Pan-vascular medicine is an emerging discipline focusing on atherosclerotic diseases,with the concept of multidisciplinary integration,emphasizing on exploring the mechanism of disease development from the whole of the organism's structure and function.At present,the basic mechanism system of pan-vascular diseases has yet to be perfected.The pan-vascular concept is highly compatible with the idea of Chinese medicine that focuses on the overall view.Deficiency of all qi is the root cause of pan-vascular diseases,while phlegm,blood stasis,and water-dampness and other tangible evils stagnate in the veins and channels as the symptoms of the disease,therefore,the disease mechanism can be highly summarized as"stagnation due to qi deficiency".Deficiency leads to the stagnation,blocking the veins and channels,and the deficiency worsens due to the stagnation and then damages the veins and channels,thus,it develops into a disease.Based on the theory of"stagnation due to qi deficiency",this paper takes endothelial cell dysfunction as the entry point of pan-vascular diseases,and considers that low endothelial cell immunity is the initiating factor of pan-vascular diseases,and that the widespread persistence of microinflammatory state is the key pathology to pan-vascular diseases.

Background/Aims: Low educational attainment is a well-established risk factor for nonalcoholic fatty liver disease (NAFLD) in developed areas. However, the association between educational attainment and the risk of NAFLD is less clear in China. Methods: A cross-sectional study including over 200,000 Chinese adults across mainland China was conducted. Information on education level and lifestyle factors were obtained through standard questionnaires, while NAFLD and advanced fibrosis were diagnosed using validated formulas. Outcomes included the risk of NAFLD in the general population and high probability of fibrosis among patients with NAFLD. Logistic regression analysis was employed to estimate the risk of NAFLD and fibrosis across education levels. A causal mediation model was used to explore the potential mediators. Results: Comparing with those receiving primary school education, the multi-adjusted odds ratios (95% confidence intervals) for NAFLD were 1.28 (1.16 to 1.41) for men and 0.94 (0.89 to 0.99) for women with college education after accounting for body mass index. When considering waist circumference, the odds ratios (95% CIs) were 0.94 (0.86 to 1.04) for men and 0.88 (0.80 to 0.97) for women, respectively. The proportions mediated by general and central obesity were 51.00% and 68.04% for men, while for women the proportions were 48.58% and 32.58%, respectively. Furthermore, NAFLD patients with lower educational attainment showed an incremental increased risk of advanced fibrosis in both genders. Conclusions In China, a low education level was associated with a higher risk of prevalent NAFLD in women, as well as high probability of fibrosis in both genders.

Objective To screen the epithelial mesenchymal transformation(EMT)-related genes in lung adenocarcinoma,perform functional enrichment analysis and construct protein interaction network(PPI).Ac-cording to the competitive endogenous RNA(ceRNA)hypothesis and the effect of gene expression on the prognosis of patients,the ceRNA network was constructed.Methods The differentially expressed genes be-tween lung adenocarcinoma tissues and normal tissues were screened by gene expression map and tumor ge-nome map database,and the genes were imported into GenClip3 to obtain EMT-related genes.Metascape was used to perform gene ontology and Kyoto encyclopedia of gene and genome enrichment analysis,and STRING database was used to construct PPI and obtain EMT key genes.The relationship between key genes and prog-nosis was analyzed by Kaplan-Meier analysis.Analysis tools such as miRTarbase,miRNet database,and EN-CORI were used to construct ceRNA networks.Results In this study,156 lung adenocarcinoma EMT-related genes and their key genes cadherin 1,interleukin-6,matrix metalloproteinase-9,platelet endothelial cell adhe-sion molecule,cyclin-dependent kinase inhibitor 2A,α1-Ⅰcollagen gene,secreted phosphoprotein 1,TIMP in-hibitor of matrix metalloproteinase-1,caveolin-1 and Zeste homologue enhance core 2(EZH2)-1 were identi-fied.The PPI of key genes was predicted,and the therapeutic drugs targeting these key genes including salvia miltiorrhiza,ginseng lu,ginseng leaf and ginseng flower were also predicted.The prognostic ceRNA regulatory network of EZH2/hsa-miR-101-3p/GSEC was constructed.Conclusion This study describes using bioinfor-matics methods system in the process of EMT gene interactions,according to the lung adenocarcinoma pa-tients clinical data to construct the prognosis of the EMT process related ceRNA network,for the treatment and prognosis of lung adenocarcinoma judgment provides a new way of thinking.

Objective:To investigate the expression levels of matrix metalloproteinase-9 (MMP-9), procalcitonin (PCT), soluble triggering receptor expressed on myeloid cells (sTREM-1) and soluble cell differentiation 14 (sCD14) in pregnant women with premature rupture of membranes (PROM) and their predictive value for chorioamnionitis.Methods:A total of 132 pregnant women with PROM who received treatment in Tengzhou Central People's Hospital from January 2016 to June 2017 were included in the study group. These women were assigned to pre-term PROM group (gestational age < 37 weeks, n = 58) and full-term PROM group (gestational age > 37 weeks, n = 74). A total of 106 concurrent full-term healthy pregnant women were included in the control group. Pregnant women in the PROM group were also assigned into an infection group ( n = 51) and a non-infection group ( n = 81). Serum levels of MMP-9, PCT, sTREM-1 and sCD14 were compared between study and control groups, and their value in the diagnosis of PROM complicated with chorioamnionitis was analyzed. Results:The expression levels of MMP-9 [(271.42 ± 34.16) ng/L], PCT [(54.57 ± 8.16) pg/mL], sTREM-1 [(0.51 ± 0.11) ng/mL] and sCD14 [(60.23 ± 9.49) ng/mL] in the study group were significantly higher than those in the control group [(54.97 ± 10.08) ng/L, (26.04 ± 1.98) pg/mL, (0.19 ± 0.04) ng/mL, (42.04 ± 10.33) ng/mL, t = 27.064, 13.767, 14.831, -13.342, all P < 0.01). The expression levels of MMP-9 [(314.05 ± 45.37) ng/L], PCT [(0.61 ± 0.18) ng/mL], sTREM-1 [(63.12 ± 10.12) pg/mL] and sCD14 [(68.07 ± 11.05) ng/mL] in the pre-term PROM group were significantly higher than those in the full-term PROM group [(238.01 ± 40.45) ng/L, (47.87 ± 8.90) pg/mL, (0.43 ± 0.14) ng/mL, (54.09 ± 10.33) ng/mL, t = 9.103, 8.862, -10.538, 6.494, all P < 0.05). The expression levels of MMP-9 [(343.74 ± 43.74) ng/L], PCT [(69.88 ± 8.83) pg/mL], sTREM-1 [(0.67 ± 0.16) ng/mL], sCD14 [(70.41 ± 8.89) ng/mL] in the infection group were significantly higher than those in the non-infection group [(230.09 ± 49.82) ng/L, (45.82 ± 11.04) pg/mL, (0.42 ± 0.19) ng/mL and (54.41 ± 12.42) ng/mL, t = 23.655, 12.014, 9.382, 11.306, all P < 0.01]. The sensitivity (94.23%), specificity (93.75%), positive predictive value (92.45%) and negative predictive value (96.20%) of combined detection of these indexes in the diagnosis of PROM complicated by chorioamnionitis were significantly higher than those of other indexes detected alone (all P < 0.05). Conclusion:Combined detection of serum levels of MMP-9, PCT, sTREM-1 and sCD14 can be used as an effective auxiliary index for the diagnosis of early premature rupture of membranes complicated with chorioamnionitis.

Objective To analyze the influence of Wiltse approach and conventional transmuscular approach on the mul?tifidus muscle by imageology, histology and electrophysiology assessment following short?segment pedicle fixation on thoracolum?bar fractures. Methods 76 patients with thoracolumbar fractures without neurological deficits who had undergone short?segment pedicle fixation between June 2010 and August 2012. Wiltse approach 36 cases, conventional transmuscular approach 40 cases. The perioperative parameters, Visual Analogue Scale scores (VAS), and radiologic parameters, esp the imageology, histology and electrophysiology changes of multifidus muscle were compared. Results 20 cases were fellowed up over 1 year in the Wiltse ap?proach group (20/36, 56%). 25 cases were fellowed up over 1 year in the conventional transmuscular approach group (25/40, 62.5%). No significant differences were found in terms of gender, age, fracture type, injured segment and follow?up period. Till the last follow?up, all patients with vertebral fractures were healed. No loosening or breaking of internal fixation was observed. Com?pared to the conventional transmuscular approach, the Wiltse approach was significantly advantageous in terms of operation time, the amount of bleeding, hospital stays and VAS scores after the surgery but the length of incision, besides, the Wiltse approach group had less incidence of multifidus atrophy and less fatty infiltration, and in conventional transmuscular approach group electro?myography demonstrated that the multifidus muscles median frequency values and average amplitude value were significantly low?er than Wiltse approach group. Conclusion The Wiltse approach for thoracolumbar fractures, retaining the posterior ligament complex, is an effective and minimally invasive treatment, with less trauma, less bleeding, less operation time, the advantages of re?liable clinical results. Especially less incidence of multifidus atrophy and less fatty infiltration.

Objective To examine the association between one-hour plasma glucose (1-hPG) level during an oral glucose tolerance test (OGTT) and serum lipid profiles in individuals with NGT. Methods 6 402 individuals with NGT who underwent a 75 g OGTT were screened from four communities of Hefei suburban areas, aged over 40 years. Then 1 291 cases of NGT were randomly selected as the object of this research by random data table method. They were divided into NGT-1 group (1-h PG < 8.6 mmol/L, n = 597)and NGT-2 group(1-h PG≥8.6 mmol/L, n = 694). Pearson correlation analysis and multivariate linear regression analyses were performed to assess correlations between 1-h PG levels and lipid profiles. Results (1) The average values of body mass index were 24.3 kg/m2 in NGT-1 group, and 24.5 kg/m2 in NGT-2 group. (2) Compared with individuals in NGT-1 group , fasting plasma glucose , two-hour plasma glucose during OGTT , HbA1c , triglyceride (TG), and high-density lipoprotein-cholesterol(HDL-c) levels, TG/HDL-c ratios, and total cholesterol(TCH)/HDL-c ratios were significantly higher in individuals than in NGT-2 group. By contranst, body mass index, blood pressure , TCH and low-density lipoprotein-cholesterol levels were not significantly different between NGT-1 group and NGT-2 group. (3) The multiple linear regression analyses showed that 1 h PG levels positively correlated with TG in individuals in both NGT-1 group and NGT-2 group (P < 0.01). In addition, 1-h PG levels negatively correlated with HDL-c ratio in both groups (P < 0.01). Conclusion 1-h PG levels during OGTT in overweight individuals with NGT closely correlate with HDL-c and TG levels.

One hundred and two pregnant women with obstructive sleep apnea hypopnea syndrome (OSAHS) and 36 healthy pregnant women( control group)were enrolled in the study.Serum visfatin and macrophage migration inhibitory factor (MIF) levels were detected by enzyme linked immunosorbent assay (ELISA).The results showed that apnea-hypopnea index (AHI),mean arterial pressure(MAP),serum visfatin and MIF levels in pregnant women with OSAHS were significantly higher than those of controls ( all P＜ 0.01 ). In pregnant women,AHI,serum visfatin and MIF levels of patients having OSAHS with hypertension were significantly higher than those of patients with OSAHS only (all P ＜ 0.01 ).Patients with severe OSAHS had higher levels of visfatin and MIF than those with moderate OSAHS,and patients with moderate OSAHS had higher visfatin and MIF levels than those with mild OSAHS ( P ＜0.01 ).The AHI was significantly correlated with MAP,serum levels of MIF and visfatin ( r =0.75,0.71,0.68,respectively,all P ＜0.01 ) in pregnant women with OSAHS.

Objective:To check the effect of immunosuppressants as adjuvants for DNA vaccine to prevent autoimmune disease.Methotis:Three immunosuppressants,Cyclosporin A(CsA),Tacrolimus(FK506)and Mycophenolate Mofetil(MMF)Were combined with DNA vaccine of Multiple Sclerosis(MS)and injected intramuscuarly.The splenocytes of immunized mice were checked for regulatory T cells(Treg),T cell proliferation and maturation of dendritic cells(Dcs)as well as release of intereleukin 10(IL-10).The immunized mice were induced as EAE animal model to check the preventive effect of FK506 as adjuvant.Results:More Treg cells Were induced in the mice immunized with FK506 and DNA vaccine and also T cell proliferation Was suppressed.DCs maturation Was blocked and high level of IL-10 in DCs Was induced in mice treated with FK506 and DNA vaccine.The clinic scores of EAE were significantly decreased in mice treated with FK506 and DNA vaccine compared with other control groups.Conclusion:FK506 as adjuvant of DNA vaccine can stimulate Treg cells and immune tolerance,then prevent from the autoimmune disease.

Objective To explore serum levels of visfatin and high-sensitivity C-reactive protein (Hs-CRP) in patients with polycystic ovary syndrome (PCOS), as well as their clinical significance. Methods Ninety patients with PCOS and 30 ovulating healthy women with body mass index (BMI) less than 25 as controls were recruited. PCOS patients were divided to two groups, 48 in obese group with BMI≥ 25 and 42 in non-obese group with BMI<25. Serum level of visfatin was measured by enzyme-linked immunosorbent assay (ELISA) and that of Hs-CRP was assayed by immunoturbidimetry in all participants. Oral glucose tolerance test (OGTT) and insulin sensitivity were assessed in PCOS patients only. Results ①Obese and non-obese patients with PCOS beth presented markedly higher serum levels of visfatin and Hs-CRP than those in controls (t=11.35, 8.46, 10.43 and 8.25, respectively, P<0.05), and levels of visfatin and Hs-CRP were higher in obese group than those in non-obese group (t=7.74 and 6.38, respectively, P< 0.05 ). ②Univariate analysis revealed that serum levels of visfatin and Hs-CRP positively correlated with BMI and homeostasis model assessment insulin resistance, respectively (P<0.05) and serum level of visfatin positively correlated with that of Hs-CRP (P<0.05). Conclusions Chronic inflammation possibly exists in patients with PCOS, which may cause their serum visfatin and Hs-CRP levels increased.