Objective To investigate serum complement 1q (C1q) levels in the patients with coronary artery disease (CAD),and evaluate its clinical values in predicting and discriminating acute coronary syndrome (ACS) and stable coronary artery disease (SCAD).Methods A total of 52 ACS patients,66 SCAD patients and 54 healthy controls were enrolled in this study.Their serum C1q and oxidized low-density lipoprotein (ox-LDL) levels were detected by an immune turbidimetric method and an enzyme linked immunosorbent assay,respectively.Their serum total cholesterol,triglyceride,high-density lipoprotein cholesterol and low-density lipoprotein cholesterol levels were also determined.Then,the Gensini scores in CAD patients were calculated,and the clinical values of Clq in predicting and discriminating ACS and SCAD were evaluated by stepwise multiple linear regression analysis and Logistic regression analysis.Results Serum C1q and ox-LDL levels in ACS (C1q:t =4.405,P＜0.001;ox-LDL:Z=5.941,P＜0.001) and SCAD (C1q:t =2.320,P=0.022;ox-LDL:Z =4.119,P ＜0.001) patients were significantly higher than those in healthy controls.Moreover,serum C1q (t =2.344,P =0.021) and ox-LDL (Z =2.166,P =0.030) levels in ACS patients were significantly higher than that in SCAD patients.Serum C1 q levels were positively correlated with serum ox-LDL (r =0.246,P =0.028) and TG (r =0.232,P =0.002) levels and Gensini scores (r =0.341,P =0.020) in ACS patients.The stepwise multiple regression analysis showed that serum ox-LDL levels were still independently correlated with serum C1 q levels in ACS patients (β =0.676,P =0.045,adjusted R2 =0.380) after adjusting for age,gender and other biochemical markers.The Logistic regression analysis showed that the increased serum C1q and ox-LDL levels were closely related to the occurrence of ACS (C1q:OR =1.05,95％ CI =1.03-1.08,P ＜ 0.001;ox-LDL:OR =1.18,95％ CI =1.08-1.29,P ＜0.001) and SCAD (C1q:OR =1.04,95％CI=1.01-1.06,P=0.003;ox-LDL:OR=I.11,95％CI=1.03-1.18,P=0.004),and that they could discriminate ACS and SCAD (C 1 q:OR =1.01,95 ％ CI =1.00-1.03,P =0.022;ox-LDL:OR =1.06,95 ％ CI =1.01-1.12,P =0.023).Conclusion Serum C1q levels increase significantly in CAD patients,and that of ACS patients is significantly higher than SCAD patients.In ACS patients,serum C1q levels are independently correlated with ox-LDL levels.Serum C1q levels may be served as a novel biomarker for the prediction and discrimination of ACS and SCAD.

Objective To investigate the value of electrocardiographic parameters in assessing severe coronary artery lesions in patients with coronary artery disease.Methods A total of 364 patients with coronary heart disease admitted to the Second Affiliated Hospital,Zhengzhou University from January 2022 to September 2023 were selected as the subjects.The patients were divided into severe lesion group(n=123)and non-severe lesion group(n=241)based on the Gensini score.The two groups were compared in terms of baseline data and electrocardiographic parameters.Logistic regression was used to analyze the factors affecting severe lesions and the efficacy of ECG parameters assessment.A column-line plot of ECG parameters to assess severe lesions was created.The joint incremental value of ECG parameters and the area under the ROC curve for assessing severe lesions were calculated.Results The patients in the severe lesion group were elder in age and they showed significantly higher rates in creatine kinase isoenzyme,amino-terminal brain natriuretic peptide precursor,QRS time frame,frontal QRS-T pinch angle,smoking,hypertension,diabetes mellitus,pathologic Q waves,left ventricular hyper voltage,fragmented QRS waves,and significantly lower rates in low HDL cholesterol and ejection fraction,as compared to the non-severe lesion group(all P<0.05).Logistic regression analysis showed that pathological Q waves(OR=3.71,95%CI:1.93～7.15,P<0.001),left ventricular hyper voltage(OR=5.05,95%CI:1.66～15.41,P=0.004),fragmented QRS waves(OR=2.17,95%CI:1.14～4.11,P=0.018),and frontal QRS-T pinch angle(OR=1.01,95%CI:1.00～1.02,P=0.023)were the factors for assessing severe lesions.The incremental value of combined ECG parameters for severe lesions:C-statistic 0.09(95%CI:0.02～0.16,P=0.009),NRI 0.37(95%CI:0.20～0.55,P<0.001),and IDI 0.12(95%CI:0.08～0.17,P<0.001).The ROC curves showed an AUC of 0.79(95%CI:0.74～0.84,P<0.001),a sensitivity of 63.41%,and a specificity of 85.89%for the combined assessment of severe lesions by ECG parameters.Conclusion The combined observations of electrocardiographic parameters such as pathologic Q waves,left ventricular hyper voltage,fragmented QRS waves,and frontal QRS-T pinch angle have an affirmativeclinical value in the assessment of severe lesions.

Spontaneous bacterial peritonitis (SBP) is a common complication in patients with liver cirrhosis, and it is also an important inducement for patients with liver cirrhosis to develop into an acute decompensated stage, and thereby has become the concern and difficulties of clinical treatment. SBP pathogenic bacteria varies with time and region, and the confirmed detection rate of Gram-positive bacteria and multidrug-resistant bacteria has been increasing year by year. Therefore, whether the antimicrobial treatment plan based on the previous guidelines is still applicable remains to be further explored. This paper focuses on introducing the pathogenic bacteria characteristics for cirrhosis combined with SBP in different study populations, different regions, different time, and different infection modes, and further summarizes empirical antimicrobial treatment plan according to the changes of SBP pathogenic bacteria, in order to provide theoretical basis for clinical treatment.

Objective:To retrospectively analyze the characteristics and influencing factors of liver function changes in 111 elderly patients with COVID-19 pneumonia.Methods:111 elderly patients with COVID-19 admitted to the Department of Infectious Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology from February 5 to March 3, 2020 were enrolled. According to the severity of disease and liver function condition, they were divided into severe group ( n=40), normal group ( n=71), abnormal liver function group ( n=86) and normal liver function group ( n=25). The indexes related to liver function changes [total bilirubin (TBil), alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP) and γ-glutamyl transferase (GGT)] and related influencing factors were analyzed. Results:Among 111 cases, 86 (77.5%) had abnormal liver function of varying degrees, and 28 (25.2%) had liver injury. The abnormal rates of TBil, AST, ALP and GGT were significantly higher in the severe group than normal group ( P<0.05). There were no significant differences in age, ribavirin, glucocorticoid and the application of lopinavir-ritonavir tablets between the abnormal liver function and the normal group ( P>0.05). The proportion of male was significantly higher in the abnormal liver function than normal liver function group ( P<0.05). Conclusion:Elderly COVID-19 patients have a higher proportion of abnormal liver function, and patients in the severe group are more likely to have higher level of TB, AST, ALP and GGT. The abnormal liver function may be related to the direct viral infection of the liver and the inflammatory immune response of the body after infection in elderly patients.

Background: Intestinal flora disorder plays an important role in the pathogenesis of chronic constipation. Either microbial agents or fecal microbiota transplantation has therapeutic effect on chronic constipation by regulating the intestinal flora. Aims: To study the characteristics of intestinal flora structure in elderly chronic constipation patients. Methods: Thirty elderly patients with chronic constipation from January 2019 to December 2019 at Nanjing Central Hospital were enrolled, and 30 elderly healthy subjects were served as controls. Stool was collected, and 16S rRNA high-throughput sequencing method was used to analyze the structure of intestinal flora. Results: Alpha diversity analysis showed that there were no significant differences in Ace, Chao, Shannon and Simpson indices between chronic constipation group and healthy control group. Twenty dominant genera accounting for more than 80% of all genera were identified in the two groups, Bacteroides was the most abundant genus. Beta diversity analysis showed that the species composition between the two groups was different, the characteristics of the two groups were not similar (R=0.098, P=0.001). Relative abundances of Prevotella, Faecalibacterium and Lachnospira were higher in the healthy control group, while Ruminococcus, Shigella, Parabacteroides and Alistipes were higher in chronic constipation group. Numbers of species with significantly different relative abundance in healthy control group and chronic constipation group were 25 and 2, respectively. Compared with healthy control group, the abundance of Alistipes, Oscillospira, Ruminococcus and Parabacteroides were higher in chronic constipation group (P< 0.05), while Megasphaera was lower (P< 0.05). Conclusions: There is no difference in the diversity of intestinal flora between elderly chronic constipation patients and elderly healthy controls, however, significant difference is detected in species composition. Therefore, targeting at modifying intestinal flora may be a promising therapeutic strategy for chronic constipation.