BACKGROUND: The FAVOR (Comparison of Quantitative Flow Ratio Guided and Angiography Guided Percutaneous Intervention in Patients with Coronary Artery Disease) III China trial demonstrated that percutaneous coronary intervention (PCI) lesion selection using quantitative flow ratio (QFR) measurement, a novel angiography-based approach for estimating fractional flow reserve, improved two-year clinical outcomes compared with standard angiography guidance. This study aimed to assess the cost-effectiveness of QFR-guided PCI from the perspective of the current Chinese healthcare system. METHODS: This study is a pre-specified analysis of the FAVOR III China trial, which included 3825 patients randomized between December 25, 2018, and January 19, 2020, from 26 centers in China. Patients with stable or unstable angina pectoris or those ≥72 hours post-myocardial infarction who had at least one lesion with a diameter stenosis between 50% and 90% in a coronary artery with a ≥2.5 mm reference vessel diameter by visual assessment were randomized to a QFR-guided strategy or an angiography-guided strategy with 1:1 ratio. During the two-year follow-up, data were collected on clinical outcomes, quality-adjusted life-years (QALYs), estimated costs of index procedure hospitalization, outpatient cardiovascular medication use, and rehospitalization due to major adverse cardiac and cerebrovascular events (MACCE). The primary analysis calculated the incremental cost-effectiveness ratio (ICER) as the cost per MACCE avoided. An ICER of ¥10,000/MACCE event avoided was considered economically attractive in China. RESULTS: At two years, the QFR-guided group demonstrated a reduced rate of MACCE compared to the angiography-guided group (10.8% vs . 14.7%, P <0.01). Total two-year costs were similar between the groups (¥50,803 ± 21,121 vs . ¥50,685 ± 23,495, P = 0.87). The ICER for the QFR-guided strategy was ¥3055 per MACCE avoided, and the probability of QFR being economically attractive was 64% at a willingness-to-pay threshold of ¥10,000/MACCE avoided. Sensitivity analysis showed that QFR-guided PCI would become cost-saving if the cost of QFR were below ¥3682 (current cost: ¥3800). Cost-utility analysis yielded an ICER of ¥56,163 per QALY gained, with a 53% probability of being cost-effective at a willingness-to-pay threshold of ¥85,000 per QALY gained. CONCLUSION: In patients undergoing PCI, a QFR-guided strategy appears economically attractive compared to angiographic guidance from the perspective of the Chinese healthcare system. TRIAL REGISTRATION ClinicalTrials.gov , NCT03656848.
Humans ; Cost-Benefit Analysis ; Percutaneous Coronary Intervention/methods* ; Male ; Female ; Coronary Angiography/methods* ; Middle Aged ; Aged ; Coronary Artery Disease/surgery* ; Quality-Adjusted Life Years ; Fractional Flow Reserve, Myocardial/physiology*

Objectives: It is unclear whether G protein-coupled receptor 61 (GPR61) affecting body weight, plays a role in the association between birth weight and weather. This study aimed to assess the effects of prenatal weather and GPR61 on birth weight. Methods: A total of 567 mother-newborn pairs were recruited in Houzhai Center Hospital during 2011-2012. We detected the maternal and neonatal GPR61 promoter methylation levels, and obtained meteorological and air pollution data. Results: A positive association was observed between maternal and neonatal GPR61 methylation levels, and both of them were affected by precipitation, relative humidity (RH) and daily temperature range (DTR). Birth weight was associated negatively with RH and positively with DTR ( P < 0.05). A significant association was observed between birth weight and neonatal GPR61 methylation. We observed that maternal GPR61 methylation seemed to modify associations between weather and birth weight ( P _interaction < 0.10), while neonatal GPR61 methylation mediated the effects of RH and DTR on birth weight ( P < 0.05). Conclusions Our findings revealed the significant associations among prenatal weather, GPR61 methylation and birth weight. Maternal GPR61 methylation may modify the susceptibility of birth weight to prenatal weather conditions, while neonatal GPR61 methylation may be a bridge of the effects of prenatal RH and DTR on birth weight.
Air Pollution/analysis* ; Birth Weight ; Female ; Humans ; Infant, Newborn ; Nerve Tissue Proteins ; Pregnancy ; Receptors, G-Protein-Coupled/metabolism* ; Temperature ; Weather

Objective: Most acute promyelocytic leukemia cases are characterized by the PML-RARa fusion oncogene and low white cell counts in peripheral blood. Methods: Based on the frequent overexpression of miR-125-family miRNAs in acute promyelocytic leukemia, we examined the consequence of this phenomenon by using an inducible mouse model overexpressing human miR-125b. Results: MiR-125b expression significantly accelerates PML-RARa-induced leukemogenesis, with the resultant induced leukemia being partially dependent on continued miR-125b overexpression. Interestingly, miR-125b expression led to low peripheral white cell counts to bone marrow blast percentage ratio, confirming the clinical observation in acute promyelocytic leukemia patients. Conclusion This study suggests that dysregulated miR-125b expression is actively involved in disease progression and pathophysiology of acute promyelocytic leukemia, indicating that targeting miR-125b may represent a new therapeutic option for acute promyelocytic leukemia.
Animals ; Humans ; Leukemia, Promyelocytic, Acute/metabolism* ; Mice ; MicroRNAs/genetics* ; Oncogene Proteins, Fusion/therapeutic use*

Adolescent ; Adult ; Beijing/epidemiology* ; Contact Tracing ; Female ; Humans ; Male ; Prevalence ; Tuberculosis/transmission* ; Universities ; Young Adult

Objective: To investigate the relations between dietary intake during pregnancy and the incidence of their babies with small for gestational age (SGA). Methods: Data on demographics, dietary intake of protein, fat, and carbohydrates of the pregnant mothers during the first, second and third trimester, were collected. Information related to birth weight and gestational age of the infants were also gathered. A total of 8 102 women, who delivered their babies at the First Affiliated Hospital of Shanxi Medical University from March 2012 to September 2016, were enrolled in this project. Among them, 961 mothers had infants with SGA but the other 7 141 of them having normal infants. Unconditional logistic regression model was used to analyze the effect of dietary nutrient intake on SGA the first, second and third trimester. Results: We found that low dietary intake of protein during the first trimester and following trimesters during pregnancy were positively associated with higher risk of SGA (OR=1.534, 95%CI: 1.217-1.934; OR=1.268, 95%CI: 1.005-1.599; OR=1.310, 95%CI: 1.036-1.655). When adjusting for maternal pre-pregnancy BMI, we found that when mothers were with a pre-pregnancy BMI less than 18.5 or with low maternal intake of protein during the first trimester, positive association with higher risk of SGA (OR=1.872, 95%CI: 1.033-3.395; OR=1.754, 95%CI: 1.125-2.734), was noticed. However, for mothers with a pre-pregnancy BMI between 18.5 and 24.0 or with low protein intake during the first trimester, significant association with higher risk of SGA (OR=1.465, 95%CI: 1.089-1.972) was found. Conclusions Through our observation, maternal dietary intake during pregnancy seemed to be associated with the risk of SGA but the effects of dietary intake were different, according to the BMI of pre-pregnancy population. Early pregnancy appeares as the key period for dietary intake which may influence the SGA.

Objective To preliminarily optimize the energy and density of laser radiation for the early treatment of hyperplastic scars in a rabbit ear model,and to explore possible therapeutic mechanisms.Methods Sixty-one hyperplastic scars were successfully established on the ears of 10 healthy New Zealand white rabbits with large ears,and randomly divided into 2 groups:1-week group (30 scars) and 3-week group (31 scars).These 2 groups were separately divided into 5 subgroups:group A treated with laser at a density of 100 PPA and an energy of 10 mJ,group B with laser at a density of 100 PPA and an energy of 50 mJ,group C with laser at a density of 169 PPA and an energy of 10 mJ,group D with laser at a density of 169 PPA and an energy of 50 mJ,and group E receiving no treatment.There were 6 scars in each group,except the group E in the 3-week group.Two healthy New Zealand white rabbits with large ears were not subjected to modeling,and served as group F (blank control group).Immunohistochemical study was performed to determine the expression of matrix metalloproteinase (MMP)-13 in the skin tissues from the rabbit ears 1 week after the treatment.Three weeks after the treatment,the skin tissues from the rabbit ears were subjected to hematoxylin-eosin (HE) staining and Masson staining.Then,the structure of scars was observed,and scar elevation index was calculated.Statistical analysis was carried out by Kruskal-Wallis H test for the comparison of scar elevation index,and by one-way analysis of variance (ANOVA) for the comparison of the average absorbance value of MMP-13.Results As HE staining revealed,the groups A,B,C and D all showed thicker dermis and increased number of collagen fibers compared with the group F (normal skin tissues),but showed thinner dermis,decreased number and more ordered arrangement of collagen fibers compared with the group E (untreated scar tissues).No obvious difference was observed in the thickness of the dermis among the groups A,B,C and D.The scar elevation index significantly differed among the 6 groups (H =22.757,P ＜ 0.05).Multiple comparisons showed that the scar elevation index was significantly lower in the groups B,C and D (2.597 ± 0.344,2.850 ± 0.282,2.658 ± 0.134,respectively)than in the group E (3.460 ± 0.583,all P ＜ 0.05).As Masson staining revealed,the groups A,B,C and D all showed thinner dermis and more irregular arrangement of collagen fibers compared with the group E.However,no obvious differences were observed in the dermal thickness or number of collagen fibers among the groups A,B,C and D.Immunohistochemical study showed that the expression of MMP-13 was significantly higher in the high-energy (50 mJ) laser groups than in the low-energy (10 mJ) laser groups (P ＜ 0.05) at the same laser density.With the same laser energy,the expression of MMP-13 was significantly higher in the group A than in the group C (P ＜ 0.01),but there was no significant difference between the group B and D (P ＞ 0.05).Conclusions Non-ablative fractional laser is effective for the treatment of early-stage hyperplastic scars.At the same laser density,50-mJ laser was superior to 10-mJ laser for the treatment of hyperplastic scars,likely because high-energy laser can stimulate the recombination of extracellular matrices and up-regulated MMP-13 expression to a greater extent.

Objective: To investigate the influence of dietary cholesterol intake on gestational diabetes mellitus (GDM), at one year prior to and first and second trimesters of pregnancy. Methods: Between March 2012 and September 2016, the pregnant women from the First Affiliated Hospital of Shanxi Medical University were asked to fill in a set of questionnaires, by which information on general demographic characteristics, diagnosis of GDM and dietary cholesterol intake was collected. Unconditional logistic regression method was used to analyze the influence of dietary cholesterol intake on GDM, at one year prior to and first and second trimesters of pregnancy. The association on dietary cholesterol intake and GDM between age groups was also analyzed. Results: Data on 9 005 subjects, including 1 388 pregnant women with GDM, was collected. When the amount of cholesterol intake was stratified into quartile, results from the unconditional logistic regression showed that dietary cholesterol intake appeared ≥76.50 mg/d, both in the periods of one year prior to and the second trimester of pregnancy. This amount of dietary cholesterol intake would increase the risk of GDM (one year prior to pregnant: OR=1.230, 95%CI: 1.018-1.485; second trimester: OR=1.228, 95%CI:1.014- 1.486). Women who took ≥76.50 mg/d of daily cholesterol during the period of one year prior to, or 46.75-76.50 mg/d during the second trimester of pregnancy, the risks of GDM (OR=4.644, 95%CI: 1.106-19.499) would increase. Women with daily cholesterol intake over 76.50 mg/d during the period of one year prior to or at the second trimester of pregnancy, there appeared a risk on GDM (OR=1.217, 95%CI: 1.012-1.463). When maternal age was divided in two different subgroups and the cholesterol intake level was ≥76.50 mg/d both in the period of one year prior to pregnancy or at the second trimester, the risk of GDM appeared in the subgroup of<35 years old (OR=1.336, 95%CI:1.083-1.647; OR=1.341, 95%CI: 1.087-1.654). However, no significant association was found in the maternal age group of ≥35 years old. Conclusion: High level of dietary cholesterol intake would increase the risk of GDM, both in the period of one year prior to and at the second trimester of pregnancy.
Adolescent ; Adult ; Asian People/statistics & numerical data* ; Cholesterol, Dietary ; Diabetes, Gestational/epidemiology* ; Female ; Humans ; Logistic Models ; Pregnancy ; Pregnancy Trimester, First ; Pregnancy Trimester, Second ; Risk Factors

OBJECTIVETo investigate the association between ambient fine particulate matter with aerodynamic diameter less than 2.5 μm (PM2.5) and the risk on preterm birth.

METHODSA total of 1 882 pregnant women with local residency of Taiyuan city and underwent delivery at the First Hospital of Shanxi Medical University with the dates of conception between January 1 and December 31, 2013, were enrolled in the study. Information on general demographics, home address and history on pregnancy, lifestyle and related environmental factors were collected through in-person interview. Birth outcomes and maternal complications were abstracted from medical records. Data on the amount of daily average PM2.5 from 8 monitor points in Taiyuan city, between March 1, 2012 and December 31, 2013 were also collected. Individual exposure during pregnancy were calculated using the inverse-distance weighting method, based on home address. Multivariate unconditional logistic regression model was used to examine the associations among PM2.5 exposure, risk of preterm birth and related clinical subtypes.

RESULTSThe overall incidence of preterm birth was 8.21% (151/1 839)in 1 839 pregnant women. Exposure to ambient PM2.5 during the second week prior to delivery was associated with an increased risk of preterm birth (OR=1.087, 95% CI: 1.001-1.182 per 10 μg/m(3) increase) and mild preterm birth (OR=1.099, 95% CI: 1.007-1.200 per 10 μg/m(3)). Compared to data from the China Environmental Air Quality Standard, higher level of exposure (≥75 μg/m(3)) of PM2.5 during the second week before delivery was associated with an increased risk of preterm birth (OR=1.008, 95%CI: 1.000-1.017) but the association was mainly seen for mild preterm birth (OR=1.010, 95%CI: 1.001-1.018).

CONCLUSIONSRESULTS from our study showed that exposure to high level of PM2.5 during late pregnancy would increase the risk of preterm birth. Future large studies are needed to examine the association by preterm clinical subtypes and to elucidate potential underlying mechanisms.

China ; epidemiology ; Environmental Exposure ; adverse effects ; analysis ; Female ; Humans ; Incidence ; Infant, Newborn ; Logistic Models ; Maternal Exposure ; Particle Size ; Particulate Matter ; analysis ; toxicity ; Pregnancy ; Pregnancy Complications ; Premature Birth ; chemically induced ; epidemiology ; Public Health ; statistics & numerical data

Objective To investigate the protective function and its mechanisms of eyclosporin A to immature brain tissue with convulsive brain damage. Methods 21-day-old SD rats were given lithium-pilocarpine to make the epilepsy model. Total 67 male rats had been investigated. Cyclosporin A (CsA) were injected three times at 6, 30, 54 hrs after model had been established. Three dosages had been chosen: 5, 10 and 25 mg/kg each time. The level of apoptotic cells, P-glycoprotein (P-gp), glial fibrillary acidic protein (GFAP) in CA1 area of hippocampus had been determined, and compared with the rats without giving CsA. Results Rats from epilepsy model group had higher level of apoptosis, P-gp, GFAP expression than those from pseudo-model group. CsA injection by dose 5 mg/kg each time for three times reduced the level of P-gp, GFAP. Model group and pseudo-model group were same. Both the interventions of CsA injection by 10 mg/kg and 25 mg/kg can reduce the level of P-gp, GFAP, however neither of their effectiveness was better than CsA 5 mg/kg each time. Conclusions Small dosage of CsA may protect the immature brain tissue from convulsive brain damage by reducing the level of P-gp, GFAP in CA1 area of hippocampus.