BACKGROUND:Inherited heart disease has a high prevalence and mortality rate,but its pathogenesis has not yet been clarified.Although relevant animal models have been established to provide a foundation for the pathogenesis research of inherited heart disease,the value of these research results has been significantly reduced due to differences among species.Therefore,a new model is needed to explore its occurrence and development. OBJECTIVE:To review the current role of induced pluripotent stem cells in disease modeling and potential application prospects in various inherited heart diseases. METHODS:The first author searched the relevant articles published nearly 13 years in PubMed from January to March 2023.The search terms were"induced pluripotent stem cell,inherited heart disease,congenital heart disease".Finally,76 articles were included for analysis. RESULTS AND CONCLUSION:Since 2007,when induced pluripotent stem cells were induced from human somatic cells,many studies have been reported on disease-specific induced pluripotent stem cells.Due to the ability of disease-specific induced pluripotent stem cells to reproduce disease phenotypes,they are expected to become a new research tool for in vitro disease modeling,used to analyze pathogenesis and develop auxiliary drugs.In the research of cardiovascular genetic diseases,cardiomyocytes derived from patient-specific induced pluripotent stem cells contain gene mutations that are involved in cardiac dysplasia.Therefore,it can be used as a new tool to study the potential mechanisms of inherited heart disease.Up to now,induced pluripotent stem cells-derived cardiomyocytes have been widely used to study the molecular mechanisms of various genetic heart diseases,such as cardiac electrophysiological diseases,cardiomyopathy,and some syndromic inherited heart diseases.

Objective To discuss the clinical application of coronary CT angiography(CCTA)-derived fractional flow reserve(CT-FFR)in evaluating the risk stratification of the coronary artery stenosis and atherosclerotic plaque quantitative parameters.Methods A total of 122 patients,who received CCTA examination at the Xuzhou Municipal Central Hospital of China,were enrolled in this study.The patients were divided into non-ischemia group(CT-FFR＞0.8,n=66)and ischemia group(CT-FFR0.8,n=56).The characteristics of atherosclerotic plaque were compared between the two groups.Logistic regression analysis was used to analyze the correlation between plaque characteristics and ischemic lesions.Results There were 218 vessels having a CT-FFR＞0.8 and 174 vessels having a CT-FFR ≤0.8.Statistically significant differences in the total plaque volume,calcified plaque volume,plaque length,and stenosis ratio＞50％existed between the two groups(all P＜0.05).Logistic regression analysis indicated that the total plaque volume,calcified plaque volume,plaque length,and stenosis ratio＞50％were the risk factors for myocardial ischemia.Conclusion CT-FFR can be used for the risk stratification of coronary stenosis and atherosclerotic plaque characteristics,which can evaluate the local myocardial blood supply condition from the anatomical stenosis and functional level so as to optimize the diagnosis and treatment measures.

OBJECTIVES: Obstructive sleep apnea hypopnea syndrome (OSAHS) is a common disease that seriously affects health. Continuous positive airway pressure (CPAP) therapy is the preferred treatment for moderate-to-severe OSAHS patients. However, poor adherence to CPAP is a major obstacle in the treatment of OSAHS. Information-motivation-behavioral (IMB) skills, as a kind of mature technology to change the behavior, has been used in various health areas to improve treatment adherence. This study aims to explore the effects of the IMB skills intervention on CPAP adherence in OSAHS patients. METHODS: Patients who were primary diagnosed with moderate-to-severe OSAHS were randomly divided into the IMB group (n=62) and the control group (n=58). The patients in the IMB group received CPAP therapy and the IMB skills intervention for 4 weeks. The patients in the control group received CPAP therapy and a usual health care provided by a registered nurse. We collected the baseline data of the general information, including age, sex, body mass index (BMI), the Epworth Sleepiness Scale (ESS) score, the Hospital Anxiety and Depression Scale (HADS) score, and indicators about disease severity [apnea-hypopnea index (AHI), percentage of time with arterial oxygen saturation SaO₂<90% (T90), average SaO₂, lowest SaO₂, arousal index]. After CPAP titration, we collected CPAP therapy-relevant parameters (optimal pressure, maximum leakage, average leakage, 95% leakage, and residual AHI), score of satisfaction and acceptance of CPAP therapy, and score of willingness to continue CPAP therapy. After 4 weeks treatment, we collected the ESS score, HADS score, CPAP therapy-relevant parameters, effective CPAP therapy time per night, CPAP therapy days within 4 weeks, CPAP adherence rate, score of satisfaction and acceptance of CPAP therapy, and score of willingness to continue CPAP therapy. Visual analog scale (VAS) of 0-5 was used to evaluate the satisfaction and acceptance of IMB intervention measures in the IMB group. RESULTS: There were no significant differences in the baseline level of demographic parameters, ESS score, HADS score, disease severity, and CPAP therapy related parameters between the IMB group and the control group (all P>0.05). There were no significant differences in score of willingness to continue CPAP therapy, as well as score of satisfaction and acceptance of CPAP therapy after CPAP titration between the IMB group and the control group (both P>0.05). After 4 weeks treatment, the ESS score, HADS score, maximum leakage, average leakage, and 95% leakage of the IMB group were significantly decreased, while the score of satisfaction and acceptance of CPAP therapy and willingness to continue CPAP therapy of the IMB group were significantly increased (all P<0.05); while the above indexes in the control group were not different before and after 4 weeks treatment (all P<0.05). Compared with the control group, the ESS score, HADS score, maximum leakage, average leakage, and 95% leakage of the IMB group after 4 weeks treatment were significantly lower (all P<0.05); the effective CPAP therapy time, CPAP therapy days within 4 weeks, score of satisfaction and acceptance of CPAP therapy, score of willingness to continue CPAP therapy of the IMB group were significantly higher (all P<0.05). The rate of CPAP therapy adherence in 4 weeks of the IMB group was significantly higher than that of the control group (90.3% vs 62.1%, P<0.05). The VAS of overall satisfaction with IMB skills intervention measures was 4.46±0.35. CONCLUSIONS IMB skills intervention measures can effectively improve the adherence of CPAP therapy in OSAHS patients, and is suitable for clinical promotion.
Continuous Positive Airway Pressure ; Humans ; Motivation ; Oximetry ; Patient Compliance ; Sleep Apnea, Obstructive/diagnosis* ; Syndrome

Many countries in the world have faced with coronavirus disease 2019 (COVID-19) epidemic since December 2019, while the proportion of elderly patients with COVID-19 in severe and death cases is relatively high. At present, China is in the rapid development stage of population aging, and the demand of the elderly for medical care, health care, nursing and life services far exceeds that of other people. Especially in the period of COVID-19, it is particularly urgent to summarize more experience and methods in time to reduce the infection rate, the incidence of critical illness, and the mortality rate. Therefore, this review combines the existing research results with clinic experience of diagnosis and treatment for senile infectious diseases, summarizes the clinical characteristics and puts forward the prevention strategies of elderly COVID-19 patients, which provide evidence for effective prevention and treatment of COVID-19 in elderly patients, improvement of cure rate, and reduction of severe incidence rate and mortality.
Aged ; Betacoronavirus ; China ; Coronavirus Infections ; diagnosis ; mortality ; therapy ; Humans ; Pandemics ; Pneumonia, Viral ; diagnosis ; mortality ; therapy

BACKGROUND: Induced pluripotent stem cells are a type of reprogrammed cells with similar characteristics to embryonic stem cells, which are capable of differentiating into phenotypes associated with patient specific diseases. Moreover, their clinical application avoids ethical issues. OBJECTIVE: To review the research progress of induced pluripotent stem cells in myocardial regeneration and repair, cardiovascular disease models, drug development and screening, and drug toxicity testing. METHODS: PubMed (2006-2018) and CNKI (2013-2018) databases were retrieved for relevant articles using the keywords of "induction of pluripotent stem cells; myocardial infarction; arrhythmia; cardiovascular disease; heart failure; heart transplantation; disease model; drug toxicity" in English and Chinese, respectively. The data were reviewed one by one, and the citations involved in the literatures were also reviewed. RESULTS AND CONCLUSION: Induced pluripotent stem cells have great potential value in myocardial regeneration and repair, establishment of cardiovascular disease models, new drug development and screening, and drug toxicity detection. The application prospect of the cells is broad, but most of the research is still in the experimental stage. In addition, safety problems, such as low induction efficiency and tumorigenicity, will limit the clinical application of induced pluripotent stem cells.

Objective To analyze the four types of laparoscopic operation in the treatment of upper ureteral calculi with diameter more than 1 cm.Methods From July 2012 to September 2015,150 cases of patients with upper ureteral calculi diameter more than 1cm were analyzed.According to the different surgical methods,patients were divided into four groups.There are 39 cases in URL group,32 cases in RLU group,36 cases in PCNL group and 43 cases in FURL group.The diameter of calculi in RLU group and PCNL group was much larger than those in URL group and FURL group(P ＜ 0.05).There was no difference in terms of sex,age,stone location,stone composition,and the ESWL treatment failure rate among the four groups(P ＞ 0.05).The operation time,postoperative hospitalization days,postoperative bowel recovery,postoperative ESWL rate,complications and postoperative calculi clearance rate were compared among the four groups.Results In RLU,PCNL,URL and FURL group,the operation time were (38.5 ± 13.0) min,(83.4 ± 6.1) min,(69.6 ± 13.0) min and (50.1 ± 6.3) min,respectively,and there were significant differences among the four groups (RLU group ＞ PCNL group ＞ FURL group ＞ URL group,P ＜ 0.05).Postoperative hospitalization days of RLU group,PCNL group,URL group and FURL group were (6.5 ± 0.6) d,(9.5 ± 0.7) d,(8.4 ± 0.7) d and (7.7 ± 0.7) d respectively,and there were significant differences in terms of hospitalization days (RLU group ＞ PCNL group ＞ FURL group ＞ URL group,P ＜ 0.05).The calculi clearance rates of RLU group,PCNL group,URL group and FURL group were 79.5％,100.0％,94.4％ and 88.4％ at 3 days after operation,and 82.1％,100.0％,97.2％ and 95.3％ at 1 month after operation.The postoperative calculi clearance rates at 3 days and 1 month in RLU group were higher than those in URL group(P ＜ 0.05),but there was no difference between PCNL group and RLU group (P ＞ 0.05).Postoperative ESWL rates of RLU group,PCNL group,URL group and FURL group were 12.8％,0,2.8％ and 4.7％,and there was no difference among the four groups.The decreased value of RBC in PCNL group and FURL group was higher than that of URL group and RLU group(P ＜ 0.05).One patient in PCNL group suffered from massive hemorrhage,and required blood transfusion.The complication rates in the four groups were 23.1％ (9/39),9.4％ (3/32),13.9％ (5/36) and 9.3％ (4/43) respectively,and there was no difference of complication among them(P ＞ 0.05).Conclusions Four types of endoscopes have the advantages of safety,small wound and quick recovery for ureter calculi larger than 1 cm.The URL operation is simple,with less injury,quick recovery,but low stone clearance rate.FURL requires high level of skill for the operator,and is an effective treatment for ureteric,renal pelvic,and kidney stones which are smaller than 2 cm.FURL avoids the extra ESWL treatment,but costs much.PCNL has more injury and requires high-level surgical skills with a high stone clearance rate.RLU has a high stone clearance rate but is much difficult,which can be used as a remedy for the failure of FURL or PCNL.

By bioinformatics analysis, a putative keratinase gene gm2886 (Accession number: KY368946) was discovered in the genome of a feather-degrading strain, Streptomyces albidoflavus Fea-10. gm2886 was ligated into integrative Escherichia coli-Streptomyces shuttle vector pSET152 under the promoter PermE and added with C-terminal His-tag. The expression vector was transformed into Streptomyces pactum ACT12 by conjugal transfer and the recombinant protein GM2886-His6 was detected in fermentation broth. GM2886-His6 was purified and characterized. Its size was nearly 36 kDa. GM2886-His6 showed proteolytic activity towards a variety of substrates and could even degrade insoluble substrates, such as azure keratin and chicken feathers. The optimal pH and temperature of GM2886-His6 for proteolysis of casein was pH 10.0 and 50 ℃, respectively. The enzyme activity was inhibited by PMSF, but not EDTA, indicating that GM2886-His6 was a serine proteinase. Our results laid the foundation for the research of the molecular biological mechanism on feather-degrading and for the further utilization of Fea-10.

Objective To investigate the autistic symptoms or autistic trait in the children with attention deficit hyperactivity disorder(ADHD) for facilitating the development of appropriate interventions.Methods Sixty-two 6-12-year-old high-functioned autism spectrum disorder (ASD),ADHD and typically developing (TD) children were assessed respectively using Chinese-version social responsiveness scale (SRS),and ADHD core symptoms were assessed in the ADHD children at the same time.Results ASD group＞ADHD group＞ TD group on the SRS total raw score and the five dimensions scores as well(P＜0.01).ASD,ADHD and TD group scored respectively 92.43±19.17,65.66±19.86 and 38.40±10.68 on the SRS total scale.The SRS total raw score of ADHD group exceeded the TD group for 2.55 standard deviant (SD) and with social communication (2.00 SD) and autistic mannerism (2.71 SD) deviating the most.22.58％ (14 out of 62) children with ADHD scored above the threshold on the SRS total raw score which was significantly higher than that in the TD group(P＜0.01).There were nonsignificant differences in the ADHD core symptoms between ADHD± children (with the SRS total raw score ≥85)and ADHD-children(with the SRS total raw score＜85) (P＞0.01).Conclusion Children with ADHD appear more ASD symptoms than the TD children and a considerable proportion of them reach the SRS diagnostic cut-off point.

Objective To compare the efficacy and safety of intravenous injection and oral taken of morphine in the treatment of severe cancer pain.Methods 35 patients with severe cancer pain were randomly divided into oral group (n =16)and IV group (n =19).Results The time from start of treatment to achievement of CR /PR in the oral group was significantly longer than that in the IV group,and there was no significant difference of incidence rate of complications be-tween two groups.Conclusion Both oral taken and intravenous injection of morphine can effec-tively alleviate severe cancer pain,and compared with oral take,the intravenous injection of mor-phine is even more effective,so it is worthy of popularization.

Objective To compare the efficacy and safety of intravenous injection and oral taken of morphine in the treatment of severe cancer pain.Methods 35 patients with severe cancer pain were randomly divided into oral group (n =16)and IV group (n =19).Results The time from start of treatment to achievement of CR /PR in the oral group was significantly longer than that in the IV group,and there was no significant difference of incidence rate of complications be-tween two groups.Conclusion Both oral taken and intravenous injection of morphine can effec-tively alleviate severe cancer pain,and compared with oral take,the intravenous injection of mor-phine is even more effective,so it is worthy of popularization.