The blood gases and acid-base disorders were analysed in 276 cases with chronic cor pulmonale at 2260m above sea level (Xining). The results demonstrated that: (1) the incidence of acid-base disorders, respiratory acidosis and the ratio of compensatory to decompensatory respiratory acidosis were low, the rate of respiratory alkolosis was high, if they were evaluated according to the formula used on plains. If normal values determined in Xining were used, the various incidences were about the same as observed on plains. (2) In diagnosing respiratory failure with blood gas analysis if the criteria commonly employed on plains was applied, the incidence of type J respiratory failure was higher, and that of type I was lower. If PaO25.33kPa were used as the criteria for respiratory failue, the incidence of type I respiratory failure became lower with type Ⅱ higher. The characteristics of acid-base disorders and diagnostic criteria of respiratory failure in patients with cor pulmonale were discussed.

Hydroxytyrosol ( 3 , 4-dihydroxyphenyle-thanol) presents in olive leaves and fruits with an ex-ceptional antioxidative activity. As a promising func-tional food ingredient, hydroxytyrosol shows many bio-logical activities, including preventing cardiovascular diseases, protecting retinal pigment epithelial cells, preventing osteoporosis, and improving the cognitive a-bility. According to the research progress in recent years,we have summarized the biological effect and the metabolism of hydroxytyrosol in this review.

Objective To establish diagnostic standards of colorectal tubular adenocarcinoma with confocal laser endomicroscopy(CLE), and to evaluate its diagnostic value in vivo.Methods The confocal images of 12 cases, which were pathologically confirmed colorectal tubular adenocarcinoma(4 well differentiated, 4 moderately differentiated and 4 poorly differentiated), were collected and analyzed to establish diagnostic standards of the disease with CLE.Then 49 lesions were prospectively evaluated based on CLE standards,which were compared to histopathology results.Results The sensitivity, specificity, accuracy, positive predictive value(PV +)and negative predictive value(PV -)of CLE in diagnosing tubular adenocarcinoma were 94.7%, 90.9%, 93.9%, 100% and 76.9%, respectively.The corresponding data of well differentiated adenocarcinoma were 100%, 83.3%, 88.9%, 85.7% and 87.0%, those of moderately differentiated adenocarcinoma were 86.7%, 90.5%, 86.1%, 86.7% and 90.5%, and those of poorly differentiated adenocarcinoma were 77.8%, 92.6%, 88.9%, 100% and 86.2%.Conclusion CLE is able to diagnose and grade colorectal tubular adenocarcinoma.

Objective To evaluate effect of continuous pelvic floor muscle training(PFMT) during pregnancy on delivery outcome, and to provide reference for clinical nursing work. Methods By searching database, the literature about continuous PFMT during pregnancy on delivery outcome were included,then EndNote was used to check the literature and RevMan5.2 was applied for Meta-analysis of the literature which met the inclusion criteria. Results A total of 11 papers were included. Meta-analysis showed that continuous PFMT during pregnancy can reduce lateral perineal resection rate (OR=0.66, 95%CI 0.48-0.89), increase rate of natural childbirth (OR=1.70, 95%CI 1.32-2.19) and promote progress of the first (MD=-0.52, 95%CI-0.92--0.12) and second (MD=-0.18, 95%CI-0.30--0.06) stage of labor. The intervention group shortened the first and the second stage of labor for 0.18h and 0.52h compared with the control group respectively. Conclusions Continuous PFMT during pregnancy can improve natural delivery rate, reduce the incidence of perineal side incision and shorten the time of labor, it is worthy of being promoted in clinical practice.

Objective: To observe the effect of Tuina (Chinese therapeutic massage) on creatine kinase (CK), mitochondrial Ca2+ concentration, and ultrastructure of skeletal muscle in delayed onset muscle soreness (DOMS) model rats.Methods: A total of 130 healthy male Sprague-Dawley rats were randomly divided into a blank group, an exercise control group, a pre-exercise Tuina group, and a post-exercise Tuina group. According to the time points for sample collection, the exercise control group was divided into a 0 h exercise control group, a 24 h exercise control group, a 48 h exercise control group, and a 72 h exercise control group; the pre-exercise Tuina group was further divided into a 0 h pre-exercise Tuina group, a 24 h pre-exercise Tuina group, a 48 h pre-exercise Tuina group, and a 72 h pre-exercise Tuina group; and the post-exercise Tuina group was divided into a 0 h post-exercise Tuina group, a 24 h post-exercise Tuina group, a 48 h post-exercise Tuina group, and a 72 h post-exercise Tuina group. Rats in all groups except for the blank group received DOMS modeling. Professionals performed Nie-Pinching manipulation and finger Nian-Twisting manipulation on the lower limbs of the rats. The samples were collected at 0 h, 24 h, 48 h, or 72 h after exhaustive exercise for each pre-exercise Tuina group. The samples were collected at 0 h, 24 h, 48 h, or 72 h after Tuina for each post-exercise Tuina group. The changes in serum CK, skeletal muscle mitochondrial Ca2+ concentration, and Ca2+-adenosine triphosphatase (ATPase) were determined. The ultrastructure changes of skeletal muscles in each group were observed by a transmission electron microscope. Results: The electron microscope showed that compared with the exercise control group, the skeletal muscle structures of the pre-exercise Tuina group and the post-exercise Tuina group were significantly improved, and the overall performance of skeletal muscle in the pre-exercise Tuina group was more similar to that of the blank group. The level of serum CK in the pre-exercise Tuina group and the post-exercise Tuina group was significantly lower than that in the exercise control group (P<0.01). The Ca2+ concentration of skeletal muscle in the 24 h, 48 h, and 72 h pre-exercise Tuina groups was lower than that in the post-exercise Tuina group at the same time point (P<0.01). The Ca2+-ATPase concentration of skeletal muscle in the 24 h and 72 h pre-exercise Tuina groups was lower than that in the post-exercise Tuina group at the same time point (P<0.05).Conclusion: Tuina effectively prevents muscle damage caused by heavy exercise and long-term exercise, which may be related to the increase of skeletal muscle Ca2+-ATPase activity and mitochondrial Ca2+ transport.

This article was aimed to study the chemical constituents of the petroleum ether fraction of Liparis nervosa.Chemicalcompoundswereisolatedandpurifiedthroughvariouschromatographytechniques.The accurate structures of chemical compounds were confirmed with spectral data and literatures. The results showed that7chemicalconstituentswereisolatedfromthepetroleumetherfractionofLiparis nervosa,whichwere moscatin (1), batatasin Ⅲ (2), bergapten (3), isoimpinellin (4), xanthotoxin (5), imperatorin (6) and β-sitosterol (7). It was concluded that chemical constituents 3-7 were isolated from this genus for the first time. And chemical constituents 1-7 were isolated from this plant for the first time.

Clinical students in 8-year program in the Zhejiang University School of Medicine carried out the "4+4" mode, namely, four undergraduate years of non-medical courses and four years of professional medical cultivation. During the professional cultivation, modular teaching of integrated medical courses was adopted for cultivating medical students with solid medical basis and broad thinking. With the background of integrated module of nerve, mind and exercise and according to students' characteristics and self-experience, teachers in neurology brought out measures focusing on "three basic courses" education when guiding students, diversifying teaching methods, utilizing Cloud Model to try new evaluation methods and so on, so as to cultivate more medical talents.

Organoids are a novel disease model that is self-assembled from stem cells or malignant tumors and is used in clinical research.They are similar to tissues and organs in the body and have partially functional 3D cell structures.There are two types of traditional models for liver cancer research,i.e.,in vivo models(animal models of liver cancer established by induction)and in vitro cell experiments using corresponding cell lines.Organoids have the advantages of the two types of traditional models and show unique advantages in tumor research.Traditional models cannot fully reflect the microenvironment of cells,which often leads to the inconsistency with clinical research findings,and the emergence of new research models provides a new direction for the research on liver cancer.This article reviews the research advances in liver cancer organoids,in order to provide a new perspective for future research on liver cancer.

Legg-Calvé-Perthes disease (LCPD) is an idiopathic necrosis of the femoral head in childhood, the deformities of the femoral head occurring in the progress of disease could result in osteoarthritis. Treatment can be surgical or nonsurgical, but the timing and indications remain unclear. Understanding of the prognostic factors of LCPD is helpful to predict the outcome and guide the clinical management. This study reviewed the literatures about the prognosis of LCPD since 2000, the prognostic factors were summarized from three categoriesas general factors, disease factors and intervention factors. The general factors were the characteristic information of patient that can be obtained at the first time clinically. The age of onset is the most definite prognostic factor, the younger the age, the better the prognosis, and 6-8 years is an important watershed. Disease factors refer to the disease characteristic information obtained through evaluation. The modified Waldenstr?m stage of the disease needs to be confirmed first, early treatment can ensure better prognosis. Then the severity was evaluated, including the involvement of necrosis, morphological changes and extrusion of the femoral head. The more severe the disease, the worse the prognosis. Most predicters, such as Catterall grading and Herring lateral column typing, have to be used in late-stage of LCPD. The degree of femoral head perfusion evaluated in enhanced MRI or DWI-MRI is an early predictor of LCPD, but it is still in the preliminary exploratory. Intervention factors are the effects of different methods of treatment on prognosis, including the comparison of surgery or non-surgery, different non-surgical and different surgical methods. The determination of surgical or non-surgical treatment mainly depends on the age of onset and severity of disease, and the younger and milder cases tend to be non-surgical treatment, but the specific indications are still controversial.

Objective: Attention deficit hyperactivity disorder (ADHD) is a polygenic neurodevelopmental disorder with significant gender differences. The sexual dimorphism of ADHD may be associated with estrogen acting through estrogen receptors (ESR). This study investigates the impact of ESR gene polymorphism and its interactions with neurodevelopmental genes on ADHD susceptibility. Methods: The study compared genotyping data of single nucleotide polymorphisms in ESR1 and ESR2 in 1,035 ADHD cases and 962 controls. The gene-gene interactions between ESR genes and three neurodevelopmental genes (brain-derived neurotrophic factor [BDNF], synaptosomal-associated protein of 25 kDa gene [SNAP25], and cadherin-13 [CDH13]) in ADHD were investigated using generalized multifactor dimensionality reduction and verified by logistic regression analysis. Results: The G allele of rs960070/ESR2 (empirical p=0.0076) and the A allele of rs8017441/ESR2 (empirical p=0.0426) were found significantly higher in ADHD cases than in the controls but not in male or female subgroups. Though no difference was found in all subjects or females, the A allele of rs9340817/ESR1 (empirical p=0.0344) was found significantly higher in ADHD cases than controls in males. We also found genetic interaction models between ESR2 gene, neurodevelopmental genes and ADHD susceptibility in males (ESR2 rs960070/BDNF rs6265/BDNF rs2049046/SNAP25 rs362987/CDH13 rs6565113) and females (ESR2 rs960070/BDNF rs6265/BDNF rs2049046) separately, though it was negative in overall subjects. Conclusion The ESR gene polymorphism associates with ADHD among Chinese Han children, with interactions between ESR genes and neurodevelopmental genes potentially influencing the susceptibility of ADHD.