Objective To explore the efficacy and safety of dapagliflozin in patients with paroxysmal atrial fibrillation (PAF) combined with heart failure with preserved ejection fraction (HFpEF). Methods A total of 120 patients with PAF combined with HFpEF treated at Jinshan Hospital of Fudan University from July 2022 to July 2023 were selected and randomly divided into the dapagliflozin group (n＝60, standard treatment combined with dapagliflozin) and the control group (n＝60, standard treatment combined with placebo). After 12 months of follow-up, the Kansas City Cardiomyopathy Questionnaire-Total Symptom Score (KCCQ-TSS), PAF duration, recurrence rate and frequency of PAF, left atrial diameter, left ventricular end-systolic diameter, left ventricular end-diastolic diameter, left ventricular ejection fraction, P-wave dispersion, blood pressure, plasma N-terminal pro-brain natriuretic peptide (NT-proBNP), estimated glomerular filtration rate (eGFR), and glycated hemoglobin A_1C (HbA_1C) were compared between the two groups. Cardiovascular outcomes and adverse events were observed. Results A total of 10 patients lost to follow-up, and 110 patients were included in the analysis (55 in each group). After 12 months of treatment, the KCCQ-TSS in the dapagliflozin group was significantly higher than that in the control group ([61.68±2.65] points vs [44.98±4.76] points, P＜0.001). The PAF duration in the dapagliflozin group was significantly shorter than that in the control group ([144±18] min vs [270±24] min, P＝0.045). After treatment, frequency of PAF, NT-proBNP levels, left ventricular end-systolic diameter, left ventricular end-diastolic diameter, left atrial diameter, P-wave dispersion, and HbA_1C levels showed statistical differences between the two groups (P＜0.05). The heart failure readmission rate and PAF recurrence rate in the dapagliflozin group were significantly lower than those in the control group (P＜0.05). There was no significant difference in the incidence of adverse events between the two groups during treatment. Conclusions Dapagliflozin improves patients’ quality of life, reduces PAF duration and recurrence rate, decreases heart failure readmission rate, lowers NT-proBNP levels, reverses cardiac remodeling, and demonstrates favorable safety in patients with PAF combined with HFpEF.

Objectives:To investigate the expression levels of autophagy-related genes Beclin1 and LC3 in ossified tissues of posterior longitudinal ligament in cervical spine and their correlations with osteogenic factors.Methods:18 posterior longitudinal ligament tissue specimens from cervical ossification of posterior longitudinal ligament(OPLL)patients underwent OPLL surgical removal from October 2020 to May 2021(OPLL group)and 15 tissue specimens of the posterior longitudinal ligament of the cervical spine that were not ossified(non-OPLL group)were collected.The morphological changes of posterior longitudinal ligament tissues were observed by hematoxylin-eosin(HE)staining;the deposition of calcium salts was observed by Von Kossa staining;The mRNA and protein expression levels of Beclin1,microtubule associated protein light chain 3(LC3),and the osteogenic factors runt-related transcription factor 2(RUNX2),bone morphogenetic protein-2(BMP2),and Osterix in the specimens of the two groups were determined with immunohistochemical staining and RT-qPCR respectively;Pearson correlation analysis was used to explore the relationship between Beclin1,LC3,RUNX2,BMP2,and Osterix.Results:Compared with the non-OPLL group,the cell morphology in the OPLL group was larger and irregular in shape,and the nuclei were more obvious;Von Kossa staining showed that there was no obvious calcium salt deposition in the non-OPLL group,whereas brownish-black calcium salts could be seen in the OPLL group,which were aggregated into flakes or clusters;The expression levels of Beclin1,LC3,RUNX2,BMP2 and Osterix proteins and mRNA in the OPLL group were higher than those in the non-OPLL group(P＜0.05);Beclin1 mRNA expression level was significantly correlated with BMP2,RUNX2 and Osterix(P＜0.05,r＞0.5),while LC3 was not correlated with osteogenic factors.Conclusions:The autophagy-related genes Beclin1 and LC3 are significantly overexpressed in ossified tissues of posterior logitudinal ligament of cervical spine,and Beclin1 is closely related to posterior longitudinal ligament osteogenesis.

Objective:To determine the contents of quercetin, kaempferol, total flavonoids and extracts in 52 samples of Lysimachiae Herba collected from different origins; To analyze the quality differences of Lysimachiae Herba among different producing areas. Methods:The quercetin and kaempferol contents of the Lysimachiae Herba from Guizhou Province, Sichuan Province and Chongqing were determined by HPLC, and the total flavonoids were determined by Symergy HTX microplate reader. Results:The total content of quercetin and kaempferol in 52 samples was among 0.146 2-2.517 0 mg/g, with an average content of 0.872 6 mg/g, among which the average content of Sichuan was 1.073 2 mg/g, that of Guizhou was 0.705 4 mg/g, and that of Chongqing was 0.865 1 mg/g. Among them, 20 samples reached the standard of the Chinese Pharmacopoeia. The average content of the samples that met the standard was 1.439 7 mg/g. The compliance rate of samples collected in Guizhou, Sichuan and Chongqing reached 12.5%, 62.5%, and 38.8% respectively. The total flavonoid content of 52 samples was among 0.994 2- 3.866 4 mg/g, and 52 samples were in conformity with the ethanol hot extract standard of the Chinese Pharmacopoeia. Conclusions:The total contents of quercetin and kaempferol from different sources in Sichuan, Guizhou and Chongqing are quite different, and the total contents of quercetin and kaempferol collected from the same district and county are also quite different, and the compliance rate is low. There are great differences in total flavonoids in different producing areas and different populations of Lysimachiae Herba samples collected in the field.

Objective:To investigate the effect in lumbar mobility and stress of the facet joint and end plate after implantation of the movable artificial lumbar spine so as to lay a biomechanical foundation for its clinical application.Methods:Total lumbar CT data of a healthy adult male were selected to construct a finite element analysis model and its effectiveness was validated (physiological group). Two groups were replicated after removing the L 3 vertebral body and adjacent discs of the model in physiological group. One group was placed with each component of the movable artificial lumbar spine to construct the non-fusion model (non-fusion group). The other group was placed with titanium cage, titanium plate and other to construct the fusion model (fusion group). The models in the three groups were loaded with 500 N axial load and 10 Nm axial load, and the torque load was used to simulate the movement in six directions: forward flexion, backward extension, left and right lateral bending, and left and right torsion. The lumbar mobility and stress peak and distribution of the proximal facet joints (J 1-2, J 4-5), L 2 inferior endplate and L4 superior endplate at the three model operating sites (L 2-3, L 3-4) and adjacent segments (L 1-2, L 4-5) under the same conditions were compared. Results:The range of motions of the surgical site in flexion, extension, left bending, right bending, left torsion and right torsion were L 2-3of 3.9°-8.7° and L 3-4 of 3.6°-8.4° in non-fusion group, significantly increased compared with fusion group (L 2-3 0.1°-0.2°, L 3-4 0.1°-0.1°) and slightly increased compared with physiological group (L 2-3 2.3°-6.0°, L 3-4 2.3°-7.1°). The range of motions of the adjacent segments in the above six directions were L 1-2 of 1.4°-4.3° and L 4-5 of 1.4°-6.0° in non-fusion group, smaller than those in fusion group (L 1-2 2.1°-6.1°, L 4-5 3.3°-8.6°) and similar to those in physiological group (L 2-3 2.3°-6.0°, L 3-4 2.3°-7.1°). The peak values of von Mises stress in the proximal facet joints were J 1-2 of 7.07-19.21 MPa and J 4-5of 6.12-12.99 MPa in non-fusion group, similar to those in physiological group (J 1-2 8.42-18.53 MPa, J 4-5 7.49-11.70 MPa) and smaller than those in fusion group (J 1-2 10.54-21.16 MPa, J 4-5 10.63-16.13 MPa). The maximum von Mises stress of the L 2 inferior endplate and L 4 superior endplate in the above six directions was 29.39-54.72 MPa and 32.31-47.87 MPa in non-fusion group, significantly increased compared with the L 2 inferior endplate (21.20-42.07 MPa), L 4 superior endplate (22.50-36.76 MPa) and L 2 inferior endplate (11.04-29.55 MPa) in fusion group and the L 4 superior endplate (13.12-21.32 MPa) in physiological group. Conclusion:Compared with the traditional fusion prostheses, the placement of the movable artificial lumbar spine can reconstruct the range of motion of the surgical site in the direction of flexion, extension, lateral bending and torsion, greatly reduce the impact on the stress of adjacent facet joints and the range of motion of adjacent segments, and theoretically reduce the incidence of prosthesis subsidence.

The medical magnetic resonance (MR) image reconstruction is one of the key technologies in the field of magnetic resonance imaging (MRI). The compressed sensing (CS) theory indicates that the image can be reconstructed accurately from highly undersampled measurements by using the sparsity of the MR image. However, how to improve the image reconstruction quality by employing more sparse priors of the image becomes a crucial issue for MRI. In this paper, an adaptive image reconstruction model fusing the double dictionary learning is proposed by exploiting sparse priors of the MR image in the image domain and transform domain. The double sparse model which combines synthesis sparse model with sparse transform model is applied to the CS MR image reconstruction according to the complementarity of synthesis sparse and sparse transform model. Making full use of the two sparse priors of the image under the synthesis dictionary and transform dictionary learning, the proposed model is tackled in stages by the iterative alternating minimization algorithm. The solution procedure needs to utilize the synthesis and transform K-singular value decomposition (K-SVD) algorithms. Compared with the existing MRI models, the experimental results show that the proposed model can more efficiently improve the quality of the image reconstruction, and has faster convergence speed and better robustness to noise.

Objective To explore the feasibility of repairing porcine bile duct defect with decellularized rabbit abdominal aorta matrix scaffold.Methods Sodium dodecyl sulfate and Sodium deoxycholate were used to remove the cells in the blood vessel,and the residual DNA and RNA fragments were removed by nuclease.The prepared scaffold was implanted to repair defect of bile duct in swine,which were sacrificed after 45 days of surgery for histological evaluation.Results HE,Masson and elastic fiber staining showed that the composition and structure of the scaffold maintained their native features after dcellularization treatment.DNA content in acelllular scaffold (0.12 ± 0.01) μg/mg dry weight) was significantly decreased as compared with the native ones (2.31 ± 0.03) μg/mg dry weight,P ＜ 0.05).Collagen content was increased from (152 ±22) μg/mg dry weight in intact aorta to (177 ±21) μg/mg dry weight.Adipose derived mesenchymal stem cells with typical morphology survived well in the decellularized vascular matrix.It was observed that seeded ASCs penetrated into the inner wall of the scaffold.After transplantation,there was no leakage in the anastomosis and collapse of acellular blood vessel matrix.After 45 days of transplantation,repaired bile duct was harvested for histological evaluation.HE and Masson staining revealed that there were a large number of cells distributed in the inner wall of the scaffold,and some suspected epithelial cells and glands were found.Conclusion Decellularized aorta matrix scaffold hold great potential in serving as scaffold repairing defect of bile duct.

Objective To investigate the blood-borne occupational exposure situation of medical staffs and to analyze its risk factors in order to provide a basis for working out the protective measures of medical staffs and risk evaluation .Methods The monitoring data of medical staffs with blood-borne occupational exposure in our hospital from January 2013 to December 2015 were retrospectively analyzed for understanding the occupational exposure risk factors of medical staffs ,exposure sources ,preventive drugs , regular check-up and follow-up situation as well as the relationship between the occupational protection training and the occupational exposure occurrence rate .Results Females among occupational exposure persons were more than males during 2013-2015 ,nurses were more than doctors ,which were dominated by persons under 30 years old .The occupational exposure links were mainly pulling out needle ,followed by operation suture and medical wastes handling ;the occupational exposure mainly occurred at morning , followed by afternoon ,night was minimal .The occupational exposure occurrence rate after protection training was significantly lower than that before training ,the difference was statistically significant(P＜0 .01) .The exposure sources were in turn hepatitis B , syphilis ,AIDS and hepatitis C .No infection case occurred after 6-12 months regular check-ups and follow-up of serology and virology .Conclusion Conducting the occupational protection training for medical staffs ,strictly complying with the medical procedures and increasing the safety protective awareness can reduce the occurrence of occupational exposure and are conducive to control the occupational risk .

OBJECTIVE To investigate the antidepressant effect of triptolide in chronically unpredictable stressed mice and its possible protective effect on brain derived neurotrophic factor(BDNF). METHODS One method was selected from 8 different stress methods each day,and the mice were treated with triptolide(20,40,80 and 160μg·kg-1)10 min before the stress method. A chroni?cally unpredictable stressed model was established and after 14 d stress experiment, the total distance in the locomotor activity and the immobility time in the force swimming test and tail test were observed respectively. Triptolide(20,40,80 and 160μg·kg-1)was given 10 min before the test. In addition, Western blot was used to analyze the expression of phosphorylated cAMP response element binding protein(p-CREB) and BDNF in the hippocampus and frontal cortex. RESULTS There was no effect on the locomotor activity in any group. Compared with the normal control group,the chronically unpre?dictable stressed group showed obvious depressive-like behavior,while the immobility time in the force swimming test decreased from(161 ± 18)s in chronically stressed group to(102 ± 14)s(P<0.05) and(83±14)s(P<0.01)when mice were ip given triptolide 80 and 160μg·kg-1, respectively,and(77± 11)s(P<0.01)in imipramine(IMI)hydrochloride group(10 mg?kg-1),and(96±9)s(P<0.01)in fluox?etine(FLU)group(10 mg?kg-1). The immobility time in the tail suspension test decreased from(128± 8)s in chronically stressed group to(93±9)s(P<0.05),(85±8)s(P<0.01)and(77±11)s(P<0.01)when mice were ip given triptolide 40,80 and 160μg · kg-1 respectively,and(64 ± 9)s(P<0.01)in IMI hydro?chloride 10 mg?kg-1 group,and(72±6)s(P<0.01)in FLU group(10 mg?kg-1). Moreover,the expression of p-CREB in the hippocampus and frontal cortex significantly increased in triptolide 80 and 160μg·kg-1 groups(P<0.05),so did the expression of BDNF in the hippocampus and frontal cortex in triptolide 80 and 160μg·kg-1 groups(P<0.05). CONCLUSION Triptolide can ameliorate the depressive-like behavior in chronically unpredictable stressed mice,which may be related to the cAMP-CREB-BDNF signal transduction cascades.

BACKGROUND:Study confirms that bone morphogenetic protein can induce osteogenesis;however the ultrastructure of periosteal cells induced by bone morphogenetic protein-7 remains poorly reported.
OBJECTIVE:To study the bioactivity and ultrastructure of periosteal cells induced by bone morphogenetic protein-7 in vitro.
METHODS:The primary periosteal cells isolated from adult tibial bone were in vitro cultured, and then divided into experimental group and control group. In the experimental group, cells were cultured with bone morphogenetic protein-7 and culture adjuvant;while cells in the control group were only cultured with the adjuvant. Three samples in each group were tested at 5, 10, 15 days, respectively. The general structure of cultured cells was observed using von Kossa staining, and the ultrastructure was observed under transmission electron microscopy.
RESULTS AND CONCLUSION:The periosteal cells in the two groups grew wel in vitro, showing uniform morphology. Early cells were spindle-shaped, with strong three-dimensional sense and ful transparency;mitotic cells were short columnar or cubic shaped, there were a lot of rough endoplasmic reticulum and Golgi complex in osteoblasts under electron microscope. Later stage of cells developed from long fusiform into wide shuttle and irregular shape, there were a large number of matrix vesicles within the cells under the electron microscope. The membrane coating, alkaline phosphatase and calcium-binding protein in the cytoplasm, as wel as calcium crystals were found. The osteogenesis basement and lateral sides appeared projections, which were connected with adjacent bone cells. Induction of bone morphogenetic protein-7 in vitro promotes the osteoblasts proliferation, division and bone formation speed. The results suggest that bone morphogenetic protein-7 can significantly enhance the proliferation ability of osteoblasts in vitro.

Objective To assess the safety, efficacy, temporary side effects and feasibility of oral ibuprofen suspension in the treatment of patent ductus arteriosus (PDA) with hemodynamic significance in premature infants. Method A randomized controlled trial including seventy-four premature infants with PDA was performed from February 2007 to May 2008. Infants were randomly assigned to two groups: testing group (36 patients) received three doses of oral ibuprofen suspension (10 mg/kg at 24-hour intervals) and control group (38 patients) did not receive such treatment. The cure rate of PDA, relative side effects of ibuprofen and complications during treatment were recorded.Results The closure rate of ductus arteriosus in the testing group was 52.8% (19/36), which was higher than that of control group (18.4%, 7/38) (χ2=9.575, P=0.002). The severe side effects did not occur in testing group, such as oliguria, renal impairment, prone of bleeding, gastrointestinal perforation and novel appearing or deteriorative of intraventricular hemorrhage (IVH). Compared with the infants in control group (26.3%, 10/38), the morbidity of abdominal distension or gastric retention in testing group (33.3%, 12/36) was higher, while there was no statistically significant difference (χ2=0.436, P=0.509). The hospital stay [(22.8±14.8) d vs (24.1±17.1) d], mechanical ventilation rate [5.6% (2/36) vs 2.6% (1/38)] and oxygen supplement time [(8.3±9.3) d vs (8.8±8.3) d] between the testing and control groups remained no significant difference (P>0.05). Conclusions Oral ibuprofen suspension could be effective in closing PDA of preterm infants; no significant complications and side-effects occurred during oral ibuprofen treatment. It is suggested that oral ibuprofen suspension treatment was safe, effective and well tolerated for preterm infants with PDA.