Background::Acute coronary syndromes mainly result from abrupt thrombotic occlusion caused by atherosclerotic vulnerable plaques (VPs) that suddenly rupture or erosion. Fibrous cap thickness (FCT) is a major determinant of the propensity of a VP to rupture and is recognized as a key factor. The intensive use of statins is known to have the ability to increase FCT; however, there is a risk of additional adverse effects. However, lower dose statin with ezetimibe is known to be tolerable by patients. The present study aimed to investigate the effect of intensive statin vs. low-dose stain + ezetimibe therapy on FCT, as evaluated using optical coherence tomography. Method::Patients who had VPs (minimum FCT <65 μm and lipid core >90°) and deferred from intervention in our single center from January 2014 to December 2018 were included in the trial. They were divided into the following two groups: intensive statin group (rosuvastatin 15-20 mg or atorvastatin 30-40 mg) and combination therapy group (rosuvastatin 5-10 mg or atorvastatin 10-20 mg + ezetimibe 10 mg). At the 12-month follow-up, we compared the change in the FCT (ΔFCT%) between the two groups and analyzed the association of ΔFCT% with risk factors. Fisher exact test was used for all categorical variables. Student’s t test or Mann-Whitney U-test was used for analyzing the continuous data. The relationship between ΔFCT% and risk factors was analyzed using linear regression analysis. Result::Total 53 patients were finally enrolled, including 26 patients who were in the intensive statin group and 27 who were in the combination therapy group. At the 12-month follow-up, the serum levels of total cholesterol (TC), total triglyceride, low-density lipoprotein (LDL-C), hypersensitive C-reactive protein (hs-CRP), and lipoprotein-associated phospholipase A2 (Lp-PLA2) levels were reduced in both the groups. The ΔTC%, ΔLDL-C%, and ΔLp-PLA2% were decreased further in the combination therapy group. FCT was increased in both the groups (combination treatment group vs. intensive statin group: 128.89 ± 7.64 vs. 110.19 ± 7.00 μm, t = -9.282, P < 0.001) at the 12-month follow-up. The increase in ΔFCT% was more in the combination therapy group (123.46% ± 14.05% vs. 91.14% ± 11.68%, t = -9.085, P < 0.001). Based on the multivariate linear regression analysis, only the serum Lp-PLA2 at the 12-month follow-up ( B = -0.203, t = -2.701, P = 0.010), ΔTC% ( B = -0.573, t = -2.048, P = 0.046), and Δhs-CRP% ( B = -0.302, t = -2.963, P = 0.005) showed an independent association with ΔFCT%. Conclusions::Low-dose statin combined with ezetimibe therapy maybe provide a profound and significant increase in FCT as compared to intensive statin monotherapy. The reductions in Lp-PLA2, ΔTC%, and Δhs-CRP% are independently associated with an increase in FCT.

目的:观察高压氧（HBO）联合醒脑静治疗对急性一氧化碳中毒迟发脑病（ACMPDE）患者血清神经损伤因子、血清炎症因子及认知功能的影响。方法:选择2018年7月至2020年7月于南宁市第一人民医院治疗的106例ACMPDE患者作为研究对象，按照随机数字表法分为研究组和对照组，每组53例。对照组患者给予HBO治疗，研究组患者在对照组治疗基础上联合醒脑静治疗，连续治疗20 d。检测治疗前后2组患者C反应蛋白（CRP）、白细胞介素-6（IL-6）、白细胞介素-10（IL-10）、肿瘤坏死因子-α（TNF-α）、神经元特异性烯醇化酶（NSE）、5-羟色胺（5-HT）、血管生成素-2（Ang-2）、诱导型一氧化氮合酶（iNOS）、丙二醛（MDA）、超氧化物歧化酶（SOD）的水平；采用蒙特利尔认知评估量表（MoCA）、简易智力状态检查量表（MMSE）及健康调查简表（SF-36）评价2组患者认知功能和生活质量；比较2组患者治疗后临床疗效。结果:治疗后，研究组CRP、TNF-α、IL-6水平低于对照组（ P<0.01），IL-10水平高于对照组（ P<0.01），5-HT水平高于对照组（ P<0.01），NSE、Ang-2、iNOS水平低于对照组（ P<0.01），SOD水平高于对照组（ P<0.01），MDA水平低于对照组（ P<0.01），MMSE、MoCA、SF-36评分高于对照组（ P<0.01）。研究组治疗后总有效率（98.11%）明显高于对照组（84.91%），差异有统计学意义（ χ2=4.371， P=0.037）。 结论:HBO联合醒脑静治疗可改善ACMPDE患者血清神经损伤因子水平，抑制炎症反应，减轻神经损伤，降低氧化应激反应，改善患者认知功能和生活质量，值得临床推广应用。

目的 对栀子遗传多样性进行研究,为栀子资源保护和新品种培育提供依据.方法 采用12条ISSR和9对SRAP分子标记,以3个居群21份栀子种质资源为材料,通过多态性检测水平、遗传多样性比较和聚类分析,揭示栀子种质资源遗传多样性.结果 ISSR引物和SRAP引物分别扩增出125和80条带数,多态性条带数分别为100和74,多态性比率(PPB)分别为80.00％和92.50％,栀子居群的总体物种水平的等位基因观察数(Na)分别为1.461 3和1.579 2,有效等位基因数(Ne)分别为1.3077和1.3421,Nei's基因多样性指数(H)分别为0.173 1和0.1974,Shannon’s指数(I)分别为0.254 5和0.2959;遗传多样性分析结果表明,ISSR和SRAP标记中3个居群之间的遗传多样性(Ht)分别为0.239 1和0.289 9,种间遗传多样性(Hs)分别为0.173 1和0.197 4,基因分化系数(Gst)分别为0.276 2和0.318 9,即72.38％和68.11％的遗传变异在种群内进行,居群间基因流(Nm)分别为1.310 3和1.068 0,证明居群间存在一定的基因流动(Nm＞1);UPGMA聚类分析表明,ISSR和SRAP标记将栀子资源分为2个类群,且以SRAP分析的聚类结果更符合实际居群.结论取样栀子种质有丰富的遗传多样性,遗传分化主要发生在居群内,SRAP标记更适合用于栀子遗传多样性分析,对栀子资源的保护和育种提供了参考.

探讨互联网+急性心肌梗死规范化快速救治体系(ISRTS)对急性ST段抬高型心肌梗死(STEMI)患者经皮冠状动脉介入治疗(PCI)急救预后的影响.方法 采用回顾性非同期队列研究方法.郑州市第一人民医院自2017年11月开始实施ISRTS及流程,选取未实施ISRTS之前的2017年4月至2017年10月收治可行PCI的STEMI患者为对照组(106例),采用传统模式进行常规救治;选取2017年11月至2018年5月收治可行PCI的STEMI患者为观察组(110例),采取ISRTS及流程进行救治.比较两组患者的一般资料、快速反应指标、入院时病情程度指标、住院期间并发症、社会效益指标、术后6个月主要不良心脏事件等.结果 观察组的快速反应指标(发病至呼救120时间、发病至首次心电图完成时间、发病至入院时间、入院至首次心肌酶完成时间、入门-球囊扩张时间、首次医疗接触到血管开通时间)均短于对照组(P均＜0.001),入院时病情程度指标(cTnI、NT-proBNP、LVEF、LVESD、LVEDD、hs-CRP)均轻于对照组(P均＜0.01),主动脉球囊反搏应用率低于对照组(P＜0.05),社会效益指标(药占比、平均住院费用、平均住院时间、患者满意度)均优于对照组(P均＜0.001),住院期间并发症(心功能不全、心源性休克、室壁瘤、恶性心律失常及总并发症)发生率低于对照组(P均＜0.05),术后6个月主要不良心脏事件低于对照组(P＜0.001).结论 ISRTS建立优化STEMI救治流程,提高救治效率,缩短心肌再灌注时间,减少并发症,有效改善STEMI患者的临床预后,创造了良好的社会效益.

人类 β-地中海贫血的发病机制与 β-样珠蛋白基因异常表达息息相关.人类 β-样珠蛋白基因以5'-ε-Gγ-Aγ-δ-β-3'的顺序排列于β-珠蛋白基因座,受5'LCR(locus control region)中5个超敏位点(hypersensitive site,HS)5'HS5～5'HS1和3'HS1调控.其中5'HS2是最重要的增强子,能产生增强子RNA(enhancer RNA)并调控ε-globin、γ-globin和β-globin的表达.为了进一步探究K562细胞中增强子5'HS2的功能,本研究首先通过染色质构象捕获技术在人慢性髓原白血病K562细胞中探测到5'HS2介导的染色质相互作用集中在以包含CTCF(CCCTC-binding factor)位点的3'HS1和5'HS5为边界的拓扑结构域中,5'HS2在三维空间上与HBE1、HBG2和HBG1启动子区域相互靠近.其次运用CRISPR DNA片段编辑技术在K562细胞系中删除了增强子5'HS2.最后通过RNA-seq和CUT&Tag(cleavage under target&tagmentation)实验分析两个5'HS2删除的单克隆细胞系的转录组和染色质H3K27ac组蛋白修饰,发现91个基因表达显著下调而且其启动子区的H3K27ac修饰程度显著降低.这些基因主要聚类于氧气运输、免疫应答、细胞粘附、抗氧化和维持血栓形成等与红细胞功能相关的生物过程中,表明K562细胞系中增强子5'HS2对红细胞功能相关基因的转录产生了广泛影响.