Consecutively hospitalized patients with confirmed coronavirus disease 2019 (COVID-19) in Wuhan, China were retrospectively enrolled from January 2020 to March 2020 to investigate the association between the use of renin-angiotensin system inhibitor (RAS-I) and the outcome of this disease. Associations between the use of RAS-I (angiotensin-converting enzyme inhibitor (ACEI) or angiotensin receptor blocker (ARB)), ACEI, and ARB and in-hospital mortality were analyzed using multivariate Cox proportional hazards regression models in overall and subgroup of hypertension status. A total of 2771 patients with COVID-19 were included, with moderate and severe cases accounting for 45.0% and 36.5%, respectively. A total of 195 (7.0%) patients died. RAS-I (hazard ratio (HR)= 0.499, 95% confidence interval (CI) 0.325-0.767) and ARB (HR = 0.410, 95% CI 0.240-0.700) use was associated with a reduced risk of all-cause mortality among patients with COVID-19. For patients with hypertension, RAS-I and ARB applications were also associated with a reduced risk of mortality with HR of 0.352 (95% CI 0.162-0.764) and 0.279 (95% CI 0.115-0.677), respectively. RAS-I exhibited protective effects on the survival outcome of COVID-19. ARB use was associated with a reduced risk of all-cause mortality among patients with COVID-19.
Angiotensin Receptor Antagonists/therapeutic use* ; Angiotensin-Converting Enzyme Inhibitors/therapeutic use* ; COVID-19 ; Humans ; Hypertension/drug therapy* ; Renin-Angiotensin System ; Retrospective Studies

Objective To investigate the risk factors for stroke in population with family history in rural areas of Zhengzhou. Methods A cluster random sampling method was used to collect 386 residents with family history of stroke from 5 villages of Zhengzhou. The participants were divided into stroke group and non-stroke group according to diagnosis. IBM SPSS STATISTICS 21.0 and SPSS Modeler 14.1 software were used to analyze the data.Results Hypertension, dyslipidemia, atrial fibrillation or arrhythmia, smoking and drinking in stroke group were significantly higher than those of the non-stroke group (P < 0.05). Logistic regression analysis indicated that hypertension (OR=35.705, 95％ CI9.045～140.950, P =0.000) and dyslipidemia (OR=2.669, 95％ CI 1.077～6.614, P = 0.034) were linked with stroke. Artificial neural network (ANN) model indicated the independent variables in predicting stroke were hypertension, dyslipidemia, smoking, drinking and atrial fibrillation or arrhythmia according significance, respectively. The accuracy of the model was 82.0％. Conclusion Among population with family history of stroke, those who had hypertension, dyslipidemia, atrial fibrillation or arrhythmia, smoking and drinking were more susceptible to develop this condition.

Objective To explore the consistency between the Chinese Version of Stressors in Nursing Students (SINS-CHI) and the Student Nurse Stress Index Scale (SNSI-CHI) in assessing the pressure of undergraduate nursing students.Methods A total of 960 nursing undergraduates from three universities in Henan province were randomly selected.SINS-CHI and SNSI-CHI were applied to all subjects and SPSS 21.0 was used to analyze the validity and reliability.Results The total score of SINS-CHI was (112.73± 26.07).The Cronbach's α was 0.926,the Guttman's partial reliability coefficient was 0.893,the test-retest reliability was 0.820,the content validity index (CVI) was 0.890,the sensitivity was 70.0％,and the specificity was 62.3％.The Yoden index was 0.323 and the area under the ROC curve was 0.710.The total score of SNSI-CHI was (58.71± 14.18).The Cronbach's α was 0.893,Guttman split-half reliability coefficient was 0.829,test-retest reliability was 0.966,CVI was 0.954,sensitivity was 71.4％,specificity was 63.6％.The Yoden index was 0.350 and the area under the ROC curve was 0.714.Conclusion The consistency of SINS-CHI and SNSI-CHI is good.

Objective To test the reliability and validity of the Chinese Version of the Student Nurse Stress Index Scale ( SNSI-CHI ) among Chinese nursing students. Methods A random sampling method was used to collect 1100 nursing students who were from two medical universities of Henan Province, China,and SPSS 17. 0 and AMOS 17. 0 software were used. Results The average total score of SNSI-CHI was 58. 46±13. 90. The Cronbach's α was 0. 886,the test-retest intra-class correlation coefficient( ICC) of SNSI-CHI was 0. 996 (95％CI:0. 992-1. 000,P<0. 01). The item-to-total correlations ranged from 0. 351 to 0. 664 ( all P<0. 01) . The content validity index( CVI) was 0. 954. The result of exploratory factor analysis ( EFA) was that three factors together explained 75. 013％ of the total variances,and the confirmatory factory analysis( CFA) also indicated a good fit (χ2/df=1. 347,GFI=0. 956,AGFI=0. 945,RMR=0. 032,RMSEA= 0. 025, NFI=0. 974, IFI=0. 993, TLI=0. 992, CFI=0. 993 ) . Criterion-related validity was between 0. 330 and 0. 903 ( all P<0. 01) . Conclusion The SNSI-CHI is proved to be reliable and valid in China, and it can be used to measure the stress of Chinese nursing students.

Bone marrow stromal cells (BMSCs) are a kind of stem cells with multiple differentiation potential in bone marrow.BMSCs have been widely used in tissue engineering,cell transplantation,gene therapy and organ transplantation,due to their characteristics of wide range of sources,weak immunogenicity weak,easily transfected by exogenous gene,long survival time in the host,multi-directional differentiation,etc.Cerebral ischemia is caused by neurological impairment,which is the most common cause of death and quality-of-life impairments.The clinical manifestations of the patients with cerebral ischemia are motor function failure,sensory dysfunction and abnormal mental consciousness.A large number of studies have reported that BMSCs transplantation has the therapeutic effects of body sensory and motor function recovery,and can treat ischemic stroke.BMSCs transplantation has brought new hope for the clinical treatment of ischemic cerebrovascular disease.In this paper,the recent progress in the study of BMSCs transplantation for ischemic stroke was reviewed.The mechanism,pathways,influencing factors and clinical application of BMSCs transplantation were summarized.

Objective To investigate expression level of endoplasmic reticulum stressmarker GRP78 in the testicular tissue in rats with different phases of morphine-dependence. To explore the role of ERS in morphine-de-pendence. Methods SD rats were divided into 6 groups: morphine (mor) -withdrawal group, mor-extinct group, mor-kindling group and their control groups, normal saline (NS)-withdrawal group, NS-extinct group, NS-kindling group. The experimental rats were injected with morphine subcutaneously on increasing dosage to establish the con-ditioned place preference (CPP) model. The rats in control groups were injected NS. Then the rats were suffered from withdrawal for 48 h, extinction and kindling by morphine, separately. The GRP78 expression level in testicular tissues of rats in the time point mentioned above were measured using Western Blot. Results The time of rats in the paired-box was (528.0 ± 81.0) s, which was significantly higher than that in the NS control group (P<0.001). It was (396.8 ± 116.9) s after extinctive phase, which was significantly higher than that the withdrawal phase of rats (P < 0.001). Also it was (396.8 ± 116.9) s after kindling with morphine which was significantly higher than that the extinctive phase of rats (P < 0.001). These changes of the time indicated that the animal models of extinction and kindling were established in the study. The GRP78 levels were down-regulated in 48 h after withdrawal (P <0.05), and increased a bit afterextinctive phase, but up-regulated highly after kindling with morphine (P < 0.01). Conclusion ERS may be related in the morphine dependence and it might play an important role of testicular dys-function in male drugabuser.

Objective To explore the regulatory role of calcium activated chloride channel (CaCC) in vascular structural remodeling in pathogenesis of pulmonary arterial hypertension (PAH) induced by high pulmonary blood flow.Method An abdominal aorta and inferior vena cava shunting operation was used to induce high pulmonary blood flow and establish a PAH rat model.Seventy-five SD rats were randomly divided into normal,sham,shunt,niflumic acid (NFA) 1 (0.2 mg/(kg · d)) and NFA 2 (0.4 mg/(kg · d)) groups.There were 15 rats in each group.Pulmonary artery pressure and vascular structural remodeling were measured,arteriole contraction ratio among these groups were compared using vascular tone analysis system,and the electrophysiology of pulmonary artery smooth muscle cell (PASMC) was recorded using patch clamp technology.Differences between multiple groups were compared through variance analysis and that between groups with q test.Result Compared with normal ((14.4 ± 1.3) mmHg,1 mmHg =0.133 kPa) and sham groups ((13.5 ± 2.3) mmHg),mean pulmonary artery pressure in shunt group ((27.4 ± 2.4) mmHg) increased significantly (P ＜ 0.05).Compared with shunt group,mean pulmonary artery pressure in NFA 1 group ((21.2 ± 2.0) mmHg) and NFA 2 group ((22.3 ± 2.0) mmHg) decreased significantly (P ＜ 0.05).Pulmonary vascular structural remodeling including pulmonary artery stenosis presented in shunt group.Compared with normal ((114.3 ± 1.2) ％) and sham ((115.5 ± 1.1) ％) groups,arteriole contraction ratio to 10-5 mol/L phenylephrine in shunt group ((132.6 ± 1.4) ％) increased significantly (P ＜ 0.05).Compared with shunt group,pulmonary vascular structural remodeling alleviated in NFA 1 and NFA 2 groups.Arteriole contraction ratio in NFA 1 group ((126.4 ± 1.3) ％) and NFA 2 group ((124.6 ± 1.0) ％) decreased significantly compared with shunt group (P ＜ 0.05).Patch clamp technique recorded typical CaCC currents.Compared with normal ((32.3 ±2.3) pA/pF) and sham groups ((35.3 ± 1.2) pA/pF),the CaCC current density of PASMC in shunt group ((51.3 ± 2.7) pA/pF) increased significantly (P ＜ 0.05).Compared with shunt group,the CaCC current density of PASMC in NFA 1 group ((40.2 ± 1.5) pA/pF) and NFA 2 group ((42.7 ± 2.2) pA/pF) decreased significantly (P ＜ 0.05).Conclusion CaCC is involved in pulmonary arterial hypertension induced by high pulmonary blood flow through regulating membrane potential.NFA attenuate pulmonary vascular structural remodeling and pulmonarv pressure through decreasing CaCC current density of PASMC membrane.

The objective of this study is to combine troponin and indicators of cardiac acoustics for synthetically evaluating cardiac fatigue of rabbits, analyzing exercise-induced cardiac fatigue (EICF) and exercise-induced cardiac damage (EICD). New Zealand white rabbits were used to conduct a multi-step swimming experiments with load, reaching an exhaustive state for evaluating if the amplitude ratio of the first to second heart sound (S1/S2) and heart rate (HR) during the exhaustive exercise would decrease or not and if they would be recovered 24-48 h after exhaustive exercise. The experimental end point was to complete 3 times of exhaustions or death from exhaustion. Circulating troponin I (cTnI) were detected from all of the experimental rabbits at rest [(0. 02±0. 01) ng/mL], which, in general, indicated that there existed a physiological release of troponin. After the first exhaustive swim, cTnI of the rabbits increased. However, with 24-hour rest, S1/S2, HR, and cTnI of the tested rabbits all returned toward baseline levels, which meant that the experimental rabbits experienced a cardiac fatigue process. After repeated exhaustion, overloading phenomena were observed, which led to death in 3 out of 11 rabbits, indicating their cardiac damage; the troponin elevation under this condition could be interpreted by pathological release. Evaluation of myocardial damage can not be based on the troponin levels alone, but can only be based on a comprehensive analysis.
Animals ; Fatigue ; Heart ; physiopathology ; Heart Rate ; Myocardium ; pathology ; Rabbits ; Swimming ; Troponin I ; blood

Objective To observe the influence of citalopram on anxiety and depression of patient with functional dyspepsia (FD).Methods One hundred and thirty-two FD patients were randomly divided into treatment group (n =68)and control group (n =64).The patients in con-trol group were given omeprazole and mosapride,while the patients in the treatment group were added citalopram based on the treatment in the control group,and meanwhile given corresponding psychology guidance.The anxiety and depression disorders were evaluated respectively by Self-rat-ing Depression Scale (SDS)and Self-rating Anxiety Scale (SAS).The symptomatic scores before treatment and on the second,fourth and eighth week of treatment,clinical efficiency and adverse reactions were observed in the two groups.Results Among 132 patients,there were 60 with de-pression and 53 patients suffering from anxiety.SDS and SAS scores on on the second,fourth and eighth week of treatment and FD symptomatic scores on the fourth and eighth weeks of treatment were obviously lower,while the overall response rate was significantly higher in treatment group than that in the control group.So the difference was statistical significant.Before and after treat-ment,there were no abnormal patients in two groups.Conclusion FD patients are usually accom-panied by anxiety and depression.The application of citalopram on the basis of routine treatment could significantly ameliorate the patients′anxiety and depression,alleviate symptoms,improve the efficiency and reduce adverse reactions.

Objective To observe the influence of citalopram on anxiety and depression of patient with functional dyspepsia (FD).Methods One hundred and thirty-two FD patients were randomly divided into treatment group (n =68)and control group (n =64).The patients in con-trol group were given omeprazole and mosapride,while the patients in the treatment group were added citalopram based on the treatment in the control group,and meanwhile given corresponding psychology guidance.The anxiety and depression disorders were evaluated respectively by Self-rat-ing Depression Scale (SDS)and Self-rating Anxiety Scale (SAS).The symptomatic scores before treatment and on the second,fourth and eighth week of treatment,clinical efficiency and adverse reactions were observed in the two groups.Results Among 132 patients,there were 60 with de-pression and 53 patients suffering from anxiety.SDS and SAS scores on on the second,fourth and eighth week of treatment and FD symptomatic scores on the fourth and eighth weeks of treatment were obviously lower,while the overall response rate was significantly higher in treatment group than that in the control group.So the difference was statistical significant.Before and after treat-ment,there were no abnormal patients in two groups.Conclusion FD patients are usually accom-panied by anxiety and depression.The application of citalopram on the basis of routine treatment could significantly ameliorate the patients′anxiety and depression,alleviate symptoms,improve the efficiency and reduce adverse reactions.