while the TNAP level was higher than that of the non-occurrence group: (6.31 ± 1.32) μg/L vs. (5.27 ± 1.24) μg/L, and the differences were statistically significant ( P<0.05). In patients with hypertension combined with CHF and arrhythmia, Beclin-1 was negatively correlated with average heart rate, NYHA classification, AASI and NT-proBNP, and positively correlated with LVEF ( P<0.05), while TNAP was positively correlated with average heart rate, NYHA classification, AASI and NT-proBNP, and negatively correlated with LVEF ( P<0.05). Mean heart rate, NYHA classification, AASI, NT-proBNP and TNAP were risk factors for arrhythmia in patients with hypertension and CHF, while LVEF and Beclin-1 were protective factors for arrhythmia in patients with hypertension and CHF ( P<0.05). The AUC of Beclin-1 and TNAP in diagnosing arrhythmia in patients with hypertension and CHF was 0.813 and 0.818, respectively. When the AUC of their combined diagnosis increased to 0.904, the AUC of their combined diagnosis for arrhythmia in patients with hypertension and CHF was better than that of Beclin-1 ( Z = 2.583, P<0.05) and TNAP ( Z = 2.559, P<0.05). Conclusions:Beclin-1 is downregulated and TNAP is upregulated in the serum of patients with hypertension complicated with CHF and arrhythmia. The combination of the two has a high value in diagnosing arrhythmia in patients with hypertension and CHF.

Objective To improve the orotracheal intubation verifying technique and reduce the complication of backflow in rat experiment.Methods A new position evaluation of anti-backflow device was designed and made of safety IV catheter and closed IV catheter system.60 adult male Sprague Dawley rats 216±20 g were randomly assigned to two groups: group A (n=40) for verifying placement, group B (n=20) for anti-backflow test.Group A was further divided into group A1 using self-designed positioning device, group A2 using aerosol, group A3 taking cotton fiber for positioning judgment.The group B was divided into two subgroups, B1 and B2, counting escaped bubbles as a means of positioning observation, the difference is that group B1 using frustum of a cone shape anti-backflow device, while the group B2 using common airway tube.Routine endotracheal intubation was performed to observe and record the time of positioning, the location of exhalation phase, and the length of inspiratory phase countercurrent water column.The group A1 further performed tracheotomy under direct vision clearly to confirm the anatomic positioning status.Results During the exhalation cycle,three or more bubbles were observed to escape continuously, indicating that the intubation tube was properly placed and open in the airway.Positioning time: It took 1.75±1.02 respiratory cycles in group A1,3.30±0.95 respiratory cycles in group A2 and 4.10±0.99 respiratory cycles in group A3 to complete the assessment the positioning status.There was no statistically significant difference between groups A2 and A3 (P> 0.05).The time needed for group A1 was significantly shorter than that of groups A2 and A3 (P < 0.01).The longest countercurrent water column length in group B1 was 3.23±0.53 cm, and 8.48±1.01 cm in the group B2.Conclusions The new designed anti-backflow positioning evaluation device is a simple and convenient appliance to evaluate the location of orotracheal intubation in rat experiment.It can effectively improve the positioning efficiency and has practical application value.

OBJECTIVETo establish the risk model for predicting the progression within 1 year of patients with gastric neuroendocrine neoplasms(gNEN) and to evaluate its value of prediction.

METHODSClinical data of 127 gENE patients with histologically comfirmed sporadic gNEN from January 1999 to February 2015 in Nanfang Hospital of Southern Medical University(n=63) and The First Affiliated Hospital of Sun Yat-sen University(n=64) were collected retrospectively. Twenty-five patients without follow-up were excluded, so a total of 102 cases were enrolled in the analysis. Tumor size enlargement, lesion number increase, recurrence after resection of primary tumor and emergence of tumor metastasis were defined as tumor progression. Patients were divided into progression group (above definitions occurred within 1 year, n=56) and non-progression group (above definitions did not occur within 1 year, n=46). Logistic regression analysis was used to identify the influencing factors of progression within 1 year and the regression equation was acquired, then the probability of progression within 1 year of gNEN patients was obtained to predict the grading: grade I(: the probability of tumor progression within 1 year was < 25.0%; grade II(: this probability was from ≥25.0% to <50.0%; grade III(: this probability was from ≥50.0% to <75.0%; grade IIII(:this probability was ≥75.0%. Spearman correlation analysis was used to study the correlation between predictive grading and the occurrence of disease progression in patients with gNEN NET within 1 years. The ROC curve of different prediction methods was drawn, then the area under the curve(AUC), sensitivity and specificity were calculated and compared.

RESULTSMultivariate regression analysis showed that tumor size(OR=1.048, 95%CI:1.014-1.083, P=0.005), Ki-67 index(OR=2.045, 95%CI:1.261-3.316, P=0.004), and surgical resection of the primary lesion(OR=0.074, 95%CI:0.011-0.497, P=0.070) were independent influencing factors of the progression of gNET within 1 year. The regression equation was as below: P(Y)=1/[1+ e -(-0.934+0.047a+0.715b-2.597c)]. (a: tumor size, b: Ki-67 grading, c: undergoing the surgical resection of the primary lesion). Prediction grading was based on regression equation: 28 cases (29.2%) belonged to grade I(, 9 cases (9.4%) to grade II(, 24 cases (25.0%) to grade III(, and 35 cases (36.5%) to grade IIII(. The probability of progression within 1 year of patients in grade I(, II(, III( and IIII( was 10.7% (3/28),5/9, 58.3%(14/24), and 91.4%(32/35) respectively, with significant difference (χ=41.236, P=0.000). Prediction grading was positively correlated with the occurrence of tumor progression in gNEN patients within 1 year(r=0.644, P=0.000). The AUC of prediction grading to predict the progression of gNEN within 1 year was 0.857, while the sensitivity was 85.2% and the specificity was 69.0%. DeLong method was used to compare the AUC values of prediction grading, Ki-67 grading and TNM staging. Comparison result revealed that the predictive value of prediction grading was not significantly different with that of TNM staging (P=0.303), but was better than that of Ki-67 grading (P=0.006).

CONCLUSIONSOur grading standard can objectively and accurately reflect the probability of progression within one year in gNEN patients. The later the grading, the higher the probability of progression within 1 year is for gNEN patients.

Aged ; Disease Progression ; Female ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Neuroendocrine Tumors ; pathology ; therapy ; ROC Curve ; Retrospective Studies ; Risk ; Sensitivity and Specificity ; Stomach Neoplasms ; pathology ; therapy

Objective Using an in vivo adeno-associated virus(AAV)-mediated gene transfer technique,this study was designed to evaluate the protective effects of human osteoprotegerin(OPG)transgene against joint destruction in collagen induced arthritis(CIA)model.MethodsAfter CIA was established in the Sprague-Dawley rats,the experimental animals were treated with PBS or rAAV-EGFP or rAAV-hOPG (100μl/d)intra-articular injection 25 days after arthritis induction for 10 days.Paraffin-embedded joints were then analyzed histologically.The joint destruction was evaluated by Larsen Score.The protein expression of OPG,IL-1,MMP-3 was identified by enzyme-linked immunosorbent assay(ELISA).Results Suecessful trans-gene expression was confirmed by the detection of OPG by ELISA and positive fluorescence of the frozen joint section. Image analysis revealed that the expression of OPG significantly protected against joint destruction by 30% compared with the CIA group. Conclusion OPG gene transfer mediated by rAAV effectively protects against bone destruction induced by CIA model. Those data suggest that gene transferring using rAAV-OPG may be a feasible and effective therapeutic approach to treat or prevent joint destruction in inflammatory arthritis.

Objective This study was designed to investigate the expression changes of osteopro-tegerin (OPG), tartrate-resistant acid phosphatase (TRAP) and vascular endothelial growth factor (VEGF) mRNA in collagen induced arthritis(CIA) rats. Methods After CIA was induced in Sprague-Dawley rats, the experimental animals were treated with PBS or rAAV-EGFP or rAAV-hOPG (100 μl/day) intra-articular injection for 10 days. Messenger RNAs (mRNAs) were obtained from CIA synovium 40days after first immun-ization. Reverse transcriptase-polymerase chain reactions (RT-PCR) were carried out to detect the mRNA encoding OPG, TRAP, VEGF and β-actin, which acted as inner control. The genes detected clearly by RT-PCR were quantified using real-time PCR. Results The expression of all genes was confirmed by specific single bands in RT-PCR. Real-time PCR showed that the expression levels of TRAP and VEGF were increased, whereas those of OPG mRNA were decreased in CIA group compared with normal controls. The intra-articular gene transduction markedly increased the gene copies of OPG by 128.21% (P<0.01). The expression change of OPG in synovium also caused the decrease of the expression levels of TRAP and VEGF by 58.79% (P<0.01)and 17.85% (P>0.05) respectively, however, the expression change of VEGF was not statistically significant. Conclusion OPG gene mediated by rAAV can be successfully tranfered to knee joint synovium in vivo. The results of this study suggest that gene transfer using rAAV-OPG may be a feasible and effective therapeutic approach to treat or prevent joint destruction in inflammatory arthritis.

Objective To analyze the clinical features,and prognosis of the interstitial lung disease (ILD) in patients with dermatomyositis (DM) and polymyositis (PM) by chest X-ray,chest high-resolution CT scan (HRCT) and pulmonary lung function.Methods Thirty-three patients hospitalized with DM/PM associated ILD were retrospectively analyzed.Results Thirty-three patients with ILD were confirmed by HRCT.Abnormal pulmonary function tests were available in 82% of patients.Clinical-imaging analysis revealed that the pathological features of ILD were non-specific interstitial pneumonia (NSIP,57%) and unusual interstitial pneumonia (UIP,25%).UIP types showed a poor prognosis and high mortality (70%).Conclusion This study shows that HRCT is more sensitive for the diagnosis of ILD than lung function tests and chest X-ray.Combined HRCT and chest X-ray with lung function tests and blood gas analysis have shown that the major pathological types of ILD are NSIP and UIP,in which UIP are associated with high mortality and poor prognosis.