AIM: To explore the effects of p38 mitogen-activated protein kinases (MAPK) and phosphoinositide 3-kinases (PI3K)/Akt on interleukin (IL)-6, the endothelin (ET)-1-mediated process of airway fibroblast activation induced by injured human bronchial epithelial cells (HBE). METHODS: Human primary cultured airway fibroblasts were co-cultured with HBE pre-treated with or without poly-L-arginine (PLA). The procedure was also performed in the presence or absence of p38 MAPK selective inhibitor SB203580, PI3K selective inhibitor LY294002 or ETA receptor blocker BQ123, respectively. Immunostaining, Western blotting or ELISA were used for detecting α-smooth muscle actin (α-SMA) expression, the activities of p38 MAPK and Akt in fibroblasts or IL-6 levels in supernatants of fibroblasts. In addition, fibroblasts were mixed with soluble collagen and cultured with HBE treated as the same mentioned above, the gel contraction was measured by serial area measurements. RESULTS: ET-1 and IL-6 levels [(13.69±1.36) ng/L, (56.7±10.7) ng/L] in the supernatants of fibroblasts cultured with injured HBE were significantly higher than those in the supernatants of fibroblasts cultured with HBE [(3.79±0.64) ng/L, (15.5±3.2) ng/L]. BQ123, SB203580 or LY294002 decreased IL-6 levels [(27.2±3.1) ng/L, (31.5±3.6) ng/L, (41.3±3.2) ng/L] differently in the supernatants of fibroblasts induced by injured HBE. Activation of p38 MAPK preceded Akt in fibroblasts cultured with injured HBE. BQ123 reduced the phosphorylation levels of p38 MAPK and Akt. SB203580 concentration-dependently attenuated Akt phosphorylation, while LY294002 had little effect on p38 MAPK phosphorylation. Fibroblasts expressed more α-SMA after cultured with injured HBE and showed significant increase in the gel contraction compared to fibroblasts cultured with HBE [percentage of gel contraction: (61.2±2.7)% vs (15.4±7.3)%], all these effects were diminished or inhibited by BQ123, SB203580 or LY294002. Furthermore, the effects of BQ123 and SB203580 on decreased gel contraction were stronger than the effect of LY294002. CONCLUSION: ET-1 exerts a key role in the airway fibroblasts activation induced by injured HBE through activating p38 MAPK, PI3K/Akt signaling and promoting IL-6 expression.

Objective To analyze the clinical significance and features of patient s' with inconsistent antineutrophil cytoplasmic antibodies (ANCA) test results between indirect immune fluorescence (IIF) and enzyme-linked immunosorbent assay (ELISA).Methods ANCA were detected with IIF and ELISA method jointly among 12 386 in-patients and a retrospective analysis on the proportion of clinical features and significance was made in 589 cases with inconsistent results using Microsoft Excel 2007 statistical software.Results Among the 589 patients,68 (11.5％) were diagnosed as vasculitis,in which 51 cases as ANCA-associated vasculitis,and 521(88.4％) were diagnosed as non-vasculitis including 181 connective disease and 340 non-connective diseases in which hypertension and cardiopathy were common.The common inconsistent results of ANCA were p-ANCA/ELISA (-),IIF (-)/anti-MPO (+),IIF (-)/anti-PR3 (+),IIF (-)/anti-PR3 (+) anti-MPO (+) accounted for 24.4％ (144/589),29.5％ (174/589),15.9％ (94/589),18.5％ (108/589) respectively,these accounted for 88.3％(520/589) of total inconsistency.Conclusion The spectrum of diseases and clinical characteristics varies widely and often presents with multiorgan involvement in patients with inconsistent ANCA results.These reasons make it easy to be misdiagnosed.Attention should be paid to identify and different these inconsistency.

Objective To investigate the relationship between the zinc and copper concentration and the clinical outcomes of in vitro fertilization and embryo transfer(ivf-et).Methods The clinical data and zinc and copper concentration of serum on the days with human Chorionic gonadotropin(hCG) injection as well as that in the follicular fluid on the the day of oocyte retrieval were retrospectively analyzed in 43 cases with IVF-ET cycles.Results Application of pearson correlation analysis showed that copper concentration in follicular fluid of the 43 cases was positively correlated with the numbers of retrieved oocytes,fertilized oocytes and cleaved embryos( r were 0.392,0.327 and 0.321,respectively,P were 0.0094,0.0325 and 0.0361 respectively ) Between the pregnant group and non-pregnant group,the zinc and copper concentration in follicular fluid was not significantly different ( P ＞ 0.05 ) ; the serum estradiol ( E2 ) on the day of hCG administration was of significantly different(t =2.177,P =0.0353 );the serum zinc concentration on the day of hCG administration was of significantly different ( t =2.153,P =0.0372).Conclusion Trace elements zinc and copper might play an important role in the process of IVF-ET.

Medical students face higher levels of stress compared to the general population. Statistical analyses of questionnaire surveys were made to compare the teaching effect between traditional teaching and PBL.The results indicate that the PBL teaching is more conducive to students to relief from the course-related stress in medical colleges.

Objective To investigate the application of PSA, fPSA concentrations and fPSA/PSA value for diagnosis and therapy of prostatic diseases detected with dissociation enhanced lauthanide fluoroimmunoassay (DELFIA) technique . Methods Thirty-four cases of normal individuals were used as control group, 46 patients with prostatitis as prostatitis group, 123 patients with prostatic hyperplasia as BPH group and 39 patients with prostate cancer as prostate cancer group. PSA, fPSA concentrations and fPSA/PSA value were detected with DELFIA technique. Results In prostate cancer group, the PSA and fPSA concentrations were significantly higher than those in other 3 groups (P0.05). Conclusion DELFI A technique is an effective method to improve the diagnosis and differential diagnosis of prostatic diseases, especially for prostate cancer.

Objective To explore the relationship between therapeutic effects of 89SrCl2 on osteodynia induced by multiple bone metastasis and ET,CGRP,TXB2 and 6-K-PGF1a.Methods 89SrCl2 treatment was used in 39 cases of multiple bone metastasis,the serum content of ET,CGRP,TXB2 and 6-K-PGF1a were detected with radioimmunological method pre-treatment and 1,3,6 months post-treatment,respectively;the ET/CGRP value was calculated.Results The content of ET showed no obvious changes 1 month post-treatment compared with pre-treatment.However,the ET contents increased significantly 3 and 6 months post-treatment compared with 1 month post-treatment and before treatment(P

Objective:To explore the effect of irbesartan in the treatment of the patients with hypertension complicated with diabetes mellitus and its influence on urine trace albumin. Methods:Totally 62 cases of patients with hypertension complicated with diabetes mel-litus were divided into the observation group and the control group randomly with 31 patients in each. The patients in the control group were given the conventional blood sugar and blood pressure control, and the patients in the observation group were treated with irbesartan additionally. The treatment course was 3 months. The changes of blood pressure and urine trace albumin of the patients in the two groups before and after the treatment were compared, and the effect of blood pressure control and the adverse effects were evaluated as well. Re-sults:The total effective rate of the observation group was 96. 8%, which was much higher than that of the control group (83. 9%, P<0. 05) , and the difference had statistical significance (P<0. 05). After the treatment, the systolic blood pressure and diastolic blood pressure of the patients in the two groups were reduced significantly (P<0. 05), and the urinary albumin excretion rate (UAER) and the level of urine trace albumin (mAlb) of the patients in the two groups were obviously lowered (P<0. 05), and the decrease in the obser-vation group was more notable than that in the control group (P<0. 05). No significant difference in the incidence of adverse reactions was shown between the two groups(P>0. 05). Conclusion:The clinical effect of irbesartan in the treatment of patients with hypertension complicated with diabetes mellitus is promising with low incidence of adverse effects,which can effectively protect renal function as well.

Objective To evaluate the monitoring value of serum albumin and plasma von willebrand factor in patients with stroke.Methods Serum albumin and plasma von willebrand factor were measured from 145 patients with stroke(95 patients with nonpoor outcome and 50 patients with poor outcome) in two weeks and after six months from stroke onset to study the relationships with prognosis.Results Serum albumin level was significantly higher in patients with nonpoor outcome(mRS≤2) after six months stroke onset than those with poor outcome(mRS≥3) and was lower after six months stroke onset than in two weeks from stroke onset.On the other hand,plasma vWF level in patients with stroke was significantly higher than that in healthy controls and was higher in two weeks than after six months from stroke onset.Patients with poor outcome had higher plasma vWF level than patients with nonpoor outcome in two weeks and after six months from stroke onset,but had no significant difference.Conclusion The level of serum albumin and plasma von willebrand factor is related with nutritional status,active extent and prognosis in patients with stroke.

Objective: To explore the mediating effect of self-efficacy for exercise on social support and kinesiophobia in patients with rheumatoid arthritis (RA), so as to provide insights into alleviating fear for exercise and formulating exercise intervention programs. Methods: RA patients hospitalized in a tertiary hospital in Harbin City from June to December 2023 were selected, and the levels of kinesiophobia, self-efficacy for exercise and social support were investigated using the Tampa Scale of Kinesiophobia (Chinese version), the Self-Efficacy for Exercise and the Social Support Rating Scale, respectively. The mediating effect of self-efficacy for exercise on social support and kinesiophobia was examined using a structural equation model. Results: A total of 216 people were investigated, including 45 males (20.83%) and 171 females (79.17%), with the median age of 54.00 (interquartile range, 13.75) years. There were 159 of patients living in the urban areas, accounting for 73.61%. There were 102 of patients with a disease course of 1 to 5 years, accounting for 47.22%. The median scores of kinesiophobia, self-efficacy for exercise and social support were 31.00 (interquartile range, 5.00), 5.00 (interquartile range, 2.00) and 39.50 (interquartile range, 17.00), respectively. Social support had a direct negative effect on kinesiophobia (effect value=-0.358, P<0.05) and a indirect negative effect on kinesiophobia through self-efficacy for exercise (effect value=-0.887, P<0.05), and the mediating effect contributed 93.86% to the total effect. Conclusion Social support can directly or indirectly influence kinesiophobia through self-efficacy for exercise among patients with RA.

Objective To evaluate the efficacy of Six Sigma management for shortening the waiting time of outpatients accepting radiography and improving patient satisfaction. Methods Six Sigma management was applied to identify the key points critical to quality in the process of radiography,analyze the factors influencing the waiting time,and take targeted measures to modify the process. Results The waiting time of patients accepting radiography was reduced by an average of 25.2min and the rate of dissatisfaction was decreased by 18%. Conclusion The application of Six Sigma management can effectively shorten the waiting time of outpatients accepting radiography and increase patient satisfaction.