Objective To discuss the application of automatic quantitative parameters of three-dimensional ultrasound(3-D ultrasound)in evaluating left ventricular function and quality of life in patients with myocardial infarction after receiving percutaneous coronary intervention(PCI),and to construct a nomogram prediction model based on the influencing factors.Methods A total of 300 patients with myocardial infarction,who were admitted to Yixing Hospital of Jiangsu University from January 2022 to January 2024,were enrolled in this study.The patients were randomly divided into experimental group(n=200)and validation group(n=100).According to the quality of life at three months after PCI,the patients in the experimental group were subdivided into poor-quality of life subgroup(n=52)and good-quality of life subgroup(n=148).The clinical data of the two subgroups were collected,and the clinical indicators having differences between the two groups were included in the logistic regression model to analyze the factors affecting the poor quality of life of myocardial infarction patients after PCI.According to the influencing factors,a nomogram prediction model was constructed.The receiver operating characteristic(ROC)curve was used to analyze the efficacy of the nomogram prediction model in predicting poor quality of life in patients with myocardial infarction after PCI.The external validation group was used to verify the predictive efficacy of the nomogram prediction model for poor quality of life in patients with myocardial infarction after PCI.Results No statistically significant differences in the clinical data existed between the experimental group and the validation group(P＞0.05).Comparison of the clinical data between the two subgroups showed that statistically significant differences in the age,BMI,diabetes history,left ventricular ejection fraction(LVEF),left ventricular end-systolic volume(LVESV),left ventricular end-diastolic volume(LVEDV),left ventricular global peak longitudinal strain(GLS),left ventricular global peak radial strain(GRS),and left ventricular global peak area strain(GAS)existed between the two subgroups(all P＜0.05).LVEF,LVESV,LVEDV and GLS were the influencing factors for poor quality of life in patients with myocardial infarction after PCI.ROC analysis showed that the AUC of LVEF,LVESV,LVEDV,GLS and nomogram prediction model were 0.763,0.790,0.786,0.729 and 0.921 respectively,indicating LVEF,LVESV,LVEDV and GLS had certain predictive value for poor quality of life in patients with myocardial infarction after PCI,and the nomogram prediction model had higher predictive value.When taking the cut-off value,the sensitivities of LVEF,LVESV,LVEDV,GLS,and nomogram prediction model were 0.728,0.730,0.838,0.660 and 0.951 respectively,and the specificity were 0.730,0.796,0.631,0.730 and 0.865 respectively.Internal validation of the nomogram prediction model using the Bootstrap method(B=1 000)showed that the prediction curve basically coincided with the ideal line,and the nomogram model had good predictive ability.The decision curve of this model showed that its net return rate was＞0 in the threshold probability range of 0.03-1.00.When the validation group was used to verify the nomogram prediction model,the AUC was 0.903,when the cut-off value was taken,the sensitivity was 0.838 and the specificity was 0.856.In the external validation group,the nomogram prediction model had a high predictive value for poor quality of life in patients with myocardial infarction after PCI.Conclusion LVEF,LVESV,LVEDV and GLS are the adverse factors affecting the quality of life in patients with myocardial infarction after PCI.The nomogram prediction model that is constructed based on LVEF,LVESV,LVEDV and GLS has a higher predictive ability for poor quality of life in patients with myocardial infarction after PCI,which is helpful for guiding clinical intervention and treatment.

Objective To explore the efficacy of endoscopic minimally invasive release surgery and ultrasound-guided percutaneous needle knife release in treating carpal tunnel syndrome(CTS).Methods A total of 96 patients with CTS,who received treatment at Yixing People's Hospital and Wuxi Ninth Hospital Orthopedic Hospital from January 2021 to December 2024,were selected for this study.Using a random number table method,the 96 patients were divided into an endoscopic group and an ultrasound group,with 48 patients in each group.The patients of endoscopic group received endoscopic minimally invasive release surgery,while the patients of ultrasound group received ultrasound-guided needle knife treatment.The surgical indicators,efficacy,wrist function,median nerve electrophysiological indicators,anatomical indicators,efficacy,and safety were compared between the two groups.Results In the ultrasound group,the surgical duration and postoperative recovery time were shorter than those in the endoscopic group(P＜0.05),and the surgical cost was lower than that in the endoscopic group(P＜0.05).The postoperative Symptom Severity Score(SSS)and Functional Status Scale(FSS)score of both groups were decreased when compared with their preoperative values(P＜0.05),and the SSS and FSS of the ultrasound group were lower than those of the endoscopic group(P＜0.05).After treatment,the resting pain score and activity pain score of both groups were decreased when compared with their preoperative values(P＜0.05),and the resting pain score and activity pain score in the ultrasound group were lower than those in the endoscopic group(P＜0.05).After treatment,both groups showed a reduction in median nerve flattening ratio(FR)and transverse carpal ligament(TCL)thickness when compared with their preoperative values(P＜0.05),and the reduction degree in the ultrasound group was greater than that in the endoscopic group(P＜0.05).After treatment,both groups showed an increase in sensory nerve conduction velocity(SNCV),sensory nerve action potential amplitude(SNAP),and motor nerve action potential amplitude(CMAP)when compared with their preoperative values(P＜0.05),which in the ultrasound group showed a greater improvement than those in the endoscopic group(P＜0.05).The postoperative distal motor latency(DML)was decreased in both groups(P＜0.05),and the DML in the ultrasound group was lower than that in the endoscopic group(P＜0.05).The therapeutic efficacy in the ultrasound group was higher than that in the endoscopic group(P＜0.05).Conclusion Compared to endoscopic minimally invasive release surgery,ultrasound-guided needle knife treatment is more effective in promoting the recovery of wrist joint function in patients with CTS.It can effectively decrease the pain severity of patients,repair anatomical injuries in the wrist,promote the recovery of nerve electrophysiological indicators of the median nerve,with good safety and lower medical costs.

OBJECTIVE: Because of the limited number of studies and small sample sizes, whether metabolic syndrome (MS) leads to the occurrence and progression of osteoporosis and the possible underlying mechanisms require further investigation. This study aimed to investigate the association between MS and osteoporosis, along with its influencing factors. METHODS: This observational cross-sectional study included 139,470 individuals aged ≥ 18 years who underwent health examinations from September 2014 to March 2022. Based on bone mineral density (BMD) screening results, the participants were categorized into a suspected osteoporosis or non-osteoporosis group (control). Participants were further divided into those who met 0 MS criteria, 1 MS criterion, 2 MS criteria, and ≥ 3 MS criteria (MS group). Participants who had undergone health examinations at least twice formed the follow-up cohort; a self-matched analysis was performed on those with follow-up periods ≥ 5 years and unchanged MS grouping. RESULTS: Several examination indicators in the suspected osteoporosis group showed statistically significant differences compared with the control group. The proportion of suspected osteoporosis in the MS group was significantly increased compared with that in the 0 MS criteria group (odds ratio [ OR]: 1.215, Z = 29.11, P < 0.001, 95% confidence interval: 1.199-1.231). After adjusting for age, sex, smoking, and alcohol consumption, the 2 MS criteria group and MS group still had OR values > 1 ( P < 0.001). In the follow-up cohort, the proportion of suspected osteoporosis increased gradually with an increase in the number of MS criteria met at baseline and during each follow-up visit ( P < 0.05), with the highest proportion observed in the MS group. However, the proportion of suspected osteoporosis did not increase significantly over time in the different MS groups ( P > 0.05). In the follow-up cohort, the proportion of individuals transitioning from normal BMD to suspected osteoporosis was higher in the MS group after ≥ 5 years of follow-up compared with the group meeting 0 MS criteria (0.08% versus 1.15%, χ ² = 10.76, P = 0.001). There was no significant difference in BMD values for the 0 MS criteria group after 5 years ( P > 0.05), whereas the other three groups experienced a significant decrease in BMD values after 5 years ( P < 0.05). CONCLUSION MS is an independent risk factor for osteoporosis, and the effect of risk factors related to MS on osteoporosis may exceed that of aging alone. The specific mechanisms warrant further investigation.
Humans ; Osteoporosis/etiology* ; Female ; Male ; Metabolic Syndrome/complications* ; Middle Aged ; Cross-Sectional Studies ; China/epidemiology* ; Aged ; Adult ; Bone Density ; Risk Factors

Humans ; Aged ; Acute Kidney Injury ; Risk Factors ; Creatinine

We aimed to evaluate the effectiveness and safety of single-course initial regimens in patients with low-risk gestational trophoblastic neoplasia (GTN). In this trial (NCT01823315), 276 patients were analyzed. Patients were allocated to three initiated regimens: single-course methotrexate (MTX), single-course MTX + dactinomycin (ACTD), and multi-course MTX (control arm). The primary endpoint was the complete remission (CR) rate by initial drug(s). The primary CR rate was 64.4% with multi-course MTX in the control arm. For the single-course MTX arm, the CR rate was 35.8% by one course; it increased to 59.3% after subsequent multi-course MTX, with non-inferiority to the control (difference -5.1%,95% confidence interval (CI) -19.4% to 9.2%, P = 0.014). After further treatment with multi-course ACTD, the CR rate (93.3%) was similar to that of the control (95.2%, P = 0.577). For the single-course MTX + ACTD arm, the CR rate was 46.7% by one course, which increased to 89.1% after subsequent multi-course, with non-inferiority (difference 24.7%, 95% CI 12.8%-36.6%, P < 0.001) to the control. It was similar to the CR rate by MTX and further ACTD in the control arm (89.1% vs. 95.2%, P =0.135). Four patients experienced recurrence, with no death, during the 2-year follow-up. We demonstrated that chemotherapy initiation with single-course MTX may be an alternative regimen for patients with low-risk GTN.
Antineoplastic Combined Chemotherapy Protocols/adverse effects* ; Dactinomycin/adverse effects* ; Female ; Gestational Trophoblastic Disease/drug therapy* ; Humans ; Methotrexate/therapeutic use* ; Pregnancy ; Retrospective Studies

OBJECTIVETo investigate the differentiation capability of kidney stem cells (KSCs) into renal tubular epithelial cells (RTECs).

METHODSKSCs isolated from the renal papilla of 4-week-old SD rats were co-cultured with hypoxia-exposed RTEC in induced medium (containing activin A, BMP-7, and retinoic acid) and renal epithelial cell growth medium (REGM) alternately. The KSCs cultured in MSC medium served as the control. The KSC differentiation rates in both groups were determined using flow cytometry, immunofluorescence assay and qRT-PCR.

RESULTSFlow cytometry showed a CK-18 positive rate of 6.5Percnt; in the control KSC group and of 44.2% in the induced group. Immunofluorescence assay detected the positivity for mature epithelial cell markers CK-18, E-cadherin, and ZO-1 in the induced cells. The results of qRT-PCR showed significantly increased expression of E-cadherin and AQP-1 mRNAs in the induced cells compared with the control cells (P<0.01).

CONCLUSIONRat KSCs can be induced to differentiate into RTECs in vitro.

Activins ; chemistry ; Animals ; Aquaporin 1 ; metabolism ; Bone Morphogenetic Protein 7 ; chemistry ; Cadherins ; metabolism ; Cell Differentiation ; Coculture Techniques ; Culture Media ; chemistry ; Epithelial Cells ; cytology ; Keratin-18 ; metabolism ; Kidney Tubules ; cytology ; Rats ; Rats, Sprague-Dawley ; Stem Cells ; cytology ; Tretinoin ; chemistry ; Zonula Occludens-1 Protein ; metabolism

This study was aimed to search anti-platelet aggregation effectors from Gardenia jasminoides extract with the employment of platelet affinity extraction method coupled with HPLC, in order to provide pharmacological experi-mental evidences of the selected effectors to verify its feasibility. Under physiological conditions, washed rat platelets were added into G. jasminoides extract and then a mixture was gained. Consequently, some components from G. jas-minoides extract were combined to the platelets in the mixture while some were not owing to their special chemical structures and properties. Firstly, the uncombined components were washed off from the mixture. Secondly, the com-bined components in the leftover was washed down and collected, respectively, right after destroying the occupied platelets' structures. Thirdly, different collected eluents were analyzed, respectively, by HPLC established in the pre-vious work to search the effectors. Fourthly, pharmacological experiments were implemented for confirmation. The re-sults showed that dominant effective components from G. jasminoides extract acting on anti-platelet aggregation were identified as geniposide. Further evident was provided as well by pharmacological experiment that geniposide exhibit-ed significant inhibitory effect on anti-platelet aggregation in rats induced by ADP, rat tail collagen and thrombin(P< 0.01). It was concluded that the platelet affinity extraction-HPLC method proposed in this paper can be utilized to analyze the correlation of effectors from G. jasminoides extract and its pharmacological effects. Moreover, there are some correlations between screened chemical substances and their pharmacological effects.

Objective To investigate the incidence,pathogenetic factors,prognosis and correlation factors of acute kidney injury(AKI) in the hospitalized elderly patients. Methods The clinical data of 4781 elderly patients (aged 65 years and over) in our hospital from June 2008 to December 2009 were collected in this study using the hospital information system(HIS).The patients with AKI were picked out and were retrospectively analyzed. Results Among 4781patients,515cases (10.8％) suffered from AKI and the incidence of AKI increased with growing age. Single factorial analysis of etiology showed that infections (39.2％) was the most common causes of AKI.Multifactorial analysis revealed that the major causes of AKI were infections (81.0％),followed by hypovolemia (67.2 ％ ),nephrotoxic drugs (64.1％ ),cardiovascular diseases (32.3 ％),respiratory failure(17.7％) and neoplasm (9.5％). Multivariate logistic analysis and cox proportional hazard models indicated multiple organ dysfunction syndrome(MODS),gastrointestinal bleeding,mechanical ventilation and malnutrition were independent risk factors inducing end events such as dialysis or death and influencing time of live. Conclusions There is high incidence of AKI in the elderly hospitalized patient.Infections,hypovolemia,nephrotoxic drugs and cardiovascular diseases are the common causes of AKI.Active treatment of primary diseases,early diagnosis and prevention are beneficial for improving the prognosis of AKI.

nts were tend to suffer from AKI, with the most common cause of pre-renal injury and drugs such as antibiotics and contrast medium used in X-ray imaging. Outcomes of the patients with AKI depends on severity of their kidney injury.

Objective To evaluate and screen out the specific characters of thyroid nodules on grayscale and color Doppler ultrasonography. Methods One hundred and four thyroid nodules in 95 patients were studied with gray-scale and color Doppler ultrasound before surgery.According to the probability of malignancy,the main independent characters were screened out by Logistic regression analysis and then got the formula which could calculate the probability of malignancy.Results Fifty three nodules,included 44 hyperplasia,7 adenomas,1 switch granuloma and 1 Hashimoto's disease,were benign.Fifty one nodules,included 47 papillary carcinomas,3 medullary carcinomas,1 metastatic carcinomas,were malignant pathologically.The significant characters to differentiate malignant from benign were the shape,margin,border,halo,echostucture,echogenecity,echo uniformity,calcicum,bolood vessel shape and partial abnormal rich blood of thyroid nodules.After two variables logistic regression analysis,a fomula were worked out.Probability of malignancy=1/1+e-z,which z=-7.44+1.30×halo+1.05×calcicum+1.5×vessel shape.If a thyroid nodule with no halo,microcalcicum and irregular vessel shape,the probability of malignancy was 0.99,while with complete halo,no calcicum and regular vessele shape,the probability of malignancy of the nodule was 0.02.Conclusions The halo,calcium and blood vessel shape of thyroid nodules were three independent characters of thyroid nodules to predict malignant thyroid nodules on gray scale and color Doppler ultrasound.