Objective To study the relationship between chlamydia pneumoniae and coronary heart disease.Methods Serology and PCR for detecting chlamydia pneumoniae were conducted in groups of non coronary heart disease(NCHD),stable angina pectoris(SAP),unstable angina pectoris(UAP)and acute angina pectoris(SAP),unstable angina pectoris(UAP)and acute myocardial infarction(AMI).Results No significant difference was found in serology among each group.The positive rate of PCR of CHD group was higher than that of CHD group,and the positive rates of PCR of both UAP and AMI were higher than that of SAP group.There was no significant difference between the positive rates of PCR of UAP and AMI group.Conclusion Chlamydia pneumoniae contributes to the formation of coronary heart disease and the ustability of plaque.

Objective To investigate the effects of levothyroxine (Levo-thyroid hormone,L-TH4) in pregnancy subclinical hypothyroidism (SCHT), and study the relationship between L-TH4 with thyroid peroxidase (TPO) and glucose metabolism. The research could provide theoretical basis for the treatment of SCHT. Methods Sixty pregnant women were selected and signed the medical informed consent. The pregnancy were divided into three groups, 20 cases in each group.Normal control group: pregnancy underwent routine thyroid function normal; SCHT group: SCHT pregnancy patients who did not use drugs to treat SCHT; L-TH4 group: SCHT pregnancy patients given L-TH4 treatment. The blood was taken to test the contents of glucose level and HbA1c were observed; the activity of TSH and TPO were tested by ELISA method; HE staining method was used to observe the changing of placenta tissue. Results Compared with normal control group, the glucose and HbA1c were significantly increased in SCHT group (P<0.05). However, L-TH4 could decrease these index, compare with the SCHT group, and reduce the level of TSH and the activity of TPO, the difference was statistically significantly (P<0.05). Moreover, L-TH4 could improve the changing of placenta tissue. Conclusion L-TH4 could reduce blood glucose and HbA1c levels, also reduced the level of TSH and the activity of TPO in SCHT. L-TH4 could improve the changing of placenta tissue.

Aim To investigate the effects of endocrinal petptide urocortin on subthalamic nucleus (STN) neuron''s discharge, also observe the convergence effect of UCN with dopamine (DA) and glutamate (GLU), so as to understand the regulation effects of UCN and its mechanism in Parkinson''s disease (PD).Methods Forty Sprague-Dawley rats were used in this experiment.Nerve electrophysiology method-microiontophoresis was used to observe the effects of UCN on STN neuron firing rates and firing wave.Astressin (AST, the blocker of CRF receptor 2), protein kinase A (PKA) were used to observe the effects of UCN whether via CRF-2R and PKA signal pathway.Moreover, given UCN during the period of DA and GLU, the effects of UCN on DA and GLU in STN neurons were determined.Results During the period of using the UCN, UCN could inhibit the firing rate of 82％ (27/33) STN neuron (P<0.01), and the firing discharge rates were reduced from(3.65±0.27)Hz to (2.05±0.33) Hz (P<0.01).However, the inhibitory effects of UCN in STN could be antagonized by AST.Given UCN during the period of microiontophoresis of inhibitory neurotransmitter (DA) and excited neurotransmitter (GLU), UCN could enhance the effects of DA and attenuate the excitatory effects of GLU (P<0.01).Conclusion UCN and GLU/DA in STN, UCN play inhibitory and regulated effects on STN neurotransmitters(DA and GLU)via CRF-2 receptor and PKA signal pathway.

Objective To observe late effect of 60Co radiation accident on eye lens in the victims.Methods Medical observations of eye lens were performed on ten victims accidentally exposed to 60Co sources in four radiation accidents that have occurred from 1986 to 2000 in Henan Province.Pathological changes of the eye lenses were examined by using slit lamp microscopy after mydriasis with compound tropicamide.Results Of these ten victims, Liang in a radiation accident in Kaifeng (in 1986), Mei in Xinxiang (in 1999) and Xu in Xuchang (in 2000) all had typical radiation-induced cataract 2, 3 and 6 years after irradiation, respectively.Follow-up observation of the lens showed the punctate and/or granular opacities present in the eye posterior subcapsular of Yan in Kaifeng accident, Jie in Zhengzhou (1987), and Tian, Yong and Yi in Xinxiang accident, featuring the early changes of radiation-induced cataract, but the posterior subcapsular opacities were not observed in Wang and Min in Xinxiang accident.Conclusions Focus should be on the eye lens as the target organ of radiation exposure in long-term follow-up of victims accidentally exposed to radiation source.Severity of the lens opacity induced by ionizing radiation is closely associated with radiation doses.

Objective To evaluate the feasibility and effect of sequential treatment by the heated humidified high flow nasal cannula oxygen therapy (HFNC) in mechanically ventilated patients following endotracheal tube extubation.Methods A prospective randomized controlled trial was conducted. Forty-nine patients with the sequential treatment after tracheal intubation extraction admitted to Department of Critical Care Medicine of Shanghai Tenth People's Hospital from January 1st to December 31st 2016 were enrolled. The patients were randomly divided into HFNC group (n = 25) and non-invasive positive pressure ventilation (NPPV) group (n = 24) in accordance with the random numbertable. During the study, arterial blood gas and the sputum viscosity were assessed at 12, 24, and 48 hours after NPPV or HFNC treatment, and the nasal and facial pressure ulcers within 1 week was also recorded. Receiver operating characteristic curve (ROC) was plotted, and the effect of NPPV or HFNC on oxygenation was analyzed.Results Among the 25 patients in the HFNC group, 1 patient who was re-intubated and 2 patients who were changed to NPPV were excluded, and a total of 22 patients with complete data were enrolled in HFNC group. Among the 24 patients in the NPPV group, 1 patient who gave up the treatment and 1 patient who was re-intubated were excluded, and a total of 22 patients with complete data were enrolled in NPPV group. After the sequential treatment, most patients in NPPV group showed moderate viscous sputum (12, 12 and 10 cases at 12, 24 and 48 hours, respectively), whereas the patients in HFNC group showed thin sputum (15, 16 and 15 cases at 12, 24 and 48 hours, respectively). Sputum viscosity of patients in HFNC group at each time point was significantly lower than that in NPPV group (allP < 0.01). Arterial oxygen saturation (SaO2) and arterial partial pressure of oxygen (PaO2) at 12, 24 and 48 hours in the HFNC group were significantly higher than those in the NPPV group [SaO2: 0.978±0.009 vs. 0.906±0.139 at 12 hours, 0.976±0.019 vs. 0.924±0.103 at 24 hours, 0.973±0.019 vs. 0.935±0.079 at 48 hours; PaO2 (mmHg, 1 mmHg = 0.133 kPa): 97.85±22.99 vs. 79.24±25.86 at 12 hours, 108.10±43.87 vs. 84.44±29.24 at 24 hours, 102.31±39.02 vs. 79.04±27.46 at 48 hours, allP < 0.05], however, the difference in arterial partial pressure of carbon dioxide (PaCO2) at all of the time points between the two groups was not significant. In NPPV group, 4 patients with nasal and facial pressure ulcers was found, and all with Ⅰ phase of pressure ulcers, and no nasal and facial pressure ulcers was found in HFNC group, which was significantly decreased as compared with NPPV group (χ2 = 4.400,P = 0.036). A good effect of oxygen therapy was defined as PaO2 at 48 hours after the sequential treatment was increased by 20% as compared with that before the treatment. ROC curve analysis showed that the area under the ROC curve (AUC) of HFNC on improving oxygenation was higher than that of NPPV (0.917 vs. 0.830); when PaO2 at 48 hours after HFNC treatment was 76.25 mmHg, the sensitivity was 100%, and the specificity was 75.0%.Conclusions Compared with NPPV, adoption of HFNC as sequential treatment is a feasible manner in dealing with the mechanically ventilated patients after endotracheal tube extubation, which can improve the oxygenation as well as reducing the degree of sputum viscosity and incidence of nasal and facial pressure ulcers. HFNC is a promising therapy, which may be worthy to recommend broadly in such a clinical situation.

Objective To detect the mutations of Von Hippel-Lindau (VHL) gene via analyzing the prevalence of family members of VHL syndrome,clinical diagnosis and treatment,and gene analysis of patients with hemangioblastoma.methods All members of the VHL syndrome family members improved all relevant tests and plotted the family map.5 ml peripheral blood was extracted for gene sequencing,and the sequencing Result s were compared with the reported mutations of VHL gene in NCBI database.Result s(1)Analysis of clinical data of four members of the family:Ⅰ-2,Ⅱ-1,Ⅱ-5 suffering from central nervous system hemangioblastoma, Ⅱ-3 with pancreatic,retinopathy and pheochromocytoma,and Ⅱ-5 also combined with kidney,pancreatic lesions.The second generation of patients in the family have been treated surgically.(2)Gene sequencing Result s showed that all subjects in the test had the same mutation:exon2 109 sequence ATATCACACTGCCA was deleted and termination codon UGA appeared in exon 502.Conclusion Through the mutations of the VHL syndrome family,it is found that the family mutation type is a new mutation.For patients with central nervous system hemangioblastoma-based should be suspected of the disease and improve the family history survey.Once the diagnosis of familial VHL syndrome patients are confirmed,it is necessary to inform the other members of the family for clinical screening,and carry out genetic testing to reduce the harm of the disease to the greatest extent.

The purpose of this study was to investigate the pharmacokinetic interaction between sunitinib and ramipril in rats. Eighteen male SD rats were divided into three groups, with each group being assigned to orally receive sunitinib, ramipril, sunitinib and ramipril, respectively, for ten days. Blood samples were collected at dif-ferent times after first-day and tenth-day administration. The concentrations of ramiprilat and sunitinib in rat plasma were determined by LC/MS/MS and the pharmacokinetic parameters were calculated and statistically analyzed. Compared with the administration of ramipril alone, after a single-dose combined administration, tmax of ramiprilat decreased significantly and t1/2 prolonged, while AUC0-∞ remained unchanged. These results indicated that the ab-sorption rate of ramiprilat increased and the elimination rate decreased, but total absorption degree was not changed. After multiple-dose administrations, CL of ramiprilat decreased and AUC0-∞ increased obviously. It sug-gested that accumulation of ramiprilat occurred in body and the drug elimination became slower. No obvious difference of sunitinib pharmacokinetic behavior was found when it was given in combination with ramipril after a single-dose administration or multiple-dose administration. Sunitinib decreased the elimination of ramiprilat after co-administration in company with drug accumulation in body after multiple-dose co-administration. The study showed that there were pharmacokinetic interactions between sunitinib and ramipril in SD rats.

0.05).No significant difference was found in c-myc and p16 protein.CONCLUSION:Human BMSCs cultured in vitro in autologous serum meets the requirement of clinic,with enough number,well growth,without karyotype variation,and BMSCs can differentiate into cardiomyocytes.No tumorigenesis is found in body after implantation.Moreover,no significant difference is seen in telomerase activation and c-myc and p16 gene expression.

BACKGROUND: Both therapeutic effects of stem cell transplantation and differentiation mechanism remain controversial;however, plentiful clinical studies have indicated that stem call transplantation might improve heart function.OBJECTIVE: To evaluate the efficacy of intracoronary autologous bone marrow mononuclear call transplantation for the treatment of chronic heart failure.DESIGN: Case analysis. PARTICIPANTS: A total of 80 patients with chronic heart failure who were selected from Henan People's Hospital from 2003 to 2008 were divided into two groups: autologous bone marrow mononuclear call transplantation group (n=48) and conventional drug therapy group (n=32). There were no significant differences in sex, age, accepting conventional drug therapy,echocardiogram before transplantation, plasma brain natriuretic peptide level, and myocardial perfusion imaging between the two goups (P>0.05).METHODS: A one-year following up before and after cell transplantation, conventional drug therapy was performed in the two groups. Based on conventional drug therapy, autologous bone marrow mononuclear call suspension (10 mL) was slowly poured into coronary artery, and the cell number was adjusted to (3.1±1.6)×10 8. MAIN OUTCOME MEASURES: Changes of heart function were measured using ultrasound apparatus; plasma brain natriuretic peptide levels were detected using double antibodies immumofluorescence method; area of myocardial perfusion defect region was detected using single photon emission computed tomography.RESULTS: Patients in the two groups finished the one-year follow-up, and adverse effects and complications were not found before and after cell transplantation. ①Compared to before cell transplantation, end-systolic volume (ESV) of the left ventricle was significantly decreased in the autologous bone marrow mononuclear cell transplantation group after one year (P < 0.05), but ejection fraction (EF) of the left ventricle was significantly increased (P < 0.05). However, both ESV and EF were not changed in the conventional drug therapy group (P> 0.05). Compared to conventional drug therapy group, ESV and EF were changed significantly in the autologous bone marrow mononuclear call transplantation group after one year (P < 0.05). ②Compared to before cell transplantation, plasma brain natriuretic peptide levels were significantly decreased in the two groups (P < 0.05 or 0.01). Area of myocardial perfusion defect region was significantly decreased (P < 0.05 or 0.01), and the area change in the autologous bone marrow mononuclear call transplantation group was significantly greater than conventional drug therapy group (P < 0.05).CONCLUSION: Autologous bone marrow mononucleer call transplantation is safe and feasible for the treatment of chronic heart failure, and it also can remarkably improve heart function and myocardial perfusion within one year.

Objective:To explore the application of high-throughput sequencing (HTS) technology in pathogens detection for spinal infection.Methods:From January 2019 to May 2020, a total of 41 patients including 31 males and 10 females with an average age of 59.7±11.9 years (29-75 years) were suspected of spinal infections. There were 37 patients with local pain, 15 with fever (≥38 ℃) and 18 with neurological dysfunction. The infected sites were as follows, 4 cases of cervical spine, 8 cases of thoracic spine and 29 cases of lumbar spine. There were 36 patients met the surgical indications and underwent open debridement, bone grafting, fusion and internal fixation, while the other 5 patients underwent conservative treatment (three received drug therapy and two were transferred to the internal department for chemotherapy). Lesions obtained from open surgery patients were underwent pathology and HTS examination. In 5 cases with conservative treatment, two of them underwent CT guided percutaneous puncture for samples, while one case underwent ultrasound guided percutaneous puncture for pus, one case for venous blood, and one case received lumbar puncture for cerebrospinal fluid. The samples were sent for pathological and HTS examination, while liquid specimens were sent for bacterial culture and HTS. The sensitivity and specificity of HTS results were determined according to pathological examination which was regarded as the "gold standard". Based on HTS results combined with the clinical manifestations, imaging examination and pathological results of the patients, targeted antibiotics or anti-tuberculosis drugs were selected for postoperative drug therapy. Patients with bacterial infection received anti-infection treatment for 3 months after operation. For tuberculosis patients, "tetrad" (isoniazid+rifampicin+pyrazinamide+ethambutanol) anti-tuberculosis treatments were underwent for one year. Inflammation indicators from the blood samples were observed before and after treatment, including white blood cell count (WBC), C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). These indicators were used to monitor disease progression and the curative effects. All patients were followed up for at least 3 months after surgery.Results:A total of 41 patients with suspected spinal infection were included in this study. The HTS pathogen detection results were obtained within 48 h. For the initial 5 patients, first-generation sequencing verification was conducted with coincidence rate 100%. Further, no further verification was conducted in the rest patients. Among the 41 cases, a total of 26 cases had positive results with a positive rate of 63.4%(26/41). Among them, thirteen cases were with mycobacterium tuberculosis (31.7%) and 6 cases with staphylococcus (14.6%). Fungi and Brucellosis were diagnosed in 2 cases respectively, accounting for 4.9% respectively. The test were negative in 15 patients (36.6%), including 2 patients with tumor or tumor-like lesions (1 hematologic tumor and 1 eosinophilic granuloma). A total of 38 patients underwent pathological examination, which confirmed 7 cases of suppurative infection, 12 cases of tuberculosis, 2 cases of tumor or tumor-like lesions and the remaining 17 cases of inflammatory lesions. The sensitivity and specificity of HTS were 80%(16/20) and 55.6% (10/18) with positive predictive value (PPV) 66.7% (16/24) and negative predictive value (NPV) 71.4% (10/14). All patients were followed up for 3 months. The inflammation indicators of blood at 3 months were all lower than that at admission. WBC decreased from (7.50±3.26)×10 9/L at admission to (6.22±2.53)×10 9/L at 3 months after treatment without statistically significant difference ( t=1.082, P=0.290). The CRP decreased from (32.2±34.1) mg/L to (4.5±10.5) mg/L, and ESR from (44.2±26.5) mm/1 h to (18.6±12.1) mm/1 h with statistically significant difference ( t=8.963, P<0.001; t=5.421, P<0.001). Conclusion:High-throughput sequencing technology can be used in detection of spinal infection pathogens, due to its relatively high positive rate, satisfied sensitivity and good diagnostic value.