Objectives:To investigate the impact of resting heart rate on the risk of all-cause mortality in ultra-high risk atherosclerotic cardiovascular disease(ASCVD)patients. Methods:A total of 3 645 patients with ultra-high risk ASCVD(as defined in the 2023 Chinese Lipid Management Guidelines)were screened from the 2006 to 2020 Kailuan Study cohort,and after excluding 602 patients with missing resting heart rate,3 043 patients were included in the final analysis.Patients were divided into＜68 beats/min group(n=744),68-74 beats/min group(n=786),75-80 beats/min group(n=760),and≥81 beats/min group(n=753)according to the resting heart rate.Cox proportional regression model was used to estimate the hazard ratios(HRs)and 95%CI for all-cause mortality associated with the different resting heart rate groups and every 10 beats/min increase of resting heart rate.The dose-effect relationship of resting heart rate level and all-cause mortality was assessed by a restricted cubic spline regression model.The Kaplan-Meier method was applied to calculate the cumulative all-cause mortality in different groups,and the differences were compared using log-rank test. Results:The median follow-up time was 5.81(3.46,9.64)years,there were 772(25.37%)all-cause deaths during follow up.After adjusting major confounding factors,the results showed that compared with＜68 beats/min group,the risk of all-cause mortality in 75-80 beats/min group and≥81 beats/min group increased by 24%(HR=1.24,95%CI:1.01-1.52,P=0.047)and 47%(HR=1.47,95%CI:1.20-1.81,P＜0.001),respectively;the risk of all-cause mortality in 68-74 beats/min group was similar(HR=1.06,95%CI:0.86-1.31,P=0.625).In addition,an increase of 10 beats/min in resting heart rate was associated with a 13%increase in the risk of all-cause mortality(HR=1.13,95%CI:1.07-1.19,P＜0.001).In stratified analyses,it was found that for every 10 beats/min increase in resting heart rate,women faced a higher risk of all-cause mortality than men,and patients＜65 years old faced a higher risk of all-cause mortality than patients≥65 years old.The restricted cubic spline analysis also showed that resting heart rate was linearly associated with the risk of all-cause mortality(Poverall＜0.001,Pnon-linear=0.933),and the risk increased significantly with resting heart rate＞70 beats/min. Conclusions:Increased resting heart rate is linearly associated with increased risk of all-cause mortality in patients with ultra-high risk ASCVD.The appropriate intervention cut-off point of resting heart rate for ultra-high risk ASCVD patients may be＞75 beats/min.

Objective:To investigate the impact of non-high-density lipoprotein cholesterol (non-HDL-C) level on major adverse cardiovascular and cerebrovascular events (MACCE) and all-cause mortality in the Kailuan Study cohort undergoing revascularization.Methods:This is a prospective cohort study, with participants from the Kailuan Study cohort who participated in physical examinations from 2006 to 2020 and received revascularization therapy for the first time. According to the level of non-HDL-C, the study subjects were divided into 3 groups:<2.6 mmol/L group, 2.6-<3.4 mmol/L group, and≥3.4 mmol/L group. Annual follow-up was performed, and the endpoint events were MACCE and all-cause mortality. Cox proportional regression model was implemented to estimate the impact on MACCE and all-cause mortality associated with the different non-HDL-C groups. The partial distributed risk model was used to analyze the impact of different non-HDL-C levels on MACCE event subtypes, and death was regarded as a competitive event. The restricted cubic spline regression model was used to explore the dose-response relationship between non-HDL-C level and all-cause mortality, MACCE and its subtypes.Results:A total of 2 252 subjects were enrolled in the study, including 2 019 males (89.65%), aged (62.8±8.3) years, the follow-up time was 5.72 (3.18, 8.46) years. There were 384 cases(17.05%) of MACCE and 157 cases(6.97%) of all-cause mortality. Compared with patients with non-HDL-C≥3.4 mmol/L, patients with non-HDL-C<2.6 mmol/L were associated with a 38% reduced risk of MACCE after revascularization [ HR=0.62(95% CI: 0.48-0.80)]. Every 1 mmol/L decrease in non-HDL-C was associated with a 20% reduction in the risk of MACCE [ HR=0.80(95% CI: 0.73-0.88)]. The results of restricted cubic spline also showed that non-HDL-C levels after revascularization therapy were positively correlated with MACCE events (overall association P<0.001, non-linear association P=0.808). For all-cause mortality, compared to the non-HDL-C≥3.4 mmol/L group, the HR for all-cause mortality after revascularization in non-HDL-C<2.6 mmol/L group was 0.67(95% CI: 0.46-1.01). Every 1 mmol/L decrease in non-HDL-C was associated with a 15% reduction in the risk of all-cause mortality [ HR=0.85(95% CI: 0.73-0.99)]. The restricted cubic spline results showed a linear association between non-HDL-C levels after revascularization therapy and the risk of all-cause mortality (overall association P=0.039, non-linear association P=0.174). Conclusion:The decrease in non-HDL-C levels after revascularization were significantly associated with a reduced risk of MACCE and all-cause mortality.

Objectives:To investigate the association of trajectories of atherogenic index of plasma(AIP)with the risk of atherosclerotic cardiovascular disease(ASCVD). Methods:A total of 51 831 employees and retirees who participated in Kailuan Group health examination for three consecutive times from 2006 to 2010 were included in this study.AIP was calculated using the log(triglycerides[TG]/high-density lipoprotein-cholesterol[HDL-C])formula.AIP trajectory models were fitted by the SAS Proc Traj program,and according to AIP trajectory,the subjects were divided into low stability group(n=11 114),low to moderate stability group(n=21 647),medium to high stability group(n=13 659),and high stability group(n=5 411).Kaplan-Meier method was used to calculate the cumulative incidence of ASCVD in different groups and compared by log-rank test.Cox proportional risk regression model was used to analyze the effects of different AIP trajectories on ASCVD risk. Results:Finally,51 831 patients were included in the analysis.During a mean follow-up of(10.19±2.22)years,5 142(9.92%)subjects developed ASCVD,4 013(7.74%)subjects died.Cox regression analysis after adjusting for confounding factors showed:compared with the low stability group,the risk of ASCVD increased by 13%(HR=1.13,95%CI:1.04-1.23,P=0.003)and 20%(HR=1.20,95%CI:1.10-1.31,P＜0.001)and 41%(HR=1.41,95%CI:1.27-1.57,P＜0.001)in the low to moderate stability group,moderate to high stability group and high stability group,respectively,and the risk increased gradually(Ptrend＜0.001).Stratified analysis showed that the risk of ASCVD in people aged＜65 years and low-density lipoprotein cholesterol(LDL-C)＜3.4 mmol/L with long-term high levels of AIP was higher than that in people aged≥65 years and LDL-C≥3.4 mmol/L(both Pinteraction＜0.01). Conclusions:In Kailuan Study cohort,those with long-term high levels of AIP had a higher risk of ASCVD,and the risk gradually increased.In addition,we found that the risk of ASCVD in people with long-term high levels of AIP was higher in＜65 years old than in≥65 years old,and the risk of ASCVD in people with LDL-C＜3.4 mmol/L was higher than that in people with LDL-C≥3.4 mmol/L.

Objective To analyze the incidence trend of hand-foot-mouth disease (HFMD) and its correlation with meteorological factors in Children in Kaizhou District, Chongqing from 2018 to 2021, and to provide a theoretical basis for the diagnosis and treatment of HFMD in children. Methods The HFMD epidemic information was collected from 2018 to 2021 in Kaizhou District of Chongqing by using the China Disease Surveillance Information and Report Management System. The epidemiological characteristics of HFMD were descriptively analyzed, and the correlation between HFMD incidence and meteorological factors was analyzed by multiple regression. Results A total of 5 121 HFMD cases were reported in Kaizhou District of Chongqing from 2018 to 2021, with an average annual incidence of 143.30/100 000. The incidence of HFMD fluctuated from 120.87/100,000 to 159.78/100,000 from 2018 to 2021, showing a downward trend year by year. There were 2929 males and 2192 females with HFMD. The incidence of HFMD was the highest in early childhood (70.13/100 000), followed by pre-school age (43.06/100 000). There was significant difference in the incidence of HFMD among different age groups (χ²=53.497, P<0.05). The cases were mainly scattered children (3127 cases, 61.06%). The second was nursery children (1627 cases, 31.77%). In addition, there were 289 cases of students (5.64%). There were 1084 laboratory-confirmed cases in Kaizhou District of Chongqing from 2018 to 2021, including 269 (24.82%) children with EV71 infection, 178 (16.42%) children with Cox A16 infection, and 637 (58.76%) children with other enterovirus infections. There were significant differences in pathogen composition among different years (Z=32.75, P<0.05). From 2018 to 2021, the proportion of EV71 increased year by year, while COX16 and other enterovirus infections showed a downward trend year by year. Average daily temperature (OR=1.873) and average daily pressure (OR=-1.498) were independent risk factors for HFMD in Kaizhou District of Chongqing (P<0.05). Conclusion The reported incidence of HFMD in Kaizhou District of Chongqing shows a decreasing trend, and the incidence is closely related to temperature and atmospheric pressure. It is still necessary to strictly implement the prevention and control measures in key population in the season of high incidence. The main virus is EV71, which can be vaccinated with EV71 HFMD vaccine to reduce the occurrence of severe cases.

Objective To investigate the death prognosis and risk factors of extensively drug-resistant Acinetobacter baumannii in hospitalized elderly patients with hematological infection, so as to facilitate clinical prevention and treatment. Methods The elderly (> 80 years old) hospitalized patients with hematological infection in our hospital from 2015 to 2021 were selected for analysis. Firstly, 314 patients with extensively drug-resistant Acinetobacter baumannii hematological infection were distinguished by etiological analysis. A total of 98 cases of death were detected during hospitalization (later referred to as the observation group). By comparing with the surviving patients (216 cases) (later referred to as the control group), the general data of patients with XDRAB infection were collected, and the risk of death and its influencing factors were analyzed. Results In the study, the proportion of patients in the observation group who used catheters was higher, the catheter retention time was longer, the acute physiology and chronic health status II scores were higher, and the proportion of patients who lost self-care ability was also higher. Conclusion The death of blood borne infection of extensively drug-resistant Acinetobacter baumannii in elderly patients is affected by many factors. Among them, patients who use catheters for a long time, have poor self-care ability and lose self-care ability have a higher risk of death, which is worthy of clinical attention.

Objective To investigate the impacts of sirolimus (SRL)on the survival time of graft and the differentiation and proliferation of regulatory T cell (Treg ) of spleen in mouse heterotopic heart transplantation model. Methods Male BALB /c → C57BL/6 mice cervical heterotopic heart transplantation model was established by Cuff method. The mice were divided into 3 groups randomly with 10 mice in each group. The control group received no treatment of special medicine after operation. Mice in SRL group were gavaged with SRL 10 mg/(kg·d)at 1-14 d after operation. Mice in ciclosporin (CsA)group were gavaged with CsA 30 mg/(kg·d) at 1-14 d after operation. The survival time of cardiac grafts were recorded. The spleen was procured after asystole of cardiac graft or 14 d after operation. Mononuclear cells were isolated and the proportion of CD4 +CD25 +Treg in CD4 +T cell (CD4 +CD25 +Treg%)were detected by flow cytometry and reverse transcription polymerase chain reaction (RT-PCR)was used to examine the expression of Foxp3 messenger ribonucleic acid (mRNA ) semi-quantitatively. Results Compared with the control group,the survival time of cardiac grafts prolonged significantly in SRL and CsA group (all in P <0.01 ),but no significant difference was observed between SRL and CsA group (P>0.05 ). Compared with the control group,CD4 +CD25 +Treg% significantly decreased in the spleen of CsA group and significantly increased in SRL group (all in P<0.01 ). And significant difference was observed between SRL and CsA group (P<0.01). Expression of Foxp3 mRNA of T lymphocyte in the spleen of SRL group was significantly higher than those in control and CsA group (P<0.01). And expression of Foxp3 mRNA in control group was significantly higher than that in CsA group (P<0.01 ). Conclusions In mouse heart transplantation model,SRL can prolong the survival time of graft and promote the proliferation and growth of CD4 +CD25 +Treg to facilitate the establishment of immune tolerance.

Objective To compare the curative effect of anatomical plate and locking plate in treatment of calcaneous intraarticular fracture. Methods 67 petiants with calcaneous intraarticular fracture were randomly divided into anatomical plate group (n=33) and locking plate group (n=34) . The Bo..hler angle, the Gissane angle, the length of calcaneal axis, the width and height of calcaneous and the Maryland grade were compared at 1 week and 6 month after operation. Results (1) week after operation, the Bo..hler angle, the Gissane angle, the height and width of calcaneous, the length of calcaneal axis, the Maryland grade had no significant difference between 2 groups . 6 months after operation, the Bo..hler angle, the Gissane angle, the height of calcaneous had significant differe nce between 2 groups. There was no significant difference in the length of calcaneal axis and the grade of Maryland between 2 groups. Conclusions The locking plate group is better than anatomical plate group in major anatomical measure indicators in 6 months follow up. The therapy of locking plate is worth of clinical promotion.

OBJECTIVETo explore the feasibility of establishing an isolated porcine liver machine perfusion model and assess its value in high-intensity focused ultrasound studies.

METHODSTwenty-one isolated porcine livers were perfused with autologous blood for 4 h through dual vessels (portal vein and hepatic artery) cannulation using an extracorporeal circulation machine under a sub-normothermic perfusion condition. The perfusion model was assessed by monitoring the liver color, texture, liver weight gain, hemodynamic parameters, color Doppler flow imaging, bile output and histopathology.

RESULTSNineteen isolated porcine livers were successfully cannulated with dual vessels, and failure of hepatic artery intubation occurred in two porcine livers. After machine perfusion for 4 h, the isolated livers maintained a soft texture with stable hemodynamic levels within relative normal physiological ranges. The bile output was more than 3 ml/h within the initial 3 h of perfusion. Histopathological examination demonstrated no morphological or structural changes of the liver tissues.

CONCLUSIONThe isolated porcine liver perfusion model is stable and feasible, and can be used for high-intensity focused ultrasound studies.

Animals ; Equipment Design ; Extracorporeal Circulation ; instrumentation ; methods ; Hemodynamics ; Liver ; blood supply ; diagnostic imaging ; Liver Circulation ; physiology ; Swine ; Ultrasonography

BACKGROUND:Subcutaneous fat of human body is a rich reservoir of adipose derived stromal stem cells(ADSCs).ADSCs can proliferate rapidly when being cultured in vitro,and has the capacity of multi-directional differentiation.ADSCs attracted much attention in research of tissue engineered seed cells.OBJECTIVE:To isolate and culture stromal vascular fraction(SVF)cells from rabbit subcutaneous fat in vitro,and to testify whether it has multiple differentiation capacity.METHODS:SVF cells were isolated in vitro from rabbits,and cultured under standard condition.Cellular surface antigens CD44,CD45 and CD29 of passage 3 SVF cells were examined using flow cytometry.Passage 3 SVF calls were induced to differentiate into osteoblasts,chondrocytes,and lipocytes.Oil red staining was used to examine lipocyte induction.Alkaline phosphatase(ALP)staining,alizarin red staining and von Kossa staining were used to examine osteoblast induction.Type Ⅱ collagen immunohistochemical staining and type Ⅱ collagen mRNA RT-PCR were used to examine chondrocyte differentiation.RESULTS AND CONCLUSION:Primary SVF cells were multi-angular or short spindle-shaped.Passage 3 SVF calls were long spindle-shaped.Flow cytometry showed CD44+,CD29+,CD45.Oil red staining exhibited positive reaction in lipocyte induction group.ALP staining,alizarin red staining and Von kossa staining demonstrated positive reactions in osteoblast induction group.Type Ⅱ Collagen immunohistochemical staining and alcian blue staining have suggested positive reactions at 14 days of chondrogenic induction group.RT-PCR of type Ⅱ collagen mRNA test showed that the product band had strong signal at 14 days of chondrogenic induction group compared with that before induction.Above mentioned results have indicated that SVF cells isolated from rabbit subcutaneous fat have identical surface makers of stem cells,and have the ability to differentiate into lipocytes,ostsoblasts and chondrocytes in vitro by induction,and it could be concluded that the SVF cells were ADSCs.

BACKGROUND: Studies demonstrated that small intestinal submucosa (SIS) had no immunogenicity, which can not lead to rejection following transplantation, thus, this is an ideal skin substitutes for natural skin.OBJECTIVE: Basic fibroblast growth factor (bFGF) gene was transfected into bone marrow mesenchymal stem cells (BMSCs),and combined the cells with SIS to construct tissue-engineered skin.METHODS: BMSCs were obtained from Japanese big-earad rabbits, and in vitro cultured. Then the subculturad BMSCs were transfected by pCDNA3.1 plasmid, followed by incubation on swine SIS to construct the tissue-engineered skin. The growth of cells and phenotype of BMSCs were detected by flow cytometry. In addition, the result of transfecting BMSCs with pCDNA-bFGF vector was measured by Western blot, and the structure of tissue-engineered skin was observed.RESULTS AND CONCLUSION: After passaged, BMSCs were grown quickly with Iong-fusiform shape. The cells were positive expressed CD90 and CD44, but negative expressed CD45. bFGF had been transfected into BMSCs, and stable expressed. The transfected BMSCs grew well in SIS. By this method, tissue-engineered skin can be constructed in vitro.