Objective To observe the expression of acid-sensing ion channel la (ASICla) and to investigate the effect of intracellular Ca2 + concentration on focal cerebral ischemia in diabetic rats.Methods 108 male Wistar rats were divided into three groups:group A [rats with middle cerebral artery occlusion (MCAO)],group B [rats with MCAO and diabetes (DM + MCAO)],group C [rats with MCAO and diabetes treated with fasudil intervention (DM+ MCAO+ fasudil)] (n=36 each).Samples were obtained at the time points of 1,3,6 and 24 h after ischemia respectively (n=9).Models of MCAO and DM+MCAO were prepared.Rats in DM+MCAO+Fasudil group were treated with fasudil 1 mg/Kg by caudal vein injection after half an hour when DM+MCAO model successfully prepared.ASICla expressions were detected at different time points of ischemia in the 3 groups respectively.Ca2+ concentration in ischemia cortex cells were determined at different time points of ischemia in group B and C.Results ASICla expressions were gradually increased along with the ischemia time in group A and B (group A:0.71±0.10,0.80±0.11,0.86±0.08,0.93±0.09;groupB:0.86±0.11,1.05±0.51,2.42±0.08,2.78±0.04; all P＜ 0.05),and ASICla expressions at different time points were higher in group B than in group A (all P＜ 0.05).Ca2-concentration were gradually increased along with the ischemia time in group B (106.32± 18.6,137.84±14.32,151.94± 18.38,183.61±7.96,all P＜0.05).Compared with group B,the levels of ASICla expression and calcium current were reduced in group C.Conclusions The activation of ASICla increases calcium ion flow internal pathway leading to intracellular calcium overload,which may be one of the reasons for the aggravation of focal cerebral ischemia in diabetes.

BACKGROUND:The influence of Tol-like receptor 2 (TLR2), Tol-like receptor 4 (TLR4), Tol-like receptor 6 (TLR6) signal transduction pathway and active Treg in children with Henoch-Schonlein purpura has been unknown.
OBJECTIVE:To investigate the expression of TLR2, TLR4 and TLR6 in peripheral blood mononuclear cells and Treg immune response in patients with Henoch-Schonlein purpura, and to explore the role of TLR2, TLR4, TLR6 and Treg activation in the pathogenesis of Henoch-Schonlein purpura.
METHODForty-two hospitalized children with Henoch-Schonlein purpura were enrol ed in this study. Another 15 healthy children were selected as controls. TLR2, TLR4 and TLR6 at protein level in peripheral blood mononuclear cells were detected by flow cytometey;reverse-transcription PCR and real-time PCR were used to evaluate the level of MyD88;the levels of transforming growth factor-βand interleukin-10 were measured by enzyme-linked immunosorbent assay. t-test or t’-test was used to compare the levels of these genes and proteins. Pearson’s correlation test was done for correlation analysis.
RESULTS AND CONCLUSION:Compared with the control group, the protein levels of TLR2, TLR4, TLR6 and the relative expression level of MyD88 mRNA were significantly up-regulated (P<0.01). The serum levels of transforming growth factor-βand interleukin-10 were higher in the Henoch-Schonlein purpura children than the healthy children (P<0.05). There was a significant correlation between the protein levels of TLR2, TLR4, TLR6 and mRNA level of MyD88 (P<0.01), but no relationship was found between TLRs and interleukin-10, transforming growth factor-β(P>0.05). The excessive activation of TLR2, TLR4, TLR6 may be involved in the process of Henoch-Schonlein purpura via MyD88-dependent pathway, and the compensatory activation of Treg may participate in protective immunity.

Objective To evaluate the influence of different blood purification ways on the incidence,distribution characteristics and related factors of depressive symptoms in end-stage renal disease (ESRD) patients.Methods Self-made questionnaires,short form 36 health survey questionnaire(SF-36),self-rating depression scale (SRS),medical coping modes questionnaire (MCMQ) and social support rating scale(SSRS) were performed to assess 80 hemodialysis patients and 78 continuous ambulatory peritoneal dialysis patients.If SDS score was higher than 53,the patient was diagnosed according to ICD-10.Results ①The detection rate of depressive symptoms in patients with ESRD was 61.22％,in which 50.8％ case met the diagnostic criteria of ICD-10.②Peritoneal dialysis group were better than hemodialysis group on the SF-36 (61.60± 18.50 vs 52.70 ± 20.00),comprehensive nutritional assessment (58.21 ± 13.56 vs 25.40 ± 11.21),urea clearance index(52.43± 14.20 vs 21.02±0.62) and SDS score (24.25±0.45 vs 23.89±0.91),and the results were statistically significant (P＜0.05).③Correlation analysis showed that the depression of ESRD patients was significantly negatively correlated with gender,educational level and household income (r =-0.278,-0.275,-0.283,P＜0.05),but positively correlated with course of disease(r=0.298,P＜0.05).In addition,the depressive symptoms were significantly negatively correlated with the face and avoidance factor of coping styles(r=-0.343,-0.316,P＜0.05),but positively correlated with yield(r=0.338,P＜0.05).Moreover,they were negatively correlated with objective support,subjective support and support utilization score (r=-0.330,-0.325,-0.297,P＜ 0.05).④Regression analysis showed that education level,social support and medical coping styles were influencing factors for patients with depression.The choice of dialysis way was also the influencing factor of depression occurrence.Conclusion Nutrition and urea nitrogen removal in peritoneal dialysis group is better than that in hemodialysis group.Education degree,social support,medical coping styles and dialysis way are the influencing factors of depression in ESRD patients.

OBJECTIVETo study the chemical constituents of Sorbus tianschanica.

METHODThe compounds were isolated and purified by recrystallization and chromatography with silica gel and resin. Their structures were identified by physicochemical properties and spectral analysis.

RESULTSeven compounds were isolated from the EtOH extraction and six structures were identified as benzoic acid (1), benzyl-O-beta-D-glucopyranoside (2), ursolic acid (3), 2alpha-hydroxyursolic acid (4), hyperoside (5), quercetin-3-O-glucoside (6).

CONCLUSIONCompounds 1-5 were isolated from S. tianschanica for the first time.

Objective To explore the diagnostic value of ultrasonography of fetal congenital cystic adenomatoid malformation of the lung (CCAM), and to predict the prognosis according to ultrasonographic findings. Methods The chest of 19 fetus with CCAM was multi-sectionally scanned with two-dimensional ultrasonography. The position, appearance and size of mass were observed, and complications were continuously followed. Results CCAM was pathologically confirmed in 13 fetus after induced abortion. One neonatal died, while CCAM in other 5 fetus disappeared before 36 weeks. The mass of typeⅠCCAM became smaller and smaller, and eventually disappeared. The echo-free spaces in typeⅡbecame smaller and fewer, and the strong echo weakened to the same level as normal lung. For type Ⅲ, the echo of solid mass weakened to the same level as normal lung, or transformed to typeⅡ gradually, and finally recovered to normal echo of lung as the gestational age increased. During follow up, there were 10 fetus (10/19, 52.63%) that lung adenoma cyst increased with the gestational age increased, and the heart, mediastinal shifted, pleural effusion, and (or) fetal edema were observed. Conclusion Ultrasound examination is a reliable method for the diagnosis of CCAM, and enable to predict the prognosis of the affected fetuses. If heart and mediustinum displacement, pleural effusion, hydrops fetal or other abnormalities exist, it's necessary to terminate the pregnancy.

Objective To invest the effect of minimal inflammation on patients with maintenance hemodialysis(MHD) and the intervention effect of ftuvastatin.Methods Blood indicators such as PA,ALB and BUN,Cr,TC,TG,HDL-C,LDL-C,Lp(a),SF,hs-CRP,IL-6 and TNF-α were detected at the first day of the study and six months later in all patients.Patients were divided into inflammation group(CRP≥8 mg/L) and non-inflammation group(CRP<8 mg/L) according to CRP levels.Only inflammation group used fluvastatin.Two groups were observed for six months.Results The level of hs-CRP,IL-6,TNF-α,TG,Lp(a),SF in MHD patients was obviously higher than the normal control group.The level of ALB was obviously lower than the normal control group.The angiocardiopathy incidence of inflammation group was obviously higher than that of the non-inflammation.The more obvious of minimal inflammation,the more significant of lipid metabolism disturbance and malnutrition.Hs-CRP,IL-6,TG,TC,LDL-C and Lp(a) of inflammation group decreased obviously(P<0.01 or P<0.05).ALB、HDL-C increased obviously(P<0.05).Indicators of the non-inflammation had no statistical difference after therapy.Conclusions Patients with MHD generally have minimal inflammation and malnutrition.Minimal inflammation has important effect on the angiocardiopathyincidence,lipid metabolism disturbance and malnutrition.Fluvastatin not only could regulate lipid metabolism but also improve the minimal inflammation of patients with MHD.Early detection and therapy of minimal inflammation has important significance on improving prognosis of patients with MHD.

Objective To investigate the changes of miR-146a expression in serum,hippocam-pus and prefrontal cortex in postoperative cognitive dysfunction (POCD) mice.Methods Fifty healthy male C57BL/6 mice,aged 12-14 weeks,weighing 25-30 g,were randomly divided into two groups (n =25 each)using a random number table:control group (group C)and anesthesia plus sur-gery group (group AS).Mice in group AS underwent open tibial fracture of the left hind paw with in-tramedullary fixation in aseptic conditions under general anesthesia with 2.1% isoflurne.Ten mice in each group received the fear conditioning test (FCT)on the 1,3 and 7 days after anesthesia/surgery. The rest of mice were sacrificed 24 h before (baseline),and 6,12,24,48 h after anesthesia/surgery, and then the serum,prefrontal cortex and hippocampus were collected or removed for detection of the expression of miR-146a using quantitative reverse transcription polymerase chain reaction (qRT-PCR).Results Compared with group C,the percentage of freezing time in contextual FCT was sig-nificantly decreased (P <0.05)in group AS,while no significant change in freezing time percentage was found in tone-cued FCT.In serum,compared with group C,miR-146a expression at 6,12,24, 48 h after anesthesia/surgery was significantly up-regulated in group AS (P < 0.05 );and in group AS,the expression of miR-146a was significantly decreased 6,24,48 h as compared to that at 12 h after anesthesia/surgery (P <0.05).In hippocampus,compared with group C,miR-146a expression at 6,12,24,48 h after surgery was significantly up-regulated in group AS (P <0.05);and in group AS,the expression of miR-146a at 6,48 h after surgery was significantly decreased as compared to that at 12 h after anesthesia/surgery (P <0.05).In prefrontal cortex,compared with group C,miR-146a expression at 24,48 h after surgery was significantly up-regulated in group AS (P <0.05);and in group AS,the expression of miR-146a was significantly increased at 48 h as compared to that at 24 h after anesthesia/surgery (P <0.05).Conclusion The expression of miR-146a in serum,hippocam-pus and prefrontal cortex in POCD mice was up-regulated,and changes of miR-146a expression may be related to the development of POCD.

Objective: To analyze the influence of reproductive health education in middle school on self efficacy and intention of condom use among college freshmen, so as to provide evidence for fertility protection related intervention and policy making. Methods: A questionnaire survey was conducted among college freshmen in Beijing by hierarchical cluster sampling method. A total of 3 001 students were surveyed. The difference was compared by using χ 2 test and ANOVA. Multivariate linear and Logistic regression model was used to analyze the influencing factors associated with condom use self efficacy and condom use intention. Results: The overall rate that reproductive health education received before college among freshmen in Beijing was 65.11%. The college freshmen from urban areas reported more adequate reproductive health education (71.11%) than those from non urban areas before college (59.36%)( P <0.05). The total scores of UNGASS (4.22±0.90 vs 4.05±0.98), condom use self efficacy (24.64±5.34 vs 23.09±4.93) and the intention of condom use (82.44% vs 70.88%) of college freshmen received reproductive health education in middle school were higher than those of college students without pre college reproductive health education( P <0.01). Multiple linear regression analysis showed that the score of condom use self efficacy of college students received pre college reproductive health education was higher than those without pre college reproductive health education( β =1.21, 95% CI =0.79-1.63, P <0.01). Multivariate Logistic regression analysis showed that reproductive health, the intention of condom use of college freshmen who received pre college reproductive health education was higher than that of college freshmen without reproductive health education( OR =1.63, 95% CI =1.33-2.01, P <0.01). Conclusion Reproductive health education in middle school can improve college freshmen s self efficacy and intention of condom use, contribute to the implementation of safe sex, and is of great significance to the protection of college students fertility.

Objective:To explore the application effect of chain pain management model in perioperative nursing of children with traumatic fractures.Methods:Using the convenient sampling method, a total of 174 children with traumatic fractures and 174 caregivers who were treated in Henan Children's Hospital from May 2020 to May 2021 and underwent surgical treatment were selected as the research subjects. Among them, 85 children and 85 caregivers from May to November 2020 were used as the control group, and they were given the conventional pain management model for intervention. A total of 89 children and 89 caregivers from December 2020 to May 2021 were selected as the experimental group, and they were given chain pain management model for intervention. The perioperative pain, psychological stress status and nursing satisfaction of caregivers were compared between the two groups.Results:At 24 hours after admission and 24 hours after operation, score of FLACC Pain Assessment Scale of the experimental group was lower than that of the control group, and the difference was statistically significant ( P<0.05) . At discharge, the Short-term Response Scale of Stress Disorder in the experimental group was lower than that in the control group, and the satisfaction score of caregivers in the experimental group was higher than that in the control group, and the differences were statistically significant ( P<0.05) . Conclusions:The application of chain pain management model in perioperative nursing of children with traumatic fractures can reduce perioperative pain, improve the psychological stress state of children and improve satisfaction of caregivers with nursing work, which has certain clinical application value.

Objective To analyze the differences of clinical manifestations and organ damage between patients with severe fever with thrombocytopenia syndrome(SFTS)and patients with tsutsugamushi disease,and to investigate the prognostic factors of SFTS.Methods The research was performed on 49 patients with SFTS and 16 patients with tsutsugamushi disease who visited the First Affiliated Hospital of Anhui Medical University from October 2014 to June 2017.The general information of patients including region,age,gender and clinical manifestations were evaluated.Blood routine,liver and kidney function,myocardial enzyme levels,lipase,amylase,electrolytes,C-reactive protein,procalcitonin,prothrombin time(PT)and activated partial thromboplastin time(APTT)were continuously monitored during the course of disease.T test was used for continuous variables of normal distribution,and non-parametric test was used for variables of non-normal distribution.Chi-square test was used for categorical variables.Results The mean age of SFTS patients was 62.1±15.5(ranging from 17 to 87 years)and the mean age of tsutsugamushi patients was 56.1±9.2(ranging from 47 to 73 years).There was no significant difference between the two groups(t=1.47,P=0.147).There were 25 males(51%)in SFTS patients and 8 males(50%)in tsutsugamushi disease patients.There was no significant difference between the two groups(x2=0.005,P=0.943).The incidences of headache,vomiting,superficial lymphadenectasis,disturbance of consciousness,proteinuria,hematuria,pulmonary infection,multiple organ dysfunction and acute pancreatitis in SFTS patients were all significantly higher than those in tsutsugamushi disease patients(x2=8.82,4.38,8.71,11.17,7.88,5.56,4.35,9.43,and 8.13,respectively,P <0.05 or 0.01).The counts of leukocytes(Z=2.73),neutrophils(Z=2.46),lymphocytes(Z=3.15),platelets(Z=4.25),albumin(Z=2.65)and sodium ion(t=2.10)in SFTS patients were all significantly lower than those in patients with tsutsugamushi disease(P <0.05 or 0.01).The levels of aspartate aminotransferase(Z=2.94),lactate dehydrogenase(Z=3.42),creatine kinase(CK)(Z=2.88),amylase(Z=2.11),lipase(Z=2.82),creatinine(Z=2.07)and urea nitrogen(Z=2.50)in fatal SFTS patients were all significantly higher than those in patients with tsutsugamushi disease(P <0.05 or 0.01).Among 49 SFTS patients,16 patients died and 33 patients recovered finally.The age(t=3.33),platelet count(Z=2.55),alanine aminotransferase(ALT)(Z=2.10),aspartate aminotransferase(AST)(Z=2.22),lactate dehydrogenase(Z=2.26),CK(Z=3.50),CK-MB(Z=3.10),creatinine(Z=2.17),urea nitrogen(Z=2.36),and sodium(t=2.65)between the two subgroups had significant differences(P <0.05 or 0.01).Conclusions SFTS is more severe and has high mortality,while tsutsugamushi disease has a better prognosis.Early differential diagnosis and early rational treatment are important to reduce the mortality of patients with SFTS.