[Objective]The clinical characteristics and the possible risk factors were explored for the low triiodothyronine syndrome(LTS)in elderly patients with chronic heart failure(CHF),and the risk prediction model of LTS was established.[Methods]For this research,291 elderly patients with CHF were selected as sample and retrospectively reviewed was used as analytical method.According to the thyroid function of admission patients,two groups including LTS group(n=107)and normal thyroid function group(n=184)were divided.The general information and biochemical indicators of patients were collected and recorded,and the risk factors for LTS were assigned scores,in which numerical variables(except age)were grouped by median.The chi-squared test was used for statistical analysis of each variable,and multivariate regression model was used to analyze the independent risk factors of LTS in elderly patients with CHF,then the nomogram model for LTS was established based on the results from the final regression analysis.Furthermore,the prediction model was evaluated using C-index,calibration curve and receiver operating characteristic(ROC)curve.[Result]Serum creatinine(Scr),C-reactive protein(CRP),interleukin-6(IL-6)and the cardiac functional grading according to the New York Heart Association(NYHA)were positively correlated with LTS(OR values were 1.893,2.356,1.021 and 1.815,respectively,P<0.05),serum Albumin(Alb)was negatively correlated with LTS(OR=0.412,P<0.05).This means that,the LTS was easily occurred as the serum Alb level declined.When introduce the above statistically significant variables into nomogram obtained the C index with 0.807[95%CI=(0.757,0.856)].The calibration curve verified by internal verification showed that the calibration degree of this prediction model was well calibrated.ROC curve analysis showed that the prediction model was well differentiated.[Conclusion]The Scr,CRP,IL-6,Alb and cardiac functional grading in elderly CHF patients may be risk factors for incidence of LTS,while serum Alb may be a protective factor for LTS.Based on the above risk factors,the nomogram model for predicting the occurrence of LTS in elderly CHF patients had good differentiation and accuracy,and can provide guidance for clinical individualized prevention and treatment.

Objective: To describe the prevalence of permanent tooth caries and associated factors among junior high school students in Haikou, and to provide reliable evidence for prevention and control of caries. Methods: A total of 3 573 students from 8 junior high school in Haikou City and towns were selected by the methods of clustered sampling survey. Questionnaire survey and oral health examinations were conducted to analyze the caries rate, mean decayed missing filled tooth (DMFT), filling rate, pit and fissure sealant rate. Logistic regression was used to analyze the influencing factors of caries in permanent tooth. Results: Among the surveyed junior high school students, the caries rate was 47.32%( n =1 691), the mean DMFT was 1.51. The caries rate and mean DMFT were higher in female students (49.59%) than in male students (44.95%), and higher in towns (50.77%) than in urban areas (44.04%), the difference were statistically significant ( χ 2=16.25, 7.72, P <0.05). The filling rate and pit and fissure sealant rate among junior high school students in Haikou were 17.13%, 6.27% respectively. The filling rate and pit and fissure sealant rate were higher in urban areas (18.97%, 7.17%) than towns (15.76%, 5.33%), the difference were statistically significant ( χ 2= 9.57, 5.13, P <0.05). The multivariate Logistic analysis showed that female student, town residence, daily consumption of sweets or sugary drinks (≥1 time), bedtime snack were risk factors for junior high school students suffering from permanent dental caries( OR =1.41, 1.45, 2.63, 2.09, 1.53), while using fluoride toothpaste daily, oral education in school were protective factors( OR =0.44, 0.34)( P <0.05). Conclusion The caries rate of permanent teeth among junior high school students in Haikou is at high level, but the filling rate of caries and pit and fissure sealant rate are lower. The prevention and treatment of dental caries should be carried out in high risk students, and oral health education in school is also needed to improve the oral health level of junior high school students.

The goal of the study was to investigate the protective effect and mechanism of Artemisia argyi ethanol extract on chemotherapeutic vancomycin (VAN)-induced acute kidney injury (AKI).The acute kidney injury model of male ICR mice was induced by intraperitoneal injection (ip) of VAN.Thirty mice were divided into the blank group, model group, high dose group, middle dose group and low dose group, which were given medicine by gastric perfusion (ig).Serum levels of cystain C (Cys C), blood urea nitrogen (BUN) and serum creatinine (Scr) were measured, which could reflect renal function of mice.Serum oxidative stress and inflammation indices were also determined, including muscular dystrophy association (MDA), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), tumor necrosis factor-alpha (TNF-α), Interleukin-1β (IL-1β), and high-sensitive c-reactive protein (hs-CRP).In addition, hematoxylin-eosin staining (HE) was employed for measuring the damage of renal tissues and the content of apoptosis b-cell lymphoma-2 (Bcl-2), Bcl-2 assaciated X protein (Bax) and caspase-3 were measured too.All results showed that Artemisia argyi extract exhibits protective effect on chemotherapeutic VAN-induced AKI, whose mechanism could be related to the oxidative stress, inflammatory reaction and apoptosis.

Objective     To evaluate the safety and efficacy of transcatheter aortic valve replacement (TAVR) using the SAPIEN 3 system. Methods    This was a prospective, multicenter, single arm study in 4 centers in China. The clinical data of 50 patients with high-risk symptomatic severe aortic stenosis who underwent TAVR using the SAPIEN 3 system from June 2017 to June 2019 were analyzed, including 27 males and 23 females aged 76.8±6.1 years. Results    The Society of Thoracic Surgeon score was 6.0%±2.8%. Totally, 20.0% of patients had severe bicuspid aortic stenosis. The operation time was 41.8±16.5 min and the hospital stay time was 8.5±5.0 d. At the postoperative 30-day follow-up, no all-cause mortality occurred and the device success rate was 89.5%. Major vascular complications occurred in one (2.0%) patient,  stroke in one (2.0%) patient, new pacemaker implantation in one (2.0%) patient, as well as coronary artery obstruction in one (2.0%) patient. There was no moderate or moderate/severe paravalvular leak. The aortic pressure gradient was decreased from 49.2±16.2 mm Hg before the operation to 12.4±4.6 mm Hg at the postoperative 30-day follow-up, and the valvular area was increased from 0.6±0.3 cm2 to 1.3±0.3 cm2 (P<0.01). Moreover, the New York Heart Association classification in 83.7% of the patients was improved during the follow-up. Conclusion    This pre-marketing multicenter study has demonstrated the safety and effectiveness of transfemoral TAVR with the SAPIEN 3 transcatheter valve system in Chinese aortic stenosis patients at high risk for surgery.

【Objective】 To understand the current situation of blood components distribution in domestic prefecture-level blood stations through analyzing the components distribution data of 24 prefecture-level blood stations in China. 【Methods】 The data of components distribution of 24 blood stations from 2017 to 2020 as well as the data of blood deployment of 24 blood stations from 2019 to 2020 were collected and analyzed. 【Results】 From 2017 to 2020, positive annual growth in red blood cells, plasma and cryoprecipitate was observed in 22, 19 and 15 out of the 24 blood stations, and the annual growth median rate of above three components was 5.24%, 3.80% and 3.25%, respectively. Among the 24 prefecture-level blood stations, 23 carried out the preparation of cryoprecipitate. 【Conclusion】 The distribution of red blood cells, cryoprecipitate and plasma in prefecture-level blood stations is increasing year by year. However, there is a overstock of plasma, and most blood stations need blood employment.

OBJECTIVE：To e stablish and compare HPLC fingerprints of green Forsythia suspensa and grown F. suspensa ，and to conduct cluster analysis and principle component analysis. METHODS ：HPLC method was adopted. The determination was performed on Hypersil C 18 column with mobile phase consisted of acetonitrile- 0.1％ formic acid （gradient elution ）. The detection wavelength was 235 nm and column temperature was 25 ℃ with the flow rate of 1.0 mL/min. The sample size was 10 μL. HPLC fingerprints of 8 batches of green F. suspensa （Q1-Q8）and 6 batches of grown F. suspensa （L1-L6）were drawn ，with phillyrin as reference；the similarity evaluation was conducted by using Similarity Evaluation System of TCM Chromatographic Fingerprint （2012 edition），and common peak was confirmed. Cluster analysis and principal component analysis were carried out with SPSS 23.0 software. RESULTS ：There were 19 common peaks for green F. suspensa and grown F. suspensa ，among which 6 peaks were identified，i.e. forsythoside A ，rutin，pinoresinol-β-D-glucoside，phillyrin，quercetin and phillygenin ；the similarities of HPLC fingerprints from green F. suspensa and grown F. suspensa were 0.351-0.767；results of cluster analysis showed that green F. suspensa and grown F. suspensa were classified into 4 categories，among which L 1-L6 were clustered into one category ，Q1 was clustered into one category ，Q2-Q6 were clustered into one category ；Q7-Q8 were clustered into one category. The results of principal component analysis showed that the cumulative variance contribution rate of the first three principal components was 83.14％， L1-L6 distribution was close ，Q2-Q6 distribution was close ，Q7-Q8 distribution was close ，and Q 1 distribution was independent ， which was consistent with the results of cluster analysis. CONCLUSIONS ：There were significant differences in the common peaks of fingerprint of green F. suspensa and grown F. suspensa of similarity eraluation ，cluster analysis and principle component analysis，the established HPLC fingerprint can be used for comprehensive evaluation and quality comparison of green F. suspensa and grown F. suspensa .

Objective:To develop a novel posterior circulation score (PCS) based on pretreatment diffusion-weighted imaging (DWI) for predicting futile recanalization (FR) of acute basilar artery occlusion (BAO) after endovascular therapy (EVT).Methods:A prospectively registered consecutive cohort of BAO patients treated with EVT in Beijing Tiantan Hospital, Capital Medical University during a six-year period was reviewed. This novel DWI-based PCS (DWI-PCS) was calculated according to the characteristics of acute infarction at four sites (pons, midbrain, thalamus and cerebellum), with a normal score of 0 point and a full score of 16 points. FR was defined as the occurrence of poor outcome (modified Rankin Scale score>3) at 90 days despite successful recanalization (modified Thrombolysis In Cerebral Infarction ≥ 2b) at final angiogram after EVT. The independent association of DWI-PCS with FR was evaluated by multivariable Logistic regression, and the predictive discrimination of DWI-PCS was measured by the area under the receiver operating characteristic (ROC) curve. Additionally, the effects of DWI-PCS on FR in different subgroups stratified by age, time window, stroke severity and etiology were explored.Results:Of 109 patients in this study, 48 (44.0%) suffered from FR. The multivariable Logistic analysis showed that DWI-PCS was significantly associated with FR (adjusted OR=1.31, 95% CI 1.07-1.62, P=0.01). The ROC curve analysis demonstrated that the area under the curve of DWI-PCS for predicting FR was 0.74 (95% CI 0.65-0.83), and the optimal cut-off value was ≥ 3 points (sensitivity 0.75, specificity 0.66, accuracy 0.70). Finally, the effects of DWI-PCS on FR were not found to be different across all subgroups ( P>0.10 for all interactions). Conclusions:The novel DWI-PCS may be a valid and reliable predictor of FR in BAO patients treated with EVT. Nevertheless, external validation with blinded outcome is still needed to confirm its performance before clinical application.

Objective To study the surgical treatment of hepatic hemangiomas and the timing of surgery.Methods A retrospective study was conducted on 908 patients with giant hemangiomas who underwent surgery between December 1997 and December 2017.The clinical data,surgical indications,surgical outcomes,lesion size,and the effect of TAE were compared.Results The diameter (mean + /-S.D.)of the resected hepatic cavernous hemangiomas was (11.1 ± 6.2) cm (the longest diameter was 60 cm).585 patients (64.4％) underwent enucleation of hepatic hemangiomas and 323 patients (35.6％) underwent anatomical hepatectomy.Six patients died perioperatively (mortality rate 0.7％).The incidence of severe complication (Clavien-Dindo grade 3 ～ 5) was 3.8％.The incidence of severe postoperative complication for enucleation (2.7％) was significantly less than anatomic liver resection (5.6％,P ＜0.05).When the lesion was more than 20 cm,the complication and mortality rates were significantly higher than those less than 20 cm (P ＜ 0.05).The complication and mortality rates in patients who underwent TAE before surgery were significantly higher than those without TAE (P ＜ 0.05).Conclusions Surgical enucleation of hemangiomas was superior to anatomical hepatectomy.With increase in tumor size,the risk of surgery increased.Surgical treatment was safe and effective for giant hepatic hemangiomas.For giant hepatic hemangiomas with significant increase in size,prompt surgical treatment is recommended.

Objective To study the curative effects of jejunal exclusion surgery for STZ-induced T2DM SD rats.Methods 60 SD rats were induced to be the T2DM SD rats by intraperitoneal injection of streptozotocini.As a result,55 T2DM SD rats were successfully acquired which were randomly divided into 3 groups,20 rats in the jejunal exclusion group (A),20 rats in the sham operation group (B) and 15 rats in the control group (C).Jejunal exclusion surgery was performed in group A,jejunojejunostomy was performed in group B,and group C were fed normally.The body weight,fasting blood glucose,fasting plasma insuhn level and GLP-1 level were measured before operation and at the 1st,2rid,4th,8th and 16th week after operation.Results As compared with that before operation and that of the control group,the body weight in group A markedly declined at the 2nd,4th,8th and 16th week (352.14±9.00,342.84±8.90,336.64±10.26,330.34±9.12,P＜0.05).The fasting plasma glucose levels in group A markedly declined at the 2nd,4th,8th and 16th week (14.62±1.10,12.12±1.38,8.75± 1.06,7.55±1.00,P＜0.05).The fasting plasma insulin level in group A was maikedly increased at the 2nd,4th,8th and 16th week (14.62±3.10,16.12±3.38,17.75±4.06,17.55±3.10,P＜0.05).GLP-1 level in group A was markedly increased at the 1st,2nd,4th,8th and 16th week (11.02±0.85,14.42±1.18,16.02±1.59,17.62±1.02,18.12±0.71,P＜0.05).Conclusions The jejunal exclusion surgery is effective in controlling blood glucose,which is an ideal and lasting method.This surgery has also showed influence on body weight.

Objective To investigate the effect of exogenous hydrogen sulfide (H2S) on neuronal apoptosis during focal cerebral ischemia-reperfusion (I/R) in rats.Methods One hundred eight male Sprague-Dawley rats,aged 6-8 weeks,weighing 250-270 g,were randomly divided into 3 groups (n =36 each) using a random number table:control group (group C),I/R group and H2S group.Focal cerebral ischemia was induced by middle cerebral artery occlusion in anesthetized rats.A nylon thread with a rounded tip was inserted into the left internal carotid artery and advanced intracranially to block blood flow into the middle cerebral artery.Middle cerebral artery occlusion was maintained for 90 min followed by reperfusion.In group H2S,0.25％ NaSH (a donor of exogenous H2S) 10 mg/kg was injected intraperitoneally at the onset of reperfusion.The equal volume of normal saline was given in C and I/R groups.At 1,3 and 7 days of reperfusion,neurological deficit was scored,and corner test was performed.Brains were removed for determination of myocardial infarct size,Bax-,Bcl-2-and caspase-3-positive cells,and cell apoptosis.The percentage of myocardial infarct size,rate of Bax-,Bcl-2-and caspase-3-positive cells and apoptosis rate were calculated.Results Compared with group C,the neurological deficit score was significantly decreased,and the corner score,percentage of myocardial infarct size,rate of Bax-,Bcl-2-and caspase-3-positive cells and apoptosis rate were increased at each time point of reperfusion in I/R and H2S groups (P＜0.05).Compared with group I/R,the neurological deficit score and Bcl-2-positive cells were significantly increased,and the corner score,percentage of myocardial infarct size,rate of Bax-and caspase-3-positive cells and apoptosis rate were decreased at each time point of reperfusion in group H2S (P＜0.05).Conclusion The mechanism by which exogenous H2S attenuates focal cerebral I/R is related to inhibition of neuronal apoptosis in rats.