Thrombolytic therapy plays a vital role in reperfusion strategy for ST-segment elevation myocardial infarction(STEMI)patients.Previous Chinese expert consensus focused on pre-hospital thrombolysis therapy in STEMI patients was published in 2018 which tremendously promoted pre-hospital thrombolysis therapy.In recent years,plenty of research progress and results of clinical trials have been released in following areas such as STEMI reperfusion strategy,anti-platelet/anti-coagulants therapy,contemporary facilitated percutaneous coronary intervention,and so on.Meanwhile,the COVID-19 pandemic makes timely reperfusion for STEMI patients even more challenging.Therefore,this consensus has been proposed aiming to summarize recent progress in STEMI thrombolysis therapy and to provide practical & evidence-based instructions conforming to national conditions.We hope this consensus will contribute to the emergency management and long-term prognosis of STEMI patients.

Objective To observe the intervention effect of hypericin(HYP)on 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine(MPTP)-induced Parkinson's disease(PD)mice model and its mechanism.Methods Thirty C57BL/6 mice were randomly divided into normal,model and experimental groups with 10 mice per group.PD mouse model was established after 7 days of intraperitoneal injection of MPTP,and drug intervention was carried out from the first day of modeling.Normal group and model group were intraperitoneally injected with 500 μL·kg·d-1 0.9％NaCl.The experimental group was intraperitoneally injected with 25 mg·kg·d-1 HYP.The three groups of rats were given the drug once each time for 14 days.The expression levels of tyrosine hydroxylase(TH),Nod-like receptor thermal protein domain protein 3(NLRP3)and ionized calcium binding adapter molecule 1(Iba1)in the striatum of nigra were detected by Western blot.Results The climbing time of normal,model and experimental groups was(5.35±0.43),(9.71±1.19)and(8.07±0.34)s;suspension scores were(2.92±0.15),(1.38±0.28)and(1.96±0.28)points;the relative expression levels of TH protein were 1.04±0.06,0.51±0.09 and 0.75±0.07;the relative expression levels of NLRP3 protein were 0.51±0.03,1.00±0.04 and 0.77±0.06;the relative expression levels of Iba1 protein were 0.68±0.10,1.30±0.28 and 0.89±0.05,respectively.The above indexes in the model group were statistically significant compared with the experimental group and the normal group(all P＜0.01).Conclusion HYP plays a therapeutic role in PD by inhibiting the expression of NLRP3 inflammasome in PD mice.

Objective To investigate the associations of reproductive health indicators with lung function and chronic obstructive pulmonary disease(COPD)among women aged 40 years and above.Methods From Jul to Sep,2021,female subjects aged 40 years and above were randomly selected from the Shanghai Suburban Adult Cohort and Biobank for COPD screening.A questionnaire was used to obtain information on demographic characteristics and reproductive health indicators.Linear regression was used to analyze the effects of reproductive health indicators on forced vital capacity(FVC)and forced expiratory volume in the first second(FEV1).Logistic regression was also used to analyze the effects of reproductive health factors on FVC as a percentage of the predicted value(FVC%Pred)and FEV1%Pred as well as on COPD.Results A total of 1876 women aged 40 years and above were enrolled with mean age of(62.1±8.2)years old,among them,78.1%were menopausal,and 40.9%had been pregnant≥3 times.Multivariate analysis showed that FVC and FEV1 decreased in postmenopausal women,but menopause was not associated with a decrease in their percentage of predicted values.Pregnancies≥3 times was a risk factor for COPD(for 3 times,OR=4.92,95%CI:1.48-19.95,P<0.05;for≥4 times,OR=9.06,95%CI:2.32-41.57,P<0.01),while pregnancies of 2 times did not increase the risk of COPD.Conclusion In women aged 40 years and above,menopause is associated with poorer FVC and FEV1,and excessive pregnancy(≥3 times)is a risk factor for COPD.

Objective To investigate the effect of sodium butyrate on apoptosis of rat mesangial cells and the regulation of phosphatidylinositol 3-kinase/protein kinase B/mammalian target of rapamycin(PI3K/AKT/mTOR)signal pathway,and analyze the possible mechanism.Methods Primary cultured,isolated and purified rat mesangial cells.The cells were randomly divided into blank group,control group[10 μg·L-1 epidermal growth factor(EGF)],low dose experimental group(10μg·L-1 EGF+0.5 mmol·L-1 sodium butyrate),medium dose experimental group(10 μg·L-1 EGF+1.0 mmol·L-1 sodium butyrate)and high dose experimental group 10 μg·L-1 EGF+2.0 mmol·L-1sodium butyrate).Cell survival rate was detected by cell counting kit-8(CCK-8)method,cell cycle was detected by propyl iodide(PI)staining,cell apoptosis rate was detected by flow cytometry,and the expression of PI3K/AKT/mTOR channel-related proteins was detected by Western blot.Results After 24 h of treatment,the optical density of blank group,control group and low,medium,high dose experimental group were 0.36±0.03,0.66 ±0.03,0.57±0.05,0.47±0.02,0.41±0.01;which at 48 h of treatment were 0.55±0.03,0.83±0.04,0.68 ±0.03,0.65±0.02,0.60±0.02,respectively.The results showed that 10 μg·L-1 EGF significantly stimulated the proliferation and activation of mesangial cells(P＜0.05),and the proliferation of mesangial cells was significantly inhibited after treatment with different concentrations of sodium butyrate for 24 and 48 h(P＜0.05).PI staining showed that the G1 phase blocking rates of blank group,control group and low,medium,high dose experimental groups were(53.37±0.43)％,(46.84±0.67)％,(57.81±0.48)％,(62.77±0.77)％,(67.57±0.71)％,respectively.The results showed that sodium butyrate could induce cell cycle arrest in G1 phase in a concentration-dependent manner(P＜0.01).The apoptosis rates of blank group,control group and low,medium,high dose experimental groups were(4.43±0.48)％,(2.45±0.31)％,(6.16±0.33)％,(8.25±0.40)％and(12.12±0.41)％,the differences were statistically significant between control group and low,medium,high dose experimental groups(all P＜0.01).Conclusion Sodium butyrate can effectively inhibit the proliferation and induce apoptosis of rat mesangial cells,and its mechanism may be related to the inhibition of PI3K/AKT/mTOR signaling pathway.

OBJECTIVE: To establishment the Sense of Security Scale for Medical Staff and test its reliability and validity. METHODS: The pre-test version scale was formulated through methods of literature review, semi-structured interviews with clinical medical staff, discussion with members of research groups, and consultation with medical experts. A total of 350 and 403 medical staff who worked in a tertiary A hospital in Guangdong Province were selected as the prediction and the verification samples, respectively, by convenience sampling method. The reliability and validity of the final version scale were tested by item analysis, exploratory factor analysis and confirmatory factory analysis. RESULTS: Through item analysis, it was determined that the scale was mainly composed of 24 items. Exploratory factory analysis extracted five characteristics: environmental factors, patient factors, self factors, organizational management, and social support, that explained 72.8% of the total variation. The results of confirmatory factory analysis showed that the ratio of chi-square to degree of freedom was 2.851, the mean square error of approximation was 0.068, the standardized mean square residual was 0.078, the goodness of fit index was 0.883, the normative fit index was 0.904, the comparative fit index was 0.935, the non-standard fitting index was 0.924, and the incremental fitting index was 0.936. The results of reliability and validity test showed that the total Cronbach alpha coefficient, Spearman-Brown coefficient and retest reliability were 0.939, 0.967 and 0.808, respectively. The item reliability of each item was 0.420-0.814, the composite reliability was 0.775-0.920, the content validity ratio was 0.904, the convergent validity was 0.514-0.741, and the discriminative validity was 0.717-0.861. CONCLUSION: The reliability and validity of each dimension of the Sense of Security Scale for Medical Staff is good, and it can be used as an evaluation tool to measure the sense of security in medical staff.

Anticholesteremic Agents/therapeutic use* ; Cholesterol, LDL ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Hypolipidemic Agents/therapeutic use* ; Lipids

This study aimed to investigate the effect and possible mechanism of carnosic acid (CA) on delaying aging. The effects of CA on senescence-related β-galactosidase (SA-β-Gal) activity and expressions of p53, p21 and p16 were evaluated by an oxidative challenge induced premature 2BS cell senescence model. Meanwhile, the animal experiment was approved by the Ethics Committee of Zhejiang Hospital. Male C57 BL/6J mice were injected with 100 mg·kg^-1·d^-1 D-galactose (D-gal) for 8 weeks to establish an aging model in vivo, and CA at 5 and 10 mg·kg^-1·d^-1 were given ig administration at the same time. Morris water maze test was used to test the spatial memory ability. Then the serum and tissue samples were collected for the detections of malondialdehyde (MDA), total superoxide dismutase (T-SOD), interleukin-6 (IL-6), tumor necrosis factor α (TNFα) and advanced glycation end products (AGEs) as well as the protein expression of p53, p21 and p16 in hippocampus of brain. The results showed that H₂O₂ induced increment of SA-β-Gal activity (95%) was prevented by CA treatment (35%) and the enhanced protein expressions of p53, p21 and p16 in H₂O₂ exposed 2BS cells were alleviated by CA treatment, suggesting a potent protective role of CA against premature senescence induced by oxidative challenge. For in vivo study, D-gal induced declined spatial memory ability was partly reversed by CA administration. Besides, the serum and cerebral levels of MDA, IL-6, TNFα and AGEs were attenuated by CA treatment when compared to those in model mice. And the protein expressions of p53, p21 and p16 in mice hippocampus were suppressed by CA in D-gal treated mice. Taken together, our results showed that CA protects premature senescence induced by oxidative stress and D-gal, which is related to its antioxidative, antiinflammatory roles and inhibition on non-enzymatic glycosylation.

BACKGROUND: Benvitimod cream, a novel synthetic small molecule, was effective in treating mild-to-moderate plaque psoriasis. We conducted a phase III clinical trial to assess the efficacy and safety of benvitimod cream in patients with mild-to-moderate plaque psoriasis. METHODS: We randomly assigned 686 patients (2:1:1) to receive 1% benvitimod cream, 0.005% calcipotriol ointment or placebo twice a day for 12 weeks. The primary efficacy end points were the percentage of patients with a 75% or greater reduction from baseline in the psoriasis area and severity index (PASI 75) score and with a score of 0 or 1 in static physician's global assessment (sPGA) at week 12. RESULTS: The results showed that 50.4% of patients in the benvitimod group achieved PASI 75, which was significantly higher than that in the calcipotriol (38.5%, P < 0.05) and placebo (13.9%, P < 0.05) groups. The proportion of patients achieving an sPGA score 0 or 1 was 66.3% in the benvitimod group and 63.9% in the calcipotriol group, which were both significantly higher than that in the placebo group (34%, P < 0.05). In the long-term follow-up study, 50.8% of patients experienced recurrence. After retreatment with 1% benvitimod, 73.3% of patients achieved an sPGA score of 0 or 1 again at week 52. Adverse events included application site irritation, follicular papules, and contact dermatitis. No systemic adverse reactions were reported. CONCLUSION: During this 12-week study, benvitimod cream was demonstrated with high effectiveness and safety in patients with mild-to-moderate plaque psoriasis. TRIAL REGISTRATION Chinese Clinical Trial Registry (ChiCTR), ChiCTR-TRC-13003259; http://www.chictr.org.cn/showprojen.aspx?proj=6300.
Double-Blind Method ; Follow-Up Studies ; Humans ; Ointments ; Psoriasis/drug therapy* ; Resorcinols ; Severity of Illness Index ; Stilbenes ; Treatment Outcome

Objective To estimate the outpatient rate of influenza-related influenza-like illness (ILI) for children younger than 5 years in Suzhou municipal districts. Methods From October 2011 to March 2017, we conducted a prospective surveillance program on ILI for children under 5 years in outpatient settings of Soochow University Affiliated Children’s Hospital (SCH). The throat swabs were collected and tested for influenza viruses by RT-PCR. Based on the healthcare utilization surveys and population data, the number of visits and the outpatient rate of influenza-related ILI for children younger than 5 years in Suzhou municipal districts were estimated. Results During 2011-2017, in total, there were 45 930 estimated influenza-related ILI cases younger than 5 years in Suzhou municipal districts, which consisted of 7 490 influenza A/H1N1 cases, 17 843 influenza A/H3N2 cases and 20 597 influenza B cases. The estimated outpatient rate of influenza-related ILI was 6.4% in 2011-2017, which was highest in 2011-2012, 20.5%, and the lowest in 2012-2013, 2.4%. Conclusion The number of visits and the outpatient rate of influenza-related ILI in children younger than 5 years was high in Suzhou municipal districts.

Objective To invesgate the safety and efficacy of the second generation biodegradable polymer Cobalt-Chromium sirolimus-eluting stent (EXCEL2) stent in diabetic patients by a subgroup analysis of of the CREDITⅡand CREDIT Ⅲ trials. Methods All patients who were implanted with the EXCEL2 stent were enrolled in the CREDITⅡand CREDIT Ⅲ trials. The primary endpoint was target lesion failure at 24-month, defi ned as a composite of cardiac death, target vessel myocardial infarction (TV-MI) and target lesion revascularization(TLR). The secondary endpoint was endpoints including all-cause death, all myocardial infarction (MI) or any revascularization.Results A total of 828 patients were included from the patients who were implanted with the EXCEL2 stent in the CREDIT II and CREDIT Ⅲ trials. 24-month follow-up rate was 99.5%. There was no significant difference in the primary endpoint (P>0.05) and event rates of the secondary endpoints(P>0.05) between the diabetic and non-diabetic group, which included all-cause death[diabetics (2.5%)vs.non-diabetics(1.4%),P>0.05],myocardial infarction(MI)(7.5% vs.5.0%,P>0.05),all from of revascularization(5.0% vs.3.9%,P>0.05),and stent thrombosis(0.6% vs.0.4%,P>0.05).Conclusions EXCEL 2 stent met the objective performance goal on effcacy and safety, which can reduce make stent restenosis, target vessel revascularization ,with 160 diabetic cases among them, and stent thrombosis in diabetic patients.