Objective:To investigate the prognostic factors in patients with acute myocardial infarction (AMI) who underwent interventional therapy assisted by venous-arterial extracorporeal membrane oxygenation (VA-ECMO).Methods:This single-center retrospective cohort study enrolled AMI patients who received VA-ECMO-assisted interventional therapy in the Department of Cardiology at the Second Hospital of Jilin University from June 2018 to November 2022. Patients were divided into the in-hospital survival group and in-hospital death group based on the in-hospital survival. Data on patient demographics, laboratory tests, imaging examinations, coronary angiography results, VA-ECMO-related parameters, complications, and prognosis were collected through the electronic medical record system.Results:A total of 71 AMI patients were enrolled, with an age of (62.4±11.1) years, of whom 54 (76%) were male. There were 46 patients in the in-hospital survival group and 25 patients in the in-hospital death group. Compared to the in-hospital survival group, the in-hospital death group exhibited significantly higher levels of cardiac troponin I (36.08 (2.86, 100.00) μg/L vs. 2.75 (0.18, 13.86) μg/L, P=0.01) and B-type natriuretic peptide (1 724.50 (50.00, 4 200.50) vs. 460.85 (163.80, 1 862.33), P=0.01), and the left ventricular ejection fraction was lower ((35.0±12.9)% vs. (43.0±12.8)%, P=0.01), moreover the incidence of patients with left main coronary artery disease (80% (20/25) vs. 39% (18/46), P<0.01), cardiac arrest (56% (14/25) vs. 20% (9/46), P<0.01), cardiopulmonary resuscitation (52%(13/25) vs. 26%(12/46), P=0.03), and the time from cardiac arrest to ECMO initiation >24 hours (84% (21/25) vs. 9% (4/46), P<0.01) were higher. Conclusions:The prognosis of AMI patients undergoing VA-ECMO-assisted interventional therapy may be influenced by a number of related factors, including cardiac troponin I, B-type natriuretic peptide levels, left ventricular ejection fraction, combined with left main coronary artery disease, cardiac arrest and cardiopulmonary resuscitation, and the interval between cardiac arrest and the initiation of ECMO.

Objective:To investigate the prognostic factors in patients with acute myocardial infarction (AMI) who underwent interventional therapy assisted by venous-arterial extracorporeal membrane oxygenation (VA-ECMO).Methods:This single-center retrospective cohort study enrolled AMI patients who received VA-ECMO-assisted interventional therapy in the Department of Cardiology at the Second Hospital of Jilin University from June 2018 to November 2022. Patients were divided into the in-hospital survival group and in-hospital death group based on the in-hospital survival. Data on patient demographics, laboratory tests, imaging examinations, coronary angiography results, VA-ECMO-related parameters, complications, and prognosis were collected through the electronic medical record system.Results:A total of 71 AMI patients were enrolled, with an age of (62.4±11.1) years, of whom 54 (76%) were male. There were 46 patients in the in-hospital survival group and 25 patients in the in-hospital death group. Compared to the in-hospital survival group, the in-hospital death group exhibited significantly higher levels of cardiac troponin I (36.08 (2.86, 100.00) μg/L vs. 2.75 (0.18, 13.86) μg/L, P=0.01) and B-type natriuretic peptide (1 724.50 (50.00, 4 200.50) vs. 460.85 (163.80, 1 862.33), P=0.01), and the left ventricular ejection fraction was lower ((35.0±12.9)% vs. (43.0±12.8)%, P=0.01), moreover the incidence of patients with left main coronary artery disease (80% (20/25) vs. 39% (18/46), P<0.01), cardiac arrest (56% (14/25) vs. 20% (9/46), P<0.01), cardiopulmonary resuscitation (52%(13/25) vs. 26%(12/46), P=0.03), and the time from cardiac arrest to ECMO initiation >24 hours (84% (21/25) vs. 9% (4/46), P<0.01) were higher. Conclusions:The prognosis of AMI patients undergoing VA-ECMO-assisted interventional therapy may be influenced by a number of related factors, including cardiac troponin I, B-type natriuretic peptide levels, left ventricular ejection fraction, combined with left main coronary artery disease, cardiac arrest and cardiopulmonary resuscitation, and the interval between cardiac arrest and the initiation of ECMO.

Objective To construct clinical imaging model,radiomics model,and a combined model based on the above two for predicting lymph node metastasis(LNM)of colon cancer(CC),and to compare the diagnostic performance of each model.Methods The data from 328 CC patients confirmed by surgical pathology were analyzed retrospectively,including 156 with LNM.All patients were randomly divided into training group(229 cases)and validation group(99 cases)at a ratio of 7∶3.The difference of clinical imaging indicators were compared between groups and a clinical imaging model for diagnosing LNM was constructed.The tumor three-dimensional volume of interest(VOI)was used for radiomics feature extraction,and after dimensionality reduction and selection,8 features were obtained to construct the Radiomics score(Radscore).A combined model of clinical imaging indicators and Radscore was built.The diagnostic performance of each model for LNM was compared,and the calibration and clinical benefit of the optimal model were evaluated.Results There were statistical differences in clinical imaging indicators between the two groups:carcinoembryonic antigen(CEA),CA199,tumor long diameter,and lymph node short diameter(P＜0.05).The area under the curve(AUC)of the clinical imaging model,radiomics model,and combined model were 0.721,0.814,0.854(training group),and 0.744,0.732,0.808(validation group),respectively.The AUC of the combined model was the highest,and both the training and validation groups were higher than that of the clinical imaging model(P＜0.05).The combined model demonstrated higher calibration,with a clinical benefit from decision curve analysis(DCA)threshold range of 0.09 to 0.91.Conclusion The nomogram constructed based on clinical imaging indicators and CT radiomics holds high value in diagnosing LNM of CC.

BACKGROUND:At present,a large number of studies have found that Liuwei Dihuang Pill can be used to treat osteoporosis,but there are few related studies on the differentiation and mineralization of osteoblasts induced by wear particles using Liuwei Dihuang Pill. OBJECTIVE:To investigate the positive effect of different concentrations of Liuwei Dihuang Pill-containing serum on titanium particle-induced mouse MC3T3-E1 osteoblast in vitro osteolysis model. METHODS:Drug-containing serum was extracted after oral administration of Liuwei Dihuang Pill.The best concentration of Liuwei Dihuang Pill-containing serum and titanium particles on the viability of MC3T3-E1 cells was screened.MC3T3-E1 cells were divided into three groups.The blank group was given osteoblastic differentiation culture.The model group was given titanium particles(5 μg/mL)ossification culture.The drug-containing serum group was given titanium particles(5 μg/mL)+ Liuwei Dihuang Pill-containing serum(10%,15%and 20%doses).Osteoblast viability was detected by CCK-8 assay.Cell alkaline phosphatase activity was detected by alkaline phosphatase staining.Cell mineralization was detected by silver nitrate(Von Kossa)and alizarin red staining.Expression levels of bone differentiation-related genes Runx-2,Osterix,Ocn,Axin,Alp,and Opn were detected by qRT-PCR.Wnt/β-catenin signaling pathways β-catenin,p-GSK-3β,GSK-3β,Runx2 and Osterix protein expression levels were detected by western blot assay. RESULTS AND CONCLUSION:(1)Liuwei Dihuang Pill-containing serum culture reversed the decrease in alkaline phosphatase activity of MC3T3E-1 cells induced by titanium particles,increased the alizarin red staining and calcification of MC3T3E-1 cells,increased the expression of osteogenesis-related genes in MC3T3E-1 cells,and increased the expression of proteins related to the Wnt/β-catenin signaling pathway.(2)These findings indicate that Liuwei Dihuang Pill-containing serum can reverse the inhibitory effect of titanium particles on the differentiation and mineralization of osteoblasts,upregulate the expression of osteogenesis-related genes,and its mechanism is related to the regulation of Wnt/β-catenin signaling pathway,suggesting that Liuwei Dihuang Pill is expected to become an effective drug for preventing aseptic loosening of artificial joints.

BACKGROUND:Spheroid culture of mesenchymal stem cells in bioreactors is an in vitro culture method to maintain their stemness properties and allow for large-scale expansion.Clarifying its effects on the immunoregulation effect of stem cells is beneficial for their clinical application. OBJECTIVE:To investigate the effects of spheroid culture in a rotating bioreactor on the secretion of inflammatory factors by human placenta-derived mesenchymal stem cells. METHODS:Placenta-derived mesenchymal stem cells isolated from human placenta tissue were cultured in two-dimensional culture or a rotating bioreactor culture.Cell morphology and proliferation ability were observed using inverted phase contrast microscopy,immunohistochemical staining,and CCK-8 assay.The gene expression and protein secretion of several inflammatory factors were detected by RT-qPCR and flow immunofluorescence assay. RESULTS AND CONCLUSION:(1)Mesenchymal stem cells cultured in a rotating bioreactor aggregated into multicellular spheroids,which gradually increased in number and volume.(2)The hematoxylin-eosin staining results showed that the mesenchymal stem cells cultured in the rotating bioreactor for 4 days were evenly distributed and had normal morphology in the spheroids.(3)Immunohistochemical staining results revealed many mesenchymal stem cells with Ki-67 positive in the spheroids.(4)The CCK-8 assay results exhibited that the viability of mesenchymal stem cells derived from spheroid culture was significantly higher than that of cells cultured in two-dimensional culture.(5)The results of RT-qPCR and flow immunofluorescence assay demonstrated that the gene expression and protein secretion(interleukin 1β,interleukin-4,interleukin-6,interleukin-8,interleukin-10,interleukin-17,tumor necrosis factor α and interferon α)of inflammatory factors derived from mesenchymal stem cells cultured in the rotating bioreactor were significantly higher than those in two-dimensional culture.(6)Our results indicate that spheroid culture in a rotating bioreactor can significantly elevate the secretion ability of various inflammatory factors by human placenta-derived mesenchymal stem cells,and enhance the immunoregulatory effect of human placenta-derived mesenchymal stem cells.

ObjectiveTo investigate the synergistic effect of Coptidis Rhizoma crude polysaccharide （CCP） and berberine （BBR） in treating ulcerative colitis （UC） model mice. MethodThirty male BALB/c mice were randomized into five groups. Except the 6 mice in the normal group， the rest were given 5% dextran sodium sulfate in their daily drinking water to establish the UC model. After modeling， the mice were administrated with corresponding agents by gavage once daily for 4 days： BBR （100 mg·kg^-1） group， BBR （100 mg·kg^-1） + low-dose （22.8 mg·kg^-1） CCP group， BBR （100 mg·kg^-1） + high-dose （45.6 mg·kg^-1） CCP group. The mice in the model group and normal group were administrated with the same volume of normal saline. At the end of the experiment， the mice were sacrificed for the collection of colon， and the expression of tight junction proteins zonula occluden-1 （ZO-1）， Claudin-1， and Occludin in colon tissue was detected by Western blot. With the normal group as the control， the disease activity index （DAI） score， colon length， colon histomorphology， and expression levels of tight junction proteins in other groups were evaluated. ResultCompared with the normal group， the modeling down-regulated the protein levels of ZO-1， Claudin-1， and Occludin （P<0.01）. Compared with the model group， BBR did not significantly change the protein level of Claudin-1 and up-regulated those of ZO-1 and occludin （P<0.01）. The expression levels of Claudin-1， ZO-1， and Occludin were up-regulated in BBR + CCP groups （P<0.01）. The expression levels of tight junction proteins in BBR + CCP groups were significantly higher than those in the BBR group （P<0.05）. ConclusionThe administration of CCP combined with BBR can effectively ameliorate intestinal mucosal barrier damage in the mice with UC.

Chest trauma is one of the most common injuries. Venous thromboembolism (VTE) as a common complication of chest trauma seriously affects the quality of patients′ life and even leads to death. Although there are some consensus and guidelines on the prevention and treatment of VTE at home and abroad, the current literatures lack specificity considering the diagnosis, treatment and prevention of VTE in patients with chest trauma have their own characteristics, especially for those with blunt trauma. Accordingly, China Chest Injury Research Society and editorial board of Chinese Journal of Traumatology organized relevant domestic experts to jointly formulate the Chinese expert consensus on the diagnosis, treatment and prevention of chest trauma venous thromboembolism associated with chest trauma (2022 version). This consensus provides expert recommendations of different levels as academic guidance in terms of the characteristics, clinical manifestations, risk assessment, diagnosis, treatment, and prevention of chest trauma-related VTE, so as to offer a reference for clinical application.

Objective:To summarize the clinical features of X-linked lymphoproliferative syndrome type 2 (XLP-2) , especially the cases with inflammatory bowel disease (IBD) as the clinical phenotype.Methods:The clinical features and the course of diagnosis and treatment of a XLP-2 patient with IBD as the primary phenotype at the Department of Gastroenterology of the Third Affiliated Hospital of Guangzhou Medical University in May 2021 were analyzed retrospectively. Key words of "X-linked lymphoproliferative syndrome type 2" , "X-linked inhibitor of apoptosis protein deficiency" , "hemophagocytic syndrome" were used to retrieve associated literatures in PubMed, CNKI and Wanfang database between January 2006 and October 2021. Associated literatures including the patients diagnosed as the XLP-2 were summarized and reviewed.Results:A total of 90 articles and 215 patients were included. Among them, 207 were males and 8 were females. There were 183 (85.1%) patients with age of diagnosis less than 14 years old. Hemophagocytic syndrome (55.3%, 119/215) , splenomegaly (27.0%, 58/215) and IBD (26.0%, 56/215) were the common clinical phenotypes. There were 56 patients with IBD as the clinical phenotype, including 52 males and 4 females. The average age of onset was 6.4 (0, 31.0) years old, the average age at diagnosis of IBD was 9.1 (0, 31.0) years old and the average age at diagnosis of XLP-2 was 10.8 (0, 41.0) years old. There were 49 of Crohn′s disease, 1 of ulcerative colitis and 6 of IBD unclassified. In the 56 patients with mutation of X-linked inhibitor of apoptosis protein ( XIAP) , nonsense mutations occurred in 26, missense mutations in 22 and deletion mutations in 8. In terms of treatment, 25 patients (44.6%) received hematopoietic stem cell transplantation, 8 (14.3%) received hormones, 11 (19.6%) received immunosuppressants, 27 (48.2%) received biologics, and 18 (32.1%) received 2 or more two biologics. Thirty-five patients were followed up for 8.46 (0.11, 34.00) years, 32 survived and 3 died. Conclusions:XLP-2 is an X chromosome recessive genetic disease, which is common in men and children. IBD is one of the common phenotypes. XLP-2 patients with IBD as phenotype mostly receive multiple drug treatments, and the disease has characteristics of refractory and delayed diagnosis. Early gene detection is of great significance for the differential diagnosis and early treatment of XIAP gene deficiency diseases.

Objective:To summarize the clinical features of X-linked lymphoproliferative syndrome type 2 (XLP-2) , especially the cases with inflammatory bowel disease (IBD) as the clinical phenotype.Methods:The clinical features and the course of diagnosis and treatment of a XLP-2 patient with IBD as the primary phenotype at the Department of Gastroenterology of the Third Affiliated Hospital of Guangzhou Medical University in May 2021 were analyzed retrospectively. Key words of "X-linked lymphoproliferative syndrome type 2" , "X-linked inhibitor of apoptosis protein deficiency" , "hemophagocytic syndrome" were used to retrieve associated literatures in PubMed, CNKI and Wanfang database between January 2006 and October 2021. Associated literatures including the patients diagnosed as the XLP-2 were summarized and reviewed.Results:A total of 90 articles and 215 patients were included. Among them, 207 were males and 8 were females. There were 183 (85.1%) patients with age of diagnosis less than 14 years old. Hemophagocytic syndrome (55.3%, 119/215) , splenomegaly (27.0%, 58/215) and IBD (26.0%, 56/215) were the common clinical phenotypes. There were 56 patients with IBD as the clinical phenotype, including 52 males and 4 females. The average age of onset was 6.4 (0, 31.0) years old, the average age at diagnosis of IBD was 9.1 (0, 31.0) years old and the average age at diagnosis of XLP-2 was 10.8 (0, 41.0) years old. There were 49 of Crohn′s disease, 1 of ulcerative colitis and 6 of IBD unclassified. In the 56 patients with mutation of X-linked inhibitor of apoptosis protein ( XIAP) , nonsense mutations occurred in 26, missense mutations in 22 and deletion mutations in 8. In terms of treatment, 25 patients (44.6%) received hematopoietic stem cell transplantation, 8 (14.3%) received hormones, 11 (19.6%) received immunosuppressants, 27 (48.2%) received biologics, and 18 (32.1%) received 2 or more two biologics. Thirty-five patients were followed up for 8.46 (0.11, 34.00) years, 32 survived and 3 died. Conclusions:XLP-2 is an X chromosome recessive genetic disease, which is common in men and children. IBD is one of the common phenotypes. XLP-2 patients with IBD as phenotype mostly receive multiple drug treatments, and the disease has characteristics of refractory and delayed diagnosis. Early gene detection is of great significance for the differential diagnosis and early treatment of XIAP gene deficiency diseases.

Objective To investigate the efficacy of calf self weight traction reduction combined with locking plate fixation for the treatment of intertrochanteric fractures in the elderly.Methods A retrospective case series study was conducted on the clinical records of 174 elderly patients with the modified Evans Ⅰ-Ⅲ types of fresh intertrochanteric fractures treated with locking plate from January 2012 to December 2015.According to treatment method,the patients were assigned to traction bed reduction with locking plate fixation (Group A,62 patients) and calf self weight traction reduction with locking plate fixation (Group B,112 patients).Group A comprised 32 males and 30 females,with age range of 65-91 years [(72.47 ± 6.35) years].Group B comprised 68 males and 44 females,with age range of 65-95 years [(73.23 ± 6.05) years].The time of reduction,operation time,incision length,intraoperative blood loss,frequency of fluoroscopy,postoperative drainage volume,hospital stay,postoperative weightbearing standing time or walking time (ambulation time),surgical complications,and fracture healing were recorded.Harris and modified Barthel index score in Chinese (MBI-C) were used to evaluate the functional recovery of hip joint.Results All patients were followed up for 5-61 months (mean,15 months),and noted with fracture healing.The time of reduction in Group A was (13.27 ± 3.03) minutes,longer than that in Group B (0 minute) (P ＜0.05).The operation time in Group A was (63.63 ± 13.90)minutes,longer than that in Group B [(59.62 ± 8.38) minutes] (P ＜ 0.05).Fluoroscopy in Group A was (5.35 ± 2.36) times,more than (4.28 ± 3.11) times in Group B (P ＜ 0.05).There were no significant differences in the incision length,intraoperative blood loss,postoperative drainage volume,ambulation time,fracture healing time,Harris score,and MBI-C index between the two groups (P ＞0.05).There were no significant differences in the postoperative complications such as deep venous thrombosis,pulmonary infection,incisional infection,urinary tract infection,delirium,bed sores,cardiac insufficiency,electrolyte disturbance,and postoperative plate rupture between the two groups (P＞0.05).The incidence of deep vein thrombosis was 9.7％ (6/62) in Group A,and 4.5％ (5/112) in Group B (P ＞0.05).No screw fracture,nail and plate combination failure,bone nonunion,or screw cut out of the femoral head were observed in both groups.Conclusions For the modified Evans Ⅰ-Ⅲ types of intertrochanteric fractures,both traction bed reduction and calf weight reduction with locking plate have equivalent efficacy.However,the latter method has advantages of shorter reduction and operation time and less intraoperative X-ray exposure,and hence is worthy of clinical application.