Objectives:To explore the impact of intensive lipid-lowering strategy on short-term prognosis of acute coronary syndrome(ACS)patients with multi-vessel disease. Methods:A total of 136 ACS patients with multi-vessel disease who received coronary stenting at Zhongnan Hospital of Wuhan University from August 2019 to November 2020 were enrolled in this study.Patients were divided into intensive lipid-lowering group(control low density lipoprotein cholesterol[LDL-C]below 1.0 mmol/L within 3 months,and continuously meet the standards within 12 months,n=69)or standard lipid-lowering group(gradually control LDL-C below 1.4 mmol/L within one year,n=67).The total cholesterol(TC),triglycerides(TG),LDL-C,high-density lipoprotein cholesterol(HDL-C),and lipoprotein(a)(Lp[a])data were collected.Incidence of major adverse cardiovascular events(MACE,including cardiac death,myocardial infarction,target vessel revascularization and stroke)were observed during 12 months of follow up. Results:The baseline data of the intensive lipid-lowering group and the standard lipid-lowering group were consistent before intervention.At the timeline of enrollment,there was no statistically significant difference in the blood lipid profiles(including TC,TG,LDL-C,HDL-C)between the two groups.After 3-months,patients in the intensive lipid-lowering group experienced significantly lower TC,TG,LDL-C and Lp(a)compared with baseline values(all P<0.05),while HDL-C remained unchanged(P>0.05).The standard lipid-lowering group showed a significant decrease in TC and LDL-C compared with baseline values(both P<0.05).The TC and LDL-C levels were significantly lower in the intensive lipid-lowering group than in the standard lipid-lowering group at 3/6/12 months follow up after discharge(all P<0.01).At 12 months follow-up,Kaplan-Meier survival analysis showed that the incidence of MACE was significantly lower in the intensive lipid-lowering group than in the standard lipid-lowering group(2.90%vs.14.93%,χ2=6.090,P=0.014).Multiple Cox regression analysis revealed that the intensive lipid-lowering strategy significantly reduced the risk of MACE compared with the standard lipid-lowering strategy(HR=0.177,95%CI:0.037-0.838,P=0.029). Conclusions:Our data show that intensive lipid-lowering strategy may probably reduce the incidence of short-term MACE in ASC patients with multi-vessel disease.Large-scale prospective multi-center studies are needed to further validate these results.

Objective:To explore potential biomarkers that can predict the clinical efficacy of PD-1/PD-L1 inhibitors in malig-nancies.Methods:The PubMed,Web of Science,CNKI,Wanfang and VIP databases were searched from the establishment of the database to September 20,2022.After literature screening,data extraction and the risk of bias were evaluated independently by two evaluators,the Meta-analysis was performed using RevMan5.4 and STATA16.0 software.Results:This paper included 18 studies with a total of 4 018 patients.Tumor patients with a high tumor mutational burden(TMB)were found to have higher overall survival(OS)(P=0.003,P=0.01)and progression-free survival(PFS)(P=0.000 2,P=0.04)with PD-1/PD-L1 inhibitors within 1 year and 2 years of follow-up.At different follow-up times,with 1%as the critical value,there was no statistical significance in the level of PD-L1 ex-pression as a biomarker for predicting OS and PFS of PD-1/PD-L1 inhibitors(P>0.05).Conclusion:TMB can be used as a biological indicator to predict the clinical efficacy of PD-1/PD-L1 inhibitors in patients with malignant tumors within 2 years after treatment,but whether its efficacy can last longer remains to be further studied.PD-L1 single test is not currently a biomarker for predicting the bene-fit of PD-1/PD-L1 inhibitors.

Objective To explore the expression and clinical significance of lysine oxidase (Lox) in primary lesion of esophageal carcinoma (ESCA) and bone metastasis lesion based on bioinformatics. Methods The Cancer Genome Atlas (TCGA) and Gene Expression Profiling Interactive Analysis (GEPIA) databases were used to screen for differentially expressed genes between ESCA and normal esophageal tissues. Follow-up information of patients with surgery for esophageal cancer in the Fourth Hospital of Hebei Medical University from January 2016 to December 2020 were screened, and the clinical materials of patients diagnosed as bone metastasis during the follow-up period were collected. Western blot was used to verify the expression of Lox in ESCA and normal esophageal tissues; immunohistochemical staining was used to detect the expression of Lox in human ESCA tissue and normal tissue; the impact of Lox expression on survival was explored by Kaplan-Meier curve and Cox regression. Results Through the analysis of ESCA data in GEPIA and TCGA databases, it was found that the expression of Lox in ESCA lesions was significantly higher than that in normal tissues (P<0.05); the Kyoto Encyclopedia of Genes and Genomes (KEGG) and Gene Ontology (GO) enrichment analyses found that Lox may be involved in the information conduction of various signaling pathways; the Western blot result showed that the expression of Lox in cancer tissue was higher than that in adjacent normal tissue (P<0.05); the analysis of follow-up data found that patients with high expression of Lox were more likely to have multiple bone metastases; survival analysis revealed that patients with high Lox expression had significantly shorter bone metastasis free survival and overall survival compared to patients with low Lox expression (P<0.05); Cox regression found that Lox was an independent risk factor for prognosis of patients with esophageal cancer bone metastasis. Conclusion Lox is highly expressed in ESCA and significantly related to clinical prognosis, which can be used as an effective target for the diagnosis and treatment of ESCA.

Mice ; Animals ; Humans ; Disease Models, Animal

Objective To prepare 4-sulfonylcalix[6]arene-modified cotton fibers for adsorption and removal of uranium based on the specific complexation of calix[6]arene with uranium (VI). Methods Chemical grafting was used for the modification of cotton, which reacted with α-bromoisobutyryl bromide, glycidyl methacrylate, and 4-sulfonylcalix[6]arene. Scanning electron microscopy (SEM), X-ray photoelectron spectroscopy (XPS), and infrared spectroscopy (FTIR) were used to characterize the structure of 4-sulfonylcalix[6]arene-modified cotton (Cotton S-C[6]a). A Franz diffusion cell was used to simulate uranium-contaminated skin. Laser fluorimetry was used to determine the uranium content. Results SEM, XPS, and FTIR showed that cotton fibers were successfully grafted with 4-sulfonylcalix[6]arene. The optimal conditions of Cotton S-C[6]a for the adsorption of uranium (VI) was pH 4.0, duration of 20 min, and 20 mg of adsorbent. The adsorption process fitted well with pseudo-secondary-order kinetics. The uranium removal efficiency of Cotton S-C[6]a was up to 78.46% in aqueous solution and 81.72% on skin. Conclusion The synthesized Cotton S-C[6]a is highly efficient in the removal of uranium (VI) in solution and on contaminated skin.

Objective:To investigate the effect of expanded polytetrafluoroethylene (E-PTFE) combined with autologous costal cartilage in rhinoplasty.Methods:Forty-two patients who underwent rhinoplasty in the form of E-PTFE combined with autologous costal cartilage in the Department of Plastic Surgery, Jiangsu Province Hospital of Chinese Medicine from January 2017 to December 2018 were selected as the research object. The polytetrafluoroethylene combined with autologous costal cartilage was used for rhinoplasty. The dorsal nasal skin was dissected through an inverted " V" type combined with subalar cartilage incision, and then the costal cartilage was cut into appropriate cartilage slices to build the nasal tip stent. According to the degree of elevation of the nasal dorsum, the sculpted E-PTFE was placed under the nasal dorsal fascia. The rectus abdominis fascia covered the apex of the nose, and the incision was closed by suture.Results:The nasal appearance of the forty-two patients was significantly improved, with good nasal shape and no serious complications. After 6-12 months of follow-up, 40 cases were satisfacted with the effect of the rhinoplasty, accounting for 95.2%.Conclusions:The use of polytetrafluoroethylene combined with autologous costal cartilage can effectively raise the dorsum of the nose, extend the length of the nose, project the nasal tip in the rhinoplasty. This procedure is accurate and safe, reach a favorable long-term shape and own high satisfaction, and it thus is worthy of popularization in clinic.

Objective:To explore the application feasibility of modified sentinel lymph node biopsy (SLNB) for acral malignant melanoma.Methods:The data of 60 patients with acral malignant melanoma in the Affiliated Tumor Hospital of Xinjiang Medical University from January 2017 to January 2020 were retrospectively analyzed. According to the sentinel lymph node (SLN) detection method, they were divided into observation group (30 cases) and control group (30 cases). The observation group used contrast-enhanced ultrasound combined with subcutaneous injection of methylene blue around the wrist or ankle joint to detect SLN; the control group used peritumoral injection of methylene blue to detect SLN. The patients were regularly followed up to evaluate the postoperative effect. The detection number, detection rate, sensitivity, false negative rate and the size of SLN were compared between the two groups.Results:In the observation group, the detection rate of SLN was 100.0% (30/30), the sensitivity was 87.5% (7/8), and the false negative rate was 3.3% (1/30); in the control group, the detection rate of SLN was 83.3% (25/30), the sensitivity was 62.5% (5/8), and the false negative rate was 12.0% (3/25); the differences were statistically significant (all P < 0.05). The number of SLN detected in the observation group (3.5±1.2) was significantly more than that in the control group (2.0±1.1), and the difference was statistically significant ( t = 7.121, P < 0.05). The minimum long-axis diameter of SLN detected in the observation group was (5.4±2.2) mm (range, 1.5-12.3 mm), and that in the control group was (11.8±5.4) mm (range, 10.0-16.8 mm), the difference between the two groups was statistically significant ( t = 6.353, P < 0.05). Conclusion:The modified SLNB for acral malignant melanoma has a higher application value in the detection of acral SLN than the peritumoral injection method, and a higher accuracy rate can be obtained.

Objective:To evaluate the curative effect of autogenous cartilage transplantation in the correction of nasal soft-tissue triangle deformities aided by 3D technology.Methods:From January 2016 to January 2018, 32 patients with nasal soft-tissue triangle deformities were collected, with 7 males and 25 females, aged from 18 to 32 years (mean 28.5±6.8 years). A part of the costal cartilage/nasal septum cartilage or auricular cartilage was cut as repair material, which was carved into strips, and used as nasal alar rim grafts to reconstruct the dome shape and correct the nasal soft triangle deformities. The costal cartilage or nasal septum cartilage was used to strengthen the support of the columella nasi and augmentation rhinoplasty was performed with prosthesis, and the fascia was placed on nose tip to relieve tension. The surgical results were evaluated by comparing the pre- and post-operative images; statistical analysis was conducted to compare the difference of alar cartilage angle along inside and outside implants before and after the fornix reconstruction, and the difference of maximum distance from the nostrils long shaft to the nose flange between pre- and post-operation, and so the effect of nasal soft triangular deformity correction was evaluated.Results:The alar cartilage angle of the 32 patients was (51.5±10.9)° before surgery, and decreased to (37.2±5.9)° after surgery; the difference was statistically significant ( P<0.05). The maximum distance from the nostrils long shaft to the nose flange was (3.3±0.6) mm before surgery, and it reduced to (1.9±0.7) mm after surgery; the difference was statistically significant ( P<0.05). The patients were followed up for 6 to 18 months, and the result showed that the curative effect was significant, with good appearance and natural feeling, and there were no serious complications, and the satisfactory rate was 87.5%. Conclusions:Autogenous cartilage is used to repair nasal soft-tissue triangle deformities aided by 3D technology; the nasal morphology is improved delicately, and the postoperative satisfaction of curative effect is high, which is an ideal surgical method.

Objective:To examine the clinical experience and outcomes of coronary artery bypass grafting (CABG) using radial artery as the second arterial graft.Methods:Totally 585 patients in whom both left internal thoracic artery and radial artery as arterial conduits were used in CABG in Department of Cardiovascular Surgery, Nanjing Hospital Affiliated to Nanjing Medical University from April 2008 to August 2019 were consecutively enrolled. There were 436 males and 149 females, aging (63±10) years (range: 36 to 86 years). There were 40.7%(238/585) of patients had diabetes and 75.6%(442/585) of them had multivessel disease (two-vessel or three-vessel diseases). From January 2017, transit time flow measurement was performed on every patient. Demographic and perioperative data were retrospectively collected, as well as follow-up data for patients who underwent CABG from January 2014 to August 2019. Analysis were made on their early and late outcomes.Results:Most patients(81.9%(479/585)) in this cohort received on-pump CABG and 11 patients had intraoperative intro-aortic balloon counterpulsation (prior to CABG) support. Forty-three patients had concomitant valve procedures. The number of distal anastomosis was 3.6±0.9 (range: 2 to 6) and number of arterial distal anastomosis was 2.1±0.3(range:2 to 5). Radial artery was anastomosed to left obtuse marginal artery in 95.8%(560/585) patients. All target vessels for radial artery conduit had significant proximal stenosis (>70%) and 72.5%(424/585) patients′ target vessels had proximal stenosis which was >90%. Intraoperative transit-time flow measurement of 151 cases showed that radial artery conduits had a flow of (29.8±10.2) ml/minutes (range: 10 to 150 ml/minutes), and a pulsatility index of 2.5±1.4 (range: 0.7 to 5.0). There was no operative death. Two in-hospital deaths occurred more than 30 days after index surgery. There was no perioperative myocardial infarction. There were 188 patients who received CABG from January 2014 to August 2019 followed-up for a median duration of 3.2 years. There were 2 noncardiac deaths. No patient had myocardial infarction or myocardial revascularization.Conclusions:Radial artery as the second arterial conduit is a safe and effective strategy for CABG. Good selection of target vessel and intraoperative transit-time flow measurement may help achieve good patency, as well as the short and mid-term outcome.

Objective:To examine the clinical experience and outcomes of coronary artery bypass grafting (CABG) using radial artery as the second arterial graft.Methods:Totally 585 patients in whom both left internal thoracic artery and radial artery as arterial conduits were used in CABG in Department of Cardiovascular Surgery, Nanjing Hospital Affiliated to Nanjing Medical University from April 2008 to August 2019 were consecutively enrolled. There were 436 males and 149 females, aging (63±10) years (range: 36 to 86 years). There were 40.7%(238/585) of patients had diabetes and 75.6%(442/585) of them had multivessel disease (two-vessel or three-vessel diseases). From January 2017, transit time flow measurement was performed on every patient. Demographic and perioperative data were retrospectively collected, as well as follow-up data for patients who underwent CABG from January 2014 to August 2019. Analysis were made on their early and late outcomes.Results:Most patients(81.9%(479/585)) in this cohort received on-pump CABG and 11 patients had intraoperative intro-aortic balloon counterpulsation (prior to CABG) support. Forty-three patients had concomitant valve procedures. The number of distal anastomosis was 3.6±0.9 (range: 2 to 6) and number of arterial distal anastomosis was 2.1±0.3(range:2 to 5). Radial artery was anastomosed to left obtuse marginal artery in 95.8%(560/585) patients. All target vessels for radial artery conduit had significant proximal stenosis (>70%) and 72.5%(424/585) patients′ target vessels had proximal stenosis which was >90%. Intraoperative transit-time flow measurement of 151 cases showed that radial artery conduits had a flow of (29.8±10.2) ml/minutes (range: 10 to 150 ml/minutes), and a pulsatility index of 2.5±1.4 (range: 0.7 to 5.0). There was no operative death. Two in-hospital deaths occurred more than 30 days after index surgery. There was no perioperative myocardial infarction. There were 188 patients who received CABG from January 2014 to August 2019 followed-up for a median duration of 3.2 years. There were 2 noncardiac deaths. No patient had myocardial infarction or myocardial revascularization.Conclusions:Radial artery as the second arterial conduit is a safe and effective strategy for CABG. Good selection of target vessel and intraoperative transit-time flow measurement may help achieve good patency, as well as the short and mid-term outcome.