Background:Clinical features and outcomes of heart failure (HF) with mid-range ejection fraction (HFmrEF) remain controversial.Thus,we systematically reviewed literatures of clinical research to assess and analyze characteristics and prognosis of patients with HFmrEF.Methods:PubMed,Embase,and Web of Science were searched for cohort studies up to April 23,2019.Clinical features and multivariate adjusted hazard ratios (HRs) of endpoints of short-term all-cause mortality (SAM),long-term all-cause mortality (LAM),long-term cardiovascular death (LCD) and long-term HF rehospitalization (LHR) among patients with HFmrEF and HF with preserved ejection fraction (HFpEF),HF with reduced ejection fraction (HFrEF) were well addressed.The primary outcome was LAM.Results:Totally 19 studies were included in this study with 164,678 patients enrolled.The follow-up time of LAM was 3.6 ± 2.5 years.HRs of LAM,SAM,LCD,LHR indicated that the risks of patients with HFmrEF were higher than HFpEF patients but lower than HFrEF patients,as for LAM,HFmrEF:HFpEF (reference) HR:1.07,95％ confidence interval (CI):1.00-1.15 (I2=63％,P =0.0005);HFmrEF:HFrEF (reference) HR:0.80,95％ CI:0.73-0.88 (I2=70％,P ＜ 0.0001).However,HFmrEF patients had the lowest rate in LAM (30.94％),SAM (2.73％),LCD (17.45％),LHR (26.36％) compared with the other two groups.Conclusions:This systematic review and meta-analysis compared features and prognosis between patients with HFmrEF and HFpEF,HFrEF by HRs.There appeared a special "separation phenomenon" showing rates of endpoints were inconsistent with their hazards in patients with HFmrEF compared with HFpEF patients.

OBJECTIVE: To investigate the expression of hyperpolarization-activated cyclic nucleotide-gated cation channel 4 (HCN4) and connexin43 (Cx43) in the sinoatrial node of electric shock death. METHODS: As experimental group, 34 cases of electric shock death who had definite current mark evidence were selected from pathology department of Xuzhou Medical College from 2010 to 2013. As the control group, 20 cases of fatal severe craniocerebral injury in traffic accidents were chosen. The expressions of HCN4 and Cx43 in the sinoatrial node were observed by immunohistochemical technology. RESULTS: HCN4 positive cells expressed in the cell membrane and cytoplasm of the sinoatrial node. Cx43 positive cells expressed in the cell membrane and cytoplasm of T cells and myocardial cells. The expression of HCN4 was significantly higher than that of the control group (P < 0.05) and the expression of Cx43 was significantly lower than that of the control group (P < 0.05). CONCLUSION The changes of HCN4 and Cx43 expressions in the sinoatrial node illustrate electric shock death might be related to the abnormalities of cardiac electrophysiology and conduction.
Connexin 43/metabolism* ; Cyclic Nucleotide-Gated Cation Channels ; Heart Rate ; Hyperpolarization-Activated Cyclic Nucleotide-Gated Channels/metabolism* ; Immunohistochemistry/methods* ; Myocardium/metabolism* ; Myocytes, Cardiac ; Sinoatrial Node/physiopathology*

OBJECTIVETo study the mechanism of reversal effect of Curcuma Wenyujin n-Butyl alcohol extract (CWNAE) on multiple drugs resistance (MDR) of SGC7901/VCR cells.

METHODSSGC7901/VCR cells were co-culured with different concentrations CWNAE (80, 40, and 20 μg/mL) and Verapamil (VP, 10 μg/mL) for 24 h, and then acted with Adriamycin (ADM) for 1, 2, and 4 h, respec- tively. SGC7901/VCR cells with no intervention were taken as the vehicle control group. SGC7901/VCR cells treated with ADM alone were taken as the control group. The effect of CWNAE on intracellular ADM concentration was detected by flow cytometry (FCM). Cells were treated as mentioned before without any intervention of ADM. SGC7901/VCR with no ADM intervention were taken as the control group. The effect of CWNAE on the expression of P-glycoprotein (P-gp), lung resistance protein (LRP), and glu- cosylceramide synthase (GCS) was studied by Western blot. The effect of CWNAE on the location and expression quantity of P-gp was further illustrated by immunohistochemistry (IHC).

RESULTSCompared with the ADM group, the expression ratio obviously increased in the W80, W40, W20, and VP10 groups with statistical difference (all P < 0.05). The comparative expression quantity of P-gp, GCS, and LRP in SGC7901/VCR cells was obviously higher than that of non-MDR with statistical difference (all P < 0.05). The expression quantity of P-gp and GCS could be obviously down-regulated by 80 and 40 μg/mL CWN- AE, and 10 μg/mL VP, with no effect on the expression of LRP. Results of IHC proved that P-gp was mainly expressed on the cytomembrane or in the plasma, and it was also expressed on the nuclear membrane. P-gp in different locations could all be down-regulated by CWNAE.

CONCLUSIONSCWNAE could reverse the MDR of SGC7901/VCR cell line probably by inhibiting the expression of P-gp and GCS. CWNAE had no effect on LRP that also highly expressed on SGC7901/VCR. So we supposed that CWNAE could become a potential drug to reverse MDR of highly expressed P-gp and GCS.

ATP-Binding Cassette, Sub-Family B, Member 1 ; Cell Line, Tumor ; Curcuma ; Doxorubicin ; Drug Resistance, Multiple ; drug effects ; Drug Resistance, Neoplasm ; drug effects ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Humans ; Stomach Neoplasms

Objective To evaluate the overall effect of transsphenoidal microsuegery for 23 patients with non-adenomas disease intrasellar region.Methods A toal of 23 patients with non-adenomas disease in- trasellar region,7 cases of Rathke's cleft cyst,3 cases of craniopharyngiomas,2 cases of meningiomas,2 ca- ses of pituitary tuberculous granuloma,5 cases of pituitary abscess,2 cases of empty sella,2 cases of chord- mas,were treated via sublabio-septo-sphenoidal microsurgery.Results There were among the 23 patients, groos total removal of the disease were achieved in 14 cases,subtotal removal in 7 cases,and partial removal in remain 2 cases.Diminished visual activity and visual field defects were improved in 13 cases.Menstrual disorder in all female cases and sexual disturbance in male were improved.There was no death in group. Conclusion Microsurgical technique via transsphenoidal approach is a safe and effective one for the treatment of patients with non-adenomas disease intrasellar region.

Objective To summarize clinical experiences for the management of upper cervical fracture associated with mild to moderate craniocerebral injury in order to improve the outcome of patients with craniocervical injury.Methods Twenty-two cases (13 males and 9 females) of non-nerve damage treated surgically from June 2008 to June 2012 were enrolled.Mean age was 41 years (range,23-68 years).Mechanisms of injury were traffic accidents in 12 cases,high falls in 7 cases and violence or others in 3 cases.Dens fractures were noted in 7 cases,Jefferson fractures in 5 cases and axial vertebral arch fractures in 4 cases,and combined atlas and axis fractures in 6 cases.Admission Glasgow Coma Score (GCS) was 12-14 points in 10 cases and 9-11 points in 12 cases.All cases suffered some degree of brain damage including brain contusion and laceration,and epidural,subdural or intracerebral hematoma.Three cases of cervical fractures were misdiagnosed in the early stage.Twelve cases required emergent craniotomy due to the primary craniocerebral injury and had elective upper cervical spine surgery until the medical condition was stabilized.Another 10 cases underwent conservation treatment of craniocerebral injury and had cervical spine surgery within 1 week due to the severe dislocation of the upper cervical spine.Operation time,blood loss,hospital stay,hospitalization cost and perioperative complications were analyzed.Outcome was evaluated with Glasgow Outcome Scale (GOS) at discharge.Fracture union,bone fusion and cervical stability were assayed with X-rays and CT films.Results All were followed up for a mean period of 18 months (range,12-36 months).Among the 12 cases of primary craniocerebral injury,operation time was (115 ± 22) min,blood loss was (280 ± 72) ml,hospitalization period was (23 ±7)d and overall cost was 88,000 yuan;one case sustained wound infection cured two weeks after debridement and dressing and two cases sustained pulmonary infection cured after antibiotic treatment;discharge GOS was grade Ⅳ in 2 cases and grade Ⅴ in 10 cases.Among the 10 cases of primary cervical injury,operation time was (125 ± 38) min,blood loss was (330 ± 90) ml,hospitalization period was (17 ± 6)d and overall cost was 61,000 yuan;no perioperative complications occurred;discharge GOS was grade Ⅳ in 1 case and grade Ⅴ in 9 cases.Pain radiating to occipital region,limited neck mobility and other clinical symptoms were alleviated at discharge.X-rays verified good healing of the bone and no malposition of the screws.Conclusion For cervical fracture associated with craniocerebral injury,cervical examination and protection are important.Once medical condition becomes stable,early surgery can be performed for upper cervical fracture.

OBJECTIVETo study the chemical constituents in roots and rhizomes of ligularia duciforms.

METHODThe compounds were isolated by column chromatography, the structures were identified by physicochemical properties and spectral analysis.

RESULTSix compounds were isolated and identified as caffeic acid (I), (E)-docosyl-3, 4-dihydroxycinnamate (II), (E)-docosyl 3-methoxy-4-hydroxyferulate (III, beta-amyrone (IV), beta-sitosterol (V), and daucosterol (VI).

CONCLUSIONAll the compound were isolated for the first time from the plant, and the compound II and IV were isolated firstly from the genus Ligularia.

Asteraceae ; chemistry ; Caffeic Acids ; chemistry ; isolation & purification ; Cinnamates ; chemistry ; isolation & purification ; Coumaric Acids ; chemistry ; isolation & purification ; Plant Roots ; chemistry ; Plants, Medicinal ; chemistry ; Rhizome ; chemistry

OBJECTIVETo investigate the protective effect of extracts from Cichorium endivia (CEE) in H2O2-induced HepG2 cell oxidative stress injury, and explore the antioxidant mechanism of CEE in HepG2 cells.

METHODThe viability of H2O2-induced HepG2 cells and the intracellular ROS level were measured by MTT assay and DCFH-DA fluorescence staining assay. The antioxidant-response element (ARE)-Luciferase activity was tested in HepG2 cells stably transected by ARE reporter gene. The fluorescence quantitative RT-PCR was adopted to determine the mRNA expressions of genes containing ARE sequence in HepG2 cells.

RESULTThe cell viability reduced, while the ROS level increased after HepG2 cells were treated by H2O2. Different concentrations of CEE could be added to significantly improve the above results. After HepG2 cells transected by ARE reporter gene were treated with different concentrations of CEE, the intracellular ARE activity could increase in a concentration-dependent manner. In addition, the mRNA expressions of regulatory genesGCLC, GCLM and HMOX-1 containing ARE sequence in HepG2 cells were up-regulated in a concentration-dependent manner by CEE.

CONCLUSIONCEE inhibited the H2O2-injured HepG2 cells by reducing the ROS level. CEE's antioxidant mechanism for HepG2 cells may be closely related to the antioxidant defense system associated with its effect of activating Nrf2-ARE pathway in HepG2 cells.

Antioxidants ; isolation & purification ; pharmacology ; Asteraceae ; chemistry ; Cell Survival ; drug effects ; Drugs, Chinese Herbal ; isolation & purification ; pharmacology ; Hep G2 Cells ; Humans ; Hydrogen Peroxide ; pharmacology ; Reactive Oxygen Species ; metabolism ; Response Elements ; genetics

Objective: To understand the relationship between coxsackievirus B and pediatric diseases. Methods: The infectious state of coxsackievirus B in hospitalized children were studied. Among 796 children studied, there were 218 upper respiratory tract infection cases, 179 pneumonia, 106 asthma, 155 myocarditis, 19 allergic purpura and 89 other diseases. The antigen (CVB-Ag) and IgM (CVB-IgM) were detected using ELISA method. Results: (1)There were 47% positive of CVB in upper respiratory tract infection and 48% positive of CVB in pneumonia(no difference between them, P>0.05). (2) There were 62% positive of CVB in asthma, 61% positive of CVB in myocarditis and 68% positive of CVB in allergic purpura(no difference among them, P>0.05)； But the positive rate of CVB in asthma, myocarditis and purpura were higher than in upper respiratory tract infection and pneumonia, (P<0.05). (3) There were lower positive rate of CVB in other kinds of diseases (16%) and in healthy children (3%)(no difference between them, P>0.05). Conclusion: CVB infection was related to several kinds of diseases, the relationship between CVB infection and diseases such as asthma, myocarditis, and allergic purpura should be further studied.

The in vitro antitumor activity of bakuchiol was exploited, compared with tamoxifen. The result of biological activities showed that bakuchiol could inhibit human breast cancer and the IC50 values were 2.89 x 10(-5) mol L(-1) and 8.29 x 10(-3) mol L(-1) against the cells line T-47D and MDA-MB-231 respectively. On the other hand, the key intermediate to synthesize bakuchiol was obtained by the method of Ireland-Claisen rearrangement. Comparing with traditional Claisen rearrangement, the reaction conditions are milder and the reaction reagents are safer.
Antineoplastic Agents, Hormonal ; pharmacology ; Antineoplastic Agents, Phytogenic ; chemical synthesis ; isolation & purification ; pharmacology ; Breast Neoplasms ; pathology ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Female ; Humans ; Inhibitory Concentration 50 ; Phenols ; chemical synthesis ; isolation & purification ; pharmacology ; Plants, Medicinal ; chemistry ; Psoralea ; chemistry ; Tamoxifen ; pharmacology

OBJECTIVETo investigate the protective effect of Danxuetong injection (DXT, a combination of Danshen and Xueshuantong injections) against testicular ischemia-reperfusion injury following testis torsion/detorsion in rats.

METHODSThirty-two 4-week-old healthy male SD rats were randomly divided into four groups of equal number: sham operation, normal saline, single DXT injection, and successive DXT injection. The rat models of testicular ischemia-reperfusion injury were established by 2-hour 720-degree torsion/detorsion of the unilateral testis. At 6 weeks after modeling, the rats were killed and their testes were harvested for measure- ment of testicular coefficients, sperm counts, sperm motility, and the levels of total anti-oxidative capacity (T-AOC) , superoxide dismutase (SOD) , nitric oxide synthase (NOS) , and malondialdehyde ( MDA) in the testis tissue.

RESULTSCompared with the rats of the normal saline group, those of the single DXT injection and successive DXT injection groups showed significant increases in the testicular coefficient (0.11 ± 0.03 vs 0.35 ± 0.04 and 0.40 ± 0.06, P < 0.05), sperm count ([0.46 ± 0.10] vs [1.44 ± 0.50] and [3.00 ± 1.28] x10(9)/ml, P < 0.05), sperm motility ([13.63 ± 14.04] vs [39.63 ± 5.04] and [76.31 ± 3.67]%, P < 0.05), the activity of SOD (72.76 ± 5.58 vs 116.25 ± 8.83 and 133.20 ± 13.84, P < 0.05), and the level of T-AOC (5.58 ± 1.07 vs 13.34 ± 5.81 and 19.21 ± 5.69, P < 0.05), but a remarkable decrease in the content of MDA (42.38 ± 8.94 vs 20.94 ± 5.65 and 15.02 ± 1.03, P < 0. 05) in the injured testes.

CONCLUSIONDXT can effectively rid the testis tissue of oxygen free radicals, improve sperm count and motility by antioxidation, and protect the testis tissue of prepubertal rats against testicular ischemia-reperfusion injury after testis torsion/detorsion. It also has a protective effect on the contralateral testis, and successive injection has a better effect than single injection of DXT.

Animals ; Antioxidants ; therapeutic use ; Drug Therapy, Combination ; methods ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Male ; Malondialdehyde ; metabolism ; Nitric Oxide Synthase ; metabolism ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Reperfusion Injury ; prevention & control ; Spermatic Cord Torsion ; complications ; therapy ; Superoxide Dismutase ; metabolism ; Testis ; blood supply ; metabolism