Objective:To evaluate the diagnostic value of coronary angiography-derived fractional flow reserve (FFR) and index of microcirculatory resistance (IMR) for identifying coronary functional abnormalities.Methods:This diagnostic study enrolled patients with clinically suspected or diagnosed coronary artery disease who underwent coronary angiography at Beijing Anzhen Hospital, TEDA International Cardiovascular Hospital, and Qilu Hospital of Shandong University between December 2021 and June 2022. All enrolled patients successfully underwent invasive wire-based FFR and IMR measurements during angiography. In a core laboratory, FFR and IMR for the target vessels were measured using artificial intelligence technology based on coronary angiographic images. Spearman correlation analysis was used to evaluate the correlation between angiography-derived FFR and wire-based FFR, and between angiography-derived IMR and wire-based IMR. Coronary hemodynamic abnormality was defined as FFR≤0.80; the diagnostic performance of angiography-derived FFR for identifying this abnormality was evaluated. Microcirculatory dysfunction was defined as IMR≥25; the diagnostic performance of angiography-derived IMR for identifying microcirculatory dysfunction was evaluated.Results:A total of 181 patients, aged (60.6±8.8) years, with 62 (34.3%) females, and 181 target vessels were included in the final analysis. Angiography-derived FFR showed a significant positive correlation with wire-based FFR ( r=0.78, P<0.001). For identifying coronary hemodynamic abnormality, angiography-derived FFR showed an accuracy of 89.0%, sensitivity of 88.8%, specificity of 89.1%, positive predictive value (PPV) of 88.8%, negative predictive value (NPV) of 89.1%, and an area under the receiver operating characteristic curve ( AUC) of 0.88. Angiography-derived IMR showed a significant positive correlation with wire-based IMR ( r=0.93, P<0.001). For identifying microcirculatory dysfunction, angiography-derived IMR demonstrated an accuracy of 89.5%, sensitivity of 86.8%, specificity of 90.2%, PPV of 70.2%, NPV of 96.3%, and an AUC of 0.95. Conclusion:Angiography-derived FFR and IMR exhibit strong correlations with their invasive wire-based counterparts and demonstrate high diagnostic value for assessing coronary hemodynamics and coronary microcirculatory function.

Objective:To evaluate the diagnostic value of coronary angiography-derived fractional flow reserve (FFR) and index of microcirculatory resistance (IMR) for identifying coronary functional abnormalities.Methods:This diagnostic study enrolled patients with clinically suspected or diagnosed coronary artery disease who underwent coronary angiography at Beijing Anzhen Hospital, TEDA International Cardiovascular Hospital, and Qilu Hospital of Shandong University between December 2021 and June 2022. All enrolled patients successfully underwent invasive wire-based FFR and IMR measurements during angiography. In a core laboratory, FFR and IMR for the target vessels were measured using artificial intelligence technology based on coronary angiographic images. Spearman correlation analysis was used to evaluate the correlation between angiography-derived FFR and wire-based FFR, and between angiography-derived IMR and wire-based IMR. Coronary hemodynamic abnormality was defined as FFR≤0.80; the diagnostic performance of angiography-derived FFR for identifying this abnormality was evaluated. Microcirculatory dysfunction was defined as IMR≥25; the diagnostic performance of angiography-derived IMR for identifying microcirculatory dysfunction was evaluated.Results:A total of 181 patients, aged (60.6±8.8) years, with 62 (34.3%) females, and 181 target vessels were included in the final analysis. Angiography-derived FFR showed a significant positive correlation with wire-based FFR ( r=0.78, P<0.001). For identifying coronary hemodynamic abnormality, angiography-derived FFR showed an accuracy of 89.0%, sensitivity of 88.8%, specificity of 89.1%, positive predictive value (PPV) of 88.8%, negative predictive value (NPV) of 89.1%, and an area under the receiver operating characteristic curve ( AUC) of 0.88. Angiography-derived IMR showed a significant positive correlation with wire-based IMR ( r=0.93, P<0.001). For identifying microcirculatory dysfunction, angiography-derived IMR demonstrated an accuracy of 89.5%, sensitivity of 86.8%, specificity of 90.2%, PPV of 70.2%, NPV of 96.3%, and an AUC of 0.95. Conclusion:Angiography-derived FFR and IMR exhibit strong correlations with their invasive wire-based counterparts and demonstrate high diagnostic value for assessing coronary hemodynamics and coronary microcirculatory function.

Objective:To explore the in vitro anticancer effect of bleomycin (Ble) combined with cisplatin (DDP) on human gastric cancer cells.Methods:CCK-8 experiment was conducted to detect the effect of Ble and DDP alone or in combination on the proliferation of gastric cancer cells; Flow cytometry was used to detect changes in cell apoptosis and changes in reactive oxygen species. Cell scratch test was employed to detect cell migration; Western blot experiment was conducted to detect protein expression.Results:The results of CCK-8 showed that 20 μM DDP could inhibit the proliferation of six types of gastric cancer cells by 40%, while the effect of 20 μM Ble was only about 20%. When used in combination, the inhibitory rate on six types of gastric cancer could reach over 60%, with the strongest inhibitory effect on AGS cells. When 10 μM Ble and 10 μM DDP were combined, the proportion of AGS apoptotic cells reached 75.68%, higher than that of the two drugs treated with 20%, respectively 20 μM processing effect. When 10 μM Ble and 10 μM DDP were used in combination, the number of migrating and invading cells was significantly reduced, and the inhibition rate reached 50%. Compared with single use, the difference was statistically significant ( P<0.05). Flow cytometry results showed that the combination of Ble and DDP promoted cancer cell apoptosis by up-regulating the level of reactive oxygen species in cells; Western blot results showed that the expression of p-JAK2 and p-STAT3 decreased after Ble and DDP were combined, indicating that the JAK2/STAT3 signal pathway was inhibited. Conclusions:The combination of Ble and DDP can inhibit the proliferation and migration of gastric cancer cells, promote the apoptosis of gastric cancer cells, and play a synergistic anti-cancer effect. Its mechanism may be related to the up-regulation of ROS levels in cells, thereby inhibiting the activation of the JAK2/STAT3 pathway.

Objective:To investigate the biomechanical characteristics and clinical outcomes of arthroscopic superior capsular reconstruction for massive irreparable rotator cuff tears (MIRCT) using the long head of biceps tendon (LHBT) with tenotomizing its distally or not (the "Chinese way" ).Methods:Eight fresh-frozen cadaveric shoulders were used to create a MIRCT model by detaching the footprints of the supraspinatus and infraspinatus tendons on the greater tuberosity. LHBT autograft was transferred and securely fixed onto the footprint of supraspinatus tendon for superior capsular reconstruction. Further, all cadaveric specimens were assigned to the tenotomy group or reservation group (4 cadaveric specimens in each group) according to whether the distal part of LHBT was tentomized or not. Biomechanical tests were conducted to observe the stiffness, ultimate load of fixed LHBT and to measure the length between LHBT tear site and its insertion on the superior labrum. A total of 41 patients with MIRCT who underwent arthroscopic superior capsular reconstruction using LHBT autograft between July 2016 and December 2018 were enrolled in the study. There were 17 males and 24 females, aged from 46 to 76 years (62.6±7.3 years). All patients were assigned to the tenotomy group (23 cases) or reservation group (18 cases) according to whether the distal part of LHBT was tentomized or not. The visual analogue scale (VAS), University of California, Los Angeles (UCLA) score, American Shoulder and Elbow Surgeons (ASES) score, Constant-Murley score and Fudan University Shoulder Score (FUSS) were used to evaluate the clinical outcomes. The range of motion (ROM) of shoulder was recorded before and after operation. Magnetic resonance imaging was used to assess the structural integrity of reconstructed tissue at 12 months after operation (refers to the failure of the transposed LHBT, which may be accompanied by a retear of partial repaired supraspinatus tendon).Results:Biomechanical research showed that the stiffness, ultimate load of fixed LHBT and the length between LHBT tear site and its insertion on the superior labrum in the reservation group (54.0±6.6 N/mm, 141.8±15.9 N, 93.3±12.4 mm, respectively) were significantly higher than those in the tenotomy group (25.7±4.2 N/mm, 80.8±8.0 N, 47.4±2.0 mm, respectively) ( P<0.05). All patients were followed up for 12-18 months (14.5±1.8 months) without significant complications and adverse reactions. No matter the distal part of LHBT was tentomized or not, the ROM and clinical scores (VAS score, UCLA score, Constant-Murley score, ASES score and FUSS) of patients improved significantly at 1 year follow-up than that before operation ( P<0.05). However, there were no significant differences between the reservation group and tenotomy group in terms of postoperative ROM [flexion, abduction, external rotation at side, internal rotation (vertebral level) were 144.3°±15.5° vs. 148.0°±10.3°, 145.1°±14.1° vs. 142.3°±11.2°, 67.3°±14.4° vs. 62.7°±11.7°, 8.3±2.1 vs. 7.8±2.5, respectively], VAS scores (2.3±1.6 vs.1.5±1.2), functional scores (Constant-Murley score, UCLA score, ASES score and FUSS were 88.2±11.4 vs. 85.6±9.6, 29.3±2.8 vs. 31.4±3.5, 86.8±11.8 vs. 82.6±9.2, 92.1±10.1 vs. 88.3±8.2, respectively) and structural failures (35.2% vs. 30.0%, P>0.05). Conclusion:Arthroscopic superior capsular reconstruction using LHBT with reserving its distal part could achieve higher mechanics strength. However, the short-term follow-up showed that tenotomizing the distal part of LHBT exerted no obvious influence on postoperative function and structural integrity.

Objective:To analyze the psychological stress of infertile patients after COVID-19 epidemic and its related factors by Chinese version of the perceived stress scale (CPSS).Method:The basic information, reproductive history, impact of the epidemic, psychological status of patients undergoing assisted reproductive technology at the General Hospital of Northern Theater Command from March 29, 2021 to April 29, 2021 were collected by questionnaire. According to CPSS, group comparison and correlation analysis were used to explore factors related to patients' psychological stress.Results:A total of 251 valid questionnaires were received. The average CPSS score of the patients was 22.43±7.07. During the epidemic, about 33.86% (85/251) of the infertility patients postponed the fertilization plan; there were significant differences in the psychological stress among patients of different genders, occupations, and postponed fertilization plans at different stages of fertilization ( P=0.001, P=0.005, P=0.002). There was no significant difference in CPSS score between infertile patients who delayed treatment or not ( P>0.05). Correlation analysis showed that the perceived stress of patients was negatively correlated with their age, income, and delay duration ( r=-0.192, P=0.002; r=-0.323, P=0.001; r=-0.282, P=0.009). Among all patients who delayed treatment, patients with higher CPSS score would restart treatment sooner; most of the infertile patients knew little about the vaccine. Conclusion:The COVID-19 epidemic has caused a certain impact on the psychological pressure of infertile couples who accepted treatment in our hospital. The psychological care for infertile patients is particularly important. In the future, in order to dispel the doubts of infertile patients about the vaccine, we should pay attention to the correct scientific promotion of the COVID-19 vaccine during the treatment process.

Objective:To analyze the psychological stress of infertile patients after COVID-19 epidemic and its related factors by Chinese version of the perceived stress scale (CPSS).Method:The basic information, reproductive history, impact of the epidemic, psychological status of patients undergoing assisted reproductive technology at the General Hospital of Northern Theater Command from March 29, 2021 to April 29, 2021 were collected by questionnaire. According to CPSS, group comparison and correlation analysis were used to explore factors related to patients' psychological stress.Results:A total of 251 valid questionnaires were received. The average CPSS score of the patients was 22.43±7.07. During the epidemic, about 33.86% (85/251) of the infertility patients postponed the fertilization plan; there were significant differences in the psychological stress among patients of different genders, occupations, and postponed fertilization plans at different stages of fertilization ( P=0.001, P=0.005, P=0.002). There was no significant difference in CPSS score between infertile patients who delayed treatment or not ( P>0.05). Correlation analysis showed that the perceived stress of patients was negatively correlated with their age, income, and delay duration ( r=-0.192, P=0.002; r=-0.323, P=0.001; r=-0.282, P=0.009). Among all patients who delayed treatment, patients with higher CPSS score would restart treatment sooner; most of the infertile patients knew little about the vaccine. Conclusion:The COVID-19 epidemic has caused a certain impact on the psychological pressure of infertile couples who accepted treatment in our hospital. The psychological care for infertile patients is particularly important. In the future, in order to dispel the doubts of infertile patients about the vaccine, we should pay attention to the correct scientific promotion of the COVID-19 vaccine during the treatment process.

Objective:To analyze the characteristics of complex severe symptomatic carotid stenosis, and to summarize the surgical techniques of endovascular stent treatment.Methods:A total of 36 cases of complex carotid stenosis with stenosis greater than 90% from January 2013 to July 2019 were selected, among which 22 patients with subtotal occlusion with stenosis of 95%~99%, 6 patients with contralateral internal carotid artery occlusion, 4 elderly patients with severe twisted aortic arch and carotid artery, and 4 patients with angular distortions of internal carotid artery that were too close at the stenosis distal end. The characteristics of pathological change and the state of cerebral blood flow compensation under digital subtraction angiography (DSA) of these 4 above-mentioned complex types were analyzed. The techniques of endovascular surgery were summarized, focusing on the individualized surgical plan, perioperative management, patients′ tolerance, revascularization structure change, complication control, and the occurrence of restenosis and other related ischemic cerebrovascular events during the 1-year postoperative follow-up.Results:Among the cases treated with subtotal occlusion by carotid artery stenting (CAS) with proximal blood flow protection device, 1 case failed and 2 cases received a secondary stent implantation. The surgeries on the patients with contralateral occlusion were performed with preoperative sedation, appropriate elevation of blood pressure, and shortening the vessel occlusion time. The patients with insufficient support due to path distortion received coaxial multi guide wire with multiple switching long sheath assisting technology. Among the patients with angular distortions at stenosis distal end, the stent was successfully released at the proximal in 2 cases, the stent was released across the angle without affecting the blood flow in 1 case, and in 1 case the stent releasing across the angle was given up during the surgery due to the distal artery kinking. A total of 34 surgeries were success (94.4%), with the stenosis severity reducing from (93.1±3.2)% (before) to (21.5±4.8)% (after). In 3 cases, the patients had transient aphasia and contralateral limb hemiplegia and ischemic symptoms during the operation. There was no cerebral hemorrhage, cerebral infarction, or no in-stent restenosis during the one-year follow-up.Conclusion:CAS treatment in complex severe carotid stenosis requires individualized surgical procedures and perioperative management. Appropriate surgical plan can ensure the success and safety of the surgery.

Objective:To analyze the characteristics of complex severe symptomatic carotid stenosis, and to summarize the surgical techniques of endovascular stent treatment.Methods:A total of 36 cases of complex carotid stenosis with stenosis greater than 90% from January 2013 to July 2019 were selected, among which 22 patients with subtotal occlusion with stenosis of 95%~99%, 6 patients with contralateral internal carotid artery occlusion, 4 elderly patients with severe twisted aortic arch and carotid artery, and 4 patients with angular distortions of internal carotid artery that were too close at the stenosis distal end. The characteristics of pathological change and the state of cerebral blood flow compensation under digital subtraction angiography (DSA) of these 4 above-mentioned complex types were analyzed. The techniques of endovascular surgery were summarized, focusing on the individualized surgical plan, perioperative management, patients′ tolerance, revascularization structure change, complication control, and the occurrence of restenosis and other related ischemic cerebrovascular events during the 1-year postoperative follow-up.Results:Among the cases treated with subtotal occlusion by carotid artery stenting (CAS) with proximal blood flow protection device, 1 case failed and 2 cases received a secondary stent implantation. The surgeries on the patients with contralateral occlusion were performed with preoperative sedation, appropriate elevation of blood pressure, and shortening the vessel occlusion time. The patients with insufficient support due to path distortion received coaxial multi guide wire with multiple switching long sheath assisting technology. Among the patients with angular distortions at stenosis distal end, the stent was successfully released at the proximal in 2 cases, the stent was released across the angle without affecting the blood flow in 1 case, and in 1 case the stent releasing across the angle was given up during the surgery due to the distal artery kinking. A total of 34 surgeries were success (94.4%), with the stenosis severity reducing from (93.1±3.2)% (before) to (21.5±4.8)% (after). In 3 cases, the patients had transient aphasia and contralateral limb hemiplegia and ischemic symptoms during the operation. There was no cerebral hemorrhage, cerebral infarction, or no in-stent restenosis during the one-year follow-up.Conclusion:CAS treatment in complex severe carotid stenosis requires individualized surgical procedures and perioperative management. Appropriate surgical plan can ensure the success and safety of the surgery.

OBJECTIVE： To investigate the effects of Danhong injection （DHI） on gene expression profile of acute myocardial infarction （AMI） model rats. METHODS： Male SD rats were randomly divided into sham operation group， model group and DHI group （0.76 mL/kg）， with 10 rats in each group. AMI model was established by ligation of left anterior descending coronary artery in model group and DHI group. After modeling， sham operation group and model group were given constant volume of normal saline intramuscularly， and DHI group was given relevant medicine intramuscularly， once a day， for consecutive 14 days. After last administration， myocardial tissue in the marginal zone of infarction was separated. The change of gene expression profile was detected by gene chip technique. Using fold-change of relative expression as index， differentially expressed microRNA （miRNA） were screened. On the basis of retrieving their corresponding genes， gene ontology （GO） and KEGG pathway enrichment analysis were carried out by using DAVID bioinformatics resource database and KEGG pathway database， respectively. TargetScan database was used to predict the target gene messenger RNA （mRNA） corresponding to differentially expressed miRNA. Cytoscape 3.6.1 software was used to construct and analyze the miRNA-mRNA network. Agilent GeneSpring GX v11.5 software was used to screen target genes and miRNA related to inflammation in the above networks. RESULTS： Compared with sham operation group， there were 22 differentially expressed miRNAs in model group， 5 up-regulated and 17 down-regulated. Compared with model group， there were 26 differentially expressed miRNAs in DHI group， and all of them were up-regulated. The differentially expressed miRNAs related to DHI therapy for AMI included rno-let-7a-5p， rno-let-7d-5p， rno-let-7f-5p， rno-miR-26b-5p， rno-miR-29b-3p， cel-miR-39-3p， cel-miR-39-5p， rno-miR-142-5p， rno-miR-191a-5p， rno-miR-409a-3p. Results of GO analysis and KEGG pathway enrichment analysis showed that differentially expressed miRNAs were mainly concentrated in membrane-bound organelles， cytoplasm， endometrial system and other cell components. The molecular functions such as protein binding and ion binding were exerted through biological processes such as anatomical structure development， multicellular tissue development and development process，which were mainly enriched in calcium signaling pathway， PPAR signaling pathway， VEGF signaling pathway， cell apoptosis， glycosylphosphatidylinositol anchored biosynthesis， valine， leucine and isoleucine degradation， etc. miRNA-mRNA network analysis showed that there were 25 target gene mRNAs corresponding to differentially expressed miRNA and 24 miRNAs related to it. There were 6 inflammation-related target genes （IL6， IL1b， TNF， TLR4， CRP， CXCL12） in this network， involving 19 differentially expressed miRNAs. CONCLUSIONS： The therapeutic effect of DHI on AMI may be related to regulating the expression of related miRNA， affecting signal transduction of calcium ion， PPAR and VEGF pathways， and regulating the secretion of inflammatory markers such as interleukin， chemokine and C-reactive protein.

Objective To investigate the characteristics of adenovirus infection in hospitalized children with respiratory tract infection in Shenzhen.Methods Nasopharyngeal swabs obtained from 25 602 children hospitalized with respiratory tract infections in Shenzhen Children's Hospital during 2014 to 2016,were tested for adenovirus with direct immunofluorescence assay.The detection rate of adenovirus and diagnosis in hospitalized children with respiratory tract infection were analyzed.Results The total adenovirus detection rate was 2.97 ％ in 25 602 samples,with a male to female ratio of 2.04:1,no significantly difference in detection rate in male (3.12％) and female (2.70％).Accounted for 724 (95.14％) of the total adenovirus positive detection children below six years old,and 409(53.75％) children were detected below two years old.There was a distinct seasonality;the detection rate was higher in summer and winter (x2 =36.631,P＜0.01).In 761 hospitalized patients of ADV positive,431 were pneumonia,109 were bronchitis,74 were tonsillitis,14 were conjunctivitis pharynx and 133 were acute upper respiratory infection.Conclusion Our study demonstrates that respiratory adenovirus infection is an important cause of hospitalization in children below the age of 6 years in Shenzhen,China.The detection rate was higher in summer and winter than spring and autumn.Most adenovirus positive children were diagnosed by pneumonia,bronchitis and acute upper respiratory tract infection.