OBJECTIVE:To observe the effects of bisoprolol combined with conventional triple therapy on the efficacy and re-lated indexes of patients with rheumatic heart valvular disease (RVD) combined chronic heart failure. METHODS:110 patients with RVD combined with chronic heart failure were randomly divided into observation group(55 cases)and control group(55 cas-es). All patients were treated with oxygen inhalation,anti-infection,correcting electrolyte imbalance,controlling arrhythmia,and giving digitalis drugs and diuretic drugs(it can be disabled after edema symptom being controlled);based on it,control group was given Enalapril tablet with initial dose of 2.5 mg,once to twice a day,then adjusted to 10-20 mg after 1 week,twice a day+20 mg Spironolactone tablet,once a day+10 mg Propranolol tablet,once a day. Observation group was additionally given Bisoprolol fuma-rate tablet initial dose of 1.25 mg,once a day,and then increased to 10 mg based on condition improved and tolerability after a meal,once a day. They were treated for 12 weeks. Clinical efficacy,and LVEF,LVEDD,LVESD,SBP,DBP,HR before and af-ter treatment and incidence of adverse reactions in 2 groups were observed. RESULTS:The total effective rate in observation group was significantly higher than control group,the difference was statistically significant (P<0.05). Before treatment,there were no significant differences in the LVEF,LVEDD,LVESD,SBP,DBP and HR between 2 groups(P>0.05). After treatment,LVEF in 2 groups were significantly higher than before,and observation group was higher than control group,LVEDD,LVESD,SBP, DBP and HR were significantly lower than before,and observation group was lower than control group,the differences were statis-tically significant(P<0.05). And there was no significant difference in the incidence of adverse reactions(P>0.05). CONCLU-SIONS:Based on conventional treatment,bisoprolol combined with conventional triple therapy shows good efficacy in the treat-ment of RVD combined chronic heart failure,it can improve cardiac function,with good safety.

Objective:To evaluate the effect of cryopreservation on clonogenic ability and apoptosis rate of mono-nuclear cells and CD34+cells in umbilical blood (UB), and to choose the index to present the freezing injury and optimize the cryopreservation of UB. Methods:hTe mono-nuclear cells (MNC) and CD34+cells were separated from UB and frozen.Atfer 30 days, they were thawed in warm water. Clonogenic capacity and clonogenic recovery before and atfer the cryopreservation was compared. We also used Annexin V-FITC-PI to investigate the apoptosis rate of the cells before and atfer the cryopreservation of these 2 types of cells. Results:hTe number of colony forming unit-granulocyte/monocyte (CFU-GMs) was not changed atfer freezing and thawing in both MNCs and CD34+cells, while the number of colony forming unit-granulocyte, erythrocyte, monocyte and megakaryocyte (CFU-GEMM) was obviously reduced after freezing in CD34+cells. The 2 types of cryopreserved cells had certain degree of apoptosis before the cryopreservation. MNC-type cryopreservation increased the cells apoptosis a little, while CD34+-type cryopreservation increased more. Conclusion:hTe cells have certain degree of apoptosis before the cryopreservation. hTe freezing and thawing procedure does affect the early stage progenitor cells-CFU-GEMM in the CD34+-type cryopreserved cells in UB. hTe damage may be induced by the cell apoptosis.

Objective To explore the effect of embryonic stem cells(ESCs) differentiating into cardiomyocytes(CM) by cardiomyocytes.Methods The blastocytes of 3.5 d from Kunming mouse,cultured on mouse embryonic fibroblaste cell feeder layers for 4～5 d,the mouse ESCs were isolated and subsequently cultured.Day 2～3 embryoid bodies(EBs) were derived from ESCs of passage 3 to 5 and then incubated with neonatal cardiomyocyte(CM) to induce into cardiomyocytes and the expression of cardiac specific cardiac troponin-T(TnT) and ?-actin were detected by immunofluoresence.Results The rhythmic beating embryoid bodies were observed on day 3 and reached 93% of rhythmic beating embryoid bodies on 12 day in group 2.All the beating cardiomyocytes derived from ESCs expressed cardiac-specific proteins for TnT and ?-actin,and the group induced by direct cell contact acquired the highest differentiating ratio as 56.5%,and was the highest differentiating ratio compared with other groups(P

BACKGROUND: Hundreds of mouse embryonic stem cell lines are established presently. Most of these cell lines are collected from 129, C57BL/6J and BALB/C mice. Success rate of creating embryonic stem cell lines with Kunming mice is very low. OBJECTIVE: To explore the method of isolation and culture of murine embryonic stem cells of kunming species to increase the efficiency of establishment of embryonic stem cell lines from Kunming species mouse. DESIGN, TIME AND SETTING: The cell experiment was performed at the Chongqing Key Laboratory of Neurology from April 2006 to June 2007. MATERIALS: Blastocysts of 3.5 days and 4 days from Kunming species mouse were collected. METHODS: The blastocysts of 3.5 days and 4 days from Kunming species mouse were cultured on the fibroblast cell feeder layers for 4-5 days, and the cells from inner cell mass were isolated and subsequently cultured in vitro in 2.5 g/L trypase-0.4 g/L ethylenediamine tetraacetic acid (EDTA) and 1 g/L trypase-0.2 g/L EDTA at room temperature for 2-4 minutes. Embryonic stem cell colony was mechanically straggled. MAIN OUTCOME MEASURES: Colony growth was observed and determined by alkaline phosphatase staining, OCT-4 staining and karyotype analysis. RESULTS: Adherence rate, inner cell mass frequency and cloning efficiency of 4 day post coitum (dpc) embryo were higher than those of 3.5 dpc embryo (P

Objective To investigate the clinical features and effective treatment of patients with severe type A H1N1 flu in Wenzhou. Methods The clinical data of 42 hospitalized patients with severe type A H1N1 flu were analyzed and the clinical features were summarized. Results A total of 42 patients with severe type A H1N1 flu all began with fever and cough. The symptoms of expectoration, pharyngalgia, chilly accounted for 92. 9%, 90. 5% and 42. 9%, respectively. The peripheral leucocyte counts were normal or reduced. C-reactive protein and erythrocyte sedimentation rate levels both increased in 30 patients (71.4%). About 95.2% (40/42) patients had changes of pulmonary imaging. All of the patients were treated with oseltamivir and effective antibiotic drugs as well as symptomatic management. No patients was treated with glucocorticoid. The patients with underlying diseases were given proper treatment. Three cases were treated with antifungal therapy and 3 pregnant patients were timely terminated of pregnancy. Conclusions Severe type A H1N1 flu progresses rapidly and the lower respiratory tract is involved soon after onset. Therefore, the patient should be diagnosed early and treated promptly after presenting fever, which will lead to good prognosis.

BACKGROUND: There still was not any report about inducing stem cells into matured cells to form products in vitro.OBJECTIVE: To induce CD34+ cells of umbilical cord blood to differentiate into mature megakaryocytes, and to investigate the mechanism of production of platelets.DESIGN, TIME AND SETTING: This cytology in vitro study was conducted at the Central Laboratory of Xiangya Hospital and Xiangya Third Hospital from 2004 to 2006. MATERIALS: Umbilical cord was collected from healthy full-term pregnant puerperants at the Xiangya Hospital.METHODS: The CD34+ cells were isolated from umbilical cord blood by magnetic activated cell sorting (MACS) and then cultured in 24-well culture plate at 5x107/L in StemPro-34 serum-free medium, supplemented with L-glutamine, saturated human transferrin, CaCl2, insulin, deionized bovine serum albumin and recombinant human thrombopoietin at 37℃, under 0.05 volume fraction CO2 saturated humidity to be differentiated into megakaryocytes for 14-21 days. Cell medium was absorbed, and centrifuged to obtain supernatant. Samples were centrifuged again, and then supernatant was removed. The remaining was platelet-like particles in cell culture plate. Platelet was isolated from normal platelet-rich plasma.MAIN OUTCOME MEASURES: The following parameters were measured: morphological changes in cultured cells and platelet-like particles in supematant; results of immunohistochemistry; observation results under a microscope; platelet aggregation; CD41 expression.RESULTS: At day 10, silk-like substances were found in megakaryocyte culture medium, with the presence of platelet-sized particles. The production of platelet-sized particles reached a peal at day 16. Cultured cells were strongly positively for platelet-specific antigen GP Ⅱb Ⅲa. Under the optical microscope, mature megakaryocytes were detected, with the presence of some immature megakaryocytes, and platelet-sized particles were found surrounding megakaryocytes. Under the electron microscope, a majority of mature megakaryocytes and a few apoptotic megakaryocytes were detected, and platelet-sized particles in the supernatant had the same size and structure with the platelet in the platelet-rich plasma. Some platelet surfaces were smooth or irregular. Platelet-sized particles in the supematant aggregated in response to thrombin as platelets in normal platelet-rich plasma. Flow cytometry demonstrated that the cultured platelets had the same high expression rate of CD41 as the platelets from platelet rich plasma.CONCLUSION: Umbilical cord blood CD34+ cells can be induced to differentiate into pudfied and mature megakaryocytes and platelets in vitro.

The relationship of erectile dysfunction (ED) with serum levels of total testosterone (TT) and free testosterone (FT) was investigated in 53 men with type 2 diabetes under 50 years of age.The relevant clinical status was matched and no significant difference was noticed for TT [ ( 14.11 ±5.81 vs 14.97 ±4.93 ) nmol/L] and FT [ (9.31 ± 8.84 vs 8.72 ± 5.33 ) pg/ml ] levels in type 2 diabetic patients with and without ED.This study has demonstrated that testicular androgen may not contribute to ED in young and middle-aged men with type 2 diabetes.

OBJECTIVE: To analyze the role and significance of promoting the construction of health enterprises in the prevention and control of coronavirus disease(COVID-19) pandemic. METHODS: The corresponding clauses in the Guidelines for Prevention and Control Measures for Restoration of Work and Production in Enterprises and Public Institutions(hereinafter referred to as the Guidelines) in the Code for Construction of Health Enterprises(Trial)(hereinafter referred to as the Code) were analyzed by analogy method. A convenient sampling method was used to select 78 health enterprises, and the questionnaire survey was used to investigate the one-time approval rate for restoration of work and production. The random sampling method was adopted to select 5 health enterprises for field inspection and qualitative interview, so as to understand the restoration of work and production and pandemic prevention and control in these health enterprises. RESULTS: The 16 clauses in the Guidelines were involved in the Code to some extent. Among them, 2 clauses in the Code were generally applicable to the 16 clauses in the Guidelines, accounting for 100.0%(16/16). There were 3 and 4 clauses in the Code that were applicable to the provisions of the Guidelines, accounting for 62.5%(10/16) and 12.5%(2/16) respectively. All the 78 health enterprises in Jiangsu Province were immediately approved for their application for resuming work and production. The results of in-depth interviews showed that the adoption of the construction framework and concept of health enterprises by relevant enterprises was beneficial for the prevention and control of COVID-19 pandemic. CONCLUSION: The concept and framework of construction of health enterprises are helpful for enterprises to carry out prevention and control work during COVID-19 pandemic, and comprehensively promote the construction of healthy China.

BACKGROUND:Traditional therapeutic methods of diabetes combined with lower limb artery obturation showed poor outcomes such as drug or intervention.Stem cell transplantation is a new method to treat this disease in recant years,and has obtained good outcomes in the clinic.Evaluating the therapeutic outcomes of stem cell transplantation has great damage and cost much.Thus,color Doppler ultrasound is used to examine non-invasion in the artery of the lower extremity,which shows important clinical value.OBJECTIVE:To evaluate improvement of lower extremity artery lesion following autologous peripheral blood stem cell transplantation using color Doppler ultrasound,and to compare with results of angiography.METHODS:A total of 41 patients diagnosed as having diabetes combined with lower limb artery obturation were included.Following administration of recombinant human granulocyte-colony stimulating factor(rhG-CSF)(150 μg/d)for 5 days,peripheral blood mononuclear cells(PBMNCs)were mobilized and harvested by using a separator at day 5 to prepare stem cell suspension,and which were injected intramuscularly in the diseased extremities(3×109 per limb).The clinical and laboratory findings were monitored every week for 3 months to 1 year following stem cell transplantation.RESULTS AND CONCLUSION:After stem cell transplantation,severe pain lameness,local cool-feeling and ulcer were significantly improved,and ankle-brachial index was increased obviously(P＜0.01).Color Doppler ultrasonography measurement showed that peak systolic velocity in diseased extremities was significantly increased post-transplantation(P＜0.01).Following transplantation,blood flow of the lower limb arterial canal was improved to different extents;collateral vessels were increased surrounding obstructed artery and in muscles.Spiral CT for new collateral vessel formation were showed increased.No related complication or adverse effects were observed in 41 patients during observation.Results indicated that color Doppler ultrasound can exactly rapidly examine and assess blood transport improvement in the lower limbs following stem cell transplantation,which is identical to results from angiography.It also provides reliable evidences for the diagnosis on the transplantation of stem cells for the treatment of diabetes combined with lower limb artery obturation.

This paper rounded up the resources and advantages leveraged by the hospital′s burn and plastic surgery department as a national key discipline. The department practiced medical services for chronic wounds in the regional hierarchical medical system for chronic wounds to promote the development medical alliances. IT development of the hierarchical medical network has achieved disease information sharing, namely centralized patients screening, patients referral confirmation, mutual recognition of test results, online consultation and treatment follow-up. Other achievements include standardization of medical criteria for chronic wounds by means of effective integration of resources imbalance within the network and improvement of internal medical regulations; elevation of primary level innovation capacity and services by means of high-caliber specialists working at primary institutions and mutual exchanges in between; effective medical cost control via guarantee system building, thus enhancing the public benefit nature of public hospitals. The paper also probed into problems and solutions expected in the way of promoting the chronic wound hierarchical medical system.