Aim To study the expression of protein kinase C(PKC) subtype PKC? in rat pulmonary microvascular endothelial cell(RPMVEC),and the effect of its inhibitor(Rottlerin) on LPS-induced RPMVEC monolayer permeability injury.Methods In cultured RPMVEC,Western blot and immunohistochemistry were used to identify the expression of PKC?.Micro-infiltrator was used to measure the changes of RPMVEC monolayer permeability coefficient(Kf) after exposure to LPS or LPS with Rotterin together.Result We found a high level of PKC? expression in cytoplasm.Rottlerin could obviously inhibit the increase of LPS-induced RPMVEC Kf value.Conclusion The activation of PKC is involved in the progress of LPS-induced RPMVEC injury.Furthermore,the inhibitor of PKC? could release LPS-induced RPMVEC Kf increase.

Objective To study the role of soluble intercellular adhesion molecule-1 ( sICAM-1 ) in the pathogenesis of adults bronchial asthma and analyze the relationship between the level of sICAM-1 and the severity of bronchial asthma.Methods Serum levels of sICAM-1 in 134 cases with different periods of bronchial asthma patients and healthy volunteers were measured by ELISA and pulmonary functions of acute asthma patients were determined by pulmonary function analyzer. Results Serum sICAM-1 levels in 63 cases of acute asthma patients were increased significantly when compared with those in remission asthma patients and healthy volunteers and its value was increased significantly with the exacerbation of asthma;A negatively correlation between FEV1％ of pulmonary function and serum sICAM-1 level in patients with acute asthma was found in this study. Conclusion sICAM-1 was one of the important adhesion molecules in the pathogenesis of bronchial asthma. It could be used as one indicator of disease severity and guide the drug application in clinic.

Objective:To investigate the application value of hepatic vein outflow tract reconstruction with ringed polytetrafluoroethylene vascular in right lobe living donor liver trans-plantation.Methods:The retrospective and descriptive study was conducted. The clinicopatho-logical data of 4 donors and 4 recipients undergoing right lobe living donor liver transplantation in Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School and 17 donors and 17 recipients undergoing right lobe living donor liver transplantation in the First Affiliated Hospital with Nanjing Medical University from June 2015 to August 2018 were collected. Of 21 donors, there were 10 males and 11 females, aged from 35 to 57 years, with a median age of 46 years. The median body mass of 21 donors were 64 kg, with a range from 56 to 72 kg. Of 21 recipients, there were 16 males and 5 females, aged from 21 to 68 years, with a median age of 42 years. The median body mass of 21 recipients were 63 kg, with a range from 47 to 77 kg. Observation indicators: (1) surgical and postoperative situations; (2) follow-up. Follow-up was conducted by outpatient examination or telephone interview to detect graft function, tumor recurrence, vascular graft complications, patency of vascular graft and survival of recipients up to August 2020. All recipients will be followed up for all their lives. Measurement data with normal distribution were represented as Mean±SD and measurement data with skewed distribution were represented as M (range). Count data were represented as absolute numbers or percentages. The Kaplan-Meier method was used to calculate patency rates of hepatic vein outflow tract and survival rates to draw patency curve and survival curve. Results:(1) Surgical and postoperative situations: the operation time, the weight of donor graft, graft to recipient weight ratio and duration of hospital stay of 21 donors were (367±72)minutes, (557±68)g, 0.89%±0.16% and (10+2)days, respectively. No major complication requiring reoperation or intervention occurred in any of the 21 donors. One donor undergoing mild bile leakage preserved peritoneal drainage for one week. All 21 recipients underwent classic orthotopic liver transplantation successfully. The time of hepatic vein outflow tract reconstruction in donor graft, operation time and time of anhepatic phase of 21 recipients were (24±4)minutes, (326±66)minutes and (42±6)minutes, respectively. The number of reconstructed middle hepatic vein in hepatic segment 5 and 8 were 18 and 15, with the diameter of (6.1±1.3)mm and (7.2±1.2)mm, respectively. The number of reconstructed inferior right hepatic vein were 10, with the diameter of (6.3±1.3)mm. The postoperative treatment time at intensive care unit and duration of hospital stay of 21 recipients were (1.5±0.9)days and (22.6±6.7)days, respectively. Ten of 21 recipients underwent postoperative complications. Five recipients underwent graft dysfunction including the level of alanine aminotransferase and aspartate aminotransferase >1 000 IU/L and the level of bilirubin slightly increasing, combined with increased ascites. Enhanced computed tomography scan showed congestion in the right anterior of graft and thrombosis in the middle hepatic vein of hepatic segment 5 and segment 8. All 5 recipients undergoing graft dysfunction recovered with normal liver function and ascites decreasing after symptomatic treatment including liver protection therapy, anticoagulation and albumin infusion. Two recipients underwent inferior vena cava thrombosis and intractable pleural effusion one month after operation. Vena cava venography examination showed thrombosis in the graft vascular. Of the 2 recipients, one case with collateral circulation formation recovered undergoing balloon dilatation and stent placement combined with anticoagulation therapy of warfarin. The other one case recovered after anticoagulation therapy of warfarin. One recipient undergoing bile leakage and abdominal infection with klebsiella pneumoniae recovered after symptomatic treatment. Two recipients undergoing abdominal infection or pulmonary infection recovered after symptomatic treatment. There was no serious complication or death during perioperative period. (2) Follow-up: all 21 recipients were followed up for 10 to 57 months, with a median follow-up time of 38 months. During the follow-up, no recipient underwent graft dysfunction and 2 recipients had tumor recurrence at postoperative 6 months. Six of the 21 recipients died within 2 years after operation including 3 cases dying of tumor recurrence, 2 cases dying of acute hemorrhage and 1 case dying of liver failure. There was no death caused by vascular graft complica-tions. The postoperative 1, 3, 6-month, and 1-year and 2-year potency rates of hepatic vein outflow tract in 21 recipients were 88.4%, 88.4%, 82.4%, 68.0% and 42.1%, respectively. The 6-month, 1-year and 2-year overall survival rates in 21 recipients were 100%, 94.4%, 71.4%, respectively.Conclusion:Application of hepatic vein outflow tract reconstruction with ringed polytetrafluoroethylene vascular in right lobe living donor liver transplantation is safe and feasible.

OBJECTIVE To study the pharmacokinetics of heat shock protein 65-mucin 1 (HSP65-MUC1) recombinant fusion protein vaccine in Macaca mulatta monkeys and tumor-bearing mice. METHODS HSP65-MUC1 was labeled by radioactive isotope 125I. M. mulatta monkeys were randomly divided into sc and iv administration groups. Simultaneously, sc administration group was designed as a multiple dose group in which M. mulatta monkeys were sc given [ 125I] HSP65-MUC1 40 μg·g-1, once every 2 weeks for a total of 3 times. Size exclusion chromatography ( SEC) was used to determine concentrations of HSP65-MUC1 in serum samples. The tumor-bearing mice were randomly divided into 0.5, 1.5, 4, 8 and 24 h groups. Mice were sc given [125I] HSP65-MUC1 550 μg·kg-1, tissues were collected and tissue distribution of [125I] HSP65-MUC1 in tumor-bearing mice was studied using trichloroacetic acid (TCA) precipitation method. RESULTS The absolute bioavailability of [125I]HSP65-MUC1 was 38.33% after M. mulatta monkeys were sc given [125I]HSP65-MUC1. In multiple dose group, concentrations of [125I]HSP65-MUC1 after the third dose administration was compared to that of the first dose administration. The accumulation factor (AUC3/AUC1) was 1.17 ±0.25. Distribution of [ 125I]HSP65-MUC1 was significantly different compared with general polypeptide and protein drugs after sc in tumor-bearing mice. The concentration in lymph nodes was the highest. The concentration in other immune tissues, such as thymus and spleen, were not relatively high, but their declined tendency was slow after reaching the peak concentration (cmax ). However, the concentrations in the serum and some other tissues with a large blood volume, such as the heart, liver, and lung, were relatively low and declined quickly after reaching cmax. Its level in the tumor was not very high. [125 I] HSP65-MUC1 was excreted mainly by the kidneys. CONCLUSION The bioavailability of [125I]HSP65-MUC1 is 38.33% after sc administration in M. mulatta. After multiple-dose administration, the vaccine does not accumulate in the body, whose concentration is the highest in lymph nodes after [1251] HSP65-MUC1 was sc given in tumor-bearing mice, but is not very high in tumor. Besides, the vaccine declined tendency is slow after reaching cmax in immune tissues such as thymus and spleen compared with other tissues with a large blood volume.

Objective To explore the effect of prevention and treatment of external application of Algoplaque for controlling phlebitis caused by peripheral indewelling needle in vein for patients. Methods This research was divided into two parts,prevention and treatment. As for prevention research,patients were randomly divided into the experimental and the control groups,each group included 30 patients. In the experimental group,we applied directly external application of Algoplaque at the upper of needle puncture site of the vein and nearby the eye. In the control group,we applied the film directly to fix the indwelling needle. As for the treatment research, it was carried out in patients with occurred phlebitis, who were randomly divided into two groups,the experimental group included 30 cases of patients and the control group included 28 cases of patients. Observation time was one to five days. Results The incidence of phlebitis in the experimental group of prevention research was 23%, in the control group it was 90%. The incidence of phlebitis in the experimental group was significantly lower than that of the control group. The effective rate in the experimental group of treatment research was 96.7% and it was 67.9% in the control group. The difference was very significant. Conclusions External application of Algoplaque can effectively control phlebitis caused by peripheral indewelling needle in vein.

Objective: To explore the effects of effort-reward imbalance (ERI) at work on the occupational burnout, job satisfaction and turnover intention of doctors in public hospitals. Methods: By using self-designed questionnaires to in-vestigate job attitude, this paper adopts a stratified random sampling method to select 1910 doctors from public hospitals in Jinan, Weifang and Dezhou cities based on the level of economic development in Shandong province. The data are ana-lyzed using descriptive analysis, correlation analysis, hierarchical regression analysis, etc. Results: The effort-reward imbal-ance at work exists in the surveyed public hospitals. The job effort of doctors is 1. 39 ± 0. 37 times higher than job reward. The effort-reward imbalance at work has positive predictive effects on occupational burnout, negative predictive effects on job satis-faction, and positive predictive effects on turnover intention. Conclusions:Public hospital administrators should improve the ef-fort-reward ratio of doctors in order to stabilize doctors' professional attitude at work and enhance their morale.

Objective To explore the clinical features of type 2 diabetic patients with hypertension , and to analyze the influencing factors of glycemic control. Methods Using stratified cluster random sampling method, 5 communities were selected from urban areas of Huai'an in 2014. Type 2 diabetic patients managed by the communities were surveyed with questionnaire, physical and biochemical examinations. The related information and clinical features were compared between diabetic patients with and without hypertension. Logistic regression analysis was used to analyze the influencing factors of glycemic control. Results The number of well-controlled diabetic patients (HbA1c<7.0%) with and without hypertension (HbA1c<7.0%) were 419 (39.3%) and 480 (52.1%), respectively. Mean values of body mass index (BMI), diabetic duration and serum creatinine in diabetic patients with hypertension were significantly higher than those in diabetic patients without hypertension (P<0.05). The proportions of macrovascular complications and dyslipidemia in diabetic patients with hypertension were significantly higher than diabetic patients without hypertension (P<0.05). Multiple logistic regression analysis showed that high degree of education, high annual family income and high frequency of glucose monitoring were beneficial factors for glycemic control in diabetic patients with hypertension. Older age, hypertension, higher waist to hip ratio (WHR), the elevated triglyceride and serum creatinine were harmful factors for glycemic control. Conclusions The situation of glycemic control in diabetic patients with hypertension in urban areas of Huai'an is not optimistic. Therefore, community managements of risk factors such as central obesity and increased triglyceride in elder diabetic patients should be strengthened.

Objective To construct and identify retroviral-mediated short hairpin RNA ( shRNA ) expression vectors of ERβ419, and explore ERβ419 unknown biological function in beagles in future.Methods To screen out the most effective gene silencing sequence of beagle ERβ419 mRNA using qRT-PCR and Western Blot assays, imitate beagle estrogen target cells.Results qRT-PCR results showed, ERβ419-shRNA1 ( P <0.01 ) and ERβ419-shRNA3 ( P <0.01)differed significantly, Western Blot result as same as qRT-PCR,ERβ419-shRNA3 is the best choice.Conclusion Beagles ERβ419-shRNA3 retrain most effectively target gene repression. It is applied to explore ERβ419 unknown biological function in beagles reproductive system, and to prevent and treat beagles reproductive function diseases.

Objective To understand the status of renal function abnormalities and explore its influencing factors in a community-based population with type 2 diabetes mellitus (T2DM).Methods Totally 9 413 patients with T2DM who have registered and received management of community public health service in 2014 were recruited in our study.All participants undertook questionnaire survey,physical examination and laboratory test.A simplified MDRD formula was used for estimating Glomerular Filtration Rate (eGFR),and Logistic Regression method was used to analyze the risk factors.Results The average eGFR was 91 ml/min · 1.73 m2 and the attack rate of people with eGFR ＜60 ml/min 1.73 m2 was 10.56％.The difference of renal function in participants with different age and gender was significant(x2 =6.306,P =0.012;x2 =269.293,P ＜ 0.001).Renal function in male patients and older patients was more worse.Multivariate analysis showed that long duration of diabetes,high levels of low density lipoprotein (LDL),total cholesterol (TC) and triglycerides (TG),uncontrolled blood glucose were independent risk factors for renal dysfunction.Conclusions Patients with T2DM are susceptible to renal function abnormalities.Comprehensively control of blood glucose,blood lipid and blood pressure should be performed to decrease the risk of the disease.

Background:With the progress and widely application of endoscopic techniques,the prevalence rate of periampullary diverticulum (PAD)is increasing in recent years. However,the results of studies investigating the correlation of PAD and its types with common bile duct (CBD)stone are different. Aims:To investigate the influence of PAD and its types on CBD stone. Methods:A total of 1524 consecutive inpatients who underwent diagnostic and therapeutic ERCP for pancreatobiliary diseases from Jan. 2014 to Dec. 2016 at the General Hospital of Xinjiang Military Region of Chinese PLA were enrolled and divided into two groups according to the presence or absence of PAD. Patients in PAD group were further classified into 3 subgroups by the papilla's location with respect to the diverticulum. Their clinical data were collected and retrospectively analyzed. Results:The proportion of elderly patients (≥60 years old)in PAD group was 82. 2% (310 /377),which was significantly higher than that in non-PAD group [60. 8% (697 / 1147),P < 0. 05]. The prevalences of CBD stone,gallstone associated with CBD stone,post-cholecystectomy and recurrent CBD stone were higher and the size of CBD stone was larger in PAD group than in non-PAD group (P all < 0. 05). Furthermore,stratified analysis revealed that the CBD stone was more prevalent and the size of stone was larger in type Ⅱ PAD than in type Ⅰ and type Ⅲ PAD (P <0. 05), while recurrent CBD stone was more frequent in type Ⅰ and type Ⅱ PAD than in type Ⅲ PAD (P < 0. 05). Multivariate analysis indicated that the elderly and PAD were the risk factors for recurrence of CBD stone,and cholecystectomy was a protective factor. Conclusions:The elderly is predisposed to PAD. PAD and its types are associated with the development and recurrence of CBD stone. CBD stone is more prevalent in patients with PAD especially type Ⅱ PAD. The size of stone is larger and the post ERCP recurrence rate is high in type Ⅱ PAD.