Objective:To investigate the predictive value of cardiopulmonary exercise test (CPET) indexes for major adverse cardiovascular events (MACE) in patients with coronary heart disease (CHD).Methods:This study was a retrospective cohort study. CHD patients were consecutively enrolled who procedure CPET before discharge from the Department of Cardiology, General Hospital of Northern Theater Command from November 2015 to September 2021 were enrolled. Demographic information, past medical history, CPET indexes and other baseline data were collected and the patients were followed up. Patients were divided into a MACE group and a control group according to the presence or absence of MACE. A multivariate Cox proportional hazard regression model was used to analyze the CPET indexes with predictive value for MACE in CHD patients.Results:A total of 3 800 patients were eligible for the criterion, age (57.2±8.8) years, 2 920 (76.84%) males. During a follow-up of 1 237 (695, 1 596) days, 390 (10.26%) patients were in MACE group, and 3 410 (89.74%) patients were in control group. In adjusted multivariable analysis, higher metabolic equivalent of tasks (MET) at anaerobic threshold (AT) is an independent protective factor for MACE in patients with CHD ( HR=0.75, 95% CI 0.62-0.90, P=0.002), higher VE/VCO 2 is an independent risk factor for MACE in CHD patients ( HR=1.05, 95% CI 1.02-1.07, P=0.001). Conclusion:In CPET, high MET at AT is an independent protective factor for MACE in patients with CHD, and high VE/VCO 2 is an independent risk factor for MACE in CHD patients.

Objective:To investigate the changes in cardiopulmonary exercise testing (CPET) characteristics before and after the outbreak of COVID-19 in patients with acute coronary syndrome (ACS) who underwent percutaneous coronary intervention (PCI).Methods:This is a cross-sectional study that included ACS patients who underwent PCI at the General Hospital of the Northern Theater Command from July 2018 to February 2023. Based on the timeline of the COVID-19 pandemic, patients were divided into two groups: the pre-pandemic group and the during-pandemic group, with January 2020 as the dividing line. Clinical data were collected from both groups, and a comparative analysis was performed on their postoperative CPET outcomes, including peak oxygen uptake (peak VO 2), peak metabolic equivalents (peak MET), and other indicators. Weber′s classification was used to assess cardiac function. In addition, the 7-tiem generalized anxiety disorder scale (GAD-7) and the patient health questionnaire-9 (PHQ-9) were used to assess the patients′ psychological anxiety and depression states, respectively. Multivariate logistic regression was used to analyze the influencing factors of CPET after PCI. Results:A total of 4 310 post-PCI ACS patients were included, with an average age of (58.7±9.1) years, and 3 464 (80.37%) were male. There were 1 698 patients in the pre-pandemic group and 2 612 patients in the during-pandemic group. The main indicator of the CPET, peak VO 2 (15.04±3.93) ml·min -1·kg -1 in the during-pandemic group, was lower than that in the pre-pandemic group (15.52±3.68) ml·min -1·kg -1, and the difference was statistically significant ( P<0.001). Multivariate logistic regression analysis showed that advanced age, female gender, high body mass index, elevated high-sensitivity C-reactive protein, reduced high-density lipoprotein cholesterol, smoking history, history of myocardial infarction, more severe ACS classification, and mild to moderate degree of depression were related to poor cardiopulmonary outcomes ( P<0.05). Conclusion:The COVID-19 pandemic had a negative impact on the cardiopulmonary outcomes of ACS patients after PCI. Reduced physical activity, and increased psychological stress should be given consideration and attention regarding their impact on patients′ cardiopulmonary function.

Objective To explore the effect and mechanism of berberine combined with curcumin on ath-erosclerosis(AS)by mediating M1 macrophages polarization.Methods M1-type macrophages were obtained from mouse mononuclear macrophages(RAW264.7)induced by lipopolysaccharide(LPS,100 ng/mL)and interferon(IFN)-γ(20 ng/mL).A cell model was established.The cells were divided into a control group,model group,berberine group,curcumin group and berberine plus curcumin group.Concentrations of berberine and curcumin were detected by CCK-8 assay.The expression levels of M1-type macrophage markers iNOS,TNF-α,CXCL9 and p-STAT6/STAT6 in macrophage supernatant were detected by ELISA.Levels of iNOS,TNF-α and CXCL9 mRNA were detected by RT-PCR.Levels of iNOS,STAT6 and p-STAT6 proteins in each group were detected by Western blot.After down-regulation of STAT6 level by siRNA technology,expression of p-STAT6 protein was detected by Western blot.Expression levels of iNOS,TNF-α,CXCL9 and p-STAT6 were detected by ELISA.Results In the polarization of M1 macrophages induced by LPS and IFN-γ,berberine(25 μmol/L)and curcumin(20 μmol/L)were the best concentrations as compared with other drug concentration groups,and neither alone nor combined use could significantly inhibit the viability of RAW264.7 cells(P<0.05).As compared with the normal group,iNOS,TNF-α and CXCL9 mRNA and protein levels were increased in the model group,while P-STAT6/STAT6 levels were decreased,with statistical differences(P<0.05).As compared with the model group,iNOS,TNF-α and CXCL9 mRNA and protein levels in the berberine group,curcumin group,and berberine plus curcumin group were decreased,while P-STAT6/STAT6 levels were increased,and the changes were more obvious in berberine plus curcumin group,with statistical difference(P<0.05).After transfection of STAT6 siRNA in M1 macrophages in the berberine plus curcumin group,P-STAT6 levels were down-regulated,while expressions of iNOS,TNF-α and CXCL9 were up-regulated,with statistical differences(P<0.05).Conclusions Both berberine and curcumin can inhibit the activity of M1-type macrophages and reduce inflammatory response.The action of berberine combined with curcumin is more advantageous than that of either drug alone,which may be the main mechanism of action through activation of STAT6.

During the Yan’an period, under the instructions of the CPC Central Committee and the Central Military Commission, the former Eighth Route Army Health School was expanded into China Medical University. As the first medical university founded by the Communist Party of China, this is a great practice of higher medical education in the new revolution. The school adhered to the policy of educating people with both ability and political integrity, the "saving the dying and healing the wounded, implementing revolutionary humanitarianism" has become the ideological guide and goal of the majority of revolutionary medical workers. The school provided a good teaching environment by strengthening teachers, enriching infrastructure and teaching equipment. Teachers and students have overcome difficulties and made great achievements in teaching and learning. At the same time, through the mass production movement and rectification movement, the development of the school was promoted from two aspects of material production and ideological construction. The practice of China Medical University in education policy, teaching curriculum and teaching content has certain enlightenment for today’s medical education.

Objective:To analyze the protecting role of facial nerve motor evoked potential (FNMEP) monitoring in facial nerves during the resection of cerebellopontine angle lesions.Methods:The clinical data and monitoring data of 83 patients with cerebellopontine angle lesions, accepted intraoperative facial nerve motor evoked potential (FNMEP) monitoring in our hospital from January 2019 to December 2019, were retrospectively investigated. Pre-surgical (opening dural), intraoperative and post-surgical (closing dural) FNMEP amplitudes were recorded. Relation of end (closing dura) to start (opening dura) amplitude ratio with facial nerve function grading at early-term (3 d after surgery) by House-Brackmann (H-B) grading was analyzed.Results:In these 83 patients, 75 patients (90.4%) achieved total tumor resection, and 8 patients (9.6%) achieved subtotal resection. Integrated anatomical preservation of facial nerves was achieved in all patients (100%); one (1.2%) was died for postoperatively delayed hemorrhage. Three d after surgery, facial nerve H-B grading I-II was noted in 62 patients, and the end to start amplitude ratio was 85.3% (66.8%, 93.4%); facial nerve H-B grading III was noted in 11 patients, and the end to start amplitude ratio was 45.6% (38.7%, 43.8%); facial nerve H-B grading IV was noted in 7 patients, and the end to start amplitude ratio was 23.1% (16.4%, 25.6%); facial nerve H-B grading V-VI was noted in 3 patients, and the end to start amplitude ratio was 6.7% (3.5%, 7.7%). There was a negative correlation between end to start FNMEP amplitude ratio and post-surgical early HB grading ( r s=-0.895, P=0.000). Conclusion:FNMEP is highly reliable in predicting early postoperative facial function during resection of cerebellopontine angle lesions, which can be a valid protection technique for facial nerve.

Objective: To discuss the affect of glycosylated hemoglobin (HbA1c) level for the onset of nonalcoholic fatty liver disease (NAFLD) in cohort population. Methods: An epidemiological survey of the relationship between HbA1c and NAFLD conducted in 2012 was based at cohort baseline, and three follow-up sessions conducted in 2013, 2014 and 2015. In total 2 811 subjects were included in the study after exclusion of NAFLD patients at baseline and those who lost their lives due to relocation, and death. The Cox proportional hazard model was used to analyze the relationship between glycosylated hemoglobin and other risk factors of NAFLD. Continuous variables were compared using the t-test or the Mann-Whitney test. χ ²-test was used for the measurement of categorical data. Results: A total of 2 811 subjects with mean age of 59 (58.2±9.8) years old, including 1 664 males and 1 147 females. Age, waist circumference, body mass index, systolic blood pressure, γ-glutamyltransferase and fasting blood glucose level of HbA1c abnormal group were higher than normal group. The incidence of NAFLD in the abnormal HbA1c level group (25.4%) was higher than normal group (14.9 %), and diastolic blood pressure, high-density lipoprotein cholesterol was lower than normal group and the differences were statistically significant. During the three follow-up intervals, there were 440 new cases of NAFLD, consisting 285 males and 155 females with cumulative incidence of 15.7% (440/2 811). Multivariate Cox regression analysis showed that patients with elevated HbA1c had a higher risk of developing NAFLD (HR 1.796; 95% CI 1.335~2.418; P < 0.01), and the increased HbA1c level after adjustment for gender, age, and metabolic syndrome-related factors remained an independent risk factors for NAFLD (HR 1.580; 95.0% CI 1.161-2.152; P < 0.01). Conclusion An elevated HbA1c levels have a positive predictive value for the onset of NAFLD.

Mutations or inactivation of parkin, an E3 ubiquitin ligase, are associated with familial form or sporadic Parkinson's disease (PD), respectively, which manifested with the selective vulnerability of neuronal cells in substantia nigra (SN) and striatum (STR) regions. However, the underlying molecular mechanism linking parkin with the etiology of PD remains elusive. Here we report that p62, a critical regulator for protein quality control, inclusion body formation, selective autophagy and diverse signaling pathways, is a new substrate of parkin. P62 levels were increased in the SN and STR regions, but not in other brain regions in parkin knockout mice. Parkin directly interacts with and ubiquitinates p62 at the K13 to promote proteasomal degradation of p62 even in the absence of ATG5. Pathogenic mutations, knockdown of parkin or mutation of p62 at K13 prevented the degradation of p62. We further showed that parkin deficiency mice have pronounced loss of tyrosine hydroxylase positive neurons and have worse performance in motor test when treated with 6-hydroxydopamine hydrochloride in aged mice. These results suggest that, in addition to their critical role in regulating autophagy, p62 are subjected to parkin mediated proteasomal degradation and implicate that the dysregulation of parkin/p62 axis may involve in the selective vulnerability of neuronal cells during the onset of PD pathogenesis.
Adaptor Proteins, Signal Transducing ; chemistry ; metabolism ; Animals ; HEK293 Cells ; Heat-Shock Proteins ; chemistry ; metabolism ; Humans ; Lysine ; metabolism ; Mice ; Neurons ; metabolism ; pathology ; Oxidopamine ; pharmacology ; Parkinson Disease ; metabolism ; pathology ; Proteasome Endopeptidase Complex ; metabolism ; Protein Stability ; Proteolysis ; drug effects ; Sequestosome-1 Protein ; Ubiquitin-Protein Ligases ; metabolism ; Ubiquitination ; drug effects

Objective To observe any therapeutic effect of laser irradiation on pathological inflammatory reactions in ulcerative colitis (UC) induced by oxazolone,and to investigate possible mechanisms.Methods Six rats were selected as a normal control group.Another 24 rats with UC induced by oxazolone were randomly assigned to a UC model group (n =8),a 400 mW laser group (161.3 mW/cm2,n =8),and a 200 mW laser group (80.6 mW/cm2,n =8).All the rats were fixed in custom-built devices.Those in the therapy groups were treated daily,10 min per time,for 10 days.After the end of the last irradiation session,disease activity indexes (DAIs)were observed.Rats from every group were sacrificed 24 h after the last irradiation in order to observe any pathological changes in colon tissue,the weight of fresh ulcerated tissues,and gross changes in morphology.Colon segments were stained with hematoxylin-eosin and histological lesion scoring was performed under a light microscope.Any changes in inflammatory edema in the colonic mucous membrane were observed before and after laser irradiation.Results The UC model was successfully established.Average body weight in the 400 mW laser group increased significantly more than in the UC model group,approaching that of the normal control group.DAI decreased significantly.The thickness of the epithelial mucous membrane,lamina propria and submucosa was basically restored.Histological lesion scores also improved significantly,and the weight of fresh ulcerative tissue was significantly lower.Mucous membrane ulcers,submucosa edema and inflammatory cell infiltration all were alleviated significantly,merely presenting a few inflamed cells and small amounts of periphlebitis.In the 200 mW laser group all these outcome measures improved significantly compared with the UC model group,but were not as good as in the 400 mW laser group,and the rats needed longer to recover.Conclusion Laser irradiation at 400 mW has advantages over 200 mW,and could significantly relieve the pathological inflammatory response in colonic tissue,decrease submucosa edema and ameliorate other symptoms of ulcerative colitis,at least in rats.

Objective To explore the effects and molecular mechanisms of laser therapy on serum and colon tumor necrosis factor α (TNF-α),interleukin-6 (IL-6) and interleukin-10 (IL-10) in rats with oxazolone induced ulcerative colitis (UC).Methods Thirty adult male SD rats were randomly divided into four groups:a normal group ( n =6),a UC model group ( n =8 ),a 400 mW laser treatment group ( n =8 ) and a 200 mW laser treatment group ( n =8 ).Odified oxasolone sensitization was used to induce UC models in the rats.The AsAlGa semiconductor laser used in the treatment had a power of 200 mW or 400 mW.The therapy lasted for 10 days with daily 10 min sessions.The rats were sacrificed after treatment and enzyme-linked immunosorbent assay (ELISA) was used to measure IL- 6,IL- 10 and TNF-α in serum and ulcer tissues in all groups.Results Compared with the normal group,the weights of the UC model rats were significantly lower,and they had severe mucoid bloody stool.TNF-α and IL-6 levels in serum and colon tissues increased significantly and IL-10 decreased significantly,so the UC model was successfully established.After laser treatment,body weight gain and stool moderation in rats were observed.in the 400 mW group,and average TNF-α and IL-6 levels in both serum and colon tissue decreased significantly.IL-10 increased significantly,close to the level of the normal group.In the 200 mW group,serum TNF-α and IL-6 levels were significantly lower,and IL-6 in the colon tissue was reduced significantly.TNF-α did not lessen significantly,and serum and colon tissue IL-10 levels did not improve significantly compared with the model group.Conclusions 400 mW AsAlGa semiconductor laser irradiation can effectively regulate cytokines after oxaZolone induced UC in rats in two ways.It reduces pro-inflammatory cytokines and increases the level of anti-inflammatory cytokines.This may imply one of the underlying molecular mechanisms of low energy laser treatment of UC.

Aim To evaluate the effect of expression inhibition of spermine oxidase(SMO)on the actitumor activity of polyamine analogue CPENSpm (N~1-cyclopropylmethyl-N~(11)-ethylnorspermine).Methods siRNA technique was used to inhibit expression of SMO in human lung cancer line A549.QT-RT-PCR and enzyme activity assay was performed to determine the expression level of SMO.The cell proliferation was detected by MTT assay.The apoptosis of A549 cells were evaluated by DNA degradation and Sub-G_1/flow cytometry assay.Results The A549 cell line with silenced SMO expression was successfully obtained.Basic SMO mRNA and enzyme activity levels in the SMO-siRNA plasmid transfected cells were 0.53% and 14% lower than that in the control cells respectively. Treating A549 control cells by 10 μmol·L~(-1) CPENSpm for 24 hours resulted in a 10-folds up-regulation of SMO in mRNA level and 20-fold increase in enzyme activity,but this drug-induced SMO expression was obviously prevented in SMO-siRNA plasmid transfected cells.MTT assay demonstrated that SMO expression inhibition decreased the sensitivity of A549 cells to CPENSpm exposure(0～20 μmol·L~(-1)).DNA degradation and sub-G_1 assay proved a deceased ability of CPENSpm to induce apoptosis in SMO-siRNA plasmid transfected cells.Conclusion Up-regulation of SMO by CPENSpm is possibly one of the molecular basics for its antitumor activity.