Objective To explore the influence of LPS treatment on related molecules in Smads and ERK1/2 signal pathway in pancreatic stellate cell line LTC-14.Methods LTC-14 cells were cultured in vitro, and were treated with LPS at different dose in different time points.Protein expressions of related molecules in Smads pathway and ERK1/2 pathway and α-SMA in LTC-14 Cells were examined by Western blot.Results On Treated LTC-14 cells by 0, 1, 5, 10, 20 and 50 mg/L LPS,protein expressions of Smad3 were 0.15±0.02, 0.37±0.02, 0.44±0.01, 0.46±0.02, 0.372±0.01 and 0.24±0.03;expressions of Smad7 were 0.79±0.05, 0.84±0.02, 0.55±0.03, 0.45±0.03, 0.34±0.02 and 0.92±0.07;p-ERK1/2 levels were 0.48±0.05, 0.74±0.03, 0.72±0.04, 0.89±0.02, 0.81±0.02 and 0.72±0.03;p-cPLA2 levels were 0.15±0.03, 0.30±0.01, 0.31±0.01, 0.30±0.02, 0.28±0.03 and 0.32±0.02;α-SMA levels were 0.56±0.06, 0.62±0.06, 0.54±0.04, 1.03±0.11, 1.39±0.08 and 1.28±0.10.The changes of protein expressions before and after LPS treatment were obvious (all P<0.01).The protein expressions of ERK1/2 were 0.56±0.03, 0.57±0.02, 0.53±0.02, 0.58±0.02, 0.59±0.05 and 0.55±0.04, which did not change obviously along with increased LPS dosages.LTC-14 cells treated with 10 mg/L LPS for 0, 1, 3, 6 and 9 h,the expressions of Smad3 were 0.69±0.05, 0.68±0.07, 1.02±0.14, 1.82±0.0 and 2.04±0.11,those of Smad7 were 2.77±0.10, 1.37±0.08, 1.45±0.14, 0.78±0.09 and 0.63±0.06,those of p-ERK1/2 were 0.16±0.03, 0.32±0.05, 0.79±0.03, 1.50±0.07 and 1.77±0.04,those of p-cPLA2 were 0.15±0.04, 0.32±0.06, 0.63±0.04, 0.95±0.04 and 1.49±0.10,those of α-SMA were 0.84±0.03, 1.26±0.21, 1.81±0.19, 4.28±0.26 and 4.37±0.15, all of which changed obviously as the treatment time increased (P<0.05 or 0.01).The expressions of ERK1/2 were 0.75±0.03, 0.72±0.02, 0.80±0.04, 0.74±0.03 and 0.85±0.09, which did not change obviously as the treatment time increased.Conclusions LPS could upregulate the expression of α-SMA in a time-and dose-dependent way, and activate intracellular Smads and ERK1/2 inflammatory pathways, which may be the potential molecular mechanism of the development of chronic pancreatitis.

Objective:To evaluate the application value of SPECT lung perfusion imaging in guiding radiotherapy path, optimizing the radiotherapy plan for lung cancer and protecting lung function during radiotherapy for locally advanced non-small cell lung cancer.Methods:In this study, 84 patients with stage Ⅲ non-resectable non-small cell lung cancer were randomly divided into the control group ( n=44) and observation group ( n=40). In the control group, radiotherapy plan based on conventional CT images was delivered, and two plans based on the lung function information suggested by conventional CT and SPECT lung perfusion imaging: P1 and P2 were given in the observation group. All patients in the observation group were finally treated according to the P2 plan. The incidence of radiation pneumonitis, and changes in lung function before and after radiotherapy were statistically compared between two groups. The dose-volume parameters of P1 and P2 were statistically compared. Results:After the plan was optimized, the incidence of radiation pneumonitis in the observation group was significantly reduced and the decline of lung function was significantly improved (both P≤0.001). The functional dose parameters were significantly improved in the P2 plans (both P<0.05), whereas the irradiation dose of organs at risk did not significantly change ( P>0.05). Conclusion:SPECT lung perfusion imaging optimizes the intensity-modulated radiotherapy plan, which can reduce the functional lung dose and increase the tumor radiotherapy dose without increasing the irradiation dose of other organs at risk.

Objective To evaluate different inflammation markers for predicting the risk of acute kidney injury (AKI) in sepsis patients. Methods A retrospective observational study was conducted. The adult patients with sepsis for more than 24 hours admitted to intensive care unit (ICU) of Beijing Friendship Hospital, Capital Medical University from March 1st, 2010 to November 1st, 2017 were enrolled. Inflammatory markers such as white blood cell count (WBC), erythrocyte sedimentation rata (ESR), neutrophil and lymphocyte ratio (NLR), C-reactive protein (CRP), procalcitonin (PCT), etc. were collected at ICU admission. The patients were divided into different groups according to the 24-hour AKI, and subgroup analysis was conducted according to the criteria of the Global Renal Disease Prognostic Organization (KDIGO)-AKI staging. The receiver operating characteristic curve (ROC) was plotted with statistically significant inflammatory markers to assess the predictive value of AKI for patients with systemic infection. Results A total of 753 patients with sepsis were enrolled. 405 AKI patients were diagnosed within 24 hours, with a prevalence of 53.8%. There were 118 cases (15.7%) in AKI stage 1, 48 cases (6.4%) in stage 2 and 239 cases (31.7%) in stage 3. PCT in AKI group was significantly higher than that in non-AKI group [μg/L: 4.98 (1.51, 32.75) vs. 3.00 (0.37, 11.40), P < 0.01]. PCT of AKI stage 2 group was significantly higher than that of AKI stage 1 and 3 groups [μg/L: 27.86 (4.80, 37.26) vs. 3.00 (0.98, 16.10), 4.98 (1.51, 42.55), both P < 0.01]. Although ESR in AKI group was lower than that of non-AKI group (mm/1 h: 45.25±37.42 vs. 52.28±34.89, P < 0.01), there was no significant difference among the subgroups. CRP in AKI group was slightly higher than the non-AKI group [mg/L: 96.00 (42.20, 160.00) vs. 73.60 (21.01, 157.50)], but the difference was not statistically significant (P > 0.05). There was no significant difference in WBC or NLR between AKI group and non-AKI group. It was shown by ROC curve analysis that the area under ROC curve (AUC) of PCT in predicting the occurrence of septic AKI was 0.619, with the 95% confidence interval (95%CI) of 0.545-0.689 (P < 0.01). When the cut-off value of PCT > 0.4 μg/L, the sensitivity was 94.2%, the specificity was 26.5%, the accuracy was 64.2%, the positive predictive value was 61.6%, and the negative predictive value was 78.6%. Conclusion PCT could be a marker to predict AKI with sepsis patients.

Objective To investigate the correlation between the manual compression on injection point and the incidence of subcutaneous bleeding after subcutaneous injection of low molecular weight heparin(LMWH)in elderly patients with coronary artery disease.Methods A total of 131 elderly patients with coronary artery disease,who received subcutaneous injection of LMWH after percutaneous coronary intervention(PCI)at the Affiliated Nanjing Hospital of Nanjing Medical University of China between January 2019 and December 2021,were enrolled in this study.According to whether the manual compression on the injection point was employed or not after the injection of LMWH,the patients were divided into the study group(n=67)and the control group(n=64).The operation process of subcutaneous injection of LMWH was carried out in accordance with the"Supervision Standard for Nursing Quality of Hypodermic Injection of Low Molecular Weight Heparin"which was included in the norms formulated by authors'hospital.For the patients of the study group,the injection point was manually pressed for 3-5 min after the injection of LMWH,the manually-used force was to press the skin down for 1cm deep.The incidence of subcutaneous bleeding was compared between the two groups.Results In the study group and the control group,the incidence of subcutaneous ecchymosis was 9.0%and 7.8%respectively,the incidence of subcutaneous hard tubercle was 4.5%and 1.6%respectively,the differences between the two groups were not statistically significant(both P＞0.05).The patient's age,gender,abdominal circumference and body mass index(BMI)carried no obvious correlation with the subcutaneous bleeding after LMWH injection(P＞0.05),while a statistically significant correlation existed between the abdominal wall fat thickness and the subcutaneous bleeding(P＜0.05),which could be used as an independent predictor for the occurrence of subcutaneous bleeding after LMWH injection.Conclusion No obvious correlation exists between the manual compression on injection point and the incidence of subcutaneous bleeding in elderly patients with coronary artery disease after subcutaneous injection of LMWH,therefore,no compression manipulation,used as a hemostatic measure,is required after subcutaneous injection of LMWH.The abdominal wall fat thickness is an independent predictor for subcutaneous bleeding after injection of LMWH.Standard operation procedures should be strictly followed so as to avoid the occurrence of subcutaneous bleeding after injection of LMWH.(J Intervent Radiol,2024,32:77-81)

Objective To investigate the relationship between the levels of soluble growth stimu-lation expressed gene 2 protein(sST2),myoglobin(Myo),interleukin-6(IL-6)in peripheral blood and cardiac function in elderly patients with diastolic heart failure(DHF)complicated with sarcope-nia.Methods A total of 122 patients with DHF were divided into DHF complicated with sarcopenia group(60 cases)and DHF group(62 cases)according to the presence or absence of sarcopenia.In addition,58 healthy healthy population with physical examination and 60 patients with sarcopenia a-lone were included in the control group and sarcopenia alone group,respectively.The levels of sST2,Myo,IL-6 and cardiac function indexes[left ventricular ejection fraction(LVEF),cardiac output(CO),heart rate(HR),stroke volume(SV),and cardiac index(CI)]were measured in each group.Pearson correlation analysis was used to analyze the correlations between sST2,Myo,IL-6 and each cardiac function index.Receiver operating characteristic(ROC)curves were drawn to analyze the diagnostic efficacy of sST2,Myo,IL-6 alone and their combination in diagnosing DHF complicated with sarcopenia.Results Compared with the control groupand the sarcopenia alone group,the levels of sST2,Myo,IL-6 and HR were increased,while LVEF,CO,SV,and CI were decreased in the DHF group and the DHF complicated with sarcopenia group(P＜0.05).Compared with the DHF group,the levels of sST2,Myo,IL-6 and HR were increased,while LVEF,CO,SV,and CI were decreased in the DHF complicated with sarcopenia group(P＜0.05).The sST2,Myo,and IL-6 were negatively correlated with LVEF,CO,SV,and CI(P＜0.001),and positively correlated with HR(P＜0.001).The sST2,Myo,IL-6,LVEF,and SV were independent influencing factors for DHF complicated with sarcopenia(P＜0.05).The area under the curve of combined detection of sST2,Myo,and IL-6 for diagnosing DHF complicated with sarcopenia was 0.936,indicating a better diagnostic efficacy than individual tests.Conclusion The levels of sST2,Myo,and IL-6 in peripheral blood are significantly increased in elderly patients with DHF complicated with sarcope-nia,and these markers are significantly correlated with cardiac function indexes.Combined detec-tion of these three markers has a higher diagnostic efficacy for DHF complicated with sarcopenia.

Objective To discuss the application of mind map in self-management of elderly patients after receiving mitral valve transcatheter edge-to-edge repair(M-TEER).Methods A total of 66 patients,who underwent M-TEER at Nanjing Hospital of Nanjing Medical University from August 2021 to October 2022,were enrolled in this study.Using the envelope concealment method,a total of 66 data analysis samples were included in the analysis.There were 33 patients each in the study group and control group.Routine health education was adopted for the patients of the control group,while the responsible nurse conducted health education for the patients of the study group under the guidance of the mind map that was designed by a multidisciplinary specialized nurses.Results There was a significant difference in postoperative medication compliance between the study group and the control group(P＜0.05),i.e.the degree of compliance,including taking medicine on time,insisting on taking medicine and taking medicine as prescribed,in the study group was obviously higher than that in the control group.The postoperative 6-min walking test,which was regarded as one of the indicators of cardiac functions,in the study group was remarkably better than that in the control group,the difference was statistically significant(P＜0.05).The postoperative quality of life(including daily activity ability,frailty degree,social support,and incidence of hospitalization for heart failure within one year after treatment)in the study group was strikingly better than that in the control group(P＜0.05).Conclusion The use of mind map in self-management of elderly patients after receiving M-TEER can effectively improve the medication compliance of the patients after discharge,improve the quality of life of patients,and reduce the incidence of hospitalization due to heart failure.

Objective To investigate the relationship between the levels of soluble growth stimu-lation expressed gene 2 protein(sST2),myoglobin(Myo),interleukin-6(IL-6)in peripheral blood and cardiac function in elderly patients with diastolic heart failure(DHF)complicated with sarcope-nia.Methods A total of 122 patients with DHF were divided into DHF complicated with sarcopenia group(60 cases)and DHF group(62 cases)according to the presence or absence of sarcopenia.In addition,58 healthy healthy population with physical examination and 60 patients with sarcopenia a-lone were included in the control group and sarcopenia alone group,respectively.The levels of sST2,Myo,IL-6 and cardiac function indexes[left ventricular ejection fraction(LVEF),cardiac output(CO),heart rate(HR),stroke volume(SV),and cardiac index(CI)]were measured in each group.Pearson correlation analysis was used to analyze the correlations between sST2,Myo,IL-6 and each cardiac function index.Receiver operating characteristic(ROC)curves were drawn to analyze the diagnostic efficacy of sST2,Myo,IL-6 alone and their combination in diagnosing DHF complicated with sarcopenia.Results Compared with the control groupand the sarcopenia alone group,the levels of sST2,Myo,IL-6 and HR were increased,while LVEF,CO,SV,and CI were decreased in the DHF group and the DHF complicated with sarcopenia group(P＜0.05).Compared with the DHF group,the levels of sST2,Myo,IL-6 and HR were increased,while LVEF,CO,SV,and CI were decreased in the DHF complicated with sarcopenia group(P＜0.05).The sST2,Myo,and IL-6 were negatively correlated with LVEF,CO,SV,and CI(P＜0.001),and positively correlated with HR(P＜0.001).The sST2,Myo,IL-6,LVEF,and SV were independent influencing factors for DHF complicated with sarcopenia(P＜0.05).The area under the curve of combined detection of sST2,Myo,and IL-6 for diagnosing DHF complicated with sarcopenia was 0.936,indicating a better diagnostic efficacy than individual tests.Conclusion The levels of sST2,Myo,and IL-6 in peripheral blood are significantly increased in elderly patients with DHF complicated with sarcope-nia,and these markers are significantly correlated with cardiac function indexes.Combined detec-tion of these three markers has a higher diagnostic efficacy for DHF complicated with sarcopenia.

Objective To compare the effects of the comprehensive health intervention by new media and the conventional telephone follow-up on patients' self-management ability after percutaneous coronary intervention (PCI), and to explore the comprehensive health interventions by new media which can improve the self-management ability of patients after PCI.Methods A total of 130 patients with coronary heart disease who received PCI in a ClassⅢ Grade A hospital in Nanjing between August and December 2016 were selected by convenient sampling and divided into the treatment group (n=64) and the control group (n=66) according to the random number table. Patients in the control group received the conventional telephone follow-up, while patients in the treatment group received the comprehensive health intervention by new media. The self-management ability was compared before and after intervention using the Coronary Disease Self-Management Scale (CSMS). The incidence of adverse cardiovascular events, readmission rate at emergency service and the number of patients with regular subsequent visits to outpatient service were recorded.Results The treatment group scored higher in all dimensions of the self-management ability than the control group (P<0.05) after intervention; the readmission rate was lower in the treatment group than in the control group (χ2=4.997, P=0.044); and more patients with regular subsequent visits to outpatient patients were found in the treatment group (χ2=7.897,P=0.007).Conclusions The comprehensive health intervention by new media can improve the self-management ability of patients, reduce the readmission rate at emergency service and increase the rate of regular subsequent visits to outpatient service.

OBJECTIVE: To establish the cell model using human leukemia cell line HL-60 for exposure of coke oven emissions( COE) in vitro and to explore the mechanism of COE-induced acute toxicity in HL-60 cells. METHODS: HL-60 cells were collected in their logarithmic growth phase and cultured in medium that had final concentrations of COE in 2. 5,5. 0,10. 0 and 20. 0 mg / L for 24 hours. Cell survival rate was examined by CCK-8 assay. The cytotoxicity was evaluated using lactate dehydrogenase release assay. Reactive oxygen species( ROS) production was determined by the 2',7'-dichlorofluorescein diacetate and nitroblue tetrazolium method. The activation of nuclear factor-κB( NF-κB) pathway was evaluated by western blot. RESULTS: With the increasing exposure concentrations of COE,the cytotoxicity of HL-60 cells increased( P < 0. 01),the cell survival rate decreased( P < 0. 01),intracellular ROS decreased( P < 0. 01),whereas extracellular ROS increased( P < 0. 01). These changes had a dose-effect relationship. The levels of phospho-nuclear factor-kappa B p65 and phospho-inhibitor of kappa Bα were higher in all the COE-treated cells compared with untreated cells( P < 0. 05),with no dose-effect relationship. CONCLUSION: COE could cause acute toxicity in HL-60 cells in a doseeffect relationship. The mechanism may be related to the COE-induced in-balanced ROS release and removal,leading to the activation of NF-κB pathway. HL-60 cells can be used as a common cell line for COE hematotoxicity analysis.