Objective To investigate the periprocedural effects of atorvastatin plus ezetimibe and atorvastatin monotherapy on lipopro-tein-associated phospholipase A2(Lp-PLA2)levels in patients with non-ST-segment elevation acute coronary syndrome(NSTE-ACS)after percutaneous coronary intervention(PCI).Methods In total,193 patients with NSTE-ACS who underwent PCI were divided into four groups:20 mg atorvastatin(A20 group),40 mg atorvastatin(A40 group),20 mg atorvastatin combined with 10 mg ezetimibe(A20+E10 group),and 40 mg atorvastatin combined with 10 mg ezetimibe(A40+E10 group).Changes in plasma Lp-PLA2 and low-density lipopro-tein cholesterol(LDL-C)levels during the perioperative period were observed,and major adverse cardiovascular events(MACE)and sta-tin-related adverse reactions were monitored for 30 d.Results Factorial analysis revealed no interaction between intensive atorvastatin and ezetimibe.Intensive atorvastatin and atorvastatin combined with ezetimibe significantly reduced the postoperative plasma Lp-PLA2 levels(P<0.05).Plasma Lp-PLA2 levels were similar between the four groups before PCI and decreased significantly after PCI(P<0.05).The changes in Lp-PLA2 during the perioperative period were compared between the four groups,and it was significantly higher in the A40 group than in the A20 group,in the A20+E10 group than in the A20 group,in the A40+E10 group than in the A20 group,and in the A40+E10 group than in the A40 group(P<0.05).No significant difference in LDL-C levels and no significant correlation between the changes in LDL-C and Lp-PLA2 levels were observed between the four groups(P>0.05).In addition,no significant differences in the incidence of major adverse cardiovascular event or statin-related adverse reactions were observed(P>0.05).Conclusion Compared with atorvastatin(20 mg)monotherapy,both intensive atorvastatin(40 mg)and atorvastatin plus ezetimibe can further reduce postoperative Lp-PLA2 levels,independent of the changes in LDL-C in patients with NSTE-ACS undergoing PCI.

【Objective】 To investigate the feasibility and safety of semiconductor blue laser in the treatment of non-muscle invasive bladder cancer (NMIBC) in the day surgery model. 【Methods】 The clinical data of 22 NMIBC patients (average age 55.8 years and tumor size 1.4 cm) who underwent outpatient screening and accepted blue laser ambulatory surgery in our hospital during Jun.2022 and Sep.2022 were retrospectively analyzed. On the day of admission, transurethral resection of cancer was performed using blue laser en bloc enucleation. On the day of surgery or in the morning of next day, bladder irrigation was stopped, the catheter was removed, and patients were discharged. The baseline data, pre-hospital waiting time, operation time, length of hospital stay, hemoglobin decrease, complications and management, follow-up, medical costs, and patients’ satisfaction rate were recorded. 【Results】 The pre-hospital waiting time was 2 to 7 days, average (4.1±1.3)days. The operation time was 29 to 50 minutes, average (40.8±5.5)minutes. The length of hospital stay was 0.6 to 1.2 days, average (0.9±0.2)days. Hemoglobin decrease was 1 g/L to 8 g/L, average (3.8±1.8)g/L. The catheter was indwelt for 0.5 to 1 day, average (0.7±0.1)day. The medical costs were 13 790 to 16 811 Yuan, average (14 941.5±690.2) Yuan. Patients’ satisfaction rate was 100.0%. Mild intraoperative and postoperative complications occurred in 2 cases. One patient developed symptoms of cystitis which disappeared after 2 days of oral antibiotic cefixime, and another patient developed bladder spasm which was relieved after oral solifenacin succinate tablets. No adverse events such as obturator nerve reflex or bladder perforation occurred. After removal of the catheter, no urinary retention was observed. 【Conclusion】 This study was the first to apply blue laser ambulatory surgery in the treatment of bladder cancer, confirming that it is a safe, feasible, economical and efficient model for selected patients, which can be promoted in suitable hospitals.

BACKGROUND: LY01005 (Goserelin acetate sustained-release microsphere injection) is a modified gonadotropin-releasing hormone (GnRH) agonist injected monthly. This phase III trial study aimed to evaluated the efficacy and safety of LY01005 in Chinese patients with prostate cancer. METHODS: We conducted a randomized controlled, open-label, non-inferiority trial across 49 sites in China. This study included 290 patients with prostate cancer who received either LY01005 or goserelin implants every 28 days for three injections. The primary efficacy endpoints were the percentage of patients with testosterone suppression ≤50 ng/dL at day 29 and the cumulative probability of testosterone ≤50 ng/dL from day 29 to 85. Non-inferiority was prespecified at a margin of -10%. Secondary endpoints included significant castration (≤20 ng/dL), testosterone surge within 72 h following repeated dosing, and changes in luteinizing hormone, follicle-stimulating hormone, and prostate specific antigen levels. RESULTS: On day 29, in the LY01005 and goserelin implant groups, testosterone concentrations fell below medical-castration levels in 99.3% (142/143) and 100% (140/140) of patients, respectively, with a difference of -0.7% (95% confidence interval [CI], -3.9% to 2.0%) between the two groups. The cumulative probabilities of maintaining castration from days 29 to 85 were 99.3% and 97.8%, respectively, with a between-group difference of 1.5% (95% CI, -1.3% to 4.4%). Both results met the criterion for non-inferiority. Secondary endpoints were similar between groups. Both treatments were well-tolerated. LY01005 was associated with fewer injection-site reactions than the goserelin implant (0% vs . 1.4% [2/145]). CONCLUSION: LY01005 is as effective as goserelin implants in reducing testosterone to castration levels, with a similar safety profile. TRIAL REGISTRATION ClinicalTrials.gov, NCT04563936.
Humans ; Male ; Antineoplastic Agents, Hormonal/therapeutic use* ; East Asian People ; Gonadotropin-Releasing Hormone/agonists* ; Goserelin/therapeutic use* ; Prostate-Specific Antigen ; Prostatic Neoplasms/drug therapy* ; Testosterone

Objective:To investigate the characteristics of bacterial community in upper gastrointestinal tumors.Methods:The study population was patients with upper gastrointestinal tumors (esophageal cancer and gastric cancer). Gastroscopy was performed on the enrolled patients ( n=17), and the specimens were taken from the tumor sites. At the same time, non-tumor tissues more than 4 cm away from the tumor tissues were taken as the control. After total DNA was extracted and purified, high-throughput 16S DNA gene sequencing was used to detect the microbiota in tumor tissues and control tissues. Bioinformatics analysis was carried out and the differences between groups were compared. Results:16S DNA PCR showed that there was no significant difference in bacterial load between tumor tissues and control tissues. The α-diversity and β-diversity indexes showed that the community composition of the two groups was similar; the samples were discrete and the colony composition was different, but there was no significant difference between the two groups. The results of Venn diagram showed that there were more operational taxonomic units (OTUs) in non-tumor tissues than in tumor tissues (2 068 vs 1 358), indicating that the bacterial species in normal tissues were more abundant than those in tumor tissues. Compared with the control tissues, the percentages of Prevotellaceae ( Prevotella), Lactobacaceae ( Lactobacillus) and Fusobacteriaceae ( Fusobacterium) in tumor tissues were relatively higher (the average percentage was more than twice that of the control). Further paired comparison of the top ten bacteria in the family and genus abundance of the two groups of samples showed that Pseudomonas decreased significantly in tumor tissues at the family ( P=0.041) and genus ( P=0.041) levels, while Prevotella was significantly enriched in tumor tissues at the family ( P=0.031) and genus ( P=0.007) levels. Conclusions:The bacterial community in the tumor microenvironment of the upper gastrointestinal tumor changed, and the species enriched in the tumor site were mainly oral common anaerobic bacteria, such as Prevotellaceae ( Prevotella), Lactobacaceae ( Lactobacillus) and Fusobacteriaceae ( Fusobacterium), especially Prevotellaceae ( Prevotella).

An in vitro synthesized random ssDNA library was subjected to 12 rounds of selection against anti-screening cells and sieving cells by SELEX. Normal and inflammatory cervical exfoliation cells were selected as anti-screening cells, and the cervical exfoliation cells of low-grade squamous intraepithelial lesion (CIN1), high-grade squamous intraepithelial lesion (CIN2, CIN3) and cervical carcinoma were selected as sieving cells during the screening process. Then, the highly specific aptamer CIN-Ap4 was established by the analysis of the specificity, affinity and cell immunofluorescence, which can be used as biomarker for Cervical Intraepithelial Neoplasia. Prime Premier 5.0 was applied to design a random ssDNA library. According to the fixed sequence at both ends of the library, a pair of primers were designed and synthesized. At the same time, the optimal annealing temperature, cycle times and primer concentration ratio of PCR procedure were selected. The results under the optimal condition are shown as follows. In the 50 μL reaction system, the optimum reaction conditions of symmetry PCR are as follows: annealing temperature is 49.5 ℃, number of cycles is 15. The optimal reaction conditions of indirect asymmetric PCR are as follows: the primer concentration ratio is 80:1, and the number of cycles is 35. The experiment proves that the oligonucleotide library is constructed successfully, and the highly specific dsDNA and ssDNA can be obtained under optimal PCR conditions with good repeatability, which establishes the foundation for the further exploration and experimentation.

Objective To explore the clinical values of ST-segment changes in ST-segment elevated myocardial infarction (STEMI) patients within 24 hours after primary percutaneous coronary intervention (PCI).Methods A total of 225 patients with STEMI underwent primary PCI were enrolled,the ST segment resolution 1 hour after PCI was calculated and the patients were divided into group A (n =135,∑STE resolved ≥ 50％) and group B (n =90,∑STE resolved ＜ 50％).The patients in group B were further divided into group C (n =56,∑STE resolved ≥ 50％) and group D (n =34,∑STE resolved ＜ 50％) according to the ST segment resolution at 24 hours after PCI.TIMI flow after PCI,in-hospital major adverse cardiac events(MACE) and cardiac function about 7 days post PCI were analyzed.Results Data between group A and group B were similar except the incidence of pre-PCI Killip ≥ Ⅱ was significantly higher in group B than in group A (37.8％ (34/90) vs.17.0％ (23/135),P ＜ 0.05).Incidence of complicated diabetes (P ＜0.05),pre-PCI Killip≥ Ⅱ (55.9％ (19/34) vs.26.8％ (15/56),P ＜0.05) and multivessel disease(70.6％ (24/34) vs.35.7％ (20/56),P ＜ 0.05) were significantly higher in group D than in group C.TIMI 3 and the opening time of IRA was similar between group A and group B and between group C and group D.The incidence of in-hospital MACE was significantly higher in group B than in group A (14.4％ (13/90) vs.3.0％ (4/135),P ＜ 0.05) which was similar between group C and group D.Conclusion Early (1 hour) but not late (24 hours) ST resolution post PCI is related to a favorable clinical outcome in STEMI patients.

Objective: To explore the influencing factors of slow blood flow phenomenon after emergency percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI). Methods: Clinical and PCI angiographic data of 488 patients, who were diagnosed as AMI and received primary PCI in our hospital from Jan 2010 to Jun 2011, were retrospectively analyzed. Patients were divided into slow blood flow group (n=51, TIMI flow ≤ grade 2) and normal flow group (n=437, TIMI flow= grade 3). Their clinical characteristics between two groups were compared. Results: Compared with normal flow group, there were significant reductions in percentages of thrombus aspiration (75.3% vs. 60.8%) and application of platelet glycoprotein IIb/IIIa receptor antagonist (81.7% vs. 68.6%) during PCI, and significant rise in total length of implanted stents [(31.8±12.2) mm vs. (35.7±12.0) mm] in slow blood flow group, P<0.05 all. Multi-factor Logistic regression analysis indicated that percentages of thrombus aspiration during PCI and total length of stents were independent influencing factors for slow blood flow (P<0.05 both). Conclusion: Percentages of thrombus aspiration and total length of stents during PCI are independent influencing factors for slow blood flow.

Objective To study the clinical value of serum cardiac troponin Ⅰ (cTnⅠ) in patients with unstable angina pectoris (UAP) and minor myocardial damage.Methods The serum cTnⅠ level of 60 UAP patients (UAP group) were determined.The patients whose cTnⅠ were ≥ 0.1 μ g/L were ascribed to cTnⅠ positive group,and the patients whose cTnⅠ were ＜ 0.1 μ g/L were ascribed to cTnⅠ negative group.The correlation among clinical data,coronary arterial lesions and adverse cardiac events were analyzed.Forty healthy people were selected as control group.Results The positive rate of cTnⅠ in UAP group (35.0％,21/60) was significantly higher than that in control group (0),and there was statistical difference (P ＜ 0.01).The incidence rate of coronary arterial multi-branch lesions and/or severe stenosis in cTnⅠ positive group (19.0％,4/21) was higher than that in cTnⅠ negative group (5.1％,2/39),but there was no statistical difference (P ＞ 0.05).The incidence rate of 90 d adverse cardiac events in cTnⅠ positive group (33.3％,7/21) was significantly higher than that in cTnⅠ negative group (5.1％,2/39),and there was statistical difference (P ＜ 0.01).Conclusions Low-level cTnⅠ demonstrates minor myocardial damage sensitively and specifically.cTnⅠ level detected quantitatively can help to assess prognosis and provide risk stratification of UAP patients.

Objective To evaluate the regional cardiac function for patients with coronary heart disease (CHD) with multiple tissue Doppler imaging (TDI) parameters in rest state and to discuss the value of regional cardiac function in diagnosing CHD.Methods Forty-seven patients with chief complain of chest pain underwent TDI examination.Maximum systolic velocity (Sm),maximum early diastolic velocity (Em),maximum late diastolic velocity (Am),isovoluminal contraction time (IVCT) and isovoluminal relaxation time(IVRT) of 16 segments of left ventricle were measured.All the patients underwent coronary angiography (CAG) at the same time.CHD was diagnosed by at least one coronary artery with no less than fifty percent diametric stenosis.Segments dominated by coronary artery with fifty to ninety and more than ninety percent diametric stenosis were defined as moderate and severe lesion segments respectively.Others were non-lesion segments.Results There was no significant difference of sex,age,heart rate,CHD risk factors,left ventricular ejection fraction (LVEF) and E/A among non-CHD (13 cases),one-lesion(11 cases),two-lesion (11 cases) and three-lesion (12 cases)(P ＞0.05).Compared with those in non-lesion segments (390sections),Sm,Em and Em/Am decreased and IVRT prolonged in both moderate lesion segments (162 sections) and severe lesion segments (144 sections) (P ＜ 0.01).IVCT prolonged only in severe lesion segments (P ＜0.05),but not in moderate lesion segments.If setting a criterion that no less than three segments with Sm ＜ 2.50 cm/s and IVRT ＞ 87 ms was for CHD diagnosis,the sensitivity,specificity,positive predictive value,negative predictive value and accuracy were 79.4％ (27/34),84.6％ (11/13),93.1％ (27/29),61.1％(11/18) and 80.9％(38/47).Conclusions In rest state,regional cardiac function of lesion segments in CHD patients shows changes of decreased systolic and diastolic velocity and prolonged isovoluminal time.Analyzing segmental cardiac velocity and time comprehensively may help to diagnose CHD.

Objective To investigate the relationship between ST resolution and early prognosis of the patients with acute ST-elevation myocardial infarction (STEMI) receiving percutaneous coronary intervention (PCI).Methods A total of 80 consecutive patients with STEMI underwent primary PCI within 12 hours.ST segment elevation amplitude sum was measured and compared before PCI and 1 hour after PCI,and the percentage of declining was calculated.According to thrombolysis in myocardial infarction (TIMI) grading after PCI,the infarction related artery blood flow was recorded and compared.Ten of them who had experienced clear ST resolution (≥30％) before PCI were set aside.Among the other 70 patients,the ST resolution was calculated and the patients were divided into group A (41 cases,ΣSTE resolved ≥50％) and group B (29 cases,Σ STE resolved ＜ 50％).The left ventricular ejection fraction (LVEF),serious adverse cardiac events (MACE,including myocardial infarction,or revascularization,malignant arrhythmia,heart failure and death) in two groups during hospitalization was compared.Results The LVEF in postoperative 1 week in group A was higher than that in group B [(51.90 ± 5.06)％ vs.(46.87 ± 4.01)％,P ＜ 0.05].The incidence of in-hospital MACE during hospitalization in group A was lower than that in group B [7.3％ (3/41) vs.24.1％ (7/29)] (P ＜ 0.05).Conclusions Degree of ST resolution early after recanalization in acute STEMI patients receiving emergency PCI degree can better reflect the level of myocardial tissue perfusion and indirectly predict cardiac systolic function and in-hospital MACE.It can be used as evaluation index of early prognosis.