Objective To use the antisense of Platelet-derived growth factor ? chain (PDGF-?) gene to inhibit the proliferation of rabbit vascular smooth muscle cells(VSMCs) in order to provide in situ basis on prevention and treatment of human restenosis. Methods A rabbit restenotic vascular model was constrcted and an antisense designed according to PDGF-? cDNA sequence as a drug was used to observe its effects on the expression of proliferating cell nuclear antigen and in situ expression of platele-derived growth factor ? chain by the VSMCs and the formation of neointima after injury. Results The antisense could significantly inhibit the expression of proliferating cell nuclear antigen and downregulate in situ expression of PDGF-? mRNA by intimal VSMCs one week after injury with inhibitory rates of 93.44% and 88.40%, respectively. Conclusion The antisense designed could inhibit the formation of neointima after injury through downregulating the expression of PDGF-? mRNA by local VSMCs, which provides the experimental basis of the antisense for the prevention and treatment the human restenosis.

AIM: To elucidate the co-transfection of platelet derived growth factor B(PDGF-B) antisense oligonucleotide and tissue-type plasminogen activator gene to prevent vascular anastomotic restenosis after coronary bypass.METHODS: A dog model of vascular anastomotic restenosis after coronary bypass was constructed. A constructed tissue-type plasminogen activator(tPA) gene plasmid and a designed PDGF-B oligonucleotide were used to transfect into the dog cardiomyocytes and anastomotic vascular smooth muscle cells(VSMCs) at the same time of coronary bypass, using a therapeutic ultrasound for the gene delivery. Effects of these two genes on thrombosis in local anastomotic vessels, the expressions of proliferating cell nuclear antigen(PCNA) and PDGF-B mRNA by VSMCs and the proliferation of vascular intima were observed with the methods of routine pathological, immuno-histochemical staining, in situ hybridization and morphometry. RESULTS: PDGF-B antisense oligonucleotide and tissue-type plasminogen activator gene were succesfully transfected. These two genes significantly inhibited the expressions of PCNA and PDGF-B mRNA in intimal VSMCs with the inhibitory rates of 65.01% and 81.75%, respectively. The local intimal thickness and area also reduce markablely and the thrombosis of the anastomosis was prevented followed by the reduction of the anastomotic restenotic rate of 62.63%. CONCLUSION: Co-transfection of PDGF-B antisense oligonucleotide and tissue-type plasminogen activator gene inhibits the dog experimental anastomotic restenosis after coronary bypass.

AIM: To elucidate the in vivo mechanisms of the proliferation of vascular smooth muscle cells (VSMCS) in injuried arteries. METHODS: A VSMCS proliferative model was constructed by injury of rabbit iliac arteries with balloon catheters and a probe designed for rabbit platelet-derived growth factor B chain (PDGF-B ) mRNA was used to detect the expression of it by intimal VSMCS on the vascular cross sections using an in situ hybridization technique at the indicated times. The relation of this expression to the proliferation of VSMCS by their expression of proliferating cell nuclear antigen (PCNA) and vascular intimal areas were estimated. RESULTS: The expression of PDGF-B mRNA of intimal VSMCS was increased when calculating the intimal PDGF-B mRNA positive cells per millimetre area at ?400 magnification with average numbers of 31.93?14.64 in 1 week group, 26 50?9 25 in 2 weeks group and 24 85?13 65 in 4 weeks group. This was in accordance with the expression of PCNA by VSMCS and the increase of intimal areas. CONCLUSION: The local production of PDGF-B by VSMCS via an autocrine mechanism is responsible for the continuous proliferation of these cells and formation of neointima after the injury. The probe designed is very useful for detecting rabbit PDGF-B mRNA.

Objective To analyze and summarize the clinical features of delayed occurrence of senile asthma,to add the knowledge and understanding of the disease. Methods To retrospectively analyze clinical data of the cases of senile asthma treated in our hospital,all the cases were divided into groups of early onset senile asthma and delayed occurrence senile asthma,according to the age of first onset.Then related indexes were analyzed,to summarize the clinical features of group of delayed occurrence of senile asthma. Results There were 28 cases of delayed occurrence of senile asthma,accounting for 34.6% of total cases.Compared to early onset group,there was no significant difference (all P＞0.05) between two groups for the following items such as age,allergic history and positive rate of family's history,disease causes,clinical symptoms,basic diseases and complications,proportion of severe cases,rate of misdiagnosis and mistreatment,proportion of standardized treatment and un-standardized treatment,prognosis of diseases and mortality.Both groups had low rate of knowledge and application on PEF monitoring equipment and ACT score.The period of misdiagnosis and mistreatment for delayed occurrence group was shorter than the early onset group (P＜0.05＝; the seasonal nature and day and night pattern was significant in delayed occurrence group (P＜0.05＝. Conclusion Late onset elderly asthma had the features such as shorter course of the disease,relatively obvious onset rule during day and night,and obvious symptoms during night,which are different from that of early onset group.

Objective　To elucidate the mechanism of interferon-gamma (IFN-γ) to inhibit the restenosis after successful percutaneous transluminal angioplasty (PTA). Methods　A rabbit vascular restenotic model was constructed and the proliferation of intimal smooth muscle cells (SMCs) were observed by monitoring their expression of proliferating cell nuclear antigen (PCNA) and platelet-derived growth factor β chain mRNA (PDGF-β mRNA) at the indicated time points. Results　IFN-γ could significantly inhibit the expression of PCNA by intimal SMCs one week after denudation, when counting 200 intimal cells for PCNA-positive reactions with an inhibitory rate of 88.50% (P<0.001). IFN-γ could downregulate in situ expression of PDGF-β mRNA by these cells as we calculated the average number of PDGF-β mRNA positive cells per square millimetre area at ×400 magnification with reduced rates of 86.85% in 1 week group (P<0.001), of 93.66% in 2 week group (P<0.001) and of 52.92% in 4 week group (0.02

Background and objective Geiftinib and Pemetrexed are drugs used as second-line therapy for ad-vanced non-small cell lung cancer (NSCLC), although studies comparing the two drugs are limited. hTe aim of this study is to explore the effects, safety, and quality of life (QoL) of Geiftinib and Pemetrexed on patients with advanced non-squamous NSCLC. Methods Forty-six advanced non-squamous NSCLC patients who failed to ifrst-line therapy were randomly divided into two groups with 23 patients each, one using oral Geiftinib (Geiftinib group) and the other using intravenous injection Pemetrexed (Pemetrexed group). hTe effects, safety, and QoL were determined and analyzed. Results For the Pemetrexed group, objective response rate (ORR) was 13.0%(3/23), disease control rate (DCR) was 30.4%(7/23), and median progres-sion-free survival (mPFS) was 3.1 months. In the Geiftinib group, ORR was 17.3%(4/23), DCR was 39.1%(9/23), and mPFS was 4.4 months. Compared with the Pemetrexed group, the ORR, DCR, and mPFS in the Geiftinib group exhibited no statisti-cal signiifcance (P>0.05). Furthermore, the most common toxicities in the Pemetrexed group were neutropenia (n=9, 39.13%) and fatigue (n=8, 34.78%), whereas those in the in Geiftinib group were skin rash (n=8, 34.78%) and diarrhea (n=4, 17.39%). Compared with baseline, the QoL improved in both groups but to different degrees. Likewise, emotional, functional well-being, and QoL aspects speciifcally related to lung cancer were better improved in the Geiftinib group than in the Pemetrexed group (P<0.05). Conclusion hTe effects of Pemetrexed and Geiftinib as second line therapy were similar, although with dif-ferent AEs. Both drugs could improve the QoL, but Geiftinib showed better overall results than Pemetrexed.

Objective: To investigate the clinical prognostic value of peripheral blood albumin and fibrinogen levels in advanced non-small cell lung cancer (NSCLC). Methods: A total of 158 patients with advanced NSCLC who were admitted to Chest Hospital District of the Affiliated Brain Hospital of Nanjing Medical University from May 2010 to September 2015 were retrospectively analyzed. All patients received systemic chemotherapy plus or not local radiotherapy. The clinicopathological characteristics of patients and the results of peripheral serum protein and fibrinogen were collected, and the correlation between peripheral serum protein and fibrinogen levels and prognosis was analyzed. Results: The median level of serum albumin and plasma fibrinogen was 40.8 g/L (27.6-46.9 g/L) and 3.4 g (2.4-5.2 g/L), respectively, and the median serum albumin and fibrinogen ratio (AFR) was 12.1 (6.2-17.0). The median overall survival (OS) time in the increased serum albumin group (≥40 g/L) and the decreased serum albumin group (<40 g/L) was 17.0 and 9.0 months, respectively, and the median OS time in the increased plasma fibrinogen group (≥40 g/L) and the decreased plasma fibrinogen group (<40 g/L) was 9.0 and 17.0 months, respectively. The median OS time in the increased AFR group (≥10) and decreased AFR group (<10) was 17.0 and 8.0 months, respectively, and there were significant differences between two groups (all P < 0.01). Multivariate analysis showed that serum albumin level (HR = 1.58, 95% CI 1.20-2.06, P = 0.003), plasma fibrinogen level (HR = 1.43, 95% CI 1.01-2.03, P = 0.046) and AFR (HR = 1.81, 95% CI 1.22-2.62, P = 0.001) were independent prognostic factors of OS. Conclusions In patients with advanced NSCLC, higher albumin level and/or lower fibrinogen level are associated with better clinical prognosis. Peripheral serum albumin, fibrinogen level and AFR are independent prognostic factors for advanced NSCLC.

OBJECTIVETo report on the result of thalassemia screening and genetic diagnosis for pregnant women from Guiyang region.

METHODSPrenatal screening for thalassemia was carried out based on erythrocyte parameters and hemoglobin electrophoresis. Single-tube multiplex GAP-PCR and PCR-reverse dot blot hybridization were performed on suspected cases to identify common alpha- and beta- thalassemia mutations, and direct sequencing was used for identifying rare mutations.

RESULTSAmong 13 738 pregnant women, 1745 (12.70%) were suspected as thalassemia. In terms of native place, the provinces with highest screening-positive rates were Guangxi, Guangdong, Jiangxi and Guizhou. And the ethnic groups with highest screening-positive rates were Zhuang, Li, and Buyi. Among 801 women subjected to genetic testing, 457 (57.05%) were diagnosed with thalassemia. In total 9 genotypes of alpha- thalassemia were detected, with the most common genotypes being --/alpha alpha (63.35%), - alpha/alpha alpha (19.37%) and - alpha/alpha alpha (8.90%). Eleven genotypes of beta- thalassemia were detected, with the most common genotypes being CD17/N (42.91%), CD41-42/N (32.46%) and IVS-II-654/N (11.94%). Two cases were detected with rare beta-thalassemia mutations (CD54-58/N and IVS-I-130/N).

CONCLUSIONThe screening-positive rate of thalassemia among pregnant women in Guiyang region is relatively high. The rates have shown substantial difference in terms of native place and ethnic group. Thalassemia-related mutations in Guizhou region have a diverse spectrum, which showed certain difference from those of other regions.

Adolescent ; Adult ; Female ; Genotype ; Humans ; Middle Aged ; Pregnancy ; Prenatal Diagnosis ; methods ; Thalassemia ; genetics ; Young Adult

Objective To study the clinical efficacy and safety of dapagliflozin combined with sacubitril-valsartan in the treatment of heart failure with preserved ejection fraction (HFpEF).Methods A total of 128 patients with HFpEF hospitalized in the cardiovascular medicine department of this hospital from March to December 2022 were selected as the study subjects and divided into the observation group and control group by the random number table method,64 cases in each group.The control group was given the conventional an-ti-heart failure therapy and orally took sacubitril-valsartan,and the observation group took the combined ap-plication of dapagliflozin on the basis of the control group.The continuous treatment lasted for 12 months. The left ventricular end diastolic diameter (LVEDd) and left ventricular ejection fraction (LVEF) were com-pleted by the cardiac color Doppler ultrasound determination in 3,6,12 months after treatment,the blood was collected for detecting NT-poBNP and 6 min walking distance (6MWD) determination was completed.The outpatient follow up was conducted monthly,the follow up contents contained the adverse reactions and major adverse cardio vascular event (MACE) events.Results After 3-month treatment,the NT-proBNP level in the two groups was decreased compared with before treatment,moreover the observation group was lower than the control group,and the differences were statistically significant (P<0.05).Compared with before treat-ment,LVEDd after 3-month treatment in the two groups was decreased compared with before treatment,LVEF was increased compared with before treatment,and the differences were statistically significant (P<0.05).LVEDd after 6-,12-month treatment in the observation group was lower than that in the control group,LVEF was higher than that in the control group,and the differences were statistically significant (P<0.05).6MWD after 3-month treatment in the two groups was increased compared with before treatment,and the difference was statistically significant (P<0.05).6MWD after 6-,12-month treatment in the observation group was higher than that in the control group,and the difference was statistically significant (P<0.05). The re-admission rate due to heart failure and MACE total occurrence rate in the observation group were low-er than those in the control group (9.38％ vs. 23.44％,12.50％ vs. 26.50％,P<0.05),and the adverse re-actions occurrence rates had no statistical difference between the two groups (P>0.05).Conclusion Dapagliflozin combined with sacubitril-valsartan could significantly improve the cardiac function in elderly patients with HFpEF,reduce the occurrence rate of MACE,moreover has good safety.