Objective To observe the influences of Yangxinshi pill on ET, NO, CRP in patients with angina pectoris belonging to manifestation of Qi-deficiency and blood stagnation. Methods 78 patients with angina pectoris were randomly divided into two groups. 40 patients in treatment group were treated with Yangxinshi pill, 4 pills once, three times a day 8 weeks. 38 patients in control group were treated with isosorbide mononitrate 8 weeks. The symptoms and the ET, NO, CRP level before and after treatment were recorded. Results Obvious drop of ET, NO, CRP were observed after treatment in the treatment group. The level of ET was reduced from (67.47?15.72)pg/mL to (37.97?7.82) pg/mL. The level of NO was increased from (78.24?13.81)?mol/mL to (96.25?12.72)?mol/mL. The level of CRP was reduced from (5.31? 2.02)mg/L to (3.42?2.17) mg/L. There was a significant difference between the two drugs (P 0.05). The total efficacy rate in improving symptom was 95%. There was a significant difference between the two drugs (P

Objective: To evaluate the diagnostic performance of conventional ultrasound, compression elastography (CE) and acoustic radiation force impulse imaging (ARFI) in diff erential diagnosis of benign and malignant breast tumors. Methods: A total of 98 patients with liver lesions were included in the study. The images of conventional ultrasound, CE and the values of virtual touch tissue quantiifcation (VTQ) of breast lesions were obtained. hTe diagnostic performance of conventional ultrasound, CE and ARFI were assessed by using pathology as the gold standard, and then evaluate the diagnosis effciency of these three approaches in differential diagnosing benign and malignant breast tumors. Results: The specificity, sensitivity and accuracy in the diagnosis of malignant breast tumors for conventional ultrasound were 80.0%, 81.1% and 81.7%, respectively, whereas for CE elastic score were 85.7%, 86.7% and 86.3%, respectively. With a cutoff value of 3.71 for the SR, the sensitivity, speciifcity, accuracy in diagnosis of malignant breast tumors were 97.1%, 83.3% and 88.4%, respectively. With a cutoff value of 3.78 m/s for VTQ, the sensitivity, speciifcity, accuracy in diagnosis of malignant breast tumors were 94.3%, 91.7% and 92.6%, respectively. The difference in diagnosis efficiency among ARFI, CE and conventional ultrasound in differential diagnosis of benign and malignant breast tumors was signiifcant (P<0.05). Conclusion: Conventional ultrasound, CE and ARFI are all useful for the differential diagnosis of benign and malignant breast tumors. But the diagnosis effciency of ARFI is superior to CE and conventional ultrasound. The three approaches can help each other in differential diagnosis of benign and malignant breast tumors.

Objective: To summarize the experience for treating pulmonary venous obstruction in patients after total anomalous pulmonary venous connection (TAPVC) operation. Methods: A total of 16 patients with post-TAPVC pulmonary venous obstruction in our hospital from 2011-01 to 2015-12 were retrospectively analyzed including10 male. All patients received echocardiography, electrocardiogram and chest X-ray examinations at pre-discharge, 1, 3, 6, 12 and 24 months post-operation. Pulmonary venous obstruction was diagnosed by echocardiography measured pulmonary vein (PV) lfow speed>2m/s. The time of re-operation was determined by clinical manifestations as recurrent heart failure and growth retardation; sutureless technique and conventional patch enlarge technique were used in the second operation. Results: No one lost contact in all 16 patients. There were 7/16 patients with anastomotic stenosis (1 mixed type, 3 infracardiac type, 2 supracardiac type and 1 cardiac type), 7 patients with one PV stenosis, 2 with two PV stenosis and nobody with three or more PV stenosis. Based on per-operative Darling classiifcation, there were 2 patients with mixed type, 5 with infracardiac type, 5 with supracardiac type and 4 with cardiac type. Most post-operative PV stenosis occurred at 3-6 months after the surgery. There were 5 patients receive re-operation, 4 with sutureless technique, 1 with conventional patch enlarge technique and all of them suffered from anastomotic stenosis. 2 patients died and 3 were followed-up. Conclusion: Post-operative anastomotic stenosis was the main indication for re-operation in patients after TAPVC; early operation could better improve the clinical condition.

Objective:To investigate the effect of hemoglobin (Hb) volatility on cardiovascular prognosis in peritoneal dialysis (PD) patients.Methods:Retrospective cohort study was designed. Patients undergoing stable PD for more than 3 months and followed up regularly for at least 1 year were enrolled from May 1, 2013 to October 31, 2014 in the General Hospital of Ningxia Medical University. According to the Hb variation based on the mean changes in Hb standard deviation at 1 month, 3 months, 6 months, 12 months over baseline Hb, all patients were divided into low volatility group (≤10 g/L), moderate volatility group (>10-20 g/L) and high volatility group (>20 g/L), and baseline information were compared among these groups. Kaplan-Meier survival analysis and Cox regression equation were used to analyze the relationship between Hb variation and cardiovascular mortality and all-cause mortality. Besides, the patients were divided into qualified group (Hb≥110 g/L) and substandard group (Hb<110 g/L) by the Hb level at the study endpoint (cardiovascular death and all-cause death) according to KDIGO guidelines and relevant literature. Cox regression analysis was used to analyze the relationship between Hb variation and cardiovascular death in qualified group or substandard group. Multivariate linear regression analysis was used to analyze the related factors of Hb fluctuation in PD patients.Results:A total of 267 patients were enrolled. There were 160 males (59.93%) in this study. The age was (52.66±13.72) years old, and the median dialysis age was 37(21, 61) months. The patients' baseline Hb (before dialysis) was (80.16±14.89) g/L and at the end of the study Hb was (105.34±22.08) g/L. Body mass index and baseline Hb levels in the high volatility group were lower than those in low volatility group and moderate volatility group (all P<0.05). Both moderate and high volatility groups had lower estimated glomerular filtration rate than that in low volatility group, and high volatility group had higher urea nitrogen level than that in low volatility group (all P<0.05). The amount of erythropoietin usage in the high volatility group was higher than that in moderate volatility group ( P<0.05). The Kaplan-Meier survival analysis results showed that there was no significant difference in survival rate for all-cause death (Log-rank χ2=0.735, P=0.693) and cardiovascular death (Log-rank χ2=2.961, P=0.228) in different Hb volatility groups. Cox regression analysis showed that after adjusting for age, sex, serum creatinine, and blood albumin, higher Hb volatility was associated with a lower risk of cardiovascular death ( HR=0.972, 95% CI 0.947-0.999, P=0.040). After adjusting for related confounding factors, higher Hb volatility was still a protective factor for cardiovascular death in the substandard group ( HR=0.946, 95% CI 0.903-0.992, P=0.022), but there was no significant correlation between Hb fluctuation and all-cause death. Multivariate linear regression analysis results showed that the fluctuation level of Hb was positively correlated with Kt/V ( B=4.682, 95% CI 2.480-6.884, P<0.001) and erythropoietin dosages ( B=0.001, 95% CI 0-0.001, P=0.003), and negatively correlated with baseline Hb ( B=-0.554, 95% CI -0.651--0.457, P<0.001). Conclusions:High Hb variability is a protective factor for cardiovascular death in PD patients with lower Hb level (substandard Hb). Adopting a reasonable program to correct anemia timely to reach the standard level has a greater impact on reducing risk of cardiovascular death in PD patients than Hb variation in anemia treatment.

ABSTRACTOBJECTIVE To observe the effects of Buxin Ruanmai granules BXRM serum on AngiotensinⅡAngⅡ?in-duced oxidative damage related indicatorssuch as SODNADPH MDAp40phoxp47 phox and p67 phoxin HUVEC.METHODS Rats were randomly divided into normal groupValsartan group and BXRM groupeach group of 10and lavaged for 6 weeks.Drug serum were prepared from arterial blood.Then 10-6 mol/L Ang Ⅱ induced HUVEC damage and apoptosis mod-el of human umbilical vein endothelial cells was establishedand drug serum was used to intervene.SOD were determined by xanthinoxidase.NADPH was determined by ELISA.MDA was determined by thibabituric acid method.The expression of p40phoxp47phox and p67phox in cell membrane and cytoplasm of HUVEC were determined by Western blot.RESULTS After HUVECs were damaged by 10-6 mol/L Ang Ⅱthe content of SOD decreased NADPH and MDA increased and p40phoxp47phox and p67phox transferred to the membrane of HUVECs.Howeverthe content of SOD increasedNADPH and MDA de-creasedand p40phoxp47phox and p67 phox were inhibited to transfer to the membraneafter the medication of BXRM serum. CONCLUSION BXRM serum can inhibited the oxidation of AngⅡ induced HUVEC damage and prevent arteriosclerosis.

Objective To analyze the clinical manifestation and genetic testing in a patient with Adams-Oliver syndrome (AOS) and summarize clinical and genetic characteristics of the dedicator of cytokinesis (DOCK) 6 gene related AOS through reviewing related references.Methods Information of the proband who was hospitalized in Affiliated Children Hospital of Capital Institute of Pediatrics in October 2016 and her family members as well as their DNA samples were collected.The gene sequencing was performed using next generation sequencing technology.Using "Adams-Oliver syndrome"and "DOCK6" as key words,the relevant articles were searched from the Pubmed,China National Knowledge Internet and Wanfang databases and reports of 19 cases were reviewed.Results The proband is an eight months old girl.She presented with severe developmental delay,terminal transverse limb defects and visual loss after birth,and then suffered from tonic seizures and myoclonic seizures at two months old.By physical examination she was found to have esotropia and visual loss.The distal phalanx and nail of the right second-fourth fingers were absent,while the phalangette of the left second-fourth fingers and bilateral distal phalanges of toes were short with small nails attachment.Thyroid function test showed hypothyroidism.The ocular fundus examination showed the residual vitreous artery in the left eye and the retinal pigment degeneration in the right eye.CT scan showed multiple bilateral periventricular calcification and cranial magnetic resonance imaging showed bilateral periventricular lesion.Two heterozygous mutations were identified in DOCK6 gene:one was a known pathogenic mutation (p.L1064Vfs*60),and the other was a novel splice site mutation (c.873+ 1G＞A).By analyzing this case and reported 19 cases,the common performances of DOCK6 gene related AOS included terminal transverse limb defects (20/20),aplasia cutis congenita (18/20),ocular abnormalities (13/20),seizures (12/20),mental retardation (12/20),microcephaly (10/20),cardiovascular malformations (10/20),intrauterine growth retardation (6/20).The mutation of the DOCK6 gene was found to be dominated by frameshift mutation and splice site mutation.Conclusions If either terminal transverse limb defects or aplasia cutis congenita was detected in a patient,AOS should be under consideration.In addition,autosomal recessive inheritance,nervous system and eyes involvement will further indicate DOCK6 gene related AOS.

Objective:To find out the occurrence of anxiety and depressive symptoms, and the major risk factors, and the participation rate, as well as the experience of medical personnel who are involved in the intervention.Methods:Since January 2018, a pilot intervention had been carried out on pregnant women registered in the antenatal clinic. The Generalized Anxiety Disorder Scale and the Patient Health Questionnaires were used as screening tools for anxiety and depression symptoms, and risk factors were screened too. Interventions were carried out on the psychological moderate and high risk women by obstetric medical staff and mental health personnel. A qualitative interview was conducted on the intervention providers.Results:A total of 9 488 pregnant women were included, and the positive rate of moderate anxiety symptoms was 3.0%, the positive rate of severe anxiety symptoms was 1.4%; the positive rate of moderate depression symptoms was 18.1%, and the positive rate of severe depressive symptoms was 5.2%; the comorbidity rate of anxiety and depression symptoms was 3.4%. The first three risk factors for pregnant women with anxiety symptoms were: once had premenstrual stress symptom, excessive fear of fetal growth, previous abnormal maternal history; the first three risk factors for pregnant women with depressive symptoms: once had premenstrual stress symptom, previous abnormal maternal history, this pregnancy was cherished; the first three risk factors for pregnant women with moderate and above anxiety combined with depression were: once had premenstrual stress symptom, excessive fear of fetal growth, and fear the delivery process is not successful. Among the psychological moderate risk pregnant women, 19.1% participated in the midwife joint counselor clinic, and 1.7% participated in the obstetrician joint psychological specialist nurse clinic, 2.2% of the pregnant women with high risk participated in the psychological multidisciplinary consultation, and 1.7% referred to the psychiatric department. From the interviews, providers believed that it was necessary to further strengthen the ability of psychological intervention capacity, and the psychological screening tools needed to be improved, and the problems sought by pregnant women involved in physical, psychological and social aspects, and the influence of pregnant women's treatment compliance included multiple factors.Conclusions:The psychological health care service during pregnancy was feasible, but the screening scales needed further examination. The mental health care ability of obstetric medical staff needed to be strengthened, and the compliance of pregnant women with mental health services needed to be improved.

Objective:To explore the association of the impaired cognition and the deposition of β-amyloid (Aβ) in normal cognitive (NC) and mild cognitive impairment (MCI).Methods:From December 2018 to January 2021, 305 subjects (113 males, 192 females; age (64.0±7.7) years) who completed neuropsychological tests and MRI in Shanghai Sixth People′s Hospital, Shanghai Jiao Tong University and 18F-florbetapir (AV45) PET imaging in Huashan Hospital, Fudan University were retrospectively analyzed. The subjects were divided into MCI group and NC group based on neuropsychological tests, and each group was further divided into Aβ-positive and Aβ-negative based on PET imaging results. Independent-sample t test, Mann-Whitney U test and χ2 test were used to analyze the data. Results:There were 118 subjects in MCI group and 187 subjects in NC group. The Aβ-positive rate in MCI group (37.3%, 44/118) was higher than that in NC group (26.2%, 49/187; χ2=4.19, P=0.041). The assessment performances of MCI group in general cognitive function, memory function, language function and executive function were inferior to those of NC group ( t values: from -10.63 to -6.31, z values: from -11.01 to -6.03, all P<0.001). The Auditory Verbal Learning Test-Long Delay Recall (AVLT-LDR) score of Aβ-positive subjects was lower than that of Aβ-negative subjects in MCI group (1.00(0.00, 3.00) and 3.00(1.00, 4.00); z=-2.49, P=0.013). The Montreal Cognitive Assessment Basic (MoCA-B) score of Aβ-positive subjects was lower than that of Aβ-negative subjects in NC group (25.29±2.67 and 26.36±2.42; t=-2.61, P=0.010). Conclusion:Compared to Aβ-negative subjects, MCI patients with Aβ-positive perform worse on memory tests, and NC subjects with Aβ-positive perform worse on general cognitive function.

Objective:To isolate and identify SARS-CoV-2 epidemic strains and analyze the sequence characteristics of the virus strains following serial passages.Methods:Eleven nasopharyngeal swabs positive for SARS-CoV-2 antigen were collected from December 2022. Quantitative real-time PCR was used to detect SARS-CoV-2 nucleic acid, and positive specimens were inoculated onto Vero cells for virus isolation. The isolated strains were identified by Western blot and indirect immunofluorescence assay. The morphology of the isolated strains was observed using transmission electron microscopy. Nucleic acid was extracted from the isolates and passaged viruses for further sequencing and analysis.Results:All 11 specimens tested positive for SARS-CoV-2 using quantitative real-time PCR. SARS-CoV-2 strains were successfully isolated from seven specimens, and could be adaptively cultured, passaged, and expanded on Vero cells, achieving a peak titer exceeding 10 6.25 50% cell culture infectious dose (CCID 50)/ml. Western blot and indirect immunofluorescence results showed that the isolates could be specifically recognized by monoclonal antibodies and convalescent serum against SARS-CoV-2. Transmission electron microscopy revealed oval-shaped viral particles with diameters of approximately 100 nm. Next-generation sequencing of the viral isolates demonstrated a sequence homology greater than 99.50% with the Wuhan-Hu-1 reference strain (NC_045512) and 99.98% among the seven isolated strains, and all of the isolates belonged to the Omicron BF.7 variant. Sequence analysis after continuous passage and plaque purification of the BJ-NVSI-20230005 isolate showed that compared with passages 1-3, passages 4-6 had one nucleotide site mutation (C→T) in the ORF1ab gene and a deletion of 3 bp in the E gene, which resulted in a change from leucine to phenylalanine and the deletion of valine, respectively. Polymorphisms were observed in the sequences of plaque-purified clones. Conclusions:The seven successfully isolated SARS-CoV-2 strains all belong to the SARS-CoV-2 BF.7 variant, which is consistent with the prevalence trend in mainland China in December 2022.