心脏性猝死者心肌HO-1和VEGF的表达及意义

目的：探讨血红素加氧酶-1（heme oxygenase-1,HO-1）、血管内皮生长因子（vascular endothelial growth factor,VEGF）在心脏性猝死病人心室肌细胞中的表达及其意义。方法：运用免疫组织化学方法和Simple PCI图像分析系统观察33例心脏性猝死组和18例非心脏性猝死对照组尸检心肌组织中HO-1、VEGF蛋白的表达情况。结果：心脏性猝死组心肌组织HO-1（155.090±8.957）和VEGF蛋白表达（121.020±10.927）均显著高于非心脏性猝死对照组（116.200±6.355、84.207±4.402,均p〈0.05）。结论：HO-1和VEGF蛋白在心脏性猝死者心肌组织表达增强,可能与心脏性猝死有一定关系。     

Changes of microcirculation in healthy volunteers and patients with septic shock in Xining

Objective: The purpose of this study is to investigate the characteristic of microcirculation in healthy volunteers and patients with septic shock in both Xining(2 260 m) and Nanjing(10 m). Methods: A total of 62 cases, 33 healthy volunteers, 22 cases in Xining,(2 260 m above sea level) and 11 cases in Nanjing(10 m above sea level); and 29 septic shock, 13 cases in Xining and 16 cases in Nanjing were collected. The total vessel density(TVD), perfused vessel density(PVD), proportion of perfused vessel(PPV) and microcirculation flow index(MFI) of both healthy volunteers and septic shock had been investigated by using sidestream dark field(SDF). Analyzed and managed the image data by using AVA3.0 software. Results: In the healthy volunteers in Xining area(22 cases),the volume of TVD(15.59 ± 2.58 mm/mm~2), PVD(15.58 ± 2.58 mm/mm~2) and PPV(96.60% ± 4.63%) were significant higher than the volume of TVD(10.0 ± 2.10 mm/mm~2), PVD(10.81 ± 2.38 mm/mm~2) and PPV(84.24% ± 8.00%) of the volunteers(11 cases) in Nanjing(11 cases). But the MFI(2.17 ± 0.31) of the healthy volunteers in the Xining was significant lower(P0.05) than the MFI(3.21 ± 0.34) in the healthy volunteers of Nanjing. In the septic shock group(13 cases) in the Xining, the volume of TVD(5.44 ± 1.94 mm/mm~2), PVD(4.18 ± 1.61 mm/mm~2), PPV(42.14%± 5.38%) and MFI(1.05 ± 0.32) compared with the volume of the healthy volunteers in Xining, the TVD(15.59 ± 2.58 mm/mm~2), PVD(5.58 ± 2.58 mm/mm~2), PPV(96.60% ± 4.63%) and MFI(2.17 ± 0.30) were significant lower(P0.05). In the healthy volunteers compare with septic shock group in Nanjing area, the TVD(6.80±1.72 vs 10.00±2.10, P0.05), PVD(5.86±1.58 vs10.81±2.38,P0.05), PPV(45.42±4.86 vs 84.24±4.86, P0.05), MFI(1.28±0.28 vs 3.21±0.34 P0.05), there was significant decreased. In the septic shock group in the Xining compared with the septic shock in Nanjing, there was no significant difference. 10 of 13 patients with septic shock were survived in Xining. 13 of 16 patients with septic shock were survived in Nanjing. Conclusion: The changes of physiological and pathophysiological characteristic in microcirculation induced by hypoxia would be useful for clinical treatment of septic shock at high altitude.     

Leptin receptor of the hind brain nuclei is involved in the conditioned taste preference of rats

Objective: Conditioned taste preference(CTP) is a taste learning reflex by which an animal learns to prefer a substance which tastes not well and has been studied with much interest in recent years. However, the neural substrates of CTP are less known. This study aimed to determine the possible neural pathways of CTP and whether serum leptin level and the leptin receptor(OB-Rb) in the hind brain are involved following CTP formation. Methods: We established CTP of quinine in rats with a 2-bottle preference test. The serum leptin concentrations were detected, the expression of c-fos in the rat brain was tested to determine the nuclei in relation with establishment of CTP. Finally, the OB-Rb m RNA expression was examined by RT-q PCR assay in parabrachial nucleus(PBN) and the nucleus of the solitary tract(NST) of the hind brain. Results: Compared with control group, the level of serum leptin was higher in the CTP group(4.58 ± 0.52 vs 1.67 ± 0.25 μg/L, P0. 01); increased c-fos positive cells were found in the anterior hypothalamus(AH, 221.75 ± 4.96 vs. 178.50±6.63 cells/mm~2, P0.05), the basal lateral amygdala(BLA, 70.75±6.17 vs 56.50±3.62 cells/mm~2, P0.05) and the nucleus of the solitary tract(NST, 41.25±1.32 vs 32.50±1.02 cells/mm~2, P0.05). But in ventromedial nucleus of the hypothalamus(VMH, 20.75±2.73 vs 38.5±1.54 per 1 mm~2, P005), PBN(21.50 ±2.24 vs 36.25±1.49 cells/mm~2, P0.05) and the central nucleus of the amygdala(Ce A, 22.25±1.53 vs 35.50 ±2.11 cells/mm~2, P0.05), the number of c-fos positive cells was decreased in the CTP group. In addition, we found OB-Rb m RNA expression in PBN of CTP group rats was higher than that of control group(0.95±0.055 vs 0.57± 0.034, P0.05), while there was no significant difference of OB-Rb m RNA expression in NST between the two groups. Conclusion: Nuclei AH, BLA, NST, VMH, PBN and Ce A participate in the formation of CTP. Leptin and its receptor in PBN may be involved in the formation and maintenance of CTP.     

Successful embryo transfer in Tianzhu white yak using standard protocol

The present study was carried out to investigate the efficiency of superovulation, oestrus synchroni-zation, and embryo recovery in Tianzhu white yaks and also to confirm the pregnancy rate of black yaks, to which embryos collected from white yaks were transplanted. Forty-seven yaks were selected from different experiment groups, including 10 Tianzhu white female yaks (donor, group A) and 37 black female yaks (recipient, groups B and C). Superovulation of the donor was induced by the application procedure of CIDR-B FSH PG. Oestrus synchronization of recipients was induced using two meth-ods: group B was given the same treatment as group A, except that the follicle-stimulating hormone (FSH) injection was not administered, whereas group C was injected with cloprostenol only once when corpus luteum (corpora lutea) was (were) palpated. The results showed that the oestrous rates in group A were higher (80%) than those in group B (60%) and group C (44.5%). As for the efficiency of su-perovulation, it was indicated that the mean numbers (±SD) of total corpora lutea, follicles, viable (transferable), and degenerated embryos were 4.75 ± 2.19, 1.13 ± 0.83, 2.50 ± 1.31, and 1.38 ± 0.92, re-spectively. The mean embryo recovery rates were 55.6%. All together, 18 viable embryos of Tianzhu white yak were obtained and 12 of them were transplanted to 10 recipients. The pregnancy rate was 50% and the delivery rate was 40%.     

Effects of Feeding Time on the Growth Performance and Variation of RNA/DNA Ratio of the Chinese Soft-shelled Turtle,Pelodiscus sinensis

The present study was to investigate the effects of feeding time on growth of the Chinese soft-shelled turtle. The experiment was carried out with a photoperiod of 12L(light):12D(dark) with lights on at 06:00 and off at 18:00. Turtles were maintained at a temperature of 32 ± 0.2 °C in tanks throughout the length of the experiment. The turtles in group 1 to group 6 were fed respectively at 00:00, 04:00, 08:00, 12:00, 16:00 and 20:00 with 60 turtles each(Initial body weight 88.27 ± 0.09 g). Acrophases of postprandial RNA/DNA ratio in liver in each group was shown between 5h and 7h after feeding. A positive linear correlation could be seen between specific growth rate(SGR) and RNA/DNA:SGR=1.1586RNA/DNA–0.7097(r = 0.9328, P = 0.0066). The results indicated that the values at the acrophases of about 6h after feeding might be used as an instantaneous growth index in the Chinese soft-shelled turtle. The turtles in group 1 grew better than group 3, group 4, group 5, group 6, because they ate more, but they ate more and grew slower than group 2, whose feed conversion rate was also higher. Meanwhile, the SGR and feeding rate of turtles fed at 12:00 were the lowest from the six groups(P 0.05). Turtles fed in group 1, group 2 and group 6 developed more heavy final body weight(FBW), higher feeding rate and SGR than the other three groups. This probably suggested that turtles fed in scotophase grew better than that fed at photophase in total.     

Human umbilical cord mesenchymal stem cells as treatment of adjuvant rheumatoid arthritis in a rat model

AIM:To investigate the effect of human umbilical cord stem cells,both mesenchymal and hematopoietic(CD34+),in the treatment of arthritis.METHODS:Mesenchymal stem cells(MSCs) and hematopoietic(CD34+) stem cells(HSC) were isolated from human umbilical cord blood obtained from the umbilical cord of healthy pregnant donors undergoing fullterm normal vaginal delivery.MSC,HSC,methotrexate(MTX) and sterile saline were injected intra-articularly into the rat hindpaw with complete freunds adjuvant(CFA) induced arthritis after the onset of disease(day 34),when arthritis had become well established(arthritis score ≥ 2).Arthritic indices were evaluated and the levels of interleukin(IL)-1,tumor necrosis factor(TNF)-α and interferon(IFN)-γ and anti-inflammatory cytokine IL-10 in serum were determined using enzyme-linked immunosorbent assay.Animals of all groups were sacrificed 34 d after beginning treatment,except positive control(PC) which was sacrificed at 10,21 and 34 d for microscopic observation of disease progression.We used hematoxylin,eosin and Masson's trichrome stains for histopathological examination of cartilage and synovium.RESULTS:The mean arthritis scores were similar in all groups at 12 and 34 d post immunization,with no statistical significant difference.Upon the injection of stem cells(hematopoietic and mesenchymal),the overall arthritis signs were significantly improved around 21 d after receiving the injection and totally disappeared at day 34 post treatment in MSC group.Mean hindpaw diameter(mm) in the MSC rats was about half that of the PC and MTX groups(P = 0.007 and P = 0.021,respectively) and 0.6 mm less than the HSC group(P = 0.047),as indicated by paw swelling.Associated with these findings,serum levels of TNF-α,IFN-γ and IL-1 decreased significantly in HSC and MSC groups compared to PC and MTX groups(P 0.05),while the expression of IL-10 was increased.Histopathological examination with H and E stain revealed that the MTX treated group showed significant reduction of leucocytic infiltrate and hypertrophy of the synovial tissue with moderate obliteration of the joint cavity.Stem cells treated groups(both hematopoietic CD34+ and mesenchymal),showed significant reduction in leucocytic infiltrate and hypertrophy of the synovial tissue with mild obliteration of the joint cavity.With Masson's trichrome,stain sections from the PC group showed evidence of vascular edema of almost all vessels within the synovium in nearly all arthritic rats.Vacuoles were also visible in the outer vessel wall.The vessel became hemorrhagic and finally necrotic.In addition,there was extensive fibrosis completely obliterating the joint cavity.The mean color area percentage of collagen in this group was 0.324 ± 0.096,which was significantly increased when compared to the negative control group.The mean color area percentage of collagen in hematopoietic CD34+ and mesenchymal groups was 0.176 ± 0.0137 and 0.174 ± 0.0197 respectively,which showed a marked decrement compared to the PC group,denoting a mild increase in synovial tissue collagen fibers.CONCLUSION:MSC enhance the efficacy of CFAinduced arthritis treatment,most likely through the modulation of the expression of cytokines and amelioration of pathological changes in joints.     

Regulation of heme oxygenase expression by alcohol, hypoxia and oxidative stress

AIM:To study the effect of both acute and chronic alcohol exposure on heme oxygenases(HOs) in the brain,liver and duodenum.METHODS:Wild-type C57BL/6 mice,heterozygous Sod2 knockout mice,which exhibit attenuated manganese superoxide dismutase activity,and liver-specific ARNT knockout mice were used to investigate the role of alcohol-induced oxidative stress and hypoxia.For acute alcohol exposure,ethanol was administered in the drinking water for 1 wk.Mice were pair-fed with regular or ethanol-containing Lieber De Carli liquid diets for 4 wk for chronic alcohol studies.HO expression was analyzed by real-time quantitative polymerase chain reaction and Western blotting.RESULTS:Chronic alcohol exposure downregulated HO-1 expression in the brain but upregulated it in the duodenum of wild-type mice.It did not alter liver HO-1 expression,nor HO-2 expression in the brain,liver or duodenum.In contrast,acute alcohol exposure decreased both liver HO-1 and HO-2 expression,and HO-2 expression in the duodenum of wild-type mice.The decrease in liver HO-1 expression was abolished in ARNT+/-mice.Sod2+/-mice with acute alcohol exposure did not exhibit any changes in liver HO-1 and HO-2 expression or in brain HO-2 expression.However,alcohol inhibited brain HO-1 and duodenal HO-2 but increased duodenal HO-1 expression in Sod2+/-mice.Collectively,these findings indicate that acute and chronic alcohol exposure regulates HO expression in a tissue-specific manner.Chronic alcohol exposure alters brain and duodenal,but not liver HO expression.However,acute alcohol exposure inhibits liver HO-1 and HO-2,and also duodenal HO-2 expression.CONCLUSION:The inhibition of liver HO expression by acute alcohol-induced hypoxia may play a role in the early phases of alcoholic liver disease progression.     

Increased telocytes involved in the proliferation of vascular smooth muscle cells in rat carotid artery balloon injury

Telocytes(TCs) are a novel type of interstitial cells that are thought to be involved in tissue regeneration and repair. However, the possible roles of TCs in vascular diseases remain unclear. In this study, we used a rat model of carotid artery balloon injury(CABI) to study the changes and potential roles of vascular TCs after vascular injury. Transmission electron microscopy(TEM) and CD34/vimentin immunolabeling were used to identify and quantify TCs in normal and injured carotid arteries. Quantitative immunofluorescence analysis revealed that, compared with the sham group, the number of TCs in the CABI group increased from 7.2±1.0 to an average of 20.4±1.8 per 1-mm~2 vascular area. The expression level of mi R-24 in TCs was three times higher than in vascular smooth muscle cells(VSMCs). The percentage of VSMCs in S phase and G2/M phase increased by approximately 5% when VSMCs were incubated with the supernatant of TCs. The antagomir of mi R-24 in TCs reduced the ratio of VSMCs in S phase and G2/M phase. This study illuminates the function of TCs in the proliferation of VSMCs.     

Salivary immunoglobulin classes in Nigerian smokers with periodontitis

AIM:To determine the levels of salivary immunoglobulin classes in Nigerian smokers and non-smokers with periodontitis.METHODS:Sixty-nine individuals were recruited into this study after obtaining informed consent.They were subdivided into three groups that consisted of 20(aged 46 ± 11 years) cigarette smokers with periodontitis(S+P);24(40 ± 12 years) smokers without periodontitis(S-P);and 25(53 ± 11 years) non-smokers with periodontitis(NS+P).An oral and maxillofacial surgeon used radiographs for periodontal probing for the diagnosis of periodontitis.The smokers included subjects who smoked at least six cigarettes per day and all the periodontitis patients were newly diagnosed.About 5 mL of unstimulated saliva was expectorated by each subject into plain sample bottles.Salivary immunoglobulin levels were estimated using enzyme linked immunosorbent assay.Student's t test was used to deter-mine significant differences between the means.Values of P 0.05 were regarded as significant.RESULTS:No significant differences were observed in the mean salivary levels of the immunoglobulin classes(IgG,IgA,IgM and IgE) when S+P was compared with S-P.Mean salivary levels of IgA(520.0 ± 155.1 ng/mL vs 670.0 ± 110 ng/mL,P = 0.000) and IgM(644.5 ± 160.0 ng/mL vs 791.4 ± 43.7 ng/mL,P = 0.000) were significantly lower in the S+P compared with NS+P group.Salivary IgA(570.4 ± 145.6 ng/mL vs 670.0 ± 110 ng/mL,P = 0.008) and IgM(703.1 ± 169.3 ng/mL vs 791.4 ± 43.7 ng/mL,P = 0.012) levels were significantly lower in the S-P compared with NS+P group.Only one(5%) periodontal patient had detectable levels of salivary IgE(0.20 IU/mL).Similarly,only one smoker(4.17%) had detectable levels of salivary IgE(0.04 IU/mL) and two non-smokers(9.52%) had detectable levels of IgE(0.24 IU/mL).CONCLUSION:Our study suggests that reduced salivary IgA and IgM levels in smokers with periodontitis could enhance increased susceptibility to periodontitis.     

心源性猝死者窦房结病理学观察和HCN4、CX45的表达及其意义

目的:研究心源性猝死者窦房结病理学改变和超级化激活环核苷酸门控阳离子通道基因4(HCN4)、缝隙连接蛋白45(Cx45)的表达.方法:实验组为21例心源性猝死者,对照组18例(交通事故损伤致死9例,心脏破裂4例,肝破裂3例,脾破裂2例).经HE染色观察窦房结的形态学变化;应用免疫组化检测HCN4和Cx45在窦房结的表达.结果:心源性猝死组HCN4的表达高于对照组(P＜0.05),心源性猝死者窦房结Cx45的表达明显低于对照组(P＜0.01).结论:窦房结病理改变是引起心源性猝死的重要原因之一,HCN4表达的增高和Cx45表达的减少与心源性猝死的发生有一定的相关性.     

QRS、QT、QTc及LVEF预测心源性猝死的价值分析

摘要 目的：探讨QRS时限值（QRS）、QT间期延长（QT）、QTc间期（QTc）及左室射血分数（LVEF）预测心源性猝死的价值分析。方法：选择2018年1月至2019年12月川北医学院附属医院心血管内科治疗的356例心源性猝死患者进行研究,设为病例组,并选择同期体检的健康人200例作为对照组,分析QRS、QT、QTc及LVEF水平变化情况及其预测价值。结果：病例组QRS、QTc水平显著高于对照组,QT、LVEF水平显著低于对照组,差异显著（P＜0.05）;轻度QRS、QTc显著低于中度、重度患者,QT、LVEF水平显著高于中度、重度患者;中度患者QRS、QTc显著低于重度患者,QT、LVEF水平显著高于重度患者,差异显著（P＜0.05）;ROC结果显示,QRS预测心源性猝死的AUC为0.989,灵敏度△为84.59%,特异度为87.68%,截断值为115.59ms;QT预测心源性猝死的AUC为0.944,灵敏度85.12%,特异度为88.45%,截断值为21.69ms;QTc预测心源性猝死的AUC为0.984,灵敏度为86.05%,特异度为88.61%,截断值为416.39ms,LVEF预测心源性猝死的AUC为0.997,灵敏度87.15%,特异度为89.05%,截断值为45.63%,（P＜0.05）。结论：QRS、QT、QTc及LVEF在心源性猝死患者中检查,可显著提高心源性猝死临床诊断效能。     

Rationale and design of the CAREFUL study

Background. Sudden cardiac death (SCD) in the young (1-45 years) is a strong risk factor for the presence of inherited cardiac diseases in surviving first-degree relatives. Postmortem investigation of the victim and cardiogenetic evaluation of the first-degree relatives is indicated to detect inherited cardiac diseases and treat relatives at an early stage to prevent SCD. In the Netherlands, postmortem investigation is often not performed and relatives of SCD and sudden unexplained death (SUD) victims are rarely evaluated for inherited cardiac diseases. Methods. A prospective population-based follow-up study carried out in two intervention regions and two control regions. In the intervention regions a comprehensive intervention (stimulate autopsy and storage of victims DNA and the referral of first-degree relatives for cardiogenetic evaluation) is applied in a ‘top down’ and ‘bottom up’ mode. In each region, young sudden death victims are registered and for all cases performance of autopsy and evaluation of relatives in a cardiogenetics outpatient clinic will be determined. Expected results. The study will provide information on the incidence of sudden death in the young and the proportion of diagnosed inherited cardiac diseases. Moreover, the additional value of the introduction of two different preventive strategies directed at early detection of inherited cardiac diseases in first-degree relatives to usual care will be evaluated. Conclusion. The CAREFUL study will help to set a new standard of care in the evaluation of young sudden death victims and their relatives to identify the presence of inherited cardiac diseases, in order to prevent sudden death. (Neth Heart J 2010;18:286-90.)     

Sudden death and its predictors in myocardial infarction survivors in an Indian population

ObjectiveThis study was conducted to assess the incidence of sudden cardiac death (SCD) in post myocardial infarction patients and to determine the predictive value of various risk markers in identifying cardiac mortality and SCD.MethodsLeft ventricular function, arrhythmias on Holter and microvolt T wave alternans (MTWA) were assessed in patients with prior myocardial infarction and ejection fraction ≤ 40%. The primary outcome was a composite of cardiac death and resuscitated cardiac arrest during follow up. Secondary outcomes included total mortality and SCD.ResultsFifty-eight patients were included in the study. Eight patients (15.5%) died during a mean follow-up of 22.3 ± 6.6 months. Seven of them (12.1%) had SCD. Among the various risk markers studied, left ventricular ejection fraction (LVEF) ≤ 30% (Hazard ratio 5.6, 95% CI 1.39 to 23) and non-sustained ventricular tachycardia (NSVT) in holter (5.7, 95% CI 1.14 to 29) were significantly associated with the primary outcome in multivariate analysis. Other measures, including QRS width, heart rate variability, heart rate turbulence and MTWA showed no association.ConclusionsAmong patients with prior myocardial infarction and reduced left ventricular function, the rate of cardiac death was substantial, with most of these being sudden cardiac death. Both LVEF ≤30% and NSVT were associated with cardiac death whereas only LVEF predicted SCD. Other parameters did not appear useful for prediction of events in these patients. These findings have implications for decision making for the use of implantable cardioverter defibrillators for primary prevention in these patients.     

乳腺导管原位癌和浸润性导管癌中MMP-7、VEGF及E-cad的表达及临床意义

目的:探讨乳腺导管原位癌(DCIS)和浸润性导管癌(IDC)中基质金属蛋白酶-7(MMP-7)、血管内皮生长因子(VEGF)及钙黏附素E(E-cad)的表达及临床意义。方法:选取2012年1月-2017年8月期间鄂东医疗集团黄石市中心医院乳甲外科的DCIS石蜡包埋标本(DCIS组)59例,IDC石蜡包埋标本(IDC组)32例,另选取同时期正常乳腺组织标本20例为对照组,检测各组MMP-7、VEGF及E-cad的表达情况,并分析MMP-7、VEGF及E-cad的阳性表达率与DCIS、IDC患者临床病理特征的关系,采用Pearson相关性分析MMP-7、VEGF与E-cad之间的相关性。结果:DCIS组、IDC组的MMP-7、VEGF阳性表达率高于对照组,E-cad的强阳性表达率低于对照组(P0.05),DCIS组与IDC组之间的MMP-7、VEGF、E-cad阳性表达率比较差异无统计学意义(P0.05)。MMP-7、VEGF及E-cad的阳性表达率均与患者的年龄、肿瘤大小无关(P0.05),临床分期为Ⅱ-Ⅲ期、中/低分化程度、有淋巴结转移患者的MMP-7、VEGF的阳性表达率高于临床分期为Ⅰ期、高分化程度、无淋巴结转移患者(P0.05),中/低分化程度、有淋巴结转移患者的E-cad的阳性表达率低于高分化程度、无淋巴结转移患者(P0.05)。经Pearson相关性分析显示,MMP-7与VEGF存在正相关关系(r=0.362,P=0.038),MMP-7、VEGF均与E-cad无显著相关性(r=0.071、0.024,P=0.057、0.089)。结论:DCIS和IDC中MMP-7、VEGF表达较高,E-cad表达较低,且与患者临床分期、分化程度、淋巴结转移有关,临床上可以通过检查MMP-7、VEGF、E-cad的表达来评估乳腺癌的发生及发展。     

Ambulatory ECG-based T-wave alternans and heart rate turbulence can predict cardiac mortality in patients with myocardial infarction with or without diabetes mellitus

ABSTRACT: BACKGROUND: Many patients who survive a myocardial infarction (MI) remain at risk of sudden cardiac death despite revascularization and optimal medical treatment. We used the modified moving average (MMA) method to assess the utility of T-wave alternans (TWA) and heart rate turbulence (HRT) as risk markers in MI patients with or without diabetes mellitus (DM). METHODS: We prospectively enrolled 248 consecutive patients: 96 with MI (post-MI patients); 77 MI with DM (post-MI + DM patients); 75 controls without cardiovascular disease (group control). Both TWA and HRT were measured on ambulatory electrocardiograms (AECGs). HRT was assessed by two parameters [BOX DRAWINGS LIGHT HORIZONTAL] turbulence onset (TO) and turbulence slope (TS). HRT was considered positive when both TO [GREATER-THAN OR EQUAL TO]0% and TS [LESS-THAN OR EQUAL TO]2.5 ms/R-R interval were met. The endpoint was cardiac mortality. RESULTS: TWA values differed significantly between MI and controls. Post-MI + DM patients had higher TWA values than post-MI patients (58 [PLUS-MINUS SIGN] 21 muV VS 52 [PLUS-MINUS SIGN] 18 muV, P = 0.029). Impaired HRT--increased TO and decreased TS were observed in MI patients with or without DM. During follow-up of 578 [PLUS-MINUS SIGN] 146 days, cardiac death occurred in ten patients and three of them suffered sudden cardiac death (SCD). Multivariate analysis determined that a HRT-positive outcome [HR (95% CI): 5.01, 1.33--18.85; P = 0.017], as well as the combination of abnormal TWA ([GREATER-THAN OR EQUAL TO]47 muV) and positive HRT had significant association with the endpoint [HR (95% CI): 9.08, 2.21--37.2; P = 0.002)]. CONCLUSION: This study indicates that AECGs-based TWA and HRT can predict cardiac mortality in MI patients with or without DM. Combined analysis TWA and HRT may be a convenient and useful method of identifying patients at high risk for cardiovascular death.     

腹腔内贝伐珠单抗辅助卵巢癌术后化疗对患者血清AFP、VEGF、TGF-β1、MIF的影响

目的:研究腹腔内贝伐珠单抗辅助卵巢癌术后化疗对患者血清甲胎蛋白(AFP)、血管内皮生长因子(VEGF)、转化生长因子(TGF-β1)、巨噬细胞移动抑制因子(MIF)的影响。方法:选取2019年1月至2021年2月的210例卵巢癌患者。按照随机数表法分为观察组(n=101)和对照组(n=109),对照组采用化疗治疗,观察组在对照组的基础上,采用腹腔内贝伐珠单抗辅助治疗。对比两组治疗效果,血清治疗前后AFP、VEGF、TGF-β1、MIF水平变化,不良反应,随访生存分析结果。结果:治疗后,观察组总有效率显著高于对照组[89.11%(90/101)vs66.05%(72/109)](P<0.05);血清AFP、VEGF、TGF-β1、MIF水平显著低于对照组[(5.19±1.37)ng/mLvs(10.21±2.38)ng/mL,(22.61±4.32)ng/Lvs(35.76±6.34)ng/L,(168.03±20.18)ng/Lvs(203.76±28.69)ng/L,(4.81±1.01)μg/Lvs(12.79±2.50)μg/L](P<0.05);两组不良反应对比无显著差异(P>0.05);平均生存时间、2年生存率显著高于对照组[(19.23±1.36)月vs(19.23±1.36)月,79.21%(80/101)vs28.44%(31/109)](P<0.05),局部复发与转移显著低于对照组[9.90%(10/101)vs13.76%(15/109)](P<0.05)。结论:腹腔内贝伐珠单抗辅助卵巢癌术后化疗可有效改善患者的临床症状,缓解疾病发展,降低血清AFP、VEGF、TGF-β1、MIF水平,提高患者生存预后。