Objective To compare the mid- and long-term clinical results of mitral valve plasty (MVP) and mitral valve replacement (MVR) in the treatment of functional mitral regurgitation (FMR). Methods Patients with FMR who underwent surgical treatment in the Department of Cardiovascular Surgery of the General Hospital of Northern Theater Command from 2012 to 2021 were collected. The patients who underwent MVP were divided into a MVP group, and those who underwent MVR into a MVR group. The clinical data and mid-term follow-up efficacy of two groups were compared. Results Finally 236 patients were included. There were 100 patients in the MVP group, including 53 males and 47 females, with an average age of (61.80±8.03) years. There were 136 patients in the MVR group, including 72 males and 64 females, with an average age of (61.29±8.97) years. There was no statistical difference in baseline data between the two groups (P＞0.05). There was no statistical difference between the two groups in the extracorporeal circulation time, aortic occlusion time, postoperative hospital and ICU stay, intraoperative blood loss, or hospitalization death (P＞0.05), but the time of mechanical ventilation in the MVP group was significantly shorter than that in the MVR group (P=0.022). The total follow-up rate was 100.0%, the longest follow-up was 10 years, and the average follow-up time was (3.60±2.55) years. There were statistical differences in the left atrial diameter, left ventricular end-diastolic diameter, left ventricular end-systolic diameter and cardiac function between the two groups compared with those before surgery (P<0.05). The postoperative left ventricular ejection fraction in the MVP group was statistically higher than that before surgery (P=0.002), but there was no statistical difference in the MVR group before and after surgery (P=0.658). The left atrial diameter in the MVP group was reduced compared with the MVR group (P=0.026). The recurrence rate of mitral regurgitation in the MVP group was higher than that in the MVR group, and the difference was statistically significant (10.0% vs. 1.5%, P=0.003). There were 14 deaths in the MVP group and 19 in the MVR group. The cumulative survival rate (P=0.605) and cardiovascular events-free survival rate (P=0.875) were not statistically significant between the two groups by Kaplan-Meier survival analysis. Conclusion The safety, and mid- and long-term clinical efficacy of MVP in the treatment of FMR patients are better than MVR, and the left atrial and left ventricular diameters are statistically reduced, and cardiac function is statistically improved. However, the surgeon needs to be well aware of the indications for the MVP procedure to reduce the rate of mitral regurgitation recurrence.

ObjectiveTo analyze the relationship of the static single-leg stance balance with ankle muscles strength and position sense in individuals with functional ankle instability (FAI). MethodsFrom March to May, 2023, 44 FAI individuals were recruited in Hebei Normal University, and the maximum isokinetic muscle strength (60°/s and 180°/s) and position sense as ankle flexion, extension, inversion and eversion were measured using isokinetic dynamometer; while the center of pressure (COP) sway distance and envelope area were measured as static single-leg stance with eyes open or closed using three-dimensional force plate. ResultsThe maximum isokinetic torque as ankle eversion at 180°/s correlated with the COP anterior-posterior sway distance with eyes closed (r = -0.378, P < 0.05). ConclusionExplosive ankle eversion strength is related with the balance in static single-leg stance, which may help to evaluate and intervent the ankle function of FAI individuals.

AIM: To explore the mechanism of osthole on elderly spontaneously hypertensive rats. METHODS: 20-month-old spontaneously hypertensive rats (SHRs) and healthy Wistar-Kyoto (WKY) rats were purchased. SHRs were treated with osthole (i.g.) for 8 weeks. The systolic blood pressure and diastolic blood pressure of rats were monitored. Hematoxylin-eosin staining (H&E), periodic acid-schiff staining (PAS) and Masson staining were used to observe the pathological changes of rat kidney tissues. The activity of superoxide dismutase (SOD), malondialdehyde (MDA) and glutathione (GSH) in rat kidney was detected by ELISA kit. PI3K/Akt/mTOR signaling pathway related proteins were detected by western blot. RESULTS: Osthole reduced the systolic and diastolic blood pressure of SHRs, improved the histopathological changes of SHRs kidney, reduced the activity of MDA in SHRs kidney, and increased the activity of SOD and GSH. Osthole reduced the levels of p-PI3K, p-Akt and p-mTOR. CONCLUSION: Osthole reduces the activity of PI3K/Akt/mTOR signaling pathway and exerts a protective effect on renal oxidative stress injury in aged spontaneously hypertensive rats.

Objective To evaluate the incidence of postoperative atrial fibrillation (POAF) after dexmedetomidine and diazepam in patients undergoing coronary artery bypass grafting (CABG). Methods A retrospective cohort study was conducted in the patients who underwent CABG in the General Hospital of Northern Theater Command from October 2020 to June 2021. By propensity score-matching method, the incidence of POAF after dexmedetomidine and diazepam application in patients undergoing CABG was evaluated. Results Finally 207 patients were collected, including 150 males and 57 females, with an average age of 62.02±8.38 years. Among the 207 patients, 53 were treated with dexmedetomidine and 154 with diazepam before operation. There was a statistical difference in the proportion of hypertension patients and smoking patients between the two groups before matching (P<0.05). According to the 1∶1 propensity score-matching method, there were 53 patients in each of the two groups, with no statistical difference between the two groups after matching. After matching, the incidence of POAF in the dexmedetomidine group was lower than that in the diazepam group [9.43% (5/53) vs. 30.19% (16/53), P=0.007]. There was no death in the two groups during hospitalization, and there was no statistical difference in the main adverse events after operation. The ICU stay (21.28±2.69 h vs. 22.80±2.56 h, P=0.004) and mechanical ventilation time (18.53±2.25 h vs. 19.85±2.01 h, P=0.002) in the dexmedetomidine group were shorter. Regression analysis showed that age, smoking and diabetes were related to the increased incidence of POAF (P<0.05), and preoperative use of dexmedetomidine was associated with a reduced incidence of POAF (P=0.002). Conclusion For patients undergoing CABG, the incidence of POAF with dexmedetomidine before operation is lower than that with diazepam. Preoperative application of dexmedetomidine is the protective factor for POAF, and old age, smoking and diabetes are the risk factors for POAF.

Objective To investigate the safety and efficacy of mitral valve replacement combined with cryoablation Maze surgery in patients with atrial functional mitral regurgitation (AFMR). Methods From January 2014 to June 2020, patients with AFMR who underwent mitral valve replacement in our department were enrolled. They were divided into two groups, a cryoablation Maze group who received cryoablation Maze surgery during mitral valve replacement, and a non-cryoablation Maze group who did not receive cryoablation Maze surgery. The baseline data, surgical data, efficacy, and prognosis between the two groups were compared. Results Finally 85 patients were enrolled. There were 16 males and 24 females with an average age of 58.65±6.86 years in the cryoablation Maze group, and 24 males and 21 females with an average age of 61.29±8.30 years in the non-cryoablation Maze group. There was no statistical difference in baseline data between the two groups (P＞0.05). The aortic occlusion time and extracorporeal circulation time of the cryoablation Maze group were longer than those of the non-cryoablation Maze group with statistical differences (P＜0.01). There was no statistical difference in postoperative ICU retention time, ventilator assistance time, length of hospital stay, intraoperative blood loss, drainage volume on the first day or occurrence rate of complications (temporary pacemaker application, electrical cardioversion, thoracic puncture drainage, hospitalization death) between the two groups (P＞0.05). At the time of discharge, postoperative 3-month, 6-month, 12-month, and 24-month, the maintenance rates of sinus rhythm in the non-cryoablation Maze group were statistically different from those of the cryoablation Maze group (P＜0.001). Compared with the non-cryoablation Maze group, the decrease values of left atrial diameter, left ventricular end-diastolic diameter, left ventricular end-systolic diameter and pulmonary artery systolic pressure were statistically different (P＜0.05). Postoperative cardiac function grading of both groups was grade Ⅰ or Ⅱ, which was significantly improved compared with preoperative level, but there was no statistical significance between the two groups (P＞0.05). There was no statistical difference in the incidence of adverse events during follow-up (P＞0.05). Conclusion Cryoablation Maze surgery combined with mitral valve replacement is safe and effective in the treatment of AFMR patients, which is conducive to the recovery and maintenance of sinus rhythm, and is beneficial to the remodeling of the left atrium and left ventricle, the reduction of pulmonary systolic blood pressure, and the improvement of life quality of the patients.

Objective To investigate the risk of diabetes mellitus in ABO blood type.Methods The da-ta of 1306397 healthy physical subjects in the Department of Health Management of the First Affiliated Hos-pital of Army Medical University from 2006 to 2018 were retrospectively analyzed,including gender,age, height,weight,blood glucose,blood lipid and ABO blood type.A total of 61296 subjects with both blood type and fasting blood glucose data were selected as the study population.Multivariable logistic regression was used to analyze the risk of diabetes in different ABO blood types.Results There were significant differences in gender,age and BMI distribution between the total population and the study population (P<0.05).The num-ber of patients with diabetes and prediabetes in the study population was 2649 (4.3％) and 3979 (6.5％),re-spectively.There were significant differences in the distribution of cholesterol,low-density lipoprotein choles-terol (LDL-C),diabetes and pre-diabetes among people with different blood types (P<0.05).Multivariate lo-gistic regression analysis showed that compared with type O blood,type A blood had an increased risk of dia-betes (OR=1.38,95％CI:1.02-1.86,P=0.04),while type B blood (OR=1.28,95％CI:0.93-1.77,P=0.13) and type AB blood (OR=1.33,95％CI:0.83-2.11,P=0.23) did not increase the risk of diabetes. Conclusion Early screening of type A blood population and preventive treatment and intervention can be used to reduce the incidence of diabetes.

Objective To explore the effect of targeted silencing wild-type p53-induced phosphatase 1(Wip1)on paclitaxel(PTX)chemosensitivity of ovarian cancer cell line A2780.Methods The ovarian cancer cell lines A2780 served as the research object,the stable cell line Wip1-sgRNA with low expression of Wip1 was constructed by infecting cell line A2780 with lentivirus(Wip1-sgRNA group),while the control cell line was NC-sgRNA(NC-sgRNA group).The cells were treated with PTX at appropriate time and divided into the Wip1-sgRNA+PTX group and NC-sgRNA+PTX group.The CCK8 method was used to detect the cell proliferation ability,the flow cytometry was used to detect the cell apoptosis,and the Transwell invasion assay was used to detect the cell invasion ability.Results Compared with the NC-sgRNA group,the expression lev-els of Wip1 mRNA and protein in the Wip1-sgRNA group were significantly down-regulated(P＜0.001).Un-der the condition of PTX gradient treatment for the same time,the cell survival rate of the Wip1-sgRNA group was significantly lower than that of the NC-sgRNA group(P＜0.001).The half maximal inhibitory concentration(IC50)of PTX in cells of the Wip1-sgRNA group at 48 h was significantly lower than that of the NC-sgRNA group(P＜0.001).Compared with the NC-sgRNA group,the proliferation ability of the Wip1-sgRNA group was significantly weakened(P＜0.001),the rate of cellular apoptosis was significantly in-creased(P＜0.001),and the number of transmenbrane cells was significantly decreased(P＜0.001).After PTX treatment,the proliferation ability was weakened compared with corresponding control groups,the rate of cellular apoptosis was significantly increased,and the number of transmenbrane cells was significantly de-creased;additionally,compared with the NC-sgRNA+PTX group,the cellular proliferation ability of the Wip1-sgRNA+PTX group was significantly weakened(P＜0.001),the rate of cellular apoptosis was signifi-cantly increased(P＜0.001),and the number of transmenbrane cells was significantly decreased(P＜0.001).Conclusion Wip1 gene silencing could increase the chemosensitivity of human ovarian cancer cell lines A2780 to PTX.

RAS, a member of the small GTPase family, functions as a binary switch by shifting between inactive GDP-loaded and active GTP-loaded state. RAS gain-of-function mutations are one of the leading causes in human oncogenesis, accounting for ∼19% of the global cancer burden. As a well-recognized target in malignancy, RAS has been intensively studied in the past decades. Despite the sustained efforts, many failures occurred in the earlier exploration and resulted in an 'undruggable' feature of RAS proteins. Phosphorylation at several residues has been recently determined as regulators for wild-type and mutated RAS proteins. Therefore, the development of RAS inhibitors directly targeting the RAS mutants or towards upstream regulatory kinases supplies a novel direction for tackling the anti-RAS difficulties. A better understanding of RAS phosphorylation can contribute to future therapeutic strategies. In this review, we comprehensively summarized the current advances in RAS phosphorylation and provided mechanistic insights into the signaling transduction of associated pathways. Importantly, the preclinical and clinical success in developing anti-RAS drugs targeting the upstream kinases and potential directions of harnessing allostery to target RAS phosphorylation sites were also discussed.

Objective To investigate the clinical values of detection of plasma miRNA-544a (miR-544a) expression level in the diagnosis and treatment of lung cancer.Methods A total of 110 patients diagnosed with lung cancer in Ⅰ-Ⅱ stage from June 2017 to March 2018 in Shiyan Taihe Hospital were collected,and 35 patients with benign pulmonary nodules and 64 healthy people were also collected as the controls.Realtime quantitative polymerase chain reaction (RT-qPCR) was used to detect the level of miR-S44a in plasma of 64 healthy people,110 patients with lung cancer (50 newly diagnosed patients without anti-tumor treatment,33 patients one week after radical resection,27 patients after one week chemotherapy with the same dose) and 35 patients with benign pulmonary nodules.Of the 50 newly diagnosed patients,42 cases were non-small cell lung cancer and 8 cases were small cell lung cancer.The plasma expression level of miR-544a in each group was compared by using Mann-Whitney U test,and the efficacy of miR-544a in the diagnosis of lung cancer was evaluated by the receiver operationg characteristic (ROC) curve and the area under the curve (AUC).Results The plasma expression levels of miR-544a in the newly diagnosed untreated lung cancer group,one week after operation group,one week chemotherapy group,healthy control group and benign pulmonary nodule group were 1.40 nmol/L (0.55 nmol/L,8.76 nmol/L),33.52 nmol/L (3.64 nmol/L,250.47 nmo/L),8.87 nmol/L (0.68 nmol/L,125.43 nmol/L),0.31 nmol/L (0.17 nmol/L,1.19 nmol/L),1.04 nmol/L (0.31 nmol/L,4.62 nmol/L),respectively,and the differences between untreated lung cancer group and the other 4 groups were statistically significant (Z =-4.483,P ＜ 0.001;Z =-4.274,P ＜ 0.001;Z =-2.562,P =0.01;Z =-2.152,P =0.031).The expression levels of miR-544a in non-small cell lung cancer group and small cell lung cancer group were 1.40 nmol/L (0.66 nmol/L,8.76 nmol/L) and 1.37 nmol/L (0.26 nmol/L,36.97 nmol/L),respectively.The differences between non-small cell lung cancer group and healthy control group and benign pulmonary nodule group were statistically significant (Z =-4.463,P ＜ 0.001;Z =-2.026,P =0.043).Compared with the healthy people,the AUC of miR-544a for diagnosing the lung cancer was 0.841,the sensitivity was 87.5 ％,and the specificity was 68.0 ％.Compared with the benign pulmonary nodule,the AUC for diagnosing lung cancer was 0.638,the sensitive was 45.7 ％,and the specificity was 80.0 ％.Conclusions The plasma expression level of miR-544a has certain significances in the differential diagnosis of early stage lung cancer and benign pulmonary nodules and healthy people,and it can be used as a potential biomarker for diagnosing early stage lung cancer,especially for the non-small cell lung cancer.The plasma expression of miR-544a is increased after surgery or chemotherapy,suggesting that its expression may be related to the occurrence and development of lung cancer,and miR-544a may become a new target for cancer treatment.

Objective To construct the Wip1 gene recombinant lentiviral expression vector and to investigate its effects on breast cancer cell biological behaviors .Methods Wip1 gene short hairpin RNAs (shRNA) was transfected into breast cancer MCF-7 cells through lentiviral infection method .Wip1 mRNA and protein expressions before and after transfection were detected by u-sing qRT-PCR and Western blotting .The effects of Wip1-shRNA on the proliferation ,apoptosis ,cell cycle ,invasion and metastasis in MCF-7 cells were determined by using the MTT assay ,flow cytometry and transwell invasion test .Interfering RNA molecule p53dsRNA inhibiting p53 gene expression (p53 dsRNA) was screened ,and the effect of p53 inhibition on MCF-7 cells invasion and metastasis was analyzed .Results After transfection for 48 h ,the cellular fluorescence in the Wip1-shRNA group was stronger , while which in the NC-shRNA group was weaker .Cellular Wip1 mRNA and protein expressions in the Wip1 shRNA group were 0 .291 ± 0 .025 and 0 .203 ± 0 .021 respectively ,which in the NC-shRNA group were 0 .954 ± 0 .090 and 0 .963 ± 0 .092 respectively , the difference between the two groups was statistically significant (P<0 .05) .The cellular survival rate at various time points had statistical difference between the two groups (P<0 .05) .The early and late cell apoptosis number in the NC-shRNA group was less than that in the Wip1-shRNA group ,the difference was statistically significant (P<0 .05) .The cells numbers at phase G0 +G1 and phase S in the NC-shRNA group were 53 .5 ± 3 .6 and 27 .3 ± 1 .5 respectively ,which in the Wip-shRNA group were 72 .3 ± 5 .2 and 14 .6 ± 0 .8 respectively ,the difference was statistically significant(P<0 .05) .The Transwell invasion and metastasis results showed that the cell transmembrane number in the NC-shRNA group was more than that in the Wip1-shRNA group(P<0 .05) .The cellu-lar p53 mRNA and protein expression had statistical difference between the control group and p53dsRNA group(P<0 .05) .Conclu-sion RNA interference can effectively suppress Wip1 expression in MCF-7 cells .Wip1 may affect the proliferation ,apoptosis ,cell cycle ,invasion and metastasis of breast cancer cells by modulating protein expression .p53dsRNA increases the invasion and metas-tasis ability of breast cancer MCF-7 cells by interfering p53 gene down-regulation .