OBJECTIVE:To explore the effects of long-term treatment with hydrochlorothiazide combined spironolactone on the activity of renin-angiotensin-aldosterone system(RAAS)and biochemical parameters in hypertensive patients.METHODS:A multicenter study was performed in patients with mild-moderate hypertension from nine Kai-luan coal mining industry hospitals.After 2-week placebo elution period and 6-week hydrochlorothiazide initiation period,the patients received hydrochlorothiazide(HCTZ)plus spironolactone for 5 years.The determination of the activity of RAAS was scheduled at the end of 2-week placebo elution period,at the end of 6-week HCTZ initiation period,at 2 and 5 years after treatment,respectively.And the biochemical parameters were determined annually.The RAAS and biochemical parameters at different time point were compared.RESULTS:At the end of 6-week HCTZ initiation period,plasma angiotensin-Ⅱ(AngⅡ)and aldosterone(ALD)concentrations in the hypertensive patients were significantly higher(P

ObjectiveTo study the relationship between fasting plasma glucose (FPG) level and the first cerebral infarction event in the population with diabetes.Methods This was a prospective cohort stndy.8 306 diabetic subjects who determined FPG ≥ 7.0 mmol/L or treated with insulin or hypoglycemic drugs and FPG ＜7.0 mmool/L as the observation population and were followed-up for (48.01 ± 3.14) months.During the course,cerebral infarction events were determined every 6 months.Results( 1 ) By the end of following-up,with the increasing levels of the baseline FPG,the total cholesterol (TC),triglyceride (TG) levels were gradually increased in the diabetic population,the differences were significant [ TC:( 4.93 ± 1.15,5.10 ± 1.20,5.15 ± 1.28,5.33 ± 1.35 ) mmol/L,TG:( 1.70 ± 1.26,1.83 ± 1.29,2.18 ± 1.76,2.41 ± 2.08 ) mmol/L,P＜0.05 ] ; the plasma low density lipoprotein-cholesterol (LDL-C),systolic blood pressure ( SBP),diastolic blood pressure ( DBP),and body mass index (BMI) levels were also increased significantly ( P＜0.05 ).(2) The ineidence of cerebral infarction event in the group of patients with 7.0 mnol/L ≤ FPG ＜ 9.0 mmol/L was the lowest,the differences were significant ( 2.1％,P ＜0.01 ).Compared with the group of 7.0 mmol/L≤ FPG＜9.0 mmol/L,after adjusting for age,sex,BMI,SBP,DBP,TC,TG,low density lipoprotein-cholesterol,high density lipoprotein-cholesterol,smoking,diabetic duration and treatment,the relative risk for cerebral infarction events were 1.85 (95％ CI 1.09-3.15,P＜0.05) and 1.54 (95％CI 1.16-2.05,P ＜ 0.01 ) for those groups with 6.1 mmol/L ≤ FPG ＜ 7.0 mmol/L and FPG ≥ 9.0 mmol/L respectively.ConclusionThe risk of new in cidence of cerebral infarction events seems to be the lowest in the group of diabetic patients whose FPGs are wihin 7.0-9.0 mmol/L range.

Objective:To investigate the clinical significance of dendritic cell(DC) infiltration and molecules expression in gastric cancer.Methods:After tumor mass was digested by enzyme and cells were seperated,anti S 100 protein antibody immunohistochemical staining and flow cytometric analysis were done in 15 cases of gastric cancer.Reverse transcription polymerase chain reaction(RT PCR)was used to detect IL 10,VEGF and TGF ? 1 mRNA expression in gastric cancer cells.Results:The number of DC in gastric cancer was just small, and correlated reversely with pathologic stages.The levels of some surface molecules expression such as MHC class Ⅱ, costimulatory molecules B7 1 and ICAM 1 in gastric cancer were negative.The number of DC and the levels of some surface molecules expression in gastric cancer were correlated reversely with pathologic stages.Levels of IL 10,VEGF and TGF ? 1 mRNA expression in gastric cancer cells were high.Conclusion:The results indicate that infiltration and surface molecules expression in gastric cancer are closely linked to tumor pathologic stages.

Objective To investigate the relationship between waist circumference and new-onset non-alcoholic fatty liver disease in non-obese patients with diabetes mellitus. Methods A total of 1 950 patients with diabetes mellitus, who determined fasting plasma glucose(FPG)≥7.0 mmol/L or who were using hypoglycemic drugs and FPG<7.0 mmol/L,and body mass index (BMI)< 25 kg/m2, was selected in this study using prospective cohort method. Patients were divided into five groups according to the baseline data of waist circumference, including waist circumference<78 cm (A group, n=387), 78 cm90 cm (E group, n=421). Multiple Logistic regression model was used to analyze influential factors of new-onset non-alcoholic fatty liver disease in non-obese patients with diabetes mellitus. Re?sults The average duration of follow-up was(47.24±5.13) months. The incidence rate was 11.85%(231/1 950) in patients with non-alcoholic fatty liver disease. The incidence rates were 6.98%, 9.28%, 12.38%, 14.19%and 15.68%in A, B, C, D and E groups, and which were increased with the increased waist circumference (P<0.05). Results of multiple Logistic re?gression model analysis showed that compared with A group,OR values were 1.97 and 2.19 in D and E groups respectively (P<0.05). Conclusion Waist circumference≥85 cm was the risk factors of new-onset non-alcoholic fatty liver disease in non-obese patients with diabetes mellitus.

The clinical data of 67 patients underwent orthotopic liver transplantation, including 4 cases of early intra abdominal hemorrhage after orthotopic liver transplantation, were analyzed retrospectively.Anastomotic liver artery hemorrhage was found in 2 cases, hemorrhage of IVC in 1 case and hemorrhage of right adrenal gland in 1 case. All the 4 patients were correctly dignosed and successfully treated by operation in time. It suggests that the early intra abdominal hemorrhage after orthotopic liver transplantation is mostly due to surgical technique. The improvement of surgical technique,correct diagnosis and timely operation are very important for the treatment of intra abdominal hemorrhage.

Objective To explore the postoperative psychological status of donors during pediatric living donor liver transplantation (LDLT) to elucidate the correlation between resilience,anxiety and depression.Methods Random sampling was employed for selecting 60 pediatric LDLT donors undergoing LDLT from September 2014 to February 2019.They were requested to answer a questionnaire.The questionnaire concluded general information,self-rating anxiety scale (SAS),selfrating depression scale (SDS) and Chinese version of Resilience Scale.Results The score of anxiety was (46.06 ± 10.06) and depression was (50.32 ± 11.49).Both values were higher than those of Chinese norm.The score of resilience was (59.55 ± 14.62).And the total score of resilience and the score of each dimension were negatively correlated with anxiety and depression (P＜0.01).Conclusions The postoperative anxiety and depression level of donors during LDLT are higher than the ordinary.Resilience is negatively correlated with the level of anxiety and depression.The lower level of resilience,the higher anxiety and depression of donors during LDLT.For clinicians,appropriate intervention measures should be taken for improving the resilience,reducing negative emotions and boosting the quality-of-life of donors during LDLT.

【Objective】 To investigate the removal efficacy of inflammatory cytokines and blood compatibility of modified PBTNF. 【Methods】 Acrylic acid (AA) was firstly UV-grafted onto the surface of PBTNF to negatively charge the surface of the material. Subsequently, the three positively charged polyelectrolytes, DA, PEI, and CS were respectively electrostatic self-assembled with GO on the surface of PBTNF, forming two layers of film with GO as the outer layer: PBTNF-(DA/GO)2, PBTNF-(PEI/GO)2, PBTNF-(CS/GO)2. 【Results】 Scanning electron microscopy results showed that compared with the PBTNF grafted with AA, the adhesion of particles was observed on the surface of the three modified materials, and the photo shows that the color of the material surface was deepened after electrostatic self-assembly. The results of wettability showed that the surface hydrophilicity was significantly improved, indicating that the electrostatic self-assembled membrane was successfully immobilized on the surface of PBTNF. The removal efficiency (%) of IL-1β for PBTNF-(DA/GO)2, PBTNF-(PEI/GO)2 and PBTNF-(CS/GO)2 were 69.00±7.36 vs -2.35±2.69 vs -1.59±3.26 (P<0.05). The removal efficiency of IL-6 (%) were 40.15±1.86 vs -13.46±5.72 vs -1.21±3.41 (P<0.05). The removal efficiency of IL-8 (%) were 96.90±0.97 vs 17.84±11.74 vs 43.68±17.38 (P<0.05). The removal efficiency of TNF-α (%) was 44.46±2.50 vs 14.90±7.12 vs 20.64±1.22 (P<0.05). Plasma protein adsorption results (total protein, immunoglobulin G, albumin) and red blood cell deformability index showed that there was no statistical difference among the three modified PBTNFs and the control group (P>0.05). Although the red blood cell osmotic fragility (g/L) of the three modified PBTNFs is higher than that of the former: control group vs PBTNF-(DA/GO)2 vs PBTNF-(PEI/GO)2 vs PBTNF-(CS/GO)2: 4.39±0.05 vs 4.62±0.02 vs 4.48±0.03 vs 4.90±0.03 (P<0.05), the hemolysis rate (%) of them were all less than 5%, and PBTNF-(DA/GO)2 performed the lowest hemolysis rate which was (0.03±0.01)% (compared with PBTNF-(PEI/GO)2, P<0.05). The coagulation function test results showed that compared with the control group, the fibrinogen (g/L) of the three modified PBTNFs had no statistical difference (P>0.05); the activated partial thrombo plastin time (S) slightly extended, but all within the normal range of clinical standard; and the prothrombin time (S) of PBTNF-(CS/GO)2 was prolonged(P<0.05). 【Conclusion】 Among the three positively charged polyelectrolytes, including DA, PEI, and CS, PBTNF-(DA/GO)2 performed the best removal rate of inflammatory cytokines, and the blood compatibility evaluation results showed that PBTNF-(DA/GO)2 had no significant effect on red blood cells and coagulation function. Consequently, in the study of inflammatory cytokines adsorption, DA is expected to be the optimal polyelectrolyte assembling with GO for further research.

【Objective】 To investigate the application prospect of platelet-rich plasma lysate (PL) microneedles in the treatment of wound healing by optimizing the preparation process and evaluating the activity of platelet growth factor. 【Methods】 Firstly, hyaluronic acid (HA) was used as needle matrix material, and the concentration of HA was preliminarily determined by investigating the fluidity of HA solution, shape of needle, pressure change performance and puncture performance.Combined with the results of HA dissolution in PL, mechanical properties of PL microneedles and skin puncture, the preparation process of platelet-rich plasma lysis microneedles (PLMN) was optimized to investigate the growth factor activity of PLMN and evaluate the effect of PLMN on wound healing in rats. 【Results】 When the concentration of HA was 30 mg/mL, the solution had good fluidity.The HA microneedles could pierce three layers of sealing film, with the puncture rate at 70%, and the solution had good mechanical properties.When HA was dissolved in PL at a concentration of 30 mg/mL at 4℃, the solution had no crystallization and was with good fluidity.The prepared PLMN showed good needle shape and no bending under HD microscope and scanning electron microscope.In vitro transdermal simulation results showed that PLMN could penetrate 4 layers of sealing membrane, and the puncture rate of the first three layers was more than 85%.In vivo lysis experiment showed that PLMNs could be completely dissolved within 10 min after being inserted into the body.Forty minutes later, the micropores left after the insertion of the microneedle were almost closed, without redness, swelling, erythema and other adverse reactions.In vitro and in vivo transdermal experiments showed that clear blue holes were visible after PLMNs penetrated the skin stain, indicating that the microneedles could pierce the skin barrier.Growth factor detection results showed that the content of platelet-derived growth factor (PDGF-BB) and transforming growth factor (TGFβ1) in platelet lysate were (17.67±1.23) ng/mL and (105.95±2.16) ng/mL, respectively.After PLMNs were prepared and stored at room temperature for 1 week, the content of PDGF-BB(ng/mL) and TGFβ1(ng/mL) were 15.48±2.12 and 56.26±1.53, respectively.Compared with PL(vs 17.67±1.23 and 105.95±2.16), the content of PDGF-BB and TGFβ1 decreased, but still maintained the activity of growth factors.The results of wound healing experiment in rats showed that the wound healing rate (%) of PLMN group on the third day was significantly different from that of the control group(52.51±6.15 vs 33.31±3.60, P<0.05). 【Conclusion】 The PLMN prepared in this experiment has good mechanical properties and can successfully pierce the skin cuticle.It can also maintain the activity of growth factors, and has a good effect on wound healing in rats, which provides a new idea for minimally invasive treatment in the field of tissue repair.

【Objective】 To compare the similarities and differences of polymerized human cord hemoglobin (PolyCHb) and free hemoglobin (FHb) on partial coagulation indexes in vitro, so as to analyze the effect of PolyCHb on coagulation dysfunction. 【Methods】 Using normal saline, two concentrations of FHb and PolyCHb and 36% methemoglobin-containing PolyCHb to mix with fresh whole blood or plasma-rich plasma (PRP) in equal proportions, and incubate at 37°C for 30 minutes to detect prothrombin time (PT), activated partial thromboplastin time (APTT), coagulation factor Ⅱactivity (FⅡ∶C), coagulation factor Ⅴactivity (FⅤ∶C), coagulation factor Ⅷactivity (FⅧ∶C), coagulation factor Ⅸactivity (FⅨ∶C), von Willebrand factor (vWF) and platelet P-selectin (CD62P). 【Results】 1) NaCl group: PT(22.68±1.76) s; APTT(59.58±7.52) s; FⅡ∶C(45.91±3.27) %; FⅤ∶C(30.86±4.43) %; FⅧ∶C(41.32±12.94) %; FⅨ∶C(23.96±5.10) %; vWF (2.14±0.54) mg/L; CD62P(7.44±4.47) %. This group kept as a diluted control. 2) 2% FHb group compared with 7% FHb group: FⅧ∶C (42.16±12.31) %vs (56.64±12.22 ) % (P<0.05). No significant difference was found in other indexes (P>0.05). 3) There is no significant difference between 2% PolyCHb group and 7% PolyCHb group (P>0.05). 4) There is no significant difference between 2% FHb group and 2% PolyCHb group (P>0.05). 5) 7% FHb group compared with 7% PolyCHb group: PT(23.31±1.34)s vs (21.97±1.56)s (P<0.05); APTT(50.12±5.72)s vs (55.43±5.43)s (P<0.05); FⅧ∶C (56.64±12.22) %vs (42.37±13.00)% (P<0.05); vWF (1.41±0.30) mg/L vs (2.25±0.41) mg/L (P< 0.05). No significant difference was found in other indexes (P>0.05). 6) 7% PolyCHb group Compared with Met-PolyCHb group: APTT(55.43±5.43) s vs (46.33±4.86)s (P<0.05); FⅧ∶C (42.37±13) %vs (60.51±10.16) % (P<0.05). No significant difference was found in other indexes (P>0.05). 【Conclusion】 The effect of PolyCHb on coagulation markers is different from FHb. At the concentration of this study, PolyCHb will not cause coagulation disorders. However, if the methemoglobin (MetHb) content is too high, it will activate the intrinsic coagulation pathway.