Objective To evaluate the effect of valsartan on endothelial function in patients with essential hypertension. Methods Thirty six patients of essential hypertension recieved valsartan(80 mg/d) for 8 weeks. After treatment, serum NO, SOD and MDA were measured using chemically colorimetric method. Brachial artery endothelium-dependent dilation function(FMD) was determined by high resolution ultrasonography. Twenty six health adults served as controls. Results Compared with the control, FMD was significantly decreased (P

Objective To explore the role of apelin in the pathogenesis of diabetic nephropathy.Methods A total of one hundred and fourteen patients with type 2 diabetes mellitus in Qingdao Municipal Hospital from July 2015 to June 2016 were divided into normal albuminuria group (56 cases in the NA group) and micro-albuminuria group (58 cases in the MA group),depending on whether the level of urinary micro-albumin in 24 h was higher than 30 mg,with 60 healthy subjects included as the controls group (NC group).Levels of serum apelin and other biochemical indexes were tested.Results (1) WC,BMI,TC,TG,LDL-C,FBG,FINS,HOMA-IR and apelin in the patients of the NA group and MA group were respectively (87.99±10.27) cm,(24.75±3.35) kg/m2,(5.27±1.28) mmol/L,(1.84±1.25) mmol/L,(3.36±0.91) mmol/L,(7.58±0.87) mmol/L,(13.29±3.57) U/L,4.50±1.41,(364.22±85.03) ng/L ,(90.10±8.97) cm,(25.47±2.82) kg/m2,(5.19±1.11) mmol/L,(2.23±1.43) mmol/L,(3.68±0.83) mmol/L,(7.89±1.11) mmol/L,(15.50±5.00) U/L,5.55±2.27,(397.42±91.29) ng/L,which were higher than those of the NC group ((83.20±5.36) cm,(22.59±2.67) kg/m2,(4.68±1.10) mmol/L,(1.37±0.58) mmol/L,(2.56±0.94) mmol/L,(5.11±0.82) mmol/L,(7.17±2.80) U/L,1.65±0.77,(309.34±68.28) ng/L,P<0.05).FINS,HOMA-IR and apelin in the MA group were significantly higher than those in the NA group (P<0.05).(2) After age,sex and BMI were taken into control,partial correlate analysis showed that serum apelin was positively correlated with LDL-C,FPG,FINS and HOMA-IR (r=0.183,0.314,0.374,0.378,P<0.05).(3) Multifactor regression analysis showed that HOMA-IR and BMI were independent related factors to serum apelin (r2=0.288,0.389,P<0.05).Conclusion Apelin levels in the MA group were significantly higher than those in the NA group,and the serum apelin was positively correlated with HOMA-IR.Thus,apelin may contribute to the pathogenesis and progress of diabetic nephropathy.

Objective To assess the effects of fluvastatin retard tablets on the elder patients of acute coronary syndrome(ACS) complicated with diabetes mellitus(DM) undergoing percutaneous coronary intervention (PCI) and the safety of drugs.Methods From December 2009 to December 2011,78 elderly patients (age≥65 years) of ACS complicated with DM who underwent PCI were enrolled in this study.They were all treated by drug elution stents.They were divided into group A(fluvastatin retard tablets 80 mg/d) and group B (fluvastatin retard tablets 160 mg/d) with 39 cases each by random digits table method.The plasma levels of high sensitivity C reactive protein (hs-CRP),matrix metalloproteinase proteinase 9 (MMP-9),monocyte chemoattractant protein 1 (MCP-1) and lipid levels were measured before and after treatment of 24 h,7 d and 180 d.All the patients were followed up for 180 d,and the adverse reaction of drug and the incidence of cardiovascular event were detected.Results Blood lipid levels had no significant changes in the two groups before and after treatment (P ＞ 0.05).The plasma levels of hs-CRP,MCP-1,MMP-9 were higher after treatment of 24 h than those before treatment in two groups [group A:(12.14 ± 2.71)mg/L vs.(8.76 ±2.25) mg/L,(491.75 ± 19.29) ng/L vs.(440.56 ± 13.15) ng/L,(449.6 ±11.8) μmol/L vs.(353.8 ± 16.0) μ mol/L;group B:(11.39 ± 2.38) mg/L vs.(9.30 ± 1.99) mg/L,(488.56 ± 17.61) ng/L vs.(436.06 ± 15.36) ng/L,(444.9 ± 19.1) μ mol/L vs.(349.8 ± 13.6) μmol/L],and there were significant differences (P ＜ 0.05).The plasma levels of hs-CRP,MCP-1,MMP-9 decreased significantly after treatment of 7,180 d compared with that after treatment of 24 h in two groups (P ＜ 0.05).Compared with those in group A,the plasma levels of hs-CRP,MCP-1,MMP-9 decreased even lower in group B[after 7 d:(4.51 ±1.16) mg/L vs.(5.43 ± 1.44) mg/L,(306.06 ± 18.49) ng/L vs.(384.64 ± 13.23) ng/L,(206.2 ± 16.8)μ mol/L vs.(263.4 ± 15.4)μ mol/L;after 180 d:(4.23 ± 1.08) mg/L vs.(4.68 ± 1.46) mg/L,(280.16 ± 14.54) ng/L vs.(354.64 ± 11.32) ng/L,(187.2 ± 14.2)μ mol/L vs.(225.4 ± 12.7) μ mol/L],and there were significant differences (P ＜ 0.05).After followed up for 180 d,there was no serious adverse reaction in two groups,and the total incidence of cardiovascular event in group B was lower than that in group A [7.7％(3/39) vs.25.6％ (10/39)],and there was significant difference (P ＜ 0.05).Conclusion Intensive lipid lowering therapy can reduce the level of inflammatory factors and cardiovascular event of the elder patients of ACS complicated with DM undergoing PCI and has good security.

Objective:To study the preventive and therapeutic effects of silk fibroin peptides (SFP) on acute alcoholism in mice. Methods:In first experiment, the mice were randomly divided into four groups, and every group was treated by 56o alcohol (ethanol dosage 7.56 ml/kg bw) via i.g. Eighty mice were fed normal saline (NS) and different dosages of SFP (0.1, 0.5, 2.5 g/kg bw) 30 min later respectively, then the rate of ebriety and time of sobriety were determined. Another 72 mice were also divided into four groups and given NS and SFP similarly. The concentration of ethanol in serum was measured 1 h, 2 h and 4 h later respectively. In second experiment, the mice were also divided into four similar groups, but 56o alcohol was given at 6.16 ml/kg?bw via i.g. NS and SFP were given similarly, 0.5 h before alcohol. Two experiments were performed to observe the effect of SFP on prevention of temulence. Results:The time of sobriety and concentration of ethanol of SFP groups fed 0.5 and 2.5g/kg bw were lower significantly than those of NS group (P

Objective To observe the effects of secoisolariciresinol (SECO) and its metabolites, enterolactone (ENL) and enterodiol (END), on proliferation of MCF-7 cell line and to the probable mechanism. Method Effect of SECO, END, ENL and genistein (GEN) on MCF-7 proliferation was investigated by MTT assay. Cell cycle arrest was measured by flow cytometry (FCM). Cell morphology was observed by optical microscope. The anticarcinogenic mechanism of SECO was analyzed. Results SECO had promotive effect on the cell growth at lower concentration (≤40 ?mol/L) but inhibition effect at higher concentration (100 ?mol/L). ENL and END, however, showed significant inhibition effect at all tested concentrations (10~100?mol/L). The cell cycle progression was arrested at G2/M phase and apoptosis was observed by optical microscope. Conclusion Effect of SECO on the MCF-7 cell proliferation depends on its concentration. Inhibition effect of SECO may relate to its metabolites ENL or END.

Objective:To investigate the relationship of polymorphism of leptin receptor gene Gln223Arg with asthma and metabolic syndrome.Methods: Collected 120 asthma patients,92 metabolic syndrome patients,54 asthma combined metabolic syndrome patients and 81 normal controls.According to the severity,the asthma patients were divided into mild-medium group and severe group.The serum leptin level was measured by ELISA,the genotypes of leptin receptor were analyzed by the method of polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP),and statistcs of each subject′s MBI,blood pressure,lung function and fasting blood glucose were collected.Results: ①There were significant differences in genotype and allele frequency in leptin receptor gene Gln223Arg between the metabolic syndrome group,asthma combined metabolic syndrome group and normal control group(P<0.05).②The allele frequency and genotype in leptin receptor gene Gln223Arg were significant different between the severe asthma group and normal control group(P<0.05).③The serum leptin level,BMI and systolic blood pressure of AA+AG genotype group were significiant higher than GG genotype group(P<0.05),while the value of FEV1% and FEV1/FVC of lung function were lower than GG genotype group(P<0.05).Conclusion: Leptin receptor gene Gln223Arg polymorphism is correlated with asthma and metabolic syndrome,and by causing leptin resistance,the A allele might be the genetic factor that contribute to individual susceptibility for asthma and metabolic syndrome.

Objective • To summarize the experiences and follow-up results of minimally invasive direct coronary artery bypass (MIDCAB) for treating coronary atherosclerotic cardiopathy for 10 years and to evaluate the long-term effects of MIDCAB. Methods • The patients who underwent MIDCAB at Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, from February 2009 to May 2019 were collected. According to whether the patients achieved complete revascularization (CR) or underwent hybrid coronary revascularization (HCR), the cases were divided into 3 groups: incomplete revascularization (IR) + optimal medical therapy (OMT) group, MIDCAB (CR) group and HCR (CR) group. The Kaplan-Meier (K-M) curve was used to analyze the long-term survival and the freedom from major adverse cardiac and cerebrovascular events (MACCE) of patients. Results • A total of 425 patients were enrolled in the study, with a median follow-up of 39.9 months (18.2-81.1 months). The hospital stay in the HCR (CR) group was significantly prolonged compared with the other two groups (P=0.000). The perioperative mortality (P=0.000), perioperative myocardial infarction (MI) rate (P=0.000), perioperative MACCE rate (P=0.000), cardiac troponin I (cTnI) levels in 48 h (P=0.011), long-term mortality (P=0.000), long-term MI rate (P=0.002), and long-term MACCE rate (P=0.005) in the IR + OMT group were significantly higher than those in the other two groups of patients who had CR. The overall 10-year survival rate and freedom from MACCE estimated by K-M curves were 80.9% (95%CI 73.1%-88.7%) and 70.5% (95%CI 62.1%-78.9%), respectively. The long-term survival (P=0.000) and freedom from MACCE (P=0.001) in IR+OMT group were significantly lower than those in the other two groups. Conclusion • MIDCAB has good long-term effects on patients with coronary atherosclerotic cardiopathy. Patients undergoing MIDCAB should complete CR, and IR can significantly affect the long-term prognosis of patients.

Objective • To provide guidance for the rational usage of antibiotics, reduction of drug-resistant strains and hospital infection control by investigating the distribution and drug resistance of pathogens isolated from burned patients. Methods • Isolates from burned patients of Ruijin Hospital, Shanghai Jiao Tong University School of Medicine between Jan. 2016 and Dec. 2017 were collected. The VITEK 2 Compact automatic microbial analysis system and K-B disc diffusion method were used for antimicrobial susceptibility test. Statistical analysis was performed to investigate the type of specimens and strains and the resistance rates of major pathogens. Chi-square test was used to compare the changes of the detection rates and drug resistance rates of major pathogens between 2016-2017 and 2013-2014. Results • A total of 1 053 isolates were isolated, and most of them (73.88%) were from wounds. Among them, 609 (57.83%) isolates were gram-negative bacilli (G-B), 422 (40.08%) were gram-positive cocci (G+C) and 9 (0.85%) were fungi. The most common pathogen of G-B was Klebsiella pneumoniae (218, 20.70%) in 2016-2017, the proportion of which was significantly higher than that in 2013-2014 (114, 10.72%) (P=0.000). The most common pathogen of G+C was Staphylococcus aureus (210, 19.94%), the proportion of which was significantly higher than that in 2013-2014 (200, 18.81%) (P=0.009). K. pneumoniae showed low resistance only to piperacillin/tazobactam, cefoperazone/sulbactam, imipenem, meropenem, fosfomycin and tigecycline (<60%), but high resistance to ampicillin and cefazolin (>90%). The resistance rates of K. pneumoniae to ceftazidime, cefepime, imipenem, meropenem and amikacin in 2016-2017 were significantly higher than those in 2013-2014 (P<0.05). S. aureus was only resistant highly to penicillin (94.63%) and 100% susceptible to vancomycin and linezolid. The proportion of methicillin-resistant S. aureus (MRSA) was 59.05% in 2016-2017, which had no statistical difference compared with that in 2013-2014 (P=0.412). Conclusion • The most two prevalent isolates from burned patients were K. pneumoniae and S. aureus with multi-drug resistance. Improved management and rational use of antibiotics can reduce the incidence of antibiotic resistant pathogens, and it's still important to keep routine surveillance on pathogens isolated from burned patients for control and prevention of nosocomial infections.

Objective • To analyze the bacterial origin and characteristics, and their influence on the process and prognosis in moderately severe acute pancreatitis (MSAP) and severe acute pancreatitis (SAP) patients with pancreatic/peri-pancreatic infections due to multiple drug resistant (MDR) Gram-negative bacteria (GNB). Methods • Patients of pancreatitis hospitalized in the Departments of Emergency, Pancreatic Surgery and Critical Care Medicine were enrolled in this study. The patients with pancreatic/peri-pancreatic GNB infections were screened and divided into MDR-GNB group and non-MDR-GNB group. The basic clinical features, the source of resistant bacteria, the progress of the disease and the prognosis were analyzed and compared within two groups. Results • 92(46.70%) out of 197 MSAP and SAP patients were confirmed as GNB infected, 61 cases (66.30%) with MDR strains and 31 cases (33.70%) with non-MDR strains. 117 GNB were isolated. The main MDR strains were Klebsiella pneumoniae (KP) (39/69) and Acinetobacter Baumannii (AB) (22/69). The incidence of percutaneous catheter drainage (PCD) associated MDR bacterial infections in MDR-GNB group was significantly higher than that of non-MDR-GNB group (36.07% vs 12.90%, P=0.020). The MDR-GNB infections could lead to prolonged mechanical ventilation[ (17.65±11.74) d vs (9.67±9.34) d, P=0.001], increased use of carbapenems and special antibiotics (P=0.000), earlier intervention of first laparotomy [(21.92±11.45) d vs (29.36±21.48) d, P=0.032], increased incidence of multiple operations (45.90% vs 22.58%, P=0.029), prolonged total hospitalization [(54.44±42.38) d vs (32.51±27.62) d, P=0.011] and higher mortality (34.43% vs 12.90%, P=0.028). The incidence of MDR-KP infections in death patients was significantly higher than that in the surviving patients (85.71% vs 52.50%, P=0.000), while the other MDR bacteria did not present statistical difference in the two groups. Conclusion • MDR-KP and MDR-AB are the main resistant GNB in MSAP and SAP patients with pancreatic/peri-pancreatic infections. The PCD associated infection is the main source of nosocomial MDR bacterial infections. Infections due to MDR-GNB could lead to prolonged therapy course, increased use of antibiotics, augmented operation, and poor outcome. The infection of MDR-KP is directly related to poor outcome.

Objective: To analyze the cases of ABPA based on 2017 version of Expert Consensus on the Diagnosis and Treatment of Allergic Bronchopulmonary Aspergillosis (ABPA) (Expert Consensus in short) developed by Asthma Group of Chinese Medical Association Respiratory Diseases Society. Methods: According to the Expert Consensus, the clinical data of 12 patients with ABPA admitted to Ruijin Hospital, Shanghai Jiao Tong University School of Medicine from January 2013 to December 2017 were retrospectively analyzed. Results: Among the 12 patients with ABPA, 6 were males and 6 were females. The clinical manifestations were cough, having phlegm, short of breath, etc. The total immunoglobulin E (tIgE) in sera of 10 cases increased, and the peripheral blood eosinophils of 9 cases increased. Seven cases underwent the skin test, 3 of whom were positive in aspergillus. Serum aspergillus-specific IgE (sIgE) of all the 5 cases tested was elevated. The most patients showed bronchiectasis in chest CT, and some also with mucus plug. Fifty percent of the cases fully met the diagnostic criteria of Expert Consensus. All the patients were treated with corticosteroid, and 9 of them were also treated with antifungal drugs. Conclusion: The clinical manifestations of ABPA are atypical. For the patients with lung diseases such as asthma and bronchiectasis, serum tIgE, aspergillus sIgE and eosinophil levels need to be monitored. Aspergillus skin test and imaging examination are helpful to the diagnosis of ABPA. The main treatment is the combination of corticosteroid and antifungal drugs.