Objective To explore the predictive value of the expression of serum forkhead box protein M1(FOXM1)and insulin-like growth factor 2(IGF2)on the prognosis of elderly patients with heart failure complicated with pneumonia.Methods A total of 126 elderly patients with heart failure complicated with pneumonia admitted to Handan Central Hospital from March 2021 to June 2022 were included in case group.According to the follow-up results,the 122 patients were grouped into poor prognosis group(n=33)and good prognosis group(n=89).Meanwhile,126 healthy people in the same period were included as the control group.The levels of serum FOXM1 and IGF2,forced vital capacity(FVC)and forced expiratory volume in the first second(FEV1)in the two groups(case group and control group)were measured.Spearman method was used to analyze the correlation between serum levels of FOXM1 and IGF2 and heart function classification in elderly patients with heart failure complicated with pneumonia.The predictive value of serum FOXM1 and IGF2 levels in elderly patients with heart failure complicated with pneumonia was analyzed by receiver operating characteristic(ROC)curve.Results Compared with the control group,the levels of FOXM1(2.39±0.55 vs 1.06±0.21)and IGF2(71.33±7.96pg/ml vs 47.82±5.14pg/ml)in the case group were significantly higher(t=25.358,27.581,all P<0.05).Compared with the good prognosis group,the levels of serum FOXM1(3.87±1.06 vs 1.95±0.51)and IGF2(85.88±9.54pg/ml vs 69.14±8.73pg/ml)in the poor prognosis group were significantly higher,and the differences were statistically significant(t=13.453,9.174,all P<0.05).There were significant differences in heart function classification between the good prognosis group and the poor prognosis group,and the differences were statistically significant(χ2=7.120,P<0.05).Compared with the poor prognosis group,FEV1(1.24±0.32 L vs 1.08±0.25 L)and FEV1/FVC(55.46%±5.77%vs 52.30%±5.38%)in good prognosis group were significantly higher,and the differences were statistically significant(t=2.592,2.735,all P<0.05).The levels of serum FOXM1 and IGF2(r=0.496,0.517,all P<0.05)in elderly patients with heart failure complicated with pneumonia were positively correlated with heart function classification.ROC curve results showed that the area under the curve(AUC)of serum FOXM1 alone in predicting the prognosis of elderly patients with heart failure complicated with pneumonia was 0.854(95CI%:0.779～0.912),with sensitivity and specificity of 75.76%and 86.52%,respectively,and the optimal cut-off value of 2.75.The AUC of IGF2 alone in predicting the prognosis of elderly patients with heart failure complicated with pneumonia was 0.874(95CI%:0.802～0.927),with sensitivity and specificity of 72.73%and 85.39%,respectively,and the optimal cut-off value of 78.30 pg/ml.The AUC of the combination of the two in predicting the prognosis of elderly patients with heart failure complicated with pneumonia was greater than the AUC diagnosed by serum FOXM1 alone and IGF2 alone(Z=2.737,2.413,P=0.006,0.016).Conclusion The serum levels of FOXM1 and IGF2 were increased in elderly patients with heart failure complicated with pneumonia,indicating the combined detection of the two may have a high predictive value for the prognosis of patients.

Objective To analyze the transcription factor binding sites(TFBS)in the promoter region of E3 ubiquitin protein ligase 1(MIB1)gene in zebrafish,the types of MIB1 interacting genes and proteins and their roles in signaling pathways,and to investigate the regulatory mode and potential function of MIB1 gene.Methods Non-coding RNA(ncRNA)was predicted by National Genomics Data Center(NGDC).Alggen and AnimalTFDB online software were used to predict the TFBS types of MIB1 gene.GeneMANIA and STRING were used to analyze the interacting genes and proteins of MIB1.The related data were obtained through DA-VID website,and gene ontology(GO)visual analysis and Kyoto Encyclopedia of Genes and Genomes(KEGG)metabolic pathway analysis were performed.Results ncRNA could be transcribed from the promot-er region and 5'untranslated region of MIB1 gene.A total of 121 TFBS were obtained by prediction.P53 tran-scription factor could bind to the promoter region of MIB1 gene and interact with MIB1 protein.A total of 6 co-expressed genes of MIB1 were predicted online,and 20 interacting genes were screened.GO visual analysis showed that MIB1 and its interaction genes had functions in regulating the growth and differentiation of cells,tissues and organs and regulating the NOTCH signaling pathway in the biological process,and were mainly enriched in the cytoplasmic perinuclear region,cell membrane,postsynaptic dense area and so on.It had molec-ular functions such as binding NOTCH proteins and PDZ domain proteins.KEGG metabolic pathway analysis showed that MIB1 and its interacting genes were involved in 4 metabolic pathways.Conclusion MIB1 con-tains a variety of TFBS,and affects a variety of biological processes such as cell carcinogenesis and immune regulation by interacting with specific transcription factors.MIB1 may also play an important role in cell growth regulation,hematopoietic stem cell differentiation,embryonic development and neuronal information transmission through the mediation of its interacting genes and proteins.

Objective: This study was devoted to identifying natural thrombin inhibitors from traditional Chinese medicine (TCM) and evaluating its biological activity in vitro and binding characteristics. Methods: A combination strategy containing molecular docking, thrombin inhibition assay, surface plasmon resonance (SPR) and molecular dynamics simulation were applied to verify the study result. Results: Gallic acid was confirmed as a direct thrombin inhibitor with IC

Objective:To explore the effects of interpregnancy interval (IPI) on pregnancy outcomes of subsequent pregnancy.Methods:A multicenter retrospective study was conducted in 21 hospitals in China. Information of age, height, pre-pregnancy weight, IPI, history of diseases, complications of pregnancy, gestational age of delivery, delivery mode, and pregnancy outcomes of the participants were collected by consulting medical records of pregnant women who had two consecutive deliveries in the same hospital during 2011 to 2018. The participants were divided into 4 groups according to IPI:<18 months, 18-23 months, 24-59 months and ≥60 months. According to the WHO′s recommendation, with the IPI of 24-59 months group as a reference, to the effects of IPI on pregnancy outcomes of subsequent pregnancy were analyzed. Stratified analysis was further carried out based on age, history of gestational diabetes mellitus (GDM), macrosomia, and premature delivery, to explore the differences in the effects of IPI on pregnancy outcomes among women with different characteristics.Results:A total of 8 026 women were included in this study. There were 423, 623, 5 512 and 1 468 participants in <18 months group, 18-23 months group, 24-59 months group and ≥60 months group, respectively. (1) The age, pre-pregnancy body mass index (BMI), history of cesarean section, GDM, gestational hypertension and cesarean section delivery rate of <18 months group, 18-23 months group, 24-59 months group and ≥60 months group were gradually increased, and the differences were statistically significant ( P<0.05). (2) After adjusting for potential confounding factors, compared with women in the IPI of 24-59 months group, the risk of premature delivery, premature rupture of membranes, and oligohydramnios were increased by 42% ( OR=1.42, 95% CI: 1.07-1.88, P=0.015), 46% ( OR=1.46, 95% CI: 1.13-1.88, P=0.004), and 64% ( OR=1.64, 95% CI: 1.13-2.38, P=0.009) respectively for women in the IPI≥60 months group. No effects of IPI on other pregnancy outcomes were found in this study ( P>0.05). (3) After stratified by age and adjusted for confounding factors, compared with women in the IPI of 24-59 months group, IPI≥60 months would significantly increase the risk of oligohydramnios for women with advanced age ( OR=2.87, 95% CI: 1.41-5.83, P=0.004); and <18 months could increase the risk of premature rupture of membranes for women under the age of 35 ( OR=1.59, 95% CI: 1.04-2.43, P=0.032). Both the risk of premature rupture of membranes ( OR=1.58, 95% CI: 1.18-2.13, P=0.002) and premature delivery ( OR=1.52, 95% CI: 1.07-2.17, P=0.020) were significantly increased in the IPI≥60 months group. After stratified by history of GDM and adjusted for confounding factors, compared with women in the IPI of 24-59 months group, IPI≥60 months would lead to an increased risk of postpartum hemorrhage for women with a history of GDM ( OR=5.34, 95% CI: 1.45-19.70, P=0.012) and an increased risk of premature rupture of membranes for women without a history of GDM ( OR=1.44, 95% CI: 1.10-1.90, P=0.009). After stratified by history of macrosomia and adjusted for confounding factors, compared with women in the IPI of 24-59 months group, IPI≥60 months could increase the proportion of cesarean section for women with a history of macrosomia ( OR=4.11, 95% CI: 1.18-14.27, P=0.026) and the risk of premature rupture of membranes for women without a history of macrosomia ( OR=1.46, 95% CI: 1.12-1.89, P=0.005). After stratified by history of premature delivery and adjusted for confounding factors, compared with women in the IPI of 24-59 months group, IPI≥60 months would significantly increase the risk of premature rupture of membranes for women without a history of premature delivery ( OR=1.47, 95% CI: 1.13-1.92, P=0.004). Conclusions:Both IPI≥60 months and <18 months would increase the risk of adverse pregnancy outcomes in the subsequent pregnancy. Healthcare education and consultation should be conducted for women of reproductive age to maintain an appropriate IPI when they plan to pregnant again, to reduce the risk of adverse pregnancy outcomes in the subsequent pregnancy.

Objective To evaluate the risk factors and sonographic findings of pregnancies complicated by placenta increta or placenta percreta. Methods Totally, 2219 cases were retrospectively analyzed from 20 tertiary hospitals in China from January 2011 to December 2015. The data were collected based on the original case records. All cases were divided into two groups, the placenta increta (PI) group (79.1％, 1755/2219) and the placenta percreta (PP) group (20.9％, 464/2219), according to the degree of placental implantation. The risk factors and sonographic findings of placenta increta or percreta were analyzed by uni-factor and logistic regression statistic methods. Results The risk factors associated with the degree of placental implantation were age, gravida, previous abortion or miscarriage, previous cesarean sections, and placenta previa (all P<0.05), especially, previous cesarean sections (χ2=157.961) and placenta previa (χ2=91.759). Sonographic findings could be used to predict the degree of placental invasion especially the boundaries between placenta and uterine serosa, the boundary between placenta and myometrium, the disruption of the placental-uterine wall interface and loss of the normal retroplacental hypoechoic zone(all P<0.01). Conclusions Previous cesarean sections and placenta previa are the main independent risk factors associated with the degree of placenta implantation. Ultrasound could be used to make a prenatal suggestive diagnosis of placenta accreta spectrum disorders.

OBJECTIVE:To observe the effectiveness and safety of Jin's three-needle combined with Jiawei wumei pill in the treatment of menopausal insomnia.METHODS:One hundred and sixty-five patients with perimenopausal insomnia were selected from our hospital during Jan.2015-Mar.2016,and then divided into group A (n=41),group B (n=41),group C (n=41) and group D (n=42) according to random number table.Group A was given Estazolam tablet 1 mg,qd;group B was given Jin's three-needle 30 min/time,qd;group C was given Jiawei wumei pill,one pill,after breakfast and supper warm taking;group D was given Jin's three-needle combined with Jiawei wumei pill with same usage as group C.Four groups were treated for 4 weeks.PSQI score,modified Kupperman score,life quality score,serum levels of E2 and FSH were observed in 4 groups before and after treatment,and the occurrence of ADR was recorded.RESULTS:Before treatment,there was no statistical significance in above score (P＞0.05).After treatment,PSQI score and modified Kupperman score of 4 groups were decreased significantly,compared to before treatment;the group B,C,D were significantly lower than the group A;the group D was significantly lower the group B,C,with statistical significance (P＜0.05).The life quality score of 4 groups were increased significantly,and the group B,C,D were significantly higher than the group A;the group D was significantly higher than the group B,C,with statistical signifi cance (P＜0.05).E2 level of group B,C,D were significantly increased,while FSH level was decreased significantly,the improvement of group D was significantly better than group B,C;the improvement of group D was significantly better than that of group B,C,with statistical significance (P＜0.05).The incidence of ADR in group A was significantly higher than group B,C,D,with statistical significance (P＜0.01),and there was no statistical significance in the incidence of ADR among group B,C,D,with statistical significance (P＞0.05).CONCLUSIONS:Jin's three needle combined with Jiawei wumei pill is effective in the treatment of perimenopausal insomnia with good safety.

Objective To investigate the intervention effect of Qingxin-Ⅱ Recipe on myocardial cell apoptosis and its fibrosis in viral myocarditis mice and its mechanism.Methods A total of 120 Balb/c mice were randomly divided into the model group (n=50),the treatment group (n=50) and the control group (n =20).Mice in the model and treatment groups were given intraperitoneal injection of CVB3 to establish the experimental model of viral myocarditis.The control and model groups were treated with normal saline and water by intragastric administration respectively and the treatment group was given Qingxin-Ⅱ Recipe.The expression level of nuclear factor-κB (NF-κB),tumor necrosis factor (TNF-α),interleukin-1β(IL-1β),collagen type Ⅰ-A1 (COL1-A1),collagen type Ⅲ-A1 (COL3-A1),matrix metalloproteinase-9 (MMP-9),tissue inhibitor of metallproteinase-1 (TIMP-1),myocardial interstitial collagen volume fraction (CVF) and apoptosis rate (Rapo) were assessed after treatment.Results The levels of NF-κB,TNF-α,IL-1 in cardiomyocytes,serum levels of COL1-A1,MMP-9,TIMP-1,the mRNA expression levels of COL1-A1,COL3-A1,MMP-9,TIMP-1 in cardiomyocytes,CVF and Rapo were lower in the treatment and control groups than in the model group (F=21.541,12.146,32.583,4.212,6.863,4.868,9.089,8.662,7.307,6.646,4.324,41.237,respectively,all P＜0.05).No significant differences in the levels of NF-κB,TNF-α,IL-1 of cardiomyocytes,in serum levels of COL1-A1,TIMP-1 and in mRNA expression levels of COL1-A1,COL3-A1,MMP-9,TIMP-1 of cardiomyocytes between the control group and the treatment group (all P＞0.05) were found,but serum MMP-9 level was higher in the treatment group than in the control group (P =0.033).Conclusions Qingxin-Ⅱ Recipe can effectively reduce inflammatory cytokines levels,protect myocardial cells from inflammatory damages and inhibit myocardial fibrosis in viral myocarditis.

Objective To investigate the pathological changes of cardiac collagen in the elderly patients with hypertensive left ventricular hypertrophy(LVH)and the difference of collagen among the groups of essential hypertension(EH),diabetes (T2DM) under the condition of the same stage,providing pathological foundation of clinical treatment for curing diseases and the early heart protection.Methods A retrospective study was performed in 140 cases over 65 years old of EH and normal cases as control out of 3520 consecutive autopsied cases from 1954 to 2001 in Chinese People's Liberation Army (PLA) General Hospital.The pathological changes of collagen were studied with hematoxylin and eosion(HE) staining,Sirius Red F3B (SR)and immunohistochemistry staining.Myocardial interstital collagen deposition was observed with light microscope and polarization technique.Quantitative measurements on the myocardial collagen volume fraction (CVF),CVFS of type Ⅰ and type Ⅲ,and the rate of collagen type Ⅰ to type Ⅲ (Ⅰ/Ⅲ) were determined with videodensitometry.Results The CVF(6.32％ ± 0.92％) and CVF Ⅰ (5.93％ ± 0.94％)were increased significantly in EH LVH Ⅰ group (P ＜0.01) ; but,CVF Ⅲ (2.23％ ±0.38％) and Ⅰ/Ⅲ (2.69 ±0.42) did not change significantly in EH Ⅰ group compared with the control group; The changes in the aforementioned four items were increased significantly in EH LVH Ⅱ and EH LVH Ⅲ groups (P ＜0.01)compared with the control group.The CVF and CVF-Ⅰ were decreased significantly(P ＜ 0.01) ; but CVF-Ⅲ and Ⅰ/Ⅲ did not change significantly in DM LVH-I group compared with the EH LVH-I group; the CVF(4.23％ ± 0.69％) and CVF-Ⅰ (3.92％ ±0.40％) were decreased significantly(P ＜0.01); but CVF-Ⅲ(1.79％ ±0.21％) and Ⅰ/Ⅲ (2.20 ±0.20) did not change significantly in DM LVH-Ⅰ group compared with the EH LVH-Ⅰ group.Conclusions (1)The myocardial stiffness and the reduction of cardiac diastolic function deteriorated most with the development of LVH.(2)Under the condition of the same stage,the myocardial stiffness and the reduction of cardiac diastolic function deteriorated seriously in EH groups,diabetes patients,myocardial stiffness and the reduction of cardiac diastolic function deteriorated slightly.

Objective To study the effectiveness and feasibility of low intensity of aerobic bicycle ergometer training on hemiplegic stroke patients unable to perform assistive or independent ambulation.Methods Thirty stroke patients unable of assistive or independent ambulation were randomly divided into a control group and a aerobic training group.Patients in the aerobic training group performed low intensity of aerobic bicycle ergometer training for 30 min,3 times a week for 6 weeks in addition to a routine rehabilitation regime.The training duration and course of routine rehabilitation training were the same in both groups.The related cardiovascular response in aerobic training and changes in motor performance as well as the risk factors for stroke were observed in both groups.Results Twenty-four patients(12 patients in each group)completed the experiment.Patients in aerobic training group performed all training regime safely without any adverse response.Their motor function(including FMA score,Rivermead index,BI ADL ability),exercise endurance duration in exercise test,glucose level at 2 h in oral glucose tolerance test,fasting insulin level and HOMA-IR index all improved greatly as compared to the control group(P ＜ 0.05).Conclusion Low intensity of aerobic bicycle ergometer training can be safely and effectively administered in hemiplegic stroke patients unable of assistive ambulation or independent ambulation.

ObjectiveTo evaluate the usefulness of an ultrasonography-based method to examine quadriceps femoris contracting. MethodsThe thickness of bilateral rectus femoris (RF) and vastus intermedius (VI) and the cross-sectional area (CSA) of RF was measured in 10 healthy subjects （n=20） in a relaxed position and 3 isometric contraction states using ultrasonography by two examiners. The date was compared with paired t test. Half of these subjects （n=10） were also measured with MRI at rest. The date was also compared with paired t test. ResultsThere was no significant difference between MRI and static compound ultrasonography, nor between two examiners. There was a significant difference (P<0.05) in thickness of RF and VI between relaxed and isometric contraction conditions. There was no significant difference among isometric contraction conditions. There was no significant difference among measurements of RF-CSA. Conclusionultrasonography shows good validity and reliability in measuring quadriceps shape.