BACKGROUND:For a long time, the myocardium of adult mammalians is the terminal y differentiated tissue with no regeneration capacity. If damaged, myocardial cells wil be replaced by fibrous connective tissue. OBJECTIVE:To rediscover the myocardial cells and to do a review for cardiac stem cells, in order to define the existence of myocardial cells. METHODS:A computer-based online research of CNKI and PubMed databases was performed to col ect articles published between 2003 and 2014 with the key words of“cardiac stem cells, stem cells, cardiac regeneration”in Chinese and English, respectively. There were 82 articles after the initial survey, and final y 40 articles were included in result analysis. RESULTS AND CONCLUSION:Cardiac stem cells exist in the heart, and some surface markers of cardiac stem cells have been discovered. Cardiac stem cells for some diseases with myocardial cellinjury have opened up a new way. Because of the smal number of myocardial cells, how to purification, culture, identification and proliferation wil be further studied to meet the need for regenerative medicine and tissue engineering. Cardiac stem cellresearch wil open a new approach for cardiac tissue engineering.

Bilingual education refers to applying a kind of foreign language to the non-language class curriculum,and the foreign language and the professional knowledge are gained in synchronization.Using bilingual education has increased students' study difficulty in the medical course.The object of Taskbased Teaching is that the student must grasp the specialized knowledge and the foreign language.

Objective To discuss the characteristics of ultrasonic images obtained by color Doppler per rectum after intrarectal pouring and the advantages of this method.Methods 40 cases who were diagnosed as rectal carcinoma prior to surgeries were investigated.The rectum was cleand and then was poured with normal saline before examination.Color Doppler ultrasonography per rectum was performed with intrarectal probe touching the inferior edge of the tumor.The 2-dimensional images and color Doppler images were then analyzed.Results The accurate typing of rectal tumors(detailedly,the ulcerative,intumescent,and confined types)can be obtained with this method.Within the 40 cases,24 were ulcerative,12 were intumescent and 4 were confined.Only one case with ulcerative tumor was misdiagnosed as intumescent.The total accuracy rate was 97.5%.As with rectal tumors less than 5cm,there was no significant difference between the measurement by ultrasonography and that by pathologic methods (P＞0.05).While for tumors larger than 5cm,the measurement by ultrasonography was significantly different from that by pathologic methods (P＜0.05).There was no significant correlation between the bloodstream signal of color Doppler and pathological grading(P＞0.05).The method can be applied for patients who have a narrow rectal duct or are suffering from agonies which prevent the passage of the colonoscope.For cases failing to detect the margin and surface of the tumor with routine method,or ultrasonic probe failing to pass the confined area leading to illegible 2-dimensional images,This method is competent as well.Conclusion Color Doppler ultrasonography per rectum after intrareetal pouring can be applied for the diagnosis of rectal tumors of all types.

Objective To screen differential Mycobacterium tuberculosis genes between Xinjiang clinical strains and H37Rv by suppression subtractive hybridization( SSH), and to analyze the function of these specifically pathopoiesis genes. Methods Both M. tuberculosis Xinjiang clinical strains and H37Rv as tester and driver each other, most identical genome was drived whereas some distinctive genes was re-mained and enriched by utilization SSH technique. Meanwhile through inserting differential genes to E. coli all of sequences that we have cloned were determined by BLAST in GenBank. The function of differential genes between M. tuberculosis H37Rv and Xinjiang clinical strains were analyzed. Results We cloned and analyzed six different DNA fragments that only existed in Xinjiang clinical strains. One is the fragment of a gene ceding monooxygenase, flavin-binding family identified by Glimmer2. One fragment belongs to acyl-transferase family protein. One for aminotransferase, class Ⅱ, acyl carrier protein. One fragment belongs to chromosomal replication initiator protein DNA and one for M. tuberculosis paralogous family 11-pyridoxamine 5'-phosphate oxidase-related. Meanwhile, we cloned ten DNA fragments only in H37Rv. Conclusion SSH technique can efficiently screen differential genes in M. tuberculosis in Xinjiang clinical strains. They are possible key genes that M. tuberculosis survive and fortify virulence in mal-environment as same as their ho-mogenic genes, such as enhanced adsorbability in wall-held protein, counteracted digestion by nitro-oxygen-ase, elevated composition capability in the acyhransferase, control chromosomal replication initiator protein, synthesized aminotransferase acyl cartier protein and pyridoxamine 5'-phosphate oxidase.

Objective To compare the effectiveness of two kinds of defluorinating agents (bone char and modified clay) for removal of fluoride in drinking water,and to analyze their application feasibility in small towns.Methods Influencing factors on defluorinating efficiencies of the two kinds of defluorinating agents under the same conditions were studied,namely the effects of adsorption time,temperature,pH,common anions and cations,and solid-liquid ratio on defluorinating efficiencies were studied.The defluorinating efficiencies of the two kinds of defluorinating agents were validated by original groundwater in Jilin Province.The homemade bone char defluorinating agent and modified clay defluorinating agent were regenerated by NaOH and Al2(SO4)3,respectively,and their regeneration abilities were investigated.Results The adsorption data of the two kinds of defluorinating agents were fitted Langmuir model well,and the maximum adsorption capacities were 10.225 g/kg(bone char) and 0.587 g/kg(modified clay).The effect of temperature on defluorinating efficiencies was limited,with increasing temperature(10-35 ℃),the adsorption capacity of bone char and modified clay for fluoride ranged from 1.568 g/kg to 1.598 g/kg and 0.423 g/kg to 0.470 g/kg,respectively.Fluoride could be easily removed under low pH conditions,with increasing of pH(4-10),the adsorption capacity of bone char and modified clay for fluoride decreased from 1.598 g/kg to 1.523 g/kg and 0.724 g/kg to 0.320 g/kg,respectively.The defluorinating efficiencies were improved by common cations(Ca2+) in groundwater,and the adsorption capacity of bone char and modified clay for fluoride increased to 1.713 g/kg and 0.485 g/kg,respectively.Whereas,the defluorinating efficiencies were inhibited by common anions(HCO3-,SO42-) at a certain degree,and the adsorption capacities of bone char and modified clay for fluoride were decreased to 1.158 g/kg(HCO3-) and 0.237 g/kg(SO42),respectively.Defluoridation bone char could be regenerated by soaking in NaOH,and modified clay by immersion in Al2(SO4)3.The adsorption capacities of the two defluorinating agents that had been regenerated for three times still reached 94.6％ and 97.3％ of their original capacities.Conclusions Both of the homemade bone char defluorinating agent and modified clay defluorinating agent have good defluorinating efficiencies and can be regenerated for many times,which are perfectly suitable for application in small towns since they are simple and can be easily applied.The homemade bone char defluorinating agent is suitable for family drinking water and the homemade modified clay defluorinating agent would be more suitable for centralized drinking water.

The basic information and clinical application of nutritional risk scales for children with cancer were reviewed, and the strengths and weaknesses of each scale were analyzed. After systematic search and reading, the scales with more clinical applications included universal scales: Pediatric Malnutrition Assessment Screening Tool (STAMP), Nutritional Risk and Stunting Malnutrition Screening Tool (STRONG kids), Pediatric Yorkhill Malnutrition Score (PYMS), Pediatric Subjective Global Nutritional Risk Assessment (SGNA); specific scales: Nutritional Screening Tool for Childhood Cancer (SCAN), Nutritional Risk Screening for Childhood Cancer (NRS-PC). In order to effectively manage the nutritional risk of pediatric cancer patients, we should selectively use and further actively Chinese or develop specific nutritional risk measurement tools adapted to our national conditions.

Objective:To analyze the clinical features and surgical outcomes of petrous bone cholesteatomas (PBCs).Methods:Data from 39 PBCs patients treated in the Department of Otorhinolaryngology, Xijing Hospital from September 2011 to December 2017 were reviewed retrospectively, including 23 males, 16 femals, aged 12-71 years old, with the median age of 37. Clinical classifications, surgical methods, facial and hearing function, and intraoperative and postoperative complications were made summary analysis.Results:In this study, five patients were congenital PBCs and 34 patients were acquired PBCs. The common clinical symptoms were hearing loss (100%, 39/39), ear discharge/pus (89.7%, 35/39) and facial paralysis (46.2%, 18/39). According to Sanna′s classification, 14 cases were supralabyrinthine, including three cases underwent transcochlear (TC) approach, six cases underwent transotic (TO) approach and five underwent translabyrinthine (TL) approach. 10 cases were infralabyrinthine, including eight cases underwent subtotal petrosectomy, one case underwent TO approach and one underwent TL approach.10 cases were massive, including seven cases underwent TC approach, three cases underwent TO approach. Five cases were infralabyrinthine-apical, including two cases underwent TC approach, two cases underwent TO approach, and one case underwent endoscope assisted infratemporal fossa type B. The degree of facial nerve (FN) dysfunction from high to low was massive (6/10), supralabyrinthine (8/14), infralabyrinthine-apical (2/5) and infralabyrinthine (2/10). 19 cases involved in facial nerve operation, three cases underwent FN decompression, four cases underwent FN rerouting, four cases underwent nerve grafting, and one case underwent facial-hypoglossal anastomosis. Preoperative FN involvement in 18 cases, and the FN function was improved in 14 cases after surgery. The improved rate of postoperative FN function was 77.8%. The bone conducted hearing retained 50.0% (14/28) postoperatively. Five cases with cerebrospinal fluid leak were managed by inserting free muscle plugs and cavity obliteration. Two cases with the cholesteatomas matrix involved the sigmoid sinus and the jugular bulb, and occlusion of the sigmoid sinus was performed. Postoperatively, two patients presented with synkinesis. The patients were followed up for 40 to 115 months, and there was no recurrence.Conclusions:There are no specific clinical manifestations for PBCs, thus, it is difficult in early diagnosis and treatment. According to Sanna′s classification, preoperative FN and hearing function, the best surgical approach should be selected with minimal recurrences and perioperative morbidity.

Objective To observe the effect of non-invasive ventilator assisted vibration sputum evacuation on the level of cardiac function indicators in patients with acute heart failure in the intensive care unit(ICU).Methods A total of 120 patients with acute heart failure who received treatment in the ICU of Tongde Hospital of Zhejiang Province from September 2020 to March 2023 were selected as the study subjects.The patients were randomly divided into a control group and an experimental group using a random number table method,with 60 patients in each group.A total of 120 patients were treated with conventional symptom therapy and non-invasive ventilation.The control group received routine nursing intervention,while the experimental group received non-invasive ventilator assisted vibration sputum evacuation.Arterial partial pressure of oxygen(PaO2),arterial partial pressure of carbon dioxide(PaCO2),pulse oxygen saturation(SpO2),respiratory rate(RR),heart rate,blood pressure,central venous pressure,serum and ultrasound cardiac function indicators,and prognosis of two groups of patients were recorded after 2 weeks of intervention.Results After the intervention,PaO2,SpO2,and left ventricular ejection fraction(LVEF)were significantly increased in both groups,while PaCO2,RR,heart rate,blood pressure,central venous pressure,N-terminal pro-brain natriuretic peptide(NT-proBNP),cardiac troponin T(cTnT),left ventricular end-systolic diameter(LVESD),and left ventricular end-diastolic diameter(LVEDD)were significantly decreased compared to before the intervention(all P<0.05).Compared with the control group,the experimental group showed significant increases in PaO2,SpO2,blood pressure,central venous pressure,and LVEF after intervention[PaO2(mmHg,1 mmHg≈0.133 kPa):68.24±5.81 vs.59.63±6.86,SpO2:0.95±0.03 vs.0.87±0.04,systolic blood pressure(mmHg):116.05±4.11 vs.104.13±3.95,diastolic blood pressure(mmHg):68.19±4.13 vs.62.85±4.12,central venous pressure(mmHg):9.42±1.29 vs.8.12±4.12,LVEF:0.49±0.05 vs.0.43±0.04,all P<0.05],while PaCO2,RR,heart rate,NT-proBNP,cTnT,LVESD,and LVEDD were significantly reduced[PaCO2(mmHg):42.12±4.08 vs.52.13±4.61,RR(beats/min):18.85±1.75 vs.21.54±2.51,heart rate(bpm):89.53±8.14 vs.101.11±10.26,NT-proBNP(ng/L):1687.25±589.67 vs.2145.36±751.03,cTnT(ng/L):70.58±5.15 vs.81.45±6.89,LVESD(mm):34.51±3.11 vs.38.89±3.55,LVEDD(mm)46.11±3.22 vs.49.74±3.75,all P<0.05].The mechanical ventilation time,ICU hospitalization time,and pulmonary infection relief time of the experimental group were significantly shortened compared to the control group[mechanical ventilation time(hours):72.14±10.06 vs.78.96±12.97,ICU hospitalization time(days):10.74±2.15 vs.12.88±3.26,pulmonary infection relief time(days):3.58±0.79 vs.5.14±1.12,all P<0.05],and the incidence of pulmonary infection was significantly reduced[1.67%(1/60)vs.11.67%(7/60),P<0.05],However,there was no statistically significant difference in the mortality rate between the experimental group and the control group[10.00%(6/60)vs.21.67%(13/60),P>0.05].Conclusion The non-invasive ventilator assisted vibration sputum evacuation can improve symptoms of hypoxemia and cardiac function,stabilize hemodynamics,shorten the course of acute heart failure in ICU patients,and reduce the incidence of pulmonary infections.

Objective:To describe the distribution of lipoprotein (a) [Lp(a)] levels in non-arteriosclerotic cardiovascular disease (ASCVD) population in China and explore its influencing factors.Methods:This study was based on a nested case-control study in the CKB study measured plasma biomarkers. Lp(a) levels was measured using a polyclonal antibody-based turbidimetric assay certified by the reference laboratory and ≥75.0 nmol/L defined as high Lp(a). Multiple logistic regression model was used to examine the factors related to Lp(a) levels.Results:Among the 5 870 non-ASCVD population included in the analysis, Lp(a) levels showed a right-skewed distribution, with a M ( Q1, Q3) of 17.5 (8.8, 43.5) nmol/L. The multiple logistic regression analysis found that female was associated with high Lp(a) ( OR=1.23, 95% CI: 1.05-1.43). The risk of increased Lp(a) levels in subjects with abdominal obesity was significantly reduced ( OR=0.68, 95% CI: 0.52-0.89). As TC, LDL-C, apolipoprotein A1(Apo A1), and apolipoprotein B(Apo B) levels increased, the risk of high Lp(a) increased, with OR (95% CI) for each elevated group was 2.40 (1.76-3.24), 2.68 (1.36-4.93), 1.29 (1.03-1.61), and 1.65 (1.27-2.13), respectively. The risk of high Lp(a) was reduced in the HDL-C lowering group with an OR (95% CI) of 0.76 (0.61-0.94). In contrast, an increase in TG levels and the ratio of Apo A1/Apo B(Apo A1/B) was negatively correlated with the risk of high Lp(a), with OR (95% CI) of 0.73 (0.60-0.89) for elevated triglyceride group, and OR (95% CI) of 0.60 (0.50-0.72) for the Apo A1/B ratio increase group (linear trend test P≤0.001 except for Apo A1). However, no correlation was found between Lp(a) levels and lifestyle factors such as diet, smoking, and physical activity. Conclusions:Lp(a) levels were associated with sex and abdominal obesity, but less with lifestyle behaviors.

Objective:To investigate the predictive value of Doppler ultrasonography combined with cytokeratin fragment 19 (Cyfra21-1) and soluble interleukin-2 receptor (sIL-2R) in cervical lymph node metastasis of thyroid micropapillary carcinoma.Methods:102 patients with minimal papillary carcinoma of thyroid confirmed by surgery and pathology admitted to Ultrasound Department, Shanxi Cancer Hospital from Aug. 2020 to Aug. 2023 were selected and treated with thyroidectomy plus central region and at least one cervical lymph node dissection. Among them, There were 24 cases in the LLNM group and 78 cases in the non-LLNM group.Results:There were significant differences in age, shape, nodular and capsule contact area, tumor shape aspect ratio > 1, blood flow, microcalcification, serum Cyfra21-1 and serum sIL-2R levels between the two groups (Cyfra21-1: P<0.001, sIL-2R: P=0.001). Logistic regression analysis showed that age ≥50 years old ( OR=0.443, 95% CI: 0.217-0.904), microcalcification ( OR=2.787, 95% CI: 1.491-5.208), Cyfra21-1>3.3ng/ml ( OR=3.117, 95% CI: 1.404-6.922) and sIL-2R > 110.45pmol/L ( OR=3.408, 95% CI: 1.473-7.884) were independent risk factors for cervical lymph node metastasis in PTMC patients ( P < 0.05). The ROC curve results showed that the area under the curve of cervical lymph node metastasis predicted by Doppler ultrasound combined with Cyfra21-1 and sIL-2R was 0.82, and the sensitivity and specificity were 83.67% and 70.56%, respectively. Conclusions:The calcification features of Doppler ultrasound and the elevation of serum Cyfra21-1 and sIL-2R are closely related to cervical lymph node metastasis of thyroid micropapillary carcinoma. The combination of Doppler ultrasound with serum Cyfra21-1 and sIL-2R has important reference value in predicting cervical lymph node metastasis.