Effects of heart valve replacement under extracorporeal circulation on left ventricular function and regulatory T cells in elderly patients with rheumatic heart disease / 中华老年医学杂志

Objective:To assess the effects of heart valve replacement under extracorporeal circulation(ECC)on left ventricular function and regulatory T cells in elderly patients with rheumatic heart disease(RHD).Methods:113 elderly patients with rheumatic heart disease receiving ECC heart valve replacement at our hospital from September 2018 to September 2020 were selected retrospectively as subjects.Another 113 healthy people from the same period were selected as the control group.Patients in the observation group received ECC heart valve replacement.Left heart function and regulatory T cells were compared between the two groups.Results:Before surgery, the left atrial transverse diameter(LA)of RHD patients was significantly increased compared with the control group[(56.2±9.3)mm vs.(29.4±3.5)mm, t=28.670, P<0.001], and the left ventricular end diastolic diameter(LVDD)[(32.4±7.7)mm vs.(38.4±8.5)mm, t=5.561, P<0.001], left ventricular ejection fraction(LVEF)[(58.4±11.5)% vs.(65.6±10.5)%, t=4.915, P<0.001]and cardiac output(CO)[(3.7±2.6)L/min vs.(4.7±1.6)L/min, t=3.482, P<0.001]were significantly decreased compared with the control group.There were no significant changes in left heart function parameter values 10 min and 1 day after surgery(all P>0.05).One month after surgery, the inner diameter of pulmonary artery(PA)[(25.2±3.8)mm vs.(31.2±5.6)mm, t=9.659, P<0.001]and LA[(46.2±7.8)mm vs.(56.2±9.3)mm, t=8.758, P<0.001]were decreased compared with those before surgery, while changes in right ventricular end diastolic inner diameter(RVDD)and left ventricular end diastolic inner diameter(LVDD)were not significant, and there were no significant differences in LVEF, CO and LVFS(all P>0.05).The proportion of CD25 + CD4 + T cells in lymphocytes and the proportion of CD4 + CD25 + Foxp3 + Treg cells in CD4 + T cells in RHD patients before surgery were significantly lower than those in the control group( P<0.01).The proportions decreased 10 min and 1 day after surgery, but increased 3 days after surgery and returned to preoperative levels 7 days after surgery, but were still significantly lower than those in the control group( P<0.05). Conclusions:After ECC heart valve replacement in elderly RHD patients, the left atrium will shrink for a short time and tricuspid regurgitation can recover, with reduced damage of cellular immune function, but its contractile function remains unchanged.

Clinical efficacy of mesalazine combined with Clostridium butyricum tablets in the treatment of colitis gravis / 中国基层医药

Objective To investigate the clinical efficacy and safety of mesalazine combined with Clostridium butyricum tablets in the treatment of colitis gravis.Methods From January 2016 to December 2016, a total of 120 patients with colitis gravis in the Second Hospital of Qinhuangdao were selected in the research .According to different treatment methods,the patients were divided into observation group and control group ,with 60 cases in each group.The control group was given mesalazine , and the observation group was given mesalazine combined with Clostridium butyricum tablets.All the patients were treated for 2 months.The changes of cytokine levels and C -reactive protein were observed.The therapeutic effects and adverse drug reactions were compared between the two groups . Results The total effective rate of the observation group was significantly higher than that in the control group (91.66%vs.78.33%),and there was statistically significant difference between the two groups ( χ2＝4.183,P＝0.041).The level of IL-10 in the observation group was significantly higher than that in the control group [(110.05 ± 2.61)pg/L vs.(98.35 ±2.42)pg/L,t＝25.462,P＜0.05].The IL-18 level in the observation group was significantly lower than that in the control group [(97.74 ±2.82) pg/L vs.(120.86 ±3.21) pg/L,t＝41.914,P＜0.05].The level of C-reactive protein in the observation group was lower than that in the control group [(8.02 ±1.97) mg/L vs.(6.33 ±3.82)mg/L,t＝14.976,P＜0.05].The incidence rate of adverse reactions of the observation group was significantly lower than that of the control group ( 5.00% vs.25.00%, χ2＝9.412, P ＝0.002 ).Conclusion Mesalazine combined with Clostridium butyricum tablets in the treatment of colitis gravis has obvious curative effect , and can effectively improve the levels of cytokines and C -reactive protein and with high safety.

Comparison of the effects of mesalazine oral plus enema and only oral administration in the treatment of ulcerative colitis / 中国基层医药

Objective To compare the efficacy and safety of mesalazine oral plus enema or only oral admin-istration in the treatment of ulcerative colitis .Methods 114 patients with ulcerative colitis were selected , and they were randomly divided into the observation group and treatment group according to random number table , with 57 cases in each group .The observation group was given mesalazine oral treatment ,and the treatment group was given mesalazine oral plus enema .The changes of CRP ,Fid,MPV after treatment were compared between the two groups .The situation of mucosa under colonoscopy , effective rate and the incidence of adverse reactions were compared between the two groups.Results After treatment,the CRP,Fid levels in the treatment group were lower than those in the observation group [(3.17 ±1.48)mg/L vs.(6.14 ±2.53)mg/L,(2.14 ±0.17)g/L vs.(2.91 ±0.27)g/L],the MPV in the treatment group was higher than that in the observation group [(10.93 ±0.59) fL vs.(10.21 ± 1.21)fL],the differences were statistically significant (t=7.650,18.220,4.038,all P<0.05).The total remission rate of the treatment group was higher than that of the observation group (100.00%vs.78.95%) (χ2 =13.412,P<0.001).The total effective rate of treatment group was higher than that of the observation group (89.47% vs .75.44%) (χ2 =3.881,P=0.049).The incidence rate of adverse reactions in the treatment group was lower than that in the observation group (3.51%vs.26.32%) (χ2 =11.683,P=0.001).Conclusion Mesalazine oral plus enema in the treatment of ulcerative colitis has good effect ,minor adverse reactions,high safety,which is worthy of clinical application .

Interpersonal Relationship Training in Intern / 中华医学教育探索杂志

This paper introduces interns shoule know the importance of interpersonal relationship in clinic practice thoroughly and good interpersonal relationship requires the teacher and medical students to make efforts together.

Ribavirin in treatment of severe acute respiratory syndrome / 第二军医大学学报

Many drugs were used in the treatment of SARS. Ribavirin,an antiviral drug, was also used to combat the SARS virus. Combination of ribavirin and corticosteroid was effective in treatment of SARS,but there were side effects.This paper reviewed its application protocol,efficacy,adverse effects and precautions.

Progress in treatment of systemic inflammatory response syndrome and multiple organ dysfunction syn- drome / 第二军医大学学报

The treatment of systemic inflammatory response syndrome (SIRS) and multiple organ dysfunction syndrome (MODS) is difficult in ICU. In addition to traditional methods, immunologic therapy has been used recently to treat SIRS and MODS through adjusting inflammatory responses and redressing abnormal responses. This article reviews the progress in treatment of SIRS and MODS,including blocking inflammatory activation, modifying the activation of inflammation, giving gene therapy and combination therapy of TCM and western medicine.

Study of serum leptin level in patients with chronic obstructive pulmonary disease / 中华老年医学杂志

Objective To explore the change of serum leptin and significance in patients with chronic obstructive pulmonary disease(COPD). Methods The levels of leptin and tumor necrosis factor-? (TNF-?) of 34 COPD patients in stationary phase and 16 healthy people were measured by radioimmunoassay. The ideal body weight percentage(IBW%), triceps skin-fold thickness(TSF), arm muscle circumference(AMC), creatinine height index percentage(CHI%), total lymphocyte(TLC), albumin(ALB) were determined at the same time. The differences of parameters between patients and healthy people were compared. The correlation between parameters and leptin levels was analysed. Results Nutritional parameters were lower in COPD patients than in healthy controls(P

Role of bone marrow cells in renewal of renal tubular epithelial cells under physiological condition / 第二军医大学学报

Objective:To observe whether bone marrow cells (BMCs) can differentiate into the renal tubular epithelial cells under physiological condition.Methods: Transgenic C57BL/6 mice labeled with green flouresent protein(GFP) served as bone marrow donors and C57BL/6 mice without fluorescence labeling were divided into 3 groups: normal group(N,n=15),total body irradiation group(TBI,n=15),and bone marrow transplantation(BMT,n=15) group.The mice in Group N received no treatment,those in Group TBI were irradiated with lethal dose of ? rays but received no transplant(sacrificed within 1 week after irradiation),and those in Group BMT were transplanted with BMCs after the irradiation(sacrificed at 58 and 84 days after transplantation).Blood samples were obtained from all 3 groups for routine analysis and analysis of urea nitrogen and plasma creatinine.Meanwhile,mice kidneys were harvested for H-E staining.The amount of GFP positive BMCs in mice of BMT group was determined by flow cytometry;the distribution and amount of GFP positive cells in renal tissues were observed by immunohistochemistry.Results: There was no difference in the levels of urea nitrogen and plasma creatinine between the 3 groups.Lethal-dose total body irradiation resulted in no significant change in renal histological structure and function,but RBC,WBC and PLT of the mice in TBI group were markedly reduced compared with those in the other 2 groups(P0.05).Conclusion: Bone marrow cells may participate in renewal of tubular epithelial cells even without the renal tubular damage.