Aim To observe the influence of emodin on bleomycin-induced pulmonary fibrosis in rats, and explore its protective mechanisms. Methods Sixty SD rats were randomly divided into normal control group, sham operation group, model group, low-dose inter-vention group, high-dose intervention group and pred-nisone group. Each group included 10 animals. Rats in the latter 4 groups were intratracheally administered with bleomycin to establish pulmonary fibrosis model. From the second day, rats in low-and high-dose inter-vention groups were intragastrically treated with 2 mL of 20 and 80 mg · kg-1 emodin, respectively. Predni-sone group were intragastrically administrated with 2 mL of 5 mg·kg-1 prednisone acetate. However, con-trol and model groups were treated with 2 mL of normal saline. All rats were sacrificed on day 28. Pulmonary tissues were then removed, and HE and Masson stai-ning were performed. The contents of hydroxyproline ( HYP ) , malondialdehyde ( MDA ) , superoxide dis-mutase ( SOD) , glutathione-peroxidase ( GSH-Px) and catalase (CAT) in pulmonary tissues were measured. Serum concentrations of tumor necrosis factor-α ( TNF-α) , interleukin ( IL )-6 and IL-17 were detected by enzyme linked immunosorbent assay ( ELISA ) . The expression of Kelch-like ECH-associated protein 1 ( Keap 1 ) , nuclear factor-erythroid 2-related factor 2 (Nrf2) and nuclear factor-κB (NF-κB) p65 in pulmo-nary tissues was analyzed using Western blot. Results The pulmonary inflammation and fibrosis in low-and high-dose intervention as well as prednisone groups was significantly improved when compared with model group ( P<0. 05 , 0. 01 ) . In comparison with normal control group or sham operation group, pulmonary HYP and MDA contents, Nrf2 and NF-κB p65 expression levels in the nucleus, and serum concentrations of TNF-α, IL-6 and IL-17 were increased ( P <0. 01 ) , but pulmonary SOD, GSH-Px and CAT contents and Keap 1 expression levels in the cytoplasm were de-creased ( P <0. 01 ) in model group. Upon treatment with low-and high-dose emodin or prednisone, pulmo-nary HYP and MDA contents, Keap 1 expression levels in the cytoplasm, NF-κB p65 expression levels in the nucleus , and serum concentrations of TNF-α, IL-6 and IL-17 were reduced while pulmonary SOD, GSH-Px and CAT contents and Nrf2 expression levels in the nu-cleus were enhanced as compared to model group ( P<0. 01 ) . The above indicators were significantly im-proved in high-dose intervention and prednisone groups compared with low-dose intervention group ( P <0. 05). Nevertheless, There was no significant differ-ence between high-dose intervention group and predni-sone group ( P >0. 05 ) . Conclusion Emodin may protect against rats with pulmonary fibrosis by enhan-cing antioxidative ability and inhibiting inflammatory response.

Aim To explore the inhibitory effects of resveratrol (Res ) on human pulmonary fibroblast growth,and its related mechanisms.Methods Hu-man pulmonary fibroblasts MRC-5 were cultured in vitro as research object.These cells were inoculated with 20 μL dimethyl sulfoxide (DMSO)as well as 0, 12.5,25 50,100 and 200 μmol·L-1 Res for 24,48 and 72 h,respectively.Inhibitory rate of cellular pro-liferation was analyzed by MTT.In addition,these cells were treated with 20 μL DMSO (medium group) as well as 50 and 100 μmol·L-1 Res for 48 h,re-spectively.Subsequently,cell cycle and apoptotic rate were measured using flow cytometry.Apoptosis index (AI ) was detected through terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL). The mRNA and protein expression of cell cycle protein D1 (Cyclin D1 ) and cyclin-dependent kinase 4 (CDK4)was detected through fluorescence real-time quantitative PCR and Western blot, respectively. Western blot was used to measure the protein expres-sion of Bcl-2 and Bax.Results With the increase of Res concentrations and prolongation of treated time, inhibitory rate of cellular proliferation was gradually el-evated (P<0.01).After 48 h of co-culture,DNA ra-tio of S and G2/M periods,mRNA and protein levels of Cyclin D1 and CDK4,and Bcl-2 protein levels were significantly decreased while DNA ratio of G0/G1 peri-od,AI,apoptotic rate and Bax protein levels were sig-nificantly increased in 50 and 100 μmol · L-1 Res-treated groups as compared to medium group (P <0.01 ).Moreover,the effects 100 μmol · L-1 Res were better than those of 50 μmol · L-1 Res (P <0.01).Conclusion Res can suppress the prolifera-tion of MRC-5 cells,which may be associated with blockade of cell cycle progression and induction of cell apoptosis.

Objective To explore the early diagnostic value of carcino-embryonic antigen (CEA) immunocytochemistry examination combined with laser scanning confocal microscope (LSCM) in the patients with meningeal carcinomatosis (MC).Methods The patients were divided into experimental group (patients with MC) and control group (patients without MC).Thermo electron corporation shandon cytospin 4 centrifuge was used in the cytologic examination of cerebrospinal fluid (CSF),whose function was to produce a monolayer of cells onto a glass slide from CSF.Giemsa staining was used in 42 cases.The CEA immunocytochemistry staining was used in 29 cases and 20 controls.The double immunofluorescence staining was used in 17 cases and 20 controls.SP staining method was used in the CEA and the results were observed under the light microscope.Nuclear DNA and CEA were stained with fluorescent probe DAPI and Cy5 respectively and the results of double immunofluorescenee staining were observed by the laser scanning confocal microscope.Results There was a high positive rate in cytologic examination of CSF,and malignant cells were found in all of 42 cases for repeated CSF testing.The positive rate of routine CSF cytologic examination and CEA immunecytochemistry examination was 85.7% (36/42) and 79.3% (23/29) respectively in the first CSF specimens.There were 17 cases using double immunofluorescence staining and observed by LSCM,and the positive rate was 13/17.Compared with experimental group and control group,fluorescent value both nuclear DNA (CEA(+) 1694.04±478.06,CEA(-)1543.04±364.71,control group 603.72±178.04,t=21.386,23.144,both P<0.01) and CEA (CEA(+)1407.04±275.30,control group 202.51±54.05,t=42.934,P<0.01) were significantly different.Conclusion Immunocytochemistry examination of CSF is an important early qualitative diagnosis method for MC.LSCM improved the level of locating,qualitative and quantitative diagnosis of MC.

Aim To establish depression rat model with kidney-yang deficiency and evaluate the related parameters.Methods A total of 24 adult SD rats were divided into control group,mod-el group and self-healing group by body weight.Model group and self-healing group were injected hydrocortisone for 21 days, meanwhile the control group was injected sodium chloride.After modeling,the related indexs detection were taken out:open-field test,sucrose preference test and forced swim test.Then the orbital blood was taken to detect 5-HT,DA and NE by LC-MS/MS.And liver,kidney,spleen,thymus,adrenal gland,testis and epididymis were taken to calculate organ index.Results Compared with the control group,model rats displayed depres-sion and kidney yang deficiency syndrome such as dry hairs, chills,back arched and so on. Correspondingly, the body weight increased slowly.Immobility in FST was significantly in-creased. Sucrose preference, horizontal scores and vertical scores was significantly decreased.Organ index decreased in liv-er,kidney,spleen,adrenal,testis and epididymis.The level of 5-HT and NE was significantly high.Compared with the model group,5-HT,NE and DA were significantly reduced,5-HT and DA were even lower than those of the control group.Conclusion Depression rat model with kidney-yang deficiency could be in-duced by continuous injection of hydrocortisone.

Aim To observe the expression of epider-mal growth factor receptor ( EGFR) in cerebral tissues around hematomas after intracerebral hemorrhage, and explore the effects of EGFR on activation of astrocytes derived from rats and the involved mechanisms. Meth-ods The specimens of cerebral tissues around hemo-tomas after intracerebral hemorrhage undergoing hemo-tomas removal operation were collected and then divid-ed into 4 groups according to the time of intracerebral hemorrhage: <1 d, 1 ~5 d, 6 ~10 d and >10 d groups. Each group included 20 cases. At the same time, 20 dropped brain tissues distant to hemorrhage in the operative process were collected as control group. Immunohistostaining and Western blot were used to measure the expression of EGFR. After isolation and culturing, the astrocytes of rat cortex were treated with culture solution ( control group) , CNTF that was used to activate astrocytes, scramble siRNA + CNTF and EGFR siRNA +CNTF for 24h, respectively. The ex-pression of glial fibrillary acidic protein ( GFAP) mR-NA was detected through fluorescence real-time quanti-tative PCR. In addition, the protein levels of GFAP, signal transducers and activators of transcription 3 ( STAT3 ) and phosphorylated STAT3 ( p-STAT3 ) were examined using Western blot. Results With the ex-tension of intracerebral hemorrhage time, positive sig-nal index and protein expression levels of EGFR gradu-ally elevated, reached the peak on 6 ~10d, and then decreased after 10 d. There was statistical difference ( P<0. 01 ) . The expression levels of GFAP mRNA and protein as well as p-STAT3 were significantly in-creased in cells treated with CNTF alone as compared to control group ( P <0. 01 ) , whereas these effects were almost completely reversed by EGFR siRNA transfection ( P <0. 01 ) . Additionally, there was no statistical difference in STAT3 protein levels among groups ( P >0. 05 ) . Conclusions EGFR expression is upregulated in the cerebral tissues around hemotomas after intracerebral hemorrhage. Gene silence of EGFR contributes to suppressing the activation of astrocytes derived from rats, which may be involved in the block-ade of STAT3 phosphorylation.

Objective To explore the feasibility and efficacy of the selective portal vein embolization (SPVE) before radiofrequency ablation(RFA) for liver tumor large than 3 cm.Methods 63 patients with 63 liver tumor (＞3 cm) located in single liver segment completely or mostly underwent RFA.21 patients (21 lesions) were randomly assigned to receive SPVE before ablation (SPVE + RFA group),other 42 patients were treated with RFA only (RFA group).The complications and treat results of two groups were collected and compared.Results SPVE were achieved in 20 of 21 patients,and no critical complication were happened in both group.During a observation period of median 14.2 months,local tumor progression were observed in 17 of 42 patients (40.5％) in RFA group and in 3 of 20 patients (15.0％) in SPVE+ RFA group,there were significant difference between two groups(P =0.043).Conclusions SPVE can safely and effectively improve the efficacy of RFA for the liver tumors which large than 3 cm and located in single liver segment.

Aim To explore the protective effects of in-terleukin-17 ( IL-17 ) monoclonal antibody ( mAb ) on bleomycin-induced pulmonary fibrosis rats and the re-lated mechanisms. Methods Seventy-five male SD rats were randomly divided into normal control group, sham operation group, model group, non-specific IgG group and IL-17 mAb group. Each group included fif-teen rats. Rats in the latter three groups were intratra-cheally administered with bleomycin A5 to establish pulmonary fibrosis model, whereas the ones in sham operation group were treated with the same volume of physiological saline. On day 7, 14 and 21, rats in non-specific IgG group and IL-17 mAb group were in-jected with non-specific IgG and IL-17 mAb, respec-tively,through the caudal vein. However,the ones in the other groups were administered with the same volume of physiological saline. All rats were sacrificed on day 28. Pulmonary tissues were then removed, and HE and Masson staining was performed. The contents of IL-17, IL-6 and tumor necrosis factor-α ( TNF-α) in pulmo-nary tissues were measured by enzyme linked immu-nosorbent assay ( ELISA ) . Western blot was used to analyze the pulmonary tissues protein expression of nu-clear factor-κB ( NF-κB) p65 in the nucleus as well as collagen type I ( Col Ⅰ) and collagen type III ( ColⅢ) in the whole cells. The levels of Col Ⅰ and ColⅢ in the pulmonary tissues were detected by fluores-cence real-time quantitative PCR. Serum was separa-ted, and the concentrations of procollagen type 1 carboxyterminal propeptide ( PICP ) and procollagen type III aminoterminal propeptide ( PIIINP ) in serum were then measured by ELISA. Results The severity of alveolitis and pulmonary fibrosis was lower in IL-17 mAb group than that in model group and non-specific IgG group ( P <0. 01 ) . In comparison with normal control group and sham operation group, pulmonary tissues IL-17, IL-6 and TNF-α contents, NF-κB p65 protein expression in the nucleus, Col Ⅰ and Col ⅢmRNA and protein levels, and serum PICP and PIIINP concentrations were significantly increased in model group and non-specific IgG group ( P<0. 01 ) . Follow-ing treatment with IL-17 mAb, the above indicators were significantly decreased as compared to model group and non-specific IgG group ( P<0. 01 ) . How-ever, there was no significant difference in these indi-cators between non-specific IgG group and model group ( P >0. 05 ) . Similar results were also seen between sham operation group and normal control group ( P >0. 05 ) . Conclusion IL-17 mAb protects rats from pulmonary fibrosis by inhibiting inflammatory response via downregulating NF-κB expression and decreasing collagen synthesis in the pulmonary tissues.

OBJECTIVE To investigate the bacterial distribution and sensitivity to antibiotics isolated from infected patients in emergency department. METHODS The antimicrobial susceptibility tests to commonly used antibiotics were performed to the specimen send by the emergency and respiratory departments in our hospital in 2007.The data were analyzed respectively. RESULTS Totally 340 strains were isolated in emergency department and 366 strains were isolated in respiratory department.The main bacteria isolated were similar in the two departments such as Acinetobacter baumannii,Pseudomonas aeruginosa,Staphylococcus aureus and Escherichia coli,but their sensitivities to antibiotics were different. CONCLUSIONS Bacterial distribution of the infected patients in emergency department is similar to respiratory departments,but their sensitivities to antibiotics are different.

Objective To explore the role of inquiry flipped classroom teaching model in enhancing teaching effective-ness of internal medicine. Methods A total of 125 students from 4 clinical natural classes in our department were se-lected as research objects, and then randomly divided into control group (n=64) and experimental group (n=61). Students in control group received traditional teaching method, whereas those in experimental group were administrated with in-quiry flipped classroom teaching model. After end of teaching, internal medicine scores were compared between both groups. Evaluation of teaching effectiveness was conducted by Internal medicine teaching effectiveness assessment table. Results Internal medicine scores in experimental group [(83.21±11.26)points] were higher than those in control group[(70.89±10.23)] points,the difference was statistically significant (P<0.05). Moreover, evaluation of teaching effec-tiveness was better in experimental group when compared with control group(P<0.05). Conclusion Inquiry flipped classroom teaching model can markedly enhance teaching effectiveness of internal medicine in medical students, which is an efficient theoretical teaching method.

The real-time reported data of treated patients from July 2017 to June 2019 Nanxiang Hospital of Jiading District were collected from chest pain center platform. The results showed that the average time of completing ECG examination from the first medical contact was 1.3 to 6.9 min with a median of 1.9 min (1.7, 2.2), meeting the quality control requirements (10 min); the time required to obtain troponin test results was 13.0 to 48.4 min with a median of 14.1 min (13.4, 18.1), meeting the requirements for quality control of 20 min; time from entry to transfer out of PCI patients was 19.0-100.0 min, with median 37.2 (29.3, 66.6) min, basically reaching quality control (30 min); the entering catheter chamber rate of STEMI patients was 50.0% to 100.0% with a median of 100.0% (73.3%, 100.0%), meeting the requirements of quality control (≥50%). Through the active construction, the main quality control indicators were well reached, the reported cases were basically stable, and the disease distribution was basically reasonable in the primary-level chest pain centers. Informed notification of transshipment and subsequent management of low-risk chest pain patients need to be further strengthened. It is suggested that the construction of chest pain centers should establish long-term normal working mechanism, strengthening the control of key quality control indicators, to play the important role of the regional treatment system.