AIM: To investigate the effects of adenovirus-mediated human tissue kallikerin (Ad-hKLK1) gene delivery on the proliferation, migration of VSMC_(SHR) induced by platelet derived growth factor-BB (PDGF-BB). METHODS: The VSMC_(SHR) proliferation induced by PDGF-BB was accessed by cell counting and methyl thiazolyl tetrazoliuin (MTT). The migration was assessed by modified Boyden chamber assay. Western blotting was used to determine the expressions of the cycle-independent kinase inhibitors p27~(Kip1) and p21~(Cip1).RESULTS: Proliferation of VSMC_(SHR) induced by PDGF-BB was inhibited after transfection of Ad-hKLK1 (20-100 MOI) in a MOI-dependent manner. The peak inhibition titer of Ad-hKLK1 fell on 100 MOI, with the peak inhibition rate of 39.3% (cell counting, n=3, P<0.01), 30.2% (MTT, n=3, P<0.01), peak stunning rate of cell-cycle in phase G0/G1 at 36.4%. The inhibitory effects of proliferation and cell-cycle caused by hKLK1 gene delivery were significantly abolished by Hoe140, a bradykinin B2 receptor antagonist. Migration of VSMC_(SHR) induced by PDGF-BB was inhibited after hKLK1 gene delivery, with the peak inhibitory rate of 34.6% (n=6, P<0.01). However the inhibitory effects of migration were not blocked by Hoe140. The protein expression of p27~(Kip1) and p21~(Cip1) increased significantly after the hKLK1 gene delivery, whereas Hoe140 nearly completely blocked these effects (n=3, P<0.01, respectively).CONCLUSION: The hKLK1 gene delivery may inhibit the proliferation and migration of VSMC_(SHR) induced by PDGF-BB. Bradykinin B2 receptor probably mediates the up-regulating expression of p27~(Kip1) and p21~(Cip1) that contributes to the inhibitory effects of proliferation of hKLK1. However, the inhibitory effects of migration by hKLK1 gene delivery may not be mediated by bradykinin B2 receptor.

The onset of hepatocelluar carcinoma, one of the serious complications of primary Budd-Chiari syndrome, is associated with poor prognosis.Although so, the diagnosis and treatment of such disease has still not been standardized at recent.In this paper, we overviewed the recent advances on Budd-Chiari syndrome associated with hepatocelluar carcinoma.

To understand the genetic origin and variation of porcine epidemic diarrhea virus (PEDV) prevailing in Henan province,a total of 22 PEDV positive samples from suckling piglets with severe diarrhea were collected from 16 pig farms and amplified by RT-PCR.ORF3 genes were then cloned into pMD18-T vector and sequenced.The result of sequencing showed that the length of ORF3 genes all were 675 bp which encoded 224 amino acids.The strains in this study had eight amino acid substitutions when compared with CV777 strain.The nucleotide homologies of the 22 strains were 95.9％-100％ and amino acid homologies were 96.4％-100％.By comparing with those of European strain CV777 and vaccine strain truncated CV777,the nucleotide homologies were 97.1％-97.9％ and 94.8％-95.4％,respectively.Based on the phylogenetic relationship of ORF3 genes,the PEDV field strains and PEDV reference strains could be divided into two groups,and all the field strains identified in this study belong to group 2.It suggested that prevalent PEDV strains in this study seem to be closely related to Henan isolates in previous years,domestic strains,Janpanese strains,American strains as well as Korean strains but differ genetically from European strains or vaccine strains used in China.This experiment analyzed the ORF3 gene sequence features in prevailing of Henan region in recent years,which provides a new support of epidemiology study and protein function research of PEDV ORF3 gene.

Objective:To explore the safety and efficacy of Castor branched stent-graft exclusion in the treatment of aortic dissection and aneurysm involving left subclavian artery.Methods:The clinical and imaging data of 88 patients with aortic dissection or aneurysm involving left subclavian artery diagnosed by CTA or DSA in our hospital from December 2017 to December 2019 were collected retrospectively, including 67 aorta dissections, 7 thoracic aortic aneurysms and 14 aorta penetrating ulcer. All patients were treated with branched stent-graft under the guidance of DSA. The postoperative curative effect and complications were observed. The paired t test was used to compare the maximum aortic diameter of the lesion before and 6 months after the operation. Results:Eighty-eight patients were successfully treated with integrated stent, the success rate of operation was 100%, and the disease-related symptoms of all patients were basically or completely relieved. The mortality rate within 1 month after the operation was 2.7% (2/88). The two deaths were complicated with other serious diseases before the operation, and the cause of death was not related the operation. All patients were followed up except 4 patients who lost contact after discharge. During the follow-up, there were 1 case of retrograde type A dissection, 1 case of new aneurysm of aortic arch, 2 cases of in-stent stenosis of left subclavian artery branch, 3 cases of mild stroke, no persistent endoleak and no death or other serious complications. The mean maximum aortic diameter at 6 months after operation [(34±4)mm] was significantly lower than that before operation [(38±6 mm)] ( t=6.63, P<0.05). Conclusion:Castor branched stent-graft is simple, mini-invasive and effective in the treatment of aortic dissection and aneurysms involving the left subclavian artery.

Objective: To study risk factors for non-alcoholic fatty liver disease (NAFLD) and vascular erectile dysfunction (ED) in patients with metabolic syndrome (MS). Methods: A total of 18 096 subjects were selected from people undergoing physical examination from 2008 to 2009 in northern cities of China by random cluster sampling method, and analyzed the risk factors for NAFLD and ED. Results: The 18 096 cases with age 18~76 (46.8±10.1) years old，containing 10 096 (55.79%) males and 8 000 (44.21%) females. Awareness rate of MS was 8.33% and prevalence rate of MS in healthy adults was 21.18%. Most common components of MS were hyperuricemia (27%, 4838/18096), obesity and overweight (21%), hypertension (20%,) and dyslipidemia (17%) in turn. Body mass index (BMI, kg/m2) and waist/hip ratio (WHR) of all MS subgroups from high to low were ED group [(28.9±1.1), (1.26±0.03)], overweight or obesity group [(27.5±2.3), (1.31±0.03)], prediabetes group [(26.8±2.6), (1.03±0.03)] and hypertension group [(26.1±1.3), (0.90±0.04)] in turn. A total of 3 721 MS patients （20.56%）complicated with NAFLD; By means of NAFLD complicated by MS as dependent variable, Logistic regression analysis indicated that increased ALT, waist circumference（WC）, age, DM family history, LDL-C and BMI (β=1.004~0.479, P=0.000~0.016 in turn) were risk factors for NAFLD, and physical exercise and occupational physical work were protective factors for NAFLD. There were 106 ED males and its prevalence rate was 1.04%; Logistic regression analysis indicated that age, WC, LDL-C, DM family history and BMI (β=0.681~0.238, P=0.000~0.018 in turn) were risk factors for ED, and educational degree, physical exercise and occupational physical work were protective factors for ED. Conclusion: Risk factors for NAFLD and ED in MS were closely correlated with MS. It’s a new path to prevent and treat NAFLD and ED through correcting risk factors of MS.

A survey on the quality of life of diabetic patients was conducted in Shanghai Changqiao community in August 2017.Total 1 002 patients with type 2 diabetes mellitus (T2DM)aged ≥60 years were randomly selected to participant in this face-to-face questionnaire survey,967 participants completed the survey with a effective rate of 96.5％.The Anxiety Self-Rating Scale and Diabetes-Specific Quality of Life Scale (A-DQOL) were applied for evaluation.The results showed that up to 48.9％(473/967) participants had an anxiety state.Multivariate stepwise regression analysis showed that the educational level was the main influencing factor of A-DQOL (P＜0.05).The educational level and fasting blood glucose were the influencing factors of satisfaction degree and impacting degree score;educational level,treatment mode and BMI were the influencing factors of grade Ⅰ anxiety;age and educational level were the influencing factors of grade Ⅱ anxiety (all P＜0.05).The survey demonstrates that age,educational level,treatment,fasting blood glucose and BMI would affect the quality of life of elderly T2DM patients.

Atherosclerosis is a chronic inflammatory disease characterized by autoimmune component,ser-ving as a primary factor in cardiovascular diseases.The atherosclerotic plaques involve a variety of immune cells which mediated complex immune and inflammatory responses at each stage of the disease's progression.Notably,within atherosclerotic plaques,T-cells,as the predominant immune cells,can be differentiated into various subsets with distinct functions.These T-cell subsets modulate the progression of atherosclerosis by se-creting either pro-inflammatory or anti-inflammatory cytokines.Understanding the impact of these immune cells on the disease's development is imperative for formulating novel therapeutic strategies.This article aims to review the roles of T-cell subsets and their secreted cytokines in atherosclerosis,aiming to offer new in-sights for the scientific research and clinical management of this condition.

Denoising methods based on wavelet analysis and empirical mode decomposition cannot essentially track and eliminate noise, which usually cause distortion of heart sounds. Based on this problem, a heart sound denoising method based on improved minimum control recursive average and optimally modified log-spectral amplitude is proposed in this paper. The proposed method uses a short-time window to smoothly and dynamically track and estimate the minimum noise value. The noise estimation results are used to obtain the optimal spectrum gain function, and to minimize the noise by minimizing the difference between the clean heart sound and the estimated clean heart sound. In addition, combined with the subjective analysis of spectrum and the objective analysis of contribution to normal and abnormal heart sound classification system, we propose a more rigorous evaluation mechanism. The experimental results show that the proposed method effectively improves the time-frequency features, and obtains higher scores in the normal and abnormal heart sound classification systems. The proposed method can help medical workers to improve the accuracy of their diagnosis, and also has great reference value for the construction and application of computer-aided diagnosis system.
Algorithms ; Heart Sounds ; Humans ; Signal Processing, Computer-Assisted ; Signal-To-Noise Ratio ; Wavelet Analysis

ObjectiveTo analyze medication regularity of presciptions containing Cangzhu （Atractylodes Lancea） - Huangbai （Phellodendron Amurense） based on data mining. MethodsAll the prescriptions containing Cangzhu-Huangbai in Dictionary of Chinese Medical Formulas （《中医方剂大辞典》） and the fifth edition of Chinese Pharmacopoeia （《中华医典》） were retrieved， setting up a database， counting the number of prescriptions involved， the composition of formulas in the prescriptions， the properties of the medicinal， the number of types of diseases and syndromes treated by the prescriptions， and the frequency of their appearances； drawing a network diagram of the medicinal combinations； analysing the medicinal combinations based on the association rules of the Apriori algorithm， and at the same time， analysing the association rules for the medicinal involved in the high-frequency diseases， and the core prescriptions containing Cangzhu-Huangbai pairs for specific diseases were extracted， and the medicinal in the core prescriptions were classified into four categories of raising yang and eliminating dampness， fortifying spleen and eliminating dampness， clearing dampness-heat， and specialised disease-use. ResultsA total of 323 prescriptions were identified， involving 318 Chinese herbal medicines， 52 syndromes， 200 diseases， among which arthralgia， beriberi， atrophy-flaccidity， leukorrhea， hernia-type diseases， headache， and haemorrhoids appeared more than 10 times. Through analyzing the core prescriptions for high-frequency diseases， we had four findings. Firstly， medicinal of spleen-fortifying and dampness-removing were the most frequent used in core prescriptions of Cangzhu-Huangbai pair （353 times）， and the medication mode was combination of qi-blood supplement medicinal and qi rectifying medicinal， usually using Huangqi （Astragalus mongholicus）， Renshen （Panax ginseng）， Processed Gancao （Glycyrrhiza glabra）， Baizhu （Atractylodes macrocephala）， Danggui （Levisticum officinale）， Chenpi （Citrus reticulata）， Xiangfu （Cyperus rotundus）. Then followed by the combination of heat-clearing and dampness-draining medicinal （213 times）， usually using Fangji （Stephania tetrandra）， Niuxi （Achyranthes bidentata）， and Banxia （Pinellia ternata）， and this type of heat-clearing and dampness-draining medicinal is most frequently used for haemorrhoids， and beriberi is the most frequent disease. The combination of yang-raising and dampness-removing medicinal （212 times）， often using Qianghuo （Hansenia weberbaueriana）， Chaihu （Elephantopus scaber）， Fangfeng （Carum carvi）， and this type of medicinal is most frequently used for headache， and atrophy-flaccidity is the most frequent disease. The combination of medicinal for specialised diseases was used the least frequently （39 times）. ConclusionCangzhu-Huangbai pair were often combined with medicinal of yang-raising and dampness-removing， spleen-fortifying and dampness-removing， and heat-clearing and dampness-draining to expel dampness pathogen， at the same time combined with disease-specific medicinal to treat disease and syndrome together.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.