Impact of anemia on long-term ischemic events and bleeding events in patients undergoing percutaneous coronary intervention: a system review and meta-analysis

Background

Data focused on the ischemic events and bleeding events are still limited. We systematically reviewed the current available literature to investigate whether anemia increase incidence of long-term ischemic events and long-term bleeding events in patients undergoing PCI.

Methods

PubMed and Embase were searched for case-control studies regarding the impact of anemia on long-term outcomes in patients undergoing percutaneous coronary intervention (PCI). The primary outcome was long-term ischemic events and long-term bleeding events. Mantel-Haenszel method with random effects model or fixed effects model was used to calculate pooled odds ratios (ORs) and 95% confidence intervals (CIs).

Results

Seventeen studies involving 68,528 patients (17,123 anemic patients and 51,405 non-anemic patients) were included. Pooled analysis suggested that anemic patients were at higher risk for long-term composite ischemic events (OR: 1.95, 95% CI, 1.21-3.14, P<0.01, I²=84%), long-term reinfarction (0R: 1.63, 95% CI, 1.16-2.28, P<0.01, I²=82%) and long-term bleeding events (OR: 2.89, 95% CI, 1.68-4.98, P<0.001, I²=89%). Anemia was also associated with long-term mortality (OR: 3.20, 95% CI, 2.72-3.75, P<0.01, I²=65%) and major adverse cardiac events (MACE) (OR: 2.06, 95% CI, 1.48-2.86, P<0.01, I²=91%).

Conclusions

Anemic patients undergoing PCI are at higher risk for both long-term ischemic events and bleeding events, and also at higher risk for long-term mortality and MACE. There’s a need for further clarification and consistency regarding dosage, timing and duration of antithrombotic therapy for the prevention of ischemic events and bleeding events in anemic patients.     

Evaluation of a new method for placing nasojejunal feeding tubes

AIM:To compare fluoroscopic, endoscopic and guide wire assistance with ultraslim gastroscopy for placement of nasojejunal feeding tubes. METHODS:The information regarding nasojejunal tube placement procedures was retrieved using the gastrointestinal tract database at Tongji Hospital affiliated to Tongji Medical College. Records from 81 patients who underwent nasojejunal tubes placement by different techniques between 2004 and 2011 were reviewed for procedure success and tube-related outcomes. RESULTS:Nasojejunal feeding tubes were successfully placed in 78 (96.3%) of 81 patients. The success rate by fluoroscopy was 92% (23 of 25), by endoscopic technique 96.3% (26 of 27), and by guide wire assistance (whether via transnasal or transoral insertion)100% (23/23, 6/6). The average time for successful placement was 14.9 ± 2.9 min for fluoroscopic placement, 14.8 ± 4.9 min for endoscopic placement, 11.1 ± 2.2 min for guide wire assistance with transnasal gastroscopic placement, and 14.7 ± 1.2 min for transoral gastroscopic placement. Statistically, the duration for the third method was significantly different (P 0.05) compared with the other three methods. Transnasal placement over a guidewire was significantly faster (P 0.05) than any of the other approaches. CONCLUSION:Guide wire assistance with transnasal insertion of nasojejunal feeding tubes represents a safe, quick and effective method for providing enteral nutrition.     

人面神经管和面神经的发生

本文对229侧胚胎儿周至出生后1年颞骨组织切片连续观测。结果表明,面神经管由膜性化骨和软骨化骨共同形成。面神经管水平段外侧壁、下壁和迷路段上壁为膜性化骨,膜性化骨顺序有一定规律性;其余部分为软骨化骨。面神经发育随胎龄的增长而递增,出生前渐近高峰;不同部位面神经在面神经管内保持相对恒定的截面积空间比。面神经在面神经管迷路段远侧端所占截面积空间比最大,在茎乳孔处所占截面积空间比最小。本文并提出,胚胎发育后期膜性化骨不全、乳突气化过度是导致面神经管缺损的主要原因。     

The orphan nuclear receptor COUP-TFII is required for angiogenesis and heart development

The embryonic expression of COUP-TFII, an orphan nuclear receptor, suggests that it may participate in mesenchymal-epithelial interactions required for organogenesis. Targeted deletion of the COUP-TFII gene results in embryonic lethality with defects in angiogenesis and heart development. COUP-TFII mutants are defective in remodeling the primitive capillary plexus into large and small microcapillaries. In the COUP-TFII mutant heart, the atria and sinus venosus fail to develop past the primitive tube stage. Reciprocal interactions between the endothelium and the mesenchyme in the vascular system and heart are essential for normal development of these systems. In fact, the expression of Angiopoietin-1, a proangiogenic soluble factor thought to mediate the mesenchymal-endothelial interactions during heart development and vascular remodeling, is down-regulated in COUP-TFII mutants. This down-regulation suggests that COUP-TFII may be required for bidirectional signaling between the endothelial and mesenchymal compartments essential for proper angiogenesis and heart development.     

2011~2013年桐城市土源性线虫病纵向观测

目的 分析2011~2013 年安徽省桐城市寄生虫病国家综合防治示范区纵向观测点的观测结果。方法 2011~2013 年,采用改良加藤厚涂片法（一粪三检）检查居民感染情况;采用抽样调查的方法调查居民家庭改水改厕情况。结果 2011~2013 年间共调查3 001 人次,3 年人群阳性率分别为2.4%,1.3%和3.0%。3 年的阳性率性别间差异均无统计学意义。3 年均以60 岁以上年龄组的阳性率均最高,3 年的阳性率分别为5.2%、3.0%和6.1%。当地的土源性线虫病以钩虫感染为主,感染度以轻度为主。无害化厕所比例在逐年提高,饮用野外自然水源的情况2012 年后已消失。结论 桐城市未来土源性线虫病的防治重点是钩虫病,60 岁以上人群是重点人群。     

Expression and cellular distribution of TLR4, MyD88, and NF-κB in diabetic renal tubulointerstitial fibrosis, in vitro and in vivo

Aim

Inflammation and extracellular matrix hyperplasia are crucial in the pathogenesis of tubulointerstitial fibrosis (TIF) involved in diabetic nephropathy (DN). Macrophage accumulation plays a major role, but whether immune factors contribute to DN pathogenesis is not well understood. This study aimed to investigate TLR4-MyD88-NF-κB-dependent pathway's involvement in TIF pathogenesis.

Methods

STZ-induced diabetic rats and rat renal tubular epithelial NRK-52E cells cultured under high glucose conditions were used as in vivo and in vitro models, respectively. Real-time RT-PCR, western blot, immunohistochemistry and immunofluorescence were performed to examine the mRNA and protein levels of TLR4, MyD88, NF-κB, MCP-1, and α-SMA.

Results

Compared with 5.5 mmol/L glucose, treatment of NRK-52E cells with 25 and 50 mmol/L d-glucose resulted in significantly increased TLR4 and MyD88 mRNA and protein levels (P < 0.05). TLR4 and MyD88 were detected in the cytoplasm of most NRK-52E cells cultured under high glucose. Pronounced damage in the renal tubulointerstitium was observed in diabetic rats (scores: 3.82 ± 0.65 vs. 0.38 ± 0.08, P < 0.01). Compared with the normal controls, a sharp upregulation of TLR4, MyD88, NF-κB p65, MCP-1, and α-SMA mRNA and protein levels was observed in diabetic rat kidneys (P < 0.05). In diabetic animals, TLR4 and MyD88 were strongly expressed in the cytoplasm, while NF-κB p65 was widely expressed in cytoplasm and nuclei of renal tubular epithelial cells.

Conclusion

The inflammatory reaction and epithelial-mesenchymal transformation observed in renal tubulointerstitium may be the result of overactivation of the TLR4-MyD88-NF-κB-dependent innate immunity under high glucose, and may be involved in DN occurrence and progression.     

工娱疗合并舒必利治疗精神分裂症阴性症状的对照研究

目的 探讨工娱疗合并舒必利对精神分裂症阴性症状的治疗康复作用。方法 将60例以阴性症状为主的精神分裂症患者随机分成两组,进行为期8周的对照研究,分别用工娱疗合并舒必利（研究组）和舒必利（对照组）治疗;采用BPRS、SANS、SAPS和临床疗效评定标准进行评定。结果 研究组在治疗后4周、8周末SANS评分较治疗前均有显著性差异。对照组仅在治疗后8周时SANS评分较疗前显著性差异。两组在治疗后4周,8周时SANS减分均数比较均有非常显著性差异（P＜0．01）。结论 工娱疗合并舒必利对精神分裂症阴性症状的疗效优于单用舒必利,且起效快。     

经脑沟入路切除中央区肿瘤(附24例临床分析)

目的 探讨中央沟区肿瘤手术切除的方式和方法.方法 24例位于中央沟区的病变,均采用解剖脑沟的方式进行切除.结果 获得全切除20例,次全切除4例,术后2例短期内存在功能下降,3个月后有不同程度的恢复.结论 通过解剖脑沟进行中央沟区占位的切除,可以在保留皮层功能的情况下最大限度的切除病灶.     

先天性主动脉弓畸形的MRI诊断

目的：评价MRI在主动脉弓畸形诊断中的作用。资料与方法：回顾分析228例心脏MR检查中61例先天性主动脉弓畸形的MRI表现，37例尚有心血管造影（CAG），44例经手术证实，结果：61例先天性主动脉畸形中，主动脉缩窄（COA）25例，右位主动脉弓24例，主动脉弓离断（IAA）5例，单纯动脉导管未闭（PDA）4例，迷走右锁骨下动脉（伴COA）2例，孤立性左有下动脉（伴右位主动脉弓）1例，永存第5对主动脉弓（伴IAA）1例，主动脉扭曲畸形（Kink A)2例，升主动脉扭曲1例，结论：比较MRI与CAG，MRI在对先天性主动脉畸形的诊断方面已达到CAG水平。