Comparison of four clinical scores for the predicting lower limb deep venous thrombosis in Chinese patients

Objective：To evaluate Wells, Kahn, St.Andr 6 and Constans scores for the prediction of deep venous thrombosis in Chinese patients. Methods：One hundred and seventy-two patients, prospectively, blinded referred for evaluation with four clinical-score systems for suspected deep venous thrombosis, were examined by ultrasonography. Sensitivity, specificity, positive predictive value, negative predictive value and receiver operation curves were calculated for four clinical scores. The difference between areas of the ROC curve for each of the scores was compared with others and reference line. Results：Forty-six of 172 patients had deep venous thrombosis proven by sonography. The sensitivity, specificity, positive predictive value and negative predictive value for Wells score was 91.3%, 57.1%, 43.8% and 94.7%, respectively, for Kahn score; 65.2%, 71.4%, 45.5% and 84.9%, respectively, for St.Andr 6 score; 63%, 38.9%, 27.4% and 74.2% respectively, for Constans score; 95.7%, 34.9%, 34.9% and 95.7% respectively. Area under ROV curve of Constans score was 0.814, which was similar to that of Wells score, then followed by Kahn score and that of St.Andr 6 score was no difference with the reference line. Conclusion：Based on the results of our study, the sensitivity, negative prediction value and area under ROC curve are larger for Constans score and Wells score in Chinese hospitalized patients than that of Kahn score or St.Andr 6 score. Considering the aim of the clinical assessment, Constans score and Wells score are more efficient for Chinese hospitalized patients.

The value of CT pulmonary angiography to the diagnosis of right ventricular dysfunction due to acute pulmonary embolism:compared with ultrasonographic cardiography

To analyze the value of CT pulmonary angiography（CTPA） in assessing right ventdcular dysfunction（RVD） after acute pulmonary embolism. Methods：Thirty-six patients with CTPA-confirmed PE who underwent ultrasonic cardiography（UCG） within the ensuing 24 hours were retrospectively reviewed. According to the severity of the disease, the patients were divided into the massive PE group（24 cases） and non-massive PE group（12 cases） respectively. CT scans were analyzed for findings suggestive of RVD. Scans were considered positive for RVD if the right ventricle was dilated（RVd/LVd 〉 1） or if the interventricular septum was straightened or deviated towards the left ventricle. Results were then compared with the results of UCG to estimate the value of CTPA in detecting RVD associated with PE, Results：In all cases, compared with UCG, the diagnostic sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, positive predictive value, and negative predictive value of CTPA was 84.61%, 78.26%, 3.892, 0.197, 68.75% and 90% respectively. Kappa value was 0.60, which suggested moderate agreement between CTPA and UCG in the whole level. In the massive PE group, the diagnostic sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, positive predictive value, negative predictive value of CTPA was 84.61%, 72.73%, 3.103, 0.212, 78.57% and 80% respectively. Kappa value was 0.58, which suggested moderate agreement between CTPA and UCG in the massive PE group. In the non-massive PE group, the diagnostic specificity of CTPA was 83.33%. By statistics, the value of RVd/LVd had significant difference between the massive PE and the non-massive PE group. Conclusion：CTPA can reliably detect RVD through the evaluation of cardiac morphology. However, this result requires confirmation using a larger prospective cohort study.

The dynamic study of the pulmonary artery obstruction degree and the right ventricular function in massive pulmonary embolism on CT pulmonary angiography

Objective： To analyze the value of CTPA in assessing the dissolve of embolus and the function of the right ventricle dynamically. Methods：Twenty-three cases of massive pulmonary embolism were analyzed retrospectively. The pulmonary artery obstruction index and the right ventricular function parameters were collected and analyzed on CTPA before thrombolytic therapy, 24 hours and 14 days after therapy, respectively. Results：The pulmonary artery obstruction index decreased gradually, and there was significant difference before therapy, 24 hours and 2 weeks after therapy. Twenty-four hours after therapy, the maximal short axes diameter and the maximal transverse area of right ventricle（RVd, RV~） decreased significantly, the maximal short axes diameter and the maximal transverse area of left ventricle（LVd, LVs） increased significantly, and the RVd/LVd, RVs/LVS decreased apparently. The pulmonary artery symbolic pressure before and 24 hours after therapy were apparently different. There was no significant difference between azygos vein, the super vena cava, the main pulmonary artery and vein reflux before and after therapy. Conclusion：CTPA can evaluate the pulmonary artery obstruction degree and right ventricular function dynamically.

牙菌斑生物膜的形成与控制

牙菌斑生物膜是附着于牙釉质表面,由复杂的微生物群落构成的一种聚集体。牙菌斑生物膜的形成与生长对口腔健康有着直接或间接的影响,许多研究证实口腔疾病如龋齿和牙周病都与细菌的积累及牙菌斑的形成有关。在牙菌斑生物膜形态建成过程中,牙齿表面最初的定殖菌对生物膜的微生物组成和结构至关重要,这些初级定殖菌决定了后续与之结合形成共生体的微生物种类和数量。不同的微生物组成可能在与生物膜形成相关的口腔病理状况中发挥不同的作用。因此,本文就牙菌斑生物膜的生长及控制进行综述,介绍其微生物的早期定殖和成熟过程、以及通过物理和化学方法对牙菌斑生物膜的控制,以期为了解牙菌斑生物膜的形成机制及相关口腔疾病的预防和治疗提供有价值的参考。

Prediction and verifcation of the key ingredients and molecular targets of Guizhi Fuling capsule against tumour metastasis and resistance

Purpose:The well-known traditional Chinese formula Guizhi Fuling capsule(GFC)has been reported to reverse ovarian cancer drug resistance.Extrachromosomal DNA(ecDNA)plays an important role in tumour metastasis and resistance.The purpose of this study was to investigate the potential mechanisms by which GFC blocks tumour metastasis and reverses drug resistance by targeting ecDNA.Methods:CNKI and PubMed were used to obtain pharmacokinetic research data on GFC in rats,and the bioactive ingredients detected in rat serum or plasma were collected.Network databases were used to screen the abnormally expressed genes in ecDNA,tumour metastasis genes,resistance genes,and the active ingredient targets of GFC.The KOBAS3.0 database was used to enrich the KEGG pathways and GO functions;the STRING platform was used to construct the core protein interaction network;and the molecular docking online tool SwissDock was used to analyse the binding activity of the core targets and the active ingredients.RT-qPCR,Western blotting and laser confocal microscopy were used to verify the efect of the sera containing GFC on ecDNA,mRNA and protein expression of key targets.Results:Twenty-three bioactive ingredients of GFC were retrieved from PubMed and CNKI.Nine shared targets were simultaneously involved in abnormal genes in ecDNA,tumour metastasis and resistance and the active ingredient targets of GFC.GO functional analysis indicated that the cotargets involved cell proliferation,apoptotic regulation,nuclear functions,etc.The potential pathways involved in the reversal of tumour metastasis and drug resistance of GFC were the PI3K-Akt signalling,cancer,and platinum drug resistance pathways.Three shared proteins targeting ecDNA(AKT1,EGFR and MYC)stand out from the top 20 PPI targets,and all of the bioactive ingredients of GFC have strong binding afnity to the three proteins.The active ingredients can reduce the expression of MYC,EGFR and AKT1 mRNA and protein and the amount of ecDNA in drug-resistant OC cells.Conclusions:GFC targeting ecDNA to reverse tumour metastasis and drug resistance has the characteristics of multiple ingredients,multiple targets,and multiple pathways,which provides a new perspective for the development of new drugs targeting ecDNA to beneft tumour treatment.

Genomic Surveillance for SARS-CoV-2 Variants: Dominance of XBB Replacement — China, January–June 2023

Introduction:In the first half of 2023,a global shift was observed towards the predominance of XBB variants.China faced a significant epidemic between late 2022 and early 2023 due to Omicron subvariants BA.5.2 and BF.7.This study aims to depict the evolving variant distribution among provincial-level administrative divisions(PLADs)in China and explore the factors driving the predominance of XBB replacement.Methods:Sequences from local and imported coronavirus disease 2019(COVID-19)cases recorded between January 1 and June 30,2023,were included.The study analyzed the changing distribution of viral variants and assessed how the prior dominance of specific variants,XBB subvariants,and imported cases influenced the prevalence of the XBB replacement variant.Results:A total of 56,486 sequences were obtained from local cases,and 8,669 sequences were from imported cases.Starting in April,there was a shift in the prevalence of XBB from imported to local cases,with varying dominance among PLADs.In PLADs previously high in BF.7,the rise of XBB was delayed.A positive correlation was found between XBB proportions in imported cases from January to March and local cases in April.The distribution pattern of XBB subvariants differed between local and imported cases within the same PLAD.No significant differences were noted in the replacement rates of XBB subvariants.Conclusions:The timing of XBB dominance differed among various PLADs in China in the first half of 2023,correlating closely with the prevalence of XBB variants among imported cases.