Objective　To study the relation between myocardia l changes and left ventricular function in preoperative patients with combined m itral diseases provide theoretical basis for clinical therapy and evaluate the effects of treatment. Methods　A total of patients with combined mitral lesions were selected randomly for study. The cases were divided into tw o groups according to the degree of ultrastructural damage of the myocardium bef ore aortic occlusion in mitral valve replacement (Flameny cla ssification). The preoperative pulmonary artery catheterization(Swan-Ganz cathe ter), color Doppler echocardiography, roentgenologic measurement of heart size, preoperative clinical data and postoperative follow-up data were collected for analysis. Results　The results showed that myocardial lesion in mitral disease had intimate correlation with the cardiac enlargement, especial c orrelated with left ventricular enlargement and cardiac pumping. Conclus ion　Results suggest that the myocardial lesions in mitral valvular dise ases mainly involved the process of rheumatism and reflected in the disturbance of left ventricular function. Operation should be performed before the appeare nce of non-reversible myocardium injury in patients with rheumatic mitral va lvul ar diseases.

There are also many unanswered questions on the duodenogastroesophageal reflux(DGER),though it has been studied for more than 100 years.Based on the references and our studies,we reviewed the bile' injury on esophageal mucosal epithelial cells,the diagnosis and treatment of bile reflux into esophagus.The relationships of the biles with Barrett's esophagus and esophageal adenocarcinoma were elucidated especially.

Oblective To observe the effect of bile reflux on the intragastric pH. Methods We used ambulatory intragastric pH monitoring along with simultaneous Bilitec 2000 to measure the pH and absorbance of the mixed gastric juice diluted with bile with increasing bilirubin concentration in vitro and the yellow and clear gastric juice aspirated under endoscopy. In vivo,we studied 20 functional dispepsia patients for 24 h with simultaneous intragastric pH and bilirubin monitoring. Results In vitro dilutions,the absorbance value reached to 0. 900 while the concentration was only 20% ,but when the pH of the solution was more than 4,it′s concentration was already up to 60％. The mean absorbance of the yellow gastric juice(0. 348± 0. 131) was significantly higher than that of the clear juice (0. 008 ± 0. 003)(P＜0.05). The pH of 80％ yellow gastric juice was less than 4, the percentage was not significantly different from the clear samples (81％) (P＞0. 05). The pH showed no correlation with the absorbance in the yellow and clear groungs. Eight of the 12 patients with the spontaneous nocturnal episcodes of alkalinization had simultaneous increase of absorbance,4 of the 8 subjects with no aikalinization had increase of absorbance. Gonclusion In some concentration,bile reflux affect little on the intragastric pH.

Humans ; Noise, Occupational ; adverse effects ; Occupational Exposure ; standards

Objective　To study the relation between myocardia l changes and left ventricular function in preoperative patients with combined m itral diseases provide theoretical basis for clinical therapy and evaluate the effects of treatment. Methods　A total of patients with combined mitral lesions were selected randomly for study. The cases were divided into tw o groups according to the degree of ultrastructural damage of the myocardium bef ore aortic occlusion in mitral valve replacement (Flameny cla ssification). The preoperative pulmonary artery catheterization(Swan-Ganz cathe ter), color Doppler echocardiography, roentgenologic measurement of heart size, preoperative clinical data and postoperative follow-up data were collected for analysis. Results　The results showed that myocardial lesion in mitral disease had intimate correlation with the cardiac enlargement, especial c orrelated with left ventricular enlargement and cardiac pumping. Conclus ion　Results suggest that the myocardial lesions in mitral valvular dise ases mainly involved the process of rheumatism and reflected in the disturbance of left ventricular function. Operation should be performed before the appeare nce of non-reversible myocardium injury in patients with rheumatic mitral va lvul ar diseases.

Objective To investigate the mechanism of presynaptic protein (Munc18) antibody in inducing epilepsy on rat. Methods Munc18 antibody was continuously micro-injected into CA1 area of hippocampus in Sprague-Dawley (SD) rat (the injection times were nine). The potential epileptic seizure was evaluated according to both electroencephalogram (EEG) and behaviors. HE, Nissle and TUNEL staining were applied on rat brain sections as to detecting the cell damage and apoptosis after tenth week. Results Ten of twelve rats produced epileptic EEG, five cases among these ten rats maintained abnormal EEG after the sixth week since injections. Nine of the above twelve rats had epileptic seizure according to Racine grade one to four, four cases among these nine rats kept seizure after the sixth week since injections. The number of neurons decreased (155?20,P

Objective To investigate the changes of circulating endothelial progenitor cells (EPCs) in patients with acute cerebral infarction or chronic cerebral ischemia and discuss the related clinical significance.Methods Circulating EPCs were isolated using staining markers of CD34,CD133,and kinase insert domain receptor (KDR).Peripheral venous blood was collected from patients with acute cerebral infarction within 24 hours of onset (infarction group,n =30),with chronic cerebral ischemia (ischemia group,n =20),and without cerebral ischemia (control group,n =10) to quantify circulating level of EPCs using flow cytometry and measure parameters of systolic pressure,glycosylated hemoglobin (HbAlc),total cholesterol (TC),and triglyceride (TG),and low density lipoprotein-cholesterol (LDL-C),and high density lipoprotein-cholesterol (HDL-C).Results CD34-,CD34/CD133-,and CD34/KDR-positive cells counted (14.2 ± 8.1)‰,(7.1 ± 4.1)‰ and (5.0 ± 3.7)‰ in infarction group,(28.5 ± 9.9)‰,(15.2 ± 3.7)‰ and (6.8 ± 2.0)‰ in ischemia group,and (44.8 ± 9.5) ‰,(22.1 ± 6.6) ‰ and (16.7 ± 6.9) ‰ in control group.Taken together,circulating level of EPCs lowered substantially in infarction and ischemia groups compared to control group (P ＜ 0.05) and a far lower level was observed in infarction group (P ＜ 0.05).Circulating level of EPCs in infarction group was in a moderate negative correlation with systolic pressure,TC,TG,and LDL-C (P ＜ 0.05).Conclusions Decreased circulating level of EPCs may be a risk factor to the development of cerebral ischemia in acute cerebral infarction patients.Therefore,level of EPCs is vital for prediction,prevention and treatment of acute cerebral infarction.

Objective:To investigate the efficacy of the combined application of fluconazole and sodium bicarbonate in treatment of oral fungal infections among elderly patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Methods:A total of 360 elderly patients with AECOPD treated in the Emergency Ward of our hospital during July 1, 2018 and December 31, 2019, were included for observation. After admission, the oral mucosal lesions were observed every day, and fungal smear and fungal culture were performed immediately once signs of fungal infection appeared. Meanwhile, fluconazole was given with 300 mg. oral. qd., followed by 150 mg. oral. qd., and 2.5% sodium bicarbonate was given three times a day as gargle.Results:The prevalence of oral fungal infection was 8.3% among which candida infection accounted for 83.2%. The mean treatment time was 5.0 ± 0.3 days. Daily observation of the oral cavity, early detection and application of fluconazole combined with sodium bicarbonate had significantly clinical effect in elderly AECOPD patients with oral fungal infection, with an effective rate of 16.7%, and a cure rate of 83.3%. No toxic side effects on liver and kidney function were found during the treatment. Obvious efficacy was found in relieving clinical symptoms, and there was no increase in hospitalization costs and time.Conclusion:Early combination of fluconazole and sodium bicarbonate has a significant clinical effect on control of oral fungal infection in elderly patients with AECOPD.

To explore the action target of praziquantel (PZQ) and its underlying mechanism of action, adult male worms of Schistosoma japonicum were collected from the hepatic vein of Kunming mice infected at least 6 or more weeks previously with single-sex cercariae of S.japonicum by perfusion method. These worms were subjected to the action of calcium channel blockers (CCBs) or actin depolymerizing/stabilizing agents interfering with function of the calcium channel. The adult male worms in DMEM culture medium were co-cultivated with near-lethal dose of PZQ(14 μmol/L) overnight(16 hours).Then, the parasites were washed 3 times with sterile physiologic saline next morning after cultivation, re-suspended in new and drug-free medium and then observed under stereo-microscopy during the following 5 days. The experimental results showed that majority of adult male worms of S.japonicum were killed by the action of PZQ in a dose of 14 μmol/L in vitro under normal condition; while the worms pre-incubated with the actin depolymerizing agent cyto chalasin D (CyD) were able to survive in the condition containing 14 μmol/L of PZQ with a survival rate of 100%, and the worms pre-incubted with CCBs, such as nitrendipine and nifedipineu showed a survival rate of about 50% under the same condition. The results of this study suggest that the calcium channel of Schistosomes may be involved in the action target of PZQ and its underlying mechanism.

AIM:To explore whether YAP protein is important in induced pluripotent stem cell ( iPSC)-induced cardiovascular progenitor cell and/or vascular smooth muscle differentiation .METHODS:Using episomal vector based reprogramming , we generated human iPSCs from donor fibroblasts .We used both this iPSCs and human H 1 embryonic stem cells to differentiate into vascular smooth muscle cells (VSMCs) through cardiovascular progenitor cells (CVPC).Western blotting, qPCR and immunofluorescence microscopy were used to check the expression of YAP and related genes during this differentiation process .RESULTS:The results showed that iPSCs expressed pluripotent stem cell markers, such as Oct4, Nanog, Sox2, TRA-1-60 and SSEA3, and could form teratoma in SCID mice.YAP was highly expressed in pluripotent stem cells , but dramatically decreased when CVPC differentiation started .YAP gradually increased dur-ing CVPC three-day differentiation.The TAZ and YAP binding partner TEAD1, but not TEAD2 and TEAD4, have similar expression pattern in CVPC differentiation .Immunofluorescence result confirmed that YAP was activated and accumulated in nucleus .Interesting-ly, both YAP and phosphorylated YAP expression decreased to very low level after CVPC differentiated into VSMCs in 7 days.TEAD4 and TAZ also decreased, while TEAD1, TEAD2 and TEAD3 expression did not change during VSMC differentiation .CONCLU-SION:YAP and TEAD1 expression increased during CVPC differentiation , while YAP and TEAD4 expression decreased from CVPC to VSMCs differentiation , which suggested YAP might have different function during diverse cell differentiation .