Objective To evaluate the research of Recombinant Human Tumor Necrosis Factor-αReceptorⅡ:IgG Fc Fusion Protein for Injection in the treatment of patients with ankylosing spondylitis in serum ESR and CRP.Methods 48 cases of patients with ankylosing spondylitis from October 2013 to October 2015 in our hospitol were randomly divided into the control group and treatment group , 24 cases in each group.The control group was treated with sulfasalazine enteric-coated Tablets orally, 1.0 g/time,bid;the experimental group was treated with rhTNFR:Fc for subcutaneous injection, 25 mg/time, two times/week.erythrocyte sedimentation rate (ESR), serum C reactive protein (CRP) level, efficiency of treatment and safety of two groups were compared before and after treatment.Results After treatment, compared with the control group, the ESR and the serum level of CRP were lower in the experimental group (P<0.05); the treatment efficiency of the experimental group 95.84% was significantly higher than that of the control group 75.00% (P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups.Conclusion The rhTNFR:Fc can significantly reduce the ESR and the serum level of CRP in patients with ankylosing spondylitis, improve clinical symptoms,the clinical efficacy and safety were high.

Objective To explore the feasibility of the application of non fasting blood lipid in the hospitalized population.Methods Self-control study was used.608 patients(aged 20~86 years old) were enrolled from April 2015 to October 2016 in lipid center of FuWai hospital.Fasting sample and non-fasting sample(1~4 h after breakfast) were collected from every patient and lipid profile including TG (triglyceride), TC (total cholesterol), HDL-C (high density lipoprotein cholesterol) and LDL-C (low density lipoprotein cholesterol) were measured in clinical laboratory.The results of two tests were compared using the Wilcoxon signed-rank test.Results The differences between non-fasting and fasting lipid test were +0.47 mmol/l (+30%) for TG,-0.03 mmol/l (-2.8%) for HDL-C,-0.09 mmol/l (-3%) for LDL-C and-0.24 mmol/l (-8.7%) for calculated LDL-C (P<0.001 respectively).The differenceswere +0.01 mmol/l for TC and +0.02 mmol/l for non-HDL-C,therefore no statistical difference was observed.When the TG level was stratified,the level of non-fasting LDL-C using directing test method was not significantly different between TG> 4.5 mmol/L and the whole (0.07 vs.0.09),but the level of non-fasting LDL-C using formula method wassignificantly different between TG> 4.5 mmol/L and the whole (0.66 Vs.0.24),andthe drops were 34.9% vs.8.7%.Conclusion Non-fasting lipid test could be an effective routine method for lipid evaluation in the hospitalized population.

Objective: To preliminarily explore the clinical characteristics and gender difference of patients with variant angina (VA) in China. Methods: A total of 312 patients with spontaneous attack of VA admitted in our hospital from 2003-01 to 2009-12 without stimulation test were retrospectively studied. The clinical features were compared between male and female patients to reveal the similarities and differences of VA by genders. Results: The predilection of VA was in male gender (274/312, 87.8%), the common risk factors including smoking, hypertension and hyperlipidemia; 55/312 (17.6%) patients had allergy history. There were 59/312 (18.9%) patients combining arrhythmia while VA attack; coronary angiography (CAG) found that 155/283 (54.8%) patients were with ifxed coronary stenosis and 22/312 (7.1%) combining coronary myocardial bridge. Nitrates, calcium antagonist and stent implantation may effectively control VA attack. Compared with male, female patients had the lower ratio of smokers (10.5% vs 78.8%),P<0.01, higher ratios of family history of coronary artery disease (CAD) (31.6% vs 11.3%),P<0.01, ventricular tachycardia (13.2% vs 3.6%)P<0.05 and ventricular ifbrillation (7.9% vs 1.8%),P<0.05. Conclusion: VA is a cardiac ischemia caused by coronary artery spasm with high incidence for combining arrhythmia, without in time treatment it may incur myocardial infarction even sudden death. VA patients should receive routine CAG and stent implantation according to the severity of stenosis. Female patients were with less smokers while higher ratios in family history of CAD, ventricular tachycardia and ventricular ifbrillation.

Objective:To evaluate the clinical correlation between the CardioChek PA analyzer (CCPA)and a clinical laboratory reference method to use for screening program purposes.Methods:Fasting blood samples were collected on 325 patients (age:23 -86 years).One venous sample was col-lected using a serum tube for the evaluation on a Beckman reference analyzer.A second venous sample was collected in a lithium heparin tube and was evaluated on the CCPA analyzer.Linear regression analy-ses and Bland-Altman method were performed for each measured analyte:total cholesterol (TC),high density lipoprotein-cholesterol (HDL-C),triglycerides (TG)and low density lipoprotein-cholesterol (LDL-C).Results:Our results demonstrated a good clinical agreement for TC,HDL-C,TG and LDL-C (97.0%,92.9%,92.4% and 83.7%)in comparison with the CCPA to the reference analyzer.The correlation coefficients were 0.875,0.81 3,0.91 0,0.864,respectively.P values all <0.001 .There was no significant difference in the detection rate of hyperlipidemia in TC,HDL-C and LDL-C.Conclu-sion:We have identified the pre-analytic phase as an important step to guarantee the quality of results and indicated that the CCPA is a reliable lipid point-of-care testing system that can be used for the appli-cation of clinical screening anywhere.

The generation of large quantities of novel human T cell clones ex vivo would make a wide range of gene-and immuno-therapies for tumor and AIDS possibly. Although it is well established that T cells are derived from CD34(+) cells, the involvement of thymic fragments from either human or murine fetus makes the in vitro T cell perliferation very cumbersome. In this report, cord blood mononuclear cells were used as accessory cells to support the differentiation of CD34(+) cells into naive T cells stimulated with SCF and IL-2. CD4(+) and CD8(+) T cells, under the cultural conditions, were continuously produced in vitro at least over a period of 3 weeks and their ratios changed gradually. CD4/CD8 double positive T cells and RAG-2 gene were existed, and RAG-2 gene, reponsible for TCR rearrangement, was expressed during the cell proliferation. Our study presents a simple culture system in vitro to acquire large quantities of naive T cell clones.

Objective: To explore the safety and efficacy of lipoprotein apheresis (LA) in treating the patients with familial hypercholesterolemia (FH).
Methods: A total of 12 FH patients treated in our hospital from 2015-02 to 2016-10 were retrospectively studied. Based on intensive cholesterol lowering therapy with rosuvastatin (10-20) mg Qd and Ezetimibe 10 mg Qd, the patients received LA by double ifltration plasma pheresis (DFPP) via bilateral elbow central vein or femoral vein. The changes of lipid level were compared at before and after LA treatment.
Results: For pre- and immediately after LA treatment, the average total cholesterol (TC) was (9.42±3.65) mmol/L vs (2.84±0.83) mmol/L, low density lipoprotein cholesterol (LDL-C) was (7.31±3.46) mmol/L vs (1.95±0.82) mmol/L; at 1, 3, 7 and 30 days after treatment, TC and LDL-C levels showed increasing trend, while they were still lower than they were before treatment, allP<0.01. For pre- and immediately, 1 day, 3 days after treatment, the average HDL-C level was (0.96±0.31) mmol/L, (0.63±0.17) mmol/L, (0.56±0.15) mmol/L and (0.68±0.22) mmol/L respectively,P<0.05-0.01. For pre- and immediately after LA treatment, the average TG level was (1.90±0.86) mmol/L vs (0.88±0.38) mmol/L,P<0.05. Only 1 patient had the symptoms of hypotension, nausea and sweat, the patient was relieved by expectant treatment.
Conclusion: LA therapy may decrease blood levels of TC and LDL-C at short term in FH patients with good tolerance;even TC and LDL-C could slowly increase after treatment, while combining with lipid lowering therapy, it has been a safe and effective method for treating relevant patients.

Objective:To investigate the influence of sulforaphane(SFN)on ventricular remodeling in myocardial infarction(MI)rat model by regulating extracellular regulated protein kinase(ERK)/nuclear respiratory factor 1(NRF1)signaling pathway.Methods:Among 48 SD male rats,12 were randomly selected as Sham group.The remaining rats were treated with ligation of left ante-rior descending coronary artery to establish myocardial infarction model.After modeling,36 rats were randomly divided into MI model group,SFN treatment group(10 mg/kg),SFN+SCH772984(ERK inhibitor)group(10 mg/kg+15 mg/kg),with 12 rats in each group.Animal ultrasound was performed to detect cardiac structure and function.Histological analysis was performed to evaluate myo-cardial fibrosis and cell apoptosis.ELISA was used to measure pro-inflammatory factor levels in serum,and Western blot assay was used to observe the expression of ERK/NRF1 pathway related proteins in myocardium of rats in each group.Results:Compared with rats in Sham group,rats in MI model group showed a loss of myocardial compliance and disarray of ventricular myocardial fibers,along with increased myocardial fibrosis and myocardial cell apoptosis.Moreover,rats in MI model group also exhibited overactive inflammatory response and inhibition of the ERK/NRF1 signaling pathway in cardiac tissues(P<0.05).Notably,SFN treatment signifi-cantly not only improved cardiac function,but also ameliorated myocardial fibrosis and cell apoptosis(P<0.05).SFN treatment inhib-ited inflammatory cytokine expression and activated the ERK/NRF1 pathway as well(P<0.05).However,SCH772984 significantly abrogated the protective effect of SFN against myocardial fibrosis and apoptosis in MI rats.Conclusion:SFN may protect against ventricular remodeling in MI rat by activating ERK/NRF1 pathway.

Objective: To study the relationship between ABO blood type and spontaneous re-canalization (SR) in patients with acute myocardial infarction (AMI). Methods: A total of 1209 consecutive AMI patients were enrolled. Based on TIMI grade, the patients were divided into 2 groups: Non-SR group, the patients with TIMI grade 0-1,n=442 and SR group, the patients with TIMI grade 2-3,n=767. The relationship between ABO blood type and SR was investigated. Results: Compared with Non-SR group, SR group had more patients with blood type O (32.3% vs 24.7%) and less blood type A (31.7% vs 24.9%). Meanwhile, we found that a lower cholesterol level was related to patients with O blood type and SR occurrence, bothP<0.05. Multi regression analysis indicated that with adjusted age, gender, BMI, hypertension, diabetes, smoking, LDL-C and C-reactive protein, ESR, fibrinogen, D-dimmer, endothelial cardiac function, blood type O may independently predict SR occurrence in AMI patients (OR=1.49, 95% CI 1.10-2.05), while blood type A may have disadvantage for SR (OR=0.65, 95% CI 0.48-0.80). Conclusion: ABO blood type has been related to SR in AMI patients, blood type O is in favor of SR, while blood type A has disadvantage for SR occurrence.

Objective To evaluate the diagnostic value of cardiac magnetic resonance(CMR)in patients with severe connective tissue disease-associated pulmonary hypertension(CTD-PAH).Methods A total of 48 patients diagnosed with CTD-PAH by right heart catheterization(RHC)in Tianjin Medical University General Hospital from June 2018 to July 2021 were retrospectively included.The parameters of right ventricular(RV)morphology,function and ventricular septum(IVS)were obtained by manual delineation on CMR images and corrected by body surface area.The late gadolinium enhancement(LGE)myocardial mass(MM)and its percentage in left ventricular(LV)MM were manually sketched and calculated on LGE images.The patients were divided into the mild-moderate group and the severe group according to mean pulmonary arterial pressure(mPAP).CMR parameters were compared between the two groups.The diagnostic value of CMR for severe CTD-PAH was analyzed by receiver operating characteristic(ROC)curve.Results A total of 48 patients with CTD-PAH were included in this study.The curvature of interventricular septum(CIVS)and RV ejection fraction(EF)were lower in the severe group than those in the mild-moderate group,and the time proportion of IVS deformation,RV end-diastolic volume index(EDVI),RV end-systolic volume index(ESVI)and RV MM were higher than those in the mild-moderate group(P＜0.05).ROC curve analysis showed that RV MM,time proportion of IVS deformation and RV ESVI had better diagnostic efficacy in severe CTD-PAH patients(AUC was 0.792,0.766 and 0.731,respectively).The combined AUC of the three parameters was 0.840,specificity was 85.7%and sensitivity was 79.4%.Conclusion The parameters of RV and IVS measured by CMR can effectively evaluate patients with severe CTD-PAH and directly reflect serverity of cardiac impairment in patients with severe CTD-PAH from the morphological and functional perspective.

Objective To compare the safety,effectiveness and affordability of robotic-assisted thoracic surgery and video-assisted thoracic surgery in the treatment of malignant pulmonary tumors,and provide ref-erences for the management of selection of different surgical strategies for malignant pulmonary tumors in hospitals and medical insurance departments.Methods The medical records homepages and information sys-tem data of patients with malignant pulmonary tumors who underwent major thoracic surgery in this hospital and discharged from January 1 to December 31,2022 were obtained.The patients were divided into the robotic-assistedthoracic surgery group and video-assisted thoracic surgery group according to the surgical methodolo-gies.After performing propensity score matching (PSM),no statistically significant difference was observed in baseline data between the two groups (117 cases in each group).Then the indicators of safety,effectiveness and affordability were compared between the two groups.Results Concerning the safety,the postoperative in-cision infection rate in the robotic-assisted thoracic surgery group was significantly lower than that in the vide-o-assisted thoracic surgery group (P<0.05),and the amount of intraoperative blood loss and postoperative complication rate were not significantly different between the two groups (P>0.05).Regarding the effective-ness,the average surgical duration in the robotic-assisted thoracic surgery group was appreciably shorter than that in the video-assisted thoracic surgery group (P<0.05),no patient in the two groups was converted to open thoracotomy,and there was no statistically significant difference in the average length of hospital stay and postoperative hospital stay between the two groups (P>0.05).With regard to the affordability,the aver-age inpatient expenditure per case and average daily inpatient expenditure per case in the robotic-assisted tho-racic surgery group were significantly higher than those in the video-assisted thoracic surgery group (P<0.05),and there were disparities in the cost structure between the two procedures.The medical cost,adminis-tration cost and consumables cost in the robotic-assisted thoracic surgery group were significantly higher than those in the video-assisted thoracic surgery group (P<0.05).The cost of medical technology in the robotic-assisted thoracic surgery group was significantly lower than that in the video-assisted thoracic surgery group (P<0.05).Conclusion Physicians should comprehensively consider the clinical efficacy and cost burden of patients when selecting the robotic-assisted thoracic surgery or the video-assisted thoracic surgery,and the monitoring and evaluation of the utilization of clinical robotic-assisted thoracic surgery should be strength-ened.