Objective:To understand the potential characteristics of decision-making preparation in outpatient hypertensive patients based on latent profile analysis, to identify the influencing factors of different categories of decision-making preparation levels, and to explore the performance of different decision-making preparation types in facilitation of patients involvement in treatment decision-making.Methods:Through a cross-sectional study, 350 hypertensive patients attending outpatient clinics in five different types of healthcare institutions (general hospitals, specialised hospitals and community hospitals) in Tianjin during January to May 2024 who met the inclusion and exclusion criteria were selected by the convenience sampling method as study subjects. General Information Questionnaires, Preparation for Decision Making Scale, and Facilitation of Patient Involvement Scale were used for investigation.Results:Totally 350 valid questionnaires [178 males and 172 females aged 25-89(57.24 ± 13.39)years old] were collected. The decision-making preparation score of outpatient hypertensive patients was (64.19 ± 18.69). The latent profile analysis results showed that the decision-making preparation of outpatient hypertensive patients could be divided into three potential categories: decision-making information scarcity type accounted for 20.0%(70/350), decision-making balance negotiation type accounted for 39.7%(139/350), and decision-making preparation adequacy type accounted for 40.3%(141/350). The results of multiple Logistic regression analysis showed that age, medical insurance type, occupation, and children′s condition were the influencing factors for the potential categories of decision-making preparation in outpatient hypertensive patients (all P<0.05). Age [less than 35 years old: OR(95% CI)=0.127(0.020-0.796)], occupation [on the job: OR(95% CI)=2.010 (1.034-3.906)], were the influencing factors of decision-making balance negotiation group (all P<0.05). Medical insurance type [basic medical insurance for urban employees: OR(95% CI)=0.372(0.193-0.720)], occupation [on the job: OR(95% CI)=2.500(1.270-4.920)], children′s condition[junior and senior high school: OR(95% CI)=0.391(0.190-0.802)] were the influencing factors of decision-making preparation adequacy group (all P<0.05). Conclusions:The level of promoting patient participation among outpatients with hypertension is relatively high, and there are differences in the perceived degree of promoting patient participation among patients with different types of decision preparation.It is recommended that medical staff provide decision-making related information based on the characteristics of different decision-making preparation categories of patients, encourage patients to actively participate in decision-making, and construct targeted decision support plans.

Objective:To understand the potential characteristics of decision-making preparation in outpatient hypertensive patients based on latent profile analysis, to identify the influencing factors of different categories of decision-making preparation levels, and to explore the performance of different decision-making preparation types in facilitation of patients involvement in treatment decision-making.Methods:Through a cross-sectional study, 350 hypertensive patients attending outpatient clinics in five different types of healthcare institutions (general hospitals, specialised hospitals and community hospitals) in Tianjin during January to May 2024 who met the inclusion and exclusion criteria were selected by the convenience sampling method as study subjects. General Information Questionnaires, Preparation for Decision Making Scale, and Facilitation of Patient Involvement Scale were used for investigation.Results:Totally 350 valid questionnaires [178 males and 172 females aged 25-89(57.24 ± 13.39)years old] were collected. The decision-making preparation score of outpatient hypertensive patients was (64.19 ± 18.69). The latent profile analysis results showed that the decision-making preparation of outpatient hypertensive patients could be divided into three potential categories: decision-making information scarcity type accounted for 20.0%(70/350), decision-making balance negotiation type accounted for 39.7%(139/350), and decision-making preparation adequacy type accounted for 40.3%(141/350). The results of multiple Logistic regression analysis showed that age, medical insurance type, occupation, and children′s condition were the influencing factors for the potential categories of decision-making preparation in outpatient hypertensive patients (all P<0.05). Age [less than 35 years old: OR(95% CI)=0.127(0.020-0.796)], occupation [on the job: OR(95% CI)=2.010 (1.034-3.906)], were the influencing factors of decision-making balance negotiation group (all P<0.05). Medical insurance type [basic medical insurance for urban employees: OR(95% CI)=0.372(0.193-0.720)], occupation [on the job: OR(95% CI)=2.500(1.270-4.920)], children′s condition[junior and senior high school: OR(95% CI)=0.391(0.190-0.802)] were the influencing factors of decision-making preparation adequacy group (all P<0.05). Conclusions:The level of promoting patient participation among outpatients with hypertension is relatively high, and there are differences in the perceived degree of promoting patient participation among patients with different types of decision preparation.It is recommended that medical staff provide decision-making related information based on the characteristics of different decision-making preparation categories of patients, encourage patients to actively participate in decision-making, and construct targeted decision support plans.

Objective:To observe the neuroanatomical properties of the projection pathway from the nucleus reuniens(Re)to the dorsal(dHC)and ventral(vHC)hippocampus.Methods:Adeno-associated virus SV40 was injected into the Re of C57BL/6 mice and the profile of downstream projection in the whole brain was examined and ranked.Retro-grade tracer Fluoro-Gold(FG)was injected into the whole hippocampus(wHC),dorsal hippocampus(dHC)or ven-tral hippocampus(vHC),and the distribution of the retrogradely labeled neurons and its relationship with calretinin(CR)in the Re were analyzed.Results:After injection of SV40 virus into the Re,we observed projection fibers or ter-minals in 18 areas across the brain.Among the areas,those to the hippocampus(HC)were mainly distributed in the dorsal and ventral lacunosum molecular layer,which ranked No.2 with regard to the projection intensity.Following injection of FG into the hippocampus,we observed that the retrogradely labeled neurons projecting to the wHC were densely distributed in the rostrocaudal segments of Re,with a more concentrated aggregation in the ventromedial part.FG+CR+double labeled neurons accounted for(47.47±0.07)％of FG labeled neurons,and for(67.13±0.10)％of CR+neurons in this case.The retrograde labeled neurons projecting to the dHC were sparse and mainly distributed in the dorsolateral part of Re.FG+CR+double labeled neurons accounted for(24.11±0.06)％of FG labeled neurons,and for(32.99±0.19)％of CR+neurons.The retrogradely labeled neurons projecting to the vHC were mainly distrib-uted in the ventralmedial part of Re.FG+CR+double labeled neurons accounted for(49.55±0.03)％of FG labeled neurons,and for(69.14±0.12)％of CR+neurons.Conclusion:Hippocampus is an essential target of the Re.The projections to the dHC and vHP differ in the location of projection neurons and the positive ratio with CR,which may re-flect the differential pathophysiological functions of the two pathways in vivo.

Objective:To observe the neuroanatomical properties of the projection pathway from the nucleus reuniens(Re)to the dorsal(dHC)and ventral(vHC)hippocampus.Methods:Adeno-associated virus SV40 was injected into the Re of C57BL/6 mice and the profile of downstream projection in the whole brain was examined and ranked.Retro-grade tracer Fluoro-Gold(FG)was injected into the whole hippocampus(wHC),dorsal hippocampus(dHC)or ven-tral hippocampus(vHC),and the distribution of the retrogradely labeled neurons and its relationship with calretinin(CR)in the Re were analyzed.Results:After injection of SV40 virus into the Re,we observed projection fibers or ter-minals in 18 areas across the brain.Among the areas,those to the hippocampus(HC)were mainly distributed in the dorsal and ventral lacunosum molecular layer,which ranked No.2 with regard to the projection intensity.Following injection of FG into the hippocampus,we observed that the retrogradely labeled neurons projecting to the wHC were densely distributed in the rostrocaudal segments of Re,with a more concentrated aggregation in the ventromedial part.FG+CR+double labeled neurons accounted for(47.47±0.07)％of FG labeled neurons,and for(67.13±0.10)％of CR+neurons in this case.The retrograde labeled neurons projecting to the dHC were sparse and mainly distributed in the dorsolateral part of Re.FG+CR+double labeled neurons accounted for(24.11±0.06)％of FG labeled neurons,and for(32.99±0.19)％of CR+neurons.The retrogradely labeled neurons projecting to the vHC were mainly distrib-uted in the ventralmedial part of Re.FG+CR+double labeled neurons accounted for(49.55±0.03)％of FG labeled neurons,and for(69.14±0.12)％of CR+neurons.Conclusion:Hippocampus is an essential target of the Re.The projections to the dHC and vHP differ in the location of projection neurons and the positive ratio with CR,which may re-flect the differential pathophysiological functions of the two pathways in vivo.

【Objective】 To study the effect of macrophage mediator 1 (MED1) deficiency on atherosclerosis in female mice. 【Methods】 ApoE knockout (ApoE^-/-), LDLR knockout (LDLR^-/-), MED1^fl/fl, and macrophage MED1 knockout (MED1^△Mac) mice were recruited in the study. Two types of mouse model were constructed:ApoE and macrophage MED1 double knockout (MED1^△Mac/ApoE^-/-) mice and their littermate controls (MED1^fl/fl/ApoE^-/-). ② LDLR knockout (LDLR^-/-) mice receiving bone marrow from MED1^△Mac (MED1^△Mac→LDLR^-/-) or MED1^fl/fl (MED1^fl/fl→LDLR^-/-) mice. Female mice from these two models were fed a Western diet (21% fat and 0.15% cholesterol) for 12 weeks to promote the development of atherosclerosis. Body weight, total cholesterol (TC), and total triglyceride (TG) content in plasma were measured dynamically. After Western diet feeding for 12 weeks, aortic tree and aortic root were collected and hematoxylin-eosin (H&E) and oil red O staining were performed. 【Results】 Plasma TC and TG did not significantly differ between MED1^fl/fl/ApoE^-/- control group and MED1^△Mac/ApoE^-/-experimental group. However, the plaque area in aortic tree and aortic root was significantly increased in MED1^△Mac/ApoE^-/-mice. Moreover, compared with that in MED1^fl/fl→LDLR^-/- control group, the plaque area of aortic tree and aortic root had an increasing trend in MED1^△Mac→LDLR^-/- mice group. 【Conclusion】 MED1 deficiency in macrophages promotes the development of atherosclerosis in female ApoE or LDLR knockout mice.

Objective:To study the value of myocardial perfusion imaging (MPI) and coronary flow reserve (CFR) combined with coronary artery calcium score (CACS) in the diagnosis of obstructive coronary artery disease (CAD).Methods:From January 2019 to December 2020, 96 confirmed or suspective CAD patients (65 males, 31 females; age: 30-81 years) who completed rest/stress MPI, CFR and CACS defection in Fuwai Central China Cardiovascular Hospital were retrospectively analyzed. Coronary angiography (CAG) was used as the diagnostic standard to calculate the sensitivity and accuracy of MPI, CFR and MPI/CFR combined with CACS in the diagnosis of CAD. The χ2 test was used to compare the diagnostic efficiency of different methods. Results:The diagnostic sensitivity of MPI was 76.06%(54/71), and the accuracy was 75.00%(72/96), while the sensitivity increased to 97.18%(69/71; χ2=13.67, P<0.001) and the accuracy increased to 87.50%(84/96; χ2=4.92, P=0.020) with significant differences after combined with CACS. The sensitivity and accuracy of CFR were 91.55%(65/71)and 87.50%(84/96), which increased to 97.18%(69/71; χ2=2.12, P=0.137) and 89.58%(86/96; χ2=0.21, P=0.411) with no significant differences after combined with CACS. The sensitivity of MPI in the diagnosis of three-vessel CAD was 70.00%(21/30), which increased to 100%(30/30; χ2=7.75, P=0.004) after combined with CACS; while the sensitivity of MPI combined with CACS in the diagnosis of single-vessel and double-vessel CAD were not significantly improved ( χ2 values: 3.29, 1.51, P values: 0.114, 0.416). Conclusion:The combination of MPI and CACS can significantly improve the diagnostic efficiency of CAD, contributed by the improvement of the diagnostic sensitivity in three-vessel disease; whereas the diagnostic efficiency of CFR for CAD is not significantly improved after combined with CACS.

Objective To investigate the tumor molecular mechanism of Hedgehog/Gli in promoting the epithelial-mesenchymal transition (EMT) in gastric cancer AZ521 cells. Methods After 24 h of treatment with GANT61,the mRNA expression of Gli1,Gli2, N-cadherin,and E-cadherin in the AZ521 cell line were detected by real-time fluorescence quantitative PCR. A Western blotting assay was conducted to determine the expression of the above cytokines,p-AKT and AKT. The effect of GANT61 on invasion was observed by transwell assay. N-Shh stimulation of the Hedgehog pathway was conducted to confirm the changes in these cytokines. Results GANT61 significantly downregulated the mRNA expression of Gli1,Gli2,and N-cadherin,but upregulated E-cadherin mRNA expression. The Western blotting assay revealed that GANT61 downregulated the protein expression of Gli1,Gli2,p-AKT,and N-cadherin,but upregulated E-cadherin expression. Furthermore,GANT61 inhibited the invasion. N-Shh proteins up-regulated Gli1,Gli2,and N-cadherin mRNA,protein expression and p-AKT protein expression,but downregulated E-cadherin mRNA and protein expressions. N-Shh promoted the invasion of tumor cells. Conclusion Downregulation of Gli1 and Gli2 can inhibit the invasion and metastasis in gastric cancer cells,which may be related to the promotion of EMT by Gli through the PI3K/AKT pathway.

BACKGROUND:Patients with knee arthroplasty mostly had bilateral lesions. It is stil controversial to perform simultaneous bilateral surgery or unilateral arthroplasty. The focus of controversy is that bilateral arthroplasty of the same period can get a real upgrade of the repair effect if it does not increase the risk of surgery. There have always existed controversies. OBJECTIVE:To comparatively analyze simultaneous bilateral and unilateral arthroplasty from aspects of safety, economy and effects. METHODS:118 patients suffering from severe bilateral knee osteoarthritis and treated by total knee arthroplasty in the First Affiliated Hospital of Anhui Medical University from April 2011 to April 2014 were divided into simultaneous bilateral arthroplasty group (n=47) and unilateral arthroplasty group (n=71). Variables reflecting safety, economy and effects were set up and data were colected and analyzed. RESULTS AND CONCLUSION: There was no evident difference in safety between simultaneous bilateral arthroplasty and unilateral arthroplasty groups (P > 0.05). In economy and effect, simultaneous bilateral arthroplasty group was significantly better than unilateral arthroplasty group (P < 0.05). These results suggest that with the same surgical management level, if the patient could resist, simultaneous bilateral surgery should be more welcomed, while performing simultaneous bilateral surgery in patients with preoperative cardiovascular diseases should be decided carefuly. Patients with diabetes melitus preoperatively should be guarded against postoperative infection.

Objective To investigate the clinical value of minimally invasive rotary resection in the treatment of mastitis with abscess formation. Methods A total of 93 cases with mastitis with abscess formation in our hospital from October 2010 to December 2014 were divided into two groups according to patients ’ willingness: one group was given ultrasound-guided Mammotome rotary surgery and drainage (minimally invasive group, n=45), the other underwent incision and drainage (control group, n=48).Surgical parameters, postoperative complications and patient satisfaction were compared between the two groups. Results The minimally invasive group was significantly superior to the control group in the operative time, blood loss, healing time, postoperative scar length and postoperative complications [(16.0 ±4.4) min vs.(30.6 ±6.8) min, t=-12.339, P=0.000;(8.5 ±2.3) ml vs.(12.7 ± 4.1) ml, t=-6.102, P=0.000;(10.1 ±1.9) d vs.(14.3 ±3.3) d, t=-7.595, P=0.000;(4.6 ±1.2) mm vs.(40.5 ± 11.8) mm, t=-20.913, P=0.000;8.9%(4/45) vs.25.0% (12/48), χ2 =4.232, P=0.040].Follow-up reviews at 3-6 postoperative months showed the comprehensive satisfaction of operation was significantly higher in the minimally invasive group (37/45, 82.2%) than that of control group (28/48, 58.3%) (χ2 =6.299, P=0.012). Conclusion For mastitis with abscess formation, minimally invasive rotary surgery has characteristics of minimal invasion, quick postoperative recovery, good cosmetic effects, few complications and high patients’ postoperative satisfaction.It deserves further clinical application.

OBJECTIVE: To analyze and explore the association between the 1607(1G/2G) single nucleotide polymorphism (SNP) in promoter of matrix metalloproteinase-1 (MMP-1) gene and susceptibility of head and neck cancer (HNC) by Meta-analysis. METHOD: By the end of January 2014, the published literatures were collected for the case-control studies evaluating the relationship between HNC and -1607 SNP of MMP-1 gene from English and Chinese literature databases according to the inclusion and exclusion criteria. Then the meta-analysis, the heterogeneity, bias and sensitivity of the results of the eligible literatures were conducted by Stata 10. 0. RESULT: A total of 9 studies including 2049 patients with HNC and 2158 controls were extracted for systematic review on the association of MMP-1 (-1607) 1G/2G SNP with the risk of HNC. Meta-analysis which based on random effects model showed that MMP-1 (-1607) 1G/2G SNP can significantly increase the risk of HNC[1G2G + 2G2G vs. 1G1G: OR = 1.45, 95% CI 1.25-1.68, P < 0.01; 2G2G vs. 1G1G + 1G2G:OR = 1.77, 95% CI 1.37-2.30, P < 0.01; 2G vs. 1G: OR = 1.52, 95% CI 1.26-1.85, P < 0.01; 2G2G vs. 1G1G: OR = 2.06, 95% CI 1.41-3.01, P < 0.01). CONCLUSION MMP-1 (-1607) 1G/2G SNP has close relationship with HNC susceptibility, people who with 2G2G genotype carriers are susceptible to HNC.
Asia ; Asian Continental Ancestry Group ; Case-Control Studies ; Genotype ; Head and Neck Neoplasms ; enzymology ; ethnology ; genetics ; Humans ; Matrix Metalloproteinase 1 ; genetics ; Polymorphism, Single Nucleotide ; Promoter Regions, Genetic