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Abstract: Acute retinal necrosis normally occurs at the periphery retina and gradually merges and progresses to the posterior pole. Optic neuropathy and central retinal artery occlusion as initial manifestation is very rare. We report the case of a patient with optic neuropathy and central retinal vessels as the first manifestations of acute retinal necrosis. Antiviral drugs, corticosteroids, and drugs that improve blood circulation were given. The necrotic retina and swollen optic disc disappeared gradually. However, the final vision of this eye declined to no light perception. From the first case report in 2001 to now, a total of 8 sporadic cases have been reported. The average onset age is 60.85±14.05 years. Most of them had no history of virus infection. Cardiovascular disease history maybe a risk factor. Acute retinal necrosis should be considered in patients with retinal vascular occlusion accompanied by granulomatous anterior uveitis. Further research is needed to determine whether treatments in addition to antiviral and corticosteroid therapy are needed.

BACKGROUND AND PURPOSE: Arterial sclerosis resulting from hypertension slows CSF transportation in the perivascular spaces, showing the intrinsic relationship between the CSF and the blood vasculature. However, the exact effect of hypertension on human CSF flow dynamics remains unclear. The present study aimed to evaluate CSF flow dynamics in treatment-naive patients with essential hypertension using phase-contrast cine MR imaging. MATERIALS AND METHODS: The study included 60 never-treated patients with essential hypertension and 60 subjects without symptomatic atherosclerosis. CSF flow parameters, such as forward flow volume, forward peak velocity, reverse flow volume, reverse peak velocity, average flow, and net flow volume, were measured with phase-contrast cine MR imaging. Differences between the 2 groups were assessed to determine the independent determinants of these CSF flow parameters. RESULTS: Forward flow volume, forward peak velocity, reverse flow volume, reverse peak velocity, and average flow in the patients with hypertension significantly decreased (all, P

Background The prevalence of coronary artery disease (CAD) continues to increase among young Chinese adults. Current smoking has been recognized as a major risk factor for premature CAD, and hyperhomocysteinaemia (HHcy) has also been suggested to be associated with CAD progression. However, the combined effect of current smoking and HHcy on the severity of coronary artery stenosis in young adults is still uncertain. Methods We consecutively collected young patients (18–35 years of age), diagnosed with CAD and underwent coronary angiography (CAG) at Anzhen Hospital between January 2013 and May 2020. HHcy was defined as serum homocysteine (Hcy) level > 15 µmol/L. The severity of coronary artery stenosis was evaluated by Gensini Score. The co-effect of current smoking and HHcy on CAD severity as well as the relationship between plasma Hcy, pack-years of smoking and CAD severity were assessed by multivariate linear regression analysis. Results A total of 989 participants (mean age, 33 years; 96.2% male) fulfilling the criteria were enrolled in this study. Patients with both HHcy and current smoking accounted for 39.1% of all the subjects. Multivariate liner analysis indicated both serum Hcy levels (β 0.302; 95% CI 0.141–0.462; P β 0.523; 95% CI 0.265–0.781; P r = 0.116, P = 0.001). Moreover, combination of HHcy and current smoking was suggested to have higher risk for CAD severity (β 17.892; 95% CI 11.314–24.469; P β 7.471; 95% CI 0.009–14.934; P = 0.048) or current smoking (β 7.421; 95% CI 0.608–14.233; P = 0.033) alone. Conclusion Combination of HHcy and smoking is independently associated with the severity of CAD in young patients ≤ 35 years of age.

Background. Renal replacement therapy (RRT), as a cornerstone of supportive treatment, has long been performed in critically ill patients with acute kidney injury (AKI). However, the majority of studies may have neglected the effect of the duration of RRT on the outcome of AKI patients. This paper is aiming to explore the effect of the long duration of RRT on the outcome of critically ill patients with AKI. Methods. This retrospective study was conducted by using the Multiparameter Intelligent Monitoring in Intensive Care II (MIMIC-II) database. The primary outcome measure of this study was the mortality at 28 days, 60 days, and 90 days in the long-duration RRT group and the non-long-duration RRT group. The secondary outcomes assessed the difference in clinical outcome in these two groups. Lastly, the effect of the duration of RRT on mortality in AKI patients was determined as the third outcome. Results. We selected 1,020 patients in total who received RRT according to the MIMIC-II database. According to the inclusion and exclusion criteria, we finally selected 506 patients with AKI: 286 AKI patients in the non-long-duration RRT group and 220 in the long-duration RRT group. After 28 days, there was a significant difference in all-cause mortality between the long-duration RRT group and the non-long-duration RRT group ( P = 0.001 ). However, the difference disappeared after 60 days and 90 days ( P = 0.803 and P = 0.925 , respectively). The length of ICU stay, length of hospital stay, and duration of mechanical ventilation were significantly longer in the long-duration RRT group than those in the non-long-duration RRT group. Considering 28-day mortality, the longer duration of RRT was shown to be a protective factor (HR = 0.995, 95% CI 0.993–0.997, P < 0.0001 ), while 60-day and 90-day mortality were not correlated with improved protection. Conclusions. The long duration of RRT can improve the short-term prognosis of AKI patients, but it does not affect the long-term prognosis of these patients. Prognosis is determined by the severity of the illness itself. This suggests that RRT can protect AKI patients through the most critical time; however, the final outcome cannot be altered.

The fatigue of running sportswear is reflected in the fatigue caused by the tightness of the tights on the skin surface of the limbs, trunk, and other parts during long-term running sports. However, the current research on the fatigue of running sportswear is not deep enough. Therefore, the purpose of this study is to study the mechanism of the fatigue of running sportswear based on BP neural network. This article first takes sportswear as the starting point and uses the surface myoelectricity index as a physiological quantity as a means to combine clothing with sports medicine and sports physiology, breaking the traditional shackles of subjective assessment of fatigue, and giving play to the advantages of interdisciplinary to expand the new direction of the apparel industry and, secondly, use muscle fatigue evaluation method to analyze the muscles of the lower leg under the pressure of sportswear to analyze the strength of the EMG signal and the number of participating sports units and the frequency of discharge synchronization. Experimental data shows that the AUC is 0.756 when wearing sports tights, the sensitivity and specificity are 72% and 19%, and the accuracy is 65%. The experimental results show that clothing pressure affects the fatigue of running sportswear based on BP neural network.

Purpose: To describe the primary tumour type, clinical features, treatment and outcome of patients with Iris metastasis.Methods: Retrospectively analyzed articles published from 1934 to 2019 in the PubMed database.Results: In total, 133 eyes of 125 patients with iris metastatic carcinoma were retrieved. The average age at metastasis diagnosis of the patients was 56 ± 15 years; 60 left eyes and 49 right eyes were involved. The most common primary tumors were lung carcinoma (42%) and breast carcinoma (15%). Approximately one-third of the patients were first diagnosed in the ophthalmology department before the primary tumor was detected. Twenty-two percent of iris metastases were discovered before and 33% were discovered after systemic metastasis. The most common complaints were blurred vision and pain. The clinical features included iris masses, neovascularization and keratic precipitates. 57 patients (64%, N = 90) had an elevated intraocular pressure. Local administration of radiation therapy or intraocular injections of anti-VEGF drugs relieved eye discomfort and controlled the high intraocular pressures.Conclusions: Iris nodules with increased intraocular pressure and neovascularization may indicate iris metastasis. Lung cancer is the most common primary tumor.

Background We aimed to investigate early arteriosclerosis and its risk factors in populations with prediabetes and new-onset diabetes. Materials and methods A total of 148 participants who did not have diabetes mellitus were assigned to three groups through an oral glucose tolerance test: the normal glucose tolerance (NGT) group; the impaired glucose regulation, also known as prediabetes group and the new-onset type 2 diabetes mellitus group. The insulin resistance index was assessed using the homeostatic model assessment of insulin resistance (HOMA-IR). An ELISA was used to determine the level of fibroblast growth factor 21 (FGF21). An arteriosclerosis detector was used to measure the brachial-ankle pulse wave velocity (baPWV) and ankle-brachial index (ABI). The baPWV, ABI, and FGF21 were used to assess early arteriosclerosis. Results Significant differences in age, systolic blood pressure (SBP), fasting plasma glucose (FPG), 2-h plasma glucose (2hPG), 2-h insulin (2hINS), and HOMA-IR were found between the NGT group and the prediabetes and new-onset diabetes groups. All of the above, except 2hINS, showed an increasing trend. Moreover, the FGF21 was higher in the new-onset diabetes group than in the NGT group. The baPWV was higher in the new-onset diabetes group than in the other two groups, but no significant difference was noted in the ABI. Age, SBP, diastolic blood pressure, FPG, 2hPG, and FGF21 were positively correlated with the baPWV. In addition, FPG, SBP, FGF21, and HOMA-IR were independent risk factors for the baPWV. Conclusions Patients with prediabetes and new-onset diabetes may have more significant early arteriosclerosis. The blood glucose level and insulin resistance index may be independent risk factors for early arteriosclerosis.

Background: Bronchial asthma (BA) is a chronic airway inflammatory disease with reversible airflow limitation as the main clinical manifestations, such as wheezing, cough, shortness of breath, chest tightness, etc., mediated by a variety of inflammatory cells, which can be recurrent. Clinical can improve symptoms, but can not be cured, glucocorticoid is the most important first-line medication. Clinical practice has shown that montelukast sodium combined with fluticasone in the treatment of adult bronchial asthma can improve clinical efficacy and reduce adverse reactions. The purpose of this study is to systematically study the efficacy and safety of montelukast sodium combined with fluticasone in the treatment of adult bronchial asthma. Methods: The Chinese databases (CNKI, VIP, Wanfang, Chinese Biomedical Database) and English databases (PubMed, the Cochrane Library, Embase, Web of Science) were searched by computer, for the randomized controlled clinical studies of montelukast sodium combined with fluticasone in the treatment of adult bronchial asthma from establishment of database to October 2020. Two researchers independently extracted the relevant data and evaluated the quality of the literatures, and used RevMan5.3 software to conduct meta-analyze of the included literatures. Results: This study assessed the efficacy and safety of montelukast sodium combined with fluticasone in the treatment of adult bronchial asthma through total effective rate, pulmonary function (FEV1, FVC, PEF, FEV1/FVC), and adverse reactions. Conclusion: this study will provide reliable evidence-based evidence for the clinical application of montelukast sodium combined with fluticasone in the treatment of adult bronchial asthma.

Objectives. To verify whether the concentrations and integrity index of circulating cell-free DNA (cfDNA) in serum may be clinically useful for the progression monitoring of colorectal cancer (CRC) patients. Methods. Serum samples were collected from 76 primary CRC patients who underwent surgery, including 60 with chemotherapy and 43 with follow-up. Long (247 bp) and short (115 bp) DNA fragments in serum were detected by real-time quantitative PCR by amplifying the ALU repeats. Ten serum traditional biomarkers levels were detected by chemiluminescence immunoassay assay. Results. The median DNA integrity index (ALU247/ALU115) of serum DNA in the preoperative group was significantly higher than those in the postchemotherapy and the follow-up groups, while cfDNA concentration (ALU115) was significantly lower in the preoperative group compared with the postchemotherapy and the follow-up groups. CEA and CA242 were significantly lower in the postoperative group than in the preoperative group. Conclusions. Serum DNA integrity index (ALU247/115) may prove to be a promising candidate biomarker for prognostic prediction of CRC who underwent chemotherapy and during short-term follow-up.

We aimed to study the infection status and distribution of human papillomavirus (HPV) in Yangzhou City to provide precise guidance for the prevention and treatment of cervical cancer in this area. Reproductive tract secretions were collected from patients admitted at Subei People's Hospital over the past 3 years. Fifteen high-risk HPV (HR-HPV) genotypes were analyzed by fluorescent polymerase chain reaction. The positive rate of HR-HPV in 34 420 subjects was 23.56%. There was no significant difference in the rate of overall infection between males and females (χ 2 = 0.04; p = 0.952 > 0.05). The five genotypes with high infection rates in the population were HPV52, HPV58, HPV16, HPV51, and HPV39. Single infection was found to be dominant, primarily with the HPV52 genotype. The infection rate was higher in patients less than 20 years old and more than 60 years old. Most patients with cervical intraepithelial neoplasms 2/3 and cervical cancer were infected by HPV16, followed by those infected by HPV52 and HPV58. There was a significant difference in the infection rate of HPV16 among patients with different cervical lesions (χ 2 = 31.660; p 20 years).

Aims: This study aims to explore early intensive lipid-lowering therapy in patients with non- ST-segment elevation acute coronary syndrome (NSTE-ACS). Background: Lowering low-density lipoprotein cholesterol (LDL-C) levels can reduce cardiovascular morbidity and mortality in patients with atherosclerotic cardiovascular disease. Due to many reasons, the need for early intensive lipid-lowering therapy is far from being met in Chinese NSTE-ACS patients at high risk of recurrent ischaemic events. Objective: This study evaluates the feasibility, safety and efficacy of starting evolocumab in hospitals to lower LDL-C levels in Chinese patients with NSTE-ACS. Methods: In this prospective cohort study initiated by researchers, 334 consecutive patients with NSTEACS who had sub-standard LDL-C levels (LDL-C ≥2.3 mmol/L after regular oral statin treatment for at least 4 weeks; or LDL-C ≥3.2 mmol/L without regular oral statin treatment) were included. Patients who agreed to treatment with evolocumab (140 mg subcutaneously every 2 weeks, initiated in hospital and used for 12 weeks after discharge) were enrolled in the evolocumab group (n=96) and others in the control group (n=238). All enrolled patients received regular statin treatment (atorvastatin 20 mg/day or rosuvastatin 10 mg/day; doses unchanged throughout the study). The primary endpoint was the change in LDL-C levels from baseline to week 12. Results: Most patients (67.1%) had not received regular statin treatment before. In the evolocumab group, LDL-C levels decreased significantly at week 4 and remained stable at week 8 and 12 (all p Conclusions: In this prospective cohort study, we evaluated the early initiation of evolocumab in NSTEACS patients in China. Evolocumab combined with statins significantly lowered LDL-C levels and increased the probability of achieving recommended LDL-C levels, with satisfactory safety and good tolerance.

SUMMARYIt was reported that about 10% of people suffer from painful knee arthritis, and a quarter of them were severely disabled. The core activities of daily living were severely limited by knee osteoarthritis (KOA). In order to reduce knee pain and prolong the life of the knee joint, there has been an increasing demand on the development of exoskeletons, for prevention and treatment. The course of KOA was closely related to the biomechanics of knee joint, and the pathogenesis was summarized based on the biomechanics of knee joint. For the prevention and clinical treatment, exoskeletons are classified into three categories: prevention, treatment, and rehabilitation after the operation. Furthermore, the design concepts, actuators, sensors, control strategies, and evaluation criteria were presented. Finally, the shortcomings and limitations were summarized. It is useful for researchers to develop suitable exoskeletons in the future.

The GABAB receptor (GABABR) agonist baclofen has been used to treat alcohol and several other substance use disorders (AUD/SUD), yet its underlying neural mechanism remains unclear. The present study aimed to investigate cortical GABABR dynamics following chronic alcohol exposure. Ex vivo brain slice recordings from mice chronically exposed to alcohol revealed a reduction in GABABR-mediated currents, as well as a decrease of GABAB1/2R and G-protein-coupled inwardly rectifying potassium channel 2 (GIRK2) activities in the motor cortex. Moreover, our data indicated that these alterations could be attributed to dephosphorylation at the site of serine 783 (ser-783) in GABAB2 subunit, which regulates the surface expression of GABABR. Furthermore, a human study using paired-pulse-transcranial magnetic stimulation (TMS) analysis further demonstrated a reduced cortical inhibition mediated by GABABR in patients with AUD. Our findings provide the first evidence that chronic alcohol exposure is associated with significantly impaired cortical GABABR function. The ability to promote GABABR signaling may account for the therapeutic efficacy of baclofen in AUD.

OBJECTIVE This study aimed to evaluate the efficacy and safety of ultrasound-guided microwave ablation combined with glucocorticoid therapy for treating idiopathic granulomatous mastitis (IGM). METHODS From June 2017 to March 2020, 50 consecutive patients diagnosed with IGM using puncture histology were included. All patients received prednisone and ultrasound-guided microwave ablation and were closely monitored for 12-15 months. RESULTS A total of 222 lesions in 50 patients were ablated. The results indicated that 78% of cases were cured within 12 months and an additional 20% were cured within 15 months; the recurrence rate was 2%. The clinical and pathological remission rate of the entire group was 98%. The main postoperative complications were local pain, skin ulcerations and sinus formation, skin and areola heat damage, subcutaneous congestion, and fat liquefaction, all of which were conservatively treated. CONCLUSION Microwave ablation combined with glucocorticoid therapy was safe and effective for the treatment of IGM, with a low recurrence rate. In addition, the cosmetic appearance of the affected breast was preserved with little trauma. Therefore, microwave ablation is a viable method that can be successfully applied in clinical practice.

Purpose: The purpose of the study was to evaluate the antitumor activity of CIK cells in vitro and investigate the clinical efficacy of cytokine-induced killer (CIK) therapy following operation of renal cell carcinoma patients in North China. Method: In vitro experiments, the secretion of IFN-γ and IL-2 in CIK cells were detected by ELISA and the degranulation was detected by flow cytometry. From January 1, 2012 to October 1, 2015, 202 patients were enrolled in the study and were followed up for at least 36 months. The information of 101 patients who received CIK treatment following nephrectomy and other 101 patients who only received nephrectomy was retrospectively collected. In addition, the correlation of CIK treatment to prognosis of patients following nephrectomy, including disease-free survival (DFS) and overall survival (OS), was analyzed by Kaplan-Meier analyses. COX proportional hazards analyses were used to investigate the benefited population. Results: In vitro, DC-CIK group exhibited the highest cytokines secretion and cytotoxicity followed by the CIK group. In addition, survival analysis showed that patients in North China who received CIK therapy has better prognosis compared to the control group. And the COX proportional hazards analyses demonstrated that in North China, patients with different characteristics can benefit from CIK treatment at the same. Conclusions: CIK immunotherapy is an effective and safety adjuvant for the patients with ccRCC following nephrectomy in North China.

Background:The aim of this study was to explore the inhibitory effect of baicalin on myocardial apoptosis induced by Ischemia-Reperfusion (I/R).Methods:Sprague Dawley rats' heart and myocardial cells I/R model were established in vivo and vitro, then 100 mg/kg and 10 μmol/l baicalin were administrated, respectively. The experiment was randomly divided into 4 groups (n=10): Control; I/R; IR+DMEM; and I/R+baicalin groups. Postoperation, the Left Ventricular (LV) End-Diastolic Pressure (LVEDP), the maximum velocity of LV contraction (dP/dtmax) and the maximum velocity of LV diastole (dP/dtmin) were recorded by the transthoracic echocardiography; the myocardial apoptosis percentage was analyzed by Annexin VFITC/ PI and TUNEL staining, and the apoptosis gene and protein were detected by RT-PCR and western blot. Furthermore, the protein expression of the calcium-sensing receptor (CaSR) and ERK1/2 phosphorylation were observed by western blot and Fura-2-acetoxymethyl ester. Moreover, primary rats’ cardiomyocytes were cultured and ERK1/2 specific inhibitor PD98059 was added to the culture medium. The cell survival rate, vitality and apoptosis were detected by MTT, lactate dehydrogenase (LDH) and TUNEL staining assay Kit, respectively.Results:Our present study showed that baicalin significantly improved LV hemodynamic parameters and myocardial apoptosis in myocardial I/R injury rats. Furthermore, we found that baicalin could down-regulate the protein expression of CaSR, but up-regulate the protein expression of ERK1/2. Furthermore, when the cells were pretreated with ERK1/2 inhibitor PD98059, the cells survival rate significantly decreased, but LDH activity and apoptosis significantly increased. The results indicated that the effect of baicalin on myocardial I/R injury could be inhibited by ERK1/2 inhibitor.Conclusion:In conclusion, our data suggests that baicalin attenuates I/R-induced myocardial injury maybe through the suppression of the CaSR/ERK1/2 signaling pathway.

Background Individuals with hepatocellular carcinoma (HCC) are at risk of tumor recurrence after surgical resection, which affects their survival. The aim of the present study was to establish a model for predicting tumor progression in patients with HCC. Methods To develop and validate the efficacy of a novel prognostic model, a retrospective cohort with HCC (n = 1005) at Beijing Ditan Hospital was enrolled from January 2008 and June 2017. Furthermore, a prospective cohort (n = 77) was recruited to validate the association between thyroid-stimulating hormone (TSH) levels and tumor progression in patients with HCC. Results The model used in predicting the progression of HCC included four variables (namely, Barcelona Clinic Liver Cancer [BCLC] stage, presence of portal vein tumor thrombus, alpha-fetoprotein level, and TSH level). The AUROC of the 1-year progression-free survival (PFS) model was 0.755 and 0.753 in the deriving cohort and validation cohort, respectively, and these values were significantly higher than those of the Child-Pugh score, Model for End-stage Liver Disease (MELD), tumor-lymph node-metastasis (TNM) staging system, Okuda classification, and CLIP score. A simple assessment using a nomogram showed the 1-year PFS rate of patients with HCC. In the prospective cohort, the KM curve showed that the high TSH level group had a shorter PFS than the low TSH level (p = 0.001). Conclusion The prognostic model of HCC progression was superior to other well-known classical tumor scoring systems. A high TSH level was correlated to poor outcome, particularly those with advanced HCC.

Aim Hypercortisolism is characterized by metabolic disorders and high mortality rates. Adrenalectomy and medical therapies are considered major treatment options. However, some patients, especially young patients, are strongly against undergoing surgery in case of secondary hypocortisolism or relapses that require replacement supplements or pharmacological interventions. In such cases, alternative therapies are needed to treat hypercortisolism. Methods We report a 27-year-old Chinese female with adrenal cortisol-producing adenoma. The patient's circadian rhythm and concentrations of cortisol were abnormal, accompanying with an increased 24-hour urinary cortisol level. Computed tomography (CT) revealed a nodular soft-tissue mass in the right adrenal gland. Results Cortisol hypersecretion from the right adrenal gland was verified by adrenal venous sampling (AVS). Adrenal artery ablation was performed. After ablation, long-term follow-up showed that the patient's symptoms subsided and abnormal laboratory test results returned to normal without pharmacological treatment. Conclusion AVS might be a promising method to aid the diagnosis of cortisol-producing adenoma. Adrenal artery ablation is minimally invasive and may be useful for the treatment of adrenal adenoma or nodular diseases, especially in patients who cannot undergo surgery.

Primary aldosteronism (PA) is associated with resistant hypertension and cardiovascular events. There are some limitations of current medical and surgical therapies for PA. To determine the efficacy and safety of catheter‐based adrenal artery ablation for treatment of PA patients who refused both surgery and medical therapy, we performed this prospective cohort study. Thirty‐six PA patients without apparent aldosteronoma were treated by adrenal artery ablation. Primary outcome was postoperative blood pressure and defined daily dose (DDD) of antihypertensive medications after adrenal ablation. Secondary outcome was biochemical success. We assessed outcomes based on Primary Aldosteronism Surgical Outcome (PASO) criteria. Adrenal CT scan, biochemical evaluation, adrenal artery ablation and adrenal venous sampling (AVS) were underwent. After adrenal ablation, complete clinical success (normotension without antihypertensive medication) was achieved in 9/36 (25.0%) patients and partial clinical success (reduction in blood pressure or less antihypertensive medication) in 13/36 (36.1%) patients. Complete biochemical success (correction of hypokalemia and normalization of aldosterone‐to‐renin ratio) was achieved in 16/36 (44.4%) patients. Office‐based and ambulatory blood pressures were reduced by 17/7 and 11/2 mmHg at 6 months after ablation, respectively. The plasma cortisol level in the ablation group decreased slightly, but no patient developed hypoadrenocorticism. Catheter‐based adrenal ablation appears to produce substantial and sustained blood pressure reduction and biochemical improvement, with only minor adverse events in PA patients without apparent aldosteronoma. This therapy could be an important supplement for current PA treatments.

Disease progression is an important factor affecting the long-term survival in hepatocellular carcinoma (HCC). The progression-free survival (PFS) has been used as a surrogate endpoint for overall survival (OS) in many solid tumors. However, there were few models to predict the PFS in HCC patients. This study aimed to explore the prognostic factors that affect the PFS in HCC and establish an individualized prediction model. We included 2890 patients with hepatitis B-related HCC hospitalized at Beijing Ditan Hospital, Capital Medical University and randomly divided into training and validation cohort. Cox multivariate regression was used to analyze independent risk factors affecting the 1-year PFS of HCC, and an artificial neural networks (ANNs) model was constructed. C-index, calibration curve, and decision curve analysis were used to evaluate the performance of the model. The median survival time was 26.2 m (95% CI: 24.08–28.32) and the 1-year PFS rate was 52.3% in whole study population. Cox multivariate regression showed smoking history, tumor number ≥ 2, tumor size ≥ 5 cm, portal vein tumor thrombus, WBC, NLR, γ-GGT, ALP, and AFP ≥ 400 ng/mL were risk factors for 1-year progression-free survival, while albumin and CD4 T cell counts were protective factors in HCC patients. A prediction model for 1-year PFS was constructed ( https://lixuan.me/annmodel/myg-v3/ ). The ANNs model’s ability to predict 1-year PFS had an area under the receiver operating characteristic curve (AUROC) of 0.866 (95% CI 0.848–0.884) in HCC patients, which was higher than predicted by TNM, BCLC, Okuda, CLIP, CUPI, JIS, and ALBI scores (p

AimsTo study the clinical characteristics of 2000 patients with uveitis admitted to the ophthalmology centre of the Second Hospital of Jilin University.MethodsWe retrospectively analysed 2000 patients with uveitis who were admitted to the uveitis clinic of the Second Hospital of Jilin University from July 2010 to June 2019 and analysed data on sex, onset age, onset season, anatomical classification, visual acuity and compared the results with those of other investigation studies.ResultsAmong 2000 uveitis patients, the mean age of onset was 39.9±14.9 years. There were 946 male patients (47.3%) and 1054 female patients (52.7%). By anatomical classification, panuveitis was the most common (986 cases, 49.3%), followed by anterior uveitis (786 cases, 39.3%), posterior uveitis (119 cases, 6.0%) and intermediate uveitis (109 cases, 5.5%). Among anterior uveitis cases, ankylose spondylitis (207 cases, 26.34%), Fuchs syndrome (74 cases, 9.41%) and viral uveitis (71 cases, 9.03%) were the most common. Among panuveitis cases, Vogt-Koyanagi-Harada syndrome (372 cases, 37.73%), Behcet’s disease (142 cases, 14.40%) and sympathetic ophthalmitis (33 cases, 3.35%) were the most common. Uveitis often occurs during the autumn–winter transition period. The prevalence of anterior uveitis is highest in November, and statistical analysis shows that the incidence of uveitis has a significant correlation with the month. Panuveitis has the most significant effect on vision.ConclusionPanuveitis and anterior uveitis are the most common anatomical classifications of uveitis, which has a significant impact on vision, and their incidence is related to seasonal changes.

Objective: To facilitate the analysis and diagnosis of X-ray coronary angiography in interventional surgery, it is necessary to extract vessel from X-ray coronary angiography. However, vessel images of angiography suffer from low quality with large artefacts, which challenges the existing vascular technology. Methods: In this paper, we propose a avessel framework to detect vessels and segment vessels in angiographic vessel data. In this framework, we develop a new matrix decomposition model with gradient sparse in the tensor representation. Then, the energy function with the input of the hierarchical vessel is used in vessel detection and vessel segmentation. Results: Through experiments conducted on angiographic data, we have demonstrated the good performance of the proposed method in removing background structure. Conclusion: We evaluated our method for vessel detection and segmentation in different clinical settings, including LAO/RAO with cranial and caudal angulation, and showed its competitive results compared with eight state-of-the-art methods in terms of extensive qualitative and quantitative evaluation. Significance: Our method can remove a large number of background artefacts and obtain a better vascular structure, which has contributed to the clinical diagnosis of coronary artery diseases.

Early molecular response is associated with improved probability of deep molecular response and superior survival in patients with CML-CP. However, ~1 in 3 patients on first-line imatinib do not achieve this threshold. The phase 2b DASCERN trial (NCT01593254) assessed the outcome of early switch to dasatinib in patients with suboptimal response to first-line imatinib. Adult patients with CML-CP were randomized (2:1) to receive 100 mg dasatinib (n = 174) or continue imatinib at ≥400 mg (n = 86). The primary endpoint was the rate of major molecular response (MMR) at 12 months, which was 29% (dasatinib) and 13% (imatinib; P = 0.005). After ≥2 years of follow-up, 45 patients (52%) randomized to continue imatinib had crossed over to dasatinib. Considering treatment crossover, the 2-year cumulative MMR rate was 64% with dasatinib and 41% with imatinib (66% and 67%, respectively by intent-to-treat). Adverse events were consistent with the established safety profiles of both drugs. The results of this first prospective study support early monitoring of patients treated with first-line imatinib, and suggest that switching to dasatinib in cases of suboptimal response may offer clinical benefit. Further follow-up is needed to assess the long-term clinical benefit of early switching.

To compare the risk of cardiovascular events between patients with two CYP2C19 loss-of-function alleles who were prescribed ticagrelor or clopidogrel after percutaneous coronary intervention (PCI). Patients with two loss-of-function alleles based on the CYP2C19 genotype were selected from patients enrolled in a retrospective institutional registry. Propensity score matching using logistic regression was performed to adjust for bias between patients prescribed ticagrelor or clopidogrel. Multivariate Cox regression was used to compare the risk of adverse events in the ticagrelor and clopidogrel groups. The primary outcome was the incidence of major adverse cardiac events plus any repeat target vessel revascularization within 12 months after PCI. The safety outcomes were minor and major bleeding events. From 1518 patients carrying two loss-of-function alleles based on the CYP2C19 genotype who underwent PCI, 638 patients treated with ticagrelor or clopidogrel were successfully propensity-score matched. The primary outcome occurred in 25 patients (7.8%) in the ticagrelor group and 47 (14.7%) in the clopidogrel group. The risk of the primary outcome was significantly lower in the ticagrelor group versus the clopidogrel group (HR 0.466, 95% CI 0.286–0.759, p = 0.002). The incidence of major bleeding events did not significantly differ between the ticagrelor and clopidogrel groups (0.3% and 0.9%, respectively), while the ticagrelor group had a higher risk of minor bleeding events (HR 1.959, 95% CI 1.396–2.750, p

Xiaojiao Jia, Lanxiang Liu, Rui Wang, Xiaoli Liu, Binbin Liu, Ning Ma, Qiang Lu Department of Endocrinology, The First Hospital of Qinhuangdao, Qinhuangdao 066000, Hebei Province, People’s Republic of ChinaCorrespondence: Qiang LuDepartment of Endocrinology, The First Hospital of Qinhuangdao, No. 258 Wenhua Road, Qinhuangdao 066000, Hebei Province, People’s Republic of ChinaTel +86-335-5908368Fax +86-335-3032042Email 13933552979@163.comBackground: Several studies have reported the relationship of diabetes mellitus (DM) and obesity with bone mineral density (BMD), but the conclusions remain unclear. This study aimed to provide more information for the relationship of plasma glucose and abdominal visceral fat (AVF) with BMD and bone mineral content (BMC) in women with different glucose metabolism status.Methods: Patients were screened by oral glucose tolerance test (OGTT) and were divided into three groups: normal glucose tolerance (NGT, n=132), pre-diabetes mellitus (pre-DM, n=28) and newly diagnosed type 2 DM (T2DM, n=27) groups. Plasma glucose concentrations, anthropometric measurements, body composition, and BMD were measured. Analysis of variance (ANOVA), pearson correlation, and multiple linear regression models were used to evaluate the relationship between BMD, plasma glucose, AVF, and other variables.Results: The percentage of subjects with osteoporosis or low BMD was 29.9%, and 66.7% subjects in T2DM group were significantly higher than that in the pre-DM (28.6%) and NGT (22.7%) groups (p=0.005 and p< 0.001, respectively). Both BMD at femoral neck (FN) and lumbar spine (LS) of T2DM group were lower than those in NGT group (p=0.009 and p=0.003, respectively), and BMC of T2DM group was lower than those of NGT and pre-DM groups (p< 0.001). The results of statistical analysis revealed that both two-hour plasma glucose (2-h PG) and age showed negative correlation with BMC, FN BMD, and LS BMD. AVF showed positive correlation with BMC and LS BMD. Furthermore, the lean mass (LM) showed independent positive effects on BMC.Conclusion: Our findings suggest that 1) Age is a strong negative predictor of bone mass. 2) A direct negative effect of increasing 2-h PG might be more prominent at bone mass in women. 3) A moderate increase in AVF is beneficial to bone mass, while excessive increase might be harmful. 4) LM is a positive predictor of BMC.Keywords: abdominal visceral fat, abnormal glucose metabolism, two-hour plasma glucose, bone mineral density, bone mineral content

Objective. In this study, we aimed to investigate the associations of three single-nucleotide polymorphisms (SNPs) on TITF1/TITF2 (rs944289, rs965513, and rs1443434) with susceptibility to papillary thyroid carcinoma (PTC) and with nodular goiter (NG) in northern Chinese Han populations. Methods. We performed a case-control study comprising 861 PTC patients, 562 NG patients, and 896 normal controls (NCs). One TITF1 SNP (rs944289) and two TITF2 SNPs (rs965513 and rs1443434) were genotyped. Departures from Hardy–Weinberg equilibrium (HWE) in the control group were evaluated using chi-square test. Associations of the SNPs with PTC and with NG were assessed by unconditional logistic regression using the online SNPStats program. Bonferroni correction was performed for multiple tests in genotype analyses. Data analysis was performed by SPSS24.0 unless otherwise specified. Results. For rs944289, T allele was associated with increased risks for both PTC (OR = 1.23, 95% CI: 1.08–1.41, P=0.002) and NG (OR = 1.28, 95% CI: 1.10–1.50, P=0.002), and TT genotype significantly increased NG risk (recessive model, OR = 1.60, 95% CI: 1.22–2.10, P=0.001). For rs965513, no association was observed after Bonferroni correction. For rs1443434, G allele was associated with increased PTC risk (OR = 1.33, 95% CI: 1.10–1.61, P=0.003). Moreover, PTC risk increased with the number of total risk alleles of the three SNPs (OR = 1.25, 95% CI: 1.13–1.37, P<0.001). After stratified by gender, the risk effect of rs944289 T allele on PTC was only observed in females (OR = 1.29, 95% CI: 1.10–1.50, P=0.001). Individuals carrying rs944289-rs965513-rs1443434 haplotypes T-G-G and T-G-T had increased risks of PTC (OR = 1.82, 95% CI: 1.25–2.64, P=0.002) and NG (OR = 1.28, 95% CI: 1.06–1.54, P=0.011), respectively. Conclusions. There are associations of rs944289 and rs1443434 polymorphisms with PTC risk and association of rs944289 polymorphism with NG risk. Haplotypes T-G-G and T-G-T are risk haplotypes of PTC and NG, respectively.

Background The study investigated the predictive value of tumor angiogenesis observed by 18F-ALF-NOTA-PRGD2 II (denoted as 18F-Alfatide II) positron emission tomography (PET)/computed tomography (CT) before concurrent chemoradiotherapy (CCRT) for treatment response and survival among patients with locally advanced non-small cell lung cancer (LA-NSCLC). Methods Patients with unresectable stage IIIA or IIIB NSCLC (AJCC Cancer Staging 7th Edition) who received CCRT were included in this prospective study. All patients had undergone 18F-Alfatide PET/CT scanning before CCRT, and analyzed parameters included maximum uptake values (SUVmax) of primary tumor (SUVP) and metastatic lymph nodes (SUVLN) and mean uptake value of blood pool (SUVblood). Tumor-to-background ratios (TBRs) and changes in tumor diameter before and after CCRT (ΔD) were calculated. The ratios of SUVP to SUVblood, SUVLN to SUVblood, and SUVP to SUVLN were denoted as TBRP, TBRLN, and T/LN. Short-term treatment response, progression-free survival (PFS), and overall survival (OS) were evaluated. Results Of 38 enrolled patients, 28 completed CCRT. SUVP, SUVLN, TBRP, TBRLN and T/LN showed significant correlation with PFS (all P P was negatively correlated with OS (P = 0.005). SUVP and TBRP were higher in non-responders than in responders (6.55 ± 2.74 vs. 4.61 ± 1.94, P = 0.039; 10.49 ± 7.58 vs. 7.73 ± 6.09, P = 0.023). ΔD was significantly greater in responders (2.78 ± 1.37) than in non-responders (-0.16 ± 1.33, P P (area under the curve [AUC] = 0.764, P = 0.018), with a cutoff value of 6.52, as the only parameter significantly predictive of the response to CCRT, with sensitivity, specificity, and accuracy values of 71.43%, 78.57%, and 75.00%, respectively. ROC curve analysis also identified SUVP (AUC = 0.942, P P (AUC = 0.895, P = 0.001, cutoff value 4.95) as predictive of OS with high sensitivity (84.21%, 93.75%), specificity (100.00%, 66.67%), and accuracy (89.29%, 82.14%). Conclusions Evaluation of tumor angiogenesis by 18F-Alfatide II at baseline may be useful in predicting the short-term response to CCRT as well as PFS and OS in patients with LA-NSCLC.

Background Ependymomas, especially intracranial ependymomas, are rare neoplasms of the CNS. The clinical courses of patients with intracranial ependymomas can be quite variable. At present, data on parkinsonism caused by ependymomas are scarce. Case presentation A 13‐year‐old girl presented with parkinsonism symptoms of clumsiness in her left leg and hand. Her mother was diagnosed with Parkinson's disease at age 30, nine years previously. Magnetic resonance imaging showed a lesion in the temporal lobe with long‐T1 signal, mixed‐T2 signal. The patient was taken in for a right tumorectomy and was diagnosed as having an ependymoma postoperatively. The patient's symptoms fully resolved in the postoperative phase. Conclusion The case describes the mechanism of intracranial ependymoma involving parkinsonism symptoms. Our findings suggest that in some patients presenting with atypical PD symptoms the underlying cause should not be overlooked; MRI examination is necessary.

Increasing women’s knowledge about maternal health is an important step towards empowering them and making them aware of their rights and health status, allowing them to seek appropriate health care. In Yemen, the ongoing conflict has hampered the delivery of health information to women in public health facilities. This study examined rural women’s knowledge of, and attitude towards, maternal and child health in Yemen and identified the factors associated with good maternal health knowledge. The study was conducted between August and November 2018. A sample of 400 women aged 15–49 years who had delivered in the 6 months prior to the survey were systematically selected from selected public health facilities in Abyan and Lahj. Women were interviewed using a structured questionnaire to gather data on their demographic and economic characteristics, obstetric history and responses to health knowledge and attitude questions. Women’s knowledge level was assessed as poor or good using the mean score as a cut-off. Chi-squared test and multiple logistic regression analysis were used to identify statistically significant factors associated with good maternal health knowledge. The percentage of women who had good knowledge was 44.8% (95% CI: 39.8–49.8). Women’s attitude towards maternal health was negative in the areas of early ANC attendance, managing dietary regime and weight during pregnancy, facility delivery, PNC visits, cord care and mother and child health management. Women with primary education, whose husbands had received no formal education, who had their first ANC visit from the second trimester of pregnancy and who had fewer than four ANC visits were more likely to have poor health knowledge. Conversely, those with higher household income and only one child were more likely to have good maternal health knowledge. Overall, women’s knowledge on maternal and child health care in rural areas of Yemen was low. Strategies are needed to increase rural women’s knowledge on maternal and child health in this conflict-affected setting.

Prostate cancer is a heterogeneous disease with high incidence and mortality. The functional role of miR-886 has been reported in various cancers and its dysregulation in prostate cancer was also found. Whether miR-886 was involved in the development of prostate cancer remains unclear, which was explored. miR-886 was evaluated in prostate cancer by RT-qPCR, and its clinical value was also assessed. Additionally, the role of miR-886 in prostate cancer cells was assessed by MTT and transwell assay. miR-886 was upregulated and was associated with the Gleason score and TNM stage of prostate cancer patients. miR-886 could predict the poor survival of patients. Moreover, miR-886 was a tumour promoter, of which the upregulation significantly promoted major cellular processes of prostate cancer. miR-886 mediated the disease development and predicted the clinical outcomes of patients. The knockdown of miR-886 inhibits cellular processes of prostate cancer, which provides a novel therapeutic target.

IMPORTANCE: Discrepancies in oxygen saturation measured by pulse oximetry (SpO(2)), when compared with arterial oxygen saturation (SaO(2)) measured by arterial blood gas (ABG), may differentially affect patients according to race and ethnicity. However, the association of these disparities with health outcomes is unknown. OBJECTIVE: To examine racial and ethnic discrepancies between SaO(2) and SpO(2) measures and their associations with clinical outcomes. DESIGN, SETTING, AND PARTICIPANTS: This multicenter, retrospective, cross-sectional study included 3 publicly available electronic health record (EHR) databases (ie, the Electronic Intensive Care Unit–Clinical Research Database and Medical Information Mart for Intensive Care III and IV) as well as Emory Healthcare (2014–2021) and Grady Memorial (2014–2020) databases, spanning 215 hospitals and 382 ICUs. From 141 600 hospital encounters with recorded ABG measurements, 87 971 participants with first ABG measurements and an SpO(2) of at least 88% within 5 minutes before the ABG test were included. EXPOSURES: Patients with hidden hypoxemia (ie, SpO(2) ≥88% but SaO(2)

Xinhui Wang, Xiaoli Liu, Peng Wang, Lihua Yu, Fengna Yan, Huiwen Yan, Dongdong Zhou, Zhiyun Yang Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, People’s Republic of ChinaCorrespondence: Zhiyun YangCenter of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, People’s Republic of ChinaTel/Fax +86-10-84322148Email yangzhiyun2016@163.comBackground and Aims: Although antiviral treatment has been shown to reduce mortality in hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) patients with high HBV-DNA levels, it is still unclear whether it is useful in reducing mortality in patients with low HBV-DNA levels.Methods: A retrospective analysis of 756 HBV-associated HCC patients at the Beijing Ditan Hospital with HBV-DNA levels < 500 IU/mL was conducted between January 2008 and June 2017. Patients were divided into antiviral and non-antiviral groups based on whether they received nucleos(t)ide analogue (NA) treatment when they were diagnosed with HCC in our hospital for the first time. We used 1:4 frequency matching by age, gender, tumor size, Barcelona Clinic Liver Cancer (BCLC) staging, anti-tumor therapy, cirrhosis, diabetes, and hyperlipoidemia to compare the antiviral (n = 366) and non-antiviral (n = 100) groups. A Cox multivariate regression analysis was employed to evaluate the effects of NA therapy on the hazard ratio (HR), and the Kaplan–Meier survival curve was used to determine the mortality risk in patients with HCC. A Log rank test was performed to analyze the effects of NA therapy on the survival rate of patients with HCC.Results: After propensity score matching, the 1-, 3-, and 5-year overall survival (OS) rates for the antiviral and non-antiviral groups were 82.5%, 68.6%, and 52.2%, and 61.0%, 51.0%, and 38.0%, respectively. The l-year progression-free survival (PFS) rates for the two groups were 68.0% and 47.0%, respectively. The OS of the antiviral group was significantly higher than that of the control group (P < 0.001, P = 0.001, and P = 0.013, respectively). The 1-year PFS for the antiviral group was also significantly better than that for the non-antiviral groups (P = 0.005). After adjusting for confounding prognostic factors in the Cox model, the HR of 5-year death after antiviral treatment was 0.721 (95% confidence interval [CI], 0.530– 0.980, P = 0.037). Antiviral therapy is an independent protective factor for 5-year mortality in patients with HCC and low-level viremia.Conclusion: Antiviral therapy significantly reduced mortality in HCC patients with low HBV-DNA levels.Keywords: antiviral therapy, hepatitis B virus, low-level viremia, hepatocellular carcinoma, prognosis, nucleos(t)ide analog

Background: With the rapid change of lifestyle, the incidence of coronary artery disease (CAD) was gradually rising among young people, but the specific reason for it was unclear. There were many evidences suggesting free fatty acids (FFAs) were involved in progression of CAD, our study was designed to discuss the relationship between serum FFAs and acute coronary syndrome (ACS) and the complexity of coronary artery disease in premature coronary artery disease (pCAD) patients. Methods: 502 pCAD patients suffering from ACS confirmed by coronary angiography in Beijing Anzhen Hospital from January to December 2019 were enrolled (ACS group), and 141 patients of the same age whose coronary angiography result was negative were selected during the same period (control group). The clinical data and characteristics of CAD among two groups were gathered and compared.Results: The level of FFAs in ACS group was significantly higher than control group (P < 0.001), and the value of FFAs in AMI group was higher than UA (P < 0.05) in both genders. The concentration of FFAs in three-vessel disease group was higher than double-vessel disease group and double-vessel disease group was higher than single-vessel disease group. The linear correlation coefficient between FFAs value and SYNTAX score was 0.370, P < 0.001. The AUC of FFAs to diagnose ACS was 0.798 (0.743-0.853, P < 0.001) in males, and 0.738 (0.677-0.800, P < 0.001) in females. Logistic regression analysis showed that elevated level of FFAs [odds ratio (OR) = 7.06, 95% confidence interval (CI) 4.40-11.33, P < 0.001] was independently associated with ACS. Conclusions: Concentration of FFAs is an independent risk factor associated with the incidence of ACS in pCAD patients and positively correlated with the complexity of CAD.

BackgroundBreast cancer is the most commonly diagnosed cancer worldwide. However, the well-known biomarkers are not enough to meet the needs of precision medicine. Novel targets are desirable and highly valuable for improved patient survival. In this regard, we identified complement component C7 as one of the candidates based on data from the OCOMINE database.MethodsC7 expression was examined by immunohistochemistry in 331 cases of invasive ductal carcinoma (IDC), 45 cases of ductal carcinomain situ(DCIS), and 52 cases of non-neoplastic tissues adjacent to tumor. Then, C7 expression was further confirmed by Western blot analysis based on IDC specimens and non-neoplastic breast specimens. The relationship between the C7 expression and prognosis of breast cancer patients was analyzed in order to investigate the function of C7 in breast cancer patients. Meanwhile, we also analyzed the relationship between the C7 expression and prognosis of 149 patients treated with conventional TE (taxane and anthracycline)-based chemotherapy. Then, a cohort of patients (22 cases) treated with TE neoadjuvant chemotherapy was used to further confirm the relationship between the C7 expression and TE-based chemosensitivity.ResultsIn our present study, we reported for the first time that C7 was an independent prognostic factor of breast cancer and C7 expression of IDC tissues was higher than non-neoplastic tissues adjacent to tumor and DCIS. In a cohort of 331 IDC patients, high expression of C7 indicated poor prognosis especially in the triple negative subtype and luminal B subtype. Furthermore, C7 was also a promoting factor for triple negative subtype patients to develop bone metastasis. Meanwhile, we provided the first evidence that patients with high C7 expression were insensitive to TE (taxane and anthracycline)-based chemotherapy by analyzing a cohort of 149 patients treated with TE-based chemotherapy and another cohort of 22 patients treated with TE neoadjuvant chemotherapy.ConclusionsIn summary, high expression of C7 may promote breast cancer development and might be insensitive to TE-based chemotherapy. Our present study laid a foundation to help clinicians improve the identification of patients for TE-based chemotherapy by C7 in the era of precision medicine.

Background Acute lung injury (ALI) is a common lung disorder that affects millions of people every year. The infiltration of inflammatory cells into the lungs and death of the alveolar epithelial cells are key factors to trigger a pathological cascade. Trophoblast stem cells (TSCs) are immune privileged, and demonstrate the capability of self-renewal and multipotency with differentiation into three germ layers. We hypothesized that intratracheal transplantation of TSCs may alleviate ALI. Methods ALI was induced by intratracheal delivery of bleomycin (BLM) in mice. After exposure to BLM, pre-labeled TSCs or fibroblasts (FBs) were intratracheally administered into the lungs. Analyses of the lungs were performed for inflammatory infiltrates, cell apoptosis, and engraftment of TSCs. Pro-inflammatory cytokines/chemokines of lung tissue and in bronchoalveolar lavage fluid (BALF) were also assessed. Results The lungs displayed a reduction in cellularity, with decreased CD45+ cells, and less thickening of the alveolar walls in ALI mice that received TSCs compared with ALI mice receiving PBS or FBs. TSCs decreased infiltration of neutrophils and macrophages, and the expression of interleukin (IL) 6, monocyte chemoattractant protein-1 (MCP-1) and keratinocyte-derived chemokine (KC) in the injured lungs. The levels of inflammatory cytokines in BALF, particularly IL-6, were decreased in ALI mice receiving TSCs, compared to ALI mice that received PBS or FBs. TSCs also significantly reduced BLM-induced apoptosis of alveolar epithelial cells in vitro and in vivo. Transplanted TSCs integrated into the alveolar walls and expressed aquaporin 5 and prosurfactant protein C, markers for alveolar epithelial type I and II cells, respectively. Conclusion Intratracheal transplantation of TSCs into the lungs of mice after acute exposure to BLM reduced pulmonary inflammation and cell death. Furthermore, TSCs engrafted into the alveolar walls to form alveolar epithelial type I and II cells. These data support the use of TSCs for the treatment of ALI.

Purpose Radionuclide-labeled fibroblast-activation-protein inhibitor 04 (FAPI-04) as a positron emission tomography (PET) imaging tracer can reveal the localized expression of fibroblast activation protein (FAP), a cell-surface serine protease that is highly upregulated in more than 90% of epithelial carcinomas. In this study, we quantified the 18F-NOTA-FAPI-04 uptake on PET/computed tomography (CT) imaging in different pathological types of lung cancer and metastatic tumors. Methods We prospectively enrolled 61 patients with histopathologically proven primary lung cancer with metastases.PET/CT scanning was performed before any antitumor therapy and 1hour after injection of 235.10 ± 3.89 MBq of 18F-NOTA-FAPI-04. Maximum standard uptake values (SUVmax) were calculated for comparison among primary and metastatic lesions. Results Sixty-one patients with adenocarcinoma (ADC, n = 30), squamous cell carcinoma (SCC, n = 17), and small cell lung cancer (SCLC, n = 14) were enrolled in this study, and 61 primary tumors and 199 metastases were evaluated. No difference in18F-NOTA-FAPI-04 uptake was observed among primary ADC, SCC, and SCLC tumors (P = 0.198).Additionally, no difference in uptake was found between primary and metastatic lesions of lung cancer with the same pathological type (P > 0.05).However, uptake did differ among metastases of differing pathological type (P max of metastatic lymph nodes was highest for SCC, followed by ADC and then SCLC (P max of bone metastases also was highest for SCC, followed by ADC and SCLC (P max of metastases in other organs was higher in SCC cases than in ADC cases, but did not differ between SCC and SCLC or ADC and SCLC. Bone metastases exhibited higher uptake than those of lymph nodes and other organs in SCC and ADC (P 18F-NOTA-FAPI-04 PET/CT imaging revealed differences in FAP expression in metastases of lung cancer, with the highest expression specifically in bone metastases, and thus, may be valuable for distinguishing different pathological types of lung cancer.

Objectives: Coronary artery bypass grafting (CABG) success is reduced by graft occlusion. Understanding factors associated with graft occlusion may improve patient outcomes. The aim of this study was to develop a predictive risk score for saphenous vein graft (SVG) occlusion after CABG.Methods: This retrospective cohort study enrolled 3,716 CABG patients from January 2012 to March 2013. The development cohort included 2,477 patients and the validation cohort included 1,239 patients. The baseline clinical data at index CABG was analyzed for their independent impact on graft occlusion in our study using Cox proportional hazards regression. The predictive risk scoring tool was weighted by beta coefficients from the final model. Concordance (c)-statistics and comparison of the predicted and observed probabilities of predicted risk were used for discrimination and calibration.Results: A total of 959 (25.8%) out of 3,716 patients developed at least one late SVG occlusion. Significant risk factors for occlusion were female sex [beta coefficients (β) = 0.52], diabetes (β = 0.21), smoking (currently) (β = 0.32), hyperuricemia (β = 0.22), dyslipidemia (β = 0.52), prior percutaneous coronary intervention (PCI) (β = 0.21), a rising number of SVG (β = 0.12) and lesion vessels (β = 0.45). On-pump surgery (β = −0.46) and the use of angiotensin-converting enzyme inhibitors (ACEI)/angiotensin receptor blockers (ARB) (β = −0.59) and calcium channel blockers (CCB) (β = −0.23) were protective factors. The risk scoring tool with 11 variables was developed from the derivation cohort, which delineated each patient into risk quartiles. The c-statistic for this model was 0.71 in the validation cohort.Conclusions: An easy-to-use risk scoring tool which included female sex, diabetes, smoking, hyperuricemia, dyslipidemia, prior PCI, a rising number of SVG and lesion vessels, on-pump surgery, the use of ACEI/ ARB and CCB was developed and validated. The scoring tool accurately estimated the risk of late SVG occlusion after CABG (c-statistic = 0.71).

Background Patients with hypertension and diabetes mellitus are susceptible to dementia, but regular therapy fails to reduce the risk of dementia. Glucagon‐like peptide‐1 receptor agonists have neuroprotective effects in experimental studies. We aimed to assess the effect of liraglutide, a glucagon‐like peptide‐1 receptor agonist, on cognitive function and whether its effect was associated with metabolic changes in patients with type 2 diabetes mellitus. Methods and Results Fifty patients with type 2 diabetes mellitus were recruited in this prospective study. All patients underwent cognitive assessment and brain activation monitoring by functional near‐infrared spectroscopy. At 12 weeks, patients in the glucagon‐like peptide‐1 group acquired better scores in all cognitive tests and showed remarkable improvement in memory and attention ( P =0.040) test compared with the control group after multivariable adjustment. Compared with the control group, liraglutide significantly increased activation of the dorsolateral prefrontal cortex and orbitofrontal cortex brain regions ( P =0.0038). After liraglutide treatment, cognitive scores were significantly correlated with changes in these activating brain regions ( P Conclusions We concluded that liraglutide improves cognitive decline in patients with type 2 diabetes mellitus. This beneficial effect is independent of its hypoglycemic effect and weight loss. The optimal intervention should be targeted to cognitive decline in the early stages of dementia. Registration URL: https://www.ClinicalTrials.gov ; Unique identifier: NCT03707171.

BackgroundMetabolic syndrome (MetS) is a pathophysiological change based on the abnormal metabolism of many substances. The study aims to investigate the performance of visceral adiposity index (VAI) and lipid accumulation product (LAP) of MetS in young adults.Methods448 young adults aged between 19 and 24 years old in Qinhuangdao had been included in this cross-sectional study. Receiver operating characteristic (ROC) curve analyses were used to assess the accuracy of these two obesity indicators for MetS.ResultsThe prevalence of MetS was 2.0%. In male subjects, LAP had the highest area under the ROC curve (AUC) value (AUC = 0.963), followed by VAI (AUC = 0.937). In female subjects, LAP also had the highest AUC value (AUC = 0.931), followed by VAI (AUC = 0.861). No significant difference was found between the two obesity indicators (P > 0.05).ConclusionThe two obesity indicators were valuable for the screening of MetS in young adults, and LAP was the simpler of the two.

We explored variables associated with patient-reported outcomes (PROs) including symptom burden, impact on daily life and work, obstacles during therapy, satisfaction level with therapy, and health-related quality of life in 1500 respondents with myeloproliferative neoplasms (MPNs) including essential thrombocythemia (ET), polycythemia vera (PV) and myelofibrosis (MF) in a multicenter, cross-sectional study across China, a representative of the developing countries. In multivariate analyses, urban household registration and higher education level were significantly-associated with no symptoms at diagnosis in respondents with ET or MF. CALR mutation was significantly-associated with lower MPN-10 scores in respondents with MF. Higher MPN-10 scores were significantly-associated with negative impact on daily life and work as well as lower satisfaction level in respondents with ET, PV and MF. Receiving ruxolitinib was significantly-associated with high satisfaction and satisfaction in respondents with MF. In addition, other demographics and clinical variables were also impacting PROs.

Mutations of internal tandem duplication in FMS-like tyrosine kinase 3 (FLT3-ITD) contribute to poor prognosis in cytogenetically normal acute myeloid leukemia (CN-AML). Chemotherapy has limited effect, while allogeneic hematopoietic stem cell transplantation (allo-HSCT) plus sorafenib maintenance is a promising protocol to improve their therapeutic outcome. However, the prognostic significance of FLT3-ITD mutant status remains controversial. To investigate this, we detected FLT3-ITD mutant ratio (high and low) and length (long and short) in enrolled 184 CN-AML patients without NPM1 mutation, and evaluated their impact on complete remission (CR), overall survival (OS), relapse-free survival (RFS) and relapse risk (RR) after chemotherapy or allo-HSCT plus sorafenib maintenance. Our studies showed that FLT3-ITD mutation had negative impact on chemotherapeutic response, OS and RFS in CN-AML patients. There was no significant difference in CR rate between high and low ratio, or long and short length. Increasing ITD mutant ratio and length were associated with decreasing OS, and long length had shorter RFS and higher RR than the short after chemotherapy. Allo-HSCT plus sorafenib maintenance was an effective strategy to improve RFS and decrease relapse probability in FLT3-ITD AML patients, and benefited to these regardless of mutant ratio, and those with long length instead of the short.

Background/Aims: Studies have shown that nucleos(t)ide analogue (NA) treatment can reduce the risk of hepatocel lular carcinoma (HCC) in chronic hepatitis B (CHB) patients, but it is unclear which NA is most effective. We performed a meta-analysis and systematic review comparing the effica cies of NAs in CHB patients. Methods: We searched litera ture databases for randomized controlled trials (RCTs) and observational studies that analyzed the hepatic biochemical response, virological response, seroconversion rate, drug re sistance rate, and HCC incidence rate in CHB patients treat ed with NAs. Meta-analyses were performed with RevMan and Stata/SE software. Results: Twelve cohort studies and one RCT were selected, in which entecavir (ETV), lamivudine (LAM), telbivudine (LdT), and/or tenofovir disoproxil fumarate (TDF) were evaluated in CHB patients. The meta-analysis showed that ETV was superior to LAM with regard to the HCC incidence (p

Background: Coronary artery disease (CAD) in adults ≤ 35 years of age is rare, but the incidence is on the rise and the risk factors for this age group are largely uncertain. Previous studies have shown that hyperuricemia (HUA) is an independent risk factor for CAD in the general population, whereas the role in adults ≤ 35 years of age with acute coronary syndrome (ACS) is unclear. Methods: Patients, 18–35 years of age, diagnosed with ACS for the first time at the documented institu- tion between January 2005 and December 2015, were enrolled in the current study. The severity of CAD was assessed by the Gensini score. Patients were divided into two groups according to the definition of HUA. The relationship between HUA and CAD severity was assessed based on multi-variate analysis. Results: Seven hundred seventy-one participants fulfilling the criteria were included in this study (mean age, 31.6 years; 94.4% male). HUA, which was defined as a serum uric acid level ≥ 7.0 mg/dL (420μmol/L) in males and ≥ 6.0 mg/dL (357 μmol/L) in females, accounted for 37% of the participants. Multivariate analysis identified that HUA is an independent risk factor of CAD severity, as assessed by the Gensini score, in very young adults with ACS (OR 8.28; 95% CI 1.96–14.59; p = 0.01), and the effect of HUA on CAD severity was second only to diabetes mellitus. Conclusions: Hyperuricemia was shown to be an independent risk factor for CAD severity in young adults with ACS (18–35 years of age).

Objective Low-cost diagnostic and prognostic biomarkers could help guide clinical management of neonates with myocardial injury after asphyxia. This study aimed to assess the utility of creatine kinase (CK)-MB, high-sensitivity cardiac troponin I (hs-cTnI), brain natriuretic peptide (BNP), and myoglobin in the early diagnosis of myocardial injury following neonatal asphyxia. Methods Eighteen neonates with asphyxia and myocardial injury, 22 neonates with asphyxia and no myocardial injury, and 19 neonates without asphyxia (controls) were enrolled consecutively at the Neonatology Department, First Hospital of Lanzhou University (August 2013 to December 2014). Serum CK-MB, hs-cTnI, BNP, and myoglobin levels were evaluated at 12 hours and 7 days after birth. Their diagnostic value for myocardial injury was assessed by receiver operating characteristic (ROC) curve analysis. Results Levels of all four markers were higher in neonates with asphyxia and myocardial injury than in neonates with asphyxia and no myocardial injury or controls 12 hours after birth. The marker hs-cTnI had the highest diagnostic value. Using a cutoff value of 0.087 µg/L for hs-cTnI, the sensitivity, specificity, and diagnostic accuracy for asphyxia-induced myocardial injury were 55.6%, 95.5%, and 77.5%, respectively. Conclusions Serum hs-cTnI levels can predict myocardial injury caused by neonatal asphyxia at an early stage.

Background Repetitive transcranial magnetic stimulation (rTMS) targeting prefrontal cortex reduces craving in different types of drug addiction. However, most studies failed to elucidate the potential gender discrepancies for the treatment effects, due to the small percentage of female subjects enrolled. The present study prospectively recruited female methamphetamine dependents for TMS treatment. Methods Ninety female methamphetamine dependents were randomly assigned into the control group (routine addiction rehabilitation) or add-on 10 Hz group (routine addiction rehabilitation plus 20 times rTMS treatments). The craving scores to drug associated cues were examined as the primary outcome for this treatment. Results The results showed that add-on rTMS treatment was as well effective in female methamphetamine dependents, and the effect lasted for at least 30 days after treatment. Drug abuse history predicts the efficacy of chronic treatment, and the effects of TMS treatment was more pronounced in young, high-craving subjects. Conclusions Add-on high frequency rTMS treatment is as well tolerable and effective in female methamphetamine dependents.

Drug abstinence is accompanied by aversive experiences and lasting changes in mood status and worsening sleep quality. This study investigated the potential effects of chronic repetitive transcranial magnetic stimulation (rTMS) in substance dependent inpatients during abstinence.This was a double-blinded study with 105 males inpatients dependent on heroin or methamphetamine (average abstinence time was six months). The inpatients were randomly divided into 10 Hz intervention (n = 40), sham stimulation (n = 40) and control (waiting list, no treatment) (n = 25) groups. Five sessions of rTMS stimulation were administrated for six consecutive weeks, reaching a total of 180,000 pulses. There was no intervention for control group. Patients were assessed using the Pittsburgh Sleep Quality Index (PSQI), Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) were assessed prior to and after six weeks of intervention.The results showed that six weeks of rTMS treatment significantly improved the sleep quality (p 0.001), alleviated depression (p 0.001) and anxiety state (p 0.001) of substance dependent inpatients in early abstinence. Furthermore, the active TMS group showed significant differences between sham and control groups.These findings suggested that chronic rTMS treatment have positive effects for substance dependent inpatients during abstinence. Future studies are required to understand the underlying mechanism for improving different clinical symptoms.