Efficacy and safety of sacubitril/valsartan after six months in patients with heart failure with reduced ejection fraction and asymptomatic hypotension / 老年心脏病学杂志（英文版）

BACKGROUND@#It is not clear whether sacubitril/valsartan is beneficial for patients with heart failure (HF) with reduced ejection fraction (HFrEF) and low systolic blood pressure (SBP). This study aimed to investigate the efficacy and tolerability of sacubitril/valsartan in HFrEF patients with SBP < 100 mmHg.@*METHODS & RESULTS@#An observational study was conducted on 117 patients, 40.2% of whom had SBP < 100 mmHg without symptomatic hypotension, and 59.8% of whom had SBP ≥ 100 mmHg in an optimized HF follow-up management system. At the 6-month follow-up, 52.4% of patients with SBP < 100 mmHg and 70.0% of those with SBP ≥ 100 mmHg successfully reached the target dosages of sacubitril/valsartan. A reduction in the concentration of N-terminal pro-B-type natriuretic peptide was similar between patients with SBP < 100 mmHg and SBP ≥ 100 mmHg (1627.5 pg/mL and 1340.1 pg/mL, respectively; P = 0.75). The effect of sacubitril/valsartan on left ventricular ejection fraction was observed in both SBP categories, with a 10.8% increase in patients with SBP < 100 mmHg (P < 0.001) and a 14.0% increase in patients with SBP ≥ 100 mmHg (P < 0.001). The effects of sacubitril/valsartan on SBP were statistically significant and inverse across both SBP categories (P = 0.001), with an increase of 7.5 mmHg in patients with SBP < 100 mmHg and a decrease of 11.5 mmHg in patients with SBP ≥ 100 mmHg. No statistically significant differences were observed between the two groups in terms of the occurrence of symptomatic hypotension, deteriorating renal function, hyperkalemia, angioedema, or stroke.@*CONCLUSIONS@#Within an optimized HF follow-up management system, sacubitril/valsartan exhibited excellent tolerability and prompted left ventricular reverse remodeling in patients with HFrEF who presented asymptomatic hypotension.

Analysis of training method of taekwondo athletes with reaction ball / Análise do método de treinamento de atletas de taekwondo com bola de reação / Análisis del método de entrenamiento de atletas de tae kwon do con pelota de reacción

ABSTRACT Introduction: Brief introduction: Taekwondo is a sport that integrates explosive power and reaction speed. The reaction speed of the athletes has a direct bearing on the result of the competition. Objective: To improve the reaction time effect of athletes. Methods: Forty-one Taekwondo team athletes were selected as the research subjects. Then, the training methods were introduced, and special technology using an emg tester and a synchronous camera system was implemented to analyze the earliest emg signals and the moment of the hit, the time from signal emergence to the emg reaction for reaction time, and from signal emergence to hit for the total time. Results: The average score of the 41 athletes before the test was 0.282673,with standard deviation of 0.0377349 and standard error of 0.0058932. The average score, standard deviation, and standard error of the 41 athletes after small training were 0.28217, 0.037744 and 0.005895. Conclusions: From the test results of the three training modes, the small training mode had a significant impact on the reaction time of Taekwondo athletes, while the medium and large training modes did not have significant effects. The results show that a small amount of training is best and plays a significant role in improving the reaction of an athlete. Level of evidence II; Therapeutic studies - investigation of treatment results.

RESUMO Introdução: Introdução breve: O Taekwondo é um esporte que incorpora força explosiva e velocidade de reação. A velocidade de reação dos atletas tem influência direta sobre o resultado da competição. Objetivo: Melhorar o efeito do tempo de reação dos atletas. Métodos: Quarenta e um atletas de equipes de Taekwondo foram selecionados como participantes da pesquisa. A seguir, foram introduzidos os métodos de treinamento e uma tecnologia especial usando um testador EMG e foi implementado um sistema de câmera sincrônica para analisar os primeiros sinais do EMG e o momento da batida, o tempo desde a emergência do sinal até a reação EMG para verificar tempo de reação e da emergência do sinal até a batida para verificar o tempo total. Resultados: O escore médio dos 41 atletas antes do teste foi de 0,282673, com desvio padrão de 0,0377349 e erro padrão de 0,0058932. O escore médio, desvio padrão e erro padrão dos 41 atletas depois de um pequeno treinamento foram 0,28217, 0,037744 e 0,005895, respectivamente. Conclusões: A partir dos resultados dos testes dos três modos de treinamento, o modo de treinamento pequeno teve impacto significativo no tempo de reação dos atletas de Taekwondo, enquanto os modos de treinamento médio e grande não tiveram efeitos significativos. Os resultados mostram que uma pequena quantidade de treinamento é melhor e tem papel significativo na melhora da reação dos atletas. Nível de Evidência II; Estudos terapêuticos - Investigação dos resultados do tratamento.

RESUMEN Introducción: Breve introducción: El Tae Kwon Do es un deporte que incorpora fuerza explosiva y velocidad de reacción. La velocidad de reacción de los atletas influye directamente en el resultado de la competición. Objetivo: Mejorar el efecto del tiempo de reacción de los atletas. Métodos: Se seleccionaron 41 atletas de equipos de Tae Kwon Do como participantes de la investigación. A continuación, se introdujeron los métodos de entrenamiento y una tecnología especial que utiliza un probador EMG y se implementó un sistema de cámaras sincrónicas para analizar las primeras señales EMG y el momento del golpe, el tiempo desde la aparición de la señal hasta la reacción EMG para verificar el tiempo de reacción y desde la aparición de la señal hasta el golpe para verificar el tiempo total. Resultados: La puntuación media de los 41 atletas antes de la prueba fue de 0,282673, con una desviación estándar de 0,0377349 y un error estándar de 0,0058932. La puntuación media, la desviación estándar y el error estándar de los 41 atletas tras una breve sesión de entrenamiento fueron de 0,28217, 0,037744 y 0,005895, respectivamente. Conclusiones: A partir de los resultados de las pruebas de los tres modos de entrenamiento, el modo de entrenamiento pequeño tuvo un impacto significativo en el tiempo de reacción de los atletas de Tae Kwon Do, mientras que los modos de entrenamiento mediano y grande no tuvieron efectos significativos. Los resultados demuestran que una pequeña cantidad de entrenamiento es mejor y desempeña un papel importante en la mejora del tiempo de reacción de los atletas. Nivel de Evidencia II; Estudios terapéuticos - Investigación de los resultados del tratamiento.

Study on diagnosis criteria of fire-heat syndrome based on receiver operating characteristic curve and principal component analysis / 中国结合医学杂志

<p><b>OBJECTIVE</b>To establish the diagnostic quantitative criteria for fire-heat syndrome (FHS) of Chinese medicine (CM) based on the receiver operating characteristic (ROC) curve and principal component analysis (PCA).</p><p><b>METHODS</b>The symptoms and signs of FHS cases and healthy subjects from Guangzhou, Henan and Hunan of China were collected through questionnaire, and the diagnostic quantitative score tables were established for the three regions, respectively, with the method of maximum likelihood analysis. The homogeneity test was then performed on the diagnostic score tables for the three regions with ROC curve, and the diagnostic efficiency of diagnostic score tables for the three regions was compared with the prospective test and retrospective test. The method of PCA was adopted to obtain the analysis matrix for classifying the tapes of FHS.</p><p><b>RESULTS</b>Twenty-seven elements of FHS were confirmed through Chi-square test, and the diagnostic score tables for the three regions were established with the method of maximum likelihood analysis on the basis of the collected case data. According to the ROC curve test, the areas under ROC curve of Guangzhou diagnostic score table assessment with candidates in Guangzhou, Henan and Hunan were 0.998, 0.961 and 0.956, respectively. It showed that the diagnostic efficiency of Guangzhou diagnostic score tables was the highest one. With the prospective test, the area under ROC of Guangzhou diagnostic score table was 0.949, and more than any other diagnostic score table. By PCA, FHS was classified into excess fire and deficiency fire, and then classified into syndrome of flaring up of Heart (Xin) fire, syndrome of Lung (Fei)-Stomach (Wei) excess fire, syndrome of deficiency of Liver (Gan)-yin and Kidney (Shen)-yin, and syndrome of deficiency of Lung-yin from the view of viscera. In the retrospective test, the consistency with clinicians' diagnosis was 69.4%, and in the prospective test, it was 70.1%.</p><p><b>CONCLUSIONS</b>The Guangzhou diagnostic score table could be used as the recommended criteria for the diagnosis of FHS. The classification of FHS was basically in conformity with the clinical situation.</p>

MG-132 enhances MSCs survival and IL-10 secretion under hypoxia and serum deprivation condition / 生理学报

Bone marrow-derived mesenchymal stem cells (MSCs) have emerged as attractive candidates for cellular therapies for heart and other organ-system disorders. However, a major dilemma in stem cell therapy for ischemic heart diseases is the low survival of transplanted cells in the ischemic and peri-infarcted region. In this study, MSCs were treated by hypoxia and serum deprivation (H/SD) to mimic the ischemic microenvironment of infarcted hearts where MSCs were transplanted. The effects of proteasome inhibitor MG-132 on H/SD-induced apoptosis and paracrine effects were investigated. Apoptosis of MSCs was detected by Annexin V-FITC flow cytometric analysis. Transcriptional levels of IL-1β, TNF-α and IL-10 were examined by real-time PCR. The nuclear translocation of NF-κBp65 was assessed by immunocytochemical staining. Translational changes of IL-1β and TNF-α were detected by Western blot. The secretion of IL-10 from MSCs was examined by ELISA assay. The results showed that MG-132 could effectively suppress H/SD-induced MSCs apoptosis. Furthermore, the induced IL-1β and TNF-α transcription was also inhibited by MG-132 treatment, which may be due to the inhibition of NF-κBp65 nuclear translocation by MG-132. Importantly, MG-132 effectively enhanced H/SD-induced transcription and secretion of IL-10, which is an important paracrine factor from MSCs. Our findings suggest that pretreatment of MSCs by MG-132 before cell transplantation may be an effective strategy to improve cell survival and enhance paracrine effects of MSCs.

Function and biological activities of the autotaxin-LPA axis / 生理学报

Autotaxin (ATX), a member of nucleotide pyrophosphatase/phosphodiesterase (NPP) family, is also named as phosphodiesterase Iα (PD-Iα) or NPP2. ATX is the unique member among the NPPs that can function as a lysophospholipase D (lysoPLD), converting lysophosphatidylcholine into lysophosphatidic acid (LPA). LPA acts on specific G-protein-coupled receptors to elicit a wide range of cellular response, including cell proliferation, cell migration and cell contraction, etc. As the major LPA-producing phospholipase, many ATX's features and functions are dependent on the production of LPA. ATX and LPA together form the ATX-LPA functional axis. The present review summarizes the current progress in function and biological activities of ATX-LPA axis.

Three dimensional finite element analysis of biomechanical distribution of dental implants with immediate loading / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To analyze the stress distribution of bone around the dental implants with lateral immediate loading of different angles by three dimensional finite element.</p><p><b>METHODS</b>An adult edentulous mandible was adopted for CT scanning. The CT image was imported to universal surgical integration system to establish a mandible three dimensional mesh model. The real shape of standard thread implant was simulated and the finite element model of mandible with dental implants for immediate loading was established. The models were immediately loaded with 150 N through the angle of 0 degrees, 10 degrees, 20 degrees, 30 degrees. The ANSYS 10.0 was used to analyze the Von Mises stress on the bone around dental implants.</p><p><b>RESULTS</b>The accurate finite element model of mandible with dental implants for immediate loading was successfully established. The three dimensional finite element analytical results showed: Under axial load, the Von Mises stress of bone contact surface concentrated on the cortical bone of the implant cervix. The strain distribution was even, and centralized at the cortical bone of the implant cervix, cancellous bone of implant bottom and thread contact area. Under different lateral angle load, the Von Mises stress of bone contact surface also concentrated on the cortical bone of the implant cervix, but the maximum value was 4 times of the vertical loading, the strain distributed unevenly, mainly concentrated on the cortical bone of the implant cervix. With the load angle increased, the stress and the strain value also increased.</p><p><b>CONCLUSION</b>When an axial force was immediately loaded, the stress value and the strain concentration value of bone interface around the dental implants are not apparently concentrated, the stress is distributed well. While a lateral force is loaded, the stress values and the strain concentration values of bone interface around the dental implants apparently increase and the strain are distributed unevenly.</p>

Effect of total flavone of Epimedium on expression of bone OPG, OPGL mRNA in ovariectomized rats / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the molecular mechanism of TFE (total flavone of epimedium) in the treatment of osteoporosis, and then provide experimental evidence for modernization and further development of TFE as an traditional Chinese medicine.</p><p><b>METHODS</b>Sixty healthy female SD rats with aged 4 months were randomly divided into three groups (including control group in which rats received sham surgery, OVX group in which ovariectomized rats didn't give any medicine after the removal of ovaries and TFE group in which ovariectomized rats administrated TFE), 20 rats in each group. Compared bone mineral density (BMD) between before operation and at 4th week after operation in order to verify the establishment of osteoporotic model (criteria: BMD decreased more than 20% at 4th week after operation). The rats in TEF group were administrated total flavone of epimedium(concentration 30 mg/ml, 10 ml/kg, qd) orally for 4 weeks. After this, killed rats to harvest the lower part of the femur and detected BMD again. Applying the reverse transcriptase-polymerase chain reaction technique (RT-PCR) to detect expression of OPG, OPGL mRNA in bone tissue.</p><p><b>RESULTS</b>(1) At 4th week after ovariectomy, the mean BMD of lumbar vertebra in TFE group fell to (0.084 +/- 0.020) g/cm2. Administrated with TFE for 4 weeks,the BMD increased to (0.112 +/- 0.009) g/cm2. There was significant improvement compare with the OVX group (P < 0.05). (2) Compared between OVX group and TFE group, The OPG mRNA expression of TFE group obviously enhanced. There was significant difference in statistics (P < 0.05). However,the promotion for OPGL mRNA expression were detected between OVX group and TFE group,there was no significant difference in statistics (P > 0.05).</p><p><b>CONCLUSION</b>This study showed that TFE could inhibit differentiation and maturation of osteoclast through enhancing OPG mRNA expression, accordingly,to treat osteoporosis.</p>

Epidemiologic study on the relationship between smoking and sleep apnea/hypopnea syndrome / 中华流行病学杂志

<p><b>OBJECTIVE</b>To investigate how smoking was affecting the prevalence of sleep apnea/ hypopnea syndrome (SAHS) among adults aged over 30 years in Chengde city of Hebei province.</p><p><b>METHODS</b>1168 subjects, over 30 years of age were derived from a random sample from a community-based population in Shuangqiao district of Chengde city. All subjects responded to a questionnaire at their own houses regarding their habits of snoring and smoking. 1168 subjects (95.2%) answered the questions satisfactorily.</p><p><b>RESULTS</b>(1) Among the smoking groups, the prevalence of snoring was 69.09%, higher than that in the nonsmoking groups 45.07% (P = 0.000). (2) In males, the smoking group had a higher prevalence (69.72%) of snoring than in the nonsmoking group (60.80%, P = 0.033). (3) Females in the smoking group had a higher prevalence of snoring (61.80%) than in the nonsmoking group (39.70%, P = 0.011). (4) The prevalence of snoring in males (60.80%) was significantly higher than that in females (39.70%, P = 0.000). (5) The prevalence (69.72%) of snoring in smoking males was similar to that in smoking females (61.80%, P = 0.336). (6) Data from logistic regression analysis indicated that smoking was one of the factors affecting snoring. (7) According to the degree of snoring, 127 moderate and severe snorers were measured by portable PSG for a whole night and the prevalence of SAHS was estimated. According to the AHI > or = 5 and the ESS > or = 9 cutoff-points, the prevalence rates of SAHS in smoking groups were both significantly higher than that in nonsmoking groups (P < 0.001).</p><p><b>CONCLUSION</b>Smoking and snoring among adults aged over 30 years had correlation in our city.</p>

Examination of anti-HBx in sera from patients of chronic hepatitis B,liver cirrhosis and hepatocellular carcinoma and its clinical significance / 中华检验医学杂志

Objective To establish a method of detecting hepatitis B virus x antigen (HBxAg) and antibody to HBxAg (anti-HBx) and to demonstrate its clinical significance of HBxAg and anti-HBx in sera from patients of chronic hepatitis B (CHB),liver cirrhosis (LC) and hepatocellular carcinoma (HCC). Methods Full length HBx gene was cloned into pET30a(+),a prokaryotic expression vector,named pET30a-X.It was transformed into Escherichia coli BL21 (DE3),followed the fusion protein of HBx-His was induced by IPTG.The purified fusion protein was used to immunize rabbit as an antigen to generate polyclonal antibody to HBx protein.The method of enzyme-linked immunosorbent assay (ELISA) was established by using purified fusion protein and generated antibody,which was used to detect HBxAg and anti-HBx in sera from patients of CHB,LC,HCC and normal healthy people.Results The positive rates of HBxAg/anti-HBx were 8.7%/10.4% for CHB,17.9%/40.6% for LC,and 9.8%/34.4% for HCC, respectively.In statistics,the positive rates of anti-HBx in LC and HCC were higher than that in CHB (P