BACKGROUND: Controversy exists as to the optimal treatment approach for ostial left anterior descending (LAD) or ostial left circumflex artery (LCx) lesions. Drug-coated balloons (DCB) may overcome some of the limitations of drug-eluting stents (DES). Therefore, we investigated the security and feasibility of the DCB policy in patients with ostial LAD or ostial LCx lesions, and compared it with the conventional DES-only strategy. METHODS: We retrospectively enrolled patients with de novo ostial lesions in the LAD or LCx who underwent interventional treatment. They were categorized into two groups based on their treatment approach: the DCB group and the DES group. The treatment strategies in the DCB group involved the use of either DCB-only or hybrid strategies, whereas the DES group utilized crossover or precise stenting techniques. Two-year target lesion revascularization was the primary endpoint, while the rates of major adverse cardiovascular events, cardiac death, target vessel myocardial infarction, and vessel thrombosis were the secondary endpoints. Using propensity score matching, we assembled a cohort with comparable baseline characteristics. To ensure result analysis reliability, we conducted sensitivity analyses, including interaction, and stratified analyses. RESULTS: Among the 397 eligible patients, 6.25% of patients who were planned to undergo DCB underwent DES. A total of 108 patients in each group had comparable propensity scores and were included in the analysis. Two-year target lesion revascularization occurred in 5 patients (4.90%) and 16 patients (16.33%) in the DCB group and the DES group, respectively (odds ratio = 0.264, 95% CI: 0.093-0.752, P = 0.008). Compared with the DES group, the DCB group demonstrated a lower major adverse cardiovascular events rate (7.84% vs. 19.39%, P = 0.017). However, differences with regard to cardiac death, non-periprocedural target vessel myocardial infarction, and definite or probable vessel thrombosis between the groups were non-significant. CONCLUSIONS The utilization of the DCB approach signifies an innovative and discretionary strategy for managing isolated ostial lesions in the LAD or LCx. Nevertheless, a future randomized trial investigating the feasibility and safety of DCB compared to the DES-only strategy specifically for de novo ostial lesions in the LAD or LCx is highly warranted.

OBJECTIVES: To investigate the incidence of extrauterine growth retardation (EUGR) and its risk factors in very preterm infants (VPIs) during hospitalization in China. METHODS: A prospective multicenter study was performed on the medical data of 2 514 VPIs who were hospitalized in the department of neonatology in 28 hospitals from 7 areas of China between September 2019 and December 2020. According to the presence or absence of EUGR based on the evaluation of body weight at the corrected gestational age of 36 weeks or at discharge, the VPIs were classified to two groups: EUGR group (n=1 189) and non-EUGR (n=1 325). The clinical features were compared between the two groups, and the incidence of EUGR and risk factors for EUGR were examined. RESULTS: The incidence of EUGR was 47.30% (1 189/2 514) evaluated by weight. The multivariate logistic regression analysis showed that higher weight growth velocity after regaining birth weight and higher cumulative calorie intake during the first week of hospitalization were protective factors against EUGR (P<0.05), while small-for-gestational-age birth, prolonged time to the initiation of total enteral feeding, prolonged cumulative fasting time, lower breast milk intake before starting human milk fortifiers, prolonged time to the initiation of full fortified feeding, and moderate-to-severe bronchopulmonary dysplasia were risk factors for EUGR (P<0.05). CONCLUSIONS It is crucial to reduce the incidence of EUGR by achieving total enteral feeding as early as possible, strengthening breastfeeding, increasing calorie intake in the first week after birth, improving the velocity of weight gain, and preventing moderate-severe bronchopulmonary dysplasia in VPIs.
Female ; Fetal Growth Retardation ; Gestational Age ; Hospitalization ; Humans ; Incidence ; Infant ; Infant, Newborn ; Infant, Premature ; Infant, Very Low Birth Weight ; Prospective Studies ; Risk Factors

OBJECTIVES: To explore the optimal maintenance dose of caffeine citrate for preterm infants requiring assisted ventilation and caffeine citrate treatment. METHODS: A retrospective analysis was performed on the medical data of 566 preterm infants (gestational age ≤34 weeks) who were treated and required assisted ventilation and caffeine citrate treatment in the neonatal intensive care unit of 30 tertiary hospitals in Jiangsu Province of China between January 1 and December 31, 2019. The 405 preterm infants receiving high-dose (10 mg/kg per day) caffeine citrate after a loading dose of 20 mg/kg within 24 hours after birth were enrolled as the high-dose group. The 161 preterm infants receiving low-dose (5 mg/kg per day) caffeine citrate were enrolled as the low-dose group. RESULTS: Compared with the low-dose group, the high-dose group had significant reductions in the need for high-concentration oxygen during assisted ventilation (P=0.044), the duration of oxygen inhalation after weaning from noninvasive ventilation (P<0.01), total oxygen inhalation time during hospitalization (P<0.01), the proportion of preterm infants requiring noninvasive ventilation again (P<0.01), the rate of use of pulmonary surfactant and budesonide (P<0.05), and the incidence rates of apnea and bronchopulmonary dysplasia (P<0.01), but the high-dose group had a significantly increased incidence rate of feeding intolerance (P=0.032). There were no significant differences between the two groups in the body weight change, the incidence rates of retinopathy of prematurity, intraventricular hemorrhage or necrotizing enterocolitis, the mortality rate, and the duration of caffeine use (P>0.05). CONCLUSIONS This pilot multicenter study shows that the high maintenance dose (10 mg/kg per day) is generally beneficial to preterm infants in China and does not increase the incidence rate of common adverse reactions. For the risk of feeding intolerance, further research is needed to eliminate the interference of confounding factors as far as possible.
Caffeine/therapeutic use* ; Citrates ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Respiration, Artificial ; Retrospective Studies

This study aimed to investigate the curative effect of spiral embedded flap urethroplasty for the treatment of meatal stenosis after penile carcinoma surgery. From January 2015 to January 2021, we used our technique to treat strictures of the external urethral orifice in seven patients, including four cases of meatal stenosis after partial penile resection and three cases of meatal stenosis after perineal stoma. All patients had previously undergone repeat urethral dilatation. The patients underwent spiral embedded flap urethroplasty to enlarge the outer urethral opening. The patients' mean age at the time of surgery was 60 (range: 42-71) years, the mean operative time was 43 min, and the median follow-up period was 18 months. The patients voided well post-operatively, and urinary peak flow rates ranged from 18.3 ml s^-1 to 30.4 ml s^-1. All patients were successful with absence of urethral meatus stricture. The present study showed that using spiral embedded flap urethroplasty to treat meatal stenosis after penile carcinoma surgery is an effective surgical technique with good long-term outcomes.
Male ; Humans ; Urologic Surgical Procedures, Male/methods* ; Penile Neoplasms/surgery* ; Constriction, Pathologic/surgery* ; Treatment Outcome ; Urethral Stricture/surgery* ; Urethra/surgery* ; Amputation, Surgical ; Carcinoma/surgery* ; Retrospective Studies

Professor
Acupuncture ; Acupuncture Therapy ; Angina, Stable ; Combined Modality Therapy ; Humans ; Moxibustion

Additional sex combs-like 1 (ASXL1) interacts with BRCA1-associated protein 1 (BAP1) deubiquitinase to oppose the polycomb repressive complex 1 (PRC1)-mediated histone H2A ubiquitylation. Germline BAP1 mutations are found in a spectrum of human malignancies, while ASXL1 mutations recurrently occur in myeloid neoplasm and are associated with poor prognosis. Nearly all ASXL1 mutations are heterozygous frameshift or nonsense mutations in the middle or to a less extent the C-terminal region, resulting in the production of C-terminally truncated mutant ASXL1 proteins. How ASXL1 regulates specific target genes and how the C-terminal truncation of ASXL1 promotes leukemogenesis are unclear. Here, we report that ASXL1 interacts with forkhead transcription factors FOXK1 and FOXK2 to regulate a subset of FOXK1/K2 target genes. We show that the C-terminally truncated mutant ASXL1 proteins are expressed at much higher levels than the wild-type protein in ASXL1 heterozygous leukemia cells, and lose the ability to interact with FOXK1/K2. Specific deletion of the mutant allele eliminates the expression of C-terminally truncated ASXL1 and increases the association of wild-type ASXL1 with BAP1, thereby restoring the expression of BAP1-ASXL1-FOXK1/K2 target genes, particularly those involved in glucose metabolism, oxygen sensing, and JAK-STAT3 signaling pathways. In addition to FOXK1/K2, we also identify other DNA-binding transcription regulators including transcription factors (TFs) which interact with wild-type ASXL1, but not C-terminally truncated mutant. Our results suggest that ASXL1 mutations result in neomorphic alleles that contribute to leukemogenesis at least in part through dominantly inhibiting the wild-type ASXL1 from interacting with BAP1 and thereby impairing the function of ASXL1-BAP1-TF in regulating target genes and leukemia cell growth.

Endoplasmic reticulum （ER） is an important organelle responsible for protein， steroid， lipid and carbohydrate synthesis and calcium-dependent signal transduction in eukaryotic cells. ER homeostasis is essential for normal cell function. ER homeostasis imbalance can induce ER stress （ERS）， which participates in the occurrence and development of diseases of the digestive system， respiratory system， circulatory system， nervous system， reproductive system， and endocrine system， and affects body health. Among various diseases， cancers seriously endanger people′s health due to its high mortality rate， disability rate， and recurrence rate. Due to the survival characteristics of unlimited proliferation， tumor cells are often exposed to various internal and external stimuli such as hypoxia， ischemia， excessive proliferation， and starvation， which destroy intracellular protein balance and induce ERS to some extent for survival. ERS plays a major role in various tumors and has dual functions in the survival of tumor cells： promoting the survival of tumor cells by activating a series of adaptive responses， while inducing ERS-related apoptosis pathways， so as to promote tumor cell death and inhibit tumor growth and invasion. As multiple functions of ERS in tumors are reported， many scholars have tried to intervene in the progress of tumors from the perspective of ERS. The therapeutic effect of traditional Chinese medicine （TCM） on tumors has been widely recognized. TCM can participate in the regulation of tumors from many aspects， including ERS， chemoradiotherapy resistance， gastrointestinal adverse reactions caused by chemotherapy， postoperative recurrence and metastasis. Since there are few reports on the antitumor effect of TCM from the perspective of ERS， this paper expounds the influence of ERS on tumorigenesis and development and the progress of TCM intervention in tumor through ERS， in order to provide a new direction for tumor treatment.

Homology of medicine and food is an important content in Chinese medicine and also works as the basis for guiding the development of compound health food containing Chinese materia medica. The top products,supplements,health care prescriptions,and medicinal meals in traditional herbal texts are the theoretical treasures of Chinese medicine compound health foods. With the implementation of the National Healthy China 2030,China's major health industry faces with tremendous opportunities. It is necessary to develop a batch of compound health food containing Chinese materia medica with Chinese medicine characteristics,in line with the needs of the country and society. Domestic research on compound health food containing Chinese materia medica mainly focuses on the extraction of functional components,preparation molding processes,quality standards,and efficacy evaluation. However,there are still some deficiencies in the related characteristics of traditional Chinese medicine(TCM) theory and function,evaluation criteria of efficacy and safety,new product R&D evaluation system and R&D platform. Based on a large number of previous studies by this laboratory,the views in nature,flavor and efficacy relationship were put forward in this paper. Based on the establishment of the Chinese medicine function-pharmacology-clinical application database system,the Chinese medicine compatibility database system,the Chinese medicine nature and flavor modern research database system,and the evaluation platform for animal models of Chinese medicine; the efficacy study,safety evaluation system,new product research and development evaluation system as well as research and development platform were established,providing a basis for the development and evaluation of compound health food containing Chinese materia medica. The modern scientific connotation of the core efficacy of compound health food containing Chinese materia medica was explained as well,helpful to promote the research and development of compound health food containing Chinese materia medica and play an important role in general health.
China ; Data Mining ; Food ; Materia Medica ; Medicine, Chinese Traditional

Objective: To investigate the effect of dodder total flavone on polycystic ovary syndrome (PCOS) rat models induced by letrozole. Method: Except the blank group, the other rats were given letrozole 1 mg·kg^-1 for 21 consecutive days to replicate PCOS animal model. On the 16^th day of the modeling, the estrous cycle was detected by vaginal smear, and rat with persistent keratinization of vaginal epithelial cells were selected as the PCOS model rat. The model rats were randomly divided into model group, Dacin-35 group, and high, middle, low-dose dodder total flavonoids groups. The corresponding drugs were given for 21 consecutive days. At the end of the administration, materials were collected to calculate ovary index, and enzyme-linked immunosorbent assay(ELISA) was used to measure estrogen (E₂), testosterone (T), gonadotropin-releasing hormone (GnRH), follicle stimulating hormone (FSH) and luteinizing hormone (LH) levels of serum. The right ovary of rats was stained with haematoxylin-eosin (HE), and the pathological changes were observed by optical microscope. Androgen receptor(AR) expressions in hypothalamus, pituitary and ovary were detected by mmunohistochemistry. Result: Compared with the blank group, serum T, GnRH and LH levels, ovarian index and LH/FSH ratio were significantly increased, while FSH and E₂ levels were significantly decreased (P<0.05,P<0.01). Ovarian tissue follicular atresia increased, and the cell layers of follicular membrane were thickened significantly. AR expressions in hypothalamus, pituitary and ovarian tissues were significantly increased in the model group (P<0.01). Compared with the model group, serum E₂, T, GnRH and LH levels, ovarian index and LH/FSH ratio were significantly decreased in high, middle and low-dose dodder total flavonoids groups (P<0.01); Serum E₂ level was significantly increased (P<0.01), and FSH level was obviously increased (P<0.05) in high and middle-dose dodder total flavonoids group. Serum E₂ level in PCOS model rats was obviously increased in low-dose dodder total flavonoids group (P<0.05). The pathological changes of ovarian tissue of cortical thickening and collagenization, atresia follicle increase and corpus luteum decrease of PCOS model rats were alleviated to different degrees in high, middle and low-dose dodder total flavonoids groups. Immunohistochemical results showed that high, middle and low-dose dodder total flavonoids groups could significantly reduce AR expressions in hypothalamus, pituitary and ovary (P<0.01). Conclusion: Dodder total flavonoids may play a protective role in PCOS model rats by regulating the secretion of estrogen and androgen and affecting the hypothalamic-pituitary-ovary axis pathway.