Objectives: To investigated the safety and efficacy of treating patients with acute non-ST-segment elevation myocardial infarction (NSTEMI) and elevated levels of N-terminal pro-hormone B-type natriuretic peptide (NT-proBNP) with levosimendan within 24 hours of first medical contact (FMC). Methods: This multicenter, open-label, block-randomized controlled trial (NCT03189901) investigated the safety and efficacy of levosimendan as an early management strategy of acute heart failure (EMS-AHF) for patients with NSTEMI and high NT-proBNP levels. This study included 255 patients with NSTEMI and elevated NT-proBNP levels, including 142 males and 113 females with a median age of 65 (58-70) years, and were admitted in the emergency or outpatient departments at 14 medical centers in China between October 2017 and October 2021. The patients were randomly divided into a levosimendan group (n=129) and a control group (n=126). The primary outcome measure was NT-proBNP levels on day 3 of treatment and changes in the NT-proBNP levels from baseline on day 5 after randomization. The secondary outcome measures included the proportion of patients with more than 30% reduction in NT-proBNP levels from baseline, major adverse cardiovascular events (MACE) during hospitalization and at 6 months after hospitalization, safety during the treatment, and health economics indices. The measurement data parameters between groups were compared using the t-test or the non-parametric test. The count data parameters were compared between groups using the χ² test. Results: On day 3, the NT-proBNP levels in the levosimendan group were lower than the control group but were statistically insignificant [866 (455, 1 960) vs. 1 118 (459, 2 417) ng/L, Z=-1.25,P=0.21]. However, on day 5, changes in the NT-proBNP levels from baseline in the levosimendan group were significantly higher than the control group [67.6% (33.8%,82.5%)vs.54.8% (7.3%,77.9%), Z=-2.14, P=0.03]. There were no significant differences in the proportion of patients with more than 30% reduction in the NT-proBNP levels on day 5 between the levosimendan and the control groups [77.5% (100/129) vs. 69.0% (87/126), χ²=2.34, P=0.13]. Furthermore, incidences of MACE did not show any significant differences between the two groups during hospitalization [4.7% (6/129) vs. 7.1% (9/126), χ²=0.72, P=0.40] and at 6 months [14.7% (19/129) vs. 12.7% (16/126), χ²=0.22, P=0.64]. Four cardiac deaths were reported in the control group during hospitalization [0 (0/129) vs. 3.2% (4/126), P=0.06]. However, 6-month survival rates were comparable between the two groups (log-rank test, P=0.18). Moreover, adverse events or serious adverse events such as shock, ventricular fibrillation, and ventricular tachycardia were not reported in both the groups during levosimendan treatment (days 0-1). The total cost of hospitalization [34 591.00(15 527.46,59 324.80) vs. 37 144.65(16 066.90,63 919.00)yuan, Z=-0.26, P=0.80] and the total length of hospitalization [9 (8, 12) vs. 10 (7, 13) days, Z=0.72, P=0.72] were lower for patients in the levosimendan group compared to those in the control group, but did not show statistically significant differences. Conclusions: Early administration of levosimendan reduced NT-proBNP levels in NSTEMI patients with elevated NT-proBNP and did not increase the total cost and length of hospitalization, but did not significantly improve MACE during hospitalization or at 6 months.
Male ; Female ; Humans ; Aged ; Natriuretic Peptide, Brain ; Simendan/therapeutic use* ; Non-ST Elevated Myocardial Infarction ; Heart Failure/drug therapy* ; Peptide Fragments ; Arrhythmias, Cardiac ; Biomarkers ; Prognosis

OBJECTIVE: The aim was to identify the gene expressions of human cytomegalovirus (HCMV)-infected human umbilical vein endothelial cells (HUVECs) and to study its possible pathogenic mechanism on atherosclerosis using microarray technology. METHODS: The gene expression differences in HCMV AD169 strain-infected HUVECs were studied by the microarray technology to explore the potential molecular mechanism of HCMV infection. The qPCRs were performed to verify the transcriptome results. RESULTS: A total of 2,583 differentially expressed genes, including 407 down-regulated genes and 2,176 up-regulated genes, were detected by the systematic bioinformatics analysis. The Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses showed that the significantly differentially expressed genes were mainly involved in regulating protein kinase activity, inflammatory response, ubiquitination, protein phosphorylation, cell metabolism, and exosomes, among which 12 genes had significant changes and were screened by protein-protein interaction (PPI) analysis and verified by qPCR. The experimental qPCR results were consistent with the microarray results. CONCLUSION The GO and KEGG analyses revealed that the regulation of protein kinase activity, inflammatory response, ubiquitination, protein phosphorylation, and cell metabolism played important roles in the process of endothelial cell infection. Furthermore, 12 genes were involved in the process of HCMV infection of endothelial cells and contributed to the current understanding of the infection and pathogenic mechanisms of atherosclerosis.
Humans ; Cytomegalovirus/genetics* ; Human Umbilical Vein Endothelial Cells ; Atherosclerosis ; Protein Kinases ; RNA, Messenger

The limited treatment options for advanced prostate cancer (PCa) lead to the urgent need to discover new anticancer drugs. Mannose, an isomer of glucose, has been reported to have an anticancer effect on various tumors. However, the anticancer effect of mannose in PCa remains unclear. In this study, we demonstrated that mannose inhibits the proliferation and promotes the apoptosis of PCa cells in vitro, and mannose was observed to have an anticancer effect in mice without harming their health. Accumulation of intracellular mannose simultaneously decreased the mitochondrial membrane potential, increased mitochondrial and cellular reactive oxygen species (ROS) levels, and reduced adenosine triphosphate (ATP) production in PCa cells. Mannose treatment of PCa cells induced changes in mitochondrial morphology, caused dysregulated expression of the fission protein, such as fission, mitochondrial 1 (FIS1), and enhanced the expression of proapoptotic factors, such as BCL2-associated X (Bax) and BCL2-antagonist/killer 1 (Bak). Furthermore, lower expression of mannose phosphate isomerase (MPI), the key enzyme in mannose metabolism, indicated poorer prognosis in PCa patients, and downregulation of MPI expression in PCa cells enhanced the anticancer effect of mannose. This study reveals the anticancer effect of mannose in PCa and its clinical significance in PCa patients.
Animals ; Apoptosis ; Cell Line, Tumor ; Humans ; Male ; Mannose ; Membrane Potential, Mitochondrial ; Mice ; Mitochondria ; Prostatic Neoplasms ; Reactive Oxygen Species

Aim To study the mechanism of anti-plate- let aggregation of sorghum root active parts. Methods The effects of active fraction (WEAE-M 30%) from sorghum roots on platelet aggregation induced by collagen, thrombin and adenosine diphosphate were investigated in vitro. Western blot, enzyme-linked immunoas-say, flow cytometry and fluorescence techniques were used to explore the mechanism of the antiplatelet aggregation effect of WEAE-M 30% . Results WEAE-M 30% had a significant inhibitory effect on platelet aggregation induced by the three agonists mentioned above. The inhibitory effect on platelet aggregation induced by collagen was the most significant, with an inhibitory rate of (72. 91 ±2. 42)%. It was found that WEAE-M 30% had a significant inhibitory effect on the collagen- mediated platelet (IPVI signaling pathway protein Src, MAPK signaling pathway protein p38 and ERK phosphorylation. It also significantly inhibited the levels of ATP, P-selection and Ca2+ in platelets. Conclusions It is suggested that the mechanism of WE-AE-M 30% antiplatelet aggregation may be related to the inhibition of platelet activation pathway GPV1, MAPK and the release of typical platelet representative particles.

Objective: To explore the effect of perioperative chemotherapy on the prognosis of gastric cancer patients under real-world condition. Methods: A retrospective cohort study was carried out. Real world data of gastric cancer patients receiving perioperative chemotherapy and surgery + adjuvant chemotherapy in 33 domestic hospitals from January 1, 2014 to January 31, 2016 were collected. Inclusion criteria: (1) gastric adenocarcinoma was confirmed by histopathology, and clinical stage was cT2-4aN0-3M0 (AJCC 8th edition); (2) D2 radical gastric cancer surgery was performed; (3) at least one cycle of neoadjuvant chemotherapy (NAC) was completed; (4) at least 4 cycles of adjuvant chemotherapy (AC) [SOX (S-1+oxaliplatin) or CapeOX (capecitabine + oxaliplatin)] were completed. Exclusion criteria: (1) complicated with other malignant tumors; (2) radiotherapy received; (3) patients with incomplete data. The enrolled patients who received neoadjuvant chemotherapy and adjuvant chemotherapy were included in the perioperative chemotherapy group, and those who received only postoperative adjuvant chemotherapy were included in the surgery + adjuvant chemotherapy group. Propensity score matching (PSM) method was used to control selection bias. The primary outcome were overall survival (OS) and progression-free survival (PFS) after PSM. OS was defined as the time from the first neoadjuvant chemotherapy (operation + adjuvant chemotherapy group: from the date of operation) to the last effective follow-up or death. PFS was defined as the time from the first neoadjuvant chemotherapy (operation + adjuvant chemotherapy group: from the date of operation) to the first imaging diagnosis of tumor progression or death. The Kaplan-Meier method was used to estimate the survival rate, and the Cox proportional hazards model was used to evaluate the independent effect of perioperative chemo therapy on OS and PFS. Results: 2 045 cases were included, including 1 293 cases in the surgery+adjuvant chemotherapy group and 752 cases in the perioperative chemotherapy group. After PSM, 492 pairs were included in the analysis. There were no statistically significant differences in gender, age, body mass index, tumor stage before treatment, and tumor location between the two groups (all P>0.05). Compared with the surgery + adjuvant chemotherapy group, patients in the perioperative chemotherapy group had higher proportion of total gastrectomy (χ(2)=40.526, P<0.001), smaller maximum tumor diameter (t=3.969, P<0.001), less number of metastatic lymph nodes (t=1.343, P<0.001), lower ratio of vessel invasion (χ(2)=11.897, P=0.001) and nerve invasion (χ(2)=12.338, P<0.001). In the perioperative chemotherapy group and surgery + adjuvant chemotherapy group, 24 cases (4.9%) and 17 cases (3.4%) developed postoperative complications, respectively, and no significant difference was found between two groups (χ(2)=0.815, P=0.367). The median OS of the perioperative chemotherapy group was longer than that of the surgery + adjuvant chemotherapy group (65 months vs. 45 months, HR: 0.74, 95% CI: 0.62-0.89, P=0.001); the median PFS of the perioperative chemotherapy group was also longer than that of the surgery+adjuvant chemotherapy group (56 months vs. 36 months, HR=0.72, 95% CI:0.61-0.85, P<0.001). The forest plot results of subgroup analysis showed that both men and women could benefit from perioperative chemotherapy (all P<0.05); patients over 45 years of age (P<0.05) and with normal body mass (P<0.01) could benefit significantly; patients with cTNM stage II and III presented a trend of benefit or could benefit significantly (P<0.05); patients with signet ring cell carcinoma benefited little (P>0.05); tumors in the gastric body and gastric antrum benefited more significantly (P<0.05). Conclusion: Perioperative chemotherapy can improve the prognosis of gastric cancer patients.
Chemotherapy, Adjuvant ; Female ; Gastrectomy ; Humans ; Male ; Neoadjuvant Therapy ; Neoplasm Staging ; Prognosis ; Retrospective Studies ; Stomach Neoplasms/surgery*

Objective: To investigate the hepatorenoprotective effects of Origanum vulgare L. against finasteride-induced oxidative injury in the liver and kidney of mice. Methods: Liquid chromatography-electrospray ionization-tandem mass spectrometry (LC-ESI/MS) analysis was utilized to yield a fingerprint of Origanum vulgare polyphenolic constituents. Thirty BALB/c mice received 0.5 mL/day distilled water, finasteride (25 mg/kg/day for 10 d), and 100, 200, or 400 mg/kg/day finasteride + Origanum vulgare extract with 6 mice per group for five weeks. On day 36, liver and kidney function as well as pro-and antiinflammatory (IFN-γ, IL-12, IL-6, TNF-α, IL-1β, and IL-10) cytokines were measured. The total antioxidant status, nitric oxide (NO), and malondialdehyde levels as well as the activities of NO synthase and catalase were also evaluated. Histopathological study was conducted to assess the effect of Origanum vulgare extract on finasteride-induced renal and hepatic toxicities. Results: Twenty-five major polyphenolic compounds were identified in the Origanum vulgare extract by LC-ESI/MS. Origanum vulgare extract, especially at 200 and 400 mg/kg/day doses, significantly improved liver and kidney biochemical indices, decreased inflammatory cytokines, increased total antioxidant status and NO synthase and catalase activities, as well as decreased plasma NO and malondialdehyde levels in a dose-dependent manner as compared to the finasteride group. Histopathological results further confirmed the protective effect of Origanum vulgare extract. Conclusions: Origanum vulgare extract ameliorates finasteride-induced hepatic and renal biochemical and histopathological alterations, and restores antioxidant/oxidant balance.

Objective To study the effect of systemic group music therapy (SGMT) on social living function and life quality in patients with schizophrenia. Methods By systematic sampling, 160 patients were divided into intervention group (80 patients) and control group (80 patients).Patients in the intervention group were treated by SGMT, and the control group was treated by general care.Comparison was made before intervention and 18 months after intervention on the following:scores of social living function as determined by the Activity of Daily Living Scale (ADL), Social Disability Screening Schedule (SDSS), and Social Maladjustment (SOC) scale.The WHO quality of Life-BREF scale was used to analyze score changes of patients′ life quality. Results ADL, SDSS and SOC scores of the patients in intervention group were significantly lower than those in control group (P values all 0.05).In comparison of the life quality scores, physical health, mental health and social relationship scores were higher in intervention group than those in control group(P values all < 0.05).There was no significant difference between two groups in environment scores(P>0.05). Conclusion Implementation of SGMT intervention can efficiently improve patients′ social living function and quality of life.

OBJECTIVE: To investigation the types and frequencies of thalassemia gene mutations in pregnant population in Nanping area of Fujian Province, so as to provide a basis for prevention and control of birth children with moderate and severe thalassaemia in this area. METHODS: The genotyping of α and β thalassemia was performed using the gap-PCR (gap-PCR) technique combined with reverse dot blot (RDB). The genotyping test was performed by Gap-PCR for three rare deficient thalassemia. The cases with negative detection were further detected by Sanger sequencing method, so as to identify rare α or β thalassemia mutation. RESULTS: 1120 specimens were genotyped for thalassemia, out of them 547 thalassemia genes were determined. The detection rate was 48.8% (547/1120). 340 specimens were diagnosed as α thalassemia, and the detection rate was 30.6%, including 266 cases of --/αα, 44 cases of -α/αα, 12 cases of -α/αα, 8 cases of αα/αα,. 3 cases of Hb H disease ( 2 cases of --/-α, 1 case of --/-α), 2 cases of αα/αα, 2 cases of αα/αα, 1 case of -α/-α, and 1 case of -α/αα. Also, they contain 11 cases of rare α thalassemia, 8 kinds of rare types of α thalassemia mutations in combination, such as 4 cases of αα/αα, 1 case of αα/αα, 1 case of αα/αα, 1 case of αα/αα, 1 case of αα/αα, 1 case of αα/αα, 1 case of αα/αα, and 1 case of --/αα. Among them, 5 α mutation sites were first reported, namely αα, αα, αα, αα and αα; 2 α thalassemia mutation sites: αα and -- were detected again in the Chinese population, respectively. 188 specimens were diagnosed as β thalassemia with a detection rate of 16.8%. Among them, 68 cases of β/βN, 47 cases of β/βN, 20 cases of β/βN, 17 cases of β/βN, 7 cases of β/βN, 7 cases of βE/βN, 3 cases of β/βN and 2 cases of β/βN. And 17 cases were diagnosed as rare β thalassemia, 8 kinds of rare types were β thalassemia mutations in combination. There were 4 cases of β/βN, 3 cases of β/βN, 3 cases of β/βN, 2 cases of β/βN, 2 cases of β/βN, 1 case of β/βN, 1 case of β/βN, 1 case of β/βN. Among them, 3 β thalassemia mutation sites were reported for the first time, namely β, β and β; it was found that in the Chinese population as β, β, β, β, and β, respectively. 19 cases were diagnosed as αβ-complex thalassemia, out of which 15 types of thalassemia mutation combinations were detected. They contain 2 cases of rare αβ-complex thalassemia, which are αα/αα complex β/βN, αα in α1/αα complex β/βN. CONCLUSION The types of thalassemia gene mutations in Nanping area of Fujian province are genetically heterogeneous. The prevention and control strategies of thalassaemia in this area should be based on the prevention and treatment of common α thalassemia and β thalassaemia. And the attention should be paid to the types of rare and unknown gene mutations using screening and testing method.
China ; Female ; Genotype ; Humans ; Mutation ; Pregnancy ; Thailand ; alpha-Thalassemia ; genetics ; beta-Thalassemia ; genetics

Objective:To investigate the expression characteristics of high mobility group box 1 protein (HMGB1) in rat models of deafferentation pain induced by posterior root injury of spinal nerves, and its relation with neuroinflammation.Methods:Sixty SD rats were divided into a blank control group ( n=10) and a model group ( n=50) according to random number table method. Neuropathic pain rat models in the model group were established by cutting the posterior root of C 5-T 1 spinal nerve, while rats in the control group were performed the same operation without cutting the posterior root of C 5-T 1 spinal nerve. Three, 7, 10, 14, and 21 d after modeling, behavioral changes, including spontaneous pain scale scores, mechanical antagonistic pain threshold, and autophagy scale scores, were evaluated in the two groups of rats. Immunohistochemical staining was used to detect the HMGB1, ionized calcium binding adapter molecule 1 (IBA-1) and phosphorylated nuclear factor κB (pNF-κB) positive cells in the spinal cord of the two groups. Western blotting was used to detect the protein expressions of HMGB1, toll-like receptor (TLR)2 and pNF-κB in the spinal cord of the two groups. Results:(1) The scores of spontaneous pain scale and autophagy scale 14 and 21 d after modeling were significantly higher than those 3, 7 and 10 d after modeling ( P<0.05), and those 21 d after modeling were significantly higher than those 14 d after modeling ( P<0.05). (2) Immunohistochemical staining showed that HMGB1, IBA-1 and pNF-κB all expressed in the spinal cord tissues of rats in the model group 3 d after modeling, and the number of positive cells in the dorsal horn of the spinal cord on the injured side became larger with prolongation of exposure time, and that was obviously larger as compared with that on the opposite side; in the spinal cord tissues of the blank control group, the number of positive cells in the spinal dorsal horn area was small, and there was no significant difference in the number of positive cells in the spinal dorsal horn area on both sides. (3) Western blotting showed that, as compared with those in the blank control group, HMGB1, TLR2 and pNF-κB protein expressions in the spinal cord tissues of the model group were significantly increased 3, 7, 10, 14 and 21 d after modeling ( P<0.05), and which showed an increasing trend with prolongation of exposure time. Conclusion:The gradual increase in HMGB1 expression in the local spinal cord of rats with deafferentation pain leads to HMGB1/TLR2/NF-κB pathway high expression and activation of microglia cells, which induces the occurrence of local neuroinflammation in the spinal cord and eventually results in pain behavioral changes.

Objective To investigate the effect of genetic variants in STAT4 and its interaction with exercise on the pathological characteristics of patients with liver cancer. Methods In the 601 new patients with primary liver cancer,