Background:Medical treatment and surgery are the two main therapeutic approaches for esophageal variceal bleeding ( EVB),but studies showed that the efficacy of medical treatment was poor,and surgery was invasive and could lead to serious complications. Aims:To investigate the efficacy and safety of endoscopic variceal ligation combined with sclerotherapy for treatment of EVB. Methods:A total of 150 cirrhotic patients with EVB admitted from May 2011 to May 2012 at Wenling Oriental Hospital were enrolled and assigned into observation group and control group by random digital table. Patients in observation group were treated with endoscopic variceal ligation combined with sclerotherapy,and patients in control group were treated with somatostatin and pantoprazole. Overall clinical efficacy,recurrence and adverse effect were compared between the two groups. Results:In observation group,the overall clinical efficacy was 94. 7%(72/76), the recurrence rate was 3. 9%(3/76),and the adverse effect rate was 13. 2%(10/76);in control group,the overall clinical efficacy was 79. 7%(59/74),the recurrence rate was 14. 9%(11/74),and the adverse effect rate was 28. 4%(21/74). Overall clinical efficacy in observation group was significantly higher than that in control group(P<0. 05), while recurrence rate and adverse effect rate were significantly lower than those in control group( P all < 0. 05 ). Conclusions:Compared with medical treatment,endoscopic variceal ligation combined with sclerotherapy is effective in improving the clinical efficacy and reducing the recurrence and adverse effect for treatment of EVB. It is worthy of being used in clinical practice.

Objective To investigate the evaluation value of serum microRNA-19b-3p(miR-19b-3p)and microRNA-933(miR-933)levels on cardiac function and prognosis in elderly patients with chronic heart failure.Methods A total of 108 elderly patients with chronic heart failure were selected as study group.According to the New York Heart Society(NYHA)classification,35 pa-tients of the study group were classified into grade Ⅱ,40 patients were classified into grade Ⅲ,and 33 patients were classified into grade Ⅳ.A total of 90 healthy people who underwent physical exami-nation during the same period were selected as control group.Serum miR-19b-3p and miR-933 levels were detected after admission.Cardiac function parameters[left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD)]were measured by echocardiography.The relationship between serum miR-19b-3p,miR-933 and cardiac function was analyzed by Pearson correlation method.Elderly patients with chronic heart failure were divided into occurrence group(n=34)and non-occurrence group(n=74)according to whether endpoint events occurred within one year of admission.The predictive value of serum miR-1 9 b-3 p and miR-9 3 3 in elderly patients with chronic heart failure was evaluated by receiver operating characteristic(ROC)curve.Multiva-riate Cox regression analysis was used to analyze the prognostic factors of elderly patients with chron-ic heart failure.Results Serum levels of miR-19b-3p and miR-933 in the study group were signifi-cantly lower than those in the control group(P＜0.05).The levels of serum miR-19b-3p,miR-933 and LVEF in patients with cardiac function grade Ⅳ were significantly lower than those in patients with cardiac function grade Ⅲ,grade Ⅱ and healthy population,and LVEDD was larger than that in patients with cardiac function grade Ⅲ,patients with cardiac function grade Ⅱ and healthy popu-lation(P＜0.05).Serum miR-19b-3p level was positively correlated with LVEF and negatively cor-related with LVEDD in elderly patients with chronic heart failure(r=0.554,-0.368,P＜0.001).Serum miR-933 level was positively correlated with LVEF and negatively correlated with LVEDD(r=0.505,-0.410,P＜0.001).The levels of serum miR-19b-3p and miR-933 in the occurrence group were significantly lower than those in the non-occurrence group(P＜0.05).The area under the curve(AUC)of serum miR-19b-3p and miR-933 to predict the prognosis of chronic heart failure in elderly patients were 0.835(95％CI,0.785 to0.885)and 0.843(95％CI,0.790 to 0.890),and the AUC of the combined prediction was 0.901(95％CI,0.851 to 0.951).Serum miR-19b-3p(HR=3.762,95％CI,1.854 to 7.634),miR-933(HR=3.480,95％CI,1.903 to 6.364)and National Institutes of Health Stroke Scale(NIHSS)score(HR=3.047,95％CI,1.837 to 5.051)were the prognostic factors of chronic heart failure in the elderly(P＜0.05).Conclusion Serum miR-19b-3p and miR-933 levels are low in elderly patients with chronic heart failure.The changes of miR-19b-3p and miR-933 levels are closely related to cardiac function and prognosis,which can be used as effective indicators to predict poor prognosis in elderly patients with chronic heart failure.

Objective To investigate the evaluation value of serum microRNA-19b-3p(miR-19b-3p)and microRNA-933(miR-933)levels on cardiac function and prognosis in elderly patients with chronic heart failure.Methods A total of 108 elderly patients with chronic heart failure were selected as study group.According to the New York Heart Society(NYHA)classification,35 pa-tients of the study group were classified into grade Ⅱ,40 patients were classified into grade Ⅲ,and 33 patients were classified into grade Ⅳ.A total of 90 healthy people who underwent physical exami-nation during the same period were selected as control group.Serum miR-19b-3p and miR-933 levels were detected after admission.Cardiac function parameters[left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD)]were measured by echocardiography.The relationship between serum miR-19b-3p,miR-933 and cardiac function was analyzed by Pearson correlation method.Elderly patients with chronic heart failure were divided into occurrence group(n=34)and non-occurrence group(n=74)according to whether endpoint events occurred within one year of admission.The predictive value of serum miR-1 9 b-3 p and miR-9 3 3 in elderly patients with chronic heart failure was evaluated by receiver operating characteristic(ROC)curve.Multiva-riate Cox regression analysis was used to analyze the prognostic factors of elderly patients with chron-ic heart failure.Results Serum levels of miR-19b-3p and miR-933 in the study group were signifi-cantly lower than those in the control group(P＜0.05).The levels of serum miR-19b-3p,miR-933 and LVEF in patients with cardiac function grade Ⅳ were significantly lower than those in patients with cardiac function grade Ⅲ,grade Ⅱ and healthy population,and LVEDD was larger than that in patients with cardiac function grade Ⅲ,patients with cardiac function grade Ⅱ and healthy popu-lation(P＜0.05).Serum miR-19b-3p level was positively correlated with LVEF and negatively cor-related with LVEDD in elderly patients with chronic heart failure(r=0.554,-0.368,P＜0.001).Serum miR-933 level was positively correlated with LVEF and negatively correlated with LVEDD(r=0.505,-0.410,P＜0.001).The levels of serum miR-19b-3p and miR-933 in the occurrence group were significantly lower than those in the non-occurrence group(P＜0.05).The area under the curve(AUC)of serum miR-19b-3p and miR-933 to predict the prognosis of chronic heart failure in elderly patients were 0.835(95％CI,0.785 to0.885)and 0.843(95％CI,0.790 to 0.890),and the AUC of the combined prediction was 0.901(95％CI,0.851 to 0.951).Serum miR-19b-3p(HR=3.762,95％CI,1.854 to 7.634),miR-933(HR=3.480,95％CI,1.903 to 6.364)and National Institutes of Health Stroke Scale(NIHSS)score(HR=3.047,95％CI,1.837 to 5.051)were the prognostic factors of chronic heart failure in the elderly(P＜0.05).Conclusion Serum miR-19b-3p and miR-933 levels are low in elderly patients with chronic heart failure.The changes of miR-19b-3p and miR-933 levels are closely related to cardiac function and prognosis,which can be used as effective indicators to predict poor prognosis in elderly patients with chronic heart failure.

Objective:To investigate the mechanism of curcumin affecting HIV-1 infection co-receptor CCR5 by regulating transcription factor FOXP3.Methods:Binding sites of transcription factor FOXP3 on CCR5 promoter were predicted and analyzed by bioinformatics method.AutoDock 4.2 software was used to connect curcumin and FOXP3 flexibly.MTT assay was used to detect cyto-toxcity of curcumin on activity of Jurkat cells.qRT-PCR and Western blot were used to detect expression levels of CCR5 and FOXP3 mRNA and protein in Jurkat cells that were treated with different concentrations of curcumin.pcDNA3.1-FOXP3 expression vector was built and combined with the prediction results of transcription factors.The mutant CCR5 gene fragment was amplified by Overlap PCR,and the mutant CCR5 promoter recombinant vector pFireRluc-Mt-CCR5 was constructed.Binding site between transcription fac-tor FOXP3 and CCR5 promoter was verified by double luciferase reporter gene assay.Results:Results of JASPAR transcription factor prediction showed that there was a binding site between CCR5 promoter and transcription factor FOXP3;molecular docking results showed that curcumin could bind to the active region of FOXP3;MTT results showed that curcumin inhibited the activity of Jurkat cells after 24 hours,and the IC50 was 34.48 μmol/L.qRT-PCR and Western blot showed that expression levels of CCR5 and FOXP3 mRNA and protein were decreased in a dose-dependent manner after different concentrations of curcumin treated Jurkat cells;double luciferase reporter gene confirmed that FOXP3 could bind to CCR5 promoter,and the transcription factor FOXP3 could regulate the activity of CCR5 promoter;results of the recovery experiment of FOXP3 on curcumin showed that when the curcumin concentration was 60 μmol/L,relative value of luciferase activity in HEK293T cells with pcDNA3.1-FOXP3 and pFireRluc-Wt-CCR5 was signifi-cantly higher than that in pFireRluc-Wt-CCR5+curcumin-60 group(P<0.01).Conclusion:FOXP3 can regulate the activity of CCR5 promoter,and the mechanism may be that curcumin affects activity of CCR5 promoter by acting on binding site of FOXP3 and CCR5 promoter.