Objective To evaluate the clinical effect of minimally invasive aortic valve replacement with Perceval sutureless aortic bioprosthesis in upper ministernotomy or right anterior thoracotomy. Methods From March to November 2022, the patients with simple aortic valve disease were enrolled in the Department of Cardiovascular Surgery of West China Hospital, Sichuan University. After preoperative evaluation, Perceval sutureless bioprosthesis was successfully used to perform aortic valve replacement through the upper ministernotomy or right anterior thoracotomy. The perioperative clinical data and ultrasonic measurement data of all patients were recorded. Results A total of 5 patients with simple aortic valve disease were included, including 3 females and 2 males, with a mean age of 71.2 years. Perceval sutureless bioprosthesis was successfully implanted in 5 patients, with a success rate of 100%. There were 3 patients receiving upper ministernotomy and 2 patients receiving right anterior thoracotomy. Two patients underwent ascending aortic plasty at the same time. The mean cardiopulmonary bypass time was 61.0 min, and aortic cross-clamping time was 32.2 min. All patients were discharged successfully without perivalvular leakage, atrioventricular block or stroke. Conclusion The implantation method of Perceval sutureless bioprosthesis is simple, which can effectively reduce the perioperative risk by shortening the overall operation time, cardiopulmonary bypass time and aortic cross-clamping time. At the same time, its clinical application has promoted the development and popularization of minimally invasive aortic valve replacement, which together with Perceval sutureless bioprosthesis effectively combinates surgical effect and minimally invasive treatment, and has a good clinical application prospect because of its reliable safety and effectiveness.

Objective To evaluate the clinical efficacy of two-stage retrograde hybrid repair for acute aortic dissection involving the aortic arch complicated with distal malperfusion syndrome. Methods From May 2019 to December 2022, the patients presented with acute aortic dissection involving the aortic arch complicated with distal malperfusion syndrome treated in the Department of Cardiovascular Surgery of West China Hospital, Sichuan University were enrolled. After preoperative evaluation, all patients underwent priority emergency interventional surgery to improve distal malperfusion, and then underwent two-stage hybrid surgery to repair proximal aortic lesions. The perioperative clinical and imaging data were retrospectively analyzed. Results Five patients were collected, including 4 males and 1 female, with a median age of 58 years. The main manifestations were lower limb ischemia and renal insufficiency in 3 patients, and poor intestinal perfusion in 2 patients. All patients were given priority to interventional surgery to implant graft stents or bare stents and necessary branch artery intervention, and then successfully performed two-stage hybrid surgery, including type Ⅰhybrid surgery for 2 patients, type Ⅱ hybrid surgery for 1 patient and type Ⅲ hybrid surgery for the other 2 patients, with a success rate of 100.0%. All patients were discharged successfully, and the function of the organs with poor perfusion returned to normal. Only 1 patient recovered to grade 4 muscle strength of the diseased lower limbs upon discharge. No adverse events such as amputation, exploratory laparotomy and intestinal resection or long-term hemodialysis occurred. Conclusion The application of two-stage retrograde hybrid repair in the surgical treatment of acute aortic dissection involving the aortic arch complicated with distal malperfusion syndrome is safe and effective, and is helpful to improve the perioperative survival rate, and clinical outcomes of such patients.

Objective To investigate the effects of adjuvant arthritis(AA)on renal function and the expression of organic anion transporter 3(OAT3)in rats.Methods The AA model was established via intradermal injection of Freund's complete adjuvant into the right hind toe of the rats.Blood and urine were collected at fixed time points to observe the dynamic changes of renal injury indicators.The kidney injury was observed by HE staining.Immuno-histochemistry and Western blot were used to detect the expression levels of OAT3 protein and inflammatory factors interleukin-6(IL-6),interleukin-1 β(IL-1 β)and tumor necrosis factor-α(TNF-α)in renal cortex.Results Compared with the normal group,the arthritis index score,the secondary paw swelling,the number of joint swell-ing,and the whole body score of AA rats significantly increased(P＜0.05).The X-ray results showed that the AA model rats had soft tissue edema and bone deformity.Biochemical indicators showed that the renal injury indicators of AA rats were significantly abnormal.The results of immunohistochemistry and Western blot showed that the ex-pression level of OAT3 in renal cortex of AA rats significantly decreased,while the expression levels of inflammato-ry factors IL-6,TNF-α and IL-1 β significantly increased(P＜0.05).Conclusion The renal injury of AA rats may be related to the decreased expression level of OAT3 and the increased expression level of inflammatory factors in kidney.

T cell receptors(TCR)immune repertoire is sum of all TCR in body,and diversity of TCR immune repertoire is closely related to HIV recognition and immune escape.High-throughput immune repertoire sequencing technology is able to detect and analyze all sequences of TCR immune repertoire,truly reflect genetic information of all TCR,and comprehensively reveal complexity and diversity of TCR immune repertoire.Analysis of changes in TCR immune group database of HIV patients through high-throughput sequencing technology can monitor their diagnosis and treatment,disease progression and prognosis,and can also contribute to vaccine development,latent reservoir clearance and clinical efficacy evaluation,so as to provide a theoretical basis for enriching prevention and treatment ideas and targets of HIV/AIDS.

Objective: To investigate the protective effect of Paeoniflorin-6 '-o-benzene sulfonate ( CP-25) on methotrexate (MTX) -induced liver injury in rats． Methods: 40 SD rats were randomly divided into normal group，model group，CP-25 treatment group，CP-25 prevention group and resveratrol prevention group．A rat model of liver injury was established by single intraperitoneal injection of MTX (20 mg / kg) ，the levels of serum alanine aminotransferase (ALT) ，aspartate aminotransferase ( AST) ，superoxide dismutase ( SOD) ，glutathione ( GSH) and malondialdehyde (MDA) were determined by ELISA，the levels of interleukin-1 β (IL-1 β) ，interleukin-6 (IL-6) ， tumor necrosis factor-α (TNF-α) ，B-lymphocyte tumor-2 (Bcl-2) ，Bcl-2-associated X (Bax) ，cytochrome C ( Cyt- C) ，cleaved cysteinyl aspartate specific proteinase8 ( cleaved-cas8 ) ，cleaved cysteinyl aspartate specific proteinase 9 (cleaved-cas9) and reduced nicotinamide adenine dinucleotide phosphate oxidase 4 (NOX4) containing cysteine were assessed by Western blot. Results: Compared with the normal group，the levels of ALT and AST in MTX-induced liver injury model rats increased (F = 70. 23，P＜0. 01 ; F = 11. 09，P＜0. 05) ，and the liver histopathology showed extensive inflammatory cell infiltration，hepatic lobular structure disorder and hepatocyte swelling. Compared with MTX model group，the levels of ALT and AST in CP-25 prevention group and treatment group were lower (F = 62. 32，86. 86，P＜0. 01 ; F = 16. 35，7. 14，P ＜0. 01 ) ，and the pathological score of liver tissue was lower (F = 18. 33，P＜0. 01 ; F = 15. 47，P＜0. 05) ．Further studies showed that compared with MTX model group， both CP-25 prevention group and treatment group could significantly down-regulate the expression of pro-apoptotic proteins Bax(F = 21. 37，P＜0. 01 ; F = 19. 35，P＜0. 05) ，Cyt-C (FCP-25 prevention group = 7. 21，P＜0. 01) ，cleavedcas8 (FCP-25 prevention group = 12. 32，P＜0. 05) and cleaved-cas9(F = 8. 41，P＜0. 01 ; F = 6. 91，P＜0. 05) ，and upregulate the expression of anti-apoptotic protein Bcl-2 (F = 13. 11，P＜0. 01 ; F = 9. 93，P＜0. 05) . At the same time，compared with MTX model group，CP-25 prevention group and treatment group decreased the levels of IL- 1 β , IL-6 and TNF-α(FCP-25 prevention group = 160. 7，46. 55，28. 89，P＜0. 01) ; FCP-25 treatment group = 127. 4，53. 70，26. 46， P ＜ 0. 01 ) ，down-regulated the levels of MDA and NOX4 ( FCP-25 prevention group = 31. 71，38. 45 ，P ＜ 0. 01 ; FCP-25 treatment group = 27. 89，31. 27，P＜0. 01) ，and up-regulated the level of GSH ( F = 39. 65，29. 04，P ＜0. 01) . Conclusion CP-25 has a good therapeutic and protective effect on hepatotoxicity induced by MTX，and this effect may be related to its inhibition of oxidative stress，inflammatory response，and reduction of apoptosis in liver tissue.

Objective:To understand the employment psychology of college students in traditional Chinese medicine universities through analyzing relevant influencing factors, and to provide solutions to improve employment quality of the medical students.Methods:An online questionnaire survey on employment psychology and employment situation was conducted from August to September in 2017 among 384 students who had graduated from Longhua Hospital of Shanghai University of Traditional Chinese Medicine from 2013 to 2017. SPSS 19.0 was used for chi-square test and linear trend test on the survey results.Results:A total of 374 valid questionnaires were recovered, with the effective recovery rate of 97.4%. The results showed that the most important factors to be considered were professional counterparts (77.01%, 288 students), salary (75.67%, 283 students) and development prospect (69.52%, 260 students) and the most important psychological characteristics were hesitation and contradiction (50.8%, 190 students) and anxiety (25.13%, 94 students). The study found that employment psychology was related to students' family situation, category, temperament and performance during their education period.Conclusion:Students have different employment psychology, which can be improved by consummating career planning, broadening employment channels, combing employment policies, supplementing professional shortcomings, and improving comprehensive skills. Meanwhile, colleges and universities can expand their practice bases, provide employment counseling, and improve education resources, speed up the construction of the second classroom, pay attention to special groups to conduct employment guidance and improve the quality of employment.

Objective:To study the effects of obesity induced by high-fat diet on T lymphocyte subsets in the adipose tissue in mice.Methods:C57BL/6 male mice were randomly divided into 2 groups, the normal control group and high-fat diet group.After feeding 16 weeks, serum was separated and CHOL, TG, HDL, LDL and glucose levels were measured by automatic biochemical analyzer.The concentrations of TNF-αwere determined by ELISA kit.FACS was used to analyze the number of T cells and the percentage of subgroup in epididymal fat adipose tissue.Results:Compared with control group,body weight,weight gain,epididymal fat pad weight,perirenal fat weight,blood lipids,glucose and TNF-αwere significantly increased in high-fat diet group,but there were no difference in the thymus index and spleen index between the two groups.Compared with the control group,the mice fed a high-fat diet had increasing proportion of CD3+T cells,CD4+T cells and CD8+T cells in adipose tissue and there was a significant increase on the proportion of Th1 and Th17 sublineage in the HFD group.Conclusion:High-fat diet induced obesity can lead to the increasing proportion of CD3+T cells,CD4+T cells and CD8+T cells in epididymal fat pads and generate a progressive Th1 and Th17 bias.

This study was aimed to explore the characteristics of urine metabolomics among HIV/AIDS patients with spleen-lung qi-deficiency. H-NMR technique was combined with principal component analysis and cluster analysis in the comparison of urine metabolic products among 24 HIV/AIDS cases with spleen-lung qi-deficiency and 20 healthy control cases. The results showed that urine metabolic products of HIV/AIDS patients with spleen-lung qi-deficiency and healthy people by H-NMR technique detection and PLS-DA analysis can classify the outline of urine metabolites. There were about 20 variables in the difference between two groups. The speculated substances contained glycyl-L-leucine, L-valine, α-aminobutyric acid, methyl succinic acid, glycine propionyl, and etc. It was concluded that H-NMR technique was able to classify the outline of urine metabolites between HIV/AIDS cases with spleen-lung qi-deficiency and healthy people. Part of the potential existed characteristic markers contributed to the clinical diagnosis of traditional Chinese medicine (TCM) syndrome differentiation of AIDS. It had certain effect in its quantitative analysis.

Objective:To carry out the large sample research of the importance of medical ethics in the stand-ardized resident doctor training. Methods:Randomly selected 100 graduated resident doctors from Jiangsu province, Zhejiang province,Shanghai and Jiangxi province of standardization training. Using the questionnaire survey form to investigate the doctor-patient relationship and carry out correlation analysis. Results:Two groups of subjects after research statistics, the analysis found the doctor-patient relationship in the model show the current mutual partici-pation pattern of the more advanced undergraduate group was 22%, 16% in the graduate student degree group has significant difference;While 66% of bachelor's degree group and 70% graduated degrees performance as the guide-cooperation mode. Conclusion:It should strengthen medical ethics in the stage of standardized training, this study further strengthen standardized training for the future stage of low qualification resident ethics application guide the importance and the influence on the doctor-patient relationship in the future physician has provided the basis, at the same time, also provides certain theoretical guidance for doctor-patient relationship training methodology.

Objective To detect the effects of 17 β-estradiol(E2)on the expression of Calbindin-D9k (CaBP-9k) in pituitary GH3 cells,and to investigate the antagonistic effect of a selective estrogen receptor antagonist,ⅡCI 182780 on CaBP-9k expression.Methods A rat pituitary prolactinoma cell line,GH3 cell was used as the in vitro model.The localization of CaBP-9k in GH3 cells was observed by immunofluorescence.GH3 cells were cultured with exogenous E2-added medium for 24 hours,and the concentrations of E2 were 10-8,10-9,10-10M,respectively.mRNA and protein expression levels of CaBP-9k in different groups were analyzed by RT-PCR and Western blot analysis.The estrogen receptor antagonist,and ⅡCI 182780 was added to GH3 cells before E2 administration (10-8M)with the concentration of 10-6M,in order to investigate the regulation of ER-mediated pathway on the expression of CaBP-9k.Immunoprecipitation was used to detect the interaction between CaBP-9k and ERα.Results E2 had significant stimulatory effect on the CaBP-9k expression of GH3 cells in a dose dependent manner,and the expression level of CaBP-9k was higher when treated with a higher concentration of E2.ⅡCI 182780 could suppress the stimulatory effect of E2 on the CaBP-9k expression of GH3 cells.The expression level of CaBP-9k was significantly reduced by coadministration of E2 with ⅡCI 182780 in GH3 cells,which meant the CaBP-9k expression was mediated through ERα pathway.The immunoprecipitation results further illustrated the fact that CaBP-9k could directly interact with ERα,and E2 could increase the interaction between CaBP-9k and ERα.Conclusion Estrogen might induce CaBP-9k expression via ERα mediated pathway and CaBP-9k could directly combine with ERα,suggesting that CaBP-9k might be involved in the biological effects mediated by ER pathway in GH3 cells.