Objective To explore the levels and the clinical significance of serum soluble Endoglin (sEng) and soluble Fms-like tyrosine kinase (sFlt-1) in patients with preeclampsia (PE). Methods Ninety-six patients with PE were included from June 2009 to June 2014. The patients were divided into mild PE group (n=54) and severe PE group (n=42), while 40 healthy pregnant women were in the control group. The general situation and laboratory testing were recorded and the serum levels of sEng and sFlt-1 were detected. All patients were routinely followed up with the recording of delivery and neonatal situation. Results The sEng and sFlt-1 levels were highest in the severe PE group [(7345.02±772.73) and (866.08±203.24) ng/L], which was followed by mild PE [(5 547.08±564.06) and (603.99±138.37) ng/L] and control group [(1 840.93±300.71) and (252.68±83.03) ng/L] (P<0.01). Levels of sEng were significantly correlated with sFlt-1 in both mild and severe PE groups. There were significantly correlations between sEng and sFlt-1 in mild or severe PE group respectively. The level of sEng and sFlt-1 was considerably positively correlated with mean arterial pressure, 24-hour urinary protein, serum creatinine, fibrinogen, umbilical artery shrink/diastole and resistance index value, but negatively correlated with prothrombin time, birth weight and the placenta weight (P<0.05). PE patients with sEng of <5 000 ng/L and sFlt-1 levels of <700 ng/L had the risk of severe complications of 6.8% and 14.0%; while patients with sEng of ≥5 000 ng/L and sFlt-1 of ≥700 ng/L had the ratio fo 40.4% and 37.0% respectively (P<0.01). Conclusion Serum levels of sEng and sFlt-1 in PE patients indicate that the severity of disease and outcomes of pregnancy.
Objectives To systematically review the efficacy and safety of clopidogrel 600 mg and 300 mg loading dose in Chinese patients underwent percutaneous coronary intervention (PCI). Methods We searched The Cochrane Library, EMbase, PubMed, CNKI, WanFang Data, CBM and VIP databases to collect randomized controlled trials (RCTs) of the efficacy and safety of clopidogrel 600 mg and 300 mg loading dose in Chinese patients underwent PCI from inception to April, 2017. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Meta-analysis was then performed using Stata 14.0 software. Results A total of 10 RCTs involving 1 166 patients were included. The results of meta-analysis showed that: the 600 mg loading dose group had lower incidence rate of major adverse cardiovascular events (MACE) in comparison with the 300 mg loading dose group (RR=0.29, 95%CI 0.17 to 0.48, P<0.000 1). However, no significant difference was found in the incidence of major bleeding events within 30 days between two groups (RR=1.64, 95%CI 0.70 to 3.80,P=0.252). Conclusions The current evidence shows that in Chinese patients underwent PCI, administration of a 600 mg loading dose of clopidogrel is associated with a lower risk of MACE than is administration of a 300 mg loading dose of clopidogrel, without increasing major bleeding risk in 30 days. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusions.
Age is the main cause of neurodegenerative changes in the central nervous system (CNS), and the loss of neurons would increase with the migration of the disease. The current treatment is also mainly used to relieve symptoms, while the function of CNS is very difficult to recover. The emergence of endogenous stem cells has brought new hope for the treatment of CNS diseases. However, this nerve regeneration is only in some specific areas, and the recovery of neural function remains unknown. More and more experts in the field of neuroscience have carried out various in vivo or in vitro experiments, in order to increase nerve regeneration and nerve function recovery through mechanism research, in the expectation that the results would be applied to the treatment of CNS diseases. This article reviews the recent progress of endogenous neural stem cells in degenerative diseases of CNS.
ObjectiveTo review the research status of anti-infective graft materials and analyze their application prospects, in order to provide inspiration for the development of anti-infective vascular endograft. MethodThe research on endovascular anti-infective grafts at home and abroad was reviewed. ResultsThe anti-infective capability of endovascular graft could be achieved through main approaches like modification of the bulk material, surface modification, or a combination of both. In terms of bulk material modification, this paper delved into the creation of antibacterial composite materials by incorporating other materials into primary materials like metals (such as Mg, Zn), biologically derived materials (such as chitosan, silk fibroin, bacterial cellulose), and synthetic polymers (such as graphene and its derivatives, polyurethane, polylactic acid). Examples included Mg-Nd-Zn-Zr alloy, bacterial cellulose/chitosan nanocrystal composites, and chitosan/silk fibroin composites. For surface modifications, inorganic coatings (such as silver, copper, and nitrides) and organic coatings (such as antibiotics, antimicrobial peptides, and anti-infection polymers) had shown promising antibacterial effects in experiments. ConclusionsThe future research focus is how to synthesize the composite graft material with the mechanical properties of ordinary graft and the cell, blood compatibility and antibacterial properties through nano technology. At the same time, how to synthesize coatings with stable long-term anti-infection and anti-bacterial biofilm performance is also considered to be an important direction of future research.
ObjectiveTo investigate the effect of Staphylococcal peptidoglycan (PGN-sa) on raw264.7 cells differentiating into osteoclasts. MethodsThere were 5 groups in the experiment: 100 ng/mL PGN-sa group, 200 ng/mL PGN-sa group, 400 ng/mL PGN-sa group, positive control group [100 ng/mL receptor activator of nuclear factor κB ligand (RANKL)], and blank control group (PBS). Raw264.7 cells were cultured with different concentrations of PGN-sa, RANKL, or PBS for 5 days, and then tartrate resistant acid phosphatase (TRAP) staining was used to detect the formation of osteoclast-like cells; Image-Pro Plus 6.0 software was used to detect the bone resorption areas of osteoclast-like cells; and MTT assay was used to observe the proliferation activity of raw264.7 cells. ResultsTRAP staining showed that PGN-sa and RANKL can induce raw264.7 cells to differentiate into osteoclast-like cells; different concentrations of PGNsa groups had more osteoclast-like cells formation than blank control group (P < 0.05), and the number of osteoclast-like cells significantly increased with the increase of PGN-sa concentrations (P < 0.05). Bone resorption cavity experiment showed that bone resorption cavities were obvious in different concentrations of PGN-sa groups and in positive control group, and the area of bone absorption cavities was increased with the increasing PGN-sa concentrations, showing significant difference between groups (P < 0.05). MTT assay showed that no significant difference was found in the absorbance (A) value between different concentrations of PGN-sa groups and blank control group, and between different concentrations of PGN-sa groups (P > 0.05). ConclusionPGN-sa can promote raw264.7 cells to differentiate into osteoclasts with bone resorption activity.
Objective To investigate the effect of peptidoglycan (PGN) on the secretion of pro-inflammatory cytokines by dendritic cells (DCs) and the regulation of T helper 17 (Th17) responses in experimental autoimmune uveitis. Methods Bone marrow cells from naive mice were cultured with granulocyte macrophage-colony-stimulating factor and interleukin (IL)-4 to induce DCs. DCs cultured for six days were randomly divided into two groups: PGNtreated group and control group. The DCs in PGNtreated group were stimulated with PGN and the same volume of phosphate buffered saline was added to the DCs as control group. The relative mRNA expression levels of IL-23, tumor necrotic factor alpha; (TNF-alpha;), IL-6,IL-1beta;were measured by real-time reverse transcriptase polymerase chain reaction (RT-PCR). Peptide fragment of interphotoreceptor retinoidbinding protein (IRBP1-20)specific T cells, which were isolated from the spleen and draining lymph nodes of C57BL/6 mice immunized with IRBP1-20 peptide fragments 13 days earlier, were co-cultured with PGN-treated or untreated DCs, respectively. Total RNA from T cells cocultured for two days were isolated and the relative expression of retinoic acid receptor-related orphan receptor gamma;t (ROR-gamma;t), IL-17, T-box expression in T cells (T-bet), interferon gamma; (IFN-gamma;) mRNA were detected by realtime RT-PCR. On the second, the fifth and the seventh day, the cocultured T cells were analyzed by flow cytometry to detect the percentages of IFN-gamma;, IL-17 positive cells. Results The real-time RT-PCR results revealed that the level of IL-23, IL-1beta;, IL-6, TNF-alpha; mRNA from PGNstimulated DCs were significantly increased compared to the control group (t=-14.363, -5.627, -3.85, -28.151; P＜0.05). The level of RORgamma;t, IL-17 mRNA from the T cells cocultured with PGN-stimulated DCs were greatly increased compared with the control group (t=-5.601, -19.76；P＜0.05). However, the level of T-bet, IFN-gamma; mRNA from the T cells cocultured with PGNstimulated DCs were significantly decreased compared with the control group (t=4.717, 11.207; P＜0.05). Data of flow cytometry showed that at two days, five days, seven days after cocultured with PGN-treated DCs, the percentages of IL-17 positive T cells were increased compared to the control group (t=-2.944, -3.03, -4.81; P＜0.05), and the percentages of IFN-gamma; positive T cells had no remarkable change (t=-1.25, -0.18, -2.16; P＞0.05). Conclusion PGN can promote the secretion of Th17-related cytokines by DCs, which favors proliferation and differentiation of Th17 in experimental autoimmune uveitis.
ObjectiveTo investigate the influence of different discontinuation time of clopidogrel and aspirin before off-pump coronary artery bypass grafting on postoperative volume of drainage and blood products imported.MethodsA total of 454 patients who underwent coronary artery bypass grafting in Beijing Anzhen Hospital from January 2017 through December 2019 were included. According to the preoperative discontinuation of clopidogrel and aspirin, all the 454 patients were divided into three groups including a guide group, a non-stop group and a stop group. There were 86 patients in the guide group including 59 males and 27 females with an average age of 64.12±6.15 years. They continued to take aspirin 100 mg/d before operation, but stopped clopidogrel for more than 5 days. In the non-stop group, there were 234 patients including 141 males and 93 females with an average age of 63.71±7.01 years. They continued to take aspirin 100 mg/d before operation, and stopped clopidogrel <5 days. In the stop group, there were 134 patients including 76 males and 58 females with an average age of 62.90±7.78 years. They stopped aspirin and clopidogrel for more than 5 days before operation. The clinical effectiveness was compared among the three groups.ResultsNo perioperative death occurred in all patients. There was no statistical difference in platelet count, coagulation function, liver function, renal function, or myocardial markers among the groups (P>0.05). The hemoglobin [97 (15) g/ L vs. 98 (21) g/L vs. 100 (20) g/ L, F=4.894, P=0.008] in the non-stop group was lower than that in the guide group and the non-stop group at 30 minutes postoperatively. The flow volume (399.87±127.19 mL vs. 367.05±125.89 mL vs. 349.63±130.68 mL, F=7.770, P=0.000) in the non-stop group at 3 hours postoperatively, the flow volume [600 (300) mL vs. 580 (245) mL vs. 550 (350) mL, Z=8.218, P=0.016] in the non-stop group at 6 hours postoperatively, the flow volume [750 (370) mL vs. 730 (350) mL vs. 730 (350) mL, Z=8.329, P=0.016] in the non-stop group at 12 hours postoperatively, the flow volume [890 (365) mL vs. 850 (340) mL vs. 850 (350) mL vs. Z=6.585, P=0.037] in the non-stop group at 24 hours postoperatively and the flow volume [950 (375) mL vs. 940 (360) mL vs. 940 (380) mL, Z=8.680, P=0.013] in the non-stop group at 48 hours postoperatively were more than those of the guide group and the stop group. The retention time of drainage tube was longer in the non-stop group [3 (1) d vs. 3 (1) d vs. 3 (1) d, Z=6.579, P=0.037] than in the guide group and the non-stop group. The amount of suspended erythrocytes input [0 (2) U vs. 0 (2) U vs. 0 (0) U, Z=6.150, P=0.046], and the amount of plasma input [200 (200) mL vs. 0 (200) mL vs. 0 (200) mL, F=4.144, P=0.016], the number of cases of plasma input (119 patients vs. 34 patients vs. 47 patients, Z=10.116, P=0.006) were more than those of the guide group and the stop group.ConclusionAspirin maintenance is recommended for patients before off-pump coronary artery bypass grafting. If not necessary, clopidogrel is discontinued for at least 5 days.
ObjectiveTo systematically review the effectiveness and safety of aspirin-clopidogrel combined anti-platelet therapy after coronary artery bypass grafting (CABG). MethodsDatabases including The Cochrane Library (Issue 2, 2013), PubMed, EMbase, CBM, CNKI, WanFang Data and VIP were searched electronically from their inception to September 2013 for randomized controlled trials (RCTs) about aspirin-clopidogrel combined anti-platelet therapy after CABG. Two reviewers selected literature independently according to the inclusion and exclusion criteria. After data extraction and methological quality assessment of the included studies, meta-analysis was performed using RevMan 5.2 software. ResultsA total of six RCTs involving 901 patients were included, of which 449 cases were in the aspirin-clopidogrel group (A+C) and 452 cases were in the aspirin with or without placebo group (A+P). The results of meta-analysis showed that: compared with A+P, A+C significantly reduced occlusion rates of the saphenous vein graft (RR=0.59, 95% CI 0.43 to 0.80, P=0.000 6). But no significant difference was found between the two groups in occlusion rates of the left internal mammary artery graft (RR=0.88, 95% CI 0.35 to 2.18, P=0.78), radial artery graft (RR=0.43, 95% CI 0.13 to 1.46, P=0.18), pleural fluid drainage volume (MD=-1.68, 95%CI-48.69 to 45.32, P=0.94), incidence of major bleeding events (RR=1.20, 95% CI 0.39 to 1.65, P=0.75), major cardiovascular events (OR=0.81, 95% CI 0.38 to 1.72, P=0.58), and mortality within 30 days (RR=0.64, 95% CI 0.17 to 2.44, P=0.52). ConclusionIn reducing occlusion rates of the saphenous vein graft, the A+C group is more effective than the A+P group. Due to the limited quantity and quality of the included studies, the above conclusion still needs to be verified by carrying out more high-quality RCTs.
ObjectiveTo evaluate the effect of nickel-titanium three-dimensional memory alloy mesh combined with autologous bone for living model of canine tibial plateau collapse fracture by biomechanical testing. MethodsSixteen healthy 12-month-old Beagle dogs were randomly divided into 4 group, 4 dogs in each group. The dogs were used to establish the tibial plateau collapse fracture model in groups A, B, and C. Then, the nickel-titanium three-dimensional memory alloy mesh combined with autologous bone (the fibula cortical bone particles), the artificial bone (nano-hydroxyapatite), and autologous fibula cortical bone particles were implanted to repair the bone defects within 4 hours after modeling in groups A, B, and C, respectively; and the plate and screws were fixed outside the bone defects. The dogs were not treated in group D, as normal control. At 5 months after operation, all animals were sacrificed and the tibial specimens were harvested and observed visually. The destructive axial compression experiments were carried out by the biomechanical testing machine. The displacement and the maximum failure load were recorded and the axial stiffness was calculated. ResultsAll animals stayed alive after operation, and all incisions healed. After 1-3 days of operation, the animals could stand and move, and no obvious limb deformity was found. The articular surfaces of the tibial plateau specimens were completely smooth at 5 months after operation. No obvious articular surface collapse was observed. The displacement and maximum failure load of specimens in groups A and D were significantly higher than those in groups B and C (P<0.05). But no significant difference was found between groups A and D and between groups B and C (P>0.05). ConclusionThe nickel-titanium three-dimensional memory alloy mesh combined with autologous bone for subarticular bone defect of tibial plateau in dogs has good biomechanical properties at 5 months after operation, and has better axial stiffness when compared with the artificial bone and autologous bone graft.
ObjectiveA competing endogenous RNA (ceRNA) regulatory network associated with long non-coding RNA (lncRNA) specific for lung adenocarcinoma (LUAD) was constructed based on bioinformatics methods, and the functional mechanism of actinfilament-associated protein 1-antisense RNA1 (AFAP1-AS1) in LUAD was analyzed, in order to provide a new direction for the study of LUAD therapeutic targets. MethodsThe gene chip of LUAD was downloaded from the Gene Expression Omnibus (GEO), and lncRNA and mRNA with differential expression between LUAD and normal tissues were screened using GEO2R online software, and their target genes were predicted by online databases to construct ceRNA networks and perform enrichment analysis. In cell experiments, AFAP1-AS1 was genetically knocked down and siRNA was constructed and transfected into LUAD cells A549 by cell transfection. CCK8, transwell, scratch assay and flow cytometry were used to detect the ability of cells to proliferate, invade, migrate and apoptosis. ResultsA total of 6 differentially expressed lncRNA and 494 differentially expressed mRNA were identified in the microarray of LUAD. The ceRNA network involved a total of 6 lncRNA, 22 miRNA, and 55 mRNA. Enrichment analysis revealed that mRNA was associated with cancer-related pathways. In cell assays, knockdown of AFAP1-AS1 inhibited cell proliferation, invasion, and migration, and AFAP1-AS1 promoted apoptosis. ConclusionIn this study, we construct a lncRNA-mediated ceRNA network, which may help to further investigate the mechanism of action of LUAD. In addition, through cellular experiments, AFAP1-AS1 is found to have potential as a therapeutic target for LUAD.