Objective To develop anoverlap syndrome (OS)rat model by intermittent hypoxia (IH) exposure on the base of pre-existing emphysema, and to explore its characters of severe systemic inflammation and immune responses. Methods Sixty Wistar rats were put into four groups:control group, IH group, emphysema group and overlap (emphysema+IH) group. The peripheral blood samples were collected for detecting apoptosis of CD3+CD4+,CD3+CD8+T lymphocytes and neutrophils (PMN). Tumor necrosis factor (TNF)-αand interleukin (IL)-6 were evaluated by ELISA. The bronchoalveolar la-vage fluid (BALF) was taken to calculate the ratio of macrophages, neutrophils and lymphocytes under light microscope. Tis-sue blocks of lung, liver, pancreas, and right carotid artery were taken for pathologic scoring. Results The apoptotic rates of PMN and CD3 +CD8 +T cells were significantly lower in overlap group than those of other three groups (P<0.05). Pro-in-flammatory factor IL-6, TNF-αand peripheral blood CD3 +CD4 +T cell apoptosis were the highest in overlap group com-pared to those of other three groups (P<0.05). The ratio of PMN and macrophages in BALF were significantly higher in em-physema group than those of other three groups (P<0.05) and the pathology scores of lung, liver, pancreas, the ratio of carot-id artery intima-media thickness of whole thickness of vascular were significantly higher in overlap group than those of other three groups (P < 0.05).Conclusion In rat model of intermittent hypoxia-emphysema there are more serious systemic multi-organ inflammation and immune responses.

Objective To investigate the effect of cluster interventions for prevention of ventilator-associated pneumonia (VAP)on mechanical ventilation.Methods A total of 110 patients with mechanical ventilation more than 48 hours at the intensive care unit(ICU)between April 2011 and June 2012 were randomly divided into three groups:control group(n=36),subglottic secre-tion drainage(SSD)group(n=37),cluster(CL)group(n=37).At the end of study,VAP incidence rate,VAP related death rate, duration of mechanical ventilation,ICU length of stay(LOS)were investigated and compared among the three groups.Results The morbidities of VAP between control group and SSD group were significantly different in the third day,the 7th day of mechanical ventilation.The morbidity of VAP of CL group was lower than that of control group,The morbidity of VAP of CL group was lower than that SSD group in the over 9 day.and its duration of mechanical ventilation and ICU LOS were significantly lower than those of SSD group and control group.However,there was no significant difference of VAP related death rate among the three groups. Conclusion Strictly implement semi-supine position and oropharynx intervention strategies of each link in mechanical ventilation that has important significance to preventing ventilator-associated pneumonia.

Objective To observe the effects of rehabilitation training combined with health education on quality of life and psychological state of elderly patients with chronic obstructive pulmonary disease (COPD).Methods A total of 108 elderly inpatients with moderate to severe COPD in stable conditions were randomly divided into an intervention group and a control group,with 54 patients in each group.The patients in both groups received general respiratory medical therapy.The patients in intervention group also received additional comprehensive rehabilitation training consisting of individualized exercise instructions and health education,while the patients in control group only received online telephone health education and rehabilitation training instruction.Patients in both groups were assessed by using St.George's respiratory questionnaire (SGRQ) and symptom checklist 90 (SCL-90) before and after one year of treatment.Results After treatment,the control group's scores for various SGRQ items were similar to the scores within the group before treatment (P ＞ 0.05).The intervention group's SGRQ scores for symptoms,mobility and impact on life and the total score were (42.12 ± 11.32),(45.17 ± 10.23),(29.98 ± 6.54) and (41.02±9.92),respectively,significantly different from their baseline values and those of the control group after treatment (P ＜ 0.01).After treatment,the intervention group's SCL-90 scores were significantly improved from baseline values and were also significantly different from the control group (P ＜ 0.05).Comparison between the two groups showed that throughout the treatment period,the number of patients with acute attacks and the number of patients' hospitalization due to acute attacks were statistically significantly lower in the intervention group (P ＜ 0.05).Conclusions Rehabilitation training combined with health education can significantly improve quality of life and psychological health of COPD patients.

Objective:To clarify the effect of miR-200c on the proliferation of retroperitoneal fibroblast, and analyze its molecular mechanism, which provide theoretical basis for the inhibition of retroperitoneal fibrosis. Methods: 36 cases of retroperitoneal tissues were collected, and the primary fibroblasts were cultured. The cells stimulated by 5 ng/ml transforming growth factor-β1 (TGF-β1) were used as TGF-β1 group;the cells were transfected with pcDNA3.1-miR-200c first, and then stimulated by 5 ng/ml TGF-β1 were used as miR-200c group;the cells transfected only by pcDNA 3.1 were used as pcDNA 3.1 group;the normal cultured cells were used as control group. The MTT assay, cell scratch and Transwell chamber were used to detect the proliferation and migration of fibroblast, respectively. The ELISA experiment was used to detect the content of Akt protein in the lysis liquid of each group. Results: The OD value of fibroblast proliferation in miR-200c group was obviously lower than that of TGF-β1 group (P<0.01);compared with TGF-β1 group, the cell migration rate was decreased significantly in miR-200c group (P<0.01);the content of Akt protein in miR-200c was obviously lower than that of TGF-β1 group (P<0.01). Conclusion: miR-200c inhibits the effect of TGF-β1 on the proliferation and migration of fibroblast by down-regulating Akt signaling pathway, which has important significance in inhibiting peritoneal fibrosis.

BACKGROUND:Endoplasmic reticulum stress participates in the occurrence and development of many diseases, such as atherosclerosis, diabetes, and Alzheimer’s disease. GRP78 is a marker of endoplasmic reticulum stress. The expression of GRP78 reflects the degree of endoplasmic reticulum stress.
OBJECTIVE:To investigate the effect of cyclic stretch on GRP78 expression of L6 rat myoblasts, and to identify the relationship between cyclic stretch and endoplasmic reticulum stress.
METHODS:In vitro culture-tensile stimulation models of myoblasts of L6 rats were established successful y. The expression of GRP78 of myoblasts exposed to cyclic stretch was determined by reverse transcription-PCR and western blot assay. Stretch groups were subjected to 15%surface elongation at a frequency of 10 cycles per minute, over a period of 1, 6, 12 and 24 hours. cells were simultaneously seeded on a plate in the control and experimental groups with no stimulation.
RESULTS AND CONCLUSION:The expression of GRP78 mRNA was continuously elevated over time after stretched treatment, and significant differences were detected as compared with the control group (P<0.05). GRP78 protein expression began to increase at 1 hour after stretched treatment, was significantly increased at 6 hours, peaked at 24 hours, and significant differences were visible as compared with the control group (P<0.05). In conclusion, cyclic stretch induced the occurrence of endoplasmic reticulum stress, which was enhanced with prolonged time. However, prolonged stretch caused severe endoplasmic reticulum stress and leaded to apoptosis of myoblasts.

BACKGROUND:The adaptive reconstruction of maxil ofacial muscles would happen when functional orthopedic treatment is done to cure micromaxil ary deformity. The myoblast is the main responder in the process of adaptive reconstruction, and cyclic stretch can induce apoptosis of myoblasts. Caspase-9 is an important factor in the mitochondrial apoptosis pathway.
OBJECTIVE:To investigate the expression of Caspase-9 in different cyclic stretch.
METHODS:Based on myoblasts cultured in vitro-mechanical stimulation model, the rat L6 myoblasts were loaded stretch for 1, 6, 12 and 24 hours through multi-channel cellstress loading system, while the control group received no stretch. The morphological change and growth of myoblasts were observed under inverted phase contrast microscope;the expression of the mRNA and protein of Caspase-9 were detected by RT-PCR and western blot analysis, respectively.
RESULTS AND CONCLUSION:Under inverted phase contrast microscope, the rat L6 myoblasts at cyclic stretch maintained a good growth state and biological characteristics;there was no celldegeneration;and the loss rate was extremely low, which could demonstrate that myoblast in vitro-mechanical stimulation model was established successful y. The results of RT-PCR and western blot analysis showed that, the expression of Caspase-9 mRNA and Cleaved Caspase-9 protein was significantly increased as the loading time prolonged, and the expression of Procaspase-9 protein was significantly decreased as the time. We can conclude that Caspase-9 is involved in the mechanical signal transduction of cyclic stretch.

Objective:To explore the application effect of case-based learning (CBL) combined with problem-based learning (PBL) interactive teaching mode on the teaching of rehabilitation nursing.Methods:The research objects were 89 nursing interns of Batch 2019 and Batch 2020 from the Department of Rehabilitation Medicine, The Second Affiliated Hospital of Chongqing Medical University, and they were divided into experimental group ( n=44) and control group ( n=45). The experimental group adopted CBL+PBL interactive teaching mode, and the control group adopted traditional teaching mode. Teaching period lasted 5 months. SPSS 17.0 statistical software was used for t test. Results:Compared with the control group, the academic and specialized operation performances of experimental group were significantly improved [(84.55±6.35) vs. (89.51±4.87) and (94.74±1.58) vs. (95.93±1.19), P<0.05]. In the comprehensive quality evaluation, the interns' work performance was also significantly improved in experimental group [(9.69±0.51) vs. (9.23±0.99), P<0.05]. Conclusion:CBL+PBL teaching method has better teaching effect than traditional teaching mode in the teaching of rehabilitation nursing interns.

OBJECTIVE: To explore the molecular reasons of weak expression of B antigen on the red cell. METHODS: Serological test for blood group was carried out, including red cell and plasma grouping, and anti-A1 and anti-H testing, and confirming weak A or B antigens by adsorption and elution. Exons 1-7 were sequenced directly, and one of them was cloned and sequenced. RESULTS: All of the 23 samples showed the weak B antigen by serological method. The alleles of the subgroups were identified by DNA sequencing, including 2 Bel subgroup, 4 B3 subgroup, 14 Bw subgroup, 2 CisAB subgroup and a novel allele. The novel allele showed a nucleotide substitution 662G>A in the exon 7, and the sequence was submitted to Blood Group Antigen Gene Mutation Database, and the novel allele was named Bel10. CONCLUSION Nucleotide substitution in exon results in blood subgroup, which showed that the antigens were weakened, and Bw phenotype was the most frequently subgroup.
ABO Blood-Group System/genetics* ; Alleles ; Exons ; Genotype ; Humans ; Nucleotides ; Phenotype

Objective To discuss the feasibility and safety of simultaneous bilateral adrenal vein sampling(AVS)using two 4F-MPA1 catheters via right elbow vein access.Methods A total of 51 consecutive patients with primary aldosteronism,who received simultaneous bilateral AVS using two 4F-MPA1 catheters(one of the two catheters was shaped into pig tail figure)via right elbow vein access at Xiangyang Municipal Central Hospital between October 2021 and October 2022,were enrolled in this study.The used catheter,the success rate of simultaneous bilateral AVS,and the incidence of complications rate were calculated.Results The 4F-MPA1 catheter was used for all of the right AVS,while a specially shaped 4F-MPA1 catheter was used for the main trunk vein AVS of the left adrenal gland and the central vein AVS of the left adrenal gland.The success rate of simultaneous bilateral AVS was 92.2%(47/51).Adrenal hematoma occurred in one patient(1.96%).Conclusion The technique of simultaneous bilateral AVS using two 4F-MPA1 catheters via right elbow vein access is simple to operate,less traumatic,and clinically safe and feasible.However,due to the small sample used in this study,the clinical value of this technique still needs further investigation and verification.

【Objective】 To investigate the serological and molecular characteristics of twenty blood samples carrying ABO^*AW.37 allele and to analyze ABO allelic enhancement. 【Methods】 The ABO phenotype of the twenty samples was determined by serological methods and the genotype of 1-7 ABO exons was analyzed by Sanger sequencing. 【Results】 Sequencing analysis showed that all twenty samples contained a c. 940A>G(p.Lys314Glu) mutation of A allele, which was defined as ABO^*AW.37. When ABO^*AW.37 and B alleles were inherited simultaneously in 9 cases, in forward typing anti-A antibodies all agglutinated and the serological phenotype was AwB. Among the 11 cases with ABO^*AW.37 and O alleles inherited simultaneously, there was no agglutination of anti-A in forward typing. For absorption and elution tests, 5 cases were weakly positive and the serological phenotype was Ael, while 6 cases were negative for absorption and elution tests and the serological phenotype was O type. 【Conclusion】 Allelic enhancement occured when both ABO^*AW.37 allele and B allele were inherited simultaneously. When ABO^* AW.37 was inherited simultaneously with O allele, the serological phenotype was Ael or O type and attention should be paid to blood type identification.