Abstract:Objective To compare the brain protection by the combination of dexmedetomidine with ketamine or remifentanil in the patients after cardiac valve replacement(CVR) under cardiopulmonary bypass. Methods Ninety patients were selected for the study, who were transferred to ICU for sedation after elective CVR under cardiopulmonary bypass in the Anesthesiology Department of Xuzhou Medical University Hospital from March 2017 to February 2018. The patients were divided into dexmedetomidine-ketamine group (DK group) and dexmedetomidine-remifentanil group (DR group), with 45 patients in each group. Both groups received dexmedetomidine 0.2-0.7 μg/(kg·h) via intravenous pumping, but ketamine 0.3-0.5 mg/(kg·h) was administered in the DK group and remifentanil 2.5-5.0 μg/(kg·h) in DR group via intravenous pumping. The patients were monitored for the hemodynamic parametersincluding the mean arterial pressure (MAP) and mean heart rate (MHR). The brain injury severity indices including central nerve specific protein (S100β) and neuron-specific enolase (NSE) were measured before sedation (T₀), and 2 h (T₁), 6 h (T₂), 12 h (T₃) and 24 h (T₄) after sedation. Records were kept of the delirium incidence, dosage of dexmedetomidine, haloperidol and dezocine, awakening time, extubation time, duration of ICU stay, postoperative hospital stay and incidence of adverse events. SPSS statistics 19.0 was used for data processing. Student′s t test, Chi-square test or rank-sum test were used for intergroup comparison, and repeated measurement variance analysis for intragroup.Results The levels of S100β and NSE at T1-4 in both groups were significantly lower than those at T₀ (P<0.05). The decrease of S100β at T1-4 and the NSE at T1-3 in the DK group was greater than that in the DR group, difference being statically significant (P<0.05). There was no significant difference in MAP and MHR between 2 groups before sedation. MAP at 30 min-9 h and MHR 30 min-8 h after sedation in the DK group were significantly higher than those in the DR group, and the differences were statistically significant (P<0.01). The fluctuation of MAP and MHR in the DK group was more moderate than in the group DR. During sedation, the recordings in the DK group were significantly lower than those in the DR group of the concentration of dexmedetomidine [(374.3±52.7) vs (504.6±69.3)μg], dezocine [(9.6±2.7) vs (15.6±3.3)mg] and haloperidol [(29.7±3.2) vs (46.6±3.4)mg]; occurrences of hypotension [6.6%(3/45) vs 24.4%(11/45)] and bradycardia [4.4%(2/45) vs 20.0%(9/45)]; and awakening time [(457.2±14.5) vs (504.2±16.9)min] and extubation time [(511.7±15.9) vs (553.5±20.9)min] (P<0.05), but no significant differences were observed in delirium ratio, nausea/vomiting, ICU stay time and postoperative hospital stay (P＞0.05). Conclusion Dexmedetomidin-ketamine and dexmedetomidin-remifentanil have similar sedative and analgesic effects after CVR with cardiopulmonary bypass, but the former provides more significant cerebral protection with more reasonable and stable hemodynamics and significantly decreased occurrences of adverse reactions.

Abstract:Objective To observe the effects of ticagrelor and a double dose of clopidogrel on the incidence of cardiovascular ischemia and bleeding after percutaneous coronary intervention (PCI) in the elderly patients with mutant CYP2C19. Methods Enrolled in this study were patients with mutant CYP2C19, who underwent PCI in the Department of Cardiology of Chinese PLA Hospital No.309. They were randomly divided into clopidogrel group and ticagrelor group, with 120 in each group. The former took aspirin and a double dose of clopidogrel and the latter aspirin and ticagrelor. Major adverse cardiovascular events (MACEs) and bleeding events were observed during the hospital stay and a follow-up of 12 months. Data were processed using SPSS statistics 17.0. Depending on data type, Student′s t-test or Chi-square test was conducted for the comparison between two groups. Results Compared with the clopidogrel group, the ticagrelor group had significantly higher R-value [(24.2±2.8) vs(15.3±2.4)s] and K-value [(13.4±2.6) vs(6.6±1.8)s], but lower MA [(46.2±2.1) vs(69.5±3.2)mm], the differences being statistically significant (P<0.01). The incidence of MACEs in the ticagrelor group was significantly lower than that in the clopidogrel group [13.3%(16/120) vs 32.5%(39/120), P<0.01]; however, there was no significant difference in the incidence of bleeding events between two groups (P>0.05).Conclusion In the patients with mutant CYP2C19, a double dose of clopidogrel can be effective in platelet inhibition but with high cardiovascular ischemic events; ticagrelor can effectively reduce drug resistance, enhance platelet inhibition, and thus decrease the incidence of cardiovascular ischemic events.

Abstract:Objective To assess improvement of the self-management in the stroke patients after attending teaching program. Methods A total of 115 stroke patients were enrolled at Fangzhuang Community Health Service Center from January 2011 to December 2016. The patients were randomly divided into study group (n=57) and control group (n=58). The control group were given routine outpatient health education, while the study group attended a self-management course once a week for 6 weeks. A comparison was made using Chronic Diseases Self-efficacy Scale on the completion of the course. SPSS statistics 19.0 was used for data analysis, and Student′s t test or Chi-square test for comparison. Results The self-efficacy scores after intervention were significantly higher in the study group than in the control group (P＜0.05). Compared with control group after intervention, the study group had higher scores in regular exercise[(7.89±1.12)vs(6.31±0.53)], geting information on disease[(9.09±0.37) vs (5.23±1.93)], obtaining help from community, family and friends [(8.28±0.06) vs (5.17±1.61)], communicating with physician[(9.13±0.78) vs (6.24±0.46)], managing disease in general[(8.12±1.77) vs (6.16±0.22)]and doing chores[(9.13±0.69) vs (6.18±1.70)]. Conclusion Self-management teaching program can effectively improve self-management of the stroke patients.

Abstract:Objective To investigate the prognostic value of preoperative fibrinogen (FIB) combined with postoperative carcino-embryonic antigen (CEA) in the patients with stage Ⅱ colon cancer in view of providing reference for clinical diagnosis and treatment. Methods A total of 129 patients with stage Ⅱ colon cancer were enrolled in this study, who were treated in the Department of Gastroenterology of Dali Bai Autonomous Prefecture People′s Hospital from March 2010 to March 2013. They were followed up for 5 years and were divided into good prognosis group and poor prognosis group, depending on whether the patient had an endpoint. SPSS statistics 19.0 was used for statistical analysis and Kaplan-Meier for survival analysis on all patients with survival curves being plotted. Cox regression analysis was performed for the factors that may affect survival time. Results The Kaplan-Meier survival curves showed a poor prognosis rate of 26.27%(31/118), and the number of patients with poor prognosis increased with time and more obviously at month 48. Multivariate Cox regression analysis predicted adenocarcinoma (RR=2.79,5%CI 1.889-4.121; P=0.028), mucinous carcinoma (RR=2.81, 95%CI 1.948-4.054; P=0.041), undifferentiated cancer (RR=2.83,5%CI 2.016-3.972; P=0.029), left colon cancer (RR=2.72,5%CI 1.476-5.014; P=0.024), right colon cancer (RR=2.71,5%CI 1.514-4.850; P=0.035), increased preoperative FIB (RR=2.49,5%CI 1.499-4.137; P=0.033), and increased postoperative CEA (RR=2.62,5%CI 1.659-4.137; P=0.026) all affected the prognosis. The preoperative FIB had an area under the receiver operating characteristic curve (AUC) of 0.581(95%CI 0.459-0.694), with an optimal cut-off point of 7.27, a sensitivity of 68.8% and a specificity of 65.4%. The AUC for postoperative CEA measured 0.773 [95%CI (0.712-0.893)] with an optimal cut-off point of 5.78, a sensitivity of 61.3% and a specificity of 78.9%. The preoperative FIB combined with postoperative CEA had an AUC of 0.812, with a sensitivity of 74.1% and a specificity of 83.2%. Conclusion Preoperative FIB and postoperative CEA are risk factors for the prognosis in the patients with stage Ⅱ colon cancer, and their combination can enhance the sensitivity and specificity of the prediction, suggesting potential clinical value.

Abstract:Objective To investigate the effects of high-flux hemodialysis (HFHD) on the nutrition, immunity, interleukin-6 (IL-6), IL-8, tumor necrosis factor-α (TNF-α) and C-reactive protein (CRP) in the elderly patients with uremia. Methods Included in this study were 112 elderly patients with uremia treated in the Nephrology Department of Beijing Aerospace Hospital from January 2014 to December 2017. The patients were randomly divided into the control group (n=56) and the observation group (n=56), the former receiving routine hemodialysis and the latter receiving high-flux hemodialysis treatment both for 6 months. Data of the two groups were collected before and at 6 month after the treatment, including hemoglobin (Hb), plasma total protein (TP), albumin (Alb), prealbumin (PA), IgA, IgM, IgG, C3, C4, blood calcium, blood phosphorus, parathyroid hormone (PTH), β₂-microglobulin (β₂-MG), IL-6, IL-8, TNF-α and CRP. Analysis of the two groups was made in the aspects of nutrition, calcium and phosphorus metabolism, immune indices and inflammation before and after treatment. SPSS statistics 22.0 was used to perform the statistical analysis. Student′s t test or Chi-square test was employed for comparison between two groups. Results The observation group had statistically significantly higher(P<0.05) recordings than the control group after treatment in Hb [(136.28±14.25) vs(98.53±12.26)g/L], TP[(69.85±6.12) vs(62.37±5.50)g/L], Alb[(37.92±3.80) vs(31.65±3.37)g/L], PA[(312.70±63.28) vs(242.18±46.27)mg/L], IgA[(1.97±0.43) vs(1.58±0.30)g/L], IgM[(1.53±0.26) vs(1.16±0.18)g/L], IgG[(10.92±2.17) vs(9.35±1.60)g/L], C3[(1.26±0.18) vs(1.05±0.15)g/L], and C4[(0.82±0.11) vs(0.54±0.07)g/L], but significantly lower recordings (P<0.05) in blood phosphorus[(1.84±0.31) vs(3.20±0.56)mmol/L], PTH[(60.54±3.38) vs(107.43±7.56)mmol/L], β₂-MG[(9.13±2.28) vs(20.82±3.27)mg/L], IL-6[(197.42±40.63) vs(324.73±52.14)ng/L], IL-8[(194.25±20.83) vs(237.15±28.60)ng/L], TNF-α[(385.20±63.57) vs(468.37±71.40)ng/L] and CRP[(5.12±1.38) vs(6.30±1.54)mg/L]. Conclusion HFHD can effectively improve the immune function and nutritional status and reduce serum inflammatory factors in the elderly uremic patients.

Abstract:Objective To investigate the characteristics of cognitive dysfunction in the elderly patients with atrial fibrillation (AF). Methods A retrospective analysis was made of 165 elderly patients hospitalized in the Department of Geriatric Cardiology of Beijing Friendship Hospital from January 2016 to December 2017, who were divided into AF group (83) and non-AF group (82). Cognitive function was assessed using Montreal Cognitive Assessment Scale (MoCA) and Mini-Mental State Examination Scale (MMSE). SPSS statistics 24.0 was used for data analysis, and Student′s t test, nonparametric rank sum test or Chi-square test for comparison between the groups. Results MoCA assessment showed that 71.1% (59/83) in the AF group had cognitive dysfunction against 56.10%(46/82) in the non-AF group (P<0.05). Compared with the AF group, the non-AF group scored lower in the visuospatial and executive function [(3.17±1.64) vs (3.96±1.23)], language [(1.98±1.00) vs (2.34±0.95)], abstraction [(1.27±0.75) vs (1.56±0.67)] and orientation [(5.20±0.85) vs (5.50±1.10)] and total score [(20.27±6.83) vs (23.16±5.78)], the differences being statistically significant (P<0.05). MMSE showed that 31.3% (26/83) in the AF group had cognitive dysfunction against 18.3% (15/82) in the non-AF group with a difference of statistical significance (P<0.05). Compared with the AF group, the non-AF group had lower scores in the time orientation [(3.92±1.60) vs (4.40±1.20)], place orientation [(4.66±0.89) vs (4.89±0.45)], attention and calculation [(3.39±1.80) vs (3.94±1.40)], object naming [(1.98±0.15) vs (2.35±0.78)], and graphic description [(0.73±0.44) vs (0.90±0.30)], and total score [(24.90±5.87) vs (26.79±4.20)], the differences being statistically significant (P<0.05). Conclusion Cognitive dysfunction in AF patients featuresmainly in visuospatial and executive function, language, abstraction, time and place orientation, attention and calculation, object naming, and graphic description, which greatly affects the daily life of the elderly. Active recovery or maintenance of sinoatrial nodular rhythm in AF patients can improve their quality of life.

Abstract:Objective To investigate frequency of pacing by temporary pacemaker and its effects on the cardiac function in the non-cardiac surgeries. Methods A total of 200 patients were selected who had undergone non-cardiac surgeries with TPM in Baoji Central Hospital from June 2012 to June 2017. Based on the frequency of right ventricular pacing (RVP), all the patients were divided into high-pacing group (>50%, n=128) and low-pacing group (≤50%, n=72). The two groups were then compared in complications, heart rate (HR) 1 day pre- and post-operatively, cardiac index (CI), left ventricular ejection fraction (LVEF), creatine kinase isoenzyme MB (CKMB), troponin T (TnT), amino-terminal pro-brain natriuretic peptide (NT-proBNP) and atrial fibrillation. SPSS statistics 22.0 was used for data analysis, and Student′s t test, ANOVA, Chi-square test or Z test for comparison. Results The incidence of complications was 4.69% (6/128) in the high-pacing group against 6.94%(5/72) in the low-pacing group, with no significant difference between the two groups (P>0.05). The levels of HR, CI and LVEF were significantly lower 1 day postoperatively than preoperatively, and the levels of TnT and NT-proBNP were significantly higher 1 day postoperatively in the high-pacing group than in the low-pacing group (P<0.05). Compared with the low-pacing group, the high-pacing group had lower HR[(62.47±6.51) vs (69.43±7.24)beats/min], CI[(2.45±0.30) vs (3.86±0.42)L/(min·m²)], and LVEF[(35.12±3.55)% vs (39.94±4.11)%], but higher CKMB[(46.87±5.43) vs (38.32±4.16)U/L], TnT[(86.45±9.05) vs (68.02±7.36)ng/L]and NT-proBNP[(275.12±30.24) vs (228.31±29.57)ng/L](P＜0.05). An incidence of new atrial fibrillation of 7.81%(10/128) in the high-pacing group was significantly higher than that of 0.00% (0/72) in the low-pacing group(χ²=4.391, P=0.045). Conclusions Low frequency of pacing (≤50%) by TPM can effectively maintain stable cardiac function in the patients undergoing non-cardiac surgery, helping to avoid the occurrence of postoperative new-onset atrial fibrillation.

Abstract:Objective To investigate supportive therapeutic efficacy of hyperthermia in patients with esophageal cancer and its effect on the level of serum carbohydrate antigen 199 (CA199) and vascular endothelial growth factor (VEGF). Methods Included in the study were 100 patients with esophageal cancer who attended the Department of Thoracic Surgery of Baoji People′s Hospital from September 2012 to September 2016. They were randomized into hyperthermia group and control group, with 50 cases in each group. The control group was given chemotherapy with docetaxel+nedaplatin and conventional radiotherapy, and the hyperthermia group were given hyperthermia in addition to the treatment for the control group. The two groups were compared in the level of serum CA199, VEGF and therapeutic efficacy, adverse reactions, and survival rates. SPSS statistics 22.0 was used for data analysis. Depending on data type, Student′s t test, Chi-square test or rank-sum test was used for comparison between groups, the paired t-test for comparison within the group, and Kaplan-Meier curve analysis for survival prognosis. Results The efficacy was higher in the hyperthermia group than in the control group, with significant difference [90.00%(45/50) vs 74.00%(37/50), P=0.04]. The serum level of CA199 and VEGF in both groups were significantly lower after treatment than those before treatment, and the serum level of CA199 [(50.42±5.54) vs (76.45±7.72)U/ml] and VEGF [(137.2±15.5) vs (203.5±24.0)pg/ml] after treatment were significantly lower in the hyperthermia group than those in the control group, the differences being statistically significant (P<0.01). No statistically significant difference was observed in the incidence of adverse reactions between the two groups (P=0.46). During 2-year follow-up, the survival rate in the hyperthermia group was significantly higher than that in control group [60.00%(30/50) vs 40.00%(20/50), P=0.03]. Conclusion Hyperthermia can effectively enhance the therapeutic efficacy of the conventional chemo-therapy and radiotherapy in esophageal cancer patients with increased survival and satisfactory safety. It is worthy of further promotion in clinical practice.

Abstract:Objective To investigate the features and relative factors of blood pressure variability (BPV) in patients suffering from severe obstructive sleep apnea hypopnea syndrome (OSAHS) with and without hypertension. Methods A total of 125 patients with severe OSAHS in our hospital from August 2016 to December 2017 were divided into hypertensive group (n=64) and normotensive group (n=61). Blood pressure (BP) was continuously monitored and measured via pulse transit time (PTT) during polysomnography (PSG) and calibrated when 3 consecutive stable supine cuff values were obtained with patients in a conscious state. Variations in BP and pulse were incorporated in PSG. The amplitude of BP fluctuation (ΔBP) was reflected by the difference between the peak and bottom values of post apneic SBP recorded during an obstructive respiratory event, and the number of ΔBP>10 mmHg(1 mmHg=0.133 kPa)per hour of sleep time was used as indicator for frequency of significant BP fluctuations (BP index). To explore the effects of arousal and hypoxia on BP fluctuations, nocturnal respiratory events were classified into three types:type A with only oxygen desaturation; type B with arousal but without oxygen desaturation; and type C with both arousal and oxygen desaturation. △BP was compared between 3 types. SPSS statistics 16.0 was used for data analysis, and all data were expressed as mean±standard deviation. The independent sample Student′s t test was used for comparison between the groups and Chi-square test for comparison between the 3 types of apnea events. Pearson′s correlation and then a stepwise multiple regression analysis were performed to investigate the relationships between variables. Results Compared with the normotensive group, the hypertensive group had more severe sleep-disordered breathing (SDB) and significant higher ΔBP [(15.4±4.5) vs (10.9±2.6) mmHg] and BP index [(57.0±16.5) vs (22.7±12.0) times/h] (P＜0.001 in both). Analysis of the nocturnal respiratory events showed that ΔBP were remarkably greater following type A than type B in hypertensive group[(15.4±4.9) vs (11.9±3.8) mmHg] and normotensive group [(10.6±3.1) vs (9.5±2.4) mmHg] (P＜0.001 in both), and that ΔBP following type C were significantly higher than both type A and type B. A stepwise multiple regression equation demonstrated that the mean level of BP had a higher correlation with BP index [awake interval:r²=0.454, P<0.001; sleep interval:r²=0.470, P<0.001)] and the percentage of sleep time with pulse oxygen saturation (SpO₂) <90% (awake interval:r²=0.051, P<0.001; sleep interval:r²=0.073, P<0.001) than with other sleep disorder parameters. Conclusion In the patients with severe OSAHS, the occurrences of hypertension are closely associated with increased nocturnal blood pressure variability (BPV) and hypoxic duration and can be induced by both hypoxia and arousal, with hypoxia being a dominant factor.

Abstract:Objective To investigate the dietary self-management of retired veteran cadres with type 2 diabetes mellitus (T2DM) and evaluate the effect of health education. Methods Chosen for the study were 1300 patients with T2DM attending the Outpatient Department for Senior Cadres of PLA General Hospital from August 2014 to February 2018. All the patients were assessed and documented by full-time nurses, and health education was offered to them with the concept of family-centered nursing. A questionnaire survey was conducted with all patients before and 3 months after education. SPSS statistics 13.0 was used for data analysis, and depending on data type, Student′s t-test or Chi-square test was used for comparison. Results Valid questionnaires were collected from 1269 patients (1024 male and 227 female) with a recovery rate of 97.6%, the ages ranging 52-91 (71.5±7.6)years. A significant increase was observed after education of the patients who would calculate calories according to doctor′s order (59.2% vs 38.4%), who would use food exchange lists for meals (66.9% vs 46.5%), who knew the sugar content of food (79.6% vs 64.5%), who participated in diabetes education (50.6% vs 29.0%), who knew about diabetes mellitus (67.3% vs 16.3%), and who paid follow-up visits (84.5% vs 74.7%, P＜0.05). A significant decline was observed after education in the average body mass index [(22.98±3.72)vs (23.78±3.06)kg/m²], systolic blood pressure [(133.90±14.44) vs (136.20±13.95)mmHg, 1 mmHg=0.133 kPa], diastolic blood pressure [(78.42±8.82) vs (80.23±7.90)mmHg], total cholesterol [(3.95±0.61) vs (4.19±0.48)mmol/L], triglycerides[(0.86± 0.29) vs (0.93±0.31) mmol/L], glycated hemoglobin [(7.02±2.77)% vs (7.38±2.94)%] and urinary albumin/creatinine ratio [(20.75±22.75) vs (25.39±24.29), P<0.05]. There was no significant difference in fasting blood glucose before and after education, but 2-hour postprandial blood glucose was significantly improved after education [(7.83±4.71) vs (8.40±4.37)mmol/L,P<0.05]. Conclusion The elderly patients with T2DM have poor dietary self-management, and targeted health education contri-butes to enhanced their adaptability to diabetes mellitus.

Abstract:Objective To investigate the effects of quercetin on learning and memory and pathway of cerebral inflammation in D-galactose-induced aging mice. Methods Thirty-two Kunming mice were randomly divided into control group (NC group), model group (M group), Q1 treatment group (Q1 group) and Q2 treatment group (Q2 group), with 8 in each group. The aging mouse model was induced by subcutaneous administration of D-galactose 100 mg/(kg·d) in M, Q1 and Q2 groups, and the same amount of normal saline was administered in the same way in the NC group. Quercetin were then given in different doses in Q1 [5 mg/(kg·d)] and Q2 [10 mg/(kg·d)] groups, and the same dose of saline was given to the NC group and M group. Intervention duration was 8 weeks. Morris water maze was used to assess the escape latency, frequency of crossing the platform and retention time in the platform quadrant in the mice. Western blotting was employed to detect the expression of advanced glycation end products (AGEs) and their receptor (RAGE), nuclear factor-κB (NF-κB) and its downstream inflammatory factors, including tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β) and cyclooxygenase-2 (COX-2). SPSS statistics 20.0 was used for data analysis, and one-way ANOVA for complete randomized design or Student′s t test for comparison between the groups. Results Compared with NC group, M group had lower escape latency, fewer crossings and shorter retention in target quadrant, but significantly higher AGEs, RAGE, NF-κB, TNF-α, IL-1β and COX-2. Compared with M group, treatment groups had lower escape latency, more crossings and longer retention in the quadrant of the platforms, and lower indices of cerebral inflammation (P<0.05). Compared with Q1 group, Q2 group had lower escape latency, more crossings and longer retention in the quadrant of platforms, and significantly lower expression of RAGE, IL-1β and COX-2. Conclusion Quercetin could effectively improve learning and memory dysfunction in the aging mice and reduce production of inflammatory factors in the brain by inhibiting AGEs/RAGE/NF-κB inflammatory pathway, hence having antiaging potential.

Abstract:Intravascular ultrasound has been used in the treatment of chronic total occlusion (CTO) lesions with unknown entrance, but repeated alteration between microcatheter and ultrasound catheter may increase operation-associated complications. Independently developed by the Bethune International Peace Hospital, a new intravascular ultrasound dual-lumen microcatheter consists of an intravascular ultrasound catheter and a parallel therapeutic microcatheter. The ultrasound catheter and working wire are inserted synchronously into the lesion, enabling operation at the precise location with the real-time exploration of intravascular ultrasound. The modified device provides the interventionist with a new tool for the chronic occlusive lesions with enhanced precision in puncture. Hereby, we present one case of CTO lesions treated successfully using this new intravascular ultrasound double-lumen microcatheter, helping the readers to have a more intuitive understanding of the new technology.

Abstract:Malignant tumors pose a major problem in public health across the world, threatening human health and socioeconomic development. Colorectal cancer (CRC) is more common in economically developed areas. In recent years, its incidences have been rising in some low-risk countries due to changes in dietary habits and lifestyle. Based on the findings in pertinent literature both at home and abroad, this article reviews the risk factors of colorectal cancer in four aspects:social demography, medical sciences, behaviors and lifestyle, and diet.

Abstract:Coronary atherosclerosis is the pathological basis of coronary heart disease, while coronary artery calcification is the major marker of coronary atherosclerotic lesions. Detection and evaluation of coronary artery calcification is of great significance for predicting cardiovascular events, and also contributes to understanding the progress of the plaques, so as to further guide clinical treatment. Coronary CT angiography (CCTA) is a non-invasive imaging technique to detect the presence, location and extent of calcified plaques in coronary arteries, and shows great clinical significance in quantitative evaluation of coronary artery calcium and estimation of prognosis. In this article, we reviewed the utilization and clinical application of CCTA in detection and measurement of coronary calcification.

Abstract:Rheumatoid arthritis (RA), one of common chronic autoimmune diseases, affects many systems. RA patients are at increased risk for cardiovascular diseases (CVD) when compared with general population. It is not only due to common CVD risk factors, such as obesity, hypertension, diabetes and smoking, but also associated with chronic inflammation caused by RA and usage of disease modifying anti-rheumatic drugs (DMARDs). Many studies showed that DMARDs can improve the remission rate of RA, but some may increase the risk of CVD, while others can have no effect or even decrease the CVD risk. This paper reviewed the impact of several RA drugs used commonly on risk of CVD so as to provide the reference for clinical practice.

Abstract:As tumor immunology research continues, the clinical trials and application of immunotherapy represented by the immunological checkpoint inhibitors have achieved satisfactory results, but its objective response rates are low, and its efficacy remains uncertain. The effectiveness of the markers in predicting the immunotherapy efficacy has been inconclusive. A number of clinical trials have found that tumor mutation burden (TMB) is positively correlated with antigens recognized by T-cells and immunotherapy efficacy. It can be, therefore, used to predict the efficacy of immunological checkpoint inhibitors, but with limitations. This article reviewed the predictive value of TMB in immunotherapy for non-small-cell lung cancer and its limitations.