Objective To investigate the effects of losartan on unstable angina (UA).Methods In a period of 14 days, 83 subjects with UA were randomly divided into 2 groups (group T and C). In group C, nitroglycerin 10-20mg plus 5%glucose 250ml was given by vein drips twice daily. Aspirin 150mg/day and metoprolol 12.5～25mg twice daily were given too. In group T, losartan, in a single dose of 50mg/day was given in addition to treatments of group A. Frequency of angina pectoris, rate pressure product, ST segments changes in 12 lead ECG and several heart function indexes in echocardiography were investigated at the beginning and the end of the study.Results The differences of efficacy between the two groups were significant ( P

Objective To understand the adherence to current treatment guidelines after training in man-agement of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) in emergency department (ED),and to assess the patients' prognosis. Methods Were ED doctors trained with a standard management flow-sheet for AECOPD. The treatment of 152 AECOPD patients recruited from November 1,2008 to April 30,2009 in our hospital and their prognosis were compared to those of 133 AECOPD patients who were treated between Novem-ber 1,0007 to April 30,2008. Results After training, the ED doctors' management of AECOPD is more standard. The rate of the combination of inhaled anticholinergics and short-acting β_2-agonists was increased from 12.0% (16/133) to 27.6% (42/152), the use of inhaled glucocorticosteroids was increased from 52.6% (70/133) to 88.8% (135/152), and the early use of noninvasive imermittent positive pressure ventilation(NIPPV) for the mod-erate to severe was increased from 10.5% (14/133) to 16.4% (25/152). The use of theophylline was decreased from 69.2% (92/133) to 49.3% (75/152). The in-ED mortality rate was decreased from 15.8% (21/133) to 12.5% (19/152). All the difference were significant (P< 0.05). The rate of inhaled β_2-agonists was increased from 78.2% (104/133) to 82.9% (126/152), the use of systemic glucocorticosteroids was decreased from 63.2% (84/133) to 56.6% (86/152),the use of antibiotics was increased from 88.0% (117/133) to 92.8% (141/152), and the use of invasive mechanical ventilation was increased from 14.3% (19/133) to 15.1% (23/152) ,the in-hos-pital mortality rate was decreased from 6.0% (8/133) to 5.3% (8/152), the average days in hospital was decreased from 13.3 to 12.4 days, but the difference was not significant (P > 0.05). Conclusions There are still some differences exist between guideline recommendations and actual ED management of AECOPD. After training ED doctora with a standard flow-sheet, their management of AECOPD is improved. The rate of the combination of inhaled anticholinergics and short-acting β_2-agonists, use of inhaled glucocorticosteroids, and early use of NIPPV is increased. The use of theophylline and the in-ED mortality rate is decreased.

Objective:To study the effects of ~(125)I-(α_v)ASODN on the in vitro invasive ability of heptocellular carcino-ma cell line(HepG2) through PEI-RGD-mediated receptor process. Methods: Intergrin α_v-specific antisense oligonucle-otide was labeled with ~(125)I, and PEI-RGD/~(125)I-(α_v)ASODN complex was prepared by combining ~(125)I-(α_v)ASODN with polyethyleneimine derivative PEI-RGD. PEI-RGD/~(125)I-(α_v)ASODN complex was transferred into HepG2 cells through the receptor-mediated process. The effect of PEI-RGD/~(125)I-(α_v)ASODN complex on the invasive ability of HepG2 cells was examined by Boyden chamber invasive assay. Results: (1) The labeling yield and radiochemical purity of ~(125)I-(α_v) ASODN were(73.78±4.09)% and(96.68±1.38)%, respectively, and the labeled compound had a good stability in vitro after 48 h at 37℃; (2) The ability of HepG2 cells to uptake PEI-RGD/~(125)I-(α_v)ASODN reached its peek ([12.77±0.85] % ) when PEI-RGD/~(125)I-(α_v)ASODN was at 4 μl/2 μg ([12.77±0.85] %), and then gredually decreased thereafter. So the dosage of PEI-RGD/~(125)I-(α_v)ASODN for the following experiment was chosen as 2 μl/1 μg; (3) The invasive capacity of HepG2 cells was significantly reduced in PEI-RGD/~(125)I-(α_v)ASODN group compared with those in other experiment and control groups (P <0.01 ). Conclusion: ~(125)I-(α_v)ASODN mediated by PEI-RGD can effectively inhibit the invasive capacity of HepG2 cells.

Objective:To assess the relationship between visceral fat area(VFA) and diabetic peripheral neuropathy (DPN) in type 2 diabets mellitues(T2DM) patients.Methods:A total of 2 615 patients with T2DM were enrolled from the National Metabolic Management Center at Ningbo First Hospital between March 2018 and February 2021. The medical history, questionnaire survey, and laboratory parameters were collected, VFA was measured using bioelectrical impedance analysis, DPN was diagnosed based on neurophysiological examination. Patients were divided into four groups by VFA and body mass index as the following: VFA<100 cm 2 and body mass index<24 kg/m 2 group [VA(-)OB(-) group], VFA<100 cm 2 and body mass index≥24 kg/m 2 group [VA(-)OB(+ ) group], VFA≥100 cm 2 and body mass index<24 kg/m 2 group [VA(+ )OB(-) group], and VFA≥100 cm 2 and body mass index≥24 kg/m 2 group [VA(+ )OB(+ ) group]. Multivariable logistic regression analysis was done to determine the relationship between body mass index, VFA and DPN in patients with T2DM. Results:The proportion of DPN in this study was 46.96%. DPN group featured with older age, higher proportion of men, longer duration of disease, higher proportion of smoking, lower diastolic blood pressure, higher HbA 1C level, lower total cholesterol, lower high density lipoprotein-cholesterol, lower low density lipoprotein-cholesterol, higher blood creatinine levels, higher urinary albumin-to-creatinine ratio, higher VFA level (all P<0.01). Grouping according to VFA and body mass index, 68.1% in the VA(+ )OB(-) group had DPN, which was highest among the four groups. In multivariable logistic regression analysis, compared with VA(-)OB(-) group, VA(+ )OB(-) group had a significantly higher risk of DPN ( OR=2.234, 95% CI 1.339-3.728, P =0.002), VA(+ )OB(+ ) group took second place ( OR=1.281, 95% CI 1.030-1.592, P =0.026). Conclusions:VFA was associated with DPN in T2DM regardless of body mass index. The VA(+ )OB(-) group has the highest risk of DPN. Therefore, evaluation of visceral adiposity may have important clinical significance for the early screening and prevention of DPN in T2DM.

Objective:To identify Down syndrome (DS) fetal encephalopathy related genes and signaling pathways via bioinformatics analysis, and to explore their potential mechanisms underlying the occurrence and development of DS neuropathology.Methods:Retrospective study.In December 2021, dataset GSE59630 was downloaded from the gene expression omnibus (GEO), and differentially expressed genes (DEGs) between DS and normal fetal brain tissue were identified by R software.Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis and gene set enrichment analysis (GSEA) were performed on the genes identified.The protein-protein interaction (PPI) network was constructed based on search tool for the retrieval of interacting genes online database and Cytoscape software, and key modules and hub DEGs were identified.Real-time quantitative polymerase chain reaction technique was used to verify the expression of hub genes related to neurodegeneration in brain tissue of 3 pairs of DS and normal fetuses at the gestational age of 22-33 weeks.Results:A total of 225 DEGs were screened out from DS and normal fetal brain tissue, including 18 up-regulated genes and 207 down-regulated genes.GO functional enrichment analysis showed that DEGs were mainly enriched in neurogenesis, neuronal apoptosis, transcriptional regulation, mitochondrial energy metabolism, etc.KEGG pathway enrichment analysis revealed that DEGs were associated with a variety of neurodegenerative diseases.GSEA suggested that apoptosis and inflammatory responses play a vital part in the occurrence of DS neuropathology.Ten hub genes were identified by the PPI network established, and they were mainly related to histone acetylation and transcriptional regulation.According to the tissue verification result, the variations of RAB8A, TBP and TAF6 expression conformed to the microarray data. Conclusions:The key genes and signaling pathways identified by transcriptome analysis of fetal brain tissue facilitate the comprehensive understanding of the molecular mechanism of DS neuropathology.This study provides a novel insight into the clinical diagnosis and treatment of neurodevelopmental abnormalities and mental retardation in DS.

To explore the relationship between sleep duration and brachial-ankle pulse wave velocity(baPWV) in patients with type 2 diabetes mellitus(T2DM). A total of 1 755 patients with T2DM received standardized management of metabolic disease from March 1, 2018 to February 29, 2020 were included. All patients were classified into three groups according to the sleep duration: short(≤6 h), medium(>6 h to 8 h) and long(>8 h). Increased arterial stiffness was defined as baPWV≥1 600 cm/s. The prevalence of baPWV≥1 600 cm/s was 39.7%, 30.8% and 38.6% in short, medium and long sleep duration group, respectively( P<0.01). Multivariate logistic regression analysis showed that patients with long sleep duration( OR=1.317, P<0.05) but not short sleep duration( OR=1.169, P>0.05) had a higher risk for baPWV≥1 600 cm/s compared with the reference group with medium sleep duration. Stratified analyses by sex showed that the OR were 1.735( P<0.05) among female and 1.131( P>0.05) among male respectively for baPWV≥1 600 cm/s in long sleep duration group when compared with medium sleep duration group. Sleep duration>8 h was found to be associated with elevated baPWV in patients with T2DM. There were gender differences in the correlation between long sleep duration and baPWV.

Objective To analyse the risk factors associated with spontaneous intestinal perforation (SIP) in extremely premature infants/extremely low birth weight infants. Method From January 2015 to December 2018, infants with gestational age (GA)<28 weeks or birth weight (BW)<1000 g admitted to our neonatal intensive care unit were enrolled to the retrospective nested case-control study.The clinical data of SIP infants (SIP group) and infants with the same GA but without SIP (control group) were randomly selected and compared. Multivariable Logistic regression was used to analyse the risk factors of SIP. Result A total of 409 extremely premature infants/extremely low birth weight infants were born during the study period. Among them, 25 SIP infants and 55 controls were enrolled. The incidence of SIP in infants with GA 22～25 weeks was 11.8％(16/136), which is higher than infants with GA 26～27 weeks (2.0％, 5/247) (χ2=16.057, P<0.001). The incidence of SIP in infants with BW 400～749 g was 13.0％(14/108), which is higher than infants with BW 750～999 g (3.4％, 8/236) (χ2=11.343, P=0.001). Multivariate Logistic regression analysis showed that twins (OR=4.153, 95％CI 1.392～12.384, P=0.011), umbilical veins catheterization (OR=15.942, 95％CI 1.026～247.789, P=0.048) and ibuprofen use within 3 days after birth (OR=15.387, 95％CI 1.519～155.883, P=0.021) were independent risk factors of SIP. Conclusion The smaller the GA and BW, the higher the incidence of SIP. Twins,umbilical veins catheterization and ibuprofen use early after birth may be independent risk factors of SIP.

Objective To investigate the anatomical structure of the first plantar lumbrical muscle in the foot and to measure the relevant data which could provide anatomical basis for repairing thumb and finger defects with the transplantation of toes accompanied with the first lumbrical muscle,and to explore the marphological function of the first lumbrical muscle of the foot.Methods From March,2016 to January,2018,a systematic and detailed dissection of the 50 formalin-fixed feet was performed to observe the exact position of the starting and ending points of the first lumbrical muscle,and a Vernier caloper was used to measure the relevant record data.Results The first lumbrical muscle originates from the medial portion of the flexor digitorum lungus tendon of the second toe,and the length of the ventral muscle was [55.87±8.67(79.30-41.16] mm.There were 2 endpoints in the tendon.The first one was in the medial tubercle of the proximal phalanges.The second one was aponeurosis of the dorsal toe and the tendon was divided into proximal and distal segments with the medial tubercle as the mark point.The length of the proximal segment was [15.34±4.81(5.52-25.18] mm,the width of the proximal segment was [2.31±1.12(3.28-1.21)] mm,the thickness was [0.44±0.14(0.28-0.68)] mm;the length of the distal segment was [11.51±4.06(3.46-14.90)] mm,the width was [6.10±1.44(9.36-3.70)] mm,and the thickness was [0.18±0.09(1.10-0.38)] mm.The length and thickness of the proximal segment was signifantly larger than those of the distal segment (P＜0.05).Conclusion The first lumbrical muscle has the function of maintaining the balance and stability of both the toe and the arch during movement,flexuring the metatarsophalangeal joint,extending the interosseous joint of the extensor phalangeal,adducting the second toe;also the function of preventing the second toe from pronation during foots' movement.

The pathogenesis of bipolar disorder(BD)is unknown,and objective biomarkers with clinical guidance are lacking.Extracellular vesicles(EV)are lipid bilayer-enclosed vesicles that carry cargo from originating cells,influencing the processes of recipient cells.They are capable of crossing the blood-brain barrier and reflecting the ongoing processes in the central nervous system.Compelling data indicates that EV could mediate BD pathophysiological processes such as neurocognitive impairment,neuroinflammatory diffusion,and metabolic dysfunction.Therefore,EV has the potential to become a reliable biomarker and therapy for BD,providing new ideas for revealing the pathogenesis and clinical diagnosis and treatment of BD.