1.Effects of Buzhong Yulin Decoction (补中愈淋汤) for Mice with Recurrent Urinary Tract Infectionon on Bladder Mucosal Barrier and Bacterial Load of Bladder Epithelial Cells
Hao YIN ; Yi XUE ; Biao ZHANG ; Zhuohui JIN ; Jiaoli ZHU ; Yi JIANG ; Xiaofang WANG ; Chen FENG ; Yunyun JIN ; Qingjiang JIN ; Qinglei JIN ; Xin WANG
Journal of Traditional Chinese Medicine 2024;65(22):2338-2346
ObjectiveTo investigate the possible mechanism of Buzhong Yulin Decoction (补中愈淋汤) in the prevention and treatment of recurrent urinary tract infection. MethodsThe mouse models of recurrent urinary tract infection were established by uropathogenic Escherichia coli (UPEC) strain UTI89 by bladder perfusion, and the successful mouse models were randomly divided into a model group, an antibiotic group, and a low- and high-dose Buzhong Yulin Decoction group, with six mice in each group. In addition, 5 C57BL/6 mice without modelling were taken as blank group. The low- and high-dose Buzhong Yulin Decoction groups received 0.1 ml/10 g of decoction by gavage, with concentrations of 1.3 g/ml and 5.2 g/ml, respectively; the antibiotic group received 0.1 ml/10 g of levofloxacin hydrochloride solution with 5 mg/ml by gavage; the blank and model groups received 0.1 ml/10 g of distilled water by gavage. Each group was gavaged once a day for 7 consecutive days. The total number of urine marks, the number of central urine marks, and the total urine volume of the urine marks were observed by the urine marking test; HE staining was used to observe the histopathological changes in the bladder of mice; serum levels of the inflammatory factors interleukin 1β (IL-1β), interleukin 6 (IL-6) and tumour necrosis factor α (TNF-α) were detected by ELISA; the morphology of the epithelial cells of bladder was observed by scanning electron microscopy; immunofluorescence assay to detect bladder tissue anti-UroPlakin 3A protein level and UPEC bacterial load; the spread plate method to detect urinary bacterial load and bacterial load of bladder epithelial cells; RT-PCR method to detect Ras-related protein Rab-11A (RAB11A) and Ras-related protein Rab-27B (RAB27B) mRNA level in bladder tissue; immunoblotting to detect microtubule-associated protein 1 light chain3 (LC3) and P62 protein levels in bladder tissue. ResultsCompared with the blank group, the bladder epithelial cell layers were lost and showed abnormal morphology in mice of the model group; bladder tissue UroPlakin 3A protein and RAB11A and RAB27B mRNA levels reduced, the total number of urine marks, the number of central urine marks, bladder tissue UPEC bacterial load, urinary bacterial load, bacterial load in bladder epithelial cells, serum IL-1β, IL-6, and TNF-α levels, and LC3 and P62 protein levels in bladder tissue all elevated (P<0.05 or P<0.01). Compared with the model group, the bladder epithelial cell layers were intact and the morphology of epithelial cells were regular in the low- and high-dose Buzhong Yulin Decoction groups; the average surface area of bladder epithelial cells reduced, the levels of UroPlakin 3A protein and RAB11A and RAB27B mRNA in bladder tissues elevated, and total number of urine marks, the number of central urine marks, bladder tissue UPEC bacterial load, urinary bacterial load, bacterial load in bladder epithelial cells, serum IL-1β, IL-6, and TNF-α levels, and P62 protein levels in bladder tissue all reduced (P<0.05 or P<0.01), but LC3 protein levels showed no statistically significant (P>0.05). In the antibiotic group, the bladder epithelial cells were partially missing and the morphology of epithelial cells was abnormal. Compared with the antibiotic group, the average surface area of the bladder epithelial cells in the mice increased in the low- and high-dose Buzhong Yulin Decoction groups, the bacterial load of the bladder epithelial cells decreased, and the P62 protein level of the bladder tissue decreased (P<0.05). When comparing between the low- and high-dose Buzhong Yulin Decoction groups, the differences in each index were not statistically significant (P>0.05). ConclusionBuzhong Yulin Decoction may prevent and treat recurrent urinary tract infection by repairing the bladder mucosal barrier, increasing RAB11A and RAB27B level and enhancing autophagy in bladder tissues, thereby facilitating bacterial clearance from bladder epithelial cells and reducing the bacterial load of bladder epithelial cells.
2.Effects of ginkgolides drops on anginal attacks and peripheral blood miR-29a and ICAM-1 levels in patients with stable angina pectoris
Huiqiong YANG ; Lei YIN ; Xiaofang YANG ; Yonghong WANG
The Journal of Practical Medicine 2024;40(16):2340-2346
Objective To observe the effects of ginkgolides drops on anginal attacks and peripheral blood levels of microRNA-29 a(miR-29a)and intercellular adhesion molecule-1(ICAM-1)in patients with stable angina pectoris.Methods 78 patients with stable angina pectoris patients,who had visited the cardiology department of our hospital during the period of January 2022 to December 2023,were selected.The patients were divided in a Chinese medicine group or a conventional group by using the random number table method,39 in each group.The conventional group received conventional Western medicine treatment,while the Chinese medicine received ginkgo ketone ester drip pills on the basis of conventional Western medicine therapies.Occurrence of angina attack,treadmill electrocardiogram test indexes,blood rheology,6-minute walking distance,TCM symptom scores and changes in peripheral blood miR-29a and ICAM-1 were observed in the two groups.The rate of nitroglycerin discontinuation or reduction and the incidence of adverse reactions were counted.Results Before treatment,there was no statistically significant difference in occurrence of angina attacks between the two groups(P>0.05).After treatment,the number of attacks per week,weekly glyceryl trinitrate uses,and duration of each attack decreased in both groups,with a greater decline in the Chinese medicine group than in the conventional group(P<0.05).Before treatment,there was no statistically significant difference in the indicators of treadmill electrocardiogram test between the two groups(P>0.05).After treatment,induction positive time,exercise termination time,and maximum ST depression time increased in both groups,with longer induction positive time and maximum ST depression time in the Chinese medi-cine group than in the conventional group,while exercise termination time,as compared with the baseline,did not differ statistically(P>0.05).Maximum ST depression amplitude and ST recovery time decreased in both groups,with a greater decrease in the Chinese medicine group than in the conventional group(P<0.05).Before treatment,there were no statistically significant differences in miR-29a,ICAM-1,and rheology between the two groups(P>0.05).After treatment,ICAM-1 and whole blood high/low shear viscosity,FIB,platelet aggregation rate,and plasma viscosity decreased in both groups,with a bigger drop in the Chinese medicine group than in the conventional group(P<0.05).As compared with the baseline,miR-29a did not differ statistically between the two groups(P>0.05).Before treatment,there were no statistically significant differences in 6min walking distance and Chinese medicine symptom scores between the two groups.After treatment,6 min walking distance increased in both groups,with a greater increase in the Chinese medicine group than in the conventional group(P<0.05);Chinese medicine symptom scores decreased in both groups,with a greater decrease in the Chinese medicine group than in the conven-tional group(P<0.05).The glyceryl trinitrate reduction rate was higher in the Chinese medicine group(79.49%,31/39 cases)than in the conventional group(56.41%,22/39 cases),and the incidence of adverse reactions did not differ statistically between the Chinese medicine group and the conventional group(7.69%vs.5.13%,3/39 vs.2/39 cases;P>0.05).Conclusions Ginkgolides drops for stable angina improve the degree of myocardial ischaemia and blood rheology,reduce angina attacks,lower ICAM-1 levels,and increase the rate of nitroglycerin discontinua-tion or reduction.
3.Clinical Study on Xuanbai Chengqi Decoction in the Treatment of Severe Pneumonia Complicated with Gastrointestinal Dys-function of Lung Heat and FU-Organ Repletion Type
Guisong ZHU ; Xiaofang YIN ; Hong ZHU ; Rong JIA ; Zimeng ZOU ; Biao XU
Journal of Nanjing University of Traditional Chinese Medicine 2024;40(8):831-837
OBJECTIVE To explore the effect of Xuanbai Chengqi Decoction on respiratory and oxygenation functions and the ex-pression levels of serum aquaporin(AQP)1 and AQP5 in patients with severe pneumonia complicated with gastrointestinal dysfunction of lung heat and fu-organ repletion type.METHODS 60 patients with severe pneumonia complicated with gastrointestinal dysfunc-tion of lung heat and fu-organ repletion type were randomly divided into control group and treatment group,with 30 cases each.The control group received standardized Western medicine treatment,and the treatment group was treated with Xuanbai Chengqi Decoction in addition to the control group.Both groups were treated for 7 d.The respiratory rate and oxygenation index,mechanical ventilation u-tilization rate,the clinical score including CURB-65 and CPIS scores,TCM syndrome score,gastrointestinal function indicators inclu-ding intra-abdominal pressure,serum gastrin(GAS)and vasoactive intestinal peptide(VIP),AQP1 and AQP5 levels were compared between the two groups before and after treatment.Ventilation utilization and ICU hospitalization days during treatment were compared between the two groups.RESULTS After treatment,compared with the control group,the respiratory rate,TCM syndrome score and intra-abdominal pressure in the treatment group were decreased significantly(P<0.05,P<0.01);meanwhile,the oxygenation index and the levels of serum GAS,AQP1 and AQP5 were increased significantly(P<0.05,P<0.01).CONCLUSION Xuanbai Chengqi Decoction can significantly improve clinical symptoms such as respiratory and oxygenation functions in patients,and its mechanism may be related to the regulation of AQP1 and AQP5.
4.Clinical characteristics and curative effect of high myopia dome-shaped macula complicated with choroidal neovascularization
Xiaofang YIN ; Zuke YE ; Minhui WU ; Xiurong TANG ; Shuke LUO ; Yan LU
Chinese Journal of Ocular Fundus Diseases 2024;40(9):706-712
Objective:To observe the clinical features of high myopia domed-shaped macula (DSM) complicated with choroidal neovascularization (CNV) and the efficacy of intravitreal injection of anti-vascular endothelial growth factor (VEGF).Methods:A retrospective clinical study. A total of 23 eyes of 23 patients with high myopia DSM combined with CNV diagnosed by ophthalmology examination in Department of Ophthalmology of The Second People's Hospital of Foshan from January 2019 to December 2023 were included in the study.Best corrected visual acuity (BCVA), intraocular pressure, optical coherence tomography (OCT) were performed in all eyes. BCVA tests are performed using the international standard visual acuity chart, which was statistically converted to logarithm of the minimum angle of resolution (logMAR) visual acuity. DSM height, central macular thickness (CMT) and choroidal thickness (ChT) were measured by OCT. According to OCT image features, DSM was divided into horizontal and vertical elliptic bulges and circular bulges. According to the literature standard, CNV was divided into subfoveal CNV and parafoveal CNV. All patients were treated with 0.05 ml intravitreal injection of ranibizumab or conbercept (IVR or IVC). The treatment regimen was 1+ on-demand treatment. The first IVR and IVC treatment were performed on 17 eyes and 6 eyes, respectively, and were divided into IVR group and IVC group. Follow-up time ≥1 month after treatment. The clinical features of the patients and the changes of BCVA, intraocular pressure, CMT and ChT after treatment were observed. Independent sample t test was used for comparison between groups. Results:There were 23 eyes in 23 cases, 7 males had 7 eyes and 16 females had 16 eyes. There were 11 and 12 eyes in the right and left eyes respectively. Age were (49±16) years old; logMAR BCVA was 0.94±0.39. Shapes of DSM were in 13 (56.52%, 13/23), 6 (26.09%, 6/23), and 4 (17.39%, 4/23) eyes, respectively. The dome height was (97.83±46.14) μm. CMT and ChT were (276.39±98.35) and (49.48±31.66) μm, respectively. There were 17 eyes in the IVR group, including 4 males and 13 females. There were 6 cases in the IVC group, 3 cases were male and 3 cases were female. At the last follow-up, logMAR BCVA and CMT were 0.60±0.39 and (209.96±71.38) μm, respectively. BCVA was significantly increased and CMT was significantly decreased compared with before treatment, with statistical significance ( t=2.98, 2.62; P=0.005, 0.010). One month after treatment and at the last follow-up, there were no significant differences in the degree of BCVA improvement ( t=1.47, 1.35), intraocular pressure change ( t=-0.20, -0.56) and ChT reduction thickness ( t=0.80, -0.62) between IVR group and IVC group ( P>0.05). At 1 month after treatment and last follow-up, the CMT of patients in IVR group and IVC group was decreased by (57.94±67.61), (83.17±78.37) μm and (13.33±9.73), (18.17±17.88) μm compared with that before treatment, respectively, and the differences were statistically significant ( t=2.64, 3.21; P<0.05). Conclusions:IVR or IVC in the treatment of high myopia DSM combined with CNV can effectively improve BCVA. The reduction of CMT with ranibizumab is better than conbercept.
5.Association between HLA-B*27:04 and genetic susceptibility to ankylosing spondylitis in Hunan Province
Xiaofang LU ; Ling WAN ; Kevin ZOU ; Liang TAN ; Quan ZHU ; Rongjiao LIU ; Xiangli YIN ; Zixuan SONG ; Leiyan WEI ; Zhiqing XIANG ; Yizhou ZOU
Journal of Central South University(Medical Sciences) 2023;48(12):1804-1811
Objective:Human leukocyte antigen(HLA)B27 is a susceptibility allele of ankylosing spondylitis(AS),and HLA-B27 antigen typing is an important indicator for clinical diagnosis of AS,but current typing methods such as sequence specific primer polymerase chain reaction(PCR-SSP)still possess limitation.Therefore,this study aims to analyze the correlation between B27 subtypes and susceptibility to AS in Hunan Province by applying high-resolution polymerase chain reaction-sequence-based typing(PCR-SBT). Methods:Peripheral blood of 116 patients with suspected AS(suspected AS group)and 121 healthy volunteers(control group)admitted to the Second Xiangya Hospital from January 2020 to December 2020 were collected for HLA-B genotyping by PCR-SBT.Among the patients in the suspected AS group,23 patients were finally diagnosed with AS(confirmed AS group),and the remaining 93 undiagnosed patients served as the non-confirmed AS group.PCR-SBT and PCR-SSP were used to detect HLA-B27 typing in 116 patients with suspected AS,and the results of the 2 methods were compared. Results:The HLA-B27 allele frequency in the suspected AS group was significantly higher than that in the control group[11.63%vs 2.48%;P<0.001,odds ratio(OR)=5.18,95%confidence interval(CI)2.097 to 12.795].B*27:04,B*27:05,B*27:06,and B*27:07 were detected in the suspected AS group and the control group.The frequency of the B*27:04 allele in the suspected AS group was significantly higher than that in the control group(9.48%vs 1.24%;P<0.001,OR=8.346,95%CI 2.463 to 28.282).The positive rate of B27 in the suspected AS group and the confirmed AS group(B27+/+ and B27+/-)was significantly higher than that in the control group(χ2=16.579,P<0.001;χ2=94.582,P<0.001,respectively).Among the confirmed AS group,21 were HLA-B27 carriers,and the B27 positive rate in the confirmed AS group was 91.3%.PCR-SBT could achieve high resolution typing of the HLA-B gene locus,with higher sensitivity,specificity,positive predictive value,negative predictive value,and accuracy than PCR-SSP. Conclusion:PCR-SBT typing analysis shows a strong correlation between HLA-B * 27:04 and AS in Hunan province.The PCR-SBT method can be used as the preferred option for the auxiliary diagnosis of clinical AS.
6.Effect of superior cervical ganglion block on cardiac function and NLRP3 signaling pathway in a rat model of myocardial ischemia-reperfusion
Ziwei GUO ; Xiaofang LI ; Hongwei ZHANG ; Teng FAN ; Xueying ZHANG ; Yumiao WANG ; Xin YANG ; Mengli YANG ; Jie YIN ; Li LI ; Xiuqin YUE
Chinese Journal of Anesthesiology 2023;43(5):597-601
Objective:To evaluate the effect of superior cervical ganglion block (SCGB) on cardiac function and nucleotide like receptor protein 3 (NLRP3) signaling pathway in a rat model of myocardial ischemia-reperfusion (I/R).Methods:Sixty healthy SPF male Sprague-Dawley rats, weighing 250-300 g, aged 2-3 months, were divided into 4 groups ( n=15 each) using a random number table method: sham operation group (sham group), myocardial I/R group (IR group), myocardial I/R + normal saline group (IR+ NS group), and myocardial I/R + SCGB group (IR+ SCGB group). Myocardial I/R model was developed by ligation of the left anterior descending branch of the coronary artery for 45 min followed by restoration of blood flow in anesthetized aninals. IR+ SCGB group received SCGB (0.25% ropivacaine 0.1 ml) at 10 min before reperfusion once a day for 2 consecutive weeks, while 0.9% sodium chloride was given instead of ropivacaine in IR+ NS group. Blood samples were collected at 24 h and 14 days of reperfusion for determination of serum concentrations of norepinephrine (NE), troponin T (TnT), tumor necrosis factor-alpha (TNF-α), interleukin-18 (IL-18) and IL-1β by enzyme-linked immunosorbent assay. Echocardiography was performed before ischemia and at 14 days of reperfusion, and left ventricular short axis shortening rate (FS), ejection fraction (EF), and cardiac output (CO) were measured. The rats were sacrificed at 14 days of reperfusion and the hearts were taken for determination of the contents of norepinephrine (NE) in myocardial tissues in the infarction area (by enzyme-linked immunosorbent assay), percentage of myocardial fibrosis area (by Masson staining), M1 macrophage marker CD68 + cell count in the infarction area (by immunohistochemical method), and expression of NLRP3 and gasdermin D (GSDMD) in myocardial tissues (by Western blot). Results:Compared with Sham group, the serum concentrations of TnT, TNF-α, IL-18 and IL-1β, percentage of myocardial fibrosis area, and NE levels in serum and myocardial tissues were significantly increased, the expression of NLRP3 and GSDMD in myocardial tissues was up-regulated, CD68 + cell count was increased, and EF, CO and FS were decreased in IR group ( P<0.05). Compared with IR group, the serum concentrations of TnT, TNF-α, IL-18 and IL-1β, percentage of myocardial fibrosis area, and NE levels in serum and myocardial tissues were significantly decreased, the expression of NLRP3 and GSDMD in myocardial tissues was down-regulated, CD68 + cell count was decreased, and EF, CO and FS were increased in IR+ SCGB group ( P<0.05), and no statistically significant changes were found in the parameters mentioned above in IR+ NS group ( P>0.05). Conclusions:SCGB can improve the cardiac function in a rat model of myocardial I/R, and the mechanism may be related to the inhibition of NLRP3 signaling pathway.
7.Analysis of related factors of cerebral collateral circulation in patients with acute cerebral infarction
Na ZHANG ; Guangbo ZHANG ; Xiaofang YIN ; Kai YU ; Ruijun JI
Chinese Journal of Postgraduates of Medicine 2023;46(12):1067-1071
Objective:To investigate the related factors of cerebral collateral circulation in patients with acute cerebral infarction (ACI).Methods:A retrospective study was conducted on 4 483 inpatients with ACI admitted to the Renqiu Kangji Xintu Hospital from January 2014 to November 2018 were selected as the research subjects. According to transcranial Doppler (TCD) and CT angiography(CTA) examination results, they were divided into the group with collateral circulation (154 cases) and the group without collateral circulation (4 329 cases) according to the presence of collateral circulation. The related factors affecting the formation of cerebral collateral circulation in the two groups were statistically analyzed. According to the Modified Rankin Scale (mRS) score, 0 - 1 score was defined as good discharge outcome, and mRS ≥ 3 scores was defined as bad discharge outcome. The relationship between collateral circulation opening and poor discharge outcome was analyzed.Results:Compared with the group without collateral circulation, age: 67.00 (61.00, 73.00) years vs. 65.00 (57.00, 72.00) years, history of stroke: 52.59% (81/154) vs. 32.08% (1 389/4 329), carotid artery stenosis: 85.71% (132/154) vs. 20.23%(876/4 329), homocysteine (Hcy): 16.85 (13.00, 28.03) μmol/L vs. 15.00 (11.00, 21.00) μmol/L, significantly promoted the formation of collateral circulation, and the differences were statistically significant ( P<0.05). After adjusting for confounding factors, age ( OR = 0.97, 95% CI 0.95 - 0.99), stroke history ( OR = 1.60, 95% CI 1.11 - 2.32), carotid artery stenosis ( OR = 23.63, 95% CI 14.64 -38.11) and Hcy ( OR = 1.01, 95% CI 1.00 -1.02) were independent factors promoting the formation of cerebral collateral circulation in ACI patients ( P<0.05), carotid artery stenosis was a significant promoting factor, OR value was 23.63. Receiver operating characteristic (ROC) curve analysis showed that the model predicted the area under the curve value of cerebral collateral circulation opening reached 0.869. Among 4 483 ACI patients, 798 cases (17.80%) had poor discharge outcome, including 18 cases (11.68%) with collateral circulation and 780 cases (18.01%) without collateral circulation, suggesting that the incidence of adverse discharge outcome was lower in the group with collateral circulation ( P<0.05), OR = 0.60, 95% CI 0.36 - 0.99, suggesting that the formation of cerebral collateral circulation was a factor promoting the good prognosis of ACI patients. Conclusions:Age, history of stroke, carotid artery stenosis and Hcy are correlated with the formation of cerebral collateral circulation in ACI patients. Existing model can effectively predict the formation of cerebral collateral circulation in ACI patients, and the formation of cerebral collateral circulation is closely related to the discharge outcome of ACI patients.
8.Validation the clinical value of good outcome following attempted resuscitation scores in Chinese populations in predicting the prognosis of in-hospital cardiac arrest
Yan REN ; Li YE ; Xia HUANG ; Xia GAO ; Guoping YIN ; Xiaofang WU ; Wenbin HUANG ; Linghong CAO ; Ping XU
Chinese Critical Care Medicine 2022;34(12):1238-1242
Objective:To verify the clinical value of the good outcome following attempted resuscitation (GO-FAR) score in predicting the neurological status of patients with in-hospital cardiac arrest (IHCA) in the Chinese population.Methods:The clinical data of patients with IHCA who were admitted to the Zigong Fourth People's Hospital from January 1 to December 31, 2020 were retrospectively analyzed. Used Glasgow-Pittsburgh cerebral performance category (CPC) score 1 point as the end point, the subjects were divided into 4 groups according to the score: ≤ 0 group, 1-8 group, 9-20 group and ≥ 21 group. Taken the group which GO-FAR score ≤ 0 as the reference group, the odds ratio ( OR) of the other three groups compared with this group was calculated. The receiver operator characteristic curve (ROC curve) was performed to evaluate the predictive value of the GO-FAR score in favorable neurological outcome. A calibration curve was drawn for the Hosmer-Lemeshow test to analyze the degree of calibration of the GO-FAR score for predicting good neurological outcome. Results:A total of 230 IHCA patients were enrolled in the study, including 130 males, aged 74 (65, 81) years old, and 23 case (10.0%) had good neurological prognosis. There were statistically significant differences in GO-FAR-related variables, including age, a normal neurological function on admitted, acute stroke, metastatic cancer, septicemia, medical noncardiac admission, hepatic insufficiency, hypotension, renal insufficiency or dialysis, respiratory insufficiency, pneumonia, etc (all P < 0.05). Taken the GO-FAR score ≤ 0 group as the reference group, the OR values of good neurological prognosis in the GO-FAR score 1-8 group were 0.54 [95% confidence interval (95% CI) was 0.17-1.53, P = 0.250], 9-20 group were 0.17 (95% CI was 0.02-0.67, P = 0.009) and ≥ 21 group were 0.25 (95% CI was 0.05-0.85, P = 0.025). The area under the ROC curve (AUC) of the GO-FAR score for predicting favorable neurological outcome in IHCA patients was 0.653 (95% CI was 0.529-0.777, P = 0.015) and there was no significant difference in Hosmer-Lemeshow test ( P = 0.311). All these suggested that there was no significant difference between the predicted value and the actual value. Conclusions:GO-FAR score can be applied to predict neurological prognosis of IHCA patients in Chinese population. It can help clinicians to predict the prognosis of cardio-pulmonary resuscitation (CPR) and propose critical recommendations in treatment for these patients or their families.
9.Long-term prognosis effects of single and staged percutaneous coronary intervention in patients with multi-vessel coronary artery disease
Yuanliang MA ; Na XU ; Chunlin YIN ; Yi YAO ; Xiaofang TANG ; Sida JIA ; Ce ZHANG ; Ying SONG ; Jingjing XU ; Xueyan ZHAO ; Yin ZHANG ; Jue CHEN ; Yuejin YANG ; Shubin QIAO ; Runlin GAO ; Bo XU ; Jinqing YUAN
Chinese Journal of Postgraduates of Medicine 2022;45(1):6-13
Objective:To compare the influence of single and staged percutaneous coronary intervention (PCI) on long-term prognosis in patients with multi-vessel coronary artery disease.Methods:Using prospective research methods, 1 832 patients with multi-vessel coronary artery disease from January to December 2013 in Fuwai Hospital, Chinese Academy of Medical Sciences were selected. According to the time of PCI, the patients were divided into single PCI group (1 218 cases) and staged PCI group (614 cases). The patients were followed up for 2 years, the primary endpoint was major cardiovascular and cerebrovascular event (MACCE), including target vessel-related myocardial infarction (TV-MI), target vessel-related revascularization (TVR), cardiogenic death and stroke, and the secondary endpoint was stent thrombosis. The propensity score matching (PSM) was applied to balance the discrepancies between 2 groups, and the baseline and follow-up data were compared. The Kaplan-Meier survival curves were drawn to evaluate the survival rates events; multifactor Cox proportional risk regression was used to analyze whether staged PCI was an independent risk factor for the endpoint events.Results:The in-hospital stay, duration of procedure and synergy between percutaneous coronary intervention with taxus and cardiac surgery (SYNTAX) score in single PCI group were significantly lower than those in staged PCI group: (5.54±3.09) d vs. (9.50±4.06) d, (43.12±28.55) min vs. (79.54±44.35) min, (14.04±7.63) scores vs. (18.51±7.79) scores, and there were statistical differences ( P<0.01); there were no statistical difference in complete revascularization rate and SYNTAX score after PCI between 2 groups ( P>0.05). Based on 2-year follow-up, the incidences of TV-MI and stent thrombosis in staged PCI group were significantly higher than those in single PCI group: 2.1% (13/614) vs. 0.5% (6/1 218) and 2.0% (12/614) vs. 0.4% (5/1 218), and there were statistical differences ( P<0.01). Kaplan-Meier survival curves analysis results showed that the event-free survival rates of TV-MI and stent thrombosis in single PCI group were better than those in staged PCI group (99.5% vs. 97.9% and 99.6% vs. 98.0%, P<0.01). Multifactor Cox proportional risk regression analysis results showed that staged PCI was an independent risk factor for stent thrombosis ( HR = 3.91, 95% CI 1.25 to 12.18, P = 0.019). After PSM, the incidences of TV-MI and stent thrombosis in staged PCI group were significantly higher than those in single PCI group: 2.1% (13/614) vs. 0.7% (4/614) and 2.0% (12/614) vs. 0.5% (3/614), and there were statistical differences ( P<0.05); Kaplan-Meier survival curve analysis results showed that the event-free survival rates of TV-MI and stent thrombosis in single PCI group were significantly higher than those in staged PCI group: (99.3% vs. 97.9% and 99.5% vs. 98.0%, P<0.05); multifactor Cox proportional risk regression analysis results showed that staged PCI was not an independent risk factor of stent thrombosis ( HR = 2.29, 95% CI 0.58 to 9.00, P = 0.234). Both before and after PSM, there were no evidences for interaction between the type of angina pectoris and staged PCI ( P>0.05). Conclusions:Although a seemingly increase exists in the incidence of TV-MI and stent thrombosis in the staged PCI group, staged PCI is an independent risk factor neither for MACCE and its components, nor for stent thrombosis. In addition single PCI reduces the in-hospital days and duration of PCI procedure, which may be a relatively reasonable approach to clinical practice.
10.Efficacy of folate-coupled quantum dots immunomagnetic beads method for detecting circulating tumor cells in epithelial ovarian cancer and the association of circulating tumor cells with clinicopathological features
Xiaofang HAN ; Haizhen YIN ; Rong ZHANG ; Jianrong LIU
Cancer Research and Clinic 2021;33(6):440-444
Objective:To explore the effectiveness of folate-coupled quantum dots (FA-QD) immunomagnetic beads method for detecting circulating tumor cells (CTC) in epithelial ovarian cancer and the association of CTC with clinicopathological features of tumor patients.Methods:A total of 67 ovarian cancer patients in Shanxi Provincial People's Hospital from August 2019 to January 2020 were selected. Ovarian cancer SKOV-3 cells were divided into 5 cell number gradients (0, 100, 150, 200, 300), the detection rates of CTC were compared by using epithelial cell adhesion molecule (EpCAM) immunomagnetic beads (single standard method) and FA-QD immunomagnetic beads method (double standard method). The number of CTC in peripheral blood of ovarian cancer patients was detected by using FA-QD immunomagnetic beads method, and those with positive CTC under fluorescence microscope were treated as CTC positive patients. The association of CTC with clinicopathological factors and tumor markers of tumor patients was analyzed.Results:The average capture efficiency rate of CTC in SKOV-3 cells detected by FA-QD immunomagnetic beads method (83.4%) was higher than that by EpCAM immunomagnetic beads method (70.3%). Among 67 patients of ovarian cancer, the proportion of CTC positive patients was 30.0% (3/10) in stage Ⅰ-Ⅱ, 91.9% (34/37) in stage Ⅲ, 95.0% (19/20) in stage Ⅳ, and the difference was statistically significant ( P < 0.05). The proportion of CTC positive patients with lymph node metastasis was higher than that of patients without lymph node metastasis [97.1% (33/34) vs. 69.7% (23/33)], and the difference was statistically significant ( P < 0.05). The proportion of CTC positive patients with human epididymis protein 4 (HE4)>110 pmol/L was lower than that of patients with HE4 ≤ 110 pmol/L [58.8% (10/17) vs. 92.0% (46/50)], and the difference was statistically significant ( P = 0.005). There were no statistically significant differences in the proportion of CTC positive patients stratified by age, menopause, pathological differentiation, distant metastasis, carbohydrate antigen (CA) 125, CA199, carcino-embryonic antigen (CEA) (all P > 0.05). Conclusions:FA-QD immunomagnetic beads method can effectively detect CTC in peripheral blood of patients with epithelial ovarian cancer. The level of CTC in patients with epithelial ovarian cancer is related to lymph node metastasis, clinical TNM stage and HE4 level.

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