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Objective:To investigate the clinical efficacy of different administration methods for labor analgesia.Methods:This randomized controlled study was conducted on 152 parturient women who underwent vaginal delivery at the Xinxiang Central Hospital from February to June 2023. These women were divided into a control group and an observation group, with 76 women per group. Women in the control group received 3 mL of 0.1% ropivacaine hydrochloride after routine epidural catheterization, followed by 3 mL of analgesic drugs after 3 minutes. For those without any special reactions, an analgesic pump containing 9 mL of medication was used after 3 minutes until the end of labor. In the observation group, 3 mL of 0.1% ropivacaine hydrochloride was administered as a trial dose before the epidural catheter was inserted into the epidural space. After 3 minutes, the postpartum woman lay flat and was given another 3 mL of analgesic pump medication. After 3 additional minutes, an additional 9 mL of the medication was administered. The analgesic pump was connected and turned on until the catheter was removed after delivery. The epidural catheter failure rate was assessed in each group. Before epidural puncture (T 1), within 30 minutes after the onset of anesthesia (T 2), and at the time of full dilation of the cervix (T 3), Visual Analogue Scale scores, the number of patient attempts to additionally use an analgesia pump, maternal satisfaction, the number of cases requiring cesarean section conversion, the incidence of adverse reactions (such as nausea, vomiting, and fever), and Apgar scores for newborns were recorded in each group. Results:The epidural catheter failure rate in the observation group was 1.3% (1/76), which was significantly lower than 10.5% (8/76) in the control group ( χ2 = 5.79, P < 0.05). At T 2 and T 3, the Visual Analogue Scale score in the observation group was (0.89 ± 0.08) points and (2.1 ± 0.07) points, respectively, which were significantly lower than (2.55 ± 0.07) points and (3.35 ± 0.07) points in the control group ( t = 238.54, 133.17, both P < 0.001). The number of patient attempts to additionally use an analgesia pump in the observation group was (1.00 ± 0.84) counts, which was significantly less than (4.00 ± 0.65) counts in the control group ( t = 29.47, P < 0.001). Maternal satisfaction in the observation group was 100% (76/76), which was significantly higher than 92.1% (70/76) in the control group ( χ2 = 6.25, P < 0.05). The number of cases requiring cesarean section conversion in the observation group was 0 (0/76), which was significantly lower than 52.6% (4/76) in the control group ( χ2 = 4.10, P < 0.05). Conclusion:Administering a trial dose (3 mL) of 0.1% ropivacaine hydrochloride before placing the epidural catheter during labor analgesia can greatly increase the placement success rate of the catheter and enhance pain relief effectiveness. This has a certain clinical application value.

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OBJECTIVE@#To investigate the predictive value of pancreatitis activity scoring system (PASS) combined with Neutrophil to lymphocyte ratio (NLR) and C-reactive protein (CRP) for infected pancreatic necrosis (IPN) in patients with severe acute pancreatitis (SAP).@*METHODS@#Clinical data of SAP patients admitted to the First Affiliated Hospital of Zhengzhou University from January 2020 to January 2023 were retrospectively collected, including basic information, vital signs at admission, first laboratory indexes within 48 hours of admission. The PASS scores at admission and 24, 48 and 72 hours after admission were calculated. According to the diagnostic criteria of IPN, the patients were divided into the non-IPN group and the IPN group, and the independent risk factors of SAP complicating IPN were determined by using univariate analysis and multifactorial Logistic regression. The receiver operator characteristic curve (ROC curve) was drawn to evaluate the predictive value of NLR, CRP, and PASS score, alone and in combination for IPN in patients with SAP.@*RESULTS@#A total of 149 SAP patients were enrolled, including 102 in the non-IPN group and 47 in the IPN group. The differences in PASS score at each time point, NLR, CRP, procalcitonin (PCT), blood urea nitrogen, blood chloride, and days of hospitalization between the two groups were statistically significant. Multifactorial Logistic regression analysis showed that 72 hours admission PASS score [odds ratio (OR) = 1.034, 95% confidence interval (95%CI) was 1.005-1.065, P = 0.022], NLR (OR = 1.284, 95%CI was 1.139-1.447, P = 0.000), and CRP (OR = 1.015, 95%CI was 1.006-1.023, P = 0.001) were independent risk factors for IPN in patients with SAP. ROC curve analysis showed that the area under the ROC curve (AUC) of the PASS score at 72 hours of admission, NLR, and CRP alone in predicting IPN in SAP patients were 0.828, 0.771, and 0.701, respectively. The AUC of NLR combined with CRP, PASS combined with NLR, and PASS combined with CRP were 0.818, 0.895, and 0.874, respectively. The combination of PASS score at 72 hours after admission, NLR, and CRP had a better predictive ability for IPN in patients with SAP (AUC = 0.922, 95%CI was 0.877-0.967), and the sensitivity was 72.3% when the cut-off value was 0.539.@*CONCLUSIONS@#The predictive value of the PASS score at 72 hours after admission, NLR and CRP in combination for IPN in SAP patients is better than that of the combination of each two and individual detection and has better test efficacy.

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Objective:To investigate the effects of vagus nerve stimulation on postoperative cognitive dysfunction and the role of hippocampal insulin growth factor 1 signaling pathway in aged mice.Methods:Seventy-five clean-grade C57 mice of both sexes, aged 21-23 months, weighing 28-34 g, were divided into 5 groups ( n=15 each) using a random number table method: sham operation group (group S), operation group (group O), operation + vagus nerve stimulation group (group O+ V), operation + IGF-1 siRNA group (group O+ I) and operation + vagus nerve stimulation + IGF-1 siRNA group (group O+ V+ I). Group O underwent exploratory laparotomy.Group O+ V received a 30-min electrical stimulation of the vagus nerve (intensity 0.5 mA, frequency 20 Hz, time 30 s, 6 times, interval 5 min) after the end of exploratory laparotomy.Group O+ I underwent exploratory laparotomy and inhaled IGF-1 siRNA solution 10 μl intranasally at 24 h before surgery and 24 and 48 h after surgery.Group O+ V+ I underwent electrical vagus nerve stimulation after exploratory laparotomy and inhaled IGF-1 siRNA solution 10 μl intranasally at 24 h before surgery and 24 and 48 h after surgery.Morris water maze tests were performed on 14-18 days after operation.On day 7 after operation, the mice were sacrificed and the hippocampus was obtained for determination of the expression of Bax, ionized calcium-binding adapter molecule 1 (Iba-1), insulin-like growth factor 1 (IGF-1), insulin-like growth factor 1 receptor (IGF1R), phosphorylated IGF1R (p-IGF1R), interleukin-1beta (IL-1β) and activated caspase-3 by Western blot. Results:Compared with group S, the escape latency was significantly prolonged on days 16-18 after operation, the frequency of crossing the platform was reduced, the time spent in the target quadrant was shortened, the expression of IGF-1 and p-IGF1R was down-regulated, and the expression of Iba-1, IL-1β, activated caspase-3 and Bax was up-regulated in group O ( P<0.05). Compared with group O, the escape latency was significantly shortened on days 16-18 after operation, the frequency of crossing the platform was increased, the time spent in the target quadrant was prolonged, the expression of IGF-1 and p-IGF1R was up-regulated, and the expression of Iba-1, IL-1β, activated caspase-3 and Bax was down-regulated in group O+ V ( P<0.05), and no significant change was found in the parameters mentioned above in group O+ I ( P>0.05). Compared with group O+ V, the escape latency was significantly prolonged on days 16-18 after operation, the frequency of crossing the platform was reduced, the time spent in the target quadrant was shortened, the expression of IGF-1 and p-IGF1R was down-regulated, and the expression of Iba-1, IL-1β, activated caspase-3 and Bax was up-regulated in group O+ V+ I ( P<0.05). There was no significant difference in the expression of IGF1R among the four groups ( P>0.05). Conclusions:Vagus nerve stimulation can reduce postoperative cognitive dysfunction, and the mechanism is related to activation of IGF-1 signaling pathway and reduction of hippocampal neuroinflammation and neuronal apoptosis in aged mice.

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Lung cancer is one of the most malignant tumors in the world. In China, the mortality rate of lung cancer has been in the first place for many years. Early screening and early diagnosis of lung cancer is the premise of prolonging the survival time of patients with lung cancer. In recent years, liquid biopsy technology, which is considered to have a bright future, has attracted more and more attention, and its value in the early diagnosis of lung cancer is worth discussing. This paper reviews the application of biomarkers in early screening and early diagnosis of lung cancer, looks for specific biomarkers from multi-omics, and discusses their significance in early diagnosis of lung cancer.

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Objective:To investigate the expression of Piezo1 in small intestinal mucosal epithelial cells of patients with Crohn′s disease (CD) and its clinical correlation with CD.Methods:From January 1st 2010 to November 30th 2020, the clinical data including age, gender, disease location and biological behavior, etc of 57 patients with CD (CD group) who underwent surgery at The First Affiliated Hospital of Anhui Medical University were retrospectively. And at same time the normal samll intestinal epithelial tissues of 10 healthy individuals who underwent colonoscopy were collected as the healthy control group. The expression of Piezo1 in small intestinal epithelial cells of CD patients with different disease sites, biological behavior and disease activity were detected by immunofluorescence staining and hematoxylin-eosin staining. The histological score system and intestinal fibrosis score were used to analyze the inflammation and fibrosis of the intestinal tissues of patients with CD. Semi-quantitative analysis of Piezo1 in small intestinal epithelial cells was analyzed by ImageJ software. And the correlation between Piezo1 expression and clinical characteristics and pathological features of small intestine was also analyzed. Independent sample t test and analysis of variance were used for statistical analysis. Results:In CD group, there were 37 males (64.9%) and 20 females (35.1%). The age was (39.1±14.2) years old, ranged from 18 to 71 years old, and the average duration of the disease was (26.5±24.1) months. There were 29 cases (50.9%)of ileal type, 26 cases (45.6%) of ileocolonin type and 2 cases (3.5%) of colonic type. There were 12 cases (21.1%) of non-penetrating non-stenotic type, 31 cases (54.4%) of stenotic type and 14 cases (24.6%) of penetrating type. There were 47 cases (82.5%) with moderate activity and 10 cases (17.5%) with severe activity. There were 17 cases (29.8%) of moderate intestinal inflammation, 40 cases (70.2%) of severe intestinal inflammation. The score of intestinal fibrosis in six cases (10.5%) was 1, 28 cases (49.1%) was 2, 18 cases (31.6%) was 3, five cases was 4. The relative expression level of Piezo1 in intestinal mucosal epithelial cells of CD group was higher than that of healthy control group (12.9±4.6 vs. 8.5±1.1), the relative expression of Piezo1 in intestinal mucosal epithelia cells of stenotic type and penetrating type CD patients were both higher than that of non-penetrating and non-stenotic CD patients (12.6±3.8 and 9.8±2.4 vs. 6.0±1.3), and the differences were all statistically significant ( t=3.00, -3.66 and -3.32, all P<0.01). The relative expression of Piezo1 in small intestinal epithelial cells of CD patients with severe intestinal inflammation was higher than that of CD patients with moderate intestinal inflammation (13.1±4.0 vs. 9.7±3.1), and the difference was statistically significant ( t=-2.65, P<0.05). The relative expression levels of Piezo1 in small intestinal epithelial cells of patients with intestinal fibrosis score of 4, 3, 2 and 1 were 17.6±5.2, 12.6±1.7, 9.1±2.1 and 5.8±1.1, respectively; the relative expression levels of Piezo1 in intestinal epithelial cells of patients scored 4 were higher than that of patients scored 3, 2 and 1, and that of patients scored 3 was higher than patients scored 2 and 1, and that of patients scored 2 was higher than that of patients scored 1, and the differences were all statistically significant ( t=-2.98, -5.10, -3.84, 4.60, 6.55 and 2.56, all P<0.05). The relative expression of Piezo1 in intestinal mucosal epithelial cells was related to the severity of intestinal inflammation and fibrosis. The more severe the intestinal inflammation and fibrosis, the higher the relative expression of Piezo1 in intestinal mucosal epithelial cells. Conclusions:The relative expression of Piezo1 in small intestinal epithelial cells is related to the biological behavior and the severity of intestinal inflammation and fibrosis of CD. It is speculated that the expression of Piezo1 in small intestinal epithelial cells may be clinically related to the process of intestinal wall fibrosis in CD to some extent, however whether it plays an important role in the process of intestinal wall fibrosis in CD and its specific mechanism need to be further studied.

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Objective To investigate the endoscopic ultrasound (EUS) features of distal biliary stricture (DBS), and to provide a clinical basis for the evaluation of DBS by EUS. Methods Related clinical data were collected from 175 patients with DBS who underwent EUS examination in The First Affiliated Hospital of Anhui Medical University from April 2016 to March 2020 to analyze their clinical manifestation, laboratory examination results, imaging findings, and EUS findings, and the patients were followed up to summarize the EUS features of DBS. The chi-square test was used for comparison of categorical data between groups, and the t -test was used for comparison of continuous data between groups. Results Among the 175 patients with DBS, 85(48.57%) had benign DBS and 90(51.43%) had malignant DBS. Compared with the patients with benign DBS, the patients with malignant DBS had a significantly longer length of stricture on EUS (14.1±3.0 mm vs 7.9±3.0 mm, t =13.358, P < 0.001) and significantly higher incidence rates of the characteristic changes on EUS such as hypoechoic space-occupying lesions in lumen (57.8% vs 34.1%, χ 2 =9.843, P =0.002), peripheral lymph node enlargement (26.7% vs 12.9%, χ 2 =5.147, P =0.023), and pancreatic duct dilatation (51.1% vs 28.2%, χ 2 =9.532, P =0.002). EUS combined with magnetic resonance cholangiopancreatography had a sensitivity of 70.6% in the diagnosis of benign DBS and a sensitivity of 92.2% in the diagnosis of malignant DBS. Conclusion The characteristic EUS features of DBS, such as long length of stricture, hypoechoic lesion, peripheral lymph node enlargement, and pancreatic duct dilatation, may help with the differential diagnosis of DBS in clinical practice.

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Objective:To evaluate the effects of intranasal administration of glial cell line-derived neurotrophic factor (GDNF) on postoperative cognitive dysfunction in aged rats.Methods:Forty healthy Sprague-Dawley rats of both sexes, aged 21-23 months, weighing 480-600 g, were divided into 4 groups ( n=10 each) using a random number table method: sham operation group (group S), operation group (group O), intranasal administration of low-dose GDNF group (group G1) and intranasal administration of high-dose GDNF group (group G2). Rats underwent exploratory laparotomy under anesthesia with chloral hydrate in O, G1 and G2 groups, while the rats in group S only received sham operation.The rats in group G1 and group G2 were intranasally treated with GDNF 25 and 50 μg (in 25 μl of PBS), respectively, and PBS 25 μl was nasally administered in group S and group O every day for 3 consecutive days after operation or sham operation.Morris water maze test was performed on days 3-7 after surgery, and then the rats were sacrificed, and hippocampal tissues were removed for determination of the expression of GDNF, high mobility group box 1 (HMGB1), interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), activated caspase-3 and Bax (by Western blot). Results:Compared with group S, the escape latency was significantly prolonged on days 5-7 after operation, the number of crossing the platform was reduced, time spent in the target quadrant was shortened, expression of GDNF was down-regulated, and expression of IL-1β, TNF-α, HMGB1, activated caspase-3 and Bax in hippocampi was up-regulated in group O, and the number of crossing the platform was reduced, time spent in the target quadrant was shortened, and expression of IL-1β and TNF-α was up-regulated in G1 and G2 groups ( P<0.05). Compared with group O, the escape latency was significantly shortened on days 5-7 after operation, the number of crossing the platform was increased, time spent in the target quadrant was prolonged, expression of GDNF was up-regulated, expression of TNF-α, HMGB1, activated caspase-3 and Bax in hippocampi was down-regulated in G1 and G2 groups, and IL-1β in hippocampi was down-regulated in group G1 ( P<0.05). Compared with group G1, the expression of TNF-α in hippocampi was down-regulated ( P<0.05), and no significant change was found in the other parameters mentioned above in group G2 ( P>0.05). Conclusions:Intranasal administration of GDNF can improve postoperative cognitive dysfunction, and the mechanism may be related to inhibiting neuroinflammatory responses and neuroapoptosis in aged rats.

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The lateral hypothalamic area (LHA) plays a pivotal role in regulating consciousness transition, in which orexinergic neurons, GABAergic neurons, and melanin-concentrating hormone neurons are involved. Glutamatergic neurons have a large population in the LHA, but their anesthesia-related effect has not been explored. Here, we found that genetic ablation of LHA glutamatergic neurons shortened the induction time and prolonged the recovery time of isoflurane anesthesia in mice. In contrast, chemogenetic activation of LHA glutamatergic neurons increased the time to anesthesia and decreased the time to recovery. Optogenetic activation of LHA glutamatergic neurons during the maintenance of anesthesia reduced the burst suppression pattern of the electroencephalogram (EEG) and shifted EEG features to an arousal pattern. Photostimulation of LHA glutamatergic projections to the lateral habenula (LHb) also facilitated the emergence from anesthesia and the transition of anesthesia depth to a lighter level. Collectively, LHA glutamatergic neurons and their projections to the LHb regulate anesthetic potency and EEG features.

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Although COVID-19 causes cardiac dysfunction in up to 25% of patients, its pathogenesis remains unclear. Exposure of human iPSC-derived heart cells to SARS-CoV-2 revealed productive infection and robust transcriptomic and morphological signatures of damage, particularly in cardiomyocytes. Transcriptomic disruption of structural proteins corroborated adverse morphologic features, which included a distinct pattern of myofibrillar fragmentation and numerous iPSC-cardiomyocytes lacking nuclear DNA. Human autopsy specimens from COVID-19 patients displayed similar sarcomeric disruption, as well as cardiomyocytes without DNA staining. These striking cytopathic features provide new insights into SARS-CoV-2 induced cardiac damage, offer a platform for discovery of potential therapeutics, and raise serious concerns about the long-term consequences of COVID-19.

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Objective:To investigate the relationship between the expression level of platelet microparticle (PMP) and the disease activity of inflammatory bowel disease (IBD) in IBD patients, and to explore the ability of PMP from different sources to induce the formation of neutrophil extracellular trap (NET) in vitro. Methods:From May 2018 to July 2019, 118 patients with IBD admitted to the Department of Gastroenterology at The First Affiliated Hospital of Anhui Medical University were selected, among whom 54 cases were ulcerative colitis (UC) patients (UC group) and mild, moderate and severe cases were 17, 25 and 12, respectively; and 64 cases were Crohn′s disease (CD) (CD group), 6 were in remission stage, and mild, moderate, severe cases were 27, 22 and 9, respectively. During the same period, 35 healthy individuals with normal checkups were selected as the healthy control group. Specimens were collected and the expression levels of PMP were measured by flow cytometry.And the correlation between the expression level of PMP and the disease activity index (DAI) score was analyzed.NET formation experiment groups were set up, including neutrophils of healthy control group (6 cases), neutrophils of IBD group (6 cases), neutrophils of healthy controls + PMP of IBD group (12 cases) and neutrophils of healthy controls+ PMP group (6 cases). After immunofluorescence staining, the proportion of NET formation of each group was observed under laser scanning confocal microscopy (LSCM). Mann-Whitney U test, Spearman correlation analysis and Independent-sample t test were used for statistical analysis. Results:The expression levels of PMP in peripheral blood of the UC group and the CD group were 2 184.5(2 817.0)/μL and 2 209.0(2 409.0)/μL, respectively, which were all higher than that of the healthy control group (776.0(407.0)/μL), and the differences were statistically significant ( U=-6.018 and -6.426, both P<0.01). The expression level of PMP of patients with severe UC was 3 873.0(4 611.3)/μL, which was higher than those of patients with mild or moderate UC (1 248.0(1 888.0)/μL and 1 432.0(1 783.0)/μL, respectively), and the differences were statistically significant ( U=-2.745 and -2.547, both P<0.05). The expression level of PMP of patients with severe CD was 5 658.0(5 067.5)/μL, which was higher than those of patients with mild or moderate CD or in remission (1 327.5(1 934.0)/μL, 1 405.0(2 965.0)/μL and 2 300.0(1 552.0)/μL, respectively), and the differences were statistically significant ( U=-1.650, -1.955 and -1.306, all P<0.05). There was no statistically significant difference in the expression level of PMP between the UC group and the CD group, between the mild and moderate UC patients, and between the CD in remission and the mild, moderate patients (all P>0.05). The results of correlation analysis showed that the expression levels of PMP in peripheral blood of patients with UC or CD were positively correlated with DAI score and CRP ( r=0.406, 0.358, 0.325, and 0.256; all P<0.05). The proportion of NET formation in the neutrophils of healthy control+ PMP of IBD group was (14.67±5.35) %, which was higher than those of the neutrophils of healthy control groap, neutrophils of IBD group and neutrophils of healthy control+ PMP group ((2.00±0.63)%, (1.67±0.82)% and (5.83±2.86)%), and the differences were statistically significant ( t=5.694, 8.230 and 3.748, all P<0.05). There was no statistically significant difference in the proportion of NET formation between the neutrophils of healthy control group and the neutrophils of IBD group ( P>0.05). Conclusions:The expression level of PMP in peripheral blood of IBD patients increases and is correlated with the disease activity degree in IBD patients. PMP has the ability to induce the NET formation in neutrophils. Moreover, PMP of IBD patients is more likely to induce NET formation than those of healthy individuals, which may be involved in the intestinal inflammatory process by activating neutrophils to produce NET.

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OBJECTIVES@#Hypertension is a serious complication of pregnancy-related acute kidney injury (PR-AKI). This study aimed to determine the effect of hypertension on the prognosis of PR-AKI, maternal outcomes, and fetal outcome.@*METHODS@#Patients with PR-AKI in a hospital from January 2008 to June 2018 were enrolled for this study. Patients with or without hypertension were grouped by 1꞉1 propensity matching score. The effect of hypertension on the prognosis of PR-AKI was evaluated by multivariate Cox regression before and after matching.@*RESULTS@#Of the 30 680 women who attended the Department of Obstetrics, 126 patients were diagnosed as PR-AKI, the incidence was 0.41%. The age was (29.04±2.32) years. There were 50 cases in the hypertension group, accounting for 39.68%. Using the propensity score method, 48 pairs of patients were successfully matched, and the covariates between the two groups were balanced. After matching and adjusting for relevant clinical factors, Cox regression analysis showed that risk of end-stage renal disease (ESRD) was increased in the hypertension group compared with the normal blood pressure group (HR=2.951, 95％ CI 1.067 to 8.275, =0.034). The risk of risk of adverse maternal outcome was increased (HR=2.815, 95% CI 1.271 to 6.233, =0.009), and the risk of fetal adverse outcome was increased (HR=1.437, 95% CI 1.028 to 4.623, =0.021).@*CONCLUSIONS@#Hypertension is an independent risk factor for ESRD, adverse maternal outcomes, and adverse fetal outcomes in the PR-AKI patients.

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Objective To investigate the effect of tripterine combined with fluorouracil on the proliferation,invasion and apoptosis of human hepatocellular carcinoma Hep3B cells,and to identify whether the combining application of the two drugs has synergistic inhibitory effect.Methods The Hep3B cells were divided into blank control group,tripterine (2.5 mol/L) treated group,fluorouracil (25 g/ml) treated group and combined treated group (2.5 mol/L of tripterine and 25 g/ml of fluorouracil) by random number table method.Proliferation,invasion and apoptosis of different drugs treated Hep3B cells were assessed by MTS,Transwell assay,and flow cytometry,respectively.The migration differences of the four groups were detected by the scratch assay.Finally,the levels of the proliferation-related proteins p-AKT,p-ERK and the apoptosis-related proteins cleaved caspase-3 and Bax were detected by Western blotting at 24 and 48 h.Results Compared with the blank control group,the cell proliferation rate (24 h:0.305％ ± 0.016％ vs.0.768％ ± 0.063％;48 h:0.201％ ± 0.008％ vs.1.111％ ± 0.037％),and the cell migration rate (24 h:0.20％ ± 0.03％ vs.0.40％ ± 0.04％,48 h:0.25％ ± 0.02％ vs.0.59％ ± 0.07％) of combined treated group decreased (P＜0.01),while the cell apoptosis rate (24 h:24.33％ ± 3.85％ vs.3.80％ ± 0.40％,48 h:45.10％ ± 4.10％ vs.8.47％ ± 1.65％) significantly increased (P＜0.01).Compared with the blank control group,the cleaved caspase-3 (24 h:1.39 ± 0.11 vs.1.01 ± 0.04,48 h:1.38 ± 0.12 vs.0.99 + 0.03) and Bax (24 h:1.35 ± 0.13 vs.1.00 ± 0.08,48 h:1.39 ± 0.09 vs.0.99 ± 0.05) protein expression of combined treated group significantly increased (P＜0.05).After 24 h of the intervention,the number of cell invasionin (15 ± 6 vs.231 ± 38) the combined group was significantly lower than that in the blank control group (P＜0.05).The protein expression of p-AKT/AKT (0.79 ± 0.04 vs.0.99 ± 0.05) and p-ERK/ERK (0.52 ± 0.04 vs.0.75 ± 0.07) in the combined group was significantly lower than that in the fluorouracil group 48 h after the intervention (P＜0.05).Conclusions The combination application of 5-FU and Tripterine on Hep3B cells significantly inhibited the cells proliferation,migration and invasion ability and promoted the apoptosis of Hep3B cells by down-regulating the expression of p-AKT and p-ERK and up-regulating the expression of cleaved caspase-3 and Bax.

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Objective To investigate the delay of door to signature time in primary percutaneous coronary intervention (PCI) and its influence in patients with ST segment elevation myocardial infarction (STEMI),therefore to provide a scientific basis for further effective shortening the time of primary PCI in patients with STEMI.Methods A total of 226 patients who diagnosed with STEMI and underwent primary PCI at Henan Provincial People's Hospital from June 2016 to December 2017 were enrolled in the study.Observation indicators include:(1) baseline data of patients;(2) time segments in primary PCI:total ischemic time (TIT),door to balloon time (DTBT),door-to-signature time (DTST),signature to balloon time (STBT);(3) the demographic characteristics of the family members who signed informed consent;and (4) the psychological factors and coping strategies of family members before signing informed consent.All data was analyzed using SPSS software (version 22.0).Multiple linear regression analysis was used to analyze the influencing factors of delay of DTST.A P＜0.05 was considered statistically significant.Results In this study,226 patients with STEMI who were first diagnosed in our hospital had a mean age of 55.23±10.80 years,and 181 (80.1％) were male.The median of TIT,DTBT,DTST,STBT were 312 min,166 min,82 min,and 80 min.The ratio of DTST in DTBT and TIT was 50％ and 28.5％,respectively.The multiple linear regression analysis showed that the number of direct family members (P＜0.001),the degree of educational in middle school and below (P=0.010),high school/technical secondary school (P=0.029),families worrying about the high cost of medical care (P=0.020),families consulted each other repeatedly (P=0.022),and consulted the other medical staff(P=0.022) are risk factors of DTST delay,and city residence (P=0.048) is the protection factor of DTST delay.Conclusions The long time of DTS is a reality of the practice of primary PCI in China.The factors that lead to longer DTST include demographic characteristics,psychological factors and coping strategies of family members.The STBT of primary PCI in China should be taken into the value while emphasizing the DTBT.

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Objective@#To investigate the prevalence characters of peripheral artery disease (PAD) and associated factors among people aged 35 and above in Beijing.@*Methods@#This was a cross-sectional study. A total of 5 208 community-based individuals aged equal and above 35 in Beijing were chosen with stratified multistage random sampling method. Structure questionnaire was used to collected the information of demographic factors, habits and chronic disease history. Ankle brachial blood pressure was detected and ankle brachial index (ABI) was calculated. ABI was used to diagnose PAD (ABI≤0.90). Based on the 2010 Beijing Municipal Population Census, the age-and gender-specific weight-adjusted sample was acquired to estimate the prevalence of PAD and corresponding 95% confidence intervals (CI). Multivariate logistic regression analysis was performed to estimate the associated factors of PAD.@*Results@#The age-and sex-standardized prevalence of PAD was 3.84% (200/5 208, 95%CI 3.32%-4.36%). There was no significant difference between male and female (3.83%(102/2 664, 95%CI 3.10%-4.56%) vs. 3.85% (98/2 544, 95%CI 3.10%-4.60%), P=0.965). The prevalence of PAD in urban was higher than that in rural (4.34% (163/3 755, 95%CI 3.69%-4.99%) vs. 2.55% (37/1 453, 95%CI 1.74%-3.36%), P=0.001). Furthermore, the prevalence of PAD increased with age (Ptrend<0.01), and the difference between genders did not change with ageing (all P>0.05). In addition, age (OR=1.03, 95%CI 1.01-1.04), urban (OR=1.52, 95%CI 1.08-2.12), smoking (OR=1.83, 95%CI 1.29-2.59), hypertension (OR=1.61, 95%CI 1.17-2.22) and diabetes (OR=1.44, 95%CI 1.08-1.93) were related with increased risk of PAD in logistic regression analysis models.@*Conclusions@#The prevalence of PAD increases with age in Beijing and there are significant difference between urban and rural on prevalence of PAD. Age, urban, smoking, hypertension and diabetes are related with increased risk of PAD.

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To observe the changes in serum interleukin-22 (IL-22) level and its correlation with other clinical indexes in patients with essential hypertension and hypertensive renal damage, and to investigate its effects and clinical significance.
 Methods: A total of 97 essential hypertension (EH) patients and 40 healthy control were enrolled in this study. The EH patients were divided into a simple hypertension (SH) group (n=45) and a hypertensive renal damage (HRD) group (n=52) according to 24 h urinary protein (24 h-UPRO) level. Basic clinical data were collected; serum IL-22 level was detected by enzyme-linked immunosorbent assay (ELISA); the proportion of Th22 cells in peripheral blood was evaluated by flow cytometry (FCM); and serum high sensitivity C-reactive protein (hs-CRP) concentration was measured by immune turbidimetry. Correlation analysis was applied between serum IL-22 level and other indexes.
 Results: Serum IL-22 level and Th22 cell proportion in patients with hypertension were significantly higher than those in the healthy controls (all P<0.01). Compared with the SH group, serum IL-22 level and Th22 cell proportion were significantly elevated in the HRD group (P<0.01, P<0.05, respectively). Bivariate linear correlation analysis revealed that serum IL-22 level was positively correlated with systolic blood pressure (SBP), diastolic blood pressure (DBP), and hsCRP (r=0.367, P<0.01; r=0.402, P<0.01; r=0.329, P<0.05); there was also a positive correlation between serum IL-22 concentration and Th22 cell proportion (r=0.478, P<0.01) in the SH group. Serum IL-22 level was positively correlated with 24 h-UPRO level (r=0.318, P<0.05) in the HRD group.
 Conclusion: Serum IL-22 level and peripheral blood Th22 cells are significantly increased in the HRD group compared with the SH group. Serum IL-22 level is closely correlated with extent of hypertensive renal damage, indicating that serum IL-22 level may involve in the pathogenesis of hypertensive renal damage.

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Objective: To investigate the rates on prevalence, awareness, treatment and control of hypertension in population older than 15 years of age in Beijing, 2013-2014. Methods: A cross-sectional survey was conducted in Beijing between 2013-2014. Stratified multistage random sampling method was used to select representative sample of 13 057 Chinese individuals aged over 15 years, from the general population. Blood pressure was measured for three readings at sitting position after resting for at least five minutes with an average reading recorded. A standardized structured questionnaire was developed to collect history of hypertension and antihypertensive treatment. Results: A total of 4 663 community residents aged over 15 years were hypertensive among the 13 057 individuals, with the standardized prevalence rate as 32.7%, in Beijing area. The age-standardized prevalence rates of hypertension appeared 34.6% in men and 30.8% in women. The age-and sexstandardized prevalence of hypertension rates were 33.3% in urban and 24.6% in rural areas. The prevalence of hypertension increased with age and appeared higher in men than in women, in urban than in rural residents. Among the hypertensive patients, rates of awareness, treatment and control were 66.8%, 64.6% and 31.6%, respectively. Conclusion: High prevalence of hypertension with low rates on awareness and treatment and control, appeared in the general population of Beijing. Related strategies should be developed regarding prevention, control and management of hypertension, to reduce the burden of this disease.

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Objective To investigate the rates on prevalence,awareness,treatment and control of hypertension in population older than 15 years of age in Beijing,2013-2014.Methods A cross-sectional survey was conducted in Beijing between 2013-2014.Stratified multistage random sampling method was used to select representative sample of 13 057 Chinese individuals aged over 15 years,from the general population.Blood pressure was measured for three readings at sitting position after resting for at least five minutes with an average reading recorded.A standardized structured questionnaire was developed to collect history of hypertension and antihypertensive treatment.Results A total of 4 663 community residents aged over 15 years were hypertensive among the 13 057 individuals,with the standardized prevalence rate as 32.7％,in Beijing area.The age-standardized prevalence rates of hypertension appeared 34.6％ in men and 30.8％ in women.The age-and sexstandardized prevalence of hypertension rates were 33.3％ in urban and 24.6％ in rural areas.The prevalence of hypertension increased with age and appeared higher in men than in women,in urban than in rural residents.Among the hypertensive patients,rates of awareness,treatment and control were 66.8％,64.6％ and 31.6％,respectively.Conclusion High prevalence of hypertension with low rates on awareness and treatment and control,appeared in the general population of Beijing.Related strategies should be developed regarding prevention,control and management of hypertension,to reduce the burden of this disease.

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Through the investigation of the difference of approximate entropy (ApEn) and Hilbert-Huang Transform Marginal spectrum entropy (HHTMSEn) of the Electroencephalogram (EEG) signals of specific low back pain (SLBP) patients before and after the massage, we wanted to reveal the impact of the massage in the brain, and provided the basis for the massage treatment of SLBP patients. We recruited twenty-six SLBP patients and collected their spontaneous EEG signals before and after the massage. Firstly, we analyzed the ApEn and HHTMSEn of fourteen channels before and after the massage, and results showed that values of ApEn and HHTMSEn after the massage were less than the values before the massage significantly. And then, we extracted δ, θ, α and ß rhythms of the EEG signal, and analyzed the ApEn and HHTMSEn of the four rhythms before and after the massage. The results showed that the ApEn values of δ and α rhythm after the massage were significantly less than the values before the massage, and the HHTMSEn values of ß rhythms were significantly less than the values before the massage. The results of this study suggested the complexity of EEG signals was reduced with the relief of the pain after the massage therapy, and the change of pain of the SLBP patients was closely related to the change of the rhythms of the brain in the massage therapy, and the ApEn and the HHTMSEn features could serve as a base for quantitative assessment of SLBP condition after the massage therapy.

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Objective To study the time extended for getting emergency intervention in different modes of transportation and factors influencing the modes of transportation of patients with ST elevation myocardial infarction (STEMI).Methods A total of 564 consecutive patients with STEMI admitted from September 2013 to June 2016 were enrolled in the study.The clinical data about time consumed for getting emergency intervention and modes of transportation were collected.Results According to the mode of transportation,patients were divided into three groups:emergency care system (EMS) transportation group (n =96),self-transportation group (n =206) and referral group in which the patients were sent in from other hospitals (n =262).EMS transportation group had significantly shorter total ischemic time before emergency treatment than self-transportation group (229 rin vs.418 min,P ＜ 0.05) and referral group (229 min vs.512 rin,P ＜ 0.05),and significantly shorter length of pre-hospital time than self-arrival group (55 min vs.110 min;P＜0.05) and referral group (55 min vs.372 min;P＜0,05).The referral group had longer pre-hospital time and the self-transportation group had longer door-to-balloon time,but there was no difference in total ischemic time between the self-arrival and referral group (Z =-1.882,P =0.068).Multivariate logistic regression was used to analyze influence factors in mode of transportation:(1) patients characterized with high school or university education,profession of civil service,and their transportation distance more than 30 km were greater in number than referral group (P ＜ 0.05);(2) patients identified with senior middle school education,staff member of public sectors or company,their transportation distance less than 30 km,and with killip grade above Ⅱ were more likely to have EMS transport (P ＜ 0.05);(3) patients defined as businessmen without taking out new rural cooperative medical insurance,taking up transportation distance less than 80 km,and subjecting to killip grade Ⅰ had a higher proportion of individuals of this kind taking self-transportation (P ＜ 0.05).Conclusion Mode of transportation is an important factor that affects the time extended to get emergency intervention.Education level,occupation,medical insurance type,transportation distance,killip grade are associated with modes of transport.

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Objective To observe the differences of cerebral activation pattern with resting state functional magnetic resonance imaging (rs-fMRI) between patients with spasmodic torticollis (ST) and healthy controls,thus to investigate the pathogenesis of ST.Methods Nineteen ST patients and 21 age,sex and education-matched healthy controls,recruited from the Department of Neurology,First Affiliated Hospital of Guangxi Medical University between November 2012 and January 2016,were included in this study.rs-fMRI and factional amplitude of low frequency fluctuation (fALFF) were used to obtain differences between patients with ST and healthy controls,and correlative analysis was made on fALFF values of abnormal brain regions and ST patients' symptom severity (Tsui scores).Results Compared with healthy controls,patients with ST had significantly increased fALFF in the left cerebellum and significantly decreased fALFF in the left posterior cingulate cortex/precuneus,right posterior cingulate cortex/precuneus,left middle temporal gyrus,right angular gyrus,left post-central gyrus,right supplementary motor area (t =-5.714-5.920,P ＜0.01),and abnormal brain regions' fALFF values had no correlation with patients' age of onset,disease course,symptom severity (P ＞ 0.05).Conclusion Abnormal sensorimotor area,default mode network and cerebellum dysfunction may play a role in the pathophysiology of ST.