Objective To analyze the differences in clinical characteristics and risk factors in patients with diastolic heart failure and systolic heart failure. Methods A total of 2 088 patients with heart failure were divided into two groups, diastolic heart failure group (EF≥0.45,n=1 356) and systolic heart failure group (EF<0.45,n=732), according to ejection fraction (EF). The clinical features and related factors affecting the two types of heart failure were compared between two groups. Results There were higher age, higher proportion of women and higher proportion of hypertensive patients in dia?stolic heart failure group than those of systolic heart failure group, but lower rates of hypoalbuminemia, anemia, renal insuffi?ciency and hyperuricimia. There was higher incidence of functional class I and II in diastolic heart failure group. And com?pared with systolic heart failure group, there were higher levels of systolic blood pressure, albumin, prealbumin, cholesterol, sodium and serum chloride in diastolic heart failure group, but lower levels of heart rates, creatinine, blood uric acid, potassi?um and brain natriuretic peptide. Compared with systolic heart failure group, there were lower left ventricular end diastolic volume (LVEDV) and left ventricular end systolic volume (LVESV) in diastolic heart failure group. And there were lower RAS blocker andβ-blocker usage, higher statin usage in diastolic heart failure group. Logistic regression analysis showed that gender and hypertension were significantly correlated with diastolic heart failure, and hypoalbuminemia and hyper?uricimia were significantly correlated with systolic heart failure. Conclusion Our results show that there are differences in clinical features and risk factors in patients with diastolic heart failure and systolic heart failure. We should take the differ?ent treatment and prevention programs for the two kinds of heart failures.

Objective To investigate the effect of cocaine-amphetamine-regulated transcript peptide (CART) on the content of 4-hydroxy-2-noneral (HNE) and infarct volume after cerebral ischemia/reperfusion in mice.Methods A total of 96 healthy male mice were randomly divided into four groups:ischemia/reperfusion (n =27),CART (n =27),normal saline control (n =27) and sham operation (n =15) groups.A middle cerebral artery occlusion (MCAO) model was induced.Two hours after MCAO,CART 55-102 and equivalent normal saline were injected respectively via the tail veins of mice in the CART group and the normal saline control group,and then they were injected every other 24 hour.The neurological scores,infarct volume and the HNE content of lipid metabolism of oxidative stress were performed and detected respectively at 12,24,48 and 72hours after reperfusion.Results CART could significantly improve the neurological deficit scores (all P ＜0.05) and reduce infarct volume (all P＜0.05) at different time points after ischemia/reperfusion.The content of HNE was upregulated (all P＜0.05) at different points after referfusion.CART could significantly down-regulate the increased HNE levd in brain after ischemia (all P＜0.05).Conclusions CART may protect ischemic brain injury in mice by inhibiting lipid peroxidation.

Objective Toinvestigatetheclinicalsignificanceofplasmamatrixmetalloproteinase9 (MMP-9)intheformationofdelayedcerebraledemaafterintracerebralhemorrhage.Methods The clinical data of 107 patients with spontaneous intracerebral hemorrhage treated with conservative medical treatment were analyzed retrospectively. According to the clinical features and imaging changes,they were divided into either a delayed cerebral edema group (case group n=39)or a non-delayed cerebral edema group (control group n =68 ). The plasma MMP-9 level was detected with enzyme-linked immunosorbent assay within 24 h after onset. The patients performed head CT scan again at day 7 and 14 after admission. The changes of hematoma and edema volume were detected. All the possible factors associated with the formation of delayed cerebral edema were firstly analyzed by the univariate analysis. Univariate analysis showed that the variables with significant differences were enrolled into multiple logistic regression analysis. Results TheplasmaMMP-9levelofthedelayedbrainedemagroupwassignificantlyhigherthanthatof the control group,they were 189 ± 51 and 118 ± 27 mg/L respectively (P<0. 01). The result of univariate analysis showed that age,history of smoking,blood glucose level,baseline hematoma volume,and National Institute of Health stroke scale (NIHSS )score on admission might be associated with the formation of delayed cerebral edema after intracerebral hemorrhage. Logistic regression analysis showed that MMP-9 level (OR,9. 745,95%CI 6. 754-15. 466,P<0. 01),baseline hematoma volume (OR,2. 411,95%CI 1. 190-2. 728,P =0. 018),blood glucose level on admission (OR,1. 327,95%CI 1. 133 -1. 850,P =0.004),and NIHSS score (OR,1. 867,95%CI 1. 272-2. 364,P=0. 020)were the independent risk factorsfortheformationofdelayedcerebraledemaafterintracerebralhemorrhage.Conclusion Theamount of bleeding,NIHSS score,and hyperglycemia are the risk factors for the formation of delayed cerebral edema in patients with spontaneous intracerebral hemorrhage,while high MMP-9 level on admission indicated that the risk of the formation of delayed cerebral edema is high.

Objective To assess the safety of early subcutaneous injection of a low-dose low molecular weight heparin (LMWH) nadroparin for prevention of deep vein thrombosis (DVT) in patients with spontaneous intracerebral hemorrhage (sICH).Methods The patients with sICH who early using nadroparin or lower limb intermittent pneumatic compression (IPC) for prevention of DVT were enrolled.A nadroparin group continuously injected nadroparin 0.4 ml/d subcutaneously for 10 days at day 4 after admission and an IPC group used lower limb IPC.Head CT was reexamined and hematoma volume changes were evaluated at day 3,5,and 14 after admission.The hemorrhagic events during the course of treatment were documented,and the lower limb DVT was examined by color Doppler sonography.Results A total of 94 patients with acute sICH (n =41 in the nadroparin group,n =53 in the IPC group) who early use of nadroparin or IPC for prevention of DVT were enrolled.Fourteen patients had lower limb DVT,5 (12.2％) of them were in the nadroparin group and 9 (17.0％) of them were in the IPC group.However,there was no significant difference in the incidence of DVT between the two groups (x2 =0.418; P =0.518).During the treatment,no patient experienced increased intracranial hematoma and rebleeding.Conclusion Early subcutaneous injection of low-dose nadroparin for the prevention of DVT in patients with sICH is safe.

Abstrsct:Objective To analyze the correlation of hyponatremia with chronic heart failure (CHF) and the prognostic analysis of CHF. Methods Patients with CHF (n=507) and healthy adult (n=212) were included in this study. The general data of the two groups were analysed. The index which was statistically significant was indicated as independent variables. Multivariate logistic analysis was used to analysis the correlation between serum sodium and CHF. The relationship between serum sodium and the prognosis of CHF include mortality and rate of readmission were included in follow-up study. The prognostic correlation of serum sodium with BNP (brain natriuretic peptide), heart failure with preserved ejection fraction (HFpEF, LVEF≥0.45) and heart failure with reduced ejection fraction (HFrEF, LVEF<0.45) were all analyzed. Results In?dicators such as sex, smoking history showed no statistical significance between two groups (P>0.05) while other indicators like age, hemoglobin, serum sodium presents statistical significance (P < 0.05). Serum sodium is the protective factor for CHF. Brain natriuretic peptide (BNP) concentration in hyponatremia group is significantly higher than that in normal serum sodium group (P<0.05). HFpEF and HFrEF were of no significant difference in these two groups. For patients with CHF, the mortality in hyponatremia group is significantly higher than that in normal serum sodium group (P<0.05), but readmission rates were not significantly different (P>0.05);While for patients with HFpEF, the mortality and the readmission rates were both significantly different (P<0.05). Conclusion Serum sodium is the protective factor in CHF, the patients with hypona?tremia have higher readmission rate and death rate in HFpEF background.

Wnt signaling is implicated in the control of cell growth and differentiation during neural stem cell(CNS) development.Wnt3a, one of wnt gene family members, has effect on regeneration neurospheres and differentiation into neurons.Wnt3a inhibits regeneration of neurospheres, and promotes its differentiation. In vitro neurosphere was cultured in a serum-free defined medium DMEM/F12 supplemented with bFGF and EGF. Dissociated cells were plated onto poly-d-lysine-coated coverslips and propagated in medium containing recombined Wnt3a-adenovirus. Plenty of Nurr1 were detected by RT-PCR after 3 days. Wnt3a combined AA would improve NSC differentiation into dopaminergic (DA) neuron. The quantity of DA neuron is obviously more than the AA alone group's. Moreover, the expression of TH mRNA is 1.86 fold in Wnt3a combined AA group. Induced cells were immunostained for TH and DAT. The proportion of TH-positive was (37.42 ? 2.54) % (P

Objective To analyze the thickness of cornea and corneal epithelium in healthy subjects by optical coherence tomography angiography (OCTA).Methods Totally 100 healthy subjects aged between 20 and 30 years were analyzed by OCTA technique.Using AngioVue OCTA system of retinal imaging mode,and using SSADA algorithm for imaging,the cornea and the corneal epithelium in the central corneal diameter range of 9 mm were measured.The differences of corneal and corneal epithelial thickness in different gender regions were compared.Results In the male and female group,the corneal central total thickness were (559.92 ±33.26) μm and(540.06 ±31.63)μm,and the corneal epithelial thickness were(57.78 ±4.88) μm and(56.88 ±4.57) μm,The total central corneal thickness and central corneal epithelial thickness of the male were greater than those of the female,the difference was statistically significant (t =3.06,2.10;all P ＜ 0.05).The cornea of male was the thickest at S5,S7 and SN9,there were significant differences at S5 and S7 compared with female (t =2.93,2.83;all P ＜ 0.05);The female cornea was the thickest at S5,SN7 and SN9,and the difference was significant at S5 compared with male.The cornea of male subjects was the thinnest at IT,which was statistically significant only at IT5 compared with female subjects in the same area (t =2.02,P ＜ 0.05);The cornea of female subjects was the thinnest at T5,IT7 and T9,which was statistically significant only at T5 and T9 compared with male subjects in the same region (t =2.63,2.20;all P ＜ 0.05);There was significant difference in corneal thickness between male and female at ST (t =3.1 1,2.79,2.33;all P ＜ 0.05).The corneal epithelium was the thickest at IT5,I7,and I9,and the lowest at S5,S7 and S9,and there was no significant difference compared with female in the same region (all P ＞ 0.05).The corneal epithelium of female at the IT5,T7,N9 were the thickest,SN5,S7,S9 were the thinnest;Except for M2 and SN5,there was no significant differences in corneal epithelium between male and female groups (all P ＞ 0.05).Corneal central epithelium accounted for the largest percentage of total corneal thickness,and gradually decreased from inside to outside.Conclusion OCTA can be used to measure the thickness of corneal and corneal epithelial regions.

Duchenne muscular dystrophy (DMD) is a severe muscular genetic disorder,which is caused by a mutation in the DMD gene encoding the dystrophin protein.The clinical manifestation of DMD is the progressive muscular dystrophy.Myostatin is a negative regulator of skeletal muscle growth and development.In recent years,it has received extensive attention in the treatment of muscle diseases.This review focuses on the structural and activity of myostatin,its regulation of skeletal muscle growth and noval approaches to Myostatin inhibitor in the treatment of DMD.

Objective: To observe the effect of crotonaldehyde long-term exposure on kidney injury in male rats, and to explore the specific mechanism of toxic action. Methods: 32 specific pathogen free healthy adult male wistar rats were randomly divided into 4 groups with 8 rats in each group: high-, moderate-, low-dose groups and a control group. Rats were treated with 8.5, 4.5, 2.5 and 0.0 mg/kg body weight crotonaldehyde by gavage, once a day for consecutive 128 days. After the last treatment, they were sacrificed and separated bilateral kidney. Kidney organ coefficients were calculated and the histopathology changes in kidney were observed by HE staining. The activities of malondialdehyde (MDA) , superoxide dismutase (SOD) , glutathion peroxidase (GSH-Px) and the levels of malaondialdehyde uric acid (UA) , urea nitrogen (BUN) , creatinine (CR) in serum were determined in the same time. Moreover, the levels of interleukin (IL) -6, 8, interferon (IFN) -γ and tumor necrosis factor (TNF) -α in kidney were determined by enzyme linked immunosorbent assay. Results: Bilateral kidneys in the 8.5 mg/kg group were reduced in size and dark in color. Under the microscope, the major pathology changes of kidneys could be summarized as summarized as protein cast renal tubule, inflammatory cells and lymphocytes infiltration among kidney cortex. Compared with the control group, the weight gain of rats in 8.5 mg/kg group were smaller, and the weight and organ coefficient of kidney in each groups were significant decreased (P<0.05) . With the increasing dosage of crotonaldehyde, the serum BUN and UA levels in 8.5, 4.5 mg/kg groups, CR level in 8.5 mg/kg group were significant increased (P<0.05) .Compared with the control group, the serum MDA level in 8.5 mg/kg group was significant increased (P<0.05) . However, serum SOD activity in 8.5 mg/kg group and GSH-PX activity in 8.5, 4.5 mg/kg groups was significant decreased (P<0.05) . With the increasing dosage of crotonaldehyde, there are upward trend in the kidney IL-6, IL-8, TNF-α, IFN-γ, β-2 microglobulin levels. Compared with the control group, IL-6, TNF-α, IFN-γ, β-2microglobulin levels in 8.5, 4.5 mg/kg groups and IL-8 level in 8.5 mg/kg group in kidney were significant increased (P<0.05) . Conclusion Crotonaldehyde could develop the inflammatory factors levels and change the oxidation balance condition in the kidney of male rats, causing the inflammatory and oxidative injures of renal tissues.

Objective: To put forward the suggestion of the occupational contact limit of tributyl phosphate in the air of the workplace. Methods: Data of production and usage, workers' basic information, occupational history, and physical examinations were collected, and the environmental and individual levels of exposure were monitored using fixed-point and individual sampling. The results of the questionnaire and health examination were statistically analyzed using exact probability method of Fisher in the workers exposed to tributyl phosphate and the control group. Results: The results showed that tributyl phosphate was widely distributed in the workplace of production and using enterprises, and the concentration of tributyl phosphate in packaging area was highest at 2.47 mg/m³, and in feeder nose was highest at 2.13 mg/m³. The discomfort symptoms were classified and results showed that tributyl phosphate exposure group of 136 people, all symptoms of 128 people, accounting for 94.44% of the total, the remaining 5.56% of the staff report had psychiatric symptoms or lethargy and irritability skin itching, the control group had no symptoms. There is or not discomfort symptoms in the tributyl phosphate exposure group and the control group was compared with the exact probability of Fisher, and the difference was statistically significant (P<0.05) . The results of healthy physical examination of workers exposed to tributyl phosphate and control group were statistically analyzed by the exact probability method of Fisher. The results showed that there was no significant difference in the results of routine internal medical examination, nervous system examination, skin examination, five senses examination, blood routine, urine routine, lung ventilation, and X ray chest fluoroscopy between the tributyl phosphate exposure group and the control group (P<0.05) . Conclusion The workplace permissible time-weighted tributyl phosphate and short-term exposure limit concentrations in China were set at 2.5 mg/m³ and 5 mg/m³, respectively.