Objective To observe the protein and mRNA expression of LOX-1,eNOS and PPARγ in type 2 diabetic rat aorta,and to investigate the effect of rosiglitazone intervention.Methods Totally 80 Wistar rats (7-week-old male) were randomized into the control group,high fat diet group,diabetic group,and rosiglitazone treatment group (n=20 each).Type 2 diabetes model was developed by intraperitoneal injection with a low dose of streptozotocin,and rats in rosiglization treatment group were treated with rosiglitazone by intragastric administration.After treatment with rosiglitazone for 6 and 12 weeks,animals were sacrificed.Aorta were collected for detecting the protein and mRNA expressions of LOX-1,eNOS and PPARγ,and the differences in expression levels were compared among groups.Results After 6 and 12 weeks,the protein expressions of LOX-1 were up-regulated in diabetic group and rosiglitazone treatment group as compared with control group and high fat diet group (all P＜ 0.01).The protein expression of LOX-1 was down-regulated in rosiglitazone treatment group as compared with diabetic group (P ＜ 0.05).The aorta protein expressions of LOX-1 in high diet group,diabetes group and rosiglitazone treatment group were upregulated after 12 weeks as compared with 6 weeks (all P＜0.01).After 6 and 12 weeks,the aorta protein expressions of eNOS were down-regulated and PPARγ were up-regulated in high fat diet group,diabetic group and rosiglitazone treatment group as compared with control group (all P＜0.01)The aorta protein expression of eNOS was down-regulated and PPARγwas up-regulated in diabetes group as compared with high fat diet group and rosiglitazone treatment group (all P＜0.01).The aorta protein expressions of eNOS in diabetes group and rosiglitazone treatment group were downregulated after 12 weeks as compared with 6 weeks (all P＜0.01).After 6 and 12 weeks,the aorta mRNA expressions of LOX-1 and PPARγ were up-regulated,but the mRNA expressions of eNOS were down-regulated in high fat diet group,diabetes group and rosiglitazone treatment group as compared with control group (all P＜0.05).The aorta mRNA expressions of LOX-1 and PPARγ were up-regulated,but the mRNA expressions of eNOS were down-regulated in diabetes group and rosiglitazone treatment group as compared with high fat diet group (all P＜0.05).The aorta mRNA expressions of LOX-1 and PPARγ were down-regulated,but the mRNA expressions of eNOS were upregulated in rosiglitazone treatment group as compared to diabetic group (all P＜0.01).Conclusions Both hyperglycemia and hyper-lipoproteinemia can induce early coronary atherosclerosis in rats with the abnormal protein and mRNA expressions of LOX-1,eNOS and PPARγ in rat aorta,and the abnormal expressions are more obvious in hyperglycemia combined with hyperlipoproteinemia.Thiazolidinediones can reverse the above abnormal expressions in diabetic rats.

BACKGROUND:Compared with bone marrow and autologous peripheral blood stem cells, umbilical cord mesenchymal stem cells are characterized as more primitive, more powerful amplification and lower immunogenicity, no ethical problems, which are more important to the elderly patients with diabetes mel itus. OBJECTIVE:To evaluate the efficacy and safety of umbilical cord mesenchymal stem cells transplantation in the treatment of the elderly patients with diabetic lower limb vascular disease. METHODS:Fifty-six elderly patients with diabetic lower limb vascular disease were randomly divided into observation group and control group. The control group was treated with conventional therapy, while the observation group was treated with umbilical cord mesenchymal stem cells transplantation. RESULTS AND CONCLUSION:Observation group showed a higher efficiency than the control group, with significant difference (P<0.05). After treatment, foot skin temperature, transcutaneous oxygen pressure, and ankle brachial index were al improved in both two groups, and the ankle brachial index showed a better value in the observation group (P<0.05). There were no significant adverse reactions in the two groups. Umbilical cord mesenchymal stem cells transplantation is a simple, safe and effective therapy for the elderly patients with diabetic lower limb vascular disease, with better short-term curative effect.

Objective To observe the levels of ethical decision-making ability and emotion control, so as to explore the correlation between them. Methods A total of 280 clinical nurses were selected from Qingdao Cancer Hospital by convenience sampling method in April 2017. Judgment About Nursing Decision (JAND) Scale and the Courtauld Emotion Control Scale (CECS) were applied to assess nurses' nursing ethical decision-making and emotion control level. Pearson correlation analysis and multiple linear regression were used to analyze the influencing factors of nursing ethical decision-making ability of clinical nurses. Results In this study, the JAND score was (264.66±14.57), at a moderate level; CECS score was (49.93±16.52), at an upper level. Pearson correlation analysis showed that JAND and CECS were negatively correlated (r=-0.185, P＜ 0.01). Univariate analysis showed that there were significant differences in nursing ethical decision-making ability among clinical nurses with different nursing age, educational background, professional title, employment style and relevant training (χ2=36.419, 66.901, 74.415, 27.053, 89.464; P＜ 0.05). Multiple linear regression analysis showed nursing age, profession title and relevant training were influencing factors for ethical decision-making ability in clinical nurses (P＜ 0.01). Conclusions The levels of ethical decision-making ability and emotion control in clinical nurses need to be improved. The nurses with longer nursing age, higher profession title and who have received relevant training, have stronger ethical decision-making ability.

Visiting students' education is an important part of laboratory medicine continuing education. In the new era, the traditional continuing education model faces severe challenges in how to improve the clinical serviceability of grass-roots laboratories, the training quality of medical laboratory students, and the students' personal quality and professional ability. In the process of exploring the new training model for a long time, combined with the characteristics of the laboratory medicine and the needs of the visiting students, we put forward the new training concept of "tutorial system" for laboratory medicine students. The "one-to-one" model is used to teach students in accordance with their aptitude according to their aptitude for students of different levels and different cultural backgrounds and it has achieved certain success. The practice shows that the "tutorial system" for visiting laboratory medicine students can increase their belonging sense, improve the quality and level of the training, and expand the effect of continuing education.

Objective To analyze the relationship between serum microRNA(miR)-204 and miR-200b lev-els and clinical efficacy in patients with oral submucosal fibrosis(OSF).Methods A total of 110 patients with OSF who visited Affiliated Hospital of Hebei Engineering University from December 2021 to December 2022 were collected as the study group,another 50 healthy people who underwent physical examination during the same period were collected as the control group.The quantitative real-time PCR(qRT-PCR)method was ap-plied to detect and compare the serum levels of miR-204 and miR-200b in the study group and the control group.The study group was divided into miR-204 high expression group and low expression group,and miR-200b high expression group and low expression group.The clinical efficacy,transforming growth factor β1(TGF-β1),interleukin-6(IL-6),clinical pathological features,and visual analogue scale(VAS)of patients with different levels of serum miR-204 and miR-200b were compared,and Spearman and Pearson methods were applied to analyze the correlation between serum miR-204 and miR-200b levels and various indicators in the study group.Results The serum level of miR-204 and miR-200b in the study group was obviously lower than those in the control group,and the difference was statistically significant(P＜0.05).The total effective rates of patients in the high expression group of miR-204 and the high expression group of miR-200b were both 100.00％,which were higher than the total effective rates of the low expression group of miR-204 and the low expression group of miR-200b(86.79％and 88.89％)respectively,and the differences were statisti-cally significant(P＜0.05).The results of univariate analysis showed that the serum levels of miR-204 and miR-200b in OSF patients with chewing betel nut,mouth opening degree≤28 mm,oral mucosal lesion area＞4 cm2,and VAS score＞3 points were obviously lower than those with non chewing betel nut,mouth opening degree＞28 mm,oral mucosal lesion area≤4 cm2,and VAS score≤3 points,and the differences were statis-tically significant(P＜0.05).The levels of TGF-β1 and IL-6 in patients with high expression of miR-204 and miR-200b were obviously lower than those in patients with low expression of miR-204 and miR-200b,and the differences were statistically significant(P＜0.05).The correlation analysis results showed that the serum levels of miR-204 and miR-200b in patients with OSF were negatively correlated with oral mucosal lesion are-a,VAS score,TGF-β1,IL-6(P＜0.05),and positively correlated with mouth opening degree(P＜0.05).Conclusion The serum levels of miR-204 and miR-200b in patients with OSF are closely related to clinical ef-ficacy,and when the serum levels of miR-204 and miR-200b increase,OSF patients have better clinical efficacy.

Objective To investigate the diagnostic value of Astograph methacholine provocation test in patients with chest tightness variant asthma ( CTVA)??Methods From January 2011 to February 2017,156 patients with CTVA in outpatient or inpatient department of respiratory medicine of Kailuan General Hospital affiliated to North China University of Science and Technology were selected as case group ( chest tightness variant asthma group )??The control group were 361 non?asthmatic patients including interstitial lung disease ( 23 cases), coronary disease ( 157 cases), hypertensive cardiopathy ( 22 cases), myocardiosis (16 cases),congenital heart disease ( 3 cases),rheumatic valvular heart disease (6 cases), central airway disease (3 cases),thyromegaly (10 cases),mediastinal tumor (5 cases),thoracic or spinal deformity (8 cases),phrenoparalysis (2 cases) and vegetative nerve functional disturbance (106 cases)??All participants received pulmonay ventilation test, average daily and nightly variation rate of PEF ( Peak expiratory flow) or PEF weekly variability, Astograph methacholine provocation test ( forced expirataory volume in one second≥70% expectation),and other relevant examinations??The diagnostic value of Astograph methacholine provocation test on CTVA was assessed by analyzing the sensitivity, specificity, positive predictive value,negative predictive value,and Yunden index of Astograph methacholine airway??Results Compared with the control group (( 1??18 ± 0??44)%), theforced expiratory flow from 75% of Forced vital capcacity ( FEF75 ) index of CTVA group (( 1??29 ± 0??50 )%) had significant difference (, t＝ 2??96, P＝0??006)??The sensitivity,specificity,positive predictive value,negative predictive value,Yunden index,and diagnostic accuracy of Astograph methacholine provocation test on CTVA were 0??814,0??695,0??536,0??305, 0??509 and 0??731, respectively??Conclusion The sensitivity, negative predictive value, Yunden index and diagnostic accuracy of Astograph methacholine provocation test on CTVA were higher,whereas the specificity and positive predictive value were relatively lower,suggesting that Astograph methacholine provocation test had a reliable diagnostic value on CTVA,with lower false negative and higher false positive??

OBJECTIVETo compare the clinical efficacy of the lymph node dissection patterns of the reverse and the traditional cabbage in hand-assisted laparoscopic D2 radical gastrectomy (HALG).

METHODSFrom December 2010 to October 2013, 194 patients with HALG in Chengdu Military General Hospital were enrolled in this study. According to the pattern of lymph node dissection, 108 patients were performed with the reverse procedure which took spleen as starting point, from left to right, and 86 patients were performed with the traditional cabbage procedure which took the abdominal cavity as the center, from both sides to middle. A retrospective comparative analysis was made on the intra- and post-operative data between the two groups.

RESULTSAll the patients were successfully performed with HALG, and no peri-operative death occurred. There were no significant differences in the incision length [(7.0 ± 0.2) cm vs. (6.9 ± 0.3) cm], the operative time [(170.9 ± 33.8) minute vs. (174.6 ± 22.4) minute], dissected lymph node number (17.6 ± 7.5 vs. 17.1 ± 5.8) and post-operative complications [(6.5%(7/108) vs. 8.1%(7/86)] between the reverse group and cabbage group (all P>0.05). However, less blood loss [(204.6 ± 98.2) ml vs. (259.1 ± 122.6) ml, P<0.01] and shorter postoperative hospital stay [(9.0 ± 1.7) day vs. (10.5 ± 4.0) day, P<0.01] were observed in reverse group as compared to cabbage group. During 1 to 6 months follow-up, no death case was found in reverse group, while 1 case died due to upper gastrointestinal bleeding 48 days after operation in cabbage group.

CONCLUSIONEfficacy is similar between the two HALG procedures in lymph node dissection, while reverse procedure has certain advantages, such as less blood loss and faster recovery.

Gastrectomy ; methods ; Hand-Assisted Laparoscopy ; Humans ; Length of Stay ; Lymph Node Excision ; Operative Time ; Postoperative Complications ; Postoperative Period ; Retrospective Studies ; Stomach Neoplasms ; surgery

Objective:To investigate the perioperative efficacy of robot surgical system assisted anatomic and non-anatomic hepatectomy.Methods:The propensity score matching and retrospective cohort study was conducted. The clinical data of 103 patients who underwent robot surgical system assisted hepatectomy in Sir Run Run Shaw Hospital, Affiliated with the Zhejiang University School of Medicine from March 2016 to December 2021 were collected. There were 54 males and 49 females, aged 56(range, 44?64)years. Of the 103 patients, 55 cases undergoing robot surgical system assisted anatomic hepatectomy were divided into the anatomic group, and 48 cases undergoing robot surgical system assisted non-anatomic hepatectomy were divided into the non-anatomic group. Observation indicators: (1) propensity score matching and comparison of general data of patients between the two groups after matching; (2) intraoperative conditions; (3) perioperative complications. Propensity score matching was done by the 1:1 nearest neighbor matching method. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the t test. Measurement data with skewed distribution were expressed as M(range), and comparison between groups was conducted using the Mann-Whitney U test. Count data were described as absolute numbers or percentages, and comparison between groups was conducted using the chi-square test or Fisher exact probability. Comparison of ordinal data was conducted using the rank sum test. Results:(1) Propensity score matching and compari-son of general data of patients between the two groups after matching. Of the 103 patients, 94 cases were successfully matched, including 47 cases in the anatomic group and 47 cases in the non-anatomic group. The elimination of preoperative body mass index, preoperative platelet and preoperative albumin confounding bias ensured comparability between the two groups after propensity score matching. (2) Intraoperative conditions. After propensity score matching, the operation time and volume of intraoperative blood loss were 175(range, 120?240)minutes and 50(range, 50?100)mL in patients of the anatomic group, versus 155(range, 105?190)minutes and 100(range, 50?200)mL in patients of the non-anatomic group, showing significant differences in the above indicators between the two groups ( Z=1.97, 2.49, P<0.05). (3) Perioperative complications. After propensity score matching, cases with pleural fluid and/or ascites, case with biliary fistula, case with thrombosis, case with peritoneal infection, case with incision infection were 11, 1, 2, 4, 1 in patients of the anatomic group, versus 12, 0, 4, 1, 0 in patients of the non-anatomic group, showing no significant difference in the above indicators between the two groups ( P>0.05). Cases with complications classified as grade Ⅰ, grade Ⅱ, grade Ⅲ, grade Ⅳ of the Clavien-Dindo classification were 33, 14, 0, 0 in patients of the anatomic group, versus 28, 14, 3, 2 in patients of the non-anatomic group, showing no significant difference in the above indicators between the two groups ( Z=?1.38, P>0.05). Conclusions:Robotic surgical system assisted anatomic and non-anatomic hepatectomy are safe and feasible for clinical application. Compared with robot surgical system assisted non-anatomic hepatectomy, patients under-going robot surgical system assisted anatomic hepatectomy have long operation time and less volume of intraoperative blood loss.