Objective To evaluate the relationship between histone deacetylase 3 (HDAC3) expression and the mechanism underlying mitigation of remifentanil postconditioning-induced protection of diabetic cardiomyocytes.Methods H9c2 cells were cultured in DMEM/F12 culture medium supplemented with 10％ fetal bovine serum.The cells were seeded in 6-well plates (2 ml/well) at a density of 105 cells/ml.After the cells were cultured for 12 h,the cells were attached to the wall and cultured for 48 h in the normoglycemic (5.5 mmol/L) or hyperglycemic (25 mmol/L) DMEM culture medium.The cells were then randomly divided into 6 groups (n =18 each) using a random number table:control group (group CON),hypoxia/reoxygenation group (group H/R),remifentanil postconditioning group (group RPC),hyperglycemia group (group HG),hyperglycemia plus hypoxia/reoxygenation group (group HG-H/R),and hyperglycemia plus remifentanil postconditioning group (group HG-RPC).In H/R,RPC,HG-H/R and HG-RPC groups,the cells were exposed to 95％ N2-5％ CO2 in an incubator for 5 h after changing the culture medium for Tyrode solution.In H/R and HG-H/R groups,the culture medium was changed to the DMEM/F12 culture medium supplemented with 10％ fetal bovine serum and glucose at the corresponding concentration,and the cells were then incubated for 1 h.In RPC and HG-RPC groups,the cells were incubated in the DMEM culture medium containing remifentanil at the final concentration of 1 μmol/L,and the cells were then incubated for 1 h.At 1 h of reoxygenation,the cell viability was measured by CCK-8 assay,the cell apoptosis was detected by AnnexinV-FITC/PI flow cytometry,and the expression of HDAC3 and caspase-3 in cells was detected by Western blot.The apoptotic rate was calculated.Results Compared with group CON,the cell viability was significantly decreased,the cell apoptotic rate was significantly increased,and the expression of caspase-3 and HDAC3 was significantly up-regulated in group H/R (P＜ 0.05).Compared with group H/R,the cell viability was significantly increased,the apoptotic rate was significantly decreased,and the expression of caspase-3 and HDAC3 was significantly down-regulated in group RPC (P＜0.05).Compared with group HG,the cell viability was significantly decreased,the apoptotic rate was significantly increased,and the expression of cspase-3 and HDAC3 was significantly up-regulated in group HG-H/R (P＜0.05).There was no significant difference in the parameters mentioned above between group HG-RPC and group HG-H/R (P＞0.05).Conclusion The mechanism underlying mitigation of remifentanil postconditioning-induced protection of diabetic cardiomyocytes is associated with hyperglycemia-induced up-regulation of HDAC3 expression.

Background Choroidal thickness is closely associated with ametropia,and to study the influence of subfoveal choroidal thickness (SFCT) on refraction is very important for understanding the mechanism of refractive error more clearly.Objective This study was to investigate the relationship between SFCT and refraction.Methods A retrospective serial cases analysis was performed.Forty anisometrope patients were recruited in Zhongshan Ophthalmic Center from June 2012 to August 2012.The subjects were divided into 6-13 years group and 14-21 years group.Vision acuity was tested by the EDTRS visual acuity chart and ocular anterior segment was examined under the slit lamp microscope,and the fundus examination was performed by direct ophthalmoscope.Subjective and objective optometry was performed after pupils were dilated.EDI OCT was used to illuminate choroidal image.Ocular axial length (AL) was obtained by Lenstar 900.The difference in SFCT between myopic eyes and hyperopic eyes was compared using Student t test,and the correlations between SFCT and refraction were analyzed by Pearson linear analysis and linear regression analysis.Results The average SFCT was (307.82±88.47) μm in all the tested eyes,and the SFCT of myopic eyes and hyperopic eyes was (270.60±70.57) μm and (376.95±76.59) μm,respectively,with a significant difference between them (P =0.000).In the 6-13 years group,positive correlations were found between SFCT and diopters with the regression coefficient 18.60 and regression equation Y =18.60X +310.79 (r=0.345,F=21.110,P=0.000) as well as between SFCT and AL with the regression coefficient -31.76 and regression equation Y =-31.76X+1 039.97 (r=0.262,F=17.320,P=0.000).In the 14-21 years group,SFCT showed positive correlation with diopters,with the regression coefficient 23.38 and regression equation Y=23.38X+353.17 (r =0.430,F =27.210,P =0.000) and negative correlation with AL,with the regression coefficient-35.82 and regression equation Y =-35.82X+1 132.75 (r=0.237,F=15.650,P=0.000).Conclusions SFCT seems to be positive correlated with diopter.When the diopter shifts toward positive value,SFCT value increases,and whenever diopter increases-1 D,SFCT decreases 20 μm approximately.SFCT decreases with the increase of AL.

Objective:To explore the application of the 4R problem analysis method combined with reverse teaching in nursing teaching in the pediatric operating room.Methods:In this study, 480 nursing students who were assigned to the operating room of Hunan Children's Hospital for internship from August 2020 to August 2022 were selected as research subjects. They were divided into control group and observation group in order of admission, with 240 students in each group. The control group received traditional teaching, while the observation group received the 4R problem analysis method combined with reverse teaching. At the end of the internship, the two groups were compared for comprehensive ability assessment scores, recognition of nursing teaching, and degree of satisfaction with the teaching. The t-test and χ2 test were performed using SPSS 22.0. Results:The scores of theoretical knowledge, basic nursing skills, specialized nursing skills in the operating room, and comprehensive nursing skill assessment of the observation group were significantly higher than those of the control group ( P<0.05). The recognition of nursing teaching among the nursing interns in the observation group was significantly higher than that in the control group ( P<0.001). There was a significant difference in the degree of satisfaction with the teaching between the two groups of nursing interns ( χ2=118.35, P<0.001). Conclusions:The 4R problem analysis method combined with reverse teaching can effectively improve the nursing teaching quality and the degree of satisfaction with the teaching among nursing interns in the pediatric operating room, enabling them to better grasp theoretical and practical skills.

Objective To investigate the influence of maternal high-protein diet during pregnancy and lactation on the growth of male rat offspring.Methods Female Wistar rats were mated with male rats and the pregnant ones were randomly assigned into three groups (n=10):Group Ⅰ,Group Ⅱ and Group Ⅲ.Three isocaloric purified diets,which were Diet Ⅰ (protein,14.0％;carbohydrate,69.3％;fat,16.7％),Diet Ⅱ (protein,24.0％;carbohydrate,59.3％;fat,16.7％) and Diet Ⅲ (protein,34.0％;carbohydrate,49.3％;fat,16.7％),were offered ad libitum to the rats in the three groups,respectively.On the 3rd day after birth,only three male rat offspring of each litter were kept.All male rat offspring at the age of 21 days were weaned onto the same normal diets until 77-day-old.Food intake (FI),body weight (BW),body length (BL) and visceral fat mass (VFM) of them were recorded.Blood lipids levels on the 21st,49th and 77th days after birth were detected.Weight gain (WG),food efficiency (FE) and percentage of VFM (VFM ％) were calculated to assess the growth of male rat offspring.One-way ANOVA,LSD or Tamhane T2 test was used for statistical analysis.Results (1) On the 3rd day after birth,male rat offspring in Group Ⅱ and Group Ⅲ had higher fast BW than those in Group Ⅰ [(9.77±0.81),(9.58±0.54) and (9.17±0.68) g;F=3.222,P=0.026].On the 7th,14th and 21st days after birth,male rat offspring in Group Ⅱ [(17.59± 1.24),(39.51 ±2.68) and (67.77±4.22) g] had higher BW than those in Group Ⅰ [(15.96±1.17),(35.35±4.11) and (63.43±3.98) g] and Group Ⅲ [(16.52±1.05),(37.06±3.27) and (64.43±3.81) g] (F=23.684,17.070 and 84.195,all P＜0.001).Male rat offspring's BL of Group Ⅱ were longer than those of Group Ⅰ on the 7th and 14th days after birth[(7.53±0.29) vs (7.53± 0.29) cm,(10.38 ±0.24) vs (9.99± 0.30) em,both P＜0.05].BL of Group Ⅲ was longer than that of Group Ⅰ,but shorter than that of Group Ⅲ on the 14th day after birth[(10.22 ± 0.25) vs (9.99± 0.30) cm,(10.22 ± 0.25) vs (10.38±0.24) cm,both P＜0.05].Male rat offspring's average WG from the 3rd to the 7th and the 7th to the 14th day after birth were higher in Group Ⅱ [(7.70±0.41) and (22.08±1.20) g] and Group Ⅲ [(7.00±0.40) and (20.75± 1.72) g] than in Group Ⅰ [(6.73±0.55) and (19.68± 1.73) g] (F=86.925 and 38.876,both P＜0.001),and the differences between Group Ⅱ and Group Ⅲ were statistically significant (both P＜0.05).(2) No significant differences in WG,FI and FE was observed among the three groups (all P＞0.05).Male rat offspring's BL on the 49th day after birth was longer in Group Ⅱ than in Group Ⅰ and Group Ⅲ [(22.03±0.26),(21.57±0.43) and (21.77±0.33) cm,F=3.222,P=0.026).VFM ％ of Group Ⅱ (3.87±0.32 and 5.13±0.32) and Group Ⅲ (3.90±0.27 and 5.15±0.33) on the 49th and 77th days after birth were higher than those of Group Ⅰ (3.50±0.34 and 4.68±0.38) (F=3.631 and 3.611,both P＜0.05).(3) Triglyceride (TG) level was higher in Group Ⅰ than in Group Ⅱ and Group Ⅲ on the 21st day after birth [(1.12±0.13),(0.89±0.10) and (0.97±0.12) mmol/L,F=7.283,P=0.004].However,Group Ⅱ and Group Ⅲ had a higher level of TG than Group Ⅰ on the 77th day after birth[(2.64±0.37),(2.43±0.32) and (1.90±0.21) mmol/L,F=12.321,P＜0.001].Conclusion Maternal high-protein diet can increase the birth weight of male rat offspring to a certain extent,which is influenced by carbohydrate content.Moreover,male rat offspring of dams fed with high-protein diet during pregnancy and lactation will have increased visceral fat accumulation and serum TG level during adulthood.

Objective: To explore the predictive value of the timed "up and go" test on falling of inpatients with stroke, providing objective reference for clinical fall risk evaluation. Methods: A total of 62 stroke in patients who were treated in the department of Neurology of the Second Affiliated Hospital of Shantou University Medical College from January 2018 to June 2018 were selected by the convenience sampling method. The timed "up and go" test was used to record the walking function of stroke inpatients. An ROC curve was used to analyze the efficacy in predicting falls of stroke inpatients. Results: The TUGT has demonstrated intraclass correlation coefficient (ICC) value of 0.963 (95%CI 0.938-0.978), and Cronbach alpha coefficient value of 0.983.The difference of the TUGT time between recurrent-fall stroke inpatients [15.69 (13.30, 19.87) seconds] and the patients without a history of falling [12.45 (10.08, 16.26) seconds] was statistically significant (Z=-2.585, P<0.05). Meanwhile, the difference of the TUGT time between male stroke inpatients [13.12 (10.23, 15.35) seconds] and female stroke inpatients [17.09 (12.98, 19.87) seconds] was also statistically significant (Z=-2.297, P<0.05). The TUGT time was significantly (P<0.05) positively correlated both with the fall history (rs=0.331) and gender (rs=0.294) in stroke inpatients. The result of ROC curve showed that the optimal TUGT cut-off point for predicting the fall of male stroke patients was 13.12 seconds with 0.696 for AUC, 78.6% for sensitivity and 68.2% for specificity (P<0.05).While the optimal TUGT cut-off point for predicting the fall of female stroke inpatients was 13.68 seconds with 0.691 for AUC, 73.3% for sensitivity and 65.6% for specificity (P<0.05). Conclusions Although TUGT has good feasibility in stroke inpatients, its predictive value for future falls of stroke inpatients is medium. The assessment and prediction of fall risk should be considered carefully by medical workers so as to reduce the occurrence of falls in stroke inpatients.

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