Objective To analyze the in-hospital and long term prognosis of acute myocardial infarction(AMI)patients with N-terminal B-type brain natriuretic peptide(NT-proBNP)peak value exceeding the up-per limit.Methods A total of 669 patients with AMI diagnosed in a hospital from 2013 to 2018 were selected as research objects.According to the peak value level of NT-proBNP,they were divided into the NT-proBNP peak value exceeding the upper limit group(50 cases)and the NT-proBNP peak value detectable group(619 cases).Propensity score was used for matching(1:2),and the patients were divided into NT-proBNP peak value exceeding the upper limit group(50 cases)and NT-proBNP peak value detectable group(107 cases),and the in-hospital prognosis and long-term prognosis of the two groups were compared,as well as the echo-cardiographic indexes of each group in the acute stage and recovery stage of AMI.Multiple linear regression a-nalysis was used to predict the factors affecting left ventricular ejection fraction in the recovery stage of AMI.Results After matching the propensity score,compared with the NT-proBNP peak value detectable group,the neutrophil to lymphocyte ratio,hypersensitive C reactive protein level and fibrinogen level in the NT-proBNP peak value exceeding the upper limit group were higher at admission,and the differences were statistically sig-nificant(P＜0.05).The proportion of Killip≥ Grade Ⅱ,left ventricular ejection fraction,hospitalization time and major adverse cardiovascular and cerebrovascular events in the NT-proBNP peak value exceeding the up-per limit group were compared with those in the NT-proBNP peak value detectable group,and the differences were statistically significant(P＜0.05).The left ventricular ejection fraction and left ventricular shortening fraction of the NT-proBNP peak value detection group in AMI acute stage were higher than those in the NT-proBNP peak value exceeding the upper limit group in AMI acute stage,and the difference was statistically significant(P＜0.05).Multiple linear regression analysis showed the relationship between the NT-proBNP peak value during hospitalization and the left ventricular ejection fraction of cardiac function during AMI re-covery.The results suggested that the NT-proBNP peak value was not a risk factor affecting the left ventricu-lar ejection fraction of cardiac function during AMI recovery.Conclusion AMI patients with NT-proBNP peak value exceeding the upper limit should be treated with a series of comprehensive treatment strategies to pro-mote their rehabilitation and improve their long-term prognosis.

It is difficult to accurately distinguish pharyngitis caused by Group A Streptococcus(GAS) from other pathogens according to the clinical presentation alone, which cannot effectively guide the rational use of antimicrobials.The pharyngeal swab culture, rapid antigen detection test, nucleic acid test, and blood test can help definitively diagnose GAS pharyngitis.However, there are differences in different guidelines on who the laboratory test methods are intended for, interpretation of laboratory test results and so on.This article summarizes and analyses the laboratory diagnostic modalities and their characteristics, as well as recommendations for GAS pharyngitis in different guidelines to provide references for the clinical diagnosis, antimicrobial treatment, and further study of GAS pharyngitis.

Objective To analyze the clinical significance and predictive indicators of N-terminal pro-brain natriuretic peptide(NT-proBNP)levels exceeding the upper limit of detection range in acute myocardial infarction(AMI).Methods A total of 669 pa-tients with AMI were enrolled and divided into two groups based on their peak NT-proBNP levels:exceeding the upper limit of detection range group(n=50)and detectable group(n=619).The two groups were matched using propensity score matching(1∶2).The clinical and laboratory indicators,coronary artery features,and in-hospital prognosis were compared,and multivariate Logistic regression analysis was used to explore early predictive indicators of NT-proBNP exceeding the upper limit of detection range.Results The neutrophil-to-lymphocyte ratio(NLR),high-sensitivity C-reactive protein levels,and fibrinogen levels were higher in the group with NT-proBNP levels exceeding the upper limit of detection range.These findings were consistent after propensity score matching.In terms of in-hospital prognosis,patients in the group with NT-proBNP levels exceeding the upper limit of detection range had a higher propor-tion of Killip class 2 or higher,longer hospital stays,lower left ventricular ejection fraction,and higher incidence of major adverse cardio-vascular and cerebrovascular events.These findings remained consistent after propensity score matching,but there was no statistically sig-nificant difference in peak myocardial enzyme levels between the two groups before and after propensity score matching.Multivariate Logis-tic regression analysis showed that early predictive indicators of NT-proBNP exceeding the upper limit of detection range included higher NLR,lower use of antiplatelet drugs,high fibrinogen levels,left anterior descending branch occlusion,and older age.After propensity score matching,the predictive indicators of NT-proBNP exceeding the upper limit of detection range were right coronary artery occlusion,high NLR,high fibrinogen levels,and left anterior descending branch occlusion.Conclusion AMI patients with NT-proBNP levels ex-ceeding the upper limit of detection range have poorer in-hospital prognosis.NLR and fibrinogen levels on admission can serve as early predictive indicators of NT-proBNP levels exceeding the upper limit of detection range.

【Objective】 To study the correlation between platelet transfusion efficacy and KIR receptor-HLA ligand. 【Methods】 Thirty-three leukemia patients with positive HLA antibody were tested for cross-matching with donor platelets. Platelets from suitable donors were selected for transfusion, and the 24-hour platelet corrected count increment (CCI) was used to determine the transfusion effect. KIR and ligand genotyping were performed on blood samples from patients and donors by PCR-SSP method, and the relationship between platelet transfusion effects and KIR receptor-HLA ligand was analyzed. 【Results】 In 74 occasions of platelet transfusion, 42 were ineffective and 32 were effective. When the donor had C2 gene and HLA-B Bw4-80T gene, the frequency of ineffective platelet transfusion in the recipient was 69.0% (29/42) and 52.4% (22/35), respectively, which was significantly higher than that in the effective group [25.0% (8/32) and 25.0% (8/32)]. When the donor had C1 gene, and the frequency of effective platelet transfusion in the recipient was 100.0%(32/32), which was higher than that in the ineffective group [83.3%(35/42)]. When the recipient-donor matching mode was KIR2DL1-C2 and KIR3DL1-(HLA-B Bw4-80T), the frequency of ineffective platelet transfusion was 69.0%(29/42) and 40.5%(22/42),higher than that of the effective group [25% (8/32) and 18.8% (6/32)]. When the recipient-donor matching model was KIR2DL3-C1, the rate of effective platelet transfusion in 32 patients (100.0%), which was higher than that (35 patients 83. 3%) in the ineffective group. When the mismatch mode of recipient iKIR+donor HLA ligand receptor was KIR2DL1-C2, the frequency of effective platelet transfusion in the recipient was 78.1% (25/32), which was much higher than that in the ineffective group [31.0% (13/42)]. When the mismatch mode was KIR3DL1-(HLA-B Bw4-80T), the rate of effective platelet transfusion in the recipient was 68.8% (22/32), which was higher than that in the ineffective group (42.9%, 18/42). The difference between the above groups was statistically significant(P<0.05). 【Conclusion】 HLA-C1 and HLA-C2 genes are the key factors affecting the efficacy of platelet transfusion.For platelet refractorines, HLA-C1 is the protective gene, while HLA-C2 and HLA-B Bw4-80T are the susceptible genes. The recipient iKIR+donor HLA ligand receptor model may play an important role in platelet refractoriness.

Objective:To investigate the relationship between serum Betatrophin levels and metabolic parameters in patients with polycystic ovary syndrome (PCOS) .Methods:98 patients with PCOS (PCOS group) treated in Zhengzhou People’s Hospital from Dec. 2017 to Sep. 2019 were selected. They were divided into non-obese group ( n=45) and obese group ( n=53) according to BMI value; They were divided into non-IR group ( n= 21) and IR group ( n=77) according to HOMA-IR value; They were divided into non-hyperandrogen group ( n=24) and hyperandrogen group ( n=74) according to TT level; Another 90 healthy women were taken as the control group. The baseline data, lipid metabolism indexes, hormone indexes, glucose metabolism indexes and Betatrophin levels of the two groups were recorded. Pearson test and logisitc regression model were used to analyze the influencing factors related to the increase of serum Betatrophin level in patients with PCOS. Results:Compared with the control group, PCOS group had higher level of BMI, body fat, WHR, VLDL, LDL, TG, TC, FAI, TT, LH, DHEA-S, 17-OHP, FSH, FBG, FINS, and HOMA-IR, while the HDL level was significantly lower. The difference was significant ( P<0.01). Serum Betatrophin level in obese group was significantly higher than that in the control group (163.99±126.97 vs 110.99±102.97), and the difference was statistically significant ( t=3.21, P<0.001) ; serum Betatrophin level in IR group was higher than that in the control group (160.26±136.80 vs 133.17±112.06), and the serum Betatrophin level in IR group was higher than that in the control group (173.51±147.85 vs 144.26±124.56), but the difference was not statistically significant ( P>0.05). Serum Betatrophin levels in PCOS group were positively correlated with BMI, WHR, TG, FAI, FBG, FINS ( P<0.05), and negatively correlated with HDL ( P<0.05). Logistic analysis showed that BMI, WHR and TG were independent factors affecting the increase of serum Betatrophin level. Conclusion:Serum Betatrophin levels of PCOS patients are significantly increased, and BMI, WHR, TG, HDL, FAI, FBG, FINS may play an important role in the occurrence and development of PCOS and obesity, insulin resistance, blood lipids and androgen metabolism disorders.

Group A Streptococcus (GAS) is a very important pathogen, especially for children.On a global scale, GAS is an important cause of morbidity and mortality.But the burden of disease caused by GAS is still unknown in China and also has not obtained enough attention.For this purpose, the expert consensus is comprehensively described in diagnosis, treatment and prevention of GAS diseases in children, covering related aspects of pneumology, infectiology, immunology, microbiology, cardiology, nephrology, critical care medicine and preventive medicine.Accordingly, the consensus document was intended to improve management strategies of GAS disease in Chinese children.

Epidemiological analysis describes and compares the characteristics of a certain number of people to make causal inferences. The formation of the study population is always the first step. In this paper, we first define the concepts of cross-sections at both individual level and population level and introduce the three assumptions needed in the measurements in observational studies, i. e. the true values of the attributes are stable with time, the attribute variables are independent and the individuals are independent during the measuring process. We also determine that the causal inference research should be unified based on the time of the occurrence or beginning of a postulated cause, or exposure, should be in. Then, based on the dual roles of the population cross-section with causal thinking, we propose that research designs can be classified into two types with different characteristics: history reconstruction research and future exploration research. Finally, we briefly analyze the research design framework and the relationship between estimated effects and different designs. The discussion of the formation of a study population from the perspective of causal thinking can make a foundation for the classification of causal inference research design with appropriate effect parameters, which needs to be further studied.

Objective:To establish a predictive model of lateral lymph node metastasis in patients with papillary thyroid carcinoma(PTC), and further to compare the diagnostic efficiency of this model with the suspected abnormal lymph node thyroglobulin in fine-needle aspirate fluid (FNA-Tg) for lateral lymph node metastasis.Methods:The preoperative clinical and ultrasonographic data of 110 patients (257 lymph nodes) who underwent PTC cervical lymph node dissection were retrospectively analyzed. According to the postoperative pathological results, they were divided into lateral lymph node metastasis and non-metastasis group. Regression analysis was used to screen out independent risk factors affecting lateral lymph node metastasis and establish a predictive model. The ROC curve was used to evaluate the diagnostic efficacy and the best diagnostic cut-off point.Results:Prediction model: Logit( P)=-2.987+ 2.189(S/L ratio of lymph nodes)+ 1.748(hilum absent)+ 2.030(hyperechoic)+ 1.849(vascular abnormalities). The sensitivity, specificity, accuracy and AUC of the prediction model in the diagnosis of lateral lymph node metastasis were 92.1%, 83.9%, 87.9% and 0.929, respectively. The Homser-Lemeshow goodness of fit test showed that the Logistic model has a good fitting effect. The sensitivity, specificity, accuracy, and AUC of FNA-Tg in the diagnosis of lateral lymph node metastasis were 87.4%, 95.4%, 90.3% and 0.968, respectively. The sensitivity, specificity, accuracy, and AUC of the combined diagnosis of the predictive model and FNA-Tg were 92.9%, 96.9%, 94.2% and 0.989, respectively. Conclusions:The model has a good predictive value for PTC cervical lymph node metastasis. Combined with FNA-Tg, it can improve its diagnostic efficiency and provide more valuable information for the decision-making of clinical surgical procedures.

In causal inference, the concept of temporality (or directionality) has not been fully clarified. Starting from causal thinking, this paper divides the time axis in nature into three time domains and two time points by the occurrence timings of both a real cause and a real effect. This has anchored that causal inference can only be realized in the third domain. The measured temporalities can be divided into five types: cross-first-to-third-domain longitudinal (or experimental temporalities), cross-second-to-third-domain longitudinal, within-domain longitudinal, within-domain reversely longitudinal, and within-domain transversal (or observational temporalities). This new classification encompasses all measurement strategies, either for first or multiple measurements, or timely and delayed measurements. Except that the actual measurement for the cause occurs either before its occurrence (only in experiment) or within the second domain, all other measurements are similar to the act of historical reconstruction or "archaeology" , where the importance of measured temporalities may be inferior to the accuracy of the measurements. From the point of view that research design should integrate bias design, this new classification for measured temporalities based on the time axis in Nature, which has a clear meaning and helps to judge the possible biases in the observation methods, provides a basis for correct causal inferences.

Aberrant regulation of miRNA genes contributes to pathogenesis of a wide range of human diseases, including cancer. The TAR DNA binding protein 43 (TDP-43), a RNA/DNA binding protein associated with neurodegeneration, is involved in miRNA biogenesis. Here, we systematically examined miRNAs regulated by TDP-43 using RNA-Seq coupled with an siRNA-mediated knockdown approach. TDP-43 knockdown affected the expression of a number of miRNAs. In addition, TDP-43 down-regulation led to alterations in the patterns of different isoforms of miRNAs (isomiRs) and miRNA arm selection, suggesting a previously unknown role of TDP-43 in miRNA processing. A number of TDP-43 associated miRNAs, and their candidate target genes, are associated with human cancers. Our data reveal highly complex roles of TDP-43 in regulating different miRNAs and their target genes. Our results suggest that TDP-43 may promote migration of lung cancer cells by regulating miR-423-3p. In contrast, TDP-43 increases miR-500a-3p expression and binds to the mature miR-500a-3p sequence. Reduced expression of miR-500a-3p is associated with poor survival of lung cancer patients, suggesting that TDP-43 may have a suppressive role in cancer by regulating miR-500a-3p. Cancer-associated genes LIF and PAPPA are possible targets of miR-500a-3p. Our work suggests that TDP-43-regulated miRNAs may play multifaceted roles in the pathogenesis of cancer.
Animals ; Cells, Cultured ; DNA-Binding Proteins ; metabolism ; Electrophoretic Mobility Shift Assay ; Humans ; Immunoprecipitation ; Mice ; MicroRNAs ; genetics ; metabolism ; Neoplasms ; genetics ; metabolism