Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has posed a serious challenge to emergency departments that usually encounter emergencies and severe diseases.[1⇓⇓⇓-5] Angiotensin-converting enzyme 2 (ACE2), a protein that interacts with the viral spike protein(s), allows SARS-CoV-2 to penetrate epithelial cells.[6] There is mounting evidence that suggests that the digestive system may also be affected.[7] An observational study described potential patterns of pancreatic injury (elevated amylase and lipase) in patients with coronavirus disease 2019 (COVID-19).[8] Additionally, sporadic case reports have described secondary pancreatitis in patients with SARS-CoV-2 infection and presented imaging evidence.[9] Moreover, a previous study showed that COVID-19 patients not only have a higher risk of developing acute pancreatitis (AP), but also have a significantly higher mortality than those without COVID-19.[10] Using bioinformatics analysis, it may be possible to reveal how COVID-19 and AP are related. In this study, two RNA-seq datasets of SARS-CoV-2 and AP were selected for analysis.

Objective:To investigate the expression and significance of serum osteoprotegerin and related inflammatory factors in patients with coronary heart disease.Methods:According to case-control study method, 236 subjects with chest pain admitted to Nanyang Second General Hospital Affiliated to Xinxiang Medical University from March 2018 to July 2019 were collected.According to the results of coronary angiography, they were divided into 132 cases of coronary heart disease group and control group(non-coronary Patients with heart disease) 104 cases.Questionnaire survey to collect general data of patients; 5 mL of fasting peripheral venous blood was collected in the morning, and serum was collected by centrifugation.Enzyme-linked immunosorbent assay was used to detect osteoprotegerin and monoclonal antibody to receptor activator of nuclear factor kappa B(RANK) ligand, interleukin 6 (IL-6), C-reactive protein, insulin-like growth factor 1 (IGF-1), monocyte chemoattractant protein 1 (MCP-1), matrix metalloproteinase 9 (MMP-9) levels.Results:The levels of serum osteoprotegerin, IL-6, C-reactive protein, IGF-1, MCP-1, and MMP-9 in patients with coronary heart disease were (1.85±0.49) μg/L, (65.93±5.18) ng/L, (15.74±2.52) mg/L, (725.19±13.36) μg/L, (302.16±15.92) μg/L and (58.31±7.94) μg/L, respectively, which were significantly higher than those in control group (1.42±0.44) μg/L, (47.56±3.51) ng/L, (1.91±0.67) mg/L, (228.61±12.05) μg/L, (246.39±10.28) μg/L and (37.09±4.76) μg/L.Soluble RANK ligand (332.69± 14.91) ng/L was significantly lower than the control group (380.85±19.56) ng/L.The difference was statistically significant (t value were 4.739, 21.065, 29.721, 27.637, 18.911, 16.463 and 17.085, respectively, all P<0.05). The levels of serum osteoprotegerin, IL-6, C-reactive protein, and IGF-1 were statistically significant among different lesion groups (all P<0.05). The levels of osteoprotegerin, IL-6, C-reactive protein and IGF-1 in three vessel disease group ((2.05±0.51) μg/L, (80.96±25.70) ng/L, (19.79±2.03) mg/L, (849.07±18.95) μg/L) were significantly higher than the double-vessel disease group ((1.83±0.45) μg/L, (62.74±20.61) ng/L, (13.82±1.75) mg/L, (714.84±19.06) μg/L) and single-vessel disease group ((1.61±0.42) μg/L, (53.09±18.37) ng/L, (9.67±1.40) mg/L, (507.51±17.83) μg/L), and the double-vessel disease group was significantly higher than the single-vessel disease group, the difference was statistically significant (all P<0.05). Multivariate unconditional Logistic regression analysis showed that serum osteoprotegerin and IGF-1 are the influencing factors of coronary heart disease.ROC curve analysis showed that the AUC of serum osteoprotegerin was 0.827.At the best cut-off point of 1.54 μg/L, the diagnostic sensitivity was 84.09% (111/132) and the specificity was 73.48% (97/132) ; the AUC of serum IGF-1 was 0.883, which was at the best cut-off point.At 395.78 μg/L, the diagnostic sensitivity was 71.21% (94/132) and the specificity was 96.21% (127/132). Conclusion:Serum osteoprotegerin and related inflammatory factor IGF-1 are influential factors in the occurrence of coronary heart disease, and are positively correlated with the severity of coronary artery disease, and have a good diagnostic value for the occurrence of coronary heart disease.

Objective To investigate the MRI features of different fibrotic stroma of hepatocellular carcinomas (HCC) and the relationships between them and delayed contrast-enhanced MR findings. Methods Twenty eight patients were enrolled in the study who had undergone dynamic contrast-enhanced MRI scanning. MRI showed largely complete rim-like enhancement in delayed phase in all the lesions which were confirmed by surgery and pathology. Delayed-enhancement in peripheral and internal position of HCC were evaluated and the thicknesses of rim-like enhancement in delayed phase were measured by analyzing the 5 minute delayed images. Among the 28 lesions, 22 were sampled and pathologically analyzed both in peripheral and internal portion of HCC and the remaining 6 were in the internal portion only. The pathological features were observed including distributions of three fibers (elastic, collagen and reticular fibers) in the periphery and internal positions of HCC, degrees of inflammatory cells infiltration outside the capsule and in the internal portion of HCC, the blood vessels in the capsules and thicknesses of fibrous capsule. The pathological features of HCC with different degrees of delayed-enhancement were compared using χ2 test, and differences in the thicknesses of rim-like enhancement of HCC in delayed phase among different pathological features were analyzed using Chi-square test. Results (1) In the periphery:pathological features: the typical fibrous capsules showed in all 22 HCC. And three kinds of fibers were crisscrossed within the capsules without quantitative differences. MRI findings:statistical differences in the amounts of blood vessels in the capsule of HCC among different degrees of delayed-enhancement were found (P<0.05), however, the differences in the thicknesses of fibrous capsule and the degrees of inflammatory cells infiltration were not found (all P>0.05). In addition, the statistical differences in the thicknesses of rim-like enhancement of HCC showed among different thicknesses of fibrous capsule, degrees of inflammatory cells infiltration and amounts of blood vessels (all P<0.05). (2) In the internal positions:pathological features: the amounts of three kinds of fibers in the internal positions were significantly lower than those in the periphery. MRI findings: the statistical differences in collagen fibers, elastic fibers, reticular fibers and the degrees of infiltration of inflammatory cells of HCC were all seen among different degrees of delayed enhancement inside tumors (all P<0.05). Conclusion The delayed MR enhancement of HCC in peripheral and internal positions showed correlation with the fibers and degrees of infiltration of inflammatory cells in the tumor.

Aim To improve the biological activity of A-ring modified analogues of camptothecin.Methods A-ring modified camptothecins were synthesized from 10-hydroxycamptothecin or 7-ethyl-10-hydroxycamptothecin (SN-38) in three or four steps. Their cytotoxicity was evaluated using MTT assay,and their in vivo antitumor activity against mouse liver cancer H22 was tested. Results Five hexacyclic camptothecins (6a, 6b, 6c, 7a and 7b) are target compounds, and ten camptothecin derivatives are new compounds. Conclusion The modification of a 1,4-oxazine-2-one ring fused with positions 9 and 10 of Aring will reduce the antitumor activity of camptothecins.

Objective:To evaluate the effectiveness of syncope unit in improving the diagnosis efficiency and treatment prognosis of patients with suspected syncope.Methods:The standardized syncope unit was established in the Affiliated Nanyang Second General Hospital of Xinxiang Medical College in 2018. Patients with suspected syncope attending from November 2018 to April 2019 (before the establishment of syncope unit) and from May to October 2019 (after the establishment of syncope unit) were enrolled in the study. There were 109 cases attending before the establishment of syncope unit (control group) and 126 cases attending after establishment (syncope unit group). The positive rate of examination, the treatment and its cost before and after the establishment of syncope unit were compared. After one year, the follow-up rate, recurrence rate, rehospitalization rate, treatment satisfaction and quality of life of patients were documented and compared between two periods.Results:The positive rates of tilt table test [61.90%), Holter monitoring [64.29%(81/126)], exercise stress test [7.14%(9/126)] invasive electrophysiology [40.48%(51/126)], cardiac imaging [9.52%(12/126)] and 24-h blood pressure monitoring [55.56%(70/126)] in syncope unit group were significantly higher than those in control group [44.95%(49/109), 36.70%(40/109), 5.50%(6/109), 10.09%(11/109), 2.75%(3/109) and 40.37%(44/109); χ2=19.28, 23.11, 6.93, 28.18, 15.85 and 11.61,respectively; all P<0.01]. The diagnostic rate of etiology in syncope unit group was significantly higher than that in control group [87.30%(110/126) vs. 77.06%(84/109), χ2=21.70, P<0.01].The time from onset to cardiac assessment and hospitalization time in syncope unit group were significantly shorter than those in control group[(3.68±1.93)h vs. (7.31±2.64)h;(6.17±1.52)d vs. (10.83±2.09)d]. The hospitalization rate [3.17%(4/126) vs. 8.26%(8/109)], hospital mortality [0.79%(1/126) vs. 2.75%(3/109)] and treatment cost [(4.91±1.14) thousands Yuan vs. (7.05±2.53) thousands Yuan] in syncope unit group were significantly lower than those in control group ( t=14.49, P<0.01; t=8.62, P=0.02;χ2=15.83, P<0.01;χ2=10.03, P=0.01; t=6.17, P=0.03).The outpatient follow-up rate [82.54%(104/126)] and treatment satisfaction rate [91.35%(95/104)] in syncope unit group were significantly higher than those in control group [61.47%(67/109) and 64.18%(43/67)]; and the recurrence rate [14.42%(15/104)] and rehospitalization rate [7.69%(8/104)] in syncope unit group were significantly lower than those in control group [40.30%(27/67) and 23.88%(16/67)](χ2=17.30, 20.37, 18.56, 15.08,all P<0.01). The scores of psychological status, physiological status, environmental status, social relations and overall quality of life in contral group were significantly lower than those in syncope unit group (43.62±12.84 vs. 59.13±13.95,43.10±11.31 vs. 5.86±12.09,52.35±12.76 vs. 63.58±13.05,54.87±12.08 vs. 67.91±14.23,58.42±11.87 vs. 69.28±13.51; t=7.74, P=0.03; t=7.50, P=0.03; t=8.66, P=0.02; t=9.77, P=0.01; t=8.46, P=0.02, respectively). Conclusion:The establishment of standardized syncope unit is helpful to improve the diagnosis efficiency and the prognosis of patients with suspected syncope, and also reduce the cost of diagnosis and treatment.

Objective:To observe the incidence of syncope in patients with acute and critical cardiovascular diseases and to explore the risk factors of death.Methods:925 cases of acute heart failure, acute myocardial infarction, pulmonary embolism, arrhythmia and aortic dissection rupture who participated in Prospective, Multi-CenterRegistered Research Project for Chinese Syncope Patients from March 2018 to March 2020, admitted to the department of emergency of Nanyang Second General Hospital were selected as the research objects. The incidence and mortality of syncope were recorded, and the patients were divided into syncope group and non-syncope group according to whether they were accompanied by syncope or not. The incidence of syncope in male and female patients with different cardiovascular critical diseases, the age and mortality of cardiovascular critical patients with syncope or not were analyzed and compared. Multivariate Logistic regression analysis was used to analyze the risk factors of death, and receiver operating characteristic curve (ROC curve) was drawn to evaluate the predictive value of risk factors on the prognosis of patients.Results:The incidence of syncope in 5 kinds of cardiovascular critical patients from high to low was: acute myocardial infarction 3.03% (28/925), arrhythmia 2.70% (25/925), pulmonary embolism 1.51% (14/925), aortic dissection rupture 1.41% (13/925), acute heart failure 0.65% (6/925), with statistically significant differences ( χ2 = 10.765, P = 0.010). There was no significant difference in the incidence of syncope between male and female patients with pulmonary embolism, aortic dissection rupture, acute myocardial infarction, arrhythmia and acute heart failure. The age of patients with aortic dissection rupture, acute myocardial infarction and arrhythmia in syncope group were significantly higher than those in non-syncope group [aortic dissection rupture (years old): 66.29±15.64 vs. 57.63±14.23, acute myocardial infarction (years old): 69.55±15.13 vs. 62.10±15.75, arrhythmia (years old): 70.48±14.93 vs. 60.29±16.31, all P < 0.05]. The mortality of patients with pulmonary embolism, aortic dissection rupture, acute myocardial infarction, arrhythmia, acute heart failure in syncope group were significantly higher than those in non-syncope group [pulmonary embolism: 5.81% (5/86) vs. 0.95% (8/839), aortic dissection rupture: 4.65% (4/86) vs. 0.60% (5/839), acute myocardial infarction: 4.65% (4/86) vs. 1.19% (10/839), arrhythmia: 2.33% (2/86) vs. 0.95% (8/839), acute heart failure: 2.33% (2/86) vs. 0.60% (5/839), all P < 0.05]. Multivariate Logistic regression analysis showed that age [odds ratio ( OR) = 2.158, 95% confidence interval (95% CI) was 0.921-4.785, P = 0.000], pulmonary embolism ( OR = 15.391, 95% CI was 8.904-27.314, P = 0.001), aortic dissection rupture ( OR = 13.079, 95% CI was 6.237-25.509, P = 0.000), acute myocardial infarction ( OR = 18.826, 95% CI was 10.420-32.921, P = 0.000), syncope ( OR = 4.940, 95% CI was 1.764-9.287, P = 0.000) were risk factors for the prognosis of patients with acute and critical cardiovascular diseases. ROC curve analysis showed that syncope had a certain predictive value for 28-day prognosis of patients [the area under the ROC curve (AUC) = 0.760, P = 0.000], when the cut-off value was 4.12, the sensitivity was 88.51%, the specificity was 78.05%, the positive predictive value was 81.31%, and the negative predictive value was 84.27%. Conclusions:Syncope is an independent risk factor of death in patients with acute and critical cardiovascular diseases. For patients with syncope as the chief complaint, we should quickly identify the types of acute and critical diseases and assess the risk of sudden death.

Twenty-five hybrid dogs were injected intravenously with oleic acid of the dose 0.3 ml/kg of body weight to prepare a model of respiratory distress syndrome (RDS) . The animals were killed 24 hours after injection. PaO2, PaCO2 and pH of the arterial and mixed venous blood were determined before and immediately, 0.5, 1?2, 4, 6, 22 and 24 hours after injection. The average pulmonary arterial pressure was measured hourly. The chest x-ray films were taken 2,4, 6 and 24 hours after injection. The electrolytes T3, T4, the hematocrit and RBC count, and the serum corticosteroid level were measured before and 24 hours after injection.25 dogs were divided into two groups; the control group consisted of 8 dogs and the therapeutic group consisted of 17 dogs, among which nine were treated with hyosine hydrobromide and 8 with dexamethasone. The histologic specimens of the animals of the control group and hyosine hydrobromide treated group were examined with both light and electron microscopes but the specimens of the animals of dexamethasone treated group were examined with light microscope only.It was found that dexamethasone is effective in the treatment of RDS produced with oleic acid injection while hyosine hydrobromide is of no value.

Objective To observe the effect and correlation of serum homocysteine(HCY),mitochondrial coupling factor-6 (CF-6) and urine trace protein(UMA) level in the diagnosis and treatment of coronary heart disease complicated with heart failure.Methods From June 2012 to June 2016 in Tangshan City worker's Hospital of Hebei Province branch from coronary heart disease with heart failure in 200 cases,as the observation group,patients received conventional treatment,according to the results of treatment were divided into effective group(n=168) and ineffective group (n=32).The treatment of hospitalized patients with coronary heart disease and heart failure in 100,set to the coronary heart disease group and heart failure group.At the same time,100 cases were admitted in the same period of healthy people as the healthy control group.Serum HCY levels were determined by enzymatic cycling method.Analysis of serum CF-6 level was detected by radioimmunoassay,using immune scattering to detect urine UMA turbidity,HCY,CF-6,UMA analysis and observation of the level of diagnosis and treatment of coronary heart disease in patients with heart failure.Results HCY,CF-6 and UMA in the observation group,CHD group,heart failure group were significantly higher than that of the control group,and the difference was statistically significant(P＜0.05),There was no significant difference in coronary heart disease group and heart failure group in HCY,CF-6 and UMA level(P＞0.05).HCY,CF-6 and UMA in the observation group were significantly higher than that of patients with coronary artery disease and heart failure group,and the difference was statistically significant(P＜0.05).HCY,CF-6 and UMA levels of effective group and ineffective group were higher than the control group,and the difference was statistically significant(P＜0.05).HCY,CF-6,UMA effective level in invalid group were low,and the difference was statistically significant(P＜0.05).There was a positive correlation between rate of coronary heart disease with heart failure and HCY,CF-6 and UMA(P＜0.05).Conclusion The detection of serum HCY,CF-6 and UMA levels in patients with coronary heart disease complicated with heart failure may play a role in the observation of the curative effect.

Objective To evaluate the effectiveness of spectral CT with multiple parameters on the diagnosis of ovarian cancer. Methods The data of 22 patients with spectral CT enhanced scan were analyzed retrospectively.The patients were divided into two groups:ovarian cancer group (n=11)and benign tumor group (n=11),according to the pathologic results.CT values at 40 keV,iodine concentration (IC),water concentration(WC)and spectral curve slope (λHU)of arterial phase and venous phase in the tumors of two groups were measured with gemstone spectral imaging(GSI)post-processing software.The independent samples t test was used to compare these multiple parameters above between two groups.Interobserver agreement with regard to various parameters was assessed using Cohen’s Kappa . For the parameters which showed statistically different,the receiver operating characteristic(ROC)curves were further generated to calculate their diagnostic effectiveness respectively.Results CT values at 40 keV,IC andλHUmeasured in arterial and venous phases were higher in ovarian cancer group than those in benign tumor group.There were significant differences between these two groups(P<0.05). While WC had no significant difference in these two groups (P>0.05).Interobserver agreement with regard to various parameters was excellent (Kappa>0.80).CT values at 40 keV,IC andλHUhad high effectiveness on the diagnosis of ovarian cancer according to ROC curves.The optimal parameter among them was IC in arterial phase with AUC of 0.90.Using 10.92 (100 μg/cm3)as a threshold value,the sensitivity and specificity for diagnosis were 90.9% and 90.9%.Conclusion Spectral CT with multiple parameters,including CT values at 40 keV,IC and λHUhave significant differences between benign and malignant ovarian tumors.IC in arterial phase has the highest effectiveness on the diagnosis of ovarian cancer.

OBJECTIVEThe chemopreventive activity and mechanism of dehydroepiandrosterone (DHEA) were studied.

METHODSModel of 7, 12-dimethylbenz (alpha) anthracene (DMBA) induced breast carcinoma in Sprague-Dawley rats, uitra-violet (UV)-induced DNA damage and Salmonella mutation assay were used.

RESULTSIn DMBA-induced rat mammary tumor model, the rats were orally given daily DHEA for 2 weeks before DMBA and continued for 10 weeks after DMBA administration. The results showed significant inhibition of tumor development by DHEA. The incidence of mammary carcinoma also decreased significantly on daily dose of oral 25 mg/kg DHEA with the mean tumor volume per rat also remarkably reduced by 92%. Moreover, 25 mg/kg DHEA treatment could significantly increase the carcinoma latency for about 3.5 weeks as compared with the control. Using polymerase chain reaction (PCR) assay, in vitro 10(-9) mol/L DHEA showed significant inhibitory effect on UV-induced DNA damage by 90%. In Ames test, DHEA was found to decrease DMBA and benzo (alpha) pyrene-induced TA98 and TA100 His(+) revertants markedly and the number of Salmonella clones were significantly reduced by 53.2% and 73.0% on dose of 5 microgram DHEA/plate. It was also shown that in vitro 10(-7) mol/L DHEA could also effectively inhibit the G-6-PDH activity, which might play an important role in its chemoprophylaxis activities.

CONCLUSIONThe results strongly prove that DHEA is a potent cancer chemoprophylaxis agent, which exhibits inhibitory potential on mutation and chemical carcinogen in vivo and in vitro.

9,10-Dimethyl-1,2-benzanthracene ; administration & dosage ; Adjuvants, Immunologic ; pharmacology ; Animals ; Antimutagenic Agents ; pharmacology ; DNA Damage ; drug effects ; Dehydroepiandrosterone ; pharmacology ; Disease Models, Animal ; Dose-Response Relationship, Drug ; Glucosephosphate Dehydrogenase ; antagonists & inhibitors ; metabolism ; Mammary Neoplasms, Experimental ; chemically induced ; prevention & control ; Mutagenicity Tests ; Rats ; Rats, Sprague-Dawley ; Salmonella ; drug effects ; genetics ; Time Factors ; Tumor Cells, Cultured