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Objective: To explore the therapeutic efficacies of three different doses of human umbilical cord mesenchymal stem cell exosomes (hucMSC-EXO) on the injury of intestinal barrier structure and dysfunction in severely burned rats, and to identify the optimal dose of hucMSC-EXO for the repair of intestinal barrier injury. Methods: The hucMSC-EXO was isolated and identified by using an exosome extraction and purification kit. A total of 30 specific pathogen free (SPF) male Wistar rats (aged 6-8 weeks) were selected, and were randomly divided into five groups ( n =6) using a random number table: sham group, burn group, burn+100 μg hucMSC-EXO group (Burn+EXO100), burn+200 μg hucMSC-EXO group (Burn+EXO200), and burn+400 μg hucMSC-EXO group (Burn+EXO400). The rats were immersed in 94 ℃ water, with the dorsal area exposed for 12 seconds and the ventral area for 6 seconds, to establish a 50% total body surface area (TBSA) third-degree burn model. The sham group rats were subjected under the same condition but with a 37 ℃ water bath. On day 1, 3, and 5 post-burn, the rats in sham group and burn group received an intraperitoneal injection of 0.5 ml phosphate buffered solution, and those in Burn+EXO100, Burn+EXO200, and Burn+EXO400 groups received intraperitoneal injections of 100, 200, and 400 μg/0.5 ml hucMSC-EXO, respectively. The activity of rats was observed and the weight was recorded daily. On day 7, the small intestine tissues and serum of the rats were collected. Hematoxylin-Eosin (HE) staining was used to observe the pathological changes of the small intestinal tissues, and the levels of inflammatory factors, such as tumor necrosis factor (TNF)-α, interleukin (IL)-1β, IL-6, IL-8, IL-10 and lipopolysaccharide (LPS) of small intestine tissues were detected by enzyme-linked immunosorbent assay (ELISA). The levels of diamine oxidase, D-lactic acid and bacterial endotoxin in serum were detected by intestinal barrier function biochemical analysis system. Results: The morphology of hucMSC-EXO was observed to be round or oval, with uniform size and a peak diameter of approximately 100 nm, expressing positive markers CD63 and TSG101. In the sham injury group, the rats' body weight increased by approximately (6.3±1.2) g/day, whereas in the burn group, the body weight significantly decreased on the first day post-injury and then gradually increased at a rate of (1.6±0.5) g daily. In contrast, the body weight of the Burn+EXO100, 200, and 400 groups increased at a rate of (2.9±1.1) g daily. By day 7 post-injury, the body weight in the Burn+EXO200 and Burn+EXO400 groups were significantly higher than those in the burn group and the Burn+EXO100 group (all P <0.05). HE staining showed that the villus height in the small intestine (duodenum, jejunum, ileum) of the burn group [(711±35), (526±25), (418±33) μm] was significantly reduced with severe structural damage, while the small intestine structure and villus height in the EXO-treated groups showed varying degrees of recovery. The villus height in the Burn+EXO200 group [(1 050±40), (798±30), (609±29)μm, respectively] and burn+EXO400 group [(1 102±46), (830±28), (625±33)μm, respectively] recovered significantly (all P <0.05). ELISA results indicated that the levels of pro-inflammatory cytokines TNF-α, IL-1β, IL-6, IL-8, and LPS in the burn group [(29.3±1.7), (81.2±2.5), (582.4±36.9), (22.1±0.6), (366.8±15.9)ng/L, respectively] were elevated, while those were significantly reduced in the EXO-treated groups, with Burn+EXO200 group [(17.9±1.0), (58.2±2.3), (206.6±38.7), (8.9±1.0), (94.9±7.3)ng/L, respectively] showing the most significant reduction (all P <0.05). The level of anti-inflammatory cytokine IL-10 was elevated in the burn group [(293.4±16.0) ng/L], and it was significantly increased in the burn+EXO100, 200, and 400 groups [(591.8±40.7), (672.5±53.7), (712.5±36.2)ng/L, respectively] (all P <0.05). Assessment of intestinal barrier function showed that serum diamine oxidase in the burn group decreased, while D-lactate and bacterial endotoxin increased. The EXO-treated groups demonstrated significant improvement in diamine oxidase, D-lactate, and bacterial endotoxin levels, with Burn+EXO200 group showing the most significant effect (all P <0.05). Conclusions: In this study, hucMSC-EXO was successfully isolated, extracted, and identified. An intraperitoneal injection of 200 μg of hucMSC-EXO demonstrates the most effective repair of intestinal structure and function in rats with severe burn injuries.

Objective: To assess the clinical efficacy of compound pholcodine syrup and compound codeine phosphate oral solution on lung cancer-related cough. Methods: A total of 60 patients diagnosed with middle-advanced stage lung cancer and had lung cancer-related cough in the Department of Geriatric Oncology of Chongqing University Cancer Hospital from January to May 2022 were prospectively enrolled. According to the random number table method, the patients were divided into two groups: observation group and control group. The observation group [ n =30, with 21 males and 9 females, and aged (62.3±10.4) years] received compound pholcodine syrup treatment, while the control group [ n =30, with 21 males and 9 females, and aged (62.0±8.1) years] received compound codeine phosphate oral solution treatment. The dosage of the two drugs was 15 ml each time, 3 times a day, and the treatment course was 5 days. The antitussive effectiveness, cough severity and quality of life (Leicester Cough Questionnaire in Mandarin-Chinese scale) were observed and compared between the two groups 3 days and 5 days after the treatment. Results: All 60 patients completed the study. Both regimens were effective in controlling lung cancer-related cough. After 3 days treatment, the antitussive effective rate of the observation group and the control group was 83.3% (25/30) and 73.3% (22/30), respectively, with no statistically significant difference ( P =0.347). Likewise, after 5 days treatment, the antitussive effective rate of observation group and control group was 90.0% (27/30) and 86.6% (26/30), respectively, with no statistically significant difference ( P =0.687). There was no statistically significant difference in the cough severity between observation group [moderate and severe cough: 56.7% (17/30)] and control group [moderate and severe cough: 67.7% (20/30)] ( P =0.414). After 3 days treatment, cough symptoms were relieved in both groups. Patients with mild cough accounted for 73.3% (22/30) in the observation group and 56.7% (17/30) in the control group, and the difference was not statistically significant ( P =0.331). Moreover, after 5 days treatment, there was also no significant difference in mild cough between observation group [86.7% (26/30)] and control group [66.7% (20/30)] ( P =0.067). Meanwhile, there were no significant differences in the physiological score, psychological score, social score and total score of the Leicester Cough Questionnaire in Mandarin-Chinese scale before the treatment, after 3 days and 5 days treatment between the two groups (all P >0.05). The incidence of both xerostomia and constipation in the observation group was 0, which was lower than those of the control group [20.0% (6/30) and 20.0% (6/30)] (both P <0.05). Conclusions: Both compound pholcodine syrup and compound codeine phosphate oral solution are effective in treating lung cancer-related cough with similar antitussive effectiveness. Compound pholcodine syrup has a lower incidence of xerostomia and constipation than control group, with a better safety profile.

Objective: To assess the therapeutic effect of the early interdisciplinary palliative care based on WARM model (whole, assessment, revaluation, management) on the quality of life, psychological state, pain and nutritional status in patients with non-small-cell lung cancer (NSCLC). Methods: A total of 60 patients from Chongqing University Cancer Hospital with newly diagnosed advanced NSCLC from Oct 15, 2019 to Jun 12, 2020 were enrolled. According to the method of random number table, the patients were divided into two groups: standard oncologic care group (SC, n =30) and early palliative care group (EPC, n =30). SC group only received standard oncological care, while EPC group received standard oncological care and additional comprehensive treatment from a MDT consisted of medical oncologists, palliative care nurses, dietitians and psychologists. The quality of life [functional assessment of cancer therapy-lung (FACT-L) scale], psychological state [hospital anxiety and depression scale (HADS) and patient health questionnaire-9 (PHQ-9)], nutritional status [patient-generated subjective global assessment (PG-SGA)], and cancer pain status [numerical rating scale (NRS)] were observed and compared between the two groups before and after the 6 months treatment, respectively. Results: A total of 45 patients completed 6 months treatment, including 24 males and 21 females, aged 38-82 (60.5±1.7), with 23 patients in the EPC group and 22 patients in the SC group. Patients assigned to EPC group had a better quality of life than those assigned to SC group [FACT-L scale: (122.3±1.6) vs (111.8±2.1), P <0.001]. Fewer patients had anxiety and depressive symptoms in the EPC group than those in the SC group [HADS anxiety subscale: (1.1±0.3) vs (2.9±0.4), P <0.001; HADS depression subscale: (0.7±0.3) vs (3.6±0.4), P <0.001]. The PHQ-9 results showed that 100.0% (23/23) patients were free of depression in the EPC group, while 45.5% (10/22) patients were free of depression in SC group ( P <0.001). Furthermore, patients in the EPC group had a better nutritional status [moderate malnutrition: 60.9% (14/23); no malnutrition: 39.1% (9/23)] than those in the SC group [severe malnutrition: 40.9% (9/22); moderate malnutrition: 50.0% (11/22); no malnutrition: 9.1% (2/22)] ( P <0.001). There was no significant difference in NRS score between EPC group and SC group ( P =0.140). Conclusion: Early interdisciplinary palliative care based on WARM model can improve the quality of life, psychological state and nutritional status in NSCLC patients.

Objective: To examine the effect of rational emotive therapy on negative emotions among advanced schistosomiasis patients with repeated hospitalizations., Methods: A total of 97 advanced schistosomiasis patients with anxiety and depressive emotions that were hospitalized in Xiangyue Hospital of Hunan Institute of Schistosomiasis Control for three times or more were enrolled, and given rational emotive therapy for 4 weeks in addition to routine nursing care. The scores for anxiety, depression and quality of life were estimated in patients before and after the rational emotive therapy using the Self-Rating Anxiety Scale (SRS), the Self-Rating Depression Scale (SDS) and WHOQOL-BREF Form., Results: The SAS and SDS scores were significantly lower 4 weeks following rational emotive therapy than before the intervention (SAS score, 45.40 ± 7.77 vs. 59.25 ± 9.29, t = 14.021, P < 0.01; 51.48 ± 8.01 vs. 63.93 ± 9.59, t = 12.991, P < 0.01). The percentages of patients with moderate and severe anxiety and depression were significantly lower 4 weeks following rational emotive therapy than before the intervention ( P < 0.01), and the scores for each item in the quality of life were all significantly greater 4 weeks following rational emotive therapy than before the intervention ( P < 0.01)., Conclusions: Rational emotive therapy may improve the negative emotions and the quality of life of advanced schistosomiasis patients with repeated hospitalizations.

Dysfunction of the immune regulatory system plays an important role in the pathogenesis of rheumatoid arthritis (RA). Vasoactive intestinal peptide (VIP) has multiple bioactivities. This study aims to investigate the role of VIP in the maintenance of the immune regulatory capacity of monocytes (Mos). Human peripheral blood samples were collected from RA patients and healthy control (HC) subjects. Mos and CD14 + CD71 - CD73 + CD25 + regulatory Mos (RegMos) were isolated from the blood samples and characterized by flow cytometry. A rat RA model was developed to test the role of VIP in the maintenance of the immune regulatory function of Mos. The results showed that RegMos of HC subjects had immune suppressive functions. RegMos of RA patients expressed less interleukin (IL)-10 and showed an incompetent immune regulatory capacity. Serum levels of VIP were lower in RA patients, which were positively correlated with the expression of IL-10 in RegMos. In-vitro experiments showed that the IL-10 mRNA decayed spontaneously in RegMos, which could be prevented by the presence of VIP in the culture. VIP suppressed the effects of tristetraprolin (TTP) on inducing IL-10 mRNA decay in RegMos. Administration of VIP inhibited experimental RA in rats through restoring the IL-10 expression in RegMos. RegMos have immune suppressive functions. VIP is required in maintaining IL-10 expression in RegMos. The data suggest that VIP has translational potential in the treatment of immune disorders such as RA., (© 2019 British Society for Immunology.)

Objective: To study the effect of rosuvastatin on myocardial infarction in rats and its mechanism of action., Materials and Methods: 24 Sprague-Dawley (SD) rats were randomly divided into 3 groups: intensive statin group (n=8), myocardial infarction control group (n=8) and sham-operation group (n=8). The left anterior descending coronary artery was ligated to establish myocardial infarction models. Rats in intensive statin group were treated with gavage via rosuvastatin (1 mg × kg) and 1.5 mL distilled water suspension at 3 d before operation, while rats in the other two groups received gavage via the same amount of distilled water till 4 weeks after operation. Venous blood was collected using capillary glass tubes at 3 d before operation (before medication) and the last day in the 4th week after operation. Interleukin-6 (IL-6) was detected via chemiluminescence assay, and tumor necrosis factor-α (TNF-α) was detected via immunofluorescence assay. Hematoxylin and eosin (HE) staining and Masson staining were performed for myocardium to detect the inflammation and fibrosis. Finally, the expressions of inflammatory protein p65, peroxisome proliferator-activated receptor (PPAR) and fibrin were detected via Western blotting, and the Snail expression was detected by immunohistochemical assay., Results: The survival rate and cardiac function of rats in intensive statin group were superior to those in control group. HE staining and detection of blood IL-6 and TNF-α, and p65 and PPAR protein expressions revealed that the inflammatory levels in the body and myocardium of rats in intensive statin group were decreased compared with those in control group. Masson staining and detection of fibrin level showed that the myocardial fibrosis level of rats in intensive statin group was reduced compared with that in control group., Conclusions: Rosuvastatin can reduce the level of myocardial fibrosis through alleviating the inflammatory response in rats with myocardial infarction.

Activities of atmospheric aerosols, bulk deposition fluxes, and undisturbed soil inventories of (7)Be were investigated in China's East Asian monsoon zone at various latitudes ranging from 23.8°N to 43.5°N. The annual latitudinal distributions of (7)Be concentrations in aerosols follow a distribution pattern which looks similar to a normal distribution with the maxima occurring in the mid-latitude region. Simultaneous measurements of (7)Be at various latitudes suggest that atmospheric circulation may play an important role in the latitudinal distributions of (7)Be in surface air. Latitude and wet precipitation are the main factors controlling the bulk (7)Be depositional fluxes. Significant seasonal variations in (7)Be depositional fluxes in Beijing, a mid-latitude city, were observed with the highest flux in summer and the lowest in winter, whereas less seasonality were found in the high- and the low-latitude cities. The highest (7)Be inventory in undisturbed soils in summer also occurred at a mid-latitudinal area in the East Asian monsoon zone. Precipitation is the main factor controlling the (7)Be soil inventory in Qingdao with the highest values occurring in autumn followed by summer., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Objective: This study aimed to assess the benefits and risks of conscious sedation with midazolam and dezocine in diagnostic flexible bronchoscopy (FB)., Patients and Methods: This prospective case control study enrolled 40 non-sedated and 40 sedated subjects who underwent diagnostic FB. All received the standard upper airway preparation, while sedated subjects received midazolam and dezocine for conscious sedation. Subject discomforts during FB were assessed using the verbal analogue score (VAS, 0-10 scale). Willingness to return was assessed as five scales to monitor subject's satisfaction level. Safety profiles throughout the procedures were also assessed., Results: Anterograde amnesia existed in 75.0% sedated subjects. Compared to non-sedated subjects, sedated ones expressed less discomfort, with lower VAS scores regarding scope insertion (4 [0-10] vs. 0 [0-4], p < 0.001), cough (5.5 [0-10] vs. 0 [0-4], p < 0.001), dyspnea (3.5 [0-10] vs. 0 [0-4], p<0.001), pain (3 [0-10] vs. 0 [0-5], p < 0.001), and global tolerance of the procedures (5.5 [1-10] vs. 0 [0-5], p < 0.001). More sedated subjects expressed willingness to return (90.0% vs. 30.0%, p < 0.001). Sedated subjects had no more hypoxemic episodes during the procedure (7.5% vs. 5.0%, p > 0.99), which were all transient and not life-threatening., Conclusions: Conscious sedation with midazolam and dezocine reduces discomforts, improves satisfaction level, and carries no significantly risks in subjects undergoing diagnostic FB.

The caesium-137 ((137)Cs) technique for estimating net, time-integrated soil redistribution by the processes of wind, water and tillage is increasingly being used with repeated sampling to form a baseline to evaluate change over small (years to decades) timeframes. This interest stems from knowledge that since the 1950s soil redistribution has responded dynamically to different phases of land use change and management. Currently, there is no standard approach to detect change in (137)Cs-derived net soil redistribution and thereby identify the driving forces responsible for change. We outline recent advances in space-time sampling in the soil monitoring literature which provide a rigorous statistical and pragmatic approach to estimating the change over time in the spatial mean of environmental properties. We apply the space-time sampling framework, estimate the minimum detectable change of net soil redistribution and consider the information content and cost implications of different sampling designs for a study area in the Chinese Loess Plateau. Three phases (1954-1996, 1954-2012 and 1996-2012) of net soil erosion were detectable and attributed to well-documented historical change in land use and management practices in the study area and across the region. We recommend that the design for space-time sampling is considered carefully alongside cost-effective use of the spatial mean to detect and correctly attribute cause of change over time particularly across spatial scales of variation., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Iris tectorum Maxim, a very popular Chinese traditional medicinal perennial herb belonging to the Iridaceae family, is widely grown as a year-round ornamental in China. During May to August 2014, as part of a survey for tospoviruses (family Bunyaviridae) in flue-cured tobacco, symptoms suspected to be caused by tospoviruses were observed on I. tectorum around farmers' fields in Kunming, Yunnan province. Symptoms were chlorotic spots on younger leaves and necrosis on older leaves. Since Tomato spotted wilt virus (TSWV) and Tomato zonate spot virus (TZSV) are two common tospoviruses in flue-cured tobacco fields in Yunnan, ELISA with monoclonal TSWV antibody (provided by J. X. Wu, Zhejiang University, China) and polyclonal TZSV antiserum (provided by J. H. Dong, Yunnan Academy of Agriculture Science, China) was performed to identify the presence of virus. Positive extinction values (OD λ405nm 0.835 ± 0.121 and 1.024 ± 0.193, as compared with the negative 0.153 ± 0.076 and the positive control 0.510 ± 0.109 at a confidence interval of P ≤ 0.05) were obtained from two symptomatic samples with TZSV antibody but not with TSWV. The absence of TSWV was confirmed with a commercially available immune-strip (Agdia, Elkhart, IN), following the manufacturer's instructions. To further verify the causal agent of these symptoms, total RNA was isolated from two symptomatic and one asymptomatic samples and reverse transcribed using degenerate primer J13 (1). These cDNAs were then used as a template in a universal PCR assay using specific primers TZSVNF (5'-ATGTCTAACGTCCGGAGTTTAACAC-3') and TZSVNR (5'-TTAAAAAGACAGATCATTGCTG-3'), which amplify the complete nucleocapsid (N) protein. The PCR was carried out for denaturation at 94°C for 3 min, and subsequently 30 cycles were carried out, with each cycle consisting of 94°C for 45 s, 55°C for 45 s, and 72°C for 1 min, followed by a final extension step at 72°C for 10 min. An 0.8-Kb DNA fragment was amplified from symptomatic samples and cloned into a pGEM-T Easy (Promega, Madison, WI) vector. Three clones of each sample were selected and sequenced. BLAST analysis of the obtained sequences (Accession Nos. KM452916 and KM452917) revealed that the N sequences of these isolates have 96 to 99% nucleotide identity and 99 to 100% amino acid identity with the deposit TZSV sequence in NCBI from Yunnan (JN116580 to JN116583 and EF552433) (2). These combined results provide further confirmation of TZSV infection. It is known that perennial herb or ornamental plants may act as reservoirs for tospoviruses that can infect cultivated crops because tospoviruses have a very broad host range. Therefore, elaborate inspections for tospoviruses and appropriate management strategies to limit virus spread are necessary for production of crops. To our knowledge, this is the first report of TZSV in I. tectorum Maxim. References: (1) I. Cortez et al. Arch Virol. 146:265, 2001. (2) J. Dong et al. Arch Virol. 153:855, 2008.

Growth hormone is a positive regulator of mammary gland development. Dairy animals that are administered growth hormone display enhanced lactation performance, a desirable agricultural trait. The objective of the current research was to generate an improved milk production phenotype in a large animal model using over-expressed GH in the mammary gland to promote mammogenesis. To this end, we constructed a mammary gland-specific expression vector, pcGH, and demonstrated effective GH expression in goat mammary epithelial cells in vitro by ELISA. Then, to produce transgenic offspring that were capable of stable GH expression in vivo, the linearized pcGH vector was electroporated into goat fetal fibroblasts. Cell colonies that were positive for GH were used as donors for nuclear transfer to enucleated oocytes. A total of 253 morulae or blastocytes developed from the reconstructed embryos were transferred to 56 recipients, resulting in 24 pregnancies at day 35. Finally, six transgenic goats were born. PCR detection confirmed the success of the cloning procedure. To observe the mammogenesis of dairy goats, the GH transgenic goats were mated with a completely healthy buck. In the later pregnancy period, the mammary gland of the GH transgenic goats were extensive than non-transgenic goats. These experiments indicated that the pcGH vector was incorporated into the transgenic goats and affected mammogenesis, which laid a solid foundation for elucidating the impact of GH on mammogenesis and lactation performance.

Dimocarpus longan Lour. is an edible and traditional herb in China, commonly referred to as longon. An improved randomly amplified polymorphic DNA (RAPD) protocol was here developed in order to determine the geographical origins of D. longan samples collected from 5 provinces in the southern and southwestern areas of China, including Sichuan, Hainan, Fujian, Guangdong, and Guangxi. Generally, the improved RAPD method generated good fingerprinting of the 5 samples using the selected 17 primers. In particular, primers SBS-A5, SBS-A13, SBS-I9, SBS-I20, SBS-M1, and SBS-Q12 produced distinguishable bands that clearly separated all 5 cultivars, suggesting that there are variations in RAPD genetic sites among the samples. The similarity index ranged from 0.69 to 0.76. The Sichuan and Hainan clades clustered together with a 0.73 similarity index. The Guangxi and Fujian clades clustered together with a 0.76 similarity index, and they formed the sister clade to the Sichuan/Hainan clade with a 0.71 similarity index. The Guangdong clade was in a basal polytomy with a 0.70 similarity index. Based on the abundant DNA polymorphisms, these longan accessions are distinguishable using our improved RAPD technique. Therefore, RAPD analysis is an effective technique in distinguishing the geographical origins of D. longan. Moreover, the improved method could also be employed for a variety of applications including genetic diversity and fingerprinting analyses.

The CURB-65 scoring system performs well at identifying patients with pneumonia who have a low risk of death. Whether it predicts mortality in community-acquired pneumonia (CAP) better than the 2007 Infectious Disease Society of America (IDSA)/American Thoracic Society (ATS) minor criteria in low-mortality-rate settings is not clear. The purpose of this study was to determine the hypothesis.A total of 1,230 adult inpatients admitted to our hospital from 2005 to 2009 for CAP were reviewed retrospectively.The hospital mortality was 1.3 %. Percentage mortality increased significantly with CURB-65 score and the increasing number of IDSA/ATS minor criteria present. The number of CURB-65 criteria or IDSA/ATS minor criteria present had significant increased odds ratios for mortality of 7.547 and 2.711, respectively. The sensitivities of a CURB-65 score of ≥ 3 and the presence of ≥ 3 minor criteria in predicting mortality was 25 % and 37.5 %, which increased to 75 % and 62.5 %, while the cut-off values reduced to ≥ 2 criteria, respectively. The area under the receiver operating characteristic curve for CURB-65 was greater than the corresponding area for IDSA/ATS minor criteria in predicting hospital mortality (0.915 vs. 0.805, p = 0.0091).CURB-65 score predicted hospital mortality better than IDSA/ATS minor criteria, and a CURB-65 score of ≥ 2 or the presence of ≥ 2 minor criteria might be more valuable cut-off values for "severe" CAP in a low-mortality-rate setting.

The standardization and validation of a one-step, single-tube, accelerated fluorescent-intercalating-dye-based reverse transcription loop-mediated isothermal amplification (RT-LAMP) assay targeting the NS3 gene of Japanese B encephalitis virus (JEV) is described for rapid, simple, and high-throughput detection of JEV. The amplification can be completed in 35 min under isothermal conditions at 63°C by employing a set of six primers targeting the NS3 gene of JEV. The RT-LAMP assay described demonstrated high sensitivity for detecting JEV, with a detection limit in swine samples of 8.13 PFU/ml. The specificity of the selected primer sets was established by cross-reactivity studies with pathogens that exhibit similar clinical signs and testing of samples from healthy animals. The clinical applicability of the RT-LAMP assay was validated using either spiked samples or samples from seasonal outbreaks. The comparative evaluation of the RT-LAMP assay revealed 79.59 % concordance with conventional RT-PCR targeting the E gene of JEV. The RT-LAMP assay reported here is a valuable tool for rapid real-time and high-throughput seasonal infection surveillance and quarantine after outbreak through blood sampling by using ordinary real-time PCR thermocyclers without purchasing an expensive Loopamp real-time turbidimeter.

Background: The CURB-65 (confusion, urea >7 mmol/l, respiratory rate ≥ 30 breaths/min, low blood pressure and age ≥ 65 years) score is a simple, well-validated tool for the assessment of severity in community-acquired pneumonia (CAP). It is unknown whether it is used routinely in China., Objective: To determine the frequency of use of the CURB-65 score in routine hospital practice and the consequences of non-implementation., Methods: A retrospective analysis of medical records from 1230 in-patients with CAP in a Chinese medical college-affiliated hospital., Results: No CAP patient underwent the CURB-65 test at admission. Based on the British Thoracic Society guidelines, the 716 (58.2%) in-patients with a CURB65 score of 0 and the 402 (32.7%) in-patients with CURB-65 score of 1 should have received ambulatory treatment, whereas the 14 (1.2%) patients with CURB65 scores of ≥ 3 should have been admitted to the critical care unit. The maximum excess total annual costs for managing CAP patients with CURB-65 scores of 0 and 1 were estimated at respectively US$94 383.12 and US$66 313.92 in the hospital., Conclusions: The CURB-65 scoring tool in patients with CAP was not applied in routine hospital practice, resulting in inappropriate hospitalisation and excess costs.

Summary: The impairment of osteoblast differentiation is one cause of the glucocorticoid-induced osteoporosis (GCOP). The quantitative proteomic analysis of the dexamethasone (DEX)-induced effects of osteoblast differentiation, proliferation, and apoptosis using stable-isotope labeling by amino acids in cell culture (SILAC) demonstrated drastic changes of some key proteins in MC3T3-E1 cells., Introduction: The impairment of osteoblast differentiation is one of the main explanations of GCOP. SILAC enables accurate quantitative proteomic analysis of protein changes in cells to explore the underlying mechanism of GCOP., Methods: Osteoprogenitor MC3T3-E1 cells were treated with or without 10(−6) M DEX for 7 days, and the differentiation ability, proliferation, and apoptosis of the cells were measured. The protein level changes were analyzed using SILAC and liquid chromatography-coupled tandem mass spectrometry., Results: In this study, 10(−6) M DEX inhibited both osteoblast differentiation and proliferation but induced apoptosis in osteoprogenitor MC3T3-E1 cells on day 7. We found that 10(−6) M DEX increased the levels of tubulins (TUBA1A, TUBB2B, and TUBB5), IQGAP1, S100 proteins (S100A11, S100A6, S100A4, and S100A10), myosin proteins (MYH9 and MYH11), and apoptosis and stress proteins, while inhibited the protein levels of ATP synthases (ATP5O, ATP5H, ATP5A1, and ATP5F1), G3BP-1, and Ras-related proteins (Rab-1A, Rab-2A, and Rab-7) in MC3T3-E1 cells., Conclusions: Several members of the ATP synthases, myosin proteins, small GTPase superfamily, and S100 proteins may participate in functional inhibition of osteoblast progenitor cells by GCs. Such protein expression changes may be of pathological significance in coping with GCOP.

The effect of the composition of the used standard reference material (SRM) on results of determination of fallout radionuclides in soil samples was studied. Using five soil types as SRMs, we measured the specific activity of (210)Pb and (137)Cs in six target samples of Chestnut soil. It was observed that the determination of the (210)Pb activity in the samples depended on the chemical composition of SRMs used to create the efficiency curves. Thus, using SRMs similar in chemical composition to the target samples should improve accuracy in the determination of (210)Pb in environmental samples., (Copyright © 2010 Elsevier Ltd. All rights reserved.)

We report the transport behavior of water molecules along a system of coaxial single-walled carbon nanotubes (SWCNTs) of different diameters with junctions under the driving force of methane molecules. The junctions are potential barriers to the transport of water molecules through SWCNTs. However, methane molecules can overcome these potential barriers and pull the water molecules across the junction region from one compartment to the next. Although a junction is an obstacle to water transport through SWCNTs, the presence of more junctions gives methane molecules a longer lasting driving force that helps them to pull the water molecules out of the SWCNTs.

The genus Elymus L. sensu lato includes Roegneria, Elymus, Hystrix, Sitanion and Kengyilia, and they are very important group in the tribe Triticeae. However, the phylogenetic relationships and taxonomic status of them are still in dispute. The ITS sequences were obtained and analyzed for their phylogenetic relationships by using Maximum Parsimony (MP) and Bayesian Inference (BI) methods. The main results were as follows: (1) Most species in Roegneria, Elymus and Sitanion were clustered in the St clade with diploid St genome species, and it was difficult to distinguish the species in Roegneria and Elymus; (2) The polyploid species with St genomes in the St clade were divided into three groups, which suggests that there exists differentiation of St genome in polyploids; (3) Most species of Kengyilia have only P-type of clone and clustered with diploid Agropyron species, which may suggest that Kengyilia is a valid genus; (4) Hy. patula, the type species of Hystrix was clustered with species of Elymus, while Hy. duthiei ssp. duthiei, Hy. duthiei ssp. longearistata, Hy. coreana and Hy. komarovii were grouped with diploid Psathyrostachys species. It indicated that Hy. patula is distinct related to other Hystrix species, and it is reasonable to treat Hystrix patula as Elymus hystrix and other species in Hystrix should be transferred to Leymus; (5) The "clones bias" in ITS sequences are widespread in the allopolyploid species.

The aim of the present study was to examine the interactions of fructose and fat on glucose regulation and lipid metabolism in CD-1 mice. Mice were assigned in five groups. The control group was provided with tap water and a gavage of vehicle; four experimental groups were treated with 150 g/l fructose solution (FS1), fat emulsion (FE), 150 g/l fructose solution and fat emulsion (FS1+FE), or 70 g/l fructose solution and fat emulsion (FS2+FE) for 12 weeks. At the end of the 8th week, both oral glucose tolerance test and insulin tolerance test were conducted. Lipid profiles in serum, liver, and red gastrocnemius muscle, and serum insulin and glucose concentrations were assessed. The FS1+FE group showed combined glucose intolerance (CGI) and decrease of insulin sensitivity. The low-density lipoprotein cholesterol (LDL-C) concentrations were elevated in all experimental groups (p<0.05). The combined diet groups showed statistically significant (p<0.01) increase in total cholesterol (TC) level in comparison with the control FE (p<0.05), or FS1 (p<0.05) group. Triglyceride levels in liver and red gastrocnemius muscle were significantly increased in FE and combined groups. In conclusion, combination of FE and 150 g/l fructose solution for 8 weeks led to CGI. Fructose enhanced the adverse effect of FE on glucose regulation with increasing percentage in the diet. Furthermore, there was a synergistic effect of fructose and fat on elevating the serum TC level.

This study investigated the effects of grape seed-derived procyanidins (GSP), gypenosides (GPE), and combination procyanidins/gypenosides on insulin resistance in mice and HepG2 cells. ICR mice were randomly divided into 2 control and 4 treatment groups. The control mice were to receive either normal diet (ND) or high-fat diet (HFD), and the treatment groups were fed high-fat diet with either 80 mg/kg of GSP (GSP80), GPE (GPE80), GSP + GPE (1: 1, GSP40 + GPE40), or 500 mg/kg of metformin for a 6-wk period. All the groups of mice except the normal control were on high-fat diet along with fructose (15%) administered in drinking water throughout the period of treatment. An insulin-resistant HepG2 cell model was developed after 24 h of 5 x 10(-7) mol/L insulin incubation. The treatment of GPE80 could significantly reduce the index of insulin resistance (HOMA-IR) and increase hepatic glycogen concentration, compared with HFD group (P < 0.05). When GSP and GPE were administered simultaneously, synergic effects were observed in decreasing the HOMA-IR index and serum total cholesterol (TC) level and enhancing glucose tolerance. All treatment groups showed considerable raise of hepatic glucokinase activity (P < 0.05 compared with HFD group). GSP application increased the consumption of extracellular glucose in HepG2 cells. Our data suggest that the combination of GSP and GPE may have functional efficacy in consumers with insulin resistance.

Based on the sequences of the internal transcribed spacers (ITS-1 and ITS-2) of nuclear ribosomal DNA (rDNA) for six taxa of anisakids, namely, Anisakis simplex (s.s.), Anisakis typica, Anisakis pegreffii, Hysterothylacium aduncum, Hysterothylacium sp, and Contracaccum osculatum C, specific primers were designed in the ITS-1 and/or ITS-2 for each of the six anisakid taxa. These specific primers were used to develop polymerase chain reaction (PCR) tools for the identification of these anisakid taxa of sea fish by amplifying partial ITS-1 and/or ITS-2 of rDNA from anisakid nematodes. This approach allowed their specific identification, with no amplicons being amplified from heterogeneous DNA samples, and sequencing confirmed the identity of the DNA fragments amplified. The minimum amounts of DNA detectable using the PCR assays were 0.5-1 ng. These PCR tools were then applied to ascertain the specific identity of 143 anisakid larval samples collected from fish in China, Canada, Thailand, and Indonesia, and these anisakid samples were identified to represent one of the six anisakid taxa. These PCR assays based on ITS sequences should provide useful molecular tools for the accurate identification and molecular epidemiological investigations of anisakid infections in humans and fish.

Measurements of SO(2) and NO(2) were conducted from January to March 2001 and August 2003 at a 325 m meteorological tower in Beijing. The concentrations of SO(2) and NO(2) observed by passive samplers at ten heights showed complex vertical distributions in winter and summer. The vertical profiles of pollutants were influenced by source emissions, meteorological conditions, urban canopy and other factors. The comparison analysis of winter and summer pollutant concentrations suggests that the decrease in SO(2) concentration was significant in summer, and the reduction of NO(2) was relatively not distinctive. Domestic heating and industrial sources were major sources of SO(2) in urban areas of Beijing. Differing from SO(2,) urban NO(2) was closely related to traffic emission. Meteorological evidence suggests that strong temperature inversions influence vertical distribution of air pollutants over urban Beijing. The high levels of SO(2) and NO(2) concentrations were due to the accumulation of pollutants resulting from the stable atmosphere prevalent during the measurement period. The vertical distributions of air pollutants were controlled and affected by atmospheric dynamical characteristics.

Using genetic markers defined previously in the second internal transcribed spacer (ITS-2) of nuclear ribosomal DNA (rDNA), isotopic, and non-isotopic polymerase-chain-reaction-coupled single-strand conformation polymorphism (SSCP) were utilized to identify each of three anisakid species [Anisakis simplex (s.l.), Contracaecum osculatum (s.l.), and Hysterothylacium aduncum] from different host species and geographical locations in Poland and Sweden. While subtle microheterogeneity was observed within each of Anisakis simplex (s.l.) and H. aduncum, distinct SSCP profiles were displayed for each of the three species, allowing identification and differentiation of the three taxa. Subsequent sequencing of the ITS-1 and ITS-2 rDNA revealed that A. simplex (s.l.) represented Anisakis simplex s.s. and Contracaecum osculatum (s.l.) represented C. osculatum C. Application of the non-isotopic SSCP assay of ITS-2 to larval anisakid samples from different hosts and geographical locations in China revealed three distinct SSCP profiles, one of which was consistent with that of A. simplex (s.l.), and the other two had different SSCP profiles from that of C. osculatum C and H. aduncum. Sequencing of the ITS-1 and ITS-2 rDNA for representative Chinese anisakid samples examined revealed three anisakid species in China, i.e., Anisakis typica, Anisakis pegreffii, and Hysterothylacium sp. These molecular tools will be useful for identification and investigation of the ecology of anisakid nematodes in China and elsewhere.

In this study, batch experiments were conducted to investigate the inhibitory effects of NaCl on H2 production from glucose by anaerobic mixed cultures. Experimental results demonstrate that NaCl concentration had significant inhibitory effects on glucose degradation, cumulative H2 production, specific H2 production rate, H2 yield and the distribution of aqueous products. The specific H2 production rate had a negative correlation with NaCl concentrations. The NaCl concentrations, at which the specific H2 production rate and H2 yield were reduced by 50%, were estimated as 209 mM and 443 mM, respectively.

Aims: This study attempted to employ response surface methodology (RSM) to evaluate the effects of glutamate concentration and pH on H(2) production from volatile fatty acids by Rhodopseudomonas capsulata., Methods and Results: A mixture of acetate, propionate and butyrate was used as a carbon source for the H(2) production by R. capsulata. The H(2) yield and H(2) production rate were strongly affected by the glutamate concentration, pH and their interaction. The predicted maximum H(2) yield of 0.534 was obtained when glutamate concentration and pH were 6.56 mmol l(-1) and 7.29 respectively. On the contrary, the maximum H(2) production rate of 18.72 ml l(-1) h(-1) was achieved at a glutamate concentration of 7.01 mmol l(-1) and pH 7.31., Conclusions: Taking H(2) yield and H(2) production rate together into account, a glutamate concentration of 6.56-7.01 mmol l(-1) and pH of 7.29-7.31 should be selected for H(2) production from a mixture of acetate, propionate and butyrate by R. capsulata., Significance and Impact of the Study: The RSM was a useful tool for maximizing H(2) production by photosynthetic bacteria (PSB).

Coke-plant wastewater was treated by an anaerobic-anoxic-aerobic (A(1)-A(2)-O) biofilm system and an anoxic-aerobic (A/O) biofilm system, respectively. At same or similar levels of hydraulic retention time (HRT), the two systems had almost identical chemical oxygen demand (COD) and NH(3) removals, but a different organic-N removal. Set-up of an acidogenic stage benefited for the removal of organic-N and the A(1)-A(2)-O system was more useful for total nitrogen removal than the A-O system. HRT did not have a substantial effect on the COD and NH(3)-N removal efficiencies, but considerably influenced the organic-N removal and distribution of oxidized nitrogen in the final effluent. The GC/MS analysis demonstrated that some refractory compounds were decomposed at the acidogenic stage and resulted in the production of some intermediates, which were more readily degraded in the subsequent aerobic stage. Hence, the A(1)-A(2)-O system had better effluent quality than the A-O system in terms of effluent composition.

Continuous experiments were conducted to study the hydrolysis and acidogenesis of sewage sludge in an upflow reactor with an agitator and a gas-liquid-solid separator. Results of this study showed that 34-78% of volatile suspended solids (VSS) in sewage sludge was hydrolyzed at pH in the range 4.0-6.5, 35 degrees C and 4-24 hours of hydraulic retention time (HRT). About 31-65% of carbohydrate in sewage sludge, 20-45% of protein and 14-24% of lipid were acidified in this reactor. Hydrogen production was favored in lower pH and HRT, whereas methane production was encouraged at higher pH and HRT. Acetate, propionate, butyrate, and i-butyrate were the main aqueous acidogenic products. The distribution of these compounds in the effluent was more sensitive to pH, but was less sensitive to HRT. The maximu specific COD solubilization rate and specific volatile fatty acids production rate were 126 mg-COD/g-VSS x d and 102 mg-VFAIg-VSS x d, respectively. Compared with a CSTR, this modified upflow reactor was shown to be a more promising biosystem for the hydrolysis and acidogenesis of sewage sludge.

Experiments were conducted to study the acidogenesis of a dairy wastewater in batch reactors at pH 5.5 and 55 degrees C. There was a biased fermentation sequence for carbohydrate and protein, and the protein fermentation was delayed by carbohydrate. The production of hydrogen was exclusively from the fermentation of carbohydrate. Acetate and butyrate concentrations both increased rapidly at the beginning and peaked at some points, then declined in the reactors fed with 8 g-COD (chemical oxygen demand)/l, or higher concentrations. Butanol and propanol fractions increased with the substrate concentration. The metabolism shifted from the volatile fatty acid-producing pathways to the alcohol-producing pathways when the substrate concentration increased beyond 8 g-COD/l. The acidogenic biomass yield was in the range 0.19-0.25 mg-VSS/mg-COD.

Acidogenesis of dairy wastewater produced volatile fatty acids, mainly acetate and propionate, plus hydrogen as by-product. Zinc (Zn) inhibited acidogenesis at concentrations over 10 mg l(-1); but at 10 mg l(-1), or less, it enhanced acidogenesis slightly. On the other hand, copper (Cu) inhibited acidogenesis at all tested concentrations ranging 5-400 mg l(-1). Production of acetate was inhibited by both metals at all concentrations; but production of propionate and hydrogen was favored at low concentrations of Zn (up to 80 mg l(-1)) and Cu (up to 40 mg l(-1)). Production of hydrogen corresponded with the degradation of carbohydrate and the production of propionate. Overall, Cu was 1.4-4.3 folds more toxic than Zn, according to the overall production patterns of fatty acids and hydrogen as well as degradation patterns of carbohydrate and protein.

Batch and continuous experiments were conducted to study the influence of dairy wastewater strength (2-30g-COD/L) on acidification at pH 5.5 and 37 degrees C. Results of batch experiments showed that carbohydrate was preferentially acidified as compared to protein and lipid. Production of VFAs (mainly acetate, propionate and butyrate) and hydrogen corresponded to carbohydrate acidification, whereas production of alcohols (mainly ethanol, propanol and butanol), plus i-butyrate and higher molecular-weight VFAs, corresponded to protein acidification. In treating high-strength wastewaters (8-30 g-COD/ L), acetate, butyrate and P(H2) decreased after reaching their peak levels before leveling off. Results of continuous experiments with 12h of hydraulic retention showed that acidification decreased with the increase of wastewater COD, from 57.1% at 2 g-COD/L to 28.8% at 30 g-COD/L; among the constituents in dairy wastewater, 92-99% of carbohydrates, 59-85% of protein and 12-42% of lipid were acidified. High-strength wastewater favored production of hydrogen and alcohols, especially propanol and butanol. The biomass yield was 0.258g-VSS/g-COD.

Two upflow anaerobic sludge blanket (UASB) reactors were concurrently operated for 146 days to examine the effects of aluminum chloride (AlCl3) on the sludge granulation process during start-up. Sludge granulation (defined as that over 10% of granules were larger than 2.0 mm) was achieved in the control reactor (R1) in approximate three months. Introduction of Al3+ at a concentration of 300 mg/l reduced the sludge granulation time by approximate one month. Throughout the experiment the AlCl3-added reactor (R2) had a higher biomass concentration, e.g., 13.8 g-MLVSS/l versus 12.8 g-MLVSS/l on Day 146. Granules became visible earlier in R2 compared with R1 (35 days versus 65 days). The average size of granules from R2 was larger than that from R1. The results demonstrated that AlCl3 enhanced the sludge granulation process in the UASB reactors.

Six upflow anaerobic sludge blanket (UASB) reactors were concurrently operated for 146 d to examine the effects of calcium on the sludge granulation process during start-up. Introduction of Ca2+ at concentrations from 150 to 300 mg/l enhanced the biomass accumulation and granulation process. The calcium concentration in the granules was nearly proportional to the calcium concentration in the feed, and calcium carbonate was the main calcium precipitate in the granules. The specific activity of granules decreased with increasing influent calcium concentration. The optimum calcium concentration for the granulation was from 150 to 300 mg/l. The addition of low-concentration calcium to the UASB reactors appeared to enhance the three steps of sludge granulation: adsorption, adhesion and multiplication, but it did not lead to a different proliferation of predominant microorganisms in the granules.

The effects of chromium (III) and cadmium on the anaerobic acidogenesis of a simulated dairy waste were examined using serum vials. At Cd dosages less than 20 mg/l, the acidogenesis process was enhanced by the dosage, resulting in a higher degree of acidification, protein conversion, and hydrogen production than the control. At dosages over 20-mg/l, Cd inhibited the acidogenesis. The Cr (III) dosage of 5 mg/l reduced overall volatile fatty acid and alcohol generation, degree of acidification, conversions of lactose, lipid and protein, and total biogas production, with the exception of accumulation of hydrogen and propionate. At dosages exceeding 5 mg/l, Cr (III) had a severe inhibition on the acidogenesis. The Cd concentrations which caused a 50% reduction in total volatile fatty acid and alcohol production, degree of acidification and cumulative gas production were higher than the corresponding values caused by Cr (III), suggesting that Cr (III) was more toxic to acidogenic bacteria than Cd.

Acidification of simulated dairy wastewater was conducted in an upflow reactor at 55 degrees C. Results showed that the degree of acidification decreased with the increase in chemical oxygen demand (COD) loading rate, from 60.8% at 4 g l(-1) day(-1) to 27.1% at 24 g l(-1) day(-1). Carbohydrate was readily degraded at all loading rates, but degradation of protein and lipid decreased with the increase in loading rate. Most carbohydrate degradation occurred at the reactor bottom, whereas protein was degraded mainly after the carbohydrate became depleted. The predominant acidification products were acetate, propionate, butyrate and ethanol, whereas formate, i-butyrate, valerate, i-valerate, caproate, lactate, methanol, propanol and butanol were present in lesser quantities. The increase in loading rate resulted in the increase of propionate and the decrease of acetate, but had little effect on ethanol and butyrate productions. Only 2.5-8.8% of influent COD was converted to hydrogen and methane. The biomass yield was 0.30-0.43 mg VSS mg(-1) COD.

One hundred eleven thymic tumors were intervened surgically, including 92 thymoma, 8 thymic carcinoid, and 10 thymic carcinoma. In this series 50.9% of the cases were complicated with various syndrome, 44.5% with myasthenia gravis (MG), more frequently in the epithelial cell type. Pure red cell aplasia often associated with the spindle-cell thymoma. Of the thymic carcinoid 50% had ectopic ACTH syndrome. Resection rate correlated with the size and invasion of the tumor. There were significant difference in resection rate among thymoma, thymic carcinoid, and thymic carcinoma. The degree of invasion undoubtedly influenced on resection. The 3-, 5-, and 10-year survival rates of the thymoma were 82.7%, 68.1% and 40.0% respectively. The prognosis depended on the pathological classification and the severity of neighbouring invasion, but MG had no significant effect on prognosis. Recurrence and metastasis of the tumor remained to be the main cause of late death.

Cytogenetic study of a patient with acute promyelocytic leukemia (APL) showed an unusual karyotype 46,xy,t(11;17) (q23;21) without apparent rearrangement of chromosome 15. Molecular studies showed rearrangements of the retinoic acid receptor alpha (RAR alpha) gene but no rearrangement of the promyelocytic leukemia gene consistent with the cytogenetic data. Similar to t(15;17) APL, all-trans retinoic acid treatment in this patient produced an early leukocytosis which was followed by a myeloid maturation, but the patient died too early to achieve remission. Further molecular analysis of this patient showed a rearrangement between the RAR alpha gene and a newly discovered zinc finger gene named PLZF (promyelocytic leukemia zinc finger). The fusion PLZF-RAR alpha gene found in this case, was not found in DNA obtained from the bone marrow of normals, APL with t(15;17) and in one patient with AML-M2 with a t(11;17). Fluorescence in situ hybridization using a PLZF specific probe localized the PLZF gene to chromosomal band 11q23.1. Partial exon/intron structure of the PLZF gene flanking the break point on chromosome 11 was also established and the breakpoint within the RAR alpha gene was mapped approximately 2 kb downstream of the exon encoding the 5' untranslated region and the unique A2 domain of the RAR alpha 2 isoform.

Between February and October 1991, 530 consecutive patients underwent myocardial revascularization or valvular surgery with warm continuous antegrade and retrograde cardioplegia (37 degrees C). Three hundred and thirty three patients had isolated myocardial revascularization, 159 valvular surgery alone and 25 had combined valvular and coronary bypass. The global mortality was 5.1%, 3.7% for coronary bypass, 7.5% for valvular surgery and 8% for combined valvular and coronary surgery. A multivariate analysis identified the "reperfusion time" as the only predictive factor of hospital mortality (p < 0.001). Intraortic balloon counterpulsation was required postoperatively in 3.2% of cases, 5.2% of coronary bypass and 0.8% of the valvular patients. Inotropic drugs were used to come off cardiopulmonary bypass in 16.5% of coronary and 37.5% of valvular patients. There were 0.9% perioperative infarctions: 1.2% in the coronary bypass cases and 0.6% in the valvular cases. Spontaneous return to sinus rythm was observed in 87.9% of cases. The average "reperfusion time" was 20.48 +/- 0.7 mn. Analysis of the influence of aortic cross clamp time on cardiac morbidity in two groups of coronary patients (Group I: short cross clamp time less than 60 mn; Group II: long cross clamp time, 60 to 33 mn) showed that the hospital mortality, the prevalence of the use of inotropic drugs and balloon counterpulsation the postoperative cardiac index, the rate of spontaneous de fibrillation and the reperfusion time did not depend on the aortic cross clamp time. Cardiac morbidity.

One hundred fifteen consecutive patients were operated on for myocardial revascularization or valvular disease or both with continuous antegrade and retrograde aerobic warm (37 degrees C) blood cardioplegia. Mean cross-clamp time was 56.3 +/- 21 minutes (+/- standard deviation). Mean reperfusion time was 18.4 +/- 11.8 minutes (range, 5 to 81 minutes). Five patients (4.3%) died, and 15 (13%) needed inotropic support. Two (1.7%) required intraaortic balloon support. Two patients (1.7%) had evidence of perioperative myocardial infarction, and 98 (85%) returned spontaneously to normal sinus rhythm. Sixteen patients had a cross-clamp time greater than 80 minutes. All 16 of them had an uneventful postoperative course except for 1 patient who required inotropic drugs. This method of myocardial protection is now used for all open heart procedures in our institution.