Objective Heart failure is due to a variety of reasons cause of the heart to lose their official duty. The heart will not be able to work properly to meet the needs of the body, it is called pump failure. It significantly reduces the patients living ability and quality of life. Appropriate exercise training as an adjuvant therapy of heart failure can make these conditions have been improved. The present study reviewed the influence of moderate exercise training to patients with heart failure′s related factors( e. g. cardiac function,quality of life, medical expenses,etc) .

Objective To develop anoverlap syndrome (OS)rat model by intermittent hypoxia (IH) exposure on the base of pre-existing emphysema, and to explore its characters of severe systemic inflammation and immune responses. Methods Sixty Wistar rats were put into four groups:control group, IH group, emphysema group and overlap (emphysema+IH) group. The peripheral blood samples were collected for detecting apoptosis of CD3+CD4+,CD3+CD8+T lymphocytes and neutrophils (PMN). Tumor necrosis factor (TNF)-αand interleukin (IL)-6 were evaluated by ELISA. The bronchoalveolar la-vage fluid (BALF) was taken to calculate the ratio of macrophages, neutrophils and lymphocytes under light microscope. Tis-sue blocks of lung, liver, pancreas, and right carotid artery were taken for pathologic scoring. Results The apoptotic rates of PMN and CD3 +CD8 +T cells were significantly lower in overlap group than those of other three groups (P<0.05). Pro-in-flammatory factor IL-6, TNF-αand peripheral blood CD3 +CD4 +T cell apoptosis were the highest in overlap group com-pared to those of other three groups (P<0.05). The ratio of PMN and macrophages in BALF were significantly higher in em-physema group than those of other three groups (P<0.05) and the pathology scores of lung, liver, pancreas, the ratio of carot-id artery intima-media thickness of whole thickness of vascular were significantly higher in overlap group than those of other three groups (P < 0.05).Conclusion In rat model of intermittent hypoxia-emphysema there are more serious systemic multi-organ inflammation and immune responses.

Objective To investigate anti-hypertension threapy on seasonal variability of blood pressure,urinary 8-OHdG levels in essential hypertension in order to provide a basis for seasonal antihypertensive treatment.Methods Fifty hypertensive patients admitted the hospital of Erdos Clinical Medical College of Inner Mongolia Medical University at summer 2013 were selected as our subjects.The final subjects was 42 cases due to 8 lost cases.The patients were randomly divided into two groups,including 30 cases in renin angiotensin aldosterone system inhibitors(RASI) group and 12 cases in Ca2+ channel blocker(CCB) group.Epidata 3.1 software was applied to perform statistic analysis.Urinary 8-OHdG concentration was measured by enzyme-linked immunosorbent assay (ELISA).Blood pressure was measured in spring,summer,autumn and winter.Results Systolic blood pressure(SBP) in RASI group and CCB group at winter periods were (158±20) mmHg,(158 ± 20) mmHg,higher than that in summer periods ((145 ± 12) mmHg,(141 ± 9) mmHg;P＜ 0.05).Diastolic blood pressure(DPB) in RASI group and CCB group at winter periods were (101 ± 13)mmHg and (100±4)mmHg,significant high than that in summer periods ((93 ±7) mmHg,(90±7) mmHg;P＜0.05).8-OhdG levels in RASI group at summer and autumn periods were (243.20±30.94) ng/L and (240.40±47.99) ng/L,significantly higher than that in winter and spring periods((190.80± 15.56) ng/L and (189.06± 13.56) ng/L),and the differences were significant(P＜0.001).No significant differences were seen in CCB group among 4 seasons in terms of 8-OhdG levels (P ＞ 0.05).Conclusion Blood pressure change still occur among 4 seasons in hypertensive patients after a single CCB containing RASI-based drug antihypertensive therapy.And blood pressure in winter periods is higher than that in summer,which indicates that therapy medication based on RASI might reduce the level of oxidative stress at winter periods.

Objective: To explore the impact of exercise rehabilitation on cardiac function in coronary artery disease (CAD) patients after percutaneous coronary intervention (PCI). Methods: A total of 130 CAD patients received primary PCI in our hospital from 2014-01 to 2015-09 were enrolled. All patients received conventional drug therapy and post-PCI knowledge education, then were randomly divided into 2 groups: Conventional group and Rehabilitation group, in which the patients received cardiac rehabilitation exercise for 3 months at different stage and intensity. n=65 in each group. The cardiac function including left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD), 6 min walking distance (6MWD) and NYHA classification were compared between 2 groups at 1, 3 and 6 months after the operation. Results: LVEF, LVEDD, 6MWD and NYHA classification were similar between 2 groups at enrollment, P>0.05. ① At 1 month post-operation: 6MWD was different between 2 groups, P<0.05, while LVEF, LVEDD, NYHA classification and the recurrence rate of angina pectoris were similar between 2 groups, P>0.05. In Rehabilitation group, 6MWD and NYHA classification were different from the enrollment condition, P<0.05, while other parameters were similar, P>0.05; in Conventional group, 6MWD was different from the enrollment condition, P<0.05, while other parameters was similar, P>0.05. ② At 3 and 6 months post-operation: all parameters were different between 2 groups, P>0.05. In Rehabilitation group, all parameters were different from the enrollment condition, P<0.05. ③ In Conventional group, at 3 months post-operation: LVEDD and 6MWD were different from the enrollment condition, P<0.05; at 6 months post-operation: 6MWD was different from the enrollment condition, P<0.05. Conclusion: Exercise rehabilitation may improve the cardiac function, therefore enhance the endurance capacity and quality of life in CAD patients after PCI.

Objective To survey birth defects of neonates conceived by using various types of in vitro fertilization and embryo transfer (IVF-ET) between 1998 and 2007 in Shanghai. Methods From 1998 to 2007, 8507 neonates from 6551 pregnancies conceived through assistant reproductive technology (ART) from 7 reproductive medicine center in Shanghai were enrolled in this retrospective study, including Shanghai Ji-Ai Genetics and IVF Institute, Shanghai Jiaotong University School of Medicine affiliated Renji Hospital,Buijin Hospital, China Welfare Institute International Maternal and Infant Health Hospital, Shanghai First Maternity and Infant Health Hospital, Shanghai the Ninth People's Hospital and the Second Military Medical University affiliated Changhal Hospital. The clinical data about the type and incidence of birth defect were analyzed. Meanwhile, the factors associated with birth defect were investigated, such as various ART,gender, mother age, numbers of gestational sac, the source and quality of sperm. Results The birth defect rate was 1.08% (92/8507) and the most remarkable malformation occurred in circulation system [34% (31/92)]. The rates of major congenital malformations were 1.21% (34/2799) in fresh conventional IVF-ET, 1.07% (20/1871) in IVF-frozen-thawed embryo transfer(IVF-FET), 1.04% (23/2212) in fresh intracyto plasmic sperm injection (ICSI)-ET and 0.92% (15/1625) in ICSI-FET, which did not show statistical difference (P>0.05). There was also no significantly different incidence of malformations between 1.12% (49/4371) in male neonates and 1.02% (42/4136) in female neonates (P >0.05).However, the occurrence of congenital malformation is positively related with maternal age, the rates were 0.84% (41/4884) in mother's age less than 30 years and 1.77% (16/902) in mother' age more than 35 years, which reached statistical difference (P < 0.05). It also showed remarkable different incidence among 0.53% (25/4679) in singletons, 1.59% (57/3576) in twins and 3.97% (10/252) in triplets (P< 0.05). No remarkable difference of malformation rate among sperm sources used in fertilization were observed, including 1.09% (81/7419)in ejaculated sperm, 1.21% (7/579)in percutaneous epididymal aspiration (PESA) and 0. 79% (4/509) in donor sperm (P>0.05). Conclusions The overall incidence of birth defect in neonates from ART is similar to those conceived naturally and is not associated with different types of IVF-ET, embryo cryopreservation, sperm sources. However, maternal age and multiple pregnancies coder the higher possibility of birth defect.

Objective:To investigate the risk factors for intrahepatic cholangiocarcinoma (ICC) after hepatectomy for hepatolithiasis.Methods:The retrospective case-control study was conducted.The clinico-pathological data of 1 071 patients who underwent hepatectomy for hepatolithiasis at the Eastern Hepatobiliary Surgery Hospital of Navy Medical University between January 2010 and December 2011 were collected. There were 379 males and 692 females, aged (53±12)years, with the range of 12-86 years. Patients completed preoperative examinations. For regional hepatolithiasis, the anatomical hepatectomy was performed. For diffused hepatolithiasis, regional damaged lesions which confined to liver segment or lobe were resected. Hepaticolithotomy or cholangio-lithotomy was performed if necessary. When severe stricture of hilar bile duct affects biliary drainage, cholangiojejunostomy or biliary stricture plasty was performed. Observation indicators: (1) preoperative examination, surgical and postoperative situations; (2) follow-up; (3) risk factors analysis of ICC within the 5 years after hepatectomy for hepatolithiasis. Follow-up using outpatient examination and telephone interview was performed to detect the incidence of ICC after hepatectomy up to December 2019. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distribution were described as M (range). Count data were described as absolute numbers or percentages. Continuous variables were converted into categorical variables according to the common clinical values or the best cut-off value of receiver operating characteristic curve. Binary logistic regression model was used for risk factors analysis. The factors with P<0.10 in univariate analysis were included for the multivariate analysis. Results:(1) Preoperative examination, surgical and postoperative situations. Results of preoperative examination: duration of hepatolithiasis-related symptoms of the 1 071 patients was 8.2 years(range, 0-27.0 years), the levels of CA19-9 and CEA were (163±87)U/mL and (5.0±2.1)μg/L, and stones located at left liver, right liver, bilateral sides, common hepatic duct or common bile duct were detected in 545, 245, 228, 53 patients. There were 226 patients complicated with biliary stricture and 172 with segmental atrophy. Of the 1 071 patients, 595 underwent anatomical hepatectomy, 272 underwent regional non-anatomical hepatectomy, 143 underwent cholangiolithotomy, and 61 underwent cholangiojejunostomy. Results of postoperative imaging examination showed residual biliary stricture in 26 patients and residual biliary stones in 74 patients. (2) Follow-up: 1 071 patients were followed up for (8.6±1.5)years. Of the 1 071 patients, 92 developed ICC, with an incidence of 8.590%(92/1 071). There were 32, 66, 90 patients developing ICC within 3, 5, 8 years after hepatectomy, with the incidence of 2.988%(32/1 071), 6.162%(66/1 071), 8.403%(90/1 071). (3) Risk factors analysis of ICC within the 5 years after hepatectomy for hepatolithiasis. The receiver operating characteristic curve of duration of hepatolithiasis-related symptoms for ICC within the 5 years after hepatectomy was constructed, and duration of hepatolithiasis-related symptoms was converted into categorical variable for following analysis using 7 years as the cut-off value based on Youden index. Results of univariate analysis showed that duration of hepatolithiasis-related symptoms>7 years, complication with metabolic diseases, segmental atrophy, postoperative residual stones were related factors for ICC within the 5 years after hepatectomy ( odds ratio=2.939, 2.654, 1.903, 2.361, 95% confidence interval: 1.582-5.460, 1.145-6.154, 1.068-3.390, 1.118-4.987, P<0.05). Results of multivariate analysis based on factors with P<0.10 in the univariate analysis showed that duration of hepatolithiasis-related symptoms>7 years, complication with metabolic diseases, segmental atrophy, postoperative residual stones were independent risk factors for ICC within the 5 years after hepatectomy ( odds ratio=2.843, 2.469, 1.922, 2.202, 95% confidence interval: 1.523-5.309, 1.042-5.851, 1.064-3.472, 1.021-4.747, P<0.05). Conclusions:There was risk of developing ICC after hepatectomy for cholelithiasis. The duration of hepatolithiasis-related symptoms >7 years, complication with metabolic diseases, segmental atrophy and postoperative residual stones are independent risk factors for ICC development within 5 years after hepatectomy.

OBJECTIVETo identify the casual mutation of a Chinese pedigree with hypertrophic cardiomyopathy (HCM), and to analyze the genotype-phenotype relationship.

METHODSThe coding exons of 26 reported disease genes were sequenced by targeted resequencing in the proband and the identified mutation were detected with bi-directional Sanger sequencing in all family members and 307 healthy controls. The genotype-phenotype correlation was analyzed in the family.

RESULTSA missense mutation (c.2191C > T, p. Pro731Ser) in the 20th exon of MYH7 gene was identified. This mutation was absent in 307 healthy controls and predicted to be pathogenic by PolyPhen-HCM. Totally 13 family members carried this mutation, including 10 patients with HCM and 3 asymptomatic mutation carriers. The proband manifested severe congestive heart failure and 8 patients expressed various clinical manifestations of heart failure, including dyspnea, palpitations, chest pain, amaurosis or syncope. Five patients were diagnosed as HCM at the age of 16 or younger. One family member suffered sudden cardiac death.

CONCLUSIONSThe Pro731Ser of MYH7 gene mutation is a causal and malignant mutation linked with familiar HCM.

Adolescent ; Asian Continental Ancestry Group ; Base Sequence ; Cardiomyopathy, Hypertrophic ; ethnology ; genetics ; Death, Sudden, Cardiac ; Exons ; Humans ; Mutation, Missense ; Myosin Heavy Chains ; genetics ; Pedigree ; Phenotype ; Research Design ; Ventricular Myosins

BACKGROUNDBu-Shen-Yi-Qi-Tang (BSYQT), which is prescribed on the basis of clinical experience, is commonly used in clinics of traditional Chinese medicine (TCM) for asthma treatment. The components of BSYQT include Radix Astragali (RA), Herba Epimedii (HE) and Radix Rehmanniae (RR). The aim of this study was to compare the effect of granules and herbs of BSYQT on airway inflammation in asthmatic mice.

METHODSSixty female BALB/c mice were randomly divided into the normal control (NC) group, asthmatic group (A), decoction of granules of BSYQT treatment group (GD), decoction of herbs of BSYQT treatment group (HD), and dexamethasone treatment group (DEX). The mouse asthmatic model was induced by ovalbumin (OVA) sensitization and challenge. GD and HD of BSYQT as well as DEX were prepared and administered by intragastric infusion. Airway hyperresponsiveness (AHR) to methacholine (Mch), lung histopathology analysis, inflammatory mediators in serum (IL-4, IL-5, IL-17A, IFN-γ, and eotaxin) and in lung (IL-4, IL-5, IFN-γ, and eotaxin) were selected for investigation and comparison.

RESULTSBoth GD and HD treatment could decrease airway resistance (RL) and increase dynamic compliance (Cdyn) to Mch compared with the A group (P < 0.05). HD treatment was more effective in RL reduction than Mch at doses of 3.125 and 6.25 mg/ml (P < 0.05) and in Cdyn increase at Mch doses of 6.25 and 12.5 mg/ml (P < 0.05). There were no marked differences in RL reduction and Cdyn improvement between mice in HD and DEX groups (P > 0.05). Both GD and HD treatment markedly attenuated lung inflammation (P < 0.05), and HD treatment demonstrated more significant therapeutic function in alleviating lung inflammation than that of GD and DEX treatment (P < 0.05). Both GD and HD treatment resulted in a significant reduction in IL-4 and IL-17A levels and an increase in the IFN-γ level in serum compared with the A group (P < 0.05). The effect of HD in lowering the IL-4 and IL-17A level was significantly greater than that of GD (P < 0.05), and was not significantly different from DEX (P > 0.05). HD treatment significantly reduced the serum level of IL-5 and eotaxin compared with the A group (P < 0.05), however, mice in the GD treatment group did not demonstrate this effect. GD and HD treatment significantly reduced IL-4 and eotaxin mRNA expression compared with the A group (P < 0.05). HD treatment significantly reduced IL-5 mRNA expression compared with the A group (P < 0.05). There was a significant difference between the GD and HD treatment groups in reducing IL-5 and eotaxin mRNA expression (P < 0.05). HD treatment was more effective in down-regulation of IL-5 in serum and eotaxin level both in serum and lung than DEX (P < 0.05). Compared with the A group, an obvious increase in mRNA expression of IFN-γ was observed in both the GD and HD treatment groups (P < 0.05). However, the effect of HD treatment on increase of IFN-γ mRNA expression was more apparent than GD and DEX treatment (P < 0.05).

CONCLUSIONSBoth GD and HD treatment could decrease AHR, attenuate lung inflammation, reduce IL-4, IL-5, IL-17A, and eotaxin levels and increase IFN-γ levels in asthmatic mice. HD treatment manifests more remarkable inhibitory effects on asthmatic inflammation than GD treatment, which could provide a guide for further research on the screening of the material basis of the best anti-inflammatory effect of BSYQT.

Animals ; Asthma ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Inflammation ; drug therapy ; Medicine, Chinese Traditional ; Mice ; Mice, Inbred BALB C

Objective: Screen the pathogenic genes of a pedigree with clinical manifestation of familial dilated cardiomyopathy in Inner Mongolia. Methods: A total of 3 patients with dilated cardiomyopathy and 20 family members from the same family were examined in Ordos Central Hospital in Inner Mongolia from October, 2003 to August, 2017. Data on medical history, physical examinations, electrocardiograms, and echocardiography were obtained. 5 ml peripheral blood was sampled for per person. Chip Capture Sequencing technology was used to capture all the exons and splice sites of the genes that associated with hereditary cardiomyopathy and hereditary arrhythmia. The mutations in these genes were detected by high-throughput sequencing. All suspected pathogenic loci identified by high-throughput sequencing were verified by Sanger sequencing used for mutation detection. One hundred and fifty gender, age and race matched healthy people were included as the control group. Results: Pathogenic gene variations were detected in 3 symptomatic family members and 1 carrier from the pedigree. Five pathogenic gene variations were identified in the proband (Ⅱ1), a pSer236Gly and a pArg215Cys variation in the MYBPC3 gene, a pGln90Arg variation in the DSP gene, and pAsn2912Asp and pGlu2910Val variation in the DMD gene. One pathogenic variation was detected in Ⅲ3, which was a pArg215Cys variation in the MYBPC3 gene. Two pathogenic variations were detected in Ⅲ7, a pSer236Gly variation in the MYBPC3 gene and a pGln90Arg variation in the DSP gene. Two pathogenic variations were detected in the Ⅳ7, a pSer236Gly variation in the MYBPC3 gene and a pGln90Arg variation in the DSP gene. No gene variation loci were detected in the other family members and the control group. Conclusion MYBPC3 gene, DSP gene and DMD gene variations are present in the familial dilated cardiomyopathy pedigree from Inner Mongolia, and these variations may be related with familial dilated cardiomyopathy.