Objectives:To investigate the prognostic value of the CHA2DS2-VASc and R2CHA2DS2-VASc scores in patients with atrial fibrillation(AF)and heart failure(HF).Methods:Patients with AF and HF from hospitals diagnosed by the Heart Failure Center in Guangdong Province between January 2017 and December 2021 were selected.Major adverse cardiovascular events(MACE)were used as the follow-up endpoint.Statistical methods such as the area under the receiver operating characteristic(ROC)curve(AUC),net reclassification index(NRI),and integrated discrimination improvement(IDI)were applied to evaluate the predictive value of the CHA2DS2-VASc and R2CHA2DS2-VASc scores in patients with AF and HF.Results:A total of 1 839 patients were enrolled in this study,comprising 703 patients in the MACE group and 1 136 patients in the non-MACE group.Compared with the non-MACE group,the MACE group exhibited significantly advanced age,higher prevalence of New York Heart Association class Ⅳ and coronary artery disease,lower diastolic blood pressure and estimated glomerular filtration rate levels,and elevated serum N-terminal pro-B-type natriuretic peptide concentrations(all P<0.05).Additionally,significantly lower proportions of patients in the MACE group received angiotensin-converting enzyme inhibitors/angiotensin receptor blockers/angiotensin receptor-neprilysin inhibitors,beta-blockers,mineralocorticoid receptor antagonists,or anticoagulant therapy(all P<0.05).Multivariable logistic regression analysis revealed that each 1-point increment in both CHA2DS2-VASc and R2CHA2DS2-VASc scores was associated with approximately 10%increased risk of MACE.ROC curve analysis demonstrated that the AUC values for predicting MACE in AF patients with HF were 0.555(95%CI:0.528-0.582,P<0.001)for CHA2DS2-VASc and 0.576(95%CI:0.549-0.608,P<0.001)for R2CHA2DS2-VASc,indicating marginally superior discriminatory capacity of the R2CHA2DS2-VASc score.Delong's test confirmed statistically significant differences between the two scoring systems(P=0.001).The R2CHA2DS2-VASc score demonstrated a NRI of 0.259(95%CI:0.166-0.352,P<0.001)and an IDI of 0.007(95%CI:0.005-0.010,P<0.001)compared with the conventional CHA2DS2-VASc score.Although the R2CHA2DS2-VASc score exhibited slightly better predictive accuracy and outcome discrimination capacity than the original scoring system,both scores demonstrated suboptimal clinical predictive performance.Conclusions:Both the R2CHA2DS2-VASc and CHA2DS2-VASc scores show suboptimal performance for predicting the risk of MACE in patients with AF and HF,and the predicting performance of R2CHA2DS2-VASc score is marginally superior to CHA2DS2-VASc score in this patient cohort.

Objective To explore the relationship between the expression of microRNA-433-3p(miR-433-3p)and β microtubule Ⅴ(TUBB6)in bladder cancer tissue and its pathological characteristics,and its predictive value for postoperative recurrence.Methods From August 2021 to August 2022,116 patients with bladder cancer underwent surgery for cancer tissue and adjacent tissue,and which were divided into recurrence group(43 cases)and non recurrence group(73 cases)according to whether there was local recurrence or distant recurrence and metastasis after surgery.The quantitative real-time polymerase chain reaction(qRT-PCR)was used to detect the mRNA levels of miR-433-3p and TUBB6.The influencing factors of postoperative recurrence of bladder cancer were analyzed by logistic regression.The predictive value of miR-433-3p and TUBB6 in postoperative recurrence of bladder cancer was analyzed by receiver operating characteristic(ROC)curve.Results The level of miR-433-3p in cancer tissue was obviously lower than that in adjacent tissue(P＜0.05),and the level of TUBB6 was obviously higher than that in adjacent tissue(P＜0.05).The level of miR-433-3p was significantly reduced(P＜0.05)in patients with TNM stage Ⅲ+Ⅳ,histological differentiation to low differentiation,and tumor infiltration,while the level of TUBB6 mRNA was significantly increased(P＜0.05).The serum miR-433-3p level in the recurrent group was significantly lower than that in the non recurrent group,,The level of TUBB6 mRNA was higher in the non recurrent group,and the difference was statistically significant(P＜0.05).TNM stage Ⅲ+Ⅳ,tumor infiltration,and high expression of TUBB6 are independent risk factors for postoperative recurrence in patients(P＜0.05),while high expression of miR-433-3p is an independent protective factor(P＜0.05).ROC curve analysis shows that,,the area under curve(AUC)predicted by serum miR-433-3p and TUBB6 levels in combination was significantly higher than that predicted by a single index(Z-miR-433-3p=2.323,Z-TUB6=1.961,P=0.020,0.048),sensitivity of 95.35％,specificity of 82.19％.Conclusion The expression of miR-433-3p and TUBB6 in bladder cancer tissues is closely related to pathological features,and the combination of the two tissues has a higher predictive value for postoperative recurrence.

Objective To explore the relationship between the expression of microRNA-433-3p(miR-433-3p)and β microtubule Ⅴ(TUBB6)in bladder cancer tissue and its pathological characteristics,and its predictive value for postoperative recurrence.Methods From August 2021 to August 2022,116 patients with bladder cancer underwent surgery for cancer tissue and adjacent tissue,and which were divided into recurrence group(43 cases)and non recurrence group(73 cases)according to whether there was local recurrence or distant recurrence and metastasis after surgery.The quantitative real-time polymerase chain reaction(qRT-PCR)was used to detect the mRNA levels of miR-433-3p and TUBB6.The influencing factors of postoperative recurrence of bladder cancer were analyzed by logistic regression.The predictive value of miR-433-3p and TUBB6 in postoperative recurrence of bladder cancer was analyzed by receiver operating characteristic(ROC)curve.Results The level of miR-433-3p in cancer tissue was obviously lower than that in adjacent tissue(P＜0.05),and the level of TUBB6 was obviously higher than that in adjacent tissue(P＜0.05).The level of miR-433-3p was significantly reduced(P＜0.05)in patients with TNM stage Ⅲ+Ⅳ,histological differentiation to low differentiation,and tumor infiltration,while the level of TUBB6 mRNA was significantly increased(P＜0.05).The serum miR-433-3p level in the recurrent group was significantly lower than that in the non recurrent group,,The level of TUBB6 mRNA was higher in the non recurrent group,and the difference was statistically significant(P＜0.05).TNM stage Ⅲ+Ⅳ,tumor infiltration,and high expression of TUBB6 are independent risk factors for postoperative recurrence in patients(P＜0.05),while high expression of miR-433-3p is an independent protective factor(P＜0.05).ROC curve analysis shows that,,the area under curve(AUC)predicted by serum miR-433-3p and TUBB6 levels in combination was significantly higher than that predicted by a single index(Z-miR-433-3p=2.323,Z-TUB6=1.961,P=0.020,0.048),sensitivity of 95.35％,specificity of 82.19％.Conclusion The expression of miR-433-3p and TUBB6 in bladder cancer tissues is closely related to pathological features,and the combination of the two tissues has a higher predictive value for postoperative recurrence.

Objective To investigate the distribution of dense fine speckled(DFS)antinuclear antibody(ANA)in different ages,genders,and diseases,and to explore its clinical significance in the diagnosis of auto-immune disease(AID).Methods A retrospective summary was conducted on the clinical basic data of 53520 patients who visited the hospital from January 2022 to April 2024,as well as the results of indirect immunoflu-orescence(IIF)ANA fluorescence karyotype and titer,and immunoblotting ANA spectrum,and the relation-ship between DFS positivity and AID was analyzed.Results Of the 53 520 serum samples,the rate of ANA fluorescence positivity was 32.40％,with DFS-positive samples accounting for 1.18％of all ANA fluores-cence-positive samples.The male-to-female ratio of DFS positives was 1∶1.94,with the highest percentage of 51.9％in the 21-40 age group.Among DFS positive individuals,only 12.14％were clinically diagnosed with AID disease,significantly lower than other ANA fluorescent karyotype positive individuals(23.31％,P＜0.001).The overall positivity rate of ANA spectra using immunoblotting in DFS-positive individuals was 23.54％,which was significantly lower than that in other fluorescent karyotype positive ANA individuals(73.26％,P＜0.001).Moreover,DFS positive individuals were mainly accompanied by antibody positivity such as anti-Ro52 antibodies,which had no diagnostic specificity in AID diagnosis.When comparing DFS posi-tive individuals with similar fluorescence morphology to those with homogeneous nuclear granules and nuclei,at an ANA titer of 1∶100,the proportion of AID patients in homogeneous nuclear granules and nuclei was 20.04％,significantly higher than the proportion of AID patients in DFS positive individuals(9.44％,P=0.001).With the increase of ANA titer,the proportion of AID diseases significantly increased in both karyo-type samples.When the ANA titer of DFS positive samples was increased to ≥ 1∶320,the proportion of AID diseases significantly increased to 30.77％(P=0.002).Conclusion DFS is a rare ANA fluorescent karyo-type,and DFS positive individuals are mainly found in females aged 21-40,mostly non AID patients.Howev-er,high titers of DFS cannot rule out the possibility of AID.In clinical work,special attention should be paid to distinguishing it from the homogeneous nuclear granule type to avoid misdiagnosis.

Objectives:To investigate the prognostic value of the CHA2DS2-VASc and R2CHA2DS2-VASc scores in patients with atrial fibrillation(AF)and heart failure(HF).Methods:Patients with AF and HF from hospitals diagnosed by the Heart Failure Center in Guangdong Province between January 2017 and December 2021 were selected.Major adverse cardiovascular events(MACE)were used as the follow-up endpoint.Statistical methods such as the area under the receiver operating characteristic(ROC)curve(AUC),net reclassification index(NRI),and integrated discrimination improvement(IDI)were applied to evaluate the predictive value of the CHA2DS2-VASc and R2CHA2DS2-VASc scores in patients with AF and HF.Results:A total of 1 839 patients were enrolled in this study,comprising 703 patients in the MACE group and 1 136 patients in the non-MACE group.Compared with the non-MACE group,the MACE group exhibited significantly advanced age,higher prevalence of New York Heart Association class Ⅳ and coronary artery disease,lower diastolic blood pressure and estimated glomerular filtration rate levels,and elevated serum N-terminal pro-B-type natriuretic peptide concentrations(all P<0.05).Additionally,significantly lower proportions of patients in the MACE group received angiotensin-converting enzyme inhibitors/angiotensin receptor blockers/angiotensin receptor-neprilysin inhibitors,beta-blockers,mineralocorticoid receptor antagonists,or anticoagulant therapy(all P<0.05).Multivariable logistic regression analysis revealed that each 1-point increment in both CHA2DS2-VASc and R2CHA2DS2-VASc scores was associated with approximately 10%increased risk of MACE.ROC curve analysis demonstrated that the AUC values for predicting MACE in AF patients with HF were 0.555(95%CI:0.528-0.582,P<0.001)for CHA2DS2-VASc and 0.576(95%CI:0.549-0.608,P<0.001)for R2CHA2DS2-VASc,indicating marginally superior discriminatory capacity of the R2CHA2DS2-VASc score.Delong's test confirmed statistically significant differences between the two scoring systems(P=0.001).The R2CHA2DS2-VASc score demonstrated a NRI of 0.259(95%CI:0.166-0.352,P<0.001)and an IDI of 0.007(95%CI:0.005-0.010,P<0.001)compared with the conventional CHA2DS2-VASc score.Although the R2CHA2DS2-VASc score exhibited slightly better predictive accuracy and outcome discrimination capacity than the original scoring system,both scores demonstrated suboptimal clinical predictive performance.Conclusions:Both the R2CHA2DS2-VASc and CHA2DS2-VASc scores show suboptimal performance for predicting the risk of MACE in patients with AF and HF,and the predicting performance of R2CHA2DS2-VASc score is marginally superior to CHA2DS2-VASc score in this patient cohort.

Objective:To analyze the correlation between chemokine CX3C ligand 1 (CX3CL1), CX3C chemokine receptor 1 (CX3CR1) and heart function grade, prognosis in patients with chronic heart failure (CHF).Methods:The clinical data of 200 patients with CHF from June 2021 to June 2023 in General Hospital of Eastern Theater of the Chinese People′s Liberation Army and Wuhan Asia Heart Hospital were retrospectively analyzed, and all patients received standardized treatment for heart failure. The baseline clinical data were recorded; the levels of CX3CL1 and CX3CR1 were detected by enzyme linked immunosorbent assay; the heart function grade was evaluated by New York Heart Association (NYHA) heart function grade method. The patients were followed up until December 2023, the patients were divided into poor prognosis group (all-cause death and readmission due to heart failure) and good prognosis group based on their prognosis. Pearson method was used for correlation analysis. Multivariate Logistic regression analysis was used to analyze the independent risk factors of poor prognosis in patients with CHF.Results:Among the 200 patients, NYHA heart function grade Ⅰ to Ⅱ was in 80 cases, Ⅲ to Ⅳ in 120 cases. The levels of CX3CL1 and CX3CR1 in patients with NYHA heart function grade Ⅲ to Ⅳ were significantly higher than those in patients with NYHA heart function grade Ⅰ to Ⅱ: (3.34 ± 0.45) mg/L vs. (2.45 ± 0.26) mg/L and (8.71 ± 0.92) mg/L vs. (2.53 ± 0.35) mg/L, and there were statistical differences ( t = 15.99 and 57.34, P<0.01). The proportion of age<60 years old, rate of coronary heart disease, CX3CL1, CX3CR1, body mass index and high-sensitivity C-reactive protein in poor prognosis group (40 cases) were significantly higher than those in good prognosis group (160 cases): 82.50% (33/40) vs. 10.62% (17/160), 90.00% (36/40) vs. 68.12% (109/160), (3.26 ± 0.77) mg/L vs. (2.25 ± 0.27) mg/L, (8.35 ± 2.01) mg/L vs. (2.48 ± 0.31) mg/L, (26.80 ± 3.55) kg/m 2 vs. (24.74 ± 2.76) kg/m 2 and (9.31 ± 2.19) mg/L vs. (3.58 ± 2.28) mg/L, the rate of smoking history and left ventricular ejection fraction were significantly lower than those in good prognosis group: 37.50% (15/40) vs. 46.88% (75/160) and (30.14 ± 5.77)% vs. (59.40 ± 6.58)%, and there were statistical differences ( P<0.01). Pearson correlation analysis result showed that the CX3CL1 and CX3CR1 were positively correlated with NYHA heart function grade ( r = 0.29 and 0.34, P<0.05), and negatively correlated with prognosis ( r = - 0.54 and - 0.36, P<0.05). Multivariate Logistic regression analysis result showed that the CX3CL1 and CX3CR1 were the independent risk factors of poor prognosis in patients with CHF ( OR = 2.110 and 1.566, 95% CI 0.445 to 3.125 and 0.270 to 3.455, P<0.01). Conclusions:The CX3CL1 and CX3CR1 are closely related to the heart function grade in patients with CHF. At the time of CHF patient admission, it may be considered to combine the two indicators for preliminary evaluation of and provide targeted interventions to improve prognosis.

Objective To construct eukaryotic expression plasmids of human promyelocytic leukaemia(hPML) gene of six transcripts and analyze the subcellular location of the recombinant proteins.Methods Primers were designed according to the hPML gene sequences registered in GenBank databases.Six transcripts of hPML gene fragments(hPML Ⅰ,Ⅱ,Ⅳ,Ⅴ,Ⅵ and Ⅶ) were amplified by RT-PCR,which were linked to the eukaryotic expression vector pCAGGS respectively.The obtained eukaryotic expression plasmids of six transcripts of hPML gene were transfected into 293T cells respectively and detected for their protein expression by Western blot,while transfected into Vero cells and detected for their subcellular location by indirect immunofluorescence assay(IFA).Results The target gene fragments of the six eukaryotic expression plasmids were consistent with the hPML gene sequences registered in GenBank.All the six recombinant proteins showed specific binding with Myc antibody,among which the recombinant protein hPML Ⅰ,Ⅱ,Ⅳ,Ⅴ and Ⅵ were located in the nucleus and cytoplasm,while the recombinant protein hPML Ⅶ was mainly located in the cytoplasm,rarely in the nucleus.Conclusion The eukaryotic expression plasmids of six transcripts of hPML gene all can be expressed correctly in mammalian cells,and the expressed recombinant proteins were located in nucleus and cytoplasm simultaneously or mainly in cytoplasm.This study provides an experimental basis for subsequent study on the antiviral and other biological functions of recombinant protein hPML.

Objective    To investigate the feasibility of video-assisted thoracoscopic surgery (VATS) lung resection in the treatment of tuberculosis. Methods    We retrospectively analyzed the clinical data of 164 tuberculosis patients who underwent lung resection in Xi'an Chest Hospital from 2013 to 2017. Patients were divided into two groups according to the surgical procedure: a VATS group (85 patients, 56 males and 29 females) and a thoracotomy group (79 patients, 52 males and 27 females). The clinical effect of the two groups was compared. Results     Compared to the thoracotomy group, the VATS group had less operation time (151.59±76.75 min vs. 233.48±93.89 min, P<0.001), amount of intraoperative blood loss (200.00 ml vs. 600.00 ml, P<0.001), the postoperative drainage (575.00 ml vs. 1 110.00 ml, P=0.001), extubation time (4 d vs. 6 d, P<0.001) and hospital stay (13.00 d vs. 17.00 d, P<0.001). There was no statistical difference in postoperative complications (10 patients vs.17 patients, P=0.092) between the two groups. A total of 97 patients underwent lobectomy, including 36 of the VATS group and 61 of the thoracotomy group. The operation time (211.39±70.88 min vs. 258.20±87.16 min, P=0.008), the intraoperative blood loss (400.00 ml vs. 700 ml, P<0.010), the postoperative drainage (800.00 ml vs. 1 250.00 ml, P=0.001), extubation time (5.00 d vs. 8.00 d, P=0.002) and hospital stay (13.11±4.45 d vs. 19.46±7.74 d, P<0.010) in the VATS group were significantly better than those in the thoracotomy group. There was no statistical difference in postoperative complication rate (4 patients vs. 14 patients, P=0.147) between the two[1]，groups. Conclusion    Compared with conventional thoracotomy, VATS lung resection has obvious advantages in treatment of tuberculosis, which may be the preferred technique.