Objective To observe the characteristics of the two-dimensional global strain index in patients with different degrees heart failure with speckle tracking echocardiography. Methods Totally 35 myocardial infarction patients with heart failure and 28 healthy subjects (control group) were enrolled in the study. The patients were divided into mild (n=14), moderate (n=13), and severe heart failure subgroup (n=8) according to left ventricular ejection fraction (LVEF). The systolic longitudinal strain (LS), radial strain (RS) and circumferential strain (CS) were measured of left ventricular with two-dimensional speckle tracking technique. The average value of left ventricular 18 segmental LS, RS and CS was calculated as the global longitudinal strain (GLS), the global radial strain (GRS) and the global circumference strain (GCS), respectively. LVEF and left ventricular end diastolic volume (LVEDV) were also measured with conventional two-dimensional echocardiography. The global two-dimensional strain and heart function between two groups were compared. The change of GLS, GRS and GCS of different heart failure and the relationship between them and LVEF were analyzed. Results Compared with control group, GLS, GRS and GCS reduced in heart failure groups (P<0.01). In heart failure groups, GLS significantly decreased with the decrease of LVEF, the difference of GLS was significant (P<0.05). GCS in severe heart failure subgroup was lower significantly than that in mild and moderate heart failure subgroups (P<0.05). No significant difference was found in GCS between mild and moderate heart failure subgroups (P>0.05). There was no significant difference in GRS among heart failure subgroups (P>0.05). GLS was closely correlated to LVEF (r=-0.65, P<0.01), GCS was also correlated to LVEF (r=-0.55, P<0.01). Conclusion The changes of GLS, GRS and GCS is different in different degrees of heart failure. GLS is closely correlated to the change of LVEF. The change of GLS, GRS and GCS may reflect degrees of myocardial injury.

Objective To assess the feasibility and accuracy of ultrasound evaluation of facet joint in the lumbar spine by comparison of ultrasonography and CT measurements in normal and degenerative lumbar vertebra small joint.Methods Fifteen patients with chronic low back pain in Shengjing hospital of China Medical University were taken as the study group,and 20 healthy volunteers as the healthy controls from physical examination center of our hospital between January 2014 and December 2014.The ultrasonic and CT values were measured in L 1-S 1 small joints between normal and abnormal lumbar joints (height and width).The length and width of the left and right side small joints of healthy controls,ultrasonic measurement of healthy controls and patients with chronic low back pain,and value of ultrasonography and CT measurements were compared by using t test.Results The abnormal facet joint can be clearly showed by sonography,characterized by bone hyperplasia of edge joints,bone destruction,wear or thinning/thickening of articular cartilage.For the length and width of the lumber joints,the difference of ultrasonic measurement values between normal and abnormal lumbar joints were statistically significant [(1.26±0.03) cm vs (1.43±0.05) cm,t=2.626,P ＜ 0.05;(0.18±0.01) cm vs (0.15±0.02) cm,t=2.264,P ＜ 0.05].In patient group,the difference of length and width values in a total of 150 small joints between ultrasonography and CT were not statistically significant [(1.43 ± 0.17) cm vs (1.42 ± 0.16) cm],t=1.655,P ＞ 0.05;(0.15 ± 0.03) cm vs (0.14±0.03) cm,t=1.656,P ＞ 0.05].Conclusions The facet joint of the lumbar can be clearly shown by sonography and it is valuable in the diagnosis of small joint degeneration for lumbar vertebra.

Objective To construct an shRNA lentiviral vector targeting the MEX3A gene and establish a bladder cancer cell line with stable MEX3A gene knockdown.Methods Real-time PCR was performed to detect the MEX3A gene expression.The recombinant lentiviral vector targeting the MEX3A gene was constructed using the GV115 plasmid.After identification and sequencing,the vectors were co-transfected with the packaging vector into 293T cells to produce lentiviral particles,which were then transduced into bladder cancer cells after viral titer determination.The cell line stably expressing the siRNA was established by antibiotic selection,and real-time PCR was carried out to detect the efficiency of the knockdown.Results Both bladder cancer cell lines,5637 and T24,expressed the MEX3A gene,and its expression was higher in 5637 than in T24.The identification and sequencing results showed that the MEX3A-shRNA lentiviral vector was successfully constructed,and the virus titer was observed to be higher after packaging.The results of the real-time PCR showed that MEX3A gene expression was stably inhibited in 5637 cells after lentiviral transduction.Conclusion Lentivirus-mediated RNAi technology could successfully establish a cell line with stable MEX3A gene knockdown.

Objective:To investigate the causal association between immune cell and different types of sepsis by using Mendelian randomization (MR) method, and to find the immune cell phenotypes causally associated with sepsis.Methods:Summary data for various circulating immune cell phenotypes were obtained from the GWAS catalog (GCST90001391-GCST90002121). Sepsis data were sourced from the UK Biobank database. Single nucleotide polymorphisms (SNP) were used as instrumental variables. The correlation threshold of P < 5×10 -6 was used to identify the strongly correlated instrumental variables, and the code was used to remove the linkage disequilibrium and the instrumental variables with F-value < 10. Inverse variance weighting (IVW) was used as the main research method to evaluate the stability and reliability of the results, including Cochran's Q test, MR-Egger regression and Leave one out. Reverse MR analysis was performed based on the immunophenotypic results of the removal of horizontal pleiotropy, and the immune cell phenotype with one-way causal association was obtained. Odds ratio ( OR) and 95% confidence interval (95% CI) were used to represent the effect value of the results. Results:CD16 on CD14 -CD16 + monocyte had horizontal pleiotropy in sepsis ( OR = 0.965?4, 95% CI was 0.933?5-0.998?3, P = 0.039?6). There were five immunophenotypes that had reverse causal associations with the types associated with sepsis. After excluding immune cell phenotypes with horizontal pleiotropy and reverse causation, a total of 42 immune cell phenotypes with sepsis, 36 immune cell phenotypes with sepsis (28-day death in critical care), 32 immune cell phenotypes with sepsis (critical care), 44 immune cell phenotypes with sepsis (28-day death), and 30 immune cell phenotypes had potential causal associations with sepsis (under 75 years old). After false discovery rate (FDR) correction, the correlations between BAFF-R on IgD - CD38br and sepsis (28-day death) were negative and strong ( OR = 0.737?8, 95% CI was 0.635?9-0.856?0, P = 6.05×10 -5, PFDR = 0.044?2). Conclusion:A variety of immune cell phenotypes may have a protective effect on sepsis, especially BAFF-R on IgD - CD38br expression is negatively correlated with sepsis (28-day death), which provides a new idea for immune modulation therapy in sepsis.

Objectives:To search, evaluate, and summarize the evidence related to the application management of over-the-counter (OTC) medications for constipation in the elderly, providing evidence-based support for the rational use of these medications.Methods:A systematic search was conducted through computerized decision support systems, guideline websites, professional association websites, and databases for clinical decisions, guidelines, evidence summaries, and expert consensus on the management of OTC medications for constipation in the elderly. The search period spanned from January 2018 to March 2023. The quality of the literature was independently assessed, and evidence was extracted. The 2014 version of the Joanna Briggs Institute (JBI) evidence grading system was used to determine the levels of evidence.Results:A total of 18 article were included, consisting of two clinical decisions, five guidelines, seven expert consensus statements, and four evidence summaries. These covered five areas: medication principles for elderly individuals with different characteristics, medication selection, medication monitoring, health education, and precautions, culminating in a total of 30 best evidence.Conclusions:This study summarizes the best evidence for the management of OTC medications for constipation in the elderly, providing evidence-based support for the rational application of these medications.

Orchitis is a common male genitourinary disorder that significantly impacts patients' life quality.Current treatment strategies have certain limitations and side effects.Ongoing therapeutic strategies focus on the interactions and regulatory networks among pathways and factors involved in the progression of orchitis.The targeted pharmacological agents include inflammatory pathways (p38MAPK, NF-κB, PI3K/Akt), cytokines (TNF-α, IL-6), and the nitric oxide synthase (NOS) system.However, these studies are currently at the animal research stage, and further clinical investigations are necessary to validate their efficacy and safety before clinical use.This article reviews the preclinical animal studies on new treatment methods of orchitis from the aspects of autoimmunity and exogenous microorganism induction, including ketotifen furmarate, aspirin, L-NAME, activin A, cortisol, melatonin, methane, long non-coding RNA MEG3, Abaloparatide, recombinant type Ⅰ interferon, and so on.