heart

摘要： Oxygen is essential for most life forms.Insufficient oxygen supply can disrupt homeostasis and compromise survival,and hypoxia-induced cardiovascular failure is fatal in many animals,including humans.However,certain species have adapted and evolved to cope with hypoxic environments and are therefore good models for studying the regulatory mechanisms underlying responses to hypoxia.Here,we explored the physiological and molecular responses of the cardiovascular system in two closely related hypoxiaadapted species with different life histories,namely,Qinghai voles(Neodon fuscus)and Brandt’s voles(Lasiopodomys brandtii),under hypoxic(10%O_(2) for 48 h)and normoxic(20.9%O_(2) for 48 h)exposure.Kunming mice(Mus musculus)were used for comparison.Qinghai voles live in plateau areas under hypoxic conditions,whereas Brandt’s voles only experience periodic hypoxia.Histological and hematological analyses indicated a strong tolerance to hypoxia in both species,but significant cardiac tissue damage and increased blood circulation resistance in mice exposed to hypoxia.Comparative transcriptome analysis revealed enhanced oxygen transport efficiency as a coping mechanism against hypoxia in both N.fuscus and L.brandtii,but with some differences.Specifically,N.fuscus showed upregulated expression of genes related to accelerated cardiac contraction and angiogenesis,whereas L.brandtii showed significant up-regulation of erythropoiesis-related genes.Synchronized upregulation of hemoglobin synthesis-related genes was observed in both species.In addition,differences in cardiometabolic strategies against hypoxia were observed in the rodents.Notably,M.musculus relied on adenosine triphosphate(ATP)generation via fatty acid oxidation,whereas N.fuscus shifted energy production to glucose oxidation under hypoxic conditions and L.brandtii employed a conservative strategy involving down-regulation of fatty acid and glucose oxidation and a bradycardia phenotype.In conclusion,the cardiovascular systems of N.fuscus and L.brandtii have evolved different adaptation strategies to enhance oxygen transport capacity and conserve energy under hypoxia.Our findings suggest that the coping mechanisms underlying hypoxia tolerance in these closely related species are context dependent.

摘要： Heart disease is one of the leading causes of death in the world today.Prediction of heart disease is a prominent topic in the clinical data processing.To increase patient survival rates,early diagnosis of heart disease is an important field of research in the medical field.There are many studies on the prediction of heart disease,but limited work is done on the selection of features.The selection of features is one of the best techniques for the diagnosis of heart diseases.In this research paper,we find optimal features using the brute-force algorithm,and machine learning techniques are used to improve the accuracy of heart disease prediction.For performance evaluation,accuracy,sensitivity,and specificity are used with split and cross-validation techniques.The results of the proposed technique are evaluated in three different heart disease datasets with a different number of records,and the proposed technique is found to have superior performance.The selection of optimized features generated by the brute force algorithm is used as input to machine learning algorithms such as Support Vector Machine(SVM),Random Forest(RF),K Nearest Neighbor(KNN),and Naive Bayes(NB).The proposed technique achieved 97%accuracy with Naive Bayes through split validation and 95%accuracy with Random Forest through cross-validation.Naive Bayes and Random Forest are found to outperform other classification approaches when accurately evaluated.The results of the proposed technique are compared with the results of the existing study,and the results of the proposed technique are found to be better than other state-of-the-artmethods.Therefore,our proposed approach plays an important role in the selection of important features and the automatic detection of heart disease.

摘要： Protozoan diseases such as Visceral Leishmaniasis (VL) have re-emerged in Northern Brazil and cases of Chagas Disease also occur. This VL increase leads to early therapy for the public. Confirmatory parasitological diagnoses in VL are performed by bone marrow or spleen aspiration, but ELISA, IFA or immunochromatographic tests for antibody detection are easily performed and can be used in the presence of clinical signs as confirmatory for specific therapy. This approach is successful in providing therapy and prevention of death in VL, but there is a chance of confusion with the emerging disease, Chagas Disease (CD), due to cross-reacting and similar clinical pictures, as in this case. Both VL and CD presented many asymptomatic or oligosymptomatic cases, complicating the picture. Our case report emphasizes these aspects. Positive serology, with an IIF titer of 1/160, and epidemiological correlation, suggests the diagnosis of VL and imposes antimony therapy. Despite the unfavorable evolution and signs of cardiac involvement, the presence of pericarditis and cardiac tamponade confirmed by the echocardiogram suggests CD. We reassessed the profiles of a suggested CD serology, the diagnosis was corrected and treatment with CD specific benznidazole. The good evolution started with benznidazole corroborates the diagnosis of CD and discards the hypothesis of double infection.

摘要： BACKGROUND Bacterial translocation exacerbates the hyperdynamic circulation observed in cirrhosis and contributes to a more severe disease course.Probiotics may reduce bacterial translocation and may therefore be useful to redress the circulatory imbalance.AIM To investigate the effect of probiotics on hemodynamic parameters,systemic inflammation,and complications of cirrhosis in this randomized placebocontrolled trial.METHODS This single-blind randomized placebo-controlled study included 40 patients with Child-Pugh class B and C cirrhosis;24 patients received probiotics(Saccharomyces boulardii)for 3 mo,and 16 patients received a placebo over the same period.Liver function and the systemic hemodynamic status were evaluated pre-and postintervention.Echocardiography and simultaneous blood pressure and heart rate monitoring were performed to evaluate systemic hemodynamic indicators.Cardiac output and systemic vascular resistance were calculated.RESULTS Following a 3-mo course of probiotics in comparison to the control group,we observed amelioration of hyperdynamic circulation[a decrease in cardiac output(P=0.026)and an increase in systemic vascular resistance(P=0.026)]and systemic inflammation[a decrease in serum C-reactive protein levels(P=0.044)],with improved liver function[an increase in serum albumin(P=0.001)and a decrease in the value of Child-Pugh score(P=0.001)]as well as a reduction in the severity of ascites(P=0.022),hepatic encephalopathy(P=0.048),and cholestasis[a decrease in serum alkaline phosphatase(P=0.016)and serum gamma-glutamyl transpeptidase(P=0.039)activity]and an increase in platelet counts(P<0.001)and serum sodium level(P=0.048).CONCLUSION Probiotic administration was associated with amelioration of hyperdynamic circulation and the associated complications of cirrhosis.

摘要： 人体词“心(heart)”属于常用词汇,具有构词能力强的特点。从对比的角度对汉英人体词“心(heart)”的词汇系统进行分析,得出三个不同特点:两者的书写形式不同,两者的词义不对等以及两者构词的结构方式不同。

摘要： 我们都知道,学生是学习的主体,一切的教学活动最后都要归结到学生的"学习"上,只有学生有了学习的热情才能够主动地积极地去学习,才能够达到学习的最佳效果.而英语作为一门外国语言,在学习的过程中由于受到客观环境的影响,不能像学习母语那样有着随时随地可以交流学习的有利条件,加上繁重的课业负担,单词的反复记忆,长句、难句、课文等的枯燥学习,有些小学生在学习的过程中渐渐失去了热情.本文主要分析如何用心——HEART来激发小学生学习英语的热情.

摘要： 随着“健康中国2030”战略对医学人文素养的重视,对高素质护理人才的培养提出了更高的要求。现阶段医学教育对护生人文精神培育方面缺乏足够重视,实效性尚不理想。通过提出以“医者之心”(HEART)课程体系为核心的创新性人文精神培育模式,使用多种教学方法,从开展护理专业及人文特色课程入手,融入医疗服务实践活动、网络交互平台及使用跨学科小组的学习模式来实践护生人文教育的培育。形成多学科交融且贯穿护理教育全程的全方位多层次临床实践创新机制,提升高层次护理人才服务健康中心战略的能力。

摘要： 随着"健康中国2030"战略对医学人文素养的重视,对高素质护理人才的培养提出了更高的要求.现阶段医学教育对护生人文精神培育方面缺乏足够重视,实效性尚不理想.通过提出以"医者之心"(HEART)课程体系为核心的创新性人文精神培育模式,使用多种教学方法,从开展护理专业及人文特色课程入手,融入医疗服务实践活动、网络交互平台及使用跨学科小组的学习模式来实践护生人文教育的培育.形成多学科交融且贯穿护理教育全程的全方位多层次临床实践创新机制,提升高层次护理人才服务健康中心战略的能力.

摘要： Objective:To compare the value of HEART and TIMI scores in predicting major adverse cardiovascular events(MACEs)of patients with chest pain in the emergency department at a tertiary care hospital in Ahmedabad,a city in western India.Methods:A prospective study was conducted on chest pain patients from January to December 2019.All adult patients with non-traumatic chest pain presenting to the emergency department were included,and their HEART and TIMI scores were evaluated.The patients were followed up within 4 weeks for monitoring any major adverse cardiac events or death.The receiver-operating characteristics(ROC)curve was used to determine the value of HEART and TIMI scores in predicting MACEs.Besides,the specificity,sensitivity,positive predictive value(PPV),and negative predictive value(NPV)of the two scores were assessed and compared.Results:A total of 350 patients were evaluated[mean age(55.03±16.6)years,56.6%of males].HEART score had the highest predictive value of MACEs with an area under the curve(AUC)of 0.98,followed by the TIMI score with an AUC of 0.92.HEART score had the highest specificity of 98.0%(95%CI:96.4%-99.6%),the sensitivity of 75.0%(95%CI:70.7%-79.3%),and PPV of 97.0%(95%CI:94.1%-99.9%)and NPV of 82.5%(95%CI:74.6%-90.4%)for low-risk patients.TIMI score had a specificity of 95.0%(95%CI:92.4%-97.6%),sensitivity of 75.0%(95%CI:69.4%-80.6%),PPV of 92.3%(95%CI:88.1%-96.5%)and NPV of 82.3%(95%CI:73.8%-90.8%)for low-risk patients.Conclusions:HEART score is an easier and more practical triage instrument to identify chest pain patients with low-risk for MACEs compared to TIMI score.Patients with high HEART scores have a higher risk of MACEs and require early therapeutic intervention and aggressive management.

摘要： Glucocorticoids(GCs)have been the mainstay of immunosuppressive therapy in solid organ transplantation(SOT)for decades,due to their potent effects on innate immunity and tissue protective effects.However,some SOT centers are reluctant to administer GCs long-term because of the various related side effects.This review summarizes the advantages and disadvantages of GCs in SOT.PubMed and Scopus databases were searched from 2011 to April 2021 using search syntaxes covering“transplantation”and“glucocorticoids”.GCs are used in transplant recipients,transplant donors,and organ perfusate solution to improve transplant outcomes.In SOT recipients,GCs are administered as induction and maintenance immunosuppressive therapy.GCs are also the cornerstone to treat acute antibody-and T-cell-mediated rejections.Addition of GCs to organ perfusate solution and pretreatment of transplant donors with GCs are recommended by some guidelines and protocols,to reduce ischemia-reperfusion injury peri-transplant.GCs with low bioavailability and high potency for GC receptors,such as budesonide,nanoparticle-mediated targeted delivery of GCs to specific organs,and combination use of dexamethasone with inducers of immuneregulatory cells,are new methods of GC application in SOT patients to reduce side effects or induce immune-tolerance instead of immunosuppression.Various side effects involving different non-targeted organs/tissues,such as bone,cardiovascular,neuromuscular,skin and gastrointestinal tract,have been noted for GCs.There are also potential drug-drug interactions for GCs in SOT patients.