AIM:To investigate the influence of programmed cell death 5 (PDCD5) on apoptosis and autoph-agy in the cardiomyocytes exposed to hypoxia/reoxygenation ( H/R) and its potential mechanism .METHODS:H9c2 cells were exposed to H/R.PDCD5 was downregulated by RNA interference .The cell viability was measured by MTT assay . TUNEL assay was used to detect cell apoptosis .The mRNA and protein levels were determined by RT-qPCR and Western blot.RESULTS:The expression of PDCD5 was upregulated in the cardiomyocytes after H/R injury.Furthermore, H/R injury obviously reduced the cell viability and enhanced the apoptosis and autophagy of the cardiomyocytes .However, knockdown of PDCD5 increased the cell viability , and attenuated H/R-induced apoptosis , accompany with reduction of Bax and augment of Bcl-2 expression .Additionally , silencing PDCD5 markedly inhibited H/R-induced autophagy by regulating the expression of LC3-II/LC3-I and beclin-1.Moreover, downregulation of PDCD5 suppressed NF-κB signaling by redu-cing the protein level of p-P65.CONCLUSION: Silencing PDCD5 suppresses H/R-induced H9c2 cells apoptosis and autophagy by blocking NF-κB signaling pathway .The result indicates a new strategy for the prevention and treatment of myocardial I/R injury.

BACKGROUND:Myocardial infarction leads to ischemic changes in the myocardium, triggering the emergence of ventricular remodeling, which is an important cause of death. Myocardial infarction is a common disease in the middle-aged and elderly population, but autologous bone marrow mesenchymal stem cells from these patients exhibit a weak ability of proliferation and differentiation. Therefore, a positive attempt of allogeneic stem cel transplantation is required in order to obtain better therapeutic outcomes. OBJECTIVE:To explore the effect of al ogeneic bone marrow mesenchymal stem cel s on ventricular remodeling after myocardial infarction. METHODS:Bone marrow mesenchymal stem cel s from 10 neonatal rats and 10 adult rats were isolated, cultured and identified. Another 40 rats were randomly assigned into four groups (n=10/group):model group, neonatal rat cel transplantation group, adult rat cel transplantation group, or sham group. Animal models of myocardial infarction were made in rats in the al groups except for the sham group in which the rats were given sham operation. Rats in the two cel transplantation groups were given the corresponding cel transplantation. Four weeks postoperatively, heart function of rats was detected in each group, and cardiac tissues were taken to detect changes in col agen formation and blood vessel density in the infarct area. RESULTS AND CONCLUSION:Four weeks after surgery, rats in the model group showed significant changes in cardiac function indexes as compared with the other groups (P<0.05), while compared with the model group, these cardiac function indexes improved in both two cel transplantation groups, but there was no significant difference between the two cell transplantation groups (P>0.05). Meanwhile, compared with the model group, significantly decreased collagen formation and increased blood vessel density were found in both two cell transplantation groups (P<0.05). Additionally, the vascular density of the infarct area was highest in the sham group (P<0.05). Experimental results show that both neonatal and adult rat bone marrow mesenchymal stem cel transplantation can improve cardiac function of rats, reduce the formation of collagen in the infarct area and delay ventricular remodeling after myocardial infarction.

Objective To investigate the expression of peripheral blood (PB) CD4+ CD25+ Foxp3+ regulatory T cells (Tregs) in patients with benign end-stage liver disease after liver transplantation and the relationship between levels of PB Tregs and acute rejection. Methods A prospective analysis was performed on 55 consecutive patients who underwent liver transplantation.Fourteen out of 55 cases suffered from acute rejection after liver transplantation were defined as rejection group,while the rest patients were classified into no acute rejection group. PB was obtained from liver transplant patients at different time points longitudinally: pre-transplant, post-transplant within one year and acute rejection. The circulating CD4+ CD25+ Foxp3+ Tregs in PB were measured by flow cytometry. Blood samples were drawn during acute rejection, at the same time, liver biopsies were performed. The circulating CD4+ CD25+ Foxp3+ Tregs were compared between two groups.Results There was no difference between two groups in levels of circulating CD4+ CD25+ Foxp3 + Tregs cells pre-transplant. However, the levels of circulating CD4+ CD25+ Foxp3+ Tregs in rejection group were decreased significantly as compared with no-rejection group (2. 23 % ± 0. 54 % vs. 2. 99 % ±0. 86 %,P＜0.01). The frequency of CD4+ CD25+ Foxp3+ T cells was negatively correlated with rejection activity index (RAI) (r = - 0. 80, P＜0. 01 ). Conclusion Monitoring PB CD4+ CD25+ Foxp3+ Tregs levels may be helpful in evaluating the immune state and act as a more sensitive marker for acute rejection diagnosis in the patients following liver transplantation.

Objective To probe the indication of biliary tract reconstruction without T-tube in orthotopic liver transplantation.Methods We put forward indications of biliary tract reconstruction without T-tube in orthotopic liver transplantation since January 2004 and there were 102 patients who underwent liver transplantation in our hospital without a T-tube in place after biliary tract reconstruction.The incidence of biliary tract complication was observed in these patients.Results All patients were followed up for more than 6 months.The incidence of biliary tract complication was 4.9 percent(5/102)in this group with 3 patients of intrahepatic difluse bile duct stenosis necessitating liver re-transplantation.The other 2 patients with common hepatic duct nonanastomotic stenosis were healed by ERCP plus stent placement.Conclusions Biliary tract reconstruction without T-tube placement helps to decrease the incidence of biliary tract complications resulting from the T-tube removal.

Objective　To investigate the relationship between the composite dietary antioxidant index (CDAI) and excess heart age (EHA), offering theoretical insights into the nutritional prevention of cardiovascular disease (CVD). Methods Data for this cross-sectional analysis was derived from the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2020, which included 16 442 participants aged 30 to 74 years without a history of CVD. The heart age was estimated using the Framingham risk score function, and EHA was subsequently calculated. The CDAI was formulated based on intake levels of vitamins A, C, E, zinc, selenium, and carotenoids to represent the overall level of antioxidants. The association between CDAI and EHA was evaluated using multivariate linear regression, multivariate logistic regression, and restricted cubic splines (RCS). Results Multiple regression analysis indicated that CDAI was negatively correlated with both EHA (β=-0.07, 95%CI: -0.14 to -0.01) and high CVD risk (defined as EHA≥10 years) (OR=0.98, 95%CI: 0.96 to 1.00), with RCS analysis suggesting that this relationship is a nonlinear and inverse L-shaped. In the female subgroup, significant negative, nonlinear associations were observed between CDAI and both EHA (β=-0.10, 95%CI: -0.12 to 0.00) and high CVD risk (OR=0.97, 95%CI: 0.94 to 0.99). Conversely, in males, these correlations did not reach statistical significance. Conclusions Our findings suggest that individuals with higher CDAI compliance had a lower risk of CVD, and this negative correlation was gender specific. This discovery offers new theoretical guidance for the nutritional prevention of CVD, underlining the necessity for more comprehensive clinical and foundational research to further explore this association.

Objective To explore causes leading to and the timing of liver retransplantation. Methods Among 164 cases of liver transplantation from Jul. 1999 to Dec. 2004, 6 cases underwent retransplantation with an incidence of 3. 65%. Causes included multiple intrahepatic bile duct stricture by ischemic reperfusion injury in 3 cases, hepatic artery stricture and thrombosis, hepatitis B recurrence, outflow obstruction of hepatic veins in one each. Results Clinical symptom improved in 4 cases, and failed to improve in 2 cases. Two cases suffered from intraabdominal bleeding, one biliary leak, one bacterial infection, two mold infection. Two patients died from bacterial and mold infection in four months. Conclusion Ischemic reperfusion injury is main cause resulting in intrahepatic bile duct stricture, liver retransplantation should be performed when the function of graft deteriorates significantly and conservative therapy fails.

Objective To analyze the relationship among perceived stress, resilience and sleep quality in patients with coronary heart disease, and to examine the mediating effect of resilience between perceived stress and sleep quality. Methods Totally 231 patients with coronaryheartdisease were selected. The Pittsburgh Sleep Quality Index (PSQI), Perceived Stress Scale (PSS), and 10-item Connor-Davidson Resilience Scale (CD-RISC-10) were used to assess the sleep quality, perceived stress and resilience respectively. Results The average scores of PSQI were (7.2 ± 2.8) points, and 71.4％ (165/231) of the participants had sleep problems (PSQI>5). CD-RISC-10 scores were negatively correlated with PSQI scores and PSS scores (r=-0.62,-0.43, P<0.01), and PSS scores were positively correlated with PSQI scores (r=0.33, P<0.01). Furthermore, Bootstrap-generated 95％CI was (0.130-0.319, P<0.01) and did not include 0, which indicated that resilience significantly mediated the relationship between perceived stress and sleep quality. The mediating effect size of resilience was 56.1％. Conclusion It suggests that patients with coronary heart disease have poor sleep quality. Perceived stress and resilience could affect sleep quality, and resilience could mediate the relationship between perceived stress and sleep quality.

Objective To investigate the diagnostic accuracy of malignant tumor of 18F-fluorodeoxyglucose positron emission tomography/computed tomograprhy (18F-FDG PET/CT) imaging in the patients of elevated serum carbohydrate antigen 19-9 (CA19-9) and its correlation with maximum standardized uptake value (SUVmax) and serum CA19-9 level.Methods Whole-body 18F-FDG PET/CT scan was performed in 149 patients with elevated serum CA19-9 level without the history of malignancy.Blood sample was drawn in each case for CA19-9 assay two weeks or less before the performing PET/CT.Final diagnoses were confirmed by operation/biopsy pathological results and clinical follow-ups.Results Among the 149 patients,64 cases were finally diagnosed as malignancies and 85 cases of non-malignancy diseases.The true positive of the diagnoses by 18F-FDG PET/CT was 60 cases,the false positive 13 cases,the true negative 72 cases,the false negative 4 cases.The accuracy of diagnosis of malignant tumor with elevated serum CA19-9 was 43.0％,while elevated serum CA19-9 combined with 18F-FDG PET/CT imaging was 88.6％,with statistically significant difference (x2 =59.882,P ＜ 0.05).The serum CA19-9 was divided into 4 groups according to the different levels of 37-100 U/ml,100-500 U/ml,500-1000 U/ml and ＞ 1 000 U/ml.The diagnostic accuracy of each group of PET/CT was 94.5％,84.9％,81.3％ and 88.0％,respectively.There was no statistically significant difference between each group (x2 =3.503,P ＞ 0.05).The area under the curve (AUC) of the serum CA19-9 for the diagnosis of malignant tumor (ROC) was 0.726,and the sensitivity and specificity of the diagnostic boundary value of 152.75 U/ml were 70.3％ and 68.2％,respectively.The AUC of SUVmax in diagnosis of malignant tumor was 0.742,the best cutoff value was 6.95,and the sensitivity and specificity were 73.3％,69.2％ respectively.Conclusions 18 F-FDG PET/CT is useful for detecting malignant tumors combined with serum tumor marker CA19-9.The patients with elevated serum CA19-9 are necessary to do PET/CT imaging,especially serum CA19-9 ＞ 152.75 U/ml.And it should be considered malignant tumor when SUVmax ＞ 6.95.

Objective:To investigate mental workload among nurses from tertiary hospitals in Shandong Province, and analyze various factors related to mental workload.Methods:From May to July 2019, a cluster sampling method was used to select 8255 nurses from 20 third class a general hospitals in 16 cities of Shandong Province as the research objects, and 8159 valid questionnaires were collected. The general information and psychological load of nurses were investigated by general information questionnaire and task load index scale. The measurement data were expressed in percentage (%) ; the nurses' psychological load scores were in accordance with normal distribution, and the differences between groups were compared by t-test or ANOVA; the related influencing factors of nurses' psychological load were analyzed by multiple stepwise regression analysis.Results:The average scores of mental workload among nurses was 77.83 (SD=12.88) . Time demands and physical demands were the two highest rated dimensions of mental workload. the average scores were 90.77 (SD=12.47) and 79.92 (SD=15.23) . Multiple stepwise regression analysis showed that Satisfaction with income, monthly average night shift and professional titles were the significant predictors of mental workload ( R2=0.08) . Conclusion:Nurses with higher psychological load, lower income satisfaction, higher number of night shifts per month and lower title have higher psychological load.

Objective:To investigate mental workload among nurses from tertiary hospitals in Shandong Province, and analyze various factors related to mental workload.Methods:From May to July 2019, a cluster sampling method was used to select 8255 nurses from 20 third class a general hospitals in 16 cities of Shandong Province as the research objects, and 8159 valid questionnaires were collected. The general information and psychological load of nurses were investigated by general information questionnaire and task load index scale. The measurement data were expressed in percentage (%) ; the nurses' psychological load scores were in accordance with normal distribution, and the differences between groups were compared by t-test or ANOVA; the related influencing factors of nurses' psychological load were analyzed by multiple stepwise regression analysis.Results:The average scores of mental workload among nurses was 77.83 (SD=12.88) . Time demands and physical demands were the two highest rated dimensions of mental workload. the average scores were 90.77 (SD=12.47) and 79.92 (SD=15.23) . Multiple stepwise regression analysis showed that Satisfaction with income, monthly average night shift and professional titles were the significant predictors of mental workload ( R2=0.08) . Conclusion:Nurses with higher psychological load, lower income satisfaction, higher number of night shifts per month and lower title have higher psychological load.