Objective To evaluate the clinical efficacy and safety of intensive insulin therapy in the pa-tients with acute myocardial infarction and provide guidance for improving the prognosis.Methods The articles involving the randomized controlled trials(RCT)focusing on the effects of intensive versus conventional insulin therapy on the clinical outcomes of the patients with acute myocardial infarction were retrieved from Cochrane,Embase,PubMed,CNKI,Wanfang Data,VIP,and CBM with the time interval from inception to October 2022.The data of each RCT were extracted and used for meta-analysis in RevMan5.4.Results A total of 8 arti-cles were included in this study,involving 726 patients(372 in the intensive insulin group and 354 in the nor-mal insulin group).The meta-analysis results showed that the intensive insulin group had lower incidence of major cardiovascular adverse events(RR =0.53,95%CI =0.44-0.64,P<0.001),lower all-cause mortality(RR = 0.51,95%CI =0.33-0.78,P =0.002),lower high-sensitivity C-reactive protein level on day 7(WMD =-2.00,95%CI =-2.17--1.83,P<0.001),higher left ventricular ejection fraction on day 30(WMD = 3.94,95%CI =2.45-5.43,P<0.001),and higher incidence of hypoglycemia events(RR =2.96,95%CI =1.12-7.83,P =0.030)than the normal insulin group.There was no significant difference between the two groups in terms of no-reflow event after percutaneous coronary intervention(RR =0.39,95%CI =0.14-1.13,P =0.080).Conclusion Intensive insulin therapy might be associated with more clinical benefits in the patients with acute myocardial infarction,while the conclusion remains to be confirmed by more studies.

Objective To explore the diagnostic efficiency of inflammatory cytokines in chronic obstruc-tive pulmonary disease(COPD)complicating pneumonia.Methods A total of 215 patients with COPD admit-ted and treated in the First Affiliated Hospital of Nanjing Medical University from July 2021 to August 2023 were selected as the study subjects.According to whether or not complicating pneumonia,the patients with complicating pneumonia were included in the observation group(n=87)and those with simple COPD were included in the control group(n=128).The changes of inflammation cytokines[procalcitonin(PCT),tumor necrosis factor-α(TNF-α),C reactive protein(CRP),interleukin-6(IL-6),WBC]and lung function indicators[peak expiratory flow rate(PEF),breathing volume in the first second(FEV1),forced vital capacity(FVC)]were compared between the two groups.The diagnostic efficiency of inflammatory cell factors in COPD com-plicating pneumonia as well as the correlation between the inflammatory cytokines and the lung function in the patients with COPD complicating pneumonia were analyzed.Results The levels of PCT,CRP,IL-6,TNF-αand white blood cell count(WBC)in the observation group were significantly higher than those in the control group(P＜0.05),and FEV1,FVC and PEF in the observation group were significantly lower than those in the control group(P＜0.05).The diagnostic efficiency of joint detection of PCT,CRP,IL-6,TNF-α and WBC in diagnosing COPD complicating pneumonia was better,the sensitivity was 90.80％,the specificity was 90.62％,the area under the curve(AUC)was 0.967.The correlation analysis revealed that the PCT,CRP,IL-6,TNF-α and WBC levels in the patients with COPD complicating pneumonia were negatively correlated with FEV1,FVC and PEF levels(P＜0.05).Conclusion The patients with COPD complicating pneumonia exhibit the typical inflammatory responses and deterioration of lung function.The combined detection of relevant in-flammatory indicators has the good diagnostic efficiency for it.

S-adenosyl-l-methionine (SAM) is ubiquitous in living organisms and plays important roles in transmethylation, transsulfuration and transamination in organisms. Due to its important physiological functions, production of SAM has attracted increasing attentions. Currently, researches on SAM production mainly focus on microbial fermentation, which is more cost-effective than that of the chemical synthesis and the enzyme catalysis, thus easier to achieve commercial production. With the rapid growth in SAM demand, interests in improving SAM production by developing SAM hyper-producing microorganisms aroused. The main strategies for improving SAM productivity of microorganisms include conventional breeding and metabolic engineering. This review summarizes the recent research progress in improving microbial SAM productivity to facilitate further improving SAM productivity. The bottlenecks in SAM biosynthesis and the solutions were also addressed.
S-Adenosylmethionine/metabolism* ; Plant Breeding ; Fermentation ; Metabolic Engineering

Adenosine triphosphate (ATP) regeneration systems are essential for efficient biocatalytic phosphoryl transfer reactions. Polyphosphate kinase (PPK) is a versatile enzyme that can transfer phosphate groups among adenosine monophosphate (AMP), adenosine diphosphate (ADP), ATP, and polyphosphate (Poly P). Utilization of PPK is an attractive solution to address the problem of ATP regeneration due to its ability to use a variety of inexpensive and stable Poly P salts as phosphate group donors. This review comprehensively summarizes the structural characteristics and catalytic mechanisms of different types of PPKs, as well as the variations in enzyme activity, catalytic efficiency, stability, and coenzyme preference observed in PPKs from different sources. Moreover, recent advances in PPK-mediated ATP regeneration systems and protein engineering of wild-type PPK are summarized.
Adenosine Triphosphate/metabolism* ; Adenosine Monophosphate ; Polyphosphates/metabolism* ; Catalysis ; Regeneration

Objective:To investigate the effects of sodium-glucose cotransporter 2 inhibitor dapagliflozin on myocardial remodeling in mice with diabetic cardiomyopathy and related mechanisms.Methods:Between January and December 2021, 60 6-week-old male C57BL/6J mice were chosen for the study, 40 were used to establish a diabetic cardiomyopathy model and the model was established in 28 mice, of whom, 14 were assigned to a non-intervention group and 14 to a dapagliflozin treatment group(intervention group).The rest of the 20 mice were in the control group.The mice in the intervention group were treated with dapagliflozin via oral gavage for 12 weeks.Cardiac structure and function were measured by ultrasound, the degree of myocardial fibrosis was evaluated by histology and electron microscopy, the concentrations of inflammatory factors were detected by enzyme-linked immunosorbent assays, apoptosis of myocardial cells was examined by terminal deoxynucleotidyl transferase mediated dUTP nick end labeling(TUNEL), and the level of myocardial oxidative stress was evaluated by dihydroethidium fluorescence.Results:At the end of the experiments, the body weight and fasting blood glucose in the intervention group were slightly lower than in the non-intervention group, but the difference was not statistically significant, while values from cardiac function parameters such as left ventricular ejection fraction were more favorable than in the non-intervention group[(61.07±4.66)% vs.(45.8±4.80)%, t=-5.24, P<0.05].Compared with the non-intervention group, the intervention group had alleviated myocardial hypertrophy, less myocardial disarray, and reduced collagen volume fraction[(18.4±1.9)% vs.(31.8±3.7)%, t=-12.0, P<0.05].Furthermore, the concentrations of inflammatory factors in the intervention group were lower than in the control group[interleukin-6: (82.19±10.90)ng/L vs.(291.02±31.02)ng/L, t=23.8, P<0.05; tumor necrosis factor-α: (70.45±12.13)ng/L vs.(201.31±27.10)ng/L( t=16.5), P<0.05; perforin 3: (13.05±2.04)μg/L vs.(42.40±1.26)μg/L( t=45.8), P<0.05; the index of myocardial apoptosis: 1.736±0.247 vs.0.864±0.129, t=11.7, P<0.05].The level of myocardial oxidative stress in the non-intervention group was higher than in the intervention group(2.655±0.252 vs.1.274±0.298, t=-13.3, P<0.05). Conclusions:Dapagliflozin can reduce myocardial hypertrophy and inhibit myocardial fibrosis through mitigating myocardial oxidative stress and inflammatory response, thus suppressing myocardial remodeling and ultimately protecting cardiac function in diabetic cardiomyopathy mice.

Objective: To evaluate the accuracy and feasibility of coronary artery calcium score ( CACS) on virtual non-contrast scan ( VNC) images obtained from coronary artery CT angiography ( CCTA) scan with dual －layer spectral detector CT (SDCT) ． Methods : The data of 197 patients who underwent CCTA scan in hospital were analyzed retrospectively，and 88 patients with CACS ＞0 were further analyzed． Linear regression analysis of CACS and coronary artery calcium volume ( CACV) of true non-contrast (TNC) images and VNC images ( CACS-TNC， CACS-VNC，CACV-TNC，CACV-VNC) was performed to obtain linear regression equation and correction coefficients λ 1AVG and λ2AVG ．CACS-VNC and CACV-VNC were corrected by the corresponding regression equation and recorded as CCACS-VNC and CCACV-VNC，respectively．Spearman correlation coefficient was used for correlation analysis and Bland-Altman plot was used for consistency test．Mann-Whitney U test was used to compare the difference between the two groups. Results : For the total coronary artery，there was a strong correlation between CACS- TNC and CACS-VNC (rs = 0. 952，P ＜0. 001 ，λ 1AVG = 2. 19 ) ，CACV-TNC and CACV-VNC ( rs = 0. 954，P < 0. 001，λ2AVG = 1. 93) ．The results of Mann-Whitney U test showed that there was no significant difference between CACS-TNC and CCACS-VNC or between CACV-TNC and CCACV-VNC，and the Bland-Altman plot showed good consistency between CACS-TNC and CCACS-VNC ，CACV-TNC and CCACV-VNC． Conclusion VNC images based on SDCT can accurately measure CACS and be used for cardiovascular risk classification，which is expected to replace TNC scan and reduce the radiation dose of patients.

Objective: To compare the clinical features and the outcome of in-hospital mortality between patients with myocardial infarction with non-obstructive coronary arteries(MINOCA)and myocardial infarction with obstructive coronary artery disease (MI-CAD). Methods: This is a retrospective study. The clinical data of acute myocardial infarction (AMI) patients admitted to Qilu Hospital of Shandong University from January 2017 to May 2021, who underwent coronary angiography, were collected. Patients were divided into MINOCA group and MI-CAD group according to the degree of coronary stenosis (<50% or ≥50%). Baseline clinical characteristics, electrocardiograph during hospitalization, myocardial bridge, length of stay in hospital, discharge medication and the outcome of in-hospital mortality were collected and compared between the two groups. Univariate and multivariate logistic regression analysis was used to screen the related factors of MINOCA and the factors predicting the nosocomial death outcome of patients with AMI. Results: A total of 3 048 AMI patients were enrolled, age was 62 (54, 69) years, 741 (24.3%) patients were women including 165 patients (5.4%) in the MINOCA group and 2 883 patients (94.6%) in the MI-CAD group. Compared with MI-CAD patients, MINOCA patients were younger, had a higher proportion of females and a higher incidence of NSTEMI, and had a lower history of smoking, diabetes, coronary heart disease and myocardial infarction. Baseline inflammatory markers such as neutrophil count, monocyte count, neutrophil count/lymphocyte count (NLR), and monocyte count/high-density lipoprotein count (MHR) were lower, creatinine, N-terminal pro-brain B-type Natriuretic peptides (NT-proBNP), creatine kinase-MB, hypersensitive troponin I, fibrinogen, baseline blood glucose levels were lower, high-density lipoprotein cholesterol was higher, and the incidence of myocardial bridge, arrhythmia, tachycardia and atrial fibrillation was higher (P<0.05). The application rates of calcium antagonists and non-vitamin K antagonists oral anticoagulants were higher in MINOCA group (P<0.05), and there was no statistical difference in hospitalization days and in-hospital death between the two groups (P>0.05). Multiple logistic regression analysis showed that young age, female, non-smoker, no history of coronary heart disease and low MHR were risk factors of MINOCA (P<0.05). MINCOA was not associated with higher in-hospital death (P>0.05). Patients with AMI and a history of coronary heart disease, chronic renal failure, higher baseline blood glucose, higher NLR, and higher D-dimer were risk factors of in-hospital death (P<0.05). Conclusions: Compared with MI-CAD patients, MINOCA patients are younger, more likely to be female and non-smokers and on history of coronary heart disease, and have lower baseline MHR. MINOCA is often associated with myocardial bridge and atrial fibrillation. The incidence of in-hospital death in MINCOA patients is similar as in MI-CAD patients.
Atrial Fibrillation/complications* ; Blood Glucose ; Coronary Artery Disease/complications* ; Female ; Hospital Mortality ; Humans ; Lipoproteins, HDL ; MINOCA ; Male ; Myocardial Infarction/complications* ; Retrospective Studies

BACKGROUND: There is a certain correlation between vitamin nutritional status and cancer patients. Studies have shown that vitamin deficiency increases the risk of cancer. The purpose of this study is to understand the vitamin D nutritional status of cancer patients and to provide scientific basis for further nutritional intervention. METHODS: Cancer patients who visited Shandong Cancer Hospital from July 2017 to June 2019 were included in this retrospective study. Serum 25-hydroxyvitamin D [25(OH)D] concentrations were measured. Univariate analysis and multiple linear regression analysis were carried out using SPSS 20.0. RESULTS: A total of 2,487 cancer patients were evaluable for this analysis. Mean 25(OH)D concentration was (12.70±6.82) ng/mL; the prevalence of vitamin D deficiency [25(OH)D concentration less than 20.00 ng/mL] was of 92.20%. In univariate analysis, age, body mass index (BMI), season and types of cancer were associated with 25(OH)D concentrations. In the multivariate analysis, BMI (β=0.71), age (β=-0.56), season (β=-0.99 for winter; β=-0.76 for autumn vs summer) and types of cancer (β=-1.17 for lung cancer; β=-1.45 for esophageal-gastric cancer; β=-1.05 for colorectal cancer vs other types of cancer) were independently and significantly associated with 25(OH)D levels (P<0.05). CONCLUSIONS Vitamin D deficiency was highly prevalent among cancer patients. Age, BMI, season and types of cancer may be associated with 25(OH)D levels, which indicate that monitoring of vitamin D level for cancer survivor should be taken into account.

Objective:To investigate the characteristics of and associated risk factors for pulmonary dysfunction in silicosis patients with progressive massive fibrosis (PMF) .Methods:In-patients with PMF treated in the Department of Occupational Medicine and Toxicology in Beijing Chao-Yang Hospital, Capital Medical University from June 2014 to October 2020 were enrolled in this study. Based on their pulmonary ventilation function, the patients were divided into normal ventilation group, obstructive ventilation dysfunction group, restrictive ventilation dysfunction group, and mixed ventilation dysfunction group. The location and area of the large opacity and the grade of emphysema were evaluated by high-resolution CT (HRCT) of the chest. Based on the location, the large opacity was classified into central type, peripheral type, and mixed type.Results:A total of 115 silicosis patients with PMF were enrolled, with 85 (73.91%) having different types of pulmonary dysfunction, including 36 cases (31.30%) in the obstructive ventilation dysfunction group, 9 cases (7.83%) in the restrictive ventilation dysfunction group and 40 cases (34.78%) in the mixed ventilation dysfunction group. As for the location of the large opacity, 41 cases (35.65%) were central type, 52 cases (45.22%) were peripheral type, and 22 cases (19.13%) were mixed type. Logistic regression analysis showed that the central large opacity and grade 3-4 emphysema were risk factors for obstructive ventilation dysfunction ( OR=52.179, 5.500, P<0.05) , class C large opacity was the risk factor for restrictive ventilation dysfunction ( OR=33.146, P<0.05) , class B, class C large opacity and central large opacity were the risk factors for mixed ventilation dysfunction ( OR=6.414, 11.561, 19.600, P<0.05) . Conclusion:In silicosis patients with PMF, the incidence rate of pulmonary ventilation dysfunction is higher, mainly obstructive and mixed ventilation dysfunction. The area and location of large opacity are associated with the incidence and types of pulmonary ventilation dysfunction.

Objective:To investigate the characteristics of and associated risk factors for pulmonary dysfunction in silicosis patients with progressive massive fibrosis (PMF) .Methods:In-patients with PMF treated in the Department of Occupational Medicine and Toxicology in Beijing Chao-Yang Hospital, Capital Medical University from June 2014 to October 2020 were enrolled in this study. Based on their pulmonary ventilation function, the patients were divided into normal ventilation group, obstructive ventilation dysfunction group, restrictive ventilation dysfunction group, and mixed ventilation dysfunction group. The location and area of the large opacity and the grade of emphysema were evaluated by high-resolution CT (HRCT) of the chest. Based on the location, the large opacity was classified into central type, peripheral type, and mixed type.Results:A total of 115 silicosis patients with PMF were enrolled, with 85 (73.91%) having different types of pulmonary dysfunction, including 36 cases (31.30%) in the obstructive ventilation dysfunction group, 9 cases (7.83%) in the restrictive ventilation dysfunction group and 40 cases (34.78%) in the mixed ventilation dysfunction group. As for the location of the large opacity, 41 cases (35.65%) were central type, 52 cases (45.22%) were peripheral type, and 22 cases (19.13%) were mixed type. Logistic regression analysis showed that the central large opacity and grade 3-4 emphysema were risk factors for obstructive ventilation dysfunction ( OR=52.179, 5.500, P<0.05) , class C large opacity was the risk factor for restrictive ventilation dysfunction ( OR=33.146, P<0.05) , class B, class C large opacity and central large opacity were the risk factors for mixed ventilation dysfunction ( OR=6.414, 11.561, 19.600, P<0.05) . Conclusion:In silicosis patients with PMF, the incidence rate of pulmonary ventilation dysfunction is higher, mainly obstructive and mixed ventilation dysfunction. The area and location of large opacity are associated with the incidence and types of pulmonary ventilation dysfunction.