OBJECTIVE To investigate the efficacy and safety of Wuling capsules combined with low-dose quetiapine in the treatment of oldest-old patients with insomnia accompanied by anxiety and depression. METHODS The clinical data of 96 oldest- old patients （aged≥80 years） with insomnia accompanied by anxiety and depression who were attending outpatient clinics or hospitalized in our hospital from June 2020 to December 2022 were retrospectively analyzed. According to the different drug treatments， the patients were divided into Wuling capsules group （0.99 g， tid， 34 cases）， quetiapine group （25-50 mg， qn， 30 cases） and combination group （using Wuling capsules and quetiapine simultaneously， same as the single drug groups， 32 cases）. Before and after 8 weeks of treatment， the patients of three groups were compared in terms of photoplethysmography sleep monitoring indexes （total sleep duration， sleep efficiency， sleep latency， and the number of awakening）， Pittsburgh sleep quality index （PSQI） score， 14-item Hamilton anxiety scale （HAMA-14） score， 17-item Hamilton depression scale （HAMD-17） score， mini-mental state examination （MMSE） score， and serum levels of interleukin-1β （IL-1β） and tumor necrosis factor-α （TNF-α）； the therapeutic effects and adverse drug reactions of the three groups were observed and compared. RESULTS Compared with before treatment， the total sleep time， sleep efficiency and MMSE scores of the three groups were significantly longer or higher after treatment （P＜0.05）， while the sleep latency， number of awakening， PSQI score， HAMA-14 score， HAMD-17 score， serum IL-1β and TNF-α levels were significantly shorter or lower after treatment （P＜0.05）. Sleep latency， number of awakening， HAMA-14 score， HAMD-17 score and serum TNF-α level in quetiapine group were significantly shorter or lower than Wuling capsules group after treatment （P＜0.05）. Moreover， the above indexes in the combination group were significantly better than quetiapine group and Wuling capsules group （P＜0.05）. The total effective rate of treatment in the combination 1731786794@qq.com group was significantly higher than the other two groups （P＜0.05）. There was no significant difference in the incidence of mail：2408797210@qq.com adverse drug reactions among the three groups （P＞0.05）. CONCLUSIONS The therapeutic effect of Wuling capsules combined with low-dose quetiapine is better than that of individual drugs for oldest-old patients with insomnia accompanied with anxiety and depression， not increasing the risk of adverse reactions.

【Objective】 To demonstrate the real incidence and clinical features of acute transfusion reactions (ATRs) and analyze its association with transfusion effectiveness. 【Methods】 The blood transfusion process of patients in the Hematology Department in our hospital from March 16, 2018 to March 16, 2019 was observed and followed up. The vital signs and clinical features were recorded, the clinical data and relevant laboratory examination results were collected, and the correlation between ATRs, clinical features and transfusion effectiveness was statistically analyzed. 【Results】 A total of 2500 transfusions were observed in the Hematology Department, out of which 138 patients developed 242 ATRs. The overall incidence of ATRs was 9.68% (95% CI, 8.52%~10.94%) and the incidence of ATRs during platelets transfusion was the highest. The clinical features of most ATRs were mild and no fatal consequences occurred. No significant difference was found in the association between transfusion effectiveness with ATRs in platelets and red blood cells transfusion (P>0.05). 【Conclusion】 None of the ATRs observed in this study resulted in serious consequences or had effect on the transfusion effectiveness. The characteristics presented in these reactions may provide certain references for clinical practice.

Objective To evaluate the immunogenicity and safety of inactivated poliovirus vaccine derived from Sabin strain (sIPV) in Banna mini pigs, and to provide experimental evidence for the new animal model. Methods sIPV vaccines which are listed at Institute of Medical Biology at Chinese Academy of Medical Sciences were used in this study. The groups of intramuscular sIPV and the wild strain IPV injections (IPV derived from wild strain, wIPV) were designed, and the saline group was used as a negative control group. The Banna mini pigs in various groups were immunized at 0, 1 and 2 months. Blood samples were collected before immunization and on days 30 after each immunization. Levels of neutralizing antibodies were tested for evaluating immunogenicity. The safety was evaluated by observation of the status and weight of mini pigs. Results After the three dose immunization schedules in the Banna mini pigs, the seroconversion rates of type Ⅰ,Ⅱ and Ⅲ sIPV experimental groups and wIPV group were all up to 100%. The neutralizing antibody levels in all the three types were much higher than the protective titer 1: 8. The weight of mini pigs increased after vaccination. Conclusions The sIPV vaccine has good immunogenicity and safety in Banna mini pigs. Banna mini pigs could be a new animal model for evaluation of sIPV vaccine.

AIM: To investigate the effect of venous marker chicken ovalbumin upstream promoter-transcription factor Ⅱ (COUP-TFⅡ) expression on vascular endothelial cell senescence and its molecular mechanism.METHODS: The mRNA expression of COUP-TFⅡ in the human coronary artery endothelial cells (HCAEC) and human umbilical vein endothelial cells (HUVEC) was detected by RT-qPCR.After transfection with a COUP-TFⅡ siRNA (siCOUP-TFⅡ) to inhibit COUP-TFⅡ expression in the HUVEC, the senescence and proliferation of endothelial cells were evaluated by β-galactosidase staining, Western blot, CCK-8 assay and cell counting after treatment with 10-5 mol/L angiotensin Ⅱ (AngⅡ).The protein levels of Akt and p-Akt were determined by Western blot.RESULTS: Compared with the HCAEC, COUP-TFⅡ was significantly highly expressed in the HUVEC.Knockdown of COUP-TFⅡ via siCOUP-TFⅡ significantly induced endothelial cell senescence and inhibited endothelial cell proliferation and p-Akt level after treatment with AngⅡ at 10-5 mol/L.Furthermore, an Akt activator SC79 at 4 mg/L partly reversed the effect of siCOUP-TFⅡ on AngⅡ-induced endothelial cell senescence and proliferation.CONCLUSION: Knockdown of COUP-TFⅡ promotes endothelial cell senescence and inhibits endothelial cell proliferation, which might be partly regulated by Akt signaling.

Objective To study the expression of hypermethylated gene 1 protein and ovarian cancer gene 1 protein in ovarian cancer and its relationship with the pathological features of ovarian cancer,and to explore its significance in ovarian cancer.Methods Sixty-three cases of ovarian cancer specimens and 63 cases of normal ovarian tissue were taken from January 2014 to December 2015 at the First Hospital of Jilin University.Western blot was used to detect the expression of hypermethylated gene 1 protein and ovarian cancer gene 1 protein in ovarian cancer tissues and normal ovarian tissues,and to analyze the relationship between the expression of two proteins and ovarian cancer.Results The expression of hypermethylated gene 1 protein and ovarian cancer gene 1 protein in ovarian cancer tissues were significantly lower than that in normal ovarian tissues (P＜0.05).There was no significant difference in the expression of hypermethylated gene 1 protein in different staging,different degree of differentiation and different pathological types in ovarian cancer (P＞0.05).The expression of ovarian cancer gene 1 protein in ovarian cancer stage Ⅰ was higher than that in stage Ⅱ and Ⅲ-Ⅳ (P＜0.05).The expression of ovarian cancer gene 1 protein in ovarian cancer stage Ⅱ was higher than that in stage Ⅲ-Ⅳ (P＜0.05).The expression of ovarian cancer gene 1 protein in high differentiation of ovarian cancer was significantly higher than that in moderately differentiated and poorly differentiated (P＜0.05).There was no significant difference between ovarian cancer gene 1 protein expression and poorly differentiated ovarian cancer (P＞0.05).There was no sig nificant difference in the expression of ovarian cancer gene 1 protein in different pathological types of ovarian cancer (P＞0.05).Conclusion Hypermethylatel gene,protein participate in the occurrence of ovarian cancer,the ovarian cancer gene 1 protein is only related to ovarian cancer clinical stage and degree of differentiation.

Objective:To describe a method based on analysis of the histogram of intensity values pro-duced from the magnetic resonance imaging (MRI)for quantifying the degree of fatty infiltration. Methods:The study included 25 patients with dystrophinopathy.All the subjects underwent muscle MRI test at thigh level.The histogram Mvalues of 250 muscles adjusted for subcutaneous fat,representing the degree of fatty infiltration,were compared with the expert visual reading using the modified Mercuri scale.Results:There was a significant positive correlation between the histogram Mvalues and the scores of visual reading (r =0.854,P <0.001).The distinct pattern of muscle involvement detected in the pa-tients with dystrophinopathy in our study of histogram M values was similar to that of visual reading and results in literature.The histogram M values had stronger correlations with the clinical data than the scores of visual reading as follows:the correlations with age (r =0.730,P <0.001 )and (r =0.753, P <0.001);with strength of knee extensor (r =-0.468,P =0.024)and (r =-0.460,P =0.027) respectively.Meanwhile,the histogram Mvalues analysis had better repeatability than visual reading with the interclass correlation coefficient was 0.998 (95% CI:0.997 -0.998,P <0.001)and 0.958 (95%CI:0.946 -0.967,P <0.001)respectively.Conclusion:Histogram Mvalues analysis of MRI with the advantages of repeatability and objectivity can be used to evaluate the degree of muscle fatty infiltration.

Objective:To report thigh muscle magnetic resonance imaging (MRI)tests of four Chinese patients with dystrophinopathy with edema changes in adductor longus muscles that mimics adductor en-thesopathy.Methods:Four boys,who were from four unrelated families and aged from 5 to 11 years, were investigated because of the clinical manifestations including myalgia or muscle weakness or the inci-dental findings of elevated serum creatine kinase levels,and were diagnosed with dystrophinopathy by gene test of Duchenne muscular dystrophy (DMD).Their creatine kinase levels were increased from 4 087 IU /L to 32 700 IU /L (Normal range:75 -175 IU /L).The muscle biopsy of three patients all demonstrated a dystrophic pattern including necrosis,regeneration,hypertrophy,atrophy and connective tissue proliferation,with different proportions of dystrophin-negative muscle fibers.The gene test of DMD showed an out-frame deletion of exons in three of the four patients,involving either exons 45 or exons 49 -52 deletion or exon 62 duplication,and c.2665 C >T with nonsense mutation in the other one. Muscle MRI tests of the bilateral thighs were performed with T1 weighed sequence and slow tau inversion recovery sequence.The degree of fatty infiltration changes was scored.Results:MRI of the thigh mus-cles showed mild to severe fatty infiltration changes in T1 weighed sequence with the total scores from 2 to 13.The most severe fatty infiltration changes were in the long head of biceps femoris and adductor mag-nus.Obvious hyperintensities appeared mainly in the adductor longus muscles on slow tau inversion re-covery (STIR)images in all the patients without any abnormal signals in the attachment of the ligament, indicating edema changes of the adductor longus muscles which mimiced adductor enthesopathy.Two of the four patients presented with edema changes in the bilateral adductor longus muscles,while the other two were with only unilateral changes.Furthermore,other thigh muscles,including adductor magnus, semitendinosus,sartorius and rectus femoris muscles,could also have mild edema changes in two of the four patients.Conclusion:Dystrophinopathy can manifest as edema changes in the adductor longus mus-cles in thigh muscle MRI tests,which is a typical lesion in adductor enthesopathy.The adductor longus muscles in the dystrophinopathy patients may be easy to be impaired due to traction injury during sports.

Objective: To investigate the differences of biochemical markers between the patients with pulmonary hypertension related to left heart disease (PH-LHD) and LHD; to explore the sensitive bio markers which may predict PH in LHD patients. Methods: A total of 355 LHD patients admitted to our hospital from 2014-01 to 2015-05 were enrolled. According to 2009 ESC/ERS guidelines, PH was deifned by pulmonary artery systolic pressure (PASP)>50 mmHg and patients were divided into 2 groups: LHD group,n=224 and PH-LHD group,n=131. The basic information with blood levels of biomarkers was recorded and their accuracy for predicting PH was analyzed. Results: The pathogenesis of LHD included 184 (51.83%) patients of coronary heart disease, 90 (25.35%) of dilated cardiomyopathy and 81 (22.81%) of cardiac valve heart disease. Compared with LHD group, PH-LHD group had increased ratio of NYHA III and IV degree (89.31% vs 45.54%), decreased LVEF [42.0 (33.0, 59.0) % vs 60.0 (42.0, 65.0) %], all P<0.001; PH-LHD group presented elevated blood levels of BNP, bilirubin, red cell distribution width (RDW), uric acid and cystatin C, while reduced lipoprotein (HDL), allP<0.001. PASP was positively related to biomarkers as BNP, bilirubin, RDW, uric acid and cystatin C, while negatively related to HDL. With the combination of BNP, direct bilirubin and RDW, the predictive value for PH-LHD under ROC curve was 0.828 with the sensitivity at 0.813, speciifcity at 0.708. Conclusion: Blood levels of biochemical markers were statistically different between the patients of PH-LHD and LHD; the combination of BNP, direct bilirubin and RDW showed the higher accuracy for predicting PH occurrence in LHD patients.

Objective To observe the clinical efficacy of fire-needle acupuncture in treating myofascial pain syndrome (MPS). Method Seventy-two patients with MPS were randomized into a treatment group and a control group, 36 in each group. The treatment group was intervened by fire-needle acupuncture, while the control group was by ordinary acupuncture. The short-form McGill Pain Questionnaire (MPQ) was observed before and after the intervention, and the clinical efficacy was compared. Result The total effective rate and markedly-effective rate were respectively 94.4% and 77.8% in the treatment group versus 80.6% and 30.6%in the control group. There was a significant difference in comparing the markedly-effective rate between the two groups (P<0.01). The MPQ item scores [pain rating index (PRI), present pain intensity (PPI), and visual analogue scale (VAS)] were significantly changed after intervention in both groups (P<0.05). After intervention, the MPQ item scores of the treatment group were significantly different from that of the control group (P<0.05). Conclusion Fire-needle acupuncture is an effective method in treating MPS.

Objective To observe the clinical efficacy of suspended moxibustion plus Chinese medication in treating icteric hepatitis. Method Ninety-two patients with icteric hepatitis were randomized into a treatment group and a control group, 46 in each group. The treatment group was intervened by suspended moxibustion plus oral administration of Chinese medication for supplementing yang, tonifying spleen, expelling dampness, and activating blood circulation;the control group was intervened only by the same Chinese medication. The symptom and sign score, and liver function items including TBil and ALT were observed, and the clinical efficacy was compared. Result The symptom and sign scores were significantly changed in both groups after intervention (P<0.05). After intervention, there was a significant difference in comparing the symptom and sign score between the two groups (P<0.05). The TBil and ALT levels were significantly changed after intervention in both groups (P<0.05). The recovery rate and total effective rate were respectively 87.0%and 95.7%in the treatment group versus 76.1%and 82.6%in the control group, and the inter-group differences were statistically significant (P<0.05). Conclusion Suspended moxibustion plus Chinese medication is an effective method in treating icteric hepatitis.