Noise is a common occupational hazardous factor in the workplace. In addition to the specific damage to the auditory ， system of workers it can also harm the cardiovascular system and cause a serious disease burden. The mechanism of ， occupational noise on the cardiovascular system of workers is mainly oxidative stress inflammation and vascular endothelial ， - - - damage. As a stressor noise mainly leads to the changes of sympathoadrenal medullary system and hypothalamic pituitary ， ， ， - ， adrenal axis. The substances that play an important role include catecholamines cortisol angiotensin Ⅱ endothelin 1 - endothelial nitric oxide synthase and interleukin 6. The population epidemiological studies have shown that occupational noise ， exposure can lead to elevated blood pressure abnormal electrocardiogram and elevated blood lipids in workers. The influencing （ ， ， ） factors include noise characteristics intensity cumulative noise exposure and frequency and noise combined with other （ ， ， ， - ， occupational hazards such as high temperature welding fumes organic solvents hand transmitted vibration and work ） ， ， ， shifts . However due to the influence of research conditions experimental design and other factors some research conclusions still have limitations. More prospective and comprehensive studies are needed to verify the relevant conclusions in the future.

Activated protein kinase ( AMPK) , an important energy receptor , plays a very important role in regulating organ-ism and the energy metabolism of the cell .AMPK has complex relationship with survival of different types of breast cancer cells .Ac-cording to different conditions , AMPK may exist both anti or promoting effect on tumor .In this review , we summarize the relationship between AMPK and breast cancer related signal pathways , AMP and breast cancer endocrine therapy , breast cancer chemotherapy , ra-diotherapy for breast cancer , treatment of triple negative breast cancer and multi drug resistance of the relationship , we also expound some drugs related to AMPK and used in clinical setting .

Sepsis associated encephalopathy (SAE)is the most common form of encephalopathy in the pediatric intensive care units and might appear before other systemic features of sepsis.The pathogenesis of SAE is complex and not clear.SAE causes increased morbidity and mortality but has limited therapeutic options.SAE has become a hot issue in critical care medicine.

Objective To compare the prognosis effect of different Helicobacter pylori (Hp)eradication methods in patients with chronic gastritis.Methods One hundred and twenty patients with chronic gastritis diagnosed by gastroscopy and pathology examination were divided into sequential therapy group (36 cases),triple-combined therapy group (34 cases),Hp positive without eradication group (30cases) and Hp negative group (20 cases) according to the Hp infection status.All patients were followed up by gastroscopy,biopsy and rapid urease test before and after therapy.Results The Hp eradication rate in sequential therapy group was 94.44％ (34/36),in triple-combined therapy group was 73.53％ (25/34),and there was statistical difference (x2 =5.775,P =0.016).The symptoms scores and gastroscopy scores after therapy in the four groups were significantly lower than those before therapy,and there were statistical differences (P ＜ 0.05).The symptoms scores and gastroscopy scores after therapy in sequential therapy group were significantly lower than those in triple-combined therapy group,and there were statistical differences (P ＜0.05).The symptoms scores and gastroscopy scores after therapy in sequential therapy group,triple-combined therapy group and Hp negative group were significantly lower than those in Hp positive without eradication group [(0.84 ± 0.60),(1.34 ± 0.59),(1.49 ± 0.62) scores vs.(2.98 ± 0.54) scores,(0.47 ± 0.37),(0.83 ± 0.35),(0.96 ± 0.75) scores vs.(1.22 ± 0.40) scores],and there were statistical differences (P ＜ 0.05).Conclusions The Hp eradication rate of sequential therapy is higher than that of triple-combined therapy.The two therapy methods can both improve the symptoms score and gastroscopy score,but the symptoms after sequential therapy are relieved faster compared with triple-combined therapy.

Objective:To investigate the changes of plasma ghrelin levels and insulin(INS) sensitivity of full-term infants small for gestational age (SGA) and the effects of breast feeding on it.Methods:Full-term SGA hospitalised in the Department of Neonatology, Wuhan Children′s Hospital from October 2014 to April 2019 were re-cruited as the SGA group (120 cases), with full-term infants appropriate for gestational age (AGA) born in the same period as the AGA group (96 cases) in this study with recorded birth weight and length.The levels of fasting blood glucose (FG), triglyceride (TG), low density lipoprotein (LDL), high density lipoprotein (HDL), INS and ghrelin were measured 7 days after birth.Homeostasis model assessment-insulin resistance (HOMA-IR) was calculated.The SGA group was subdivided into breast feeding group and formula feeding group.The above indexes were tracked and mea-sured in the 3 rd and 6 th month, respectively, and their growth parameters were recorded. Results:There were no diffe-rences in serum FG, TG, LDL and HDL levels between the SGA and the AGA group (all P>0.05). Compared with the AGA group, the serum INS[(4.21±0.83) mIU/L vs.(3.54±1.10) mIU/L], ghrelin levels[(0.80±0.23) μg/L vs.(0.69±0.19) μg/L] and HOMA-IR (0.85±0.25 vs.0.72±0.25) increased in the SGA group, the differences were statistically significant (all P<0.05). Serum INS, HOMA-IR and ghrelin levels changed with the duration of breast feeding, the differences were statistically significant( F=12.394, 9.810, 5.531, all P<0.05). Conclusions:The serum ghrelin levels of SGA infants increased and INS sensitivity decreased.Breastfeeding can decrease levels of serum INS, HOMA-IR and ghrelin, and can improve INS sensitivity of SGA infants.

Objective:To provide clinical data for early identification and diagnosis of vascular embolism in children.Methods:We collected and analyzed the clinical data of children with vascular embolism diagnosed at the Children Medical Center of the First Affiliated Hospital of Hunan Normal University from January 2017 to January 2020.Results:A total of 29 children with vascular embolism were included.The male to female ratio was 2.2∶1(20/9); the age range was 1 month to 13 years, and the median age(IQR) was 16 (6-41)months.Among them, 22 cases were diagnosed with venous thrombosis, including 13 children with lower limb venous thrombosis(13/29, 44.8%), and six children with intracranial venous thrombosis(6/29, 20.7%). Arterial embolism was found in six cases, and left atrial appendage thrombosis was found in one case.Severe pneumonia was the most common primary disease(19/29, 65.5%), followed by cardiopulmonary resuscitation(3/29, 10.3%), and Kawasaki disease(3/29, 10.3%). Analysis on the risk factors of vascular embolization diseases, including catheter-related, long-term bed rest, elevated D-dimer, mechanical ventilation, and intravenous hormone administration, showed that 89.2%(25/29)had ≥3 risk factors at the same time, and 82.8%(24/29)had ≥5 risk factors at the same time.Conclusion:In children with vascular thrombotic diseases, deep venous thrombosis, especially lower extremity venous thrombosis, are common.The severe pneumonia is more common in primary disease.Children with multiple risk factors have a higher risk of developing vascular embolism.In clinic, coagulation function should be monitored and local symptoms should be observed for early identification.

Objective To investigate the impact and significance of the vagus nerve intervention on the atrial electrical emodeling.Methods 30 mongrel dogs were given metoprolol in order to eliminate the effects of sympathetic nerve on atrial electrical remodeling;observe the atrial effective refractory period (ERP) and atrial fibrillation susceptible window(VW) in the high right atrial(SA) and coronary sinus (CS) by the vagus nerve stimulation(VS) or vagus nerve stimulation(Non-VS) before and after using atropine and after atrial electrical remodeling was observed.Results Before using vagus nerve blocking agents atropine,ERP shortened significantly [(54.83 ± 46.23) ms] and VW increased significantly [(19.86±13.23) ms] after VS,this time with atrial fibrillation-prone ; After using atropine,ERP increased significantly [(112.33 ± 9.63) ms] under VS,did not induce atrial fibrillation; After atrial electrical remodeling,the value of ERP was no significant difference under basis and VS (t =2.116,0.853,all P ＞0.05).Conclusion VS can increase the atrial electrical remodeling,an increase of atrial fibrillation susceptibility;vagus nerve block can reduce atrial electrical remodeling and atrial fibrillation susceptibility decreased.

Objective To investigate the impact of preoperative portal vein thrombosis (PPVT) on living donor liver transplantation (LDLT).Methods In this study,99 patients who underwent LDLT by the same surgical team of Tianjin First Centre Hospital from 2007 to 2011 were retrospectively analyzed.According to whether there was a PPVT,all the patients were divided into PPVT group (26 cases) and non-PPVT group (73 cases).The preoperative risk factors and the impact of PPVT on LDLT and outcomes were analyzed.Results Among 26 PPVT patients there were 23 cases in grade Ⅰ and 3 cases in grade Ⅱ.Splenectomy was found to be an independent risk factor for PPVT (x2 =10.211,P =0.001).PPVT prolonged the anhepatic phase (Z =-2.430,P =0.015),but the incidence of surical complications and mortality were no statistical differences between the PVT group and the non-PVT groups.Meanwhile,there was no statistical difference of 1-and 3-year survival rate between the two groups(x2 =0.505,P =0.477).Conclusions With proper intraoperative treatment and postoperative prevention,PPVT does not affect the outcomes of patients suffering from grade Ⅰ or Ⅱ PPVT.However,PPVT added to difficulties of operation,so the detailed preoperative evaluation and careful intraoperative operation is necessary.

Objective:To establish an HPLC method for the determination of related substances in piperazine ferulate. Methods:An HPLC method was used to determine the related substances in piperazine ferulate. The separation was performed on an Xtimate C18 column (250 mm × 4. 6 mm, 5 μm). The mobile phase was 0. 5% acetic acid-methanol-acetonitrile with gradient elution. The flow rate was 1. 0 ml·min-1 and the column temperature was 30℃. The detection wavelength was 286 nm and the injection volume was 20μl. Results:Ferulic acid had a good linear relationship within the range of 5-30 μg·ml-1(r=1.0000). The detection limit was 0. 02 ng. Conclusion:The method is reliable, simple, accurate, stable and durable, and suitable for the determination of related sub-stances in piperazine ferulate.

Objective To investigate the effects of UVB irradiation and calciu m at different concentrations on the expression of pemphigus antigens by culture d human keratinocytes. Methods Human keratinocyte cultures were treated with eit her 2 mmol/L calcium added to the serum free media, or exposure to UVB irradiat ion. Immunofluorescence staining was performed with sera from patients with pemp higus vulgaris (PV) or pemphigus foliaceus (PF) as the first antigen. Extracts f rom both epidermis and keratinocytes were run on SDS-PAGE according to Laemmli ′s method and transferred to nitrocellulose membrane for immunoblot with PV and PF sera. Results Specific staining with PV sera was always detectable on kerati nocyte culture by immunofluorescence assay with or without high concentrations o f calcium while PF antigen was detected on stratified cells only. However, expos ure to UVB irradiation could not evoke keratinocyte culture express PF antigen. The reactivities were found at 160 kd band with PF sera while at both 160 kd and 130 kd bands with PV sera. Conclusions Monolayer or stratified keratinocytes ca n produce PV antigen, by increasing the concentration of calcium in the culture media, the human cultured kera tinocytes can be induced to stratify and express PFA. Human keratinocytes can not express PF antigen after exposure to UVB in intro.