Objective To explore the expression of thrombospondin-1 ( TSP-1 ) and bone morphogenetic protein-7 ( BMP-7 ) in mucus membrcane of chronic rhinosinusitis ( CRS ) and its potential significance in pathogenesis . Methods TSP-1 ,BMP-7 and TGF-β1 were detected by ELISA .Results The expression level of TSP-1 and TGF-β1 increased gradually with the advanced stage of CRSsNP ( P<0.05 ) .The expression of BMP-7 decreased gradu-ally with the advanced stage of CRSsNP ( P<0.05 ) .The expression of TSP-1 and TGF-β1 decreased gradually with the advanced stage of CRSwNP ( P<0.05 ) .The expression level of BMP-7 increased gradually with the ad-vanced stage of CRSwNP ( P<0.05 ) .Conclusions The expressions of TSP-1 and BMP-7 were abnormal in nasal mucosa of CRS , which might be involved in the pathogenesis of CRS .

Objective To explore the bacterial drug resistance in blood culture in 2015 from the members of Antimicrobial Re-sistant Investigation Net of Shaanxi province,and to guide the clinicians touse antimicrobial drugs rationally.Methods All the objective bacterial isolates were collected and identifiedsusceptibility date by software WHONET 5.6.Results 6 871 bacterial isolates and their antibacterial susceptibilitydata were collected which included 3 199 (46.56%)Gram-negative bac-terial isolates and 3 672 (53.44%)Gram-positivebacterial isolates.The top five populationsof Gram-positive bacterial iso-lates were Staphylococcus epidermidis (30.94%),Staphylococcus hominis (17.84%),Staphylococcus haemolyticus (11.74%),Staphylococcusaureus (9.69%)and Enterococcus feacium (6.29%).The top five populationsof Gram-negative bacterial isolates were E.coli (43.67%),Stenotrophomonas maltophilia (14.63%),K.pneumoniae (13.47%), P.aeruginosa (4.13%)and Acinetobacter baumannii (3.63%).Theisolating rates of methicillin-resistant Staphylococcus aureus (MRSA)and methicillin-resistant coagulase negative Staphylococcus (MRCNS)were 31.2% and 76.1%,respec-tively.No vancomycin resistant Staphylococcusisolates were found.There were 0.9% E.faecium vancomycin-resistant iso-lates.The isolates of Enterobacteriaceae were still highly susceptible to carbapenem,whosetotal resistance rate was below 4.0%.The resistance rates of A.baumannii to most surveillance drugs in cludingimipenem were above 50.0% and the iso-lates of P.aeruginosa were still highly susceptible to most surveillancedrugs.Conclusion It is severe that the situation of bacterial drug resistance in blood culture in Shaanxi province.Should fullyuse bacterial drug resistance surveillance results for supervision and administration,and take effective measures forcontrolling the spread of resistant isolates.

Objective To follow-up the imaging findings in the SARS.Methods The serial thoracic images in 15 cases of SARS were taken in 7 months from the onset of this disease,and the imaging findings were analysed.Results The detecting rate of the pathological changes in lung by spiral CT was higher than that of X-ray film(t = 5.5228,P

Objective :To observe therapeutic effect of atorvastatin on patients with coronary heart disease (CHD ) complicated diabetes mellitus and its influence on blood lipids ,hemorheological indexes and coagulation function . Methods : A total of 112 patients with type 2 diabetes mellitus (T2DM) complicated CHD ,who were treated in our hospital from Feb 2016 to Oct 2017 ,were enrolled .Patients were randomly and equally divided into routine treat—ment group and combined treatment group (atorvastatin+ routine treatment group ) ,both groups were treated for three months.Levels of blood glucose ,blood lipids ,coagulation function indexes :activated partial thromboplastin time (APTT) ,prothrombin time (PT) ,tissue plasminogen activator (t—PA) ,hemorheological indexes :whole blood viscosity ,plasma viscosity ,fibrin level and therapeutic effect were observed and compared between two groups be—fore and after treatment .Results : Total effective rate of combined treatment group was significantly higher than that of routine treatment group (98.21% vs.80.36%) , P＝0.002. Compared with before treatment ,after three—month treatment ,there were significant reductions in levels of FPG ,2hPG ,HbA1c ,TG ,TC ,LDL—C ,whole blood viscosity ,plasma viscosity ,fibrin ,and significant rise in levels of HDL—C ,APTT ,PT and t—PA in two groups except HDL—C and fibrin levels of routine treatment group , P＜0.05 or ＜0.01. Compared with routine treatment after three—month treatment ,there were significant reductions in levels of above blood glucose indexes ,TC ,TG ,LDL—C ,whole blood viscosity [ (12.19 ± 2. 67) mPa／s vs.(10.15 ± 2.18) mPa／s] ,plasma viscosity [ (2.31 ± 0.29 ) mPa／s vs .(1. 78 ± 0. 23) mPa／s] and fibrin [(3.29 ± 1.29) g／L vs.(2. 29 ± 0.94) g／L] ,and significant rise in lev—els of HDL—C ,APTT [ (29.98 ± 2.92) s vs.(32.07 ± 3.24) s] ,PT [ (13. 89 ± 1.63) s vs.(15. 14 ± 1.75) s] and t—PA [ (394. 62 ± 12. 76) U／L vs .(437. 56 ± 13. 54) U／L] in combined treatment group , P＜0. 05 or ＜0.01. Con—clusion : Atorvastatin can significantly reduce blood lipid levels ,contribute to improving hemorheological indexes and coagulation function in CHD + DM patients .

Objective:This study aimed to systematically evaluate the efficacy and safety of ivabradine in patients with dilated cardiomyopathy, and to provide evidence-based reference for clinical treatment.Methods:We searched PubMed, Embase, Cochrane Library, Web of Science, CNKI, Wan Fang, VIP databases from inception to 1 September 2021 for randomized controlled trials (RCTs) that compared conventional therapies and ivabradine with conventional therapies in dilated cardiomyopathy patients. Studies meeting the inclusion criteria were included and analyzed. After data extraction and literature quality evaluation, we use the Review Manager 5.4 to perform the meta-analysis and publication bias test.Results:5 studies enrolling 494 patients were included. Compared with conventional therapies (control group), ivabradine and conventional therapies (observation group) significantly reduced resting heart rate [ MD=-7.58, 95% CI(-12.40, -2.76), Z=3.08, P=0.002], left ventricular end diastolic diameter (LVEDD) [ MD=-4.48, 95% CI(-7.33, -1.64), Z=3.09, P=0.002], left ventricular end systolic diameter (LVESD) [ MD=-4.94, 95% CI(-7.29, -2.59), Z=4.12, P<0.001], B-type natriuretic peptide (BNP) [ MD=-212.39, 95% CI(-230.55, -194.23), Z=22.92, P<0.001], New York Heart Association (NYHA) class [ MD=-0.36, 95% CI(-0.44, -0.27), Z=8.46, P<0.001] and Minnesota Questionnaire Score [ MD=-10.43, 95% CI(-15.72, -5.13), Z=3.86, P=0.001]. The left ventricular ejection fraction (LVEF) levels [ MD=1.31, 95% CI(0.64, 1.97), Z=3.85, P=0.001], 6-minute walk test level (6MWT) [ MD=54.83, 95% CI(40.58, 69.08), Z=7.54, P<0.001], systolic blood pressure [ MD=4.72, 95% CI(0.91, 8.54), Z=2.43, P=0.02], the incidence of visual symptoms (phosphene) [ OR=7.22, 95% CI(1.32, 45.00), P=0.02] and symptomatic bradycardia [ OR=8.90, 95% CI(1.21, 65.75), P=0.03] in the observation group were higher than those in the control group after treatment. In addition, there were no significant difference in the incidence of acute event between the two groups [ OR=0.72, 95% CI(0.12, 4.29), P=0.72]. Conclusions:Meta analysis showed that ivabradine combined β receptor blockers can effectively reduce resting heart rate and improve cardiac function in patients with dilated cardiomyopathy, but may increase the incidence of hallucinations and symptomatic bradycardia.

Objective:To explore the application value of CT pulmonary function imaging in patients with Coronavirus Disease 2019 (COVID-19) in the convalescent phase.Methods:The COVID-19 patients who were clinically cured and discharged from Union Hospital, Tongji Medical College, Huazhong University of Science and Technology were prospectively collected from January to April 2020. Clinical pulmonary function tests (PFTs) and CT pulmonary function imaging were performed 3 months after discharge. The Philips IntelliSpace Portal image post-processing workstation was used to obtain the paired inspiratory-expiratory CT quantitative indexes of the whole lung, left lung, right lung and five lobes. The patients were divided into two groups according to whether residual lesions remain in inspiratory CT images: non-residual lesion group and residual lesion group. The chi-square test was used to compare the differences in the PFT results between groups; the Mann-Whitney U test was used to compare the differences in PFT indexes [forced expiratory volume in the first second as percentage of predicted value (FEV 1%), FEV 1/forced vital capacity (FEV 1/FVC), total lung capacity as percentage of predicted value (TLC%), FVC%] and the differences in quantitative CT indexes [lung volume (LV), mean lung density (MLD), volume change in inspiratory phase and expiratory phase (?LV)] between groups. Multiple linear regression was used to analyze the relationship between CT pulmonary function imaging and PFT indexes of convalescent COVID-19 patients. Results:Of the 90 patients with COVID-19, 35 were males and 55 were females; 45 were included in the non-residual lesion group and 45 were included in the residual lesion group. Fifty-three patients had clinical pulmonary dysfunction 3 months after discharge, including 22 patients in the non-residual lesion group and 31 patients in the residual lesion group. In patients with residual disease, left lower lobe and right lower lobe LV, left lower lobe and right lower lobe ?LV in the inspiratory and expiratory phase were smaller than those without residual disease; whole lung, left lung, right lung, left upper lobe, left lower lobe and right lower lobe MLD in the inspiratory phase and left lower lobe and right lower lobe MLD in the expiratory phase were greater than those without residual disease ( P<0.05). Since there was no significant difference in FEV 1/FVC and FVC% between residual and non-residual lesion groups ( P>0.05), FEV 1/FVC and FVC% of two groups were combined. Multiple linear regression analysis showed FEV 1/FVC=91.765-0.016×LV in-right middle lobe+0.014×MLD ex-left lower lobe ( R2=0.200, P<0.001), FVC%=-184.122-0.358×MLD in-right lung-0.024×?LV left upper lobe ( R2=0.261, P<0.001). There was significant difference in TLC% between residual and non-residual lesion groups ( P<0.05), so multiple linear regression analysis was performed both in the two groups. In the non-residual lesion group, TLC%=80.645+0.031×LV ex-right lower lobe ( R2=0.132, P<0.001); In the residual lesion group, TLC%=-110.237-0.163×MLD in-right upper lobe-0.098×MLD ex-left upper lobe -0.025×LV ex-right lower lobe ( R2=0.473, P<0.001). Conclusion:CT pulmonary function imaging can quantitatively analyze the whole lung, unilateral lung and lobulated lung, thus reflecting the regional pulmonary function, providing more valuable diagnostic information for the assessment of pulmonary function in convalescent patients with COVID-19.

Objective To evaluate the value of 2012 classification criteria for early rheumatoid arthritis (ERA),2010 American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) classification criteria,and 1987 ACR classification criteria in the diagnosis of early rheumatoid arthritis (RA).Methods Patients who had at least one swollen and tender joint with disease duration no more than 2 years,and age more than 16 years were enrolled.The patients were diagnosed as RA or other non-RA by 2 experienced rheumatologists.The clinical and laboratory parameters were recorded.The sensitivity and specificity of three RA classification criteria were compared by McNemar test,The areas under the receiver operating characteristic curve (ROC) curve (AUC) of each RA classification criteria were analyzed using MedCalc software.Results Atotal of 310 patients were enrolled in this study,including 182ERA and 128 non-RA.The sensitivity(88.5％) of ERA criteria was much higher than that of the 1987 ACR criteria (45.6％,x2=75.013,P＜0.05),and not significantly different with the 2010 ACR/EULAR criteria (91.8％,X2=1.042,P＞0.05).The specificity of ERA criteria (91.4％) of 2010 ACR/EULAR criteria (87.5％,x2=1.8,P＞0.05) was similar to that of the 1987 ACR criteria (96.1％,x2=3.1,P＞0.05).The AUC of ERA criteria was 0.962 [95％CI(0.934,0.980)],which was slightly better than that of the 2010 ACR/EULAR criteria 0.959 [95％CI(0.931,0.978)],Z=0.380,P=0.7038,and much higher than that of the 1987 ACR criteria 0.885 [95％CI (0.845,0.919)],Z=4.517,P＜0.01.Conclusion Overall evaluation,the diagnostic value of ERA criteria is better than 1987 ACR and 2010 ACR/EULAR criteria in early rheumatoid arthritis.Compared to 2010 ACR/EULAR classification criteria,ERA criteria is more simple and practical.

ObjectiveTo investigate the effect of Glycyrrhizae Radix et Rhizoma （GR）-containing serum on lipopolysaccharide （LPS）-induced inflammation in human colon epithelial adenocarcinoma cells （Caco2） based on inhibition of ferroptosis by the nuclear factor erythroid 2-related factor 2 （Nrf2）/heme oxygenase-1 （HO-1） pathway. MethodCaco2 cells were divided into a normal group， a model group （LPS， 200 μg·L^-1）， low-， medium-， and high-dose GR-containing serum groups （5%， 10%， 20%）， and a ferroptosis inhibitor group （3-amino-4-cyclohexylamino-benzoic acid ethyl ester， Fer-1， 10 μmol·L^-1）. The cells in the normal group were cultured normally， while those in other groups underwent the induction of an inflammation model. The cells in the low-， medium-， and high-dose GR-containing serum groups were treated with 5%， 10%， and 20% GR-containing serum for 24 hours， respectively， and the cells in the ferroptosis inhibitor group were treated with Fer-1 for 24 hours. Transmission electron microscopy was used to observe mitochondrial morphology in each group. Flow cytometry was used to detect intracellular Fe²⁺ levels. Microplate assays were performed to measure superoxide dismutase （SOD） activity， malondialdehyde （MDA） and glutathione peroxidase （GSH-Px） levels. Enzyme-linked immunosorbent assay （ELISA） was used to measure interleukin-1β （IL-1β）， IL-6， IL-10， and tumor necrosis factor-α （TNF-α） levels. Western blot was used to measure the expression levels of Nrf2， HO-1， ferritin heavy chain 1 （FTH1）， and glutathione peroxidase 4 （GSH-Px4） proteins. Small interfering RNA （siRNA） was used to investigate the role of Nrf2 in ferroptosis regulation. The cells after interference were divided into a negative control （NC） group， a Si-Nrf2 group， a GR-containing serum （20%） + Si-Nrf2 group， and a GR-containing serum （20%） + NC group. Microplate assays were performed to measure MDA， SOD， and GSH-Px levels， and Western blot was used to measure the expression levels of Nrf2， HO-1， FTH1， and GSH-Px4 proteins. ResultCompared with the normal group， the model group showed mitochondrial contraction， increased mitochondrial membrane thickness， and smaller mitochondrial morphology， increased Fe²⁺ content （P<0.01）， blunted SOD activity （P<0.01）， decreased GSH-Px expression （P<0.01）， increased MDA content （P<0.01）， reduced expression levels of Nrf2 and HO-1 （P<0.05）， reduced FTH1 expression （P<0.01）， and down-regulated GSH-Px4 expression （P<0.01）. In the GR-containing serum groups， the medium- and high-dose groups showed a significant decrease in Fe²⁺ content （P<0.01）， potentiated SOD and GSH-Px activities （P<0.01）， and decreased MDA levels （P<0.01）. The high-dose group showed a significant increase in Nrf2 expression （P<0.05）， and the medium-dose group showed increased expression of HO-1 and GSH-Px4 proteins （P<0.05）. The expression levels of FTH1 significantly increased in the low-， medium-， and high-dose groups （P<0.01）. The study on mechanism revealed that compared with the NC group， the cells transfected with Nrf2 siRNA showed increased MDA content （P<0.01）， blunted SOD activity （P<0.01）， decreased GSH-Px activity （P<0.01）， decreased expression of Nrf2 and HO-1 （P<0.01）， and reduced levels of FTH1 and GSH-Px4 proteins （P<0.01）. Compared with the Si-Nrf2 group， the cells treated with GR-containing serum showed a decrease in MDA content （P<0.01）， an increase in SOD activity （P<0.01）， an increase in GSH-Px activity （P<0.01）， increased expression of Nrf2 and FTH1 proteins （P<0.05）， and higher expression levels of HO-1 and GSH-Px4 proteins （P<0.01）. ConclusionGR-containing serum can reduce the inflammatory cytokines and oxidative stress levels in LPS-induced Caco2 cells. Its mechanism is related to the promotion of Nrf2/HO-1 signaling pathway expression， alleviating intracellular lipid peroxidation and inhibiting ferroptosis.