Objectives:To investigate the correlation between lumbar intervertebral disc degeneration and paraspinal muscle fat infiltration,abdominal fat,vertebral bone quality(VBQ)score as well as body mass index(BMI).Methods:A retrospective analysis was conducted on 280 patients who underwent lumbar MRI exami-nation at the affiliated Su Bei People's Hospital of Yangzhou University from August 2022 to March 2023.The patients included 159 males and 121 females,with ages ranging from 24 to 87 years(51.4±15.1 years).The L4/5 and L5/S1 intervertebral discs were classified according to the Pfirrmann grading system:grade Ⅱwas included in the normal group,and grades Ⅲ-Ⅴ were included in the degeneration group(no grade Ⅰpatients).The degree of paraspinal muscle fat infiltration was evaluated based on the modified Goutallier grad-ing system using MRI T2-weighted images.Abdominal fat indicators were measured,including abdominal di-ameter(AD),sagittal diameter(SAD),ventral subcutaneous thickness(VST),dorsal subcutaneous thickness(DST)at the level of the posterior margin of the L5/S1 disc,and visceral fat ratio(VFR).VBQ score was assessed us-ing MRI T1-weighted images(the average signal intensity of L1-L4 vertebrae divided by the signal intensity of cerebrospinal fluid at L3 level).Chi-square tests and independent sample t-tests were used to compare the differences in paraspinal muscle fat infiltration,abdominal fat,VBQ scores,and BMI between the two groups.Pearson and Spearman correlation analyses were performed to examine the correlations between lumbar inter-vertebral disc degeneration and paraspinal muscle fat infiltration,abdominal fat,VBQ scores,and BMI.Logis-tic regression analysis was conducted to determine the odds ratios(OR)and 95％confidence intervals(CI)for factors related to lumbar disc degeneration.Receiver operating characteristic(ROC)curves were further used to analyze the correlation between lumbar disc degeneration and paraspinal muscle fat infiltration,abdominal fat,and VBQ scores.Results:For the L4/5 intervertebral disc,107 cases were classified as grade Ⅱ(normal group)and 173 cases as grades Ⅲ-Ⅴ(degeneration group)according to the Pfirrmann classification;For the L5/S1 intervertebral disc,101 cases were grade Ⅱ(normal group)and 179 cases were grades Ⅲ-Ⅴ(degenera-tion group).There were statistically significant differences between L4/5 intervertebral disc degeneration and the degree of paravertebral muscle fat infiltration,AD,SAD,VFR,and VBQ scores(P＜0.05).L4/5 interverte-bral disc degeneration was positively correlated with the degree of paravertebral muscle fat infiltration,AD.SAD.VFR,and VBQ scores(r=0.412,r=0.244,r=0.234,r=0.244,r=0.254).L4/5 intervertebral disc degenera-tion was negatively correlated with DST(r=-0.139,P＜0.05),and there was no correlation between L4/5 inter-vertebral disc degeneration and BMI(P＞0.05).There were statistically significant differences between L5/S1 in-tervertebral disc degeneration and the degree of paravertebral muscle fat infiltration,AD,SAD,VFR,and VBQ scores(P＜0.05).L5/S1 intervertebral disc degeneration was positively correlated with the degree of par-avertebral muscle fat infiltration,AD.SAD,VFR,and VBQ scores(r=0.424,r=0.201,r=0.150,r=0.201,r=0.205).L5/S1 intervertebral disc degeneration was negatively correlated with DST(r=-0.175,P＜0.05),and there was no correlation between L5/S1 intervertebral disc degeneration and BMI(P＞0.05).Logistic regression analy-sis showed that L4/5 disc degeneration was closely related to SAD(OR=1.065),DST(OR=0.904),VBQ score(OR=2.143),and paraspinal muscle fat infiltration(OR=5.110).L5/S1 disc degeneration was closely related to DST(OR=0.889)and paraspinal muscle fat infiltration(OR=4.739).Conclusions:Lumbar disc degeneration is significantly correlated with paraspinal muscle fat infiltration,abdominal fat,and VBQ score.

Objective::This study aimed to assess the impact of proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor treatment immediately after percutaneous coronary intervention (PCI) on the myocardial salvage index (MSI) in patients with anterior ST-segment elevation myocardial infarction (STEMI) 5-10 d after the procedure.Methods::The early PCSK9 inhibitor thERapy Following pErcutaneous Coronary inTervention (PERFECT) trial is a prospective randomized controlled trial. From January 2021 to December 2023, 32 patients with anterior STEMI from Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Songjiang Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, and Shanghai Tenth People’s Hospital were enrolled in the PERFECT trial. Patients were randomly assigned in a 1∶1 ratio to the PCSK9 inhibitor group ( n = 16) or the control group ( n = 16), and their baseline data were collected. Patients in the PCSK9 inhibitor group (ie, alirocumab group) received a subcutaneous injection of PCSK9 inhibitor (alirocumab, 75 mg) immediately after PCI based on conventional treatment. In the control group, patients received only conventional treatment. The primary endpoint was the MSI measured by cardiovascular magnetic resonance 5-10 d after PCI. The secondary endpoints included the left ventricular ejection fraction measured by cardiovascular magnetic resonance 5-10 d after PCI and the time to peak of creatine kinase isoenzyme-MB and high-sensitivity cardiac troponin T. Safety endpoints included any clinical adverse events that occurred during the 6-month follow-up period. Results::Baseline data during admission showed no intergroup significance. No significant difference in MSI (55.54% ± 14.80% vs. 44.72% ± 15.42%, P = 0.056) and left ventricular ejection fraction (51.24% ± 8.91% vs. 44.99% ± 8.84%, P = 0.060) was observed. Additional, there was no significant difference in the time to peak of creatine kinase isoenzyme-MB ((12.97 ± 5.67) h vs. (14.31 ± 7.04) h, P = 0.557) and high-sensitivity cardiac troponin T ((21.03 ± 12.46) h vs. (21.44 ± 9.99) h, P = 0.920) between the 2 groups. During the 6-month follow-up period, only 1 patient in the PCSK9 inhibitor group developed cerebral hemorrhage 6 months after PCI. Conclusions::Early treatment with alirocumab did not exhibit a significant increase in MSI at 5-10 d in patients with anterior STEMI. Larger trials are necessary to evaluate the impact of early administration of PCSK9 inhibitors after myocardial infarction.

Objective::This study aimed to assess the impact of proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor treatment immediately after percutaneous coronary intervention (PCI) on the myocardial salvage index (MSI) in patients with anterior ST-segment elevation myocardial infarction (STEMI) 5-10 d after the procedure.Methods::The early PCSK9 inhibitor thERapy Following pErcutaneous Coronary inTervention (PERFECT) trial is a prospective randomized controlled trial. From January 2021 to December 2023, 32 patients with anterior STEMI from Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Songjiang Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, and Shanghai Tenth People’s Hospital were enrolled in the PERFECT trial. Patients were randomly assigned in a 1∶1 ratio to the PCSK9 inhibitor group ( n = 16) or the control group ( n = 16), and their baseline data were collected. Patients in the PCSK9 inhibitor group (ie, alirocumab group) received a subcutaneous injection of PCSK9 inhibitor (alirocumab, 75 mg) immediately after PCI based on conventional treatment. In the control group, patients received only conventional treatment. The primary endpoint was the MSI measured by cardiovascular magnetic resonance 5-10 d after PCI. The secondary endpoints included the left ventricular ejection fraction measured by cardiovascular magnetic resonance 5-10 d after PCI and the time to peak of creatine kinase isoenzyme-MB and high-sensitivity cardiac troponin T. Safety endpoints included any clinical adverse events that occurred during the 6-month follow-up period. Results::Baseline data during admission showed no intergroup significance. No significant difference in MSI (55.54% ± 14.80% vs. 44.72% ± 15.42%, P = 0.056) and left ventricular ejection fraction (51.24% ± 8.91% vs. 44.99% ± 8.84%, P = 0.060) was observed. Additional, there was no significant difference in the time to peak of creatine kinase isoenzyme-MB ((12.97 ± 5.67) h vs. (14.31 ± 7.04) h, P = 0.557) and high-sensitivity cardiac troponin T ((21.03 ± 12.46) h vs. (21.44 ± 9.99) h, P = 0.920) between the 2 groups. During the 6-month follow-up period, only 1 patient in the PCSK9 inhibitor group developed cerebral hemorrhage 6 months after PCI. Conclusions::Early treatment with alirocumab did not exhibit a significant increase in MSI at 5-10 d in patients with anterior STEMI. Larger trials are necessary to evaluate the impact of early administration of PCSK9 inhibitors after myocardial infarction.

Objectives:To investigate the correlation between lumbar intervertebral disc degeneration and paraspinal muscle fat infiltration,abdominal fat,vertebral bone quality(VBQ)score as well as body mass index(BMI).Methods:A retrospective analysis was conducted on 280 patients who underwent lumbar MRI exami-nation at the affiliated Su Bei People's Hospital of Yangzhou University from August 2022 to March 2023.The patients included 159 males and 121 females,with ages ranging from 24 to 87 years(51.4±15.1 years).The L4/5 and L5/S1 intervertebral discs were classified according to the Pfirrmann grading system:grade Ⅱwas included in the normal group,and grades Ⅲ-Ⅴ were included in the degeneration group(no grade Ⅰpatients).The degree of paraspinal muscle fat infiltration was evaluated based on the modified Goutallier grad-ing system using MRI T2-weighted images.Abdominal fat indicators were measured,including abdominal di-ameter(AD),sagittal diameter(SAD),ventral subcutaneous thickness(VST),dorsal subcutaneous thickness(DST)at the level of the posterior margin of the L5/S1 disc,and visceral fat ratio(VFR).VBQ score was assessed us-ing MRI T1-weighted images(the average signal intensity of L1-L4 vertebrae divided by the signal intensity of cerebrospinal fluid at L3 level).Chi-square tests and independent sample t-tests were used to compare the differences in paraspinal muscle fat infiltration,abdominal fat,VBQ scores,and BMI between the two groups.Pearson and Spearman correlation analyses were performed to examine the correlations between lumbar inter-vertebral disc degeneration and paraspinal muscle fat infiltration,abdominal fat,VBQ scores,and BMI.Logis-tic regression analysis was conducted to determine the odds ratios(OR)and 95％confidence intervals(CI)for factors related to lumbar disc degeneration.Receiver operating characteristic(ROC)curves were further used to analyze the correlation between lumbar disc degeneration and paraspinal muscle fat infiltration,abdominal fat,and VBQ scores.Results:For the L4/5 intervertebral disc,107 cases were classified as grade Ⅱ(normal group)and 173 cases as grades Ⅲ-Ⅴ(degeneration group)according to the Pfirrmann classification;For the L5/S1 intervertebral disc,101 cases were grade Ⅱ(normal group)and 179 cases were grades Ⅲ-Ⅴ(degenera-tion group).There were statistically significant differences between L4/5 intervertebral disc degeneration and the degree of paravertebral muscle fat infiltration,AD,SAD,VFR,and VBQ scores(P＜0.05).L4/5 interverte-bral disc degeneration was positively correlated with the degree of paravertebral muscle fat infiltration,AD.SAD.VFR,and VBQ scores(r=0.412,r=0.244,r=0.234,r=0.244,r=0.254).L4/5 intervertebral disc degenera-tion was negatively correlated with DST(r=-0.139,P＜0.05),and there was no correlation between L4/5 inter-vertebral disc degeneration and BMI(P＞0.05).There were statistically significant differences between L5/S1 in-tervertebral disc degeneration and the degree of paravertebral muscle fat infiltration,AD,SAD,VFR,and VBQ scores(P＜0.05).L5/S1 intervertebral disc degeneration was positively correlated with the degree of par-avertebral muscle fat infiltration,AD.SAD,VFR,and VBQ scores(r=0.424,r=0.201,r=0.150,r=0.201,r=0.205).L5/S1 intervertebral disc degeneration was negatively correlated with DST(r=-0.175,P＜0.05),and there was no correlation between L5/S1 intervertebral disc degeneration and BMI(P＞0.05).Logistic regression analy-sis showed that L4/5 disc degeneration was closely related to SAD(OR=1.065),DST(OR=0.904),VBQ score(OR=2.143),and paraspinal muscle fat infiltration(OR=5.110).L5/S1 disc degeneration was closely related to DST(OR=0.889)and paraspinal muscle fat infiltration(OR=4.739).Conclusions:Lumbar disc degeneration is significantly correlated with paraspinal muscle fat infiltration,abdominal fat,and VBQ score.

Objective:To explore the prognostic value of tumor deposits (TD) by number and anatomical distribution in gastric cancer (GC) patients without lymph node metastasis.Methods:From Aug 2012 to Aug 2018 all 91 GC patients undergoing radical gastrectomy and without nodal metastasis at Yijishan Hospital of Wannan Medical College were enrolled in this study. Patients were divided into L1, L2, and L3 groups according to the number of TD and into Q1 and Q2 groups according to the anatomical regions of the TD.Results:The 3-year overall survival (OS) rates of groups L1, L2, and L3 were 58.9%, 52.1%, and 31.5%, respectively ( χ2=9.769, P=0.008). The 3-year OS rates of groups Q1 and Q2 were 58.9% and 7.1% ( χ2=46.310, P<0.001). The number of TD, their distribution, neural invasion, vascular invasion, tumor size, and pT stage were all related to prognosis by univariate analysis (all P<0.05). Tumor size>4 cm ( HR=2.460, 95% CI:1.307-4.629, P=0.005), distribution of TD (non-perigastric)( HR=3.959, 95% CI:2.077-7.545, P<0.001), neural invasion ( HR=4.299,95% CI:1.953-9.461, P<0.001), and pT 4 stage ( HR=2.283, 95% CI:1.250-4.171, P=0.007) were independent risk factors for prognosis by multivariate analysis. Conclusion:The distribution of TD (non-perigastric) is an independent risk factor for poor prognosis in gastric cancer patients after radical gastrectomy and with negative lymph node metastasis.

Objective:To explore the value of bedside chest radiograph in the diagnosis and follow-up of severe and critical COVID-19.Methods:Twenty-nine patients with severe or critical COVID-19 were collected from January 23 to February 23, 2020，from four COVID-19 designated hospitals in Guangdong Province. Bedside radiography was taken in all the 29 patients, ranged from 1 to 16 times for each patient. Twenty-seven patients underwent follow-up, and the number of re-examination ranged 1 to 15 times, and the interval of review is 1 to 8 days.The imaging findings of bedside chest radiography and the imaging changes on follow-up chest radiography were analyzed retrospectively.Results:Twenty-nine patients were collected. The radiography showed the lesions involved all more than 3 lung fields. The films showed consolidation shadow in 19 cases, multiple patches of shadow in 23 cases, reticular pattern in 12 cases, strips shadow in 14 cases, interlobar fissure thickening in 18 cases, and "white lung" in 4 cases.The complications included pleural effusion in 4 cases, pneumothorax in 2 cases, mediastinal and subcutaneous emphysema in 1 case. The radiography showed the lesions progressed in 15 cases, with expanded involvement of the lung.The increase of lesion density was found in 6 cases, new lesions were noted in 5 cases, while both of them were found in 4 cases. Nine cases showed improvement, with reduced range and decreased density. Patchy or consolidation shadow turned to strips shadow or articular pattern shadow in 8 cases.There was no significant change in 3 cases with large consolidation shadow.Conclusions:Bedside chest radiography has a good value in the follow-up of severely and critically ill patients with COVID-19, and can provide great help for clinicians to evaluate their condition.

OBJECTIVE: To explore the clinical features and genetic diagnosis of two cases with rare diseases and X chromosome abnormalities. METHODS: Multiple ligation-dependent probe amplification (MLPA) and karyotype analysis were carried out on an 8-year-old girl who was diagnosed with Duchenne muscular dystrophy. Karyotype analysis and PCR assay for SRY and AZF genes were carried out for a-2-month-old male infant with short penis. RESULTS: The girl, who featured short stature and cubitus valgus, was diagnosed as Turner syndrome with a karyotype of 46,X,i(Xq). The male infant was detected with a karyotype of 45,X, with presence of SRY gene but absence of AZF gene. CONCLUSION Both cases may be associated with abnormalities of X chromosome. Genetic testing can facilitate early diagnosis and clinical intervention for such patients.
Chromosomes, Human, X ; Humans ; Infant ; Karyotyping ; Male ; Muscular Dystrophy, Duchenne ; genetics ; Rare Diseases ; Turner Syndrome ; genetics

OBJECTIVETo investigate the role of triggering receptors expressed on myeloid cells-1 (TREM-1) in the oncogenesis and progression of hepatocellular carcinoma (HCC).

METHODSThe expression and localization of TREM-1 were detected by immunohistochemistry in 76 specimens of HCC, 33 specimens of liver cirrhosis, 30 specimens of hepatitis and 20 normal liver tissues. The association between TREM-1 expression and the clinicopathologic parameters of HCC was analyzed. Human normal hepatic cell line LO2 and HCC cell line SMMC-7721 were examined for TREM-1 expression pattern using RT-PCR and Western blotting.

RESULTSAll the normal liver samples showed negative expression of TREM-1 protein, which was significantly up-regulated in the other 3 tissues. The positivity rates of TREM-1 expression were not significantly different between hepatitis, cirrhosis and HCC tissues [20.00% (6/30), 24.24% (8/33), and 21.05% (16/76), respectively; Χ² =0.195, P=0.907]. Different from chronic hepatitis and liver cirrhosis tissues where TREM-1 expression was located mainly in the nucleus and occasionally in the cytoplasm of the hepatocytes, HCC tissues showed a cellular localization of TREM-1 protein almost exclusively in the cytoplasm. In HCC, TREM-1 expression was negatively correlated with the histological grade of the tumor (r=-0.261, P=0.023) but not related with the patients' age, gender, tumor size, clinical stage, pre-existing hepatitis and cirrhosis, lymph node metastasis, or intrahepatic vascular embolism (all P>0.05). In the in vitro experiments, low levels of TREM-1 mRNA and protein expressions were detected in LO2 cells line, but their expressions were markedly up-regulated in SMMC-7721 cells.

CONCLUSIONAberrant enhancement of the expression and cytoplasmic accumulation of TREM-1 may correlate closely with the oncogenesis and progression of HCC.

Carcinogenesis ; Carcinoma, Hepatocellular ; metabolism ; Cell Line ; Cell Line, Tumor ; Cell Nucleus ; Cytoplasm ; Disease Progression ; Gene Expression Regulation, Neoplastic ; Hepatocytes ; metabolism ; Humans ; Immunohistochemistry ; Liver Cirrhosis ; Liver Neoplasms ; metabolism ; Membrane Glycoproteins ; metabolism ; Receptors, Immunologic ; metabolism ; Triggering Receptor Expressed on Myeloid Cells-1 ; Up-Regulation

Objective To investigate the role of triggering receptors expressed on myeloid cells-1 (TREM-1) in the oncogenesis and progression of hepatocellular carcinoma (HCC). Methods The expression and localization of TREM-1 were detected by immunohistochemistry in 76 specimens of HCC, 33 specimens of liver cirrhosis, 30 specimens of hepatitis and 20 normal liver tissues. The association between TREM-1 expression and the clinicopathologic parameters of HCC was analyzed. Human normal hepatic cell line LO2 and HCC cell line SMMC-7721 were examined for TREM-1 expression pattern using RT-PCR and Western blotting. Results All the normal liver samples showed negative expression of TREM-1 protein, which was significantly up-regulated in the other 3 tissues. The positivity rates of TREM-1 expression were not significantly different between hepatitis, cirrhosis and HCC tissues [20.00%(6/30), 24.24%(8/33), and 21.05%(16/76), respectively;χ2=0.195, P=0.907]. Different from chronic hepatitis and liver cirrhosis tissues where TREM-1 expression was located mainly in the nucleus and occasionally in the cytoplasm of the hepatocytes, HCC tissues showed a cellular localization of TREM-1 protein almost exclusively in the cytoplasm. In HCC, TREM-1 expression was negatively correlated with the histological grade of the tumor (r=-0.261, P=0.023) but not related with the patients' age, gender, tumor size, clinical stage, pre-existing hepatitis and cirrhosis, lymph node metastasis, or intrahepatic vascular embolism (all P>0.05). In the in vitro experiments, low levels of TREM-1 mRNA and protein expressions were detected in LO2 cells line, but their expressions were markedly up-regulated in SMMC-7721 cells. Conclusion Aberrant enhancement of the expression and cytoplasmic accumulation of TREM-1 may correlate closely with the oncogenesis and progression of HCC.

Objective To investigate the role of triggering receptors expressed on myeloid cells-1 (TREM-1) in the oncogenesis and progression of hepatocellular carcinoma (HCC). Methods The expression and localization of TREM-1 were detected by immunohistochemistry in 76 specimens of HCC, 33 specimens of liver cirrhosis, 30 specimens of hepatitis and 20 normal liver tissues. The association between TREM-1 expression and the clinicopathologic parameters of HCC was analyzed. Human normal hepatic cell line LO2 and HCC cell line SMMC-7721 were examined for TREM-1 expression pattern using RT-PCR and Western blotting. Results All the normal liver samples showed negative expression of TREM-1 protein, which was significantly up-regulated in the other 3 tissues. The positivity rates of TREM-1 expression were not significantly different between hepatitis, cirrhosis and HCC tissues [20.00%(6/30), 24.24%(8/33), and 21.05%(16/76), respectively;χ2=0.195, P=0.907]. Different from chronic hepatitis and liver cirrhosis tissues where TREM-1 expression was located mainly in the nucleus and occasionally in the cytoplasm of the hepatocytes, HCC tissues showed a cellular localization of TREM-1 protein almost exclusively in the cytoplasm. In HCC, TREM-1 expression was negatively correlated with the histological grade of the tumor (r=-0.261, P=0.023) but not related with the patients' age, gender, tumor size, clinical stage, pre-existing hepatitis and cirrhosis, lymph node metastasis, or intrahepatic vascular embolism (all P>0.05). In the in vitro experiments, low levels of TREM-1 mRNA and protein expressions were detected in LO2 cells line, but their expressions were markedly up-regulated in SMMC-7721 cells. Conclusion Aberrant enhancement of the expression and cytoplasmic accumulation of TREM-1 may correlate closely with the oncogenesis and progression of HCC.