Objective:To analyze the effects of centralized volume-based procurement policy for coronary stents on direct medical expenses related to cardiovascular disease within one year after first Percutaneous Coronary Intervention(PCI)among patients with Acute Coronary Syndrome(ACS),based on real-world data of Shanghai medical institutions.Methods:ACS patients who underwent their first PCI in Shanghai between March 2019 and April 2022 were selected,and their data of cardiovascular-related medical care and direct medical expenses in outpatient visits and readmissions within one year after first PCI were collected.The policy effects on direct medical expenses related to cardiovascular disease within 1 month,3 months,6 months and 1 year after first PCI were analyzed,using Wilcoxon rank sum tests and a multilevel generalized linear mixed model.Results:After the implementation of coronary stent policy,the average total direct medical expense(including outpatient visits and readmissions)related to cardiovascular disease within 1 month,3 months,6 months and 1 year after first PCI in ACS patients significantly decreased in Shanghai;and the multivariate generalized linear mixed model also indicated that the policy implementation reduced the direct medical expenses related to cardiovascular disease for these patients within one year after first PCI.Conclusions:The implementation of coronary stent policy in Shanghai reduced direct medical expenses related to cardiovascular disease within one year after first PCI in ACS patients,alleviating patients' financial burden.It is recommended that medical expenses after first PCI among patients with ACS should be further reduced and that long-term follow-up assessment on social impacts of coronary stent policies should be conducted.

Objective:To analyze the effects of centralized volume-based procurement policy for coronary stents on direct medical expenses related to cardiovascular disease within one year after first Percutaneous Coronary Intervention(PCI)among patients with Acute Coronary Syndrome(ACS),based on real-world data of Shanghai medical institutions.Methods:ACS patients who underwent their first PCI in Shanghai between March 2019 and April 2022 were selected,and their data of cardiovascular-related medical care and direct medical expenses in outpatient visits and readmissions within one year after first PCI were collected.The policy effects on direct medical expenses related to cardiovascular disease within 1 month,3 months,6 months and 1 year after first PCI were analyzed,using Wilcoxon rank sum tests and a multilevel generalized linear mixed model.Results:After the implementation of coronary stent policy,the average total direct medical expense(including outpatient visits and readmissions)related to cardiovascular disease within 1 month,3 months,6 months and 1 year after first PCI in ACS patients significantly decreased in Shanghai;and the multivariate generalized linear mixed model also indicated that the policy implementation reduced the direct medical expenses related to cardiovascular disease for these patients within one year after first PCI.Conclusions:The implementation of coronary stent policy in Shanghai reduced direct medical expenses related to cardiovascular disease within one year after first PCI in ACS patients,alleviating patients' financial burden.It is recommended that medical expenses after first PCI among patients with ACS should be further reduced and that long-term follow-up assessment on social impacts of coronary stent policies should be conducted.

Objective:To study the effect of long noncoding RNA growth arrest-specifific transcript 5 (lncRNA GAS5) on the occurrence and development of triple-negative breast cancer (TNBC) by analyzing the differential expression of lncrna GAS5 in The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) databases.Methods:The expression of GAS5 in each subtype and pathological stage of breast cancer was studied by the TCGA data. The correlation of GAS5 was analyzed by using TNBC data GSE76124 and GSE83937 from the GEO database of the United States. The elated genes were collected and take the intersection. The positive correlation genes were used to analyze the GO function and the enrichment of KEGG pathway. GSEA of GAS5 was analyzed with TCGA database and GEO76124 data. GSE40525 and GSE76250 were selected from GEO data set to screen different miRNA and mRNA of TNBC, and construct the ceRNA network of GAS5-mirna-mrna through prediction.Results:The expression of GAS5 in breast cancer was lower than that in the adjacent tissues. GAS5 was mainly involved in various metabolic processes, including organic metabolism, macromolecular metabolism, nitrogen metabolism, etc. In terms of pathway, GAS5 mainly affected the ribosome biogenesis in eukaryotes, Wnt signaling pathway. By constructing the regulatory network of GAS5 in TNBC, we found that GAS5 was most likely to regulate the expression of 25 genes including SLC7A2 and lLONRF2 by adsorbing hsa-mir-650 and has-mir-532-5p.Conclusion:lncrna GAS5 may play a role of tumor suppressor gene in breast cancer and provide a new therapeutic target for gene therapy of breast cancer.

Objective To determine the clinicopathological risk factors and reliable biochemical predictors of the development of hypoparathyroidism after total thyroidectomy plus central compartment node dissection in papillary thyroid carcinoma (PTC).Methods A study was performed on 93 patients who underwent a total thyroidectomy with central compartment node dissection due to PTC.The rate of hypoparathyroidism was calculated.We evaluated the correlations between hypoparathyroidism and clinicopathological factors by chi-square test and logistic regression model for multivariate analysis.The prediction value of PTH and serum calcium level was assessed by a 2×2 contingency table and ROC curve analysis.Results Postoperative hypoparathyroidism was found in 46 patients (49.5％) and 2 with permanent hypoparathyroidism.Univariate analysis showed that tumor size (P=0.034),perithyroidal extension (P=0.003),bilateral cancer(P=0.045)and bilateral central neck dissection (P=0.028)were risk factors for postoperative hypoparathyroidism in patients with PTC.Multivariate analysis showed that perithyroidal extension (P=0.003) and bilateral central neck dissection(P=0.044)were independent risk factors for postoperative hypoparathyroidism in patients with PTC.ROC curve analysis showed that PTH level in the first after operation played significant roles in predicting hypoparathyroidism(AUC 0.875).Conclusions Hypoparathyroidism is the most common complication after total/near-total thyroidectomy.Perithyroidal extension and bilateral central neck dissection are the important risk factors of hypoparathyroidism.The level of PTH is a reliable and early predictive indicator of postoperative hypoparathyroidism.

With the rise of microecology and medical model getting into the stage of the development of the ecological medicine, the intersection and consistency in the cognition traditional of Chinese and Western medical system are highlighted. Yin-yang theory is the core theory in TCM. In order to extend the guidance effects of theory of the balance of yin and yang in the clinic, and help TCM theory and curative effect be further recognized by the world, this article analyzed the consistency of different systems by comparing TCM balance theory and microecology, with a purpose to explore the closed link between TCM balance theory and microecology and microscopic nature of TCM balance theory.

OBJECTIVETo test whether splicing overlapping extension(SOE) method can be a tool for obtaining rare fusion gene's transcripts and to study the tumorigenic capacity of a novel fusion gene AML1-MTG16.

METHODSSOE method was used to obtain AML1- MTG16 fusion gene's transcripts. MTG16, AML1-MTG16 and AML1-MTG16 without III,VI conserved domains of MTG16 segment were inserted into pEGFP- C1,pDsRed-N1 vector respectively,then transfected NIH3T3 cell line by lipofection. Forty-eight hours later, the transfected cells were examined by laser-scanning confocal microscopy. Stable transfected cells were obtained by G418 500ug/ul selection for one month. Growth curve, soft agar colonies formation tumorigenesis in nude mice were done to compare the difference between stable transfected cells.

RESULTSRecombined AML1-MTG16 by SOE contained its CDS. NIH3T3 expressing AML1-MTG16 had a faster proliferation in medium, colony growth in soft agar. AML1-MTG16 expression cells also induced tumors formation following injection into nude mouse. MTG16,AML1-MTG16 and AML1-MTG16 without III,VI conserved domains of MTG16 were colocalized in the nucleus of cotransfected NIH3T3 cells under the examination of laser-scanning confocal microscope.

CONCLUSIONSOE is an effective method to get rare fusion gene's transcripts. AML1-MTG16 plays an important role in leukemogenesis. MTG16 may also have a carcinogenic property within the AML1-MTG16 fusion gene. Carcinogenic property of AML1-MTG16 is restricted to its localization in the nuclear matrix. N terminal of MTG16 may play an important part in the carcinogenic activity of AML1-MTG16.

3T3 Cells ; transplantation ; Animals ; Cell Division ; genetics ; Cell Transformation, Neoplastic ; genetics ; Cell Transplantation ; Core Binding Factor Alpha 2 Subunit ; Green Fluorescent Proteins ; Luminescent Proteins ; genetics ; metabolism ; Mice ; Mice, Nude ; Microscopy, Confocal ; Neoplasms, Experimental ; genetics ; pathology ; Oncogene Proteins, Fusion ; genetics ; Plasmids ; genetics ; Recombinant Fusion Proteins ; genetics ; metabolism ; Time Factors ; Transcription Factors ; genetics ; Transfection