Objective:To investigate the effects of gene silencing inducible cyclooxygenase-2 (COX-2) combined with hyperbaric oxygen (HBO) on neuronal cell edema, apoptosis, autophagy and neural functional recovery in rats with intracerebral hemorrhage.Methods:SPF-grade adult male SD rats ( n=96) were used to establish a cerebral hemorrhage model through stereotactic injection of thrombin VII into the caudate nucleus. They were randomized (random number) into 4 groups ( n=24/group): control group, hyperbaric oxygen (HBO) group, COX-2 RNAi group and combined group (COX-2 RNAi+HBO). The siRNA plasmid targeting silencing COX-2 gene expression was constructed. After group treatment, the four rats were randomly selected from each group for testing in each category. Postoperative day 1, 7, and 14 were assessed using the modified neurological severity score (mNSS) for evaluating neurofunctional deficits. On the 7th day, the water content of the brain tissue was measured using the dry/wet weight method. The blood-brain barrier permeability was assessed using the Evans method. Annexin V and TUNEL assays were employed to assess the apoptotic rate of neural cells. The mRNA expression level of COX-2 in brain tissue was determined using the RT-PCR method. The protein expression levels of Beclin-1, COX-2, aquaporin 4 (AQP-4), B cell lymphoma/lewkmia-2 (Bcl-2), caspase-3, hypoxia-inducible factor-1α (HIF-1α) and matrix metalloprotein-2/9 (MMP-2/9) were detected by Western blot (WB). SPSS software was used for data analysis. One-way ANOVA was used for inter group comparisons and LSD- t test was used for further pairwise comparison. Results:The SD rat intracerebral hemorrhage model and plasmid construction were successfully achieved. The mNSS scores were significantly decreased in COX-2 RNAi, HBO and combined groups compared with control group on the 7th day and 14th day (all P<0.01), especially in combined group ( P<0.01). The contents of Evans blue and the water content of brain tissue of all treatment groups were significantly lower than those in control group (all P<0.05), especially in combined group ( P<0.01). The apoptotic rate of neural cells decreased in all treatment groups compared with the control group (all P<0.05), and the combined group decreased the most ( P<0.01). The mRNA expression levels of COX-2 were significantly decreased in all treatment groups compared with the control group (all P<0.01), and combined group silenced COX-2 expression most obviously ( P<0.05). The results of WB showed that the protein expression levels of Beclin-1, COX-2, AQP-4, Caspase-3, HIF-1α, MMP-2/9 were significantly lower than control group (all P<0.05), while the expression of Bcl-2 was increased in all treatment groups (all P<0.01). Among them, the combined group exhibited the most pronounced trend ( P<0.01). Conclusions:Gene silencing of COX-2 in combination with hyperbaric oxygen therapy can effectively restore neurological function in rats with cerebral hemorrhage. The mechanism may be associated with reduced blood-brain barrier permeability, alleviated brain edema, and inhibition of neuronal apoptosis and autophagy.

Objective:To establish an early prediction model based on triglyceride glucose index (TyG) and procalcitonin (PCT) for patients of acute pancreatitis (AP) complicated with acute kidney injury (AKI), and evaluate the diagnostic value of prediction model.Methods:This study was a single center prospective study. AP patients were recruited from the Emergency Department at Peking University People’s Hospital from January to December 2022. The observation endpoint was 14 days after the diagnosis of acute pancreatitis, patients were divided into AKI and control (no AKI) groups according to the observation endpoint. The general characteristics, clinical laboratory examinations, complications, and clinical scores were compared. The risk for AKI development was determined using logistic analyses to establish a risk prediction model. The receiver operating characteristic curve was drawn and the area under the curve (AUC) was calculated. The diagnostic sensitivity and specificity of the model were calculated, and the diagnostic value of the model was compared with that of Ranson score, APACHEⅡ score and BISAP score.Results:A total of 258 patients were selected for this study, including 79 in the AKI group and 179 in the control group. There was no significant difference in serum creatinine and blood urea nitrogen levels between the two groups. Compared with the control group, the AKI group had a higher proportion of males, older age, and had a higher proportion of hypertension. The ratio of neutrophil/lymphocyte ratio, PCT, and TyG were significantly increased. The Ranson score, APACHE Ⅱ score, and BISAP score were higher, and more patients had ARDS and serous fluid accumulation in the later period. Multivariate logistic regression showed that age ( OR=1.071, 95% CI: 1.020-1.125, P=0.006), increased TyG index ( OR=2.632, 95% CI: 1.423-4.866, P=0.002), and elevated PCT ( OR=1.275, 95% CI: 1.067-1.524, P=0.008) were risk factors for AKI in AP patients. According to the risk factors, forecast the AP patients complicated with AKI risk assessment model is established: Logistic (AKI/AP) = -16.697+0.069×age+ 0.968×TyG+0.243×PCT. The sensitivity and specificity of the model for predicting AKI in AP were 79.75% and 96.65%, respectively, and the AUC was 0.856 (95% CI: 0.790-0.922). The predictive ability was better than that of Ranson score, BISAP score and APACHE Ⅱ score (AUC: 0.856 vs. 0.691 vs. 0.745 vs. 0.705, P=0.041). Conclusion:The prediction model based on age, TyG and PCT was valuable for the prediction of AP concurrent AKI in early stage.

Objective: To explore the relationship between lifestyle and myopia and construct Nomogram model to predict myopia risk among primary school students in Tianjin, so as to provide a scientific basis for precision myopia prevention and control. Methods: From April to July of 2022, a census method was used to conduct vision testing and lifestyle related questionnaires among 373 180 primary school students in 15 districts of Tianjin. The relationship between lifestyle and myopia was analyzed by the multivariate Logistic regression, and a nomogram prediction model was constructed to predict myopia risk. Results: The detection rate of myopia among primary school students in Tianjin was 37.6%. The results of the multivariate Logistic regression showed that daily outdoor activity time of 1-2 h ( OR =0.94) and >2 h ( OR =0.84), time of using daily electronic devices of >2 h ( OR =1.03), daily paper materials reading and writing time of 1-2 h ( OR =1.02) and >2 h ( OR =1.09), weekly fresh vegetable intake of 2-6 times ( OR =0.93) and ≥7 times ( OR =0.88) were statistically correlated with myopia ( P <0.01). The Nomogram prediction model showed that the factors associated with myopia were grade, family history of myopia, gender, daily outdoor activity time, weekly frequency of fresh vegetable intake, daily paper materials reading and writing time, and time of using daily electronic devices time. Conclusions The lifestyle of primary school students in Tianjin is associated with myopia. The constructed nomogram model could provide a scientific basis for identifying key intervention populations for myopia prevention and taking targeted prevention and control measures.

Humans ; Adolescent ; Acne Vulgaris/therapy* ; Skin Care ; Surveys and Questionnaires ; Cognition ; China ; Skin

Objective:To explore the efficacy and safety of Neuroform Atlas stent-assisted coil embolization in ruptured anterior communicating wide-necked aneurysms.Methods:Thirty-two patients with ruptured anterior communicating wide-necked aneurysms accepted Neuroform Atlas stent assisted coil embolization in Department of Neurosurgery, People's Hospital Affiliated to Shandong First Medical University from January 2022 to June 2023 were chosen. DSA was performed immediately after surgery, and aneurysm embolization was assessed using Raymond grading. Prognoses were assessed by modified Rankin Scale (mRS, mRS scores≤2 as good prognosis and mRS scores>2 as poor prognosis) at last follow-up. DSA was performed again 6 months after surgery to assess the aneurysm healingResults:Neuroform Atlas stents were successfully implanted in all 32 patients; Postoperative DSA showed that aneurysm embolization reached Raymond grading I in all 32 patients(100%). No such complications as in-stent thrombosis, cerebral vasospasm, or poor opening of the stent were noted excepted for one with intraoperative aneurysm rupture hemorrhage. At the last follow-up, 31 patients had good prognosis and 1 had poor prognosis; in 22 patients underwent DSA re-examination, Raymond grading I was noted in 20 patients (90.91%) and grading II in 2 (9.09%).Conclusion:Neuroform Atlas stent-assisted coil embolization for ruptured anterior communicating wide-necked aneurysms seems safe and effective.

Objective To explore the value of ¹⁸F-FDG PET/CT in the diagnosis of cholangiocarcinoma. Methods Data were collected from 44 patients with cholangiocarcinoma who underwent PET/CT in Affiliated Cancer Hospital of Shandong First Medical University from September 2017 to October 2020. All patients underwent upper abdominal CT and MRI and whole-body PET/CT. The diagnostic value of three examinations was compared for primary lesions, recurrent lesions, and regional lymph node metastasis of cholangiocarcinoma. Results There were no significant differences in the diagnostic sensitivity of CT, MRI, and PET/CT in the primary lesions and regional lymph node metastasis of cholangiocarcinoma (P > 0.05). There were significant differences in the diagnostic sensitivity of the three examinations for recurrent cholangiocarcinoma lesions (P < 0.05). Conclusion PET/CT has high diagnostic value for recurrent lesions of cholangiocarcinoma, but the three examinations showed no significant differences in the diagnostic sensitivity for primary lesions and regional lymph node metastasis.

COVID-19 ; Humans ; Inflammation/genetics* ; Lung ; Pneumonia ; SARS-CoV-2 ; Serologic Tests

Objective:To investigate the effect of lenalidomide (LEN) combined with temozolomide (TMZ) on proliferation, invasion, drug resistance and O6-methylguanine-DNA methyltransferase ( MGMT) gene epigenetic modification of TMZ-resistant human glioblastoma cell line U251/TR. Methods:A TMZ-resistant human glioma cell line, U251/TR, was successfully established by stepwise exposure of U251 parental cells to TMZ. U251/TR cells were divided into dimethyl sulfoxide (DMSO) group, LEN group, TMZ group and LEN+TMZ group (DMSO group: without any drug intervention; LEN group, TMZ group, and LEN+TMZ group were pretreated with 100 μmol/L LEN, 200 μmol/L TMZ, 100 μmol/L LEN+200 μmol/L TMZ, respectively; the drugs were administered once every 24 h). The proliferation rate of these cells in each group was detected by sulfonylrhodamine B colorimetric assay at different time points (24, 48, 72, and 96 h after treatment). At 96 h after treatment, the invasion and migration abilities of cells in each group were detected by Transwell assay; the proliferation cycle of cells in each group was detected by flow cytometry; Western blotting, immunohistochemical staining and immunofluorescence staining were used to detect the MGMT protein expression, and the MGMT mRNA expression in cells of each group was detected by reverse transcription-PCR; methylation specific PCR was used to detect the MGMT gene promoter methylation in each group of cells. Results:The cell proliferation rate of LEN+TMZ group was significantly decreased as compared with TMZ, LEN, and DMSO groups at 24, 48, 72 and 96 h after treatment ( P<0.05). At 96 h after treatment, LEN+TMZ group had significantly decreased number of transmembrane cells, and significantly increased ratio of cells at G0/G1 phase as compared with the other 3 groups ( P<0.05); the MGMT protein and mRNA expression levels in TMZ group and LEN+TMZ group were significantly lower than those in LEN group and DMSO group ( P<0.05); and the number of cells with strong or moderate MGMT expression in TMZ group and LEN+TMZ group was obviously less than that in LEN group and DMSO group, and the MGMT fluorescence intensity in TMZ group and LEN+TMZ group (+) was obviously lower than that in LEN group (+++) and DMSO group (+++). The MGMT gene promoter was unmethylated in all groups. Conclusion:LEN alone does not obviously inhibit the proliferation and invasion of U251/TR cells; but LEN combined with TMZ could inhibit the proliferation and invasion of U251/TR cells and co-reverse the drug resistance of U251/TR cells, whose mechanism is not related to the changes of MGMT gene promoter methylation.

Objective:To explore the effect of student standardized patients in experimental teaching of Internal Medicine Nursing. Methods:Totally 440 undergraduate students in Batch 2016 from the Nursing Department of Chengdu Medical College were divided into 9 groups with 5-6 students in each group. The situational teaching method of students' standardized patients playing clinical cases was adopted in internal medicine experimental teaching, and the teaching effect was evaluated by the questionnaire survey after the class.Results:More than 90.45% (398/440) of the students thought that this teaching method could enhance the ability of knowledge understanding and memorizing, 91.36% (402/440) of them thought that it could improve their corporation with classmates, 90.23% (397/440) of them thought that various abilities such as clinical thinking could be improved, and 87.27% (384/440) of them were satisfied with it.Conclusion:Applying standardized patients to the experimental teaching of internal medicine nursing is effective and can stimulate students' learning enthusiasm, thus improving the teaching effect.

Objective:To investigate the effect of hyperbaric oxygen combined with RNA interference (RNAi) technology targeting aquaporin-4 (AQP-4) on improving cognitive function in rats with traumatic brain injury (TBI), and to explore its mechanism.Methods:Totally 112 adult male SD rats were randomly divided into four groups: control group, hyperbaric oxygen(HBO) group, AQP-4 RNAi group and combined treatment group, with 28 rats in each group.The TBI model of rat was established by hydraulic percussion and siRNA targeting aquaporin 4 was constructed. Rats were given corresponding intervention according to their groups.Then the modified neurological severity scores(mNSS)was evaluated on the 7th day and 21th day after operation. Morris water maze test was carried out from the 21st day to 25th day after operation and the percentage of target quadrant and daily escape latency were recorded.The changes of the brain permeability of blood-brain barrier and moisture in brain tissues were measured by Evans blue fluorometry and a wet-dry-weighing technique respectively. The protein expression levels of AQP-4, Caspase-3, Bcl-2, MMP-2 and MMP-9 were detected by Western blot method. The mRNA expression of AQP-4 in TBI brain tissue was measured by RT-PCR method, and the apoptosis rate of TBI brain cells was detected by TUNEL and AnnexinV methods on the 7th day after operation. SPSS 23.0 and Graphpad Prism 7.0 softwares were used for data analysis.One-way ANOVA was used for inter group comparison.Repeated measurement ANOVA was used for Morris results, and the LSD- t test was used for pairwise comparisons. Results:The results of mNSS showed that there were significant differences among the groups on the 7th day and 21st day after operation ( F=4.89, 7.59, both P<0.05). The scores of each treatment group were lower than that of the control group, and the effect of the combined treatment group was the best (7th day: t=3.98, -7.75, both P<0.05; 21st day: t=47.82, 7.94, both P<0.05). The results of Morris water maze test showed that the time and group interaction of rats in the target quadrant residence time and escape latency were not statistically significant( F=1.83, 8.42, both P>0.05). The escape latency and the percentage of stay in the target quadrant in the combined treatment group were better than those in other groups on the 24th and 25th day after operation (all P<0.05). Evans blue staining showed that the contents of Evans blue in AQP-4 RNAi group, hyperbaric oxygen group and combined treatment group were lower than that in the control group(all P<0.05), and that in the combined treatment group was the lowest( t=6.19, P<0.05). The results of dry-wet specific gravity method showed that the water content of brain tissue in the combined treatment group((68.15±1.52)%) was the lowest, and that in the AQP-4 RNAi group((76.71±1.06)%) was lower than that in the HBO group ((80.23±1.43)%)( t=4.38, P<0.05). The results of Western blot showed that the protein levels of AQP-4, Caspase-3, MMP-2 and MMP-9 in the combined treatment group were significantly lower than those in other groups(all P<0.05), while the expression of Bcl-2 was increased in the combined treatment group( P<0.05). RT-PCR results (gray value ratio) showed that AQP-4 mRNA levels in AQP-4 RNAi group(0.61±0.21), HBO group (0.83±0.12), combined treatment group(0.22±0.05) and CON group (1.31 ± 0.25) were significantly different( F=175.05, P<0.05), while the AQP-4 mRNA levels decreased in AQP-4 RNAi group which was better than that in hyperbaric oxygen group ( t=5.25, P<0.05). The decrease was the most obvious in the combined treatment group ( t=58.94, P<0.05). The results of TUNEL and AnnexinV showed that the treatment groups were more effective than the control group in inhibiting neuronal apoptosis, especially in the combined treatment group ( P<0.01). Conclusion:The combination of targeted AQP-4 RNAi and hyperbaric oxgen can effectively promote the recovery of neurological and cognitive function, and the mechanism may be related to protecting the integrity of blood-brain barrier, alleviating brain edema and inhibiting apoptosis of nerve cells after TBI.