Objective: To compare the efficacy and safety of pro-urokinase and reteplase in the treatment of patients with acute ST elevation myocardial infarction (STEMI). Methods: STEMI patients, who received intravenous thrombolytic therapy in Henan STEMI registry between September 2016 and August 2018, were eligible for this study. A total of 5479 patients from 66 hospitals were screened and patients were divided into pro-urokinase group (n=638) and reteplase group (n=702) according to thrombolytic drugs. Data including patient demographics, risk factors, medical histories, patient information at admission, in-hospital treatment, time delays, and clinical events were collected. The clinical recanalization rate, in-hospital mortality, in-hospital death or treatment withdrawal, in-hospital main adverse cardiovascular and cerebrovascular events (MACCE, death or treatment withdrawal, congestive heart failure, reinfarction and ischemic stroke) and post-thrombolysis bleeding were compared between the two groups. Bleeding events were evaluated with Bleeding Academic Research Consortium (BARC) criteria. Results: The median age [61.8 (53.2, 69.0) vs. 62.6 (52.1, 69.8), P=0.833] or the proportion of women [23.0% (147/638) vs. 25.1% (176/702), P=0.385] were similar between the pro-urokinase and reteplase groups. Clinical recanalization rates were similar between the pro-urokinase and reteplase groups [82.1% (524/638) vs. 84.9% (596/702), P=0.172], and there was no difference in the median time from onset to thrombolysis [194.5 (135.0,290.0) min vs. 190 (126.0,292.0) min, P=0.431] and the median recanalization time [95 (67.5,120.0) min vs. 95 (71.0,119.0) min, P=0.561] between the two groups. There was no significant difference in in-hospital mortality [5.5% (35/638) vs. 5.1% (36/702), P =0.770], in-hospital all-cause mortality, treatment withdrawal [8.9% (57/638) vs.7.7% (54/702), P=0.410], and in-hospital MACCE [13.0% (83/638) vs. 10.4% (73/702), P=0.137] between pro-urokinase and reteplase groups. However, the incidence of post-thrombolysis bleeding was significantly higher in reteplase group than in pro-urokinase group [7.8% (55/702) vs. 3.8% (24/638), P=0.002]. Further analysis found that the incidence of oral bleeding and the BARC grades 1-2 bleeding were significantly higher in reteplase group than in pro-urokinase group, whereas the incidence of cerebral hemorrhage was similar between the two groups [0.6% (4/638) vs. 0.4% (3/702), P=0.715]. The comparison of efficacy and safety outcomes between the two groups after adjusting for baseline characteristics using general linear mixed models was consistent with those before the adjustment. There was no significant difference in in-hospital mortality, in-hospital death or treatment withdrawal, in-hospital MACCE after adjusting for baseline characteristics and post-thrombolysis bleeding between the two groups. Conclusions: Pro-urokinase and reteplase have similar clinical efficacy in the treatment of STEMI. In terms of safety, the incidence of cerebral hemorrhage is similar, while the incidence of BARC grades 1-2 bleeding and oral bleeding is higher in reteplase group than in pro-urokinase group, which has no impact on in-hospital outcomes.
Female ; Fibrinolytic Agents/therapeutic use* ; Hospital Mortality ; Humans ; Myocardial Infarction/drug therapy* ; Recombinant Proteins ; ST Elevation Myocardial Infarction/drug therapy* ; Thrombolytic Therapy ; Tissue Plasminogen Activator ; Treatment Outcome ; Urokinase-Type Plasminogen Activator

Objective: To investigate the curative effect of rib cartilage framework supporting combined with local flap grafting for correction of cryptotia. Methods: Fourteen cases (nineteen ears) were corrected by rib cartilage framework supporting combined with local flap grafting method from January 2017 to March 2019. Part of the 7th rib cartilage was carved into a scalloped cartilage piece, which was implanted on the retroauricular cartilage to release and expand the deformed cartilage. A "M" incision was designed on the retroauricular skin to make the local flap grafting. Results: All corrected auricles were followed up for four months to three year and abtained satisfactory and stable appearance. In one case, the edge of the helix was broken two weeks after the operation, and well healed after repairing. Conclusions: The rib cartilage framework supporting combined with local flap grafting method can fully correct the deformity of cryptotia, and the long-term effect is satisfied. It can be an important complement to the classic methods.
Cartilage ; Ear, External/surgery* ; Humans ; Reconstructive Surgical Procedures ; Ribs ; Surgical Flaps

Objective:To explore the epidemiologic characteristics and the possible risk factors of microtia in China. Meanwhile, the significant variables related to severe cases are integrated into a predictive nomogram.Methods:A total of 593 patients with congenital microtia from July 2015 to July 2018 were included. Patients conforming to congenital microtia with or without associated malformations were enrolled in this study, and patients with clear chromosomal syndromes were excluded. Questionnaire surveys were conducted among the parents to collect the demographic information and risk factors for exposure during perinatal period. Using Chi-Square and Fisher’s tests to statistically analyze the frequencies of variables. Univariate and multivariate logistic regression analysis were used to select variables related to severe cases for constructing nomogram. Concordance index (C-index), calibration plot, Hosmer-Lemeshow test, and receiver operating characteristics (ROC) curve were used to assess the nomogram model.Results:Of the patients, 456 (76.9%) were male and 137 (23.1%) were female. Right side was involved in 329 cases (55.5%), left side in 217 cases (36.6%) and both sides in 47 cases (7.9%). Among them, 16 cases were familial and the rest were sporadic. Multiple deformations were in 392 cases (66.1%). Maternal illness in early pregnancy( OR=2.205, 95% CI: 1.020-4.020)and parternal drinking history( OR=2.221, 95% CI: 1.329-3.677)were independent risk factors for severe microtia. While mother aged from 26 to 35 years old ( OR=0.507, 95% CI: 0.281-0.913; OR=0.258, 95% CI: 0.125-0.531) and father living in plain area( OR=0.512, 95% CI: 0.288-0.913)may be protective factors. All the significant predictors were combined into a predictive nomogram. The C-index was 0.703(95% CI: 0.646-0.760). The calibration plotshowed good performance of the nomogram, and the model passed Hosmer-Lemeshow goodness-of-fit test ( χ2=4.512, P=0.808). ROC curve analysis revealed a high sensitivity and specificity. Conclusions:The majority of microtia patients are male, sporadic, occur on right side, and often associated with other malformations. This nomogram predicting severe microtia based on multiple parental risk factors was with good discrimination and accuracy, which could provide scientific guidance for individualized prevention in clinical practice.

Objective:To explore the epidemiologic characteristics and the possible risk factors of microtia in China. Meanwhile, the significant variables related to severe cases are integrated into a predictive nomogram.Methods:A total of 593 patients with congenital microtia from July 2015 to July 2018 were included. Patients conforming to congenital microtia with or without associated malformations were enrolled in this study, and patients with clear chromosomal syndromes were excluded. Questionnaire surveys were conducted among the parents to collect the demographic information and risk factors for exposure during perinatal period. Using Chi-Square and Fisher’s tests to statistically analyze the frequencies of variables. Univariate and multivariate logistic regression analysis were used to select variables related to severe cases for constructing nomogram. Concordance index (C-index), calibration plot, Hosmer-Lemeshow test, and receiver operating characteristics (ROC) curve were used to assess the nomogram model.Results:Of the patients, 456 (76.9%) were male and 137 (23.1%) were female. Right side was involved in 329 cases (55.5%), left side in 217 cases (36.6%) and both sides in 47 cases (7.9%). Among them, 16 cases were familial and the rest were sporadic. Multiple deformations were in 392 cases (66.1%). Maternal illness in early pregnancy( OR=2.205, 95% CI: 1.020-4.020)and parternal drinking history( OR=2.221, 95% CI: 1.329-3.677)were independent risk factors for severe microtia. While mother aged from 26 to 35 years old ( OR=0.507, 95% CI: 0.281-0.913; OR=0.258, 95% CI: 0.125-0.531) and father living in plain area( OR=0.512, 95% CI: 0.288-0.913)may be protective factors. All the significant predictors were combined into a predictive nomogram. The C-index was 0.703(95% CI: 0.646-0.760). The calibration plotshowed good performance of the nomogram, and the model passed Hosmer-Lemeshow goodness-of-fit test ( χ2=4.512, P=0.808). ROC curve analysis revealed a high sensitivity and specificity. Conclusions:The majority of microtia patients are male, sporadic, occur on right side, and often associated with other malformations. This nomogram predicting severe microtia based on multiple parental risk factors was with good discrimination and accuracy, which could provide scientific guidance for individualized prevention in clinical practice.

Two previously undescribed steroidal compounds, 16, 23-epoxy-22, 26-epimino-cholest-22(N), 23, 25(26)-trien-3β-ol-3-O-β-D-glucopyranosyl-(1→2)-β-D-glucopyranosyl-(1→4)-β-D-galactopyranoside (1) and 26-O-β-D-glucopyranosyl-(25R)-5α-furost-20(22)-en-3β, 26-diol (2), together with 7 known ones including 26-O-β-D-glucopyranosyl-(25R)-5, 20(22)-dien-furost-3β, 26-diol (3), (25R)-5-en-spirost-3β-ol-O-β-D-glucopyranosyl-(1→4)-[α-L-rhmanopyranosyl-(1→2)]-β-D-galactopyranoside (4), funkioside D (5), aspidistrin (6), tigogenin-3-O-β-D-lucotrioside (7), desglucolanatigonin II (8), and degalactotigonin (9), were isolated from Solanum lyratum Thunb. Their cytotoxic activities were tested in two cancer cell lines by MTT method. One of the steroidal glycosides (6) showed significant cytotoxic activity against gastric cancer SGC7901 and liver cancer BEL-7402 cells.
Alkaloids ; chemistry ; isolation & purification ; toxicity ; Antineoplastic Agents ; chemistry ; isolation & purification ; toxicity ; Cell Line, Tumor ; Cell Survival ; drug effects ; Glycosides ; chemistry ; pharmacology ; toxicity ; Humans ; Inhibitory Concentration 50 ; Molecular Structure ; Phytosterols ; chemistry ; isolation & purification ; toxicity ; Plant Extracts ; chemistry ; toxicity ; Plants, Medicinal ; chemistry ; Solanum ; chemistry ; Sterols ; chemistry ; pharmacology ; toxicity

Objective Based on the different physiological characteristics of the mastoid skin and soft tissue in congenital microtia malformation ,the different ear reconstructivemethod were respectively applied for the individuals with microtia .And the feasibility of personalized treatment to microtia patients was explored in this study .Method Considering different thickness and tightness in mastoid hairless skin and soft tissue,2129 microtia patients were received the skin expansionmethod of ear reconstruction surgery , while 1321 cases were treated with Nagata ' s technique, and 330 cases with skin and fascia expansionmethod . Result With average 10-month follow-up,1944 ( 91.31％) cases using the mastoid skin expansionmethod were satisfied with the outcome of the reconstructed ear including three dimensional position and subunit appearance.305(92.42％)cases using the skin and fascia expansionmethod were satisfied with theresult .1264 (95.69％) cases using Nagata ' s two—stagemethod received satisfactory outcomes .49 ( 3.71％) cases showed partial exposure of the cartilage framework .There were no postoperative complications , such as chest wall deformity or affected normal physical function .Conclusion Based on the different physiological characteristics of the mastoid skin and soft tissue ,it's beneficial to select individualized operationalmethod in ear reconstruction for congenital microtia among Chinese patients .

Objective Based on the different physiological characteristics of the mastoid skin and soft tissue in congenital microtia malformation ,the different ear reconstructivemethod were respectively applied for the individuals with microtia .And the feasibility of personalized treatment to microtia patients was explored in this study .Method Considering different thickness and tightness in mastoid hairless skin and soft tissue,2129 microtia patients were received the skin expansionmethod of ear reconstruction surgery , while 1321 cases were treated with Nagata ' s technique, and 330 cases with skin and fascia expansionmethod . Result With average 10-month follow-up,1944 ( 91.31％) cases using the mastoid skin expansionmethod were satisfied with the outcome of the reconstructed ear including three dimensional position and subunit appearance.305(92.42％)cases using the skin and fascia expansionmethod were satisfied with theresult .1264 (95.69％) cases using Nagata ' s two—stagemethod received satisfactory outcomes .49 ( 3.71％) cases showed partial exposure of the cartilage framework .There were no postoperative complications , such as chest wall deformity or affected normal physical function .Conclusion Based on the different physiological characteristics of the mastoid skin and soft tissue ,it's beneficial to select individualized operationalmethod in ear reconstruction for congenital microtia among Chinese patients .

OBJECTIVEDespite substantial research efforts worldwide, the role of inflammatory cytokine IL-1β in the onset of febrile seizures (FS) remains controversial. The aim of this study was to assess the relationship between rs16944 polymorphism of the IL-1β-511T gene and occurrence of simple FS in a sample of Han children in northern China.

METHODSThe IL-1β-511T gene rs16944 was genotyped by SNaPshot SNP technique in 141 FS children and 130 healthy control subjects. The genotypic and allelic frequencies in the two groups were comparatively analyzed.

RESULTSThere were no significant differences in genotypic and allelic frequencies of rs16944 polymorphism of the IL-1β-511T gene between FS patients and control subjects (P>0.05).When the clinical data on A/A, A/G and G/G genotypes of the rs16944 polymorphism in FS patients, there was statistically significant difference in age of first onset (χ(2)=19.491, P<0.01), temperature of first onset (χ(2)=9.317, P<0.05) and family history of FS (χ(2)=26.798, P<0.01).

CONCLUSIONSThere is no association between rs16944 polymorphism of the IL-1β-511T gene and the incidence of FS in Han children in Northern China. However, the differences in genotypes of this polymorphism might be associated with pathogenesis and prognosis of simple FS in the population studied.

Child, Preschool ; China ; ethnology ; Female ; Humans ; Infant ; Interleukin-1beta ; genetics ; Male ; Polymorphism, Single Nucleotide ; Seizures, Febrile ; genetics

OBJECTIVETo investigate the emergency treatment for large amputated ear defect.

METHODSFrom Feb. 2010 to Oct. 2013, 5 cases with large unilateral amputated ear defects were treated. The amputated auricular cartilage was replanted subcutaneously in mastoid area at the first stage. Cranioauricular sulcus was reconstructed and skin grafting was performed at the second stage.

RESULTSAll cases were followed up for 3-6 months with satisfactory result. The reconstructed helix, scapha and cavity of auricular concha had similar color and elasticity as the ear at healthy side. Scar at donor sites, such as inguinal region and armpit, was inconspicuous.

CONCLUSIONSThe method of auricular cartilage replantation is an effective way for emergency treatment of large amputated auricular defect with less morbidity at donor site.

Adolescent ; Adult ; Ear Cartilage ; transplantation ; Ear, External ; injuries ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Replantation ; Treatment Outcome ; Young Adult

AIM: To study the chemical constituents of stems of Gymnema sylvestre (Retz.) Schult. METHODS: Chromatographic techniques using silica gel, C18 reversed phase silica gel, and prep-HPLC were used. The structures were elucidated on the basis of MS and spectroscopic analysis (1D and 2D NMR), as well as chemical methods. RESULTS: Seven compounds were isolated and their structures were elucidated as conduritol A (1), stigmasterol (2), lupeol (3), stigmasterol-3-O-β-D-glucoside (4), the sodium salt of 22α-hydroxy-longispinogenin-3-O-β-D-glucopyranosyl-(1→3)-β-D-glu-curono-pyranosyl-28-O-α-L-rhamnopyranoside (5), oleanolic acid-3-O-β-D-glucopyranosyl-(1→6)-β-D-glucopyranoside (6), and the sodium salt of 22α-hydroxy-longispinogenin 3-O-β-D-glucuronopyranosyl-28-O-α-L-rhamnopyranoside (7). The inhibition activities of compounds 1, 5-7 on non-enzymatic glycation of protein in vitro were evaluated. CONCLUSION Compound 7 is a new triterpenoid saponin. It was shown that compounds 1, 5-7 have weak inhibition activities for non-enzymatic glycation of protein in vitro.
Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Gymnema sylvestre ; chemistry ; Molecular Structure ; Plant Stems ; chemistry