Objective　To compare the effects of mild hypothe rmic cardiopulmonary bypass (CPB) and moderate hypothermic cardiopulmonary bypas s in pediatric cardiac surgery. Methods　A total of 118 cas es of less than 3 years of age that had undergone open heart surgery were review ed, in which 46 patients received moderate hypothermic CPB(group 1) and 72 patie nts received mild hypothermic CPB(group 2). The CPB duration, incidence of low c ardiac output and postoperative concentration of CK-MK, etc, were compared with each other betwee n the two groups. Results　Duration of bypass and postoperative mechanical respiratory assistance of group 2 was shorter than that of group 1 ( P<0.05). Transfusion requirements, incidence of low cardiac output syndrome, concentration of CK-ME and percentage of metabolic acidosis were lower in grou p 2 than in group 1 (P<0.05), while the index of oxygenation was higher in g roup 2(P<0.05). Conclusion　The mild hypothermic CPB is saf er and more effective and therefore is superior to moderate hypothermic CPB in p ediatric cardiac surgery.

Objective To summarize the experience in surgical treatment of Ebstein anomaly,and evaluate the therapeutic effect.Methods Thirty-five patients of Ebstein anomaly were treated by operation.New York heart association(NYHA)heart function classⅠ?was in 11 cases,classⅡ?was in 14 cases,class III-Ⅳ?was in 10 cases.The cue of echocardiogram about tricuspid valve regurgitation in 24 cases were severe,5 cases were moderate and 6 cases were mild.Two patients accepted tricuspid valve replacement.Thirty-three cases were accepted tricuspid valve repair and right ventricle folded,in which 2 cases accepted Danielson method,and 31 cases accepted Carpentier method,among them,9 cases accepted one and a half ventricular repair.Associated heart anomaly was corrected at the same time.Results One patient died.There were 2 cases with third degree atrioventricular block after tricuspid valve replacement,2 cases with low cardiac output syndrome and 2 cases with atrial fibrillation combined premature ventricular contraction.The heart was lower by chest X-ray and echocardiogram examination,tricuspid valve regurgitation in 22 cases were disappeared,9 cases were mild,3 cases were moderate.All patients were followed up from 1 month to 7years,tricuspid valve regurgitation in 21 cases were disappeared,12 cases were mild,heart function were class Ⅰ-Ⅱ.Because of heart function aggravation,1 patient was operated again 3 years after operation.Condusions Ebstein anomaly is a rare congenital heart disease,Carpentier method tricuspid valve repair can decrease regurgitation obviously and protect right ventricular function.One and a half ventricular repair should be adopted according to the function of tricuspid valve and right ventricle.

Objective To research ischemic postconditioning on heart function after myocardial ischemia-reperfusion(I/R),and the protective mechanisms. Methods Thirty-two rats were divided into four groups:I/R group ( n = 8 ) , ischemic postconditioning group (n=8),myocardial ischemic postconditioning+ NSC-74859 (STAT3 inhibitor) group(n=8),and control group(n=8). Establish a model of rat to observe changes of the heart rate,LVSP,+dp/dtmax,-dp/dtmax,coronary flow and myocardial enzyme spectrum in each group un-der different conditions. Results Compared with ischemia-reperfusion group,heart rate of the reperfusion period,CK and LDH of coronary ef-fluent in the ischemic postconditioning group were obviously lower,while left ventricular systolic pressure,change of intraventricular pressure, and coronary effluent volume increased obviously. And after inhibition of STAT3 expression,this protective effect decreased significantly. Con-clusion Ischemic postconditioning can provide potent cardioprotective effect in which STAT3 mediates the cardioprotective effects.

Objective To observe hypoxia-induced pulmonary arterial endothelial-to-mesenchymal transition and investigate the role of transforming growth factor β1 (TGF-β1) in the process. Methods Pulmonary arterial cells improved by adherence method were cultured in normoxia (containing 21%O2,5%CO2 and 74%N2) or hypoxia (containing 1%O2,5%CO2 and 94%N2) for 1,4,or 7 days,respectively. Endothelial-to-mesenchymal transition was confirmed with morphological observation and expression of α-smooth muscle actin (α-SMA) by immunocytochemistry. Expression of TGF-β1 was evaluated by RT-PCR and Western blot,and α-SMA by Western blot. Results Hypoxia-induced paving-stone-like pulmonary arterial endothelial cells transdifferentiating to polygonal cells with high-expression of α-SMA. TGF-β1 expression was increased significantly after 7 days of hypoxia. TGF-β1 stimulating alone increasedα-SMA expression of pulmonary arterial en-dothelial cells;while,SD-208,inhibitor of TGF-β1,abolished the above effect. Conclusion Hypoxia can induce endothelial-to-mesenchymal transition. And TGF-β1 plays an important role in the process.

AIM To study the inhibitory effect of bioactive compounds from entomogenous fungi(BCEF0083) on monoamine oxidase. METHODS Spectrofluorometer was used to detect the activity of MAO in mouse and rat brain mitochondria; Dose effect and time effect relationship of BCEF in inhibition of MAO were studied in vivo and in vitro in mice and rats; Method of Lineweaver Burk was used to assay the Km of MAO. RESULTS The antagoning action of BCEF0083 on MAO( BCEF 500 mg?kg -1 , 0 5, 1, 2, 4, 8, 16, 24, 48, 72 h after ig; 500, 400, 200, 100, 50, 25 mg?kg -1 , 2 h after ig)showed some extent of dose effect and time effect relationship. BCEF0083 in vitro inhibited the activity of MAO A,B in a dose dependent manner with IC 50 (95% of confidence limits)of 128 88(82 70～200 86),184 14(156 17～217 11) ?g?ml -1 in rats. The antagonism type of BCEF0083 on MAOA, B were both mixed type, their Km were 11 97, 8 13 ?mol?L -1 . CONCLUSION The results suggest that BCEF0083 could obviously inhibite the activity of MAO on brain remitochondria in mice and rats.

Objective To investigate DNA methylation markers in the whole blood of patients with systemic lupus erythematosus(SLE),in hope to facilitate the evaluation of SLE severity.Methods Whole blood samples were obtained from 58 patients with SLE(including 14 cases of severe SLE,25 moderate SLE,19 inactive SLE)and 50 healthy controls.Bisulphite sequencing was performed to determine the methylation status of interleukin-2 common receptor gamma chain(IL-2RG)promoter region,and real-time reverse transcriptionPCR to quantify the expression level of IL-2RG mRNA,in these subjects.Results The methylation level of IL2RG promoter region was 0.217 ± 0.140,0.325 ± 0.230,0.342 ± 0.085 and 0.175 ± 0.036 in the patients withsevere,moderate and inactive SLE and healthy controls,respectively.A significant increase was observed in the methylation level of IL-2RG promoter region in the patients with inactive SLE compared with the patients with severe SLE and healthy controls(both P ＜ 0.01),and in the patients with SLE compared with the healthy controls(0.263 ± 0.047 vs.0.175 ± 0.036,P ＜ 0.05).The expression level of IL-2RG mRNA was significantly lower in the patients with SLE than in the healthy controls(2.550 ± 0.823 vs.4.293 ± 1.283,P ＜ 0.05).A negative correlation was observed between the expression level of IL-2RG mRNA and methylation level of IL2RG promoter region in 20 patients with SLE(r =-0.44,P ＜ 0.05).Conclusion The methylation status of IL2RG promoter region is statistically higher in patients with SLE than in healthy controls,and significantly different between patients with active SLE and those with stable SLE.

Objective To explore the appropriately operative chance , method, and perioperative management of coronary arterybypass grafting (CABG) in the patients with severe left main artery (LMA) stenosis with three-vessel-disease.Methods A total of296 patients with severe LMA stenosis with three-vessel-disease who underwent CABG surgery was analyzed retrospectively from 2003through 2013.Of them, 276 patients underwent conventional coronary artery bypass surgery on pump ( CCABG)and 20 patients underwentoff-pump CABG( OPCAB); 172 Patients was over 60 years old (58.1%)and 246 patients (83.10%) had concomitant diseasesincluding valve lesion, hypertension, diabetes, myocardial infarction, left ventricular aneurysm with septal defect , stroke, renal failure,and cancer.Left internal mammary artery use was in 281 patients (95.1%); and 32 patients were implanted intra-aortic ballonpump(IABP) perioperatively.Results There were 7 cases(2.36 %) death of postoperative low cardiac output , ventricular fibrillation,cerebral infarction, renal failure, and multiple organ failure, respectively.Postoperative complications were low cardiac output ,respiratory failure , ventricular fibrillation, cereboembolism, cardiac tampomade, renal failure, stroke, and multiple organ failure.Afterfollow-up 2 to 84 months, there was 3 death in which 2 death of cardiac factors.Conclusions CCABG was a safe and effectivemethod in patients with severe LMA stenosis with severe three -vessel-disease.Preoperative insertion of IABP can certainly avoid the po -tential operative risk factor and significantly decrease the mortality and morbidity .

Objective:To investigate the effects of different doses of rosuvastatin on blood lipid levels and 1-year outcomes in patients undergoing coronary artery bypass grafting.Methods:A total of 106 patients who underwent coronary artery bypass grafting at the Affiliated Hospital of Jining Medical University from February 2020 to February 2022 were prospectively selected and randomly divided into two groups using a random number table. The high-dose group (53 cases) was treated with 20 mg/d rosuvastatin, while the low-dose group (53 cases) was treated with 10 mg/d rosuvastatin. The two groups were compared after treatment in terms of the clinical efficacy, blood lipid levels [total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C)], cardiac function indicators [left ventricular end diastolic diameter (LVDD), left atrial diameter (LAD), left ventricular ejection fraction (LVEF), one-year follow-up [recurrence, readmission, death, major adverse cardiovascular events (MACE)], and adverse reactions (liver injury, elevated creatine kinase, gastrointestinal reactions, rash).Results:The total effective rate of the high-dose group was 94.34%(50/53) higher than that of the low-dose group, which was 77.36%(41/53) ( P<0.05); After treatment, the levels of TC, TG, and LDL-C in both groups decreased, while the level of HDL-C increased (all P<0.05), and the levels of TC, TG, and LDL-C in the high-dose group were lower than those in the low-dose group, while the level of HDL-C was higher than that in the low-dose group (all P<0.05); After treatment, LVDD and LAD in both groups decreased, while LVEF increased (all P<0.05), and LVDD and LAD in the high-dose group were lower than those in the low-dose group, while LVEF was higher than that in the low-dose group (all P<0.05); After a one-year follow-up, the recurrence rate of the high-dose group was 7.55%(4/53), and the readmission rate was 5.66% (3/53), both lower than those of the low-dose group [26.42%(14/53), 20.75%(11/53)] (all P<0.05). There was no statistically significant difference in case fatality rate, MACE, and incidence of adverse reactions between the two groups (all P>0.05). Conclusions:The use of high-dose rosuvastatin in patients undergoing coronary artery bypass grafting can effectively reduce blood lipid levels, improve cardiac function, and has high safety. It is worthy of clinical application.

Cardiac arrest is the fourth stage of sudden cardiac death, which is characterized by the cessation of electrical activity in the heart, rapid circulatory and respiratory failure, and the prognosis is often poor. How to effectively predict cardiac arrest is the key and difficult point in the diagnosis and treatment process. In recent years, the research on the application of early warning scoring system in cardiac arrest has made continuous breakthroughs, from initially formulating a traditional scoring system containing only basic vital signs indicators according to a certain number of samples to continuously increasing and changing indicators, increasing the sample size, and formulating an improved scoring system with better sensitivity and specificity. Nowadays, with the continuous development of electronic information technology, machine learning technology is introduced into the formulation of scoring system, which breaks through the limitations of previous scoring system and has achieved good results in clinic. This article analyzes and compares the relevant research and cutting-edge progress of different early warning scoring systems at home and abroad, and summarizes the research results, gaps and shortcomings. Finally, combined with the relevant policies of graded diagnosis and treatment in China, this paper discusses the development and application direction of cardiac arrest early warning scoring system in the future.

Epithelial and stromal tissues are components of the tumor microenvironment and play a major role in tumor initiation and progression. Distinguishing stroma from epithelial tissues is critically important for spatial characterization of the tumor microenvironment. Here, we propose BrcaSeg, an image analysis pipeline based on a convolutional neural network (CNN) model to classify epithelial and stromal regions in whole-slide hematoxylin and eosin (H&E) stained histopathological images. The CNN model is trained using well-annotated breast cancer tissue microarrays and validated with images from The Cancer Genome Atlas (TCGA) Program. BrcaSeg achieves a classification accuracy of 91.02％, which outperforms other state-of-the-art methods. Using this model, we generate pixel-level epithelial/stromal tissue maps for 1000 TCGA breast cancer slide images that are paired with gene expression data. We subsequently estimate the epithelial and stromal ratios and perform correlation analysis to model the relationship between gene expression and tissue ratios. Gene Ontology (GO) enrichment analyses of genes that are highly correlated with tissue ratios suggest that the same tissue is associated with similar biological processes in different breast cancer subtypes, whereas each subtype also has its own idiosyncratic biological processes governing the development of these tissues. Taken all together, our approach can lead to new insights in exploring relationships between image-based phenotypes and their underlying genomic events and biological processes for all types of solid tumors. BrcaSeg can be accessed at https://github.com/Serian1992/ImgBio.