Objective To explore an optimal scheme for diagnosis and treatment of patients with acute viral myocarditis (AVM) with an experience prescription of professor Zhang Zengying, Junkang oral liquid.Methods A prospective study was conducted. Sixty patients with AVM admitted into the Affiliated Hospital of Tianjin Academy of Traditional Chinese Medicine (TCM) from March 2012 to January 2014 were randomly divided into two groups: a control group and a treatment group (each, 30 cases). The patients in control group were treated with routine western medicine, including antiviral drugs, polarized solution, adenosine disodiu, and oxygen inhalation; while in treatment group, besides the comprehensive treatment in the control group, the patients were given Junkang oral liquid (main ingredients: Codonopsis pilosula, Salvia miltiorrhiza, Polygonatum odoratum, Notopterygii, Paris polyphylla Smith var. chinensis Hera, Forsythia suspensa, rhizome Ligustici Chunxiong, Hedyotis diffusa, Ophiopogonis tuber), 10 mL each time, three times a day; the treatment was consecutively applied for 3 months in both groups, 15 days constituting one therapeutic course. The changes of cardiac function [heart ejection fraction (EF), stroke volume (SV)] and myocardial enzyme [creatine kinase (CK), MB isoenzyme of creatine kinase (CK-MB), aspartate aminotransferase (AST), lactate dehydrogenase (LDH)], and the TCM syndrome integral score, symptoms and signs such as fever with chills, palpitation or severe palpitation, oppressed feeling in chest, deficiency of qi and disinclination to talk, dizziness, weakness and shortness of breath, spontaneous sweating, night sweating, body limb aches, premature beat shown on electrocardiogram (ECG) and curative effect were observed before and after treatment in the two groups.Results Compared with those before treatment, in the two groups after treatment, the EF and SV were significantly elevated, while the CK, CK-MB, AST, LDH, TCM syndrome integral score were obviously decreased, the degree of improvement in the treatment group being more prominent [EF: 0.601±0.088 vs. 0.538±0.084, SV (mL): 67.02±6.78 vs. 61.03±5.88, CK (U/L): 76.25±28.41 vs. 92.54±31.68, CK-MB (U/L): 18.34±8.94 vs. 22.45±9.70, AST (U/L): 31.29±14.28 vs.33.45±11.21, LDH (μmol·s-1·L-1): 2.28±0.51 vs. 2.34±0.68, TCM syndrome integral score: 12.34±1.24 vs. 18.36±1.98, allP < 0.05]; the degrees of improvement in symptoms and signs such as palpitation or severe palpitation, oppressed feeling in chest, shortness of breath, exhaustion, etc and the total effective rate of premature beat in treatment group were significantly higher than those in the control group [palpitations or severe palpitation: 92.59% (25/27) vs. 75.87% (22/29), oppressed feeling in chest: 92.00% (23/25) vs. 76.92% (20/26), shortness of breath exhaustion: 90.00% (18/20) vs. 76.19% (16/21), premature beat: 88.24% (15/17) vs. 75.00% (12/16), allP < 0.05], and the comparisons of total effective rates between the two groups including fever with chills [100.00% (15/15) vs. 93.75% (15/16)], deficiency of qi and disinclination to talk [88.00% (22/25) vs. 83.33% (15/18)], dizziness [87.50% (7/8) vs. 80.00% (8/10)], spontaneous sweating or night sweating [86.67% (13/15) vs. 80.00% (12/15)] and body limb ache [91.67% (11/12) vs. 84.62% (11/13)] showed no statistical significant differences (allP > 0.05).Conclusion Junkang oral liquid can significantly improve the clinical symptoms in patients with AVM, reverse its acute course and control arrhythmia, showing the advantage in diagnosis and treatment with combination of traditional Chinese and western medicine.

Objective:To investigate the effect of single-port laparoscopy and conventional laparoscopic surgery in ovarian cystectomy.Methods:The clinical data of 139 patients with laparoscopic surgery for ovarian cyst admitted to the same department of gynecology from December 2016 to December 2019 in Suzhou Hospital Affiliated of Anhui Medical University were retrospectively analyzed, and they were divided into single-port laparoscopic surgery group (62 cases) and conventional laparoscopic surgery group (77 cases) according to different surgical methods. The clinical indictors, the levels of estrogen, T lymphocyte subgroups, the complications rate and incision satisfaction rate between two groups were compared.Results:The operation in both groups was smooth and there was no conversion to open surgery. Compared with the conventional laparoscopic surgery group, the surgery time, intraoperative blood loss in single-port laparoscopic surgery group were higher, the hospital stays in single-port laparoscopic surgery group was shorter, but there were no significant differences ( P>0.05). The levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E 2) in two groups before operation had no significant differences ( P>0.05). At 30 d after operation, the levels of FSH, LH and E 2 in single-port laparoscopic surgery group were higher than those in conventional laparoscopic surgery group, but the differences were no statistically significant ( P>0.05). Before operation, the levels of CD 4+, CD 8+ and CD 4+/CD 8+ in two groups has no significant differences ( P>0.05). At 3 d after operation, the levels of CD 4+, CD 8+ and CD 4+/CD 8+ in single-port laparoscopic surgery group were higher than those in conventional laparoscopic surgery group: 0.51 ± 0.03 vs. 0.47 ± 0.02, 0.41 ± 0.23 vs. 0.39 ± 0.05, 1.36 ± 0.02 vs. 1.24 ± 0.02, and the differences were statistically significant ( P<0.05). The rate of complication in two groups had no significant difference ( P>0.05). At 3 d after operation, the scores of visual analogue scale (VAS) of pain in single-port laparoscopic surgery group were lower than that in conventional laparoscopic surgery group: (1.12 ± 0.21) scores vs. (3.56 ± 0.65) scores, and the difference was statistically significant ( P<0.05). The incision satisfaction rate in single-port laparoscopic surgery group was significantly higher than that in conventional laparoscopic surgery group: 90.32%(56/62) vs. 72.73%(56/77), and the difference was statistically significant ( P<0.05). Conclusions:Single-port laparoscopy can be safely and smoothly implemented in ovarian cystectomy, and can reduce postoperative pain, improve cell immunity, and have better cosmetic result.

Objective To observe the effect of electroacupuncture with different frequencies on learning and memory ability, synaptic morphology and synaptic density in the hippocampus of Alzheimer's disease rats. Methods Forty-eight healthy Wistar rats were randomly di-vided into normal group, sham operation group, model group, 2 Hz, 30 Hz and 50 Hz electroacupuncture groups with 8 cases in each group. The Alzheimer's disease model was established by injecting Aβ1-42 into two sides of lateral cerebral ventricle. The sham operation group was injected with normal saline instead. The electroacupuncture groups received electroacupuncture at Baihui (DU20) and Shenshu (BL23) acu-points. The learning and memory ability was evaluated with Morris water maze test, and the morphology and density of synapse were ob-served by electron microscope. Results Compared with the model group, the latency was shorter, the time of crossing the platform was short-er and the number of crossing the platform was more in the electroacupuncture groups (P<0.01), especially in the 50 Hz electroacupuncture group (P<0.01). The number of synapse and the synaptic density were more in the electroacupuncture groups than in the model group (P<0.01), especially in the 50 Hz electroacupuncture group (P<0.01). Conclusion Electroacupuncture could improve learning and memory abili-ty and increase synaptic density in rats with Alzheimer's disease, especially with high frequency.

OBJECTIVE:To discuss the general pattern and the characteristics of macrolides-induced anaphylactic shocks. METHODS:The original articles of 78 macrolides-induced anaphylactic shocks cases reported in Chinese medical science journals during the period from 1985 to 2009 were retrieved from CNKI literature base,and a related database was established for statistical analysis. RESULTS:Seven kinds of macrolides involved in the anaphylactic shocks,with azithromycin,erythromycin and kitasamycin respectively dominated the first 3 places. The anaphylactic shocks were predominantly induced by intravenous drip infusion(88.46%). Of all the 78 cases,4 cases were dead. CONCLUSION:Great attention should be paid to the macrolides-induced anaphylactic shocks in clinical practice to ensure medication safety.

Objective To investigate the value of ADC and T2WI in differentiating of skull base chordoma and invasive pituitary adenomas(IPA).Methods 15 patients with skull base chordoma and 19 patients with IPA which involve paranasal sinus were reviewed retrospectively.All diagnosis were demonstrated by pathology.Quantitative analysis of minimum ADC, normal ADC and rT2WI values were performed.Differences in minimum ADC, normal ADC and rT2WI values between skull base chordoma and IPA were evaluated using the independent samples t test and receiver operating curves(ROC).Results Statistical analysis revealed a significant difference among normal ADC, minimum ADC and rT2WI values (P<0.01),and the area under the ROC curves decreased in turn.Conclusion Both ADC values and rT2WI SI are effective parameter for differentiating diagnosis of skull base chordoma and IPA.

Objective To evaluate the relationship between smoking and p53 gene mutation in the lung cancer patients with Meta-analysis.Methods PubMed,Web of Science,ProQest and Medline were used to search all the relevant studies about the association between smoking and p53 gene mutation in the patients with lung cancer. Based on reviewing full text,the studies were selected and evaluated and the data was extracted.Statistical analysis was performed with Stata 1 2.0 software including the heterogeneity inspection, publication bias assessment, sensitivity analysis,effect consolidating and cumulative Meta-analysis.Results Totally 15 articles with 1 770 lung cancer patients were identified. 69.6% of the patients were smokers,30.4% were non-smokers.Overall,the smokers with lung cancer had a 2.70-fold higher risk for p53 gene mutation than the non-smokers with lung cancer (OR=2.70,95%CI=2.04-3.59).Conclusion p53 gene mutation is associated with smoking in the patients with lung cancer.The smokers with lung cancer have higher risk for p53 mutation than non-smokers.

Objective To investigate the features of parental attachment in children with attention deficit hyperactivity disorder(ADHD).Methods Experience in Close Relationship Scale Revised(ECR-R),Relationship Questionnaire(RQ) and Homemade General Situation Table was conducted among 164 parents of ADHD and 328 parents of normal children.Results The attachment repretation in fathers of children with ADHD showed that autonomous(43.9％ ) was lower than those of the control group (52.4％),dismissing type (41.5％ ) was higher than the normal group (34.1％),preoccupied( 12.2％ ) was higher than those in the control group (8.0％),unresolved type (2.4％) was lower than those of the control group (5.5％),the difference was not statistically significant (P ＞ 0.05 ).The attachment repretation in mothers of children with ADHD showed that autonomous (40.2％) was lower than those of the control group (50.0％),dismissing type (30.5％) belowed the normal group (32.3％),preoccupied type ( 20.7％ ) higher than those in the control group ( 10.4％ ),unresolved type (8.5％) higher than those in the control group (7.3％),the difference was not statistically significant (P ＞0.05).Two groups had no statistical differences in paternal attachment anxiety,paternal attachment avoidance、maternal attachment anxiety and maternal attachment avoidance dimensions ( ( 3.44 + 0.97 ) vs ( 3.37 + 0.82 ),(3.70+0.57)vs(3.72 +0.57),(3.37+0.87) vs(3.36 +0.83),(3.74+0.68)vs(3.64±0.59),allP＞0.05).Conclusion There is no significant differences in the features of parental attachment between children with ADHD and normal children.

Objective To investigate the immune injury in genital tract of BALB/c mice induced by plasmid protein pORF5 of Chlamydia trachomatis and its possible mechanism.Methods GST(glutathione-S-transferases)-pORF5 fusion protein was expressed and digested with PreScission Protease to obtain the target protein without GST tag.After further purification and endotoxin removal,pORF5 protein was injected into the posterior fornix of BALB/c mice on day 1,3 and 6,while the control groups were injected with PBS or GST protein respectively,and then all the mice were sacrificed on day 7 to evaluate genital tract gross pathology and histopathological characterization.The levels of TNF-α,IL-1β and IL-6 in serum,splenocytes culture supernatant and vaginal douche were detected by ELISA.Results Mice in pORF5 group developed different degrees of swelling in isthmic portion and ampulla of uterine tube,connective tissue adhesion and hydrosalpinx in the genital tract tissues,while the PBS group and the GST group did not show any obvious change.The inflammatory score showed that the genital tract pathology in pORF5 group was much more severe than PBS and GST control groups (P＜0.O1).The levels of TNF-α,IL-1β and IL-6 in vaginal douche and splenocytes culture supernatants in pORF5 group were obviously higher than those of PBS and GST groups (P＜0.05).The levels of TNF-α and IL-1β in serum were also higher than those of GST and PBS groups (P＜0.01).Conclusion pORF5 plasmid protein could induce pathological immune response in the genital tract of BALB/c mice,which may be associated with the increase of the production of the inflammatory cytokines TNF-α,IL-1β and IL-6 in BALB/c mice.

ObjectiveTo study the synergistic effect of p38MAPK and ERK1/2 in bone marrow mesenchymal stem cells (BMSCs), and to explore their influence on osteogenic differentiation in BMSCs cultures. MethodsMouse BMSCs were cultured in phenol red-free α-MEM containing osteogenic supplements (OS) for inducing osteogenic differentiation. The temporal sequence of osteogenic differentiation in BMSCs cultures was assayed by measuring alkaline phosphatase activity (ALP) and calcium deposition gene expression. The activation of p38MAPK and ERK1/2 was detected by western blotting using phospho-specific MAP kinase antibody. BMSCs were treated with the inhibitor of p38MAPK pathway(SB203580) or ERK1/2 pathway (PD98059), and osteogenic differentiation was measured. BMSCs were treated with SB203580 or sodium arsenite(ARS), a strong activator of p38MAPK, and the phosphorylation of ERK 1/2 was measured. BMSCs were treated with PP2A inhibitor, Okadaic acid(OA), the phosphorylation of ERK1/2 and osteogenic differentiation were measured. lmmunoprecipitation was used to test the binding interaction between PP2A and ERK1/2, and the effect of SB203580 on the interaction. ResultsTreatment of BMSCs with osteogenic supplements resulted in activation of p38MAPK and ERK1/2 that coincided with osteogenic differentiation. Inhibition of p38MAPK activation by SB203580, blocked the osteogenic differentiation, whereas inhibition of ERK1/2 activation by PD98059, enhanced the osteogenic differentiation in a dose-dependent manner.SB203580 treatment resulted in increased ERK1/2 phosphorylation. By contrast, ARS treatment resulted in decreased ERK1/2 phosphorylation. Inhibition of PP2A by OA resulted in increased ERK1/2 phosphorylation. OS-induced osteogenic differentiation was also attenuated by PP2A inhibition. Immunoprecipitation confirmed the association of PP2A with ERK1/2 in BMSCs cultures, which was decreased by SB203580 treatment. ConclusionThe present study demonstrates a synergistic effect between p38MAPK and ERK1/2 signaling pathways via PP2A in BMSCs cultures, which may regulate the osteogenic differentiation of BMSCs.