Background::The 2017 American College of Cardiology/American Heart Association (ACC/AHA) blood pressure (BP) guideline lowered the threshold defining hypertension to 130/80 mmHg. However, how stage 1 hypertension defined using this guideline is associated with cardiovascular events in Chinese adults remains unclear. This study assessed the association between stage 1 hypertension defined by the 2017 ACC/AHA guideline and clinical outcomes in the Chinese population.Methods::Participants with stage 1 hypertension ( n = 69,509) or normal BP ( n = 34,142) were followed in this study from 2006/2007 to 2020. Stage 1 hypertension was defined as a systolic blood pressure of 130–139 mmHg or a diastolic blood pressure of 80–89 mmHg. None were taking antihypertensive medication or had a history of myocardial infarction (MI), stroke, or cancer at baseline. The primary outcome was a composite of MI, stroke, and all-cause mortality. The secondary outcomes were individual components of the primary outcome. Cox proportional hazards models were used for the analysis. Results::During a median follow-up of 11.09 years, we observed 10,479 events (MI, n = 995; stroke, n = 3408; all-cause mortality, n = 7094). After multivariable adjustment, the hazard ratios for stage 1 hypertension vs. normal BP were 1.20 (95% confidence interval [CI], 1.13–1.25) for primary outcome, 1.24 (95% CI, 1.05–1.46) for MI, 1.45 (95% CI, 1.33–1.59) for stroke, and 1.11 (95% CI, 1.04–1.17) for all-cause mortality. The hazard ratios for participants with stage 1 hypertension who were prescribed antihypertensive medications compared with those without antihypertensive treatment during the follow-up was 0.90 (95% CI, 0.85–0.96). Conclusions::Using the new definition, Chinese adults with untreated stage 1 hypertension are at higher risk for MI, stroke, and all-cause mortality. This finding may help to validate the new BP classification system in China.

Pyroptosis is a kind of proinflammatory programmed cell death mediated by inflammasome.It affects the occurrence and development of gastric cancer through different ways,showing dual effects.On the one hand,inflammasome-mediated inflammatory response is highly likely to participate in the formation and development of early tumors;on the other hand,drugs can inhibit the deterioration process of tumor proliferation,invasion and metastasis through activating the pathways of inflammasome and pyroptosis.Recently,many agents based on pyroptosis have been found to inhibit gastric cancer by promoting the secondary pyroptosis pathway,regulating NOD-like receptor family pyrin domain containing 3(NLRP3)inflammasome and inhibiting caspase-1.The establishment of cell pyrodeath models can predict the prognosis of gastric cancer patients.Most of the models show that gastric cancer patients with high pyroptosis level have better prognosis and longer overall survival.Pyroptosis scores can also be used to predict the response of gastric cancer patients to immunotherapy and to screen potential anti-gastric cancer drugs.Therefore,in-depth understanding of the potential mechanism of pyroptosis affecting the progression of gastric cancer and the role of pyroptosis score in the treatment and prognosis assessment of gastric cancer will be helpful to find a new and effective method for the treatment of gastric cancer.

Coronavirus disease 2019 (COVID-19) is a highly contagious disease and a serious threat to human health. COVID-19 can cause multiple organ dysfunction, such as respiratory and circulatory failure, liver and kidney injury, disseminated intravascular coagulation, and thromboembolism, and even death. The World Health Organization reports that the mortality rate of severe-type COVID-19 is over 50%. Currently, the number of severe cases worldwide has increased rapidly, but the experience in the treatment of infected patients is still limited. Given the lack of specific antiviral drugs, multi-organ function support treatment is important for patients with COVID-19. To improve the cure rate and reduce the mortality of patients with severe- and critical-type COVID-19, this paper summarizes the experience of organ function support in patients with severe- and critical-type COVID-19 in Optical Valley Branch of Tongji Hospital, Wuhan, China. This paper systematically summarizes the procedures of functional support therapies for multiple organs and systems, including respiratory, circulatory, renal, hepatic, and hematological systems, among patients with severe- and critical-type COVID-19. This paper provides a clinical reference and a new strategy for the optimal treatment of COVID-19 worldwide.
Antiviral Agents ; therapeutic use ; Betacoronavirus ; Coronavirus Infections ; drug therapy ; therapy ; Humans ; Oxygen Inhalation Therapy ; Pandemics ; Pneumonia, Viral ; therapy ; Respiration

Objective: To analyse the mental state of patients with allergic rhinitis (AR) in Chengdu. Methods: One thousand five hundred and thirty-six AR patients from Sichuan Provincial Integrated Traditional Chinese and Western Medicine Hospital, West China Hospital of Sichuan University, Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Sichuan People′s Hospital, Sichuan Second Hospital of Traditional Chinese Medicine were selected from July 2013 to January 2018. Eight hundred and twenty-seven patients were screened into study group by inclusion and exclusion standards. The symptom check list 90 (SCL-90) was used to group and score the mental state of these patients according to nine classification criteria: gender, BMI, age, marital status, monthly salary, disease duration, living environment, education level and working environment. Then, the scores were compared within groups. Inter-group comparison was made between the study group and the Chinese norm, and the positive factors for psychological disorders were extracted. Four symptoms in the study group, i.e. nasal itching, sneezing, clear discharge and nasal congestion, were scored on the visual analogue scale (VAS). SPSS 19.0 software was used to carry out statistical analysis. Partial correlation analysis was performed between the positive factors and the symptom scores by multiple regression statistical method. Results: The total score of SCL-90 in the study group was 2.64±0.25, which was accorded with mild to moderate mental health impairment. There were 124 (15.0%) without mental health damage, 176 (21.3%) with mild damage, 474 (57.3%) with mild to moderate damage, 41 (5.0%) with moderate to severe damage and 12 (1.4%) with severe damage. The in-group comparison showed that the top three categories of different items were the living environment, gender and working environment. The scores of somatization, obsessive-compulsive symptoms, interpersonal sensitivity, depression, anxiety, psychosis, other (sleep, diet) and total average score of urban residents were higher than that of country residents (3.29±0.61 vs 2.65±0.50, 2.81±0.77 vs 2.05±0.38, 3.10±0.19 vs 2.49±0.67, 3.40±0.84 vs 2.49±0.70, 3.04±0.64 vs 2.33±0.51, 3.02±0.55 vs 2.40±0.77, 3.40±0.41 vs 2.52±0.77, 2.91±0.11 vs 2.29±0.40, Z value was 4.88, 5.25, 4.57, 5.91, 5.09, 4.63, 5.55, -4.55, respectively, all P<0.05). Women scored higher than man for somatization, interpersonal sensitivity, depression and others (2.66±0.51 vs 2.00±0.45, 3.37±0.47 vs 2.63±0.51, 3.44±0.57 vs 2.85±0.52, 3.47±0.36 vs 2.76±0.45, Z value was -5.10, -5.51, -4.86, -5.28, respectively, all P<0.05). The scores of somatization, interpersonal sensitivity, psychosis and other (sleep, diet) were higher in the indoor group than those in the outdoor group (3.49±0.64 vs 2.78±0.46, 3.33±0.30 vs 2.56±0.68, 3.28±0.60 vs 2.67±0.31, 3.50±0.85 vs 2.85±0.37, Z value was 5.31, 5.79, 4.89, 5.00, respectively, all P<0.05). The outdoor group scored higher on obsessive-compulsive symptoms, anxiety and hostility (3.44±0.40 vs 2.83±0.35, 3.40±0.50 vs 2.57±0.93, 3.34±0.88 vs 2.69±0.56, Z value was 4.96, 6.22, 5.08, respectively, all P<0.05). The inter-group comparison found that depression, anxiety, psychosis and other (sleep, diet) could be partially correlated with VAS scores as 4 positive factors. The results of partial correlation analysis showed that depression was positively correlated with sneezing and nasal runny discharge, anxiety was positively correlated with nasal itching and nasal obstruction, psychosis was positively correlated with nasal itching and sneezing, and other (sleep, diet) was positively correlated with nasal runny discharge and nasal obstruction. Conclusion AR patients have mild to moderate mental health impairments, which are correlated with AR symptoms.

Early detection and timely intervention are very essential for autism. This paper used the wavelet transform and empirical mode decomposition (EMD) to extract the features of electroencephalogram (EEG), to compare the feature differences of EEG between the autistic children and healthy children. The experimental subjects included 25 healthy children (aged 5-10 years old) and 25 children with autism (20 boys and 5 girls aged 5-10 years old) respectively. The alpha, beta, theta and delta rhythm wave spectra of the C3, C4, F3, F4, F7, F8, FP1, FP2, O1, O2, P3, P4, T3, T4, T5 and T6 channels were extracted and decomposed by EMD decomposition to obtain the intrinsic modal functions. Finally the support vector machine (SVM) classifier was used to implement assessment of autism and normal classification. The results showed that the accuracy could reach 87% and which was nearly 20% higher than that of the model combining the wavelet transform and sample entropy in the paper. Moreover, the accuracy of delta (1-4 Hz) rhythm wave was the highest among the four kinds of rhythms. And the classification accuracy of the forehead F7 channel, left FP1 channel and T6 channel in the temporal region were all up to 90%, which expressed the characteristics of EEG signals in autistic children better.

Objective To evaluate the fallopian tube patency with transvaginal real-time three-dimensional hysterosalpingo-contrast sonography (3D-HyCoSy) in diagnosis of infertility.Methods Taking laparoscopy and dye test as the reference standard,a total of 126 infertile women underwent both transvaginal real-time 3D-HyCoSy with SonoVue and laparoscopy.Bilateral fallopian tubes were dynamic observed.Results Transvaginal real-time 3D-HyCoSy showed that in clinical suspected infertility patients,125 fallopian tubes were patent,81 fallopian tubes were narrow and circuitous,and 37 fallopian tubes were obstructed.Among all the patients,60 cases (115 fallopian tubes) underwent laparoscopy with chromopertubation.The results showed that 10 fallopian tubes were patent,73 fallopian tubes were narrow and circuitous,and 32 fallopian tubes were obstructed.Taking laparoscopy and dye test as the reference standard,107 fallopian tubes of the 60 cases were diagnosed correctly,and the coincidence rate of 3D-HyCoSy and laparoscopy and dye test was 93.0％ (107/115).Taking laparoscopy and dye test as the gold standard,the accuracyof transvaginal real-time 3D-HyCoSy in diagnosis of fallopian tubes patency or obstruction was 93.0％(107/115),the sensitivity was 94.3％ (99/105),the specificity was 80.0％ (8/10).Conclusions Tansvaginalreal-time 3D-HyCoSy can provide dynamic,real-time and three-dimensional display of the fallopian tubes.Itcan get more accurate diagnostic information,so it's an important method.3D-HyCoSy is a safe and non-invasivemethod,so it plays an important clinical role in the screening,diagnosis and treatment of gynecological diseases.

OBJECTIVETo discuss the genetic diagnosis of congenital adrenal hyperplasia (CAH) and investigate the resource of gene mutations in CAH.

METHODEnzymatic methods with restriction endonucleases that specifically recognized the mutation sites were used to detect the gene mutations in patients with CAH and their relatives. Polymerase chain reaction and direct sequencing were used to identify the mutations in 21-hydroxylase gene, and short tandem repeat (STR) typing was used to determine the sources of the mutations.

RESULTSOne CAH patient had two known mutations in 21-hydroxylase gene, namely the I2g and I172N mutations. The former mutation was inherited from the biological mother and the latter was not inherited.

CONCLUSIONThe 9 common mutations of CAH are also the hotspots for new mutations.

Adrenal Hyperplasia, Congenital ; diagnosis ; genetics ; Gene Deletion ; Genotype ; Humans ; Mutation ; Point Mutation ; Polymerase Chain Reaction ; Steroid 21-Hydroxylase ; genetics

ObjectiveTo observe the affection of cilostazol combined with valsartan in treating patients with early diabetic nephropathy on serum homocysteine and cystatin C,MethodsNinety-six cases with early diabetic nephropathy were divided into two groups by random digits table method with 48 cases each:observation group was treated with cilostazol and valsartan,control group was treated with valsartan alone.The effect and the levels of 24 h urinary albumin,serum homocysteine and cystatin C before and after treatment in two groups were compared.ResultsThe total effective rate in observation group [85.4％(41/48) ] was significantly higher than that in control group [66.7％(32/48) ](P ＜ 0.05 ).The levels of 24 h urinary albumin,serum homocysteine and cystatin C were significantly decreased after treatment of three weeks in observation group and control group [ (125.48±13.76) mg,(9.25±3.52)p mol/L,(7.82±2.14) mg/L and (168.38±15.43) mg,(13.72±4.23) μ mol/L,(9.57±2.85) mg/L vs.(279.31±21.52) mg,(18.52±6.14) μ mol/L,( 13.25±3.79) mg/L and (275.24±19.31 ) mg,( 18.48±6.12) μ mol/L,( 13.19±3.76)mg/L](P＜ 0.05).And the levels of 24 h urinary albumin,serum homocysteine and cystatin C after treatment of three weeks in observation group were obviously lower than those in control group(P ＜ 0.05).Conclusions Cilostazol combined with valsartan in treating patients with early diabetic nephropathy can improve clinical effect obviously,degrade the level of urinary albumin,homocysteine and cystatin C.Therefore,it deserves to be applied in clinic.

OBJECTIVETo study the clinical application of denature high performance liquid chromatography (DHPLC) technique on mutation screening and prenatal diagnosis for Wilson's disease (WD).

METHODSGenomic DNA of the probands with Wilson's disease and their parents from 6 families was subjected to polymerase chain reaction (PCR) for the 21 exons and the 5' untranslated region of ATP7B gene. Mutation screening of the PCR products was performed by DHPLC. The abnormal peaks were confirmed by further sequencing analysis. Based on the successful gene diagnosis for the patients, prenatal diagnosis was performed in 4 families, including 1 twin and 3 singletons.

RESULTSFive disease-causing mutations and 8 polymorphisms were found in the 6 probands by DHPLC and sequencing. The parents were carriers with the same mutation as their affected children. Prenatal diagnosis showed that two pregnancies were abnormal, including a twin pregnancy with compound heterozygote for Arg778Leu and IVS4-1G>C mutation, and a single pregnancy with a compound heterozygote for Ser975Tyr and Pro992Leu mutations. These two pregnancies were terminated after genetic counseling. Another two pregnancies included a singleton carrier with Ser975Tyr mutation and a normal genotype fetus, respectively. These two pregnancies were continued and the babies were healthy.

CONCLUSIONDHPLC is a powerful tool in prenatal diagnosis as well as in postnatal diagnosis.

Adenosine Triphosphatases ; genetics ; Cation Transport Proteins ; genetics ; Chromatography, High Pressure Liquid ; methods ; Copper-transporting ATPases ; DNA Mutational Analysis ; Exons ; genetics ; Female ; Fetal Diseases ; diagnosis ; genetics ; Genetic Testing ; methods ; Hepatolenticular Degeneration ; diagnosis ; genetics ; Humans ; Male ; Mutation ; Pedigree ; Pregnancy ; Prenatal Diagnosis ; methods

Objective To approach the effect of down regulation of fast glucose damge standard on endothelial funtion. Methods The FBS 、serum lipid、 uric acid of 54101 normal subjects were detected, those subjects were divided by FBG value into four groups: A B C D ,the value of TC、 TG、 uric acid in group B were higher than which in group A, lower than in group C. The value of PBG、FINS、PINS、ET、NO of 655 subjects choiced randomly were detected .At the same time the endodermis dependence angiectasia funtion mediated by bloodstream and the no-endodermis dependence angiectasia funtion mediated by glycerol trinitrate were detected . Results The value of group B was lower than which in group A, having no statistical meanings compared with group C、D;the no-endodermis dependence angiectasia funtion mediated by glycerol trinitrate of group B was higher than that of group C, that of group C was lower than group A, the comparison of other two groups has no statistical meanings. Conclusions Down regulation of fast glucose damge standard can effect on the endothelial funtion.