Myocardial ischemia/reperfusion injury(MIRI)occurs after cardiopulmonary bypass open heart surgery,cardiovascular intervention and thrombolytic therapy,which is the most important cause of cardiac insufficiency,heart fail-ure,and even death in patients after treatment.In recent years,studies have found that the release of endogenous active peptides can alleviate the production of MIRI,and regulating the function and action of endogenous peptides may be one of the most effective ways to treat MIRI.Dipeptidyl peptidase 4(DPP4)is an important serine protease in mammals,with enzymatic activity to hydrolyze endogenous peptides.Its primary physiological function is to metabolize short peptides,in-cluding growth factors,hormones,etc.This review aims to better understand and search for effective therapeutic targets by elucidating the impact of DPP4 on the hydrolysis of endogenous peptides in MIRI,and ultimately provide new ideas for the therapeutic effects of MIRI.

Objective:To construct and validate a risk prediction model for major complications 30 days after surgery in the elderly patients with hip fracture.Methods:A retrospective study was conducted to analyze the clinical data of 276 elderly patients with hip fracture who had been admitted to Department of Trauma and Orthopaedics, The Hospital Affiliated to Chengde Medical University from June 2019 to December 2021. There were 96 males and 180 females with an age of (74.5±9.3) years, and 139 femoral neck fractures and 137 intertrochanteric fractures. The outcome of this study was whether major complications occurred within 30 days after surgery. Multiple logistic regression analysis identified the risk factors for major complications in the elderly patients with hip fracture within 30 days after surgery. The forward step-by-step method and likelihood ratio test were used to screen the best prediction model. A nomogram was constructed to display the model. The stability and effectiveness of the model were evaluated by the receiver operating characteristic curve (ROC), Hosmer-Lemeshow goodness-of-fit test, clinical decision curve and clinical impact curve analysis.Results:Logistic regression analysis showed that decreased preoperative hemoglobin ( P< 0.05), time from admission to surgery >72 hours ( OR=3.001, 95% CI: 1.564 to 5.758, P<0.001), control of nutritional status (CONUT) score >4 points ( OR=3.394, 95% CI: 1.724 to 6.680, P<0.001), and age-adjusted modified frailty index (aamFI) >2 points ( OR=2.875, 95% CI: 1.548 to 5.339, P= 0.001), increased operation time ( OR=1.016, 95% CI: 1.006 to 1.025, P=0.001), and surgical bleeding >60 mL ( OR=2.373, 95% CI: 1.016 to 5.540, P=0.046) were independent risk factors for major complications within 30 days after surgery in the elderly patients with hip fracture. The area under the ROC curve in the logistic risk prediction model was 0.846 (95% CI: 0.799 to 0.889), and the results of Hosmer-Lemeshow goodness-of-fit test showed ( χ2=8.080, P=0.426). The clinical decision curve and clinical impact curve showed that the prediction model was accurate and effective. Conclusion:Based on the patients' preoperative hemoglobin, time from admission to surgery, control of nutritional status score, age-adjusted modified frailty index, operation time and surgical blood loss, this study has constructed successfully a risk prediction model for complications 30 days after surgery in the elderly patients with hip fracture which enables medical staff to predict the occurrence of major postoperative complications.

OBJECTIVE: To explore the clinical and molecular characteristics of a child with Congenital disorders of glycosylation (CDG). METHODS: A 4-month-old boy who had presented at the Children's Hospital Affiliated to Zhejiang University Medical School on December 31, 2019 due to feeding difficulties after birth was selected as the study subject. High-throughput sequencing was carried out for the patient, and real-time qPCR was used for validating the suspected deletion fragments and the carrier status of other members of his family. RESULTS: High-throughput sequencing revealed that the child had lost the capture signal for chrX: 153 045 645-153 095 809 (approximately 50 kb), which has involved 4 OMIM genes including SRPK3, IDH3G, SSR4 and PDZD4. qPCR verified that the copy number in this region was zero, while that of his elder brother and parents was all normal. CONCLUSION The deletion of the fragment containing the SSR4 gene in the Xq28 region probably underlay the SSR4-CDG in this child.
Aged ; Child ; Humans ; Infant ; Male ; Gene Deletion ; Glycosylation ; High-Throughput Nucleotide Sequencing ; Neoplasm Proteins ; Parents ; Siblings

Objective:Primary biliary cholangitis (PBC) and Primary Sj?gren′s syndrome (pSS) are autoimmune epithelial inflammatory diseases that share many common clinical symptoms. The aim of this study was to investigate the differences and diagnostic value of Autotaxin (ATX) in PBC and SS.Methods:The clinical data of 237 cases diagnosed with PBC, PBC secondary to SS, pSS and healthy individuals(HC) between September 2020 and September 2021 were retrospectively analyzed. The levels of ATX in each group were measured by enzyme-linked immunosorbent assay (ELISA), and the corresponding sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and area under the curve ( AUC), etc were analyzed. Normally distributed data were expressed as mean ±SD and non-normally distributed as median (IQR). The differences and correlations between ATX and the biochemical tests in each group were assessed by applying the Mann-Whitney U test, Spearman correlation analysis, etc. P<0.05 was considered statistically significant difference. Results:The results showed that ATX was positive in 33.9%, 33.3% and 53.3% for PBC, PBC secondary SS, and pSS, respectively, with the specificities of 93.1%, 100% and 93.2%, respectively. The highest accuracy was achieved in pSS and the sensitivity and specificity were 86.5% and 93.2%, which were higher than those in PBC group(56.8%, 93.1%), respectively. Compared with HC [32.6(21.8, 60.5)ng/ml], ATX levels in PBC[59.3(48.6, 86.3)ng/ml, U=1 750.50, P<0.001], PBC-SS [73.6 (53.3,102.4)ng/ml; U=199.00, P<0.001], and pSS [152.6 (97.4,192.1)ng/ml, U=264.00, P<0.001] were elevated with significant difference ( P<0.05). ATX levels showed a decreasing trend from the pSS group to the HC group. ATX in PBC group[AUC(95% CI)= 0.73(0.651,0.812), P<0.001], PBC secondary SS group [AUC(95% CI)=0.82(0.730, 0.912), P<0.001], and pSS group [AUC(95% CI)=0.94(0.898, 0.984), P<0.001] had prediction accuracy. ATX was associated with total protein ( r=-0.31, P=0.041) level and glutaminase (r=-0.26, P=0.024) level. Conclusion:ATX has diagnostic value in both PBC and SS, and with higher sensitivity and specificity for the latter.

Objective To explore the mechanism of Jiawei Bazhen Yimu Capsule on premature ovarian failure rats from the perspective of metabolomics.Methods Female SD rats were randomly divided into sham operation group,model group and Jiawei Bazhen Yimu Capsule low,medium and high dose groups,with 10 rats in each group.The model of premature ovarian failure was replicated by removing bilateral ovaries of rats and administered intragastrically once a day for 21 days.The serum samples of rats in each group were analyzed by ultra-high performance liquid chromatography-quadrupole-time of flight tandem mass spectrometry(UPLC-Q-TOF-MS).Combined with multivariate statistical analysis,the effects of Jiawei Bazhen Yimu Capsule on differential metabolites in rats with premature ovarian failure were investigated.The differential metabolites identified by MELIN database or KEGG database were imported into Metaboanalyst 5.0 online platform for metabolic pathway analysis.Results A total of 18 potential differential metabolites were screened and identified.Most of the differential metabolites showed a good callback trend after intragastric administration of Jiawei Bazhen Yimu Capsule.These 18 differential metabolites were enriched into 2 metabolic pathways(Pathway Impact>0.1),which were glycerophospholipid metabolism and arachidonic acid metabolism pathways.Conclusion The therapeutic effect of Jiawei Bazhen Yimu Capsule on premature ovarian failure may be related to improving the level of differential metabolites in serum and restoring normal metabolic activities in rats.

Objective:To explore the prognostic value of the serum concentration of human soluble stromelysin-2(sST2)combined with ultrasonic left ventricular diastolic function parameters for elderly patients with septic shock.Methods:This prospective study involved 150 elderly patients with septic shock admitted to the intensive care unit(ICU)of the First Hospital of Jiaxing between May 2019 and May 2022.Data on the following parameters were recorded on days 1, 3, 5, and 7 in the ICU: sST2 concentration, mitral early-diastolic inflow peak velocity(E), mitral late-diastolic inflow peak velocity(A), E/A ratio, early diastolic mitral annular velocity(e'), and E/e' ratio.According to the 28-day prognostic outcome obtained during follow-up, patients were divided into a survival group and a death group to compare differences in values of the above parameters between the two groups and at different time points.Logistic regression was used to analyze independent risk factors for 28-day mortality.The receiver operating characteristic(ROC)curve was used to analyze the predictive value for 28-day mortality, and further risk stratification was performed according to optimal cut-off values to compare differences in 28-day mortality under different risk stratification methods.The Kaplan-Meier survival curve was used to compare 28-day cumulative survival under different risk stratification methods and analyze the predictive value of the combination of the parameters for 28-day mortality.Results:On day 5 following ICU admission, e' was lower and E/e' and sST2 were higher in the death group than in the survival group.Univariate and multivariate Logistic regression analysis suggested that sST2(odds ratio: 1.010, P<0.001)was an independent risk factor for 28-day mortality in elderly patients with septic shock.sST2 had a sensitivity of 50.2%, a specificity of 79.1%, and an area under the curve of 0.660 for predicting 28-day mortality in patients with septic shock.The sST2 concentration was 89.3 μg/L on day 5 after ICU admission, which was the clinical cutoff point for predicting 28-day mortality.Based on the risk stratification of sST2 levels, the 28-day mortality rate was higher in the sST2>89.3 μg/L group than in the sST2≤89.3 μg/L group.Kaplan-Meier survival analysis showed that the 28-day cumulative survival rate was significantly lower in the sST2>89.3 μg/L group than in the sST2≤89.3 μg/L group(44.0% vs.66.7%, log-rank test: χ2=9.101, P=0.003).The receiver operating characteristic curve showed that the combination of sST2, e', and E/e' significantly improved the prediction efficiency of 28-day mortality in elderly patients with septic shock, with an area under the curve of 0.844, a sensitivity of 89.7%, and a specificity of 66.5%. Conclusions:sST2 is an independent risk factor for 28-day mortality in elderly patients with septic shock.When combined with e' and E/e', sST2 can more accurately evaluate the survival prognosis of these patients.

Objective:To investigate the status quo of subclinical thyroid diseases in the faculty and staff of a university and to explore their affecting factors.Methods:A total of 4 219 faculty and staff members who met the exclusion criteria and underwent the health examination in the Community Health Service Center of Beijing Jiaotong University in 2021 were enrolled in the study. General clinical data and laboratory findings of the enrolled subjects were collected. According to the upper and low reference range of thyroid stimulating hormone (TSH) in our laboratory (0.35-5.5 μIU/ml), subjects were classified into subclinical hyperthyroidism group, subclinical hypothyroidism group and normal thyroidism group. The association of gender, age and body mass index (BMI), as well as the metabolic indices with the prevalence of subclinical thyroid disease was analyzed.Results:The prevalence rates of subclinical hypothyroidism and subclinical hyperthyroidism were 4.10% (173/4 219) and 0.69% (29/4 219), respectively. The prevalence of subclinical thyroid diseases in females was higher than that in males(5.90% (77/2 101) vs. 3.66%(125/2 018),χ 2=11.58, P<0.05); there was a significant difference in prevalence among different age groups(χ 2=39.49, P<0.05)and the prevalence increased with the age. There were significant differences in levels of total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), diastolic blood pressure(DBP), fasting blood glucose (FBG), free triiodothyronine (FT 3), free thyroxine (FT 4), thyroglobulin antibody (TGAb) and thyroid peroxidase antibody (TPOAb) among three groups ( P<0.05). TSH levels were positively correlated with the age ( r=0.58, P<0.001), and levels of TG ( r=0.66, P<0.001), TC ( r=0.67, P<0.001), LDL-C ( r=0.62, P<0.001), TPOAb ( r=0.78, P<0.001), TGAb ( r=0.77, P<0.001); was negatively correlated with FBG ( r=-0.50, P<0.001). Conclusion:The prevalence of subclinical thyroid diseases among faculty and staff of the studied university is relatively high, and it is related to gender, age, thyroid antibodies, blood glucose and lipid levels.

Objective: To investigate adolescent haze weather health protection behavior, and to provide scientific basis for behavioral intervention and health guidance for adolescents in haze weather. Methods: From June 2015 to April 2016, 1 025 adolescents were selected from 22 classes in two middle schools of Baoding City, Hebei Province, by stratified cluster sampling method. General information questionnaire and the Brief Haze Weather Health Protection Behavior Assessment Scale Adolescent Version (BHWHPBAS AV) were used. Multiple linear regressions were conducted to explore factors affecting adolescent haze weather health protection behavior. Different models were used to confirm associations between influencing factors and BHWHPBAS AV scores. Results: Adolescents had a low overall score of BHWHPBASAV (45.81±13.16). The score rate of self adjustment after haze weather was the highest (64.54%). The score rate of obtaining relevant knowledge before haze weather was the lowest (50.28%). Compared with adolescents in urban area, rural adolescents had a lower BHWHPBAS AV score ( β=-3.20, P <0.01). Compared with students (living with parents), those living without parents had a lower BHWHPBAS AV score ( β=-4.16, P =0.01). Compared with students never receive physical examination,those had received physical examination during the past years had a higher BHWHPBAS AV score ( β=4.44，5.66，9.04, P <0.01). Compared with students with no knowledge of respiratory system diseases, those with moderate to sufficient knowledge had a higher BHWHPBAS AV score ( β=9.34，12.19，P <0.01). These associations were stable and consistent.Multiple linear regression analysis showed that residence, residence with parents, physical examination and knowledge of respiratory diseases were the relevant factors of BHWHPBAS AV score ( P <0.05). Conclusion Adolescent haze weather health protection behavior level is low and is affected by many factors. Cooperation should be strengthened to conduct behavioral interventions and health guidance on haze health protection for adolescents, so as to promote healthy growth of adolescents.

Objective:To investigate the characteristics of newly diagnosed patients with chronic obstructive pulmonary disease (COPD) in Shenzhen primary care.Methods:Random sampling was conducted in 10 jurisdictions of Shenzhen, permanent residents who were over 40 years old and lived for more than 6 months were included for lung function test, COPD Population Screener (COPD-PS) questionnaire and information survey, the prevalence of COPD was estimated, and statistical comparison was made between the two groups of subjects with newly diagnosed and previously diagnosed COPD.Results:Among 3 916 subjects, 3 591 had completed the whole screening process. The results showed that 280 COPD patients were diagnosed and the estimated standardized prevalence of COPD was 5.92% (95% CI: 4.05-8.34). Among them, 251 (89.64%) were newly diagnosed COPD patients and 29 (10.36%) were previously diagnosed COPD patients. Compared with previously diagnosed COPD, the proportion of female in the newly diagnosed COPD was higher (50.20% vs 10.34%, P<0.001), educational level in the newly diagnosed COPD was lower (the proportion of primary school and below was higher, 42.23% vs 20.69%, P=0.023), the proportion of those with frequent wheezing symptoms in the newly diagnosed COPD was lower (4.78% vs 51.72%, P<0.001), the proportion of those with mild degree of airway obstruction (GOLD 1) in the newly diagnosed COPD was higher (81.67% vs 20.69%, P<0.001). The detection rates of COPD-PS in newly diagnosed COPD and previously diagnosed COPD were 43.03% and 41.38% respectively. The area under the receiver operating characteristic curve of COPD-PS was 0.705. Conclusion:The phenomenon of insufficient diagnosis of COPD in Shenzhen primary care is common and we should vigorously popularize pulmonary function examination.

ObjectiveTo investigate the effect of Jiawei Bazhen Yimu capsule on serum sex hormones， sexual organs and estrogen signaling pathway in female rats with premature ovarian failure. MethodThe key target proteins of Jiawei Bazhen Yimu capsule in the treatment of premature ovarian failure were screened out by network pharmacology analysis. Female healthy SD rats were selected, and the rat model of premature ovarian failure was established by ovariectomy. Fifty ovariectomized rats were randomly divided into a model group, an estradiol (E₂) valerate group, and Jiawei Bazhen Yimu capsule low, medium, and high-dose groups. Another 10 healthy female rats were set as a sham operation group. The sham operation group and the model group were given distilled water by gavage, and other administration groups were given corresponding doses of drugs by gavage. After 21 d, the serum hormone levels of female rats were measured, including E₂, progesterone (P), follicle stimulating hormone (FSH), and luteinizing hormone (LH). Immunofluorescence staining (IF) was used to detect the protein expression levels of estrogen receptor 1 (ESR1), estrogen metabolism P4503A4 enzyme (CYP3A4), and P45019A1 enzyme (CYP19A1) in the uterine tissues of female rats. ResultAs compared with the model group, the serum E₂ and P levels of female rats in the Jiawei Bazhen Yimu capsule low, medium, and high-dose groups were significantly increased. Jiawei Bazhen Yimu capsule improved the endometrial status of female rats and increased positive expression of ESR1, CYP3A4, and CYP19A1 in the uterine tissues of female rats (P<0.05). ConclusionThe mechanism of Jiawei Bazhenyimu capsule in the treatment of premature ovarian failure may be related to its hormone-like effect and activation of the estrogen signaling pathway.