Objective To determine whether acute withdrawal of simvastatin treatment in healthy normocholesterolemic men impairs the brachial artery endothelial function.Methods The study was performed on 16 healthy,young male subjects with desirable serum levels of cholesterol.They were administered with simvastatin(20 mg/d)for 4 weeks.Endothelial dependent flow-mediated vasodilation (FMD)was assessed on the brachial artery using high-resolution ultrasound,and fasting serum lipid profiles as well as vasoactive substances[NO,endothelin(ET)and 6-keto-PGF1α] were measured.The parameters mentioned above were obtained at indicated time points before and after simvastatin treatment. Resuts Simvastatin treatment for 4 weeks significantly improved FMD and reduced low density LDL-C and total TC levels.Withdrawal of simvastatin.however,resulted in dramatic impairment of endothelium- dependent relaxation on the first day after with drawal [(4.6±0.48)%and(10.9±0.89)%,P＜0.01 ], Furthermore,FMD decreased significantly as compared with baseline level[(4.6±0.48)%vs(6.4±0.47)%,P＜<0.01].Serum NO level varied according to the change of endothelial-dependent relaxation(γ=0.496,P＜0.01).After discontinuing simvastatin therapy,plasma ET increased and plasma 6-keto-PGF1α decreased progressively.In addition,serum TC and LDL-C were not significantly modified during the initial 2 days.No correlation was shown between FMD and serum LDL-C level(γ=-0.172,P=0.101). Conclusions Withdrawal of simvastatin not only abrogates the beneficial effect on endothelial function of healthy normocholesterolemic men rapidly,but also induces further endothelial deterioration as compared with pretreatment status.This adverse effect is independent of serum cholesterol.The underlying mechanism may be related to the suppression of endothelial NO production.

A new stent with triangular wire cross-section was proposed. The new stents were compared with traditional circular wire cross-section stent in the same porosity in order to investigate its effectiveness in treating intracranial aneurysms. Three models were established separately, including the aneurysm model with circle cross section stent, the aneurysm model with triangular cross section stent and the aneurysm model with non-stent. Then the same boundary conditions were set to contrast the resistance to flow, velocity, pressure, wall shear stress and total mesh displacement. The resistance to flow of triangular cross section stent was lower than circle cross section stent and the velocity, pressure, total mesh displacement of aneurysm model with triangular cross section stent were all higher than those of the model with circle cross section stent. Moreover, the peak value and valley value of wall shear stress in aneurysm model with triangular cross section stent were higher than those of the other. Triangular cross section stent might play a negative role to aneurysm rupturing. Thus, the therapeutic effect of stent with triangle cross section was not better than the stent with circle cross section. In the clinical application, doctors should consider the various factors, and choose the most suitable one.
Aneurysm ; therapy ; Computer Simulation ; Hemorheology ; physiology ; Humans ; Intracranial Aneurysm ; therapy ; Prosthesis Design ; Stents

Objective To compare the cardiac function in patients with type 2 diabetes (T2DM) and insulin resistance(IR),and analyze the correlation between IR and cardiac function.Methods A total of 282 patients with T2DM were enrolled randomly in this study from our clinic and ward from Aug.2015 to Aug.2016.All the subjects were divided into two groups according to the level of HOMA-IR:HOMA-IR ＜2.69 group(n=153) and HOMA-IR≥2.69 group(n=129).Healthy subjects were selected as the normal control group (NC group,n=150).The clinical data and biochemical index were collected in all the subjects.The cardiac function index included LVPWTd,WsTd,LVSV,LVFS and LVEF were tested and compared among the three groups.Pearson's correlation analysis was used to evaluate the correlation between HOMA-IR and cardiac function index.Multiple stepwise linear regression was adopted to analyze the influencing factors for cardiac systolic function(LVEF) and diastolic function(E/A).Results (1) FPG,2 hPG and FIns decreased,while HOMA-β increased from HOMA-IR≥ 2.69 group,HOMA-IR＜ 2.69group to NC group (P＜0.05 or P＜0.01);(2) LVPWTd [(15.43±1.92) vs (11.38±1.78) vs (10.16±1.50) mm,P＜0.05 or P＜0.01)and WSTd [(14.35±2.00) vs (10.46±1.67) vs (9.00±1.08) mm,P＜0.05 or P＜0.01)were higher in HOMA-IR≥2.69 group and HOMA-IR＜2.69 group than in NC group.LVSV[(55.15±8.26)％ vs (60.27±8.12)％ vs (65.33±7.78)％,P＜0.05 or P＜0.01],LVEF [(62.41±8.89)％ vs (71.57±5.16)％ vs (76.35±7.80)％,P＜0.05 or P＜0.01],and E/A[(0.65±0.11) vs (0.76±0.18) vs (1.03±0.23),P＜0.05 or P＜0.01] were lower in HOMA-IR≥2.69 group and HOMA-IR＜2.69 group than in NC group.(3)Pearson correlation analysis showed that HOMA-IR was negatively correlated with LVEF and E/A(r=-0.746,-0.729,P=0.001).(4) Multiple stepwise linear regression analysis showed that HOMA-IR was an influencing factor for LVEF and E/A(P＜0.05 or P＜0.01).Conclusion With the aggravating of IR,LVEF and E/A are declined in diabetic patients.IR is a common risk factor for LVEF and E/A.

Objective To study the relationship between liver enzymes [ alanine transaminase ( ALT), gamma-glutamyltransferase ( GGT), aspartate amino transferase ( AST)] and the incidence of impaired glucose tolerance(IGT) in middle-aged and elderly people. Methods A group of middle-aged and elderly residents who participated in the REACTION study in 2011 from Guiyang community were enrolled in our study. Of which, a total of 4228 participants with normal blood glucose detected by oral glucose tolerance test (OGTT) and serum ALT levels were investigated as baseline population. The baseline survey included questionnaire survey and physical examination (height, weight, waist circumference, blood pressure, etc. ), and the serum ALT, AST, GGT, total cholesterol ( TC ), triglyceride ( TG ), high density lipoprotein-cholesterol ( HDL-C ), low density lipoprotein-cholesterol (LDL-C), fasting blood glucose, postprandial 2h plasma glucose(2hPG) in OGTT, and fasting insulin(FINS) were tested. After 3 years of follow-up, all subjects received quartile grouping according to the basal liver enzyme levels, and the incidence of IGT was respectively calculated. One-way analysis of variance was used to compare the differences of basal liver enzyme levels between IGT and normal blood glucose groups. The risk of IGT based on quartile grouping was assessed by multivariate regression analysis, and the odds ratios (ORs) were estimated by the logistic regression model. Results After eliminating the 35 died patients, 3188 participants were followed over 3 years. Among them, 2400 subjects revealed normal blood glucose level, 61 developed into type 2 diabetes mellitus(T2DM), 91 developed into IFG, and 636 developed into IGT. The incidence of IGT increased along with the elevation of serum ALT level (P<0. 01). After adjusting the risk factors including body mass index, regular smoking, regular drinking, regular exercise, family history of diabetes,homeostasis model assessment for insulin resistant index(HOMA-IR), post-load 2h blood glucose, and GGT, the results manifested that patients in high basal ALT level group had 1. 462-fold chance of susceptibility in developing IGT compared with that in the low level group, with 95％ CI of 1. 129 to 1. 891. The analysis based on gender showed that the incidence of IGT was associated with basal ALT level in the female group. The OR value was estimated to be 1. 481(95％ CI 1. 107-1. 981) in high basal ALT level group as compared with the low level group. Basal serum GGT and AST levels were not associated with the incidence of IGT. Conclusion Even an elevated level of ALT within normal reference range also tends to be a risk factor for IGT in middle-aged and elderly women.

Objective:To explore the clinical effect of transvaginal and laparoscopic myomectomy.Methods:A total of 40 cases treated with hysteromyomectomy in Xinhua Hospital Affiliated to Dalian University and Dalian Women′s and Children′s Medical Center from Decedmber 2018 to March 2020 were selected as the research objects. According to the random number table method, they were assigned into the observation group (20 cases) and the control group (20 cases). In the observation group, hysteromyomectomy was performed via vagina, and in the control group, hysteromyomectomy was performed via laparoscope. Then the time of operation, the amount of bleeding, the recovery time of gastrointestinal function, 24 h postoperative drainage, 12 h postoperative pain and hospitalization expenses were compared between the two groups.Results:The operation of the observation group and the control group were completed as planned. The operation time, the amount of bleeding of the observation groupwere less than those of the control group: (69.75 ± 19.43) min vs. (84.50 ± 22.4) min, (119.25 ± 56.37) ml vs. (159.00 ± 63.73) ml, the differences were statistically significant ( P<0.05). The recovery time of gastrointestinal function, 24 h postoperative drainage, 12 h postoperative pain in two groups had no significant differences ( P>0.05). The hospitalization expenses in observation group was lower than that in control group: (2.27 ± 0.12) ten thousand Yuan vs. (2.66 ± 0.10) ten thousand Yuan, the difference was statistically significant ( P<0.05). Conclusions:Compared with laparoscopic myomectomy, transvaginal myomectomy has the advantages of shorter operation time, less bleeding and less hospitalization expenses.

Objective To investigate the intra- and interobserver repeatability of coronary artery disease (CAD) diagnosis based on invasive coronary angiography (ICA) and CT coronary angiography (CTCA).Methods Two readers with comparable experience ( over 10 years) independently evaluated ICA results of 42 consecutive patients with a blind method. After 30 days,one of them reviewed the same patients again.Another two comparable-experience (over 10 years) readers evaluated the results of CTCA (prospectively ECG-triggering) from the same 42 patients in the same way.The inter-reader and intra-reader repeatability of ICA and CTCA were analyzed by performing Kappa test and calculating the percentage of the segments with agreement on stenotic degree.Using ICA as reference,the accuracy of CTCA in diagnosing CAD was studied by comparing the area under ROC. Results The Kappa between readers for ICA and CTCA were 0.91 and 0.81.Intra-reader Kappa were 0.92 and 0.83 respectively (x2 =509.4 and 432.5,all P ＜0.01 ).The percentage of the segments with agreement between readers on the degree of stenosis were 80.8％ (494/611) in ICA and 75.2％ (469/624) in CTCA ( x2 =2.75,P =0.10),and within the same reader,86.9％ (531/611)in ICA and 81.9％ (511/624) in CTCA(x2 =3.76,P =0.053).With≥ 50％narrowing as a CAD diagnosis criterion,the agreement rates for two readers were 96.6％ (590/611 ) in ICA and 94.4％ (589/624) in CTCA( x2 =3.36,P =0.07),and for the same reader,97.4％ (595/611) in ICA,95.4％ (595/624) in CTCA ( x2 =3.62,P =0.06).Using ICA as reference,two readers of CTCA results achieved a sensitivity and specificity of 84.9％ (530/624)and 98.1％ (612/624).The area under ROC was 0.94 (95％ CI 0.91-0.97).Conclusions Both ICA and CTCA demonstrate good repeatability in diagnosing CAD.The repeatability of ICA is superior to that of CTCA.A certain discrepancy exists in two readings from the same reader or two readers.

Objective:To observe the utility of event-related potential P300 in diagnosing post-stroke cognitive impairment.Methods:Forty-nine stroke survivors at high risk of cognitive impairment formed the observation group, while 54 healthy volunteers were the control group. General clinical data and Montreal Cognitive Assessment Scale (MoCA) scores were compiled for all of the subjects, and the two groups′ P300 latencies, amplitudes and mean reaction times (MRTs) were compared. A total MoCA score <26 (corrected for education level) was taken as the diagnostic criterion for cognitive impairment. The receiver operating characteristics (ROC) curve was employed to analyze the diagnostic efficacy of P300 for post-stroke cognitive impairment and determine the diagnostic cutoff.Results:(1) The average MoCA score, P300 latency and P300 MRT of the observation group were all significantly different from the control group′s averages. There was, however, no significant difference between the two groups′ median P300 amplitudes. (2) According to the ROC curve analysis, the diagnostic limit of P300 latency was 376.50ms. With the area under the curve 0.795, sensitivity was 70.8% and specificity was 78.9%. The diagnosis cut-off value of P300 MRT was 423.35ms, with the area under the curve 0.695, giving a sensitivity of 80.0% and a specificity of 52.6%.Conclusions:Event-related potential P300 has useful efficacy in diagnosing post-stroke cognitive impairment.

Objective To explore a method of subsection adjustment for the proportion of three capacity nutrients in patients with metabolic syndrome (MS).Methods Totally 334 MS patients who were diagnosed in the physical examination center and the department of endocrinology and nutrition of Xi'an Central Hospital Affiliated to Xi'an Jiaotong University of School of Medicine were enrolled in this study.According to calculator random digital method,the patients were divided into intervention group (n=168) and the control group (n=166).The energy of two groups were calculated according to the following formula,y =13.5-0.025x1 + 0.215x2-0.006x3+0.342x4-0.268x5+0.623x6 (x1:age,x2:activity intensity index,x3:waist circumference,x4:environmental temperature,x5:BMI,x6:sex).The limit of daily energy was set to 5.02-7.53 MJ.The proportion of the three major nutrients for energy was adjusted of different energy segments of intervention group.When the daily energy was 5.02 MJ,the protein energy ratio was 30％,and the energy increased by 0.42 MJ per time while the protein energy supply ratio was reduced by 2.5％.The energy ratio of carbohydrate was 40％,and the energy increased 0.42 MJ per time while the energy ratio increased by 2.5％.The energy ratio of fat was 30％ on various stages of energy supply.The energy proportions of the three major nutrients in the control group were as follows:protein 15％,fat 25％,and carbohydrate 60％.Results After the intervention by 6 months,the 2-hour postprandial blood glucose of intervention group decreased from (9.22±5.57) mmol/L to (6.05±4.68) mmol/L,the hemoglobin A 1 c decreased from (6.79 ± 1.12) ％ to (5.56± 1.32) ％,and the triglyceride decreased from (3.14±1.73) mmol/L to (1.72±1.17) mmol/L.There was significant difference compared with those in control group (P =0.000,0.027,0.034).Conclusion The proportions of the three major nutrients in MS can remarkably improve the glucose and lipid metabolism in MS patients.

Objective To investigate the value of age and D-dimer (D-D) combined with Model for End-Stage Liver Disease (MELD) score in predicting the prognosis of patients with hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF). Methods A total of 111 patients with HBV-ACLF who were hospitalized in The First Affiliated Hospital of Zhengzhou University from December 2019 to October 2021 were enrolled, and according to their prognosis on day 90 after confirmed diagnosis, they were divided into survival group with 49 patients and death group with 62 patients. Related clinical data were collected, including age, sex, underlying liver diseases, alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBil), Albumin (Alb), D-D, prothrombin time (PT), plasma fibrinogen (FIB), prothrombin activity (PTA), international normalized ratio (INR), serum creatinine (SCr), and serum sodium (Na), and MELD score was calculated. Immunoturbidimetric assay was used to measure the plasma level of D-D. The t -test or the Mann-Whitney U test was used for comparison of continuous data between the two groups, and the chi-square test was used for comparison of categorical data between the two groups; a binary Logistic regression analysis was used to investigate the independent risk factors for the prognosis of patients, and the receiver operating characteristic (ROC) curve was used to predict the accuracy of variables. Results There were significant differences between the two groups in age, TBil, D-D, PT, PTA, INR, SCr, Na, and MELD score (all P < 0.05). The binary Logistic regression analysis showed that age (odds ratio [ OR ]=1.088, 95% confidence interval [ CI ]: 1.001-1.183, P =0.047), D-D ( OR =1.521, 95% CI : 1.078-2.145, P =0.017), and MELD score ( OR =1.892, 95% CI : 1.408-2.543, P < 0.001) were independent risk factors for the prognosis of HBV-ACLF patients. Age, MELD score and D-D had an area under the ROC curve (AUC) of 0.664, 0.869, and 0.887, respectively, in predicting the prognosis of HBV-ACLF, while D-D combined with age, age combined with MELD score, D-D combined with MELD score, and the combination of these three indicators had an AUC of 0.895, 0.906, 0.965, and 0.970, respectively. A combination of the three indices had a significantly increased AUC compared with other indices except D-D combined with MELD score. and the combination of these three indicators had relatively high sensitivity (0.935) and specificity (0.918). Conclusion Age, D-D, and MRLD score are independent risk factors for the prognosis of HBV-ACLF, among which D-D and MELD score have a good value in predicting prognosis, and the combination of these three indicators has a significantly better predictive value.

Amyotrophic lateral sclerosis (ALS) is a rare neurodegenerative disease affecting the upper and lower motor neurons. It is characterized by progressive muscle weakness, atrophy and ultimate death due to dysphagia and dyspnea. There are many causes of ALS, among which the genetic factors show great relevance. Imbalance of protein homeostasis in neurons, prion-like proliferation and propagation of abnormal proteins, mitochondrial dysfunction, glutamate mediated excitotoxicity, and intraneuronal substance transport disorders are recognized as the pathogenesis.The study on gene mutation related to pathogenesis will bridge the molecular and cellular research of ALS, which can deepen the understanding of the occurrence and development of ALS and the role of gene mutation in ALS, and provide new ideas and enlightenment for the treatment of ALS.
Amyotrophic Lateral Sclerosis/genetics* ; Humans ; Motor Neurons ; Mutation ; Neurodegenerative Diseases ; Proteins