BACKGROUND: Apoptosis plays a key role in intestinal mucosal ischemia-reperfusion injury and recovery; meanwhile, effect of shenfu injection on apoptosis of intestinal epithelial cells during intestinal mucosal ischemia-reperfusion injury should be studied further.OBJECTIVE: To investigate the relationship between the apoptosis of intestinal epithelium and characteristics of intestinal mucosal ischemia-reperfusion injury and recovery.DESIGN: Randomized controlled animal experiment.SETTING: Department of General Surgery, Xianning Central Hospital;Department of General Surgery, Renmin Hospital of Wuhan University.MATERIALS: The experiment was carried out in the Central Laboratory,Xianning Central Hospital from March to August 2005. Fifty-four healthy male SD rats weighting 200-250 g were provided by Animal Center of Medical School, Wuhan University.METHODS: The rats were divided randomly into 3 experimental groups:control group (n=6), ischemia-reperfusion group (n=24) and shenfu treatment group (n=24). ① Pentobarbital sodium solution (40 mg/kg) was administrated into the intraperitoneal cavity to induce anaesthesia. Through a midline abdominal incision, the mesenteric blood vessel of a 15-cm segment of mid-intestine was occluded for 60-minute with an atraumatic vascular forceps. The control group underwent the same procedure except for unblocking the mesenteric blood vessel. At the end of 60 minutes ischemia period the forceps was removed to allow reperfusion, the abdominal cavity was closed. ShenFu injection (8 mL/kg ·h, 20 mL/kg ·d, produced from Yaan Three-Nine Pharmaceuticals Co, No: 030302) was injected 30 minutes before occlusion in SF treatment group, same quantity of 0.9% natrii chloride was injected in control group and ischemia-regeneration group at the same time, and oxygen was inbreathed during the operation and ischemia-regeneration. ② Experimental intestinal canals were sampled for the following analysis when all groups were respectively performed sham ischemia for 1 hour, intestinal ischemia for 1 hour and reperfusion for 1, 24and 72 hours. Sections were observed in light microscope. Histological mucosal damage in each sample was evaluated as followed scoring system: 0score, normal muscosal villi and gland; 1 score, slight lesion near the tip of the villi; 2 scores, slight lesion of subepithelial gland; 3 scores, development of subepithelial (Gruenhagen) spaces near the tip of the villi with capillary congestion; 4 scores, extension of the subepithelial space with moderate epithelial lifting from the lamina propria; 5 scores, a few denuded villous tips; 6 scores, massive denuded villi; 7 scores, denuded villi with exposed lamina propria and obvious gland lesion; 8 scores, disintegrateon of the lamina propria; 9 scores, haemorrhage and ulceration. ③ The Tunel method (TdT mediated biotin-dUTP nick and labeling; TdT-Frag EL DNA fragmentation detection kit) was used. Inbrief, this method allowed the identification of apoptosis nuclei in tissue samples through DNA fragment and labeling. Apoptosis Index (AI) was set as the average number of apoptosis cells in per 100 cells by observing ten high power fields of adjacent villi and crypts. ④ The mitotic phase of crypt epithelial nucleus within intestinal mucosa was observed in intestinal sections stained with haematoxylin and eosin. The number of cells with nucleus mitotic phase was counted in ten adjacent mucosal crypts, which was taken as the index of mitotic activity of intestinal mucosal epithelial cell.MAIN OUTCOME MEASURES: Intestinal mucosal histopathological changes, apoptosis of intestinal mucosal epithelial cell and mitotic activity of intestinal mucosal crypt.RESULTS: All 54 rats were involved in the final analysis. ①) Scores of histopathological changes were (0.65 ±0.35) points in 1-hour ischemia group, (3.87±0.86) points in 1-hour reperfusion group and (0.65±0.35)points in 24-hour reperfusion group; which were lower than those in ischemia-reperfusion group [(7.11±1.01), (8.05±1.34), (1.53±0.48) points; P＜ 0.05]. ② Indexes of apoptosis were 17.24±7.05 in 1-hour ischemia group, 24.20±9.87 in 1-hour reperfusion group, 11.49±4.71 in 24-hour reperfusion group and 6.02±2.16 in 72-hour reperfusion; which were lower than those in ischemia-reperfusion group (51.09±13.76, 54.89±15.58,23.54±9.64, 12.47±5.52; P ＜ 0.05). Activities of mitosis were 10.37±2.03and 11.72±2.07 in 1-hour ischemia group and 1-hour reperfusion group,respectively; which was higher than those in ischemia-reperfusion group(8.24±1.69, 9.95±1.93; P ＜ 0.05).CONCLUSION: Shenfu injection can significantly attenuate apoptosis of intestinal epithelium, increase crypt mitotic activity, and promote intestinal epithelium regeneration or repair.

Objective To investigate the effects of different marriage modes of parents on mental health of Mosuo middle school students.Methods Basic information questionnaire and symptom checklist-90 (SCL-90)were adopted to compare and to analyze 226 Mosuo students' mental health condition with regard to different marriage modes of parents.Results (1) In the comparison between the students from Monogamous Marriage families and the students from the Walking marriage families,the mean scores of somatization and depression were higher in the former group than in the latter group(0.73 ± 0.59 vs 0.58 ± 0.46,P＜ 0.05 ;0.87 ±0.65 vs 0.70 ±0.52,P＜ 0.05).(2)Among the students fromWalking marriage families,the mean scores of interpersonal sensitivity,depression,anxiety and phobic anxiety were higher in girls than those in boys (1.10 ± 0.76 vs 0.80 ±0.47,P＜0.05;0.83 ±0.54 vs 0.58 ±0.48,P＜0.05;0.99 ±0.71 vs 0.62 ±0.48,P＜0.05;0.99 ±0.77 vs 0.55 ± 0.53,P＜ 0.05).(3) Among the students from Walking-Marriage families,some students had closer relationship with their fathers,and some were closer to maternal uncles,the mean scores of somatization,obsessivecompulsive factor and hostility were higher in the former sub-group than in the latter sub-group (0.69 ± 0.52 vs 0.43 ±0.34,P＜0.05;1.22 ±0.46 vs 1.01 ±0.59,P＜0.05;0.94±0.66 vs0.65 ±0.57,P＜0.05).Conclusion The mental health status of Mosuo students are different regarding the marriage modes of their parents.In the Walking-Marriage families,the mental health of Mosuo students has relationship with their gender and the male whom the students are closer to.

Objective To explore phenotypic modulation of vascular smooth muscle cells(VSMC) and change of p38 mitogen-activated protein kinase(MAPK) expression after intimal injury of rabbit carotid arteries. Methods The model of vascular restenosis established by balloon injury of rabbit carotid common arteries was used.HE staining,immunohistochemistry staining and Western blot were used to detect the change of proliferation cell nuclear antigen(PCNA),smooth muscle ?-actin(SM?-actin),p38 expression and morphology of sham-injured arteries and injured arteries at different time points.Results ⑴The proliferating VSMC was observed on the side of the medium lumen at 1 day and on the surface of vascular lumen at 3 days after injury.The neointima was formed and gradually being thicken at 5～7 days,and the thickening was accelerated at 14～35 days after injury.⑵PCNA was negative in the medium and endothelium of sham-injured arteries.Positive cell rate of PCNA was gradually increased at 1～14 days in the medium and at 5～14 days in the neointima after injury,with the maximum rate at 14 days.However,it declined gradually after 28 days.Positive cell rate of PCNA in the neointima was slightly higher than that in the medium.⑶SM?-actin was positive in the medium,negative in the endothelium of sham-injured arteries.Positive cell area of SM?-actin initially decreased at 1 day in the medium after injury with the minimum rate at 3 days,but it increased gradually after 5 days.Expression of SM?-actin in the neointima was slightly less than that in the medium.⑷p38 expression was very low or negative in the medium of sham-injured arteries.Expression of p38 was sustained and increased at 1～35 days after injury with the most remarkable elevation at 3～14 days.Expression of p38 in the neointima was higher than that in the medium.There was positive relationship between the p38 expression and PCNA expression in the vascular wall at different time points after injury.Elevation of p38 was earlier than decrease of SM?-actin.Conclusion There was a close relationship between the phenotypic modulation and proliferating ability of VSMC.P38 participated in signal transduction of phenotypic modulation of VSMC after intimal injury.

Objective:To survey on the status quo of the management capabilities of general practice team leaders in community health service centers in Shanghai.Methods:Using stratified sampling method, 18 community health service centers in the urban and suburban areas of Shanghai were selected, then the general practice team leaders and general practitioners (team members) in the centers were selected as the study participants. The questionnaire survey on the management capabilities of general practice team leaders was conducted among selected participants from November to December 2021. The self-assessment by general team leaders and the other-assessment by team members were carried out, and the total scores was calculated according to the weight of self-evaluation score (30%) and other-evaluation score(70%).Results:A total of 110 general practice team leaders and 749 team members participated in the survey. Among the team leaders, 63.64% (70/110) were females, 82.73% (91/110) were bachelor degree holders, 71.82% (79/110) had intermediate professional title, and 50.91% (56/110) worked for more than 9 h per day. The total score of general practice team leaders was (87.15±10.76) points, the other-assessment score was significantly higher than self-assessment score ((88.62±9.34) vs.(83.71±14.08), t=2.22, P<0.05). The average score of the 5 dimensions was 4.41 for special business management, 4.39 for organizational management, 4.38 for personal quality, 4.27 for teaching and research management and 4.22 for strategy and cultural construction, respectively. Conclusion:The overall management capabilities of Shanghai community general practice team leaders are at the upper-middle level, however, the capabilities in scientific research and team planning are relatively weak.

Objective:To analyze the relationship between capacity of general practice team leaders and the team performance in community health service centers.Methods:This study was a cross-sectional study. A questionnaire survey was conducted between November and December 2022, among general practice team leaders and general practitioners (GPs) from 18 community health service centers in the urban and suburban areas of shanghai selected by stratified sampling method. The personal information questionnaire, leadership of general practice team leader questionnaire,and work performance scale of general team members were used for the survey. The relationship between leadership of general practice team leaders and team performance was analyzed based on structural equation model (SEM).Results:A total of 944 questionnaires were distributed and 856 valid ones were returned with a response rate of 91.0%, including 110 general practice team leaders and 749 were GPs. The SEM analysis showed that some dimensions of the management ability of the general practice team leader had significant effect on the employee organization loyalty (organizational management: β=0.37, teaching and research management: β=-0.29, strategy and cultural construction: β=0.23, personal quality: β=0.11) and work performance (special business management: β=0.95, organizational management: β=0.54) (all P<0.05); and employee organization loyalty played a partial mediator role in relationship between leadership of general practice team leaders and work performance with a mediating effect of 39.50%. Conclusion:The management ability of the general practice team leader directly affect or indirectly affect the work performance of team members through team members′ organizational loyalty.