Background::Carotid intima-media thickness (IMT) and diameter, stiffness, and wave reflections, are independent and important clinical biomarkers and risk predictors for cardiovascular diseases. The purpose of the present study was to establish nationwide reference values of carotid properties for healthy Chinese adults and to explore potential clinical determinants.Methods::A total of 3053 healthy Han Chinese adults (1922 women) aged 18-79 years were enrolled at 28 collaborating tertiary centers throughout China between April 2021 and July 2022. The real-time tracking of common carotid artery walls was achieved by the radio frequency (RF) ultrasound system. The IMT, diameter, compliance coefficient, β stiffness, local pulse wave velocity (PWV), local systolic blood pressure, augmented pressure (AP), and augmentation index (AIx) were then automatically measured and reported. Data were stratified by age groups and sex. The relationships between age and carotid property parameters were analyzed by Jonckheere-Terpstra test and simple linear regressions. The major clinical determinants of carotid properties were identified by Pearson’s correlation, multiple linear regression, and analyses of covariance.Results::All the parameters of carotid properties demonstrated significantly age-related trajectories. Women showed thinner IMT, smaller carotid diameter, larger AP, and AIx than men. The β stiffness and PWV were significantly higher in men than women before forties, but the differences reversed after that. The increase rate of carotid IMT (5.5 μm/year in women and 5.8 μm/year in men) and diameter (0.03 mm/year in both men and women) were similar between men and women. For the stiffness and wave reflections, women showed significantly larger age-related variations than men as demonstrated by steeper regression slopes (all P for age by sex interaction <0.05). The blood pressures, body mass index (BMI), and triglyceride levels were identified as major clinical determinants of carotid properties with adjustment of age and sex. Conclusions::The age- and sex-specific reference values of carotid properties measured by RF ultrasound for healthy Chinese adults were established. The blood pressures, BMI, and triglyceride levels should be considered for clinical application of corresponding reference values.

Objective To analyze the correlation between cumulative fluid balance volume and increasing plasma volume and aggravated clinical congestion symptoms in patients with heart failure on admission for 1～7 d,and to explore the application value of cumulative fluid balance volume in predicting volume overload.Methods Using the convenience sampling method,235 heart failure patients hospitalized from October 2022 to February 2023 in a total of 3 tertiary hospitals in Nanjing,Lianyungang,Jiangsu Province,and Zhumadian,Henan Province,were selected and classified into an increasing/decreasing plasma volume group and an aggravated/alleviated clinical congestion symptoms group.General information,clinical characteristics,and 1～7 d cumulative fluid balance volume of the study subjects were collected to compare the differences in cumulative fluid balance volume between the 2 groups.Logistic regression was used to analyze the effect of cumulative fluid balance volume on plasma volume and clinical congestion symptoms.Receiver operating characteristic curves were used to analyze the optimal cutoff value of cumulative fluid balance volume for predicting increasing plasma volume and aggravated clinical congestion symptoms.Results Excluding 15 pat ients who were discharged early and 3 patients with inaccurate records of fluid intake and excretion,a total of 217 patients were included.The incidence of positive fluid balance was lowest on day 1,at 65.90%,with the smallest cumulative volume of(0.235±0.983)L;the highest incidence of positive balance occurred on day 6,at 75.58%,with the largest cumulative volume of(2.444±5.445)L.The cumulative fluid balance at 4～7 d in the increasing plasma volume group was higher than that in the decreasing plasma volume group,and the difference was statistically significant(P<0.05);the cumulative fluid balance at 4～7 d was an independent risk factor for plasma volume elevation,and a cumulative fluid balance of 2.308,3.361,3.518,and 3.702 L at 4～7 d was predictive of a plasma volume elevation,and areas under receiver operating characteristic curve were 0.686,0.721,0.647,and 0.766,respectively.The cumulative fluid balance for 4～7 d in the aggravated clinical congestion symptoms group was higher than that in the alleviated clinical congestion symptoms group,and the difference was statistically significant(P<0.05);the cumulative fluid balance for 4～7 d was an independent risk factor for the aggravated clinical congestion symptoms,and a cumulative fluid balance for 4～7 d of 2.574,3.383,4.995,and 4.235 L predicted aggravated clinical congestion symptoms,and area under receiver operating characteristic curve was 0.640,0.693,0.654,and 0.720,respectively.Conclusion The incidence of cumulative positive fluid balance in heart failure patients is high,and the amount of cumulative fluid balance can better predict the occurrence of volume overload,and the increase of plasma volume precedes the appearance of clinical congestion symptoms.It is suggested that heart failure patients with more than 3 d of cumulative positive balance should be closely monitored,and when the cumulative positive balance exceeds 2.308 L,measures should be taken in time to drain excessive fluid,so as to avoid the incidence of volume overload.

Objective:To explore the influence of mutuality between patients with chronic heart failure (CHF) and family caregivers on their positive emotions and positive coping styles based on the actor-partner interdependence model (APIM) .Methods:This study was a cross-sectional study. From January to July 2020, convenience sampling was used to select 101 pairs of CHF patients and their family caregivers in the Department of Cardiovascular of the First Affiliated Hospital with Nanjing Medical University. The self-designed General Information Questionnaire, the Mutuality Scale (MS) , the Chinese version of Positive and Negative Affect Scale (PANAS) and the Chinese version of Simple Coping Style Questionnaire (SCSQ) were used to conduct a cross-sectional survey of patients with heart failure and their family caregivers, and we established the APIM for the mutuality to positive emotions and positive coping styles.Results:In terms of the actor effect, the mutuality of CHF patients and their family caregivers could affect their own positive emotions (regression coefficients were 3.922, 3.427; P<0.01) and positive coping styles (regression coefficients were 2.936, 2.828; P<0.01) . In terms of the partner effect, the mutuality of family caregivers could affect the positive emotions (regression coefficient was 2.744, P<0.01) and positive coping styles (regression coefficient was 2.198, P<0.05) of CHF patients. Conclusions:CHF patients' emotions and coping behaviors are positively affected by the perceived mutuality between themselves and family caregivers, suggesting that clinicians should pay attention to the evaluation of the mutuality in CHF family care and actively explore intervention programs focusing on the mutuality.

Objective:To explore the effect of salt restriction strategy based on salt taste on salt taste preference (STP) and sodium intake in patients with chronic heart failure.Methods:From April to September 2020, convenience sampling was used to select 166 patients with chronic heart failure in the Cardiology Department of a Class Ⅲ Grade A hospital in Nanjing City, Jiangsu Province as the research object. The patients were randomly divided into the experimental group (83 cases) and the control group (83 cases) . Both groups of patients were given standardized chronic heart failure treatment methods and health education. On this basis, the experimental group was given a low-salt nutrient meal of 5.0g, 6.0g, and 7.5 g per day according to the different STP of the patients.The 24-hour urine sodium, STP, and Dietary Sodium Restriction Questionnaire (DSRQ) were used to evaluate the intervention effect.Results:After the intervention, there was a statistically significant difference in STP between the two groups of patients ( P<0.05) . The 24-hour urine sodium of the experimental group after intervention was lower than that of the control group, and the difference was statistically significant ( P<0.01) . After the intervention, the DSRQ score of the experimental group was higher than that of the control group, and the difference was statistically significant ( P<0.01) . Conclusions:The salt restriction strategy based on salt taste can reduce the STP and urine sodium of patients with chronic heart failure, and improve the current status of the implementation of sodium restriction diet.

Objective? To investigate the dietary sodium intake level of patients with heart failure and analyze its influencing factors, so as to provide reference for formulating dietary intervention strategies for patients with heart failure. Methods? From July 2018 to April 2019, 153 patients with heart failure in the First Affiliated Hospital of Nanjing Medical University were selected as the subject by convenient sampling. The General Questionnaire and Dietary Sodium Restriction Questionnaire(DSRQ) were collected, and 24-hour urine sodium determination was used to assess the patient's dietary sodium intake level. Results? A total of 155 questionnaires were distributed and 153 questionnaires were returned. The average dietary sodium intake of 153 patients with heart failure was (3 725.39±1 741.84) mg/d. The dietary sodium intake of 24 patients was within the recommended range (2 000-3 000 mg/d), accounting for 15.7%(24/153). The total score of the DSRQ was (54.83±9.15), and the scores of attitude and subjective normative dimension, cognitive dimension and perceptual behavior control were (23.24±3.15), (11.77±2.08), and (19.82±6.13), respectively.Univariate analysis showed different genders, tastes, dental health status, and whether the dietary sodium intake was different for patients prescribed a low-sodium diet, the differences were statistically significant (P＜ 0.05);correlation analysis showed that appetite score and sodium intake in patients with heart failure was correlated, the difference was statistically significant (r=0.174, P=0.031), and the sodium-stable diet behavioral control score was associated with sodium intake in patients with heart failure (r=-0.329, P＜ 0.001). Multiple linear regression analysis showed that the patient's gender, taste, and patient's perceptual behavioral control of sodium-restricted diet were the main influencing factors of dietary sodium intake in patients with heart failure, explaining 21.5% of the total variation in dietary sodium intake. Conclusions? The dietary sodium intake of patients with heart failure is higher than the recommended amount of the guideline, and the current situation is not optimistic. In particular, health care workers should pay attention to individualized dietary guidance and interventions in men with low salty taste and low sodium-stable dietary behavioral scores to reduce heart failure and readmission rates.

Objective: To explore the relationship between coronary tortuosity and coronary microvascular disease (CMVD). Methods: Patients with typical angina symptoms and without serious coronary artery stenosis by coronary angiography were enrolled from June 2014 to December 2016, and CMVD was diagnosed by single photon emission tomography (SPECT). According to the SPECT results, patients were divided to the CMVD group and non-CMVD group. The baseline clinical characteristics, results of coronary angiography were compared between the two groups. The logistic analysis was used to analyze the relationship between coronary tortuosity and CMVD. Result: A total of 117 cases were enrolled, with 69 cases in the CMVD group and 48 cases in the non-CMVD group. No differences were found in gender distribution, age, hypertension, lipid abnormality, hyperuricemia and uses of statins between the two groups (all P>0.05). Incidence of diabetes (78.26%(54/69) vs. 35.42% (17/48) , P<0.05), hs-CRP ((4.29±2.15)mmol/L vs. (2.63±1.20)mmol/L, P<0.001), LDL-C ((2.98±0.96)mmol/L vs. (2.52±0.83)mmol/L, P=0.008) and homocysteine ((13.7±5.61)mmol/L vs. (11.5±4.38)mmol/L, P=0.025) levels were higher in the CMVD group than in the non-CMVD group. The data derived from echocardiographic examination were similar between the two groups. The Corrected TIMI frame counts were higher in the CMVD group than in non-CMVD group (LAD: 31.56±4.92 vs. 27.31±3.75, LCX: 29.47±4.18 vs. 26.62±3.19, RCA: 29.09±5.05 vs. 26.24±3.28, all P<0.001). The incidences of coronary atherosclerosis (76.81% (53/69) vs. 27.08% (13/48) , P<0.001) and coronary tortuosity ( (60.87% (42/69) vs. 33.33% (16/48) , P=0.035) were also higher in the CMVD group than in non-CMVD group. Logistic analysis found that coronary tortuosity (OR=6.111, 95%CI 2.707-13.794, P<0.001), diabetes (OR=6.565, 95%CI 2.883-14.948, P<0.001) and coronary atherosclerosis (OR=8.918, 95%CI 3.822-20.808, P<0.001) were independent risk factors of CMVD. Conclusion Coronary tortuosity, diabetes and coronary atherosclerosis are related to CMVD in this patient cohort.

Objective To detect the mRNA expression levels of PI3KCB and AKT1 genes in the peripheral blood lymphocytes of acute and chronic schizophrenia patients in different stages,and to explore the relationship between them and the clinic symptoms.Methods Twenty-four cases of schizophrenia patients without medication for at least 1 month,19 chronic schizophrenia patients with long-term clozapine medication,and 20 normal controls were involved in the study.The mRNA expression of PI3KCB and AKT1 genes of all the subjects were measured by real-time qRT-PCR,and the positive and negative symptom scales (PANSS) of schizophrenia patients were also evaluated.Spearman's correlation was used to analyze the relationship between PI3KCB,AKT1 and PANSS score.Results The gene expression of PI3KCB in acute schizophrenia patients,chronic schizophrenia patients with clozapine medication and normal control were (0.79±0.04),(0.83±0.08) and (0.87±0.09) respectively,and the difference was significant among the three groups (F=8.77,P=0.001).The AKT1 gene expression levels were (0.80±0.03),(0.27±0.13)and (0.29±0.12) respectively,and the difference was also significant among the three groups (F=302.31,P＜0.01).The PI3KCB mRNA levels of acute schizophrenia patients were significantly lower than the levels in healthy controls (MD =0.09,P=0.002),and the AKT1 mRNA levels of acute schizophrenia patients were significantly higher than the levels in chronic schizophrenia patients (MD=0.53,P＜0.01) and healthy controls (MD =0.51,P＜ 0.01).In schizophrenia patients,no significant relationship was found between PI3KCB,AKT1 expression levels and PANSS scores.Conclusion The gene expression status of PI3K-AKT pathway is significantly different in different stages of acute and chronic schizophrenia and that is no significant relationship with clinic symptoms,and clozapine treatment may affect its gene expression levels.

Objective: To explore the relationship between fragmented QRS complex(fQRS) and coronary collateral circulation(CCC) in patients with chronic total occlusion(CTO)lesion without prior myocardial infarction. Methods: This retrospective study analyzed 238 consecutive patients with CTO lesion in one of the major coronary arteries from May 2014 to October 2015 in our department. Patients were divided into poor CCC group (grade 0 and 1, 58 cases) and good CCC group(grade 2 and 3, 180 cases) based on Rentrop′s classification of CCC. The fQRS was defined as the presence of an additional R wave or notching of R or S wave or the presence of fragmentation in two contiguous electrocardiogram leads corresponding to a major coronary artery territory. Multivariate logistic regression was used to analyze the relationship between CCC and fQRS on electrocardiogram. Results: Compared with good CCC group, patients in poor CCC group had older age((65.2±8.9)years old vs. (60.3±10.1) years old, P=0.03), higher plasma glucose ((7.22±3.00) mmol/L vs.(6.31±1.83)mmol/L, P=0.04), and lower left ventricular ejection fraction ((45.2±11.4)% vs. (51.2±13.5)%, P=0.02). None of patients had Rentrop grade 0, the presence of fQRS on ECG in patients with Rentrop grade 1, grade 2, and grade 3 CCC was 69.0% (40/58), 48.6% (35/72) , and 19.4% (21/108), respectively (P<0.01). The presence of fQRS were higher in poor CCC group than in good CCC group (69.0%(40/58)vs. 31.1%(56/180), P<0.01), and number of leads with fQRS were higher in poor CCC group than in good CCC group (3(0, 4)vs.0(0, 3), P<0.01). Multivariate logistic regression analysis demonstrated that poor CCC growth in patients with CTO lesion without prior myocardial infarction was independently related to the presence of fQRS (OR=3.659, 95%CI 1.619-8.217, P<0.01). Conclusion Poor CCC in patients with CTO lesion without prior myocardial infarction is independently related to the presence of fQRS on electrocardiogram.

Objective To observe the protective effect of progesterone(PROG) on rat retinal ganglion cells(RGCs) in chronic ocular hypertention models.Methods The chronic ocular hypertention rat model was made by cauterizating three episcleral veins.Rats were divided into control group,high level PROG group,middle level PROG group,low level PROG group according to different concentrations of PROG injected intraperitoneally.The left eye was model eye and the right eye was control eye.Three months later,the animals were executed and the eyeballs were enucleated.The RGCs were detected by HE staining and Thy-1.1 immunohistological staining.The apoptosis of RGCs was detected by TdT-dUDP terminal nick end-labeling(TUNEL) technique.Results The number of RGCs of model eyes in high level PROG injection group was more than those in control group,low level and middle level groups(P

Aim To evaluate the short-term biocompatibility of a newkind of prosthetic nucleus-Evergel, which is made from the modifiedpolyvinyl alcohol hydrogel. Methods According to China national standardGB/T16886 documents, the toxicity of Evergel prosthetic nucleus materialwas investigated by the cytotoxicity test, sensitization test, haemolysis test,Ames test, mice marrow micronucleus test and chromosome aberration test ofmammalian cell in vitro. Results This material had no cytoxicity, no sen-sitivity, no obvious haemolysis, and no mutagencity in Ames test, micemarrow micronucleus test and chromosome aberration test of mammalian cellin vitro. Conclusion The Evergel prosthetic nucleus has a good biocom-patibility and can be used clinically.