Objective To determine the changes of blood cytokines values and inductions of cytokines expressions after CPB and cardiac valve replacement. Methods Thirty patients undergoing cardiac valve replacement were randomly selected, The plasma cytokines levels or activities and inductions of cytokine expressions were measured before CPB, 1st, 3rd, 7th, 14th d after operation.Results Compared with the baselines, IL 1 activity and souluble interleukin 2 receptor(SIL 2R) level increased on the 1st, 3rd d , then decreased significantly on the 7th d, plasma IL 8 level increased in 14 d after CPB, but IL 2 activity decreased during 7 d postoperatively(P0.05); induction of IL 1 expression increased significantly on the 1st d and decreased on the 3rd d (P

Objective To explore the expression of acid seining ion channels-3 (ASIC3) in lung tissue in rats with acute lung injury (ALI). Method Twenty four male Sprague-Dawley (SD) rats were randomly divided into four groups: LPS groups (LPS 2 h, LPS 4 h, LPS 6 h group, n=6), stimulated by LPS for 2, 4, 6 hours, respectively; normal control group, injected with saline (NS group, n=6). The ALI models were produced through venous injection of LPS, and the criteria was the characteristic pathological changes in the lung tissue. Ar-terial blood gas analysis was observed, lung wet and dry weight ratio (W/D), lung histopathology and ASIC3 ex-pression were detected. Data were expressed as mean±standard deviation. Independent Sample T test and One-way ANOVA and Kendall's tau_b were used for comparison in SPSS 13.0, and changes were considered as statistieal-ly significant if P value was less than 0.05. Results The partial pressure of oxygen (PaO2) in LPS 2 h, LPS 4 h, LPS 6 h group was (67.47±6.01), (59.17±7.18), (52.54±7.62) , respecively, and was significantly lower than that in eontrol group (98.15±1.06) (P<0.01). Compare with control group, pH was significantly lower in LPS4 h group (7.28±0.04), LPS6 h group (7.24±0.03) (P<0.01). Inflammation cells gradually increased, alveolar septum was widened, edema existed in interstitial spaces, and pulmonary structures gradually destroyed in LPS groups.The expression of ASIC3 in LPS4 h, LPS 6 h group was (205.91±10.12), (196.51± 18.60), respectively, and was significantly lower thanthat in control group (220.23±10.11) (P<0.05). The W/D in LPS 6 h group was (5.18±0.21), and was significantly higher than that in the control group (4.45± 0.18) (P<0.05). Conclusions ASIC3 is expressed in alveolar epithelial cells and bronchial epithehal cells in LPS-induced ALI rats.

Objective To investigate the curative effects of dexamethasone in the prevention of delayed encephalopathy after acute carbon monoxide poisoning in the rats.Methods Eighty healthy male Wistar rats were randomly(random number)divided into hyperbaric group(H),dexamethasone group (D),combined treatment group(C)and model control group(M)after carbon monoxide poisoning,twenty rats in each group.Twelve air-modeling rats were selected as normal control group(N).Using eight-arm maze training and testing,the rat's function of cognitive and memory was detected.The serum MBP levels were detected by enzyme-linked immunosorbent assays(ELISA).Magnetic resonance imaging was used for observing the demyelination of the head and the morbidity of delayed encephalopathy.Measured data was analyzed with single factor analysis of variance(one-way ANOVA).Results The result of eight-arm maze showed that there were 6,7,1,1 rats with delayed encephalopathy in groups M,H,C,D,respectively.At 3 days after poisoning,except N group,the serum MBP levels of every groups increased significantly.At 10 days after poisoning,serum MBP levels in groups C and D were significantly decreased,then returned to normal levels at day 18.The serum MBP in groups M and H was higher than normal levels at all the time.Head MRI showed except D group,the rest groups were abnormal signals,which appeared 7 in M group,6in H group and 1 in C group.Conclusions Dexamethasone administrated as soon as possibly after acute carbon monoxide poisoning may reduce the serum MBP levels,prevent demyelination occurs,decrease the pathological damage,eventually play a preventive role in DE.

Objective:To explore the clients' assessment for the ethical behavior of the counselors and psychotherapists.Methods:The main method used in this evaluation was questionnaire,and the self-made questionnaire of the ethical problems in psychotherapy and counseling(for the clients)were used as evaluation tools.Totally 1100 clients,from 12 cities in China,were investigated with 807 questionnaires returned.Results:84.5% of the clients were confident in the treatments,and 89.2% of them gave positive assessment for the ability of their counselors and psychotherapists.15.9% of clients said the counselors and psychotherapists showed impatience or talked to them about their stress sometimes.Besides,59.1% knew about the characters,names and charge of the psychotherapies and counseling,and 53.4% knew the background of the counselors and psychotherapists.91.3% of clients thought the privacy and treatment could be kept secret.7% of clients had intimate relationship with their counselors or psychotherapists,1.5% had sexual relations,and 18.3% made friends in lives.79% of clients could receive timely psychotherapies and counseling.Conclusion:From the assessment of the clients,the vast majorities of the counselors and psychotherapists do well in work ability,confidentiality and time-setting,but not so well in informed-consent and dual relations,which need to be paid attention to and improved.

Sinacalia davidii (Franch) Koyama. grows only in China, its chemical constituents have never been studied before. The compounds were isolated by column chromatography on silica gel and Sephadex LH-20, and the structures were identified on spectroscopic data (MS, 1H-NMR, 13C-NMR). Six compounds were isolated from S. davidii, and were characterized as p-sitosterol (1), 3-oxo-2alpha, 23-dihydroxy-olean-12-en-28-oic acid (2), 28-hydroxy-olean-12-en-3, 11-dione (3), 3beta-methoxy-olean-11-oxo-18-ene (4), luteolin (5) and 2alpha-hydroxy-ursolic acid (6). All the six compounds above were isolated from S. davidii for the first time.
Asteraceae ; chemistry ; Chromatography, High Pressure Liquid ; Magnetic Resonance Spectroscopy ; Mass Spectrometry ; Organic Chemicals ; analysis ; isolation & purification

The 2017 edition of expert consensus onclassification and clinical strategy of constipation was released in March 2018. This artide makes a joint interpretation of it with the Guideline for surgical diagnosis and treatment of constipation ( 2017 edition). The similarities and differences between the two mainly include: (1) The concept of constipation is basically the same, the main difference is that the consensus puts forward the association between constipation and mental disorders. (2) For constipation in terms of etiology, examination methods and evaluation, the consensus does not mention the etiology, but the examination methods are completely consistent. The reference standard of mental and psychological assessment is added in the consensus. (3) For the diagnosis of constipation, the diagnostic criteria and classification of constipation are specified in the guideline, and only the classification of constipation is mentioned briefly, while the consensus further develops the three different degrees of constipation. (4) For the treatment of constipation, the basic principles are the same. In the description of the specific treatment plan, the guideline divides the treatment methods of constipation into two categories: non-surgical treatment and surgical treatment, and then focuses on the suitability and specific operation of surgical treatment, while the consensus focuses more on coping strategies and treatment options for different degrees of constipation, including how to deal with the unavoidable mental and psychological disorders in the diagnosis and treatment of constipation questions. It can be seen that the consensus is a supplement and improvement of the guideline for surgical diagnosis and treatment of constipation. The consensus provides more targeted and applicable clinical reference ideas for clinical practice from different perspectives, especially the better auxiliary clinical decision-making after the quantification of the classification standard of constipation.

The 2017 edition of expert consensus onclassification and clinical strategy of constipation was released in March 2018. This artide makes a joint interpretation of it with the Guideline for surgical diagnosis and treatment of constipation ( 2017 edition). The similarities and differences between the two mainly include: (1) The concept of constipation is basically the same, the main difference is that the consensus puts forward the association between constipation and mental disorders. (2) For constipation in terms of etiology, examination methods and evaluation, the consensus does not mention the etiology, but the examination methods are completely consistent. The reference standard of mental and psychological assessment is added in the consensus. (3) For the diagnosis of constipation, the diagnostic criteria and classification of constipation are specified in the guideline, and only the classification of constipation is mentioned briefly, while the consensus further develops the three different degrees of constipation. (4) For the treatment of constipation, the basic principles are the same. In the description of the specific treatment plan, the guideline divides the treatment methods of constipation into two categories: non-surgical treatment and surgical treatment, and then focuses on the suitability and specific operation of surgical treatment, while the consensus focuses more on coping strategies and treatment options for different degrees of constipation, including how to deal with the unavoidable mental and psychological disorders in the diagnosis and treatment of constipation questions. It can be seen that the consensus is a supplement and improvement of the guideline for surgical diagnosis and treatment of constipation. The consensus provides more targeted and applicable clinical reference ideas for clinical practice from different perspectives, especially the better auxiliary clinical decision-making after the quantification of the classification standard of constipation.

Objective: The current study reported a case series to illustrate the early computed tomography (CT) findings of coronavirus disease 2019 (COVID-19) in pediatric patients. Materials and Methods: All pediatric patients who were diagnosed with COVID-19 and who underwent CT scan in Zhongnan Hospital of Wuhan University from January 20, 2020 to February 28, 2020 were included in the current study. Data on clinical and CT features were collected and analyzed. Results: Four children were included in the current study. All of them were asymptomatic throughout the disease course (ranging from 7 days to 15 days), and none of them showed abnormalities in blood cell counts. Familial cluster was the main transmission pattern. Thin-section CT revealed abnormalities in three patients, and one patient did not present with any abnormal CT findings. Unilateral lung involvement was observed in two patients, and one patient showed bilateral lung involvement. In total, five small lesions were identified, including ground-glass opacity (n = 4) and consolidation (n = 1). All lesions had ill-defined margins with peripheral distribution and predilection of lower lobe. Conclusion Small patches of ground-glass opacity with subpleural distribution and unilateral lung involvement were common findings on CT scans of pediatric patients in the early stage of the disease.

Objective: To identify predictors of pulmonary fibrosis development by combining follow-up thin-section CT findings and clinical features in patients discharged after treatment for COVID-19. Materials and Methods: This retrospective study involved 32 confirmed COVID-19 patients who were divided into two groups according to the evidence of fibrosis on their latest follow-up CT imaging. Clinical data and CT imaging features of all the patients in different stages were collected and analyzed for comparison. Results: The latest follow-up CT imaging showed fibrosis in 14 patients (male, 12; female, 2) and no fibrosis in 18 patients (male, 10; female, 8). Compared with the non-fibrosis group, the fibrosis group was older (median age: 54.0 years vs. 37.0 years, p = 0.008), and the median levels of C-reactive protein (53.4 mg/L vs. 10.0 mg/L, p = 0.002) and interleukin-6 (79.7 pg/L vs. 11.2 pg/L, p = 0.04) were also higher. The fibrosis group had a longer-term of hospitalization (19.5 days vs. 10.0 days, p = 0.001), pulsed steroid therapy (11.0 days vs. 5.0 days, p < 0.001), and antiviral therapy (12.0 days vs. 6.5 days, p = 0.012). More patients on the worst-state CT scan had an irregular interface (59.4% vs. 34.4%, p = 0.045) and a parenchymal band (71.9% vs. 28.1%, p < 0.001). On initial CT imaging, the irregular interface (57.1%) and parenchymal band (50.0%) were more common in the fibrosis group. On the worst-state CT imaging, interstitial thickening (78.6%), air bronchogram (57.1%), irregular interface (85.7%), coarse reticular pattern (28.6%), parenchymal band (92.9%), and pleural effusion (42.9%) were more common in the fibrosis group. Conclusion Fibrosis was more likely to develop in patients with severe clinical conditions, especially in patients with highinflammatory indicators. Interstitial thickening, irregular interface, coarse reticular pattern, and parenchymal band manifested in the process of the disease may be predictors of pulmonary fibrosis. Irregular interface and parenchymal band could predict the formation of pulmonary fibrosis early.

Objective To explore the prognosis and management of atrial fibrillation (AF) in patients with atrial septal defect(ASD) accompanied by AF after transcatheter closure of ASD. Methods During the period from July 2010 to May 2013, a total of 24 patients with ASD accompanied by AF were admitted to authors’ hospital to receive transcatheter closure of ASD. Electrocardiogram (ECG), chest X-ray film and transthoracic echocardiography (TTE) were performed before and one day after the operation. Follow-up information was obtained through telephone or at out-patient clinic interview. Results Successful occlusion of ASD was obtained in all patients, and in no patient the AF rhythm turned to sinus rhythm after the procedure. In one patient preoperative AF turned to postoperative atrial flutter, and AF recurred in one case who had received transcatheter ablation of AF before the procedure. One female patient developed gastric bleeding during the course of orally taking warfarin, and she died of cerebral infarction at three days after ceasing the use of warfarin. Of the 24 patients, no anticoagulant drug was used in 5 (20.8%), oral administration of aspirin was given in 7 (29.2%), and oral medication of warfarin was employed only in 11 (45.8%). Conclusion The spontaneous conversion rate of AF is very low in patients with ASD complicated by AF after transcatheter closure of ASD. Postoperative medication of anticoagulation should be strictly standardized and carefully managed.