Objective To summarize the effect and experience of nursing of patients with rheumatic valvular heart disease with atrial fibrillation treated with Cox Ⅲ labyrinth and simultaneous valve replace-ment operation. Methods A retrospective analysis was carried out in the nursing of 58 patients with rheumatic valvular heart disease with atrial fibrillation treated with Cox Ⅲ labyrinth and simultaneous valve replacement operation in our hospital from April 2006 to July 2008. Results One patient died of periop-erative renal failure,one died of low cardiac output,one died of infectious endoearditis.Tbe mortality rate reached 5.2%.Other patients were discharged from hospital after completely cured.The survived patients maintained sinus rate during hospitalization days after operation and short-term follow-up after being dis-charged.Among 43 patients who completed follow-up of 6 months after operation,3 patients (7.0%) damon-strated atrial fibrillation,while others still kept sinus rate. Conclusions Attention should be paid to psy-chological nursing,respiratory tract preparation,cardiac function monitoring and nursing of anticoagulation treatment for patients treated with Cox Ⅲ labyrinth and simultaneous valve replacement operation.

Objective To explore the effect of diversified and teamwork health education mode on disease-related knowledge of coronary artery disease patients.Methods 147 cases of patients with coronary artery disease hospitalized in the general hospital of Tianjin medical university were divided into the treatment group which was given diversified health education of teamwork mode and the control group which was given traditional health education.The self-designed questionnaire was used to evaluate the effect of teamwork health education mode.Results Level of knowledge in the treatment group was significantly improved when compared with the control group,the increase amplitude of knowledge level in the treatment group was higher than the control group,and the scores of the treatment group were higher than the control group in the dimensions of diet,prevention,clinical manifestation,treatment,activity,the differences were statistically significant.Conclusions With diversified,multidisciplinary,and teamwork health education mode the patients' level of knowledge was significantly improved,the correct and positive awareness about disease were increased,and the patients were urged to take healthy behavior,so that their physical and mental state will maintain the best.

Objective To evaluate the diagnostic value of the aldosterone-renin ratio (ARR) for primary aldosteronism (PA). Methods Serum aldosteronos ( ALD ) and plasma renin activities (PRA)among 44 subjects with primary aldosteronism, 9 subjects with phecchromocytoma, 8 subjects with nonfunctional adrenal tumors, 12 subjects with Cushing syndrome, 4 subjects with stenosis of renal artery and 13 subjects with primary hypertension were retrospectively reviewed. ARR was calculated. The receiver operating characteristics (ROC) curves for every index were used to evaluate diagnostic value. Results The area under the curve(AUC) in the ROC curve of ALD in a supine position was 0. 947, the cut-off value of diagnosis of PA. The AUC for the ROC curve of ALD in upright position was 0. 889, the cut-off value of ALD diagnosis of PA. The AUC for the ROC curve of ARR in a supine position was 0. 978, the cut-off value of diagnosis of PA. The AUC for the ROC curve of ARR in upright position was 0. 981, the cut-off value of specificity. If ARR was combined with ALD in upright position was used, the diagnostic value was better than either index. When ALD > 275 ng/L and the AUC for the ROC curve in upright position was 0. 989,specificity. Conclusions The diagnostic value of ARR in diagnosis of primary aldosteronism is higher than ALD and PRA. ARR in upright position is better than that in supine position, especially when combined with ALD > 275 ng/L in upright position.

Three strains having degrading poly(?-hydroxybutyrate)(PHB) activity were isolated from activated sludge of different ecological environments and areas,named DS9701, DS9710 and DS9713.The properties of PHB depolymerase produced by DS9701, DS9710 and DS9713 were studied. All the PHB depolymerases are extracellular enzyme and are induced enzyme. The time that enzyme activities of the PHB depolymerases reach the maximum is 96 hours after inoculation. The apparent optimal temperature range for crude enzymes extract is 40℃～45℃.

Objective To observe the Th17, IL-17 and Tr cells equilibrium state as well as their changes of HIV infected or AIDS suffered patients in one-year HAART treatment. Methods Select 33 HIV/AIDS patients received HAART treatment while 33 healthy volunteers as controls. Flow cytometry was used to analyze Th17 and Tr cells in venous blood at the time of pre-therapy, 6th, 12th month when IL-17 levels in serum are tested by ELISA. Results The ratio of Th17 cells in CD4 cells in HIV/AIDS patients and volunteers were (1.20±0.37)%, (2.50±1.03)%, (3.70±1.56)%, (4.70±1.43)%, respectively; The ratio of Tr cells were (9.16±3.33)%, (7.19±2.91)%, (5.53±1.88)%, (4.43±0.97)%, respectively; The levels of IL-17 in serum were (5.3±2.5) pg/ml, (7.7±2.4) pg/ml, (10.4±3.1) pg/ml, (17.7±6.6) pg/ml respectively. The Th17 cells' level was positively correlative with the amount of CD4 cells, negatively correlate with the count of viral load. However, the Tr cells level is positively correlative with the count of viral load, negatively relate to the quantity of CD4 cells. Conclusion HIV could make IL-17, Th17 cells and Tr cells lost their balance, but the immune equilibrium state may gradually recover after HAART treatment. Which indicates the IL-17, Th17 cells and Treg cells may play an important role in the pathogenesis of AIDS, and they are likely to be the effective indexes to observe the progress of AIDS and the treatment effect of highly active antiretroviral therapy(HAART).

OBJECTIVETo elucidate the effect of angiotensin II (AngII) on the expression of tissue factor (TF) by monocytes and its mechanisms.

METHODSMonocytes were isolated from healthy volunteers by Ficoll-Hypaque gradient and Percoll, and cultured in RPMI-1640. Procoagulant activity (PCA) was determined by one-stage clotting method, TF antigen by ELISA. Reverse transcriptase-polymerase chain reaction (RT-PCR) was used to detect the TF gene mRNA. The levels of IkappaBalpha was detected by Western blot. Electrophoretic mobility shift assays (EMSA) were performed to evaluate the activity of NF-kappaB.

RESULTSAngII (10(-9) - 10(-7) mol/L) significantly increased monocyte PCA, TF antigen and TF mRNA expression in a dose and time dependent manner. Losartan (10(-6) - 10(-5) mol/L) significantly inhibited the effects of AngII on TF activity, antigen and mRNA expression in a dose-dependent effects. Staurosporine (2.5 x 10(-7) mol/L) and genistein (4 x 10(-5) mol/L) lowered TF level of monocytes (P < 0.05). Western blot analysis revealed that after exposure to AngII (10(-7) mol/L), IkappaBalpha level decreased at 15 min, reached nadir at 60 min, and recovered at 180 min. EMSA showed NF-kappaB binding activity increased at 15 min, reached peak at 60 min, and recovered at 180 min. Pyrrolidine dithiocarbamate (PDTC, 10(-4) mol/L), an inhibitor of NF-kappaB, or AT1R antagonist losartan (10(-5)mol/L) inhibited AngII-induced NF-kappaB translocation.

CONCLUSIONSAngII could induce the expression of TF in human monocytes, and this effect was mediated by AT1R. The PKC pathway played the most important role in AngII-induced TF expression. The activation of NF-kappaB was involved in TF expression in monocytes.

Angiotensin II ; pharmacology ; Gene Expression Regulation ; drug effects ; Genistein ; pharmacology ; Humans ; Losartan ; pharmacology ; Monocytes ; drug effects ; metabolism ; NF-kappa B ; metabolism ; Protein Kinase C ; physiology ; RNA, Messenger ; analysis ; Receptor, Angiotensin, Type 1 ; physiology ; Staurosporine ; pharmacology ; Thromboplastin ; genetics

Objective To observe the effect of different thyroid hormone level on the expression of synaptotagmin Ⅰ(Syt Ⅰ) in adult rat hippocampus. Methods All 28 adult male SD rats were assigned randomly into hypothyroid, hyperthyroid and control group, hypothyroid group was established by daily intraperitoneal injections with propylthiou raci(PTU, 10.0 mg/kg body weight) for 6 weeks and hyperthyroid group with L-Thyroxine (L-T4, 0.5 mg/kg body weight) for 3 weeks. Radioimmunity method was used to assay the levels of serum T3 and T4, immunohistochemical S-P technology to assay the levels of Syt Ⅰ protein in hippoeampus CA1, CA3 and dentate gyrus (DG). The layers analyzed in the different subfields include the polymorphic cell layer(the stratum oriens, SO), pyramidal cell layer(PCL), stratum radiatum (SR), lacunosum-molecular layer (SLM) in CA1 and CA3, granular cell layer(GL) and molecular layer(ML) in DG. Results The levels of serum T3 and T4[(0.34±0.12), (41.03± 11.37)nmol/L]in the hypothyroid rats were significantly lower than those in the control group[(0.65±0.15), (55.20±10.68)nmol/L, P < 0.01 or < 0.05], and the positive granule of Syt Ⅰ was significantly lower in PCL and SR of CA1 and CA3, GL of DG. The average optical value responsible for Syt Ⅰ immunoreactivity was obviously reduced in SO(0.048±0.007), PCL(0.299±0.035), SR(0.042±0.007), SLM(0.038±0.006) of CA1, PCL(0.085± 0.019), SR(0.040±0.011), SLM (0.038±0.006) of CA3, GL (0.076±0.019) of DG than normal controls (0.068± 0.014, 0.376±0.053, 0.053±0.008,0.056±0.009,0.118±0.026,0.052±0.010,0.053±0.009,0.099±0.015; P< 0.01 or < 0.05). Serum T3 and T4 levels [(1.43±0.30), (157.18±19.95)nmol/L]of hyperthyroid rats were significantly higher than those of control group(P < 0.01). The value was reduced in PCL(0.322±0.050), SR(0.039±0.006), SLM (0.042±0.006) of CA1, PCL(0.098±0.034), SR(0.046±0.013), SLM(0.046±0.010) of CA3 and GL(0.085± 0.024), ML (0.042±0.009) of DG (P < 0.05 or < 0.01). Conclusion Adult-onset of hypothyroidism and hyperthyroidism can reversibly decrease the expression of Syt Ⅰ in CA1, CA3 and DG regions of hippocampus.

Objective To investigate the immunological pathogenesis of immune reconstitution inflammatory syndrome (IRIS) during highly active antiretroviral therapy( HAART), in this prospective cohort study we analyzed the lymphocyte subsets, lymphocyte activation, changes in regulatory T cells, and levels of Th1 and Th2 cytokines in both IRIS and non-IRIS groups. Methods Two hundred and thirty-eight AIDS patients received HAART and participated prospective research cohort for 24 weeks follow-up. Forty-seven IRIS cases and 191 non-IRIS cases were enrolled in the IRIS group or non-IRIS group respectively. Blood samples were collected in both groups at pre- and post-HAART 12 weeks, 24 weeks. Using flow cytometer to detect the immunophenotypes of lymphocyte subsets (CD4 + CD45RA+ CD62L+, CD8+ CD45RA+ CD62L+naive T cells; CD4+ CD45RO+, CD8+ CD45RO+ memory T cells), activated T lymphocytes (CD4+CD38 +, CD8 + CD38 + cells), and regulatory T cell ( CD4 + CD25 + Foxp3 + ). Blood samples collected at pre-and post-HAART4 weeks, 12 weeks, 24 weeks and used ELISA to detect IL-2, IFN-γ, IL-4, IL-10and IL-7 cytokine serum levels. Results The percentages of CD4 + and CD8 + naive T cells and mlemory T cells exhibited no significant differences at the baseline, 12 weeks, 24 weeks of HAART initiation between both groups, but CD4 + and CD8 + memory T cells were demonstrated a trend towards to increase while compared to baseline during HAART. The percentages of CD4 + and CD8 + activated T cells are significantly higher at the baseline while compared to normal control and demonstrated a downward trend, but between both groups showed no significant difference. The percentages of CD4 + regulatory T cell was lower in IRIS group than non-IRIS group at the baseline, 12 weeks, 24 weeks and the onset of IRIS. Th1 cytokines, IL-2 and IFN-γshowed an upward trend during HAART at the levels of IRIS group had significantly increased at 4 weeks and the onset of IRIS. Th2 cytokines, IL-4 and IL-10 showed a downward trend during HAART,and the levels of IL-10 in IRIS group had significantly decreased at 4 weeks and the onset of IRIS. IL-7 was higher than normal control at the baseline in two groups and showed a downward trend during HAART. The level of IL-7 was higher than non-IRIS group at all follow-up points. Conclusion Memory T cells appear rapid increase in the early stage of HAART and may play a significant role in the inflammatory response of IRIS. CD4 + and CD8 + naive T cells, memory T cells and activated T cells showed no significant difference between IRIS and non-IRIS group within 24 weeks after HAART started. There was a significant reduction in the frequency of regulatory T cells in IRIS group without obvious upward trend during HAART, suggesting that the immune suppression function of regulatory T cells in IRIS was impaired. IL-2 and IFN-γ significantly increased while IL-10 significantly decreased at 4 weeks post-HAART initiation and onset of IRIS in IRISgroup than non-IRIS group, suggested that IRIS was related to cytokines environment disorder. That is, a significant increase in inflammatory cytokines, while the relative lack of non-inflammatory cytokines. The level of IL-7 decreased gradually after HAART started, and it was higher in IRIS group when compared to non-IRIS group in the first 24 weeks after HAART started. Also IL-7 may play a role in the pathogenesis of IRIS.

Objective:To explore the predictive value of the distance between the placenta and the internal os of the cervix (IOD) in second trimester to placenta previa.Methods:476 pregnant women with placenta previa diagnosed by systematic ultrasound in the Affiliated Hospital of North Sichuan Medical College from May 2016 to June 2020 were analyzed retrospectively. The ultrasonic parameters such as IOD, cervical length and placental main attachment position were measured, and the clinical characteristics and pregnancy outcome were recorded. Logistic regression analysis was used to analyze the influencing factors of placenta previa from mild pregnancy to late pregnancy. The receiver operating characteristic (ROC) curve was used to analyze the predictive value of IOD value for placenta previa.Results:197 cases of placenta previa were diagnosed in this study. Multivariate regression analysis showed that the number of previous pregnancies, IOD and history of cesarean section were the related factors of placenta previa from mid pregnancy to late pregnancy ( P<0.05). The risk of placenta previa in pregnant women ≥3 pregnancies was 1.826 times that in pregnant women with less than 3 pregnancies. The risk of placenta previa when the lower edge of placenta covers and crosses the internal orifice of cervix (IOD<0 mm) was 11.494 times that of IOD=0 mm and 22.222 times that of IOD>0 mm<20 mm (low placenta). The risk of placenta previa in pregnant women with a history of cesarean section was 1.908 times that of pregnant women without a history of cesarean section. When the cutoff value of IDO was 20 mm, all pregnant women with placenta previa could be screened out in the group with cesarean section history and the area under the curve (AUC) was 0.840 (95% CI: 0.783-0.896, P<0.05); When the cutoff value of IOD was 13.5 mm, all pregnant women with placenta previa could be screened in the group without cesarean section history, and the AUC was 0.814 (95% CI: 0.759-0.869, P<0.05). Conclusions:The second trimester IOD has a good predictive value for placenta previa.

Objective To investigate the toxic effect of hemin on primary cultured neurons,astrocytes,and brain capillary endothelial cells (BCECs),and the damage effect of hemin with different concentrations on the above cells. Methods (1) Primary cultured neurons,astrocytes and BCECs from the cortex of rats were exposed to different doses of hemin for 2 h,and continue culture of these cells for 24 to 96 h after withdrawing hemin was performed; the cellular morphology was examined under phase-contrast microscope; cellular survival rate was measured with Alama blue staining; and the releasing rate of lactate dehydrogenasing (LDH) was detected with regular biochemical method. (2) Primary cultured cells were exposed to different doses of hemin for 2 h,and continue culture of the cells for 4 h was performed after washing out the hemin; and then,concentrated formic acid was employed to dissociate the cells, and heme content in dissociated cells was measured with spectrophotometer. (3) Primary cultured cells was exposed to different doses ofhemin for 30,60 and 120 min,respectively,and continue culture of the cells for 4 h was performed after washing out hemin; and then,intracellular Fe3+was examined with Prussian blue staining. Results (1) Cultured neurons were injured by a low dose ofhemin (5 mmol/L) with a decreased survival rate by 40.2％ and an increased LDH releasing rate by 22.2％; and the pathological changes of cellular morphology were severe after 24 h of exposure to hemin.Following the increased doses ofhemin and time of post-exposure,the cellular death and LDH releasing were increased,and the morphological changes of cells were much severe. (2) The low and medium doses of hemin (5 mmol/L and 25 mmol/L) did not induce cellular death, LDH releasing and morphological changes in astrocytes; and a high dose ofhemin (50 mmol/L) could induce a death rate of astrocytes decreasing by 52.4％, a LDH releasing rate increasing by 31％ and obvious morphological changes of astrocytes; however, the injured astrocytes could regenerate fluent cellular monolayer 96 h after exposing to high dose of hemin treatment.(3) Hemin with either low or high dose did not induce any changes in cellular survival,LDH releasing and cellular morphology of BCECs.(4) The heme content in cultured neurons was significantly higher than that in astrocytes and BCECs after hemin treatment for 2 h.(5) The blue Fe3+ stained granules appeared in neurons as early as 30 min after neurons being exposed to hemin, and Fe3+ stained positive cells in neurons were significantly higher than those in astrocytes and BCECs at any dose ofhemin and any time point ofhemin treatment. Conclusion Hemin is highly toxic to neurons, but it can only injure astrocytes at a high dose and it can not induce direct damage in BCECs; free hemin could rapidly enter and accumulate in neurons,but less accumulate in astrocytes and not accumulate in BCECs.