[ ABSTRACT] AIM:To investigate the effects of everolimus on the experimental IgA nephropathy in rats and its possible mechanisms .METHODS:The rat model of experimental IgA nephropathy was established .The rats were ran-domly divided into control group , IgA group and everolimus treatment group .After the corresponding treatments were gi-ven, urinary red blood cells , protein and N-acetyl-β-D-glucosaminidase ( NAG) were examined .Immunofluorescence stai-ning was used to analyze the level of IgA precipitation in the renal tissues .Additionally, the protein expression of myeloid differentiation factor 88 (MyD88), TLR4, NF-κB, IL-4 and IL-13 was determined by Western blot.The mRNA levels of IL-4 and IL-13 were detected by qPCR .RESULTS:Everolimus significantly inhibited the increases in the urinary levels of red blood cells, protein and NAG in experimental IgA nephropathy rats .Furthermore, IgA nephropathy-induced increases in the protein expression of MyD88, TLR4, NF-κB, IL-4 and IL-13 were attenuated after everolimus treatment .Similar re-sults were obtained in the mRNA levels of IL-4 and IL-13 by qPCR detection .CONCLUSION: Everolimus improves the impairments of renal function in experimental IgA nephropathy rats as evidenced by decreasing urinary red blood cells , pro-tein and NAG, which may be related to the inhibition of MyD 88, TLR4, NF-κB, IL-4 and IL-13 expression.

Objective To investigate the points of perioperative nursing of patients with diabetic foot ulcers (DFUs)treated with continuous thrombolysis.Methods A total of 78 cases of DFUs patients treated with continuous infusion of urokinase through femoral artery from February 2006 to August 2011 were recruited into the study.Besides,psychological care,education guidance,and materials preparation were given to them before the operation.Meanwhile,a module of “Nursing observation and assessment indicators to DFUs treated with interventional thrombolysis” was set up and used to give a dynamic evaluation.Results Foot ulcers of all the subjects were healed,and no case occurred serious complications such as bleeding or infection and so on.Conclusions Our results indicate that professional psychological care,education guidance,and fully materials preparation in perioperative period lay the foundation of clinical efficacy.The establishment and application of “Nursing observation and assessment indicators to DFUs treated with interventional thrombolysis” is the key to the success of thrombolytic therapy because it can effectively reduce postoperative adverse events and promote ulcer healing.

Objective To investigate the protective effects of insulin like growth factor 1(IGF-1) on cortical neurons under condition of hypoxia and the possible mechanism. Methods Cerebral cortical neurons from newborn rats were cultured under the condition of oxygen and glucose deprivation (OGD) . On day 7, neurons were treated with IGF-1 or IGF-1 plus LY294002 or PD98059 under condition of OGD or normal condition. MTT assay was used to analyze the viability of neurons in each group. The expression of total Akt and p-Akt were analyzed by Western blot. Results Compared with the control, the neuron viability was significantly higher in IGF-1 treated group under normal or OGD condition (P＜0.05). The protective effects of IGF-1 were attenuated in the presence of LY294002 but not PD98059. The result of Western blot showed IGF-1 upregulated the expression of p-Akt, which was inhibited by LY294002. Conclusion PI3K pathway may play an important role in neuroprotection afforded by IGF-1.

Objective To investigate the postmortem redistrib ution of morphine in rat model of chronic morphine poisoning. Methods Samples including cardiac blood, liver, heart, kidney, lung and brain tissues were collected in the rats with chronic morphine poisoning at 0～96 h after death, respectively. The morphine amount was measured with solid phase ext raction-gas chromatography. Results The study showed an increase in morphine concentrat ion of postmortem cardiac blood. Significant increase in morphine level was also observed 24～96 h after death in liver, heart and brain tissues, while the kid ney morphine levels decreased at 96 h after death. In the liver there was the g reatest increase (25-fold) in morphine levels 96 h after death. All the sample s showed marked alterations in morphine concentration within 96 h after death c ompared with cardiac blood at time of death. The postmortem morphine levels in b rain were closely related to those in the heart blood. Conclusion The postmortem redistribution of morphine exists in rats with chronic morphine poisoning. The brain tissues may better represent morphine levels in heart blood at the time of death.

Objective: To investigate the mechanism of Glytan lowering portal pressure induced by biliary liver fibrosis. Methods: SD male rats, 240-260g weight around, were randomly divided into sham-operation group, model group, propranolol group, Glytan high-dose, middle-dose and low-dose group according to the weight. Portal hypertension was induced by common bile duct ligation in rats. After two and four weeks, measured the portal pressure(PP) of each group, observed the histological changes of liver by HE staining, tested liver function and the concentration of endothelin-1 in systemic circulation and mesenteric circulation radioimmnuoassay. Results: After two and four weeks, portal pressure of model group rats increased significantly. Both Glytan and propranolol can decrease PP after two and four weeks, and the pressure-relief effect was similar between the two drugs. HE staining showed that Glytan can significantly inhibit the formation of collagen, promote the recovery of liver tissue structure; liver function indicated a significant decrease in serum AST, ALT, TBIL and Na+ concentration. In addition, Glytan decreased the concentration of endothelin -1 in systemic circulation, increased it in mesenteric circulation after two weeks. Conclusion: Glytan decrease PP by improving liver function and microcirculation, inhibiting collagen formation and water-sodium retention after long-term therapy, ameliorating hyperdynamic circulation at the early stage.

Objective To explore the feeling and experience of the nursing undergraduate students in the simulation training for the doctor-nurse cooperation emergency before their internship,in order to provide reference for making excellent teaching and practical plan of emergency nursing.Methods Using phenomenology method,the experience records of thirty-six nursing students were collected.The experience was recorded by Colaizzi method.Results Five themes were summarized by Colaizzi method:preliminary acquaintance of doctor-nurse cooperation; reflection on division of labor cooperation; scan self-ability; focus on interpersonal communication;comprehension of emergency characteristics.Conclusions Simulation training for doctor-nurse cooperation emergency can give nursing students' opportunity of cooperative learning; Simulation training for doctor-nurse cooperation emergency can arouse nursing students' interest of active learning; Simulation training for doctor-nurse cooperation emergency can develop nursing students'habit of reflective learning;Simulation training for doctor-nurse cooperation emergency can improve nursing students' ability of integrative learnng.

Objective: To analyze the characteristics and influencing factors of the newly diagnosed cases locally infected with HIV through sexual contact in Jinhua,so as to provide reference for AIDS prevention and control. Methods: An epidemiological survey was conducted among the HIV/AIDS cases diagnosed in 2017 in Jinhua to collect the information about demographic characteristics,local infection and sexual behaviors. The logistic regression model was used to analyze the related factors for local HIV infection. Results: A total of 438 HIV/AIDS cases infected through sexual contact were recruited,with 272（62.10%）cases infected in Jinhua. The proportion of local infection was 86.67%,79.47%,63.04%,69.09%,77.46% and 77.97%,respectively,among those people aged 60 years or over,permanent residents in Jinhua,employees / students,farmers,those who had lived in Jinhua for more than five years,and those who had a HIV testing in one year. The Results of the multivariate logistic regression analysis showed that heterosexual transmission cases who were permanent residents in Jinhua（OR=3.437,95%CI：1.250-9.451）,who had lived in Jinhua for more than five years（OR=3.609,95%CI：1.403-9.284）,who had commercial heterosexual behaviors in Jinhua（OR=5.463,95%CI：2.529-11.803）were more likely to be infected with HIV in Jinhua;homosexual transmission cases who were permanent residents in Jinhua（OR=4.812,95%CI：1.744-13.275）and who had non-commercial,temporary homosexual behaviors in Jinhua（OR=10.641,95%CI：4.369-25.916）were more likely to be infected with HIV in Jinhua. Conclusion Among the HIV/AIDS cases diagnosed in 2017 infected through sexual contact in Jinhua,having permanent residence,long-term residence,commercial heterosexual behaviors and non-commercial,temporary homosexual behaviors were risk factors for local infection.

Objective To investigate the intervention effects ofYinao Jieyu Prescription on the behaviors and damages in hippocampal CA1 area of the rats with post-stroke depression (PSD).Methods Totally 168 SPF male SD rats were randomly divided into normal group, sham-operation group, stroke group, PSD group, Western medicine group and TCM group. There were 24 rats in the normal group and sham-operation group, and 30 rats in the other groups. Rats in the normal group received no intervention. Rats in the sham-operation group received no suture. Rats in the stroke group were given middle cerebral artery occlusion operation and normally fed after operation. Rats in the PSD group, Western medicinal group and TCM group were made into PSD models by chronic immobilization stress for one week and individual battery to the end. At the inception of modeling, Western medicine group received fluoxetine hydrochloride for gavage; TCM group receivedYinao Jieyu Prescription for gavage; other groups received distilled water for gavage, once a day. At the end of week 2, 4, and 8, the morphology of the hippocampal CA1 area in each rat was observed by microscope after HE stained.Results Except for the week 2, at the same time point, the behavior scores of the rats in the TCM group were higher than those in the PSD group. At the same time point, the CA1 region of the hippocampus in the TCM group was more complete than the PSD group, and the cells were arranged neatly and in normal morphology.ConclusionYinao JieyuPrescription can improve the symptoms of PSD rats, and has protective effects on hippocampal CA1 area.

Objective:In this study, the clinical data of biliary atresia(BA) and infant intrahepatic cholestasis(IHC) was reviewed, and the utility of gamma-glutamyl transpeptidase(GGT) and liver Young′s modulus in the differential diagnosis of BA and IHC in infants was discussed.Methods:Based on the clinical data of 120 infants with cholestasis treated in the Children′s Hospital Affiliated to Xi′an Jiaotong University, from September 2017 to December 2019, the infants were divided into two groups according to the results of intraoperative cholangiography and follow-up: BA group( n=50); IHC group( n=70). The age, clinical manifestations, laboratory examination results, gallbladder contraction rate, hepatobiliary scintigraphy, liver Young′s modulus, and medical treatment effects were compared between the two groups.The utility of GGT and liver Young′s modulus in the differential diagnosis of BA and IHC was analyzed. Results:The age, alanine aminotransferase(ALT), aspartate aminotransferase(AST), total bile acid, fasting blood glucose, blood ammonia and splenomegaly between the two groups were compared and the results showed no statistical significance( P>0.05). In contrast, there were statistically significant differences( P<0.001) in stool color, liver size, total bilirubin(TB), direct bilirubin(DB), GGT, liver Young′s modulus, positive hepatobiliary scintigraphy, gallbladder contraction rate at 1 hour after meal, and medical treatment effect between the two groups.TB, DB, GGT, liver Young′s modulus and GGT combined with liver Young′s modulus were analyzed using ROC curves, and the area under the curve(AUC) were 0.820, 0.809, 0.906, 0.876 and 0.926, respectively.When GGT exceeded the cut-off value of 198.85 U/L, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of BA were 82.0%, 84.3%, 78.8%, 86.8% and 83.3%, respectively.When liver Young′s modulus exceeded the cut-off value of 8.6 kPa, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of BA were 88.0%, 80.0%, 75.9%, 90.3% and 83.3%, respectively.The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of GGT combined with liver Young′s modulus in diagnosing BA were 98.0%, 68.6%, 69.0%, 98.0% and 80.8%, respectively.Multivariate logistic regression analysis found that DB>115.55 μmol/L, GGT>198.85 U/L, and liver Young′s modulus>8.6 kPa were risk factors for BA( OR=9.510, P=0.001; OR=24.634, P<0.001; OR=21.469, P<0.001). Conclusion:GGT and liver Young′s modulus are useful in the differential diagnosis of BA and IHC.If GGT and liver Young′s modulu sexceed the threshold values of 198.85 U/L and 8.6 kPa respectively, it can effectively indicate that the child is BA.

Objective To investingate the features of insulim resistance in elderly hypertensive patients. Methods The levels of serum toatal eholesterol(TC),serum triglycedde(TG),fasfing blood glnsose(FBG),2h postprandial blood glucose(PBG),fasting insulin (FINS),2h postprandial insulim (PINS),intracellular free calcium of lymphocyte ([Ca2+i) were respecfived measured,then the insulin sensitivity index (ISI) wad calculated,and compared in 60 essential hypertensive patients (30 elderly,30 non-elderly) and 20 weight index matched normotensive control subjects. Results (1)the hypertensive patients compared with normotensive control subjects,the patients had hyperinsumlinemia,insulin resistance and multiple metabolic disorders. (2)The elderly hypertensive patients compared with the non-elderly hypertensive patients,the levels of TG,FBG,PBG,FINS,PINS and [Ca2+]i were Significantly higher but ISI was significantly lower,in the elderly hypertensive patients. Conclusion The elderly hypertensive patients had more obvious hyperonsulinemia,severe insulin resistance and multiple metaboie disorders,these maybe related to aging and degeneracy.