Objective To investigate the clinical significance of CGRP level and gene sequence in congenital heart disease(CHD)with pulmonary hypertension.Methods The level of serum CGRP was tested by radioimmunoassy in 36 children with left to right shunt CHD,including 29 children with different severity of pulmonany hypertension(PH).Echo cardiography pulse wave Doppler tested the ratio of the pulmonary and systemic arterial pressure.The exon 5 in CGRP gene was directly sequenced in these patients. Results There were significant differences in serum levels of CGRP between the patients with mild PH and control group.The levels of serum CGRP were significantly decreased in patients with moderate or severe PH.There was significant negative line correlation between the levels of CGRP and pulmonary pressure.Base mutation were not found in the exon 5 in CGRP gene.Conclusion The CGRP might be involved in the pathophysiologic process of pulmonary hypertension in CHD.There is no gene expression polymorphism in encode sequence in CHD patients with pulmonary hypertension.

Objective This study was aimed to discuss the safety, feasibility and availability of perimembranous ventricular septal defects(PmVSD) closure via super minimal intercostal incision under transesophageal echocardiography(TEE) guidance in children.Methods There were 81 cases of PmVSD via super minimally invasive transintercostal device closure operation(length of incision ≤ 1cm) from August 2014 to August 2016.TEE was used to guide and monitor the entire procedure.Assessed the effectiveness of device closure by postoperative regular follow-up.Results 80 patients were successfully operated by super minimally invasive transintercostal device closure in all 81 cases.Operation success rate reached 98.77%.The average diameter of ventricular septal defects was(3.72±0.96)mm.The average diameter of amplatzer occluder was(4.88±0.95)mm.Postoperative follow-up time was from 6 months to 24 months.One of 16 cases that with aneurysm of membranous septum had more than two shunts, remained a mild residual shunt beside of the amplatzer occluder but self cured during follow-up.Mild pericardial effusion was found in one patients after the operation and disappeared during follow-up.There were no cases of perioperative death, device deformation or displacement, residual shunt, complete atrioventricular block and valve involvement in the patients whom were successfully operated.One patient transferred to ventricular septal defect repair operation under direct visualization with a cardiopulmonary bypass, because ventricular fibrillation happened when guide wire passed the ventricular septal.Conclusion Super minimally invasive transintercostal device closure of PmVSD in children guided by TEE was safety and availability, that could avoid x-ray radiation and sternotomy, and operate simply, with small incision and low complication.

Objective To analyze the clinical features and the correlation between radiographic parameters and incidence of calcaneal spur in the patients from Nanfang Hospital,Southern Medical University,China.Methods Three experienced observers independently used the image acquisition and transmission system (PACS) to collect the data of lateral and axial X-ray images of calcaneus or ankle joint in neutral position from the patients with calcaneal spur and normal controls who had undergone radiological examination in Nanfang Hospital,Southern Medical University from July 2014 through December 2015.Ten radiological parameters of the foot (B(o)hler angle,Gissane angle,calcaneal inclination angle,talocalcaneal angle,talus horizontal angle,posterior facet inclination angle,calcaneal length,height of the posterior facet,absolute foot height,and calcaneal width) were measured in both the patients and normal controls.The location,morphology and length of calcaneal spurs were compared between genders,sides and age groups.Results A total of 216 parpatients were included in the study.Female patients were more than male ones,simple plantar spurs more than simple achilles tendon ones,type B spurs more than type A ones,the length of achilles tendon spurs larger than that of plantar ones,female plantar spurs more than males ones,and the length of right foot plantar spurs larger than that of left foot ones.All the differences above were statistically significant (P ＜ 0.05).There were no significant differences in the location,morphology or length of calcaneal spurs between the age group of ≤ 60 years old and the age group of ＞ 60 years old (P ＞ 0.05).The incidence of calcaneal spur were significantly correlated to Gissane angle (P =0.000,OR =0.944,95％ CI 0.917-0.973),posterior facet inclination angle (P=0.017,OR=0.957,95％ CI 0.924-0.992) and height of the posterior facet (P =0.007,OR =0.933,95％ CI O.886-0.981).Conclusions Calcaneal spur favored more females than males.Plantar spurs were more common than Achilles ones.Plantar spurs of Type B were more common than those of Type A.Achilles spurs were longer than plantar ones.More females suffered plantar spur than males.Right foot spurs were longer than left foot ones.Age had no significant influence on the spur characteristics.The incidence of spur might have been related to the Gissane angle,posterior facet inclination angle and height of the posterior facet of the foot.

To discover the novel compounds with biological activity, N-hetercycle substituted derivatives were synthesized based on the structure of benzofuran. A series of novel N-hetercycle substituted benzofuran derivatives(2a-2j)were synthesized by the reaction of 2-(4′-florobenzoyl)benzofuran with N-heterocyclic compounds. And the structures were characterized by 1H NMR, 13C NMR and HRMS. Their anti-tumor activities were studied in vitro against a panel of human tumor cell lines(HeLa, A549 and H1975)by the MTT assay. The results indicate that compounds 2a, 2f and 2j are the most potent within this series of compounds against human tumor cell lines, showing that they are promising lead compounds for further structural modifications and biological evaluation.

Objective To evaluate the design scheme of information data on critical care under the whole chain intelligent management and its clinical application value,and provide the basis for improving nurses' work mode and enhancing digital work efficiency.Methods A data connectivity channel was constructed by taking nurses as the main body and cooperating with computer engineers,which could capture target data automatically in the critical care information system,integrate into nursing documents,achieve the "whole chain intelligent control" of nursing data acquisition-summary statistics-quality control analysis,and generate structured handover content with one key.The time of nurses writing nursing records,the time of nurses analyzing data,the qualified rate of nursing documents,and the time of nurses preparing handover content were compared before and after the application of the "whole chain intelligent control".Results After applying the "whole chain intelligent control",the time of nurses writing nursing records,analyzing data,and preparing handover content in the observation group was all obviously shorter than that in the control group[the time of writing nursing records(minutes):14.60±3.97 vs.51.94±6.24;the time of analyzing data(minutes):9.19±4.19 vs.26.74±5.84;the time of preparing handover content(minutes):12.44±5.04 vs.66.99±6.77],with statistically significant differences(all P<0.01).The qualified rate of nursing documents in the observation group was remarkably higher than that in the control group[97.06％(66/68)vs.85.29％(58/68),P<0.05].Conclusion The construction of the mechanism of the "whole chain intelligent control" for information data on critical care can guarantee the accuracy of patient data,enhance nursing work efficiency,and give nurses more time for patients,thus laying the foundation for the establishment of fully digital intensive care unit(ICU)management.

Objective To explore effects and potential mechanisms of high insulin environment on high density lipoprotein (HDL) generation-related functional protein ABCA1.Methods [3 H] labeled cholesterol efflux from mature 3T3-L1 adipocytes was detected by liquid scintillation counting.ABCA1 mRNA and protein expression in mature 3T3-L1 adipocytes post stimulation with various concentrations of insulin was detected by real-time fluorescence-based quantitative techniques and Western blot,respectively,in the absence and presence of CHX (cycloheximide,CHX),calpeptin (calpain pathway inhibitor) or MG-132 (proteasome pathway inhibitor).Results Cholesterol efflux rates were reduced post insulin stimulation in a dose-dependent manner ((7.06 ± 0.27) ％,(6.59 ± 0.30) ％,(6.34 ± 0.24) ％,(5.07 ± 0.40) ％,and (4.71 ±0.40)％ at 0,1,10,102,and 103 nmol/L of insulin,P ＜0.05).Cholesterol efflux rates decreased in a time-dependent manner post 103 nmol/L insulin stimulation (6.52 ± 0.30) ％,(5.59 ± 0.71)％,(5.44 ± 0.37)％,(4.52 ± 0.32)％,and (4.38 ± 0.33)％ at 0,2,4,6,12 h,respectively).ABCA1mRNA levels were not affected by insulin(P ＞ 0.05).ABCA1 protein level was significantly downregulated in 103 nmol/L insulin group compared to 0 nmol/L insulin group (P ＜ 0.01).Compared with the 0 h group,ABCA1 protein level was significantly reduced in 6 h group (P ＜ 0.05) and further reduced in 12 h group (P ＜ 0.01).Both calpeptin and MG-132 could partly reduce insulin-induced degradation of ABCA1.Compared with the negative control group,ABCA1 protein levels were significantly upregulated by cotreatment with calpeptin and MG-132,respectively (both P ＜ 0.01).Conclusion Our data suggest that high insulin level could promote the ABCA1 protein degradation and reduce cholesterol efflux from mature 3T3-L1 adipocytes through calpain and proteasome pathway,thus,produce a circumference not suitable for nascent HDL formation in 3T3-L1 adipocytes.

Long non-coding RNAs (lncRNAs) are a kind of transcripts which are longer than 200nt and have not protein-coding ability due to the lack of an open reading frame. However, lncRNAs can be involved in tumorigenesis and progression in various ways at the transcriptional and post-transcriptional levels. Bladder cancer associated transcript 1 (BLACAT1) as a lncRNA located on human chromosome 1q32.1, is ectopic expression in various tumors (bladder cancer, gastric malignant tumor, lung carcinoma, et al) and can regulate tumor cell proliferation, anti-apoptosis, invasion and metastasis by different mechanisms leading to occurrence and development of tumors. In this review, we summarized current studies of the functions and mechanisms of BLACAT1 in malignant tumors.

Objective To explore the application effect of visualization pre-hospital and in-hospital information connection technique in pre-examination and triage of emergency critically ill patients.Methods The critically ill patients transferred by 120 ambulances to the Affiliated Hospital of Jiaxing University,the First Hospital of Jiaxing from March to August 2023 were selected as research objects.Prospective non-concurrent control was adopted.The 90 critically ill patients transferred by 120 ambulances to our hospital from June to August 2023 were used as an experimental group,while the 90 critically ill patients transferred by 120 ambulances to our hospital from March to May 2023 were used as a control group.Before establishing visualization pre-hospital and in-hospital information connection technique,the patients or their family members in the control group called an ambulance;after pre-hospital rescuers sent the patients to the hospital,they connected with in-hospital medical workers in an oral or written form;pre-examination nurses received the patients,performed illness evaluation,obtained their identity information,and helped card registration;and meanwhile,the in-hospital medical workers conducted standardized treatment for the patients.After establishing visualization pre-hospital and in-hospital information connection technique,the patients or their family members in the experimental group called an ambulance;pre-hospital rescuers input corresponding basic information of the patients(including name,gender,age,vital sign,severity of illness,etc.)via the special APP of the emergency center,and pushed relevant information to the target network hospital;pre-examination nurses received the message that the ambulance was about to arrive via the pre-hospital and in-hospital collaborative treatment platform,obtained the basic information of the patients provided before admission in the emergency pre-examination system,performed card registration in advance,and opened a green channel;and meanwhile in-hospital medical workers developed a rescue plan according to the severity of illness assessed by 120 doctors.The time of critically ill patients setting up a medical card,the time of pre-examination nurses completing triage,and the satisfaction of the patients and their family members with the emergency treatment process were compared between the two groups.Results The time of critically ill patients setting up a medical card and the time of pre-examination nurses completing triage in the experimental group were significantly shorter than those in the control group[the time of critically ill patients setting up a medical card(minutes):1.3±0.3 vs.2.6±0.4,the time of pre-examination nurses completing triage(minutes):1.1±0.3 vs.3.5±0.7,both P<0.05].Moreover,the satisfaction of the patients and their family members on the emergency treatment process in the experimental group was obviously higher than that in the control group[95.6%(86/90)vs.86.7%(78/90),P<0.05].Conclusion The establishment of visualization pre-hospital and in-hospital information connection technique can achieve pre-hospital and in-hospital data transmission and accomplish"information goes ahead of patients",which effectively shortens pre-examination and triage time for critically ill patients,wins an opportunity to rescue them,improves pre-examination and triage efficiency for ordinary patients,and enhances their medical experience.

Objective:To evaluate the efficacy and safety of oral semaglutide versus sitagliptin in Chinese patients with type 2 diabetes mellitus(T2DM) inadequately controlled with metformin. Methods:The PIONEER 12 study was a phase Ⅲ clinical trial. Chinese patients were prospectively randomized to oral semaglutide(3mg, 7 mg, and 14 mg) or sitagliptin 100 mg. The primary endpoint was the change in HbA 1C from baseline to week 26, and the confirmatory secondary efficacy endpoint was the change in body weight from baseline to week 26. Results:Totally 1 084 Chinese participants(mean age 53 years, male 62.2%, mean duration of diabetes 5.5 years, HbA 1C 8.2%, and body weight 74.3 kg) were enrolled. The changes in HbA 1C at week 26 from baseline were -0.9%, -1.4%, and -1.6% for oral semaglutide 3 mg, 7 mg, and 14 mg, respectively, and -0.7% for sitagliptin. Compared to sitagliptin, oral semaglutide 3 mg, 7 mg, and 14 mg significantly reduced HbA 1C [estimated treatment difference(ETD), -0.2%(95% CI -0.4--0.0), -0.8%(95% CI -0.9--0.6), and -0.9%(95% CI -1.1--0.8), respectively; 3 mg, P=0.011, 7 mg and 14mg, P<0.001]. The estimated mean changes in body weight at week 26 from baseline were -1.1 kg, -2.5 kg, and -3.4 kg for oral semaglutide 3 mg, 7 mg, and 14 mg, respectively, and -0.4 kg for sitagliptin 100 mg. Compared with sitagliptin, oral semaglutide 3 mg, 7 mg, and 14 mg significantly reduced body weight [ETD, -0.8 kg(95% CI -1.3--0.2), -2.1 kg(95% CI -2.6--1.6), and -3.0 kg(95% CI -3.5--2.5), respectively; 3 mg, P=0.004, 7 mg and 14 mg, P<0.001]. The overall incidence of adverse events was similar across all treatment groups. The most common adverse events were gastrointestinal disorders, mostly mild or moderate in severity and transient in duration. Conclusions:Oral semaglutide resulted in significantly greater reduction in HbA 1C and body weight versus sitagliptin at week 26, with a favorable safety and tolerability profile in Chinese T2DM patients inadequately controlled with metformin.

Objective:To investigate the prognostic value of 18F-fluorodeoxygen-D-glucose-positron emission tomography /computerized tomography ( 18F-FDG-PET-CT) in Hodgkin′s lymphoma (HL) at the end of first-line treatment (PET-end), by comparing the ratio of maximum standardized uptake value (SUV max) of lesion and liver SUV (rLL), SUV max reduction between baseline PET (PET-0) and PET-end (ΔSUV max), and Deauville 5-point scale (5-PS). Methods:Patients with HL newly treated in our hospital from August 2006 to December 2015 were retrospectively analyzed. All the patients enrolled in the study underwent post-treatment FDG PET-CT. The rLL and ΔSUV max were calculated, and all the cases were scored using Deauville 5-PS. The receiver operating characteristic (ROC) approach was applied to identify the optimal cut-point value, and survival curves according to different PET-CT assessment methods were estimated using the Kaplan-Meier analysis. The prognostic efficacy of different PET-CT assessment methods was compared, and DeLong test was used to verify it. Kaplan-Meier method and multivariate analysis using the Cox proportional hazards model were performed to analyze the potential independent risk factors. Results:There were 5 patients progressed within a 3-year follow-up. In the three PET-CT assessment methods, the predictive value of rLL and Deauville 5-PS were significant effective. ROC analysis for rLL as a progression predictor showed an optimal cut-point of 1.29. Deauville 5-PS=4 and rLL=1.29 showed the best prognostic accuracy. The sensitivity of rLL and Deauville 5-PS were both 80.0%, and the specificity of each was 98.0% and 93.7%, respectively. The positive predictive value (PPV) and negative predictive value (NPV) of rLL were 66.7% and 98.7%, while the PPV and NPV of 5-PS were 44.4% and 98.7%. The 3-years progression-free survival (PFS) rates of rLL≥1.29 group and rLL<1.29 group were 33.3% and 98.7%, with significant difference ( P<0.001). The 3-years PFS rates of post-treatment Deauville 5-PS<4 group and Deauville 5-PS≥4 group were 98.7% and 55.6%, with significant difference ( P<0.001). The prognostic evaluation efficacy of rLL was positively correlated with that of Deauville 5-PS ( r=0.75, P<0.05). Area under curves (AUC) of rLL and Deauville 5-PS were 0.93 (95% CI: 0.825-1.000) and 0.91 (95% CI: 0.757-1.000), respectively. DeLong test showed the significant difference between the two methods ( P<0.05). The univariate analysis results showed that clinical baseline stage, post-treatment rLL and Deauville 5-PS were associated with the prognoses of HL patients ( P<0.05). The multivariate analysis results showed that post-treatment rLL and Deauville 5-PS were independent prognostic factors of HL ( P<0.05). Conclusions:The rLL and Deauville 5-PS are potential prognostic factors for HL response assessment. The new semi-quantitative method rLL has methodological advantages over visual analysis, and it is a good supplement for Deauville 5-PS. rLL can improve prognostic evaluation accuracy of PET-CT and is useful to early identify patients with HL at a high risk of relapsing after first-line treatment.