Objective To explore the mortality rate and changes in splenic cell cycle and apoptosis in rats with ab-dominal infection.Methods An animal model of sepsis was induced by cecal ligation and puncture(CLP)in rats.At serial time points 0 h,6 h,12 h,24 h,48 h,and 72 h after CLP,the animal death rate was calculated.The percentage of cell cycle G1,S,G2/M phase and apoptosis of isolated spleen cells were analyzed using flow cytome-ter.The expression of p27 of spleen tissue was determined by Western blot analysis.Results In the rat model of CLP-induced systemic inflammatory response,the mortality of animals gradually increased at 0 h,6 h,12 h,24 h,48 h and 72 h after CLP surgery,reaching a maximum of 88.81%.The abdominal infection in the animals gradual-ly worsened at 0 h,6 h,12 h,and 24 h after CLP surgery,but localized and gradually alleviated after 48 h and 72 h.Within 48 h after CLP surgery,there was a blockage in the G1 phase of the spleen cell cycle,an increase in the percentage of apoptotic cells,and an elevation in p27 expression.After 48 h,the G1 phase blockage gradually recovered,the number of apoptotic cell decreased,and p27 expression declined.Additionally,with-in 48 h after CLP surgery,there was a decrease in the percentage of cells in the S and G2/M phases of the spleen cell cycle,but the percentage of cells in these phases gradually increased after 48 h.Conclusions Cell cycle arrest and apoptosis of the spleen cells are potentially contributed to the change of animal mortality after abdominal infection.

With the economic development of China and transformation of medical model, people pay more attention to their spiritual world and psychological health, and medical psychology has become a major in urgent need of construction. Foreign medical/clinical psychology education was established earlier and has become relatively mature, thus making its experience valuable for reference. This paper compares and analyzes the current situation of undergraduate medical psychology education, and puts forward optimization strategies from the aspects of college planning, curriculum training scheme and teachers’ teaching philosophy, hoping to provide some ideas for the construction of undergraduate medical psychology education in China.

Objective:To investigate the safety and efficacy of J-valve transapical catheter aortic Valve replacement(TA-TAVI) in the early treatment of aortic stenosis with low coronary ostium.Methods:From January 2020 to April 2022, 20 patients with aortic stenosis with coronary opening height ≤10 mm who underwent TA-TAVI treatment in the Valve Surgery Center of Beijing Anzhen Hospital Affiliated to Capital Medical University were enrolled retrospectively. All patients underwent preoperative imaging screening, and 5 patients underwent preoperative coronary artery protection: The height of coronary artery opening was less than 5 mm in 3 cases. 2 cases had stent stenosis & LT after coronary artery stenting 50%, and the position of the coronary artery opening was less than 8mm. The postoperative complications, mortality and cardiac function prognosis of TA-TAVI were analyzed.Results:There were 5 males and 15 females. The average age of the whole group was(73.00±6.20) years. Transthoracic echocardiography showed that all patients had severe aortic valve stenosis, and 85% of the patients had NYHA grade Ⅲ-Ⅳ, and 80% of the patients had aortic valve stenosis with insufficiency. The mean height of left coronary artery opening was(9.07±3.70) mm. RCA(11.39±3.00) mm; The opening height of coronary artery was ≤5 mm in 3 cases(left 7.5%), 5-8 mm in 5 cases(12.5%), and 8-10mm in 16 cases(40.0%). Mean aortic sinus(valsalva) diameter: Left(30.06±5.90) mm; Right(28.50±5.68) mm; Non(29.96±6.15) mm. J-valve Valve was successfully implanted through apical catheter in all patients, most of whom were size 23. CPB was performed in 2 patients at the same time, permanent pacemaker was inserted in 2 patients, and moderate or above perivalvular leakage was found in 0 patients. All patients had TNI( P=0.12) and MYO( P=0.03) before and 24 hours after operation. None of the 5 patients underwent coronary artery stenting. None of the 5 patients died within 30 days after the operation. Ta-tavi is effective 30 days after operation, with low complication rate and good prognosis of cardiac function. Conclusion:J-valve transapical catheter aortic Valve replacement is safe and effective in the treatment of aortic stenosis with low coronary ostium.

【Objective】 To perform electrochemiluminescence immunoassay (ECLIA) and Western blotting (WB) confirmation tests for HIV reactive samples in blood screening, and analyze the correlation between ELISA (enzyme-linked immunosorbent assay), ECLIA results and confirmed infection, so as to provide data support for the application of ECLIA in blood screening. 【Methods】 177 HIV reactive samples in blood screening testing detected by our laboratory from February to October 2019 were collected, of which 137 were reactiv to isolated ELISA reagent e, 39 to dual ELISA reagent, and 1 in window period. Ten maker-negative samples were randomly selected to undergo ECLIA with the above 177 samples. HIV reactive samples were sent to Centers for Disease Control and Prevention (CDC) for confirmation tests, and the results were analyzed and compared. 【Results】 Among the 177 HIV reactive samples, 66 were ECLIA reactive, 111 negative, and the 10 maker-negative samples remained negative. The sensitivity, specificity, positive predictive value, negative predictive value and total concordance rate of ECLIA were 97.1%, 81.1%, 55%, 99.1% and 84.2%, respectively, showing better performance than that of two ELISA reagents(P<0.05) with exception of sensitivity(P>0.05). The positive predictive value and specificity were tested by chi-square test, and the difference between ECLIA and reagent 2 was statistically significant (P<0.05). The ECLIA results showed significant correlation with the confirmation results with good consistency(examed by Kappa test). Among the three reagents, ECLIA presented highest accuracy and largest Youden index. 【Conclusion】 ECLIA presents high detection sensitivity, which can improve the detection ability of early HIV infection and shorten the window period of HIV detection, therefore should be popularized in blood screening.

【Objective】 To establish deferral criterion of HIV ELISA (enzyme-linked immunosorbent assay) and electrochemiluminescence immunoassay(ECLIA) by using receiver operating characteristic curve(ROC) method to screen HIV reactive blood donors suitable for entering the re-entry process and improve the management efficiency of reactive blood donors. 【Methods】 The test results of 92 001 blood donors from February to September 2019 were analyzed, and 177 reactive samples were screened by conventional screening mode (twice ELISA and once nucleic acid), supplemented with electrochemiluminescence immunoassay assay (ECLIA), and confirmed by Western blotting (WB). Screening reactive samples were divided into three groups: group A was both serological and nucleic acid reactivity, group B was only serological reactive, and group C was only nucleic acid reactivity. Its efficacy in blood donor classification was assessed by drawing ROC curves with 99% specific corresponding S/CO low values as the deferral criterion of the corresponding serological method. 【Results】 1) A total of 177 HIV reactive samples were detected in conventional mode, including 34 in group A, 142 in Group B and 1 in Group C. The positive predictive value (PPV) was 100%, 0.75% and 100%, respectively. ECLIA detection mode (once ECLIA and once NAT), a total of 67 HIV reactive samples including 34 in group A, 32 in group B and 1 in group C, with positive predictive values of 100%, 3.7% and 100%, respectively.2) The HIV test results showed diversity, with 36 true positive samples including 1 HIV elite controller and 3 early HIV infections (1 HIV ELISA antigen/antibody window and 2 ELISA HIV antibody window), and 32 serological and NAT cases were reactive infections.3) The deferral limit of ELISA 1 and ELISA 2 in conventional screening mode were 20.25 and 9.85, respectively, can screen 97.14% (34/35) of all true positive samples in group A and B, except for one ELISA HIV antibody window (ELISA 2 reactivity). The positive predictive values were 93.94% and 92.85%, respectively. The ECLIA deferral limit of 7.83 can screens all true positive samples in Groups A and B (35/35)in ECLIA mode. The positive predictive value was 94.59%. 【Conclusion】 The establishment of deferral limits in this study can effectively screen HIV-positive blood donors, and the number of screened blood donors is greatly reduced, which is helpful to fine and scientific management of HIV-reactive blood donors. The deferral limit values of different testing reagents are quite different, so each laboratory should choose appropriate testing methods to establish the deferral limit values suitable for the laboratory according to its own testing ability, so as to provide technical support for optimizing the process of returning blood donors to the team.

【Objective】 To investigate the HBV infection of TMA initially reactive but discriminatory test non-reactive samples(NDR) after the individual donation nucleic acid detection(ID-NAT)of TMA, and analyze its serological and molecular biological characteristics, so as to improve the safety of blood transfusion. 【Methods】 121 970 samples of blood donors in the center from January 1, 2021 to December 31, 2021 were routinely tested by serology and nucleic acid of ID NAT, and 21 HBsAg(-)/ NDR samples were random collected. After the plasma samples were concentrated by ultra-high speed centrifugation, the gene sequences of BCP/PC, pre-S/S and S region were amplified by Nested PCR. The S region sequence was also sequenced to analyze the viral genotype and amino acid variation. At the same time, the original TMA retest discriminatory test was adopted, and Roche MPX 2.0 was used for ID-NAT, and the samples was not virus-concentrated.NDR samples were supplemented with electrochemiluminescence for anti-HBc and anti-HBs quantitative detection. 【Results】 Of the 121 970 samples screened, 117(0.096%) were found to be HBsAg(-)/NDR samples, of which 21 samples underwent a confirmation test. Sixteen(76.2%) cases were positive for HBV DNA by TMA retest, 7(33.3%) positive for HBV DNA by Roche MPX 2.0 ID-NAT, 9(42.9%) confirmed by Nested PCR, and 8(38.1%) positive by any two methods. Test results of serological markers were as follows: 17(80.9%) positive anti-HBc and 8(38.1%) positive anti-HBs. Eight infected cases were confirmed to have occult hepatitis B infection(OBI). The gene sequence of S region was successfully amplified and sequenced in 3 cases, all of which belonged to C type. Two mutations occurred in specimen S-2, all of which were outside MHR. There were 13 mutations in sample S-6, 6 mutations outside MHR and 7 mutations inside MHR. 【Conclusion】 Nearly 40% of NDR samples can still be detected as HBV DNA positive after virus concentration. Anti-HBc has a high detection rate, and there may be a potential risk of HBV transmission. The current NAT detection sensitivity should be improved. The amino acid mutation of S gene sequence may be related to OBI formation.

Objective:To explore the clinical significance of different endovascular interventional therapies in extracranial artery dissection and summarize their therapeutic experiences.Methods:Forty-two patients with extracranial artery dissection underwent endovascular interventional therapies in our hospital from August 2016 to January 2021 were chosen. In these 42 patients (26 with simple intravascular dissection and 16 with dissecting aneurysms), the dissection located in carotid C1 or C2 segment was noted in 37 patients and that in vertebral artery V2 segment was noted in 5 patients. According to the nature, location, and scope of lesions, different endovascular interventional therapies (such as overlapping braided vascular stent implantation, flow-diverter stents implantation, intracranial covered stent implantation and embolism of aneurysm) were adopted. DSA results immediately after surgery and DSA follow-up results 6 months after surgery were evaluated, and the occurrence of adverse events during and within 24 h after surgery was observed and recorded.Results:In the 26 patients with simple intravascular dissection, 3 patients showed vascular occlusion by DSA angiography (1 patient accepted sequential stent implantation [2 Neuroform EZ stents] and 2 patients accepted sequential stent implantation [Neuroform EZ+Wallstent stent] after recanalization; in the left 23 patients, 21 received overlapping braided stent implantation (19 patients had 2 Wallstent stents and 2 patients had 2 LVIS stents) and 2 patients had intracranial covered stent implantation (single Willis stents). Among the 16 patients with dissecting aneurysm, overlapping braided stents were implanted (11 patients had 2 Wallstent stents, 4 patients had single flow-diverter stent, and 1 patient had single Willis stent). The stents were successfully placed in all patients intraoperatively. Immediately after surgery, DSA showed that the stents were well attached, and the blood flow of the responsible vessels was unobstructed; no postoperative complications such as bleeding, vascular occlusion or acute thrombosis were noted. After 6 months of follow-up, all patients had smooth blood flow in the diseased vessels, complete aneurysm occlusion, and no obvious stenosis in the stents.Conclusion:Endovascular interventional therapy is safe and effective for extracranial artery dissection; stent placement should be selected according to the characteristics of the dissection.

Objective: To investigate the impact of change of ideal cardiovascular behavior and related factors on healthy vascular aging(HVA). Methods: This study was a multi-center cross-sectional survey. Six thousand three hundred and sixteen participants who underwent at least 2 healthy examinations from 2006 to 2015 at 11 hospitals, including Kailuan Hospital and so on, and examined brachial-ankle pulse wave velocity (baPWV) during 2010 and 2016, with available information about cardiovascular behavior and factors were included. The cardiovascular health score (CHS) was calculated. Basic CHS was collected from the first examination. The second CHS derived from the healthy examination in the same year of baPWV examination. Change of cardiovascular health score (ΔCHS) was calculated. Participants were defined into 5 groups according to ΔCHS, namely ΔCHS≤-2 (n=2 166), ΔCHS=-1 (n=1 284), ΔCHS=0 (n=1 187), ΔCHS=1 (n=860), and ΔCHS≥2 (n=819). Participants′ characteristics, value of baPWV and proportion of HVA were compared among different groups. Multiple logistic regression analysis was used to investigate the association between ΔCHS and HVA. The ΔCHS was recalculated and included in multiple logistic regression analysis model again after each component of the cardiovascular health metrics was removed separately in order to investigate effects of removal factors on HVA by observing changes in effect values. Results: The percentage of the participants with HVA in the group of ΔCHS≤-2, ΔCHS=-1, ΔCHS=0, ΔCHS=1 and ΔCHS≥2 were 23.3%(505/2 166), 27.8%(357/1 284), 28.7%(341/1 187),31.9%(274/860) and 33.9%(278/819), respectively. After adjustment for age, sex, income, education, alcohol consumption and the basic CHS, a significant positive association between ΔCHS and proportion of participants with HVA was observed (OR=1.50, 95%CI 1.44-1.56). Multiple regression analysis after removing each single cardiovascular behavior or factor showed that the OR value decreased as follow systolic blood pressure (OR=1.04, 95%CI 1.00-1.09), fasting blood glucose (OR=1.14, 95%CI 1.09-1.18), physical exercise (OR=1.16, 95%CI 1.11-1.21), salt intake (OR=1.17, 95%CI 1.12-1.22), body mass index (OR=1.18, 95%CI 1.13-1.23), smoking(OR=1.18, 95%CI 1.13-1.23) and total cholesterol (OR=1.20, 95%CI 1.16-1.24). Conclusion The improvement of every ideal cardiovascular behavior and factor is associated with the increase of the proportion of HVA population.

Objective: To investigate the impact of blood pressure and age on arterial stiffness in general population. Methods: Participants who took part in 2010, 2012 and 2014 Kailuan health examination were included. Data of brachial ankle pulse wave velocity (baPWV) examination were analyzed. According to the WHO criteria of age, participants were divided into 3 age groups: 18-44 years group (n=11 608), 45-59 years group (n=12 757), above 60 years group (n=5 002). Participants were further divided into hypertension group and non-hypertension group according to the diagnostic criteria for hypertension (2010 Chinese guidelines for the managemengt of hypertension). Multiple linear regression analysis was used to analyze the association between systolic blood pressure (SBP) with baPWV in the total participants and then stratified by age groups. Multivariate logistic regression model was used to analyze the influence of blood pressure on arterial stiffness (baPWV≥1 400 cm/s) of various groups. Results: (1)The baseline characteristics of all participants: 35 350 participants completed 2010, 2012 and 2014 Kailuan examinations and took part in baPWV examination. 2 237 participants without blood pressure measurement values were excluded, 1 569 participants with history of peripheral artery disease were excluded, we also excluded 1 016 participants with history of cardiac-cerebral vascular disease. Data from 29 367 participants were analyzed. The age was (48.0±12.4) years old, 21 305 were males (72.5%). (2) Distribution of baPWV in various age groups: baPWV increased with aging. In non-hypertension population, baPWV in 18-44 years group, 45-59 years group, above 60 years group were as follows: 1 299.3, 1 428.7 and 1 704.6 cm/s, respectively. For hypertension participants, the respective values of baPWV were: 1 498.4, 1 640.7 and 1 921.4 cm/s. BaPWV was significantly higher in hypertension group than non-hypertension group of respective age groups (P<0.05). (3) Multiple linear regression analysis defined risk factors of baPWV: Multivariate linear regression analysis showed that baPWV was positively correlated with SBP(t=39.30, P<0.001), and same results were found in the sub-age groups (t-value was 37.72, 27.30, 9.15, all P<0.001, respectively) after adjustment for other confounding factors, including age, sex, pulse pressure(PP), body mass index (BMI), fasting blood glucose (FBG), total cholesterol (TC), smoking, drinking, physical exercise, antihypertensive medications, lipid-lowering medication. (4) Multivariate logistic regression analysis of baPWV-related factors: After adjustment for other confounding factors, including age, sex, PP, BMI, FBG, TC, smoking, drinking, physical exercise, antihypertensive medication, lipid-lowering medication, multivariate logistic regression analysis showed that risks for increased arterial stiffness in hypertension group were higher than those in non-hypertension group, the OR in participants with hypertension was 2.54 (2.35-2.74) in the total participants, and same results were also found in sub-age groups, the ORs were 3.22(2.86-3.63), 2.48(2.23-2.76), and 1.91(1.42-2.56), respectively, in each sub-age group. Conclusion SBP is positively related to arterial stiffness in different age groups, and hypertension is a risk factor for increased arterial stiffness in different age groups. Clinical Trial Registry Chinese Clinical Trial Registry, ChiCTR-TNC-11001489.

Objective To analyze the physicochemical properties and photothermal properties after introducing a certain proportion of phaeophorbide into polyvinyl alcohol-lipoic acid polymer.Methods The "one-step" method was adopted to synthesize the PVA27K-4 ％LA-10 ％ Pheide (PLP) polymer.The laser particle diameter tester was used to detect the particle size,polydispersity index and ζ potential of PLP nanoparticle (PLPN);the morphology was observed under transmission electron microscope (TEM);the in vitro fluorescent and photothermal properties were investigated by using spectrophotometric method and infrared thermal imager;the ovarian-cancer nude mice models were established and the preliminary in vivo experiment evaluation was performed.Results The synthetic PLP polymer could self-assembly form spherical PLPN in aqueous environment,which showed the tightly spherical structure under TEM.The average particle diameter,polydispersity index and ζ potential were (22.92 ± 9.00)nm,(0.117±0.056) and (-25.43±0.77)mV respectively.The fluorescence intensity of PLPN in PBS solution was significantly lower than that in SDS solution (P＜0.05).However,the temperature of the PBS solution of PLPN was significantly higher than that of the SDS solution after exposure to the near infrared light (P＜0.05).In the model of tumor-bearing nude mice,PLPN could targetaccumulated in the tumor site.The temperature in the tumor site was significantly increased after exposure to the near infrared light,which could kill tumor cells.Conclusion PLPN could emit red fluorescence,and could target-accumulated in tumor site and conduct the in vivo image,which has significant photothermal conversion properties in vivo and in vitro,and can effectively inhibit the tumor growth in vivo.