Objective To study the clinical effect of levosimendan combined with recombinant human brain natriuretic peptide(rhBNP)on patients with acute heart failure.Methods A total of 100 patients with acute heart failure in the hospital from December 2019 to December 2021 were selected as the research sub-jects.According to different treatment options,the subjects were divided into the control group,levosimendan group,rhBNP group and combined treatment group,with 25 cases in each group.The control group received traditional conventional diuretic,tube expansion and other treatment;the levosimendan group was treated with levosimendan on the basis of the control group;the rhBNP group was treated with rhBNP on the basis of the control group;the combined treatment group was treated with levosimendan and rhBNP on the basis of the control group.The improvement of New York Heart Association(NYHA)classification,death,rehospitaliza-tion rate,6-minute walking distance,improvement of serological indicators and adverse reactions were recor-ded in each group.Results Before treatment,there was no significant difference in baseline data between the groups(P>0.05).On the 1 st and 3 rd day after treatment,the improvement of NYHA classification in the combined treatment group was better than that in the other groups(P<0.05),and the improvement of NY-HA classification in the levosimendan group and rhBNP group was better than that in the control group(P<0.05).The readmission rate within 6 months after treatment in the combined treatment group was lower than that in the other groups(P<0.05).At 5 and 9 days after treatment,the 6-minute walking distance in the combined treatment group was longer than that in the other groups(P<0.05).At 9 days after treatment,the left ventricular ejection fraction(LVEF)in the combined treatment group was higher than that in the other groups(P<0.05),and the level of N-terminal B-type natriuretic peptide(NT-proBNP)in the combined treatment group was lower than that in the other groups(P<0.05).No significant difference was found in the comparison of the occurrence of adverse reactions among the four groups(P>0.05).Conclusion The combina-tion of levosimendan and rhBNP in the treatment of patients with acute heart failure is superior to traditional treatment and monotherapy in early clinical improvement,and dose not increase the incidence of adverse reactions.

AIM: To investigate the relationship between objective ocular torsion and near stereopsis in patients with primary superior oblique overaction(PSOOA).METHODS: Retrospective study. A total of 59 strabismus patients with PSOOA who underwent strabismus surgery at Renmin Hospital of Wuhan University between January 2019 and November 2023 were collected. Based on the collected fundus photographs and the position of the fovea relative to the horizontal line through the optic disc, the eyes were categorized as incyclotorsion, excyclotorsion, or no cyclotorsion. Additionally, the fovea-disc angle(FDA)and the relationship between objective ocular torsion status, FDA, and near stereopsis function in the patients were further measured and analyzed.RESULTS: Totally 59 patients(92 eyes)showed superior oblique overaction. There were no cases of excyclotorsion, 32 cases with no cyclotorsion, and 27 cases with incyclotorsion. The total binocular FDA was significantly smaller in the no-cyclotorsion group compared with the incyclotorsion group(2.83°±2.89° vs 16.12°±5.74°, P<0.001). The preservation rates of near stereopsis were 66% and 15% in the no-cyclotorsion and incyclotorsion groups, respectively, with a significant statistical difference(P<0.001), and the preservation rates of fine near stereopsis were 38% and 11% in the no-cyclotorsion and incyclotorsion groups, respectively, with a significant statistical difference(P=0.02). Among all patients, near stereopsis was correlated with total binocular FDA(r=-0.526, P<0.001), with the strongest correlation observed with the FDA of the incyclotorsion(r=-0.546, P<0.001). In the incyclotorsion group, there was no correlation between near stereopsis and total binocular FDA(r=-0.366, P=0.060), with a negative correlation between near stereopsis and the FDA of both the incyclotorsion and the overaction(r=-0.424, P=0.028; r=-0.485, P=0.010). In the no-cyclotorsion group, near stereopsis was not correlated with total binocular FDA, incyclotorsion FDA, or overaction FDA.CONCLUSION:PSOOA patients with incyclotorsion have a lower preservation rate of near stereopsis than those without cyclotorsion. Near stereopsis function of patients with PSOOA is negatively correlated with total binocular FDA, especially the greater the FDA of the incyclotorsion and overaction, the worse the near-stereoscopic function.

Objective:To compare the consistency of lymphoma multigene detection panels based on next-generation sequencing (NGS) with FISH detection of B-cell lymphoma gene rearrangement.Methods:From January 2019 to May 2023, fusion genes detected by lymphoma-related 413 genes that targeted capture sequencing of 489 B-cell lymphoma tissues embedded in paraffin were collected from Henan Cancer Hospital, and the results were compared with simultaneous FISH detection of four break/fusion genes: BCL2, BCL6, MYC, and CCND1. Consistency was defined as both methods yielding positive or negative results for the same sample. The relationship between fusion mutation abundance in NGS and the positivity rate of cells in FISH was also analyzed.Results:Kappa consistency analysis revealed high consistency between NGS and FISH in detecting the four B-cell lymphoma-related gene rearrangement ( P<0.001 for all) ; however, the detection rates of positive individuals differed for the four genes. Compared with FISH, NGS demonstrated a higher detection rate for BCL2 rearrangement, a lower detection rate for BCL6 and MYC rearrangement, and a similar detection rate for CCND1 rearrangement. No correlation was found between fusion mutation abundance in NGS and the positivity rate of cells in FISH. Conclusions:NGS and FISH detection of B-cell lymphoma gene rearrangement demonstrate overall good consistency. NGS is superior to FISH in detecting BCL2 rearrangement, inferior in detecting MYC rearrangement, and comparable in detecting CCND1 rearrangement.

Objective By employing surgically induced varicocele(VC)in SD rats and an apomorphine(APO)test,we screened rats with erectile dysfunction(ED)after VC and explored method to establish VC and ED models.Methods Sixty rats were randomly divided into Control,Sham,and Model groups with 20 rats in each group.Using the Turner method,we partially ligated the left renal vein to induce left VC three times.APO tests were conducted to screen rats with ED after inducing VC.The numbers of erections,genital grooming,and yawning were observed and recorded.The diameter of bilateral spermatic veins were measured.Both testises and kidneys were weighed.HE staining was used to observe pathological changes of penis and left testis.The success rate of modeling was calculated in the Model group.Results A VC and ED model was successfully established in 15 out of 20 rats in the Model group with a success rate of 75％.After modeling,the diameter of the left spermatic vein in the model group was increased significantly(P＜0.01)and was significantly larger than that before modeling(P＜0.01).The diameter of the right spermatic vein in the Model group was increased(P＜0.05)and higher(P＜0.05)than that before modeling.The weight of the left testis in the Model group was significantly decreased(P＜0.01)compared with that of the right testis.No significant difference in the bilateral kidney weights were observed between or within groups(P＜0.05).In the Model group,the numbers of erections,yawning,and genital grooming decreased significantly(P＜0.01)with the time of modeling.Pathological changes of the left testis and penis were significant in the Model group.Conclusions The Turner method increases the diameter of the spermatic vein in rats,causing testis injury and weight loss,and APO tests can be used to screen rats with ED after VC induction.The combination of the two method is suitable to establish an animal model of VC with an ED status similar to humans.

Objective To analyze the distribution characteristics and clinical significance of allergens in children with allergic diseases in Yangzhou area. Methods A total of 1, 025 children who were treated in the Affiliated Hospital of Yangzhou University from December 2022 to December 2023 and tested for allergens were selected as study objects. The detection results of allergens were collected and the distribution characteristics of allergens were analyzed. Results Among the 1, 025 children with allergy-related diseases, 83.41% (855 cases) tested positive for allergens, with a positive rate of 66.24% (679 cases) for inhalant allergens and 61.17% (627 cases) for food allergens. The most common allergens were milk (36.20%), molds (33.27%), and house dust mites (30.34%). There was no statistically significant difference in the positive rate of allergens among different age groups (P>0.05). The positive rate of allergen detection in boys was higher than that in girls, the difference was statistically significant (P < 0.05). The positive rate of inhalation allergens in children with respiratory symptoms was higher than that of food allergens, and the positive rate of food allergens in children with digestive tract symptoms was higher than that of inhalation allergens (P < 0.05). For children with immune system diseases such as skin symptoms and allergic purpura, there was no statistically significant difference in the positive rates of inhalant and food allergens (P>0.05). Conclusion The most common allergens in children with allergic diseases in Yangzhou area are milk, molds, and dust mites. Allergen testing can provide reference opinions for the prevention, diagnosis, and treatment of allergic diseases in children in Yangzhou area.

Objective:To study the learning curve in laparoscopic left lateral hepatic sectionectomy.Methods:The clinical data of 62 consecutive patients who underwent left lateral hepatic sectionectomy by a single operator from February 2015 to May 2022 in General Hospital of Northern Theater Command were retrospectively analyzed. There were 22 males and 40 females, with mean ±s.d. of (50.7±11.7) years. The learning curve was depicted and evaluated by using the cumulative summation test. The general information, operation and postoperative indicators of the growth level group and the master level group were compared.Results:The average operation time of the 62 consecutive subjects was (172.9±70.1) minutes. Intraoperative blood loss was 100 (50, 200) ml. Two patients were converted to open hepatectomy. Clavien-Dindo grade I postoperative complications occurred in 20 patients (32.3%), with grade Ⅱ in 1 patient (1.6%) and grade Ⅲb in another patient (1.6%). The learning curve reached its highest point on the 20th patient by using the cumulative summation test. The study subjects were then assigned into the growth level group (patient 1-20) and the master level group (patient 21-62). The master level group had a significantly wider spread of patient age [(52.9±11.0) years vs (46.1±11.9) years], decreased operation time [(146.8±55.6) min vs (227.9±66.7) min], shortened drainage tube removal time [4(3, 5) d vs 6(4, 7) d] and decreased postoperative hospital stay [5(5, 7) d vs 6.5(4, 9) d] (all P<0.05) when compared with the growth level group. Conclusion:Left lateral hepatic sectionectomy was safe and feasible, and a single operator went through a learning curve of 20 patients before he/she could master the operation more proficiently.

Background Imidacloprid is a neonicotinoid insecticide that is widely used in agricultural production, with a high detection rate in human biological samples. Previous studies have shown a high correlation between imidacloprid exposure and liver injury, but the specific mechanism is still unknown. Objective To observe potential toxic effects of HepG2 cells and its perturbation of non-targeted metabolic profile after imidacloprid exposure, and to explore possible molecular mechanisms of hepatotoxicity of imidacloprid by analyzing invovlved biological processes and signaling pathways. Methods HepG2 cell suspension was prepared and seeded in a 96-well plate, which was divided into blank control group, dimethyl sulfoxide (DMSO) solvent control group and imidacloprid exposure groups with multiple concentrations. Each group was set with 5 parallel samples. The viability of HepG2 cells viability were determined after 8 h of exposure to different concentrationsof imidacloprid (1, 2.5, 5, 7.5, 10 mmol·L⁻¹), and the dose-effect relationship was analyzed. A proper concentration (3 mmol·L⁻¹ with 80% viability) was chosen for imidacloprid exposure, non-targeted metabolomic analysis was applied to the cultivated HepG2 cells using UHPLC-Q-TOF/MS technology, the differential metabolites between groups were screened, and the bioprocess and related signaling pathways of their enrichment were annotated using the Kyoto Encyclopedia of Genes and Genomes (KEGG) database. Results Compared to the other two groups, the survival rates of HepG2 cells in the imidacloprid exposure groups decreased. A survival rate of about 86% of HepG2 cells was found in HepG2 cells exposed to 2.5 mmol·L⁻¹ imidacloprid exposure. The non-targeted metabolomics studies showed that 61 metabolites were significantly affected in HepG2 cells after 3 mmol·L⁻¹ imidacloprid exposure, including creatine (variable importance in projection VIP=1.11, P<0.001), arginine (VIP=1.47, P=0.048), taurine (VIP=4.28, P=0.001), and α-D-glucose (VIP=1.90, P=0.006). The differential metabolites enriched in bioprocess and related signaling pathways were mainly directed to mTOR signaling pathways (P<0.001), arginine and proline metabolism (P=0.002), and galactose metabolism (P=0.015). Conclusion Imidacloprid exposure can significantly inhibit the survival rate of HepG2 cells, and interfere with the mTOR signaling pathway, arginine and proline metabolism, galactose metabolism, and so on.

Objective To explore the differences in clinical symptoms and laboratory examination indexes between patients with HIV/AIDS infection complicated with tuberculosis (TB) and those with HIV/AIDS alone, so as to provide a reference for early identification and diagnosis of HIV/AIDS infection with TB. Methods A total of 206 patients with HIV/AIDS infection and TB who were admitted to Suining Central Hospital from January 2015 to April 2019 were selected as the study group. 86 patients with pure HIV/AIDS were selected as the disease control group. Data of clinical diagnosis and treatment as well as follow-up of the patients were retrospectively analyzed. The clinical symptoms, laboratory examination indexes and clinical treatment outcomes were compared between the two groups. Results The incidence rates of fever, emaciation, electrolyte imbalance, hypoproteinemia, cough and chest pain in the study group were significantly higher than those in the disease control group (P<0.05). However, there was no significant difference in other symptoms between the two groups (P>0.05). The positive rates of sputum smear acid fast stain, sputum mycobacterium tuberculosis culture and PPD test in the study group were significantly higher than those in the disease control group, while the CD3⁺ count, CD4⁺ count and CD4⁺/CD8⁺ were obviously lower than the disease control group (P<0.05). There was no significant difference in CD8+ between the two groups (P>0.05). The ROC curve suggested that the areas under the curve of CD3⁺, CD4⁺, CD4⁺/ CD8⁺ and the three combined indicators to evaluate HIV/AIDS infection combined with TB were 0.799, 0.841, 0.913, and 0.935, respectively. The hospitalization time in the study group was significantly longer than that in the disease control group. The proportion of discharged patients (improved) in the study group was significantly lower than that in the disease control group, while the proportion of discharged patients (not improved) was significantly higher than that in the disease control group (P<0.05). Conclusion Although the clinical symptoms of patients with HIV/AIDS infection combined with TB are similar to those of patients with HIV/AIDS alone, the main symptoms of the former are fever, emaciation and electrolyte imbalance. The detection of laboratory immune function indexes is of positive significance for improvement of the diagnostic sensitivity and accuracy of HIV/AIDS infection with TB.

Objective To explore the effect of bilateral hand function training on the hand function of stroke survivors.Methods Thirty-one patients with unilateral hand dysfunction after stroke were randomly divided into an experimental group of 16 and a control group of 15.Both groups were given 60 minutes of hand function training of their affected hands daily,five days a week for 4 weeks.The experimental group was additionally provided with 40 minutes of bilateral hand training on the basis of the aforementioned intervention.Before the treatment and after the 4 weeks,integrated surface electromyography (iEMG) signals were recorded from both hands' flexor and extensor muscles.Both groups were also assessed using the Fugl-Meyer motor assessment for the upper extremities (FMA-UE).Results After the treatment,the average iEMG of the flexor and extensor muscles during flexion and extension were significantly better than before the treatment in both groups.There was no significant difference between the two groups in their average iEMGs before the treatment,but afterward significant differences were observed in all the iEMG measurements.After the treatment the average total FMA-UE score of the experimental group was significantly higher than that of the control group.Conclusion Bilateral hand function training is significantly more effective than unilateral training in promoting the recovery of flexor and extensor muscle function after a stroke.

Objective To obtain the recombinant protein LytA (rLytA) of Streptococcus pneumoniae strain (ATCC49619) through prokaryotic expression system and to investigate their diagnostic value for patients with community acquired pneumonia (CAP).Methods The specific primers were designed according to LytA gene sequence of Streptococcus pneumoniae M66 strain recorded in Genbank.The recombinant plasmid pET32a(+)/LytA was constructed and transformed into BL21(DE3) to express LytA.The expressed protein LytA was purified by electroeluting of bag filter.Serum IgM of anti-LytA accordingly of patients with CAP were detected by ELISA.The results were evaluated by Chi-square test.Results The recombinant protein LytA was expressed and purified successfully with a relative molecular weight of 56 000.The IgM antibodies level of anti-LytA was significantly higher than the healthy control group (P=0.000).Diagnostic sensibility and specificity of LytA-IgM were 27.8% and 100.0%,while sensibility and specificity of sputum culture were 19.4% and 72.2%,respectively.The sensibility of LytA-IgM was equal to sputum culture(χ2=0.693,P=0.405),but the specificity was higher than it(χ2=14.316 P=0.000).Conclusions A rLytA-ELISA assay maybe has clinical value for diagnosis of pneumococcal infections.It is more rapid and objective than the culture method.