OBJECTIVE:To investigate the effects of simvastatin intensive treatment on the Postoperative Related Indexes of patients with acute coronary syndrome(ACS) underwent percutaneous coronary intervention(PCI). METHODS:106 patients with were included in the study and randomly divided into observation group(53 cases)and control group(53 cases). Both groups were given aspirin 100 mg,qd+clopidogrel 75 mg,qd before PCI for 4 weeks;observation group was additionally given Simvastatin tablet orally 20 mg before supper 15 d before surgery. TC,TG,LDL-C,HDL-C,hs-CRP,IL-6 and IL-18 levels,LVEF,the occurrence of coronary artery restenosis were detected in 2 groups before surgery and 6 months after surgery. The occurrence of ADR was recorded during treatment. RESULTS:There was no statistical significance in the levels of TG,TC,LDL-C and HDL-C between 2 groups before surgery and 6 months after surgery (P>0.05). There was no statistical significance in hs-CRP,IL-18, IL-6 and LVEF levels between 2 groups before surgery(P>0.05). 6 months after surgery,hs-CRP,IL-6,IL-18 and LVEF levels of 2 groups were significantly higher than before treatment;hs-CRP,IL-6 and IL-18 levels of observation group were significantly lower than those of control group,and LVEF was significantly higher than control group,with statistical significance (P<0.05). The incidence of coronary artery restenosis in observation group was significantly lower than control group, with statistical significance (P<0.05). No ADR was found in 2 groups during treatment. CONCLUSIONS:Preoperative simvastatin intensive treatment can effectively reduce cardiovascular inflammation degree in patients with ACS after PCI,prevent the formation of coronary artery thrombus,and reduce the incidence of coronary artery restenosis so as to effectively improve the prognosis and don' t increase the incidence of ADR.

Aim To investigate the effects of Rehmannia glutinosa oligosaccharides(ROS)on the damage induced by glutamate in hippocampal neurons.Methods The neurons isolated from hippocampus in new born SD rats were cultured for 7~9 days,which were specifically stained with NSE and then randomly divided into four groups:(Ⅰ)Normal cultures(control);(Ⅱ)ROS control cultures;(Ⅲ)Glutamate-exposed control cultures;(Ⅳ)Glutamate-exposed cultures pretreated with ROS.The neurons morphology was observed under inverted microscope;cell viability was assayed by MTT staining;LDH release was detected with chromatometry and flow cytometric analysis for identification and quantification of cell apoptosis.Results Compared with normal group,after exposure of glutamate for 24 h,the viability of neurons was decreased,LDH release and cell apoptosis were increased(P

This study is to investigate the treatment of Jin Chai antiviral capsule for influenza virus FM1/47 (H1N1) infection. The model of pneumonia was established by dropping influenza virus into the nose of normal mice, real-time PCR and Western blot technique were used to detect the virus load and the interferoninducible transmembrane protein3 (IFITM3) in lung of mice at the 1st day, 3rd day, 5th day and 7th day after affected. The results showed that Jin Chai antiviral capsule in large, middle, small dose groups can decrease virus load significantly at each time point, after being affected (P<0.05, P<0.01), Jin Chai antiviral capsule can increase the interferoninducible transmembrane protein3 in lung of mice, large dose groups are significantly higher in expression of IFITM3 compared with model group at each time point (P<0.05, P<0.01). Middle dose groups are significantly higher in expression of IFITM3 compared with model group at the 3th day and the 5th day (P<0.05), small dose groups are significantly higher in expression of IFITM3 compared with model group at the 3th day (P<0.05). It can be concluded that Jin Chai antiviral capsule exerts antiviral effects against influenzavirus by raised expression of IFITM3.

Objective To study the clinical characteristic of acquired immune deficiency syndrome (AIDS) patients younger than 15 years old and to explore the influence of human immunodeficiency virus (HIV) infection on them. Methods The clinical information, including demographic profile, clinical stages of the disease, laboratory test results and developmental status were gathered from 275 antiretroviral therapy naive patients. Results Seventy eight point nine percent patients were infected by vertical transmission. Sixteen percent were infected by receiving blood products. The average age was (7.6±3. 7) years, with 5 cases younger than 1 year old, 104 cases ranging from 1 - 5 years and 166 cases elder than 6 years. Seventy point one percent patients were classified as stage 3 or 4 according to World Health Organization definitions. The average CD4 count was ( 137 ± 159 )/μL, ( 304 ± 317 ) /μL and ( 1 246 ± 776 )/μL respectively in children elder than 6 years, ranging from 1 to 5 years and younger than 1 year. One hundred and eighty one cases suffered from anemia on different severity grading. The most common HIV related symdromes included persistent fever, skin damage, persistent diarrhea, oral candidiasis and recurrent upper respiratory tract infection. Among these infected children, 49. 6% showed height lower than x - 2s and 19. 9% showed weight lower than x - 2s. Conclusions Most survival pediatric AIDS patients are elder than 6 years. HIV infection can significantly affect the children's immune system function,growth and development.

Objective:To investigate the clinical situation of 201 emergency adult sudden death patients, and analyze the influence of white blood cell count and arterial blood lactate level on prognosis.Methods:The clinical data of 201 patients diagnosed with sudden death in the emergency department of Medical College of Cangzhou people's Hospital from January 2017 to January 2021 were retrospectively analyzed. The gender, age, disease composition and etiology of the patients were statistically analyzed. The independent sample t-test was used to compare the measurement data with normal distribution, the χ 2 test or Fisher exact probability method was used to compare the counting data between groups, and the logistic regression model was used to screen the risk factors of emergency death, and the impact of white blood cell count and arterial blood lactate level on the prognosis was analyzed. Results:After active rescue, 11.44% (23/201) of the patients were successfully rescued, and 88.56% (178/201) of the patients were ineffective; ≥46-≤65 years old was the age group with high incidence of sudden death (55.22%(111/201)). The proportion of male (43.28% (87/201), 23.38% (42/201)) in the age group of ≥46-≤65 years old and the age group over 65 years old were higher than that of female (11.94% (24/201), 14.43% (29/201)), with a statistically significant difference (χ 2=4.801, 9.209; P=0.028, 0.002). In the past history of sudden death patients, the proportion of cardiovascular disease (53.23% (107/201)) was the highest; the proportion of patients may have inducements before sudden death was 74.13% (149/201), the proportion of patients have premonitory symptoms before sudden death was 67.66% (136/201), and sudden cardiac death was the first cause. Logistic regression analysis showed that white blood cell count ( OR=4.442,95% CI: 1.898-10.395), arterial blood lactic acid concentration ( OR=4.272,95% CI: 2.024-9.016), and albumin concentration ( OR=2.657,95% CI: 1.302-5.422) were independent risk factors affecting emergency sudden death patients ( P values were 0.001, <0.001, 0.007, respectively). Conclusions:There are some differences in gender, age and past history of adult sudden death patients. Most of them have premonitory symptoms and inducements. Sudden cardiac death is the primary cause. The increases of white blood cell count and lactic acid level, the decrease of albumin level are the risk factors of sudden death.

Objective:To explore the clinical application of time of flight-magnetic resonance angiography (TOF-MRA), silent magnetic resonance angiography (SilenZ-MRA) and high-resolution vessel wall imaging (HR-VWI) in non-invasive evaluation of intracranial aneurysm after embolization.Methods:From February 2021 to February 2022, 39 patients, including 8 males and 31 females, who were 29-86 (54.50±11.80) years old and had received intracranial aneurysm embolization were collected in the Second Affiliated Hospital of Nanchang University. Kruskal-Wallis test was used to compare the image quality score and the evaluation results of lumen stenosis rate in the stent segments by TOF-MRA, SilenZ-MRA and HR-VWI. The diagnostic value of TOF-MRA, SilenZ-MRA and HR-VWI was analyzed by receiver operating characteristic (ROC) curve with DSA as the reference standard.Results:The image quality scores of TOF-MRA, SilenZ-MRA and HR-VWI were 2(1, 3), 4(3, 4) and 4(4, 4), respectively, with statistically significant difference ( H=80.78, P<0.05). The pairwise comparison results were as follows: TOF-MRA vs SilenZ-MRA, P<0.017; TOF-MRA vs HR-VWI, P<0.017; SilenZ-MRA vs HR-VWI, P>0.017. The lumen stenosis rates of stent segments measured by TOF-MRA, SilenZ-MRA, HR-VWI and DSA were 45.00% (29.60%, 61.05%), 17.60% (10.80%, 26.80%), 13.35% (8.90%, 15.95%) and 7.95% (4.80%, 11.25%), respectively, with statistically significant difference ( H=67.96, P<0.05). The results of comparison between TOF-MRA, SilenZ-MRA, HR-VWI and DSA were respectively as follows: TOF-MRA vs DSA, P<0.017; SilenZ-MRA vs DSA, P<0.017; HR-VWI vs DSA, P>0.017. DSA review showed that 12 (27.91%,12/43) aneurysms were not completely embolized, and 31 (72.09%, 31/43) aneurysms were completely embolized. The area under the curve of TOF-MRA, SilenZ-MRA and HR-VWI for evaluating the postoperative complete embolization of aneurysm was 0.75, 1.00 and 0.94, respectively, with statistically significant differences between TOF-MRA and HR-VWI ( Z=2.53, P<0.05) as well as between TOF-MRA and SilenZ-MRA ( Z=3.32, P<0.05). Conclusions:HR-VWI can clearly display the stent-segment lumen of the parent artery, and evaluate the stent-segment arterial wall and whether the stent-segment lumen is unobstructed or not. SilenZ-MRA is significantly superior to TOF-MRA in the evaluation of postoperative embolization status of aneurysms, and slightly superior to HR-VWI in tumor neck display. Combined application of HR-VWI and SilenZ-MRA has certain clinical significance for non-invasive evaluation of intracranial aneurysm after embolization.

Objective:To investigate the effects of different durations of antiretroviral therapy (ART) on metabolism in HIV/AIDS patients.Methods:a single center cross-sectional study, 424 HIV/AIDS were divided into four groups according to the different duration of treatment: group Ⅰ (0.5-2 years), group Ⅱ (2-4 years including 2 years), the group Ⅲ (4-6 years including 4 years), group Ⅳ (≥6 years), the differences of abnormal blood lipid, renal function, blood glucose and liver function in each group were compared.Results:incidence of hypercholesteremia: group Ⅰ 9/106 (8.5%), group Ⅱ 17/134 (12.7%), group Ⅲ 22/123 (17.9%), group Ⅳ 4/61 (6.6%), p=0.076; incidence of hypertriglyceridemia: groupⅠ 32/106 (30.2%), group Ⅱ 58/134 (43.3%), group Ⅲ 50/123 (40.7%), group Ⅳ 27/61 (44.3%), p=0.152; incidence of High LDL-C: group Ⅰ 8/106 (7.5%), group Ⅱ 17/134 (12.7%), group Ⅲ 15/123 (12.2%), group Ⅳ 3/61 (4.9%), p=0.249; Incidence of low HDL-C: groupⅠ 48/106 (45.3%), group Ⅱ 66/134 (49.3%), group Ⅲ 55/123 (44.7%), group Ⅳ 33/61 (54.1%), p=0.612; incidence of glomerular filtration rate < 90 ml/min / 1.73 m2: groupⅠ4/106 (3.8%), group Ⅱ 6/134 (4.5%), group Ⅲ 6/123 (4.9%), group Ⅳ 2/61 (3.3%), P=0.953; eGFR was negatively correlated with treatment duration (r=-0.165, P <0.001). Incidence of hypophosphatemia: group Ⅰ 7/106 (6.6%), group Ⅱ 7/134 (5.2%), group Ⅲ 12/123 (9.8%), group Ⅳ 6/61 (9.8%), P=0.478; incidence of hyperuricemia: groupⅠ26/106 (24.5%), group Ⅱ 35/134 (26.1%), group Ⅲ 28/123 (22.8%), group Ⅳ 10/61 (16.4%), P=0.508; incidence of diabetes: groupⅠ1/106 (0.9%), group Ⅱ 9/134 (6.7%), group Ⅲ 6/123 (4.9%), group Ⅳ 3/61 (4.9%), P=0.140; incidence of GGT > 60 U/L: group Ⅰ(21.7%), 23 group Ⅱof 34 (25.4%), 25 group Ⅲ (20.3%), group Ⅳ of 12 (19.7%), P=0.736; incidence of ALT > 50 U/L: groupⅠ(21.7%), 23 group Ⅱ of 33 (24.6%), group Ⅲ of 24 (19.5%), group Ⅳ of 12 (19.7%), p=0.761Conclusion:The types of dyslipidemia in HIV/AIDS patients treated for more than half a year are mainly low HDL-C and hypertriglyceridemia, and the incidence of dyslipidemia does not increase with the prolonging of treatment. It showed a decreasing trend of eGFR with the prolongation of treatment and the occurrence of hypophosphatemia and hyperuricemia should be concerned. The damage of ART drugs to liver function persisted during treatment.

ObjectiveTo reveal the effect of Wenxin prescription on mitochondrial energy metabolism and silent information regulator 1 （SIRT1）/peroxisome proliferator-activated receptor-γ coactivator-1α （PGC-1α）/recombinant estrogen-related receptor α （ERRα） signaling pathway in rats with myocardial ischemia-reperfusion injury. MethodTotally 90 male Wistar rats of SPF grade were randomly assigned into a sham operation group， a model group， and low-， medium-， and high-dose Wenxin prescription groups， with 18 rats in each group. The rats in low-， medium-， and high-dose Wenxin prescription groups were administrated with 0.99， 1.98， and 3.96 g·kg^-1 granules by gavage， respectively， and those in the sham operation group and model group with the same amount of normal saline. Twenty-one days after pre-administration， the rat model of myocardial ischemia-reperfusion injury was established by ligation of the left anterior descending coronary artery for 30 min and reperfusion for 2 h， and the rats in the sham operation group were only threaded without ligation. Myocardial infarction area was observed through 2，3，5-triphenyl-2h-tetrazolium chloride （TTC） staining， and the myocardial histopathology through hematoxylin-eosin （HE） staining. The levels of creatine kinase-MB （CK-MB） and lactate dehydrogenase （LDH） in serum， cytochrome C oxidase （CCO） and succinate dehydrogenase （SDH） in mitochondrion， and ATP in myocardial tissue were detected according to kit instructions. The mRNA and protein levels of SIRT1， PGC-1α， ERRα， and mitochondrial transcription factor A （TFAM） in myocardial tissue were determined by Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） and Western blot， respectively. ResultCompared with the sham operation group， the model group showed broken and disordered myocardial fibers， cytoplasmic edema， and pyknosis and deviation of nuclei. Moreover， the modeling increased the levels of CK-MB and LDH （P<0.05， P<0.01）， lowered the levels of ATP， CCO， and SDH （P<0.05， P<0.01）， and down-regulated the mRNA and protein levels of SIRT1， PGC-1α， ERRα， and TFAM in myocardial tissue （P<0.05， P<0.01）. Compared with the model group， Wenxin prescription reduced the myocardial infarction area （especially in the high-dose group， P<0.01）， restored the pathological changes， lowered the levels of CK-MB and LDH （P<0.05， P<0.01）， increased the levels of ATP， CCO， and SDH （especially in the high-dose group， P<0.01）， and up-regulated the mRNA and protein levels of SIRT1， PGC-1α， ERRα， and TFAM in myocardial tissue （P<0.05， P<0.01）. ConclusionWenxin prescription can protect rats from myocardial ischemia-reperfusion injury by regulating myocardial mitochondrial energy metabolism via the SIRT1/PGC-1α/ERRα signaling pathway.

Objective:To analyze the clinical features, genetic characteristics, treatment and follow-up results of patients with hydrocephalus caused by methylmalonic acidemia combined with homocysteinuria, and to discuss the optimal strategies for assessing and treating such patients.Methods:From January 1998 to December 2020, 76 patients with hydrocephalus due to methylmalonic acidemia combined with homocysteinuria in the Department of Pediatrics in 11 hospitals including Peking University First Hospital were diagnosed by biochemical, genetic analysis and brain imaging examination. The patients were divided into operation-group and non-operation-group according to whether they underwent ventriculoperitoneal shunt. The clinical features, laboratory examinations, genotype, and follow-up data were retrospectively analyzed. Data were compared between the two groups using rank sum test, and categorical data were compared using χ 2 test. Results:Among the 76 patients (51 male, 25 female), 5 were detected by newborn screening, while 71 were diagnosed after clinical onset, 68 cases (96%) had early-onset, 3 cases (4%) had late-onset. The most common clinical manifestations of 74 cases with complete data were psychomotor retardation in 74 cases (100%), visual impairment in 74 cases (100%), epilepsy in 44 cases (59%), anemia in 31 cases (42%), hypotonia or hypertonia in 21 cases (28%), feeding difficulties in 19 cases (26%) and disturbance of consciousness in 17 cases (23%). Genetic analysis was performed in 76 cases, all of whom had MMACHC gene variations, including 30 homozygous variations of MMACHC c.609G>A. The most common variations were c.609G>A (94, 62.7%), followed by c.658_660del (18, 12.0%), c.567dupT (9, 6.0%) and c.217C>T (8, 5.3%). Therapy including cobalamin intramuscular injection, L-carnitine and betaine were initiated immediately after diagnosis. A ventriculoperitoneal shunt operation was performed in 41 cases (operation group), and 31 patients improved after metabolic intervention (non-operation group). There was no significant difference in the age of onset, the age of diagnosis, the blood total homocysteine, methionine, and urinary methylmalonic acid concentration between the two groups (all P>0.05). The symptoms of psychomotor development, epilepsy, and visual impairments improved gradually after a long-term follow-up in the operation group. Conclusions:Hydrocephalus is a severe complication of methylmalonic acidemia combined with homocysteinuria. The most common clinical manifestations are psychomotor retardation, visual impairment, and epilepsy. It usually occurs in early-onset patients. Early diagnosis and etiological treatment are very important. Hydrocephalus may improve after metabolic intervention in some patients. For patients with severe ventricular dilatation, prompt surgical intervention can improve the prognosis.

Objective:To investigate the factors affecting phenotypes in the patients of methylmalonic acidemia combined with homocysteinemia cblC type with MMACHC c. 609G>A homologous variant. Methods:A retrospective study on the clinical manifestations, complications, treatment, and outcome in 164patients of cblC type with MMACHC c. 609G>A homologous variant was conducted.The patients were diagnosed by biochemical and genetic analysisfrom January 1998 to December 2020. Results:Among the 164 patients, 2 cases were prenatally diagnosed and began treatment after birth. They are 3 and 12 years old with normal physical and mental development. Twenty-one cases were diagnosed by newborn screening. Among them, 15 cases had with normal development. They were treated fromthe age of two weeks at the asymptomatic period. Six cases began treatment aged 1 to 3 months after onset. Their development was delayed. One hundred and forty-one cases were clinically diagnosed. Their onset age ranges from a few minutes after birth to 6 years old. 110 cases had early-onset (78.0%). 31 cases had late-onset (22.0%). Five of them died. 24 patients lost to follow-up. Of the 141 clinically diagnosed patients, 130 (92.2%) with psychomotor retardation, 69 (48.9%) with epilepsy, 39 (27.7%) with anemia, 30 (21.3%) had visual impairment, 27 (19.1%) had hydrocephalus, 26 (18.4%) had feeding difficulties, 7 (5.0%) with liver damage, and 5 (3.5%) with metabolic syndrome. The frequency of hydrocephalus and seizures was significantly higher in the early-onset group. The urinary methylmalonic acid increased significantly in the patients with epilepsy. During the long-term follow-up, the level of plasma total homocysteine in the seizure-uncontrolled group was significantly higher than that in the seizure-controlled group, the difference had a statistical significance ( P<0.05). Conclusion:Most of the patients with MMACHC c. 609G>A homozygous variant had early-onset disease, with a high mortality and disability rate. If not treated in time, it will lead to neurological damage, resulting in epilepsy, mental retardation, hydrocephalus, and multiple organ damage. Pre-symptomatic diagnosis and treatment are crucial to prevent irreversible neurological damage. Neonatal screening and prenatal diagnosis are important to improve the outcome of the patients.