Objective:To assess the diagnostic value of anti-salivary gland protein-1(SP1)antibody combined with anti-parotid secretory protein(PSP)antibody for Sj?gren's syndrome(SS).Methods:A total of 60 patients with primary SS(pSS)who were treated in the outpatient and inpatient department of Department of Rheumatology and Immunology of the Second Hospital of Hebei Medical University from January 2020 to December 2022 were collected.Thirty patients with other autoimmune diseases accompa-nied by dry mouth and/or dry eyes were collected as disease control group.Thirty healthy subjects from the physical examination center were collected for healthy control group,serum samples were obtained from all of them.Their general features and clinical information including clinical manifestations,labora-tory examinations and other examinations were recorded.The 2016 American College of Rheumatology(ACR)/European League against Rheumatism(EULAR)classification criteria were adopted as the diag-nostic standard of pSS.Immunoglobulin G(IgG)subtype of anti-SP1 antibody and anti-PSP antibody were detected by chemiluminescence immunoassay.The receiver operating characteristic(ROC)curve was used to evaluate the accuracy of anti-SP1 antibody and anti-PSP antibody in diagnosing pSS.The cli-nical characteristics of anti-SP1 antibody and anti-PSP antibody positive patients and negative patients in pSS group were further compared.Independent samples t test,Mann-Whitney U test,variance analysis,Kruskal-Wallis test,Chi-square test or Fisher's exact test and Spearman correlation analysis were used for statistical analysis.Results:There was no significant difference in age(F=1.406,P=0.495)and gender(x2=2.105,P=0.349)among pSS group,disease control group and healthy control group.The expression levels of anti-SP1 antibody(H=16.73,P＜0.001)and anti-PSP antibody(H=26.09,P＜0.001)were statistically different among the three groups.An intergroup comparison of anti-SP1 antibody expression levels showed that there was a statistically significant difference between pSS and healthy con-trol group(P＜0.001),but no statistically significant difference between the other groups.Comparison of anti-PSP antibody expression levels between the groups showed that there were statistically significant differences between pSS and healthy control group(P＜0.001),and between disease control group and healthy control group(P=0.009),while no statistically significant differences between the other groups.The positive rate of anti-SP1 antibody in pSS group was significantly higher than that in disease control group and healthy control group(58.33％vs.40.00％vs.13.33％,P＜0.001).The positive rate of anti-PSP antibody in pSS group was significantly higher than that in disease control group and healthy control group(75.00％vs.56.17％vs.16.67％,P＜0.001).The area under the curve for anti-SP1 antibody was 0.688(P＜0.001).The sensitivity and specificity of anti-SP1 antibody were 58.33％(35/60)and 70.00％(42/60)respectively,the positive predictive value was 66.04％(35/53)and the negative predictive value was 54.55％(42/77)of anti-SP1 antibody.The area under the curve of anti-PSP antibody was 0.720(P＜0.001),with a sensitivity was 75.00％(45/60),and spe-cificity was 63.33％(38/60).The positive predictive value and negative predictive value of anti-PSP an-tibody were 67.16％(45/67)and 71.70％(38/53)respectively.All the 13 pSS patients were negative for anti-Sjogren's syndrome A(SSA,including SSA52 and SSA60)antibody and anti-Sjogren's syn-drome B(SSB)antibody.Among them,11 patients were positive for both anti-SP1 antibody and anti-PSP antibody,1 patient was positive for anti-SP1 antibody and 1 patient was positive for anti-PSP anti-body.The clinical features of anti-SP1 antibody and anti-PSP antibody positive and negative groups were compared in pSS patients.The duration of disease in anti-SP1 antibody positive group was shorter(Z=-2.277,P=0.023)when compared with the negative patients.The patients with positive anti-PSP an-tibody were younger than those in the negative group(t=2.598,P＜0.05),the positive rate of rheuma-toid factor(P=0.002)and the serum level of IgG(t=3.806,P=0.003)in anti-PSP antibody positive group were higher than in the negative group.Analysis of the correlation between anti-SP1 antibody and anti-PSP antibody in the pSS patients showed that there was significant correlation between them(r=0.801,P＜0.001).Conclusion:Both anti-SP1 antibody and anti-PSP antibody are valuable in the diag-nosis of SS,and anti-SP1 antibody is helpful for the early diagnosis of pSS.The combined detection of anti-SP1 antibody and anti-PSP antibody is helpful for the early diagnosis of pSS patients with negative anti-SSA antibody and anti-SSB antibody.

Objective:To study the prevalence and association factors of depressive and anxiety disorders in the hypertensive population.Methods:Using the database obtained from the 2013 China Chronic Disease and Risk Factor Surveillance and the 2013-2015 China Mental Health Survey,4 861 hypertensive residents were used as study subjects.And using the Diagnostic and Statistical Manual of Mental Disorders,Fourth Edition(DSM-Ⅳ)as diagnostic criterion for depressive and anxiety disorders,the 12-month prevalence was calculated.Multifactorial lo-gistic regression models were used to explore the association factors of hypertension comorbid depressive and anxie-ty disorders.Results:The 12-month prevalence rates of depressive disorders and anxiety disorders were 4.1％and 5.0％in 4 861 hypertensive residents.Chinese Han[OR(95％CI):2.00(1.01-3.93)],lack of sleep[OR(95％CI):1.82(1.34-2.48)],having myocardial infarction[OR(95％CI):2.35(1.18～4.67)]and stroke in the past year[OR(95％CI):2.10(1.19-3.72)],and chronic obstructive pulmonary disease[OR(95％CI):2.11(1.11-4.05)]were risk factors of hypertension comorbid depressive disorder.Hypertensive people with controlled blood pressure[OR(95％CI):2.01(1.30-3.13)]had a higher risk of co-morbid depressive disorder than those with blood pressure above the normal range on this measurement.Chinese Han[OR(95％CI):2.51(1.32-4.80)],Southwest China[OR(95％CI):1.64(1.02-2.63)],and lack of sleep[OR(95％CI):1.45(1.09-1.93)]were risk factors of hypertension comorbid anxiety disorder.Former but current non-smoking[OR(95％CI):0.48(0.23-0.99)]was a protective factor of hypertension comorbid anxiety disorder.Conclusion:The 12-month prevalence of anxiety disorder was higher than that of depressive disorder in this hypertensive population.Both Han and sleep deprived hypertensive people had a higher risk of comorbid depressive and anxiety disorders.

Objective:To analyze the comorbidity status and influencing factors of hypertension, diabetes, and dyslipidemia among middle-aged and elderly Chinese adults and to provide support for the "co-management of three diseases".Methods:Using the relevant information collected from the National Chronic Disease and Risk Factor Surveillance in China in 2018, 134 950 permanent residents aged ≥45 years were selected as the research objects. After being weighed, the prevalence and comorbidity of hypertension, diabetes, and dyslipidemia in residents with different groups were compared; a multivariate logistic regression model was used to explore the influencing factors of comorbidity of the "three diseases".Results:The prevalence of hypertension, diabetes, and dyslipidemia among middle-aged and elderly Chinese adults were 46.0% (95% CI:45.1%-47.0%), 19.5% (95% CI:18.7%-20.2%), 43.3% (95% CI:42.3%-44.4%), respectively. The comorbidity rates of hypertension and diabetes, hypertension and dyslipidemia, and diabetes and dyslipidemia were 12.3% (95% CI:11.7%-12.8%), 22.8% (95% CI:22.1%-23.4%),11.6% (95% CI:11.1%-12.0%), respectively; the comorbidity rate of hypertension, diabetes, and dyslipidemia was 7.6% (95% CI: 7.2%-8.0%). These comorbidity rates increased with age and BMI, which was more significant in the urban areas than rural areas and more outstanding in North and Northeast China ( P<0.05). The comorbidity rate of hypertension, diabetes, and higher cholesterol was 1.9% (95% CI:1.7%-2.1%). The comorbidity rate of hypertension, diabetes, and higher low-density lipoprotein was 1.6% (95% CI:1.4%-1.7%), which was higher in women than in men ( P<0.05). Multivariate logistic regression results showed that male, age, city, overweight/obesity, excessive drinking, physical inactivity, daily sedentary behavior time ≥5 hours, and sleep duration <7 hours were risk factors for the comorbidity of the "three diseases". Conclusions:The comorbidity of hypertension, diabetes, and dyslipidemia, is common among middle-aged and elderly adults in China; comprehensive prevention and control of risk factors and "co-management of three diseases" are critical measures for health promotion in middle-aged and elderly populations.

Objective:To understand the regular leisure-time physical activity status of residents aged ≥60 years in China and to explore the potential influencing factors.Methods:National Chronic Disease and Risk Factor Surveillance were conducted in 298 counties (districts) in China in 2018, which covered 31 provinces (autonomous regions, municipalities), using a multi-stage stratified cluster random sampling method to select 194 779 permanent residents aged ≥18 years, using a questionnaire containing the Global Physical Activity Questionnaire. A face-to-face survey to obtain demographic information about the survey respondents, the frequency of moderate and vigorous-intensity leisure-time physical activity in their spare time and time, and other information related to chronic diseases and risk factors. Daily temperatures of 298 monitored counties (districts) in 2018 were obtained by inversion of satellite remote sensing data information such as MODIS, OMI, and AIRS, and the number of parks in 2017 was obtained by me. In this study, 68 379 residents aged ≥60 years who completed the survey and had complete information on leisure-time physical activity-related variables, temperature, and parks were used as survey respondents, and the prevalence of regular leisure-time physical activity and average weekly exercise time was calculated by gender in groups of age, urban and rural areas, education level, and geography. Multi-factor logistic regression models were used to analyze the individual and environmental influences on the regular exercise rate. All the results were weighted according to a complex sampling scheme.Results:The prevalence of regular leisure-time physical activity of residents aged ≥60 years in China in 2018 was 13.1% (95% CI: 12.1%-14.0%). The figures were slightly higher for men [13.6% (95% CI: 12.6%-14.7%)] than for women [12.5% (95% CI: 11.5%-13.5%)]; urban [17.5% (95% CI: 15.9%-19.1%)] were significantly higher than those in rural areas [9.6% (95% CI: 8.8%-10.4%)]; the prevalence of regular leisure-time physical activity in East China [15.1% (95% CI: 13.3%-16.9%)] was higher than those in other regions; older residents in counties (districts) with ≥28 parks [17.3% (95% CI: 15.3%-19.2%)] the highest. The average weekly exercise time of elderly residents in China was 68.3 (95% CI: 63.5-73.2) minutes; among them, men [74.3 (95% CI: 68.1-80.5) minutes] was higher than women [62.5 (95% CI: 57.8-67.2) minutes]; urban [89.8 (95% CI: 82.0-97.7) minutes] were higher than rural [51.4 (95% CI: 46.8-56.1) minutes]. The results of the multi-factorial logistic analysis showed that factors such as: living in rural areas, lower annual household income for literacy, poorer self-rated health status, and lack of parks in the area of residence were associated with a lower prevalence of regular leisure-time physical activity among elderly residents. Conclusions:The prevalence of regular leisure-time physical activity among elderly residents in China is still at a low level, and exercise time needs to be improved. We should increase the publicity of "national fitness", pay attention to the disadvantaged elderly groups and provide more suitable activity places to encourage more elderly residents to participate in leisure-time physical activity.

Objective To observe the clinical efficacy and safety of nifedipine controlled-release tablets on the antihypertensive effect of hypertensive patients under high altitude environment. Methods 42 hypertensive inpatients in the 940th hospital (altitude 1500 ) were set to the plain hypertension group, and 42 cases of hypertensive inpatients in Bayi hospital (altitude 3800 m) were set to the plateau hypertension group. Both groups of patients were given nifedipine controlled-release tablets 30 mg daily, taken orally in the morning for 6 consecutive days. Monitor blood pressure and heart rate three times a day to compare the clinical efficacy and occurrence of adverse drug reactions in the two groups. Results After treatment, the total effective rates of the high-altitude hypertension group and the plain hypertension group were 47.62% (20 cases/42 cases) and 76.19% (32 cases/42 cases) respectively with no statistical difference (P<0.05). The adverse drug reactions of the two groups of patients were tachycardia and palpitations. The incidence of total adverse drug reactions in the high-altitude hypertension group and the plain hypertension group were 14.29% and 11.90% respectively with no statistical difference (P>0.05). Conclusion The high-altitude hypoxic environment could affect the antihypertensive effect of nifedipine controlled-release tablets, which could not control the patient's blood pressure effectively in the short term.

Objective:To investigate the efficacy and safety of different stents assisted embolization in the treatment of subarachnoid hemorrhage(SAH) caused by V4 dissecting aneurysm of vertebral artery.Methods:The clinical data of 39 patients with spontaneous SAH V4 dissecting aneurysm treated at the Department of Neurosurgery, the Northern Theater General Hospital from January 2016 to June 2019 were analyzed retrospectively.There were 21 males and 18 females, aged (48±17) years(range:35 to 68 years).There were 24 cases of HUNT-HESS grade Ⅰ and 15 cases of grade Ⅱ.Among them, 20 cases were treated with single stent-assisted embolization, 9 cases with multi-stent-assisted embolization, 9 cases with semi-dense mesh-assisted embolization, and 1 case with dense-mesh stent-assisted embolization.The perioperative and postoperative complications, postoperative recurrence were collected.Results:Intraoperative complications included 2 cases of aneurysm rupture and 2 cases of acute thrombosis.All aneurysms were densely packed according to the angiography performed immediately after operation.Postoperative complications included 3 cases of long-term responsible vascular ischemia(modified Rankin score<2). The patients were followed up for 15.1 months(range: 12 to 29 months). At the last follow-up, aneurysms recurrence occured in 10 cases, the recurrence rate was 25.6%(10/39). There were 6 cases of recurrence and 2 cases of complications in 20 cases with single stent-assisted embolization, 3 cases of recurrence and 4 cases of complications in 9 cases with multi-stent-assisted embolization, 1 case of recurrence and 1 case of complications in 9 cases with semi-dense mesh stent.Conclusion:Endovascular treatment is feasible for patients with vertebral artery dissecting aneurysm, and the appropriate surgical method should be selected according to the vascular structure and the location of the aneurysm.

Objective:To investigate the efficacy and safety of different stents assisted embolization in the treatment of subarachnoid hemorrhage(SAH) caused by V4 dissecting aneurysm of vertebral artery.Methods:The clinical data of 39 patients with spontaneous SAH V4 dissecting aneurysm treated at the Department of Neurosurgery, the Northern Theater General Hospital from January 2016 to June 2019 were analyzed retrospectively.There were 21 males and 18 females, aged (48±17) years(range:35 to 68 years).There were 24 cases of HUNT-HESS grade Ⅰ and 15 cases of grade Ⅱ.Among them, 20 cases were treated with single stent-assisted embolization, 9 cases with multi-stent-assisted embolization, 9 cases with semi-dense mesh-assisted embolization, and 1 case with dense-mesh stent-assisted embolization.The perioperative and postoperative complications, postoperative recurrence were collected.Results:Intraoperative complications included 2 cases of aneurysm rupture and 2 cases of acute thrombosis.All aneurysms were densely packed according to the angiography performed immediately after operation.Postoperative complications included 3 cases of long-term responsible vascular ischemia(modified Rankin score<2). The patients were followed up for 15.1 months(range: 12 to 29 months). At the last follow-up, aneurysms recurrence occured in 10 cases, the recurrence rate was 25.6%(10/39). There were 6 cases of recurrence and 2 cases of complications in 20 cases with single stent-assisted embolization, 3 cases of recurrence and 4 cases of complications in 9 cases with multi-stent-assisted embolization, 1 case of recurrence and 1 case of complications in 9 cases with semi-dense mesh stent.Conclusion:Endovascular treatment is feasible for patients with vertebral artery dissecting aneurysm, and the appropriate surgical method should be selected according to the vascular structure and the location of the aneurysm.

Objective To explore the value of methylation of SDC2 and SFRP2 genes promoter in fecal DNA for colorectal cancer ( CRC) screening. Methods All stool samples were enrolled from Changhai Hospital of Naval Medical University, the Tenth People' s Hospital of Tongji University and the Seventh Medical Center of Chinese People's Liberation Army General Hospital. A total of 500 stool samples collected from March 2018 to December 2018 were allocated to CRC group ( 132 CRCs ) , adenoma group ( 38 advanced adenomas), healthy group (152 healthy individuals), interferential group (178 cases of benign colorectal disease or other non-colorectal tumors) and negative group (330 cases composed of healthy group and interferential group ) . The promoter methylation of fecal SDC2 and SFRP2 genes was detected by methylation-specific PCR (MSP) and compared with single gene methylation and the fecal immunochemical tests ( FIT) to evaluate its sensitivity and specificity. Results The stool sample analysis showed that the sensitivity of combined detection of SDC2 and SFRP2 in CRC group was 97. 73％ ( 129/132 ) , which was significantly higher than those of the single gene SDC2 test [ 70. 45％ ( 93/132) , P=0. 000] , single SFRP2 test [81. 82％ (108/132), P=0. 000] and FIT [69. 70％ (92/132), P=0. 000]. In adenoma group, the sensitivity of combined detection of SDC2 and SFRP2 was 57. 89％ (22/38), which was significantly higher than those of the single gene SDC2 test [ 15. 79％ ( 6/38 ) , P= 0. 000 ] and FIT [ 21. 05％ ( 8/38 ) , P=0. 021] , with no significant difference compared with that of SFRP2 test [ 47. 37％ ( 18/38) , P=0. 358] . In healthy group, the specificity of combined detection of SDC2 and SFRP2 was 98. 68％ (150/152), with no significant difference compared with those of single gene SDC2 test [ 100. 00％( 152/152) , P=0. 156] , single SFRP2 test [98. 68％ (150/152), P=1. 000] or FIT [95. 39％ (145/152), P=0. 091]. Specificities of combined detection of two genes in interferential and negative groups were 90. 45％ ( 161/178) and 94. 24％( 311/330) , which were significantly higher than 73. 03％( 130/178, P=0. 000) and 83. 33％( 275/330, P=0. 000) of FIT, respectively. Conclusion The combined detection test of methylation of SDC2 and SFRP2 is superior to single gene test, whose sensitivity of CRC and aggressive adenoma and specificity of distinguishing benign and malignant lesions are higher than FIT, which has potential application value.

OBJECTIVE: A failed electrocardiography (ECG)-trigger often leads to a long acquisition time (TA) and deterioration in image quality. The purpose of this study was to evaluate and optimize the technique of self-gated (SG) cardiovascular magnetic resonance (CMR) for cardiac late gadolinium enhancement (LGE) imaging of rats with myocardial infarction/reperfusion. MATERIALS AND METHODS: Cardiovascular magnetic resonance images of 10 rats were obtained using SG-LGE or ECG with respiration double-gating (ECG-RESP-gating) method at 7T to compare differences in image interference and TA between the two methods. A variety of flip angles (FA: 10°–80°) and the number of repetitions (NR: 40, 80, 150, and 300) were investigated to determine optimal scan parameters of SG-LGE technique based on image quality score and contrast-to-noise ratio (CNR). RESULTS: Self-gated late gadolinium enhancement allowed successful scan in 10 (100%) rats. However, only 4 (40%) rats were successfully scanned with the ECG-RESP-gating method. TAs with SG-LGE varied depending on NR used (TA: 41, 82, 154, and 307 seconds, corresponding to NR of 40, 80, 150, and 300, respectively). For the ECG-RESP-gating method, the average TA was 220 seconds. For SG-LGE images, CNR (42.5 ± 5.5, 43.5 ± 7.5, 54 ± 9, 59.5 ± 8.5, 56 ± 13, 54 ± 8, and 41 ± 9) and image quality score (1.85 ± 0.75, 2.20 ± 0.83, 2.85 ± 0.37, 3.85 ± 0.52, 2.8 ± 0.51, 2.45 ± 0.76, and 1.95 ± 0.60) were achieved with different FAs (10°, 15°, 20°, 25°, 30°, 35°, and 40°, respectively). Optimal FAs of 20°–30° and NR of 80 were recommended. CONCLUSION: Self-gated technique can improve image quality of LGE without irregular ECG or respiration gating. Therefore, SG-LGE can be used an alternative method of ECG-RESP-gating.
Animals ; Electrocardiography ; Gadolinium* ; Magnetic Resonance Imaging ; Methods ; Myocardial Infarction* ; Rats* ; Respiration

Objective To investigate the effect of melatonin on mice with ischemia-reperfusion via a silent information regulator 1 (SIRT1) reducing mitochondrial oxidative stress mechanism. Methods A transient middle cerebral artery occlusion ( MCAO) cerebral ischemia-reperfusion ( IR) model in mice was established by the suture-occluded method. One hundred and ninety mice were injected with melatonin intraperitoneally or the SIRT1 inhibitor (EX527) intracerebroventricularly,30 dead and model failure mice were excluded. They were divided into IR,melatonin,melatonin +EX527,and EX527 groups (n =40 in each group ) according to the random number table. The cerebral infarct volume was detected by the triphenyltetrazolium chloride (TTC) method,the brain edema was measured by the wet and dry weight method and the neurological deficit scores were measured. Western blot was used to detect SIRT1,Ac-P53, acetylated-nuclear factorκB (Ac-NF-κB),BCl2,Bax proteins in the mitochondria and cytoplasm,as well as the cytochrome C protein expression. A single factor analysis of variance was used for comparison among the groups. Results ( 1 ) There were significant differences in cerebral infarction volume, neurological dysfunction scores and cerebral edema among the four groups ( F values,16. 452,23. 622,and 18. 786, respectively (all P<0. 05). There were significant differences in the expression levels of SIRT1,Ac-P53, Ac-NF-κB,BCl2, and Bax among the four groups ( F values, 2348. 158, 1434. 841, 7042. 563, 14627. 128,and 691. 475,respectively,all P<0. 05). There were significant differences in mitochondrial membrane potential,mitochondrial reactive oxygen species,and complex I activity in mice among the four groups (F value,28. 454,33. 728 and 29. 716,respectively,all P <0. 05). (2) Compared with the IR group,the infarct volume was reduced (32 ± 5 mm3 vs. 57 ± 5 mm3,P<0. 05),neurological deficit scores were decreased (2. 4 ± 0. 3 vs. 3. 5 ± 0. 3,P<0. 05);brain edema was reduced (80. 2 ± 0. 9% vs. 83. 9 ± 1. 2%,P<0. 05);the expression levels of SIRT1 and anti-apoptosis protein BCL2 were increased in the melatonin group (P<0. 05);the expression levels of pro-apoptotic protein BAX and Ac-P53,Ac-NF-κB were reduced ( P <0. 05 );the mitochondrial membrane potential, mitochondrial complex I activity and cytochrome C level were increased (P<0. 05);and the cytoplasmic reactive oxygen species and cytochrome C level were decreased (P < 0. 05). (3) Compared with the melatonin group,cerebral infarction volume were increased (42 ± 5 mm3 vs. 32 ± 5 mm3,P < 0. 05);nerve dysfunction scores were increased(3. 2 ± 0. 3 vs. 2. 4 ± 0. 3,P<0. 05);cerebral edema was aggravated (83. 4 ± 0. 8% vs. 80. 2 ± 0. 9%, P < 0. 05 );the expression levels of SIRT1 and anti-apoptotic protein BCL2 were reduced (P <0. 05);the pro-apoptotic protein BAX,Ac-P53,and Ac-NF-κB expression levels were increased (P<0. 05);the mitochondrial membrane potential and mitochondrial complex I activity and cytochrome C level were decreased (P<0. 05);and the cytoplasmic reactive oxygen species and cytoplasmic cytochrome C level were increased in the melatonin+EX527 group (P<0. 05). Conclusion In ischemic stroke model mice, melatonin plays a neuroprotective role by activating the SIRT1 signaling pathway and reducing oxidative stress injury and cell death in mitochondria,thus plays a role in cerebral protection.