Objective To investigate living quality of patients after orthotopic cardiac transplantation and to provide scientific evidence for specific strategy of therapy and improvement of living quality of patients with cardiac transplantation. Methods SF-36 and the social support questionnaire were used to analyze living quality of 79 patients who received orthotopic cardiac transplantation in the Department of Cardiovascular surgery of Affiliated Union Hospital of Fujian Medical University. The mode of SF-36 was from the investigative numerical value of residents in Sichuan province. Description, t-test and Spearman correlation analysis were used to study the related factors. Results Compared with a reference general population, the heart transplant recipients showed a significantly worse living quality score on all domains of the SF-36 scales (P＜0. 05), except the domain of somatic pain. Among the patients after cardiac transplantation, living quality was more significantly improved in ＞2-year survival group than that in ＜one-year survival group (P＜0. 05),except the domain of somatic pain. The relationships between the social support and living quality were analyzed,and it was found that as compared with a reference general population, the heart transplant recipients showed significantly lower scores on all domains of the social support questionnaire (P＜0. 01 ). The total social support scores were positively related to mental health related living quality (P＜0.05, r = 0.223 - 0.710), except the domain of somatic pain. Conclusion Compared with a general population, heart transplant recipients demonstrated a significantly worsened living quality. But evidence showed the living quality can be improved gradually with the prolongation of the survival time after heart transplantation. Social support was related to the living quality of heart transplantation patients. Improvement of availability on social support will probably improve living quality.

OBJECTIVE To investigate the antitumor effect of cadmium (Ⅱ) complex of pyrazolone derivatives 1-phenyl-3-methyl-4-propionyl-5-pyrazolone salicyloyl hydrazide-cadmium (Ⅱ) (Cd-PMPP-SAL) on the murine melanoma B16 cells in vitro and in vivo and its mechanisms. METHODS B16 cells were incubated with Cd-PMPP-SAL at 1.0, 1.5, 3.0, 5.0 and 10.0 mg·L-1 for 24, 48 or 72 h. The prolifera? tion rate of B16 cel s was evaluated by MTT assay. B16 cel s were incubated with Cd-PMPP-SAL at 6.25, 12.50 and 25.00 mg·L-1 for 24 h, while cell morphology was observed by Hoechst33258 staining. Apop?tosis of B16 cells was detected by Annexin Ⅴ-FITC/PI staining. The activity of caspases in B16 cells was detected by caspase activity assay. C57BL/6J mice were inoculated subcutaneously with B16 cells to establish a tumor-bearing model. Five days later, Cd-PMPP-SAL at 6.25, 12.50 and 25.00 mg·kg-1 was injected into tumors of C57BL/6J mice once a day for 12 d. The body mass was recorded daily. One day after the last administration, all the mice were killed and the tumor was harvested. Tumor volume and mass were measured, and the tumor inhibitory rates were calculated. Pathological changes of the tumor, liver and lung were observed under a microscope. The expressions of vascular endothelial growth factor (VEGF) and fibroblast growth factor 2 (FGF2) in tumor tissues were detected by immuno?histochemistry. The apoptotic cells in transplanted tumor tissues were detected by TUNEL. RESULTS Cd-PMPP-SAL inhibited the proliferation of B16 cells. The IC50 was 4.946 mg · L-1, and 95% confidence interval was 4.24-5.65 mg · L-1. The apoptosis rates(12.8 ± 1.4)% and (18.4 ± 0.4)% of Cd-PMPP-SAL 12.50 and 25.00 mg · L-1 groups were significantly higher than those of control group (1.7 ± 0.1)% (P<0.01). The activity of caspase 3 and 9 of Cd-PMPP-SAL 25.00 mg · L-1 group was significantly higher than that of control group (P<0.01), but there was no significant difference in caspases 3/7. The relative tumor volumes of Cd-PMPP-SAL 6.25, 12.50 and 25.00 mg · kg-1 treated groups from the 8th day of treatment were significantly decreased compared with the model group (P<0.01). The result of paraffin sections showed that the transplanted tumor tissues in Cd-PMPP-SAL 12.50 and 25.00 mg · kg- 1 groups exhibited different degrees of necrosis, but there was no significant pathological damage to the liver or lung tissues of mice. Compared with model group, expressions of VEGF and FGF2 in Cd-PMPP-SAL 12.50 and 25.00 mg · kg-1 treated groups were significantly inhibited (P<0.05), and apoptotic cell rates were significantly higher (P<0.05). CONCLUSION Cd-PMPP-SAL can inhibit growth of B16 cells in vivo and in vitro, which may be associated with induction of tumor cell apoptosis and inhibition of tumor angiogenesis.

Objective To investigate the expression of HMGB1 mRNA in endometrial carcinoma and its correlation with clinicopathological features of endometrial carcinoma. Methods Semi-quantitative RT-PCR method was used to detect the expression level of HMGB1 gene in 56 cases of endometrial carcinoma and 20 cases of normal endometrium. Results The expression of HMGB1 mRNA in endometrial carcinoma (0. 3512 ± 0. 0985 ) was significantly higher than that in normal endometrium (0. 2208 ± 0. 0170 ).There was a significant difference in the two groups( P ＜0. 05 ). Grouping by clinicopathological features,the expression of HMGB 1 mRNA in endometrial carcinoma had a correlation with clinical-surgical stage ( P＜0. 05), metastasis of lymph nodes ( P ＜ 0. 05), and depth of myometrial invasion ( P ＜ 0. 05 ). Conclusion The high level of HMGB1 mRNA indicated that HMGB1 might play an essential role in the genesis, growth, invasion and metastasis of endometrial carcinoma.

Objective To summarize the clinical features of children with viral encephalitis accompa-nied with respiratory failure,and to improve the early diagnosis and treatment. Methods The clinical data of 64 cases with viral encephalitis combined with respiratory failure in our unit from May 2005 to May 2015 were analyzed retrospectively. Results All children were characterized by sudden onset. Among them, 60 cases (93. 7%) had fever,50 cases(78. 1%) had convulsion onset,46 cases(71. 8%) had consciousness disorders, 30 cases(46. 8%) had positive pathological signs. Most of them developed respiratory failure in acute stage. Total 56 cases occurred central respiratory failure,6 cases occurred central respiratory failure with peripheral respiratory failure,2 cases occurred respiratory and circulatory failure. Total 46 cases underwent cerebrospinal fluid examination. Routine biochemical test found 32 abnormal cases,of which 10 cases had intracranial hyper-tension and 19 cases had leukocytosis,and 17 cases had increased protein content. Ten cases were positive in cerebrospinal fluid etiology examination,including herpes simplex virus positive in 8 cases,EB virus positive in 1 case,and coxsackie virus positive in 1 case. There were 6 of 64 cases with abnormal CT scans and 29 of 34 cases with abnormal MRI. The results of EEG examination were abnormal in all patients for the first time. The EEG of 48 cases showed diffuse slow waves-δ activity. EEG examination showed generalized discharges or focal discharges during treatment in 22 cases. Five cases of electrophysiological examination showed cervical spinal cord anterior horn injury. Total 24 cases were complicated with stress ulcer,4 cases with liver damage,6 cases with heart damage,4 cases with renal damage,1 case with lung damage. All cases underwent mechanical ventilation for 2-50 days. Total 33 cases(51. 5%) improved and discharged,14 cases died during hospitaliza-tion,17 cases were given up treatment. Total 25 cases had variety of neurological dysfunctions left. Total 14 cases with epilepsy were followed up for 3 months to 6 years in our department,of which 8 cases were medical-ly intractable epilepsies. Conclusion The children with viral encephalitis complicated with respiratory failure have acute onset,rapid progress,high disability and mortality. Early diagnosis and evaluation,effective mechani-cal ventilation in time,and protecting organ function,help to improve the prognosis.

Objective To explore the effects of virtual reality (VR) combined with motor imagery therapy on the upper limb function of hemiplegic stroke survivors.Methods Thirty-nine hemiplegic stroke patients were divided randomly into a treatment group (n =20) and a control group (n =19).Both groups were treated with motor imagery therapy,but the treatment group also received VR training lasting 20 min/day,6 days/week for 8 weeks.All of the patients were assessed with the Fugl-Meyer (FMA) upper limb assessment,the modified Barthel index (MBI) and electromyography at the beginning and after eight weeks of treatment.Results Before the intervention there was no significant difference between the groups in any of the assessments.After eight weeks of treatment,all the assessment results in the treatment group were significantly better than those in the control group.Conclusion Virtual reality combined with motor imagery therapy can distinctly improve the upper limb motor function of hemiplegic stroke survivors and their ability in the activities of daily living.

Objective:To explore the value of stress hyperglycemia ratio (SHR) in predicting the prognosis of patients with acute heart failure (AHF).Methods:AHF patients admitted to the Emergency Department of Shanghai Jiao Tong University Affiliated Sixth People's Hospital from December 2016 to January 2019 were retrospectively included. Clinical data were recorded and SHR was calculated. According to the survival of the patients within 1 year, they were divided into the death group ( n=89) and the survival group ( n=218). Logistic regression analysis was used to analyze the risk factors of mortality. Kaplan-Meier analysis was used to evaluate the correlation between SHR and the prognosis of AHF patients. Results:A total of 307 patients aged 83 ( range 74-87) years old who met the inclusion criteria were included in this study, including 153 males and 104 females. The age, SHR and N-terminal prohormone of brain natriuretic peptide (NT-proBNP) in the death group were higher than those in the survival group [84 (78, 88) vs 82 (72, 86), 1.11 (0.91, 1.51) vs 1.02 (0.86, 1.27), 5 351 (2 098, 14 039)μg/L vs 4 243 (2 294, 7 565)μg/L ]. The left ventricular ejection fraction (LVEF) in the death group was significantly lower than that of the survival group [53 (45, 57) % vs 58 (44, 64) %, P< 0.05]. Logistic regression analysis showed that SHR was an independent risk factor for death in AHF patients ( OR=2.397, 95% CI: 1.285-4.471, P< 0.05). Median SHR was used to draw the survival curve. Patients with high SHR had a lower cumulative survival rate, and the difference was statistically significant ( P<0.05). Conclusion:SHR can identify critically ill patients and is an independent risk factor for death in AHF patients.

Objective To search MRI features of patients with HIV-negative cryptococcus meningoencephalitis (CM)and evaluate the value in judging the prognosis of CM.Methods The findings of cranial MRI and prognosis were retrospectively analyzed in 19 cases with India-ink capsule staining-proved HIV-negative CM in our department.The prognosis was evaluated by Glasgow Outcome Scale:score 1=death,score 2=persistent vegetative state,score 3=severe disability,score 4=moderate disability,score 5=good recovery. The patients with score 1-3 were classified as the group of poor prognosis,while those with score 4,5 as good prognosis.Results Abnormal manifestations on cranial MRI were observed in 84.2%(1 6/1 9)cases,meninges enhanced in 84.2% (1 6/1 9),brain edema in 31.6%(6/1 9),brain parenchyma lesion in 47.4% (9/1 9 ),vasculitis in 5.2% (1/1 9 ).The mean duration of follow-up was 3.5 years,The prognosis of 5/9(44.4%)cases with brain parenchyma lesion confirmed by cranial MR was poor.Conclusion The MRI manifestation of HIV-negative CM is diverse,and brain parenchyma lesion confirmed by cranial MRI may associated with poor prognosis.

Objective To observe the effects of a lower-limb rehabilitation robot plus psychological intervention on depression and lower limb motor function of the stroke patients.Methods Sixty stroke patients were randomly divided into a treatment group (n =30) and a control group (n =30).The patients of control group were treated with routine rehabilitation and psychological intervention,while the treatment group were treated with lowerlimb rehabilitation robot,in addition to the interventions of the control group,for 10-20 minutes daily,6 days per week for 8 weeks.Both groups were assessed with Hamilton Depression Scale (HAMD),Simplified Fugl-Meyer assessment (FMA) and Functional Ambulation Category (FAC) before and at the end of 2,4 and 8 weeks of treatment.Results There was no significant difference between the 2 groups in all the assessment parameters before and after 2 weeks of treatment.At the end of 4 weeks of treatment,both groups improved significantly with regard to the scores of HAMD,FMA and FAC classification,and the treatment group improved to a significantly greater extent than the control group (P ＜ 0.05).At the end of 8 weeks of treatment the scores of HAMD,FMA and FAC classification were further improved significantly in treatment groups when compared with values obtained at the end of 4 weeks after treatment,but the scores of the control group was not significantly improved at the end of 8 weeks when compared with those at the end of 4 weeks of treatment.Conclusion Lower-limb rehabilitation robot plus psychological intervention can significantly help relieve the post-stroke depression and improve lower motor function of stroke patients.

Objective To explore the correlation between sex hormone binding globulin (SHBG) and cardiovascular disease (CVD) in community elderly population.Methods In 2014,1916 elderly people (796 males,and 1 120 females) were selected from Baoshan District Friendship Community,Shanghai.We collected basic epidemiological data and fasting venous blood samples to carry out the detection of biomarkers,and then calculated their ten-year Framingham risk score.In this study,obesity,systolic blood pressure,fasting blood glucose,lipid concentration,and high-sensitive C-reactive protein were considered as CVD risk factors;Framingham risk score was considered as a CVD event prediction risk score.We analyzed the correlations of these factors with SHBG.Results SHBG mean values in the population with a history of CVD were lower than those without a history of CVD (P＜0.001).The correlation coefficient between male SHBG and waist circumference,hip circumference,BMI,systolic pressure,cholesterol,triglycerides,high density lipoprotein cholesterol,apolipoprotein A,high sensitive C-reactive protein were-0.312,-0.307,-0.266,-0.113,0.155,-0.277,0.510,0.394 and-0.130,respectively (P＜0.01).The correlation coefficient between female SHBG and waist circumference,hip circumference,BMI,fasting glucose,cholesterol,triglycerides,high density lipoprotein cholesterol,apolipoprotein A,high-sensitive C-reactive protein were-0.236,-0.248,-0.168,-0.183,0.135,-0.264,0.445,0.358 and-0.295,respectively (P＜0.001).The decrease of SHBG level was consistent with the increase of Framingham score (κ =0.062,P＜0.001).Elevated level of SHBG would reduce the risk of CVD in ten years (P＜0.01).Conclusions There was a negative correlation between baseline SHBG level and CVD risk factors,positive correlation between baseline SHBG level and CVD protection factors in community elderly population;lower SHBG level indicated higher risk of developing CVD events.

AIM: To observe the dynamic changes of myocardial collagen metabolism in pressure-overloaded rats.METHODS: The pressure-overloaded rat model was established by partial abdominal aortic coarctation.The rats underwent surgery but not constrictive were used as sham-operated control group.The rats were euthanized at 3, 4, 8 and 12 weeks.The body mass, heart mass and left ventricular mass were weighed, and the heart mass index (HMI) and left ventricle mass index (LVMI) were calculated.Masson trichrome staining was used on the myocardial sections, alkaline hydrolysis was used to detect the content of myocardial hydroxyproline (HYP), and the serum levels of procollagen type I carboxy-terminal peptide (PICP), procollagen type III amino-terminal peptide (PIIINT), and collagen C telopeptide type I (CTX-I) were also measured.RESULTS: Compared with sham-operated control group, the collagen deposition was evident, and collagen volume fraction (CVF) was increased significantly in model group (P<0.01), which further increased over time.HMI, LVMI and HYP significantly increased in model group (P<0.05), and HYP showed a tendency to increase over time.In addition, the serum concentration of PICP was increased significantly in model group, and the difference was significant at 4, 8 and 12 weeks (P<0.05).The serum concentration of PIIINP was increased significantly, but CTX-I was lowered significantly in model group (P<0.01).CONCLUSION: In the state of pressure overload, myocardial collagen metabolism is in disorder, and myocardial fibrosis is the major pathological change, which further increases over time.