Objective:To investigate the effect of extracorporeal membrane oxygenation (ECMO) on in-hospital survival and prognosis of adult patients with fulminant myocarditis.Methods:The registration materials of 21 patients with fulminant myocarditis supported by veno-arterial ECMO (VA-ECMO) from March 2019 to January 2022 in the Heart Center of the First Hospital of Lanzhou University were selected from the Chinese Society for Extracorporeal Life Support (CSECLS) Registry Database. The clinical baseline data, laboratory and echocardiographic data, VA-ECMO related parameters, complications and in-hospital outcome were recorded. The main end events of follow-up were death and readmission due to heart failure.Results:① The median age of 21 patients was (42.7±16.4) years, there were 12 males (57.1%) and 9 females (42.9%), and 16 patients (76.2%) survived in hospital and 5 patients (23.8%) died in hospital. ② Compared with the survival group, patients in the death group had a higher proportion of invasive ventilator support and continuous renal replacement therapy (CRRT) [3/16 (18.8%) vs. 4/5 (80.0%), 3/16 (18.8%) vs. 4/5 (80.0%)], and a lower survival after VA-ECMO score (SAVE) [score: -5.0 (-5.0, -3.0) vs. 1.0 (-6.0, 5.0)], the serum creatinine (SCr) level was higher during VA-ECMO support [μmol/L: 248.0 (144.0, 447.0) vs. 83.0 (71.7, 110.9)], the platelet count (PLT) level was lower [×10 9/L: 60.0 (31.5, 96.5) vs. 100.0 (71.0, 139.3)], and the ECMO initial support flow rate was higher (L/min: 3.2±0.7 vs. 2.6±0.4). All the differences were statistically significant (all P < 0.05). ③ The echocardiography indexes of the survival group were significantly improved at discharge compared with those at admission [left ventricular ejection fraction (LVEF, %): 54.0±6.7 vs. 30.0±7.2], left ventricular end-diastolic volume [(LVESV, mL): 55.7±27.5 vs. 85.9±28.7], cardiac index [(CI, L·min -1·m -2): 2.6±0.4 vs. 1.9±0.6], cardiac output [(CO, L/min): 4.5±0.7 vs. 3.2±0.9]. All the differences were statistically significant (all P < 0.05). ④ The median follow-up time of the 16 survivial patients was 9 (2, 14) months. During the follow-up period, 5 patients (31.3%) were readmitted to the hospital due to heart failure (1 case of cardiogenic death). The average ECMO support duration of the 5 patients who readmitted to the hospital due to heart failure was significantly shorter than that of the 11 patients without heart failure [hours: 82.0 (47.0, 99.0) vs. 116.0 (98.0, 156.0), Z = -2.381, P = 0.017]. Conclusions:On the basis of immunomodulatory and other treatments, early application of VA-ECMO in adult patients with fulminant myocarditis can significantly improve in-hospital survival rate and cardiac function. Heart failure after discharge may be related to short VA-ECMO support time during hospitalization.

Objective:To explore the relationship between the exercise of cervical and lumbar muscles of military flying personnel and the prevalence of cervical and lumbar spine diseases, and to verify the protective effect of the exercise of cervical and lumbar muscles on cervical and lumbar of flying personnel.Methods:A self-made questionnaire and cluster sampling method were used. Air Force pilots of different aircraft types were selected to survey the situation of physical exercise and the prevalence of cervical and lumbar diseases by a questionnaire. Pilots were grouped by if stretching before flight, if relaxing after flight, and if regularly exercising on the strength of cervical and lumbar muscles. The prevalence of the cervical and lumbar diseases was compared. Influence factors were searched by Logistic regression analysis to investigate the protective effect of cervical and lumbar muscle exercise on the neck and waist.Results:In this study, 779 valid questionnaires out of 923 were obtained. The effective rate of the questionnaires was 84.4%. The prevalence of cervical and lumbar diseases in the flying personnel without cervical and lumbar muscles stretching before flight was 36.2%, while the prevalence of flying personnel with cervical and lumbar muscles stretching before flight was 27.6%. There were significant differences between them (χ 2=6.217, P<0.05). The prevalence rate of cervical and lumbar diseases in the flying personnel without cervical and lumbar muscles relaxation after flight was 37.9%, while the prevalence of flying personnel without cervical and lumbar muscles with relaxation after flight was 23.7%. There were significant differences between them (χ 2=16.30, P<0.01). The prevalence rate of cervical and lumbar diseases in the flying personnel without regular training was 41.1%, while the prevalence of relaxation after flight was 29.8%. There were significant differences between them (χ 2=8.89, P<0.01). Logistic regression analysis showed that age, relaxing after the flight, and regular training of cervical and lumbar muscles were all independent factors that affected cervical and lumbar diseases. Among them, increased age was the risk factor of cervical and lumbar diseases ( OR=1.073, 95 %CI: 1.033-1.114, P<0.01), cervical and lumbar relaxing after the flight ( OR=0.456, 95 %CI: 0.303-0.686, P<0.01) and regular training of cervical and lumbar muscles ( OR=0.656, 95 %CI: 0.463-0.930, P<0.05) were both protective factors for cervical and lumbar diseases. Conclusions:The stretching before flight, relaxing after flight, and regular training of cervical and lumbar muscles can significantly reduce the prevalence of cervical and lumbar diseases in flying personnel.

Objective:To explore the relationship between the exercise of cervical and lumbar muscles of military flying personnel and the prevalence of cervical and lumbar spine diseases, and to verify the protective effect of the exercise of cervical and lumbar muscles on cervical and lumbar of flying personnel.Methods:A self-made questionnaire and cluster sampling method were used. Air Force pilots of different aircraft types were selected to survey the situation of physical exercise and the prevalence of cervical and lumbar diseases by a questionnaire. Pilots were grouped by if stretching before flight, if relaxing after flight, and if regularly exercising on the strength of cervical and lumbar muscles. The prevalence of the cervical and lumbar diseases was compared. Influence factors were searched by Logistic regression analysis to investigate the protective effect of cervical and lumbar muscle exercise on the neck and waist.Results:In this study, 779 valid questionnaires out of 923 were obtained. The effective rate of the questionnaires was 84.4%. The prevalence of cervical and lumbar diseases in the flying personnel without cervical and lumbar muscles stretching before flight was 36.2%, while the prevalence of flying personnel with cervical and lumbar muscles stretching before flight was 27.6%. There were significant differences between them (χ 2=6.217, P<0.05). The prevalence rate of cervical and lumbar diseases in the flying personnel without cervical and lumbar muscles relaxation after flight was 37.9%, while the prevalence of flying personnel without cervical and lumbar muscles with relaxation after flight was 23.7%. There were significant differences between them (χ 2=16.30, P<0.01). The prevalence rate of cervical and lumbar diseases in the flying personnel without regular training was 41.1%, while the prevalence of relaxation after flight was 29.8%. There were significant differences between them (χ 2=8.89, P<0.01). Logistic regression analysis showed that age, relaxing after the flight, and regular training of cervical and lumbar muscles were all independent factors that affected cervical and lumbar diseases. Among them, increased age was the risk factor of cervical and lumbar diseases ( OR=1.073, 95 %CI: 1.033-1.114, P<0.01), cervical and lumbar relaxing after the flight ( OR=0.456, 95 %CI: 0.303-0.686, P<0.01) and regular training of cervical and lumbar muscles ( OR=0.656, 95 %CI: 0.463-0.930, P<0.05) were both protective factors for cervical and lumbar diseases. Conclusions:The stretching before flight, relaxing after flight, and regular training of cervical and lumbar muscles can significantly reduce the prevalence of cervical and lumbar diseases in flying personnel.

The 2019 novel coronavirus disease (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has occurred in China and around the world. SARS-CoV-2-infected patients with severe pneumonia rapidly develop acute respiratory distress syndrome (ARDS) and die of multiple organ failure. Despite advances in supportive care approaches, ARDS is still associated with high mortality and morbidity. Mesenchymal stem cell (MSC)-based therapy may be an potential alternative strategy for treating ARDS by targeting the various pathophysiological events of ARDS. By releasing a variety of paracrine factors and extracellular vesicles, MSC can exert anti-inflammatory, anti-apoptotic, anti-microbial, and pro-angiogenic effects, promote bacterial and alveolar fluid clearance, disrupt the pulmonary endothelial and epithelial cell damage, eventually avoiding the lung and distal organ injuries to rescue patients with ARDS. An increasing number of experimental animal studies and early clinical studies verify the safety and efficacy of MSC therapy in ARDS. Since low cell engraftment and survival in lung limit MSC therapeutic potentials, several strategies have been developed to enhance their engraftment in the lung and their intrinsic, therapeutic properties. Here, we provide a comprehensive review of the mechanisms and optimization of MSC therapy in ARDS and highlighted the potentials and possible barriers of MSC therapy for COVID-19 patients with ARDS.
Adoptive Transfer ; Alveolar Epithelial Cells ; pathology ; Animals ; Apoptosis ; Betacoronavirus ; Body Fluids ; metabolism ; CD4-Positive T-Lymphocytes ; immunology ; Clinical Trials as Topic ; Coinfection ; prevention & control ; therapy ; Coronavirus Infections ; complications ; immunology ; Disease Models, Animal ; Endothelial Cells ; pathology ; Extracorporeal Membrane Oxygenation ; Genetic Therapy ; methods ; Genetic Vectors ; administration & dosage ; therapeutic use ; Humans ; Immunity, Innate ; Inflammation Mediators ; metabolism ; Lung ; pathology ; physiopathology ; Mesenchymal Stem Cell Transplantation ; methods ; Mesenchymal Stem Cells ; physiology ; Multiple Organ Failure ; etiology ; prevention & control ; Pandemics ; Pneumonia, Viral ; complications ; immunology ; Respiratory Distress Syndrome, Adult ; immunology ; pathology ; therapy ; Translational Medical Research

Objective To investigate the sleep quality ,emotional state and their relationship for flying personnel so as to provide reference for the targeted aeromedical support. Methods Two hundred and forty-nine flying personnel participated in the anonymous questionnaire surveys ,including Pittsburgh sleep quality index (PSQI) ,self-evaluation of anxiety scale (SAS) ,self-rating depression scale (SDS ) , and profile of mood state (POMS ).Comparisons of sleep quality among flying personnel ,norm and ordinary soldiers were conducted.The correlation between sleep quality and emotional state was analyzed then. Results There were 238 questionnaires returned and the effective rate was 95.6%.The prevalence of sleeping disorders in 238 flying personnel was 36.6%.Their total score of PSQI was (6.79 ± 3.06) ,which was significantly higher than that of norm and ordinary soldiers (t＝ 14.706 ,5.967 , P＜0.01) and their scores of anxiety and depression were higher than those of the domestic norm (t＝4.867 ,3.147 , P＜0.01).In addition ,with the total score of PSQI increased the scores on SAS , SDS , tension-anxiety , depression-dejection , anger-hostility , fatigue-inertia and confusion-bewiderment showed upward trend.But the score on vigor-activity was decreased.Correlation analysis showed that the total score of PSQI was positively correlated with the scores on SAS , SDS , tension-anxiety , depression-dejection , anger-hostility , fatigue-inertia and confusion-bewiderment (r＝0.549-0.665 ,P＜0.01) ,and was negatively correlated with vigor-activity (r＝ －0.417 , P＜ 0.01 ). Conclusions Sleep quality is an important indicator of emotional state. Sleep quality of flying personnel is lower than that of norm and ordinary soldiers and this means the flying personnel are in obviously higher tension and stress state.

Objective To investigate the sleep quality ,emotional state and their relationship for flying personnel so as to provide reference for the targeted aeromedical support. Methods Two hundred and forty-nine flying personnel participated in the anonymous questionnaire surveys ,including Pittsburgh sleep quality index (PSQI) ,self-evaluation of anxiety scale (SAS) ,self-rating depression scale (SDS ) , and profile of mood state (POMS ).Comparisons of sleep quality among flying personnel ,norm and ordinary soldiers were conducted.The correlation between sleep quality and emotional state was analyzed then. Results There were 238 questionnaires returned and the effective rate was 95.6%.The prevalence of sleeping disorders in 238 flying personnel was 36.6%.Their total score of PSQI was (6.79 ± 3.06) ,which was significantly higher than that of norm and ordinary soldiers (t＝ 14.706 ,5.967 , P＜0.01) and their scores of anxiety and depression were higher than those of the domestic norm (t＝4.867 ,3.147 , P＜0.01).In addition ,with the total score of PSQI increased the scores on SAS , SDS , tension-anxiety , depression-dejection , anger-hostility , fatigue-inertia and confusion-bewiderment showed upward trend.But the score on vigor-activity was decreased.Correlation analysis showed that the total score of PSQI was positively correlated with the scores on SAS , SDS , tension-anxiety , depression-dejection , anger-hostility , fatigue-inertia and confusion-bewiderment (r＝0.549-0.665 ,P＜0.01) ,and was negatively correlated with vigor-activity (r＝ －0.417 , P＜ 0.01 ). Conclusions Sleep quality is an important indicator of emotional state. Sleep quality of flying personnel is lower than that of norm and ordinary soldiers and this means the flying personnel are in obviously higher tension and stress state.

Objective To study the effect of rhodiola crenulata compound on serum corticosterone and myocardial glucocorticoid receptor ( GR) in rats exposed high sustained +Gz.Methods Seventy-two healthy SD rats were randomly divided into six groups: blank control group, stress control group, +10 Gz stress group and low, medium, high dose drug group, with twelve rats in each.20 mL/kg menstruum was fed to each rat once per day for 14 days.Low, medium and high dose drug group were fed with rhodiola crenulata compound at doses of 0.75 g/kg, 1.5 g/kg and 3.0 g/kg respectively, the other three groups were fed with equal volume saline.Rats were exposed to high +Gz in 15th day.The concentration of corticosterone in the serum of each group rats was detected with ELISA. Western blot was used to detect the expressions of GR in the myocardium of each group rats .Results The content of corticosterone was significantly elevated in +10Gz stress group, while the expression of GR in the myocardium was markedly declined (P <0.01,P <0.05).However, compound preconditioning could decrease concentration of corticosterone in the serum and enhance the expression of GR in the myocardium from rats after +10 Gz exposure. The corticosterone concentration of medium and high dose drug groups was significantly lower and the level of GR expression in the myocardium was significantly higher than that of +10 Gz stress group ( P <0.05 , P <0.01 ) . Conclusion Rhodiola crenulata compound preconditioning could regulate the concentration of corticosterone in the serum and the level of GR expression in the myocardium of the rats exposed +10 Gz, which may be related with its protective effect on high sustained +Gz-induced injury of myocardium.

OBJECTIVE:To establish a reasonable return level for Chinese pharmaceutical industry and to study the return level of the domestic pharmaceutical industry from 2000 to 2005.METHODS:In view of the financial data of Chinese pharmaceutical industry in the statistical yearbook from 2001 to 2006,the return level for Chinese pharmaceutical industry was established based on its risk level using the principle of "risk-return equilibrium",and the rationality of the return level of Chinese pharmaceutical industry over the 6 years was validated as well.RESULTS:Over the 6 years,the average lowest anticipating rate of return for the Chinese medicine industry was 7.72% and the actually average assets income rate stood at 8.53%,i.e.the average abnormal return rate over the 6 years was 0.81%.CONCLUSION:The return rate of Chinese pharmaceutical industry corresponds to the risk level as well as the reasonable return level.

OBJECTIVE:To probe into the profits level and profits-gaining capability of Chinese pharmaceutical industry.METHODS:Based on the data recorded in yearbooks between 2001 and 2006,the profits levels were compared between Chinese pharmaceutical industry and China social average assets,other industries in China and overseas pharmaceutical industry.RESULTS:Between 2000～ 2005,the profits level of Chinese pharmaceutical industry was lower than that of Chinese social average assets,i.e.the profit-gaining capability of Chinese pharmaceutical industry was lower than that of China social average assets.Between 2002～ 2004,the profits level of Chinese pharmaceutical industry ranked at the first 10 places among the 39 industries,but dropped far behind in 2005,meanwhile the number of pharmaceutical enterprises who suffered loss increased greatly.CONCLUSION:The prospect for the development of Chinese pharmaceutical industry and the industry environment they confronted are far from optimistic.