Objective To measure the mRNA expression of immediate-early gene c-fos in endothelial cells by the use of different intermittent hypoxia (IH) protocols. Methods A gas control delivery system was homemade, which pro-duced IH/re-oxygenation(ROX) environmental exposure. The endothelial cells were exposed to IH/ROX cycles, and were di-vided into three groups (A, B and C). There were five sub-groups in each group. Group A included intermittent normoxia group, standard incubator control group, continuous hypoxia group (CH), 1.5%O2 IH group and 10%O2 IH group. There were different frequency IH of 1.5%O2 and 10%O2 sub-groups in group B and group C. Hypoxia time was 15 s. The intermittent hypoxia cycle was 60 and the ROX time was different. The total cycle time was different, including 1.5 h group, 3 h group, 5 h group, 6.5 h group and 9.5 h group. The mRNA expression of immediate-early gene c-fos was measured by real-time PCR. Results There was no significant difference in the level of c-fos mRNA between intermittent normoxia group and CH group. The expression of c-fos mRNA was significantly higher in 1.5%O2 IH group and 10%O2 IH group than that of intermit-tent normoxia group, and there was a higher expression level of c-fos mRNA in 1.5%O2 IH group than that of 10%O2 IH group (P＜0.01). It was found that the mRNA expression of c-fos increased gradually at first, and then gradually decreased. The expression of c-fos mRNA was significantly higher in 5 h group than that of other groups (P＜0.01). Conclusion The mRNA expression of immediate-early gene c-fos is increased after exposing to IH/ROX in endothelial cells, which is closely related with IH extents and frequencies.

Objective To investigate the effect of emphysema and intermittent hypoxia (IH) on the hepatic oxidative stress and inflammatory injury in rats. Methods Sixty male Wistar rats were randomly assigned to 4 groups, control group (A), emphysema group (B), IH group (C) and emphysema+IH group (D). Group A was normally fed. Group B was exposed to smoke, 30 min per time, twice everyday. Group C was exposed to 5%O2 30 s/Air 90 s for 8 h/d. Group D was exposed to smoke twice, about 30 min each time, and exposed 5%O2 30 s/Air 90 s for 8 h/d. After continues exposure for 8 weeks, five rats in each group were randomly selected for arterial blood gas analysis. The tissue blocks of liver was obtained for pathologi-cal scoring and measurements of liver oxidative stress in the rest 10 rats of each group. HE staining was used to calculate the mean lining interval (MLI) and mean alveolar number (MAN). The hepatic inflammatory factor interleukin-6 (IL-6), tumor necrosis factor-α(TNF-α), superoxide dismutase (SOD) activity, catalase (CAT) activity and malondialdehyde (MDA) con-centration were measured in four groups. Results Characteristics of emphysema were found in group B and group D. The values of MLI were significantly higher in Group B and group D than those of group A and group C (P<0.05). The values of MAN were significantly lower in group B and group D than those of group A and group C (P<0.05). The levels of SOD and CAT were significantly lower in group B, group C and group D than those of group A (P<0.05). And the levels of SOD and CAT were significantly lower in group D than those of group B and group C (P<0.05). The values of liver MDA were signifi-cantly higher in group B, group C and group D than those of group A, and the values were significantly higher in group D than those of group B and group C (P<0.05). The liver histological scores and the levels of IL-6 and TNF-αwere signifi-cantly higher in group B, group C and group D than those of group A, and the values were significantly higher in group D than those of group B and group C (P<0.05). Conclusion Emphysema and IH have synergistic action in causing hepatic oxidative stress and inflammation.

Objective To explore the effect of intermittent hypoxia (IH) on RhoA/ROCK pathway in lung and on the muscularization in pulmonary vascular in rat model. Methods Wistar rats (n=40) were randomly divided into two groups:the normal oxygen control group (n=20) and the IH group ( n=20). For 4 weeks, rats in control group and IH group were ex?posed to intermittent normal oxygen (21%O2) or IH (5%-21%O2) respectively. Then, mRNA transcription and protein trans?lation levels of RhoA/ROCK were examined by Real-time PCR and Western blot. Expression of proliferation cell nuclear an?tigen (PCNA) andα-smooth muscle actin (SM-α-actin ) of lung and pulmonary artery were detected by immunohistochemis?try. Results RhoA mRNA transcription level(0.463 ± 0.067 vs 0.182 ± 0.040), ROCK mRNA transcription level(0.384 ± 0.062 vs 0.192 ± 0.052), RhoA protein expression level(0.827 ± 0.065 vs 0.424 ± 0.075)and ROCK protein expression level (0.488±0.088 vs 0.336±0.102)were higher in IH group than those in control group(P<0.05);Levels of PCNA in lung tissue [(54.67±1.80)%vs (9.14±0.91)%], PCNA in pulmonary artery [(49.40±1.21)%vs (8.38±1.13)%], SM-α-actin in lung tis?sue [(42.66±1.63)%vs (35.44±1.41)%] and SM-α-actin in pulmonary artery [(62.62±2.53)%vs (45.54±2.58)%] were also higher in IH group than those in control group(P<0.05). Conclusion Rho/ROCK pathway may play an important role in developing pulmonary hypertension (PH) associated with IH;and IH can promote the muscularization in pulmonary vascular to accelerate PH.

OBJECTIVE To study the degree and regular of Aspergillus flavus air contamination in hospital.METHODS Some ambient air of different environment in our hospital was taken 5 times in one day of four seasons one year by using centrifugal air sampler,and then cultivated(using eumycete cultural methods),counted and analyzed.RESULTS A.flavus strain was collected in all sampling points in four seasons.The concentration of Aspergillus flavus in six standort was diverse from each other,and the highest was the out-patient clinic with 1238.9 CFU/m3.The concentration of Aspergillus flavus in each division of Medical Department was significant difference during four seasons(P0.05).The difference between internal medicine and external enviroment was significant between the first and the third season(P=0.022,P=0.039),but that of the second and the fouth season was not significant(P=0.022,P=0.624).CONCLUSIONS The contamination of Aspergillus flavus in hospital was severe.So it′s necessary to prevent the Aspergillus flavus infection and enhance the environmental control of susceptible population.

Objective:To analyze the problems existing in the cases of hospitals infringing upon patients′ informed consent right after the promulgation of the Civil Code of the People′ s Republic of China, and to provide reference for improving the legal system of informed consent. Methods:Search for judgment documents published from January 1, 2021 to June 30, 2023 on the China Judgment Document Network using the keyword " liability dispute for infringing on patients′ informed consent rights", and conduct descriptive and textual analysis on the cases in the judgment documents.Results:68 judgment documents were included in total.There were 11 judgment documents on infringement of patients′ right to informed consent, and all related cases have undergone appraisal. The content of infringement mainly included infringement of patients′ right to know their condition (12/20), infringement of patients′ right to access their medical records (6/20), infringement of patients′ right to bodily integrity without consent (2/20). There were 15 judgment documents which judge that the right of informed consent of patients wasn′t infringed, and only one case in the document has been appraised. The main focus of controversy was the issue of the priority of the exercise of the right to informed consent (2/15), the fulfillment of the obligation to inform the right to informed consent (5/15), the issue of surgery without notification (1/15), and the issue of determining the authenticity of medical records and providing medical materials (7/15).Conclusions:The legal protection of patients′ right to informed consent still faces judicial difficulties such as unclear order of the exercise of rights subject, insufficient specificity of the scope of the exercise of the right, conflicts between the right to informed consent and medical intervention, and lack of unified identification methods for infringement liability. It is suggested to standardize the order of the exercise subject of the right to informed consent, clarify the content of the obligation of the medical party to inform, construct a system for medical intervention, and unify the identification methods for disputes related to the right to informed consent.

Objective To find out the epidemic characteristics of brucellosis in Harbin and provide scientific evidences for development of countermeasures.Methods The brucellosis surveillance data were collected from the "National Diseases Surveillance Information Management System" and the municipal surveillance results from 2013 to 2017 in Harbin;the place,time and population distribution characteristics of brucellosis were analyzed by descriptive epidemiological methods.Results A total of 2 909 cases of brucellosis were reported in Harbin from 2013 to 2017,and the incidence of brucellosis declined from 5.98 per 100 000 to 4.53 per 100 000,the epidemic situation was mainly sporadic,and an outbreak caused by a live Brucella vaccine (A19 strain) was reported in 2017;all eighteen districts (counties or cities) in Harbin had reported epidemic in the past five years,Shuangcheng,Yilan,Binxian and Bayan had a large number of cases,accounted for 53.76％ (1 564/2 909) of the total number of patients in Harbin;the time of onset focused on March to July,which accounted for 57.17％ (1 663/2 909) of annual incidence;age distribution,mainly young adults aged 30 to 59,accounted for 72.57％ (2 111/2 909);gender distribution predominandy male,accounted for 75.42％ (2 194/2 909);and occupational distribution predominantly farmers,accounted for 86.28％ (2 510/2 909).In the municipal surveillance stations from 2013 to 2017,7 005 cases were surveyed,of which 2 141 cases received serological test,the positive rate was 3.32％ (71/2 141),except 2016,the serum positive rate was decreasing year by year (x2 =13.927,P ＜ 0.05),and the monitoring results of municipal monitoring stations can better reflect the epidemic trend.Conclusions The incidence of brucellosis in Harbin is decreasing year by year.However,the outbreak caused by the new vaccines should be given high attention and we should strengthen prevention and control of the disease.