ObjectiveTo investigate the clinical efficacy of Gandouling tablet （GDL） on abnormal lipid metabolism in Wilson's disease （WD） and the correlation between the prediction model of hepatic steatosis and the related indexes of lipid metabolism in WD. MethodA total of 86 patients with abnormal lipid metabolism in WD were selected. The 24-hour urine copper， alanine aminotransferase （ALT）， aspartate aminotransferase （AST）， serum triglyceride （TG）， total cholesterol （TC）， apolipoprotein B （ApoB）， low density lipoprotein cholesterol （LDL-C）， bile acid （BA）， γ-glutamyl transferase （GGT）， prediction model of hepatic steatosis ［hepatic steatosis index （HSI） and Zhejiang University index （ZJU index）］， ultrasonic attenuation coefficient imaging （ATT）， and traditional Chinese medicine （TCM） syndrome score were statistically analyzed before treatment. Pearson correlation test was used to analyze the correlation between TG， TC， LDL-C， ApoB， ALT， AST， ALT/AST， BA， GGT， TCM syndrome score， ATT， and HIS and ZJU. The patients were divided into an observation group and a control group by random number table method， with 43 cases in each group. The observation group was treated with GDL combined with sodium dimercaptopropane sulfonate （DMPS）， while the control group was only treated with DMPS as a control. After six courses of treatment， 24-hour urine copper， TC， TG， LDL-C， ApoB， HSI， ZJU， ATT， TCM syndrome score， and clinical efficiency before and after treatment were observed and compared between the two groups. The correlation between HSI and ZJU and serum TC， TG， LDL-C， ApoB， ALT， AST， ALT/AST， BA， GGT， TCM syndrome scores， and ATT was analyzed. ResultPearson correlation analysis showed that serum TC （r = 0.811）， TG （r = 0.826）， LDL-C （r = 0.802）， ApoB （r = 0.820）， ALT （r = 0.497）， ALT/AST （r = 0.826）， TCM syndrome score （r = 0.716）， and ATT （r = 0.736） were positively correlated with HSI （P<0.01）， while AST， BA， and GGT had no significant correlation with HSI. TC （r = 0.718）， TG （r = 0.765）， LDL-C （r = 0.667）， ApoB （r = 0.699）， ALT/AST （r = 0.403）， TCM syndrome score （r = 0.666）， and ATT （r = 0.684） were positively correlated with ZJU （P<0.01）. ALT， AST， BA， and GGT had no significant correlation with ZJU. The total effective rate of the observation group was 86.05 （37/43）， and that of the control group was 72.09% （31/43）. The total effective rate of the observation group was higher than that of the control group （Z = -2.301， P<0.05）. After treatment， the 24-hour urine copper of the two groups increased significantly. The levels of TC， TG， LDL-C， and ApoB were significantly decreased， and the HSI， ZJU， and ATT were significantly decreased （P<0.01）. Compared with those in the control group after treatment， the above indexes improved better in the observation group （P<0.05， P<0.01）. ConclusionGDL can effectively improve the level of copper and lipid metabolism in patients with WD， with high clinical safety and good clinical application value. The prediction model of hepatic steatosis can effectively reflect the degree of abnormal lipid metabolism in WD.

Objective To observe the effect of a new cell delivery tool(MSC exo)on the proliferation of pancreatic cancer by transferring targeted genes.Methods Transmission Electron Microscope(TEM)and Nanoparticle Tracking Analysis(NTA)were used to identify human mesenchymal stem cell exosomes(MSC-exo)and transport miR-450a-5p into CFPAC-1,to explore the effect of miR-450a-5p targeting BZW2 on inhibiting the proliferation of pancreatic cancer cells.Results The expression of miR-450a-5p was low in pancreatic cancer tissue(P<0.05),and the expression of CD63 and TSG101 of MSC-exo-miR-450a-5p in CFPAC-1 cells was higher than that of MSC-exo by Western blot(P<0.05).CCK-8 and EdU results showed that MSC-exo-miR-450a-5p significantly inhibited the proliferation of CFPAC-1 cells(P<0.05).Cell scratch and Transwell experiments showed that MSC-exo-miR-450a-5p can inhibit the migration and invasion of CFPAC-1 cells(P<0.05).Through dual luciferase assay,it was confirmed that miR-450a-5p targets BZW2,and RT-qPCR and Western blotting showed a negative correlation(P<0.05)between miR-450a-5p and BZW2 expression.Overexpression of BZW2,CCK-8,EdU,cell scratch,and Transwell experiments confirmed that pc-BZW2 reversed the anti-cancer function of MSC-exo-miR-450a-5p on CFPAC-1.Western blot detected PCNA,Ki-67,MMP2,MMP9,and the results were consistent with the above experiments(P<0.05).Conclusion hMSC exo is a new delivery system,targeting BZW2 to transport miR-450a-5p to inhibit the biological malignancy of pancreatic cancer cells,which provides an important clue for the research of targeted treatment of pancreatic cancer.

Objective:To investigate the effect of different administration methods of recombinant human prourokinase (rhPro-UK) during emergency percutaneous coronary intervention (PCI) on myocardial perfusion and prognosis of patients with acute ST segment elevation myocardial infarction (STEMI).Methods:The clinical data of 132 patients with STEMI who underwent emergency PCI in the Military Hospital of the 71st Army Group of the Chinese People′s Liberation Army from August 2017 to August 2022 were analyzed retrospectively. Among them, 66 patients treated with rhPro-UK injection after the guide wire passed through the coronary artery lesion, balloon dilation and stent placement were included in group A. The other 66 patients treated with rhPro-UK injection once after the guide wire passed through the coronary artery lesion were included in group B. The two groups were compared in terms of PCI conditions, target vessel perfusion status [corrected TIMI frame count (CTFC) and blood flow (thrombolysis in myocardial infarction, TIMI) grade], myocardial perfusion status [TIMI myocardial perfusion grade (TMPG), ST segment regression rate (STR) at 90 min after operation and the incidence of no reflow/slow flow (NR/SF)], cardiac function indicators [left ventricular end diastolic volume (LVEDV), left ventricular end systolic volume (LVESV) and left ventricular ejection fraction (LVEF)], the incidence of major adverse cardiovascular events (MACE), and the incidence of bleeding events.Results:There were no statistically significant differences between the two groups in terms of the distribution of culprit blood vessels, intubation methods, and number of stents implanted ( P>0.05). After treatment, the proportion of TIMI blood flow grade 3 in the group A was higher than that in the group B:99.97% (64/66) vs. 87.88% (58/66). CTFC of the two tgroups decreased, and CTFC of group A was lower than that of group B: (23.49 ± 4.27) frames vs. (27.14 ± 4.83) frames ( P<0.05). The proportion of TMPG grade 3 in group A was significantly higher than that in group B: 95.45% (63/66) vs. 83.33% (55/66)( P<0.05). STR in group A was significantly higher than that in group B: 95.45% (63/66) vs. 83.33% (55/66)( P<0.05). The incidence of NR/SF in group A was lower than that in group B: 3.03% (2/66) vs. 14.29% (10/66)( P<0.05). There were no statistically significant differences in LVEDV or LVESV between the two groups before and after treatment ( P>0.05). After 1 month of treatment, LVEF of the two groups increased, and LVEF of group A was higher than that of group B: (71.08 ± 6.38) % vs. (66.24 ± 6.49) % ( P<0.05). After treatment, the incidence of MACE in group A was lower than that in group B: 6.06%(4/66) vs. 13.64%(9/66) ( χ2 = 2.13, P = 0.144). There was no statistically significant difference in the incidence of bleeding events between the two groups ( P>0.05). Conclusions:For patients with STEMI undergoing PCI, fractional injection of rhPro-UK can better improve myocardial perfusion, reduce the incidence of MACE, and effectively improve the prognosis, compared with one-time injection of rhPro-UK.

ObjectiveTo characterize the chemical constituents of Dayuanyin based on ultra-performance liquid chromatography-quadrupole/electrostatic field orbitrap mass spectrometry（UPLC-Q-Exactive Orbitrap MS）. MethodThe detection was performed on a Thermo Acclaim™ RSLC 120 C₁₈ column（2.1 mm×100 mm， 2.2 μm）， the mobile phase was acetonitrile（A）-0.1% formic acid aqueous solution（B） for gradient elution （0-7.5 min， 10%-19%A； 7.5-12 min， 19%-22.5%A； 12-23 min， 22.5%-27%A； 23-27 min， 27%-56%A； 27-35 min， 56%-84%A； 35-36 min， 84%-90%A）， the flow rate was 0.3 mL·min^-1， and the column temperature was 30 ℃. The data were collected in the positive and negative ion modes by heated electrospray ionization（HESI）， and the detection range was m/z 80-1 200. Combining the retention time of the reference substance， fragment ions， databases such as PubChem and related literature， Xcalibur 3.0 was used to identify the chemical constituents of Dayuanyin. ResultA total of 161 compounds were identified， including 14 alkaloids， 60 flavonoids， 16 terpenoids， 26 saponins， 18 phenylpropanoids， 16 organic acids and 11 others. ConclusionThe established method can effectively and quickly identify the chemical components in Dayuanyin， and clarify its chemical composition， which can provide a basis for the development of compound preparations of this famous classical formula.

Background: We hypothesized that specific amino acids or acylcarnitines would have benefits for the differential diagnosis of diabetes. Thus, a targeted metabolomics for amino acids and acylcarnitines in patients with diabetes and its complications was carried out. Methods: A cohort of 54 normal individuals and 156 patients with type 2 diabetes mellitus and/or diabetic complications enrolled from the First Affiliated Hospital of Jinzhou Medical University was studied. The subjects were divided into five main groups: normal individuals, impaired fasting glucose, overt diabetes, diabetic microvascular complications, and diabetic peripheral vascular disease. The technique of tandem mass spectrometry was applied to obtain the plasma metabolite profiles. Metabolomics multivariate statistics were applied for the metabolic data analysis and the differential metabolites determination. Results: A total of 10 cross-comparisons within diabetes and its complications were designed to explore the differential metabolites. The results demonstrated that eight comparisons existed and yielded significant metabolic differences. A total number of 24 differential metabolites were determined from six selected comparisons, including up-regulated amino acids, down-regulated medium-chain and long-chain acylcarnitines. Altered differential metabolites provided six panels of biomarkers, which were helpful in distinguishing diabetic patients. Conclusion Our results demonstrated that the biomarker panels consisted of specific amino acids and acylcarnitines which could reflect the metabolic variations among the different stages of diabetes and might be useful for the differential diagnosis of prediabetes, overt diabetes and diabetic complications.

The robotic bronchoscopy system is a new technology for lung lesion location, biopsy and interventional therapy. Its safety and effectiveness have been clinically proven. Based on many advanced technologies carried by the robotic bronchoscopy system, it is more intelligent, convenient and stable when clinicians perform bronchoscopy operations. It has higher accuracy and diagnostic rates, and less complications than bronchoscopy with the assistance of magnetic navigation and ordinary bronchoscopy. This article gave a review of the progress of robotic bronchoscopy systems, and a prospect of the combination with artificial intelligence.

Background: We hypothesized that specific amino acids or acylcarnitines would have benefits for the differential diagnosis of diabetes. Thus, a targeted metabolomics for amino acids and acylcarnitines in patients with diabetes and its complications was carried out. Methods: A cohort of 54 normal individuals and 156 patients with type 2 diabetes mellitus and/or diabetic complications enrolled from the First Affiliated Hospital of Jinzhou Medical University was studied. The subjects were divided into five main groups: normal individuals, impaired fasting glucose, overt diabetes, diabetic microvascular complications, and diabetic peripheral vascular disease. The technique of tandem mass spectrometry was applied to obtain the plasma metabolite profiles. Metabolomics multivariate statistics were applied for the metabolic data analysis and the differential metabolites determination. Results: A total of 10 cross-comparisons within diabetes and its complications were designed to explore the differential metabolites. The results demonstrated that eight comparisons existed and yielded significant metabolic differences. A total number of 24 differential metabolites were determined from six selected comparisons, including up-regulated amino acids, down-regulated medium-chain and long-chain acylcarnitines. Altered differential metabolites provided six panels of biomarkers, which were helpful in distinguishing diabetic patients. Conclusion Our results demonstrated that the biomarker panels consisted of specific amino acids and acylcarnitines which could reflect the metabolic variations among the different stages of diabetes and might be useful for the differential diagnosis of prediabetes, overt diabetes and diabetic complications.

Objective To investigate the association between the three single nucleotide polymorphisms (SNP) in angiotensin Ⅱ type one receptor (AT1R) gene with coronary artery disease (CAD) in Chinese Han nationality.Methods Extracted DNA and RNA samples of peripheral blood white cells from 192 CAD patients and 189 healthy individuals in Jan 2011 to Oct 2013 from the general hospital of the PLA Rocket Force.Designed primes and the three SNPs as rs6801836,rs2675511 and rs5182 of AT1R gene were analyzed with allele-specific fluorogenic oligonucleotide probes in an assay combining extension and hybridization.Results The genotype and allele frequencies of the three SNPs were not significantly different between the control group and CAD group (x2 =0.047～2.226,all P＞0.05).The major haplotype constructed with linkaged rs6801836 and rs5182 was TT.The frequency of every haplotypes showed no significantly difference between the two groups (x2 =0.025～1.020,all P＞0.05).Conclusion The three polymorphisms of AT1R gene studied in this work showed no association with CAD susceptibility.

Objective To investigate the association between single nucleotide polymorphisms (SNP)and expression levels ofα-adducin(ADD1)gene in coronary artery disease (CAD)patients.Methods Extracted DNA and RNA samples of peripher-al blood white cells from 114 CAD patients and 116 healthy individuals in Jan 2011 to Oct 2013 from the General Hospital of the PLA Rocket Force.SNPs of rs3775067 and rs1263359 mutations in the ADD1 gene were analyzed with allele-specific flu-orogenic oligonucleotide probes combining hybridization.The gene expression levels were analyzed with fluorescence labeled and capillary electrophoresis technology.Results The frequencies of the genotypes and alleles of the two SNPs in the ADD1 gene were not significantly different between the two groups (χ2=0.018~1.317,all P>0.05).The ADD1 gene expression levels of CAD group (0.226±0.284)were obviously higher than that of control group (0.153±0.144,P<0.05).The gene expression levels of TC genotype of rs3775067 were obviously higher in CAD group (0.250±0.319)than that of control group (0.154±0.156,P<0.05),but the levels of the other genotypes had no significant difference between the two groups (t=0.557~1.867,all P>0.05).Conclusion The elevated ADD1 gene expression level would be risk factor for CAD.The polymorphisms of rs3775067 and rs1263359 had no relevance with CAD susceptibility.

Purpose To investigate the value of real-time three-dimensional contrast-enhanced ultrasound (RT3D-CEUS) for the evaluation of blunt renal trauma hemorrhage. Materials and Methods Nine healthy New Zealand white rabbits were randomly divided into three groups, and after heparinization, the models of ongoing hemorrhage of blunt renal trauma were developed by self-made minitype striker in the three groups with different force levels:77.2 N (group A), 106.2 N (group B), 135.1 N (group C). All rabbits were performed ultrasonography (US), color Doppler flow imaging (CDFI) and RT3D-CEUS before and after strike (within 20 minutes). The results achieved by US, CDFI, 2D-CEUS (A-plane results in RT3D-CEUS) and RT3D-CEUS were compared with each other, and further compared with the pathological results of the executed animals after blood pressure decreased lower than 40 mmHg. Results All rabbits showed traumatic renal lesions and it proved that the bigger the force the heavier the injury (group A: 1 case of levelⅠ, 2 cases of levelⅡ;group B:3 cases of levelⅢ;group C:1 case of levelⅢ, 2 cases of level Ⅳ ). After strike, US identified the presence of increasing hematoma under the capsule but could not detect active bleeding. In CDFI, only 1 case was detected ongoing hemorrhage. 2D-CEUS clearly presented the bleeding in all cases. RT3D-CEUS presented a vivid real-time and stereoscopical image of active hemorrhage in all cases and also showed that the wider the bleeding area was shorter than the shock duration time. Conclusion RT3D-CEUS can present a real-time dynamic bleeding and locate headstream of blood in renal trauma vividly and stereoscopically, and can be used to preliminarily evaluate the degree of ongoing hemorrhage in traumatic kidney.