Breast cancer is a malignant tumor with the highest morbidity and mortality in female in recent years, and it is a complex disease that affects human health. Studies have shown that dynamic network biomarkers (DNB) can effectively identify critical states at which complex diseases such as breast cancer change from a normal state to a disease state. However, the traditional DNB method requires data from multiple samples in the same disease state, which is usually unachievable in clinical diagnosis. This paper quantitatively analyzes the time series data of MCF-7 breast cancer cells and finds the DNB module of a single sample in the time series based on landscape DNB (L-DNB) method. Then, a comprehensive index is constructed to detect its early warning signals to determine the critical state of breast cancer cell differentiation. The results of this study may be of great significance for the prevention and early diagnosis of breast cancer. It is expected that this paper can provide references for the related research of breast cancer.
Using modular identification methods in gene-drug multiplex networks to infer new gene-drug associations can identify new therapeutic target genes for known drugs. In this paper, based on the gene expression data and drug response data of lung cancer in the genomics of drug sensitivity in cancer (GDSC) database, a multiple network algorithm is proposed. First, a heterogeneous network of genes of lung cancer and drugs in different cell lines is constructed, and then a network module identification method based on graph entropy is used. In this heterogeneous network, network modules are identified, and five lung cancer gene-drug association modules are identified through iterative convergence. Compared with other methods, the algorithm has better results in terms of running time, accuracy and robustness, and the identified modules have obvious biological significance. The research results in this article have guiding significance for the medication and treatment of lung cancer, and can provide references for the treatment of other diseases with the same targeted genes.
Due to the high dimensionality and complexity of the data, the analysis of spatial transcriptome data has been a challenging problem. Meanwhile, cluster analysis is the core issue of the analysis of spatial transcriptome data. In this article, a deep learning approach is proposed based on graph attention networks for clustering analysis of spatial transcriptome data. Our method first enhances the spatial transcriptome data, then uses graph attention networks to extract features from nodes, and finally uses the Leiden algorithm for clustering analysis. Compared with the traditional non-spatial and spatial clustering methods, our method has better performance in data analysis through the clustering evaluation index. The experimental results show that the proposed method can effectively cluster spatial transcriptome data and identify different spatial domains, which provides a new tool for studying spatial transcriptome data.
Abstract: Objective To investigate the clinical results of the coronary artery bypass grafting (CABG) for coronary artery disease (CAD) patients with completed hypothyroidism. Methods Twentyone CAD patients with hypothyroidism (hypothyroidism group) operated by a single surgeon from September 2002 to June 2009 in our department were enrolled in this study. Among them, there were 6 males and 15 females. Their average age was 60.4 years old. Three patients underwent CABG with onpump beating heart; one underwent CABG with onpump arrested heart; and 17 patients underwent CABG with offpump beating heart. All patients on thyroxine replacement therapy underwent CABG after free triiodothyronine（FT3）,free thyroxin（FT4）, thyroidstimulating hormone（TSH）, total triiodothyronine（TT3） and total thyroxin（TT4） were obviously improved. At the same time, twenty CAD patients without hypothyroidism were chosen as the control group (control group). Among them, there were 6 males and 14 females with an average age of 62.1 years old. The data of thyroid gland function and clinical prognostic indicator were observed after the operation. Results For the hypothyroidism group, one patient with pericardial effusion, heart failure and low thyroxine before surgery died during the onpump operation. Among the 20 survivors who had undergone CABG with beating heart, 17 were offpump CABG patients. Followup was done for 230 months. Postoperative eject factor of the survivors were significantly higher than their preoperative eject factor (55%±21% vs. 48%±17%). Twenty patients in the control group all survived. There was no significant difference in cardiac index ［2.7±1.4 L/(min·m2) vs. 2.8±1.5 L/(min·m2), t=0.530, P=0.530］, hospital stay (12.2±4.7 d vs. 10.1±3.9 d , t=0.170, P=0.170), or mechanical ventilation time (17.6±9.1 h vs. 15.1±13.7 h, t=0.120, P=0.120) between the hypothyroidism group and the control group. Perioperative thyroxine examination showed that there was no profound impact on thyroxine by offpump CABG. Conclusions With full preparation made before operation, CABG with beating heart is comparatively safe for CAD patients with hypothyroidism. The key of the treatment is perioperative thyroxine replacement therapy. There is much risk to perform onpump CABG on patients with severe hypothyroidism.
Objective To investigate the management during offpump coronary artery bypass grafting (OPCAB) for patients with ascending aorta atherosclerosis and to find appropriate treatment for minimizing the postoperative cerebrovascular accidents. Methods 236 patients with ascending aorta atherosclerosis were retrospectively analyzed underwent OPCAB in this hospital from Sep.2004 to Dec.2007, 4 of them received “No-touch” technique, 35 of them had the proximal anastomoses with the Enclose assistant, and 197 of them had the proximal anastomoses with the assistant of Heartstring. Hemodynamic indexes were consecutively monitored, blood streams of grafts was monitored by transit time flow measurement (TTFM) to evaluate the quality. Results Distal anastomoses 881，proximal anastomoses 267, the blood stream of 881 grafts was monitored, the mean flow was 16.2±18.7 ml/min, and the pulsatility index (PI) were 4.9±2.3, indicating the good quality of all grafts. The change of hemodynamic indexes including mean artery pressure (MAP, 78.1±10.4 mmHg vs. 80.9±8.1 mmHg）, pulmonary capillary wedge pressure (PCWP, 11.9±3.6 vs. 10.9±2.1 mmHg）, mean pulmonary artery pressure (MPAP, 17.3±4.3 mmHg vs. 15.3±2.8 mmHg）, cardiac output (CO, 4.2±1.2 L/min vs. 4.5±1.6 L/min）, center vinous pressure (CVP, 9.2±2.3cmH2O vs. 9.3±1.8 cmH2O）, heart rate (HR, 71.4±14.0 beats/min vs. 73.4±16.5 beats/min）, there were no statistically difference between before and after proximal anastomoses (Pgt;0.05). Two patients died of low cardio output during operation, 4 patients with transient ischemic attack were improved by 2 months medical therapy, and others had no postoperative complications as perioperative myocardial infarction etc, and the time of stay hospital was 10.5±4.2d. Followup 3-24 months for 185 patients, all living patients had no myocardial or cerebrovascular accidents, the symptoms were alleviated and myocardiac function improved. Conclusion Assessing the degree of the ascending aorta atherosclerosis sufficiently before and during the operation, choosing different operational strategy, and decreasing the manipulation of aorta can decrease the incidence of cerebrovascular accident and get better clinical result.
Objective To analyse the characteristic of hemodynamic changes during off-pump coronary artery bypass grafting （OPCAB）. Methods One hundred consecutive patients received OPCAB and the hemodynamic changes were monitored during the grafts was anastomosed. They were anastomosis of the left internal mammary artery （LIMA） to left anterior descending （LAD） in 97 patients, the anastomosis of saphenous vein （SV） or radial artery（RA） to right coronary artery （RCA） including posterior descending artery （PDA） and posterior left branch （PLB） in 84 patients, to left circumflex coronary artery （LCX） in 50 patients, to optuse marginal artery（OM） in 27 patients, to diagonal artery （DG） in 25 patients. The grafts number in each patient was 3. 1±0. 7. Results Hemodynamics changed when LAD and DG were anastomosed with significantly increase of heart rate （HR）, significantly decrease of mean arterial pressure （MAP） and left ventricular stroke work index （LVSWI, P〈0.05）. Hemodynamics changed when LCX,PDA,PLB,OM were anastomosed with significantly increase of HR and center veinous pressure （CVP, P 〈 0. 05）, significantly decrease of MAP, cardiac index （CI）, stroke index （SI）, right ventricular ejection fraction （RVEF）, right ventricular end-diastolic volume （RVEDV）, LVSWI and right ventricular stroke work index （RVSWI,P〈0.05）. Hemodynamics tended to be stable and CI improved at the end of operation. Conclusion There are no or little hemodynamic changes during the LAD and DG were anastomosed in OPCAB, while hemodynamics changed significantly during LCX, PDA, PLB and OM were anastomosed. Hemodynamics become stable and CI improves after operation.
【摘要】 目的 探讨血尿酸水平、颈动脉斑块与冠心病之间的关系。 方法 收集2006年1月-2009年12月拟诊为冠心病的住院患者280例,冠状动脉造影检查冠状动脉狭窄程度gt;50%的194例为冠心病组,冠状动脉无狭窄或狭窄程度lt;50%的86例为对照组;冠心病组又分为单支、双支、多支病变亚组。分别测定冠心病组与对照组颈总动脉与颈动脉分叉处内膜中层厚度(IMT)、等级评分、Crouse积分、血尿酸浓度。结果 与对照组相比,冠心病组颈总动脉与颈动脉分叉处IMT、等级评分、Crouse积分、血尿酸浓度均高于对照组,差异有统计学意义。在冠心病组,随病变分支的增多,颈动脉超声检查指标与血尿酸随之升高(Plt;0.05或0.01)。 结论 颈动脉IMT、等级评分、Crouse积分、血尿酸浓度与冠心病相关,是冠心病的独立危险因素。【Abstract】 Objective To investigate the relationships between serum uric acid levels, carotid artery plaque and coronary heart disease (CHD). Methods 194 patients with CHD and 86 nonCHD patients were selected through coronary angiography in patients with essential hypertension. CHD group was divided into three subgroups including a single branch, doublebranch and multivessel disease. Intimamedia thickness (IMT) of carotid artery and carotid bifurcation, grade score, Crouse score, serum uric acid concentrations were detected in patients with coronary heart disease and control group. Results IMT of carotid artery and carotid bifurcation, grade score,crouse score, serum uric acid concentrations were higher in CHD group than that in control group, and the difference was statistically significant. In the CHD group, ultrasound parameters of carotid artery and serum uric acid increased with the increase in branch lesions (Plt;005 or 001). Conclusions Carotid IMT, grade score, Crouse score, serum uric acid concentration relate to coronary heart disease, which is an independent risk factor for coronary heart disease, respectively.
Hybrid coronary revascularization (HCR) combines the advantages of minimally invasive direct coronary artery bypass grafting (MIDCAB) and percutaneous coronary intervention (PCI), and avoids its relative shortcomings, which has received particular attention in recent years. HCR seems to have become the third revascularization strategy for multi-vessel disease in coronary heart diseases. However, the clinical researches on HCR are still limited. This article will systematically review the comparison of HCR with coronary artery bypass grafting (CABG) and PCI, the results of HCR in specific patients, and the clinical results of different HCR strategies.
ObjectiveTo improve the clinicians’ understanding and treatment level of electrical status epilepticus during sleep by analyzing the clinical data of patients with ESES retrospectively.MethodsWe collected 20 cases from 2018 to 2019 diagnosed in our hospital by clinical and 24-hour video EEG confirmed and analyzed the clinical manifestations, EEG features, seizure type, classification of epilepsy syndrome as well as the imaging findings.ResultsAmong the 20 patients, there were 12 males and 8 females, the mean age was (10.96±2.68) years old, and the first onset age was (8.90±1.93) years old. Epilepsy seizure as the first symptom is most common, the EEG showed a broad or localized sustained discharge, generalized tonic clonic seizure is the main form of seizure type in most patients, ECSWS is the most prominent in the epilepsy syndrome, for small lesion through MR can be found early.ConclusionMost patients have partial or generalized seizures, which have a range of cognitive impairment, mental decline or other issues. It is important to improve the cognitive function, behavior, neuropsychology of patients by long term video EEG monitoring in the early stage.
Objective To investigate the effectiveness on the re-fracture of the femur with occult infection by using non-contact locking plate which was placed under the deep fascia. Methods Clinical data of 12 cases of occult infective re-fracture after femoral fracture operation were retrospectively analysed between January 2010 and December 2014. There were 8 males and 4 females with an age of 28-69 years (mean, 42.8 years). Femur re-fractured in 5 cases after 3 days to 4 weeks (mean, 10.6 days) of removal of internal fixation, including 4 cases of plate fixation and 1 case of intramedullary nail fixation; femur in 7 cases re-fractured because of breakage of internal fixator after 7-16 months (mean, 9.3 months) of internal fixation, including 5 cases of plate fixation and 2 cases of intramedullary nail fixation. The tissues near the fracture were collected for bacteria culturing and pathological examining. All the patients were treated by debriding the site of the fracture, bridging with the non-contact locking plate, and transplanting with granulated cancellous bone autograft. Intravenous infusion of antibiotics were used for 2-3 weeks after operation and oral administration for 4 weeks. The X-ray films were taken regularly and the function of the knees were evaluated by the Hospital for Special Surgery (HSS) score system. Results The results of bacteria culturing were positive in 8 patients and negative in 4 patients, and the pathological results of all the patients were confirmed to be chronic bone infection. All the fractures healed with no signs of exudation and ulceration of the incisions. The 12 patients were followed up 18-36 months (mean, 29.6 months). The fracture healed well and no re-fracture occurred. The fracture healing time was 14-22 weeks (mean, 18 weeks). At last follow-up, the function of the knee joint was excellent in 9 cases and good in 3 cases according to HSS score system. Conclusion The treatment of re-fractures after femur fracture operation needs to determine whether there is an occult infection, and non-contact locking plate placed under the deep fascia is an effective way for the re-fracture.