OBJECTIVE:To investigate the clinical efficacy of alprostadil combined with edaravone in the treatment of unsta-ble angina pectoris(UAP),and their effects on serum oxidative stress indexes,the levels of MMP-2 and MMP-9. METHODS:Be-sides conventional treatment,control group was treated with Alprostadil injection 2 ml added into 0.9% Sodium chloride injection (NS)100 ml,ivgtt,qd;while observation group was additionally treated with Edaravone injection 15 ml added into NS 100 ml, ivgtt,qd. Treatment courses of 2 groups lasted for 2 weeks. The frequency and duration of UAP attack,serum levels of MDA, SOD,TAC,MMP-2 and MMP-9 levels were observed 2 groups;the occurrence of ADR was also observed. RESULTS:There was no statistical significance in frequency of angina pectoris attack,duration,MDA,SOD,TAC,MMP-2 and MMP-9 between 2 groups before treatment (P>0.05). After treatment,the total effective rate of observation group (94.3%) was significantly higher than that of control group(81.4%). The frequency of angina pectoris attack and the level of MDA,were significantly reduced,and the duration of angina pectoris was significantly shortened SOD and TAC increased significantly;the change of observation group was more significant than that of control group with statistical significance(P<0.05). ADR was mild in 2 groups;there was no statisti-cal significance in the incidence of ADR(P>0.05). CONCLUSIONS:Alprostadil combined with edaravone is significantly effec-tive for UAP,reduces the frequency of angina,shortens the duration of angina pectoris,alleviates oxidative stress and reduces se-rum levels of MMP-2 and MMP-9 with good safety.

Objective To investigate the nursing professional values of different nursing groups and probe into the influencing factors.Methods By cluster and stratified sampling,a total of 583 participants including nursing students and registered nurses were investigated by Nursing Professional Values Scale.Results Nursing students and registered nurses hold a higher level of nursing professional values.Nursing professional value scores of nursing students were significantly higher than registered nurses.There was statistical difference between different nursing groups.Working years and monthly income were important influencing factors.Conclusions Nursing educators and administers could choose effective methods according to the condition to improve nursing professional values.

Objective To investigate the effect of Dexmedetomidine hydrochloride combined with Butorphanol tartrate on stress state in elderly patients with severe illness.Methods A total of 120 elderly patients with severe illness admitted into our hospital from March 2016 to March 2018 were randomized into group A,B and C(n=40,each).Group A was given intravenous Midazolam for analgesia,group B was treated with intravenous Medetomidine for analgesia,and group C received Dexmedetomidine combined with Butorphanol tartrate for analgesia.The differences in mean artery pressure(MAP),heart rate(HR),C-reaction protein(CRP),interleukin-6 (IL-6),visual analogue scale (VAS)score and Ramsay score were compared among the three groups.Results The levels of MAP,HR,CRP,IL-6 and VAS score after 24,48 and 72 hours of combined treatment of dexmedetomidine and butorphanol tartrate were lower in group C than in group B(P ＜0.05).There was no significant difference in the levels of MAP,HR,CRP,IL-6 and VAS score between group A and B after 24,48 and 72 hours of administration(P＞0.05).Ramsay score was higher in group C (intravenous both Dexmedetomidine and Butorphanol tartrate) than in group B (intravenous Dexmedetomidine alone)at 24,48 and 72 hours after administration (P ＜ 0.05).There was no significant difference in Ramsay score after 24,48 and 72 hours of administration between group A and B(P＞0.05).The incidence of adverse reactions was lower in group C than in group A and B(10.0％ vs.35.0％ and 32.5％,x2 =7.168 and 6.050,P =0.007 and 0.014).There was no significant difference in the incidence of adverse reactions between group A and BCx2=0.056,P =0.813).Conclusions Dexmedetomidine hydrochloride combined with Butorphanol tartrate can effectively improve hemodynamics,and alleviate inflammatory reaction and pain in elderly patients with severe illness,with a good security.And it is worthy of clinical generalization.

Objective:To explore the clinical and genetic characteristics of a fetus diagnosed with Congenital myasthenic syndrome type 16 (CMS16).Methods:A couple who had visited Tianjin Medical University General Hospital in February 2018 due to "adverse outcome of two pregnancies" was selected as the study subject. Clinical data was gathered. Peripheral blood and amniotic fluid samples were collected and subjected to whole exome sequencing (WES). Candidate variant was verified by Sanger sequencing. Low-depth whole-genome sequencing was carried out to detect copy number variation (CNV) in the fetus.Results:The couple′s first pregnancy had resulted in a miscarriage at 27 + 5 weeks, when ultrasound had revealed pleural effusion and polyhydramnios in the fetus. Their second pregnancy was terminated at 30 + 5 weeks due to fetal hand malformations, polyhydramnios and pleural fluid. Both couple had denied family history of genetic conditions. For their third pregnancy, no CNV abnormality was detected, whilst a compound heterozygous variants, including a maternally derived c. 3172C>T (p.R1058W) and paternal c. 1431delG (p.K477fs*89) in the SCN4A gene were detected. Based on the guidelines from the American College of Medical Genetics and Genomics, the c. 3172C>T (p.R1058W) was predicted as a likely pathogenic variant (PM1+ PM2_supporting+ PP3+ PP4), whilst the c. 1431delG (p.K477fs*89) was predicted as a pathogenic variant (PVS1+ PM2_supporting+ PP4). Conclusion:The c. 3172C>T (p.R1058W) and c. 1431delG (p.K477fs*89) compound heterozygous variants of the SCN4A gene probably underlay the CMS16 in the third fetus.

Objective:To explore the clinical and molecular basis for a Chinese pedigree affected with Complete androgen insensitivity syndrome (CAIS).Methods:A CAIS pedigree presented at Tianjin Medical University General Hospital between 2019 and 2021 was selected as the study subject. Clinical data of the proband was collected, along with peripheral blood samples from the proband and her family members. Chromosomal karyotyping, sex-determining region of the Y chromosome ( SRY) testing, and next-generation sequencing (NGS) were carried out for the proband, and candidate variant was verified by Sanger sequencing of her family members. Prenatal diagnosis was provided for the sister of the proband. This study was approved by Medical Ethics Committee of the Tianjin Medical University General Hospital (Ethics No. IRB2023-WZ-070). Results:The 18-year-old proband, who has a social gender of female, underwent laparoscopic examination, which showed no presence of uterus and ovaries. The karyotype of peripheral blood sample was 46, XY, with SRY gene detected. NGS indicated that the proband has harbored a heterozygous c. 1988C>G (p.Ser663Ter) variant of the AR gene. Sanger sequencing confirmed that her mother and sister had both harbored the same variant, whilst her father and younger sister were of the wild-type. Prenatal diagnosis revealed that her sister′s first fetus had harbored carried the same variant, which had led to termination of pregnancy. Her second fetus did not carry the variant, and a healthy boy was born. Based on guidelines from the American College of Medical Genetics and Genomics (ACMG), the variant was classified as likely pathogenic (PM2_Supporting+ PM4+ PP3_Moderate+ PP4). Conclusion:The c. 1988C>G (p.Ser663Ter) variant of the AR gene probably underlay the CAIS in the proband. The accurate diagnosis of sex development disorders will rely on the physicians′ thorough understanding of the clinical symptoms and pathogenic genes. Genetic testing and counseling can enable precise diagnosis, prenatal diagnosis, and guidance for reproduction

Objective:To investigate the effect of serine/arginine-rich splicing factor 2 (SRSF2) on ferroptosis and its possible mechanism in glioblastoma cells.Methods:The online database of gene expression profiling interactive analysis 2 (GEPIA 2) and Chinese Glioma Genome Atlas were used to analyze the expression of SRSF2 in glioblastoma tissue and its association with patients prognosis. To validate the findings of the online databases, the pathological sections of glioblastoma and non-tumor brain tissues from Tianjin Medical University General Hospital, Tianjin, China were collected and analyzed by using immunohistochemistry. Silencing SRSF2 gene expression in glioblastoma cells by siRNA was analyzed with Western blot. The proliferation index was detected by using CCK8 assay. The rescued experiment was conducted by using expression plasmid of pcDNA3.1(+)-SRSF2. The activity of ferroptosis was assessed by using the levels of iron ions and malondialdehyde in glioblastoma cells and the changes in the ratio of glutathione to oxidized glutathione. The changes of gene expression and differential pre-mRNA alternative splicing (PMAS) induced by SRSF2 were monitored by using the third-generation sequencing technology analysis, namely Oxford nanopore technologies (ONT) sequencing analysis.Results:SRSF2 expression was higher in glioblastoma tissues than non-tumor brain tissues. Immunohistochemistry also showed a positive rate of 88.48%±4.60% in glioblastoma tissue which was much higher than the 9.97%±4.57% in non-tumor brain tissue. The expression of SRSF2 was inversely correlated with overall and disease-free disease survivals ( P<0.01). The proliferation index of glioblastoma cells was significantly reduced by silencing with SRSF2 siRNA ( P<0.01) and could be reversed with transfection of exogenous SRSF2. The levels of intracellulariron ions and malondialdehyde increased ( P<0.05), but the glutathione/oxidized glutathione ratio and the expression of key proteins in the glutathione pathway remained unchanged ( P>0.05). ONT sequencing results showed that silencing SRSF2 in glioblastoma cells could induce a significant alternative 3' splice site change on ferroptosis suppressor protein 1 (FSP1). Conclusion:SRSF2 inhibits the ferroptosis in glioblastoma cells and promotes their proliferation, which may be achieved by regulating FSP1 PMAS.