Objective To observe the clinical efficacy of acupuncture plus medication and kinesiotherapy in treating cerebral stroke.Method A total of 126 patients with cerebral stroke were randomized into a treatment group of 42 cases, control group 1 of 40 cases and control group 2 of 44 cases. The treatment group was intervened by acupuncture, Chinese medication plus kinesiotherapy, control group 1 by acupuncture alone and control group 2 by kinesiotherapy alone. Before the intervention and respectively after 2-week and 4-week treatment, the three groups were observed by adopting the modified Barthel Index (MBI) and Fugl-Meyer Assessment (FMA), as well as the Activities of Daily Living (ADL).Result After the treatment, the MBI score, FMA score and ADL grading were significantly changed in the three groups (P<0.01). After 4-week treatment, the MBI score in the treatment group was significantly different from that in control group 2 (P<0.05). After 4-week treatment, the FMA score and ADL grading in the treatment group were significantly different from those in both control group 1 and 2 (P<0.05).Conclusion Acupuncture plus medication and kinesiotherapy is an effective approach in treating cerebral stroke and it can improve the ADL.

Objective To investigate the effects of Trim34α on the activation of luciferase reporter gene containing NF-κB promoter induced by adaptor proteins TAB2. Methods The total RNA was isolated from HeLa cells. After amplification with RT-PCR, the target sequences were cloned into 5'-Flag-pcDNA3.1 (+) vector. The recombinant vector was confirmed by restriction enzyme digestion, colony PCR and sequencing. It was transfected into HEK293T cells to detected Trim34α expression by Western blot. Simultaneously, the effects of Trim34α on the NF-κB activation induced by TAB2 were determined by dual-luciferase reporter assay. Results Restriction enzyme digestion, colony PCR and sequencing confirmed the vector was constructed successfully, furthermore it expressed Trim34α protein in HEK293T cells. Moreover, trim34α could form high-molecular-weight oligomeric protein, and here we called it trimsome. Interestingly, dual-luciferase assay showed that Trim34α could effectively block TAB2-induced NF-κB activation. Conclusion Trim34α was involved in negative regulation of TAB2-induced NF-κB activation and could form high-molecular-weight oligomer.

Objective Background Pulmonary endarterectomy (PEA) is a safe and effective surgical treatment for chronic thromboembolic pulmonary hypertension. University of California at San Diego Medical Center is widely recognized as the world's leading referral center for PEA surgery with extensive surgical experience, which has surgically treated about 2400 patients till 2009, which account for more than 50% of the total cases in the world. Methods During visiting in UCSD, 32 pulmonary endarterectomy operations were performed by Prof. Stuart W Jamieson and Mechel M Madani. In these patients, 17 were males (53%), the average age was (47.56 ± 16.04 ) years, 47% with prior history of pulmonary embolism and/or deep vein thrombosis. Obvious pulmonary hypertension and hypoxemia were observed in all patients. Bilateral pulmonary endarterectomy was performed under cardiopulmonary bypass with profound hypothermic circulatory arrest. Results According to the classification of surgical specimens, 21.8% are type Ⅰ , 28.1% are type Ⅱ and 37.5% are type Ⅲ. The average time of cardiopulmonary bypass (CPB) was (236.32 ± 37.27) mins. The aortic cross clamp time was ( 111.69 ± 28.14) mins. The circulatory arrest time was (38.00±13.58 ) mins [ right side (21.39 ± 9.57 ) mins and left side ( 16.61 ± 6.83) mins]. Postoperatively the average mechanical ventilation time was ( 66.23 ± 99.24) hours, and the ICU stay was (4.62 ± 4.50 ) days.There was no postoperative moorality. All cases had significant decrease in systolic pulmonary artery pressure [(81.03 ± 16.92)mm Hg vs. (51.20±12.16) mm Hg] and pulmonary vascular resistance [(88.91 ±42.32) kPa · s · L-1 vs. (34.38 ±15.68 ) kPa · s · L-1 ], great improvement in cardiac output [(3.65 ±1.08 ) L/min vs. ( 5.85 ± 1.21 ) L/min ] and central venous pressure [(13.07 ± 2.11) cmH2O vs. ( 9.86 ± 3.02 ) cmH2O] postoperatively compared to preoperative data. Shortterm follow-up showed that the cardiac function of all cases returned to NYHA class Ⅰ or Ⅱ, with great improvement in CTPA.Conclusion PEA is definitive treatment of chronic thromboembolic pulmonary hypertension. According the successful experience of UCSD PEA team, first and foremost pulmonary endarterectomy is a bilateral procedure, because chronic thromboembolic pulmonary hypertension is mostly a bilateral disease. Second, cardiopulmonary bypass with the aid of deep hypothermia and circulatory arrest are essential to operator in recognizing the true endarterectomy plane of the media and in following the specimen to its feathered tail end in each branch, using these approaches can effectively reduce pulmonary hypertension and provide good hemodynamic and symptomatic results. Third, PEA remains an uncommon procedure in China. Only a few centers can perform high qualified PEA surgery. In most of inexperienced centers, type Ⅰ and type Ⅱ disease should be choose to operation.Patients with sPAP ≥100 mm Hg, PVR ≥ 100 kPa · s · L-1 or type Ⅲ disease will face more dangers peri-operation.

BACKGROUND:There is no effective drug for idiopathic pulmonary fibrosis (IPF), because of a lack of the animal model imitating the complete pathogenesis of human IPF. Therefore, it is critical to establish an ideal animal IPF model used for investigating the underlying pathogenesis and developing a kind of effective drug. OBJECTIVE:To establish an animal model that can mimic more characters of human IPF. METHODS:Seventy male C57BL/6 mice were randomly divided into two groups, fol owed by subjected to the intraperitoneal injection of bleomycin (35 mg/kg) on days 1, 4, 8, 11, 15, 18, 22, and 25, twice (group A) or once (group B) a week. Mice were sacrificed at 2, 4, 6, 8, and 10 weeks after the eighth injection, and the lung tissues were moved used for hematoxylin-eosin, Masson and immunohistochemical stainings. RESULTS AND CONCLUSION:There were various degrees of alveolitis and pulmonary fibrosis in the two groups at different time points after the last injection. The scores of alveolitis and pulmonary fibrosis in the group A began to gradual y increase from the 2nd week and reached the highest level at the 6th-8th weeks until the 10th week. In contrast, the scores of alveolitis and pulmonary fibrosis in the group B peaked at the 2nd week, then fluctuately decreased, and were significantly lower than those in the group A at the 6th week (P<0.05). Immunohistochemistry showed that type I col agen deposition was mainly distributed in the subpleural region, peri-vascular region and alveolar septa, which was consistent with Masson staining findings. The expression levels of transforming growth factorβ1 (TGF-β1) andα-smooth muscle actin (α-SMA) in the regions developing alveolitis and pulmonary fibrosis were significantly increased. In the group A, the expression levels of type I col agen, TGF-β1,α-SMA, and the hydroxyproline content in the lung tissues reached the peak level at 6-8 weeks. However, in the group B, al above indicators reached the highest level at the 2nd week, but gradual y decreased thereafter. At the 4th week, the expression Levels of TGF-β1 andα-SMA in the group B were significantly lower than those in the group A (P<0.05). At the 6th week, the hydroxyproline and type I col agen levels in the group B were significantly lower than those in the group A (P<0.05). In conclusion, the mouse model of pulmonary fibrosis induced by intraperitoneal injection of 35 mg/kg bleomycin twice weekly can be used to mimic the repetitive wound healing process, pathological morphology and cytokine changes of human IPF, which is prone to administration, with better stability and repeatability. This model is of great significance for the study on IPF. Subject headings:Disease Models, Animal;Pulmonary Fibrosis;Bleomycin

Objective To evaluate the effects of astragalus on liver injury and TGF-β1 mRNA expression in immature rats with obstructive jaundice(OJ).Methods Forty immature male Wistar rats were randomly divided into a control,a shamoperation,an OJ,and an OJ+A groups.Wistar rats in the OJ and OJ+A group were subjectedto common bile duct ligation(CBDL),while the sham group had the bile duct mobilized but not tied.The control,sham,and OJ groups were giyen 0.5ml of normal saline by intrapedtoneal injection daily.In the OJ+A group,250mg/100g body weight of astragalus injection was applied intraperitoneally daily from day 1 to 7 of the study.All animals were sacrificed on postoperative day 8.Liver tissue and peripheral blood were colleered.Serum Alanine aminotransferase(ALT),Aspartate aminotransferase(AST),and total cholic acid(TCA)level were detected.Hepatic morphological findings were observed by light microscopy.TGF-β1 mRNA were extracted from liver and measured by reverse transcription polymerase chain reaction(RT-PCR).Data were analyzed using chi-square test and student's test(-x±s),P＜0.05 was considered statistical significance.Results ①Serum AST,ALT,and TCA value in each OJ group were significantly higher than that of the control and sham operation groups.②In the control and sham operation group,normal structure of the liver remained,but in the OJ group,obvious degeneration of hepatocytes was detected,such as cholastasis,starch accumulation and fatty degeneration.Kupffer cells and dilated Disse'space were common in the OJ group.In the OJ group.histopathologic findings of the liver demonstrated intense degree of fibrosis,but in the OJ+A group.typical changes of large duct obstruction were significantly improved after astragalus injection treatment.③The TGF-β1 mRNA over-expression in the OJ group was seen compared with the control and the OJ+A groups.Conclusion ①In growing rat model of experimental obstructive jaundice,hepatic morphology and liver biochemical tests altered significantly.②The administration of astragaius can ameliorate liver damage and diminish expression of TGF-β1 mRNA of hepatic tissue,thus administration of astragalus may be effective in preventing hepatic injury in growing rats with obstructive jaundice.

Objective To evaluate the right ventricular function of chronic thromboembolic pulmonary hypertension (CTEPH) after pulmonary thromboendarterectomy (PTE) by Doppler echocardiography. Methods In 16 patients with CTEPH,end-diastolic left ventricular diameter(LVDd), end-diastolic right ventricular areas (RVEDA), end-systolic right ventricular areas (RVESA), right ventricular fractional area change (RVFAC), pulmonary accelerative time (Pact), pressure gradient of tricuspid valve regurgitation (PGT1), area of tricuspid valve regurgitation (AT1) were measured by echocardiography. Results Fifteen and thirty days after surgery,the LVDd and Pact had increased,RVEDA, RVESA,PGT1 and AT1 had decreased while RVFAC had increased in all cases. Conclusions PTE may effectively improve the right ventricular function of patients with CTEPH.

AIM: To investigate drug resistance of Acinetobacter baumannii strains isolated in the hospital from 2018 to 2019, and explore plasmid-mediated delivery of quinolones resistance genes (PMQR) in Acinetobacter baumannii, to provide references for the clinical therapy of infections and to analysis the genetic mechanisms of resistance by aid of molecular methods. METHODS: Bacteria were identified by VITEK-2 compact System, the results of antibiotics susceptibility test was determined by using microdilution method MIC. We amplified genes of qnrA, B, C, D, S, aac(6')-Ib and qepA on plasmid by PCR, and PCR products of each resistant gene for sequencing analysis were random selected. We analyzed the results of antibiotics susceptibility of 152 clinical isolates based on WHONET 5.6 software. RESULTS: In the past two years, 152 strains of Acinetobacter baumannii have been detected from clinical specimens. The antibiotics resistance rate of Acinetobacter baumannii isolates was an increasing trend year by year. PCR indicated that some strains of Acinetobacter baumannii have products of aac(6')-Ib and qnrB gene, 29.6%(45/152) strains carrying aac(6')-Ib and 1.3%(2/152) strains carrying qnrB; there were no products of qnrA, C, D, S and qepA genes on plasmid. CONCLUSION: The current drug-resistance rate among Acinetobacter baumannii strains in Hefei to common antibiotics is high, and PMQR carrying rate is low.

Objective:To assess the changes of left ventricular systolic function and global synchronization and myocardial work in patients with left bundle branch pacing (LBBP) by two-dimensional multi-layered speckle tracking imaging.Methods:Forty-two patients with Ⅱ degree Ⅱ type or Ⅲ degree atrioventricular block (AVB) in the Cardiovascular Hospital of Xiamen University from April to December 2019 were selected as pacing group, which were further divided into two groups according to different pacemaker modes: twenty patients with right ventricular septal pacing (RVSP), twenty-two patients with LBBP, and twenty patients with normal ECG and cardiac structure were enrolled as control group. Echocardiography of pacing group and control group was performed and analyzed. The left ventricular subendocardial longitudinal strain peak(LSendo), the middle layer myocardial longitudinal strain peak(LSmid), subepicardial longitudinal strain peak(LSepi), global myocardial longitudinal strain peak(GLS), peak strain dispersion (PSD), global work index (GWI), global constructive work (GCW), global wasted work (GWW) and global work efficiency (GWE) were acquired. The differences among the three groups were analyzed and the high difference indexes were screened by statistical modeling.Results:LSendo in three groups had no difference ( P>0.05). LSmid, LSepi, GLS in the control group, LBBP group and RVSP groups were decreased gradually ( P<0.05). GLS in LBBP group was higher than in RVSP group ( P<0.05). Compared with the control group, the increases of QRS and PSD in LBBP group were not statistically significant ( P>0.05), while the decreases of QRS and PSD in LBBP group were statistically significant compared with the RVSP group ( P<0.05). The values of GCW among three groups had no statistical significance ( P>0.05). Compared with the control group, the decrease of GWI in LBBP group was not statistically significant ( P>0.05), while the increase of GWW and the decrease of GWE were statistically significant ( P<0.05). Compared with the RVSP group, the increases of GWI and GWE and the decrease of GWW in LBBP group were statistically significant ( P<0.05). QRS, LSendo, GLS, LSmid, left ventricular apex rotation to basal rotation peak time(ApexBase period) were the indexes with significant difference among LBBP and RVSP groups and all index characteristics showed better in LBBP than RVSP group. Conclusions:Two-dimensional multi-layered speckle tracking imaging can be used to evaluate the effect of LBBP on left ventricular systolic function and global synchronization and myocardial work. LBBP longitudinal mechanical synchronization is better than right ventricular septal pacing by improving the peak global myocardial longitudinal strain and myocardial work after pacemaker.