Objective To investigate the role of Rho kinase on collagen(COL)Ⅰ and Ⅲ expression of human renal tubular epithelial cells .Methods Human kidney tubular epithelial (HK‐2) cells were cultured in the RPMI‐1640 culture solution containing 15% fetal bovine serum .After 30 min pretreatment by the ALD receptor antagonist eplerenone(10 μmol/L) and Rho kinase inhibi‐tor Y27632(1 μmol/L) ,100 nmol/L ALD acted the HK‐2 cells for 24 h .The expressions of collagenⅠ and Ⅲ mRNA in each group were detected by real time PCR and the expression levels of COL Ⅰ ,Ⅲ and Rho kinase protein were detected by ELISA .Results ALD could up‐regulate the expressions of COLⅠ ,Ⅲ mRNA in HK‐2 cells ,and increased the levels of Rho kinase ,COLⅠ and Ⅲprotein ,while the Rho kinase inhibitor Y27632 and ALD receptor inhibitor eplerenone could antagonize these effects .Conclusion ALD could activate Rho kinase signal transduction pathway in HK‐2 cells and accelerate the progression of tubular interstitial fibro‐sis via Rho kinase induced expression of COL Ⅰ and Ⅲ .

Objective:To investigate the use of psychological testing in hospital and its potential existent ethical issues.Methods:Eleven psychometricians from 6 specialized and 5 general hospitals accepted a semi-structural interview.With (10.8 ± 8.8) years of experiences on average in this field,they tested 2 to 30 patients each day.Content analysis was used to investigate the psychometricians' qualification,usage of tests,informed consent,scoring,explanation and preservation.Results:Normally,the number of psychometricians in one hospital varied from 1 to 4.Out of 11 interviewees,2 were unqualified.Three of the interviewees pointed out there were non-standard circumstances when some doctors choosing the tests.Six of them thought that the frequently used tests' norms were obsolete.Eight interviewees considered that comparatively low psychometric fee influenced their devotion of explaining the results.Conclusion:In hospital,it's necessary to strength the ethical awareness of decision-makers and executors in psychological testing.

Objective To investigate the effect of Suanzaoren Decoction on hippocampus, cortex BDNF and TrKB gene expression in depression model rats. Methods Depression rat models were established by social-isolated raise and chronic stress stimulation. Suanzaoren decoction was administrated to the models. RT-PCR was adopted to detect the expression of mRNA BDNF and TrKB genes. Results The mRNA expression of BDNF and TrKB in cortex of Suanzaoren decoction high dose group、medium dose group and clomipramine group(0.213±0.094, 0.639±0.023, 1.032±0.015, 1.089±0.014, 1.580±0.012, 1.860±0.019)were all higher than the model group(0.032±0.008, 0.001±0.000), showing a significant difference among four groups (P<0.01), and the mRNA expression of BDNF and TrKB in hippocampus of Suanzaoren decoction high dose group, medium dose group and clomipramine group(0.213±0.094, 0.639±0.023, 1.032±0.015, 1.089±0.014, 1.580± 0.012, 1.860±0.019)were higher than the model group (0.021±0.015, 0.125±0.013), there was a significant difference between four groups(P<0.01). Compared with the model group, the mRNA expression of low-dose group of Suanzaoren decoction in both cortex and hippocampus of BDNF and TrKB was not significantly different to the model group(P>0.05). Conclusion Suanzaoren decoction can increase the expression of BDNF and TrKB gene, promote neuronal proliferation, and resist depression.

Abstract: Objective　To analyze the genotype of carbapenemase resistance genes and their genetic homology in multidrug-resistant Acinetobacter baumannii, and to provide a theoretical basis for guiding the rational use of antibiotics and controlling the prevalence of nosocomial infections. Methods A total of 83 multidrug-resistant Acinetobacter baumannii isolated from patients in the intensive care unit (ICU) and environmental specimens in the Sixth People's Hospital of Nantong from July 2020 to December 2021 were collected. The bacteria were identified and subjected to drug sensitivity tests using the BioMérieux DL96-Ⅱ automatic bacterial identification susceptibility system. The carbapenemase-related drug resistance gene types were detected using the polymerase chain reaction (PCR) method, and clones were analyzed by pulsed field gel electrophoresis (PFGE). Results The types of 83 ICU Acinetobacter baumannii specimens include sputum (43 strains), broncholavage fluid (20 strains), and surfaces of objects such as ventilators (20 strains). The resistance rates of all strains to imipenem, tetracycline, gentamicin, amikacin and ciprofloxacin were 100%, 32.5%, 38.6%, 41.0% and 77.1% respecitively, while the resistance rates to others such as ticarcillin and clavulanate were greater than 95%. All strains carried were detected to carry OXA-23 and OXA-51 genes, while OXA-24, OXA-58, IMP-1, VIM, IMP-4, SIM and NDM-1 resistance genes were all negative. PFGE homology analysis confirmed that 83 strains of Acinetobacter baumannii, with counts of 12, 18, 12, 13, 10, 6, 7, 5 respectively, mainly A, B, C, D, E clones, the rest were sporadic clones. Conclusions The carbapenem resistant Acinetobacter baumannii isolated from our ICU are widely drug-resistant to commonly used antimicrobial drugs, with B clone strain being the major prevalent strain. Carrying OXA-23 and OXA-51 genes may be an important reason for the resistance of Acinetobacter baumannii to carbapenem antibiotics in our ICU. Rational use of antimicrobial drugs, enhanced monitoring of bacterial resistance, and effective control of the generation and further spread of drug-resistant strains should be emphasized.

Objective To analyze the disease spectrum of abdominal external hernia during medical selection of flying cadets and compare the medical standards between US Air Force and Chinese PLA Air Force in order to improve the system of medical selection.Methods The data about abdominal external hernia among flying cadets during Chinese PLAAF medical selection between 2012 and 2015 were retrospectively analyzed and compared with the medical standards of the USAF flying cadets.Results Twenty-nine candidates were eliminated because of hernia,including 4 cases of hiatal hernia,3 cases of umbilical hernia and 22 cases of inguinal hernia.4.70% of the candidates were eliminated because of hernia disease.Empirical research showed difference in hernia standards between China and the USA.Conclusion Compared with Chinese medical selection standards,the USAF standards give more weight to whether the symptoms of disease impact air safety and efficiency.Our medical selection standards need to be improved by learning from foreign practices.

BACKGROUND: Endoscopic transnasal lacrimal duct reconstruction by grafting of autogenous tissue is a novel method for treatment of severe lacrimal duct obstruction and it needs detailed anatomical data for surgery.OBJECTIVE: To study the applied microsurgical anatomy of lacrimal duct and to provide anatomical evidence for endoscopic transnasal lacrimal duct reconstruction by grafting of autoganous tissue.DESIGN, TIME AND SETTING: This study was performed at the laboratory of the Department of Ophthalmology, Armed Police General Hospital from July 2006 to June 2007.MATERIALS: Twenty 10% formaldehyde-treated adult cadaveric heads, 14 males and 6 females, comprising 40 lacrimal ducts were included in this study.METHODS: The cadaveric heads were split on the level of the line between the superior border of the superciliary arch and the site 10 mm higher than occipital tuberosity. After removal of brain tissue,the heads were decalcified for approximate 1 week with 10%nitric acid. This promised non-alteration of morphological structure and facilitation for surgical cutting. Following dissection of facial cranium in the median sagittal plane, the nasal septum was excised to expose the lateral wall of the nasal cavity.MAIN OUTCOME MEASURES: The anteroposterior diameter and depth of lacrimal fossa; at middle third level, the thickness of lacrimal fossa at the anterior lacrimal crest, vertical middle line, and posterior lacrimal crest; the cross section area of nasolacrimal canal upper opening, middle part, and lower opening; horizontal distance, 30° oblique distance, and 45°oblique distance from lacrimal caruncie to nasal cavity; distance from lacrimal caruncle to nasolacrimal canal upper opening; and the included angle between lacrimal caruncle-nasolacrimal canal upper opening line and Aeby's plane.RESULTS: The length, anteroposterior diameter, and depth of lacrimal fossa were (17.85±1.72) mm, (6.74+1.28) mm, and (3.09+0.78) mm, respectively. At middle third level, the thickness of lacrimal fossa at the anterior lacrimal crest,perpendicular bisector, and posterior lacrimal crest was (4.03±0.89) mm, (0.61±0.36) mm, and (0.63±0.24) mm, respectively.Anterior lacrimal crest was significantly thicker than vertical middle line and posterior lacrimal crest (P ＞ 0.05). Horizontal distance, 30°oblique distance, and 45° oblique distance from lacrimal caruncle to nasal cavity was (17.23±0.70) mm,(14.51±1.72) mm, and (17.34±2.38) mm, accordingly, with a difference which was not significant (P ＞ 0.05). The distance from lacrimal caruncle to lateral wall middle point of nasolacrimal duct superior opening was (11.86±1.84) mm, and the included angle between lacrimal caruncle-lateral wall middle point of nasolacrimal duct superior opening line and Aeby's plane averaged (49.9±1.8)°.CONCLUSION: The distances from lacrimal caruncle to nasal cavity and lacrimal sac and the included angles between lacrimal caruncle-nasolacrimal canal upper opening line and Aeby's plane provide guidance significance for selection of bony opening position on the lateral wall of nasal cavity and determinations of tunnel oblique angle and autogenous tissue length. Creation of bony tunnel should start from the middle or posterior middle part of lacrimal fossa and then extend towards anterior inferior region with an optimal downward oblique angle of 45°. The length of autogenous tissue used for lacrimal duct reconstruction should exceed 21.22 mm.

Objective To summarize the results of valve re-operative cases after cardiac valve replacement, to find the better re-operative time, and to estimate the re-operative methods and influencing factors of the operation. Methods Thirteen valve re-operative cases after cardiac valve replacement from October 2008 to February 2010 were retrospectively studied. According to NYHA classification, 9 cases belonged to class Ⅳ, and only 4 cases belonged to class Ⅲ preoperatively. Mitral valve replacement (MVR)was performed in 7 cases, aortic valve replacement (AVR) in 3 cases, MVR + AVR in 3 cases. Results The early-stage postoperative mortality was 7.7%( 1/13),and the reason was low cardiac output syndrome. Two cases who underwent re-operation and re-intubation respectively after operation for hemorrhage were improved after treatment. Twelve cases were discharged in 3-6 weeks after heart valve surgery and all were followed up for 6-15 months. The cardiac function of all the discharged patients recovered well and no death occurred during follow-up. Conclusion The key factors to reduce the death of re-operation are improving preoperative heart function,setting up extracorporeal circulation as soon as possible,consummating myocardial preservation,perfecting operating skills,correcting low cardiac output syndrome in time and preventing complications.

ObjectiveTo explore the surgical treatment of congenital heart disease combined with severe pulmonary hypertension.MethodsThirty-two patients of congenital heart disease combined with severe pulmonary hypertension were included in the study.The saturation of arterial oxygen ranged from 0.84 to 0.94 and echocardiography showed left to right slow velocity shunt in 20 eases,double direction shunt in 10 cases and no shunt in 2 cases.The pulmonary arterial pressure was 65-120 (82 ± 14) mm Hg ( 1 mm Hg =0.133 kPa).All patients received surgical repairs under cardiopulmonary bypass and were treated preoperatively with oxygen inhalation therapy,oral intake of beraprost sodium or silaenafil respectively according to the degree of pulmonary hypertension.During cardiopulmonary bypass,pulmonary artery perfusion was performed with protective solution containing ulinastatin for lung protection.Vasoactive drugs were routinely administrated postoperatively.Results Thirty-two cases underwent the surgical treatment successfully with their postoperative pulmonary arterial pressure decreased 20 -40 mm Hg and 2 cases died of severe low cardiac output syndrome and fatal arrhythmia.The mortality was 6.25％(2/32).ConclusionComprehensive perioperative management followed by radical operation can achieve a good clinical result on congenital heart disease combined with pulmonary hypertension.

Objective:To learn the cognition and attitudes of psychometric ethics of graduate students whose major was clinical psychology or counseling psychology,and to investigate whether ethics training could influence their cognition and attitude.Methods:Researchers distributed the questionnaire online regarding cognition and attitudes of psychometric ethics among clinical and counseling psychology graduate students.Seventy-six feedbacks were collected (4 students were learning ethics courses,27 students had learned ethics courses,45 students hadnt learned ethics courses).The questionnaire included the Psychometric Cognition Questionnaire (PCQ),Situational Judgement Questionnaire (SJQ) and Psychometric Attitude Questionnaire (PAQ).The first two sets of questionnaires reflected ethics knowledge.The last one showed ethics attitudes and behavioral tendencies.Results:The correct rates in participants who had learned or were learning ethics were 76.5％ and 75.1％ at the first and second set of questionnaires,while were 73.9％ and 74.2％ in other participants.The correct rates of three major clauses in PCQ were 90.3％,67.7％ and 74.2％,significantly higher than participants who never learned ethics,whose correct rates were 88.9％,66.7％,and 44.4％ (Ps ＜ 0.05).There were no significant differences in SJQ between those who had learned or was learning ethics and those who had never learned ethics (Ps ＞0.05).Participants who had learned or were leaning ethics scored in sum in PAQ that had no significant differences with those who had never learned ethics(Ps ＞ 0.05).Conclusion:Clinical and counseling psychology graduate students master considerable level of knowledge on ethics and attitude.Ethics training is essential for acquiring psychometric ethics.

Preeclampsia(PE) is a unique disease to pregnancy women,and women who had a history of preeclampsia significantly increased the risk of cardiovascular disease.Preeclampsia etiology and pathogenesis is not clear yet,it may have common pathophysiology with cardiovascular disease(CVD),such as oxidative stress,endothelial injury,insulin resistance,lipid metabolic disorder and so on.The article reviewed the relationship between preeclampsia and long-term cardiovascular disease among women,especially discussed the disease such as coronary heart disease,hypertension and stroke,to find the association and to explore the potential risk management options for these high-risk women.To block,intervene,and prevent cardiovascular disease starting with preeclampsia,it is of significance to the cardiovascular health of over 300 million women worldwide.