Objective To explore the clinical characteristics and prognosis of the patients of acute myocardial infarction complicated with heart failure by analyzing the prognostic factors of these patients.Methods This was a single-center prospective study of 349 patients with acute heart failure and ECG documented acute ST elevated myocardial infarction.All patients were treated with primary PCI.After PCI,clinical,angiographic and ECG characteristics,and prognosis of those with preserved (≥50％) or reduced (＜ 50％) left ventricular ejection fraction (LVEF) were assessed.Heart failure patients were divided into two groups:124 with reduced EF (HFREF) and 225 with preserved EF (HFPEF).After 367 days of average follow-up,the primary outcome and number of death were recorded.Results Of them,4 (1.8％) patients in the HFPEF group vs.6 (4.8％) in the HFREF group died.The difference in rate of death between two groups was not significant (P =0.314).There were significant difference in main adverse cardiac and cerebra vascular events (MACCE) occurred during follow-up period between the two groups (P =0.022).The Killip Classification of heart failure (HR =1.092,95％ CI 1.040 ～ 1.149,P ＜0.01) was significantly related to the death rate during follow-up.Conclusions The independent factors affecting prognosis in patients with acute heart failure after coronary revascularization were closely consistent with the stratums of the Killip Classification.Patients with HFPEF had a similar prognosis as those with HFREF after primary stenting.

Objective:To investigate the changes in synaptic transmission function of hippocampal dentate gyrus granule cells in depression model mice induced by chronic unpredictable mild stress (CUMS) and to explore the effect of exercise on it.Methods:Totally 48 SPF grade 7-week-old male C57BL/6J mice were randomly compartmentalised into control group (CTRL group), model group (CUMS group), model + exercise group (CUMS+ EXE group), and model + fluoxetine group (CUMS+ FLX group), with 12 mice in each group. CUMS method was used for preparating the depression model for 21 d. Mice in the CUMS+ EXE group were given roller locomotion training and mice in the CUMS+ FLX group were given fluoxetine intraperitoneally (10 mg/kg) daily during the modelling period, and the other two groups were administrated intraperitoneally with equal volume of 0.9% NaCl solution.Sucrose preference test (SPT), tail suspension test (TST) and forced swimming test (FST) were used to detect depressive-like behavior, and open field test (OFT) was used to detect anxiety-like behavior. Whole-cell recordings were used to detect spontaneous excitatory postsynaptic currents (sEPSC), spontaneous inhibitory postsynaptic currents (sIPSC), miniature excitatory postsynaptic currents (mEPSC), and miniature inhibitory postsynaptic currents (mIPSC) in hippocampal dentate gyrus granule cells.One-way ANONA was performed to analyze the data by SPSS 23.0.Results:(1) There were statistically significant differences among the 4 groups of mice in terms of activity time in the center, total distance of OFT and sugar preference rate( F=37.85, 18.41, 28.81 all P<0.01). The activity time in the center((47.81±3.51)s) and total distance((19.63±1.24)m) of OFT and sugar preference rate((55.63±9.11)%) in the CUMS group were lower than those in the CTRL group (all P<0.01), while those in the CUMS+ EXE group((59.87±3.25)s, (23.18±1.24)m, (69.03±8.22)% respectively) were higher than those in the CUMS group (all P<0.05).The sugar preference rate of the CUMS+ EXE group was lower than that in the CTRL group and CTRL+ FLX group (both P<0.01). The differences in immobility time of TST and FST were statistically significant among the 4 groups of mice ( F=113.70, 56.97, both P<0.01). The immobility time of TST and FST of the CUMS group was lower than that of mice in the CTRL group (both P<0.01), while that in the CUMS+ EXE group were lower than that in the CUMS group (both P<0.05) and higher than that in the CTRL group (both P<0.01). (2)There were statistically significant differences in frequency, amplitude and quantification of sEPSC among the 4 groups of mice ( F=22.02, 17.98, 179.00, all P<0.01). The sEPSC frequency, amplitude, and quantification of mice in the CUMS group were lower than those in the CTRL group (all P<0.05), while those in the CUMS+ EXE group were higher than those in the CUMS group (all P<0.05) and lower than those in the CTRL group and CUMS+ FLX group (all P<0.05). The differences in frequency and quantification of sIPSC among the 4 groups of mice were statistically significant ( F=22.12, 184.80, both P<0.01). The sIPSC frequency and quantification of mice in the CUMS group were higher than those in the CTRL group (both P<0.05), while those in the CUMS+ EXE group were lower than those in the CUMS group (both P<0.05) and higher than those in the CTRL group (all P<0.05).The difference in quantification of sEPSC/sIPSC ratios among the 4 groups of mice was statistically significant ( F=267.10, P<0.01). The quantification of sEPSC/sIPSC ratio of mice in the CUMS group was lower than that in the CTRL group ( P<0.05). The quantification of sEPSC/sIPSC ratio of mice in the CUMS+ EXE group was higher than that in the CUMS group ( P<0.05) and lower than that in the CTRL group and CUMS+ FLX group(both P<0.05). (3) The differences in mEPSC frequency and amplitude among the 4 groups of mice were statistically significant ( F=25.07, 23.57, both P<0.01). The mEPSC frequency and amplitude in the CUMS group were lower than those in the CTRL group (both P<0.05), while those in the CUMS+ EXE group were higher than those in the CUMS group (both P<0.05) and lower than those in the CTRL group and CUMS+ FLX group(all P<0.05). The difference in mIPSC frequency among the 4 groups of mice was statistically significant ( F=13.79, P<0.01). The mIPSC frequency of mice in the CUMS+ EXE group was lower than that in the CUMS group ( P<0.05) and higher than that in the CTRL group ( P<0.05). Conclusion:Exercise can partially improve depressive-like behaviours and enhances hippocampus granule cell synaptic transmission in depression model mice.

Objective:To investigate the effects of enriched environment on the behavior of depressive-like mice induced by chronic stress and the synaptic transmission function of hippocampal pyramidal neurons.Methods:Thirty-six 7-week-old SPF grade male C57BL/6J mice were divided into control group, model group and enriched environment group according to the random zone method, with 12 mice in each group.The mice in model group and enriched environment group were subjected to chronic unpredictable mild stress to establish depression models.During the modeling period, the mice in enriched environment group lived in the enriched environment for 6 hours per day, and lived in the routine environment for the rest time just like the mice in control group and model group.The depressive behaviors of mice were detected by sucrose preference test (SPT), forced swimming test (FST) and tail suspension test (TST).The motor function and anxious behavior of mice were detected by open field test (OFT) and the cognitive function was detected by Morris water maze test.In vitro electrophysiological techniques were used to record field excitatory post-synaptic potentials (fEPSP) in the hippocampus, and whole-cell recording was used to record spontaneous excitatory post-synaptic currents (sEPSC) and miniature excitatory post-synaptic currents (mEPSC) in hippocampal pyramidal neurons.Statistical analysis was conducted by SPSS 23.0 software.Multiple group comparisons of data were conducted by one-way ANOVA and repeated measures ANOVA.Results:(1) Behavioral results showed statistically significant differences among the three groups in terms of total activity time in the central area of OFT, sugar water preference rate of SPT and immobility time of TST and FST ( F=17.12, 26.07, 41.13, 60.18, all P<0.01).The activity time in the central area of OFT and sugar water preference rate of model group were lower than those in the control group (both P<0.01), and the immobility time of TST and FST were higher than those in the control group (both P<0.01).The activity time in the central area of OFT ((56.56±3.47) s) and sugar water preference rate ((71.22±8.37) %) of enriched environment group were higher than those in the model group((52.56±3.47) s, (59.53±8.72)%) (all P<0.05), and the immobility time of TST ((94.19±10.77) s) and FST ((76.98±12.10) s) were lower than those in the model group ((104.58±8.24) s, (111.41±9.56) s)(all P<0.05).(2)The results of spatial learning memory showed that there was a significant difference of group and time interaction effects for latency to find the platform ( F=12.02, P<0.01), and the latency to find the platform in model group was higher than that in control group and enriched environment group (both P<0.01).The results of spatial exploration showed that there were statistically significant differences in the target quadrant residence time and the times crossing the platform among the three groups( F=19.67, 20.27, both P<0.01).The both indexes in the model group were lower than those in control group and enriched environment group (all P<0.01).(3) The results of electrophysiological experiment showed that the interaction effect of fEPSP between groups and stimulations intensity among the three groups was significant( F=1.86, P<0.01).At the stimulation level of 150 mA and 200 mA, the fEPSP of the model group was lower than those of control group and enriched environment group (all P<0.05).(4)The results of the long-term potentiation(LTP) showed a statistically significant difference among the three groups( F=15.32, P<0.01).The LTP of the model group mice ((137.42±4.48)%) was lower than those of the control group ((156.62±4.79)%) and the enriched environment group ((147.86±9.14)%) (both P<0.05).(5) The whole-cell recordings results showed that there was a statistically significant difference in the frequencies of sEPSC and mEPSC among the three groups ( F=15.30, 13.72, both P<0.01).The sEPSC and mEPSC frequencies of the model group mice ((0.60±0.31) Hz, (0.63±0.26) Hz) were lower than those of the control group ((1.27±0.46) Hz, (1.02±0.28) Hz) and the enriched environment group ((0.96±0.45) Hz, (0.83±0.22) Hz) (all P<0.05). Conclusion:Environmental enrichment can alleviate the depressive behaviors induced by chronic stress and enhance cognitive performance, hippocampal pyramidal neuron synaptic transmission and synaptic plasticity in depressive-like mice.

Objective:To investigate the effect of ginkgo biloba extract (GBE) on oxidative stress in medial prefrontal cortex and excitatory/inhibitory balance of pyramidal neurons in chronic unpredictable mild stress (CUMS)-induced depressive model mice.Methods:Totally 48 SPF grade 7-week-old male C57BL/6J mice were divided into 4 groups according to random number table method: control+ saline group (CTRL+ Veh), control+ GBE group (CTRL+ GBE), model+ saline group (CUMS+ Veh), model+ GBE group (CUMS+ GBE), with 12 mice in each group.Mice in CUMS+ Veh group and CUMS+ GBE group were established by CUMS method, and mice in CTRL+ GBE group and CUMS+ GBE group were intraperitoneally injected with GBE (70 mg/kg) once a day, and mice in CTRL+ Veh group and CUMS+ Veh group were injected intraperitoneally with 0.9% sodium chloride solution.Then, the sucrose preference test, forced swimming test (FST) and tail suspension test (TST) were performed to evaluate the depressive-like behavior of mice, and open field test (OFT) was performed to evaluate the autonomous locomotion and exploration ability and anxiety-like behavior.The content of malondialdehyde (MDA) and activity of superoxide dismutase (SOD) in mPFC were determined by ELISA.Spontaneous excitatory postsynaptic currents (sEPSC) and spontaneous inhibitory postsynaptic currents (sIPSC) were detected by whole-cell recording.SPSS 23.0 was used for data analysis and two-factor analysis of variance(whether to get GBE, whether to mold, show as GBE×CUMS) was used for statistical analysis.Results:(1) Behavioral results: the the time spent in center and total distance of OFT and sugar preference rate of the four groups of mice were compared, and the interaction of GBE×CUMS was significant( F=24.90, 4.82, 3.91, all P<0.05). The results of simple effect analysis showed that the time spent in center ((47.15±3.58) s), the total distance((19.33±0.86) m) and the sugar preference rate((59.11±8.79)%) of the mice in CUMS+ Veh group were lower than those in the CTRL+ Veh group((61.55±2.49) s, (23.24±1.21) m, (84.02±7.45) %) (all P<0.01), and the above indexes in CUMS+ GBE group ((56.51±3.53) s, (20.75±1.31) m, (70.80±11.79)%) were higher than those in CUMS+ Veh group (all P<0.05). In the immobility time of FST and TST of mice in the 4 groups, the interaction of GBE×CUMS were significant( F=85.53, 83.39, both P<0.01). The immobility time of FST and TST in CUMS+ Veh group were higher than those in CTRL+ Veh group (both P<0.01 ), and the above indexes in CUMS+ GBE group were lower than CUMS+ Veh group(both P<0.05). (2)The results of ELISA showed that the interaction of GBE×CUMS of SOD level of mice in the 4 groups was not significant ( F=3.52, P=0.07), but the main effects of GBE factor and CUMS factor were both significant ( F=4.69, 46.93, both P<0.05). The interaction of GBE×CUMS of MDA level was significant( F=16.61, P<0.01). The level of SOD in the CUMS+ Veh group was lower than that in the CTRL+ Veh group ( P<0.01), and the level of SOD in the CUMS+ GBE group was higher than that in the CUMS+ Veh group ( P<0.05). The level of MDA in the CUMS+ Veh group was higher than that of the CTRL+ Veh group ( P<0.01), and the level of MDA in CUMS+ GBE group was lower than that of the CUMS+ Veh group ( P<0.01). (3) The results of whole-cell recording showed that the interaction of GBE×CUMS of frequency and quantification of sEPSC in the four groups were significant ( F=5.45, 6.94, both P<0.05). The sEPSC frequency and quantification in the CUMS+ Veh group were lower than those in the CTRL+ Veh group (both P<0.01), and the sEPSC frequency and quantification in CUMS+ GBE group were higher than those of CUMS+ Veh group (both P<0.05). The interaction of GBE×CUMS of frequency and quantification of sIPSC in the four groups were significant ( F=7.78, 8.96, both P<0.01). The sIPSC frequency and quantification of the CUMS+ Veh group were higher than those of CTRL+ Veh group (both P<0.01), and the above indexes of CUMS+ GBE group were lower than those of CUMS+ Veh group (both P<0.01). As for the sEPSC/sIPSC ratio, GBE×CUMS interaction was significant ( F=5.45, P=0.02). The sEPSC/sIPSC ratio of CUMS+ Veh group (0.09±0.01) was lower than that of CTRL+ Veh group (0.28±0.04) ( P<0.01), and the sEPSC/sIPSC ratio of CUMS+ GBE group (0.14±0.03) was higher than that of CUMS+ Veh group ( P<0.05). Conclusion:Ginkgo biloba extract can improve the depression-like behavior of mice induced by CUMS, reduce the oxidative stress of mPFC and improve the excitation/inhibition balance of pyramidal neurons in depressive model mice.

Objective To explore the clinical efficacy of fluoxetine hydrochloride capsules and escitalopram oxalate tablets in the treatment of first-episode depression disorder.Methods Eighty patients with first-episode depression disorder who were hospitalized in the 14th district of Integrated Traditional Chinese and Western Medicine of Xiamen Xianyue Hospital from February to November 2023 were selected,and divided into fluoxetine hydrochloride capsules group(n=40)and escitalopram oxalate tablets group(n=40)according to random number method;Conducted the Hamilton depression scale(HAMD)estimates before treatment and four weeks after treatment,to analyze and compare the clinical efficacy of two groups.Results After four weeks of treatment,the HAMD scores of all patients significantly decreased compared to before treatment in this group(P＜0.01);There was no statistically significant difference between two groups(P＞0.05).There was no statistically significant difference in the total effective rate between two groups(P＞0.05).Conclusion Escitalopram oxalate tablets and fluoxetine hydrochloride capsules were both effective in treatment of the first-episode depression disorder patients,and the total effective rates of them were similar.