Objective:To investigate the relationship between adipokines Apelin, adiponectin, Vaspin and susceptibility to coronary atherosclerotic heart disease (CHD) in the aged and their influence on the degree of coronary lesions.Methods:A total of 120 elderly patients with CHD admitted to Huozhou Coal and Power General Hospital from June 2022 to June 2023 were retrospectively selected(CHD group), and 120 elderly healthy physical examination subjects without CHD were selected as the control group in a 1:1 ratio. Baseline data, the levels of Apelin, adiponectin and Vaspin of the two groups were compared. Logistic regression was used to analyze the related factors of CHD susceptibility, and the levels of Apelin, adiponectin and Vaspin in patients with different CHD types, stenosis degree and number of lesions were compared. Spearman test was used to analyze the correlation between Apelin, adiponectin and Vaspin with stenosis degree and number of lesions.Results:The levels of Apelin, adiponectin and Vaspin in the CHD group were lower than those in the control group: (70.02 ± 13.54) ng/L vs. (86.75 ± 7.40) ng/L, (2.03 ± 0.67) μg/L vs. (2.80 ± 0.29) μg/L, (1.02 ± 0.31) μg/L vs. (2.10 ± 0.28) μg/L, there were statistical differences ( P<0.05). The Logistic regression equation was as follows: Logit ( P) = 2.953+1.401 × triglyceride + 1.446× low-density lipoprotein -0.761× Apelin -0.892 × adiponectin - 0.847 ×Vaspin, each coefficient had statistical significance ( P<0.05), it was suggested that with the increase of triglyceride and low-density lipoprotein levels and the decrease of Apelin, adiponectin and Vaspin levels, the susceptibility to CHD was gradually increased ( P<0.05). The levels of Apelin, adiponectin and Vaspin in patients with stable angina pectoris, unstable angina pectoris and acute myocardial infarction were decreased successively ( P<0.05). The levels of Apelin, adiponectin and Vaspin in patients with mild, moderate and severe stenosis were decreased successively ( P<0.05). The levels of Apelin, adiponectin and Vaspin in patients with single, double, 3 or more branches were decreased successively ( P<0.05). The results of Spearman test showed that Apelin, adiponectin and Vaspin were negatively correlated with the degree of stenosis ( r = - 0.728, - 0.808, - 0.779, P<0.05) and the number of lesions ( r = - 0.686, - 0.773, - 0.717, P<0.05). Conclusions:Apelin, adiponectin, and Vaspin are associated with the susceptibility of elderly people to CHD, and all three are negatively correlated with the severity of CHD stenosis and the number of diseased vessels. They are expected to become biomarkers for the onset and severity of CHD, providing a target idea for the prevention and treatment of CHD.

Purpose: The poor retention and ambiguous differentiation of stem cells (SCs) within corpus cavernosum (CC) limit the cell application in erectile dysfunction (ED). Herein, the effects and mechanism of microRNA-145 (miR-145) gene modification on modulating the traits and fate of bone marrow-derived mesenchymal stem cells (BMSCs) were investigated. Materials and Methods: The effects of miR-145 on cell apoptosis, proliferation, migration, and differentiation were determined by flow cytometry, cell counting kit-8, transwell assays and myogenic induction. Then, the age-related ED rats were recruited to four groups including phosphate buffer saline, BMSC, vector-BMSC, overexpressed-miR-145-BMSC groups. After cell transplantation, the CC were harvested and prepared to demonstrate the retention and differentiation of BMSCs by immunofluorescent staining. Then, the target of miR-145 was verified by quantitative real-time polymerase chain reaction and immunohistochemical. After that, APTO-253, as an inducer of Krüppel-like factor 4 (KLF4), was introduced for rescue experiments in corpus cavernosum smooth muscle cells (CCSMCs) under the co-culture system. Results: In vitro, miR-145 inhibited the migration and apoptosis of BMSCs and promoted the differentiation of BMSCs into smooth muscle-like cells with stronger contractility. In vivo, the amount of 5-ethynyl-2′-deoxyuridine (EdU)+cells within CC was significantly enhanced and maintained in the miR-145 gene modified BMSC group. The EdU/CD31 co-staning was detected, however, no co-staining of EdU/α-actin was observed. Furthermore, miR-145, which secreted from the gene modified BMSCs, dampened the expression of KLF4. However, the effects of miR-145 on CCSMCs could be rescued by APTO-253. Conclusions Overall, miR-145 modification prolongs the retention of the transplanted BMSCs within the CC, and this effect might be attributed to the modulation of the miR-145/KLF4 axis. Consequently, our findings offer a promising and innovative strategy to enhance the local stem cell-based treatments.

Objective    To systematically review the impact of chronic kidney disease (CKD) at different stages on prognosis of transcatheter aortic valve replacement (TAVR). Methods    Databases including PubMed, the Cochrane Library, EMbase, Web of Science, CNKI, Wanfang and the Chinese Biomedical Literature Database (CBM) were searched by computer to collect cohort studies on impact of different stages of CKD on prognosis of TAVR from inception to July 2020. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies, and then, meta-analysis was performed by using Stata 15.0 software. Risk of study bias was assessed using the Newcastle-Ottawa Scale (NOS). Results    A total of 17 cohort studies were included with NOS score≥6 points. The results of meta-analysis indicated that: compared with the patients without CKD, all-cause mortality of CKD stage 3 patients at 30 day (RR=1.29, 95%CI 1.22-1.37, P<0.001) and 1 year (RR=1.24, 95%CI 1.19-1.28, P<0.001), all-cause mortality of CKD stage 4 patients at 30 day (RR=2.10, 95%CI 1.90-2.31, P<0.001) and 1 year (RR=1.89, 95%CI 1.62-2.19, P<0.001), and all-cause mortality of CKD stage 5 patients at 30 day (RR=2.22, 95%CI 1.62-2.19, P<0.001) and 1 year (RR=2.24, 95%CI 1.75-2.87, P<0.001) were significantly increased and were associated with the severity of CKD. The occurrence rates of 1-year cardiovascular mortality, postoperative acute kidney injury and bleeding events were all higher in patients with CKD. Conclusion    CKD at stages 3, 4 and 5 is associated with increased all-cause mortality after TAVR, and the higher the stage of CKD is, the higher the risk of all-cause mortality at 30-day and 1-year follow-up is. Due to limited quality and quantity of the included studies, more high-quality studies are required to verify above conclusions.

Objective:To investigate the factors associated with the occurrence of coccoid forms in clinical isolates of Helicobacter pylori ( H. pylori) and its relationship with the pathological changes of gastric mucosa. Methods:A total of 66 H. pylori-infected patients admitted to People′s Hospital of Ningxia Hui Autonomous Region from January 2020 to June 2021 were included.The clinical data of the patients were collected. Immunohistochemical staining was performed on gastric mucosal biopsy specimen to observe the occurrence of coccoid forms of H. pylori and pathological changes of gastric mucosa. Chi-square test was used for statistical analysis. Results:After immunohistochemical staining of 66 gastric mucosa biopsy specimens from H. pylori-infected patients, the co-existence of helical and coccoid forms of H. pylori was found in 26(39.39%) specimens, and no simple coccoid H. pylori change was found. Among them, the patients with a history of eradication therapy had a coccoid forms rate of 52.63%(20/38), and those without a history of eradication therapy had a coccoid forms rate of 21.43%(6/28), and the difference was statistically significant ( χ2=6.57, P=0.012). There were no significant differences in the coccoid forms rates between patients with different gender, ethnicity, age and gastric mucosal pathological changes (including atrophy, gastric intestinal metaplasia, inflammation, activity)(all P>0.050). Seventeen (73.9%) of the 23 patients whose endoscopy was more than one to three months from the last eradication therapy developed coccoid forms, while three of 15 patients whose endoscopy was more than three months from the last eradication therapy had coccoid forms, and the difference was statistically significant ( χ2=10.59, P=0.002). Conclusions:The transformation of H. pylori coccoid forms is related to the previous eradication therapy. The coccoid forms of H. pylori is equally pathogenic relative to the helical forms of H. pylori.

Early brain injury (EBI) is a series of pathophysiological changes occurring within 72 h after subarachnoid hemorrhage (SAH) and before cerebral vasospasm, which is a key factor affecting the outcome of SAH. The possible pathological mechanisms include cell metabolism, oxidative stress and immune inflammation, in which inflammatory response plays an important role. As the important immune cells in the central nervous system, microglia undergo M1/M2 polarization after brain injury. On the one hand, microglia secrete proinflammatory cytokines through Toll-like receptor 4 (TLR4), calcium sensing receptor (CaSR) and triggering receptor expressed on myoid cells 1 (TREM-1) mediated signaling pathways, which are involved in neuronal apoptosis, blood-brain barrier damage and brain edema after SAH. On the other hand, microglia play the anti-inflammatory and protective effects through the expression of neuroglobin and heme oxygenase 1. This article reviews the M1/M2 polarization process of microglia in EBI after SAH and its dual mechanisms of action.

Objective:To compare ultrasound (US) guided versus computed tomography (CT) guided radiofrequency ablation (RFA) in treatment of early hepatocellular carcinoma (HCC).Methods:The data of 133 patients with early HCC treated by RFA in the Department of Hepatobiliary Surgery of Shandong Provincial Hospital from February 1, 2015, to January 31, 2017, was analyzed retrospectively. These patients were divided into two groups: the US-guided group and the CT-guided group. The clinical data was collected and the factors affecting prognosis were analyzed.Results:Compared with the CT-guided group, the operation time of the US-guided group was significantly shorter [(29.0±12.0)min vs. (55.0±19.0)min, P<0.05], but the number of ablation sessions per tumor was significantly less [(1.1±0.3) vs. (2.0±0.6), P<0.05]. There was no significant difference in the complete ablation rates, postoperative complication rates and postoperative length of hospital stay between the two groups ( P>0.05). The CT-guided group was superior to the US-guided group in the local tumor recurrence and progression-free survival rates ( P<0.05). On multivariate analysis, CT-guided RFA was an independent protective factor for local tumor recurrence ( HR=0.266, 95% CI: 0.073-0.967, P<0.05) and progression-free survival ( HR=0.415. 95% CI: 0.213-0.806, P<0.05), while AFP >20 ng/ml ( HR=4.821, 95% CI: 1.714-13.560, P<0.05) was an independent risk factor for progression-free survival. Conclusion:CT-guided percutaneous RFA was superior to US-guided RFA in local treatment of early HCC, probably related to more needle placements and longer ablation time under CT guidance.

The laboratory is an indispensable part in a hospital, and it is always providing very important and much support for public third-level grade-A hospital in medical treatment, scientific research and teaching. As one of JCI review points, how to strengthen the laboratory safety and management is one of the important tasks, which cannot be ignored. Our hospital managers try their best to strengthen the supervision at the following nine aspects: Laboratory rules and regulations, environment and management, safety facilities, safe water and electricity, chemical safety, biological safety, radiation safety, safe instruments and equipment, and personal protective measures. Based on above nine aspects, our hospital managers actively take measures to ensure our laboratory safety. Following are the measures: We arrange lectures on laboratory safety in order to improve the personnel laboratory safety awareness. We carry out network examination and popularize knowledge of laboratory safety. We not only have phased examination, but also give positive feedback to laboratory managers. In a word, our challenge is very big, but we harvest a lot of achievements.

Objective To evaluate the role of gray-white-matter ratio (GWR) on neurological outcome in patients with coma after cardiopulmonary resuscitation (CPR) post-respiratory and cardiac arrest (CA).Methods Respiratory and CA patients with restoration of spontaneous circulation (ROSC) and coma after CPR admitted to Nanjing Drum Tower Hospital Clinical Medical College of Nanjing Medical University from February 2013 to June 2016 were enrolled. All patients were subjected to target temperature management (TTM) after CPR, and received cranial CT within 5 days after ROSC. Attenuation (hounsfield units) was measured at special sites (basal ganglia, centrum semiovale), and specific locus (caudate nucleus, put amen, corpus callosum, posterior limb of internal capsule, medial cortex, medial white matter). The GWR was calculated for basal ganglia and cerebrum. Neurological outcome was judged according to the Glasgow-Pittsburgh cerebral performance category (CPC) at 3 months after ICU discharge. CPC 1-3 were divided into good prognosis, CPC 4-5 were divided into poor prognosis. The receiver-operating characteristic (ROC) curve was drawn to evaluate the prognostic value of GWR in patients with respiratory and CA.Results Forty-three patients were enrolled, including 26 males and 17 females; age (63±15) years old; 14 good prognosis and 29 poor prognosis. Compared with the good prognosis group, the basal ganglia GWR (GWRbg) and the average GWR (GWRav) were significantly lowered in the poor prognosis group (1.064±0.103 vs. 1.163±0.818, 1.068±0.087 vs. 1.128±0.071, bothP < 0.05), the centrum semiovale GWR (GWRce) was similar to that in the good prognosis group (1.072±0.077 vs. 1.092±0.075,P >0.05). It was shown by ROC curve analysis that the GWRbg, GWRav could evaluate the neurological outcomes of patients, but GWRce could not. The area under the ROC curve (AUC) of GWRbg was 0.756 [95％ confidence interval (95％CI) =0.607-0.905,P = 0.007], the cut-off value was 1.13, the sensitivity was 71.4％, and specificity was 69.0％; the AUC of GWRav was 0.701 (95％CI = 0.532-0.869,P = 0.035), the cut-off value was 1.13, the sensitivity was 71.4％, andspecificity was 65.5％; the AUC of GWRce was 0.590 (95％CI = 0.405-0.775,P = 0.344).Conclusions Respiratory and CA patients receiving TTM with high GWR had favorable neurological outcome. GWR, especially GWRbg could provide help for clinical treatment and prognostic value of survival after CA.

Objective To compare the clinical values of laparoscopic surgery and laparoscopic surgery by pull through technique for anterior of rectum in patients with rectal cancer. Methods From Jan, 2013 to Jan, 2014, 120 patients with low rectal cancer were prospectively collected. The patients were randomly divided into study group (n= 60) and control group (n= 60). Patients in the study group were treated with laparoscopic surgery by pull through technique for anterior resection of rectum, while patients in the control group were treated with laparoscopic surgery. The primary outcomes were intraoperative situations, postoperative complications and recovery. Results When compared with the control group, patients in the study group got a significantly shorter operative duration [(132.32±14.92) vs (154.73±17.65) min, P=0.000];a signiifcantly lower postoperative drainage volume [(299.93±56.49) vs (365.24±68.94) ml, P= 0.000]; a significantly shorter gastrointestinal function recovery time [(57.42±5.84) vs (61.85±7.40) h, P=0.002]; and a signiifcantly less of length of hospital stay [(12.54±2.76) vs (14.75±2.10) d, P= 0.000]. There was no significant difference between the two groups in the amount of bleeding, the number of lymph node dissection, pneumonia, lower extremity arteriovenous thrombosis, incision infection, anastomotic leakage, intestinal obstruction, 2-year recurrence rate and mortality rate (P> 0.05). Conclusion laparoscopic surgery by pull through technique for anterior resection of rectum can accelerate postoperative recovery.

Objective To evaluate the feasibility of the combination of amplification refractory mutation system (ARMS) and quantitative real-time polymerase chain reaction (PCR) method in fast detection of clarithromycin resistance of Helicobacter pylori (H.pylori) in gastric mucosa.Methods A total of 150 gastric mucosal specimens with positive H.pylori culture were collected from the H.pylori positive patients who failed in H.pylori eradication from January to August in 2013.The drug resistant gene mutation types of H.pylori in these samples were detected by quantitative real-time PCR based on ARMS.And the accuracy was confirmed by sequencing.The clarithromycin resistance of H.pylori was determined by E-assay.Chi-square test was used for statistical analysis.Results Among 149 gastric mucosal specimens (one specimens without wild type or mutation type had been eliminated),the results of quantitative real-time PCR based on ARMS of two samples were not consistent with the results of sequencing;the consistent rate was 98.7％ (147/149).Among 149 specimens with positive H.pylori culture,104 samples (69.8％) were clarithromycin resistance.In 101 samples the clarithromycin resistance was detected by quantitative real-time PCR based on ARMS;the consistent rate was 97.1％ (101/104).Both E-assay and clarithromycin resistant rate detected by E-assay or quantitative real-time PCR based on ARMS was 69.8％ (104/149) and 67.8％ (101/149),respectively,and the difference was not significant (x2 =0.141,P=0.932).Conclusion The combination of ARMS and quantitative real-time PCR method in fast detection of clarithromycin resistance of H.pylori in gastric mucosa is strongly feasible and highly consistent has high consistent rate with sequencing and E-assay.