Objective To explore the association between the relative expression level of SNORD55 in peripheral blood and the outcomes of all-cause mortality and stroke in patients with atrial fibrillation(AF),and to evaluate the predictive value of SNORD55 for prognosis.Methods A total of 133 patients with non-valvular AF admitted in Department of Cardiology of the First Affiliated Hospital of Army Medical University from January 2014 to December 2017 were enrolled in this study.Their baseline information was collected,and the relative expression level of plasma SNORD55 was detected.Cox proportional hazards model was used to explore the association between the relative expression level of SNORD55 in peripheral blood and all-cause mortality as well as stroke in the patients.The predictive performance of CHA2DS2-VASc score for all-cause mortality and stroke was compared with the score combined with the relative expression level of SNORD55 in the AF patients.The area under the receiver operating characteristic curve(AUC)was utilized to evaluate the discrimination,and the net reclassification index(NRI)and comprehensive discriminant improvement index(IDI)were calculated to evaluate the improvement of reclassification ability.Decision curve analysis(DCA)was applied to analyze the change in clinical net benefit.Results The results of multivariate Cox regression showed that high expression of SNORD55 in peripheral blood was an independent risk factor for all-cause mortality and stroke in the AF patients.In predicting the outcomes of all-cause mortality and stroke,the addition of relative expression SNORD55 level with the CHA2DS2-VASc score obtained higher AUC value[0.80(95％CI:0.67～0.93)vs 0.67(95％CI:0.53～0.81),P＜0.05].In predicting the outcome of all-cause death and stroke,combination of the relative expression level of SNORD55 with CHA2DS2-VASc score increased both NRI[54.3(95％CI:10.6～61.9)vs 31.9(95％CI:2.8～47.5),P＜0.05]and IDI[16.1(95％CI:2.4～27.0)vs 7.9(95％CI:0.5～14.8),P＜0.05].The results of DCA showed that our combination of CHA2DS2-VASc score relative expression level of SNORD55 had higher clinical net benefits than the foreign ABC score in the prediction of the outcomes.Conclusion Peripheral blood SNORD55 level is an independent risk factor for all-cause mortality and stroke in AF patients,and has good predictive performance for all-cause mortality and stroke in the patients.

Objectives To explore the association of peripheral blood PIWI-interacting RNA,piR-hsa-2700592,with all-cause mortality and stroke outcomes in patients with atrial fibrillation(AF),and to determine whether piR-hsa-2700592 has the potential to be an AF biomarker.Methods A total of 127 patients with non-valvular AF were enrolled,and the relative expression level of plasma piR-hsa-2700592 was detected.Cox proportional hazard regression was used to analyze the correlation between the expression of piR-hsa-2700592 and all-cause death as well as stroke outcome in the patients.Then the molecule expression level was combined with CHA2DS2-VASc score and ABC stroke(or death)score to establish 2 new prediction models,the improvement of the predictive performance was compared and analyzed.Receiver operating characteristic(ROC)curve analysis(area under the curve,AUC),net reclassification index(NRI),and comprehensive discriminant improvement index(IDI)were used to evaluate the predictive performance,and decision curve analysis(DCA)was employed to assess the clinical benefit.Results Multivariate Cox regression analysis showed that the patients with higher expression level of piR-hsa-2700592 in peripheral blood had a higher risk of stroke(HR:2.203,95%CI:1.120～4.332;P=0.022).In the stroke outcome,combination of plasma piR-hsa-2700592 expression level with CHA2DS2-VASc score and ABC stroke score obtained an AUC of 0.70(95%CI:0.55～0.85,P＜0.001)and 0.84(95%CI:0.73～0.96,P=0.02),respectively.But,no significant association was observed between high plasma piR-hsa-2700592 level and all-cause mortality in the AF patients(HR:1.997;95%CI:0.884～4.509;P=0.096).Combination of plasma piR-hsa-2700592 level improved the discriminative capability than the single CHA2DS2-VASc score and ABC stroke score models,with an NRI and IDI value of 44.20%(95%CI:3.40～59.90,P＜0.001)and 8.20%(95%CI:0.60～15.40,P＜0.001),respectively for the new CHA2DS2-VASc score model,and an NRI and IDI value of 44.20%(95%CI:9.80～58.90,P＜0.001)and 10.40%(95%CI:0.70～21.40,P＜0.001),respectively for the new ABC stroke score model.The DCA curve showed that both new prediction models obtained better net clinical benefits.Conclusion High peripheral blood expression of piR-hsa-2700592 is an independent risk factor for stroke in the AF patients,and the indicator has a good predictive value for prognosis of the patients.piR-hsa-2700592 might be used as a potential biomarker in the diagnosis and prevention of cardiovascular diseases.

Objective To investigate the molecular mechanism of taurine regulating the polarization of M2 macrophages by mitophagy. Methods THP-1 cells were divided into four groups: M0 group (THP-1 cells were treated by 100 nmol/L phorbol myristate ester for 48 hours to polarize into M0), M2 group (THP-1 cells were induced to polarize into M2 macrophages by 20 ng/mL interferon-4 (IL-4) for 48 hours), M2 combined with taurine groups (added with 40 or 80 mmol/L taurine on the basis of M2 macrophages). The mRNA expression of mannose receptor C type 1(MRC-1), C-C motif chemokine ligand 22(CCL22) and dendritic cell-specific ICAM-3 grabbing non-integrin (CD209) in M2 macrophages were detected by quantitative real-time PCR. Mitochondrial and lysosome probes were used to detect the number of mitochondria and lysosomes by multifunction microplate reader and confocal laser scanning microscope. The level of mitochondrial membrane potential (MMP) was detected by JC-1 MMP assay kit. The expression of mitophagy-related proteins PTEN-induced putative kinase 1 (PINK1) and microtubule-associated protein 1 light chain 3 (LC3) were detected by Western blot analysis. Results Compared with M0 group, the expression of MRC-1, CCL22, CD209 and PINK1, the number of mitochondria and the level of MMP in M2 group were significantly increased, whereas the number of lysosomes and LC3II/LC3I ratio were decreased. Compared with M2 group, the expressions of MRC-1, CCL22 and CD209, the number of mitochondria and the level of MMP in M2 combined with taurine group dropped significantly while the number of lysosomes was found increased, and the protein expression of PINK1 and LC3II/LC3I ratio were also increased. Conclusions The polarization of M2 macrophages is regulated by taurine to prevent excessive polarization via reducing the level of MMP, improving the level of mitophagy, reducing the number of mitochondria, and inhibiting the mRNA expression of polarization markers in M2 macrophages.
Mitophagy ; Taurine ; Macrophages/metabolism* ; Protein Kinases/metabolism* ; RNA, Messenger

Objective:To investigate the current status of family caregivers learned helplessness in patients with advanced digestive tract tumor and analyze its influencing factors, so as to provide reference for the physical and mental management of cancer families.Methods:Totally 181 family caregivers of advanced digestive tract tumor patients from July 2018 to November 2019 in 4 gradeⅢclass A hospitals in Fuzhou were selected by convenient sampling method for investigation with the general information questionnaire and Learned Helplessness Scale. Multiple linear regression analysis was used to analyze the influencing factors of learned helplessness of family caregivers of patients with advanced digestive tract tumor.Results:The total score and the average items score of learned helplessness was (38.61 ± 15.40), (2.15 ± 0.88) points, which was at a lower level. Multiple linear regression analysis showed that the gender of caregiver, physical condition of caregivers, average monthly household income were significant influencing factors of family caregivers learned helplessness in patients with advanced digestive tract tumor ( P<0.05). Conclusions:The learned helplessness of family caregivers of patients with advanced digestive tract tumor is at a mild level. Nurses should focus on the physical and mental conditions of low-income groups and female caregivers with advanced digestive tract tumor, and regularly assess their nursing needs and health status to improve their quality of life.

Background::The CHA 2DS 2–VASc score was initially applied to stratify stroke risk in patients with atrial fibrillation (AF) and was found to be effective in predicting all-cause mortality outcomes. To date, it is still unclear whether circulating long non-coding RNAs (lncRNAs) as emerging biomarkers, can improve the predictive power of the CHA 2DS 2–VASc score in stroke and all-cause mortality. Methods::Candidate lncRNAs were screened by searching the literature and analyzing previous RNA sequencing results. After preliminary verification in 29 patients with AF, the final selected lncRNAs were evaluated by Cox proportional hazards regression in 192 patients to determine whether their relative expression levels were associated with stroke and all-cause mortality. The c-statistic, net reclassification improvement (NRI), and integrated discrimination improvement of the patients were calculated to evaluate the discrimination and reclassification power for stroke and all-cause mortality when adding lncRNA expression levels to the CHA 2DS 2–VASc score model. Results::Five plasma lncRNAs associated with stroke and all-cause mortality in AF patients were selected in our screening process. Patients with elevated H19 levels were found to have a higher risk of stroke (hazard ratio [HR] 3.264, 95% confidence interval [CI]: 1.364–7.813, P = 0.008). Adding the H19 expression level to the CHA 2DS 2–VASc score significantly improved the discrimination and reclassification power of the CHA 2DS 2–VASc score for stroke in AF patients. In addition, the H19 level showed a marginally significant association with all-cause mortality (HR 2.263, 95% CI: 0.889–5.760, P = 0.087), although it appeared to have no significant improvement for the CHA 2DS 2–VASc model for predicting all-cause mortality. Conclusions::Plasma expression of H19 was associated with stroke risk in AF patients and improved the discriminatory power of the CHA 2DS 2–VASc score. Therefore, lncRNA H19 served as an emerging non-invasive biomarker for stroke risk prediction in patients with AF.

Objective:To investigate relationships between fear of disease progression, invasive rumination, active rumination and post-traumatic growth in patients with chronic kidney disease (CKD) , so as to provide reference for carrying out physical and mental care in clinical nursing and improve the mental health level of patients with chronic kidney disease.Methods:From September 2019 to February 2020, 204 patients with stage 1 to 5 CKD were selected from Department of Nephrology in the Third Medical Center of PLA General Hospital by convenient sampling. They were investigated using a general data survey, the Short Form of the Fear of Progression Questionnaire (FoP-Q-SF) , Event Related Rumination Inventory (ERRI) and Posttraumatic Growth Inventory (PTGI) . Pearson product-moment correlation was used to analyze the correlations between fear of disease progression, ruminant thinking and post-traumatic growth. PROCESS 3.0 plug-in was used to analyze the mediating effect of the data, and Boopstrap was used to test the mediating effect.Results:The total scores of fears of disease progression, invasive rumination, active rumination and post-traumatic growth for CKD patients were respectively (29.40±11.85) , (21.17±8.37) , (23.54±8.44) and (51.68±27.18) . The results of correlation analysis showed that fear of disease progression, invasive rumination, and active rumination were positively correlated with post-traumatic growth ( P<0.01) . Analysis of mediating effect results showed that fear of disease progression could not directly affect post-traumatic growth of patients, but the chain mediating effect of invasive rumination and active rumination had an effect on post-traumatic growth of patients. And the chain mediating effect of invasive rumination and active rumination was statistically significant, which played a complete mediating effect. Conclusions:Fear of disease progression can indirectly affect post-traumatic growth through the chain mediating effect of invasive rumination and active rumination. Maintaining a moderate fear of disease progression and a reflective attitude is conducive to post-traumatic growth.

Objective To assess the diagnostic value of 3.0T magnetic resonance imaging (MRI) and ultrasonic cardiography in women with high altitude pulmonary arterial hypertension (PAH). Methods Seventy-six women with high altitude PAH treated at our hospital were divided into either an MRI group (group A) or an ultrasonic cardiography group (group B), with 38 cases in each group. Fifty healthy women from high altitude areas were enrolled as a control group (group C). Group A underwent MRI examination alone, Group B underwent ultrasonic cardiography examination alone, and Group C underwent concomitant MRI and ultrasonic cardiography examinations. Diagnosis accuracy and diagnostic results were compared among different groups. Results Compared with group B, diagnosis accuracy significantly rose in group A (P < 0.05). MRI showed that except right ventricular end diastolic transverse diameter,left atrial diameter, aortic diameter, and right ventricular end systolic transverse diameter, other indexes differed significantly between groups A and C (P < 0.05). Ultrasonic cardiography showed that the SPAP of group B was (44.5 ± 8.6) mmHg. Right ventricular outflow tract, pulmonary artery, right ventricular inner diameter, right atrial inner diameter, right ventricle anterior wall, interventricular septal thickness, right ventricular Tei index, and right ventricular ejection fraction differed significantly between groups B and C (P<0.05), although there was no significant difference in LVEF or LV-Tei between the two groups (P>0.05). Conclusion Both MRI and ultrasonic cardiography can diagnoses high altitude PAH in women effectively. MRI can accurately evaluate the heart structure and function in women with high altitude PAH, representing a more efficient diagnostic method.

Ideal blood glucose control requires accurate insulin injections under the guidance of frequent glucose monitoring.Artificial pancreas (AP),the closed-loop control system can adjust the input amount of insulin automatically with the body's blood glucose levels.The AP allows diabetics to control blood glucose ideal,then get the benefit of prevention of complications and bring convenience and safety in clinical application.Accuracy is the key issue of the AP.To improve the accuracy of such a system need to improve the detection accuracy and reliability,increase speed and accuracy of the output control,and improve the accuracy of the system regulation model.

Objective To analyze the differences of coronary artery anomalies between Han and Tibetan nationality living in middle and high altitude.Methods A total of 7 028 adults living in the Qinghai Plateau (1 800-7 720 m altitude),who underwent coronary CT angiography in Qinghai Cardiocerebro-vascular Disease Special Hospital between 2010 to 2015,were included in this study.There were 6 391 cases of the Han nationality and 637 cases of the Tibetan nationality.The differences of coronary artery anomalies between Han and Tibetan nationality were analyzed retrospectively.Results (1) Incidence of coronary artery anomalies was lower in Han nationality than in the Tibetan nationality (1.596％ (102/6 391) vs.4.239％ (27/637),P ＜0.001).(2) There was 64.7％ (66/102) male residents with coronary artery anomalies in Han nationality,and 74.1％ (20/27) male residents with coronary artery anomalies in Tibetan nationality (P =0.359).(3) Left side coronary artery anomalies in Han nationality was similar as in Tibetan nationality (64.4％ (67/104) vs.55.6％ (15/27),P =0.396).(4) Incidence of benign coronary artery anomalies was significantly lower in Han nationality than in Tibetan nationality (0.720％ (46/6 391) vs.2.200％ (14/637),P ＜ 0.001).Incidence of potentially dangerous coronary artery anomalies was also significantly lower in Han nationality than in Tibetan nationality (0.876％ (56/6 391) vs.2.041％ (13/637),P =0.004).(5)Ten kinds of coronary artery anomalies were found in this study.There were significant differences between Han and Tibetan nationality in left coronary artery originated from right coronary sinus(0.046％ (3/6 391) vs.0.471％ (3/637),P =0.012),in left circumflex branch originated from right coronary sinus (0.046％ (3/6 391) vs.0.471％ (3/637),P =0.012),and opening of right coronary artery in left coronary sinus or left anterior descending (0.704％ (45/6 391) vs.1.570％ (10/637),P =0.018).Conclusion The incidences of coronary artery anomalies and benign coronary artery anomalies were significantly lower in Han nationality residents than that of the in Tibetan nationality residents living in middle and high altitude.

Objective To study the role of endoplasmic reticulum stress and related inflammation in the kidneys of rats with diabetic nephropathy and the effect of valsartan on these lesions.Methods The diabetic rat model was induced by intraperitoneal injection of streptozotocin.Thirty-four healthy male SD rats were randomly divided into normal control group (n=10), diabetic group (n=12), and valsartan group (n=12).Valsartan (10 mg/kg) was administered daily by gavage from the next day of the diabetes induction for 6 weeks.The expression and distribution of ERS-related proteins P-IRE1α, P-JNK, and MCP-1 were examined by immunohistochemistry and Western blot.Real-time fluorescence quantita-tive PCR was used to detect the mRNA expressions of IRE1α, JNK and MCP-1.The 24-hour urine protein excretion, Scr, and BUN were checked.Results Compared with the control group, infiltration of inflammatory cells was aggravated in the kidneys of DM+V group, the expressions of P-IRE1α,IRE1α,P-JNK,MCP-1 were significantly increased, and the levels of IRE1mRNA and MCP-1mRNA increased compared with the DM group, infiltration of inflammation cells was alleviated in the kidney of DM+V group, the protein expressions of P-IRE1α,IRE1α,P-JNK,MCP-1 were significantly reduced, the levels of IRE1mRNA and MCP-1mRNA were reduced.While there was no significant difference in the expression of JNK mRNA and protions among the three groups.Conclusions ERS and related inflammation are activated in the kidney of di-abetic rats.Inhibition of the IRE1/JNK/MCP-1 pathway of ERS and related inflammation might be responsible for the pro-tective effects of valsartan on the kidneys of diabetic rats.