Objective To assess the relationship between fractional esterification rate of high density lipoprotein cholesterol (FERHDL) and coronary artery disease .Methods The patients were underwent coronary angiography in this hospital in the last three years were collected ,according to the results of coronary angiography ,286 patients were divided into CHD group(n=196) and non-CHD group(control group ,n=90) .And according to the number of pathological coronary artery ,the patients with coronary heart disease were divided into single-vessel subgroup(n=73) ,double vessel lesion subgroup(n=72) ,three branch lesions subgroup (n=51) .The relationship between FERHDL and coronary artery disease were analyzed .Results The FERHDL of CHD group was significantly higher than that in the control group ,the difference was statistically significant (P<0 .05) .It was a tendency that the FERHDL increased with coronary lesions increasing (P<0 .05) .The FERHDL was significant independent correlated with the low density lipoprotein cholesterol b-C(LDLb-C) ,triglycerides(TG) ,high density lipoprotein cholesterol 2-C(HDL2-C) ,high density lipoprotein cholesterol C(HDL-C) .FERHDL was positively correlated with LDLb-C(r=8 .473 ,P=0 .000) ,TG(r=0 .714 ,P=0 .002) and negatively correlated with HDL2-C(r= -0 .692 ,P=0 .024)、HDL-C(r= -0 .829 ,P=0 .008) .Conclusion The value of FERHDL was significantly increased in CHD patients and correlated with the aggravation severity of the CHD .The change of FERHDL was significant correlated with particle size of HDL and LDL particle size .

BACKGROUND: Due to dentition defect, dentition loss, periodontal disease, trauma and tumor, many patients have to face insufficient buccal-lingual mandibular width. At present, there is no consistent conclusion in suitable peri-implant buccal-lingual mandibular width. OBJECTIVE: To investigate the stress of implant-bone interface with three-dimensional finite element method, in order to evaluate buccal-lingual mandibular width suitable for implants. METHODS: Classes Ⅰ and Ⅲ mandible implant models (the buccal-lingual width of implant neck region was 1, 1.5, 2, 2.5, 3 and 3.5 mm) were loaded with 200 N forces vertical y and at 60° oblique. Then, the stress and strain in the implant-bone interfacial were analyzed. RESULTS AND CONCLUSION: Almost 2 mm or more than 2 mm of mandible bone width could result in good stress distribution in implant-bone interface. The stress distribution of oblique loading was much greater than that of vertical loading. Proper quantity of peri-implant mandibular width is good for stress distribution in implant-bone interface. In the clinical treatment, the oblique loading should be avoided or reduced.

Objective To explore the practicality and feasibility and evaluation of the team based learning method (TBL) combined with the clinical pathway leaning method (CP) in clinical teaching of department of gynecology and obstetrics. Methods Toltally 40 clinical specialist interns selected for the study were randomly divided into two groups (each 20) respectively, using TBL com-bined with CP teaching method and traditional teaching method, and to make analysis and comparisons on the above two teaching methods. Differences were compared with t testing. Meanwhile, a question-naire survey was carried out among students of TBL combined with CP teaching group for qualitative analysis of the implementation effect of TBL combined with CP pedagogy. (Qualitative analysis is the medical students' evaluation of teaching effect, without further statistical processing). Results The professional test results of TBL combined with CP teaching team were superior to the traditional teach-ing group [(83.95 ±7.63) vs. (72.00 ±5.26)] and the difference was significant by paired t tests and analysis (t=5.063,P<0.05). The knowledge contest results of TBL combined with CP teaching team were superior to the traditional teaching group(90 vs. 85,95 vs. 75,85 vs. 70). TBL combined with CP method has been recognized by 90% medical students and they think that most of their quality has been further improved. Conclusions TBL combined with CP method for the clinical teaching of de-partment of gynecology and obstetrics is practical and feasible, and should be widely applied.

OBJECTIVETo explore the expression of CASZ1 and its relationship with the pulmonary microvascular development in lung tissue of newborn rats exposed to hyperoxia which induced bronchopulmonary dysplasia (BPD).

METHODForty-eight newborn Sprague Dawley(SD) rats (male and female unlimited) were randomly divided into two groups: experimental group and control group according to random digits table with 24 in each.The rats in experimental group were exposed to high oxygen volume fraction of 800 ml/L and the rats in control group were exposed to normal air. Eight rats were randomly selected from each group on day 3 and 7 after oxygen exposure.The sections of lung were stained with HE method in order to assess lung histological changes, the alveolar development was evaluated by the number of radial alveolar count (RAC) and septal wall thickness. CD31 was detected by immunohistochemistry (IHC) method and the capillary density was calculated. The location, distribution and expression of CASZ1 in the lung tissue were detected by the immunohistochemistry, Western blotting, and quantitative PCR (qPCR).

RESULT(1) Stained by HE, lungs of experimental group showed destroyed alveoli, alveoli fusion and increased septal wall thickness, RAC were significantly lower than those in control group(14 d: septal wall thickness (12.69 ± 0.63) μm vs. (6.53 ± 0.16) μm, RAC 5.9 ± 0.4 vs. 8.4 ± 1.0, t = 19.046, 4.760, P both = 0.000). (2) CD31 protein was expressed predominantly in cytoplasm of pulmonary microvascular endothelial cells. The experimental group CD31 average optical density (AIOD) were decreased compared with control group((16.6 ± 1.6) × 10(3) vs.(40.1 ± 2.4) × 10(3), (18.1 ± 1.4) × 10(3) vs.(83.2 ± 5.2) × 10(3), (49.2 ± 5.4) × 10(3) vs.(136.2 ± 28.1) × 10(3), t=16.185, 16.066 and 6.078, P<0.01 for all comparisons). Capillary density in experimental group was also significantly decreased compared with control group ((3.84 ± 0.15)% vs.(6.01 ± 0.22)%, (4.17 ± 0.38)% vs.(6.15 ± 0.24)%, (5.43 ± 0.44)% vs. (9.13 ± 0.25)%, t = 16.124, 8.773 and 14.076, P all < 0.01). (3)RT-qPCR and Western blotting showed that the CASZ1 mRNA significantly increased in experimental group compared with control group(0.56 ± 0.17 vs. 1.00 ± 0.26, 0.32 ± 0.29 vs. 0.58 ± 0.14, 0.14 ± 0.22 vs. 0.56 ± 0.15, t=3.890, 3.303 and 2.388, P < 0.05 for all comparisons), and the protein expression of CASZ1 also significantly increased in experimental group compared with control group (0.65 ± 0.02 vs. 0.78 ± 0.23, 0.46 ± 0.03 vs. 0.75 ± 0.05, 0.34 ± 0.22 vs. 0.75 ± 0.04, t=6.200 and 10.485 and 14.998, P < 0.05 for all comparisons). (4)The protein level of CASZ1 in experimental group was positively correlated with capillary density (r=0.519, P<0.01).

CONCLUSIONCASZ1 is involved in the whole process of newborn rats BPD and may be linked to pulmonary microvascular dysplasia.

Animals ; Animals, Newborn ; Bronchopulmonary Dysplasia ; pathology ; Female ; Hyperoxia ; pathology ; Lung ; blood supply ; pathology ; Male ; Oxygen ; adverse effects ; Pulmonary Alveoli ; RNA, Messenger ; metabolism ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Transcription Factors ; metabolism

Objective To evaluate the effects of applying clinical pathway (CP) in clinical teaching of gynecology and obstetrics. Methods Totally 200 clinical specialist interns selected for the study were randomly divided into two groups (each 100), respectively, using CP teaching and tradi-tional teaching. After the internship, professional assessment (clinical skills assessment, theory test, the respondent)were conducted to two groups of students and their professional examination scores were compared, while questionnaires were conducted in the CP teaching group. All date were analyzed by SPSS 17.0 software. Chi-square test was used for enumeration date while t test was used for mea-surement data. Results CP teaching team of professional test results [(80.01 ± 9.34) vs. (72.37 ± 10.79)], the passing rate(96%vs. 87%) were superior to the traditional teaching group(P=0.000 and 0.022). The questionnaire showed that: applying CP in clinical teaching of obstetrics and gynecology can improve interns' learning enthusiasm and initiative, improve their comprehensive analysis ability, clinical thinking ability, practical ability and many other capabilities and it got about 90% of interns' recognition. Conclusions The application of the CP in clinical teaching of obstetrics and gynecology can help enhance the teaching effectiveness, standardize the teaching process, and improve the qual-ity of teachers teaching gynecology and obstetrics.

Objective To investigate the effect of cystatin C (Cys C) on adventitia in rabbit abdominal aorta restenosis after angioplasty and its mechanism.Methods 48 New Zealand white rabbits were randomly divided into injury group (receiving balloon dilation of abdominal aorta),the treatment group (taking Cys C monoclonal antibody therapy) and the control group (receiving femoral artery puncture and catheter sheath without balloon dilation and intervention of Cys C monoclonal antibody injection),and each group had 16 rabbits.Peripheral vein blood was drawn to measure the serum level of cystatin C before and 8 h,1 day,1 week,3 weeks,6 weeks after the operation in all rabbits.After 6 weeks of operation,the abdominal aorta were taken and stained with HE.Vascular morphometry analysis and adventitial cell count were conducted.Smooth muscle actin (SM-actin) and proliferating cell nuclear antigen (PCNA) expressions in the adventitia were observed by immunohistochemical staining.The number of PCNA positive cell in the adventitia was counted and the PCNA proliferation index was calculated.The vascular remodeling index,vascular external elastic lamina area (EELA),internal elastic lamina area (IEIA) were used to evaluate the vascular remodeling and the residual stenosis and vascular cavity area was used to measure the vascular stenosis.Results Plasma Cys C level began to rise at 8h after operation and reached the peak at 1 week after operation,and continuously increased for 5 weeks in injury group,and reached to respectively at 3 weeks and 6 weeks after operation.The Cys C levels were significantly higher in injury group than in the treatment and control groups at different time points (all P＜0.05).There were no significant differences in Cys C levels at different time points between the treatment group and the control group.The injury group showed that the number of PCNA positive cells was higher in injury group than in treatment and control groups,both P＜0.05).Compared with the control group,the vascular luminal area,EELA and IELA were significantly increased (all P＜0.05).After treated with the monoclonal antibody Cys C intervention,the treatment group showed that lumen area,vascular EELA,IELA was significantly decreased (P＜0.05),and the vascular remodeling index and residual stenosis rate were decreased as compared with the injury group (0.871 vs.0.784,33.1％ vs.19.7 ％,both P＜0.05).Correlation analysis showed that Cystatin C level was positively correlated with the vascular lumen area,neointimal area,internal elastic lamina area,external elastic lamina area and the number of PCNA positive cells (r=0.812,0.797,0.876,0.932 and 0.822 respectively,all P＜0.01).Conclusions Plasma Cys C level is increased in rabbit after abdominal aorta balloon injury and has a positive correlation with the severity of arterial stenosis.High Cys C level can induce adventitial fibroblast activation,proliferation,phenotype transformation and migration,and accelerate the processes of atherosclerosis and stenosis.Cys C level is the independent risk factor for abdominal aortic stenosis.

OBJECTIVETo Verify the safety and reliability of one-stage repair of complete cleft Lip and palate in infancy and to obtain the primary result.

METHODSThe simultaneous repair of complete cleft Lip and palate in infants 3 to 12 months of age were performed in 271 cases. The deformities include 185 cases of typical complete unilateral clefts and 75 cases of complete bilateral clefts, and other 11 atypical cleft infants. The preoperative orthopedic treatment for wide alveolar cleft was undertaken in 24 infants and the lip appearance and speech outcome were evaluated in 116 children by 1 to 4 years' postoperative follow-up.

RESULTSAll infants, except for dyspnea in 2 babies, palatal fistula formation in 6 cases and temporary wound hemorrhage in 5 infants, were recovered without complications. After orthopedic treatment, the width of the alveolar cleft was reduced 6.1 mm in average. The evaluation showed that 93.1% of children had got good or excellent lip appearance. And the acceptable or excellent speech was found in 94.8% children.

CONCLUSIONSSimultaneous repair of complete cleft lip and palate in infancy is safety and reliable. The preoperative orthopedic procedure is able to reduce the wide alveolar cleft and to achieve alignment of alveolar segments. The acceptable and or excellent lip appearance and speech function could be obtained in this one-stage operative procedure in infants.

Cleft Lip ; surgery ; Cleft Palate ; surgery ; Female ; Humans ; Infant ; Male ; Treatment Outcome

OBJECTIVETo determine whether the level of serum cardiac troponin T (cTnT) was increased in patients with congestive heart failure (CHF).

METHODSThis study consisted of 265 patients with CHF and 75 healthy people. Serum cTnT was measured by electrochemiluminescence immunoassay using an Elecsys 1010 automatic analyzer.

RESULTScTnT concentration was 0.181 +/- 0.536 ng/mL in CHF patients and 0.003 +/- 0.001 ng/mL in controls (P < 0.001). Patients were categorized according to the levels of heart function and left ventricular ejection fraction (LVEF). In the first group consisting of 105 patients with LVEF 35%, cTnT was 0.07 +/- 0.0 5 ng/mL (P < 0.01). In patients with NYHA class I, II, III and IV, cTnT values were 0.062 +/- 0.022 ng/mL, 0.113 +/- 0.121 mg/mL, 0.191 +/- 0.231 mg/ml and 0.384 +/- 0.211 mg/mL, respectively (class I vs class II P > 0.05, class II vs class III P < 0.01, class III vs class IV P < 0.01). A negative correlation was observed between serum cTnT concentration and LVEF in 265 patients with CHF (r = -0.493, P < 0.001).

CONCLUSIONSThis study shows that the level of serum cTnT is increased in patients with CHF and that the increased level indicates the severity of CHF.

Adult ; Aged ; Female ; Heart Failure ; blood ; physiopathology ; Humans ; Male ; Middle Aged ; Stroke Volume ; Troponin T ; blood ; Ventricular Function, Left

Objective:To explore the clinical manifestations and genetic characteristics of Wolf-Hirschhorn syndrome (WHS) to improve the ability of diagnosis and differential diagnosis of the disease.Methods:The clinical features and auxiliary examinations and treatment of a proband with WHS caused by microdeletion of 4p16.3 segment who admitted to the Third Affiliated Hospital of Zhengzhou University in December 2021 were recorded, and whole exome sequencing (WES) of the family was performed. The prognosis was followed up.Results:The female proband, 11 months old, presented with convulsions at the age of 8 months, with the characteristics of heat sensitivity and cluster seizures, and her identical twin sister had a similar medical history. Physical examination found malnutrition, retarded development, special face, prominent forehead, wide nasal bridge, small jaw, precordial murmur and grade 3/6 murmur in the whole period, hyperactivity of P2, and low limb muscle tone. The whole exon and copy number variation (CNV) test of the family revealed that the proband had a 1.99 Mb heterozygous deletion in the chromosome 4p16.3 segment, including WHSC1 (NSD2), WHSC2 (NEFLA) and other genes. Copy number variation sequencing (CNV-Seq) of the proband and her sister showed 1.97 and 1.92 Mb heterozygous deletion of chromosome 4p16.3, respectively. Genealogical analysis by quantitative polymerase chain reaction revealed that the CNV was de novo, and it was determined to be a pathogenic variant according to the American College of Medical Genetics and Genomics guidelines. The proband took sodium valproate orally, and her sister took oral sodium valproate, zonisamide, and levetiracetam successively, and at the same time they received family rehabilitation training. The age at the last follow-up was 1 year and 8 months. Neither of them had convulsions again in the past 3 months, but the developmental delay was obvious. Conclusion:WHS patients may present with growth retardation, epilepsy, Greek warrior helmet-like special face, and congenital heart disease, and may have microdeletions in the chromosome 4p16.3 segment.

Objective To comprehensively characterize the diterpene alkaloids in Radix Aconiti Kusnezoffii.Methods The diterpene alkaloids were isolated and purified by strong acid cation exchange resin solid phase extraction column(SCX-SPE),and identified by ultra high performance liquid chromatography-Q-Exactive Orbitrap mass spectrometry(UHPLC-Q-Exactive Orbitrap MS).Results A total of 99 diterpene alkaloids were identified from Radix Aconiti Kusnezoffii,including 27 diester diterpene alkaloids(DDA),29 monoester diterpene alkaloids(MDA),40 amide diterpene alkaloids(ADA),2 polyester diterpene alkaloids(PDA)and 1 long-chain ester diterpene alkaloid(LDA).Conclusion The SCX-SPE combined with UHPLC-Q-Exactive Orbitrap MS method,established in this paper,can rapidly identify a large number of diterpene alkaloids in Radix Aconiti Kusnezoffii,which provides scientific proof for the study of pharmacodynamic substance basis and quality control of Radix Aconiti Kusnezoffii.