Objective To investigate the protective effects of ischemic preconditioning on myocardial ischemia/reperfusion injury in diabetic rats.Methods Twenty-eight healthy male rats were injected streptozotocin at dose of 45 mg/kg by tail and be fed with normal diet for 4 weeks,then rats were randomly divided into iscbemia/reperfusion (I/R) group and ischemic preconditioning (IP) group.ST segment of electrocardiograph changes and arrhythmias of all rats were recorded before ischemia and 0,15,30 minuets after ischemia and 0.5,2 h after reperfusion.TTC staining was performed to determine myocardial infarct size.TUNEL assay was used to assesse cardiomyocyte apoptosis.The expression of antiapoptotic gene (Bcl-2) and proapoptotic (Bax) was determined by immunohistochemistry.Results Compared with I/R group,ST segment elevation of patients in IP group decrease from (0.675 ±0.150) mV to (0.489 ±0.161) mV at 30 min after ischemia(P ＜0.05).Meanwhile the onset of ventricular premature contraction(VPC) in IP group was (18.21 ± 5.36) min,later than that of control group ((6.47 ± 4.28) min,t =5.241,P =0.000).The duration of VPC was (6.07 ± 4.33) min,shorter than that of I/R group ((16.71 ± 5.48) min,t =4.924,P ＜ 0.01)).The incidence of ventricular tachycardia (VT) and ventricular fibrillation (VF) of lP group remarkably decreased compared with I/R group (VT:57.14％ (8/14) vs.14.29％ (2/14),x2 =5.600,P =0.018 ; VF:50.00％ (7/ 14) vs.14.29％ (2/14),x2 =4.094,P=0.043).The myocardial infarct size in IP group was (12.50 ± 9.45) ％,smaller than that of I/R group ((37.50 ± 11.40)％,t =3.211,P =0.006).Cardiomyocyte apoptotic index (AI) was attenuated in IP group than that of I/R group((24.31 ± 3.12)％ vs.(19.01 ± 4.32)％,t =3.227,P =0.006),which was correlate with increased the ratio of Bcl-2/Bax((0.103 ±0.045) vs.(0.221 ±0.101),t =2.670,P =0.015).Conclusion IP treatment for diabetic rats shows a protect effect on myocardial I/R injury through attenuating myocardial apoptosis,and increasing the ratio of Bcl-2/Bax.

Objective To investigate the effect of EP4 gene silencing on the growth and migration of K1 cells. Methods K1 cells with stable knockdown of EP4 were constructed with lentiviral vector. QRT-PCR and western blot analysis were used to detect the expression of EP4 mRNA and protein in K1 cells. CCK8 assay and flow cytometry were employed to measure cell viability and apoptosis. Transwell assay was applied to detect cell migration. Results Compared with the negative control group,the mRNA and protein expression of EP4 were sig-nificantly decreased in K1 cells with stable knockdown of EP4. Furthermore,shRNA-mediated silencing of EP4 gene remarkably suppressed cell viability and induced apoptosis of K1 cells.The migration of K1 cells with knock-down of EP4 was decreased compared with the negative control group. Conclusions EP4 gene silencing can in-hibit growth and induce apoptosis of K1 cells.Downregulation of EP4 can significantly reduce migration of K1 cells.

Objective:To explore the risk factors for recurrence of intussusception in children after successful ultrasound-guided saline enema reduction.Methods:The clinical and follow up data of 355 hospitalized children with intussusception at the First Affiliated Hospital of Zhengzhou University from Feb 2018 to Feb 2023 were reviewed.Patients were divided into two groups by recurrence develped and the differences were compared, Data with significant differences were incorporated into multi-factor logistic analysis.Results:The overall recurrence rate was 15.8% (56/355). By univariate variable analysis model, there were statistically significant differences between the two groups in age, previous intussusception history, vomiting, maximum diameter of concentric circles shown by ultrasound, and concurrent bowel organic diseases (lead points) (all P<0.05). In multivariate Logistic regression model, age, previous intussusception history, maximum diameter of concentric circles, and lead points were independent risk factors for recurrent intussusception after saline enema.The optimal cut-off values for age and maximum diameter of concentric circles were 2 years and 33.5 mm, respectively, according to ROC curve analysis. Conclusion:Age older than 2 years, previous intussusception history, maximum diameter of concentric circles longer than 33.5 mm, and lead points are independent risk factors for recurrence after saline enema.

Objective: To explore the effect of nursing intervention on the biofeedback effect of functional constipation in children. Methods: A total of 112 children (4-16 years old) who were diagnosed with functional constipation in the Department of Pediatric Surgery of the First Affiliated Hospital of Zhengzhou University were randomly divided into the experimental group (54 cases) and the control group (53 cases). Children in the experimental group were treated with biofeedback training and personalized nursing intervention for functional constipation in children. The control group used biofeedback combined with traditional nursing intervention to treat functional constipation in children. The WHO-5 (World Health Organization′s five physical and mental health) scales were used to compare the effects of the two groups and were followed up for 3-6 months. Results: A total of 107 children completed the study, 54 in the experimental group and 53 in the control group. There were no significant differences in the scores of the WHO-5 scale and clinical symptoms between the two groups before the intervention (P>0.05). After intervention, the total score of WHO-5 in the experimental group was (21.69± 2.28), the total score of clinical symptoms was (6.56±1.16), the total score of WHO-5 in the control group was (17.85±3.189), and the total score of clinical symptoms was (9.04±2.121). The difference was significant (t=-7.146, t=7.491, P<0.01). Conclusion Personalized nursing intervention can enhance the effect of biofeedback training on children and adolescents with functional constipation and improve their quality of life.

Objective:To investigate the clinical efficacy of anal dimple anorectoplasty on female infants with congenital anal atresia combined rectal vestibular fistula.Methods:Clinical data of 69 female infants with congenital anal atresia combined rectal vestibular fistula admitted to Department of Pediatric Surgery, the First Affiliated Hospital of Zhengzhou University from July 2012 to July 2022 were retrospectively analyzed.They were divided into 2 groups according to the surgical methods: 34 cases of anal dimple anorectoplasty(group A) and 35 cases of anterior sagittal anorectoplasty(group B). The operation time, length of stay, short-term complications, long-term complications and bowel function (determined by the Rintala score at 6 months postoperatively) of the two groups were compared.The difference in the incidence of postoperative complications between groups was compared by Chi- square test, and the remaining differences between groups were compared by the paired t-test. Results:The operative time [(80.18±9.29) min vs.(103.85±8.26) min] and postoperative hospital stay[(6.10±1.52) d vs.(7.63±2.40) d] in group A were significantly shorter than those of group B ( t=11.40, 2.62; all P<0.05). The Rintala total score at 6 months postoperatively in group A was significantly higher than that of group B[(19.36±0.93) points vs.(18.76±0.44) points]( t=3.20, P<0.05). There were no significant differences in the incidences of short-term [(4/34, 11.8%) vs.(7/35, 20.0%)] and long-term complications [(2/34, 5.9%) vs.(4/35, 11.4%)]between group A and group B ( χ2=0.75, 0.75; all P>0.05). Conclusions:Anal dimple anorectoplasty for female infants with congenital anal atresia combined rectal vestibular fistula is safe and effective.