Background:Recurrent miscarriage(RM)affects an estimated 1-3%of couples attempting to conceive,and its molecular components stay ineffectively caught on.This study aims to explore potential therapeutic targets for RM ...Background:Recurrent miscarriage(RM)affects an estimated 1-3%of couples attempting to conceive,and its molecular components stay ineffectively caught on.This study aims to explore potential therapeutic targets for RM by examining gene expression patterns and biological pathways in both mouse and human RM models.Meanwhile,explore relevant traditional Chinese medicine(TCM)components targeting potential therapeutic targets.Methods:We utilized the GSE211251 mouse and the GSE26787 human datasets,employing gene set enrichment analysis and gene metaphysics analysis to examine differentially expressed genes and enriched pathways.Single-cell RNA analysis uncovered cellular heterogeneity and arranged pharmacology-mapped potential drug-target intelligence.We employed molecular docking strategies to assess the affinity of TCM components for key proteins.Results:In the mouse model,genes such as Ly6f1 and Gpr26 were upregulated,while Stc5a and Galca exhibited downregulation.Gene set enrichment analysis identified key pathways,including the tumor necrosis factor-mediated signaling pathway.In human samples,Gene Ontology analysis highlighted processes such as apoptosis and cell adhesion.Single-cell RNA analysis revealed distinct cellular populations between normal and RM samples.Systems pharmacology identified C-X-C motif chemokine receptor 4(CXCR4)and endothelin 1(EDN1)as potential key targets,and molecular docking confirmed that stearic acid from TCM appears to regulate these proteins.Conclusion:This study presents a comprehensive analysis of the genetic and cellular underpinnings of RM,identifying CXCR4 and EDN1 as promising therapeutic targets.Stearic acid from TCM could provide targeted treatment by modulating these key proteins,paving the way for new RM treatment strategies.展开更多
OBJECTIVE To access the efficacy and safety of the double-ProGlide technique for the femoral vein access-site closure in cryoballoon ablation with uninterrupted oral anticoagulants(OAC),and its impact on the electroph...OBJECTIVE To access the efficacy and safety of the double-ProGlide technique for the femoral vein access-site closure in cryoballoon ablation with uninterrupted oral anticoagulants(OAC),and its impact on the electrophysiology laboratory time as well as hospital stay after the procedure in this observational study.METHODS Patients with atrial fibrillation undergoing cryoballoon ablation with uninterrupted OAC at Department of Cardiology,Beijing Anzhen Hospital,Capital Medical University,Beijing,China from May 2019 to May 2021 were enrolled in this study.From October 2020,double-ProGlide technique was consistently used for hemostasis(ProGlide group),and before that conventional manual compression was utilized(manual compression group).The occurrence of vascular and groin complications was accessed during the hospital stay and until the three-month follow-up.RESULTS A total of 140 participants(69.30%of male,mean age:59.21±10.29 years)were evaluated,70 participants being in each group.Immediate hemostasis was achieved in all the patients with ProGlide closure.No major vascular complications were found in the ProGlide group while two major vascular complications were occurred in the manual compression group.The incidence of any groin complication was obviously higher in subjects with manual compression than patients with ProGlide devices(15.71%vs.2.86%,P=0.009).In addition,compared with the manual compression group,the ProGlide group was associated with significantly shorter total time in the electrophysiology laboratory[112.0(93.3–128.8)min vs.123.5(107.3–158.3)min,P=0.006],time from sheath removal until venous site hemostasis[3.8(3.4–4.2)min vs.8.0(7.6–8.5)min,P<0.001],bed rest time[8.0(7.6–8.0)h vs.14.1(12.0–17.6)h,P<0.001]and hospital stay after the procedure[13.8(12.5–17.8)h vs.38.0(21.5–41.0)h,P<0.001].CONCLUSIONS Utilization of the double-ProGlide technique for hemostasis after cryoballoon ablation with uninterrupted OAC is feasible and safe,which has the clinical benefit in reducing the total electrophysiology laboratory time and the hospital stay length after the procedure.展开更多
Pulmonary embolism(PE),a form of venous thromboembolism,is a relatively frequent car-diovascular emergency,and a potentially life-threatening condition that needs prompt identification and treatment.[1]PE is often mis...Pulmonary embolism(PE),a form of venous thromboembolism,is a relatively frequent car-diovascular emergency,and a potentially life-threatening condition that needs prompt identification and treatment.[1]PE is often misdiagnosed or unrecogn-ized with many patients experiencing atypical sympt-oms.[2,3]Early diagnosis and treatment of PE are import-ant.In this case,PE was found in a 73-year-old male pa-tient with three-vessel coronary artery disease who un-derwent percutaneous coronary intervention(PCI)for concomitant acute myocardial infarction(MI).展开更多
Background The computational fluid dynamics(CFD)approach has been frequently applied to compute the fractional flow reserve(FFR)using computed tomography angiography(CTA).This technique is efficient.We developed the D...Background The computational fluid dynamics(CFD)approach has been frequently applied to compute the fractional flow reserve(FFR)using computed tomography angiography(CTA).This technique is efficient.We developed the DEEPVESSEL-FFR platform using the emerging deep learning technique to calculate the FFR value out of CTA images in five minutes.This study is to evaluate the DEEPVESSEL-FFR platform using the emerging deep learning technique to calculate the FFR value from CTA images as an efficient method.Methods A single-center,prospective study was conducted and 63 patients were enrolled for the evaluation of the diagnostic performance of DEEPVESSEL-FFR.Automatic quantification method for the three-dimensional coronary arterial geometry and the deep learning based prediction of FFR were developed to assess the ischemic risk of the stenotic coronary arteries.Diagnostic performance of the DEEPVESSEL-FFR was assessed by using wire-based FFR as reference standard.The primary evaluation factor was defined by using the area under receiver-operation characteristics curve(AUC)analysis.Results For per-patient level,taking the cut-off value<0.8 referring to the FFR measurement,DEEPVESSEL-FFR presented higher diagnostic performance in determining ischemia-related lesions with area under the curve of 0.928 compare to CTA stenotic severity 0.664.DEEPVESSEL-FFR correlated with FFR(R=0.686,P<0.001),with a mean di&ference of-0.006士0.0091(P=0.619).The secondary evaluation factors,indicating per vessel accuracy,sensitivity,specificity,positive predictive value,and negative predictive value were 87.3%,97.14%,75%,82.93%,and 95.45%,respectively.Conclusion DEEPVESSEL-FFR is a novel method that allows efficient assessment of the functional significance of coronary stenosis.展开更多
Background Coronary artery calcification （CAC） is a predictor of cardiovascular events and plaque burden and is closely associatedwith chronic inflammation. Intedeukin （IL）-37 is a newly discovered member of the I...Background Coronary artery calcification （CAC） is a predictor of cardiovascular events and plaque burden and is closely associatedwith chronic inflammation. Intedeukin （IL）-37 is a newly discovered member of the IL-1 family and is considered an anti-inflammatorycytokine. Our recent study on mice indicated that IL-37 could attenuate atherosclerosis and vascular calcification, which suggests that IL-37could be associated with the development of atherosclerosis and related diseases. The aim of this study was to investigate if IL-37 plays arole in the progression of CAC in patients. Methods Two hundred participants with suspected cardiovascular disease were recruited. Thelevels of plasma IL-37, osteoprotegerin （OPG）, hypersensitive C-reactive protein （hsCRP） together with other biochemical parameters weremeasured, and a coronary calcium assessment was carried out by multi-detector row CT. A score of 〈 10 AU （Agatston units） denotes anabsence of CAC, a score of 11-100 AU denotes mild CAC, 101-400 denotes moderate CAC, and 〉 400 AU denotes severe CAC. ResultsOur initial data showed that there were no apparent differences in plasma IL-37 levels among patients with or without mild or moderate CAC.However, IL-37 levels were significantly increased in patients with severe CAC （P 〈 0.001）. Similar results were observed for plasma OPGand hsCRP levels. When IL-37 levels in patients with severe calcification were compared with that in all of the other non-severe CAC groups,it became apparent that there was a significant positive correlation between IL-37 level and severe CAC （r = 0.360, P 〈 0.001; OR = 1.033）using Spearrnan＇s correlation and binary logistic regression analysis. Conclusions This study demonstrates that the anti-inflammatory cy-tokine IL-37 is associated with high coronary calcium levels, suggesting that IL-37 expression may be caused by the activation ofinf/amma-tion and that IL-37 might become a predictor of severe CAC in the future, which requires further investigation.展开更多
BACKGROUND Syphilis is a common sexually transmitted disease caused by the Treponema pallidum (T.pallidum).Malignant syphilis is a rare presentation of secondary syphilis.Here,we present a case diagnosed with malignan...BACKGROUND Syphilis is a common sexually transmitted disease caused by the Treponema pallidum (T.pallidum).Malignant syphilis is a rare presentation of secondary syphilis.Here,we present a case diagnosed with malignant syphilis accompanied with neurosyphilis.CASE SUMMARY A 56-year-old man present with a 2-mo history of spreading ulcerous and necrotic papules and nodules covered with thick crusts over the face,trunk,extremities,and genitalia.The patient was diagnosed with malignant syphilis accompanied by neurosyphilis based on the characteristic morphology of the lesions,positive serological and cerebrospinal fluid tests for syphilis,brain magnetic resonance imaging,and histopathology,along with resolution of the lesions following the institution of penicillin therapy.The lesions and neurological condition successfully resolved after a course of treatment with penicillin.CONCLUSION We suggest that neurosyphilis should be considered whenever people have psychiatric symptoms without cutaneous lesions or human immunodeficiency virus.展开更多
AIM: To investigate whether posture affects the accuracy of 13C-urea breath test(13C-UBT) for Helicobacter pylori(H. pylori) detection in partial gastrectomy patients. METHODS: We studied 156 consecutive residual stom...AIM: To investigate whether posture affects the accuracy of 13C-urea breath test(13C-UBT) for Helicobacter pylori(H. pylori) detection in partial gastrectomy patients. METHODS: We studied 156 consecutive residual stomach patients, including 76 with H. pylori infection(infection group) and 80 without H. pylori infection(control group). H. pylori infection was confirmed if both the rapid urease test and histology were positive during gastroscopy. The two groups were divided into four subgroups according to patients' posture during the 13C-UBT: subgroup A, sitting position; subgroup B, supine position; subgroup C, right lateral recumbent position; and subgroup D, left lateral recumbent position. Each subject underwent the following modified 13C-UBT: 75 mg of 13C-urea(powder) in 100 m L of citric acid solution was administered, and a mouth wash was performed immediately; breath samples were then collected at baseline and at 5-min intervals up to 30 min while the position was maintained. Seven breathsamples were collected for each subject. The cutoff value was 2.0‰.RESULTS: The mean delta over baseline(DOB) values in the subgroups of the infection group were similar at 5 min(P > 0.05) and significantly higher than those in the corresponding control subgroups at all time points(P < 0.01). In the infection group, the mean DOB values in subgroup A were higher than those in other subgroups within 10 min and peaked at the 10-min point(12.4‰± 2.4‰). The values in subgroups B and C both reached their peaks at 15 min(B, 13.9‰± 1.5‰; C, 12.2‰± 1.7‰) and then decreased gradually until the 30-min point. In subgroup D, the value peaked at 20 min(14.7‰± 1.7‰). Significant differences were found between the values in subgroups D and B at both 25 min(t = 2.093, P = 0.043) and 30 min(t = 2.141, P = 0.039). At 30 min, the value in subgroup D was also significantly different from those in subgroups A and C(D vs C: t = 6.325, P = 0.000; D vs A: t = 5.912, P = 0.000). The mean DOB values of subjects with Billroth Ⅰ anastomosis were higher than those of subjects with Billroth Ⅱ anastomosis irrespectively of the detection time and posture(P > 0.05).CONCLUSION: Utilization of the left lateral recumbent position during the procedure and when collecting the last breath sample may improve the diagnostic accuracy of the 13C-UBT in partial gastrectomy patients.展开更多
BACKGROUND Triglyceride(TG)and its related metabolic indices,all recognized as surrogates of insulin resistance,have been demonstrated to be relevant to clinical prognosis.However,the relative value of these TG-relate...BACKGROUND Triglyceride(TG)and its related metabolic indices,all recognized as surrogates of insulin resistance,have been demonstrated to be relevant to clinical prognosis.However,the relative value of these TG-related indices for predicting cardiovascular events among patients with acute coronary syndrome(ACS)has not been examined.METHODS The TG,the triglyceride-glucose(TyG)index,the atherogenic index of plasma,TG to high-density lipoprotein cholesterol ratio,and the lipoprotein combine index were assessed in 1694 ACS patients undergoing percutaneous coronary intervention.The primary endpoint was major adverse cardiovascular event(MACE),which was the composite of all-cause mortality,stroke,myocardial infarction,or unplanned repeat revascularization.RESULTS During a median follow-up of 31 months,345 patients(20.4%)had MACE.The risk of the MACE was increased with higher TG and the four TG-derived metabolic indices[TG-adjusted hazard ratio(HR)=1.002,95%CI:1.001-1.003;TyG index-adjusted HR=1.736,95%CI:1.398-2.156;atherogenic index of plasma-adjusted HR=2.513,95%CI:1.562-4.043;TG to high-density lipoprotein cholesterol ratio-adjusted HR=1.148,95%CI:1.048-1.258;and lipoprotein combine index-adjusted HR=1.009,95%CI:1.004-1.014;P<0.001 for all indices].TG and all the four indices significantly improved the predictive ability for MACE in addition to the baseline model.Among them,TyG index showed the best ability for predicting MACE compared with the other three indices from all the three measurements(P<0.05 for all comparison).CONCLUSIONS TG and TG-derived metabolic indices were all strongly associated with MACE among ACS patients undergoing percutaneous coronary intervention.Among all the indices,TyG index showed the best ability to predict the risk of MACE.展开更多
OBJECTIVE To determine the association of serum complement C1q levels with cardiovascular outcomes among patients with acute coronary syndrome(ACS)undergoing percutaneous coronary intervention(PCI),and evaluate the va...OBJECTIVE To determine the association of serum complement C1q levels with cardiovascular outcomes among patients with acute coronary syndrome(ACS)undergoing percutaneous coronary intervention(PCI),and evaluate the value of C1q modified by high-sensitivity C-reactive protein(hs-CRP)levels as an independent predictor.METHODS As a single-center prospective observational study,we analyzed 1701 patients who had received primary or elective PCI for ACS at Beijing Anzhen Hospital,Capital Medical University,Beijing,China between June 1,2016 and November 30,2017.The associations of C1q modified by hs-CRP with major adverse cardiovascular events(MACE)were determined in survival analysis.RESULTS Patients with the lowest C1q tertile had the highest cumulative risk of MACE(log-rank P=0.007).In fully adjusted Cox regression models,stratifying the total population according to hs-CRP dichotomy,C1q was significantly associated with MACE in patients with hs-CRP levels less than 2 mg/L but not in those with 2 mg/L or more(P_(interaction)=0.02).In patients with hs-CRP levels less than 2 mg/L,with the lowest C1q tertile as reference,the risk of MACE was reduced by 40.0%in the middle C1q tertile[hazard ratio(HR)=0.600,95%CI:0.423–0.852,P=0.004]and by 43.9%in the highest C1q tertile(HR=0.561,95%CI:0.375–0.840,P=0.005).CONCLUSIONS Serum complement C1q is significantly associated with cardiovascular outcomes in patients with ACS undergoing PCI,only when hs-CRP levels are less than 2 mg/L.This finding implicates the usefulness of C1q for the risk stratification in ACS patients with reduced systemic inflammation.展开更多
BACKGROUND Rhinocerebral mucormycosis(RCM)is a rare fatal fungal infection which is on the increase among immunocompromised hosts such as patients who have had hematological cancers,or have received immunosuppressive ...BACKGROUND Rhinocerebral mucormycosis(RCM)is a rare fatal fungal infection which is on the increase among immunocompromised hosts such as patients who have had hematological cancers,or have received immunosuppressive drugs,corticosteroids,or other T cell suppressing agents.CASE SUMMARY We report a case of RCM caused by Rhizopus oryzae,one of the most common opportunistic pathogens,in a patient suffering from a fourth relapse of acute myeloid leukemia.The patient developed RCM after he had received long-term antibiotic agents and corticosteroids.The pathogen was isolated three times from nasal secretions collected from the deep parts of the nasal cavity and was identified by morphology and internal transcribed spacer sequencing.Blood infection was excluded by droplet digital polymerase chain reaction and blood culture.The patient was empirically treated with caspofungin and voriconazole for several days while the lesions continued to progress.The patient was given amphotericin B in combination with caspofungin after RCM was suspected,and the lesions improved over the course of treatment,which lasted several days.However,the patient eventually died of the primary disease.CONCLUSION This case indicates that immunosuppressive drugs,including corticosteroids and antimetabolites in hematological tumor,do increase the risk of infections of this type.Early diagnosis,prompt and frequent surgical debridement,and treatment with amphotericin B without delay are all essential in combatting RCM.展开更多
Erratum to:J Zhejiang Univ-Sci B(Biomed&Biotechnol)201920(10):816-827 https://doi.org/10.1631/jzus.B1900071The original version of this article unfortunately contained a mistake.In p.823,Figs.8 c and 8 d were inco...Erratum to:J Zhejiang Univ-Sci B(Biomed&Biotechnol)201920(10):816-827 https://doi.org/10.1631/jzus.B1900071The original version of this article unfortunately contained a mistake.In p.823,Figs.8 c and 8 d were incorrect,and the obvious pathological changes were mistakenly placed in the picture.展开更多
Objective: The present study was designed to evaluate whether and how itraconazole affects the macrophage polarization and its reactivity to Candida albicans. Methods: Cell toxicity of itraconazole was measured using ...Objective: The present study was designed to evaluate whether and how itraconazole affects the macrophage polarization and its reactivity to Candida albicans. Methods: Cell toxicity of itraconazole was measured using cell counting kit-8 assay in RAW264.7 cells. The cell models were induced by lipopolysaccharide (LPS), interleukin (IL)-4, or Candida albicans. Levels of cytokines secreted by RAW246.7 treated with itraconazole were detected by Luminex or Cytometric Bead Array compared to the controls without itraconazole treatment, and the expressions of inducible nitric oxide synthase and arginase (Arg) were determined by Western blot. Phagocytosis ability was measured by both flow cytometry and fluorescence microscope. The Student's t test and one-way analysis of variance were used to calculate the differences between groups. Results: In comparison to the control, itraconazole inhibited the growth of the cells in both a time- and a dosedependent manner. Increased secretion of IL-6 (0.25μmol/L ITZ [538.03±60.23pg/mL, P<0.05], 0.5μmol/L [550.32 ±47.87 pg/mL, P<0.05] and 1 μmol/L [626.95±75.24pg/mL, P<0.01] vs. control [370.43±33.98pg/mL]) and tumor necrosis factor-alpha (TNF-α) (1μmol/L ITZ vs. control: 2521.51±444.06pg/mL vs. 1617.85±94.57 pg/mL, P<0.05) were detected in the LPS-induced cell model with itraconazole treatment. In the cells induced by IL-4, itraconazole increased the secretion of IL-6 (1μmol/L ITZ vs. control: 528.33±11.60pg/mL vs. 466.99±28.32 pg/mL, P<0.05), TNF-α (1μmol/L ITZ vs. control: 4.85±0.32pg/mL vs. 4.30±0.19 pg/mL, P<0.05), and IL-1β (0.25μmol/L [325.95±13.97pg/mL, P<0.05], 0.5μmol/L [332.38±11.97pg/mL, P<0.05] and 1μmol/L [334.35±16.23 pg/mL, P<0.05] vs. control [291.62±17.03pg/mL]), and reduced the secretion of IL-10 (1μmol/L ITZ vs. control: 7.21±0.68 pg/mL vs. 9.11±0.14pg/mL, P<0.05). The secretion of IL-6 (1μmol/L ITZ vs. control: 38.34±1.36pg/mL vs. 32.32± 0.84pg/mL, P<0.05) and TNF-α (1μmol/L ITZ vs. control: 1060.17±80.16pg/mL vs. 890.84±52.82 pg/mL, P<0.01) was improved in Candida albicans-stimulated RAW264.7 cells under the treatment of itraconazole, while the secretion of IL-4 (0.5μmol/L [2.86±0.20 pg/mL, P<0.05] and 1μmol/L [2.24±0.33 pg/mL, P<0.001] vs. control [3.91±0.23 pg/mL]) and IL-10 (1μmol/L ITZ vs. control: 19.46±2.05pg/mL vs. 25.67±1.95pg/mL, P<0.05) decreased. In all three activated patterns, itraconazole enhanced the expression of inducible nitric oxide synthase (P<0.01) and slightly inhibited the Arg-1 expression (P<0.05). Phagocytosis ability of RAW264.7 cells at 1μmol/L ITZ treatment was increased by 7.53%±2.21% (P<0.01) and 9.73%±2.03% (P<0.01) at the ratio of cells: yeast of 1:4 and 1:8, respectively, in comparison to the control group.Itraconazole improved M1 polarization of RAW264.7 cells and enhanced the phagocytic capacity of RAW264.7 to Candida albicans, indicating a significant immunological enhancement. The study improves the understanding of undergoing mechanisms related to the anti-tumor and anti-infection effects of itraconazole.展开更多
Introduction Trichorrhexis nodosa (TN), one of the most common hair shaft anomalies, was first identified by Samuel Wilks in 1852(1)As either a congenital or acquired hair shaft disorder, TN is characterized by fragil...Introduction Trichorrhexis nodosa (TN), one of the most common hair shaft anomalies, was first identified by Samuel Wilks in 1852(1)As either a congenital or acquired hair shaft disorder, TN is characterized by fragile and easily broken hair accompanied by frayed cortical fibers and loss of the cuticle(2)Complete fracture of the hair shaft subsequently occurs. Moreover, hair shaft fragility may increase the risk of developing TN. Congenital TN, including trichothiodystrophy[3], argininosuccinic aciduria[4], Menkes syndrome[5] and trichohepatoenteric syndrome[6], is rare in the clinical setting. Acquired TN, which is provoked by hair injury secondary to physical or chemical trauma (usually physical trauma), is often overlooked in daily life. We herein reported a case of TN in a woman with androgenetic alopecia.展开更多
基金support from the Ningxia Hui Autonomous Region Key Research and Development Program(Project No.2021BEG03041).
文摘Background:Recurrent miscarriage(RM)affects an estimated 1-3%of couples attempting to conceive,and its molecular components stay ineffectively caught on.This study aims to explore potential therapeutic targets for RM by examining gene expression patterns and biological pathways in both mouse and human RM models.Meanwhile,explore relevant traditional Chinese medicine(TCM)components targeting potential therapeutic targets.Methods:We utilized the GSE211251 mouse and the GSE26787 human datasets,employing gene set enrichment analysis and gene metaphysics analysis to examine differentially expressed genes and enriched pathways.Single-cell RNA analysis uncovered cellular heterogeneity and arranged pharmacology-mapped potential drug-target intelligence.We employed molecular docking strategies to assess the affinity of TCM components for key proteins.Results:In the mouse model,genes such as Ly6f1 and Gpr26 were upregulated,while Stc5a and Galca exhibited downregulation.Gene set enrichment analysis identified key pathways,including the tumor necrosis factor-mediated signaling pathway.In human samples,Gene Ontology analysis highlighted processes such as apoptosis and cell adhesion.Single-cell RNA analysis revealed distinct cellular populations between normal and RM samples.Systems pharmacology identified C-X-C motif chemokine receptor 4(CXCR4)and endothelin 1(EDN1)as potential key targets,and molecular docking confirmed that stearic acid from TCM appears to regulate these proteins.Conclusion:This study presents a comprehensive analysis of the genetic and cellular underpinnings of RM,identifying CXCR4 and EDN1 as promising therapeutic targets.Stearic acid from TCM could provide targeted treatment by modulating these key proteins,paving the way for new RM treatment strategies.
基金supported by the National Natural Science Foundation of China(No.81100143)the Beijing Nova Program(Z121107002512053)+4 种基金the Beijing Health System High Level Health Technology Talent Cultivation Plan(No.2013-3-013)the Beijing Outstanding Talent Training Program(No.2014000021223ZK32)the Beijing National Science Foundation(No.7212100)the Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special Funding Support(ZYLX201303)the National Key Clinical Speciality Construction Project。
文摘OBJECTIVE To access the efficacy and safety of the double-ProGlide technique for the femoral vein access-site closure in cryoballoon ablation with uninterrupted oral anticoagulants(OAC),and its impact on the electrophysiology laboratory time as well as hospital stay after the procedure in this observational study.METHODS Patients with atrial fibrillation undergoing cryoballoon ablation with uninterrupted OAC at Department of Cardiology,Beijing Anzhen Hospital,Capital Medical University,Beijing,China from May 2019 to May 2021 were enrolled in this study.From October 2020,double-ProGlide technique was consistently used for hemostasis(ProGlide group),and before that conventional manual compression was utilized(manual compression group).The occurrence of vascular and groin complications was accessed during the hospital stay and until the three-month follow-up.RESULTS A total of 140 participants(69.30%of male,mean age:59.21±10.29 years)were evaluated,70 participants being in each group.Immediate hemostasis was achieved in all the patients with ProGlide closure.No major vascular complications were found in the ProGlide group while two major vascular complications were occurred in the manual compression group.The incidence of any groin complication was obviously higher in subjects with manual compression than patients with ProGlide devices(15.71%vs.2.86%,P=0.009).In addition,compared with the manual compression group,the ProGlide group was associated with significantly shorter total time in the electrophysiology laboratory[112.0(93.3–128.8)min vs.123.5(107.3–158.3)min,P=0.006],time from sheath removal until venous site hemostasis[3.8(3.4–4.2)min vs.8.0(7.6–8.5)min,P<0.001],bed rest time[8.0(7.6–8.0)h vs.14.1(12.0–17.6)h,P<0.001]and hospital stay after the procedure[13.8(12.5–17.8)h vs.38.0(21.5–41.0)h,P<0.001].CONCLUSIONS Utilization of the double-ProGlide technique for hemostasis after cryoballoon ablation with uninterrupted OAC is feasible and safe,which has the clinical benefit in reducing the total electrophysiology laboratory time and the hospital stay length after the procedure.
文摘Pulmonary embolism(PE),a form of venous thromboembolism,is a relatively frequent car-diovascular emergency,and a potentially life-threatening condition that needs prompt identification and treatment.[1]PE is often misdiagnosed or unrecogn-ized with many patients experiencing atypical sympt-oms.[2,3]Early diagnosis and treatment of PE are import-ant.In this case,PE was found in a 73-year-old male pa-tient with three-vessel coronary artery disease who un-derwent percutaneous coronary intervention(PCI)for concomitant acute myocardial infarction(MI).
文摘Background The computational fluid dynamics(CFD)approach has been frequently applied to compute the fractional flow reserve(FFR)using computed tomography angiography(CTA).This technique is efficient.We developed the DEEPVESSEL-FFR platform using the emerging deep learning technique to calculate the FFR value out of CTA images in five minutes.This study is to evaluate the DEEPVESSEL-FFR platform using the emerging deep learning technique to calculate the FFR value from CTA images as an efficient method.Methods A single-center,prospective study was conducted and 63 patients were enrolled for the evaluation of the diagnostic performance of DEEPVESSEL-FFR.Automatic quantification method for the three-dimensional coronary arterial geometry and the deep learning based prediction of FFR were developed to assess the ischemic risk of the stenotic coronary arteries.Diagnostic performance of the DEEPVESSEL-FFR was assessed by using wire-based FFR as reference standard.The primary evaluation factor was defined by using the area under receiver-operation characteristics curve(AUC)analysis.Results For per-patient level,taking the cut-off value<0.8 referring to the FFR measurement,DEEPVESSEL-FFR presented higher diagnostic performance in determining ischemia-related lesions with area under the curve of 0.928 compare to CTA stenotic severity 0.664.DEEPVESSEL-FFR correlated with FFR(R=0.686,P<0.001),with a mean di&ference of-0.006士0.0091(P=0.619).The secondary evaluation factors,indicating per vessel accuracy,sensitivity,specificity,positive predictive value,and negative predictive value were 87.3%,97.14%,75%,82.93%,and 95.45%,respectively.Conclusion DEEPVESSEL-FFR is a novel method that allows efficient assessment of the functional significance of coronary stenosis.
文摘Background Coronary artery calcification （CAC） is a predictor of cardiovascular events and plaque burden and is closely associatedwith chronic inflammation. Intedeukin （IL）-37 is a newly discovered member of the IL-1 family and is considered an anti-inflammatorycytokine. Our recent study on mice indicated that IL-37 could attenuate atherosclerosis and vascular calcification, which suggests that IL-37could be associated with the development of atherosclerosis and related diseases. The aim of this study was to investigate if IL-37 plays arole in the progression of CAC in patients. Methods Two hundred participants with suspected cardiovascular disease were recruited. Thelevels of plasma IL-37, osteoprotegerin （OPG）, hypersensitive C-reactive protein （hsCRP） together with other biochemical parameters weremeasured, and a coronary calcium assessment was carried out by multi-detector row CT. A score of 〈 10 AU （Agatston units） denotes anabsence of CAC, a score of 11-100 AU denotes mild CAC, 101-400 denotes moderate CAC, and 〉 400 AU denotes severe CAC. ResultsOur initial data showed that there were no apparent differences in plasma IL-37 levels among patients with or without mild or moderate CAC.However, IL-37 levels were significantly increased in patients with severe CAC （P 〈 0.001）. Similar results were observed for plasma OPGand hsCRP levels. When IL-37 levels in patients with severe calcification were compared with that in all of the other non-severe CAC groups,it became apparent that there was a significant positive correlation between IL-37 level and severe CAC （r = 0.360, P 〈 0.001; OR = 1.033）using Spearrnan＇s correlation and binary logistic regression analysis. Conclusions This study demonstrates that the anti-inflammatory cy-tokine IL-37 is associated with high coronary calcium levels, suggesting that IL-37 expression may be caused by the activation ofinf/amma-tion and that IL-37 might become a predictor of severe CAC in the future, which requires further investigation.
基金Supported by the National Natural Science Foundation of China,No.81773337the Shandong Traditional Chinese Medicine Science and Technology Development Plans,China,No.2017-415+1 种基金the Medical and Health Science Technology Project of Shandong Province,China,No.2017WS345the Natural Science Foundation of Shandong Province,China,No.ZR2015HL127
文摘BACKGROUND Syphilis is a common sexually transmitted disease caused by the Treponema pallidum (T.pallidum).Malignant syphilis is a rare presentation of secondary syphilis.Here,we present a case diagnosed with malignant syphilis accompanied with neurosyphilis.CASE SUMMARY A 56-year-old man present with a 2-mo history of spreading ulcerous and necrotic papules and nodules covered with thick crusts over the face,trunk,extremities,and genitalia.The patient was diagnosed with malignant syphilis accompanied by neurosyphilis based on the characteristic morphology of the lesions,positive serological and cerebrospinal fluid tests for syphilis,brain magnetic resonance imaging,and histopathology,along with resolution of the lesions following the institution of penicillin therapy.The lesions and neurological condition successfully resolved after a course of treatment with penicillin.CONCLUSION We suggest that neurosyphilis should be considered whenever people have psychiatric symptoms without cutaneous lesions or human immunodeficiency virus.
基金Supported by The Guidance Project of Science and Technology Commission of Shanghai MunicipalityNo.134119a1700+5 种基金the Appropriate Project of Shanghai Municipal Health BureauNo.2013SY049Shanghai Key Laboratory of Clinical Geriatric MedicineNo.13DZ2260700the Scientific Research Projects of Shanghai Municipal Health BureauNo.20134377
文摘AIM: To investigate whether posture affects the accuracy of 13C-urea breath test(13C-UBT) for Helicobacter pylori(H. pylori) detection in partial gastrectomy patients. METHODS: We studied 156 consecutive residual stomach patients, including 76 with H. pylori infection(infection group) and 80 without H. pylori infection(control group). H. pylori infection was confirmed if both the rapid urease test and histology were positive during gastroscopy. The two groups were divided into four subgroups according to patients' posture during the 13C-UBT: subgroup A, sitting position; subgroup B, supine position; subgroup C, right lateral recumbent position; and subgroup D, left lateral recumbent position. Each subject underwent the following modified 13C-UBT: 75 mg of 13C-urea(powder) in 100 m L of citric acid solution was administered, and a mouth wash was performed immediately; breath samples were then collected at baseline and at 5-min intervals up to 30 min while the position was maintained. Seven breathsamples were collected for each subject. The cutoff value was 2.0‰.RESULTS: The mean delta over baseline(DOB) values in the subgroups of the infection group were similar at 5 min(P > 0.05) and significantly higher than those in the corresponding control subgroups at all time points(P < 0.01). In the infection group, the mean DOB values in subgroup A were higher than those in other subgroups within 10 min and peaked at the 10-min point(12.4‰± 2.4‰). The values in subgroups B and C both reached their peaks at 15 min(B, 13.9‰± 1.5‰; C, 12.2‰± 1.7‰) and then decreased gradually until the 30-min point. In subgroup D, the value peaked at 20 min(14.7‰± 1.7‰). Significant differences were found between the values in subgroups D and B at both 25 min(t = 2.093, P = 0.043) and 30 min(t = 2.141, P = 0.039). At 30 min, the value in subgroup D was also significantly different from those in subgroups A and C(D vs C: t = 6.325, P = 0.000; D vs A: t = 5.912, P = 0.000). The mean DOB values of subjects with Billroth Ⅰ anastomosis were higher than those of subjects with Billroth Ⅱ anastomosis irrespectively of the detection time and posture(P > 0.05).CONCLUSION: Utilization of the left lateral recumbent position during the procedure and when collecting the last breath sample may improve the diagnostic accuracy of the 13C-UBT in partial gastrectomy patients.
基金supported by the National Key Research and Development Program of China (2017YFC 0908800)the Beijing Municipal Administration of Hospitals’ Mission Plan (SML20180601)+2 种基金the China Postdoctoral Science Foundation (2021M692253)the Beijing Postdoctoral Research Foundation (2021-ZZ023)the Beijing Municipal Health Commission (Jing 19-15)
文摘BACKGROUND Triglyceride(TG)and its related metabolic indices,all recognized as surrogates of insulin resistance,have been demonstrated to be relevant to clinical prognosis.However,the relative value of these TG-related indices for predicting cardiovascular events among patients with acute coronary syndrome(ACS)has not been examined.METHODS The TG,the triglyceride-glucose(TyG)index,the atherogenic index of plasma,TG to high-density lipoprotein cholesterol ratio,and the lipoprotein combine index were assessed in 1694 ACS patients undergoing percutaneous coronary intervention.The primary endpoint was major adverse cardiovascular event(MACE),which was the composite of all-cause mortality,stroke,myocardial infarction,or unplanned repeat revascularization.RESULTS During a median follow-up of 31 months,345 patients(20.4%)had MACE.The risk of the MACE was increased with higher TG and the four TG-derived metabolic indices[TG-adjusted hazard ratio(HR)=1.002,95%CI:1.001-1.003;TyG index-adjusted HR=1.736,95%CI:1.398-2.156;atherogenic index of plasma-adjusted HR=2.513,95%CI:1.562-4.043;TG to high-density lipoprotein cholesterol ratio-adjusted HR=1.148,95%CI:1.048-1.258;and lipoprotein combine index-adjusted HR=1.009,95%CI:1.004-1.014;P<0.001 for all indices].TG and all the four indices significantly improved the predictive ability for MACE in addition to the baseline model.Among them,TyG index showed the best ability for predicting MACE compared with the other three indices from all the three measurements(P<0.05 for all comparison).CONCLUSIONS TG and TG-derived metabolic indices were all strongly associated with MACE among ACS patients undergoing percutaneous coronary intervention.Among all the indices,TyG index showed the best ability to predict the risk of MACE.
基金supported by the National Key Research and Development Program of China(2017 YFC0908800)the China Postdoctoral Science Foundation(2021M692253)the Beijing Postdoctoral Research Foundation(2021-ZZ-023)。
文摘OBJECTIVE To determine the association of serum complement C1q levels with cardiovascular outcomes among patients with acute coronary syndrome(ACS)undergoing percutaneous coronary intervention(PCI),and evaluate the value of C1q modified by high-sensitivity C-reactive protein(hs-CRP)levels as an independent predictor.METHODS As a single-center prospective observational study,we analyzed 1701 patients who had received primary or elective PCI for ACS at Beijing Anzhen Hospital,Capital Medical University,Beijing,China between June 1,2016 and November 30,2017.The associations of C1q modified by hs-CRP with major adverse cardiovascular events(MACE)were determined in survival analysis.RESULTS Patients with the lowest C1q tertile had the highest cumulative risk of MACE(log-rank P=0.007).In fully adjusted Cox regression models,stratifying the total population according to hs-CRP dichotomy,C1q was significantly associated with MACE in patients with hs-CRP levels less than 2 mg/L but not in those with 2 mg/L or more(P_(interaction)=0.02).In patients with hs-CRP levels less than 2 mg/L,with the lowest C1q tertile as reference,the risk of MACE was reduced by 40.0%in the middle C1q tertile[hazard ratio(HR)=0.600,95%CI:0.423–0.852,P=0.004]and by 43.9%in the highest C1q tertile(HR=0.561,95%CI:0.375–0.840,P=0.005).CONCLUSIONS Serum complement C1q is significantly associated with cardiovascular outcomes in patients with ACS undergoing PCI,only when hs-CRP levels are less than 2 mg/L.This finding implicates the usefulness of C1q for the risk stratification in ACS patients with reduced systemic inflammation.
基金National Natural Science Foundation of China,No.81773337Medical and Health Science Technology Project of Shandong Province,No.2017WS345and Traditional Chinese Medicine Science and Technology Development Plans of Shandong Province,No.2017-415.
文摘BACKGROUND Rhinocerebral mucormycosis(RCM)is a rare fatal fungal infection which is on the increase among immunocompromised hosts such as patients who have had hematological cancers,or have received immunosuppressive drugs,corticosteroids,or other T cell suppressing agents.CASE SUMMARY We report a case of RCM caused by Rhizopus oryzae,one of the most common opportunistic pathogens,in a patient suffering from a fourth relapse of acute myeloid leukemia.The patient developed RCM after he had received long-term antibiotic agents and corticosteroids.The pathogen was isolated three times from nasal secretions collected from the deep parts of the nasal cavity and was identified by morphology and internal transcribed spacer sequencing.Blood infection was excluded by droplet digital polymerase chain reaction and blood culture.The patient was empirically treated with caspofungin and voriconazole for several days while the lesions continued to progress.The patient was given amphotericin B in combination with caspofungin after RCM was suspected,and the lesions improved over the course of treatment,which lasted several days.However,the patient eventually died of the primary disease.CONCLUSION This case indicates that immunosuppressive drugs,including corticosteroids and antimetabolites in hematological tumor,do increase the risk of infections of this type.Early diagnosis,prompt and frequent surgical debridement,and treatment with amphotericin B without delay are all essential in combatting RCM.
文摘Erratum to:J Zhejiang Univ-Sci B(Biomed&Biotechnol)201920(10):816-827 https://doi.org/10.1631/jzus.B1900071The original version of this article unfortunately contained a mistake.In p.823,Figs.8 c and 8 d were incorrect,and the obvious pathological changes were mistakenly placed in the picture.
基金the Chinese Academy Medical Sciences Initiative for Innovative Medicine (2016-I2M-3-021).
文摘Objective: The present study was designed to evaluate whether and how itraconazole affects the macrophage polarization and its reactivity to Candida albicans. Methods: Cell toxicity of itraconazole was measured using cell counting kit-8 assay in RAW264.7 cells. The cell models were induced by lipopolysaccharide (LPS), interleukin (IL)-4, or Candida albicans. Levels of cytokines secreted by RAW246.7 treated with itraconazole were detected by Luminex or Cytometric Bead Array compared to the controls without itraconazole treatment, and the expressions of inducible nitric oxide synthase and arginase (Arg) were determined by Western blot. Phagocytosis ability was measured by both flow cytometry and fluorescence microscope. The Student's t test and one-way analysis of variance were used to calculate the differences between groups. Results: In comparison to the control, itraconazole inhibited the growth of the cells in both a time- and a dosedependent manner. Increased secretion of IL-6 (0.25μmol/L ITZ [538.03±60.23pg/mL, P<0.05], 0.5μmol/L [550.32 ±47.87 pg/mL, P<0.05] and 1 μmol/L [626.95±75.24pg/mL, P<0.01] vs. control [370.43±33.98pg/mL]) and tumor necrosis factor-alpha (TNF-α) (1μmol/L ITZ vs. control: 2521.51±444.06pg/mL vs. 1617.85±94.57 pg/mL, P<0.05) were detected in the LPS-induced cell model with itraconazole treatment. In the cells induced by IL-4, itraconazole increased the secretion of IL-6 (1μmol/L ITZ vs. control: 528.33±11.60pg/mL vs. 466.99±28.32 pg/mL, P<0.05), TNF-α (1μmol/L ITZ vs. control: 4.85±0.32pg/mL vs. 4.30±0.19 pg/mL, P<0.05), and IL-1β (0.25μmol/L [325.95±13.97pg/mL, P<0.05], 0.5μmol/L [332.38±11.97pg/mL, P<0.05] and 1μmol/L [334.35±16.23 pg/mL, P<0.05] vs. control [291.62±17.03pg/mL]), and reduced the secretion of IL-10 (1μmol/L ITZ vs. control: 7.21±0.68 pg/mL vs. 9.11±0.14pg/mL, P<0.05). The secretion of IL-6 (1μmol/L ITZ vs. control: 38.34±1.36pg/mL vs. 32.32± 0.84pg/mL, P<0.05) and TNF-α (1μmol/L ITZ vs. control: 1060.17±80.16pg/mL vs. 890.84±52.82 pg/mL, P<0.01) was improved in Candida albicans-stimulated RAW264.7 cells under the treatment of itraconazole, while the secretion of IL-4 (0.5μmol/L [2.86±0.20 pg/mL, P<0.05] and 1μmol/L [2.24±0.33 pg/mL, P<0.001] vs. control [3.91±0.23 pg/mL]) and IL-10 (1μmol/L ITZ vs. control: 19.46±2.05pg/mL vs. 25.67±1.95pg/mL, P<0.05) decreased. In all three activated patterns, itraconazole enhanced the expression of inducible nitric oxide synthase (P<0.01) and slightly inhibited the Arg-1 expression (P<0.05). Phagocytosis ability of RAW264.7 cells at 1μmol/L ITZ treatment was increased by 7.53%±2.21% (P<0.01) and 9.73%±2.03% (P<0.01) at the ratio of cells: yeast of 1:4 and 1:8, respectively, in comparison to the control group.Itraconazole improved M1 polarization of RAW264.7 cells and enhanced the phagocytic capacity of RAW264.7 to Candida albicans, indicating a significant immunological enhancement. The study improves the understanding of undergoing mechanisms related to the anti-tumor and anti-infection effects of itraconazole.
文摘Introduction Trichorrhexis nodosa (TN), one of the most common hair shaft anomalies, was first identified by Samuel Wilks in 1852(1)As either a congenital or acquired hair shaft disorder, TN is characterized by fragile and easily broken hair accompanied by frayed cortical fibers and loss of the cuticle(2)Complete fracture of the hair shaft subsequently occurs. Moreover, hair shaft fragility may increase the risk of developing TN. Congenital TN, including trichothiodystrophy[3], argininosuccinic aciduria[4], Menkes syndrome[5] and trichohepatoenteric syndrome[6], is rare in the clinical setting. Acquired TN, which is provoked by hair injury secondary to physical or chemical trauma (usually physical trauma), is often overlooked in daily life. We herein reported a case of TN in a woman with androgenetic alopecia.
