Objective Through establishing a rat model of atrial fibrillation,to study myocardial angiotensin type Ⅰ (AT1R) and type Ⅱ receptor (AT2R) mRNA expression levels in of the state atrial fibrillation and Artemisia annua extract on its expression.Methods Rat model of atrial fibrillation was established,Artemisia annua extract was used for intervention and captopril was adopted as controls.AT1R,AT2R mRNA and protein expression were observed by PCR and Western-blot technology.Results Compared with the control group (0.36±0.05),myocardial AT1R mRNA expression was significantly increased in the model group (0.84±0.04) (P＜0.05).BothArtemisia annua (0.56±0.03) and captopril (0.53±0.04) could significantly reduce the myocardial AT1R mRNA expression in the atrial fibrillation rats (P＜0.05).Captopril showed obvious AT1R mRNA reduction trend,but there was statistical significance compared with Artemisinic extract (P＞0.05).Artemisinic extract showed no impact on AT2R mRNA expression.Conclusion AT1R was closely related to the incidence of atrial fibrillation.AT1R expression was significantly increased in atrial fibrillation rat.The artemisinic extract can be effectively reduced fibrillation myocardial AT1R expression,which may link with its artemisinic antiarrhythmic mechanism.

AIM: To investigate the effect and the mechanism of apolipoprotein (a) [apo (a) ] on proliferation of vascular smooth muscle cells ( VSMCs). METHODS: All VSMCs used in experiments were serial subcultured from primary cells and were identified by immunohistochemistry staining of a - actin. Cell growth assay was observed as cell counting and MTT assay. Western blotting was also employed to detect the related mechanism. RESULTS: All cells used in experiments were confirmed as VSMCs. Although apo (a) enhanced VSMCs proliferation, this effect was attenuated by anti -integrin α_vβ_3, LM609.Use these reagents alone had no effect on VSMCs growth. The results of Western blotting demonstrated that focal adhesion kinase (FAK) was activated by apo (a) and the expression of total or phosphorylated transforming growth factor β_1 (TGF -β_1) was also decreased. However, these effects described above were all blocked by LM609.CONCLUSION: Apolipoprotein (a) enhances VSMCs proliferation and this effect is mediated by integrin α_vβ_3, which activates FAK and attenuates TGF - β_1 and phospho -TGF - β_1 expression.

Objective To construct the permanent colostomy patients with rectal cancer in archives information module content. Methods Using expert meeting,semi- structured interview, literature review, Delphi expert consultation method, establish the system of permanent rectal cancer patients file information specific module. Results In two- round consultation authority coefficient was 0.847. Kendall coordination coefficient (Kendall′s W) was 0.195-0.331, the difference had statistical significance (P<0.01); through the expert consultation method to construct the file information module for permanent colostomy patients with rectal cancer, which contained 4 first-level indicators (colostomy patient information module, stoma nursing modules, stoma patients transitional care modules, colostomy patients with network platform module), 11 secondary indicators, 36 third grade indicators. Conclusions This study established file information module content for permanent stoma patients with rectal cancer. It has good scientificity and reliability, and can provide a theoretical basis for the clinical development of a file information system network for transitional care of permanent stoma patients with rectal cancer.

Objective To explore the effect of psychological intervention on first episode schizophrenia in quality of life and social function.Methods 120 inpatients with first episode schizophrenia were randomly divided into the observed group (60 cases) in which patients were treated with risperidone plus psychological intervention and the control group (60 cases) in which patients were treated with risperidone only. All patients had been treated for 8 weeks and followed up for 6 months after discharge. The assessments included the Positive and Negative Symptoms Scale(PANSS), WHO, QOL-100 and Social Disability Screening Schedule(SDSS) before the treatment and at the end of the follow-up.Results The scores of PANSS, SDSS and QOL-100 in both groups did not show significant difference before the treatment(P>0.05). At the end of follow-up, the total score, negative score and positive score of PANSS in the observed group were lower than that in the control group(P<0.01), while the total score of QOL-100, areas of mentality, dependence, social relation factor scores and the scores of SDSS in the observed group were higher than that in the control group(P<0.05 or P<0.01). Conclusion Psychological intervention can help to improve the symptom of first episode schizophrenia and enhance their quality of life and social function.

Objective To investigate the association between plasma lipoprotein (a) [LP (a)] concentra-tion and in-stent restenosis after coronary stent implantation. Methods 152 patients with successful elective coro-nary stont implantation and percutancous transluminal coronary angioplasty (PICA) undergoing foUow-up angiogra-phy were retrospectively analyzed. These patients were divided into restenosis group( n = 29) and no-restenosis group (n = 123 ). The serum LP (a) levels of all patients were also investigated. The general clinical data were analyzed. Multivariate logistic regression was used for statistical analysis. Results We compared the serum Lap (a) levels, smoking and diabet in the two groups, and there was a statisticaLly significant difference between the restenosis group and no-restenosis group(P<0.05). Multivariate logistic regression showed that the elevation of Lap (a) level re-mained as an independent predictor of restenosis (RR =2. 648,95% CI 1. 066-6. 575,P <0. 05). Other risk fac-tors,such as smoking(P =0.023) ,diabet(P =0. 036) and the type of stent(P = 0.011 ) were also correlated with restenosis. Conclusions High plasma LP (a) concentration is an independent predictor of stent restenosis after stent implantation.

OBJECTIVETo investigate the effects of Xuezhikang (XZK) on serum levels of high sensitivity-C reactive protein (Hs-CRP), matrix metalloproteinase-9 (MMP-9) and lipoprotein in patients with acute coronary syndrome (ACS).

METHODSSixty-nine ACS patients were divided into the XZK group (40 cases) treated with conventional therapy and XZK and the control group (29 cases) with conventional therapy alone, another 30 healthy persons were assigned as the normal group. Before and after the treatment, the levels of Hs-CRP, MMP-9 and lipids were detected.

RESULTSCompared with those in the normal subjects, Hs-CRP and MMP-9 levels in the ACS patients increased significantly (P <0.05), parallel with the extent of myocardial injury. After 2 weeks of XZK treatment, levels of Hs-CRP and MMP-9 of the XZK group decreased significantly (P <0.05), while lipids levels had no remarkable changes.

CONCLUSIONHs-CRP and MMP-9 levels were closely correlated to the genesis and severity of ACS. Anti-inflammatory action of XZK plays an important role in early stage treatment of ACS patients.

Acute Coronary Syndrome ; blood ; drug therapy ; Adult ; Aged ; Angina, Unstable ; blood ; drug therapy ; C-Reactive Protein ; metabolism ; Cholesterol ; blood ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Lipoproteins, LDL ; blood ; Male ; Matrix Metalloproteinase 9 ; blood ; Middle Aged ; Myocardial Infarction ; blood ; drug therapy ; Phytotherapy ; Triglycerides ; blood

Ventilator associated pneumonia(VAP)is one of the major source of nosocomial infection in PICU, of which the pathogenesis remains unclear.Recent metataxonomic and metagenomic technologies, from 16S ribosomal RNA to whole genome sequencing, have revealed that healthy lungs harbor a dynamic ecosystem of bacteria and dysbiosis of the respiratory microbiome involved in the pathogenesis and progression of VAP.Recent studies have illustrated that the imbalance of species diversity and abundance of lung microbiome might be the underlying cause of VAP through regulating local mucosal immune response.These methods offer the potential to better interrogate the relationship between an intubated individual′s respiratory microbiota and the underlying disease process to provide important insights into the pathogenesis of VAP, optimizing disease surveillance and multi-drug resistant microbes detection.

UNLABELLEDObjective To compare the impact of right ventricular apical (RVA) versus right ventricular outflow tract (RVOT) pacing on left ventricular systolic synchronization.

METHODSSixty patients were prospectively recruited and randomized into RVA group (n=30) with the right ventricle leads placed in the RVA and RVOT group (n=30) with right ventricle leads placed in the septum of the RVOT. Speckle tracking imaging was performed with 100% ventricle pacing to measure the differences in the time to maximum left ventricle (LV) radial strain.

RESULTSIn RVA group, the difference in the time to 6-segment maximum LV radial strain after pacing was 105.27 ± 19.74 ms, significantly greater than that in RVOT group (41.65 ± 12.17 ms, P<0.001). The standard difference of time to 6-segment maximum LV radial strain was also significantly greater in RVA group than in RVOT group (42.71 ± 17.63 vs 17.63 ± 5.62 ms, P<0.001).

CONCLUSIONLeft ventricle systolic synchronizaition after RVOT pacing is superior to RVA pacing.

Cardiac Pacing, Artificial ; methods ; Heart ; Heart Ventricles ; Humans ; Systole

Objective:To dynamically monitor the pediatric sequential organ failure assessment(pSOFA) score of children in PICU at different time points, and to evaluate the predictive value of pSOFA score for the prognosis of children with sepsis.Methods:A multicenter prospective observational study was conducted to collect the data of children with sepsis admitted to the PICU of four children′s hospitals in Shanghai from December 2018 to December 2019(Children′s Hospital of Fudan University, Shanghai Children′s Medical Center Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai Children′s Hospital Affiliated to Shanghai Jiaotong University School of Medicine, and Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine). We collected their pSOFA scores on the 1st, 3rd, and 7th day after sepsis diagnosis and the highest score.The patients were divided into survival group and death group according to the clinical outcomes at the time of leaving PICU.The clinical characteristics of two groups were compared.Receiver operating characteristic(ROC) curve were used to assess the resolution of the pSOFA score.Logistic regression was used to analyze the relationship between pSOFA score and sepsis mortality.Results:A total of 170 cases diagnosed sepsis were included, with a median age of 32.5(11.5, 83.2) months, and a median length of stay in PICU of 10(6, 21) days.Forty-two died and 128 survived.The medians of the 1st, 3rd, 7th day and the highest pSOFA score of the children in death group[10(7, 12) points, 9(5, 10) points, 7(4, 10) points, 11(7, 12) points, respectively] were higher than those in survival group[4(2, 8) points, 3(1, 6) points, 2(0, 5) points, 6(3, 8) points, respectively]( P<0.05). The area under the ROC curve of the pSOFA score predicting death on day 1 after sepsis diagnosis was greater than that on days 3, 7 and the highest pSOFA score[0.84(95% CI 0.79-0.91) vs.0.80(95% CI 0.71-0.89), 0.77(95% CI 0.65-0.89), 0.83(95% CI 0.77-0.90)], but the difference was not statistically significant( χ2=1.660, P=0.646). The pSOFA score on the first day of diagnosis had the best cut-off value of >6 points for predicting the risk of death from sepsis, with a sensitivity of 97.6% and a specificity of 53.9%.Logistic regression analysis of pSOFA score and childhood sepsis death showed that the OR values corresponding to the 1st, 3rd, 7th day of diagnosis and the highest pSOFA score were 1.58(95% CI 1.350-1.840), 1.39(95% CI 1.218-1.595), 1.38(95% CI 1.184-1.617) and 1.55(95% CI 1.333-1.800), respectively(all P<0.05). The 1-point increase in pSOFA score on the first day of diagnosis of sepsis was associated with a 58% increase in the hazard ratio for death, and each 1-point increase in the highest pSOFA score was associated with a 55% increase in the hazard ratio for death. Conclusion:The 1st, 3rd, 7th day of sepsis diagnosis and the highest pSOFA score could better predict the mortality risk of sepsis in children.Dynamic monitoring of the pSOFA score at different time points has a certain clinical value in predicting the progression and prognosis of children with sepsis.

ObjectiveTo explore the status and influencing factors of electric bicycle （e-bike）-related traffic injury in Songjiang District of Shanghai， and to provide reference for prevention and control of the injury. MethodsA self-designed questionnaire was used to investigate the community residents over 16 years old who rode e-bike in Songjiang Western Industrial Zone. The survey included general demographic characteristics， physical and psychological conditions， e-bike use， accidents and injuries. Descriptive analysis， chi-square test and Fisher's exact probability method were used to explore the influencing factors of traffic injury by e-bike in Songjiang District. Results1 030 questionnaires were distributed and 1 013 valid questionnaires were recovered. The effective rate of the questionnaire was 98.35%. From June 2020 to May 2021， the incidence of e-bike traffic accidents in Songjiang Western Industrial Zone was 17.47% and the incidence of injuries was 12.64%. The difference between e-bike accident group and non accident group was statistically significant （P<0.05） in the following factors： gender， registered residence， educational level， sleeping time， fatigue， violation of traffic regulations including speed limit 25 km‧h^-1 and crossing of red traffic lights， riding after alcohol drinking， riding speed higher than 30 km‧h^-1， riding on the phone， wearing headset， turning without prompting signal， riding on the lane of motor vehicles，and e-bike life. The top three injured body parts were limb pelvis （48.10%）， body surface （27.85%） and head （13.92%）. The nature of injury was mainly contusion / abrasion （82.03%）， followed by fracture （17.19%）. ConclusionThe incidence of e-bike traffic accidents in Songjiang District is high. We should strengthen the traffic safety education of e-bike riders， strengthen the road traffic control， and reduce the occurrence of e-bike road traffic accidents in Songjiang District.