Diagnostic accuracy of quantitative flow ratio (QFR) and vessel fractional flow reserve (vFFR) estimated retrospectively by conventional radiation saving X-ray angiography

Background

Angiography derived FFR reveals good performance in assessing intermediate coronary stenosis. However, its performance under contemporary low X-ray frame and pulse rate settings is unknown. We aim to validate the feasibility and performance of quantitative flow ratio (QFR) and vessel fractional flow reserve (vFFR) under such angiograms.

Methods

This was an observational, retrospective, single center cohort study. 134 vessels in 102 patients, with angiograms acquired under 7.5fps and 7pps mode, were enrolled. QFR (fQFR and cQFR) and vFFR were validated with FFR as the gold standard. A conventional manual and a newly developed algorithmic exclusion method (M and A group) were both evaluated for identification of poor-quality angiograms.

Results

Good agreement between QFR/vFFR and FFR were observed in both M and A group, except for vFFR in the M group. The correlation coefficients between fQFR/cQFR/vFFR and FFR were 0.6242, 0.5888, 0.4089 in the M group, with r_vFFR significantly lower than r_fQFR (p?=?0.0303), and 0.7055, 0.6793, 0.5664 in the A group, respectively. AUCs of detecting lesions with FFR?≤?0.80 were 0.852 (95% CI 0.722–0.913), 0.858 (95% CI 0.778–0.917), 0.682 (95% CI 0.586–0.768), for fQFR/cQFR/vFFR in the M group, while vFFR performed poorer than fQFR (p?=?0.0063) and cQFR (p?=?0.0054). AUCs were 0.898 (95% CI 0.811–0.945), 0.892 (95% CI 0.803–0.949), 0.843 (95% CI 0.746–0.914) for fQFR/cQFR/vFFR in the A group. AUC_vFFR was significantly higher in the A group than that in the M group (p?=?0.0399).

Conclusions

QFR/vFFR assessment is feasible under 7.5fps and 7pps angiography, where cQFR showed no advantage compared to fQFR. Our newly developed algorithmic exclusion method could be a better method of selecting angiograms with adequate quality for angiography derived FFR assessment.

     

Metabolomics and Proteomics Reveal the Variation of Substances in Apheresis Platelets during Storage and Their Effects on Cancer Cell Proliferation

IntroductionApheresis platelets (APs) are clinically and crucially important in the prevention and treatment of bleeding in patients with thrombocytopenia or cancer. However, few researchers have addressed the variation of supernatant metabolites and exosome proteins in APs during storage and their effects on cancer cell proliferation.ObjectiveThis study was designed to explore the change rules of the metabolites and exosomal proteins of APs during storage and their effects on cancer cell proliferation.MethodsMetabolomics and proteomics were separately applied to analyze the variation of AP supernatant metabolites and exosomal proteins between freshly prepared day-0 and day-5 terminal-stored APs. Cell counting kit (CCK)-8 assay was performed to detect the effects of AP supernatants and exosomes on the proliferation of cancer cells.ResultsWe found that the supernatant metabolites and exosomal proteins in APs were significantly different on day 0 and day 5, and that many differential metabolites and exosomal proteins were associated with cancer characteristics. Furthermore, the day-5 AP supernatants had a greater inhibition of the proliferation of K562, HepG2, and HCT116 cancer cells, but the day-5 AP exosomes had no significant effect on the proliferation of these cancer cells.ConclusionThe variant terminal-stored AP supernatants may inhibit the proliferation of cancer cells but the variant terminal AP exosomes have no effect on cancer cell proliferation.     

内镜逆行胰胆管造影术应用于高龄胆管结石合并十二指肠憩室患者的安全性及临床疗效观察

目的 探讨内镜逆行胰胆管造影术（ERCP）应用于高龄胆管结石合并十二指肠憩室患者的安全性及临床疗效。方法 收集2012年6月－2018年6月于苏北人民医院行ERCP检查的300例高龄胆管结石患者的临床资料,根据有无合并十二指肠憩室分为两组,A组为十二指肠憩室患者,B组为非十二指肠憩室患者,比较两组患者胆管结石的复发率、不同憩室类型的胆管结石复发的差异、ERCP应用于高龄胆管结石患者的安全性及术后并发症。结果 A组胆管结石复发率为32.08%,B组为18.58%,两组比较,差异有统计学意义（P < 0.05）。十二指肠憩室内乳头患者的胆管结石复发率高于憩室旁乳头及憩室间乳头患者,差异有统计学意义（P < 0.05）。300例患者的取石成功率为93.00%,其中一次性成功取石231例,48例行第2次ERCP术后完全取出,21例取石失败。ERCP术后并发症发生率4.33%,其中高淀粉酶血症8例,一过性胆管炎2例,轻型急性胰腺炎3例,均经内科保守治疗后好转。结论 应用ERCP治疗高龄胆管结石的安全性较好,十二指肠憩室可促进胆管结石形成,其中憩室内乳头对结石的复发有较大影响。     

7875例血脂异常患者证素分布及合并高尿酸血症分析

目的:研究血脂异常人群中医健康状态要素分布规律及合并高尿酸血症与中医健康状态要素的相关性.方法:纳入7875例高脂血症体检者,运用SPSS 19.0软件分析其中医健康状态类型分布规律及血脂、血尿酸水平等.结果:①不同性别、不同年龄段人群中医健康状态类型分布具有统计学差异.②各中医健康状态要素人群的甘油三酯、高密度脂蛋白水平有统计学差异:湿要素组的甘油三酯水平明显高于阴虚、阳虚、肝、气虚组,痰要素组甘油三酯水平明显高于肝、肾、气虚、阳虚组,热要素组甘油三酯水平明显高于阴虚、阳虚、肝、气虚组;痰要素组高密度脂蛋白水平明显低于阴虚、气滞、阳虚、肝、气虚、肾、正常组,热要素组高密度脂蛋白水平低于阴虚、气滞、阳虚、肝、气虚、肾、正常组.③各中医健康状态要素人群合并高尿酸血症发生率有统计学差异,依次为热要素组(22.54％)、痰要素组(21.07％).④各中医健康状态要素人群的血尿酸水平有统计学差异,湿、痰、热要素组人群血尿酸水平显著高于阴虚、气滞、阳虚、肝、气虚、肾组.结论:痰、湿、热状态要素人群甘油三酯较高,高密度脂蛋白水平较低;痰、热状态要素血脂异常人群易合并高尿酸血症;湿、痰、热状态要素人群血尿酸水平显著升高.     

Resveratrol protects human bronchial epithelial cells against nickel‐induced toxicity via suppressing p38 MAPK,NF‐κB signaling,and NLRP3 inflammasome activation

Nickel is a common environmental pollutant that can impair the lung, but the underlying mechanisms have not yet been fully elucidated. Furthermore, natural products are generally used to inhibit cell damage induced by heavy metal. Resveratrol possesses wide biological activities, including anti‐inflammation and antioxidative stress. This study was conducted to explore the toxicity of nickel on human bronchial epithelial (BEAS‐2B) cells and evaluate the protective effect of resveratrol. The results showed that nickel could induce cell apoptosis, increase oxidative stress, and promote the expression of pro‐inflammatory cytokines, including tumor necrosis factor‐α, interleukin (IL)‐1β, IL‐6, IL‐8, C‐reaction protein. Western blot analysis showed that nickel activated p38 mitogen‐activated protein kinase (MAPK), nuclear factor‐kappa B, and nucleotide‐binding oligomerization domain‐like receptor pyrin‐domain‐containing protein 3 pathways, while resveratrol could reverse these effects. Our results suggested that resveratrol could protect BEAS‐2B cells from nickel‐induced cytotoxicity. Therefore, resveratrol is a potential chemopreventive agent against nickel‐induced lung disease.     

Combinational treatment of 5‐fluorouracil and casticin induces apoptosis in mouse leukemia WEHI‐3 cells in vitro

Leukemia is one of the major diseases causing cancer‐related deaths in the young population, and its cure rate is unsatisfying with side effects on patients. Fluorouracil (5‐FU) is currently used as an anticancer drug for leukemia patients. Casticin, a natural polymethoxyflavone, exerts anticancer activity against many human cancer cell lines in vitro, but no other reports show 5‐FU combined with casticin increased the mouse leukemia cell apoptosis in vitro. Herein, the antileukemia activity of 5‐FU combined with casticin in WEHI‐3 mouse leukemia cells was investigated in vitro. Treatment of two‐drug combination had a higher decrease in cell viability and a higher increase in apoptotic cell death, the level of DNA condensation, and the length of comet tail than that of 5‐FU or casticin treatment alone in WEHI‐3 cells. In addition, the two‐drug combination has a greater production rate of reactive oxygen species but a lower level of Ca²⁺ release and mitochondrial membrane potential (ΔΨ_m) than that of 5‐FU alone. Combined drugs also induced higher caspase‐3 and caspase‐8 activities than that of casticin alone and higher caspase‐9 activity than that of 5‐FU or casticin alone at 48 hours treatment. Furthermore, 5‐FU combined with casticin has a higher expression of Cu/Zn superoxide dismutase (SOD [Cu/Zn]) and lower catalase than that of 5‐FU or casticin treatment alone. The combined treatment has higher levels of Bax, Endo G, and cytochrome C of proapoptotic proteins than that of casticin alone and induced lower levels of B‐cell lymphoma 2 (BCL‐2) and BCL‐X of antiapoptotic proteins than that of 5‐FU or casticin only. Furthermore, the combined treatment had a higher expression of cleaved poly (ADP‐ribose) polymerase (PARP) than that of casticin only. Based on these findings, we may suggest that 5‐FU combined with casticin treatment increased apoptotic cell death in WEHI‐3 mouse leukemia cells that may undergo mitochondria and caspases signaling pathways in vitro.     

国产注射用盐酸头孢甲肟质量评价

目的 评价国内不同企业生产的注射用盐酸头孢甲肟的质量及存在问题。方法 根据国家评价性抽验计划要求,采用法定标准检验结合探索性研究对样品进行检验,并统计分析检验结果。结果 共抽取130批次样品,按法定标准检验,合格率100%。探索性研究结果表明杂质的含量、聚合物的量与溶液的颜色有一定的相关性;研究了主要杂质的来源和结构;建议现行标准修订有关物质和残留溶剂方法,增加碳酸钠含量测定。结论 目前国内的注射用头孢甲肟的总体质量一般;为提升药物的有效性和安全性,现行标准应进一步提高。     

202株肺炎链球菌感染的临床分布及耐药性分析

目的调查大庆某医院临床分离的202株肺炎链球菌的临床分布特征及耐药状况,为临床合理用药提供依据。方法对2014年1月—2018年12月期间大庆某医院分离的202株肺炎链球菌进行回顾性分析。结果202株肺炎链球菌主要分离自呼吸道标本(痰61.4%、咽拭子20.3%)及血液标本(14.9%);感染者以儿童及中老年人为主(87.6%),患者主要来源于ICU(16.8%)、呼吸内科(15.3%)、耳鼻喉科(12.4%)及儿科(11.9%)。肺炎链球菌对红霉素(99.3%)、四环素(91.3%)、复方磺胺甲噁唑(74.0%)耐药性较严重,青霉素的耐药率为37.1%,对三代头孢菌素(头孢曲松、头孢噻肟)、氯霉素、氟喹诺酮类及厄他培南较敏感,万古霉素和利奈唑胺全部敏感。结论肺炎链球菌以呼吸系统感染为主,感染人群以儿童及中老年人多见。肺炎链球菌对四环素、红霉素及复方磺胺甲噁唑耐药严重,临床应根据药敏结果合理使用抗菌药物治疗。