Identification of immune feature genes and intercellular profiles in diabetic cardiomyopathy

BACKGROUND Diabetic cardiomyopathy(DCM)is a multifaceted cardiovascular disorder in which immune dysregulation plays a pivotal role.The immunological molecular mechanisms underlying DCM are poorly understood.AIM To examine the immunological molecular mechanisms of DCM and construct diagnostic and prognostic models of DCM based on immune feature genes(IFGs).METHODS Weighted gene co-expression network analysis along with machine learning methods were employed to pinpoint IFGs within bulk RNA sequencing(RNA-seq)datasets.Single-sample gene set enrichment analysis(ssGSEA)facilitated the analysis of immune cell infiltration.Diagnostic and prognostic models for these IFGs were developed and assessed in a validation cohort.Gene expression in the DCM cell model was confirmed through real time-quantitative polymerase chain reaction and western blotting techniques.Additionally,single-cell RNA-seq data provided deeper insights into cellular profiles and interactions.RESULTS The overlap between 69 differentially expressed genes in the DCM-associated module and 2483 immune genes yielded 7 differentially expressed immune-related genes.Four IFGs showed good diagnostic and prognostic values in the validation cohort:Proenkephalin(Penk)and retinol binding protein 7(Rbp7),which were highly expressed,and glucagon receptor and inhibin subunit alpha,which were expressed at low levels in DCM patients(all area under the curves>0.9).SsGSEA revealed that IFG-related immune cell infiltration primarily involved type 2 T helper cells.High expression of Penk(P<0.0001)and Rbp7(P=0.001)was detected in cardiomyocytes and interstitial cells and further confirmed in a DCM cell model in vitro.Intercellular events and communication analysis revealed abnormal cellular phenotype transformation and signaling communication in DCM,especially between mesenchymal cells and macrophages.CONCLUSION The present study identified Penk and Rbp7 as potential DCM biomarkers,and aberrant mesenchymal-immune cell phenotype communication may be an important aspect of DCM pathogenesis.

长岛型掌跖角化病:SERPINB7基因突变位点研究

目的报道2例长岛型掌跖角化病,确定其致病基因突变。方法收集患者及其中1例母亲外周血和临床资料,提取基因组DNA,PCR扩增SERPINB7基因8个外显子及其侧翼序列,对扩增产物进行DNA测序以查找基因突变位点。结果 2例患者均存在SERPINB7基因c.796C>T杂合突变伴c.455G>T杂合突变,前者可导致编码蛋白质第266位氨基酸出现终止改变(p.R266*),后者可导致第6外显子第1个核苷酸发生改变,使得该外显子的剪接受体位点消失。例1患者母亲为c.455G>T杂合突变而不伴另一突变。正常对照未见这2种突变。结论 SERPINB7基因的c.796C>T和c.455G>T突变是引起2例患者长岛型掌跖角化病的原因。

Impact of homeobox genes in gastrointestinal cancer

Homeobox genes, including HOX and non-HOX genes, have been identified to be expressed aberrantly in solid tumors. In gastrointestinal(GI) cancers, most studies have focused on the function of non-HOX genes including caudal-related homeobox transcription factor 1(CDX1) and CDX2. CDX2 is a crucial factor in the development of pre-cancerous lesions such as Barrett's esophagus or intestinal metaplasia in the stomach, and its tumor suppressive role has been investigated in colorectal cancers. Recently, several HOX genes were reported to have specific roles in GI cancers; for example, HOXA13 in esophageal squamous cell cancer and HOXB7 in stomach and colorectal cancers. HOXD10 is upregulated in colorectal cancer while it is silenced epigenetically in gastric cancer. Thus, it is essential to examine the differential expression pattern of various homeobox genes in specific tumor types or cell lineages, and understand their underlying mechanisms. In this review, we summarize the available research on homeobox genes and present their potential value for the prediction of prognosis in GI cancers.

SERPINB7基因纯合突变的长岛型掌跖角化症一例

15岁男性患者,双手足出生即出现弥漫性红斑伴角化,家族中无类似病史,父母非近亲结婚。全外显子测序:SERPINB7基因c.522-523insT(p.Val175Cysfs^(*)46)纯合突变,先证者父母为杂合突变。诊断:长岛型掌跖角化症。

Prevalence of shiga toxins(stx_1,stx_2),eaeA and hly genes of Escherichia coli O157:H7 strains among children with acute gastroenteritis in southern of Iran

Objective:To survey the prevalence severe diarrhea arising from these bacteria in children under 5 years old in Marvdasht.Methods:In this study faecal sample from 615 children aged <5years old who were hospitalized lor gastroenteritis in Fars hospitals in Iran were collected and then enriched in Escherichia coli(E.coli) broth and modified tryplone soy broth with novobiocin media,fermentation of sorbitol,lactose and β— glucoronidase activity of isolated strains was examined by CT—SMAC,VRBA and chromogenic media respectively.Then isolation of E.coli O157:H7 have been confirmed with the use of specific antisera and with multiplex PCR method presence of virulence genes including:xtx_1.stx_2,eae.A.hly has been analyzed.Results:E.coli O157:H7 was detected in 7(1.14%) stool specimens.A significanl difference was seen between detection rale of isolated bacteria from age groups 18-23 months and other age groups(P=0.004).Out of considered virulence genes.only 1 of the isolated strains(0.16%)he stx,and eaeA genes were seen and also all isolated hacleria had resistance to penicillin,ampicillin and erythromycin antibiotics.Conclusions:We found thai children < 2 years of age were at highest risk of infection with E.coli O157:H7.Regarding severity of E.coli O157:H7 pathogenesis,low infectious dose and lack of routine assay for detection ol these bacleria in clinical laboratory,further and completed studies on diagnosis and genolyping of this E.coli O157:H7 strain has been recommended.

Sequence Analysis of Type III Effector tccP and tccP2 Genes in Escherichia coli O157:H7 from Chinese Water-chestnut

[Objective] This study aimed to analyze the type III effector tccP and tccP2 genes in Escherichia coli O157：H7 from Chinese water-chestnut. [Method] Gene-specific and locus-specific primers were utilized to amplify tccP/tccP2 and their flanking regions for sequence analysis. [Result] E. coli O157：H7 CWN11 harbored intact tccP and tccP2 genes, however, the number of proline-rich repeats in tccP gene was only one that probably resulted in biological incapability, whereas, the tccP2 gene consisted of five and half proline-rich repeats and could encode functional protein. [Conclusion] Here, we reported the first sequence of tccP gene that consisted of only one proline-rich repeat and tccP2 was assumed to play a crucial role in colonization and subsequent signaling cascades.

长岛型掌跖角化病:一例纯合缺失的SERPINB7基因突变

目的报道1例长岛型掌跖角化病,确定其致病基因突变。方法在先证者家系调查的基础上,收集家系患者和正常人的血样,并采集正常对照血样100份,采取聚合酶链反应技术对长岛型掌跖角化病致病基因SERPINB7基因进行扩增,并对其产物进行测序。结果先证者存在SERPINB7基因7号外显子的c.650-653delCTGT(p.S217Lfs*7)纯合突变。先证者父母为杂合缺失。结论 SERPINB7基因的c.650-653delCTGT(p.S217Lfs*7)纯合突变是引起患者长岛型掌跖角化病的原因,这是该疾病、该位点作为纯和突变的首次报道。

Antimicrobial Effects of Plant Compounds against Virulent <i>Escherichia coli</i>O157:H7 Strains Containing Shiga Toxin Genes in Laboratory Media and on Romaine Lettuce and Spinach

Escherichia coli strains produce Shiga-toxins Stx-1 and Stx-2 that contribute to their virulence. The objective was to evaluate antimicrobial activities of plant essential oils (oregano, cinnamon, lemongrass), their active components (carvacrol, cinnamaldehyde, citral) and plant-extracts (green tea polyphenols, apple skin, black tea, decaffeinated black tea, grapeseed and pomace extracts) against E. coli O157:H7 strains containing Stx-1 and Stx-2 genes, as determined by Multiplex Polymerase Chain Reaction, in vitro and on leafy greens. Antimicrobials at various concentrations in sterile PBS were added to bacterial cultures (~3 - 4 logs CFU/ml), mixed thoroughly, and incubated at 37°C. Surviving bacteria were enumerated at 0, 1, 3, 5 and 24 h. The most effective essential oil (oregano oil;0.5%) and plant extract (green tea;3%) were evaluated against E. coli O157:H7 on romaine lettuce and spinach stored at 4°C for 7 days. Microbial survival was a function of the concentration of antimicrobials and incubation times. All antimicrobials reduced bacterial population to below detection levels in vitro;however, essential oils and active components exhibited greater activity than plant extracts. Oregano oil and green tea reduced E. coli O157:H7 on lettuce and spinach to below detection. Plant-based antimicrobials have the potential to protect foods against E. coli O157:

Construction of genetically engineered macrophages expressing Smad6 and Smad7 genes with adeno-associated virus

Objective: To construct the genetically engineered macrophages expressing Smad6 and Smad7 genes with adeno-associated virus (AAV). Methods: The plasmids containing pcDNA3-Smad6/Flag and pcDNA3-Smad7/Flag were digested with BamHⅠ and XhoⅠ, respectively. Then the Smad6/Flag and Smad7/Flag gene segments obtained were cloned into plasmid pAAV-MCS respectively to construct the recombinant pAAV-Smad6/Flag and pAAV-Smad7/Flag plasmids. The resulting recombinant plasmids (pAAV-Smad6/Flag or pAAV-Smad7/Flag) or pAAV-LacZ plasmid were co-transfected into the HEK 293cells with pHelper and pAAV-RC by calcium-phosphate precipitation method. Recombinant AAV-2 viral particles were prepared from infected HEK293 cells and then were used to infect mouse macrophages. The expressions of Smad6 and Smad7 in macrophages were detected by immunocytochemical staining and expression of b-galactosidase was evaluated by X-gal staining. Results: The recombinant AAV vector containing Smad6 or Smad7 genes was successfully constructed. More than 95% macrophage cells expressed X-gal and Smad6 and Smad7 genes at 72 h after infection. Conclusion: These results indicate that the genetically engineered macrophages can express Smad6 and Smad7 proteins effectively, laying the foundation for the studies of TGF-β-induced diseases in vivo and highlighting the feasibility of macrophage-based gene therapy.

Prediction of Tumor Microenvironment Characteristics and Treatment Response in Lung Squamous Cell Carcinoma by Pseudogene OR7E47P-related Immune Genes

Objective Pseudogenes are initially regarded as nonfunctional genomic sequences,but some pseudogenes regulate tumor initiation and progression by interacting with other genes to modulate their transcriptional activities.Olfactory receptor family 7 subfamily E member 47 pseudogene(OR7E47P)is expressed broadly in lung tissues and has been identified as a positive regulator in the tumor microenvironment(TME)of lung adenocarcinoma(LUAD).This study aimed to elucidate the correlation between OR7E47P and tumor immunity in lung squamous cell carcinoma(LUSC).Methods Clinical and molecular information from The Cancer Genome Atlas(TCGA)LUSC cohort was used to identify OR7E47P-related immune genes(ORIGs)by weighted gene correlation network analysis(WGCNA).Based on the ORIGs,2 OR7E47P clusters were identified using non-negative matrix factorization(NMF)clustering,and the stability of the clustering was tested by an extreme gradient boosting classifier(XGBoost).LASSO-Cox and stepwise regressions were applied to further select prognostic ORIGs and to construct a predictive model(ORPScore)for immunotherapy.The Botling cohorts and 8 immunotherapy cohorts(the Samstein,Braun,Jung,Gide,IMvigor210,Lauss,Van Allen,and Cho cohorts)were included as independent validation cohorts.Results OR7E47P expression was positively correlated with immune cell infiltration and enrichment of immune-related pathways in LUSC.A total of 57 ORIGs were identified to classify the patients into 2 OR7E47P clusters(Cluster 1 and Cluster 2)with distinct immune,mutation,and stromal programs.Compared to Cluster 1,Cluster 2 had more infiltration by immune and stromal cells,lower mutation rates of driver genes,and higher expression of immune-related proteins.The clustering performed well in the internal and 5 external validation cohorts.Based on the 7 ORIGs(HOPX,STX2,WFS,DUSP22,SLFN13,GGCT,and CCSER2),the ORPScore was constructed to predict the prognosis and the treatment response.In addition,the ORPScore was a better prognostic factor and correlated positively with the immunotherapeutic response in cancer patients.The area under the curve values ranged from 0.584 to 0.805 in the 6 independent immunotherapy cohorts.Conclusion Our study suggests a significant correlation between OR7E47P and TME modulation in LUSC.ORIGs can be applied to molecularly stratify patients,and the ORPScore may serve as a biomarker for clinical decision-making regarding individualized prognostication and immunotherapy.

SERPINB7复合杂合突变所致长岛型掌跖角化症家系1例报道

对1例长岛型掌跖角化症(NPPK)患儿及其家系进行全外显子组测序。患儿,男,8岁,自3岁起双手足出现弥漫性红斑、角化、脱屑、多汗、异味。全外显子组测序检测到丝氨酸蛋白酶抑制剂B7(SERPINB7)基因c.796C>T(p.R266*)及c.455G>T(p.G152V)的复合杂合突变。患儿父亲携带c.796C>T,p.R266*杂合突变,双手足可见弥漫性红斑;患儿母亲携带c.455G>T,p.G152V杂合突变,无明显临床异常表现。结合患儿临床及基因检测均诊断为NPPK。SERPINB7基因的c.796C>T及c.455G>T的复合杂合突变是引起本例患儿NPPK的原因。

长岛型掌跖角化病二例 SERPINB7基因突变研究

目的：报告2例长岛型掌跖角化病，确定其致病基因突变。方法收集患者及其父母外周血和临床资料，提取基因组 DNA，PCR 扩增 SERPINB7基因8个外显子及其侧翼序列，对扩增产物进行 DNA 测序以查找基因突变位点，并以200例无关健康人 DNA 作为对照进行扩增测序。结果2例患者均存在 SERPINB7基因 c.796C 〉 T 纯合突变，导致编码蛋白质第266位氨基酸出现终止改变（p.R266＊），其父母均为 c.796C 〉 T 杂合突变，而无关健康对照未发现上述突变。结论 SERPINB7基因的 c.796C 〉 T 突变可能是引起2例患者长岛型掌跖角化病的原因。

SERPINB7基因突变长岛型掌跖角化病一家系3例临床研究

目的总结一家系3例SERPINB7基因突变长岛型掌跖角化病患者及先证者父母SERPINB7基因突变情况。方法采集该家系3例掌跖角化病患者(先证者及其姐姐、叔叔)及先证者父母的外周血,提取基因组DNA,采用高通量测序法检测皮肤病相关基因各外显子编码区域的序列变异情况,对致病性变异经PCR-Sanger测序验证,并与100例健康者进行比较。结果先证者及其姐姐、叔叔临床表现为双手掌、双足足底红斑基础上角化过度。基因测序显示,先证者及其姐姐、叔叔SERPINB7基因携带c.336+2T>G和c.522dupT位点复合杂合突变,先证者父亲携带c.522dupT(p.V175Cfs*45)杂合移码突变,先证者母亲携带c.336+2T>G(splicing)杂合剪切突变;100例健康对照均未见c.336+2T>G(splicing)杂合剪切突变和c.522dupT位点杂合移码突变。结论 SERPINB7基因c.336+2T>G和c.522dupT位点的复合杂合突变可能是该家系3例长岛型掌跖角化病患者的致病原因。

缺血性脑卒中铁死亡特征基因NFE2L2的鉴定与验证

背景:铁死亡与缺血性脑卒中的发病密切相关,靶向铁死亡是一种治疗缺血性脑卒中有前景的方案,但具体调控靶点尚不明确。目的:通过生物信息学和机器学习方法筛选缺血性脑卒中铁死亡相关特征基因,并通过细胞实验进行验证,探讨铁死亡在缺血性脑卒中的作用。方法:基于GEO数据库和FerrDb数据库选取符合条件的缺血性脑卒中相关数据集和铁死亡表达数据集,通过t检验筛选铁死亡相关差异基因。对铁死亡相关差异基因进行GO功能富集分析与KEGG信号通路富集分析。通过PPI网络分析和机器学习筛选缺血性脑卒中铁死亡的特征基因,利用ROC分析和GSEA分析探究特征基因的准确性和生物功能。然后进行细胞实验,将HT22细胞分为对照组与缺血性脑卒中组,对照组不作任何干预,缺血性脑卒中组加入0.1 mol/L的H_(2)O_(2)干预24 h诱导细胞氧化应激和铁死亡,通过实时荧光定量RT-PCR和Western Blot验证铁死亡的发生和特征基因表达。结果与结论:(1)共获取45个铁死亡相关差异基因,GO和KEGG富集分析发现差异基因与氧化应激、自噬、铁死亡、脂肪细胞因子信号通路和线粒体代谢密切相关。(2)通过PPI网络中的MCODE插件和cytoHubba插件与机器学习中的LASSO算法和SVM-RFE算法共鉴定出1个铁死亡特征基因核因子E2相关因子2(nuclear factor erythroid 2-related factor 2,NFE2L2)。(3)对NFE2L2进行ROC曲线分析,发现在训练集和验证集中构建的诊断预测模型具有良好的准确性与特异性;对NFE2L2进行GSEA分析,发现特征基因通过免疫、炎症反应、氨基酸代谢及神经因子调控等方面参与缺血性脑卒中发病机制的调控。(4)细胞实验的RT-PCR和Western Blot分析表明,与对照组对比,缺血性脑卒中组中的酰基辅酶A合成酶长链家族成员4 mRNA和蛋白表达水平显著增高(P<0.05),谷胱甘肽过氧化物酶4 mRNA和蛋白表达水平显著降低(P<0.05);与对照组对比,缺血性脑卒中组中特征基因NFE2L2 mRNA和蛋白表达水平显著增高(P<0.05)。(5)上述结果证实,缺血性脑卒中与铁死亡密切相关,靶向特征基因NFE2L2可以为研究和治疗缺血性脑卒中提供一定的思路与方向。

Basonuclin 1 deficiency causes testicular premature aging: BNC1 cooperates with TAF7L to regulate spermatogenesis

Basonuclin(BNC1)is expressed primarily in proliferative keratinocytes and gametogenic cells.However,its roles in spermatogenesis and testicular aging were not dear.Previously we discovered a heterozygous BNC1 truncation mutation in a premature ovarian insufficiency pedigree.In this study,we found that male mice carrying the truncation mutation exhibited progressively fertility loss and testicular premature aging.Genome-wide expression profiling and direct binding studies(by chromatin immunoprecipitation sequencing)with BNC1 in mouse testis identified several spermatogenesis-specific gene promoters targeted by BNC1 including kelch-like family member 10(Klhl1O),testis expressed 14(Tex14)9 and spermatogenesis and centriole associated 1(Spatcl).Moreover,biochemical analysis showed that BNC1 was associated with TATA-box binding protein-associated factor 7 like(TAF7L),a germ cell-specific paralogue of the transcription factor IID subunit TAF7,both in vitro and in testis,suggesting that BNC1 might directly cooperate with TAF7L to regulate spermatogenesis.The truncation mutation disabled nuclear translocation of the BNC1/TAF7L complex,thus,disturbing expression of related genes and leading to testicular premature aging.Similarly,expressions of Y-box-binding protein 2(YBX2),outer dense fiber of sperm tails 1(ODfl),and glyceraldehyde-3-phosphate dehydrogenase,spermatogenic(GAPDHS)were significantly decreased in the testis of men with non-obstructive azoospermia.The present study adds to the understanding of the physiology of male reproductive aging and the mechanism of spermatogenic failure in infertile men.

Exploring novel candidate genes from the Mouse Genome Informatics database: Potential implications for avian migration research

To search for genes associated with migratory phenotypes in songbirds,we selected candidate genes through annotations from the Mouse Genome Informatics database and assembled an extensive candidate-gene library.Then,we implemented a next-generation sequencing approach to obtain DNA sequences from the Painted Bun­ting genome.We focused on those sequences that were conserved across avian species and that aligned with candidate genes in our mouse library.We genotyped short sequence repeats from the following candidate genes:ADRA1d,ANKRD17,CISH and MYH7.We studied the possible correlations between allelic variations occur­ring in these novel candidate migration genes and avian migratory phenotypes available from the published lit­erature.We found that allele variation at MYH7 correlated with a calculated index of speed of migration(km/day)across 11 species of songbirds.We highlight the potential of the Mouse Genome Informatics database in providing new candidate genes that might play a crucial role in regulating migration in birds and possibly in other taxa.Our research effort shows the benefits and limitations of working with extensive genomic datasets and offers a snapshot of the challenges related to cross-species validation in behavioral and molecular ecology studies.

Efficacy of electroacupunture at Zusanli(ST36)on jumping-injured muscle based on transcriptome sequencing and genes analysis

METHODS:In the present study,female SpragueDawley rats were randomly divided into four groups with 6 of each,including normal control group(NC),jumpinginduced muscle injury model group(JI),JI with electroacupuncture stimulation treatment group(EA),and JI with non-electroacupuncture stimulation group(NEA).Transmission electron microscopy,transcriptome sequencing and analysis,prediction of protein interaction networks,real-time polymerase chain reaction verification,and Western blotting were performed on the gastrocnemius muscle of ipsilateral lower limbs.RESULTS:The structural repair of injured gastrocnemius myofibers following jumping training in EA rats was better than that of NEA rats.A total of 136 genes were differentially expressed in EA rats relative to JI rats,with 55 genes upregulated and 81 genes downregulated.According to results of transcriptome analysis,and prediction of protein mutual interaction by the online STRING database,Heat shock protein beta-7(Hspb7)and myozenin2(Myoz2)genes were targeted.Expressions of Hspb7 and Myoz2 mRNAs were increased in EA rats relative to JI rats(P<0.05).The expression of Hspb7 protein was upregulated in EA rats relative to that in NC,JI,and NEA rats(P<0.01,<0.05,and<0.05,respectively).The expression of Myoz2 protein was upregulated in EA rats relative to that in NC and JI rats(both P<0.01,respectively).CONCLUSIONS:The present results suggest that electroacupuncture stimulation at Zusanli(ST36)could improve muscle healing following jumping-induced muscle injury,owing to the upregulation of Hspb7 and Myoz2 proteins.

长岛型掌跖角化症的发病机制与治疗进展

长岛型掌跖角化症(NPPK)是一种由SERPINB7基因突变导致的常染色体隐性遗传性掌跖角化症,具体发病机制尚不明确,可能与SERPINB7结构和功能异常、环境因素、屏障受损及炎症反应相关。目前NPPK缺乏特异性、标准化治疗,临床上以局部治疗为主,严重者可联合系统药物或手术方式对症处理;针对病因的靶向治疗药物庆大霉素显示出一定的潜力,但仍需更多的临床研究来验证其疗效和安全性。本综述旨在总结NPPK致病基因、发病机制和治疗策略。

神经元限制性沉默因子REST/NRSF参与调控癫痫作用及机制研究

目的探究神经元限制性沉默因子(REST/NRSF)参与调控癫痫作用及分子机制。方法采用免疫组织化学染色、免疫荧光、Western blot和qPCR检测癫痫患者病灶组织和海人藻酸(kainic acid,KA)癫痫小鼠海马脑区REST/NRSF表达水平的变化;采用病毒注射,脑电图记录和行为学方法检测在海马CA1区分别敲低或过表达REST/NRSF后对小鼠癫痫发作的影响。结果癫痫患者病灶REST/NRSF表达水平相对于脑外伤患者脑组织明显升高;KA模型组小鼠海马CA1区REST/NRSF蛋白和mRNA水平均明显升高,Kv7.2、Kv7.3钾通道mRNA表达水平明显下调;脑内注射NMDA兴奋海马脑区小鼠REST/NRSF表达水平明显上调;海马CA1区敲低REST/NRSF明显升高Kv7.2、Kv7.3钾通道mRNA表达水平,明显降低小鼠脑电图棘波、尖波发放频率以及癫痫发作等级;海马CA1区过表达REST/NRSF明显降低Kv7.2、Kv7.3钾通道mRNA表达水平,明显升高小鼠棘波、尖波发放频率,癫痫症状明显加重。结论小鼠海马脑区REST/NRSF通过转录调控Kv7.2、Kv7.3钾通道参与癫痫疾病发生发展。

基于心功能及IGFBP7、sST2、CGRP、ET分析沙库巴曲缬沙坦在治疗冠心病合并慢性心力衰竭中的应用效果

目的 分析冠心病(CHD)合并慢性心力衰竭(CHF)患者应用沙库巴曲缬沙坦治疗的效果。方法 选择2020年1月至2023年1月邯郸市第四医院收治的86例CHD合并CHF患者,以随机数字表法将其分为对照组和试验组各43例。两组CHD治疗均应用硝酸酯类、他汀类及抗血小板药物,对照组CHF治疗应用坎地沙坦酯片、醛固酮受体拮抗剂及β受体阻滞剂,试验组治疗则将对照组中的坎地沙坦酯片替换为沙库巴曲缬沙坦钠片。比较两组疗效、不良反应、心功能指标[左室短轴缩短率(LVFS)、左室射血分数(LVEF)、6min步行距离(6 MWD)]、心室重构指标[Ⅲ型胶原前肽(PⅢP)、层粘蛋白(LN)、基质金属蛋白酶-9(MMP-9)]、心肌损伤和血管内皮功能相关指标[胰岛素样生长因子结合蛋白7(IGFBP7)、可溶性生长刺激表达基因2(sST2)、降钙素基因相关肽(CGRP)、内皮素(ET)]。结果与对照组比,试验组治疗3个月后的总有效率更高,差异有统计学意义(P<0.05)。两组治疗3个月后的LVFS、LVEF、6 MWD、IGFBP7、CGRP与治疗前比升高,且试验组与对照组比更高,差异有统计学意义(P<0.05);PⅢP、LN、MMP-9、sST2、ET降低,试验组与对照组比更低,差异有统计学意义(P<0.05)。两组不良反应总发生率对比差异无统计学意义(P>0.05)。结论 沙库巴曲缬沙坦可有效调节CHD合并CHF患者IGFBP7、sST2、CGRP、ET,改善血管内皮功能、心肌损伤、心室重构及心功能,进而可提高疗效,且具有良好的安全性。