Objective To investigate the protective effects of erythropoietin (EPO) on myocardium injury after sepsis in rats in order to clarify the mechanisms.Methods The rat models of sepsis were produced by cecal ligation and perforation method (CLP).Ninty-six healthy SD rats were randomly (random number) divided into 3 groups:the sham operation group (Sham group,n =32),the sepsis group (CLP group,n =32),and the EPO treatment group (EPO group,n =32) treated with EPO 1000 IU/kg intraperitoneal injection after the CLP.The observation intervals were set at 3 h,6 h,12 h and 24 h after the surgery.The cardiac hemodynamics of the CLP group were measured.Plasma levels of inflammatory factors and myocardial enzyme indicators were determined by enzyme-linked immunosorbent assay (ELISA) ; Membrane potential levels of chondriosome of myocardial cells,cell apoptosis rates and expressions of nuclear factor-κB p65 of myocardium tissue were detected by flow cytometer; Then the pathological change of myocardium with HE staining was observed under light microscopy.Results (1) Compared with the CLP group,left ventricle systolic pressure (LVSP),left ventricle diastolic end pressure (LVEDP),the maximum rate of left ventricle rise and fall (+ dp/dtmax and-dp/dtmax) in the EPO group improved (P ＜0.05,P＜0.01); (2) Compared with the Sham operation group,plasma levels of tumor necrosis factoralpha (TNF-α),interleukin-6 (IL-6),C-reactive protein (CRP),cardiac troponin-I (cTNI),creatine kinase (CK),lactate dehydrogenase (LDH) and glutamine-oxaloacetic transaminase (GOT) in the CLP group increased at each interval (P ＜ 0.05),and those biomarkers in the EPO group were lower than those in the CLP group (P ＜ 0.05) ; On the contrary,plasma level of anti-inflammatory factor IL-10 in EPO group was higher than that in the CLP group (P ＜ 0.01) ; (3) Compared with the Sham operation group,the cell apoptosis rates in the CLP group increased significantly (P ＜ 0.01),and it decreased obviously in the EPO group (P ＜ 0.01); (4) Compared with the Sham group,membrane potential levels of chondriosome of myocardial cell in the CLP group decreased (P ＜0.01),while it increased in the EPO group in comparison with the CLP group (P ＜ 0.01) ; (5) Pathological changes of myocardium after the CLP could be lessened by the EPO treatment.Conclusions EPO may increase membrane potential levels of chondriosome and decrease the apoptosis rates of myocardial cell in rats after sepsis,and it may reduced the production of inflammatory factors to protect the myocardial cell by down-regulating NF-κB p65.Both increased membrane potential level of chonriosome and decreased inflammatory factor may implicate in myocardium protection thereby improving cardiac function after sepsis.

Objective To explore the relationship between the types of female breast density and age and breast cancer .Methods By accepting the digital mammography X -ray examination for 5 006 women cases and according to the ACR BI -RADS standard in the fourth edition ,the breast density assessment was quantified . We analysed the relationship between the breast density and age and breast cancer .Results In 5 006 cases,the average female age was between 44.22 ±8.09 years old,median age was 43 years old.The components of the breast density were fat type , small amount type , large amount type and compact type each count were 256 (5.11%),726(14.51%),3 719(74.29%),305(6.09%)respectively.By dividing into different age -group to analyze the breast density,there was significant statistical differences of the breast density among age -groups(P<0.001).Among them the breast cancer were 184 cases.Age was between 51.26 ±10.15 years old.Breast cancer in each breast density were fat type 10.16%(26/256),small amount type 9.09%(66/726),large a-mount type 2.45%(91/3719)and compact type 0.33%(1/305).There were statistical differences among age -groups and breast densities and breast (P<0.001).Conclusion Age plays a very important effects on the fe-male breast density .The lower breast density is a high risk factor to breast cancer occurrence .

Objective To observe the changes of lipoprotein‐associated phospholipase A2(Lp‐PLA2) in patients with athero‐thrombosis acute ischemic stroke and the correlation of Lp‐PLA2 with cerebra infarction volume ,neurologic impairment and early prognosis .Methods A total of 104 patients with atherothrombosis acute ischemic stroke and 100 healthy people(controls) were collected .The levels of Lp‐PLA2 were detected by immunoturbidimetry .The cerebral infarction volume was checked by Cranial MRI or CT .The neurological impairment degree was assessed by National Institute of Health Stroke Scale (NIHSS) score .The early prognosis was assessed by Barthel index .The changes of serum Lp‐PLA2 levels in patients with different infarct volumes and neurologic impairment were compared ,the influence of early prognosis were analysised .Results The levels of serum Lp‐PLA2 in the patients with atherothrombosis ischemic stroke were significantly higher than those in control group (P<0 .05) ,and signifi‐cantly correlated with the levels of serum LDLC (r=0 .859 ,P<0 .05) .The levels of serum Lp‐PLA2 were significantly correlated with the increasing of cerebral infarction volume and cerebral neurological impairments (r=0 .531 ,P<0 .05 ;r=0 .623 ,P<0 .05) . The patients with higher level of Lp‐PLA2 has poor prognosis(P<0 .05) .Conclusion The level of Lp‐PLA2 was significantly higher in patients with atherothrombosis ischemic stroke and may reflect the severity and early prognosis in patients with athero‐thrombosis acute ischemic stroke .

Objective To explore the correlation and significance of V312F locus polymorphism of PCSK9 gene in patients with coronary heart disease.Methods We selected 3560 patients with coronary heart disease who came to our hospital from January 2014 to January 2016 as the case group.They were divided into 5 subgroups:angina group,myocardial infarction group,silent myocardial ischemia group,ischemic cardiomyopathy group,and sudden death group,according to their anatomic and pathophysiological features.Data of 1 000 people for physical examination served as the control group.PCR assay combined with direct sequencing method was applied to test V312F locus polymorphism of PCSK9 gene.Logistic regression analysis was used to analyze relationship between V312F locus polymorphism of PCSK9 gene and types of coronary heart disease.The concentration of serum PCSK9 and lipids of the two groups were also measured.Results The serum levels of PCSK9,TC,TG and LDLC and ratio of positive family history in the case group were significantly higher than those in the control group,while the level of HDLC was lower than that of the controls (all P＜0.05).Indexes of sudden death subgroup in the case group showed the most significant changes,while asymptomatic myocardial ischemia subgroup showed the weakest changes.The frequency of genotype TT,GT and allele T in the case group was 3.4％,16.6％ and 11.7％,respectively,which was significantly higher than that in the control group (1.1％,10.2％ and 6.2％) (all P＜0.01).The highest frequency of genotype TT,GT and allele T was found in sudden death subgroup,and the lowest frequency of these indexes was found in asymptomatic myocardial ischemia subgroup (P＜0.05).Results of Logistic regression analysis showed that genotype TT in V312F locus of PCSK9 gene was related to the severity of coronary heart disease (OR =8.463,95％ CI from 3.505 to 17.854,P＜0.001).Conclusion The mutation of V312F (T/G)locus of PCSK9 gene might be related to the severity of coronary heart disease.

Objective To investigate the core competence of humanistic quality of the surgical nurses in primary hospitals ,therefore to detect problems and find corresponding solutions .Methods Based on the scale of core competence of registered nurses of China , we adopted the method of stratified cluster sampling , and choose one grade-three comprehensive hospital , two grade-two comprehensive hospitals and conducted the survey among 189 surgical nurses .The competence difference was compared between nurses of different professional titles and hospitals , and the correlation analysis was made .Results Among the 189 nurses surveyed , the average scores of the critical thinking and scientific research , ethics and legal practice , interpersonal relationship, and education and consultation were (21.32 ±2.54),(20.49 ±1.56),(20.75 ±1.67), (17.81 ±2.20)respectively, with the scoring rates of 53.3%,64.0%,64.8%, and 63.6%respectively.The scores of the senior nurses were higher than those of the junior and intermediate nurses with statistical significance (F=78.814,P<0.01).In terms of interpersonal relationship and ethics and legal practice the scores in grade-three hospitals were higher than those in the grade-two hospitals with statistical significance ( t=2.603,2.249,respectively;P<0.01).The four items of core competence of humanistic quality in the surgical nurses of primary hospitals were positively correlated ( P <0.01 ).Conclusions The core competence of humanity quality of the surgical nurses was comparatively low , with the phenomenon more obvious in junior and intermediate nurses .The cooperation between hospitals and colleges and universities should be promoted so as to strengthen the education on the core competence of humanistic quality in the students .Meanwhile long-term training programs should be implemented by hospitals to give stratified education on the core competence of humanistic quality .

Objective: To investigate the CT features of primary mediastinal neuroendocrine carcinoma and improve the diagnostic accuracy. Methods: CT findings of 12 patients with primary mediastinal neuroendocrine carcinoma diagnosed by clinic and pathology were retrospectively analyzed. The location, size, growth pattern, density, degree of enhancement, invasion of surrounding tissues and metastasis of the tumor were observed, a control analysis was performed. Results: Among the 12 cases, 4 cases were located in the anterior superior mediastinum, 4 cases in the middle superior mediastinum and 4 cases in the middle mediastinum. There were 5 cases on the left side, 4 cases on the right side and 3 cases in the middle. The maximum diameter of the tumor ranged from 1.5 cm to 12.0 cm, with an average of (6.74±3.65) cm. The tumors were round or quasi-round in 6 cases, irregular in 6 cases, clear boundary in 9 cases and unclear in 3 cases. Uniform density was found in 6 cases. The density was heterogeneous in 6 cases, including necrosis and cystic degeneration in 4 cases, and fine-grained calcification in 1 case. The average CT value of plain scan was (38±4.8) HU. There was 1 case of perivascular growth, 2 cases of adjacent vascular compression, 3 cases of adjacent pleural invasion, and 6 cases of infiltrating the surrounding fat space. After contrast enhancement, all cases showed mild and moderate enhancement, including 4 cases with homogeneous enhancement and 8 cases with heterogeneous enhancement. After contrast enhancement, the mean CT value was (55±7.7) HU. There were 9 cases with mild enhancement and 3 cases with moderate enhancement. There were 3 cases with small linear abnormally enhanced vascular shadow in the tumor, and 4 cases with no enhancement both in the central necrosis and the cystic areas. There were 7 cases of typical carcinoid, 2 cases of atypical carcinoid, 2 cases of small cell carcinoma and 1 case of large cell neuroendocrine carcinoma. Conclusion Primary mediastinal neuroendocrine carcinoma is mainly located in the anterior-mediastinum. When the tumor is large, necrosis, cystic degeneration and invasive growth are easy to occur. The enhanced scan shows mild and moderate enhancement. Combined with clinical history, it can improve the accuracy of diagnosis.

Objective To investigate the clinical value of high-frequency ultrasound in the diagnosis of pronator teres syndrome (PTS). Methods The high-frequency ultrasound was employed to examine and measure the median nerve of the pronator teres muscle in 30 patients with PTS and 30 healthy volunteers (control group).The long-axis diameter (LA),short-axis diameter (SA) and cross-sectional area (CSA) of the median nerve were measured.The receiver operating characteristic curve of the median nerve ultrasonic measurement results was established,and the area under the curve (AUC) was calculated.The diagnostic efficiency of each index for PTS was compared with the surgical results as a reference. Results The PTS group showed larger LA[(5.02±0.50) mm vs.(3.89±0.41) mm;t=4.38,P=0.013],SA[(2.55±0.46) mm vs.(1.70±0.41) mm;t=5.19,P=0.009],and CSA[(11.13±3.72) mm² vs.(6.88±2.68) mm²;t=8.42,P=0.008] of the median nerve than the control group.The AUC of CSA,SA,and LA was 94.3% (95%CI=0.912-0.972,Z=3.586,P=0.001),77.7% (95%CI=0.734-0.815,Z=2.855, P=0.006),and 78.8% (95%CI=0.752-0.821,Z=3.091,P=0.004),respectively.With 8.63 mm² as the cutoff value,the sensitivity and specificity of CSA in diagnosing PTS were 93.3% and 90.0%,respectively. Conclusion High-frequency ultrasound is a practical method for diagnosing PTS,and the CSA of median nerve has a high diagnostic value.
Humans ; Forearm/innervation* ; Muscle, Skeletal/innervation* ; Median Nerve/diagnostic imaging* ; Ultrasonography/methods* ; Sensitivity and Specificity

Dilated cardiomyopathy(DCM)has a concealed onset with left or even whole heart enlargement as the main imaging manifestation.It is a common primary disease of heart failure and arrhythmia.With the continuous deepening of research in recent years,the intrinsic molecular mechanism of regulatory cell death(RCD)has gradually become clear.Researchers have found that the RCD mode plays a very important role in the occurrence and development of DCM.At present,the RCD modes involved in DCM mainly include apoptosis,necrotic apoptosis,pyroptosis,iron death,autophagy,and cuproptosis,and a certain correlation exists among them,which interact and regulate each other.This article provides an overview of the current research status on the mechanisms of the six RCD modes involved in DCM to provide a reference for future basic research and clinical applications.

Objective:To describe and analyze the epidemiological characteristics of premature death (death before age of 70 years) and related risk factors in approximate 100 000 adults recruited from 10 regions of China during a 10-year follow-up.Methods:Data, including demographic characteristics, lifestyle and physical indicators as well as health outcomes as of December 31, 2017, were obtained from baseline survey and long-term follow-up of the China Kadoorie Biobank (CKB) study. All-cause and cause-specific premature death in different areas, in men and women and in people with different lifestyles were analyzed. Cox proportional risk model was used to analyze the associations between baseline factors and premature death.Results:A total of 99 993 participants aged 56-69 years were included in the study. During 10 years of follow-up, 7 530 premature deaths were recorded and the premature death rate was 7.15 per 1 000 person-years. The main causes of premature death were cancer and cardiovascular and cerebrovascular diseases. The premature mortality rate was higher in rural areas, in northern region and in men, and decreased with age ( P<0.05). Premature death was more likely to occur in smokers, and a dose-response relationship was observed. Compared with non-drinkers, the risk for premature death was higher in ex-drinkers ( HR: 1.25 [95% CI:1.16-1.36]) and heavy drinkers (average alcohol consumption ≥60 g/d) ( HR: 1.20 [95% CI:1.08-1.34]). The risk for premature death decreased with the increase of physical activity. Low body weight and central obesity were independently associated with increased risk for premature death ( HR: 1.67 [95% CI:1.55-1.81] and 1.13 [95% CI:1.05-1.21], respectively). Conclusions:The main causes of premature death in adults aged 56-69 years in China during 10-year follow-up were cancer and cardiovascular and cerebrovascular diseases. The premature mortality rate varied with socioeconomic and demographic characteristics. The risk for premature death was influenced by multi factors, such as lifestyle and physical conditions.

Objective:To evaluate the associations of sociodemographic characteristics and lifestyle factors with longevity status in older adults in China.Methods:After excluding those born after 31 st December 1938, a total of 51 870 older adults from the China Kadoorie Biobank (CKB) were included. The attained age was defined according to the survival age or age on 31 st December 2018. According to the attained age, the old persons were categorized into non-longevity (died before age 80 years) and longevity (attained age ≥80 years). The longevity group was further divided into two groups: longevity with death occurring before 2019, and longevity and survival to 2019. The information about socio-demographic characteristics and lifestyles was collected at the 2004-2008 baseline survey. Multinomial logistic regression models were used to analyze the associations between exposure factors and outcomes by taking the non-longevity group as the reference group. Results:A total of 51 870 older adults aged 65-79 years in the baseline survey were included for analysis. During a follow-up for (10.2±3.5) years, 38 841 participants were longevity, and 30 354 participants still survived at the end of 2018. Compared to men, rural populations, non-married individuals, those with an annual household income of less than 10 000 yuan, and those with education levels of primary school or below, the adjusted ORs(95% CI) for longevity and survival to 2019 in women, urban residents, married individuals, those with annual household incomes ≥20 000 yuan, and those with education levels of college or university were 1.68 (1.58-1.78), 1.69 (1.61-1.78), 1.15 (1.10-1.21), 1.44 (1.36-1.53), and 1.32 (1.19-1.48), respectively. The OR (95% CI) for longevity and survival to 2019 was 1.09 (1.08-1.10) for those with an increase of 4 MET-hour/day in total physical activity level. With those who never or almost never smoked, had no alcohol drinking every week, had normal weight (BMI: 18.5-23.9 kg/m 2), and WC <85 cm (man)/<80 cm (woman) as the reference groups, the ORs(95% CI) of longevity and survival to 2019 were 0.64 (0.60-0.69) for those smoking ≥20 cigarettes per day, 1.29 (1.14-1.46) for those with alcohol drinking every week, 1.13 (1.01-1.26) for those with pure alcohol drinking <30 g per day, 0.56 (0.52-0.61) for those being underweight, 1.27 (1.19-1.36) for those being overweight, 1.23 (1.11-1.36) for those with obesity, and 0.86 (0.79-0.93) for those with central obesity. Further stratified analysis by WC was performed. In the older adults with WC <85 cm (man)/<80 cm (woman), the ORs (95% CI) of longevity and survival was 1.80 (1.69-1.92) for those with each 5 kg/m 2 increase in BMI and 1.02 (0.96-1.08) for those with WC ≥85 cm (man)/≥80 cm (woman). There was a statistically significant difference in the association between BMI and longevity between the two WC groups (interaction test P<0.001). Conclusion:This study showed that women, the married, those with higher socioeconomic status and education level, and those with healthy lifestyles were more likely to achieve longevity.