Objective To investigate the influence of combined irbesartan/hydrochlomthiazide on morning blood pressure surge(MBPS)and left ventricular mass(LVM) in essential hypertension.Methods After 4-8 weeks' run-in period,if blood pressure wagn't up to the standard,the 120 patients were given irbesartan/hydrochlorothiazide once daily from 150 mg/12.5 mg for 12 months to 300 mg/25mg for another 12 months.MBPS was conducted by arnbuhry blood pressure monitoring(ABPM)and LVM was determined by echocardiography at the end of placebo baseline and 12 months later.Results (1)After treatment the patients with MBPS(+)decreased and patients with MBPS(-) increased.(2)After treatment the extents of MBPS were reduced in MBPS(+)patients[systolic blood pressure(SBP)difference(16.1±1.8)mm Hg(1mm Hg=0.133 kPa)vs(29.4±2.8)mm Hg,diastolic blood pressure(DBP)difference(10.2±2.3)mm Hg vs(21.2±2.2)mm Hg,P<0.01]with little change in MBPS(-)patients[SBP difference(11.2±2.4)mm Hg vs(10.1±1.2)mm Hg,DBP difference(5.9±1.9)mm Hg vs(6.8±3.2)mm Hg]compared with before treatment.(3)LVM indexes of all patients were significantly reduced.Conclusion Irbesartan/hydrochlorothiazide can effectively attenuate the extent of MBPS, and has advantages on reversing left ventricular hypertrophy.

Objective: To study the correlations between galectin-3, soluble ST2 (sST2) levels and chronic heart failure (CHF) classiifcation, traditional HF indicator and short-term death in relevant patients. Methods: This research included 2 groups: CHF group, containing 142 relevant patients treated in our hospital from 2014-02 to 2015-10 and Control group, containing 85 normal subjects from physical examination at the same period of time. Based on NYHA criterion, the patients were classiifed in NYHA grade II, III and IV respectively. Blood levels of N-terminal brain natriuretic peptide (NT-ProBNP), high-sensitivity C reactive protein (hs-CRP) and ultrasonic morphology were examined upon admission; protein expressions of galectin-3 and sST2 were assessed by ELISA. Results: The patients with NYHA grade III and IV had increased levels of galectin-3 and soluble sST2; galectin-3, sST2 were positively related to NT-ProBNP, hs-CRP and LVEDD, while negatively related to LVEF. Logistic regression analysis indicated that galectin-3 and sST2 were related to short-term death in CHF patients,P<0.05. Area under ROC curve of galectin-3 and sST2 for diagnosing CHF were 0.738 and 0.771,P<0.01. Conclusion: Galectin-3 and sST2 levels were related to traditional HF indicator and could be used for CHF diagnosis in relevant patients.

Objective To determine whether the 12-lead-resting electrocardiogram(ECG) is a predictor of left vertricular(LV) recovery after successful recanalization of chronic total coronary occlusions(CTO).Methods The 12-lead-resting ECG was evaluated for Q-wave areas and parameters of QT dispersion.Impairment of regional wall motion was evaluated by real-time three-dimensional echocardiography(RT-3DE) at baseline and at follow-up.Results The wall motion score index(WMSI) was improved from 1.56?0.31 to 1.12?0.21(P0.05).Conclusion In patients with recanalization of CTO,recovery of regional wall motion is reliably predicted by analysis of the12-lead-resting ECG.

Objective To investigate the relationship between interleukin 1β( IL?1β) , interleukin?33 ( IL?33) , neutrophil?to?lymphocyte ratio ( NLR ) and atrial fibrillation. Methods Eighty?two patients with nonvalvular atrial fibrillation treated in the department of cardiology in the Fourth People′s Hospital of Jinan from October 2015 to October 2016 were enrolled in the study,including 43 patients with persistent atrial fibrillation and 39 patients with paroxysmal atrial fibrillation. 50 healthy subjects were selected as the control group. Enzyme linked immunosorbent assay (ELISA) was used to determine the concentration of IL?1βand IL?33,and the left atrial diameter ( LAD) was measured by echocardiography. Results ( 1) The concentrations of IL?1β,NLR and LAD in the paroxysmal atrial fibrillation group were (24. 44±4. 89) ng/L,(2. 51±1. 22) %,(36. 16± 6. 12) mm,the concentrations of IL?1β,NLR and LAD in the persistent atrial fibrillation group were (26. 95±5. 86) ng/L,(5. 7±1. 8) %,(39. 36±4. 78) mm and the values in the control group were (19. 53±4. 51) ng/L,(1. 82 ± 0. 41 ) %, ( 33. 31 ± 2. 89 ) mm, respectively. The differences among the three groups were statistically significant ( F=16. 74,11. 82,14. 85,P<0. 01) . The indexes of paroxysmal atrial fibrillation group and persistent atrial fibrillation group were higher than those of the control group ( P<0. 01 ) . ( 2 ) In the persistent atrial fibrillation group, NLR and LAD were ( 5. 7 ± 1. 8 )% , and ( 39. 36 ± 4. 78 ) mm, higher than those of the paroxysmal atrial fibrillation group ( (2. 51±1. 22)%,(36. 16±6. 12) mm),the differences were statistically significant ( P<0. 01) . However,the level of IL?1βin the persistent atrial fibrillation group was not significantly different from that in the paroxysmal atrial fibrillation group ( (26. 95±5. 86) ng/L vs. (24. 44±4. 89) ng/L,P>0. 05). (3) The concentrations of IL?33 in the paroxysmal atrial fibrillation group,atrial fibrillation group, control group were ( 48. 31 ± 4. 72 ) ng/L, ( 50. 03 ± 2. 18 ) ng/L, ( 56. 87 ± 5. 12 ) ng/L, respectively. The difference among the three groups has no statistical significance ( F=2. 52, P>0. 05 ) . ( 4 ) NLR level was positively correlated with LAD ( r=0. 32,P=0. 002) . There was no significant correlation among IL?1β,IL?33 and LAD ( r=0. 16, P=0. 11, r=0. 02, P=0. 37 ) . Conclusion The levels of IL?1β, NLR and LAD in peripheral blood of patients with atrial fibrillation were significantly higher than those in patients with sinus rhythm,and there was a positive correlation between NLR and LAD.

From August 2011 to March 2012,5 241 type 2 diabetic patients with body mass index ≥ 24kg/m2 were enrolled from 60 hospitals in Guangdong Province.According to estimated glomerular filtration rate (eGFR),a total of 2 631 subjects with norml urine microalbumin level (＜30 ng/L) were divided into normal eGRF group and decreased eGRF group.Binary logistic regression was used to analyze the associations between eGFR and its related risk factors.The results showed that age,blood uric acid,blood urea nitrogen,history of hypertension and coronary heart disease,family history of diabetes,and hyperuricemia were positively related to lowering of eGFR (P＜ 0.05 or P＜0.01).HbA1C＜7％,regular glucose monitoring,and regular physical activity were negatively related to eGFR decrease (all P＜ 0.01).These results suggest that urine microalbumin and eGFR should be applied to overweight or obese patients with type 2 diabetes in order to screen diabetic nephropathy.Furthermore,intensive control of blood glucose,uric acid,and blood pressure is beneficial to lowering the risk of diabetic nephropathy.

Objective To understand the coronary characteristic of acute coronary syndrome patients with ischemic J wave. Methods Comparison was made between 60 acute coronary syndrome patients with ischemic J wave and 60 acute coronary syndrome patients without ischemic J wave. All patients were examined by Holter monitoring electrocardiogram and coronary arteriongraphy. To distinguish the stenosis degree was defined in three degree based on Genisini score of 0, 1-80, and 81-160. Plaque types were divided into Ⅰ,Ⅱ, Ⅲ by Ambrose classification,the coronary and plaque characteristics of acute coronary patients were observed with ischemic J wave. Results There were no significant difference of stenosis degree between the two groups ( U = 3. 0686, P = 0. 0022), whereas there were significant difference of plaque types (x2 =16. 0890, P = 0. 0003) and coronary vessel numbers(x2 =12. 1045, P = 0. 0024). The degree of stenosis, the plaque types, and number of stent in coronary vessel were positively correlated with ischemic J wave(r =0. 44,0. 34,0. 31 ;P <0. 05). Conclusions The acute coronary syndrome with ischemic J wave patients is often not only accompanied with serious coronary stenosis and high incidence rate of multivessel disease,but also high probability of unstabilized plaque. Ischemic J wave can be a predictor of super-acute ischemic of myocardium.

Objective:To examine the changes of mimecan protein expression in development of atherosclerosis induced by sinoaortic denervation,and to explore the effects of mimecan knock down on the proliferation and migration of vascular smooth muscle cells.Methods:The animals were randomly divided into a sham group and a model group (n=8 in each group).The rat model of blood pressure variability was established by sinoaortic denervation,and the hemodynamic indexes were recorded 20 weeks after the surgery to confirm the success of the model.The thoracic aorta was excised and stained with immunohistochemistry to observe the pathological changes of smooth muscle tissues and the changes of mimecan expression.The mice vascular smooth muscle cells were isolated,and which were treated with mimecan siRNA to knock down the mimecan expression,The cell proliferation was observed by 5-ethynyl-2'-deoxyuridine (Edu) in corporation test and the changes of cell migration was observed by wound healing test.Results:Twenty weeks after sinoaortic denervation,the blood pressure variability in the model group was significantly increased compared with that in the sham group,suggesting the model was successfully established.In addition,the increased blood pressure variability in the model group promoted the proliferation and migration of the vascular smooth muscle cells in thoracic aorta,while the expression of mimecan protein was significantly decreased.In in vitro assays,the knock down of mimecan in mice vascular smooth muscle cells could promote the cell proliferation and migration.Conclusion:Mimecan plays a protective role in the development of sinoaortic denervation induced atherosclerosis through amechanism involving suppression of the proliferation and migration of vascular smooth muscle cells.

Objective:To analyze the clinical characteristics of patients undergoing extracorporeal cardiopulmonary resuscitation (ECPR), and to explore the risk factors leading to poor prognosis.Methods:The clinical data of 95 patients with ECPR admitted to the First Affiliated Hospital of Zhengzhou University from January 2020 to May 2023 were retrospectively analyzed. According to the survival status at the time of discharge, the patients were divided into the survival group and death group. The difference of clinical data between the two groups was compared to explore the risk factors related to death and poor prognosis. Risk factors associated with death were identified by Binary Logistic regression analysis. Results:A total of 95 patients with ECPR were included in this study, 62 (65.3%) died and 33 (34.7%) survived at discharge. Patients in the death group had longer low blood flow time [40 (30, 52.5) min vs. 30 (24.5, 40) min ] and total cardiac arrest time[40 (30, 52.5) min vs. 30(24.5, 40) min], shorter total hospital stay [3 (2, 7.25) d vs. 19 (13.5, 31) d] and extracorporeal membrane oxygenation (ECMO) assisted time [26.5 (17, 50) h vs. 62 (44, 80.5) h], and more IHCA patients (56.5% vs. 33.3%) and less had spontaneous rhythm recovery before ECMO (37.1% vs. 84.8%). Initial lactate value [(14.008 ± 5.188) mmol/L vs.(11.23 ± 4.718) mmol/L], APACHEⅡ score [(30.10 ± 7.45) vs. (25.88 ± 7.68)] and SOFA score [12 (10.75, 16) vs. 10 (9.5, 13)] were higher ( P< 0.05). Conclusions:No spontaneous rhythm recovery before ECMO, high initial lactic acid and high SOFA score are independent risk factors for poor prognosis in ECPR patients.

OBJECTIVETo study the effect of Mps1 on BRAFWT/MEK/ERK pathway in the presence of wild type BRAF or BRAFV600E in melanoma.

METHODSMelanoma cells harboring BRAFWT genotype were transfected either with pBabe-puro-GST-BRAF-WT and/or pBabe-puro-GFP-Mps1-WT or pBabe-puro-GST-BRAFV600E and/or pBabe-puro-GFP-Mps1-WT, followed by Western blot to detect Mps1 and p-ERK expression. The melanoma cells harboring BRAFWT and BRAFV600E genotype were infected with pSUPER-Mps1 retrovirus to knockdown the endogenous Mps1 protein, followed by Western blot to detect Mps1 and p-ERK expression. Meanwhile, melanoma cells harboring BRAFV600E genotype were infected with pBabe-puro-GFP-Mps1 and Western blot was performed to detect Mps1 and p-ERK expression.

RESULTSIn melanoma cells harboring BRAFWT genotype and transfected with pBabe-puro-GST-BRAF-WT and pBabe-puro-GFP-Mps1-WT, phospho-ERK levels were notably reduced as compared to either negative control or empty vector. However, cells transfected with pBabe-puro-GST-BRAFV600E and pBabe-puro-GFP-Mps1-WT, phospho-ERK levels did not change significantly compared with either negative control or empty vector. Knockout of Mps1 in BRAF wild-type cell lines led to an increased ERK activity. However, there was no significant change of ERK activity in BRAFV600E cell lines in the absence of Mps1. The expression of p-ERK in BRAFV600E mutant cell lines infected with pBabe-puro-GFP-Mps1-WT did not show any significant difference from either negative control or empty vector.

CONCLUSIONSBased on these findings, it suggests that there exists an auto-regulatory negative feedback loop between the Mps1 kinase and BRAFWT/ERK signaling. Oncogenic BRAFV600E abrogates the regulatory negative feedback loop of Mps1 on the MAPK pathway.

Cell Cycle Proteins ; metabolism ; Cell Line, Tumor ; Humans ; MAP Kinase Signaling System ; Melanoma ; genetics ; metabolism ; Mutation ; Phenotype ; Protein-Serine-Threonine Kinases ; metabolism ; Protein-Tyrosine Kinases ; metabolism ; Proto-Oncogene Proteins B-raf ; metabolism ; Signal Transduction ; Transfection

Objective To study the clinical value of enhanced recovery after surgery (ERAS) in the perioperative treatment of type Ⅰ (Todami,1975) biliary dilatation (BD) of children.Methods To retrospectively analyze the data of children with type Ⅰ BD who were treated in the General Surgery Department of Zhengzhou Children's Hospital from June 2014 to May 2018.A total of twenty children with type Ⅰ BD treated with ERAS and 20 children treated with the traditional method in our department were selected in this study using the random number table method.Postoperative indicators (including operation time,first defecation time,changes in amylase in blood and abdominal cavity exudates,length of hospital stay,and hospitalization fee) and relevant postoperative complications (including sore throat,nausea and vomiting,urethral pain,upper respiratory tract infection,incision wound infection,adhesive intestinal obstruction,anastomotic leakage and pancreatic fistula) of the ERAS group and the control group were compared.Results The first defecation time,length of hospital stay and hospitalization fee were significantly lower in the ERAS group than the control group (all P ＜ 0.05) [first defecation time (1.98 ± 0.25) d vs.(2.25 ± 0.31) d;length of hospital stay (6.91 ± 1.25) d vs.(9.95 ± 1.53) d;hospitalization fee (23.32 ± 2.25)thousand yuan vs.(25.99 ±3.10) thousand yuan].Moreover,the incidences of sore throat,nausea and vomiting,urethral pain and upper respiratory tract infection were significantly lower in the ERAS group than the control group (all P ＜ 0.05) [the incidences of sore throat (5.0％ vs.45.0％);the incidences of sickness and vomiting (5.0％ vs.30.0％);the incidences of urethral pain (5.0％ vs.45.0％);the incidences of upper respiratory tract infection (5.0％ vs.40.0％)].On the other hand,there were no significant differences in the mean operation times,changes in amylase levels in the blood or abdominal cavity exudates,incision wound infection,and incidences of adhesive intestinal obstruction,anastomotic leakage and pancreatic fistula (all P ＞ 0.05).Conclusions ERAS for type Ⅰ BD surgery was safe and reliable in children.It effectively promoted recovery of postoperative gastrointestinal function and reduced the incidence of complications.