Objective:To explore prognosis and related risk factors of patients with systemic lupus erythematosus(SLE)combined with decreased complement C3 level.Methods:A total of 173 SLE patients with decreased complement C3 level who were treated in Chongzuo People's Hospital from June 2018 to March 2022 were selected as research subjects,and divided into good progno-sis group(n=151)and poor prognosis group(n=22)according to follow-up prognostic effect.Clinical data and biochemical indicators of patients were recorded.A nomogram model was established for analysis and model validation.Results:There were statistical signifi-cance in lupus activity,C3,A/G,hs-CRP between two groups(P<0.05);lupus activity,C3,A/G,hs-CRP were independent risk factors for outcomes of SLE patients with reduced complement C3.Prediction effect of nomogram model was good,and consistency of model validation was strong.Complement C3 level was correlated with SLE(χ2=7.524,P=0.002),with a linear dose-response relation-ship(χ2=1.527,P=0.118).Conclusion:SLE patients with decreased complement C3 level have poor prognosis,who has many risk factor.Prognosis of SLE can be enhanced from aspects of lupus activity,C3,A/G and hs-CRP.

Objective To investigate the factors associated with unplanned readmission within 30 days after discharge in adult patients who underwent coronary artery bypass grafting (CABG) and to develop and validate a risk prediction model. Methods A retrospective analysis was conducted on the clinical data of patients who underwent isolated CABG at the Nanjing First Hospital between January 2020 and June 2024. Data from January 2020 to August 2023 were used as a training set, and data from September 2023 to June 2024 were used as a validation set. In the training set, patients were divided into a readmission group and a non-readmission group based on whether they had unplanned readmission within 30 days post-discharge. Clinical data between the two groups were compared, and logistic regression was performed to identify independent risk factors for unplanned readmission. A risk prediction model and a nomogram were constructed, and internal validation was performed to assess the model’s performance. The validation set was used for validation. Results A total of 2 460 patients were included, comprising 1 787 males and 673 females, with a median age of 70 (34, 89) years. The training set included 1 932 patients, and the validation set included 528 patients. In the training set, there were statistically significant differences between the readmission group (79 patients) and the non-readmission group (1 853 patients) in terms of gender, age, carotid artery stenosis, history of myocardial infarction, preoperative anemia, and heart failure classification (P<0.05). The main causes of readmission were poor wound healing, postoperative pulmonary infections, and new-onset atrial fibrillation. Multivariable logistic regression analysis revealed that females [OR=1.659, 95%CI (1.022, 2.692), P=0.041], age [OR=1.042, 95%CI (1.011, 1.075), P=0.008], carotid artery stenosis [OR=1.680, 95%CI (1.130, 2.496), P=0.010], duration of first ICU stay [OR=1.359, 95%CI (1.195, 1.545), P<0.001], and the second ICU admission [OR=4.142, 95%CI (1.507, 11.383), P=0.006] were independent risk factors for unplanned readmission. In the internal validation, the area under the curve (AUC) was 0.806, and the net benefit rate of the clinical decision curve analysis (DCA) was >3%. In the validation set, the AUC was 0.732, and the DCA net benefit rate ranged from 3% to 48%. Conclusion Females, age, carotid artery stenosis, duration of first ICU stay, and second ICU admission are independent risk factors for unplanned readmission within 30 days after isolated CABG. The constructed nomogram demonstrates good predictive power.

Objective:To explore prognosis and related risk factors of patients with systemic lupus erythematosus(SLE)combined with decreased complement C3 level.Methods:A total of 173 SLE patients with decreased complement C3 level who were treated in Chongzuo People's Hospital from June 2018 to March 2022 were selected as research subjects,and divided into good progno-sis group(n=151)and poor prognosis group(n=22)according to follow-up prognostic effect.Clinical data and biochemical indicators of patients were recorded.A nomogram model was established for analysis and model validation.Results:There were statistical signifi-cance in lupus activity,C3,A/G,hs-CRP between two groups(P<0.05);lupus activity,C3,A/G,hs-CRP were independent risk factors for outcomes of SLE patients with reduced complement C3.Prediction effect of nomogram model was good,and consistency of model validation was strong.Complement C3 level was correlated with SLE(χ2=7.524,P=0.002),with a linear dose-response relation-ship(χ2=1.527,P=0.118).Conclusion:SLE patients with decreased complement C3 level have poor prognosis,who has many risk factor.Prognosis of SLE can be enhanced from aspects of lupus activity,C3,A/G and hs-CRP.

Objective To explore the risk factors of early neurological deterioration(END)in patients with acute cerebral infarction(ACI)based on the characteristics of computed tomography angiography(CTA)images of head and neck plaques.Methods A total of 218 ACI patients were selected,and according to whether END occurred within 72 h after onset,they were divided into an END group(54 cases)and non END group(164 cases).The clinical data and imaging indicators were compared and analyzed between the two groups.Multivariate logistic regression analysis was used to analyze risk factors,and a nomograph prediction model was constructed and evaluated.Results National Institutes of Health Stroke Scale(NIHSS)score at admission ≥4 points,glycated hemoglobin(HbA1c)≥7.7％,severe or above ipsilateral carotid artery stenosis,and unstable plaque(soft plaque and mixed plaque)were the independent risk factors in END patients(P＜0.05).The result of nomograph prediction model showed that its discrimination,accuracy and effectiveness were better.Conclusion NIHSS score at admission,HbA1c level,ipsilateral carotid artery stenosis degree,and plaque type are all independent influencing factors for the occurrence of END.

Sanguinarine is the main active component of the Papaver plants, and protopine-6-hydroxylase(P6 H), involved in the sanguinarine biosynthetic pathway, can oxidize protopine to 6-hydroxyprotopine. The investigation on the diversity of P6 H genes in the medicinal Papaver plants contributes to the acquirement of P6 H with high activity to increase the biosynthesis of sanguinarine. Five P6 H genes in P. somniferum, P. orientale, and P. rhoeas were discovered based on the re-sequencing data of the Papaver species, followed by bioinformatics analysis. With the elongation factor 1α(EF-1α), which exhibits stable expression in the root and stem, as the internal reference gene, the transcription levels of P6H genes in roots and stems of the Papaver plants were detected by real-time fluorescent quantitative PCR. As indicated by the re-sequencing results, there were two genotypes of P6H in P. somniferum and P. orientale, respectively, and only one in P. rhoeas. The bioinformatics analysis showed that the P6 H proteins of the three Papaver plants contained the conserved domain cl12078, which is the characteristic of p450 supergene family, and transmembrane regions. The existence of signal peptide remained verification. Real-time fluorescent quantitative PCR results revealed that the transcription level of P6 H in roots of P. somniferum was about 1.44 times of that in stems(α=0.05). The present study confirmed genetic diversity of P6 H in the three medicinal Papaver plants, which lays a basis for the research on the biosynthesis pathway and mechanism of sanguinarine in Papaver species.
Benzophenanthridines ; Berberine Alkaloids ; Cytochrome P-450 Enzyme System/genetics* ; Genetic Variation ; Papaver/genetics*

Objective:To prepare rat spinal synaptosomes, and to conduct qualitative and quantitative analysis of various neurotransmitters in rat spinal synaptosomes to explore the physiological activities. Methods:Rat spinal synaptosomes were prepared by discontinuous Percoll density gradient centrifugation and their morphology and structure were observed under transmission electron microscopy. The properties and content of neurotransmitters in rat spinal synaptosomes were determined by ultra performance liquid chromatography-tandem mass spectrometry. Results:Under the experimental conditions, rat spinal synaptosomes were found to contain dopamine, norepinephrine, serotonin, homovanillic acid, 3,4-dihydroxybenzene, 5-hydroxyindoleacetic acid, methoxytyramine, tryptophan, γ-aminobutyric acid, kynurenine, 3-hydroxy kynurenine and 3-hydroxy-2-aminobenzoic acid, and so on. The corresponding neurotransmitter contents were detected, and the corresponding linear relationship and correlation coefficient were obtained. Conclusion:Discontinuous Percoll density gradient centrifugation could prepare rat spinal synaptosomes and detect neurotransmitters and their contents in rat spinal synaptosomes.

OBJECTIVETo assess the relationship of high altitude de-adaptation response (HADAR) with acute high altitude response (AHAR) and cardiac function.

METHODSNinety-six military personnel of rapid entering into high altitude (3 700 to 4 800 m) with strong physical work were analyzed, all subjects were male, aged 18 - 35 years. According to the symptomatic scores of AHAR were divided into 3 groups: sever AHAR (group A, 24), mild to moderate AHAR (group B, 47) and non-AHAR (group C, 25) at high altitude. According to the symptomatic scores of HADAR were divided into 3 groups: severe HADAR (group E, 19), mild to moderate HADAR (group F, 40) and non-HADAR (group G, 37) after return to lower altitude (1 500 m). Mean pulmonary arterial pressure (mPAP), right ventricular internal dimension (RVID), outflow tract of right ventricle (RVOT), left ventricular internal dimension (LVID), left ventricular ejection fraction (LVEF), cardiac muscle work index (Tei index), creatine kinase isoenzymes-MB (CK-MB), lactic dehydrogenase isoenzyme-1 (LDH-1) were measured at high altitude stayed 50 days and after return to lower altitude 12 h, 15 d, and 30 d. Fifty healthy volunteers (group D) at 1 500 m altitude served as control.

RESULTSLevel of mPAP, RVID, RVOT, RVID/LVID ratio, Tei index, CK-MB,and LDH-1 were higher, and LVEF was lower in group A than those in group B, C and D, there were significant differences between group B and C, C and D (all P < 0.01). AHAR scores were positively correlated with HADAR scores (r = 0.863, P < 0.01). Twelve hours after return to lower altitude, level of mPAP, RVID, RVOT, RVI/LVID ratio, Tei index, CK-MB, and LDH-1 were higher, and LVEF was lower in group E than those in group F, G and D, there were significant differences between group F and G, G and D (all P < 0.01). Fifteen days after return to lower altitude, level of mPAP, RVID, RVOT, RVID/LVID ratio were higher in group E than those in group F, G, and D, there were significant differences between group F and G, and D (P < 0.01 or P < 0.05), there were no significant differences between group G and D (all P > 0.05), LVEF, Tei index, CK-MB, LDH-1 showed no significant differences among groups (all P > 0.05). Thirty days after return to lower altitude, these parameters in group E, F, and G showed no significantly differences compared with those of group D (all P > 0.05).

CONCLUSIONThe severity of HADAR is associated with severity of AHAR and cardiac injury, the more serious of AHAR and cardiac injury at high altitude, the more serious of HADAR and cardiac injury after return to lower altitude, the more long of restore of right cardiac morphologic injury.

Adaptation, Physiological ; Adolescent ; Adult ; Altitude ; Altitude Sickness ; metabolism ; physiopathology ; Case-Control Studies ; Heart ; physiopathology ; Heart Function Tests ; Humans ; Male ; Myocardium ; enzymology ; Young Adult

Objective To investigate the safety and efficacy of ultrasound ablation in treatment of uterine fibroids. Methods Ninety-nine patients with 117 leiomyomas in total treated by Haifu JC focused ultrasound tumor therapeutic system were enrolled in prospective and non-randomized clinical trial in First Affiliated Hospital of Chongqing Medical University and Academy of Military Medical Sciences. Ultrasound ablation was performed guided by real-time ultrasonography under conscious sedation for single session. All patients were followed up at 6 months after treatment. On the day of treatment and after 1 month, patients were given by magnetic resonance imaging(MRI) exam to evaluate the effect of fibroids ablation. At 3 and 6months after treatment, the ratio of ablated area and volume reduction of fibroids more than 50% were evaluated by MRI exam again. The symptoms improvements were evaluated by uterine fibroid symptom (UFS) and complications were analyzed by guideline of society of international radiation (SIR). Results The average ablated area ratio of the target fibroid was (76 ± 24)%. The average reduction in fibroid volume determined by MRI at 3 and 6 months after treatment was (45 ± 21)% and (59 ± 26)%. Which were significantly decreased than those before treatment (P < 0. 05). At 6 months after treatment, 84. 6% (99/117) of patients showed more than 50% volume reduction, the rate of improved symptom score was 92%(66/72). All patients could resume normal daily activities at 2 hours after treatment. The adverse reactions of SIR C - D included delayed hospitalization, repeat treatment and increased level of nursing. E - F included permanent sequelae and death. In this study, no adverse reactions of C - F were recorded. Common complications (SIR A- B, only observation or simple management without sequelae) were 35% (35/99).Four cases with adverse reactions B of SIR were found, including 2 cases with skin burning of degree Ⅱ and 2 cases with febrile, they were administered by symptomatic therapy and changing dressing The other adverse reaction A of SIR included sorness of buttock, vaginal discharge, dysuria and painful urination, they were only suggested by follow-up. Conclusion It was efficacy and safe that ultrasound ablation as a single strategy were used in treatment of uterine fibroids.

Objective To analysis complications and its associated risk factors of high intensity focused ultrasound (HIFU) in treatment of uterine leiomyoma for selecting rationale indicated patients and reducing complications. Methods Medical documents of 171 patients with 231 leiomyomas in total treated by HIFU were studied retrospectively. Common complications were categorized and analyzed, the relationship between risk factors and complications were studied. Results Common complications in treatment of uterine leiomyomas by HIFU were 71.9% (123/171) of abdominal pain, 17.5% (30/171) of vaginal bloody discharge, 8.2% (14/171) of sacroiliac or buttock pain, 7. 6% (13/171) of skin blister,4. 7% (8/171) of leg pain, 2. 9% (5/171) of hematuria and 1.8% (3/171) of febrile. By logistic regression analysis, the factor correlated with abdominal pain included diameter of uterine leiomyomas,sonication time and average power (P < 0. 05). The factor correlated with sacroiliac or buttock pain was uterine leiomyomas located in posteriors of uterine wall(P <0. 05); the factors correlated with vaginal bloody discharge were sonication time and type of uterine leiomyomas (submucous > intramural > subserous, P <0. 05); the factors correlated with skin blister was sonication time (P < 0. 05). There were no statistical relationship between multiple factors and leg pain, hematuria, febrile (P > 0. 05). Conclusion The modality of high-power and short-term treatment might reduce complications of HIFU ablation.