Objective To compare the gas and heat exchange performance of membrane oxygenator DDMO-100S and membrane oxygenator Terumo SX-10 in cardiopulmonary bypass(CPB)in children.Methods 39 children aged 3-12 yrs who suffered from congenital heart disease were selected,and the repair of ventricle septal defect or/and atrial septal defect was performed under cardiopulmonary bypass.The 39 children were randomly divided into Group DD(n =21)and Group SX(n = 18).Membrane oxygenator DDMO-100S(Made by Xi'an Daidai,China)was used in Group DD and Membrane oxygenator Terumo SX-10(Made by Terumo,Japan)in Group SX,respectively.The hypothermic cardiopulmonary bypass with high perfusion flow and the cool crystalloid cardioplegia were applied in all children.The artery blood samples were taken for measuring PO2 and PCO2 and the oxygenating index(OI)was calculated by the formulae(OI = PaO2/FiO2).The temperature at nasal pharynx was monitored and the rewarming time was recorded.Results The total priming volume in Group DD was bigger than in Group SX [(742.5 ± 107.3)ml vs(531.3 ± 84.3)ml,P ＜ 0.05].The PO2,OI and PCO2 at 15 min after CPB or at 5 min before cease of CPB had no differences in both group(P ＞0.05).The rewarming time had no difference in both group [(31.5 ± 10.2)min vs(30.61 ± 8.2)min,P ＞0.05].Conclusions Under our observation condition,the gas and heat exchange performance of membrane oxygenator DDMO-100S were the same as membrane oxygenator Terumo SX-10,when it was used in cardiopulmonary bypass in children,but it had a little bit more priming volume.

Objective To explore the effect of oropharyngeal healthy exercise combined with guided education in the treatment of dysphagia in patients with Alzheimer's disease (AD). Methods 90 AD inpatients in the geriatric psychiatric department of Guangzhou Huiai Hospital during May 2014 and August 2015 were equally randomized into the study group and the control group with a random digit table:the former group was treated with routine oral muscles training and the latter with oropharyngeal healthy exercises combined with guided education plus routine muscles training. The comparison was done between the groups in terms of the total curative effectiveness 4 weeks following the intervention. Result The total effective rate in the study group was significantly higher than that in the control group (P<0.01). Conclusion The oropharyngeal healthy exercise combined with guided education can effectively promote the recovery of swallowing function in AD patients.

Tripterygium wilfordii is a valuable medicinal plant rich in biologically active diterpenoids, but there are few studies on the origins of these diterpenoids in its secondary metabolism. Here, we identified three regions containing tandemly duplicated diterpene synthase genes on chromosomes (Chr) 17 and 21 of T. wilfordii and obtained 11 diterpene synthases with different functions. We further revealed that these diterpene synthases underwent duplication and rearrangement at approximately 2.3-23.7 million years ago (MYA) by whole-genome triplication (WGT), transposon mediation, and tandem duplication, followed by functional divergence. We first demonstrated that four key amino acids in the sequences of TwCPS3, TwCPS5, and TwCPS6 were altered during evolution, leading to their functional divergence and the formation of diterpene secondary metabolites. Then, we demonstrated that the functional divergence of three TwKSLs was driven by mutations in two key amino acids. Finally, we discovered the mechanisms of evolution and pseudogenization of miltiradiene synthases in T. wilfordii and elucidated that the new function in TwMS1/2 from the terpene synthase (TPS)-b subfamily was caused by progressive changes in multiple amino acids after the WGT event. Our results provide key evidence for the formation of diverse diterpenoids during the evolution of secondary metabolites in T. wilfordii.