0.05). Conclusion:overweight and central obesity influence blood pressure,blood lipid and blood glucose. Lack of exercises is main risk factor in pilots. It is necessary to carry out effective measures for overweighted and central obese pilots to reduce risk of hypertension,diabetes,and abnormal blood lipid.

ObjectiveTo identify exon 20,24,25 mutations of ELN in patients with PFD.MethodsThe study was designed as case-control analysis.The PFD patients were from the second hospital of the Hebei medical university.30 PFD patients were examined and scored according to the Pelvic Organ Prolapse (POP-Q) classification,and the patients were divided into two groups,the low-grade ( A1 ) group and the high-grade (A2) group.20 non-PFD women were selected as the control group (B).Venous blood had been collected and DNA sequences were determined and compared with the standard sequence in NCBI GENEBANK.ResultsExon 20 114 G ｜ A mutation was found in PFD patients,which can induce protein structure change.There were seven cases in the A2 group and one in the B group; it had statistically different between two groups ( P ＜0.05).Exon 24 81C | G mutation was found in the trial group,it had no statistically difference between two groups ( P ＞ 0.05 ).None mutation of Exon 25 was found in all the groups.IVS20 17T｜ C mutation was found in the A2 group,which had statistically difference compared with control group and the low-grade group ( P ＜ 0.05 ).IVS24 69A | T mutation was found in the trial group,it had no statistical difference with control group ( P ＞ 0.05 ).ConclusionsMutations of elastingene exon 20,exon 24 were found in the PFD patients,which can induce the change of the primary protein structure.IVS20 17T | C mutation also existed in the trial group; the elastin gene mutation may be the reason that people are easy to suffer from PFD.

AIM:To observe the expression of Toll like receptor 4 (TLR4) in the left ventricle of Goldblatt rats and to explore the role and mechanism of TLR4 in left ventricular remodeling of hypertension.METHODS:Goldblatt model of Two-kidney,one-clip (2K1 C) renovascular hypertension was induced in twenty-five rats(H group),and twenty rats served the sham-operated group(sham group).The tail cuff blood pressure was detected every week and echocardiogram was observed every other week.After eight weeks of operation,the rats were killed and the samples of the left ventricle were collected.The concentration of Ang Ⅱ in left ventricle was assessed by tadioimmunoassay.Western blotting and RT-PCR were used to exam the mRNA and protein expression of TLR4 in the left ventricle.Immunohistochemistry was adopted to exam the location of TLR4 in the myocardium.RESULTS:TLR4 mRNA and protein expression were consistently upregulated in the left ventricle of H group compared with sham group.In H group, predominantly sarcolemmal staining was observed,especially focal areas of intense TLR4 staining were found in juxtaposed regions of two or more adjacent myocytes;However,in sham group,TLR4 expression was diffuse and presumably cytoplasmic.Considerable correlation was found between blood pressure,MESS,LVMI,RWT,the concentration of Ang Ⅱ in left ventricle and the protein expression of TLR4 in myoeytes.CONCLUSION:During the development of left ventricular remodeling of Goldblatt rats,expression of TLR4 increases significantly.Enhanced expression of TLR4 locates in the sarcolemma,especially in juxtaposed regions of two or more adjacent myocytes.These indicate that TLR4 transmembrane receptor which is closely relative with inflammation and immunity probably contributes to the development of ventricular remodeling.[KEY WORDS]Hypertension;Ventricular remodeling;Receptors,Toll-like;Goldblatt rats

BACKGROUND: It is a new tendency to treat central nervous system injury or tumor therapy using the combination of seed cells and gene therapy.OBJECTIVE: To observe the dose-relationship between transfection and expression of rabbit bone marrow mesenchymal stem cell (BMSCs) with adenovirus vector carrying green fluorescent protein (Ad-GFP), and to study its effects on cell biological properties, in addition, to explore the feasibility of using Ad-GFP vector to construct gene modified BMSCs.DESIGN, TIME AND SETTING: A randomized grouping, contrast observation. The experiment was performed at the Southern Medical University between August 2008 and March 2009.MATERIALS: New Zealand white rabbits, irrespective of genders, weighing 2.0-3.0 kg, were selected.METHODS: BMSCs were separated and cultured in vitro, and then the cell immunophenotypes were detected by flow cytometry.The adenovirus was obtained by packaging 293 cells and was used to transfect BMSCs with various liters (1 ×-10~3-1×10~(10) PFU/mL).Cytometry was used to analyze the transfection efficiency.MAIN OUTCOME MEASURES: Cell morphological changes were detected under an invert microscope. The cell proliferation was detected by CCK8 kits. BMSCs transfected with Ad-GFP were induced differentiating into neuron-like cells by adding of β-mercaptoethanol.RESULTS: The surface markers of 3-6-generation BMSCs were negative to CD34 and CD45, but positive for CD29 and CD44.When the virus titers were 1 ×10~7 PFU/mL, the transfection rate was 55%, which were 85% when the virus titers were 1 ×10~9 and1×10~(10) PFU/mL. However, cell pathology phenomenon occurred when the virus titer was 1 ×10~(10) PFU/mL. The fluorescence was strongest expressed at day 7, and it still can be seen at day 28. The BMSCs trasfected with Ad-GFP could differentiate into neuron-like cells under induction of p-mercaptoethanol, with positive neuron-specific enolase.CONCLUSION: Ad-GFP with suitable titers can infect BMSCs effectively with little influence on the biology property or differentiation function. BMSCs can serve as seeds cell in gene therapy field when utilizing ad-GFP vector system.

Objective To explore the morbidity and risk factors of postoperative delirium in the patients undergoing coronary artery bypass grafting (CABG).Methods A total of 286 patients were continuously enrolled for CABG surgery from January to December 2013 in cardiac surgery ward in Beijing Anzhen Hospital.Delirium Rating Scale-Revised-98 was used as the diagnostic tool for the analysis of the morbidity and risk factors of postoperative delirium.Results (1) Delirium occurred in 24 patients of 286 patients and morbidity of postoperative delirium was 8.4％.Sixteen of 24 patients (66.7％) suffered from transient delirium (＜24 h).Eight of 24 patients (33.3％) suffered from continuous delirium (≥48 h).(2) The common clinical presentation of postoperative delirium included increased psychomotor activity, a disordered sleep-wake cycle and a reduced level of consciousness.(3) Univariate Logistic regression analysis results showed that delirium was associated with advanced age over 70 years old (OR =3.05, 95％ CI 2.55-72.94, P =0.023), previous cerebral infarction(OR =1.78, 95％ CI 1.07-2.96, P =0.026), previous brain heamorrhage (OR =1.99, 95 ％ CI 1.20-3.31, P =0.003), surgery time (OR =1.05, 95％ CI0.05-2.04, P =0.047), intensive care unit (ICU) staying time (OR =2.87, 95％ CI 1.43-5.72, P=0.003), use offentanyl (OR=2.78, 95％ CI 1.02-7.57, P=0.045).(4) The multiple Logistic stepwise regression analysis indicated that the perioperative risk factors of delirium included advanced age over 70 years old (OR =3.196, 95％ CI 1.574-6.488, P =0.001), cerebrovascular accident history(OR =2.610, 95％ CI 1.538-4.431, P =0.000) and ICU duration time(OR =1.480, 95 ％ CI 1.070-2.046, P =0.018).Conclusions The morbidity of postoperative delirium after CABG is 8.4％.Many predisposing and precipitating factors contribute to postoperative delirium.These factors include age ＞ 70 years, cerebral infarction and ICU staying time.Assessment and preventive strategies should be considered to reduce the incidence of delirium, particularly among those patients with high risks.

OBJECTIVE:To investigate the clinical efficacy and safety of butylphthalide combined with nimodipine in the treat-ment of vascular cognitive impairment. METHODS:Totally 156 patients with vascular cognitive impairment were randomly divided into control group and observation group. All patients were given anti-platelet,control of blood pressure,lowering blood glucose, lowering statin therapy for stable plaque and symptomatic treatment. On this basis,control group was orally treated with nimodipi-he 30 mg,tid;observation group was orally treated with Butylphthalide capsule 0.2 g based on the treatment of control group,tid. The course lasted for 3 months. The clinic data was observed,including clinical efficacy,and Montreal cognitive assessment(Mo-CA)score,activities of daily living scale(ADL)score,stenosis great vessels distal blood flow velocity and incidence of adverse reactions before and after treatment. RESULTS:The total effective rate in observation group was significantly higher than control group,with significant difference(P<0.05). After treatment,the MoCA score,ADL score and stenosis great vessels distal blood flow velocity in 2 groups were significantly higher than before,and observation group was higher than control group,with signifi-cant differences(P<0.05). There were no obvious adverse reactions during treatment. CONCLUSIONS:Based on the conventional treatment,butylphthalide combined with nimodipine has better efficacy than nimodipine alone in the treatment of vascular cognitive impairment,and can improve the stenosis great vessels distal blood flow velocity better,with similar safety.

Objective To explore the relationship between gastric juice pH and hospital-acquired pneumonia ( HAP) , the gastric bacterial colonization and etiology of HAP in neurologic intensive care unit patients by monitoring gastric juice pH value.Methods From October 2014 to May 2015, consecutive seventy-two tube feeding patients admitted in the Department of Neurology Intensive Care Unit in Xijing Hospital were enrolled in this research.The type and concentration of pathogens from gastric contents were collected, while samples from upper respiratory tract and pharynx were detected dynamically at the same time.Results (1)The group with new onset HAP was higher in gastric juice pH (6.4(5.4,6.4) vs 5.4 (2.5, 6.4), Z=-2.37, P=0.01); (2) The isolation rate of colonized bacteria in gastric cavity was associated with the pH of gastric juice , achieving 60.8% ( 42/69 ) in HAP group; ( 3 ) When the gastric juice pH was >4, the isolation rate of Gram-negative bacilli in gastric cavity obviously increased (63.6%(28/44) vs 35.7%(10/28),χ2 =5.323, P=0.021); (4)The same pathogens were found in stomach-pharynx-upper respiratory tract in 7 cases ( 17.5%) of the total 40 HAP patients.Conclusion Increased gastric juice pH was associated with gastric colonization , especially Gram-negative bacilli , and may lead to a higher incidence of new onset HAP in patients on enteral feeding.

Objective: To investigate the fatigue status of military personnel stationed in plateau and high cold region, and to analyze the mediator effect of trait coping style on job stress and fatigue. Methods: In October 2010, with the method of cluster random sampling survey, 531 military personnel stationed in plateau and high cold region were chosen as subject. The fatigue status were evaluated by the Chinese version multidimensional fatigue inventory (MFI-20) , job stress were evaluated by the Job Stress Survey (JSS) , and trait coping style were evaluated by the Trait Coping Style Questionnaire (TCSQ) . Results: According to the information of different population characteristics, mean rank of physical fatigue about the urban (town) group were higher than that of rural group (Z=-2.200, P<0.05) ; mean rank of reduced motivation about the urban (town) group were higher than that of rural group (Z=-2.781, P<0.05) ; mean rank of general fatigue scores about the urban (town) group were higher than that of rural group (Z=-3.026, P<0.05) ; mean rank of physical fatigue about the up or equal 20-years old age group were higher than that of below 20-years old age group (Z=-4.045, P<0.05) ; mean rank of reduced motivation about the up or equal 20-years old age group were higher than that of below 20-years old age group (Z=-2.182, P<0.05) ; mean rank of mental fatigue about the up or equal 20-years old age group were higher than that of below 20-years old age group (Z=-2.879, P<0.05) ; mean rank of general fatigue scores about the up or equal 20-years old age group were higher than that of below 20-years old age group (Z=-3.647, P<0.05) ; mean rank of reduced motivation were significant statistical difference among the military officers, sergeancy and soldier group (F=18.965, P<0.05) ; mean rank of general fatigue scores were significant statistical difference among the military officers, sergeancy and soldier group (F=14.711, P<0.05) . The score of negative coping style were positively correlated with the score of physical fatigue (r_s=0.129) , reduced activity (r_s=0.123) , reduced motivation (r_s=0.149) and general fatigue (r_s=0.174) respectively, the score of organizational support lack strength were positively correlated with the score of physical fatigue (r_s=0.090) , reduced activity (r_s=0.098) , reduced motivation (r_s=0.099) and general fatigue (r_s=0.130) respectively. The mediator effect of negative coping style on the job stress and fatigue was 0.013 (P<0.01) . Conclusion The fatigue statuses of the urban (town) group and the up or equal 20-years old age group are poor, and the negative coping style plays mediator effect on the job stress and fatigue.

Since the outbreak of corona virus disease 2019(COVID 19), the epidemic has spread rapidly, which brings great challenge to the surgical diagnosis, treatment and management of lung neoplasm Sichuan International Medical Exchange &Promotion Association organized thoracic surgery experts to sum up experiences from experts in major hospital, and formulated the Guidance suggestion on surgical diagnosis, treatment and management of lung neoplasm during the outbreak of COVID-19 to provide references for thoracic surgeons.

Objective:To investigate the relationship between the levels of serum cytokines and chemokines and the prognosis of patients with acute B-ALL after receiving chimeric antigen receptor (CAR)-T cell immunotherapy and acute graft-versus-host disease (aGVHD) in patients after bridging allogeneic hematopoietic stem cell transplantation (allo-HSCT).Methods:According to the case-control principle, Forty-two patients with B-ALL who received CD19-CAR-T cell immunotherapy bridged to allo-HSCT at Heibei Yanda Ludaopei Hospital from September 18, 2019 to May 9, 2022 were enrolled. Mann-Whitney U test was used to compare the changes of aGVHD-related cytokines and chemokine levels between CAR-T cell immunotherapy and bridging transplantation in different patients at the same time. Their plasma levels of cytokines and chemokines related to aGVHD were monitored at the day before CAR-T therapy and after CAR-T treatment at day 4, 7,14,21,28. The receiver operating characteristic curve was drawn to evaluate the predictive value of cytokines and chemokines in predicting the occurrence and the death of aGVHD patients. Kaplan-Meier method and Log-rank tests were used for Overall survival (OS) analysis. Results:Twenty-four of total 42 patients had aGVHD, of which 11 patients died and 31 patients survived. There was no significant difference in cytokines and chemokines between the aGVHD group and the non-aGVHD group on the day before CAR-T cell treatment. According to statistical analysis, the serum Elafin levels of aGVHD group was higher than that of non-aGVHD group at the 21st day [4 482 (2 811, 6 061) ng/L vs 2 466 (1 948, 3 375) ng/L, Z=3.145, P=0.001] and the 28st day [4 391 (2 808, 5594) ng/L vs 2 463 (1 658, 2 830) ng/L, Z=2.038, P=0.048] separately. At the 14th day, serum cytokines and chemokines levels between the two group were as follows,MIP-1 α [21.02 (12.36, 30.35) ng/L vs 5.56 (3.64, 10.79) ng/L], sCD25 [422.47 (257.99, 1 233.78) IU/ml vs 216.11 (133.75,457.39) IU/ml], Elafin [4 101 (2 393, 5 006) ng/L vs 2 155 (1 781, 3 033) ng/L], IL-6 [119.08 (23.97, 183.43) ng/L vs 8.39 (2.91, 17.42) ng/L] and IL-8 [13.56 (12.50, 24.52) ng/L vs 2.83 (1.73,6.87) ng/L] were at higher levels ( Z=2.653, P=0.007; Z=2.176, P=0. 030; Z=2.058, P=0.041; Z=3.329, P<0.001; Z=3.162, P=0.001). The KM survival curve showed that the cumulative survival rates of patients with higher serum levels of MIP-1α, sCD25, Elafin, IL-6 and IL-8 were lower than those with low levels at day 14, and the difference was statistically significant (χ 2=12.353, 4.890, 6.551, 10.563, 20.755, P<0.05). Conclusion:The outcomes of patients treated with CAR-T cell therapy bridged to allo-HSCT was correlated with serum MIP-1α, sCD25, Elafin, IL-6 and IL-8 levels after receiving CAR-T therapy. High concentrations of MIP-1α, sCD25, Elafin, IL-6 and IL-8 suggest poor prognosis and can be used as biomarkers to suggest appropriate clinical selection of therapy.