Myocardial infarction is one of the main factors causing heart failure and is associated with a high rate of morbidity and mortality in the developing countries.Due to infracted cardiac muscles,heart function will aggravate and myocardium will remodel leading to exacerbation of the disease.Current treatment modalities may not be adequate to prevent myocardial remodeling.It is necessary to explore a new approach to restore the damaged myocardium.Stem cell-based therapy is developing rapidly and has been used in the field of cardiovascular disease.There are many problems still to be solved.

Objective To explore the combination of lamivudine and adefovir dipivoxiltreatment in HBeAg positive patients with inappropriate timing of decompensated hepatitis B cirrhosis.Methods Make a retrospective analysis of HBeAg positive patients with decompensated hepatitis B cirrhosis of the liver our hospital in 2014 January ~2015 January were,100 cases of initial treatment, 50 patients given lamivudine plus adefovir dipivoxil resistance as control group,50 cases patients given lamivudine plus adefovir dipivoxil combined as the observation group, compared two groups of clinical curative effect of treatment.Results Observation group after treatment in patients with HBeAgseroconversion rate of 26.00% was significantly higher than that in control group 4.00% (P<0.05);after 12 weeks of treatment in the observation group (9.63 ±1.42), 24 weeks(8.57 ±1.45), 48 weeks(7.43 ±1.57) Child-Pugh grading score was significantly lower than the control group(9.74 ±1.21),(9.45 ±1.33)(8.57 ±1.04)(P <0.05); level of HBV-DNA after treatment in the observation group (2.23 ±1.25) was significantly lower than that of the control group(5.18 ± 1.63), and the Patients in the observation group (2.23 ±1.25)HBV-DNA load in serum was significantly lower than that before treatment(6.47 ± 1.55)(P<0.05).Conclusion patients with decompensated hepatitis B cirrhosis with combination of lamivudine and adefovir dipivoxil treatment, the clinical efficacy is more significant, HBeAg seroconversion rate is increased , the score of Child-Pugh become low and improve liver reserve function, reduce HBV-DNA load in serum.

AIM: To observe the heart rate、 electrocardiogram and electrophysiology effect of Qibo Capsule (Radix astragali, Radix aconii lateralis praeparata, etc) on rabbit model with sick sinus syndrome (SND), and to explore their therapy and mechanism. METHODS: 30 rabbits were used to establish sick sinus syndrome models and divided randomly into 3 groups: model group、 Qibo Capsule group、 Xinbao Pill group. To observe the changes of heart rate、 electrocardiogram、electrophysiology after 10 d. RESULTS: Comparison with the model group, the Qibo Capsule group had significant statistics differences in SCL (sinus cardiac cycle)、 SACT (sinoartrial conduction time)、 SNRT (sinus node recovery time)、 SNRTc (corrected sinus node recover time) and HR (heart rate) item (P0.05). CONCLUSION : The experiments show that Qibo Capsule is effective in the recovery of the functional harm of SND rabbits. It is worth further studys.

Objective:To explore the value of preablative stimulated thyroglobulin (ps-Tg) in predicting distant metastasis (DM) at the time of 131I therapy in children and adolescents with differentiated thyroid cancer (DTC). Methods:From January 2016 to March 2020, 54 children and adolescents who underwent total thyroidectomy due to DTC in Peking Union Medical College Hospital were retrospectively reviewed and divided into 2 groups according to the presence of DM or not: M0 group( n=29, 10 males, 19 females, age (16.3±3.8) years) and M1 group( n=25, 13 males, 12 females, age (12.4±4.3) years). Independent-sample t test, χ2 test (or Fisher′s exact test) and Mann-Whitney U test were used to analyze the general characteristics between the two groups. According to status of regional lymph node (RLN) at the time of 131I therapy, the two groups were further divided into M1RLN+ ( n=8) and M1RLN-( n=17), M0RLN+ ( n=5) and M0RLN-( n=24) subgroups. Mann-Whitney U test was used to analyze the different ps-Tg levels between M0 and M1, M1RLN+ and M1RLN-, as well as M0RLN+ and M0RLN-groups. The receiver operating characteristic (ROC) curve analysis was employed to obtain a cut-off value of ps-Tg as a predictor of DM. Results:Patients with DM tended to have higher ps-Tg level (medians: 406.80 μg/L vs 7.90 μg/L, U=690.000, P<0.001), younger age ( t=-3.559, P=0.001), larger tumor size ( t=3.523, P=0.001), more advanced T stage ( U=506.500, P=0.010) and more multifocality( P=0.013) in comparison with those without DM. Though ps-Tg did not significantly differ between M1RLN+ group and M1RLN-group ( U=98.500, P>0.05) or between M0RLN+ group and M0RLN-group ( U=63.000, P>0.05), the two RLN+ groups tended to hold higher medians than the two RLN-groups (18.05 vs 5.71 μg/L; 1 698.50 vs 216.40 μg/L). In order to avoid the possible influence on the ps-Tg cut-off value, 13 RLN+ samples were removed, and the area under the ROC curve was 0.946 (95% CI: 0.883-1.000). The ps-Tg level of 55.87 μg/L was established as the optimal cut-off value to distinguish M0RLN- from M1RLN-, with the sensitivity and specificity of 14/17 and 95.8%(23/24), respectively. Conclusion:Ps-Tg holds a high predictive value in identifying DM, which may be of great help in avoiding inadequate 131I treatment in children and adolescents with metastatic DTC ignored by radiological examinations.

Objective To survey the situation and related factors of maintenance medication treatment in schizophrenic patients re-hospitalized for relapse. Methods 362 patients re-admitted with schizophrenia and their relatives were interviewed with questionnaire which included 16 factors that might affect maintenance medication treatment. Results 63.8% patients stopped medication and 21.1% patients were on low-dose maintenance medication treatment by themselves, while 7.7% patients were on reasonable dose anti-psychotics in 2 years. The time of maintenance medication treatment related with insight (OR=2.2144, P=0.001), family care (OR=4.8842, P=0.025), outcomes of treatment (OR=2.2056, P=0.007) and negative life events (OR=0.4529, P=0.003). Conclusion Schizophrenic patients re-admitted with relapse often withdraw or reduce their medication by themselves, which risked with poor insight, poor therapeutic effect, poor care from their family, and more negative life events

Transcatheter aortic valve replacement (TAVR) techniques have been rapidly developed in recent years. Current guidelines and studies mainly focus on aortic stenosis patients treated by transfemoral approach, but they are not completely appropriate to patients with isolated aortic regurgitation or other patients who need transapical TAVR (TA-TAVR), which affects the standardized treatment of those patients. Therefore, our team pronounced the operational standards for TA-TAVR, based on fully reviewing the literatures worldwide, combined with the opinions of experts from 15 heart centers with rich experience in carrying out TA-TAVR in China. This standard aims to provide clinicians with standardized diagnosis and treatment principles of TA-TAVR and improve the quality of TA-TAVR in China.

Objective : To explore the effects and possible mechanism of 2-hydroxy-3-methylanthraquinone (HMA) on the growth inhibition of colon cancer cells (HCT116，HT-29) ． Methods : The target of HMA was searched and analyzed by TCMSP database．The colon cancer HCT116 and HT-29 cells were cultured in vitro ，and then they were intervened with different concentrations of HMA．The effects of HMA on the viability，growth，survival ability and apoptosis of colon cancer cells were detected by CCK-8，trypan blue count，colony formation and Annexin V / PI double staining respectively．The effects of HMA on potential targets and apoptosis-regulating proteins were detected by Western blot. Results: TCMSP search analysis showed that there was HMA in Hedyotis diffusa，Scutellaria barbata and Morinda officinalis ，which contained 32 potential targets ，including apoptosis-related gene Caspase-3．Different concentrations of HMA could inhibit cells viability，growth and number of formed colonies， and induce apoptosis．The results of Western blot showed that HMA could down-regulate anti-apoptosis gene Bcl-2， up-regulate pro-apoptosis gene Bax，and promote the activation and cleavage of apoptosis-related proteins (cleaved Caspase-9，cleaved Caspase-3) ，thus promoting apoptosis． Conclusion HMA can inhibit growth and induce apoptosis of colon cancer cells，which may be related to regulating expressions of Bcl-2 ，Bax ，cleaved Caspase-9， cleaved Caspase-3 and other apoptosis proteins.

Objective: To investigate the effect and mechanism of LncRNA ANRIL on the radiosensitivity of HCT116 cells line and nude mouse transplant tumors. Methods: The expression of LncRNA ANRIL in colorectal cancer cells was detected by qPCR. The negative control siRNA, ANRIL siRNA, miR-NC mimic, miR-195 mimic, miR-NC inhibitor and miR-195 inhibitor were transfected into HCT116 cells, and marked as negative control group, silencing ANRIL group, overexpressing miR-NC group, overexpressing miR-195 group, inhibiting miR-NC group and inhibiting miR-195 group, and the HCT116 cells without any treatment were marked as the blank control group. The clone formation assay was used to detect radiosensitivity of colorectal cancer cells, flow cytometry was used to detect apoptosis. The web site, StarBase, was used to predict the downstream miRNAs of ANRIL and dual luciferase reporter gene assay was used to further verify. Subcutaneous tumor transplantation assay was used to detect the effect of ANRIL on the growth of colorectal cancer cells after irradiation. Results: After irradiation with 2, 4, 6 and 8 Gy, the cell survival fraction of silencing ANRIL group was significantly decreased when compared with that of negative control group (P<0.05), and the radiosensitivity ratio was 1.52. The apoptosis rate of the silencing ANRIL+ 4 Gy group was significantly higher than that of the negative control+ 4 Gy group ((27.86±2.78)% vs. (12.06±1.46)%, P<0.05). The results of the experiment on nude mouse transplant tumors showed that the tumor volume in the negative control group was lower than that of the silent ANRIL group on days 13, 16, 19, 22 and 25 ((234±66) mm³, (273±63) mm³, (296±72) mm³, (321±85) mm³ and (403±94) mm³ vs. (357±79) mm³, (485±124) mm³, (617±143) mm³, (764±174) mm³ and (985±221) mm³P<0.05). MiR-195 is a target gene of ANRIL, and inhibition of miR-195 can reverse the inhibitory effect of silencing ANRIL on radiosensitivity, apoptosis and xenografts of HCT116 cells. Conclusions LncRNA ANRIL regulates the radiosensitivity of colorectal cancer cells by miR-195, which may provide a new sensitizing target for clinical colorectal cancer radiotherapy.

Objective     To discuss the key points of anesthesia for patients undergoing transcatheter aortic valve implantation (TAVI) surgery. Methods     We retrospectively collected and analyzed the data of 70 patients who underwent TAVI in the Department of Cardiovascular Surgery, West China Hospital from March 2014 to October 2015. There were 39 males and 31 females with an average age of 73.7±4.5 years. The perioperative preparation and anesthesia points of TAVI were summarized. Results     All of the 70 included patients were aged and at high risk severe comorbidities such as ischemic heart disease and stroke. The aortic stenosis and regurgitation occurred in 39 and 31 patients respectively. No patients died during the surgery. The total success rate was 95.7%. Conclusion     TAVI is a complex procedure for high risk patients and need more attention during anesthesia. The successful conduction of the procedure requires the whole team to prepare carefully and cooperate closely.

Objective     To report our experience with enhanced recovery after surgery (ERAS) protocol in patients undergoing transapical transcatheter aortic valve implantation (TAVI) and to determine perioperative predictors for ERAS failure. Methods     Between May 2018 and January 2019, 80 patients undergoing TAVI in our hospital were recruited. Among them, 40 patients (24 males, 16 females, aged 73.0±5.0 years) successfully received ERAS, defined as successful extubation in operating room (an ERAS group) and the other 40 patients (28 males, 12 females, aged 73.0±7.0 years, a non-ERAS group) failed to perform ERAS.  Results     Compared with the non-ERAS group, patients in the ERAS group were associated with a significantly lower incidence of postoperative complications (30.0% vs. 52.5%, P=0.04), shorter postoperative ICU stay (2.2±0.4 d vs. 4.0±4.8 d, P=0.00) and hospital stay (7.0±2.3 d vs. 9.5±4.8 d, P=0.00), and less medical cost (311±20 thousand yuan vs. 347±80 thousand yuan, P=0.00). Independent predictors of ERAS failure were poor preoperative heart function and elevated B-type natriuretic peptides.  Conclusion     ERAS protocol is feasible and effective in patients undergoing TAVI. Poor preoperative heart function is an independent predictor of failure in early extubation which, in turn, is associated with prolonged ICU and hospital stay and dramatic worsening of patient outcomes.