Survey of prevalence of hepatitis C in people aged 1-69 years in Henan Province, 2020 / 中华流行病学杂志

Objective: To understand the infection status and epidemiological characteristics of hepatitis C in people aged 1-69 years in Henan Province in 2020. Methods: The estimated sample size was 5 827. From August to December 2020, multistage sampling was used to select 8 counties (districts) in Henan, and two survey sites were selected in each county (district), and a questionnaire survey was conducted in local people aged 1-69 years, blood samples were collected from them for anti-HCV, HCV RNA and genotype detections. Results: A total of 5 165 people aged 1-69 years completed the questionnaire survey. Men accounted for 44.76% (2 312/5 165), women accounted for 55.24% (2 853/5 165). In the people aged 1-69 years, the overall prevalence rates of anti-HCV and HCV RNA were 0.69% (95%CI: 0.68%-0.70%) and 0.20% (95%CI: 0.19%-0.21%) respectively. The prevalence rates of anti-HCV and HCV RNA were 0.48% (95%CI: 0.46%-0.50%), 0.09% (95%CI: 0.08%-0.10%) in men and 0.86% (95%CI: 0.85%-0.87%), 0.30% (95%CI: 0.28%-0.32%) in women. The prevalence rates of anti-HCV and HCV RNA increased with age. The prevalence rates of anti-HCV and HCV RNA were 0.87% (95%CI: 0.86%-0.88%), 0.28% (95%CI: 0.26%-0.30%) in urban residents and 0.53% (95%CI: 0.51%-0.55%), 0.14% (95%CI: 0.13%-0.15%) in rural residents. The genotyping results of 10 HCV RNA positive samples ware genotype 1b (4/10), genotype 2 (3/10), genotype 1b/3 (1/10), genotype 1b/3/6 (1/10) and genotype 2/6 (1/10). Conclusions: The prevalence of hepatitis C was low in Henan in 2020. It is necessary to strengthen hepatitis C surveillance in people aged 40 years and above. The major HCV genotypes were 1b and 2, and mixed genotype infection existed.

The correlations between influenza and meteorological factors in 15 cities of northern China, 2008-2020 / 中华流行病学杂志

Objective: To understand the influence of meteorological factors on the morbidity of influenza in northern cities of China and explore the differences in the influence of meteorological factors on the morbidity of influenza in 15 cities. Methods: The monthly reported morbidity of influenza and monthly meteorological data from 2008 to 2020 were collected in 15 provincial capital cities, including Xi 'an, Lanzhou, Xining, Yinchuan and Urumqi (5 northwestern cities), Beijing, Tianjin, Shijiazhuang, Taiyuan, Hohhot, Ji'nan, Zhengzhou (7 northern cities), Shenyang, Changchun and Harbin (3 northeastern cities). The panel data regression model was applied to conduct quantitative analyze on the influence of meteorological factors on influenza morbidity. Results: The univariate and multivariate panel regression analysis showed that after controlling the population density and other meteorological factors, for each 5 ℃ drop of monthly average temperature, the morbidity change percentage (MCP) of influenza was 11.35%, 34.04% and 25.04% in the 3 northeastern cities, 7 northern cities and 5 northwestern cities, respectively, and the best lag period months was 1, 0 and 1 month; When the monthly average relative humidity decreased by 10%, the MCP was 15.84% in 3 cities in northeastern China and 14.80% in 7 cities in northern China respectively, and the best lag period months was 2 and 1 months respectively; The MCP of 5 cities in northwestern China was 4.50% for each 10 mm reduction of monthly accumulated precipitation, and the best lag period months was 1 month; The MCPs of 3 cities in northeastern China and 5 cities in northwestern China were 4.19% and 5.97% respectively when the accumulated sunshine duration of each month decreased by 10 hours, the best lag period months was 1 month. Conclusions: In northern cities of China from 2008 to 2020, the temperature, relative humidity, precipitation and sunshine duration all had negatively impact on the morbidity of influenza, and temperature and relative humidity were the main sensitive meteorological factors. Temperature had a strong direct impact on the morbidity of influenza in 7 cities in northern China, and relative humidity had a strong lag effect on the morbidity of influenza in 3 cities in northeastern China. The duration of sunshine in 5 cities in northwestern China had a greater impact on the morbidity of influenza compared with 3 cities in northeastern China.

Assessment of intensity of seasonal influenza activity in Beijing-Tianjin-Hebei region, 2019-2021 / 中华流行病学杂志

Objective: To explore the feasibility of moving epidemic method (MEM) in the assessment of seasonal influenza (influenza) activity intensity from the perspective of urban agglomeration, assess influenza activity intensity in the Beijing-Tianjin-Hebei region from 2019 to 2021 and evaluate the reliability of surveillance data and the effectiveness of the MEM model application. Methods: The weekly reported incidence rate (IR) of influenza and the percentage of influenza-like illness (ILI%) from 2011-2021 in Beijing-Tianjin-Hebei region were collected to establish MEM models respectively. The model fitting effect and the reliability of the two data were evaluated for the purpose of establishing an optimal model to assess the influenza activity intensity in Beijing-Tianjin-Hebei region from 2019-2021. A cross-validation procedure was used to evaluate the performance of the models by calculating the Youden's index, sensitivity and specificity. Results: The MEM model fitted with weekly ILI% had a higher Youden's index compared with the model fitted with weekly IR at both Beijing-Tianjin-Hebei region level and provincial level. The MEM model based on ILI% showed that the epidemic threshold in Beijing-Tianjin-Hebei region during 2019-2020 was 4.42%, the post-epidemic threshold was 4.66%, with medium, high and very high intensity thresholds as 5.38%, 7.22% and 7.84%, respectively. The influenza season during 2019-2020 had 10 weeks (week 50 of 2019 to week 7 of 2020). The influenza season started in week 50 of 2019, and the intensity fluctuated above and below medium epidemic level for six consecutive weeks. The high intensity was observed in week 4 of 2020, the threshold of very high intensity was excessed in week 5, and the intensity gradually declined and became lower than the threshold at the end of the influenza season in week 8. The epidemic threshold was 4.29% and the post-epidemic threshold was 4.35% during 2020-2021. Influenza activity level never excessed the epidemic threshold throughout the year, and no epidemic period emerged. Conclusions: The MEM model could be applied in the assessment of influenza activity intensity in Beijing-Tianjin-Hebei region, and the use of ILI% to assess influenza activity intensity in this region was more reliable than IR data. Influenza activity intensity in Beijing-Tianjin-Hebei region was higher during 2019-2020 but significantly lower in 2020-2021.

Investigation on the chronic disease management of hypertension in county-level medical institutions in China / 中华医院管理杂志

Objective:To investigate the development of hypertension specialty and chronic disease management of county-level hospitals in China, for reference in improving the standardized chronic disease management level of hypertension in the counties.Methods:From September to November 2020, a questionnaire survey on 597 county-level hospitals in 24 provinces was conducted on a voluntary basis. The survey covered such areas as the setup of hypertension specialty, team building of professionals and the management regulations of chronic hypertension of the hospital. The survey data were analyzed by descriptive statistics.Results:Among the 597 county-level hospitals, 54(13.5%) hospitals had independent hypertension departments, 147(24.6%) had hypertension clinics, and 143(24.0%) hospitals had hypertension beds. 431(72.2%) hospitals had hypertension diagnosis and treatment process in outpatient clinics, 454(76.0%) hospitals had hypertension diagnosis and treatment process in wards, and 535(89.6%) hospitals had graded diagnosis and treatment process of hypertension. 473(79.2%) hospitals had established county medical alliance as the lead unit, including 167 compact medical alliances. 97.7% of the hospitals were equipped with basic hypertension risk stratification screening items, and 63.8% could carry out primary screening of secondary hypertension.Conclusions:The pattern of chronic diseases management of hypertension in county-level medical institutions has basically taken shape, but there is still room for improvement. In the future, we should focus on the construction of professional teams of hypertension, the standardized management of diagnosis and treatment of hypertension, and a smoother path of tiered medical service, so as to increase the health management level of hypertension in China.

The value of combined measurement of soluble growth stimulation expressed gene 2 protein, interleukin-6 and tumor necrosis factor-α in peripheral blood in evaluating the prognosis of elderly patients with heart failure / 中华老年医学杂志

Objective:To investigate the predictive value of measuring soluble growth stimulation expressed gene 2 protein(sST2), interleukin-6(IL-6)and tumor necrosis factor-α(TNFα)as individual parameters or as a test panel in the prognosis of elderly patients with heart failure.Methods:A total of 128 elderly patients with heart failure hospitalized at the Cardiology Department of the Medical Alliance of Chest Hospital and Hexi Hospital between April 2019 and April 2020 were retrospectively selected.Based on heart failure readmissions, all-cause deaths and cardiovascular death events within a one-year follow-up, the patients were divided into a good prognosis group(n=60)and a poor prognosis group(n=68).The general condition and routine laboratory examination test results were recorded.At admission, blood samples were taken to measure sST2, IL-6 and TNFα.The individual parameters, combinations of two parameters and the combination of all three parameters were used to draw receiver operating characteristic curves(ROCs)and their value in evaluating the prognosis of heart failure patients was analyzed.Results:In the poor prognosis group, sST2, IL-6 and TNFα levels were(29.4±7.7)mg/L, (23.1±45.7)ng/L and(30.9±82.1)ng/L, respectively, higher than those in the good prognosis group[(25.0±9.1)mg/L, (22.5±49.1)ng/L, (13.5±22.3)ng/L, t=2.42, -2.32, -2.37, all P<0.05)].The area under ROC(AUC)values of sST2, IL-6 and TNFα were 0.636, 0.619 and 0.622, respectively(all P>0.05).The specificity of sST2(56.7%)was higher than that of IL-6(51.7%)and of TNFα(46.7%), and the difference was statistically significant( P<0.05).The sensitivity of TNFα(80.9%)was higher than that of sST2(64.7%)and of IL-6(79.4%), and the difference was statistically significant( P<0.05); As the combinations of two parameters, the predictive power of the sST2+ TNFα combination was higher than that of the other two combinations, based on AUC values(both P<0.05).The AUC and specificity of the sST2+ IL-6+ TNFα combination were higher than those of any two-parameter combination(both P<0.05). Conclusions:The combined detection of sST2+ IL-6+ TNFα has a good performance in predicting the one-year prognosis of elderly patients with heart failure and can be easily implemented in clinical practice.

Clinical characteristics and prognosis of middle-aged and elderly in-patients with acute decompensated and mid-range ejection fraction heart failure in the medical alliance setting / 中华老年医学杂志

Objective:To investigate the clinical characteristics and the risk of major adverse cardiac events within 1 year of middle-aged and elderly in-patients with acute decompensated and mid-range ejection fraction heart failure(HF)in the medical alliance setting.Methods:A retrospective cohort study was conducted among a total of 180 in-patients with acute decompensated heart failure in Cardiovascular Hexi Hospital Consulting Area of Tianjin Chest Hospital.According to ejection fraction measured by echocardiogram, the in-patients were classified into three groups: heart failure with reduced ejection fraction(HFrEF)group(n=70, 38.9%), HFmEF group(n=50, 27.8%), and heart failure with preserved ejection fraction(HFpEF)group(n=60, 33.3%). Clinical feature and 1-year prognosis between different groups were compared.Results:Univariate Cox regression analysis of 1-year all-cause death and cardiovascular death showed that there was no significant difference between HFrEF group and HFmEF group, HFpEF group and HFmEF group(all P>0.05); 1-year readmission analysis of heart failure showed that 47.1%(33 cases)of HFrEF group was higher than 24.0%(12 cases)of HFmEF group, 48.3%(29 cases)of HFpEF group was higher than HFmEF group( HR=2.307, 2.368, 95% CI: 0.187-4.480, 1.207-4.644, respectively, all P<0.05); The major 1-year cardiovascular events were 57.1%(40 cases)higher in the HFrEF group than 34.0%(17 cases)in the HFmEF group( HR=2.053, 95% CI: 0.187-4.408, P< 0.05). Multivariate analysis showed that the 1-year risk of major cardiovascular events was significantly different between HFmEF group and HFpEF group( HR=0.477, 95% CI: 0.241-0.941, P< 0.05). Pulmonary heart disease( P< 0.05), atrial flutter and/or atrial fibrillation( P< 0.01), New York Cardiology class Ⅳ( P< 0.01)were risk factors for death.Hypertension and cor pulmonale were the risk factors for readmission in patients with heart failure(all P< 0.01). Conclusions:The clinical characteristics of inpatients with HFmEF in the medical alliance setting tended to be consistent with those with HFrEF, while the feature of ischemic heart disease was more prominent in HFmEF.The 1-year risk of heart failure readmission in HFmEF group was significantly lower than that in HFpEF and HFrEF group, and the risk of all-cause mortality and cardiovascular mortality at 1 year was not significantly different among the three groups.

Analysis of factors associated with the structure of the gut microbial community in HIV/AIDS patients in some areas of Henan province / 中华流行病学杂志

Objective: To investigate the related factors associated with the structure of the gut microbial community in HIV infection/AIDS cases (HIV/AIDS) in Henan province. Methods: The convenience sampling method was used to select 122 cases who were receiving Antiviral Treatment (ART) or ART-naive in Henan. Whole blood and stool specimens were collected. Genomic DNA of stool samples was extracted, and the V3-V4 hypervariable regions of the 16S rRNA gene were sequenced using Illumina NovaSeq 6000 high-throughput sequencing system. The analysis was performed mainly at the genus level, and the 30 genera with the highest abundance were selected as a measure of the gut microbial community structure. The correlation between community structure and related factors was analyzed using redundancy analysis and Envfit function. Results: 122 cases were finally completed sequencing and analysis, the average BMI was (23.62±2.78) kg/m2 and the average age was (47±13) years. Among them, male accounted for 66.39% (81/122), and heterosexual transmission route constituted the largest ratio, accounting for 51.64% (63/122). 36 cases were treatment naive (29.51%, 36/122). The top five dominant genera of the total population (122 cases) were Prevotella, Roseburia, Megamonas, Bacteroides and Faecalibacterium and the top five dominant genera of the ART population (86 cases) were Prevotella, Megamonas, Bacteroides, Roseburia and Faecalibacterium. The top five dominant genera of the ART-naive population (36 cases) appeared as Prevotella, Faecalibacterium, Roseburia, Bacteroides and Megamonas. In the total population, ART (P<0.001) was the most significant factors of community structure. Other significant factors were: duration of diagnosis (P=0.009), viral load (P=0.022) and anti-HCV (P=0.018). ART was positively correlated with Megamonas and negatively correlated with Prevotella, Roseburia and Faecalibacterium, while the other three factors of duration of diagnosis, viral load and anti-HCV were positively correlated with Prevotella, Roseburia and Faecalibacterium and negatively correlated with Megamonas. In the ART-naive population, duration of diagnosis (P=0.003) were the factors significantly associated with community structure. Duration of diagnosis was positively correlated with Roseburia, Faecalibacterium, Megamonas and Prevotella and negatively correlated with Bacteroides. Conclusion: ART and duration of diagnosis were factors significantly associated with gut microbial community structure and had a significant impact on multiple high-abundance genera.

Association Study of Polymorphisms in Neuronal Nicotinic Acetylcholine Receptor Subunit Genes With Schizophrenia in the Han Chinese Population

Objective@#To investigate the relation between nicotinic acetylcholine receptor subunit (nAChR) genes and schizophrenia, and the relation between tag single nucleotide polymorphism (rs1317286, rs1044396, rs6494212, rs16969968, and rs684513) and schizophrenia in Han Chinese people. @*Methods@#The protein-protein interaction (PPI) network among nAChR protein and 350 proteins encoded by schizophrenia-related susceptibility genes was constructed through the String database to explore whether nAChR genes were associated with schizophrenia in these known databases. Then, five single nucleotide polymorphisms (SNPs) of CHRNA3 (rs1317286), CHRNA4 (rs1044396), CHRNA7 (rs6494212), and CHRNA5 (rs16969968, rs684513) were analyzed in a sample of 1,035 schizophrenic patients and 816 healthy controls. The interaction between the markers was analyzed using multifactor dimensionality reduction (MDR) software. Power analysis was performed using the Quanto program. @*Results@#There are no significant differences in genotype or allele distribution were identified between the patients and controls (p>0.05). The haplotypes constructed by four markers rs1317286, rs6494212, rs16969968, and rs684513 were not associated with schizophrenia either. However, a significant association between models made of rs1317286, rs1044396, rs6494212, and rs684513 and schizophrenia was revealed in interaction analysis (p<0.05). @*Conclusion@#The nAChR protein may have effects on the development of schizophrenia through the interaction with proteins encoded by schizophrenia-related susceptibility genes, but no relation was found between selected polymorphisms and schizophrenia in the collected Han Chinese people. However, interaction analysis suggested four-SNP model has an important effect on schizophrenia.

Meplazumab treats COVID-19 pneumonia: an open-labelled, concurrent controlled add-on clinical trial

BackgroundSARS-CoV-2 is a novel human coronavirus, there is no specific antiviral drugs. It has been proved that host-cell-expressed CD147 could bind spike protein of SARS-CoV-2 and involve in host cell invasion. Antibody against CD147 could block the infection of SARS-CoV-2. We aimed to assess the efficacy and safety of meplazumab, a humanized anti-CD147 antibody, as add-on therapy in patients with COVID-19 pneumonia. MethodsAll patients received recommended strategy from Diagnosis and Treatment for 2019 Novel Coronavirus Diseases released by National Health Commission of China. Eligible patients were add-on administered 10 mg meplazumab intravenously at days 1, 2, and 5. Patients hospitalized in the same period were observed as concurrent control. The endpoints include virological clearance rate, case severity, chest radiographic, and laboratory test. This trial was approved by the Ethics Committee of Institution at the Tangdu hospital, and registered with ClinicalTrials.gov, NCT 04275245. Findings17 patients were enrolled and assigned to meplazumab group between Feb 3, 2020 and Feb 10, 2020. 11 hospitalized patients served as concurrent control. Baseline characteristics were generally balanced across two groups. Compared to control group, meplazumab treatment significantly improved the discharged (p=0.006) and case severity (p=0.021) in critical and severe patients. The time to virus negative in meplazumab group was reduced than that in control group (median 3, 95%CI[1.5-4.5] vs. 13, [6.5-19.5]; p=0.014, HR=0.37, 95%CI[0.155-0.833]). The percentages of patients recovered to the normal lymphocyte count and CRP concentration were also increased remarkably and rapidly in meplazumab group. No adverse effect was found in meplazumab-treated patients. InterpretationMeplazumab efficiently improved the recovery of patients with SARS-CoV-2 pneumonia with a favorable safety profile. Our results support to carry out a large-scale investigation of meplazumab as a treatment for COVID-19 pneumonia. FundingNational Science and Technology Major Project.

SARS-CoV-2 invades host cells via a novel route: CD147-spike protein

Currently, COVID-19 caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been widely spread around the world; nevertheless, so far there exist no specific antiviral drugs for treatment of the disease, which poses great challenge to control and contain the virus. Here, we reported a research finding that SARS-CoV-2 invaded host cells via a novel route of CD147-spike protein (SP). SP bound to CD147, a receptor on the host cells, thereby mediating the viral invasion. Our further research confirmed this finding. First, in vitro antiviral tests indicated Meplazumab, an anti-CD147 humanized antibody, significantly inhibited the viruses from invading host cells, with an EC50 of 24.86 g/mL and IC50 of 15.16 g/mL. Second, we validated the interaction between CD147 and SP, with an affinity constant of 1.85x10-7M. Co-Immunoprecipitation and ELISA also confirmed the binding of the two proteins. Finally, the localization of CD147 and SP was observed in SARS-CoV-2 infected Vero E6 cells by immuno-electron microscope. Therefore, the discovery of the new route CD147-SP for SARS-CoV-2 invading host cells provides a critical target for development of specific antiviral drugs.

Simultaneous determination of verapamil and its metabolite norverapamil in human plasma by liquid chromatography-tandem mass spectrometry / 药学学报

A sensitive and simple high-performance liquid chromatographic tandem mass spectrometric (LC-MS/MS) method for the determination of verapamil and norverapamil in human plasma was established and utilized in a pharmacokinetic study in healthy patients. Protein was precipitated by methanol in plasma samples, and the analytes and internal standard were separated on an Agilent Zorbax Eclipse C18 column (50 mm×4.6 mm, 5 μm) with a gradient procedure using methanol-acetonitrile (50∶50) as the organic phase and 0.1% formic acid - 5% acetonitrile - 10 mmol·L-1 ammonium formate solution as the mobile phase at flow rate of 0.5 mL·min-1. Electrospray ionization (ESI) and multiple reaction monitoring (MRM) detection modes were used for quantitative detection of verapamil, norverapamil and verapamil-d6 (IS). In the mode of multiple reaction monitoring of positive-ions, the monitoring ion pairs of verapamil, norverapamil and the verapamil-d6 were m/z 445.0→165.2, m/z 441.0→165.2 and m/z 461.1→165.2, respectively. The quantitative lower limit (LLOQ) for the determination of verapamil and norverapamil concentrations in human plasma can reach 0.1 ng·mL-1 in this assay. The calibration curve concentration ranged from 0.1 to 50 ng·mL-1 with high linearity (r2 > 0.997). The matrix effect of verapamil and norverapamil was 99.2%-100% and 101%-102%, respectively. The recovery of verapamil and norverapamil was 86.8%-95.9% and 87.4%-94.8%, respectively. This method has good specificity and high sensitivity. The determination of the verapamil and norverapamil was not subject to the matrix effect and stable extraction recovery was achieved in this assay. This method could be used to determine the concentration of verapamil and norverapamil in human plasma and suitable for human pharmacokinetic studies after approved by ethics committee.

Expression of Blimp1、ATF4 and CHOP in Multiple Myeloma Cells and Effect of Aspirin on Their Expression / 中国实验血液学杂志

OBJECTIVE@#To explore the expression of Blimp1, ATF4 and CHOP in bone marrow mononuclear cells from patients with multiple myeloma as well as the effect of aspirin on their expression.@*METHODS@#Sixty untreated patients with multiple myeloma and 30 patients with relatively normal bone marrow were selected. Mononuclear cells from the bone marrow fluid were separated using Ficoll separation solution. CD138 plasma cells were sorted by immunomagnetic beads method. RT-PCR was used to detect the expression levels of Blimp1, ATF4 and CHOP mRNA in U266 cells cultured in vitro. The cells were divided into blank control group, negative control group (no-loaded virus transfection) and positive experimental group [LV-Blimp1-RNAi (40051-2) transfection] by lentivirus transfection. RT-PCR was used to detect the expression of Blimp1, ATF4 and CHOP mRNA in cells of different groups. U266 cells were stimulated in vitro with different concentrations of aspirin solution (0, 0.5 mmol/L, 2.5 mmol/L, 5.0 mmol/L) for 24, 48 h and 72 h, respectively. The ability of cell proliferation in different groups was measured by CCK-8. U266 cells were stimulated with different concentrations of aspirin for 48 hours. And the mRNA expression of Blimp1, ATF4 and CHOP was detected by RT-PCR.@*RESULTS@#Compared with plasma cells in normal group, the expression of Blimp1 mRNA in CD138 plasma cells of MM patients significantly increased (8.040±1.878), and the mRNA expression levels of ATF4 and CHOP significantly decreased (0.735±0.089; 0.837±0.062) (P＜0.05). U266 cells were cultured in vitro. Compared with the blank control group and the negative control group, the mRNA expression level of Blimp in the positive experimental group was significantly down-regulated after infection with LV-Blimp1-RNAi (40051-2) lentiviral expression vector (0.637±0.021). ATF4 and CHOP mRNA expression levels were significantly increased (1.452 ± 0.027; 1.721 ± 0.038) (P＜0.05). The proliferation of U266 cells decreased after stimulation with aspirin. In the range of (0.5-5) mmol/L, aspirin could significantly inhibit the proliferation of U266 cells. The inhibition effect of aspirin was increased along with prolongation of time and increase of concentrations. After aspirin stimulation of different concentrations for 48 hours, the expression level of Blimp1 in U266 cells decreased with increasing of drug concentration, while the expression levels of ATF4 and CHOP increased with increasing of drug concentration.@*CONCLUSION@#Inhibition of Blimp1 expression in multiple myeloma cells can promote the expression of ATF4 and CHOP. Aspirin can inhibit the proliferation activity of myeloma cells by down-regulating Blimp1 expression in myeloma cells and up-regulating ATF4 and CHOP expression, therefore plays an anti-tumor rote.

Effect of propofol on right ventricular hypertrophy induced by pulmonary arterial hypertension in rats / 中华麻醉学杂志

Objective:To evaluate the effect of propofol on right ventricular hypertrophy induced by pulmonary arterial hypertension (PAH) in rats.Methods:Twenty-two clean-grade healthy adult male Wistar rats, weighing 250-280 g, were divided into 3 groups using a random number table method: control group (group C, n=8), PAH group (group PH, n=6) and propofol group (group P, n=8). In PH and P groups, monocrotaline 60 mg/kg was injected intraperitoneally to establish the model of PAH, while the equal volume of normal saline was administered in group C. Propofol 100 mg/kg was injected intraperitoneally twice a week for 6 consecutive weeks starting from 2 weeks after establishment of the model in group P. The weight of rats was measured before establishment of model and after administration, and the weight difference (△BW=weight after administration-weight before administration) was calculated.At the end of administration, the right ventricular end-diastolic dimension (RVEDD), right ventricular wall thickness in diastole (RVWTd), intraventricular septum in diastole (IVSd), left ventricular posterior wall in diastole (LVPWd) and maximal velocity of pulmonic valve (PV) were measured using cardiac ultrasound.The animals were then sacrificed, and the lungs and hearts were removed for examination of the pathological changes (after haematoxylin and eosin staining) and for determination of the degree of myocardial fibrosis in right ventricular (by Masson staining), expression of interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) in lung tissues and myocardial tissues of the right ventricle (by immunohistochemistry). Results:Compared with group C, △BW and PV were significantly decreased, RVWTd, IVTd and RVEDD were increased, the thickness of the wall of pulmonary arterioles and myocardial cell penetration area in right ventricular were increased, the expression of IL-6 and TNF-α in lung tissues and myocardial tissues of right ventricle was up-regulated ( P<0.05 or 0.01), inflammatory cell infiltration and structural disorders were found in lung tissues, and intercellular spaces were widened, and the myocardial tissue was extensively fibrotic in group PH.Compared with group PH, △BW and PV were significantly increased, RVWTd, IVTd and RVEDD were decreased, the thickness of the wall of pulmonary arterioles and myocardial cell penetration area (the area of cardiomyocytes in which the nucleus located in the middle) were decreased, the expression of IL-6 and TNF-α in lung tissues and myocardial tissues of right ventricle was down-regulated ( P<0.05 or 0.01), inflammatory cell infiltration, structural disorders, intercellular spaces and degree of fibrosis were improved in group P. Conclusion:Propofol can alleviate right ventricular hypertrophy induced by PAH, and the mechanism is probably related to reduction of inflammatory responses in rats.

Therapeutic effects of noninvasive ventilation on heart failure after acute myocardial infarction in rats / 中华老年医学杂志

Objective:To investigate the therapeutic effects of noninvasive ventilation on heart failure(HF)after acute myocardial infarction(AMI)in rats.Methods:A rat model of HF after AMI was established by ligation of the left ventricular branch.Thirty male Wistar rats were randomly divided into three groups according to the random number table method: sham operation group, non-treatment group and noninvasive ventilation treatment group(n=30, each group). Echocardiography was performed on the third day after surgery, and parameters including left atrial diameter(LAD), left ventricular end diastolic diameter(LVEDD), interventricular septum thickness(IVS)and left ventricular ejection fraction(LVEF)were recorded.Serum levels of brain natriuretic peptide 45(BNP45), tumor necrosis factor α(TNF-α), matrix metalloproteinase-2(MMP-2), matrix metalloproteinase-9(MMP-9), and heat-shock protein 70(HSP70)were measured at day 3 after operation by enzyme-linked immunosorbent assays(ELISA). Morphological changes of myocardial tissue were analyzed with hematoxylin-eosin(HE)staining, and cardiomyocyte apoptosis was detected by terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling(TUNEL).Results:Compared with the non-treatment group, LVEDD decreased[(153.9±8.1)mm/m 2vs.(164.7±10.4)mm/m 2, P<0.05]and LVEF increased[(63.9±7.6) % vs. (54.4±9.4) %, P<0.05]in the noninvasive ventilation group .Compared with the non-treatment group, serum levels of BNP45[(0.65±0.07) % vs. (0.73±0.07) μg/L, P<0.05], TNF-α(361.5±13.1) μg/L vs. (399.1±12.6) μg/L( P<0.05), MMP-2(6 892.8±530.2) μg/L vs. (7 406.0±667.5) μg/L( P<0.05)and MMP-9(143.8±5.9) μg/L vs. (151.1±8.3) μg/L( P<0.05)decreased and levels of HSP70[(1.7±0.1)μg/L vs.(1.4±0.1)μg/L, P<0.05]increased in the noninvasive ventilation group.HE staining showed focal accumulation of neutrophils in the epicardium, loss of muscle striation, disorganized cell polarity and enlarged nuclei in the non-treatment group.Meanwhile, alleviated inflammation, scattered neutrophils between cardiomyocytes and misaligned muscle striation were observed in the noninvasive ventilation group.TUNEL results showed that the myocardial apoptotic index was lower in the noninvasive ventilation group than in the non-treatment group( P<0.05). Conclusions:Noninvasive ventilation can effectively improve heart function, reduce inflammatory response and cardiomyocyte apoptosis in rats with AMI-induced HF and may be an effective treatment for HF after AMI.

Effect of noninvasive ventilation on heart failure after acute myocardial infarction in rats and the underlying mechanisms / 中华老年医学杂志

Objective To study the effect of noninvasive ventilation on heart failure(HF)in rats after acute myocardial infarction(AMI)and the mechanisms involved.Methods A total of 30 Wistar rats were randomly divided into three groups:the noninvasive ventilation group,the non-treatment group and the sham operation group(n=10 in each group).The model for HF after AMI was established by left anterior descending coronary artery ligation.Serum levels of B-type natriuretic peptide-45 (BNP-45),70 000 heat-shock protein(HSP70),matrix metalloproteinases(MMP-2 and-9),tumor necrosis factor-α(TNF-α)and echocardiography parameters,such as left atrium(LA)diameter,left ventricular(LV)end-diastolic diameter,interventricular septal(IVS)thickness,and left ventricular ejection fraction(LVEF),were measured at 3,5,7 and 14 days after operation in each group.Results Compared with the non-treatment group,LVEDD was reduced and LVEF was increased in the noninvasive ventilation group at 14 days after operation(155.92±14.74)mm/m2 vs.(149.35±11.29)mm/m2,(92.13±3.72)％ vs.(76.39±9.24)％,(P＜0.05),while LA diameter and IVS thickness showed no significant difference(P＞0.05).Compared with the non-treatment group,serum levels of BNP45,MMP-2,MMP-9,and TNF-α were decreased and HSP70 levels were increased in the noninvasive ventilation group at 3,5,7,and 14 days after operation (P ＜ 0.05).In the noninvasive ventilation group,serum levels of BNP45,MMP-2,MMP-9 and TNF-α at 5,7,and 14 days after operation were lower than those at 3 days after operation,and serum HSP70 levels at 7 and 14 days after operation were higher than those at 3 days after operation (P ＜ 0.01).Conclusions Noninvasive ventilation can effectively reduce the inflammatory response in rats with HF after AMI and reduce myocardial ischemia-reperfusion injury.It is an effective treatment for HF after AMI.

Quantification of norfloxacin in human plasma by LC-MS/MS and validation of the analytical method / 药学学报

A LC-MS/MS method for quantification of norfloxacin in human plasma had been developed. This method was applied to the pharmacokinetics study of norfloxacin in the human. The plasma sample was precipitated by methanol and ciprofloxacin was used as the internal standard (IS). Chromatographic separation was performed on a Symmetry® C18 column(100 mm×4.6 mm, 5 μm). Mobile phase contains 0.3% formic acid and 5% methanol in deionized water at a flow rate of 0.45 mL·min-1. Norfloxacin and ciprofloxacin (IS) were ionized with an ESI source and operated in positive ion mode. The detected ions were m/z 320.3→302.1 (norfloxacin), m/z 332.3→314.1 (ciprofloxacin). This LC-MS/MS method yielded a linearity over the range of 10-1 000 ng·mL-1 with the lower limit of quantitation (LLOQ) of 10 ng·mL-1. The intra and inter-assay precisions (RSD%) were within the range of 2.64%-7.23% and the accuracy (RE%) was less than ±5.00%. The pharmacokinetic parameters tmax, Cmax, AUC0-t, and t1/2 were 1.28±0.364 h, 627±171 ng·mL-1, 2 938±850 h·ng·mL-1, and 6.01±1.36 h, respectively. This LC-MS /MS method was proven simple, sensitive, rapid and suitable for pharmacokinetics study of norfloxacin in the human and Approved by the Medical Ethics Committee of Liuzhou Workers' Hospital.

The relationship between structure and function of uterine junctional zone and endometriosis disease / 中国医师杂志

Uterine junctional zone (JZ) was first described by Hricak et al in 1983,which is a low signal-intensity zone between myometrium and endometrium on T2-weighted MR images.Subsequent studies confirmed that JZ is located in the innermost layer of the myometrium.It has been confirmed that JZ dysfunction is strongly associated with uterine fibroids、adenomyosis、endometriosis,etc.In recent years,researchers have focused their attention on the ultrastructure of JZ,tring to find out the structural basis that caused the abnormality of JZ.This review focuses on the physiological characteristics and ultrastructure of normal and endometriosis disease uterus JZ.

Analysis of risk factors of ventricular arrhythmia in patients with Brugada syndrome / 中华心血管病杂志

Objective@#To investigate the risk factors of ventricular arrhythmias in patients with Brugada syndrome.@*Methods@#Clinical data of 60 Brugada syndrome patients admitted in the department of cardiology of the First Affiliated Hospital of Nanjing Medical University from March 2003 to December 2016 were collected and retrospectively analyzed. The age at diagnosis was (43.2±13.1) years (0.6-83.0 years), 98.3% were males (n=59), and the patients were followed up to (92±41) months (12-169 months). The 12-lead surface electrocardiogram (ECG) recorded at the time of diagnosis and showing the highest type 1 ST elevation, either spontaneously or after provocative drug test, was used for the analysis. Patients were divided into ventricular arrhythmia (VA, n=12) group and non-ventricular arrhythmia (non-VA, n=48) group depending on the presence or absence of clinical VA event. The demographic data and ECG data of the 2 groups were compared, and the independent risk factors of VA events were analyzed by stepwise logistic regression.@*Results@#Incidence of family history of sudden death (7/12 vs. 22.9% (11/48)) and percentage of type 1 ST elevation in the peripheral ECG leads (6/12 vs. 16.67% (8/48)) were significantly higher in VA group than in non-VA group (both P<0.05). Max Tpeak-Tend (Max-Tpe) interval ((144±53)ms vs. (110±16)ms) and dispersion of Tpe ((74±50)ms vs. (43±17)ms) were significantly higher in VA group than in non-VA group (both P<0.05). The area under receiver operating characteristic (ROC) curves for the Max-Tpe interval was 0.693 and Max-Tpe interval ≥140 ms was determined as an optimized cutoff point with increased risk of VA event, which had a sensitivity of 50.0%, a specificity of 98.0%, a positive predictive value of 85.7%, and a negative predictive value of 88.7% for predicting VA event. The ROC curves for the dispersion of Tpe was 0.775 and dispersion of Tpe ≥45 ms was determined as an optimized cutoff point for predicting VA event, which had a sensitivity of 91.7%, a specificity of 64.6%, a positive predictive value of 39.3%, and a negative predictive value of 96.9% for predicting VA event. In multivariate analysis, Max-Tpe interval ≥140 ms (OR=27.53, 95%CI 1.07-706.77, P=0.045) and family history of sudden death (OR=24.63, 95%CI 2.05-295.38, P=0.011) were found to be the independent risk factors of arrhythmic events.@*Conclusions@#Max-Tpe interval ≥140 ms and family history of sudden death are risk factors of VA event in included patients with Brugada syndrome.

Intervention effect of music therapy under digestive endoscopic process:a meta analysis / 重庆医学

Objective To systematically evaluate the psychological intervention effect of music therapy on the patients during the digestive endoscopic process.Methods The databases of EMbase,PubMed,Cochrane Library,CNKI,VIP,Wanfang and CSCD were retrieved by computer,the retrieval time was from their establishment to March 2016.The randomized controlled trials (RCTs) on the music therapy application in the digestive endoscopic process were included.The data were independently extracted by 2 researchers for conducting the literature quality assessment.After extracting and checking the data,the meta analysis was performed by using the RevMan 5.3 software.Results Twenty-six RCTs conforming to the standard were included,involving 4593 patients.The meta analysis results showed that the music therapy could alleviate the anxiety status(SMD=-0.82,95％ CI:-1.14--0.49,P＜0.01),relieve the pain perception(WMD=-1.27,95％CI:-1.87--0.66,P＜0.01),remit the vital signs fluctuations of blood pressure,heart rate and respiratory rate(P＜0.01),meanwhile shorten the duration of examination procedure (WMD=-4.64,95％CI:-6.75--2.52,P＜0.01).Conclusion The current evidences indicate that the music application during the digestive endoscopic process can obviously decrease the anxiety status and pain perception.

Effect of beraprost sodium on HPH rats and expression of oxygen-sensitive Kv channels in pulmonary artery smooth muscle / 西安交通大学学报(医学版)

Objective To explore the effect of beraprost sodium (BPS) on hypoxia-induced pulmonary artery hypertension (HPH) in rats and the expression of oxygen-sensitive Kv channels in pulmonary artery smooth muscle (PASM).Methods The HPH model of rats was established by exposing rats to low-pressure and low-oxygen cabin which was auto-modulated for 8h every day.Rats in the BPS group were given an intragastric administration of BPS [300 μg/(kg · d)],while those in the control group and HPH group were given an intragastric administration of 3 ml/kg of 0.9％ saline.After 4 weeks,the mean pulmonary artery pressure (mPAP) was measured and right heart ventricle hypertrophy index (RVHI) was calculated;pulmonary artery remodeling was evaluated by HE staining;the expressions of Kv 1.2,Kv 1.5 and Kv2.1 in the pulmonary artery were detected by Real-time PCR and Western blot.Results The HPH model was successfully established in rats exposed to chronic hypoxia for 4 weeks.Compared with those in HPH group,mPAP,RVHI and pulmonary artery remodeling were decreased in BPS group [mPAP:(13.48±2.18)mmHg vs.(23.87±2.23)mmHg vs.(17.09±1.20)mmHg;RVHI:0.28±0.02 vs.0.46±0.03 vs.0.36±0.04;％ area of medial smooth muscle:35.72±6.58 vs.68.52±5.64 vs.46.58±8.43;P＜0.05],and the mRNA and protein expressions of Kv 1.2,Kv 1.5 and Kv 2.1 were increased (relative protein expression level:Kv1.2,0.78±0.10 vs.0.15±0.03 vs.0.57±0.13;Kv1.5,0.61±0.10 vs.0.31±0.05 vs.0.59±0.13;Kv2.1,0.29±0.05 vs.0.10±0.02 vs.0.28±0.07;P＜0.05).Conclusion BPS can improve pulmonary arterial hypertension induced by hypoxia,and upregulate the decreased mRNA and protein expressions of Kv 1.2,Kv 1.5 and Kv 2.1 in pulmonary artery.