Objective To explore the influence of autophagy on lipopolysaccharide (LPS) induced acute lung injury (ALI) . Methods Forty‐eight Sprague Dawley (SD) rats were randomly divided into four groups ,12 cases in each group :(1)normal saline control group (NS) ,(2)LPS model group (L) ,(3) LPS and autophagy group (L +A) and (4) LPS and autophagy inhibition group (L+I) .Arterial blood samples was obtained for detecting the blood gas ,including PaO2 ,PaCO2 and pH ,and the lung tissue dry/wet ratio was calculated .The HE staining was used to observe the histopathological changes of lung tissue .Moreover the lung le‐sion score was performed ;the expression of microtubule associated protein ,light chain protein 3b(LC3b) ,myeloperoxidase(MPO) , macrophage inflammatory protein 2(MIP‐2) ,interleukin‐1β(IL‐1β) and tumor necrosis factor‐α(TNF‐α) in serum and bronchoalve‐olar lavage fluid(BALF) was assessed by ELISA .Results Compared with the NS group ,arterial blood PaO2 and pH in the group L were decreased and PaCO2 was increased (P<0 .05);compared with the L group ,the arterial blood PaO2 and pH in the L+A group were increased and PaCO2 was declined (P<0 .01) ,the arterial blood PaO2 and pH in the L+ I group were decreased and PaCO2 was elevated ,the differences were statistically significant (P<0 .01) .The LC3b concentration in serum and BALF in the L group and L+I group was declined ,while MPO ,MIP‐2 ,IL‐1βand TNF‐αconcentrations were increased ,while which in the L+ A group were just the opposite .Conclusion Autophagy plays a improvement and protective effect on LPS induced acute lung injure in rat .

To evaluate the value of the vaccinations with 3 strains of gene-deleted mutants from pseudorabies virus(PRV), PRV TK-, PRV gE-/gI- and PRV TK-/gE-/gI- after to exposure to the wild Fa strain, these mutant strains from the PVR reference isolate Fa were used to vaccinate 4 weeks old PRV-free pigs with a dosage of 105 PFU each ,and followed by nasally challenged by the parental Fa strain with a dosage of 107 PFU at 14 days post vaccination. The pathological changes, virus discharge and distribution were evaluated after vaccination and challenge. It was found that the histopathological observations in the 10 collected samples including cerebrum, cerebellum, heart, liver, lungs, spleen, kidneys, tonsils, lymph nodes and trigeminal ganglion from these 3 mutant strains showed that the rates of occurrence of pathological changes in various organs were 4/10, 3/10 and 4/10 respectively, whereas that of the positive controls were 9/10. The damage in lungs was more serious in pigs vaccinated with PRV TK-mutant and positive control in comparison with other groups of pigs inoculated, and the damages in cerebrum, cerebellum and trigeminal ganglion in positive controls were more serious than those of pigs vaccinated with the 3 gene-deleted mutants. However, the tonsils, the main organ for latent infection were damaged mildly in the pigs inoculated with these 3 gene-deleted mutants in comparison with that of the positive controls. As demonstrated by Southern blot analysis, all the vaccinated pigs could discharge viruses by secretion through nasal cavity, but the soldier pigs were not infected successively by the gene-deleted mutants and the gene-deleted mutants were also unable to establish infection in cerebrum and cerebellum. Nevertheless, they could not effectively block discharge of PRV Fa after exposure to Fa virus, but could block effectively the virulent Fa virus invading into cerebrum and cerebellum. From these observation, it is evident that the deleted mutants of the TK, gE/gI , TK/gE/gI genes can block the invasion of virulent Fa virus into cerebrum and cerebellum and lessen the damages on multiple organs or tissues ,indicating that the deleted mutant of TK/gE/gI gene may be the most promising candidate of vaccine strain for development of the commercial vaccine.

Background and purpose:The young breast cancer patients were treated with goserelin without individualized regimen, and lack of available clinical marker. The aim of this study was to investigate the role of anti-Müllerian hormone (AMH) in evaluation of individualized treatment of ovarian function suppression in the young breast cancer patients.Methods:Forty-one young patients with estrogen receptor (ER) and progesterone receptor (PR) positive breast cancer from May 2012 to Jan. 2014 were randomly divided into 2 groups to undergo radical resection of breast cancer. According to postoperative treatment, one group was treated with goserelin + chemotherapy (n=20), and the other group received chemotherapy alone (n=21). Thirty female patients in the same age group were selected as normal control group. The time of menopause and menstrual recovery after the goserelin + chemotherapy or chemotherapy alone were observed in 2 groups. In early follicular phase (day 3-5) of the cycle preceding the operation and 3, 6 courses after the goserelin + chemotherapy treatment or chemotherapy treatment, serum levels of AMH, FSH and E2 were measured in 2 groups. Accordingly, serum levels of AMH, FSH and E2 were evaluated as well in normal control group.Results:There were no signiifcant differences in preoperative general conditions and preoperative serum FSH and E2 levels among the 3 groups (P>0.05). Compared with normal control group, the preoperative serum AMH levels of young breast cancer patients were decreased signiifcantly (P=0.04). The menopause time and menstrual recovery time in 2 chemotherapy groups were signiifcantly shorter than that in normal control group (P=0.00). Compared with normal control group and preoperative measurement, the differences in serum FSH and E2 levels were not statistically significant in goserelin + chemotherapy group or chemotherapy alone group (P<0.05). The serum AMH levels measured at different time points of the goserelin + chemotherapy group and chemotherapy alone group were decreased signiifcantly (P<0.05). Compared with the chemotherapy group, the serum AMH levels of the goserelin + chemotherapy group after 6 courses were signiifcantly decreased, and then signiifcantly increased 6 months after menstrual recovery (P<0.05).Conclusion:This study demonstrated that the serum AMH levels were obviously decreased after the ovarian function suppression treatment and increased after the menstrual recovery compared with evaluation of other ovarian reserve index. The serum AMH level could suggest ovarian reserve damage even after ovarian function has recovered to the noticeable level. Thus, AMH could be used clinically to evaluate the ovarian reserve of breast cancer patients as a potential marker for the individualized ovarian function suppression treatment in young breast cancer patients.

Objective To explore the risk factors of multiple organ dysfunction syndrome (MODS) in severe trauma patients, put forward a new warning scoring system of MODS, and to provide a more accurate scoring method for doctors to judge the clinical condition and prognosis of patients. Methods Clinical data of 342 patients with severe trauma admitted to intensive care unit (ICU) of the Affiliated Hospital of Zunyi Medical College and Daping Hospital of the Third Military Medical University from January 1st, 2015 to December 31st, 2016 were retrospectively analyzed. The patients were divided into MODS groups (n = 251) and non-MODS group (n = 91) according to clinical outcomes. The clinical data of patients, including gender, age, heart rate (HR) and blood pressure within 24 hours after admission to the hospital, indicators of blood routine and blood biochemistry, severity of disease, severity of trauma, whether received the emergency intubation or surgery within 24 hours or not, whether developed sepsis or acute respiratory distress syndrome (ARDS) during hospitalization, were recorded, and univariate analysis was conducted. The indicators with statistical significance found by univariate analysis were enrolled in multivariate Logistic regression analysis, and the risk factors for MODS in patients with severe trauma were screened and assigned, and the final total score was MODS warning score. Receiver operating characteristic (ROC) curve was plotted to evaluate MODS warning score for predicting the occurrence of MODS in patients with severe trauma. Results Compared with non-MODS group, HR, Na+, serum creatinine (SCr), activated partial thromboplastin time (APTT), injury severity score (ISS), new injury severity score (NISS), acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score and sequential organ failure assessment (SOFA) score in MODS group were significantly increased, pH value, red blood cell (RBC), platelet (PLT), albumin (Alb) and Glasgow coma score (GCS) were remarkably decreased, and multiple injury, the patients with shock at admission, blood transfusion, central venous catheter, emergency intubation and infection were also increased, and more patients suffered from sepsis and ARDS. Multivariate Logistic regression analysis showed that the number of injured places equal or more than 2, shock at admission, APACHEⅡ score ≥ 15, SOFA score ≥ 4 and APTT > 40 s were risk factors for MODS in patients with severe trauma, with total MODS warning score of 7.5. ROC curve analysis showed that the area under ROC curve (AUC) of MODS warning score for predicting MODS in patients with severe trauma was 0.822, which was significantly higher than that of APACHEⅡ score (AUC = 0.698, P < 0.001), APTT (AUC = 0.693, P < 0.001) and SOFA score (AUC = 0.770, P = 0.025). When the cut-off value of MODS warning score was 2.5, the sensitivity was 61.35%, the specificity was 90.11%, and Youden index was 0.515. Conclusions MODS warning score is composed of five factors, including the number of injured places, shock at admission, APACHEⅡ score, SOFA score and APTT, which could be regarded as early warning score system for predicting MODS in patients with severe trauma. MODS warning score can be more comprehensive and timely to assess the possibility of MODS and prognosis of patients with severe trauma, and the prediction result is better than the single use of APTT, APACHEⅡ or SOFA score.

Objective To explore the effect of tea polyphenols on the growth of human papillomavirus 16 (HPV16) subgenes-immortalized human cervical epithelial cells (H8 cells).Methods Cultured H8 cells were divided into 5 groups to be treated with 0 (control group),6.25,12.5,25 and 50 mg/L tea polyphenols respectively for 24,36,and 48 hours,and then cell counting kit-8 (CCK8)assay was performed to detect cell proliferation.After 24 hours of incubation,flow cytometry was conducted to detect cell apoptosis and cell cycle,and fluorescence microscopy to observe the morphology of apoptotic cells.Results After incubation with tea polyphenols at different concentrations for 24,36 and 48 hours,the proliferation of H8 cells was inhibited,and 12.5 mg/L tea polyphenols could inhibit the relative growth rate of H8 cells in a time-dependent manner.Flow cytometry showed that there was a significant difference in cell apoptosis rate among the 6.25-,12.5-,25-,50-mg/L tea polyphenols groups and the control group (52.62％ ± 0.62％,52.22％ ± 0.72％,42.52％ ± 0.90％,45.96％ ± 2.11％,29.96％ ± 0.70％ respectively,F =272.0,P ＜ 0.05).Moreover,all the tea polyphenol groups showed significantly increased cell apoptosis rate compared with the control group (all P ＜ 0.05).Fluorescence microscopy showed karyopyknosis,nuclear fragmentation and other typical apoptotic morphological changes in H8 cells in tea polyphenols groups.There were significant differences in the percentage of cells in G1,G2 phase and cell proliferation index among the 5 groups (all P ＜ 0.05).Compared with the control group,the 6.25-,12.5-,25-mg/L tea polyphenols groups showed significantly increased percentage of cells in G1 phase (55.96％ ± 0.72％,54.12％ ± 3.20％,65.30％ ± 1.51％ respectively,all P ＜ 0.05),but significantly decreased percentage of cells in G2 phase (3.17 ± 1.82％,4.94 ± 1.46％,4.65 ± 4.26％ respectively,all P ＜ 0.05) and lower cell proliferation index(0.44 ± 0.01,0.46 ± 0.02,0.36 ± 0.01 respectively,all P ＜ 0.05).Conclusion Tea polyphenols can inhibit the proliferation of H8 cells,induce cell apoptosis,and block cell cycle progression.

Objective To investigate the impact of the Shared Medical Appointment(SMA)model on blood glucose levels and self-management behaviors in patients with gestational diabetes mellitus(GDM).Methods A total of 87 pregnant women diagnosed with GDM at the Obstetrics and Gynecology and Endocrinology Outpatient Departments of the Affiliated Suqian Hospital of Xuzhou Medical University from October 2021 to October 2022 were enrolled and divided into treatment group(n=44)and control group(n=43).The treatment group received SMA-based GDM management,while the control group underwent routine outpatient follow-up.Baseline data,flash glucose monito-ring(FGM)-related indicators before and after treatment,and self-management behavior scale scores were compared between the two groups.Results No statistically significant differences were observed between the two groups in age,body mass index(BMI),systolic blood pressure(SBP),diastolic blood pressure(DBP),fasting blood glucose(FBG),blood urea nitrogen(BUN),creatinine(Cr),uric acid(UA),triglycerides(TG),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),and glycated hemoglobin(HbA1c)(P＞0.05).After treatment,the time in range(TIR)of glucose was higher in the treatment group than that in the control group,while mean amplitude of glycemic excursions(MAGE),standard devia-tion of blood glucose(SDBG),coefficient of variation(CV),and mean blood glucose(MBG)were lower in the treatment group(P＜0.05).Within the treatment group,post-treatment TIR was higher,and MAGE,CV,SDBG,and MBG were lower than pre-treatment levels(P＜0.05).In the control group,post-treatment TIR was higher,and SDBG and MBG were lower than pre-treat-ment levels(P＜0.05).After treatment,the total score and scores for dietary management,exer-cise management,medication management,and blood glucose monitoring management in the self-management behavior scale were significantly higher in the treatment group than in the control group(P＜0.05).In the treatment group,post-treatment scores for all self-management behaviors were higher than pre-treatment levels,while post-treatment total scores and scores for medication manage-ment and blood glucose monitoring management in the control group were higher than pre-treatment levels(P＜0.05).Conclusion SMA management model can comprehensively improve blood glu-cose levels and enhance self-management behavior capabilities in GDM patients.

Objective To investigate the impact of the Shared Medical Appointment(SMA)model on blood glucose levels and self-management behaviors in patients with gestational diabetes mellitus(GDM).Methods A total of 87 pregnant women diagnosed with GDM at the Obstetrics and Gynecology and Endocrinology Outpatient Departments of the Affiliated Suqian Hospital of Xuzhou Medical University from October 2021 to October 2022 were enrolled and divided into treatment group(n=44)and control group(n=43).The treatment group received SMA-based GDM management,while the control group underwent routine outpatient follow-up.Baseline data,flash glucose monito-ring(FGM)-related indicators before and after treatment,and self-management behavior scale scores were compared between the two groups.Results No statistically significant differences were observed between the two groups in age,body mass index(BMI),systolic blood pressure(SBP),diastolic blood pressure(DBP),fasting blood glucose(FBG),blood urea nitrogen(BUN),creatinine(Cr),uric acid(UA),triglycerides(TG),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),and glycated hemoglobin(HbA1c)(P＞0.05).After treatment,the time in range(TIR)of glucose was higher in the treatment group than that in the control group,while mean amplitude of glycemic excursions(MAGE),standard devia-tion of blood glucose(SDBG),coefficient of variation(CV),and mean blood glucose(MBG)were lower in the treatment group(P＜0.05).Within the treatment group,post-treatment TIR was higher,and MAGE,CV,SDBG,and MBG were lower than pre-treatment levels(P＜0.05).In the control group,post-treatment TIR was higher,and SDBG and MBG were lower than pre-treat-ment levels(P＜0.05).After treatment,the total score and scores for dietary management,exer-cise management,medication management,and blood glucose monitoring management in the self-management behavior scale were significantly higher in the treatment group than in the control group(P＜0.05).In the treatment group,post-treatment scores for all self-management behaviors were higher than pre-treatment levels,while post-treatment total scores and scores for medication manage-ment and blood glucose monitoring management in the control group were higher than pre-treatment levels(P＜0.05).Conclusion SMA management model can comprehensively improve blood glu-cose levels and enhance self-management behavior capabilities in GDM patients.

Objective:To explore the expression pattern of aryl hydrocarbon receptor (AhR) in mice peritoneal macrophages (PMs) after major trauma and analyze the effects of enhanced AhR expression on the inflammatory cytokine level and bactericidal ability after trauma.Methods:The experimental study method was used. Forty 6-8-week-old male C57BL/6J mice (the same mouse age, sex, and strain below) were divided into control group, post trauma hour (PTH) 2 group, PTH 6 group, and PTH 12 group according to the random number table (the same grouping method below), with 10 mice in each group. Mice in the latter 3 groups were constructed as severe trauma model with fracture+blood loss, while mice in control group were left untreated. The primary PMs (the same cells below) were extracted from the mice in control group, PTH 2 group, PTH 6 group, and PTH 12 group when uninjured or at PTH 2, 6, and 12, respectively. Then the protein and mRNA expressions of AhR were detected by Western blotting and real-time fluorescence quantitative reverse transcription polymerase chain reaction, respectively, and the gene expressions of AhR signaling pathway related molecules were analyzed by transcriptome sequencing. Twenty mice were divided into control group and PTH 6 group, with 10 mice in each group, and the PMs were extracted. The level of ubiquitin of AhR was detected by immunoprecipitation. Twelve mice were divided into dimethyl sulfoxide (DMSO) alone group, PTH 6+DMSO group, MG-132 alone group, and PTH 6+MG-132 group, with 3 mice in each group. After the corresponding treatment, PMs were extracted, and the protein expression of AhR was detected by Western blotting. Twenty mice were constructed as PTH 6 model. Then, the PMs were extracted and divided into empty negative control adenovirus (Ad-NC) group and AhR overexpression adenovirus (Ad-AhR) group. The protein expression of AhR was detected by Western blotting at 36 h after some PMs were transfected with the corresponding adenovirus. The rest cells in Ad-NC group were divided into Ad-NC alone group and Ad-NC+endotoxin/lipopolysaccharide (LPS) group, and the rest cells in Ad-AhR group were divided into Ad-AhR alone group and Ad-AhR+LPS group. The expressions of interleukin-6 (IL-6) and tumor necrosis factor α (TNF-α) in the cell supernatant were detected by enzyme-linked immunosorbent assay at 12 h after the corresponding treatment ( n=6). Twenty mice were obtained to extract PMs. The cells were divided into control+Ad-NC group, PTH 6+Ad-NC group, control+Ad-AhR group, and PTH 6+Ad-AhR group, and the intracellular bacterial load was detected by plate spread method after the corresponding treatment ( n=6). Data were statistically analyzed with one-way analysis of variance, least significant difference test, analysis of variance for factorial design, and independent sample t test. Results:Compared with 1.16±0.28 of control group, the protein expressions of AhR in PMs in PTH 2 group (0.59±0.14), PTH 6 group (0.72±0.16), and PTH 12 group (0.71±0.17) were all significantly decreased ( P<0.05). The overall comparison of the difference of AhR mRNA expression in PMs among control group, PTH 2 group, PTH 6 group, and PTH 12 group showed no statistical significance ( P>0.05). The AhR signaling pathway related molecules included AhR, AhR inhibitor, cytochrome P450 family member 1b1, cytochrome P450 family member 11a1, heat shock protein 90, aryl hydrocarbon receptor-interaction protein, and heat shock protein 70 interaction protein. The heat shock protein 90 expression of PMs in PTH 2 group was higher than that in control group, while the expressions of other molecules did not change significantly after trauma. Compared with that in control group, the level of ubiquitin of AhR in PMs in PTH 6 group was increased. Compared with that in DMSO alone group, the protein expression of AhR in PMs in PTH 6+DMSO group was decreased, while that in PMs in MG-132 alone group had no significant change. Compared with that in PTH 6+DMSO group, the protein expression of AhR in PMs in PTH 6+MG-132 group was up-regulated. At transfection hour 36, compared with that in Ad-NC group, the protein expression of AhR in PMs in Ad-AhR group was increased. At treatment hour 12, compared with those in Ad-NC+LPS group, the expressions of IL-6 and TNF-α in PM supernatant of Ad-AhR+LPS group were significantly decreased (with t values of 4.80 and 3.82, respectively, P<0.05). The number of intracellular bacteria of 1×10 6 PMs in control+Ad-NC group, PTH 6+Ad-NC group, control+Ad-AhR group, and PTH 6+Ad-AhR group was (3.0±1.8), (41.8±10.2), (1.8±1.2), and (24.2±6.3) colony forming unit, respectively. Compared with that in PTH 6+Ad-NC group, the number of intracellular bacteria of PMs in PTH 6+Ad-AhR group was significantly decreased ( t=3.61, P<0.05). Conclusions:Ubiquitin degradation of AhR in PMs of mice after major trauma results in decreased protein expression of AhR. Increasing the expression of AhR in post-traumatic macrophages can reduce the expressions of LPS-induced inflammatory cytokines IL-6 and TNF-α, and improve the bactericidal ability of macrophages after trauma.