Objective To study the basic pathogenic cause,clinical characteristics,treatment methods and prognosis of sub-acute infective endocarditis (IE) ,and to improve the diagnosis and treatment against it Methods The basic cardiac disease,clinical characteristics,pathogenic bacteria,ultrasound cardiogram, therapy and prognosis of 36 cases of sub-acute IE was retrospectively analyzed. Results Compared to previous reports, the proportion of rheumatic cardiac disease was a little lower, whereas the proportion of congenital cardiac disease and not-recorded cardiac diseases were a little higher.The main clinical characteristics showed as fever, heart failure, increasing in number of neutrophile granulocyte,blood sedimentation and anemia, The positive rate of blood culture was 58. 33% with the most common pathogenic bacterium of streptococcus viridans. Endocardial vegetation has been diagnosed in 63. 89% of patients through-thoracic echo-cardiography. The short-term fatality rate was 19. 44% . Conclusions There have been significant changes in the basic pathogenic causes,clinical characteristics and pathogenic bacteria of sub-acute IE as compared to the previous reports. The fatality rate remains high even after active treatment. Early surgical operation is recommended to those suitable patients.

Objective To evaluate the emotions and quality of life in the patients with thyroid-associated ophthalmopathy (TAO) .Methods 38 TAO patients with normal thyroid function and 34 healthy subjects were recruited .The patients with TAO were further divided into the mild and moderate-severe group by EUGOGO criteria .The depressive and anxious status and quality of life of all subjects were assessed by the rating scales .Results The incidence rate of anxiety and depression in the patients with TAO was 36 .8% and 28 .9% separately ,which were higher than 8 .8% and 5 .9% in the controls(P<0 .05) ,but the quality of life scores in TAO patients were lower than those in the controls (P<0 .05) .The subgroup analysis indicated that the incidence rate of anxiety and depression in female TAO patients was 50 .0% and 45 .5% separately ,which were higher than that in male TAO pa-tients 18 .8% vs .6 .3% (P<0 .05) ,but the quality of life scores in female TAO patients were lower than those in male TAO pa-tients(P<0 .05) .Compared with the mild-moderate group ,an obviously higher incidence rate of anxiety (21 .7% vs .60 .0% ,P<0 .05) and depression(8 .7% vs .60 .0% ,P< 0 .05) were observed in the severe group with the lower quality of life scores (P<0 .05) .Conclusion (1) TAO affects the emotions and the quality of life of TAO patients .(2) TAO patients have a statistically higher incidence rate of anxiety and depression and a lower quality of life ;this phenomenon is more obvious in female patients .(3) The patients with severe TAO are more likely to have anxiety and depression ,as well as a lower quality of life .

Objective To observe the effects of LPS and PMA on proliferation of human len epithelial( HLE )cells and expression of epidermal growth factor receptor(EGFR) in HLE cells.Methods The expressions of EGFR protein of HLE cells from felus,adult lens age-related cataract and cultured HLE cells were detected by immunohistochemical staining.The expression of EGFR mRNA was detected by RT-PCR.The effects of LPS (0.5,1.0,2.0 mg?L-1 ) and PMA(25,50,100 nmol?L-1 )on proliferation of HLE cells were detected by MTT colorimetry method,and the EGFR mRNA expression in HLE cells was determined by RT-PCR. Results The expressions of EGFR protein and mRNA were positive in HLE cells from felus,adult lens age-related cataract and cultured HLE cells.The proliferation rates of HLE cells treated with 0.5,1.0,2.0 mg?L-1 LPS were (3.21?0.42)%,(12.25?1.34)% and (36.67?3.65)%,respectively.The proliferation rate of HLE cells in 2.0 mg?L-1 LPS group was higher than those in 0.5 and 1.0 mg?L-1 LPS groups(F=7.709,P0.05).PMA(25,50,100 nmol?L-1 )could not effect the expression of EGFR mRNA in HLE cells .Conclusion Inflammation stimulant factor such as LPS can promote the proliferation of HLE cells by increasing the expression of EGFR and result in occurrence of posterior capsular opacifition(PCO).

The basical structure of diketopiperazines is a cyclic dipeptide condensed by two amino acids. Because of the stable framework of the six-member ring structure, and having two hydrogen bond donor and two hydrogen bond receptor, DKPs have become important chemical pharmacophores, with strong biological activities and pharmacological activities in the drug. A series of cyclic compounds were found from marine organisms in recent years, research showed that their functions are not limited on anti-bacterial, cytotoxic activity, and so on, but also playing an important role in regulatory mechanism of quorum sensing as signal molecules, they have become research hot point in ecological chemistry. This paper reviewed the research progress of diketopiperazines found in the marine microbial metabolites, and the future study trends was discussed and outlooked.

Object To optimize the best extraction of the total saponins in the root of Ophiopogon japonicus (Thunb.) Ker-Gawl. (RO). Methods The extract condition of total saponins in RO was observed by orthogonal design with ophiopogonis D as index. Results The optimum extract condition of RO was established. The more effective way was to smash RO to 5-10 mesh and extract total saponins in RO with ten times amount of 80% alcohol thrice by refluxing, one hour each time. Conclusion The total saponins in RO could be fully extracted in this condition.

BACKGROUND: Varicocele (VC) can induce the infertility in males, so the investigation on its mechanism is important for the treatment of male infertility. OBJECTIVE: To analyze the effects of VC induced by surgical operation on the contents of mitochondria calcium, cytochrome C and cell apoptosis as well as the changes of microstructure and ultrastructure in epididymis. DESIGN: Randomized control experiment. MATERIALS: The experiment was conducted in Jiamusi University between June 2003 and May 2004. Forty male adolescent Wistar rats with the average body mass of (220±20) g were selected, which were provided by the Animal Laboratory of Jiamusi University. Rats were randomly divided into sham-operation group and deligation group with 20 rats in each group at one week after feeding at room temperature. METHODS: Rats in the sham-operation group were made into sham-op eration models by exposing the left renal vein. Rats in the deligation group were deligated of partial left renal veins so as to establish VC models. Bilateral epididymides were removed at ten weeks after operation. The levels of mitochondria calcium in head and body of epididymis as well as the contents of cytochrome C and cytoplasm cytochrome C were detected. The cell apoptosis was detected by in situ terminal deoxynucleotityl transferase mediated dTUP nick end labeling (TUNEL) technique. The specimens of corpus epididymis were routinely made for observation under optimal microscope and electron microscope. The changes of microstructure and ultrastructure of epididymis were studied.MAIN OUTCOME MEASURES: The contents of mitochondria calcium, cytochrome C and cytoplasm cytochrome C. Cell apoptosis. Changes of cellular morphous in epididymis. RESULTS: A total of 40 rats were involved in the analysis of results.① The contents of mitochondria calcium in bilateral epididymis were obviously decreased in the deligation group than the sham-operation group [(4.72±1.45), (5.90±1.97), (10.13±2.34) mg/g, (P ＜ 0.01)].②The content of mitochondria cytochrome C in right epididymis obviously increased more in the deligation group than the sham-operation group [(0.36±0.20), (0.19±0.14), (0.15±0.07) μmol/L (P ＜ 0.05)]. ③The contents of cytoplasm cytochrome C in bilateral epididymis greatly increased more in the deligation group than the sham-operation group [(8.17±1.49), (7.48 ± 1.60), (5.93±1.60) mol/L, (P ＜ 0.05)].④The apoptotic rate of bilateral cells in the deligation group was significantly increased than the sham-op eration group [( 13.3±1.9)%, ( 12.6±1.5)%, (6.2±0.3)%,(P ＜ 0.01 )]. However, there were no significant differences in mitochondria calcium, cytochrome C, cytoplasm cytochrome C and apoptotic rate between the left and right mitochondria of the deligation group (P ＞ 0.05).⑤Main changes under light microscope: cuctus epididymis shrinked, the blebbing appeared in epithelial cells, and the light cells as well as halo cells in epithelia were significantly increased. ⑥Main representation under electron microscope: the cytolysosome inside the chief cells were increased and enlarged with increased residual bodies, and the endoplasmic reticulum expanded, the mitochondria cristae was dim, the Golgi complex was vacuolated. Besides, nuclear chromatin were dense and in lump at different size, which located mainly in the nuclear membrane. The microvilli of columnar epithelial cells were sparse and local defects could be seen. CONCLUSION: The cytochrome C is released to kytoplasm via mitochondrial outer membrane, which activates the caspase 3 and leads to the apoptosis, and accordingly causes excessive apoptosis of epididymal tissues and as well as the changes of microstructure and ultrastructure. All these changes may be one of the important reasons of infertility resulting from VC.

OBJECTIVE:To prepare Resveratrol-poloxamer 188-solid dispersion(RES-P188-SD)and study its dissolving char-acteristic in vitro and antibacterial activity. METHODS:With P188 as the carrier, solvent method was used to prepare RES-P188-SD. With the mass ratio of drug to carrier,melting temperature and mesh number as the observed factors,and solubility and yield of RES as the observed indexes,L9(34)orthogonal test was designed to optimize the preparation technology,and compre-hensive score of observed indexes were analyzed. The verification test was carried out. After RES-P188-SD was prepared by the op-timal technology,basket method was used to determine its dissolution rate and then its accumulative dissolution rate was calculat-ed,scanning electron microscopy to analyze phase characterization and cylinder-plate method to determine antibacterial activity. RE-SULTS:The optimal technology was as follows as the mass ratio of drug to carrier of 1∶10,melting temperature of 70 ℃ and mesh number of 80. For the sample prepared by the optimal technology,average solubility was 0.51 mg/ml (RSD=1.96%,n=3),average yield was 91%(RSD=0.64%,n=3),average 15 min accumulative dissolution rate was up to 83%(RSD=0.69%, n=3);the drug in amorphous form was homogenously distributed in the carrier;RES-P188-SD could inhibit Staphylococcus aure-us and Escherichia coli. CONCLUSIONS:The optimal technology is stable and feasible,by which RES-P188-SD has been pre-pared successfully,providing reference for increasing the solubility,dissolution rate and antibacterial activity of RES.

Objective:To understand the present situation of occupational benefit and job satisfaction of nurses in Guangzhou medical and nursing institutions, and to analyze the influencing factors of occupational benefit, so as to provide reference for the managers of pension institutions to formulate measures.Methods:A total of 83 in-service nurses from four medical and nursing institutions in Guangzhou were selected by convenient sampling. The general data questionnaire, nurses′ occupational benefit scale, job satisfaction scale, organizational support scale and job input scale were used to adjust the questionnaire.Results:The total score of occupational benefit of nurses in Guangzhou medical and nursing institutions was 106.14±16.38, which was in the middle level. Among them, the score of good nurse-patient relationship (76.40%) was the highest, the score of positive occupational perception(69.20%) was the lowest, and the total score of job satisfaction was 95.25±14.06. Among them, the score of satisfaction with colleagues (76.87%) was the highest, and the score of welfare treatment and professional development opportunity (55.40%, 56.15%) was lower. The total scores of organizational support and work input were 40.18 ± 9.58 and 54.92 ± 9.58, respectively. The results of multiple linear regression showed that nurses′ age, job satisfaction, organizational support and job input were the important factors affecting nurses′ sense of professional benefit( t values were -3.518-6.668, P<0.01 or 0.05). Conclusions:The managers of pension institutions should take positive measures to improve the welfare treatment of nurses, increase their professional development opportunities, strengthen emotional support for nurses, improve nurses′ concentration and energy input to work, so as to improve nurses′ sense of professional benefit and job satisfaction.

Objective To enhance the recognition of the ethical principles and provide reference for the ethical review in medical research involving human subjects.Methods By summarizing the ethical review of the projects involving human subjects in past three years,analyzing common issues identified,and proposing the corresponding solutions.Results Conducting ethical review for research involving human subject according to ethical principles,is helpful for the protection of human subject,and also for the internationalization of medical research in China.Conclusions For the development of medical research in long term,the ethical review is necessary.All investigators need to improve their understandings and execute the ethical principles well in their research practice.

Objective:To explore the efficacy and safety of different anti-platelet regimens in the treatment of high-risk non-disabling ischemic cerebrovascular events (HR-NICE) guided by point-of-care testing of CYP2C19 gene. Methods:A single-centre, prospective, randomised, open-label, and blinded endpoint design was uesd in the study. From July 2020 to January 2022, HR-NICE patients were enrolled in the Stroke Green Channel and Department of Neurology of Xuzhou Central Hospital, and all patients were scraped the buccal mucosa for screening for CYP2C19 loss-of-function allele carriers by point-of-care testing . Patients with intermediate metabolism were defined as those who carried 1 loss-of-function allele and patients with poor metabolism were those who carried 2 loss-of-function alleles. This study reduced the test turnaround time to 1 hour by using a fully automated medical polymerase chain reaction analyzer for a point-of-care test of CYP2C19 genotype. CYP2C19 loss-of-function allele carriers were divided according to the random number table method into the conventional treatment group (clopidogrel 75 mg, once a day), the ticagrelor group (ticagrelor 90 mg, twice a day) and the intensive dose group (clopidogrel 150 mg, once a day) separately combined with aspirin (100 mg, once a day) dual antiplatelet for 21 days. Baseline information, Acute Stroke Org 10172 Treatment Trial staging, 90-day modified Rankin Scale score, occurrence of adverse events and severe adverse events were collected for all the 3 groups. The primary efficacy outcome was new stroke within 90 days, and the primary safety outcome was severe or moderate bleeding within 90 days. Results:A total of 716 patients were included: 240 in the conventional treatment group, 240 in the ticagrelor group and 236 in the intensive dose group. There was no statistically significant difference between the 3 groups at baseline (all P>0.05). There were 26 cases (10.8%) with new stroke events in the conventional treatment group, 11 cases (4.6%) in the ticagrelor group and 4 cases (1.7%) in the intensive dose group, with statistically significant differences among the 3 groups (χ 2=19.28, P<0.05), and the differences between the conventional treatment group and the ticagrelor group (χ 2=6.59, P=0.010) and between the conventional treatment group and the intensive dose group (χ 2=16.83, P<0.001) were statistically significant, whereas the difference between the ticagrelor group and the intensive dose group was not statistically significant ( P>0.05). In the 3 groups, there was 1 case (0.4%) of severe bleeding in the conventional treatment group, 6 cases (2.5%) in the ticagrelor group and none in the intensive dose group, which showed statistically significant differences (χ 2=7.23, P<0.05), and there was statistically significant difference between the ticagrelor group and the intensive dose group ( P=0.030). Among the patients with intermediate CYP2C19 metabolism, there were 13 cases (13/158, 8.2%) with 90-day recurrent stroke in the conventional treatment group, 4 cases (4/153, 2.6%) in the ticagrelor group, and 0 case (0/159) in the intensive dose group, with statistically significant difference (χ 2=16.04, P<0.001), and the differences between the intensive dose group and the conventional treatment group were statistically significant (χ 2=13.64, P<0.001), whereas there was no statistically significant difference between the intensive dose group and the ticagrelor group ( P>0.05). In the patients with 90-day recurrent stroke in the intensive dose group, there was 0 case (0/159) with intermediate metabolism and 4 cases (4/77,5.2%) with poor metabolism, with statistically significant differences ( P=0.011), whereas there were no statistically significant differences in the conventional treatment group and the ticagrelor group ( P>0.05). Conclusions:Screening carriers of CYP2C19 loss-of-function alleles by point-of-care testing can quickly and precisely guide the treatment of patients with non-cardiogenic HR-NICE. An intensive clopidogrel dose of 150 mg, once a day combined with aspirin was effective in reducing stroke recurrence with less occurrence of any bleeding and adverse events, and patients with intermediate CYP2C19 metabolism may be the best population to benefit.