目的:观察低能激光照射(LLLI)对心肌梗死后大鼠心肌组织中超氧化物歧化酶(SOD)活性和丙二醛(MDA)含量的影响,并探讨其意义.方法:SD大鼠120只分为三组:假手术组(30只)、对照组(45只)、LLLI治疗组(45只).对照组和LLLI治疗组大鼠10％水合氯醛腹腔注射麻醉后开胸结扎左冠状动脉前降支,制备大鼠心肌梗死模型,假手术组手术操作同模型制作,但穿针后不结扎缝线.3周后所有大鼠再次开胸,治疗组进行LLLI(635nm,6mW,125s,0.96J/cm2),对照组和假手术组操作同治疗组,但不开通低能激光设备,于二次开胸处理后1h、24h、48h、72h、1周采用黄嘌呤氧化酶法和硫代巴比妥酸(TBA)法分别检测各组大鼠梗死心肌组织SOD活性和MDA含量,并做心肌组织病理学观察.结果:心肌梗死后,对照组和LLLI治疗组大鼠梗死心肌组织中SOD活性明显降低(P<0.05),1～48h时LLLI治疗组SOD活性高于对照组(P<0.05),72h和1周时对照组和治疗组无明显差异;对照组和LLLI治疗组大鼠梗死心肌组织中MDA含量较假手术组大鼠明显增加(P<0.05),1～48h LLLI治疗组低于对照组(P<0.05),72h和1周时对照组和治疗组无明显差异.结论:低能激光照射可以显著增加大鼠梗死心肌组织中抗氧化物质的SOD活性,抑制脂质过氧化产物MDA含量的产生,对心肌组织有较好的保护作用.

目的 探讨孕妇妊娠晚期疲乏特征的潜在类别,比较不同类别孕妇在人口学特征及睡眠质量、心理韧性上的差异.方法 于2022年4—7月便利选取郑州市某三级甲等医院产科门诊就诊的251例孕妇为研究对象,采用一般资料调查表、疲劳自评量表、匹兹堡睡眠质量指数量表及心理韧性量表进行调查.结果 孕妇妊娠晚期疲乏特征可分为2个潜在类别,即高情境性-广泛疲乏型(29.08％)和积极情境性-疲乏低发型(70.92％);Logistic回归分析结果显示:孕周、不良妊娠史、睡眠质量及心理韧性是孕妇妊娠晚期疲乏特征的潜在类别的影响因素(P<0.05).结论 孕妇妊娠晚期疲乏特征存在群体异质性,可分为2个潜在类别,妊娠周数较大、既往有不良妊娠史、睡眠质量差的孕妇妊娠晚期疲乏症状较重,应对该类别孕妇给予更多关注.

目的 观察心脏手术后左室射血分数(left ventricular ejection fraction,LVEF)＜40％者应用左西孟旦治疗后LVEF变化,探讨左西孟旦对其预后的影响.方法 心脏手术后LVEF＜ 40％患者80例,40例采取常规治疗者为对照组,40例在常规治疗基础上静脉滴注左西孟旦者为观察组.比较2组年龄,男性、体质量指数＞24 kg/m2、合并高血压比率及手术方式,体外循环时间,主动脉阻断时间;比较2组术前及术后0、12、48 h时LVEF和血浆乳酸水平;随访90 d,比较2组低心排血量综合征发生率及生存率.结果 2组年龄,男性、体质量指数＞24 kg/m2、合并高血压比率,手术方式,体外循环时间,主动脉阻断时间比较差异均无统计学意义(P＞0.05).观察组术前及术后0h时LVEF[(45.68±2.90)％、(39.85±3.60)％]、血浆乳酸水平[(1.65±0.07)、(2.79±0.32) mmol/L]与对照组[LVEF:(45.93±3.02)％、(38.35±4.29)％;血浆乳酸:(1.67±0.08)、(2.81±0.35) mmol/L]比较差异均无统计学意义(P＞0.05),术后12、48 h时LVEF[(54.30±2.83)％、(67.55±6.72)％]高于对照组[(52.75±1.81)％、(62.45±4.68)％](P＜0.05)、血浆乳酸水平[(2.32±0.18)、(1.59±0.11)mmol/L]低于对照组[(2.41±0.23)、(1.90±0.19)mmol/L] (P＜0.05);观察组、对照组术后0、12、48 h LVEF依次升高,血浆乳酸水平依次降低(P＜0.05).观察组术后90 d低心排血量综合征发生率(10.0％)低于对照组(32.5％)(P＜0.05),生存率(95.0％)高于对照组(80.0％)(P＜0.05).结论 心脏手术后LVEF＜40％的患者应用左西孟旦可改善术后恢复期间的心输出量和组织灌注,减少低心排血量综合征的发生,提高生存率.

Objective:To study the role of microRNA (miRNA, miR)-29a-5p in myocardial fibrosis after myocardial infarction, and further study the mechanism of miR-29a-5p regulating myocardial fibrosis after myocardial infarction through target gene Endoglin.Methods:Thirty patients with myocardial infarction and 20 patients with non acute coronary syndrome were recruited. Blood samples were collected to detect miR-29a-5p and NTpro-brain natriuretic peptide (BNP). In vivo, the myocardial infarction model of mice was established, and the tail vein was injected with miR-29a-5p agomir and negative control reagent respectively. Four weeks later, After the mice were killed, some of the myocardial tissues were detected by real-time quantitative polymerase chain reaction (Real-time PCR) and Western blotting for miR-29a-5p, Endoglin and BNP respectively. In vitro experiments, 1-day-old mice were killed, myocardial fibroblasts were isolated and cultured. The cultured cells were transfected with miR-29a-5p MICs and negative control reagent with liposome 2000. After transfection, 50 μmol/L angiotensin Ⅱ (Ang Ⅱ) or phosphate buffer (PBS) of equal volume were added for 48 hours. The surface area of each fiber cell was measured by Image J software. The cells were co transfected with miR-29a-5p mimics or antigomir, pRL-tk-endoglin-3’untranslated regions (3’UTR) vector and pGL3 basic plasmid. After 48 hours of transfection, the cells were obtained, and the relative luciferase activity was detected by double Luciferase Report System. The expression of Endoglin in each group was detected by Real-time PCR and Western blotting respectively. Results:The content of miR-29a-5p [(3.57±0.53) ng/ml] in serum of acute myocardial infarct (AMI) patients was significantly reduced ( F=935.899, P<0.01), and the content of NTPRO-BNP [(9.47±5.06) ng/ml] was significantly increased ( F=65.440, P<0.01). The expression level of miR-29a-5p (0.51±0.12) in the MI group of rats was significantly reduced ( t=4.315, P<0.01), and the expression level of miR-29a-5p (0.65±0.26) was also found to be significantly reduced in the Ang Ⅱ-induced myocardial fibrosis model ( t=4.511, P<0.01). The content of Endoglin protein and mRNA expression (0.49±0.09) in cardiac fibroblasts treated by miR-29a-5p mimics decreased ( t=352.312, P<0.01). Endoglin protein in cardiac fibroblasts treated with miR-29a-5p antagomir The content and mRNA expression level (2.15±0.14) increased ( t=7.814, P<0.05). Conclusion:MiR-29a-5p is an important regulator of myocardial fibrosis.

Objective:To explore the value of combined detection of carcinoembryonic antigen (CEA) and tumor-associated macrophage (TAM) in prognosis assessment of rectal cancer.Methods:The clinical data of 128 patients with stage Ⅱ-Ⅲ rectal cancer who underwent radical resection of rectal cancer in our hospital from January 2014 to June 2015 were analyzed and the prognosis of the patients was followed up. According to preoperative CEA and TAM indexes, the patients were randomly divided into four groups, namely CEA(+ )/TAM(+ ) group, CEA(+ )/TAM(-) group, CEA(-)/TAM(-) group, and CEA(-)/TAM(-) group. The clinical and pathological data of the four groups were compared by C2 test, the survival of the patients was analyzed by Kaplan-Meier method, and the factors that might affect the prognosis of the patients were analyzed by COX risk regression model.Results:There were no statistically significant differences in age or gender between the four groups (age χ2=1.855, P>0.05; Gender χ2=1.419, P>0.05, all P<0.05); The tumor differentiation degree and TNM stage of the 4 groups were compared, and the difference was statistically significant (tumor differentiation degree χ2=20.919, P<0.01; TNM stage χ2=15.844, P<0.01, all P>0.05); The differences in tumor differentiation degree, TNM stage and overall survival (OS) were statistically significant ( P<0.05). The comparison of OS stage among the four groups showed that THE CEA(+ )/TAM(+ ) group had the shortest OS {45.9 months [95% confidence interval ( CI) 41.5-50.3]}, and the CEA(-)/TAM(-) group had the longest OS [58.9 months (95% CI 55.2-62.6)], with statistically significant differences ( χ2=21.307, P<0.01). Univariate analysis results suggested that the prognosis of rectal cancer patients was related to CEA, TAM, tumor differentiation degree and TNM stage. Multivariate analysis suggested that CEA, TAM, degree of tumor differentiation and TNM stage were independent risk factors for the prognosis of rectal cancer patients. Conclusion:The prognosis of rectal cancer is related to CEA, TAM, tumor differentiation degree and TNM stage. Preoperative serum CEA, TAM and TNM stage may be independent risk factors for rectal cancer, and combined detection of preoperative CEA and TAM levels may be of prognostic value in patients with rectal cancer.

Objective: To retrospectively analyze the effect of levosimendan on the survival and prognosis of cardiac surgery patients with LVEF < 40%. Methods: the clinical data of 224 patients with preoperative LVEF < 40% were retrospectively analyzed. According to different treatment schemes, the patients were divided into levosimendan group (n = 60) and no-levosimendan group (n = 164,). The control group was treated with routine treatment, and the observation group was treated with levosimendan on the basis of routine treatment. Then a multivariate logistic regression model with a propensity score analysis was used to limit biases and finally the data of 40 patients in each group were selected for analysis. Results: Hemodynamic data showed that the cardiac index, LVEF and PAOP of patients in levosimendan group were significantly improved. The concentration of serum lactic acid in the levosimendan group was lower than that in the control group (P < 0.05). At the same time, postoperative ICU and hospital stay were significantly reduced in levosimendan group (P < 0.05.), Logistics regression analysis showed that levosimendan was the only protective factor for Low cardiac output syndrome (LCOS) (HR=4.33; 95% confidence interval: 1.27- 14.78; P = 0.019). Conclusion: levosimendan can better improve hemodynamics and reduce postoperative ICU time and hospital stay. The use of it tended to decrease the incidence of LCOS significantly.

Objective: To investigate the protective effect of erythropoietin (EPO) on myocardial infarction in rats with cardiac injury and its mechanism. Methods: 60 healthy female Sprague Dawley rats aged 8 weeks were randomly divided into mock surgical (MS) group, myocardial infarction (MI) group and EPO group, with 20 in each group. 4 weeks after modeling, among the three groups of rats, the left ventricular ejection fraction (LVEF), fractional shuotening (FS), LDH and CK-MB expression of related biochemical indicators, infarct size, cardiomyocytes apoptosis, and the expression of p-Akt protein in myocardial tissues were detected. Among the myocardial infarction rats, the correlation between myocardial apoptosis index and p-Akt protein expression in myocardial tissues was analyzed. Results: The LVEF value, FS value, and expression of LDH and CK-MB in the MS group were better than those in MI and EPO group (P<0.05). The indicators in the EPO group were better than those in the MI group (P<0.05); the myocardial infarct size and cardiomyocyte apoptosis in the MS group were smaller than those in the MI group and the EPO group (P<0.05). However, the myocardial infarct size and cardiomyocyte apoptosis in the EPO group were lower than those in the MI group (P<0.05). The p-Akt protein in the MS group was higher than that in the MI group and EPO group. The p-Akt protein in the EPO group was increased than that in the MI group (P<0.05). Among the myocardial infarction rats, there was a negative correlation between myocardial apoptosis index and p-Akt protein expression in myocardial tissues (r=-0.623, P<0.05). Conclusion: For rats with myocardial infarction, EPO can effectively improve their cardiac function, and reduce myocardial infarct size and myocardial apoptosis. The mechanism of protective effect on cardiomyocytes may be relied on the regulation of Akt anti-apoptotic signaling pathway.

Objective:To investigate whether the severity of white matter hyperintensities is related to bilirubin level.Methods:A total of 484 healthy subjects were included, and those with acute cardio-cerebral vascular disease, liver disease, bilirubin abnormality and other diseases causing high white matter hyperintensities were excluded. A cross-sectional study analyzing the correlation between the severity of white matter hyperintensities and bilirubin was conducted. The severity of white matter hyperintensities was measured by the Fazekas visual score.Results:The average age of patients in the mild group and severe group was 63.66±12.21 and 78.37±10.36 years old respectively. Comparison between the two groups [ t=1.748, P<0.01, odds ratio ( OR)=1.100 95% confidence interval ( CI): 1.076-1.125]. There were 183 patients (56.83%) with hypertension in the mild group and 130 patients (80.25%) with hypertension in the severe group ( P<0.05, OR=1.907, 95% CI: 1.119-3.249). Hypertension was an independent risk factor for white matter hyperintensities in the brain. Low bilirubin level was a risk factor for high signal in the white matter. After adjusting for the influence of other related factors, the lowest quartile bilirubin level Q1 was used as a reference, there were 88 cases (56.45%) in the mild group and 34 cases (43.55%) in the severe group; 86 cases (70.97%) in the Q2 mild group and 34 cases (29.03%) in the Q2 severe group ( P<0.01, OR=0.418, 95% CI: 0.220-0.792); 81 cases (71.77%) in the Q3 mild group and 40 cases (28.23%) in the Q3 severe group ( P<0.05, OR=0.504, 95% CI: 0.265-0.957). There was statistically significant. Conclusion:Low bilirubin levels may be risk factors of white matter hyperintensities.

Background: Ribonucleoside-diphosphate reductase subunit M2 (RRM2) is the catalytic subunit of ribonucleotide reductase and modulates the enzymatic activity, which is essential for DNA replication and repair. However, the role of RRM2 in lung adenocarcinoma (LUAD) remains unclear. Methods: In this study, we explored the expression pattern and prognostic value of RRM2 in LUAD across TCGA, GEO, Oncomine, UALCAN, PrognoScan, and Kaplan-Meier Plotter, and confirmed its independent prognostic value via Cox analyses. LinkedOmics and GEPIA2 were applied to investigate co-expression and functional networks associated with RRM2. Besides, we used TIMER to assess the correlation between RRM2 and the main six types of tumor-infiltrating immune cells. Lastly, the correlations between immune signatures of immunomodulators, chemokines, and 28 tumor-infiltrating lymphocytes (TILs) and RRM2 were examined by tumor purity-corrected partial Spearman's rank correlation coefficient through TIMER portal. Results: RRM2 was found upregulated in tumor tissues in TCGA-LUAD, and validated in multiple independent cohorts. Moreover, whether in TCGA or other cohorts, high RRM2 expression was found to be associated with poor survival. Cox analyses showed that high RRM2 expression was an independent risk factor for overall survival, disease-specific survival, and progression-free survival of LUAD. Functional network analysis suggested that RRM2 regulates RNA transport, oocyte meiosis, spliceosome, ribosome biogenesis in eukaryotes, and cellular senescence signaling through pathways involving multiple cancer-related kinases and E2F family. Also, RRM2 expression correlated with infiltrating levels of B cells, CD4+ T cells, and neutrophils. Subsequent analysis found that B cells and dendritic cells could predict the outcome of LUAD. B cells were identified as an independent risk factor among six types of immune cells through Cox analyses. At last, the correlation analysis showed RRM2 correlated with 67.68% (624/922) of the immune signatures we performed. Conclusion: Our research showed that RRM2 could independently predict the prognosis of LUAD and was associated with immune infiltration. In particular, the tight relationship between RRM2 and B cell marker genes are the potential epicenter of the immune response and one of the critical factors affecting the prognosis. Our findings laid the foundation for further research on the immunomodulatory role of RRM2 in LUAD.

冠心病是动脉粥样硬化引起冠脉管腔狭窄或闭塞,冠脉血流量不能满足心肌代谢的需要,导致心肌缺血缺氧或坏死的缺血性心脏病 [1],简称冠心病(CHD).CHD是成人中最常见的心血管疾病类型,预计在2030年冠心病将成为全球第一大杀手 [2].虽然冠心病影响生活的许多方面,但其大多数风险因素,如高血压、血脂异常、吸烟都是可以预防的.而健康教育作为冠心病预防的有效干预措施之一,在降低CHD复发率及病死率、改善预后方面发挥着重要作用.传统健康教育模式是单向传输健康教育内容,但高达80％的信息被立即遗忘,几乎有一半的患者回忆不正确 [3,4].Teach-back模式又称为反馈式教育或回授法,教育者以简单的形式解释教育的内容,以便参与者更好地理解,并在培训结束后,要求患者以自己的语言解释内容,如果患者不能很好地理解,教育者则继续重复教育内容,直到确定患者已完全理解 [5].本研究旨在探讨Teach-back模式对冠心病患者健康自我管理的影响,为临床治疗、康复及教学提供一种模式参考.

Objective:To investigate the protective effect and molecular mechanism of trimetazidine preconditioning on myocardial ischemia reperfusion injury in rats.Methods:Thirty healthy adult male sprague-dawley (SD) rats weighing 280-300 g were randomly divided into sham operation group, model group and trimetazidine pretreatment group. In addition to the sham group, all models of myocardial ischemia-reperfusion injury were established in vivo. The rats were sacrificed and their hearts were removed after 120min of reperfusion, and the levels of creatine kinase (CK), creatine kinase isoenzyme (CK-MB) and lactate dehydrogenase (LDH) in serum were detected, and the expression levels of factor associated suicide (Fas), FasL, B cell lymphoma/leukemia-2 (bcl-2) and cysteinyl aspartate-specific protease (Caspase)-3 in myocardial tissue were measured. Statisticalanalysis of data using the statistical product and service solutions 19.0 software. Results:Compared with the sham operation group, the serum contents of CK [ (248.52±7.35), (177.93±5.11) U/L], CK-MB [ (68.54±2.95), (50.92±2.94) U/L], LDH [ (763.96±21.56), (310.06±28.33) U/L] in the model and the trimetazidine pretreatment groupgroup were significantly increased ( F=3 275.866, 675.844, 555.003, P<0.01), and the mRNA expressions of Fas (3.22±0.36, 1.80±0.21), FasL (2.85±0.34, 1.69±0.16), bcl-2 (1.45±0.09, 3.12±1.86) and Caspase-3 (4.46±0.27, 2.34±0.23) in the myocardial tissue were significantly increased ( F=218.549, 187.601, 351.196, 730.616, P<0.01). Compared with the model group, the serum contents of CK, CK-MB and LDH in the trimetazidine pretreatment group were significantly reduced ( t=24.944, 13.375, 11.218, P<0.01), the mRNA expressions of Fas, FasL and Caspase-3 in the myocardial tissue were significantly decreased ( t=10.213, 8.975, 19.004, P<0.01), and the mRNA expressions of bcl-2 were significantly increased ( t=16.141, P<0.01). Conclusion:The mechanism by which trimetazidine preconditioning can alleviate myocardial ischemia-reperfusion injury is related to inhibiting overactivation of the Fas/FasL pathway and inhibiting myocardial apoptosis.

目的 探讨氯雷他定对氧化型低密度脂蛋白(ox-LDL)诱导的人血管内皮细胞黏附和炎症反应的影响.方法 将培养的人体主动脉内皮细胞(HAECs)分为空白对照组、ox-LDL组、氯雷他定组,空白对照组细胞未做任何处理,ox-LDL组细胞采用10 mg·L-1 ox-LDL处理24h,氯雷他定组细胞采用10 mg·L-1 ox-LDL1 mL和100 μmol氯雷他定处理24h.将3组细胞与钙黄绿素染色后的人单核细胞THP-1共同培养2h,荧光显微镜下观察THP-1黏附情况,计算THP-1黏附率;采用Western blot法检测3组HAECs中血管细胞黏附分子-1(VCAM-1)、E-选择素(E-selectin)蛋白的表达,采用实时荧光定量聚合酶链反应检测3组HAECs中肿瘤坏死因子-α(TNF-α)、白细胞介素(IL)-6和IL-8 mRNA表达.结果 空白对照组、ox-LDL组和氯雷他定组HAECs的单核细胞黏附率分别为(23.00±8.46)％、(50.83±11.02)％、(36.67±7.97)％;ox-LDL组HAECs的单核细胞黏附率显著高于空白对照组(P＜0.05),氯雷他定组HAECs的单核细胞黏附率显著低于ox-LDL组(P＜0.05).ox-LDL组HAECs中VCAM-1、E-selectin蛋白的相对表达量显著高于空白对照组(P＜0.05),氯雷他定组HAECs中VCAM-1、E-selectin蛋白的相对表达量显著低于ox-LDL组(P＜0.05).ox-LDL组HAECs中TNF-α、IL-6、IL-8 mRNA相对表达量显著高于空白对照组(P＜0.05),氯雷他定组HAECs中TNF-α、IL-6和IL-8 mRNA相对表达量显著低于ox-LDL组(P＜0.05).结论 ox-LDL能够诱导HAECs黏附分子VCAM-1和E-selectin及炎症因子TNF-α、IL-6和IL-8的表达,而氯雷他定能抑制ox-LDL诱导的细胞黏附和炎症反应.

目的:研究在手术治疗后出现急性肾损伤的急性Stanford A型主动脉夹层患者接受连续性肾脏替代治疗的临床效果.方法:选择以往在我院接受手术治疗后出现急性肾损伤症状的急性Stanford A型主动脉夹层患者78例,通过随机分组的方式分成对照组(39例)和治疗组(39例).对照组采用常规透析方案进行治疗;治疗组采用连续性肾脏替代治疗.结果:治疗组患者治疗总有效率达到92.3％,高于对照组的71.8％;治疗前后血肌酐和尿素氮水平的改善幅度大于对照组.组间差异有统计学意义(P<0.05).结论:在手术治疗后出现急性肾损伤的急性 Stanford A型主动脉夹层患者接受连续性肾脏替代治疗,可以大幅度改善肾功能,使治疗的总有效率提升.

A high level of difficulty is associated with the surgical procedure of total thoracoabdominal aortic aneurysm repair (tTAAAR), widespread clinical use has not been attained due to high demands of the procedure on the skill level of vascular surgeons, high incidence of complications and high mortality rates are often encountered in tTAAAR with deep hypothermic circulatory arrest (DHCA). In October 2014, a case of off-pump tTAAAR combined with left renal artery stent placement was performed at the Second Affiliated Hospital of Zhengzhou University, with short operative time, rapid postoperative recovery, no postoperative complications, 36 months follow-up of patients alive.

Objective To investigate the protective effect of salvia miltiorrhiza ligustrazine injection (SLI) pretreatment on myocardial cells after myocardial ischemia reperfusion injury in rats and its potential mechanism.Methods Thirty health male Sprague-Dawley rats were randomly divided into three groups,Sham group (Sham),myocardial ischemia-reperfusion injury model group (I/R),salvia miltiorrhiza ligustrazine treatment group (I/R + SLI).Except Sham group,myocardial ischemia-reperfusion injury models were established in vivo in rats.The pathological changes of electrocardiogram (ECG) in each group of rats were observed and the myocardial infarction area was measured well.The apoptosis of myocardial cells was detected by TUNEL.Reverse transcription-polymerase chain reaction (RT-PCR) was used to determine the mRNA expression levels of apoptosis-related genes B cell lymphoma/leukemia-2 (bcl-2),bcl-2 associated X protein (bax) and cysteinyl aspartate-specific protease (Caspase)-3.Statisticalanalysis of data using the statistical product and service solutions 19.0 software.Results Compared with I/R group,ECG waveform in I/R + SLI group is obviously improved,ST segment changes are reduced,and waveform is close to normal.Myocardial infarction area (32.14 ± 3.09) and myocardial cell apoptosis index (19.09 ± 13.91) were decreased significantly (t =10.684,t =9.012,P ＜ 0.01).The expression level of bcl-2 mRNA (4.52 ± 0.50) in myocardial cells was significantly increased (t =19.834,P ＜0.01),while the expression levels of bax and Caspase-3 mRNA (2.73 ± 0.29,3.00 ± 0.36) were significantly decreased,with significant differences (t =10.976,14.936,P ＜ 0.01).Conclusion SLI can effectively reduce myocardial injury induced by myocardial ischemia-reperfusion and has certain protective effect on cardiac function.Its mechanism may be related to inhibiting myocardial cell apoptosis.

Background: The ability to distinguish between a normal thymus, thymic hyperplasia, and thymoma should aid in clinical management and decision making for patients with myasthenia gravis (MG). We sought to determine the accuracy of routine radiological examinations in predicting thymic pathology. Methods: We retrospectively analyzed the records of patients with MG who had undergone thymectomy from the Second Affiliated Hospital of Zhengzhou University. Each patient received at least one initial radiological diagnosis and one histological diagnosis, and the patients were classified into the all-patient, CT, contrast CT, and MRI groups. The sensitivity, accuracy and specificity of each group were calculated for different histological types. Results: This study included 114 patients. All sensitivity, specificity and accuracy values except for sensitivity to hyperplasia in each group for different histological types were satisfactory. MRI had higher sensitivity (68.4, 95% CI: 43.5-87.4%) to histological hyperplasia than did CT (14.3, 95% CI: 0.4-57.9%) and contrast CT (26.7, 95% CI: 7.8-55.1%). Contrast CT had higher specificity (97.9, 95% CI: 88.9-99.95%) for histological hyperplasia than did MRI (88.5, 95% CI: 69.9-97.6%). Discussion: For patients with MG, CT, contrast CT, and MRI examinations can effectively identify thymoma. Additionally, compared with CT or contrast CT, MRI may have a stronger ability to distinguish thymoma and detect hyperplasia.

Cholangiocarcinoma (CCA) is a biliary malignancy which is prone to lymphatic metastasis and has a high mortality rate. This disease lacks effective therapeutic targets and prognostic molecular biomarkers. The aim of the current study was to investigate differentially expressed genes and elucidate their association with CCA and the underlying mechanisms of action. mRNAs, long non-coding RNAs (lncRNAs) and microRNAs (miRNAs) obtained from 36 CCA samples and nine normal samples from The Cancer Genome Atlas were integrated. Subsequently, 1,095 differentially expressed (DE) mRNAs and 75 DE miRNAs were identified using a threshold of |log2 fold change|>2 and an adjusted P<0.01. Weighted gene co-expression network analysis was used to identify the DEmRNAs that could be key target genes in CCA. A total of 12 hub DEmRNAs were identified as targetable genes. Furthermore, the hub DEmRNAs-DElncRNAs pairs were identified using the miRTarBase and miRcode databases. Cytoscape software was used to construct and visualize the protein-protein interactions and the competing endogenous RNA network. Survival time analysis and correlation analysis were used to further evaluate the hub genes. The results obtained in the current study suggested that spalt like transcription factor 3 and OPCML intronic transcript 1 may serve an important role in the development and progression of CCA.

目的 探讨注射用磷酸肌酸钠联合冻干重组人脑利钠肽治疗对冠心病患者PCI术后心功能及心肌再灌注损伤的影响.方法 选取2015年9月至2017年4月我院收治的冠心病患者102例,按照随机数字表法分为观察组与对照组,每组51例.两组患者均在常规治疗的基础上行PCI术治疗,对照组患者PCI术前2h给予重组人脑利钠肽冻干粉负荷剂量静脉推注,之后持续泵入治疗3～5d;观察组患者在对照组治疗的基础上加用注射用磷酸肌酸钠治疗,患者PCI术后即静脉滴注注射用磷酸肌酸钠1g,1次/d,连续治疗3～5d.比较两组患者术前及术后2周的心功能状况,比较两组患者术前及术后3d的心肌损伤情况以及术后1年两组患者的主要不良心脏事件(MACE)发生情况.结果 PCI术前,两组患者的LVEF、LVESV及LVEDV比较差异无统计学意义(P＞0.05).术后2周,两组患者的LVEF均显著升高,LVESV及LVEDV均显著降低;观察组患者的LVEF高于对照组,LVESV及LVEDV显著低于对照组,差异有统计学意义(P＜0.05).PCI术前,两组患者血清CK-MB、cTnI水平比较差异无统计学意义(P＞0.05).术后3d,两组患者血清CK-MB、cTnI水平均显著升高,观察组患者的血清CK-MB、cTnI水平显著低于对照组,差异有统计学意义(P＜0.05).术后1年,观察组患者MACE的发生率(11.76％)显著低于对照组(27.45％),差异有统计学意义(P＜0.05).结论 联合使用注射用磷酸肌酸钠与冻干重组人脑利钠肽治疗可显著减轻冠心病患者PCI术后的心肌再灌注损伤,降低不良心血管事件的发生率,改善患者预后.

AIMS:Excessive inflammatory response and oxidative stress are considered as important pathogenic factors in the development of acute lung injury. Isorhynchophylline (IRN), a tetracyclic oxindole alkaloid isolated from Uncaria rhynchophylla, possesses anti-inflammatory and anti-oxidant activities. Our study aimed to investigate the effects and potential mechanisms of IRN on lipopolysaccharide (LPS)-stimulated murine alveolar macrophage cell lines MH-S and NR8383.MAIN METHODS:CCK-8 assay was used to evaluate the cytotoxicity of IRN and LPS. Inflammatory response was assessed by detecting the mRNA expressions and release of tumor necrosis factor α (TNF-α), interleukin (IL)-1β, IL-6, and plasminogen activator inhibitor-1 (PAI-1) using qRT-PCR and ELISA. The expressions of inducible nitric oxide synthase (iNOS) and cyclooxygenase (COX)-2 were examined by qRT-PCR and western blot. Oxidative stress was evaluated by detecting malondialdehyde (MDA) level and the activities of superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) and catalase (CAT). The changes of the toll like receptor (TLR4)/nuclear factor-kappa B (NF-κB)/nod-like receptor protein 3 (NLRP3) inflammasome pathway was detected by western blot.KEY FINDINGS:Treatment with LPS or IRN for 24 h showed no cytotoxicity on MH-S and NR8383 cells. IRN pretreatment inhibited LPS-induced production of inflammatory cytokines, expressions of iNOS and COX-2, and oxidative stress in murine alveolar macrophages. Additionally, IRN inhibited LPS-induced activation of TLR4/NF-κB/NLRP3 inflammasome pathway in MH-S cells. Mechanistically, inhibition of TLR4/NF-κB/NLRP3 inflammasome pathway by si-TLR4 suppressed LPS-induced inflammation and oxidative stress in murine alveolar macrophages.SIGNIFICANCE:IRN exerted anti-inflammatory and anti-oxidant effects on LPS-stimulated murine alveolar macrophages via inhibition of the TLR4/NF-κB/NLRP3 inflammasome pathway.

Effect of puerarin preconditioning on the expression levels of nuclear factor κB (NF-κB), interleukin 6 (IL-6), interleukin 8 (IL-8), troponin I (cTnI), and creatine kinase isoenzyme MB (CK-MB) in the neutrophils of patients undergoing cardiac valve replacement under cardiopulmonary bypass (CPB) was evaluated. We enrolled 50 patients scheduled for cardiac valve replacement and assigned them randomly divided into either a puerarin or a control group. Puerarin was dissolved in 10 ml normal saline before CPB, and administered by intravenous infusion to patients in the puerarin group. The control group was administered an equivalent amount of saline. We used flow cytometry to determine the expression levels of NF-κB, IL-6 and IL-8 in neutrophils and an auto chemistry analyzer to determine the serum levels of cTnI and CK-MB before anesthesia induction (T0), 30 min after aortic declamping (T1), 4 h after aortic declamping (T2), and 8 h after aortic declamping (T3). We found the mean serum cTnI and CK-MB levels of the puerarin group tended to decrease with time. The positive rates of NF-κB, IL-6 and IL-8 at different time-points were lower in patients of the puerarin group than in those of the control group (and the differences at T3 were statistically significant). The clinical manifestations of patients in the puerarin group after operation were better than those in the control group (P<0.05). We found that the expression levels of NF-κB, IL-6 and IL-8 were positively correlated with the levels of CK-MB and cTnI (P<0.05). Puerarin preconditioning can reduce the NF-κB activation and the overexpression of IL-6 and IL-8 in neutrophils, and it inhibits the release of myocardial enzyme cTnI and CK-MB reflecting myocardial cell protection. Puerarin seems to improve safety and efficacy of valvular replacement operations.