Objective:To study the feasibility,safety and effectiveness of intrapericardial injection with a trans-diaphragmatic approach in rats and its value in the study of heart diseases. Methods:Blue-black ink,recombinant adeno-associated virus carrying enhanced green fluorescent protein((eGFP)) gene,0.9% sodium chloride solution were respectively injected into pericardium of rats in three different groups(Group ink,Group eGFP and Group sodium chloride) by intrapericardial injection with a trans-diaphragmatic approach.Autopsy was done and hemodynamic parameters were measured and cryosection was analyzed by fluorescence microscopy. Results:The injection was proved successful in all rats in Group ink.Green fluorescence was detected in cryosection of all hearts in Group eGFP and the expression of green fluorescent protein was ubiquitously,but not homongeneous.No rat died during and after the operation among the operated rats(rats in Group eGFP and Group sodium chloride).There was no difference between hemodynamic parameters of the operated rats and those of the controls.Conclusion:The intrapericardial injection with a trans-diaphragmatic approach is a simple,feasible,safe and valid operation and suitable for small experimental animals.And it suggests an easy, safe,efficient and cheap technique in the study of heart diseases.

Endogenous formaldehyde is generated in the human body.When the system of endogenous formaldehyde generation with scavengation is damaged,excess accumulation of endogenous formaldehyde induces vascular endothelial injury,atherosclerosis,myocardial damage and neurodegenerative diseases.Studies show that endogenous formaldehyde is one of the key factors during the process of cardiovascular and cerebrovascular diseases.Moreover,polyphenols are used as capture agents of endogenous formaldehyde to prevent and treat cardiovascular and cerebrovascular diseases.

Objective To assess whether a follow-up endoscopy after endoscopic submucosal dissec-tion(ESD)for gastric lesions is effective for prevention of delayed bleeding. Methods Papers published in Medline,Embase,Cochrane library,Elsevier,Wanfang,VIP and CNKI were searched for the studies eval-uating the efficacy of follow-up endoscopy for reducing delayed postoperative bleeding after ESD for gastric le-sions. Statistic analyses were performed using RevMan 5. 1 software. Results A total of 10 studies including 4 randomized control trials and 6 cohort studies were enrolled. Analysis of these studies showed that the inci-dence of delayed bleeding was not significantly different between the patients receiving a follow-up endoscopy and those not(OR= 1. 38,95% CI:0. 89-2. 13,P= 0. 15). Also,there was no difference in the incidence of delayed bleeding between the prophylactic hemostasis and nonprophylactic hemostasis groups( OR = 1. 45, 95% CI:0. 65-3. 22,P= 0. 36). Conclusion A follow-up endoscopy after gastric ESD may contribute little to the prevention of delayed bleeding,but may be useful for the high-risk patients,which can control the bleeding rate at a low level.

Objecitve To investigate the changes of chronotropic response before and after percutaneous coronary intervention ( PCI)in patients with coronary disease .Methods A total of 339 patients with coronary disease was included in this study .All sub-jects underwent treadmill exercise test and coronary angiogram , and some patients underwent PCI if necessary .The parameters of chro-notropic response were recorded and analyzed , including ratio of the highest to predicted heart rates ( rHR) ,chronotropic response in-dex ( CRI) , and heart rate reserve ( HRR) .After coronary angiogram , the score of gensin was recorded and analyzed .Results There was significant difference in the parameter of CRI between unstable angina pectoris and silent myocardial ischemia groups ( P <0.05 ) , CRI were 0.80 ±0.11 and 0.89 ±0.07 , respectively .After coronary angiogram and PCI , there were significant differences in the parameters of rHR, CRI, and HRR between pre-therapy and post-treatment ( t =2.440, 1.977, 2.529, all P <0.05).A nega-tive correlation was found between the parameters of rHR , CRI, and HRR and the score of Gensin ( r =-0.686 , -0.673 , and-0.672, all P <0.05).The significant difference in rHR, CRI, and HRR existed between the groups of <20 and >40 ( t =2.567, 2.223, 2.062, all P <0.05).Conclusions Parameters (rHR, CRI, and HRR) had important clinical values in evaluating the changes of chronotropic response before and after PCI in patients with coronary disease with a negative correlation with the score of Gensin.

Objective To compare the differences of cardiac function and interstitial remodeling between diastolic heart failure(DHF) and systolic heart failure(SHF) rabbit models. Methods To establish DHF model with abdo-mial aorta constriction and SHF model with abdomial aorta constriction plus aortic insufficiency. The cardiac func-tion was examined by UCG parameters and homodynamic parameters. The collagen content was measured through hydroxyproline colorimetric assay and shown as collagen area(CA), collagen volume fraction(CVF) and area ratio of Ⅰ to Ⅲ type collagen with PSR. Results Compared with control group, there were significantly increased thick-ness and stiffness of myocardium, impaired diastolic function but normal ejection fraction (EF), and significantly increased collagen content, CA, CVF and area ratio of Ⅰ to Ⅲ type collagen in DHF group; heart chamber was sig-nificantly enlarged, systolic function decreased, and collagen content, CA, CVF significantly increased, but ratio of Ⅰ to Ⅲ type collagen decreased in SHF group(P <0.05 or P <0.01). Conclusion DHF and SHF rabbit mod-els were established successfully, which can simulate clinical profiles and provide technical support to future re-search.

Aim To investigate the effects of mmLDL on the up-regulation ofα1 receptors in moues mesenter-
ic arteries. Methods Mice tail intravenous injection of mmLDL was used . Vitro sensitive myograph was empl-
oyed to examine Noradrenaline ( NA) induced vascular contraction on mice mesenteric artery, and the mRNA and protein expressions ofα1 andα2 receptors were an-alyzed by real-time PCR and Western blot, respective-ly. Results mmLDL significantly increased NA in-duced concentration-contractile curve, and the data of Emax and pEC50 were from ( 122. 61 ± 9. 40 )% and (5. 65 ± 0. 05 ) in normal saline ( NS ) group to (161. 01 ± 6. 90 )% and ( 6. 20 ± 0. 08 ) in mmLDL group (P <0. 01, P <0. 01), respectively. The α1 adrenoceptor antagonist prazosin shifted the concentra-
tion-contractile curve induced by NA towards right. Af-ter using mmLDL, the mRNA and protein levels of α1 adrenoceptor were significantly increased, but the mR-NA and protein levels of α2 adrenoceptor were not changed. Conclusion Tail intravenous injection of mmLDL enhances the vascular expressions of α1 adre-noceptors and the contractile effects mediated byα1 ad-renoceptors.

AIM: To establish an animal model of experimental autoimmune myocarditis (EAM) in BALB/c mice and to investigate the expression and significance of Toll-like receptor 3 in mouse EAM. METHODS: BALB/c mice were immunized with cardiac myosin extracted from porcine ventricular myocardium covered by complete freund's adjuvant (CFA) on 0 d and 7 d, then divided into immunized with CFA only. Serum and myocardium samples were collected at 14 d and 21 d after the first immunization. HE staining was used to identify the areas of inflammation. The myosin IgG antibody was examined by indirect ELISA assay. The changes of TLR3 protein and mRNA expression in myocardial tissue were measured by immunohistochemistry and real time-PCR. RESULTS: Compared to control group, immunohistochemistry results showed that there was positive expression of TLR3 in the myocardium of mice with EAM and the mRNA of TLR3 were more than 20 times (P<0.05). The expression of interferon beta mRNA in EAM group was more than 14 times as many as basal expression, that of tumor necrosis factor alpha was more than 18 times (P<0.05). CONCLUSION: The expression of Toll-like receptor 3 in myocardium is up-regulated in experimental autoimmune myocarditis. The inflammatory response to cardiac myosin may associate with the TLR3 signal transduction pathway.

Objective To study the clinical distribution characteristics of psychiatric symptoms in patients with multiple system atrophy ( MSA ) and analyze the influence factors of neuropsychiatric symptoms.Methods Twelve psychiatric symptoms were evaluated in 47 patients with MSA by the Neuropsychiatric Inventory of the Chinese version ( CNPI ) .The occurrence rate and distribution were evaluated.The correlation between the neuropsychiatric symptoms and the clinical features including gender , age, education duration, disease course, cognitive level, Unified Multiple System Atrophy Rating Scale part 3 ( UMSARS-Ⅲ) score, Unified Parkinson's Disease Rating Scale part 3 ( UPDRS-Ⅲ) score, Hamilton Depression Rating Scale ( HAMD) score, Hamilton Anxiety Scale ( HAMA) score, MSA subtype and levodopa and benserazide usage dose was also analyzed .Results A total of 74.5%( 35/47 ) of the MSA patients presented at least one kind of psychiatric symptoms .The most common neuropsychiatric symptoms were depression (66.0%, 31/47) and sleep disorder (63.8%, 30/47), while the symptom of euphoria was not found.The highest mean score was found for depression ( mean score:5.23 ±1.67 ) .The CNPI scores of MSA patients were negatively correlated to the education duration and Simple Mental State Examination (MMSE) score (r=-0.238, -0.334 respectively, both P<0.01).The CNPI scores of MSA patients were positively correlated to the disease course and HAMD score ( r=0.308, 0.307 respectively, both P<0.01) .The CNPI scores of MSA patients had no relevance to the gender , age, UMSARS-Ⅲscore, UPDRS-Ⅲscore, MSA subtype and levodopa and benserazide dosage ( all P>0.05). Multiple liner regression analysis showed that HAMA and MMSE scores had the greatest impact on CNPI (r2 =0.196, 0.270, respectively, both P=0.000) .Conclusions The incidence of neuropsychiatric symptoms is high and varied in patients with MSA .The neuropsychiatric symptoms were more severe in MSA patients with lower cognitive levels and longer disease courses .

Objective To evaluate different methods in detecting intraperitontal free cancer cells (IFCCs) in patients with gastric cancer and to clarify the relationship between positive IFCCs and short-term prognosis.Methods A total of 119 gastric cancer patients who underwent surgical treatment were enrolled.Peritoneal lavage was performed with 300-400 ml saline respectively at three points of time:immediately after abdominal cavity entry;when surgical operation was completed;when extensive intraoperative peritoneal lavage was done.The IFCCs were detected with methods of traditional centrifugal cytology,membrane cytology,ICC and RT-PCR.The survival curve of patients with gastric cancer was drawn using Kaplan-Meier method.Results The positive rate of PLC was 16.8％,20.7％ and 11.2％ respectively at 3 timepoints (P ＜ 0.05).The positive rates of ICC were 28.6％,38.8％ and 20.7％ respectively at 3 timepoints.The positive rates of RT-PCR were 39.3％,69.5％ and 50.8％ respectively at 3 time points.The positive rate of IFCCs detected through RT-PCR was higher than that of PLC and ICC (P ＜ 0.05).The short-term prognosis of patients with positive IFCCs was worse than those with negative results detected with any three method at the timg point immediately after opening the abdomen (P ＜ 0.05).At the timg point immediately after removing the tumors,the short-term prognosis of patients with positive IFCCs detected with PLC was worse (P ＜ 0.05).Conclusion The short-term prognosis was poor in patients with positive IFCCs.It is the best time to detect IFCCs before radical resection.Surgical procedures increase the risk of shedding of IFCCs.

Objective:To screen lipid biomarker in sepsis patients with different survival outcome based on ultra high performance liquid chromatography-mass spectrometry(UHPLC-MS/MS) technique.Methods:From September 2019 to April 2020, 30 septic patients admitted in Department of Intensive Care Unit and 30 cases of physical examination at the same time in Shanxi Bethune Hospital were studied. Lipid metabolite in serum were detected by UHPLC-MS/MS technique. According to the 28 day survival outcome of sepsis patients, they were divided into survival group (21 cases) and death group (9 cases). The baseline data of case group and control group, survival group and death group were compared respectively. Independent sample t-test and orthogonal partial least squares discriminant analysis (OPLS-DA) were further performed to identify lipid biomarkers related to sepsis survival outcome. Receiver operating characteristic (ROC) curve to evaluate the predictive efficacy of differential lipids on the survival outcome of biomarker sepsis patients. Results:There were 32 lipid subclasses and 1 437 differential lipid molecules in the sepsis group compared with the control group. 196 differential lipid molecules in the sepsis survival group and the death group were screened according to the OPLS-DA model (variable weight of projection (VIP)>1), which were glycerophosphingolipids (129), sphingolipids (52), glycerides (14), and sterols (1).All the original data were statistically analyzed by univariate independent sample t-test. There were statistically significant differences in 15 lipid molecules between the two groups. Combined with VIP > 1 and P < 0.01, three lipid molecules were finally screened, which were sphingomyelin (SM) lipid molecules, SM (d30∶1), SM (d32∶2), SM (d32∶1). ROC curve analysis showed that the areas under curves of the above three lipid molecular were 0.915, 0.892, 0.898, respectively. The sensitivity was 77.27%, 95.45%,72.73%. The specificity was 100.0%, 87.5%,100.0%. Further Z-test showed that there was no significant difference in the area under the ROC curve ( Z(SM (d30∶1) and SM (d32∶1)) =0.36, P=0.722; Z(SM (d30∶1) and SM (d32∶2))=0.34, P=0.732; Z(SM (d32∶1) and SM (d32∶1))=0.07, P=0.942). Conclusions:Sphingomyelin may be involved in the formation of different clinical outcomes of sepsis, and has a good predictive effect on the survival outcome of sepsis.