AIM: We used an animal model of chronic hypoxia to mimic right ventricular hypertrophy and try to study the potential mechanism of myocardium apoptosis of right heart in rat under chronic hypoxia.METHODS: Rat hypoxia models were established by exposing the rats to normobaric chronic hypoxia(oxygen levels were maintained at 9.5%-10.5%).Sixty rats were separated into two groups: one exposed to hypoxia and the other serving as control.Ten rats,randomly selected from each group were killed at 14,21,28 d after hypoxia.The apoptosis was determined.The changes of RV weight to left ventricle and interventricular septum weight ratio[RV/(LV+S)],the RV weight to body weight ratio(RV/BW) were also observed.The ?-MHC,bcl-2 and bad mRNA levels in right ventricle were detected by semi-quantitative RT-PCR assays and expression of ?-MHC,Bcl-2 and Bad protein levels were detected by Western blotting.RESULTS: The RV/(LV+S),RV/BW and apoptosis index in chronic hypoxia group were higher than those in normal control group(P0.05).Finally,a decreased bcl-2/bad ratio in chronic hypoxia group was found compared with control group(P

ObjectiveTo explore the regulation of claudin-4 expression in endometrial adenocarcinoma cell lines by progesterone.Methods Ishikawa cells were treated with various concentrations of megestrol acetate (MA:2,5,10,15,20 mg/L).After cultured for 24,48 and 72 hours,cells growth were measured by methyl thiazolyl tetrazolium (MTT).The group of Ishikawa cells incubated with MA at the 50％ inhibitory concentration ( IC50 ) was selected for cell apoptosis assay by using transmission electron microscopy and flow cytometry method.Real-time PCR and western blot were used for detecting the mRNA and protein expression levels of claudin-4.The localization of claudin-4 was examined by immunofluorescent staining.Results The inhibitory effects of megestrol acetate on the growth of Ishikawa cells were dosedependent and time-dependent.IC50 of MA on Ishikawa cells was 15 mg/L after incubated for 72 hours.After MA treatment,Ishikawa cells showed shrinkage,nuclear chromatin condensation,fractures of nuclear membrane and endoplasmic reticulum expansion,even round apoptotic bodies were found.The apoptosis rate of cells before MA treatment was (0.076 ±0.024)％,and the rate was (3.934 ±0.816)％ by MA treated for 72 hours,in which there were signicant difference( P ＜ 0.05 ).The relative quantification of claudin-4 mRNA and protein of the cells before MA treatment were 0.64 ± 0.20 and 0.94 ± 0.18,while they were 0.47 -0.15 and 0.62 ±0.15 after MA treated.The expression of claudin-4 was significantly decreased after MA treatment ( P ＜ 0.05 ).The localization of claudin-4 transferred from cytomembrane to cytoplasm and nucleus after MA treatment.Conclusions MA could inhibite the growth of Ishikawa cells,in which the mechanism may be decrease the expression of claudin-4 and the apoptosis of cells.The distribution change of claudin-4 may be related to the anti-cancer effect of progesterone.

In this study, the "150-cavity", next to the H5N1 influenza virus neuraminidase activity site, has been used as the target to design and synthesize a structural analogue of chlorogenic acid, N-caffeoyl-GABA, using the flexible docking simulation. The docking study showed that the N-caffeoyl-GABA could be inserted into the "150-cavity" and combined with the Arg156 side chain by hydrogen bond. The best binding free energy of H5N1 NA-N-caffeoyl-GABA complex was -7.70 kcal mol(-1), equivalent that of the NA-oseltamivir. At the same time, using the H5N1 pseudotyping virus-based NA inhibitors screening model, we determined the inhibitory effect of oseltamivir, chlorogenic acid and N-caffeoyl-GABA on the NA. Compared with chlorogenic acid, N-caffeoyl-GABA significantly enhanced the inhibitory effect on NA, but less than oseltamivir. This study showed that the "150-cavity" could possibly be used as a new neuraminidase inhibitors target, and provided a path for the development of new neuraminidase inhibitors.

Objective To study the effect of skin protective membrane, semi-transparent dressing and combination of the two in critically ill patients with incontinence associated dermatitis (IAD) skin protection. Methods A total of 114 patients who were admitted into ICU and NICU of Hebei Xingtai People′s Hospital from December 2013 to November 2014 were selected. These subjects were divided into 3 groups randomly. All three groups received routine skin care, on this basis, skin protective membrane group (34 cases) used skin protective membrane for skin protection, semi-transparent dressing group (40 cases) adopted semi-permeable dressing for skin protection, while the combination group (40 cases) used skin protective membrane combined with semi-transparent dressing for skin protection. The incidence, occurrence and severity of IAD in the three groups were compared. Results The incidence rate of IAD in the combination group was 20.0%(8/40), 20.6%(7/34) in the skin protective membrane group, and significantly lower than 47.5% (19/40) in the semi-transparent dressing group, the difference was significant ( χ2=9.201, P<0.05). The occurrence time of IAD in the combination group was (4.75±0.46) days, which was significantly longer than those of the skin protective membrane group [(3.86±1.35) days] and the semi-transparent dressing group [(2.74±0.73) days], the difference was significant (F=17.120, P < 0.05). The IAD severity of the combination group scored 3.63 ±0.92, which was significantly lower than those of the skin protective membrane group (5.29±1.11) and the semi-transparent dressing group (6.74±1.79), the difference was significant (F=12.240, P<0.05). Conclusions Skin protective membrane combined with semi-transparent dressing have priority in decreasing IAD incidence rate, and delaying the occurrence time of IAD, and relieving the severity of IAD, which is better than either of the two.

Objective To find a safer and more effective facial care method,reduce the incidence rate of facial skin injury,and improve patients' comfort level,as well as work efficiency of nursing.Methods 90 patients with orotracheal intubation were divided into the control group,transparent dressing group and skin protecting membrane group by random number table method.The control group was conducted with basic facial nursing;the transparent dressing group was applied with protective transparent dressing on the basis of basic facial nursing;the skin protecting membrane group was applied with skin protecting membrane on the basis of basic facial nursing.This research was conducted by observing and recording the incidence rate of skin injury,severity of skin injury,patients' comfort level,duration of skin care and the results.Results The incidence rate of facial skin injury was as follows:skin protecting membrane group 6.89％ (2/29)and transparent dressing group 15.15％(5/33)were better than the control group 50.00％(14/28),statistical significance was found among the three groups (X2=16.75,P ＜ 0.05);The times of facial skin nursing was as follows:the skin protecting membrane group (4.28±0.53) times was less than transparent dressing group (4.52±0.76) times and the control group (6.04±1.35) times,statistical significance was found among the three groups (Hc=32.65,P ＜ 0.05).Patients' comfort level comparison were as follows:the skin protecting membrane group was better than transparent dressing group and the control group,statistical significance was found among the three groups (Hc=22.42,P ＜ 0.05);Duration of skin care were as follows:skin protecting membrane group (10.40±1.35) minutes was less than transparent dressing group (14.09±1.27) minutes and the control group (12.35±1.28) minutes,statistical significance was found among the three groups (F=85.87,P＜ 0.05).Conclusions Skin protective membrane can effectively reduce the incidence and severity of facial skin injury on patients with orotracheal incubation,improve patients' comfort level,and greatly reduce operation time for nurses through its easer operation and less time consumption.

Objective To evaluate the efficacy of Glutamine enriched enteral nutrition in the treatment of severe traumatic brain injury (sTBI).Methods PubMed,Cochrane Library,Chinese National Knowledge Infrastructure (CNKI),VIP Database for Chinese Technical Periodicals,and Wanfang databases were searched to identify randomized controlled trials (RCT) on the application of Glutamine enriched enteral nutrition for severe TBI patients from database establishment time to May 2017.Two investigators screened the literature strictly according to the inclusion and exclusion criteria,extracted the data,evaluated the literature quality,and performed meta-analysis using RevMan 5.3 software.The effects of glutamine enhanced enteral nutrition on albumin content,immunoglobulin G (IgG) level,the incidence of diarrhea,incidence of pulmonary infection,blood glucose,Glasgow Coma Scale (GCS),length of hospital stay,and mortality were evaluated.Results A total of 17 articles involving 939 sTBI patients were included,with 512 patients in Glutamine group and 427 controls in control group.There were no significant differences in the length of hospital stay and mortality between the two groups (P ＞ 0.05).Significant differences were found in albumin content (95 ％ CI 0.19-2.54,Z =2.27,P＜0.05),level of IgG (95％ CI 0.67-1.80,Z =4.25,P ＜0.01),incidence of diarrhea (95％ CI 0.23-0.57,Z =4.41,P ＜ 0.01),incidence of lung infections (95％ CI 0.14-0.56,Z =3.62,P＜0.01),blood sugar (95％ CI-2.53--0.52,Z=2.98,P＜0.01),and the GCS score (95％CI0.50-2.68,Z=1.49,P＜0.01) between the two groups.Conclusion Compared with routine enteral nutrition,Glutamine enriched enteral nutrition can increase albumin content and IgG level,reduce the incidence of diarrhea and lung infections,reduce blood sugar,and improve the GCS score,but it cannot shorten hospital stay or reduce mortality.

Objective To study the relationship between behavioral problems and family environment in preschool-age children. Methods Children between 4-6 years of age in the kindergartens of Zhongshan city were randomly selected. Child Behavior Checklist (CBCL) was used to assess the behavioral problems in children, and self-designed general situation question-naire and Family Environment Scale-Chinese Version (FES-CV) were applied to evaluate the family environment. Results A total of 3445 children were enrolled and 29.87%children showed behavioral problems. There were signiifcant differences in the scores of feeling expression, family conlfict, intelligence, recreation, organization and control between children with and without behavior problems (P<0.001). The scores of feeling expression, intelligence, recreation, organization and control were signiif-cantly higher and the score of family conlfict was lower in healthy children in comparison with children with behavior problems. Through multivariate logistic regression, it was suggested that female (OR=2.04), non-urban population (township OR=1.45, rural OR=1.51), non-local Zhongshan resident (OR=1.39), father’s low educational level (technical secondary school OR=1.77, junior high school OR=2.17, primary school and below OR=3.24), discipline styles (indulgent OR=1.47, mixed OR=1.37), family conlfict (OR=1.13) were independent risk factors for behavioral problems (P<0.05). Mother’s age over 30 (OR=0.74) or over 40 (OR=0.46), feeling expression (OR=0.94) and intelligence (OR=0.87) were independent protective factors for behavioral prob-lems (P<0.05). Conclusions Behavioral problems in preschool-age children are closely related to family environment, which needs to be paid more attention.

Objective:To observe and verify the changes of transcriptome in hyperoxia-induced acute lung injury (HALI), and to further clarify the changes of pathways in HALI.Methods:Twelve healthy male C57BL/6J mice were randomly divided into normoxia group and HALI group according to the random number table, with 6 mice in each group. The mice in the normoxia group were fed normally in the room, and the mice in the HALI group was exposed to 95% oxygen to reproduce the HALI animal model. After 72 hours of hyperoxia exposure, the lung tissues were taken for transcriptome sequencing, and then Kyoto Encyclopedia of Genes and Genomes database (KEGG) pathway enrichment analysis was performed. The pathological changes of lung tissue were observed under light microscope after hematoxylin-eosin (HE) staining. Real-time fluorescence quantitative reverse transcription-polymerase chain reaction (RT-PCR) and Western blotting were used to verify the key molecules in the signal pathways closely related to HALI identified by transcriptomics analysis.Results:Transcriptomic analysis showed that hyperoxia induced 537 differentially expressed genes in lung tissue of mice as compared with the normoxia group including 239 up-regulated genes and 298 down-regulated genes. Further KEGG pathway enrichment analysis identified 20 most significantly enriched pathway entries, and the top three pathways were ferroptosis signaling pathway, p53 signaling pathway and glutathione (GSH) metabolism signaling pathway. The related genes in the ferroptosis signaling pathway included the up-regulated gene heme oxygenase-1 (HO-1) and the down-regulated gene solute carrier family 7 member 11 (SLC7A11). The related genes in the p53 signaling pathway included the up-regulated gene tumor suppressor gene p53 and the down-regulated gene murine double minute 2 (MDM2). The related gene in the GSH metabolic signaling pathway was up-regulated gene glutaredoxin 1 (Grx1). The light microscope showed that the pulmonary alveolar structure of the normoxia group was normal. In the HALI group, the pulmonary alveolar septum widened and thickened, and the alveolar cavity shrank or disappeared. RT-RCR and Western blotting confirmed that compared with the normoxia group, the mRNA and protein expressions of HO-1 and p53 in lung tissue of the HALI group were significantly increased [HO-1 mRNA (2 -ΔΔCt): 2.16±0.17 vs. 1.00±0.00, HO-1 protein (HO-1/β-actin): 1.05±0.01 vs. 0.79±0.01, p53 mRNA (2 -ΔΔCt): 2.52±0.13 vs. 1.00±0.00, p53 protein (p53/β-actin): 1.12±0.02 vs. 0.58±0.03, all P < 0.05], and the mRNA and protein expressions of Grx1, MDM2, SLC7A11 were significantly decreased [Grx1 mRNA (2 -ΔΔCt): 0.53±0.05 vs. 1.00±0.00, Grx1 protein (Grx1/β-actin): 0.54±0.03 vs. 0.93±0.01, MDM2 mRNA (2 -ΔΔCt): 0.48±0.03 vs. 1.00±0.00, MDM2 protein (MDM2/β-actin): 0.57±0.02 vs. 1.05±0.01, SLC7A11 mRNA (2 -ΔΔCt): 0.50±0.06 vs. 1.00±0.00, SLC7A11 protein (SLC7A11/β-actin): 0.72±0.03 vs. 0.98±0.01, all P < 0.05]. Conclusions:HALI is closely related to ferroptosis, p53 and GSH metabolism signaling pathways. Targeting the key targets in ferroptosis, p53 and GSH metabolism signaling pathways may be an important strategy for the prevention and treatment of HALI.

Objective To investigate the effect of anti-human immunoglobulin M (IgM) on proliferation,apoptosis,cell cycle and tumor formation in human nasopharyngeal carcinoma HNE-1 cell line in vitro and in vivo.Methods After treatment with anti-human IgM antibody,proliferation of HNE-1 cells was observed by cell proliferation inhibition assay,apoptosis and cell cycle of HNE-1 cells were detected by flow cytometry,and apoptotic cells were detected by TUNEL staining.Nude mouse models were constructed,and were injected intraperitoneally with anti-human IgM antibodies (once every 3 days).The growth of transplanted tumor was observed once every 4 days.After the fifth injection,the expression levels of IgM and gp96 protein in transplanted tumor were observed by immunohistochemical method (streptavidin-peroxidase conjugated method,SP).Results MTS assay showed that anti-human IgM antibody can significantly inhibit the proliferation of HNE-1 cells in concentration-and time-dependent manner (P＜0.05).Flow cytometry showed that the anti-human IgM antibody promoted a significant decrease in percentage of cells in G1 phase,a significant increase in percentage of cells in S phase,and a significant increase in apoptotic rate of HNE-1 cells (P＜0.05).TUNEL staining showed that the anti-human IgM antibody promoted apoptosis of HNE-1 cells (P＜0.01).Transplantation tumor experiment showed that anti-human IgM antibody can significantly inhibit the volume and weight of transplanted tumor (P＜0.05).The immunohistochemistry showed that the expression levels of IgM and gp96 proteins in mouse transplanted tumors after intraperitoneal injection with anti-human IgM antibodies were significantly lower than those of the control group (P＜0.05).Conclusion The anti-human IgM anti-body could effectively inhibit the proliferation of HNE-1 cells,promote apoptosis,and arrest cell cycle.Anti-human IgM antibody could also inhibit the growth of transplanted tumor in nude mouse,which might be related to inhibition of the expressions of IgM and gp96 proteins.

Objective:To investigate the effect of the duration of preoperative biliary drainage on postoperative complications after pancreaticoduodenectomy.Methods:The clinical data of 102 patients with benign and malignant hepatopancreatic ductal periampullary tumors who underwent pancreaticoduodenectomy and preoperative biliary drainage in Beijing Friendship Hospital, Capital Medical University from January 2016 to July 2020 were retrospectively analyzed. According to the median duration of preoperative biliary drainage, the patients were divided into short-term drainage group (≤ the median duration of biliary drainage) and long-term drainage group (> the median duration of biliary drainage). The general data, the effect of biliary drainage, inflammation-related indicators and postoperative complications were compared between the two groups. Multivariate logistic regression was used to screen the risk factors related to the postoperative severe complications.Results:Of the 102 patients, 68 (66.7%) were males and 34 (33.3%) were females, with a median age of 63 years (43-80 years). The median duration of preoperative biliary drainage was 14 d. There were 68 patients in short-term drainage group and 34 patients in long-term drainage group. There were no statistically significant differences in age, gender, body mass index (BMI), hypertension, diabetes mellitus, surgery history of upper abdominal, American Society of Anesthesiologists (ASA) grade, carcinoembryonic antigen, carbohydrate antigen 125, alpha-fetoprotein, prothrombin time, pancreaticojejunostomy method, operation time, and pathological type between the two groups (all P > 0.05). However, patients in long-term drainage group had higher conversion rate, more blood loss and longer hospital stay compared with those in short-term drainage group (all P < 0.05). Before biliary drainage, alanine aminotransferase (ALT) level in short-term drainage group was higher than that in long-term drainage group ( Z = -2.59, P = 0.009), and there were no statistically significant differences in aspartate aminotransferase (AST), albumin (ALB), total bilirubin (TB) and direct bilirubin (DB) levels between the two groups before biliary drainage (all P > 0.05). After biliary drainage, DB in short-term drainage group was higher than that in long-term drainage group ( Z = -3.34, P = 0.001), and there was no statistically significant difference in ALT, AST, ALB, TB levels between the two groups (all P > 0.05). There were no statistically significant differences in the levels of white blood cells, neutrophils, lymphocytes and the ratio of neutrophils to lymphocytes between the two groups on the 1st and 3rd day after the operation (all P > 0.05). The total incidence of postoperative related complications in short-term drainage group and long-term drainage group was 63.2% (43/68), 70.6% (24/34), respectively, and the difference was statistically significant ( χ2 = 0.54, P = 0.461); the incidences of bile leakage, abdominal or gastrointestinal bleeding, intra-abdominal infection, delayed gastric emptying, all grades of pancreatic leakage, grade B and C pancreatic leakage were not statistically different between the two groups (all P > 0.05); the incidence of severe postoperative related complications in short-term drainage group was higher than that in long-term drainage group [27.9% (19/68) vs. 8.8% (3/34), χ2 = 4.90, P = 0.027]. Multivariate logistic regression analysis showed that the long-term preoperative biliary drainage was an independent protective factor for postoperative severe complications (long-term drainage vs. short-term drainage: OR = 0.253, 95% CI 0.066-0.975, P = 0.046), while BMI ( OR = 1.174, 95% CI 0.986-1.398, P = 0.071) and pathological type (benign or borderline vs. malignant tumor: OR = 0.247, 95% CI 0.043-1.419, P = 0.117) were not independent influencing factors for postoperative severe complications. Conclusions:Short-term biliary drainage (≤14 d) is a risk factor for postoperative severe complications in patients with hepatopancreatic ductal periampullary tumor undergoing preoperative biliary drainage. Preoperative biliary drainage time is not associated with postoperative total complications, pancreatic leakage, bile leakage, abdominal or gastrointestinal bleeding, intra-abdominal infection, delayed gastric emptying.