Objective To analyze the relationship between serum intermedin ( IMD ) , CystatinC ( CysC ) and fibro-blast growth factor23(FGF23) with hypertensive left ventricular hypertrophy (HLVH). Methods Serum IMD,Cy-sC and FGF23 levels of 30 patients with essential hypertension(EH group),30 hypertensions with LVH(HLVH group)and 30 healthy subjects(control group)were detected by enzyme-linked immunosorbent assay(ELISA). All the subjects did UCG for LVMI. Results LVMI and serum IMD,CysC,FGF23 levels were significantly higher in EH group than in control(P<0. 05),higher in HLVH group than in EH and control groups(P<0. 05). In the pa-tients with hypertension LVMI and serum IMD,CysC,FGF23 levels were increasing with increased blood pressure levels. LVMI level was positively correlated with serum IMD,CysC and FGF23 levels(r=0. 769,0. 517,0. 700;P<0. 01). Line to LVMI level as the dependent variable,multiple stepwise regression analysis showed that:systolic blood pressure( SBP) ,IMD,CysC,homocysteine( Hcy) ,FGF23 entered regression equation. They were independent risk factors for LVMI. Conclusion Serum IMD, CysC and FGF23 levels are closely associated with EH and HLVH. They may participate in the development of EH and affect the process of HLVH. Combined-detection of ser-um IMD,CysC and FGF23 can be used as a reference index for the condition and prognosis of HLVH.

Objective To investigate the effect of complete revascularization strategy on the prognosis of elderly patients suffering from acute ST-segment elevated myocardial infarction(STEMI)complicated with multivessel disease(MVD). Methods A total of 390 elderly patients(over 60 years old)suffering from acute STEMI with MVD treated by clinical revascularization administration were enrolled for the study and divided into complete revascularization group(CR group,n=139)and non-complete revascularization group(NCR group,n=251). The effect of complete re-vascularization strategy on the prognosis was then analyzed by COX regression analysis. Results Compared with the NCR group,the patients of the CR group are younger and with a higher ratio of old myocardial infarction ,as well as the average number of stents ,and the mean value of total stent length is larger. The application of calcium channel blocker for post-operation patients is rarer as well. No significant difference can be found between the two groups on the ratio of post-operation all-cause mortality,cardiac mortality,nonfatal myocardial infarction,unplanned repeat revas-cularization. Multivariate COX analysis showed that the complete revascularization had no obvious difference on the prognosis of these patients be-tween the two groups. Conclusion There is individual diversity in the revascularization strategy choosing for elderly patients of acute STEMI alongside MVD;however,the prognosis is not significantly improved.

This study researched the results transformation problem in medical universities,sorted the current situation in this filed,analyzed the causes of the low transformational rate.Then by referring to the domestic and overseas experience,the author designed the classified transforma tional path of medical research results according to their respective features,finally put forward policy suggestions for institutional guarantee policy to promote the transformation of medical universities.

Objective: To study the expression of hepatocyte growth factor(HGF) in acute pulmonary embolism, and the diagnostic value of HGF thereof. Methods: The acute autoblood pulmonary thromboembolism was used to establish rat pulmonary embolism model. There were blood plasma HGF detection group,organization HGF mRNA detection group and control group respectively. The expressions of plasma HGF and organization HGF were observed during the different periods of acute pulmonary embolism. Results:The expression of HGF was much higher in blood plasma HGF detection group than that of control group at different time points(P ＜ 0.01). The expression of HGF mRNA increased in organization HGF detection group compared with that of control group at 12 h after pulmonary embolism(P ＜ 0.01). Conclusion: The expression of HGF increased in acute pulmonary embolism, which can be used as a diagnosis indicator in acute pulmonary embolism.

Objective To establish a mouse model of acute liver failure induced by lipopolysaccharide /D-galac-tosamine ( LPS/D-GalN) .Methods The optimum dose of LPS/D-GalN was determined by i .p.injection of eight differ-ent doses of LPS and D-GalN into 40 female C57BL/6 mice and observation of their survival time .Then, 32 female C57BL/6 mice were i.p.injected with the optimal dose of LPS/D-GalN and sacrificed at 0, 1, 4, 8 hours after the injec-tion, 8 mice in each group.The control mice received saline injection .Hepatic changes were observed by pathology and se-rum ALT, IL-6, MCP-1 and TNF-αwere measured by biochemistry or flow cytometry .Results LPS (2.5 mg/kg) and D-GalN (0.3 g/kg) were determined as the optimal dose for the establishment of mouse model of acute liver injury .Com-pared with the control group , the hepatocellular damages were progressing in a positive correlation with the time course after LPS/D-GalN administration .The level of serum ALT was significantly increased after LPS/D-GalN administration ( P <0.001).The levels of inflammatory cytokines IL-6, MCP-1 and TNF-αwere increased and reached a peak at one hour after LPS/D-GalN administration and then decreased almost to that of the control group 8 hours later(P<0.001).Conclusions The mouse model of acute liver injury is successfully established by LPS /D-GalN administration , and provide an effective animal model for the study of pathogenic mechanisms of acute liver failure and evaluation of therapeutic drugs .

Objective To investigate the clinical and laboratorial characteristics of patients with myelodysplastic syndrome ( MDS) and erythroid hyperplasia.Methods MDS patients whose bone marrow was hypercellular with erythroid lineage more than 50% and blasts account for less than 20% of non-erythroid cells were enrolled in this study.The ratio of mature erythrocytes to nucleated erythrocytes was no more than 20, namely MDS patients with erythroid hyperplasia ( MDS-E ).The retrospective analysis comprised 102 patients with MDS-E from the First Affiliated Hospital of Suzhou University.Clinical characteristics , karyotype , and the prognostic significance of erythroid hyperplasia were evaluated.Results A total of 48 MDS-E patients (47.1%) presented a variety of cytogenetic abnormalities.The most frequently involved chromosomes were chromosome 8 (39.5%of all abnormal karyotypes ), chromosome 7 (22.9%), followed by chromosome 5 ( 18.8%) , chromosome 1 ( 16.7%) and chromosome 20 ( 16.7%) .Hemoglobin ( Hb) level affected the prognosis by survival analysis.The overall survival ( OS) of MDS-E patients with Hb equal or more than 70 g/L was longer than that of patients less than 70 g/L ( P<0.001).Allogeneic hematopoietic stem cell transplantation (HSCT) significantly improved the OS compared with best supportive care (P<0.001) and chemotherapy (P<0.001).The extent of erythroid hyperplasia in bone marrow did not impact on prognosis ( P=0.187 ).Conclusions Compared with previous reports of MDS patients, MDS-E patients have higher level of erythroid hyperplasia , more common erythroid dyshematopoiesis , more frequent 8 and 1 chromosome abnormalities .The degree of erythroid hyperplasia is not correlated with prognosis.Allogeneic hematopoietic stem cell transplantation improves the prognosis.

Objective To investigate the clinical features and risk factors for chronic heart failure in elderly patients.Methods The 2,407 chronic heart failure patients were enrolled,including 1,513 elderly patients (62.9％) (aged≥≥65 years).Risk factors for chronic heart failure,clinical features,biochemical and physical examination were retrospectively analyzed.The effects of different factors on patients with different age were analyzed by Logistic regression analysis.Results Compared with the young and middle-aged patients,the higher prevalences of New York Heart Association functional classification (NAFC),diabetes,ischemic heart disease,hypertension,anemia,renal insufficiency and hyperuricemia were found,but the percentages of males,smoker,patients with dilated cardiomyopathy,valvular heart disease and hyperlipidemia were reduced in elderly patients.The levels of blood creatinine,high density lipoprotein (HDL),serum potassium,hemoglobin,albumin,pre-albumin,total cholesterol (TC),lower density lipoprotein (LDL),triglyceride (TG) and diastolic blood pressure were lower,but left ventricular ejection fraction (LVEF) and systolic blood pressure were higher,in the elderly patients than in young and middle-aged patients.Elderly patients had higher usage rates of stain and angiotensin converting enzyme inhibitors (ACEI) or angiotensin receptor blocker (ARB),but lower usage rate of β-blocker as compared with young and middle-aged patients.In elderly patients,logistic regression analysis revealed that gender (OR=1.89,95％CI:1.566-2.285),a history of ischemic heart disease (OR=1.81,95％ CI:1.457-2.243),hypertension (OR=1.87,95％CI:1.462-2.389),anemia (OR=2.66,95％ CI:2.197-3.211),hyperuricemia (OR =1.41,95％ CI:1.186-1.678) were significantly related with chronic heart failure,whilein young and middle-aged patients,dilated cardiomyopathy (OR=0.49,95％ CI 0.351-0.689),hyperlipidemia (OR=0.53,95 ％ CI:0.433-0.641),smoking (OR=0.79,95 ％ C I:0.652 0.966) were significantly related with chronic heart failure.Conclusions Gender,ischemic heart? disease,hypertension,anemia,hyperuricemia are the independent risk factors for chronic heart failure in elderly patients.

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 examine the relationship between self-management behaviors and time perspective among patients with comorbid diabetes, so as to provide the evidence for improving self-management behaviors among patients with comorbid diabetes. Methods: The patients with comorbid diabetes who were registered in the chronic disease health management system of Minhang District, Shanghai Municipality in 2021, followed up regularly, and lived in Meilong Town were recruited. Demographic information and family history of diabetes were collected through questionnaire surveys. Time perspective and self-management behaviors were assessed using the Zimbardo Time Perspective Inventory and Diabetes Self-Management Behavior Scale, respectively. The relationship between self-management behaviors and time perspective was analyzed using a multivariable ordinal logistic regression model. Results: A total of 907 patients with comorbid diabetes were enrolled, including 472 males (52.04%) and 435 females (47.96%). There were 652 cases aged 65 years and above, accounting for 71.89%. In terms of the types of time perspective, 280 patients were future-oriented (30.87%), 236 were balanced (26.02%), 162 were sensation-seeking (17.86%), 123 were fatalistic (13.56%), and 106 were negative (11.69%). In terms of the self-management behaviors, 46 patients were good (5.07%), 643 were moderate (70.89%), and 218 were poor (24.04%). Multivariable ordinal logistic regression analysis showed that after adjusting for age, gender, educational level, marital status, occupation status, monthly income, and family history of diabetes, the patients with comorbid diabetes who had a future-oriented time perspective had better self-management behaviors (OR=1.874, 95%CI: 1.204-2.915). Conclusion The self-management behaviors among patients with comorbid diabetes are moderate to poor, and patients with a future-oriented time perspective can better engage in self-management behaviors.