Objective To explore the relationship between endothelial dysfunction and insulin resistance (IR) during reduction of body weight in obese subjects. Methods 260 obese subjects without metabolic disorders, cardiovascular disease and other clinically detectable diseases were enrolled in this study. Among them 157 patients were found to have impaired endothelial function and 103 with normal endothelial function. They were randomly divided into body weight reduction intervention group and nonintervention group. The measures of intervention included food restriction, exercise, and drugs for weight reduction, and they were continued for two years. 87 subjects with normal weight and without endothelial dysfunction served as normal control. IR index (HOMA-IR) and flow-mediated endothelium-dependent dilatation function were measured before and after the study period. Results After two years, it was found that the endothelial function was markedly improved (4.56?4.79 vs 15.17?5.80, P

Objective To approach the effect of down regulation of fast glucose damge standard on endothelial funtion. Methods The FBS 、serum lipid、 uric acid of 54101 normal subjects were detected, those subjects were divided by FBG value into four groups: A B C D ,the value of TC、 TG、 uric acid in group B were higher than which in group A, lower than in group C. The value of PBG、FINS、PINS、ET、NO of 655 subjects choiced randomly were detected .At the same time the endodermis dependence angiectasia funtion mediated by bloodstream and the no-endodermis dependence angiectasia funtion mediated by glycerol trinitrate were detected . Results The value of group B was lower than which in group A, having no statistical meanings compared with group C、D;the no-endodermis dependence angiectasia funtion mediated by glycerol trinitrate of group B was higher than that of group C, that of group C was lower than group A, the comparison of other two groups has no statistical meanings. Conclusions Down regulation of fast glucose damge standard can effect on the endothelial funtion.

Objective To evaluate the fallopian tube patency with transvaginal real-time three-dimensional hysterosalpingo-contrast sonography (3D-HyCoSy) in diagnosis of infertility.Methods Taking laparoscopy and dye test as the reference standard,a total of 126 infertile women underwent both transvaginal real-time 3D-HyCoSy with SonoVue and laparoscopy.Bilateral fallopian tubes were dynamic observed.Results Transvaginal real-time 3D-HyCoSy showed that in clinical suspected infertility patients,125 fallopian tubes were patent,81 fallopian tubes were narrow and circuitous,and 37 fallopian tubes were obstructed.Among all the patients,60 cases (115 fallopian tubes) underwent laparoscopy with chromopertubation.The results showed that 10 fallopian tubes were patent,73 fallopian tubes were narrow and circuitous,and 32 fallopian tubes were obstructed.Taking laparoscopy and dye test as the reference standard,107 fallopian tubes of the 60 cases were diagnosed correctly,and the coincidence rate of 3D-HyCoSy and laparoscopy and dye test was 93.0％ (107/115).Taking laparoscopy and dye test as the gold standard,the accuracyof transvaginal real-time 3D-HyCoSy in diagnosis of fallopian tubes patency or obstruction was 93.0％(107/115),the sensitivity was 94.3％ (99/105),the specificity was 80.0％ (8/10).Conclusions Tansvaginalreal-time 3D-HyCoSy can provide dynamic,real-time and three-dimensional display of the fallopian tubes.Itcan get more accurate diagnostic information,so it's an important method.3D-HyCoSy is a safe and non-invasivemethod,so it plays an important clinical role in the screening,diagnosis and treatment of gynecological diseases.

ObjectiveTo observe the affection of cilostazol combined with valsartan in treating patients with early diabetic nephropathy on serum homocysteine and cystatin C,MethodsNinety-six cases with early diabetic nephropathy were divided into two groups by random digits table method with 48 cases each:observation group was treated with cilostazol and valsartan,control group was treated with valsartan alone.The effect and the levels of 24 h urinary albumin,serum homocysteine and cystatin C before and after treatment in two groups were compared.ResultsThe total effective rate in observation group [85.4％(41/48) ] was significantly higher than that in control group [66.7％(32/48) ](P ＜ 0.05 ).The levels of 24 h urinary albumin,serum homocysteine and cystatin C were significantly decreased after treatment of three weeks in observation group and control group [ (125.48±13.76) mg,(9.25±3.52)p mol/L,(7.82±2.14) mg/L and (168.38±15.43) mg,(13.72±4.23) μ mol/L,(9.57±2.85) mg/L vs.(279.31±21.52) mg,(18.52±6.14) μ mol/L,( 13.25±3.79) mg/L and (275.24±19.31 ) mg,( 18.48±6.12) μ mol/L,( 13.19±3.76)mg/L](P＜ 0.05).And the levels of 24 h urinary albumin,serum homocysteine and cystatin C after treatment of three weeks in observation group were obviously lower than those in control group(P ＜ 0.05).Conclusions Cilostazol combined with valsartan in treating patients with early diabetic nephropathy can improve clinical effect obviously,degrade the level of urinary albumin,homocysteine and cystatin C.Therefore,it deserves to be applied in clinic.

Objective:To investugate the unique electrocardiogram (ECG) characteristics of fulminant myocarditis (FM) patients and provide important clues for the diagnosis of FM.Methods:This was a retrospective study. Patients diagnosed with acute myocarditis at Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology from February 2017 to April 2022 were enrolled and divided into fulminant myocarditis group (FM) and non-fulminant myocarditis group (NFM) according to clinical diagnosis. A total of 246 healthy people who underwent physical examination in the Health examination Center of Tongji Hospital at the same period were selected as the control group. The clinical data and ECG characteristics of the above 3 groups were analyzed and compared. Logistic regression model was used to analyze the influence of ECG parameters on left ventricular ejection fraction in FM patients. Receiver operating curves were constructed to evaluate the predictive value of different ECG parameters for FM.Results:A total of 180 patients were included in this study (FM group: n=123; NFM group: n=57), with an age of (35.0±16.2) years and 106 males (58.89%). Compared with NFM group, ECG was significantly abnormal in FM group, with a higher incidence of sinus tachycardia, ventricular tachycardia or ventricular fibrillation, escape rhythm, right bundle branch block, third degree atrioventricular block, ST-segment elevation, low voltage, prolonged QTc interval, and widened QRS wave in the FM group (all P<0.05). The ECG parameters showed that the amplitude of the full lead QRS wave in FM group was lower than that in NFM group ( P<0.01). The average heart rate and QTc interval of FM group were significantly higher than those of NFM and control groups (all P<0.05). Although ST-segment elevation had a higher incidence in the FM group, ECG parameters showed that except for leads Ⅲ and aVF, the ST segment levels in all leads in the FM group were lower than those in the control group (all P<0.05). There was a statistically significant difference in some ST segment changes between FM and NFM groups, while there was no statistical difference between the NFM and control groups. Multivariate regression analysis showed that widened QRS wave and increased heart rate were the influencing factors for left ventricular systolic dysfunction in FM patients ( OR=16.914, 95% CI: 1.367-209.224, P=0.028; OR=1.026, 95% CI: 1.010-1.042, P=0.001). Receiver operating curve analysis showed that heart rate>86.90 beat/min, QTc>431.50 ms, and RV5+SV1<1.72 mV had certain predictive value for FM diagnosis. Conclusions:FM patients displayed marked and severe ECG abnormalities, and characteristic changes in ECG can provide important first clues for the diagnosis of FM.

Objective To create a mouse model of colorectal polyps with Apc-Kras-Cre gene mutations using the tamoxifen induction method.Methods Mice with Apc-Kras-Cre mutations were divided into four groups and injected intraperitoneally with different concentrations and dosages of tamoxifen for different durations,with group 1 injected with low dosage tamoxifen(5 mg/kg)for 1 day,group 2 injected with low dosage tamoxifen(5 mg/kg)for 3 days,group 3 injected with high dosage tamoxifen(50 mg/kg)for 1 day,group 4 injected with high dosage tamoxifen(50 mg/kg)for 3 days.C57BL/6J mice were used as a healthy control group and survival and changes in body weight were observed.All mice were euthanized 4 weeks post-tamoxifen induction and the colon length and number and size of intestinal polyps were observed.Histological changes in the intestinal tissue and polyps were detected by hematoxylin and eosin staining.Results The survival rate of male mice was higher(P＜0.001)and the morbidity rate of male mice was lower compared with female mice(P＜0.05).The survival rate differed significantly among the four groups(P＜0.01).All groups showed significant changes in body weight compared with the healthy control group(P＜0.001).There were also significant differences in weight changes between tamoxifen-induced groups 1 and 2,between groups 2 and 3,and between groups 1 and 4(P＜0.001,P＜0.01,P＜0.05,respectively).There were no significant differences in colon length between any treated group and the healthy control group(P＞0.05),but colon length did differ between tamoxifen-induced groups 1 and 3(P＜0.05).Polyp size varied in each group of tamoxifen-treated mice,with most polyps occuring at the distal end of the colon,while mice in groups 3 and 4 had more and larger polyps.Histopathological examination showed intestinal polyps with uneven and misaligned glandular and epithelial arrangements,a loosely-packed intestinal mucosal barrier,and irregularly-distributed crypts in tamoxifen-induced mice compared with the healthy control group,while mice in tamoxifen-induced groups 3 and 4 showed signs of inflammation and mice in group 4 showed necrosis of cells in some regions.Conclusions Tamoxifen-induced Apc-Kras-Cre model mice were successfully established,with the group 3 induction method being the most suitable.

OBJECTIVETo establish the ADAR1 (adenosine deaminase that act on RNA 1) knockout MLL-AF9 acute myeloid leukemia (AML) mouse model, and to preliminarily investigate the effects of ADAR1 deletion on the development of AML.

METHODSThe lineage⁻ (Lin⁻) cells of ER-CreADAR1(lox/lox) mice and their ADAR1(lox/lox) counterparts were enriched by magnetic activated cell sorting (MACS) and then transduced with retrovirus carrying MSCV- MLL/AF9-IRES-GFP fusion gene. The efficiency of transduction was detected by flow cytometry, and equal number of GFP⁺ cells were transplanted into lethally irradiated recipient mice. The recipient mice were treated with tamoxifen at 48 hours after transplantation to induce ADAR1 knockout and divided into following groups: experimental group (ER-Cre;ADAR1(lox/lox)+tamoxifen), control groups ((1)ER-Cre;ADAR1(lox/lox)+vechile, (2)ADAR1(lox/lox)+tamoxifen, (3)ADAR1(lox/lox)+vechile). The percentage of GFP⁺ cells in peripheral blood was examined at 10, 15 and 20 days respectively after transplantation and the survival of the recipient mice was observed. In vitro study, ER-Cre;ADAR1(lox/lox) and ADAR1(lox/lox) AML cells were cultured and the apoptosis rates of these cells 48 hours after 4-hydroxytamoxifen treatment were examined.

RESULTSThe ADAR1 deletion MLL-AF9 AML mouse model was successfully established. Deletion of ADAR1 could decrease the percentage of GFP⁺ cells in the peripheral blood and significantly prolong the survival rate of recipient mice（P<0.05）. In vitro study showed that the cultured total cell number, percentage of GFP⁺ cells decreased and the apoptosis rate of AML cells increased.

CONCLUSIONAblation of ADAR1 could delay the progression of AML in recipient mice. ADAR1 plays a critical role in the development and maintenance of murine MLL-AF9 AML.

Adenosine Deaminase ; Animals ; Apoptosis ; Disease Models, Animal ; Leukemia, Myeloid, Acute ; Mice ; Myeloid-Lymphoid Leukemia Protein ; Tamoxifen ; analogs & derivatives

Coronavirus disease 2019 (COVID-19) is a highly contagious disease and a serious threat to human health. COVID-19 can cause multiple organ dysfunction, such as respiratory and circulatory failure, liver and kidney injury, disseminated intravascular coagulation, and thromboembolism, and even death. The World Health Organization reports that the mortality rate of severe-type COVID-19 is over 50%. Currently, the number of severe cases worldwide has increased rapidly, but the experience in the treatment of infected patients is still limited. Given the lack of specific antiviral drugs, multi-organ function support treatment is important for patients with COVID-19. To improve the cure rate and reduce the mortality of patients with severe- and critical-type COVID-19, this paper summarizes the experience of organ function support in patients with severe- and critical-type COVID-19 in Optical Valley Branch of Tongji Hospital, Wuhan, China. This paper systematically summarizes the procedures of functional support therapies for multiple organs and systems, including respiratory, circulatory, renal, hepatic, and hematological systems, among patients with severe- and critical-type COVID-19. This paper provides a clinical reference and a new strategy for the optimal treatment of COVID-19 worldwide.
Antiviral Agents ; therapeutic use ; Betacoronavirus ; Coronavirus Infections ; drug therapy ; therapy ; Humans ; Oxygen Inhalation Therapy ; Pandemics ; Pneumonia, Viral ; therapy ; Respiration