Objective: To observe the impact of vareniline tartrate on vascular endothelial function and inlfammatory factor releasing in acute coronary syndrome (ACS) patients with nicotine dependence after smoking withdrawal treatment.
Methods: We recruited the in-hospital ACS patients who were smoking ≥10 cigarettes/day for more than 10 years with at least moderate nicotine dependence, and randomly divided them into 2 groups: Varenicline group, the patients received oral medication for 2 weeks and Self withdrawal group, the patients without medication assistance.n=52 in each group. All patients received (10-30) min daily mission and consulting for quit smoking for 2 weeks. The basic information was recorded and blood levels of NO, IL-6 and ET-1 were compared before and after withdrawal treatment.
Results: Compared with they were before, after 2 weeks withdrawal treatment, in Varenicline group, blood levels of ET-1 decreased as (33.950 ± 1.439) ng/L vs (170.198 ± 12.602) ng/L and IL-6 decreased as (0.103 ± 0.020) ng/L vs (0.307 ± 0.051) ng/L; in Self withdrawal group, ET-1 decreased as (60.795 ±7 .036) ng/L vs (170.511 ± 12.374) ng/L, all P<0.05; while NO levels were similar,P>0.05. After treatment, ET-1 level in Varenicline group (33.950 ± 1.439) ng/L was lower than Self withdrawal group (60.795 ± 7.036) ng/L and IL-6 level in Varenicline group (0.103 ± 0.020) ng/L was also lower than Self withdrawal group (0.258 ± 0.042) ng/L, allP<0.05; while NO levels were similar between 2 groups,P>0.05.
Conclusion: Compared with self withdrawal, varenicline tartrate may effectively inhibit inlfammatory factor releasing in ACS patients with nicotine dependence, and therefore improve the vascular endothelial function.

BACKGROUND: Recent studies have demonstrated that sterol regulatory element binding protein-2 (SREBP-2) plays a key role in osteoarthritis, but its exact pathogenesis remains incompletely understood yet. OBJECTIVE:To investigate the expression of SREBP-2 in the process of interleukin-1β-induced articular chondrocyte degenerationin vitro. METHODS: Articular chondrocytes obtained from C57BL/6J mice were culturedin vitro. After the second passage, cels were randomly divided into four groups: control group, and three experimental groups treated with 10 μg/L interleukin-1β for 24, 48 and 72 hours, respectively. RESULTS AND CONCLUSION:The cels became hypertrophic after being stimulated by interleukin-1β, and the staining of colagen X was positive at 72 hours. MTT assay demonstrated that the cel activity after stimulation with interleukin-1β decreased with time. Results of RT-PCR showed that the expression of SREBP-2 and SREBP cleavage activating protein mRNA was significantly increased after stimulation with interleukin-1βas compared with the control group and increased with time. On the contrary, the expression of aggrecan and colagen II mRNA was decreased with time. It is revealed that interleukin-1β could inhibit the proliferation of regular chondrocytes and the expression of its extracelular matrix, and furthermore, induce chondrocyte hypertrophy. The expression of SREBP-2 showed a negative relationship with key cartilage genes during this interleukin-1β-induced degeneration.

AIM:To investigate the protective effect of losartan(Los) on apoptosis of H9c2 cells induced by isoprenaline(ISO),and to discover its related mechanism.METHODS:H9c2 cells cultured on plastic plates were divided into control,ISO,ISO+Los,ISO+Los+LY294002 and DMSO groups.Cell apoptosis was evaluated by flow cytometery and agarose gel electrophoresis.The mRNA levels of bax,bcl-2 and caspase-9 were detected by RT-PCR and the expressions of phosphorylated and total Akt(p-Akt and t-Akt) were assessed by Western blotting.The cAMP was measured by radioimmunoassay.RESULTS:ISO at concentration of 10 ?mol/L induced apoptosis of H9c2 with an increase in bax/bcl-2,caspase-9 and cAMP.Addition of 10 ?mol/L losartan inhibited apoptosis obviously with a decrease in bax/bcl-2,caspase-9 and cAMP.A significant increase in p-Akt was observed,and its protein level was elevated.LY294002 at concentration of 1 ?mol/L abolished the protective effects of losartan on ISO-induced apoptosis in H9c2 cells.CONCLUSION:ISO might induce H9c2 cell apoptosis through stimulation of ?-adrenergic receptor(?-AR).Los inhibits downstream signaling of ?-AR,and promotes the activation of Akt.Subsequently it might attenuate the apoptosis induced by ?-adrenergic stimulation of ISO.

Objective To investigate the effect of TGFβ1 siRNA on hepatic satellite cells (HSCs) activation, proliferation and extracellular matrix production. Methods The TGFβ1, siRNA plasmid was transfected into HSCs with Lipofectamine 2000. The supernatant and HSCs were collected after incubation for 72h. The expression of TGFβ1, and a-SMA protein in HSCs was detected by. Western blotting. The expression of type Ⅰ and Ⅲ collagen mRNA was detected by RT-PCR. The cell proliferation was assayed by MTT method. Contents of typeⅣ collagen and hyaluronic acid in supernatant were determined by radioimmuno-assay.Results Compared with scrambled control group, the TGFβ1, and a-SMA protein expression,the activity of HSCs proliferation,the expression of typeⅠ and Ⅲ collagen mRNA,and the contents of type Ⅳ collagen and hyaluronic acid in supernatant were reduced in TGFβ1, siRNA group by (79±5)%,(55±4)%, (25±4)% ,(63±6)% ,(57±4)% ,(53±8)% ,(46±8)% ( P<0.01),respectively.Conclusion TGFβ1, siRNA could significantly reduce the expression of TGFβ1,inhibited HSC activation,proliferation and extracellular matrix production.

Objective To explore the genetic pathogen of patients with non-syndromic hearing impairment and to provide prenatal diagnosis for the families of hereditary deafness. Methods Mutation screening of GJB2, SLC26A4, GJB3 and mitochondrial 12 S rRNA genes was performed in 208 patients with non-syndromic hearing impairment by gene chip. Then direct sequencing was used in 41 patients who were found one mutation of GJB2 or SLC26A4 gene. And prenatal diagnosis was carried out in two families by direct sequencing. Results Eighty-six patients (41.35％) were found at least one mutation by gene chip. Among them, 40 patients were found to carry two mutations and 46 patients were found to carry one mutation. The most frequent mutation was 235delC, which was found in 46 patients. And 12 cases were found the second mutation through direct sequencing. A total of 52 (25.00％) patients were detected two mutations. Prenatal diagnosis showed that one fetus carried compound mutations of 299-300delAT and 235delC, and another one carried heterozygous mutation of IVS7-2A>G. Conclusion Patients with non-syndromic hearing impairment can be accurately diagnosed by gene chip and Sanger sequencing. The prenatal diagnosis is primary means for high-risk fetuses.

Objective To investigate the usage of BiPAP noninvasive positive pressure ventilation in pre-hospital first aid and the effect. Methods A total of 108 patients with any of the following diseases, AECOPD,AHF,ARDS and se-vere bronchial asthma were selected and divided into BiPAP treatment group and routine treatment group according to digital randomized method. Each group included 54 patients. Breath, heart rate, blood gas analysis, changes in hemo-dynamic parameters of two groups before and after treatment and curative effecty were analyzed. Results After treat-ment, breath, heart rate, blood gas analysis, hemodynamic parameters of BiPAP treatment group were better con-trolled than that of conventional treatment group (P < 0.05). The total effective rate of BiPAP treatment group was 92.59%, which was significantly higher than that of the conventional treatment group (P< 0.05). Conclusion The ap-plication of BiPAP in pre-hospital emergency treatment can quickly relieve symptoms and increase curative effect. It is worthy of using widely in clinical treatment.

Objective:To compare and analyze the clinical efficacy of laparoscopic microwave ablation and laparoscopic hepatectomy in the treatment of hepatic hemangioma.Methods:The clinical data of 98 patients with hepatic hemangioma admitted to the Hepatobiliary Center, the First Affiliated Hospital of Nanjing Medical University from June 2019 to June 2023 were retrospectively analyzed, including 20 males and 78 females, aged 24-69 years. According to the surgical method, they were divided into two groups: laparoscopic microwave ablation group (ablation group) with 34 cases, and laparoscopic hepatectomy group (resection group) with 64 cases. The differences in intraoperative and postoperative recovery related indicators, follow-up and prognosis between the two groups were compared and analyzed.Results:The operative time and blood loss in the ablation group were (90.6±21.8) min and (60.3±40.8) ml, respectively, which were lower than those in the resection group (128.7±30.0) min and (165.8±212.7) ml, and the differences were statistically significant ( t=-6.54, -2.86, P<0.001, P=0.005). There were 5 cases (14.71%) of residual lesions in the ablation group and none in the resection group, with a significant difference between the two groups ( χ2=0.01, P=0.003). The ablation group was superior to the resection group in hospital stay, drainage tube removal time and postoperative pain, with statistical significance (all P<0.05). On the 1st and 3rd day after surgery, the levels of alanine aminotransferase, aspartate aminotransferase, total bilirubin and direct bilirubin in ablation group were lower than those in resection group, and the differences were statistically significant (all P<0.05). In the ablation group, there were 14 cases of hemoglobinuria (41.2%), 2 cases of abdominal hemorrhage (5.9%), 0 cases of bile leakage and 6 cases of pleural effusion (17.7%), while in the resection group, these complications were 2 cases (3.1%), 18 cases (28.1%), 11 cases (17.2%) and 32 cases (50.0%), respectively, and there were statistical significance between the two groups (all P<0.05). In terms of prognosis, there was both one recurrence in each group (2.9% vs. 1.6%), with no significant difference ( χ2=1.00, P=0.653). Conclusion:Compared with laparoscopic hepatectomy, laparoscopic microwave ablation has obvious advantages in terms of operation time, intraoperative blood loss, hospital stay, postoperative pain and complications.

Objective: To investigate the clinical effect and safety of long-acting pegylated interferon-α-2b (Peg-IFN-α-2b) (Y shape, 40 kD) injection (180 μg/week) in the treatment of HBeAg-positive chronic hepatitis B (CHB) patients, with standard-dose Peg-IFN-α-2a as positive control. Methods: This study was a multicenter, randomized, open-label, and positive-controlled phase III clinical trial. Eligible HBeAg-positive CHB patients were screened out and randomized to Peg-IFN-α-2b (Y shape, 40 kD) trial group and Peg-IFN-α-2a control group at a ratio of 2:1. The course of treatment was 48 weeks and the patients were followed up for 24 weeks after drug withdrawal. Plasma samples were collected at screening, baseline, and 12, 24, 36, 48, 60, and 72 weeks for centralized detection. COBAS® Ampliprep/COBAS® TaqMan® HBV Test was used to measure HBV DNA level by quantitative real-time PCR. Electrochemiluminescence immunoassay with Elecsys kit was used to measure HBV markers (HBsAg, anti-HBs, HBeAg, anti-HBe). Adverse events were recorded in detail. The primary outcome measure was HBeAg seroconversion rate after the 24-week follow-up, and non-inferiority was also tested. The difference in HBeAg seroconversion rate after treatment between the trial group and the control group and two-sided confidence interval (CI) were calculated, and non-inferiority was demonstrated if the lower limit of 95% CI was > -10%. The t-test, chi-square test, or rank sum test was used according to the types and features of data. Results: A total of 855 HBeAg-positive CHB patients were enrolled and 820 of them received treatment (538 in the trial group and 282 in the control group). The data of the full analysis set showed that HBeAg seroconversion rate at week 72 was 27.32% in the trial group and 22.70% in the control group with a rate difference of 4.63% (95% CI -1.54% to 10.80%, P = 0.1493). The data of the per-protocol set showed that HBeAg seroconversion rate at week 72 was 30.75% in the trial group and 27.14% in the control group with a rate difference of 3.61% (95% CI -3.87% to 11.09%, P = 0.3436). 95% CI met the non-inferiority criteria, and the trial group was non-inferior to the control group. The two groups had similar incidence rates of adverse events, serious adverse events, and common adverse events. Conclusion In Peg-IFN-α regimen for HBeAg-positive CHB patients, the new drug Peg-IFN-α-2b (Y shape, 40 kD) has comparable effect and safety to the control drug Peg-IFN-α-2a.