Soluble ST2 in serum predicts the prognosis of idiopathic pulmonary fibrosis: a retrospective study

Background

Methods

Results

Conclusions

[Application of deep learning-based chest CT auxiliary diagnosis system in emergency trauma patients]

Objective: To investigate the diagnostic efficacy and potential application value of deep learning-based chest CT auxiliary diagnosis system in emergency trauma patients. Methods: A total of 403 patients, including 254 males and 149 females aged from 16 to 100 (50±19) years, who received emergency treatment for trauma and chest CT examination in the Eastern Theater General Hospital from September 2019 to November 2019 were retrospectively analyzed. Dr. Wise Lung Analyzer's chest CT auxiliary diagnosis system was applied to detect 5 types of injuries, including pneumothorax, pleural effusion/hemothorax, pulmonary contusion (shown as consolidation and ground glass opacity), rib fractures, and other fractures (including thoracic vertebrae, sternum, scapula and clavicle, etc.) and 6 other abnormalities (bullae, emphysema, pulmonary nodules, stripe, reticulation, pleural thickening). The diagnostic reference standards were labeled by two radiologists independently. The sensitivity and specificity of the auxiliary diagnosis system were evaluated. The imaging diagnostic reports were compared with the results of the auxiliary diagnosis system, and the diagnostic consistency between the two was calculated by using the Kappa test. Results: According to the reference standards, among the 403 patients, 29 were pneumothorax, 75 were pleural effusion/hemothorax, 131 were pulmonary contusion, 124 were rib fractures, and 63 were other fractures. The sensitivity and specificity of the auxiliary diagnosis system for detection of pneumothorax, pleural effusion/hemothorax, rib fractures, and other fractures were 96.6%, 97.6%, 80.0%, 99.7%, 99.2%, 83.9%, 84.1%, and 99.7%, respectively. The sensitivity of detecting lung contusion was 97.7%. There was a high consistency between the auxiliary diagnosis system and imaging diagnosis in the diagnosis of injuries, in which the kappa values of pneumothorax, pleural effusion, rib fracture and other fractures were 0.783, 0.821, 0.706 and 0.813, respectively (all P<0.001). Two cases of pneumothorax, three cases of pleural effusion/hemothorax, nine cases of rib fractures, and six cases of other fractures missed by imaging diagnosis were all detected by the auxiliary diagnosis system. The detection sensitivity of the auxiliary diagnosis system was higher for emphysema, pulmonary nodules and stripe (all>85%), but lower for bullae, reticulation and pleural thickening. Conclusions: The deep learning-based chest CT auxiliary diagnosis system could effectively assist chest CT to detect injuries in emergency trauma patients, which was expected to optimize the clinical workflow.

Changed hemodynamics in acute vasoreactivity testing: prognostic predictors in chronic thromboembolic pulmonary hypertension

Chronic thromboembolic pulmonary hypertension (CTEPH) is similar to pulmonary arterial hypertension (PAH) in its pathogenesis. Changed hemodynamic parameters in acute vasoreactivity testing (AVT) have proved to be prognostic predictors of PAH. We wanted to determine whether these changed indices also impacted the prognosis of CTEPH. Data was retrieved for 86 CTEPH patients who underwent right heart catheterization (RHC) with AVT at Shanghai Pulmonary Hospital from 2009 to 2018 and following up for 20 ± 15 months for event. Cox proportional hazards models were performed to determine the predictors of independent event-free survival. Receiver operating characteristic curve was plotted to determine the cut-off value of independent parameters in CTEPH. Kaplan-Meier method and log-rank test were used to perform the Survival analyses. Forty seven patients had an event. Many hemodynamic indices improved after AVT. The event-free group had better mean right atrial pressure, mean pulmonary arterial pressure, pulmonary vascular resistance (PVR) and oxygen saturation of mixed venous blood (SvO2) both at baseline and after AVT. The event-free group also showed higher cardiac output (CO) and cardiac index (CI) after AVT. Among the changed hemodynamic parameters during the AVT, ΔCO, ΔCO/baseline CO, ΔCI, ΔCI/baseline CI and ΔPVR/baseline PVR were significantly higher in the event-free group. Foremost, ΔPVR/baseline PVR, PVR after AVT and baseline SvO2 were independent predictors for event-free survival. Patients with SvO2 ≥ 61.65% at baseline or PVR < 8.09 WU after AVT or ΔPVR/baseline PVR ≥ 0.054 had significantly better survival. Hemodynamic indices both at baseline and after AVT as well as the changes in these indices reflected the severity of CTEPH. Baseline SvO2, PVR after AVT, and ΔPVR/baseline PVR could be used as independent predictors to estimate the outcomes of CTEPH patients.

Variable predictors of acute pulmonary embolism recurrence with duration of follow-up

Background

Acute pulmonary embolism (PE) is a critical disease and often leads to a high mortality and morbidity. Several studies have identified predictors of PE recurrence, but whether these predictors have prognostic value and how they vary during varied follow-up periods remain unclear.

Methods

We retrospectively assessed the occurrence of recurrent PE and the survival time of patients with a diagnosis of acute PE at Shanghai Pulmonary Hospital from May 2007 to May 2018. Potential predictors of recurrent PE were evaluated at different points (1, 3, 6, 12, 24, 60 and 120-month) during a long-term follow-up for each patient. Patients were stratified into two groups by gender to analyze the impact of sex in period-guided prognostic prediction. Receiver operating characteristic curve analysis, survival analysis and multivariate Cox proportional hazards analysis were implemented as statistical analysis methods.

Results

In total, 597 acute PE patients were included, of whom 62 reported a PE recurrence. Male patients tend to have a lower risk of PE recurrence than female patients during 3- to 60-month follow-up period but have a higher risk of PE recurrence than female patients during 120-month follow-up period. The independent predictors of recurrence-free survival varied among different follow-up periods: In all patients, diabetes was an independent predictor only within 30 days follow-up period and female was considered as an independent predictor during 3- to 120-month follow-up period. Among male patients, hyperlipidemia and Log D-dimer (cut-off value =3.436) was observed as a predictor of recurrent PE within 6-month and over 12-month follow-up respectively. However, there is no unified independent prognostic indicator for female patients identified.

Conclusions

In the early stage of follow-up, male PE patients have better prognosis, but with the extension of follow-up, female PE patients have better prognosis. The independent predictors of recurrence-free survival vary in different follow-up periods in PE patients when stratified based on gender and associated medical conditions.

Sex differences of hemodynamics during acute vasoreactivity testing to predict the outcomes of chronic thromboembolic pulmonary hypertension

BACKGROUND

Acute vasoreactivity testing (AVT) which reflects the compliance of the pulmonary vascular bed has been proven to be of prognostic value. The purpose of the present study is to explore the sex differences of hemodynamics during the AVT and their impact on event-free survival in patients with chronic thromboembolic pulmonary hypertension (CTEPH).

METHODS

Eighty-six patients underwent a right heart catheterization and AVT at Shanghai Pulmonary Hospital from February 2009 to February 2018. Univariate and multiple stepwise regression analysis were performed to determine the predictors of independent event-free survival, and receiver operating characteristic curve was plotted to determine the cut-off value of independent parameters in CTEPH.

RESULTS

There were no significant differences in both demographics and hemodynamics between male and female patients with CTEPH. Except ΔPVR/PVR showed a significantly higher difference in female than male patients (P = 0.034). Male patients had higher mRAP of pre- and post-AVT than female patients in the event-free subgroup, while, female patients showed higher PVR of pre-AVT than male patients in the event subgroup (P < 0.05). The mRAP and SvO₂ were independent predictors of event-free survival in female patients both before and after the AVT, whereas ΔSvO₂ was an independent predictor of event-free survival in male patients.

CONCLUSION

Hemodynamics during the AVT varied between male and female patients with CTEPH. Both sexes displayed unique hemodynamic responses that were independently able to predict event-free survival. Therefore, better estimates of prognosis in CTEPH can be made when sex differences are also taken into consideration.

Upregulated circZMIZ1 promotes the proliferation of prostate cancer cells and is a valuable marker in plasma

Increasing evidences have proved that circular RNAs (circRNAs), identified as a specific kind of non-coding RNAs, play a potential critical role in tumorigenesis including prostate cancer. However, the function of circRNAs in human prostate cancer remain largely unknown. In this study, we demonstrated that the expression of circZMIZ1 was higher in plasma of human prostate cancer than the paired benign prostatic hyperplasia (BPH) patients' plasma. Moreover, in cultured prostate cancer cells, knockdown of circZMIZ1 inhibited cell proliferation and caused cell cycle arrest at G1. Mechanistically, we also showed that circZMIZ1 could increase the expression of androgen receptor (AR) and androgen receptor splice variant 7 (AR-V7), which may be partly contributed to the occurrence and development of prostate cancer. In conclusion, these results revealed that circZMIZ1 might serve as a novel biomarker and a treatment target for prostate cancer treatment.

[Study on the effect and mechanism of hepatitis B virus X protein transactivates gene 4 in HepG2 cell apoptosis]

Objective: To investigate the effect and mechanism of XTP4 gene in apoptotic hepatoblastoma HepG2 cell line. Methods: HepG2 cells were transiently transfected with small interfering RNA of XTP4 genes, plasmid pcDNA3.1/myc-His(-) A-XTP4, and hepatitis B virus X protein transactivated x gene 4 (HBX protein trans-activate gene4, XTP4) and their respective negative controls. After 48h, the overexpression and interference expression condition of XTP4 in HepG2 cells were detected by Western blot. HepG2 cells apoptosis was detected by flow cytometry. The expression levels of apoptosis-related proteins P53, Bcl-2, Bax and Caspase-3 in HepG2 cells were detected by Western blot, and Bcl-2/Bax ratio was calculated. The chemiluminescence assay was used to detect activity of caspase-3 in HepG2 cells. The measured data were presented as (x ± s), and independent sample t-test was used for comparison between the two groups. Results: HepG2 cells had successfully achieved the overexpression and interference expression of XTP4 protein. Compared with the control group, the overexpression of XTP4 in HepG2 cells had significantly decreased the number of apoptotic cells (P < 0.05), and increased Bcl-2/Bax (P < 0.05) ratio, but decreased the expression of P53 protein (P < 0.05). The protein expression of Caspase-3 and activity of caspase-3 was decreased (P < 0.05). However, interference with XTP4 expression in HepG2 cells had significantly increased the number of apoptotic cells (P < 0.05) and decreased Bcl-2/Bax (P < 0.05) ratio, but increased the expression of P53 protein (P < 0.05). The protein expression of Caspase-3 and activity of caspase-3 was increased (P<0.05). Conclusion: In HepG2 apoptosis XTP4 has inhibitory effect, and its effect on inhibiting HepG2 apoptosis may be achieved by regulating the Bcl-2/Bax ratio, and the P53 protein may be involved.

PROTEIN EXPRESSION OF METADHERIN AND SENSIBILITY OF BREAST CANCER MDA-MB-231 CELLS TO TREATMENT BEFORE AND AFTER TRANSFECTION

Breast cancer tends to have an increasing mortality, severely threatening the health of females. The invasion and metastasis of breast cancer are the leading causes of death. It has been reported that breast cancer is caused by the activation of a series of proto-oncogenes and inactivation of anti-oncogenes. In the present study, Real-time PCR and Western blot were used to detect the protein expression level of metadherin before and after transfecting MDA-MB-231 cells to identify the effect, while the sensitivity of MDA-MB-231 cells to 1 mg/L doxorubicin and 8mg/L taxol was measured by methylthiazolyldiphenyl-tetrazolium bromide (MTT). The results demonstrated that mRNA and protein expression level of metadherin both improved after transfection. The inhibition effect of 1 mg/L doxorubicin and 8 mg/L taxol on breast cancer cells decreased after transfection. Detected by flow cytometry, the apoptosis rate of breast cancer cells was 39.68±0.42%, 20.64±0.55%, respectively, under the effect of 1 mg/L doxorubicin; while under the effect of 8 mg/L taxol, the rate was 24.89±0.41% and 13.8±0.63%, respectively. Thus the inhibition effects of 1 mg/L doxorubicin and 8mg/L taxol to breast cancer cells and their effects on apoptosis were different, and the differences were statistically significant (P<0.05). Based on the statistics on the expression level of metadherin after transfecting breast cancer cells MDA-MB-231 and the exploration of the sensitivity of the cells to treatment, the effect of metadherin on breast cancer MDA-MB-232 cells was proved.

Nicorandil prevents right ventricular remodeling by inhibiting apoptosis and lowering pressure overload in rats with pulmonary arterial hypertension

Background

Most of the deaths among patients with severe pulmonary arterial hypertension (PAH) are caused by progressive right ventricular (RV) pathological remodeling, dysfunction, and failure. Nicorandil can inhibit the development of PAH by reducing pulmonary artery pressure and RV hypertrophy. However, whether nicorandil can inhibit apoptosis in RV cardiomyocytes and prevent RV remodeling has been unclear.

Methodology/Principal Findings

RV remodeling was induced in rats by intraperitoneal injection of monocrotaline (MCT). RV systolic pressure (RVSP) was measured at the end of each week after MCT injection. Blood samples were drawn for brain natriuretic peptide (BNP) ELISA analysis. The hearts were excised for histopathological, ultrastructural, immunohistochemical, and Western blotting analyses. The MCT-injected rats exhibited greater mortality and less weight gain and showed significantly increased RVSP and RV hypertrophy during the second week. These worsened during the third week. MCT injection for three weeks caused pathological RV remodeling, characterized by hypertrophy, fibrosis, dysfunction, and RV mitochondrial impairment, as indicated by increased levels of apoptosis. Nicorandil improved survival, weight gain, and RV function, ameliorated RV pressure overload, and prevented maladaptive RV remodeling in PAH rats. Nicorandil also reduced the number of apoptotic cardiomyocytes, with a concomitant increase in Bcl-2/Bax ratio. 5-hydroxydecanoate (5-HD) reversed these beneficial effects of nicorandil in MCT-injected rats.

Conclusions/Significance

Nicorandil inhibits PAH-induced RV remodeling in rats not only by reducing RV pressure overload but also by inhibiting apoptosis in cardiomyocytes through the activation of mitochondrial ATP-sensitive K⁺ (mitoK_ATP) channels. The use of a mitoK_ATP channel opener such as nicorandil for PAH-associated RV remodeling and dysfunction may represent a new therapeutic strategy for the amelioration of RV remodeling during the early stages of PAH.

Origin of negative chi((3)) in squaraines: experimental observation of two-photon states

Femtosecond pump-probe experiments performed on squaraines demonstrate strong couplings between the first excited state and high-lying two-photon states. The experimental data agree well with our earlier quantum many-electron calculations based on multiple-excited configuration interactions. We show that high-lying twophoton states in squaraines are critically important to understanding the observed third-order optical properties and that two-level models are inadequate even for molecules with negative third-order optical susceptibilities.

[Chronic process with Non-A and Non-B hepatitis disseminated from the intestine (appended 500 cases followed up for two years)]

At present Non-A and Non-B hepatitis disseminated from the intestine in the world is believed to have a better prognosis and has no chronicity. From 1980-1986, this hepatitis has occurred in the south of Xinjiang. It was sporadic (1980-1985) and there was an outbreak (1986). Our study indicated that the results from 500 cases followed up for two years were different from the literature reported. 1. Patients with hepatomegaly were 11.2% at 7th months, 12.8% at 19th months and 45.3% at 28th months. At the same time there were 3 cases of splenomegaly and spider in each of the 19th month and 28th month. 2. Liver function test showed that gamma-GTP, BSP and gamma-globulins rose in different degrees among the 3-7 month cases. Reexamined at 19th months, 3.6% cases of both ZTT and SGPT were high. General proteins of 8% patients dropped. In 42% of the patients the globulins rose and the album in dropped. 3. Biopsy of the liver after 28th months demonstrated that it was in agreement with the pathologic changes found in chronic lobule hepatitis of CPH under the light microscope and electron microscope.

Prosthetic heart valves: waveform comparisons and average value disposition for pulsatile flow in vitro

With the development of the in vitro testing of heart valves, the standardization of the test methods becomes increasingly important and they should also be improved continuously. This paper discusses the problems of waveform comparison and average value dispositions. In the pulsatile model driven by pneumatics, the pressures before and after the valve, and the flow through it, are measured as three one-dimensional variates. The mean values are calculated according to the FDA and the ISO. A comparison and analysis of experimental waveforms indicate that, for basically the same ranges of pressures and flow rate, the flow curves of different types of valve are clearly different. The mean values and the waveforms in the time domain should be taken into consideration synthetically so that the pusatile characteristics of the valve can be more completely reflected. Using numerical filtering methods to treat the waveforms allows for better comparisons between the measured results taken from the different devices. By means of the constellation graphical method for treating mean values as multivariates, it is feasible to classify the valves and to judge their qualities under conditions of pulsatile flow.