[The role of CT coronary angiography in improving the positive rate of coronary angiography in patients with low-or moderate-risk non-ST segment elevation myocardial infarction]

Objective: To investigate whether CT coronary angiography (CTA) can safely and effectively reduce the number of invasive coronary angiography (ICA) in patients with non-ST-segment elevation myocardial infarction (NSTEMI) whose Grace score is low-or moderate-risk, and increase ICA positive rate. Methods: One hundred and two NSTEMI patients, including 61 males and 41 females, aged 38-80 (58±12) years, were prospectively included and treated in Henan Provincial People's Hospital from February 2017 to February 2018. By using random number method, the patients were divided into control group (51 cases) and experimental group (51 cases). Patients in the control group were arranged for elective ICA examination according to the risk stratification. If further intervention or surgical treatment was required, the ICA examination was positive; in the experimental group, the CTA examination was completed through the green channel first. If the CTA showed that the main coronary artery and its main branches were severe or extreme stenosis, further ICA examination was arranged; otherwise, a secondary prophylactic drug treatment was developed and the patients were then discharged and followed up for 1 year. ICA number, ICA positive rate, length of hospital stay, hospital cost, hospital anxiety and depression score (HADS), major cardiovascular events (MACE) within 1 year, and other serious adverse events related to examination or surgery were compared between the two groups. Results: A total of 37 patients in the experimental group underwent ICA, and the positive rate of ICA was 94.59% (35/37), which was significantly higher than that of the control group [62.75% (32/51)] (P<0.05). The average length of hospital stay and the HADS score before ICA in the experimental group were significantly lower than those in the control group [(3.8±2.2) d vs (4.8±2.4) d; 8.8±4.5 vs 11.4±6.8] (all P<0.05). There was no significant difference in the cumulative incidence of MACE (3 cases vs 5 cases, P=0.423) and other serious adverse events (8 cases vs 10 cases, P=0.548) within 1 year between the two groups. Conclusion: CTA significantly reduces the number of ICA and the average length of hospital stay, and increases the positive rate of ICA in NSTEMI patients whose Grace score is low-or moderate-risk. There is no increase in cardiovascular risks within 1 year.

[Biomarkers screening for viral myocarditis through proteomics analysis of plasma exosomes]

Objective: To compare and analyze the differentially expressed plasma exosomic proteome between healthy control group (Control group) and viral myocarditis group (VMC group) to search for biomarkers that maybe used for early diagnosis of VMC. Methods: Fifty plasma samples of Control group and VMC group were collected respectively from Henan Provincial People's Hospital (from January 2016 to December 2017), and then 5 samples (1 ml) of each group were selected randomly, after exosomes extraction with ultra-centrifugation, difference gel electrophoresis (DIGE) was used to isolate the total proteins, and then the protein spots with more than 2-fold changes between VMC and Control group were picked up after the software analysis, afterward, the varied proteins were identified by MALDI-TOF/TOF mass spectrometry. Finally, the specifically related protein was selected to be verified by ELISA with the plasma exosomic samples of Control (n=40) and VMC (n=40). Results: A total of 10 varied protein spots were found including 8 up-regulated proteins and 2 down-regulated proteins between VMC and Control group. After MS analysis, the up-regulated proteins in VMC group contained KRT2, KRT5, KRT9, KRT77, KRT78, AZGP1, HP and RBP4, whereas the down-regulated ones were CD5L and C1QB. RBP4 was selected to validate by ELISA analysis, and the corresponding results showed that RBP4 was increased specifically in plasma exosomes of VMC group (P<0.05) after comparing with Control group, which was consistent with DIGE. Conclusion: Ten proteins related to VMC are detected in total, and RBP4 might serve as a potential specific biomarker for early screening and diagnosis of VMC.

A targeted disruption of the murine Brca1 gene causes gamma-irradiation hypersensitivity and genetic instability

Germline mutations of the Brcal gene are responsible for most cases of familial breast and ovarian cancers, but somatic mutations are rarely detected in sporadic events. Moreover, mouse embryos deficient for Brca1 have been shown to die during early embryogenesis due to a proliferation defect. These findings seem incompatible with the tumor suppress function assigned to this gene and raise questions about the mechanism by which Brca1 mutations cause tumorigenesis. We now directly demonstrate that BRCA1 is responsible for the integrity of the genome. Murine embryos carrying a Brca1 null mutation are developmentally retarded and hypersensitive to gamma-irradiation, suggesting a failure in DNA damage repair. This notion is supported by spectral karyotyping (SKY) of metaphase chromosomes, which display numerical and structural aberrations. However, massive chromosomal abnormalities are only observed when a p53-/- background is introduced. Thus, a p53 dependent cell cycle checkpoint arrests the mutant embryos and prevents the accumulation of damaged DNA. Brca1-/- fibroblasts are not viable, nor are Brca1-/-:p53-/- fibroblasts. However, proliferative foci arise from Brca1-/-: p53-/- cells, probably due to additional mutations that are a consequence of the accumulating DNA damage. We believe that the increased incidence of such additional mutations accounts for the mechanism of tumorigenesis associated with Brca1 mutations in humans.

Heavy-chain variable regions in carcharhine sharks: development of a comprehensive model for the evolution of VH domains among the gnathanstomes

We determined the sequence of 18 DNA clones encoding VH regions of sandbar shark and bull shark. All of these sequences exhibit key structural coding features characteristic of known VH genes of higher vertebrates. These VH sequences disclosed considerable diversity, and can be divided into six families according to the criterion of 80% DNA sequence identity. The overlapping of some VH gene clones to two or more families is a particular feature found in carcharhine sharks, which suggests that VH diversification is a continuing process. The basic sequence patterns of heavy-chain V regions found in all representative gnathanstomes and in VH of the shark heavy immunoglobulin IgW provides evidence for selection of canonical residues in all VH structures. Elasmobranch VH sequences can be divided into two classes or clans, one comprising the 'classical' VH set and the other comprising VHS related to those of IgW (V omega). Phylogenetic analyses place the VH cluster as the root of all the classic VHS and indicates that the V omega set is most probably that of the primordial heavy chain.

The incidence of insulin-dependent diabetes mellitus in urban districts of Shanghai (1989-1993)

A retrospective study on the incidence of insulin-dependent diabetes mellitus (IDDM) among children aged 0-14 years was carried out from 1989-1993 in urban Shanghai, China. The average annual population at risk (0-14 yr) consisted of 1,401,664 children. All the cases were collected from the hospitals (primary source) and from primary and middle schools and kindergartens (second source) with independent validation of case ascertainment. There were 53 IDDM cases from the primary source, 23 from the secondary source, with a total of 58. The ascertainment corrected total number of IDDM cases was 67 by the capture-recapture method. The average crude annual incidence rate was 0.83 [95% confidence interval (CI) 0.61-1.04] and ascertainment corrected incidence rate 0.96 (95% CI 0.80-1.12) per 100,000. Peak incidence fell in 1992 and in the 9 year-old group. The incidence of childhood IDDM in the urban districts of Shanghai was reconfirmed to be the lowest in the world but by comparing the results of former investigations a trend was found of increasing incidence of IDDM.

Shanghai, China, has the lowest confirmed incidence of childhood diabetes in the world

OBJECTIVE

To determine the incidence of insulin-dependent diabetes mellitus in 0- to 14-year-old children in Shanghai, China, from 1980 to 1991.

RESEARCH DESIGN AND METHODS

Data were collected from hospitals with pediatric departments. The secondary source of validation was primary and middle schools.

RESULTS

The average crude annual incidence rate was 0.61/100,000 (95% confidence interval, 0.48-0.77). The ascertainment-corrected incidence rates were 0.72/100,000 (0.57-0.91).

CONCLUSIONS

The incidence of childhood diabetes in Shanghai, China, was one of the lowest, if not the lowest, in the world.

17OH-progesterone response to acute dexamethasone administration in congenital adrenal hyperplasia

Glucocorticoid-related changes in 17OH-progesterone (17P) concentrations were studied in 13 patients receiving treatment for 21-hydroxylase deficiency congenital adrenal hyperplasia (CAH). Blood spot and saliva 17P levels were elevated, with or without loss of diurnal rhythm, within 24 h of stopping maintenance glucocorticoid therapy. A single dose of dexamethasone (0.01 mg/kg) given either intravenously or orally at 09.00 h resulted in rapid onset of complete pituitary-adrenal suppression characterised by a prompt and exponential fall in 17P levels (first-order elimination half-life, mean 2.87 h, range 1.98-3.98 h). Concentrations of 17P remained low throughout the day until the onset of an abrupt nocturnal rise, which occurred between 24.00 and 05.00 h. There were individual differences in both the rate of fall and the timing of the nocturnal rise in 17P levels which may partly explain the need to vary individual steroid requirements in the treatment of CAH.

Restriction endonucleases from three strains of Haemophilus influenzae

The restriction endonucleases, Hin P1 I1), Hin S1 I and Hin S2 I are isolated from three strains of Haemophilus influenzae respectively. By polymin P treatment, ammonium sulphate, precipitation and column chromatography on phosphocellulose and on heparin-Sepharose Hin P1 I is partially purified. No contaminating deoxyribonuclease activities have been detected in this purified enzyme preparation. The fact that the digestion patterns of Hin P2 I and Hha I on phage lambda, plasmids ColE1 an pBR 322 DNAs are identical that they are isoschizomers but theri splitting sites are different. The banding patterns of Hin S1 I and Hin S2 I are also the same as that of Hha I.