Objective To investigate the different concentrations of progesterone on the expression of a disintegrin and metalloprotease 10 (ADAM10),long form leptin receptor (Ob-R) and the secretion of soluble leptin receptor (SLR),leptin (LEP) in primary pregnancy human chorionic trophoblast cells. Methods Cultured primary human trophoblast cells and added in different concentrations of progesterone (0,100,150 and 200 ng/mL) for 24 hours. The relative expression of ADAM10 and Ob-R in the cells and the content of SLR and LEP in the supernatant were detected. Results With increasing concentrations of progesterone,early human trophoblast cells ADAM10 content gradual-ly decreased,the difference between the two groups was significant (P<0. 05). With increasing concentrations of progesterone,human chori-onic trophoblast cells in early pregnancy Ob-R expression levels increased, the difference was no statistically significant between each two groups (P>0. 05). SLR content of the cell supernatants as the concentration of progesterone increased and decreased,there are significant differences between each two groups (P>0. 05). LEP cell supernatant in each group with the increase of the concentration of progesterone concentration increased gradually between the two groups were significantly different(P>0. 05). Pearson’s test showed that the expression of expression SLR and LEP exists a significant negative correlation (R= -0. 949,P<0. 01). Conclusion Progesterone may influence the ex-pression of ADAM10,SLR and LEP by the regulation of leptin to participate GDM occurs.

Object To establish a calli culture system for the rapid propagation of Speiraea japonica L. f.. Methods Callus and shoot induction were carried out on MS, 6, 7 V or B 5 media with different parts of the plant such as stem tip, tender leaves and petiole as explants. Results A calli culture system was established for the rapid propagation of S. japonica. Conclusion MS cultural medium was found to be most suitable for calli induction. MS with 2.0 mg/L 2,4 D+0.3 mg/L KT can induce calli when the explants were used for the induction, with stem tips being the most satisfactory explant. Clusters of seedlings can be induced on MS+2 mg/L BA+0.1 mg/L NAA and when these seedlings were transferred to 1/2 MS +0.25 mg/L BA+0.5 mg/L NAA medium, root were developed to give young seedlings.

Objective To establish pulmonary acute lung injury(ALI)model in rats.Methods ALI model was induced in rats by intratracheal Escherichia coli injection[3 ml/kg,O111B4,(4.0～6.0)×1012 CFU/L].Mechanical ventilation was applied 12,24,36,48 and 72 h after Escherichia coli injection,PaO_2/FiO_2 and dynamic compliance were recorded,and the normal control group was also subjected to mechanical ventilation.After the experiment,lungs were fixed with formalin to perform pathological examination.Results At 12,24,36,48 and 72 h,the PaO_2/FiO_2 were(30.71±7.95)kPa,(21.66±5.34)kPa,(21.09±4.75)kPa,(25.01±8.78)kPa and(33.82±8.02)kPa,respectively,which were significantly lower than that in the normal control group(63.82±3.03)kPa(P＜0.01).At 12,24,36,48 and 72 h,the Cdyn were(4.23±0.13)ml/(kg·kPa),(4.19±0.96)ml/(kg·kPa),(4.28±0.69)ml/(kg·kPa),(4.44±0.62)ml/(kg·kPa)and(4.58±0.35)ml/(kg·kPa)respectively,which were significantly lower than that in the normal control group(8.16±0.78)mL/(kg·kPa)(P＜0.01).At 12,24,36,48 and 72,the percentage of ALI was 71.4%,100.0%,100.0%,83.3%and 57.1%respectively,and the percentage of ARDS was 28.6%,85.7%,83.3%,66.7%,14.3%respectively.As for pathological examinations,predominance of alveolar collapse,fibrinous exudates,alveolar wall edema and neutrophil recruitment into the alveolar space was observed.Hyaline membrane formation was found.At 72 h,inflammation was relieved.Conclusion We successfully established pulmonary ALI/ARDS model in rats induced by intratracheal Escherichia coli injection,and acquired some useful information by observing the lung function and morphological changes at different time points.

Objective To study the adrenal function in rats with pulmonary acute lung injury (ALI) induced by Escherichia coli (0111B4) . Methods ALI rat model was induced by intratracheal injection of E.coli (3 ml/kg,0111B4,(4.4-5.6) x 10~(12) CFU/L).ALI rats were then randomly divided into three groups,and each group had 10 rats.Mechanical ventilation was applied at three time points,6 hours,24 hours,and 36 hours after injection At each time point 8 rats were used as control with saline administered intratracheally.The plasma ACTH and corticosterone levels were measured after stimulated by 100 μg porcine ACTH.Results Compared with control group,the model group had a higher level of plasma ACTH at each time point (P < 0.01).The plasma ACTH level reached the peak at 24 hours.The model group had a higher level of plasma corticosterone at 6 hours (P < 0.01) and 24 hours (P <0.05),but had a lower level of plasma corticosterone at 36 hours (P < 0.05).The plasma corticosterone level reached the peak at 6 hours in model group,which was higher than 24 hours (P < 0.05).After stimulated by ACTH,the increased levels of corticosterone were lower in model group than those in control group (6 hours,P < 0.05; 24 hours and 36 hours,P < 0.01).Conclusions Adrenal dysfunction may occur at early stage of ALI in rats.With the disease developed,adrenal response to ACTH decreased.Low dose corticotrophin-stimulated test could evaluate adrenal function in rats with pulmonary ALI induced by Escherichia coli (O111B4).

Objective To explore otolaryngology nurses' knowledge of pain and attitude toward pain management and to provide reference for pain management.Methods A total of 102 otolaryngology nurses who participated in 2014 in Chongqing of Otolaryngology Head and Neck Surgery Symposium were surveyed by the nurses' general condition and current management situation and attitude survey regarding Chinese Knowledge and Attitude Survey Regarding Pain(KASRP).Results Average correct response rateon the KASRP from otolaryngology nurses was 45.9％,the interquartile range was 38.9％-51.0％,nurses' knowledge was relate to continuing education,P＜0.05,while irrelevant to age,work experience,education,job title,school education,clinical application of pain assessment tools,etc,P＞0.05.The proportion of nurses who accept the education of pain knowledge was 69.6％ (71/102),there was 74.5％ (76/102) nurses assess the patient by pain assessment tools in their daily work.Nurses first want to get the information of pain assessment,followed by pain medication,operational knowledge of analgesia pump and non-drug interventions for pain.Conclusions Nurses lack knowledge of pain,need to strengthen pain management training by continuing education and get knowledge of pain from academic journals,to provide reference for pain management.

Objective To clone human Sjogren's syndrome antigen A(SSA)for expressing of antigen SSA-52kD and establishing a new clinical detecting method.Methods According to the human SSA-52kD cDNA sequence reported in GenBank,primers of human SSA-52kD cDNA were designed and synthesized.Human SSA-52kD cDNA was amplified from RNA of cultured Hela cell by reverse transcriptase polymerase chain reaction(RT-PCR).The production of amplification was ligated to PET-30a vector and then transformed into the competent bacteria DH5?to construct the recombinant plasmid PET-30a-SSA-52kD.The recombinant plasmid was digested with Bgl Ⅱ and Hind Ⅲ,and positive clones were sequenced.Results The Human SSA-52kD cDNA fragment containing 1447bp was amplified by RT-PCR.Restriction endonuclease mapping using Bgl II and Hind III showed that the target gene was inserted into the recombinant plasmid.The complete coding sequence of Human SSA-52kD was consistent with that of GenBank through DNA sequencing.Conclusions The full length of human SSA-52kD cDNA was successfully cloned and the recombinant plasmid PET-30a-SSA-52kD was constructed.

Objective:To investigate the value of routine echocardiography and two-dimensional speckle tracking echocardiography in evaluating the left ventricular function of patients with gestational diabetes mellitus (GDM) prenatal and postpartum.Methods:Twenty-two patients with clinically confirmed GDM in Xiamen Zhongshan Hospital from October 2019 to December 2020 were chosed as the case group, and 22 healthy pregnant women were chosed as the control group. Routine echocardiography and two-dimensional speckle tracking echocardiography were performed in the third trimester and about 3 months postpartum. Routine echocardiographic parameters and longitudinal strain (LS), circumfirential strain (CS) were obtained. The correlation between global longitudinal strain(GLS) and other cardiac function parameters was analyzed. The relationship between clinical parameters of pregnant women and GLS was analyzed by multiple linear regression.Results:In comparison with the control group, the interventricular septal diameter at disatole, left ventricular posterior wall diameter at diastole, Tei index were increased, e′ was decreased in GDM group(all P<0.05); the GLS, each layer LS of GDM group were lower than the control group(all P<0.05), the GLS, each layer LS and torsion parameters were improved at 3 months postpartum(all P<0.05). There was a negative correlation between GLS and Tei( r=-0.224, P=0.036). GLS and HbA 1c was linearly correlated with the regression equation: GLS=-27.458+ 1.534×HbA 1c( R2=0.115). Conclusions:The left heart function of pregnant women with GDM in the third trimester are significantly impaired, but the cardiac function recovers to a certain extent about 3 months after delivery. Two-dimentional speckle-tracking echocardiography is a more accurate and sensitive technique to evaluate the early damage of cardiac function in pregnant women with GDM.

Objective:To observe the efficacy and factors influencing sequential or combined tenofovir alafenamide fumarate (TAF) after treatment with entecavir (ETV) in patients with chronic hepatitis B (CHB) with low-level viremia (LLV).Methods:126 CHB cases treated with ETV antiviral therapy in the Department of Infectious Diseases of the First Affiliated Hospital of Nanchang University from January 2020-September 2022 were retrospectively collected. Patients were divided into a complete virologic response (CVR) group ( n = 84) and a low-level viremia (LLV) group ( n = 42) according to the HBV DNA level during treatment. Clinical characteristics and laboratory indicators of the two groups at baseline and 48 weeks were analyzed by univariate analysis. Patients in the LLV group were divided into three groups according to their continued antiviral treatment regimen until 96 weeks: continued use of ETV as a control group; replacement of TAF as a sequential group; and combination of ETV and TAF as a combined group. The data of the three groups of patients were analyzed by one-way analysis of variance for 48 weeks. HBV DNA negative conversion rate, HBeAg negative conversion rate, alanine aminotransferase (ALT), creatinine (Cr), and liver stiffness test (LSM) were compared among the three groups after 96 weeks of antiviral treatment. Multivariate logistic regression was used to analyze the independent factors influencing the occurrence of HBV DNA non-negative conversion in LLV patients at 96 weeks. Receiver operating characteristic curve (ROC) was used to evaluate the effectiveness of predicting the occurrence of HBV DNA non-negative conversion in LLV patients at 96 weeks. Kaplan-Meier was used to analyze the cumulative negative rate of DNA in LLV patients, and the Log-Rank test was used for comparison. HBV DNA and HBV DNA negative conversion rates during treatment were observed dynamically. Results:Univariate analysis showed statistically significant differences in age, BMI, HBeAg positivity rate, HBV DNA, HBsAg, ALT, AST, and LSM at baseline between the CVR group and the LLV group ( P < 0.05). Univariate analysis of variance revealed no statistically significant difference among the three groups of LLV patients at 48 weeks ( P > 0.05). HBV-DNA negative conversion rate in the sequential group and the combination group was significantly higher than that in the control group after 96 weeks of treatment (88.89% vs. 41.18%, 85.71% vs. 41.18%, χ2 = 10.404, P = 0.006). HBeAg negative conversion rate was higher than that of the control group, with no statistically significant difference ( P > 0.05).Compared with the control group, ALT, Cr, and LSM in the sequential group and the combined group were equally improved to varying degrees, with a statistically significant difference ( P < 0.05). Subsequent use of ETV and HBV DNA at 48 weeks were independent risk factors for HBV DNA positivity at 96 weeks in LLV patients ( P < 0.05). The AUC of HBV DNA at 48 weeks was 0.735 (95% CI: 0.578 ~ 0.891), the cut-off value was 2.63 log 10 IU/ml, and the sensitivity and specificity were 76.90% and 72.40%, respectively. DNA conversion rate was significantly lower in LLV patients receiving 48-week ETV and 48-week HBV DNA≥2.63 log10 IU/mL than in patients receiving sequential or combined TAF and 48-week HBV DNA < 2.63 log 10 IU/mL. HBV DNA negative conversion rates in the sequential group and combined group at 72 weeks, 84 weeks, and 96 weeks were higher than those in the control group during the period from 48 weeks to 96 weeks of continuous treatment, and the differences were statistically significant ( P < 0.05). Conclusion:Sequential or combined TAF antiviral therapy could more effectively improve the 96-week CVR rate, as well as hepatic and renal function, and alleviate the degree of hepatic fibrosis in CHB patients with LLV following ETV treatment. Subsequent use of ETV and HBV DNA load at 48 weeks were independent predictors of HBV DNA positivity at 96 weeks in LLV patients.

OBJECTIV E To in vestigate the situation ，achievements and proble ms of consistency evaluation policy of generic medicines in China. METHODS The descriptive analysis was performed after collecting and sorting out the information of generic medicine passing consistency evaluation （GMPCE） published on the official website of the National Medical Products Administration. The basic information ，the distribution and changes of GMPCE were analyzed statistically in National Essential Medicine List （hereinafter refer to as “essential medicine list ”），Medicine List for National Basic Medical Insurance ，Industrial Injury Insurance and Maternity Insurance （hereinafter refer to as “medical insurance list ”）and the result of the successful selection of centralized medicine procurement organized by the state （hereinafter refer to as “centralized procurement list ”）. RESULTS From 2017 to 2021，415 chemical generic drugs had passed consistency evaluation in China ，including 309 varieties，1 822 specifications， 6 dosage forms ，and 17 pharmacological mechanisms ，basically belonging to 30 provinces，and 492 drug manufacturers （except 12 products had not been found the manufacturers ）；the proportion of GMPCE in essential medicine list increased from 0.96％ in 2012 edition to 25.40％ in 2018 edition；that of GMPCE in medical insurance list increased f rom 2.13％ in 2017 edition to 11.68％ in 2021 edition；in the first 5 batches of centralized procurement list，GMPCE accounted for 81.65％，and the maximum price drop after entering the list was 97.52％. CONCLUSIONS The policy linkage has been achieved with the continual increase of the number of GMPCE and their total amount in three lists in China. The accessibility and affordability of related medicines have been improved with the apparent decrease of the price of those medicines. H owever，total number of GMPCE is a little small，with the higher repetition rate of variety and the low proportion in the three lists ；the guarantee measures of those medicine supply need to be strengthened.