[The variation of serum uric acid levels among patients with myocardial infarction treated with ticagrelor and the association between serum uric acid and platelet reactivity]

Objectives: To compare the impact of ticagrelor or clopidogrel on serum uric acid levels among patients with ST-segment elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (PCI) and further evaluate the effects of variation of serum uric acid levels on platelet reactivity. Methods: STEMI patients who admitted to Fuwai Hospital from April 2017 to January 2020, and underwent primary PCI and discharged alive with aspirin and ticagrelor or clopidogrel were included in this study. Patients were divided into ticagrelor group and clopidogrel group. The baseline clinical data were collected. Serum uric acid and creatinine levels at baseline and 30 days post-PCI were measured. Light transmittance aggregometry was used to assess maximum aggregation rate induced by adenosine diphosphate and arachidonic acid. The changes of serum uric acid and creatinine were compared between the two groups. Multivariate logistic regression was performed to evaluate independent related factors for rise in the uric acid levels, and the effect of variation of serum uric acid level on platelet reactivity was analyzed. Results: A total of 967 patients were included, the age was (59.4±12.1) years, and 163 case were female. There were 550 cases in ticagrelor group (56.9%) and 417 cases in clopidogrel group (43.1%). Baseline serum uric acid and creatinine levels were similar between the 2 groups. At 30 days, the serum uric acid level [(347.2±96.5) mmol/L vs. (341.2±105.3) mmol/L, P=0.009] and absolute [46.4 (-2.4, 88.1) mmol/L vs. 25.0 (-21.9, 73.0) mmol/L, P=0.001] and percentage [13.2 (-0.01, 29.0) % vs. 7.9 (-5.7, 25.0) %, P=0.007] increase in the serum uric acid levels were significantly higher in ticagrelor group than in clopidogrel group. The level of serum creatinine at 30 days was significantly lower in ticagrelor group than in clopidogrel group [(89.7±21.3) μmol/L vs. (94.4±43.9) μmol/L, P<0.05], whereas there were no differences in absolute [8.0 (-1.4, 16.6) μmol/L vs. 7.8 (-2.0, 16.6) μmol/L] and percentage [10.5 (-1.7%, 22.6%) vs. 9.8 (-2.4%, 22.1%)] change in the serum creatinine between the 2 groups (all P>0.05). Logistic regression analysis showed that, after adjusting for confounding factors, ticagrelor therapy was an independent related factor of serum uric acid elevation (OR=1.582, 95% CI:1.023-2.447, P=0.039). The variation of the serum uric acid levels did not affect platelet aggregation and the percentage of high platelet reactivity in both groups. Conclusions: Ticagrelor use is related to a significant increase in the serum uric acid levels at 30 days post-PCI in this patient cohort. The variations in the uric acid levels do not increase the percentage of high platelet reactivity in STEMI patients treated with ticagrelor or clopidogrel.

LncRNA MALAT1 affects high glucose-induced endothelial cell proliferation, apoptosis, migration and angiogenesis by regulating the PI3K/Akt signaling pathway

OBJECTIVE

To investigate the effects of long non-coding ribonucleic acid (lncRNA) metastasis-associated lung adenocarcinoma transcript 1 (MALAT1) on the high glucose-induced proliferation, apoptosis, migration and angiogenesis of endothelial cells and its potential mechanism.

MATERIALS AND METHODS

Human umbilical vein endothelial cells (HUVECs) were divided into 3 groups, including control group (medium with 5.5 mmol/L glucose), high glucose group (HG group, medium with 33.5 mmol/L glucose) and lncRNA MALAT1 knockdown group [HG + MALAT1 small interfering RNA (siRNA) group, medium with 33.5 mmol/L glucose]. Cell Counting Kit-8 (CCK-8) assay was performed to observe the proliferation of HUVECs in each group at different time points. Meanwhile, the wound-healing assay was applied to detect the migratory ability of HUVECs in each group at 0 h and 24 h. The apoptosis rate of each group of cells was measured by means of flow cytometry, and the expression of Bcl-2-associated X protein (Bax) was detected via immunofluorescence at the same time. In addition, the amount of neovascularization in each group of cells was observed through the tube formation assay. Finally, Western blotting was utilized to determine the expression level of proteins in phosphatidylinositol 3-kinase (PI3K)/Akt signaling pathway in each group of cells.

RESULTS

Compared with that in the control group, the expression level of lncRNA MALAT1 in the HG group was elevated markedly (p<0.05). The proliferative capacity of HUVECs in the HG group was increased notably after knocking down lncRNA MALAT1 with siRNA (p<0.05). According to wound-healing assay, the knockdown of lncRNA MALAT1 could prominently reverse the declined HUVECs migratory ability induced by high glucose (p<0.05). Flow cytometry results manifested that the apoptosis level of HUVECs in the HG group was increased markedly, but inhibition on lncRNA MALAT1 could lower the apoptosis level evidently (p<0.05). The results of immunofluorescence showed that the expression of Bax in the HG + MALAT1 siRNA group was remarkably lower than that in the HG group (p<0.05). It was revealed in Western blotting that the knockdown of lncRNA MALAT1 could reverse the inhibition of high glucose on the PI3K/Akt signaling pathway in HUVECs (p<0.05).

CONCLUSIONS

Inhibiting lncRNA MALAT1 can promote endothelial cell proliferation, migration and angiogenesis and repress endothelial cell apoptosis simultaneously, whose mechanism may be related to the activation of the PI3K/Akt signaling pathway.

Converse magneto-electric effects in a core-shell multiferroic nanofiber by electric field tuning of ferromagnetic resonance

This report is on studies directed at the nature of magneto-electric (ME) coupling by ferromagnetic resonance (FMR) under an electric field in a coaxial nanofiber of nickel ferrite (NFO) and lead zirconate titanate (PZT). Fibers with ferrite cores and PZT shells were prepared by electrospinning. The core-shell structure of annealed fibers was confirmed by electron- and scanning probe microscopy. For studies on converse ME effects, i.e., the magnetic response of the fibers to an applied electric field, FMR measurements were done on a single fiber with a near-field scanning microwave microscope (NSMM) at 5-10 GHz by obtaining profiles of both amplitude and phase of the complex scattering parameter S11 as a function of bias magnetic field. The strength of the voltage-ME coupling Av was determined from the shift in the resonance field Hr for bias voltage of V = 0-7 V applied to the fiber. The coefficient Av for the NFO core/PZT shell structure was estimated to be - 1.92 kA/Vm (- 24 Oe/V). A model was developed for the converse ME effects in the fibers and the theoretical estimates are in good agreement with the data.

Prognostic value of age-adjusted d-dimer cutoff thresholds in patients with myocardial infarction treated by percutaneous coronary intervention

Introduction

The association between D-dimer and outcomes of patients with myocardial infarction (MI) remains controversial. Using age-adjusted D-dimer cutoff thresholds significantly improves the accuracy of diagnosis for thrombotic diseases. This study aimed to investigate the prognostic value of age-adjusted D-dimer in MI patients treated by percutaneous coronary intervention (PCI).

Methods

In this observational study, 3614 consecutive patients with MI treated by PCI were retrospectively recruited. The baseline age-adjusted D-dimer threshold was 500 ng/mL, and was calculated as age × 10 in patients older than 50 years. Cox regression was used for outcome analysis. The primary outcome was all-cause death. Discrimination and reclassification were calculated to assess the additional prognostic value of D-dimer when combined with established clinical risk factors and the Global Registry of Acute Coronary Events (GRACE) risk score.

Results

During a median follow-up of 652 days, a total of 194 deaths occurred. High D-dimer level, as defined by age-adjusted thresholds, was an independent predictor for all-cause death (hazard ratio:1.67, 95% confidence interval: 1.23–2.27, P=0.001). Addition of D-dimer level (high or low) significantly improved risk classification for death when combined with established clinical risk factors (net reclassification index [NRI]: 0.601, P&lt;0.001; integrated discrimination improvement [IDI]: 0.011, P=0.046) and GRACE score (NRI: 0.618, P&lt;0.001; IDI: 0.015, P=0.011).

Conclusions

In patients with MI treated by PCI, D-dimer elevation defined by age-adjusted thresholds was an independent predictor for adverse outcomes, and provided additional prognostic value when combined with clinical risk factors and GRACE score.

Funding Acknowledgement

Type of funding source: Public Institution(s). Main funding source(s): Chinese Academy of Medical Sciences

Association between pre-infarction angina and culprit-lesion morphology in patients with ST-segment elevation myocardial infarction: an optical coherence tomography study

Background

Previous studies reported the cardiac protection effect of pre-infarction angina (PIA) in patients with acute myocardial infarction (AMI). However, the association between PIA and culprit plaques characteristics in AMI patients through optical coherence tomography (OCT)assessment remains unclear.

Purpose

We sought to identify culprit-plaque morphology associated with PIA in patients with ST-segment elevation myocardial infarction (STEMI) using OCT.

Methods

A total of 279 STEMI patients who underwent intravascular OCT of culprit-lesion were included. Baseline clinical data and culprit-plaque characteristics were compared between the PIA group the non-PIA group.

Results

Patients with PIA represented 54.8% of the study population (153 patients). No differences were observed in clinical and angiographic data between two groups, except STEMI onset with exertion was significantly less common in PIA group (24.2% versus 40.5%, P=0.004). Patients with PIA exhibited a significantly lower incidence of plaque rupture (40.5% versus 61.9%, P&lt;0.001) and lipid-rich plaques (48.4% versus 69.0%, P=0.001). The thin-cap fibroatheroma (TCFA) prevalence was lower in PIA group, presenting a thicker fibrous cap thickness, although statistically significant differences were not observed (20.3% versus 30.2%, P=0.070; 129.1±92.0μm versus 111.4±78.1μm, P=0.088; respectively). Multivariate logistic regression analysis indicated that PIA was an independent negative predictor for plaque rupture (odds ratio: 0.44, 95% confidence interval: 0.268–0.725, P=0.001).

Conclusion

STEMI patients with PIA showed a significantly lower prevalence of plaque rupture and lipid-rich plaques in culprit-lesion than non-PIA group, implying different mechanisms of STEMI attack.

Flow chart + Bar graphs of OCT findings

Funding Acknowledgement

Type of funding source: Public Institution(s). Main funding source(s): Association between pre-infarction angina and culprit-lesion morphology in patients with ST-segment elevation myocardial infarction: An optical coherence tomography study

Local and Nonlocal Electron Dynamics of Au/Fe/MgO(001) Heterostructures Analyzed by Time-Resolved Two-Photon Photoemission Spectroscopy

Employing femtosecond laser pulses in front and back side pumping of Au/Fe/MgO(001) combined with detection in two-photon photoelectron emission spectroscopy, we analyze local relaxation dynamics of excited electrons in buried Fe, injection into Au across the Fe-Au interface, and electron transport across the Au layer at 0.6 to 2.0 eV above the Fermi energy. By analysis as a function of Au film thickness we obtain the electron lifetimes of bulk Au and Fe and distinguish the relaxation in the heterostructure's constituents. We also show that the excited electrons propagate through Au in a superdiffusive regime and conclude further that electron injection across the epitaxial interface proceeds ballistically by electron wave packet propagation.

The importance of proper and prompt treatment of ocular syphilis: a lesson from permanent vision loss in 52 eyes

BACKGROUND

Ocular involvement can occur at any stage of syphilis. Prompt diagnosis and proper treatment of ocular syphilis are vital to avoid long-term consequences.

OBJECTIVES

To describe the risk factors for ocular syphilis and clinical features of blindness caused by syphilis.

METHODS

We report risk factors for ocular syphilis amongst patients seen at the Shanghai Skin Disease Hospital between October 2009 and October 2017. We identify patients with ocular syphilis resulting in blindness and report the clinical characteristics, laboratory findings and treatment outcomes of these patients.

RESULTS

A total of 8310 new cases of syphilis were seen, of which 213 patients had ocular disease and 50 patients had blindness due to syphilis. Increasing age and higher RPR titres were associated with ocular involvement but there was no association with HIV status. Blindness in syphilis was restricted predominantly to patients with optic nerve involvement and not patients with isolated uveitis. Fifty patients (and a total of 67 eyes) met the WHO definition of blindness prior to treatment for syphilis. At the end of follow-up, vision had improved in 24 of 67 eyes (35.8%) after treatment. Successful treatment of uveitis was associated with the best improvement in visual acuity, whilst patient with underlying optic atrophy prior to treatment had the worst visual outcome.

CONCLUSIONS

Ocular involvement is an important manifestation of syphilis which may result in blindness. Our data demonstrate outcomes for ocular syphilis are poor if detected late; early recognition and diagnosis is therefore vital to avoid permanent visual loss.

[The analysis of clinical characteristics of 34 novel coronavirus pneumonia cases in Ningxia Hui autonomous region]

Objective: To analyze the clinical characteristics of 34 COVID-19 cases and to provide the basis for the prevention and control of the epidemic disease. Methods: Thirty-four COVID-19 patients diagnosed with RT-PCR in the isolation ward of the Fourth People's Hospital of Ningxia Hui autonomous region (infectious diseases hospital) from the January 22 to February 4, 2020 were selected as the research subjects. The clinical data were collected. Excel was used to describe the relationship between clinical classification and age distribution, contact history and date of onset. SPSS 25.0 statistical software was used for analysis. The general information, clinical symptoms, blood test, virus nucleic acid test results, epidemiology, CT imaging, treatment and prognosis were analyzed. Results: There were 5 mild cases (5/34), 24 ordinary cases (24/34), 5 severe cases (5/34). The elderly was more common in severe patients. The main clinical symptoms were fever (27/34)and dry cough(26/34). The peripheral blood showed normal or decreased leukocyte count (33/34), decreased lymphocyte count (12/34). The increase of C-reactive protein (CRP) and D-dimer was related to the severity of the disease. Some patients had mild liver and kidney damage. Six patients were diagnosed through 3 or more times of nucleic acid tests. Sixteen cases had Wuhan related history,13 cases were close contacts, 5 cases had no confirmed route. The clustered infections were found in 6 families. In typical cases, CT showed single or multiple patchy ground glass shadow with thickening of interlobular septum. In severe cases, diffuse lesions of both lungs were found, with ground glass shadow, consolidation shadow and strip shadow coexisting. Thirty-four patients were treated with interferon-α and Lopinavir/Ritonavir with good prognosis. Conclusions: The clinical characteristics of COVID-19 were similar to that of general viral pneumonia but with strong infectivity. Close contact and family aggregation caused disease outbreaks. COVID-19 could not be excluded if two nucleic acid tests were negative and high-resolution CT was helpful for differential diagnosis. Early detection, early isolation, early diagnosis and early treatment are important for good prognosis. The effectiveness of antiviral drugs needs to be further verified.

[Associations between postprocedural D-dimer, hs-CRP, LDL-C levels and prognosis of acute myocardial infarction patients treated by percutaneous coronary intervention]

Objective: To investigate the association between postprocedural D-dimer, high sensitivity C-reactive protein(hs-CRP) and low-density lipoprotein-cholesterol(LDL-C) and outcomes of acute myocardial infarction (AMI) patients treated by percutaneous coronary intervention(PCI), in order to clarify the impacts of thrombotic, inflammatory and cholesterol risks on long-term prognosis. Methods: Patients with AMI who underwent emergency PCI from January 2010 to June 2017 in Fuwai Hospital with complete baseline data were enrolled. Patients were stratified into four groups according to quartiles of D-dimer, hs-CRP and LCL-C. Cox regression was used to analyze the relationship between these biomarkers and prognosis. Restricted cubic spline (RCS) was used to characterize the continuous association between risk of all-cause death and biomarkers. The primary outcome was all-cause death. Results: A total of 3 614 patients were included in the analysis. The age was (59.2±12.0) years old, and 2 845 (78.7%) were male and 3 161 (87.5%) patients were diagnosed as ST-segment elevation myocardial infarction. The follow-up time was 652 (414, 1 880) days. Survival analysis showed that postprocedural D-dimer and hs-CRP were significantly associated with all-cause mortality (all P<0.05). Cox regression with multiple adjustments showed that patients with D-dimer≥580 μg/L presented higher risk of all-cause death (HR=2.03, 95%CI 1.22-3.38, P=0.006), compared to patients with D-dimer<220 μg/L. RCS analysis showed that risk of all-cause death was stably high when D-dimer reached 500 μg/L. Multivariable Cox regression also showed that patients with hs-CRP<2.74 mg/L (HR=1.86, 95%CI 1.10-3.15, P=0.020)or hs-CRP≥11.99 mg/L (HR=2.14, 95%CI 1.35-3.40, P=0.001) presented higher mortality compared to patients whose hs-CRP was 2.74-7.18 mg/L. RCS analysis indicated a J-shaped relation between hs-CRP and mortality, as greater risk of death was observed when hs-CRP was lower than 2 mg/L or higher than 10 mg/L. LDL-C was not associated with outcomes (all P>0.05). Conclusions: Postprocedural D-dimer is significantly associated with long-term prognosis of AMI patients treated by PCI. Patients with extremely high or low levels of hs-CRP presents worse outcomes. Intensive and tailored antithrombotic or anti-inflammatory therapies should be considered for patients with increased thrombotic risk and those with extremely high or low inflammatory risk.

MicroRNA-142-3p suppresses cell proliferation and migration in bladder cancer via Rac1

Expression of microRNA(miR)-142-3p has been implicated to be associated with several cancers, whereas its function in bladder cancer (BC) remains unknown. The present study aimed to explore the correlation between the expression of miR-142-3p and the proliferation, migration and invasion of bladder cancer cells by activating Rac1. qRT-PCR was used to measure the expression of miR-142- 3p in bladder cancer tissues and cell lines. RNA transfection was used to silence and accelerate the expression of miR-142-3p in bladder cancer cells. CCK-8 and trans-well assays were used to detect the proliferation, migration and invasion of cells before and after RNA transfection. The direct interaction between Rac1 and miR-142-3p was demonstrated by a dual luciferase reporter assay. qRT-PCR and Western blot assays were used to detect the expression changes in Rac1 before and after transfection. The results showed that miR-142-3p in bladder cancer tissues was significantly lower than that in adjacent tissues and lower than that in HT1376 and T-24 cells but higher than that in T5637 and BIU- 87 cells. Additionally, upregulating miR-142-3p expression not only inhibits the proliferation of SV-HUC-1 and BIU-87 cells but also inhibits migration and invasion, and downregulating miR-142-3p expression showed the opposite results. The expression of Rac1 was promoted after stimulating miR- 142-3p expression, but was inhibited after silencing miR-142-3p expression. In conclusion, miR-142-3p affects the proliferation, migration and invasion of bladder cancer cells by regulating Rac1.

[Long-term outcomes of patients with ST-elevation myocardial infarction undergoing early versus late delayed percutaneous coronary intervention using drug-eluting stents]

Objective: To compare the long-term outcomes in ST-elevation myocardial infarction (STEMI) patients who underwent early or late delayed percutaneous coronary intervention (PCI) using drug-eluting stents (DES). Methods: This study was a retrospective, observational and single-center study. Consecutive STEMI patients (n=977), who admitted to Fuwai Hospital in 2013 and underwent successful selective PCI using drug-eluting stents (DES) within 3 to 35 days after symptom onset were enrolled and divided into the early delayed PCI (3-14 d) group (n=495) and the late delayed PCI (15-35 d) group (n=482). General clinical data of the patients and related data of coronary angiography and interventional therapy were collected, and the endpoint events were followed up. The primary endpoint was 2-year major adverse cardiac and cerebrovascular events (MACCE) including cardiac death, recurrent myocardial infarction, definite or probable stent thrombosis and ischemic stroke. The secondary endpoint was 2-year ischemia-driven target vessel revascularization. The incidence of endpoint events of the two groups was compared, and it was compared again after the primary baseline characteristics such as age and gender were matched by the propensity scoring method at a 1∶1 ratio. Results: A total of 910 (93.1%) patients who underwent delayed PCI were transferred from other hospitals, and 292 (29.9%) patients received thrombolysis before PCI. The time interval before PCI was 14 (10, 20) days. The incidence of 2-year MACCE (3.0%(15/495) vs. 2.3%(11/482), P=0.468) and ischemia-driven target vessel revascularization (3.8%(19/495) vs. 5.0%(24/482), P=0.385) were similar between the two groups. The incidence of 2-year MACCE (3.3%(15/453 vs. 2.4%(11/453), P=0.426) and ischemia-driven target vessel revascularization (4.2% (19/453) vs. 4.9%(22/453), P=0.632) were also similar between the two groups after matching propensity score. Conclusion: The long-term clinical outcomes after early delayed PCI using DES is statistically equivalent to those of late delayed PCI using DES for STEMI patients who missed the time window for emergency PCI.

An efficient in vitro regeneration system from different wild apple (Malus sieversii) explants

BACKGROUND

Wild apple, Malus sieversii, is an endangered species and a valuable genetic resource that requires a variety of conservation techniques. This study aimed to investigate the influence of different concentrations of hormones on wild apple regeneration from leaf and stem explants to establish an optimal regeneration system.

RESULTS

Leaves and stems derived from seedlings were cultured on several media supplemented with various concentrations of thidiazuron (TDZ) or 6-benzylaminopurine (BA) in different combinations with 1-naphthaleneacetic acid (NAA). The results showed that the most efficient shoot formation media (35% and 90%) were MS medium containing 4.0 mg L^-1 TDZ and 1.0 mg L^-1 NAA for leaf explants and MS medium containing 1.0 mg L^-1 BA without NAA for stem explant. MS medium supplemented with 0.4 mg L^-1 BA and 0.1 mg L^-1 NAA (for shoot multiplication) and 1/2 MS + 0.1 mg L^-1 NAA + 1.5% sucrose (for rooting) were effective media. Shoot regeneration from leaf explants was the most effective when the explants were placed abaxial side down onto the medium and were subjected to a pre-treatment of 3 weeks in darkness.

CONCLUSIONS

An optimized regeneration system for M. sieversii that allowed regeneration within 2-3 months developed. The protocol developed herein can be used in large-scale clonal propagation for the conservation of wild apple, M. sieversii.

An improved production-theoretical approach to decomposing carbon dioxide emissions

Production-theoretical decomposition analysis (PDA), built on production theory and data envelopment analysis, has been widely used to quantify the factors that drive CO₂ emission changes to support policy analysis and making. Existing PDA methods are usually linked to Shephard distance function and Malmquist productivity index. However, decomposition results associated with these methods may be biased and incomplete. The challenges with these methods mainly stem from the problems associated with underestimating disaggregated efficiencies and the infeasibility of linear programming. This paper proposes a modified PDA approach based on a non-radial directional distance function and global Malmquist-Luenberger productivity index. This new approach addresses the problems associated with conventional PDA methods. To show the usefulness of the proposed approach, we apply it to study CO₂ emissions in China and use the bootstrap method to test the statistical significance of the estimated results.

Decelerated lattice excitation and absence of bulk phonon modes at surfaces: Ultra-fast electron diffraction from Bi(111) surface upon fs-laser excitation

Ultrafast reflection high-energy electron diffraction is employed to follow the lattice excitation of a Bi(111) surface upon irradiation with a femtosecond laser pulse. The thermal motion of the atoms is analyzed through the Debye–Waller effect. While the Bi bulk is heated on time scales of 2 to 4 ps, we observe that the excitation of vibrational motion of the surface atoms occurs much slower with a time constant of 12 ps. This transient nonequilibrium situation is attributed to the weak coupling between bulk and surface phonon modes which hampers the energy flow between the two subsystems. From the absence of a fast component in the transient diffraction intensity, it is in addition concluded that truncated bulk phonon modes are absent at the surface.

P819Post-procedural cholesterol and inflammatory risk in acute myocardial infarction patients undergoing percutaneous coronary intervention

Objective

This study sought to depict the combined association of post-procedural cholesterol and inflammatory risk with clinical outcomes among acute myocardial infarction (AMI) patients undergoing percutaneous coronary intervention (PCI) and pick out patients with highest comprehensive risk.

Methods

A total of 4802 AMI-PCI patients were divided into quartiles according to post-procedural low-density lipoprotein cholesterol (LDL-C), C-reactive protein (CRP) level respectively and in combinations for risk analysis. Univariate and adjusted multivariate analysis with Cox model were performed. Hazard ratio (HR) for short-term (90 days) and long-term (1 year) were compared for major adverse cardiovascular events (MACE), including cardiac death, recurrent myocardial infarction and ischemic stroke.

Results

A significant change in the hazards of 90-day MACE was seen among patients in the highest quartile of post-procedural LDL-C [HR: 0.526 (0.291, 0.951), p=0.034] and highest quartile of CRP [HR: 2.119 (1.150, 3.920), p=0.016]. For 1-year outcomes, only a trend for increasing risk was seen in patients with higher post-procedural CRP (p-trend = 0.016). Combination analysis for cholesterol/inflammatory risk showed that patients lying simultaneously in the lowest quartile of LDL-C and highest quartile of CRP gained the highest risk in the 90-day [HR: 3.16 (1.124, 8.886), p=0.029] and 1-year [HR: 2.515 (1.153, 5.486), p=0.020] follow up.

Hazard ratios (HR) for short-term (90 days) and long-term (1 year) primary outcomes according to cholesterol and inflammatory risk 90 days 1 year Type of risk Unadjusted HR (95% CI) P value Adjusted HR (95% CI) P value P for trend Unadjusted HR (95% CI) P value Adjusted HR (95% CI) P value P for trend LDL, mmol/L   Quartile 2 0.742 (0.441, 1,248) 0.260 0.663 (0.390, 1.125) 0.128 0.033 0.722 (0.364, 1.125) 0.150 0.683 (0.435, 1.072) 0.097 0.251   Quartile 3 0.653 (0.381, 1.121) 0.122 0.597 (0.344, 1.038) 0.068 0.850 (0.557, 1.229) 0.453 0.850 (0.550, 1.312) 0.462   Quartile 4 0.517 (0.288, 0.928) 0.027 0.526 (0.291, 0.951) 0.034 0.673 (0.427, 1.061) 0.088 0.708 (0.444, 1.131) 0.149 CRP, mg/L   Quartile 2 1.365 (0.717, 2.599) 0.334 1.295 (0.654, 2.522) 0.448 0.007 1.063 (0.656, 1.722) 0.805 0.998 (0.608, 1.636) 0.992 0.016   Quartile 3 1.306 (0.681, 2.502) 0.442 1.279 (0.654, 2.499) 0.472 0.999 (0.612, 1.630) 0.996 0.968 (0.586, 1.597) 0.897   Quartile 4 2.354 (1.312, 4.221) 0.004 2.119 (1.150, 3.920) 0.016 1.657 (1.069, 2.570) 0.024 1.528 (0.967, 2.413) 0.069 Multivariate analysis was adjusted for age, sex and traditional cardiovascular risk factors.

Combined cholesterol/inflammatory risk

Conclusion

AMI-PCI patients with lower post-procedural LDL-C and higher CRP might encounter greater cardiovascular risk. Patients with the lowest LDL-C and highest CRP gained extremely high risk and required special attention.

[Research progress of congenital preauricular fistula]

Congenital preauricular fistula can be sporadic or genetic. When inherited, it exhibits incomplete autosomal dominant genetic patterns. It can occur alone or with other diseases such as branchio-oto-renal syndrome. According to the position of fistula opening, congenital ear fistula can be divided into four categories: congenital preauricular fistula, congenital posterior ear fistula, congenital auricular fistula and congenital external auditory canal fistula. Congenital auricle fistula can be subdivided into congenital auricular fistula, congenital teal fistula, congenital earlobe fistula and so on. The diagnosis of preauricular fistula should be based on its clinical manifestation, and the diagnosis and treatment of special type of preauricular fistula should be emphasized. The treatment methods of congenital preauricular fistula include medicine, incision and surgical excision. According to the clinical practice of us and other scholars, surgical treatment is recommended in the period of acute infection, and the recurrence rate is not increased. The operation method of preauricular fistula, the application of microscope, dye tracer, probe and general anesthesia, and the clear surgical visualization are all helpful to reduce the recurrence rate.

Long non-coding RNA ENST00000434223 inhibits the progression of renal cancer through Wnt/hygro-catenin signaling pathway

OBJECTIVE

The purpose of this study was to determine the function of long non-coding RNA (LncRNA) ENST00000434223 (Lnc ENST) in renal carcinoma, and to explore the potential molecular mechanism.

PATIENTS AND METHODS

Quantitative Real-Time-Polymerase Chain Reaction (qRT-PCR) was used to detect the expressions of lncRNA ENST00000434223 and Wnt/β-catenin pathway-related mRNAs in tissues and cells of renal cancer. Chi-square test was performed to figure out the relationship between lncRNA ENST00000434223 and clinic-pathologic features of renal cancer patients. Besides, si-NC, si-ENST00000434223, pcDNA-NC and pcDNA-ENST00000434223 were transfected into renal cancer cells. The proliferative ability, metastasis and invasiveness of cells were detected using Cell Counting Kit-8 (CCK-8) and transwell assay, respectively. Lastly, the activation of the Wnt/hygro-catenin signal transduction pathway was evaluated by TOP/FOP Wnt Luciferase reporter assay and Western blot.

RESULTS

The expressions of Wnt2b and β-catenin were significantly increased in renal carcinoma, while E-cadherin was markedly down-regulated. Lowly expressed ENST00000434223 was involved in the poor prognosis of patients with renal cancer. In addition, down-regulating ENST00000434223 could enhance the viability, metastasis and invasiveness of renal cancer cells. However, overexpressing ENST00000434223 remarkably weakened the above cell functions. At the same time, interference or overexpression of ENST00000434223 could affect the expression level of proteins related to the Wnt/β-catenin signal pathway.

CONCLUSIONS

LncRNA ENST00000434223 inhibits the progression of renal cancer through the Wnt/shell-catenin signal pathway.

[Analysis of occupational pneumoconiosis in Jiangsu province from 2006 to 2017]

Objective: To analyze the characteristics and patterns of occupational pneumoconiosis in Jiangsu Province, China, from 2006 to 2017, and to provide a scientific basis for government departments to develop effective interventions and preventive strategies against occupational pneumoconiosis. Methods: The data of 9327 patients with occupational pneumoconiosis were retrieved from the online report of occupational pneumoconiosis in Jiangsu Province from 2006 to 2017. Excel worksheet and SPSS 20.0 software were used to organize and analyze the data, respectively. An epidemiological statistical analysis was performed on age of onset, length of dust exposure, type of work, industry category, type of pneumoconiosis, annual incidence of pneumoconiosis, regional distribution, enterprise scale, and economic category in those patients. Results: A total of 9 327 patients with occupational pneumoconiosis were reported in Jiangsu Province from 2006 to 2017. In those patients, 8 559 were newly diagnosed and 768 had advanced disease. The male-female ratio was 16.34:1.Patients with stage I pneumoconiosis(6 994, 74.99%) were dominant in all the patients. The mean age of onset and length of dust exposure were 58.5±10.7 and 15.3±10.9 years, respectively. Most of the patients (6 012, 64.46%) had an age of onset between 50 and 69 years. For the length of dust exposure, the highest percentage was observed in patients exposed for no more than 5 years (2 231, 23.92%).The largest number of patients diagnosed with pneumoconiosis(1 200, 12.87%) was reported in 2010. Most of the patients(7 012, 75.18%) were from four cities, i.e, Wuxi (2 090, 22.41%), Yancheng (1 987, 21.30%), Suzhou (1 552, 16.64%), and Xuzhou (1 383, 14.83%). In all the patients, the incidence of silicosis (6791, 72.81%) was highest, followed by coal worker pneumoconiosis (1 364, 14.62%) and electric welder pneumoconiosis (563, 6.04%).Pneumoconiosis complicated by tuberculosis was found in 28 (0.3%) patients.A total of 1616 (17.33%) patients were reported in health, social security, and social welfare industries, while 1474 (15.80%) patients worked for coal mining and washing. Rock drillers (2 818, 30.21%) were dominant in those patients.State-owned economic enterprises reported the largest number of patients(5 441, 58.34%).Patients from small enterprises (4 323, 46.35%) had the highest percentage. Conclusion: Pneumoconiosis is an occupational disease with a high incidence in Jiangsu Province. Pneumoconiosis patients show an industry- and job-centered distribution. The length of dust exposure is decreasing.

Evaluating the effects of mobile health intervention on weight management, glycemic control and pregnancy outcomes in patients with gestational diabetes mellitus

PURPOSE

To explore the effects of mobile health (mHealth) intervention on pregnancy weight management, blood glucose control and pregnancy outcomes.

METHODS

A total of 124 patients with gestational diabetes mellitus (GDM) were selected. Patients were randomly divided into two groups. The 60 patients in the control group received standard outpatient treatment, while the remaining 64 patients received a nurse's online guidance both through a mobile medical App installed on their phone and through regular offline clinical treatment in the mHealth group. Patients were treated for an average of 13 weeks and general conditions, compliance, blood glucose, glycosylated hemoglobin, weight gain, pregnancy, and neonatal outcomes were monitored in both groups longitudinally.

RESULTS

The mHealth group demonstrated higher levels of compliance (83.3 ± 12.5% vs. 70.4 ± 10.1%, t = - 6.293, df = 122, p < 0.001), lower frequency of outpatient service (8.1 ± 1.3 vs. 11.2 ± 1.1, t = 14.285, df = 122, p < 0.001), lower hemoglobin A1C before delivery (4.7 ± 0.2 vs. 5.3 ± 0.3, t = 13.216, df = 122, p < 0.001) as well as the rates of off-target measurements both fasting (4.6 ± 0.4% vs. 8.3 ± 0.6%, t = 40.659, df = 122, p < 0.001) and 2 h post-prandial (7.9 ± 0.7% vs. 14.7 ± 0.8%, t = 50.746, df = 122, p < 0.001). Weight gain in the mHealth group was less than control group (3.2 ± 0.8 vs. 4.8 ± 0.7, t = 11.851, df = 122 p < 0.001).

CONCLUSION

Mobile health intervention management of gestational diabetes mellitus improves patients' compliance and blood glucose control, and reduces weight gain, thereby reducing the rates of complications in both pregnant women and fetuses during delivery during pregnancy.