Plant centromeres

Plant centromeres are generally composed of tandem arrays of simple repeats that are typical of a particular species, but that evolve rapidly. Centromere specific retroelements are also present. These arrays associate with a centromere specific variant of histone H3 that anchors the site of the kinetochore. Although such DNA arrays are typical of the centromere, the specification of centromere activity has an epigenetic component as shown by the fact that centromeres are formed in the absence of such repeats and that centromeres in dicentric chromosomes regularly undergo inactivation.

Solution chemistry and analytical characterization of ormaplatin

Ormaplatin is a racemic, platinum(IV), anti-cancer drug which is currently involved in phase 1 clinical trials. Characterizing the purity of ormaplatin represents an analytical challenge for several reasons. These include the lack of solution stability of ormaplatin, its process impurities and solution decomposition products, the strong concentration and pH dependence of various decomposition pathways and solution equilibria and the absence of chromatographic reproducibility. Two independent types of aqueous decomposition pathways have been observed. The first pathway involves the generation of soluble PtIV containing species which remain in equilibrium with the parent material in solution. The second pathway involves the generation of PtII containing materials which tend to be less soluble. The most interesting material in this latter class is probably the chloride bridged mixed valence material which has been characterized structurally by X-ray diffraction. Liquid chromatography and sample handling procedures have been developed which allow for the accurate determination of bulk drug purity, as well as, an understanding of numerous reversible equilibria.

Different frequencies of p53 codon-249 hot-spot mutations in hepatocellular carcinomas in Jiang-su province of China

Environmental carcinogens often induce specific mutations in the p53 gene, apparent in tumors. The relation between aflatoxin B1 (AFB1 )-related hepatocellular carcinomas (HCCs) and hot spot at codon 249 of the p53 gene has received a great deal of attention, but its significance is still controversial. To clarify this problem, we analyzed the p53-mutational status of HCCs in Jiang-su province in China, where AFB1 contamination of the staple food significantly differs between the northern and southern parts (prominent only in the latter), while other conditions are quite similar. Background liver status and mutations in exons 5 to 8 of p53 in a total of 31 cases were divided approximately equally between the 2 areas. In all, 15 tumors exhibited a total of 17 mutations in the p53 gene; 9 cases from the southern part of the province had the hot-spot mutation at codon 249 (9/16, 56%), but only one case from the northern part (1/15, 8%). These results suggest that AFB1 contamination may correlate with codon-249 mutations in HCC.

Phasing macromolecular structures via structure-invariant algebra

Owing to the breakdown of Friedel's law when anomalous scatterers are present, unique values of the three-phase structure invariants in the whole range from 0 to 2pi are determined by measured values of diffraction intensities alone. Two methods are described for going from presumed known values of these invariants to the values of the individual phases. The first, dependent on a scheme for resolving the 2pi ambiguity in the estimate omega(HK) of the triplet phi(H) + phi(K) + phi(-H-K), solves by least squares the resulting redundant system of linear equations phi(H) + phi(K) + phi(-H-K) = omega(HK). The second attempts to minimize the weighted sum of squares of differences between the true values of the cosine and sine invariants and their estimates. The latter method is closely related to one based on the 'minimal principle' which determines the values of a large set of phases as the constrained global minimum of a function of all the phases in the set. Both methods work in the sense that they yield values of the individual phases substantially better than the values of the initial estimates of the triplets. However, the second method proves to be superior to the first but requires, in addition to estimates of the triplets, initial estimates of the values of the individual phases.

Deep branch of the radial nerve in lateral surgical approaches to the radial head - A cadaveric study

INTRODUCTION

The traditional Kocher approach for lateral radial head exposure may be complicated by injury to the deep branch of the radial nerve (DBRN) and the radial collateral ligament. Kaplan approach is less commonly used, due to its known proximity to the DBRN. Extensor Digitorum Communis (EDC) splitting approach allows possible wide surgical exposure and low risk of radial collateral ligament injury. The comparison of the proximity of the DBRN to the surgical dissection at the level of radial head among approaches to the radial head has not previously been evaluated. We aimed to determine the anatomical proximity of the DBRN in these 3 common radial head approaches and to define a safe zone of dissection for the surgical exposure.

METHODS

Cadaveric dissections of 9 pairs of fresh frozen upper extremities were performed using EDC splitting, Kaplan and Kocher approach to the radial head sequentially in a randomized order. A mark was made on the radial head upon initial exposure during dissection. Measurements from the marked point of the radial head to the DBRN were made at the level of radial head.

RESULTS

The distance of DBRN to the radial head was 20 (17-22) mm in EDC splitting approach, 7 (3-11) mm in Kaplan approach and 29 (25-33) mm in Kocher approach. The EDC splitting approach was associated with a significantly lower chance of encountering the DBRN at the level of radial head as compared to the Kaplan approach (P<0.001). In all cases, lateral ligamentous complex was not exposed in Kaplan and EDC approaches, but were encountered in Kocher approach, risking injury to the radial collateral ligament.

CONCLUSIONS

The EDC splitting approach provides adequate exposure without the need to elevate or retract the EDC and ECU muscle mass that could risk injuring the DBRN. The Kaplan approach should be done by experienced surgeons who are familiar with the anatomy in this region, with extreme caution due to proximity of the DBRN to the surgical dissection at the level of the radial head. Caution of the DBRN should be taken during anterior elevation and retraction of the muscle mass in Kocher approach.

LEVEL OF EVIDENCE

IV.

[Correlation of gastric cancer and effects of vitamin D receptor gene FokⅠ polymorphism on C-reactive protein and D-dimer in Uygur nationality patients]

OBJECTIVE

This study aimed to determine the correlation of Uygur gastric cancer and the polymorphism effects of vitamin D receptor gene FokⅠ on C-reactive protein and D-dimer.

METHODS

Method of random sampling was used to select 147 Uygur patients with gastric cancer who admitted at Tumor Hospital of Xinjing Medical University (Group A) and 151 healthy controls with the same nationality (Group B). Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method was used to determine FokⅠ loci polymorphism in both groups to identify the gastric cancer susceptibility gene. All patients were divided into Group FF (Group a) and Group Ff+ ff (Group b) by PCR-RFLP according to the f-gene carrier to compare the expression level of C-reactive protein and D-dimer.

RESULTS

The expression frequency of the f allelic gene of patients with gastric cancer was higher than that of healthy control patients (57.8% vs 47.4%, P<0.05). The carriers of the f allelic gene (Ff+ ff) had increased risk of gastric cancer (OR=2.85). Measurement levels of C-reactive protein and D-dimer in the f allelic gene group were higher than those of the non-f allelic gene group (4.72±1.65 vs 2.81±0.93, and 2.79±1.21 vs 1.09±0.65, respectively), and the differences were statistically significant (P<0.05).

CONCLUSIONS

The FokⅠ loci polymorphism of vitamin D receptor gene was related to gastric cancer susceptibility in Uygur. f allelic gene may be one of the risk factors of gastric cancer in Uygur. Moreover, f allelic gene may be a factor that increased the level of C-reactive protein and D-dimer in Uygur patients with gastric cancer.

[Occupational health risk assessment of coal dust in coal industry chain]

Objective: To grasp the present situation of occupational hazards of coal dust in our country, understand our country coal dust workers' occupational health risks, provide information based on evidence and analysis for the government and organize to effectively deal with the current status of high coal workers pneumoconiosis incidence in China, and protect coal dust workers' occupational health. Methods: The research object is the " mining-transportation-use" of coal industrial chain, referring to 33 units. Use field investigation to obtain the coal dust exposure, dust prevention measures and the occupational health data of study object. Use quantitative evaluation method of International council on mining and metals occupational health risk assessment model (ICMM method) and occupational hazard risk index method (index method) , with coal workers pneumoconiosis as health outcomes, to evaluate the coal dust occupational health risks of coal industrial chain. Results: The free silica content of partial coal dust in China is more than 10%, and even to 19.5%. coal dust concentration in workplaces, such as excavating system of dust coal mining (total dust: 22.1~46.5 mg/m(3), respiratory dust: 8.4~17.7 mg/m(3)) , dumper (total dust: 25.2 mg/m(3), respiratory dust: 6.9 mg/m(3)) , transfer tower (total dust: 35.4 mg/m(3)) of coal transportation and belt coal plough device of coal use (total dust: 36.3 mg/m(3), respiratory dust: 14.0 mg/m(3)) , are much higher than those in other workplaces, and coal dust concentration of workers in these places (2.6~9.3 mg/m(3)) are much higher than those in other places, which are statistically significant. ICMM method evaluation results show that the risk value of excavating system is between 504~1 089, and the risk value of comprehensive mining system is between 347~2 040, which are far statistically significant higher than that of other systems. Index method evaluation results (excavating system risk value between 3.1~9.7, fully mechanized system risk value between 3.7~9.3) , are basically identical with ICMM method (correlation coefficient r=0.857, P<0.01) . The new cases of coal worker pneumoconiosis are distributed in three post of coal mining, excavating and coal mine mixing. Conclusion: Coal-dust hazards are widely distributed in the coal "mining, transportation, and use" industrial chain, which of the underground coal mine is as serious as intolerable, meanwhile the risk of other industrial chain is basically can tolerable. The high coal dust concentration and the high risk of coal dust occupational hazard are concentrated in the excavating system and the comprehensive mining system. It is recommended to start the study on risk assessment and risk response of coal dust health hazard at the national level, and the occupational exposure limit of coal dust should be established according to the content of free silica.

Gastric cancer nodal tumour-stroma ratios influence prognosis

This study showed that nodal tumour-stroma ratio (NTSR) is an independent prognostic factor for overall and disease-free survival of patients with gastric cancer. Both relative stroma-rich primary tumour-stroma ratio (PTSR) and NTSR were independent negative prognostic factors for overall survival in gastric cancer. This study supports assessment of tumour-stroma ratio in the routine pathological diagnosis of gastric cancer. validated in node-positive disease.

[Effects of LINC00839 targeting miR-3666 on proliferation, migration and invasion of hepatocellular carcinoma cells]

Objective: To investigate the effects of lncRNA LINC00839 on the proliferation, migration and invasion of hepatocellular carcinoma cells and its mechanism. Methods: Real-time quantitative polymerase chain reaction (RT-qPCR) was used to detect the expression of LINC00839 and miR-3666 in hepatocellular carcinoma tissues and adjacent tissues. Pearson correlation was used to analyze the correlation between LINC00839 and miR-3666 expression in liver cancer tissues. Hepatocellular carcinoma cells MHCC97H were cultured in vitro and divided into si-NC group, si-LINC00839 group, miR-NC group, miR-3666 group, si-LINC00839+ anti-miR-NC group, and si-LINC00839+ anti-miR-3666 group. Methylthiazoletrazolium (MTT) method and clone formation experiment were used to detect cell proliferation. Transwell array was used to detect the cell migration and invasion. Western blot was used to detect the protein expressions of p21, E-cadherin and MMP-2. The double luciferase reporter gene experiment was used to verify the regulatory relationship between LINC00839 and miR-3666. Results: Compared with adjacent tissues, the expression level of LINC00839 in hepatocellular carcinoma tissues increased (2.82±0.27 vs. 0.96±0.10, P<0.001), but the expression level of miR-3666 decreased (0.23±0.02 vs. 1.01±0.10, P<0.001). The expression levels of LINC00839 and miR-3666 in liver cancer tissue were negatively correlated (r=-0.658, P<0.001). The survival rate of MHCC97H cells in the si-LINC00839 group [(53.91±5.41)% vs. (100.53±10.22)%], the number of clones formed (92.0±8.0 vs. 164.0±14.3), the number of migration (131.0±12.7 vs. 247.0±22.4), the number of invasion (66.0±6.4 vs. 120.0±11.6) and the protein level of MMP-2 (0.20±0.02 vs. 0.67±0.06) were lower than those in the si-NC group (P<0.001). However, the protein levels of p21 (0.76±0.07 vs. 0.25±0.02) and E-cadherin (0.78±0.08 vs. 0.14±0.01) were higher than those in the si-NC group (P<0.001). LINC00839 targeted and negatively regulated the expression of miR-3666. The survival rate of MHCC97-H cells in the miR-3666 group [(47.93±4.86)% vs. (100.11±10.21)%], the number of clone formation (78.0±7.7 vs. 166.0±15.9), the number of migration (117.0±12.1 vs. 250.0±25.0), the number of invasion (57.0±5.7 vs. 121.0±12.3) and the protein level of MMP-2 (0.16±0.01 vs. 0.69±0.07) were lower than those in the miR-NC group (all P<0.001). However, the protein levels of p21 (0.83±0.08 vs. 0.24±0.02) and E-cadherin (0.87±0.09 vs. 0.13±0.01)were higher than those in the miR-NC group (all P<0.001). The survival rate of MHCC97-H cells in the si-LINC00839+ anti-miR-3666 group [(89.94±9.05)% vs. (54.12±5.39)%], the number of clones (143.0±13.8 vs. 94.0±9.4), the number of migration (208.0±19.8 vs. 129.0±12.6), the number of invasion (108.0±10.1 vs. 65.0±6.4) and the protein level of MMP-2 (0.31±0.03 vs 0.66±0.06) were higher than those in the si-LINC00839+ anti-miR-NC group (P<0.001). However, the protein levels of p21 (0.31±0.03 vs. 0.74±0.07) and E-cadherin (0.28±0.03 vs. 0.80±0.08) were lower than those int the si-LINC00839+ anti-miR-NC group (P<0.001). Conclusion: Inhibition of LINC00839 expression may inhibit the proliferation, migration and invasion of hepatocellular carcinoma cells by targeting up-regulation of miR-3666 expression.

[Cluster analysis and significance of clinical subtypes in patients with obstructive sleep apnea hypopnea syndrome]

Objective: To study the clinical subtypes of obstructive sleep apnea hypopnea syndrome (OSAHS) by cluster analysis, and to discuss the characteristics and clinical significance of these subtypes. Methods: A retrospective analysis was done among patients who were diagnosed with OSAHS in the Sleeping Center of the Second Affiliated Hospital of Soochow University from January 2010 to June 2018. In this cluster analysis, 16 main symptoms, 7 comorbidities and 3 assessment scales were included. After selecting the best model, the parameters and characteristics of different subtypes were compared and analyzed. Results: A total of 2 592 patients with complete data were included in this study. After cluster analysis, they were divided into 4 groups: sleep apnea group (1 173 cases, 45.3%), daytime sleepiness group (518 cases, 20.0%), insomnia and memory loss group (212 cases, 8.2%), mild symptom group (689 cases, 26.6%). In the sleep apnea group, the patients were found to be younger [(40.2±10.4) years old], with higher body mass index (BMI) [(27.7±3.7) kg/m(2)] when compared to the other groups. In addition, the prevalence of comorbidities of this group was found to be lower, whereas the probability of sleep apnea symptom was the highest (94.7%). In daytime sleepiness group, the Epworth Sleepiness Scale (ESS) score was the highest [(12.4±5.5) points], and the probability of daytime sleepiness symptom was also found to be the highest (88.0%). The age of patients in the insomnia and memory loss group was the highest [(51.1±13.0) points], with the highest percentage of women (19.3%). The probability of insomnia was found to be 70.3%, and memory loss symptoms was 88.2% which were the highest when compared to the other groups. The prevalence of comorbidities was the highest, and the scores of short mental state scale (MMSE) and Montreal cognitive assessment (MoCA) were the lowest with a mean of [(28.5±2.4) points] and [(25.4±3.2) points], respectively, among the 4 groups. The probability of most symptoms and comorbidities were found be the lowest in the mild symptom group. There were significant differences in the main symptoms among the 4 groups (P<0.05). Symptoms like sleep apnea, daytime sleepiness, insomnia, memory loss, headache and dry mouth upon awakening were found significantly different in pairwise comparisons among the groups (P<0.002). Conclusion: The patients with OSAHS can be divided into four clinical subtypes by cluster analysis, each of which is significantly heterogeneous, and this is helpful to evaluate the condition and guide individualized treatment.

[Strategy for wound repair of skin and soft tissue defect and systematic rehabilitation treatment for functional reconstruction of patients with severe burn or trauma on knees]

Objective: Strategy for wound repair of skin and soft tissue defect and systematic rehabilitation treatment for functional reconstruction of patients with severe burn or trauma on knees. Methods: From January 2015 to October 2016, 26 patients with skin and soft tissue defect on knees after severe burn or trauma were hospitalized in our unit. Among these patients, 14 patients had patellar ligament defect, and 16 patients had knee joint capsule defect. Wound debridement was operated on 1 to 3 days after admission. After debridement, the area of skin and soft tissue defect ranged from 10 cm×7 cm to 42 cm×18 cm. Vacuum sealing drainage (VSD) treatment was performed after debridement, and flap transplantation operation was performed after VSD treatment for 5 to 7 days. Defects of nine patients were treated with local rotation flaps. Seven patients with skin and soft tissue defects on knees and knee joint capsule defects of 5 cm×3 cm to 9 cm×7 cm were treated with free anterolateral femoral flaps combined with fascia lata. Ten patients with skin and soft tissue defects on knees and patellar ligament defects of 6 cm×3 cm to 12 cm×4 cm were treated with free anterolateral femoral flaps combined with iliotibial tract. The area of flaps ranged from 11 cm×9 cm to 22 cm×15 cm. After flap transplantation operation, functional reconstruction of knee joint was carried out according to early, continuous, and sequential systematic rehabilitation treatment strategy. The pain degree and function of knee joint of patients were scored by the International Knee Documentation Committee (IKDC) Knee Evaluation Form before operation and 12 months after operation. The knee joint flexion and extension degrees of patients were measured by joint protractor in 2 weeks and 12 months after operation. The color Doppler ultrasound was used to evaluate integrity of knee joint capsule and continuity of patellar ligament of patients in 6 and 12 months after operation. Results: All flaps of 26 patients survived well, and wounds healed completely after the operation. Distal parts of flaps of 2 patients treated with free anterolateral femoral flaps had local necrosis after the operation, and their wounds healed after debridement and transplantation of autologous intermediate split-thickness skin graft of thigh. The IKDC Knee Evaluation Form score of patients was (79±8) points in 12 months after operation, which was significantly higher than (64±7) points before operation (t=7.20, P<0.05). The flexion degree of knee joint of patients was (117±10)° in 12 months after operation, which was significantly larger than (35±8)° in 2 weeks after operation (t=32.65, P<0.05). The extension degree of knee joint of patients was (12±9)° in 12 months after operation, which was significantly smaller than (61±9)° in 2 weeks after operation (t=19.63, P<0.05). In 6 and 12 months after operation, 9 patients treated with local rotation flaps had good integrity of knee joint capsule and continuity of patellar ligament; 7 patients treated with free anterolateral femoral flaps and fascia lata had good integrity of knee joint capsule; 10 patients treated with free anterolateral femoral flaps and iliotibial tract had good continuity of patellar ligament. During follow-up of 12 months, all flaps survived well; knees of all patients had good appearance; knee joints functioned normally. Conclusions: Good appearance and function of knees can be achieved by repairing wound of skin and soft tissue defect on knees after severe burn or trauma with local rotation flaps or free anterolateral femoral flaps with fascia lata or iliotibial tract plus systematic rehabilitation treatment of knee joint in early stage after flap transplantation operation.

Direct methods: the identification of space-group-specific inconsistent three-phase structure invariants

Certain space groups often permit the generation of pairs of triple relationships involving the same three parent reflections in different symmetry forms, giving rise to two equally probable invariant estimates which, because of the space-group symmetry, must disagree by an a priori known phase shift. The 230 space groups have been examined to identify those which permit inconsistent triples, and the complete list which describes the forms of the pair of triples and their phase inconsistency is given.

[A comparative study of new gastric cancer screening scoring system and new ABC method for screening gastric cancer and precancerous lesions]

Objective: To compare the value of new gastric cancer screening scoring system and serum pepsinogen (PG) combined with gastrin-17 (G-17) (new ABC method) in screening gastric cancer and precancerous lesions. Methods: A total of 576 patients were enrolled after the examination of endoscopy at Endoscopy Center,Department of Gastroenterology,from December 2017 to December 2019. There were 275 males and 301 females with an age of 40-72 (52±10) years. According to the new ABC method and the new gastric cancer screening scoring system, the population was divided into three groups according to age,gender,serum helicobacter pylori antibody test, PG Ⅰ/PG Ⅱ(PGR) and G-17 before endoscopy. The detection rates of gastric cancer and atrophic gastritis by two different methods were analyzed and the value in screening gastric cancer and precancerous lesions were evaluated. Statistical analysis was accomplished by Chi-square test and Gamma coefficient analysis. Results: A total of 576 patients were enrolled. According to the new ABC method, 382 patients were classified into low-risk group, 170 patients into middle-risk group and 24 patients into high-risk group, respectively. In the new ABC method, 1 case of gastric cancer (0.3%) was detected in low-risk group, 8 cases (4.7%) in middle-risk group and 3 cases (12.5%) in high-risk group. As for atrophic gastritis, 89 cases (23.3%) was detected in low-risk group, 94 cases (55.3%) in middle-risk group and 18 cases (75.0%) in high-risk group. According to the new gastric cancer screening scoring system, 336 patients were classified into low-risk group, 205 patients into middle-risk group and 35 patients into high-risk group, respectively. One case of gastric cancer (0.3%) was detected in low-risk group, 6 cases (2.9%) in middle-risk group and 5 cases (14.3%) in high-risk group. As for atrophic gastritis, 41 cases (12.2%) were detected in low-risk group, 134 cases (65.4%) in middle-risk group and 26 cases (74.3%) in high-risk group. In this two methods, the prevalence of gastric cancer increased according to the disease stage (χ²=22.509, P<0.01; χ²=24.156, P<0.01); in terms of atrophic gastritis, the detection rate of the new screening scoring system in the low-risk group was significantly lower than that in the new ABC method (χ²=14.844, P<0.01), but higher in the middle-risk group (χ²=3.955, P=0.047). Gamma coefficient test showed that there were strong correlations between gastroscopy pathology and classification grade of both methods (P<0.01). Conclusions: Both methods are suitable for screening gastric cancer and precancerous lesions, and the new scoring system may be more valuable in screening gastric cancer and precancerous lesions.

MicroRNA-199 inhibits proliferation and promotes apoptosis in children with acute myeloid leukemia by mediating caspase-3

OBJECTIVE

The aim of this study was to detect the expression level of microRNA-199 in acute myeloid leukemia (AML). Meanwhile, we also investigated whether microRNA-199 could inhibit the proliferation and promote apoptosis of AML cells by regulating caspase-3.

PATIENTS AND METHODS

The expression level of microRNA-199 in peripheral blood samples of AML patients and healthy controls was determined using Real Time-quantitative Polymerase Chain Reaction (RT-qPCR). Similarly, microRNA-199 expression was also detected in AML cells and human medullary cells. The overexpression plasmid of microRNA-199 was constructed and transfected into cells. Subsequently, the regulatory effects of microRNA-199 on the proliferation, cell cycle, apoptosis, invasion and migration were accessed. The relationship between microRNA-199 and caspase-3 expression was further elucidated by Western blot and RT-qPCR.

RESULTS

MicroRNA-199 was lowly expressed in peripheral blood of AML patients and AML cell lines than normal controls. The overexpression of microRNA-199 significantly decreased proliferative, invasive and migratory capacities of AML cells, whereas markedly increased apoptotic rate. Western blot results showed that microRNA-199 increased caspase-3 expression in AML cells. Rescue experiments demonstrated that microRNA-199 inhibited malignant progression of AML by targeting caspase-3.

CONCLUSIONS

MicroRNA-199 is lowly expressed in AML patients. Furthermore, it inhibits the malignant progression of AML by targeting caspase-3.

[Efficacy of intravascular ultrasound-guided rotational atherectomy combined with cutting balloon for pretreatment of severe coronary artery calcified lesions]

OBJECTIVE

To investigate the efficacy and safety of intravascular ultrasound (IVUS)-guided rotational atherectomy (RA) combined with cutting balloon for pretreatment of severe calcified lesions in the coronary artery before stent placement.

METHODS

A total of 120 patients with severe coronary artery calcifications detected by IVUS that required percutaneous coronary intervention (PCI) were recruited from our hospital between January, 2016 to January, 2019. The patients were randomized into two groups for pretreatment of the lesions with semicompliant balloon (SB group, 60 cases) or RA combined with CB (RA+CB group, 60 cases), and drug-eluting stents were implanted after the procedure. The immediate success rate of PCI, vascular parameters detected by IVUS after PCI, and the rates of residual stenosis < 10% were compared between the two groups. The incidences of intraoperative complications and major adverse cardiac events (MACE) within 24 months after the surgery were also observed in the two groups.

RESULTS

The immediate success rate was significantly higher in RA+CB group than in SB group (P=0.032). After pretreatment and stent placement, the minimum stent lumen diameter (P=0.035), minimum stent lumen cross-sectional area (P=0.029), immediate lumen acquisition, immediate lumen cross-sectional area acquisition and the rate of residual stenosis < 10% were all significantly higher in RA+CB group than in SB group (P < 0.001). The patients in RA+ CB group showed obviously less residual stenosis of lumen cross-sectional area than those in SB group after the surgery (χ²= 7.859, P=0.005). The incidences of intraoperative complications (χ²=5.997, P=0.014) and MACE within 24 months after the operation (χ²=4.285, P=0.038) were significantly lower in RA+CB group than in SB group.

CONCLUSION

For patients with severe coronary artery calcifications eligible for PCI, RA combined with CB angioplasty can significantly improve the success rate of immediate PCI, expand the lumen diameter and cross-sectional area of the stent after PCI, enhance immediate lumen gain, and reduce the incidence of intraoperative complications and MACE after the operation.

Catheter ablation of atrial fibrillation in patients with heart failure with preserved ejection fraction: a systematic review and meta-analysis

Background

Catheter ablation improves clinical outcomes in symptomatic atrial fibrillation (AF) patients with heart failure (HF) with reduced ejection fraction (HFrEF). However, the role of catheter ablation in HF patients with a preserved ejection fraction (HFpEF) is less clear.

Purpose

To determine the efficacy of catheter ablation of AF in patients with HFpEF relative to those with HFrEF.

Methods

We performed an extensive literature search and systematic review of studies that compared AF recurrence at one year after catheter ablation of AF in patients with HFpEF versus those with HFrEF. Risk ratio (RR) 95% confidence intervals were measured using the Mantel-Haenszel method for dichotomous variables, where a RR&lt;1.0 favors the HFpEF group.

Results

Four studies with a total of 563 patients were included, of which 312 had HFpEF and 251 had HFrEF. All patients included were undergoing first time catheter ablation of AF. Patients with HFpEF experienced similar recurrence of AF one year after ablation on or off antiarrhythmic drugs compared to those with HFrEF (RR 0.87; 95% CI 0.69–1.10, p=0.24), as shown in Figure 1. Recurrence of AF was assessed with electrocardiography, Holter monitoring, and/or event monitoring at scheduled follow-up visits and final follow-up.

Conclusion

Based on the results of this meta-analysis, catheter ablation of AF in patients with HFpEF appears as efficacious in maintaining sinus rhythm as in those with HFrEF.

Funding Acknowledgement

Type of funding source: None