Objective To investigate the correlation of fetuin-A and MGP with the degree of coro-nary artery calcification and prognosis in elderly patients with ACS.Methods A total of 187 eld-erly ACS patients admitted to our hospital from June 2021 to June 2023 were recruited in this study.All of them underwent coronary CT examination,and the prognosis at 1 year after treat-ment was statistically analyzed.According to their CACS of coronary CT,the patients were divid-ed into non-calcification group(50 cases),and mild,moderate and severe calcification groups(67,43 and 27 cases,respectively).They were also assigned into poor(58 cases)and good prognosis groups(129 cases)according to the prognosis.Serum fetuin-A and MGP levels were compared be-tween above groups.Pearson correlation analysis was used to analyze the correlation between CACS and fetuin-A as well as MGP levels.Multivariate logistic regression analysis was conducted to identify the prognostic factors in the elderly ACS patients.ROC curve was plotted to evaluate the predictive value of fetuin-A and MGP for poor prognosis in the patients.Results The serum fetuin-A and MGP levels were gradually decreased in the non-calcification group,and then fol-lowed by the mild,moderate and severe calcification groups in turn,with statistical differences(P＜0.05).CACS was negatively correlated with serum fetuin-A and MGP levels(r=-0.434,P=0.000;r=-0.512,P=0.000).The poor prognosis group had obviously older age and larger proportions of concomitant frailty syndrome,Killip grade Ⅲ-Ⅳ and coronary artery calcifica-tion,and notable lower serum fetuin-A and MGP levels than the good prognosis group(P＜0.05,P＜0.01).Age and coronary artery calcification were risk factors for poor prognosis in elderly ACS patients(OR=1.386,95％CI:1.227-1.565,P=0.000;OR=16.732,95％CI:4.747-58.968,P=0.000),while serum fetuin-A and MGP were protective factors(OR=0.856,95％CI:0.744-0.986,P=0.032;OR=0.760,95％CI:0.670-0.862,P=0.000).ROC curve analysis showed that the AUC value of fetuin-A and MGP levels and their combination in predicting the prognosis in elderly ACS patients was 0.731,0.841 and 0.928,respectively,and combined the two indicators showed better predictive performance than alone(P＜0.01).Conclusion Serum fetuin-A and MGP levels in elderly ACS patients are associated with the degree of coronary artery calci-fication and prognosis.The two indicators have certain prognostic value for the patients,and their combined detection can further improve the prognostic performance.

Objective To investigate the correlation of fetuin-A and MGP with the degree of coro-nary artery calcification and prognosis in elderly patients with ACS.Methods A total of 187 eld-erly ACS patients admitted to our hospital from June 2021 to June 2023 were recruited in this study.All of them underwent coronary CT examination,and the prognosis at 1 year after treat-ment was statistically analyzed.According to their CACS of coronary CT,the patients were divid-ed into non-calcification group(50 cases),and mild,moderate and severe calcification groups(67,43 and 27 cases,respectively).They were also assigned into poor(58 cases)and good prognosis groups(129 cases)according to the prognosis.Serum fetuin-A and MGP levels were compared be-tween above groups.Pearson correlation analysis was used to analyze the correlation between CACS and fetuin-A as well as MGP levels.Multivariate logistic regression analysis was conducted to identify the prognostic factors in the elderly ACS patients.ROC curve was plotted to evaluate the predictive value of fetuin-A and MGP for poor prognosis in the patients.Results The serum fetuin-A and MGP levels were gradually decreased in the non-calcification group,and then fol-lowed by the mild,moderate and severe calcification groups in turn,with statistical differences(P＜0.05).CACS was negatively correlated with serum fetuin-A and MGP levels(r=-0.434,P=0.000;r=-0.512,P=0.000).The poor prognosis group had obviously older age and larger proportions of concomitant frailty syndrome,Killip grade Ⅲ-Ⅳ and coronary artery calcifica-tion,and notable lower serum fetuin-A and MGP levels than the good prognosis group(P＜0.05,P＜0.01).Age and coronary artery calcification were risk factors for poor prognosis in elderly ACS patients(OR=1.386,95％CI:1.227-1.565,P=0.000;OR=16.732,95％CI:4.747-58.968,P=0.000),while serum fetuin-A and MGP were protective factors(OR=0.856,95％CI:0.744-0.986,P=0.032;OR=0.760,95％CI:0.670-0.862,P=0.000).ROC curve analysis showed that the AUC value of fetuin-A and MGP levels and their combination in predicting the prognosis in elderly ACS patients was 0.731,0.841 and 0.928,respectively,and combined the two indicators showed better predictive performance than alone(P＜0.01).Conclusion Serum fetuin-A and MGP levels in elderly ACS patients are associated with the degree of coronary artery calci-fication and prognosis.The two indicators have certain prognostic value for the patients,and their combined detection can further improve the prognostic performance.

[Summary] Considerable efforts have been made to understand the cellular and molecular mechanisms of metformin ,a potent antihyperglycemic agent now recommended as the first‐line treatment of patients with T2DM. The main effect of this drug is to reducethe hepatic glucose output ,primarily through inhibition of the mitochondrial respiratory chain complex Ⅰ and then activating AM P‐activated protein kinase (AMPK) ,which provide a generally acceptable mechanism for the action of metformin on hepatic gluconeogenesis. Beyond its effect on glucose metabolism ,metformin has been reported to improve ovarian function of patients with polycystic ovary syndrome (PCOS) and to reduce the risk of microvascular and macrovascular complications in patients with T2DM. In addition ,metfomin has also recently been suggested as an adjuvant treatment of cancer. Here we reviewed the progress of mechanism research and clinical application of metformin.

For the purpose of thrombocytopenia gene therapy, recombinant RevTet-On and pRevTRE/TPO retrovirus were packaged and transfected to NIH3T3 after selected with G418 and hygromycin, the two inserting recombinant retrovirus cell strain RevTet-On3T3/TPO were established. TPO expression was controlled and regulated by doxycydine (Dox). After using Dox to control the expression of TPO in RevTet-On3T3/TPO cells, the result showed that when Dox is added to the RevTet-On3T3/TPO cells, cell populations expressed TPO highly in the presence of 2 mg/L of Dox, and lowly in the absence of Dox. By using the RevTet-On gene expression system (the retrovirus vector RevTet-On regulation system to control the expression gene by Dox), it could modulate the expression of multiple genes by tetracyline and its derivatives. This system maybe provides a safe and efficacient way for the thrombocy to penia gene therapy.