Objective: To explore value of exercise stress test guiding aerobic exercise rehabilitation in patients with myocardial infarction.Methods: A total of 102 patients with myocardial infarction in recovery were selected.According to random number table, they were randomly and equally divided into routine rehabilitation group (received routine rehabilitation guidance) and aerobic exercise rehabilitation group (received aerobic rehabilitation exercise in guidance of exercise stress test).Amount of exercise, hemodynamic parameters and psychological state were compared between two groups.Results: After treatment, amount of exercise: compared with routine rehabilitation group, there were significant rise in amount of exercise[(6.79±0.58)METs vs.(7.42±0.69)METs], maximum heart rate[(126.27±5.26) beats/min vs.(138.18±5.81) beats/min], heart rate blood pressure product[(221.87±21.46) vs.(244.85±23.09)]and exercise duration[(10.36±1.36) min vs.(11.18±1.45) min]in aerobic rehabilitation group, P<0.05 or <0.01;hemodynamic parameters: compared with routine rehabilitation group, there were significant rise in cardiac output[(5.36±0.57) L/min vs.(5.72±0.68) L/min], cardiac index[(2.96±0.53) L min-1 m-2 vs.(3.25±0.52) L min-1 m-2], stroke volume[(73.16±8.47) ml vs.(78.12±9.14) ml]in aerobic exercise rehabilitation group, P<0.05 all;psychological state: compared with routine rehabilitation group, there were significant reductions in scores of Hamilton rating scale for anxiety[HAMA, (9.74±3.26) scores vs.(6.35±1.18) scores]and Hamilton rating scale for depression[HAMD, (14.83±4.58) scores vs.(10.56±3.27) scores]in aerobic exercise rehabilitation group, P<0.05 both.Conclusion: Exercise stress test guiding aerobic exercise rehabilitation can help to improve exercise function and hemodynamic indexes, alleviate the negative mood, then promote patients recover.

Objective To investigate the protective effects of daidzein (DD) on myocardial hypertrophy and fibrosis induced by pressure overload in rats and to study its mechanism. MethodsMyocardial hypertrophy and fibrosis model of rats induced by pressure overload was prepared by constricting abdominal aorta. The operated rats were randomly divided into sham operated control group, aorta-constricted model group, and three DD groups (30, 60, and 120 mg/kg). Four weeks later, the heart-weight (HW), left ventricular weight (LVW), the ratio of HW/BW and LVW/BW (LVI), and the cardio-myocyte diameters (MD) after dying by HE color were measured. The content of collagen and nitric oxide (NO), the activity of calcineurin (CaN) and Na+, K+-ATPase, Ca2+-ATPase in the left ventricle were quantified with spectrophotometry. The angiotension Ⅱ (AngⅡ) in the left ventricle was messured with radioimmunoassay. Results In aorta-constricted model group, the ratio of HW/BW, LVI, and MD as well as the content of collagen and AngⅡ, the activity of CaN in the left ventricle was significantly increased, and Na+, K+-ATPase, Ca2+-ATPase activity and NO content in the left ventricle were obviously decreased. After treatment of the left ventricular with DD, NO content, Na+, K+-ATPase, Ca2+-ATPase activity were significantly increased, the content of collagen and of AngⅡ and the activity of CaN in the left ventricle and the ratio of HW/BW, LVI, and MD were significantly reduced. ConclusionDD has protective effects on ventricular remodeling in rats with myocardial hypertrophy and fibrosis induced by pressure overload and its mechanism may be related to raising NO content and reducing the level of AngⅡ and the activity of CaN.

Objective To observe the therapeutic efficacy of electrical stimulation and balloon dilatation in treating cricopharyngeal achalasia after a brainstem stroke.Methods Thirty dysphagia patients with cricopharyngeal achalasia after a brainstem stroke were randomly divided into an experimental group and a control group, each of 15.The experimental group was given real-time electrical stimulation and balloon dilatation, while the control group was treated using common electrical stimulation and balloon dilatation.Results Twenty-six patients in the 2 groups returned to oral feeding after treatment.Videofluoroscopy revealed that the cricopharyngeal sphincter had relaxed and the food passed successfully when swallowing.No aspiration was observed.There was no significant difference in swallowing between the two groups, but the average treatment time, days of treatment and cost of therapy in the experimental group were significantly less than in the control group.Conclusions Either real-time electrical stimulation or common electrical stimulation combined with balloon dilatation can treat dysphagia effectively, but the former can shorten the course of treatment and lower its cost.

The distribution of the Na-K-2Cl co-transporter (NKCC1) in the cochlear K+ cycling pathway in cochlea and cochlear histological changes in the NKCC1 knockout mice were investigated. By using immunohistochemistry and toluidine blue staining, the localization of NKCC1 in cochlea of the C57BL/6J mice and the cochlear histological changes in the NKCC1 knockout mice were observed. It was found that the NKCC1 was expressed mainly in the stria marginal cells and the fibrocytes in the inferior portion of the spiral ligament in the adult C57BL/6J mice. Subpopulation of the fibrocytes in the suprastrial region and the limbus was also moderately immunoreactive. While in the cochlea of the NKCC1 knockout mice, Reissner's membrane was collapsed and scala media disappeared, accompanied with the loss of inner hair cells, outer hair cells and the support cells. The tunnel of Corti was often absent. All the findings suggested the localization of NKCC1 in the cochlea was closely correlated with cochlear K+ cycling. Loss of NKCC1 led to the destruction of the cochlear structures, and subsequently influenced the physiological function of cochlea.

Objective To investigate the predictive value of early measurement of serum inflammatory mediators for infectious pancreatic necrosis secondary to severe acute pancreatitis (SAP).Methods A retrospective analysis was performed for the clinical data of 166 patients who were admitted to our hospital from January 2012 to January 2017.According to the presence or absence of secondary infectious pancreatic necrosis,the patients were divided into infection group with 58 patients and non-infection group with 108 patients.The serum levels of inflammatory factors were compared between the two groups.The receiver operating characteristic (ROC) curve was used for the analysis of indices with statistical significance.The independent samples t-test was used for comparison of continuous data between groups,and the chi -square test was used for comparison of categorical data between groups.Results Of all 166 SAP patients,58 experienced secondary infectious pancreatic necrosis,resulting in an incidence rate of 34.9％.Compared with the non-infection group,the infection group had significantly higher serum lipase,procalcitonin (PCT),C-reactive protein (CRP),and APACHE Ⅱ score (t =8.679,20.416,18.429,and 8.563,all P ＜0.05).The ROC curve analysis showed that serum lipase,PCT,CRP,and APACHE Ⅱ score had areas under the ROC curve of 0.647,0.877,0.823,and 0.655,respectively,with cut-off values of 612.5 U/L,7.5 ng/ml,226.5 mg/L,and 16.5 points,sensitivities of 68.5％,91.2％,86.8％,and 60.5％,and specificities of 59.3％,83.6％,80.1％,and 68.7％,respectively.Conclusion The abnormally elevated serum levels of CRP and PCT have a certain predictive value for infectious pancreatic necrosis secondary to SAP with convenient and fast operation,and therefore,it holds promise for clinical application.

Objective To observe the effect of inferior vena cava filter (IVCF) on prevention of bone cement implantation syndrome (BCIS). Methods Ten sheep were divided into 2 even groups, BCIS and LVCF intervention ones. First IVCF was implanted into the inferior vena cava through cervical vena-right atrium pathway under fluoroscopic monitoring to observe the influence of IVCF on BCIS. Then BCIS was es-tablished in the same sheep by compressing 10 mL of bone cement into a sheep medullary canal after mutilation of the left femur. Arterial blood pressure, heart rate, central venous pressure (CVP) and blood gas were monitored, while an ultrasonic device was utilized to monitor fat embolisms in the right atriums of the sheep. Oil red staining was performed to detect fat embolisms in pulmonary arteries after the sheep were executed. Results In BCIS group, dotted uneven resonances were found in the right atrium and right ventricle when the medullary canal pressure was increased to 120 mm Hg, indicating embolisms in the right chambers. The dotted resonances were increased to ponderous, snowflake-like ones as the medullary canal pressure climbed up. At the same time, blood pressure and Pa02 dropped significantly, the systolic blood pressure dropped to (80±11) mm Hg and PaO<.2> to the minimum 25 minutes after cone cement implantation. The heart rate and CVP increased continuously. The blood gas assay indicated respiratory and metabolic acidosis. The oil red staining showed bulk fat embolus in pulmonary arteries. But in IVCF group, the similar resonances were not observed throughout the surgery and the medullary canal pressure climbed to 400 mm Hg, reaching the maximum of our pressure gage range. The blood pressure, PaO2, heart rate and CVP did not change much compared to those before implantation. The blood gas and pulmonary oil red staining showed few changes either. Conclusion IVCF implantation can prevent the genesis of BCIS.

Objective:To introduce the experience of vacuum sealing drainage(VSD)in the treatment of bedsore .Methods:A total of 11 patients with bedsore from Aug 2006 to Sep 2011 were debridemented and covered with VSD for the treatment of bedsore in Department of Plastic Surgery ,Zhongnan Hospital ,Wuhan University .Results:All the patients were dealt with VSD for 8‐15 d .The size of wound reduced and granulation tissue grew well .The wound were covered with flap ,the bedsore recov‐ered satisfactorily when flap reconstruction was applied .Conclusions:VSD can immediately control the infection of wounds ,ef‐fectively promote the growth of the granulation and considerably shorten the healing time .

Objective: To investigate the expression of programmed death-1 (PD-1) in liver tissue and its association with liver pathology in patients with autoimmune hepatitis (AIH). Methods: A total of 54 AIH patients (38 in the active stage and 16 in the remission stage) were enrolled, and 9 healthy volunteers were enrolled as control group. Immunohistochemistry combined with quantitative image analysis was used to measure the expression of PD-1 in liver tissue. The t-test, rank sum test, one-way analysis of variance, least significant difference t-test, Mann-Whitney U test, and Pearson relation analysis were used for statistical analysis of different types of data. Results: The AIH group had a significantly higher positive rate of PD-1 in liver tissue than the control group (13.57%±6.84% vs 2.22%±0.66%, P < 0.01), and the patients in the active stage of AIH had a significantly higher positive rate of PD-1 in liver tissue than those in the remission stage (16.53%±7.72% vs 6.56%±3.16%, P < 0.01). The positive rate of PD-1 in liver tissue was 6.56%±3.16% in G0 group, 14.33%±5.08% in G1-2 group, and 19.23%±5.41% in G3-4 group (P < 0.01), but there was no significant difference in the positive rate of PD-1 between S0, S1-2, and S3-4 groups (P > 0.05). In AIH patients, the positive rate of PD-1 in liver tissue was positively correlated with the levels of total bilirubin, alanine aminotransferase, aspartate aminotransferase, and IgG (r = 0.665, 0.721, 0.711, and 0.813, all P < 0.01). Conclusion AIH patients have regulated PD-1 expression in liver tissue, which is closely associated with liver inflammation and is not associated with fibrosis degree, suggesting that PD-1 is involved in the development and progression of inflammation in AIH patients.

Objective To analyze the trajectory categories of fatigue development in middle-aged and elderly stroke patients and explore its influencing factors.Methods A convenient sampling method was used to select 230 middle-aged and elderly stroke patients in the Luzhou People's Hospi-tal from January 2021 to January 2023 as the research subjects.A self-compiled general information-questionnaire,the Fatigue Severity Scale(FSS),the Pittsburgh Sleep Quality Index(PSQI),and the Beck Depression Inventory(BDI)were used to investigate the sociodemographic and clinical da-ta,fatigue,sleep quality,and depression status of patients at 2 days after admission and 3 and 6 months after discharge.The latent growth curve model was used to fit the categories and trajectories of fatigue development,and the unordered multinomial Logistic regression model was used to analyze the influencing factors of trajectory categories of fatigue development.Results The fatigue development trajectory of middle-aged and elderly stroke patients showed three potential categories,namely the low-level fatigue stability group(33.04％),the medium-level fatigue rapid aggravation group(42.17％),and the high-level fatigue slow aggravation group(24.79％).The results of unordered multinomial Logistic regression analysis showed that age,marital status,education level,disease severity,the Ac-tivity of Daily Living(ADL)score,PSQI score,and BDI score were the influencing factors of fatigue development trajectory in middle-aged and elderly stroke patients(all P＜0.05).Conclusion The fatigue development trajectory of middle-aged and elderly stroke patients is heterogeneous.Nurses should understand the evolution characteristics of fatigue in different patients and implement targeted management measures according to patients'symptoms to improve their health outcomes.

Objective To explore the predictive value of serum homo sapiens microRNA(hsa-miR)-30c-5p expression in patients with type 2 diabetes mellitus(T2DM)for microvascular complications.Methods A total of 205 T2DM patients admitted to Bazhong Central Hospital from May 2021 to September 2022 were selected as the diabetes group,and the diabetes group was further divided into diabetes with combined group(n=124)and non combined group(n=81)according to the microvascular complications of the patients.In addition,205 healthy people who underwent physical examination during the same period were selected as the control group.The expression of hsa-miR-30c-5p in serum was detected by reverse transcription-polymerase chain reaction(RT-PCR)and compared.The factors affecting microvascular complications were analyzed using multivariate logistic regression analysis,and receiver operating characteristic(ROC)curves were plotted to predict the value of serum hsa-miR-30c-5p expression in predicting microvascular complications in T2DM patients.Results The expression of serum hsa-miR-30c-5p in the combined group(0.58±0.06)and the non-combined group(0.72±0.08)were lower than that in the control group(0.89±0.21),and the differences were significant(t=16.038,7.079,all P=0.001).The combined group was lower than the non-combined group,and the difference was significant(t=14.289,P=0.001).The course of diabetes[(OR(95％CI):3.873(2.976～4.770)],uric acid[(OR(95％CI):2.125(1.211～3.040)]and glycosylated hemoglobin[(OR(95％CI):2.680(1.745～3.616)]were independent risk factors for microvascular complications in T2DM patients(all P＜0.05),while the time within the target range of glucose[(OR(95％CI):0.491(0.135～0.846)]and serum hsa-miR-30c-5p[(OR(95％CI):0.532(2.976～4.770)]were protective factors for microvascular complications in T2DM patients(all P＜0.05).The sensitivity,specificity and area under the curve(95％CI)of serum hsa-mir-30c-5p expression in predicting microvascular complications in T2DM patients were 81.45％,85.19％and 0.802(0.741～0.854),respectively.Conclusion The expression of serum hsa-miR-30c-5p in patients with T2DM is abnormally reduced,and serum hsa-miR-30c-5p is a protective factor for microvascular complications in patients with T2DM.It may have a certain predictive value for microvascular complications in patients with T2DM.