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 analyze current status of physical exercise of primary and middle school students in Henan province, and to explore its relationship with physical fitness. Methods: Data on physical exercise and related indicators among 9-18 years old students was retrieved from Henan Provincial Student Physical Fitness and Health Survey in 2019. Physical fitness index (PFI), body mass index (BMI) was calculated. ANOVA was used to compare differences of physical exercise between men and women, urban and rural areas. Correlations between physical exercise with PFI and BMI were evaluated. Results: The majority of students had two PE classes per week (41.9%), daily active recess (44.5%), one sports meeting in each school year (46.8%), and half to one hour of physical exercise per day (50.1%). Boys were more likely to exercise than girls, while rural students were more likely to excecise than urban students. The proportion of parents who support sports activities in their spare time was the highest (75.8%), and the proportion of parents who both like sports was the highest (47.3%). PFI was positively correlated with exercise scores and negatively correlated with non exercise scores. BMI was negatively correlated with exercise scores and positively correlated with non exercise scores ( r =0.12, -0.13, -0.20, 0.14, P ＜0.01). Conclusion Physical exercise of primary and middle school students in Henan is satisfactory.Exercise scores are positively correlated with physical fitness, but negatively correlated with BMI.

Objective: To analyze dental caries and associated factors among primary and middle school students in Henan Province, so as to provide reference for dental caries prevention and control. Methods: The data of physical health survey of students in Henan Province in 2019 was analyzed for caries and other related index of students aged 7, 9, 12, 14 years. Chi square test was used to compare detection rate of caries by sex and residence, analysis of variance was used to compare the height between with and without risk of caries, and Logistic regression analysis was conducted for the influencing factors of caries. Results: The caries rate was 56.6%. And the male students (53.4%) was lower than the female students (59.7%). The urban students (53.4%) was lower than the rural students (59.8%)( χ 2=52.31,54.00, P <0.01). The height of the caries free group was higher than that of the caries group, and the height difference was 0.5-1.6 cm; the prevalence of caries decreased with the increase of age( χ 2=992.01, P < 0.01 ). The detection rate of anemia in caries group (16.7%) was higher than that in caries free group (14.9%)( χ 2=7.98, P <0.01). Multivariate Logistic regression analysis showed that age ( OR =0.82) gender ( OR =1.27) urban area and rural ( OR =1.26) overweight ( OR =0.67) and obesity ( OR = 0.67 ) were all influencing factors of dental caries( P <0.01). Conclusion Dental caries is high among primary and middle school students in Henan Province, and dental caries affects their growth, development and nutritional status, and the prevention and control measures of dental caries among primary and middle school students should be strengthened.

Objective To explore the effects of nursing management based on plan-do-check-action (PDCA) on side effects and life quality after peripherally inserted central catheter (PICC) in acute leukemia patients with chemotherapy.Methods From January 2017 to January 2018, we selected 96 acute leukemia patients in Hematology Department of He'nan Provincial People's Hospital as subjects by convenience sampling. All of the patients were divided into observation group and control group with the random number table, 48 cases in each group. Control group carried out routine nursing care, while observation group received nursing management based on PDCA. And then, we recorded and compared the indwelling time of PICC, hospital stay, complications and the incidence of side effects of patients between two groups. The Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS) and Quality of Life Index (QLI) were used to evaluated patients' anxiety, depression and life quality three days before intervention and one month after intervention. The self-designed questionnaire was used to assess the quality of special nursing in two groups.Results The indwelling time of PICC and hospital stay of observation group were shorter than those of control group with statistical differences (P<0.01). Before intervention, there was no statistical difference in the scores of SAS, SDS and QLI (P>0.05). After intervention, the scores of SAS and SDS of observation group were lower than those of control group; and the scores of QLI and dimension scores of the quality of special nursing of observation group were higher than those of control group; the differences were all statistical (P<0.01). The incidences of complications and side effects of observation group were statistically lower than those of control group (P<0.05). Conclusions Nursing management based on PDCA can effectively decrease the occurrence risk of side effects and complications after PICC among acute leukemia patients with chemotherapy, improve patients' life quality and emotional state which has clinical application and promotion value.

Objective To explore the effects of case nursing combined with cognitive nursing intervention on general status and cognitive function in stroke patients with depression.Methods From October 2016 to April 2018, we selected 96 stroke patients with depression in Department of Neurology of He'nan Provincial People's Hospital. All of the patients were divided into observation group and control group with the random number table, 48 cases in each group. Control group received routine nursing. On the basis of that in control group, observation group applied case nursing combined with cognitive nursing intervention. The investigation was carried out with the Mini-mental State Examination (MMSE), Nurses' Observation Scale for Inpatient Evaluation (NOSIE), Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD) before and after intervention. We also observed patients' abnormal body condition and hospital days.Results The incidence of abnormal body condition of patients in observation group was lower than that in control group with a statistical difference (P<0.05). After intervention, the scores of NOSIE of patients in observation group, the scores of personal neatness, interest and social competence were higher than those in control group; the scores of depression, irritability and slowness were lower than those in control group; the differences were all statistical (P<0.01). The incidence of cognitive disorder and the scores of HAMA as well as HAMD all decreased after intervention, and the improvements of observation group were statistically better than those of control group (P<0.05). There was statistical differences in the hospital days between two groups (P<0.05). Conclusions Case nursing combined with cognitive nursing intervention can improve depression, anxiety and cognitive function, and shorten hospital days among stroke patients with depression which is worth further promotion in clinical application.

Objective According to the clinical and gene mutation characteristics of ACADVL-related very long chain acyl-CoA dehydrogenase deficiency(VLCADD),the types that contribute to the gene mutation of ACADVL were summarized.Methods By analyzing clinical,laboratory and genetic data of 1 case with ACADVL-related very long chain acyl-CoA dehydrogenase deficiency diagnosed from Department of Pediatrics,the Affiliated Hospital of Inner Mongolia Medical University in August 2016,based on the agreement signed by both the litde patient's parents and the hospital,plus the high-throughput sequencing analysis and PCR sequencing test for the 2 generation genes,some presented mutation sites were analyzed and concluded,in addition to taking "ACADVL" as key words to search the databases from CNKI,Wanfang(updated in 2016) as well as PubMed and related documents from On-line Mendal Inheritant databases of Man (OMIM) and HGMD.Results Through physical examination,VLCADD was diagnosed.After being given Levocamitine and the diet likemedium-chain fatty acid food for a week,the metabolism returned to normal.Tracking him for 3 months,his hepatitis obviously rebounded,within the reach of 3 cm under the right rib and 1 cm under the xiphoid.The exome sequencing study (trios) was identified the novel heterozygous mutation according to the statistics below A CAD VL (N M_000018.3) Exon7:c.608 C ＞ T;p.(Pro203 Leu) (heterozygous) and A CAD VL (NM _000018.3) Exon18:c.1748C ＞ T;p.(Ser583Leu) (heterozygous) in ACADVL.Relevant literature reported suggest these two mutations from both the parents are pathogenic genes,which can account for the reason why the boy got ill.However,these two mutations had not been reported in ACADVL-related VLCADD so far.Up to now,73 types of mutations from documents index were related to the VLCADD,but the clinical case included 75 kinds of gene mutations.Conclusions The apparent symptoms of the boy with the gene mutation were reflected in abnormal heart rates,hepatomegaly and hypoglycemia.VLCADD was diagnosed through genetic testing,and systematic treatment can partly control the development of the disease.In conclusion,the findings (exon 7 and 18) show that according to the genetic tests,disease-causing genes from both parents are new mutations of ACADVL and they are pathogenic.

Objective: To analysis gender disparities in epidemiological trend of HIV/AIDS disease burden among Chinese population aged 10-24 years from 1990 to 2019. Methods: The Global Burden of Disease Study (GBD 2019) results tool was used to extract the number of deaths, mortality rate, disability adjusted life years (DALY), DALY rate, years of life lost (YLL), YLL rate, years lived with disability (YLD) and YLD rate to comprehensively analyze the change range of HIV/AIDS disease burden in the Chinese population aged 10-24 years from 1990 to 2019. Results: In 2019, the number of deaths, mortality rate, DALY, DALY rate, YLL, YLL rate, YLD and YLD rate of Chinese population aged 10-24 years due to HIV/AIDS were 847, 0.37 per 100 000 , 62 621 person years, 27.51 per 100 000, 58 036 person years, 25.49 per 100 000, 4 584 person years, 2.01 per 100 000 respectively, with the increase of 401.18%, 691.49%, 370.48%, 648.26%, 409.53%, 710.33%, 138.87% and 279.25% , compared with the data in 1990. In term of gender, the number of deaths, mortality rate, DALY, and DALY rate of Chinese male population aged 10-14, 15-19 and 20-24 years due to HIV/AIDS in 2019 were higher than those of female, and the growth rate (compared with 1990) was also higher than that of female. In term of the age group, the increase in people aged 10-14 years was higher than that of people aged 20-24 years. From 1990 to 2019, with the increase of year and age, gender disparity between mortality and DALY rate widened. Conclusion Compared with data in 1990, the risk of HIV/AIDS infection in 2019 among Chinese population aged 10-24 years continued to increase, especially among young people of 10-14 years. Gender disparity is exacerbating.

Objective: To analyze the present situation and associated factors of physical fitness and overweight and obesity among primary and middle school students in Henan Province, and so as to explore the related factors and to provide reference for improving students physical fitness. Methods: The data of students physical health survey in Henan Province in 2019 were used to analyze the PFI and BMI of students aged 7-18. The Chi square test was used to compare difference in overweight and obesity prevalence by gender and residence. Analysis of variance was used to compare PFI differences among students of different age groups. Multi variable Logistic regression analysis was conducted to analyze the influencing factors of physical fitness. Results: A large proportion of students PFI was between -5 and 5. 0-<5 group(46.8%), followed by -5-<0 group(44.0%), and ≥5 group. The detection rates of overweight and obesity were higher in boys (16.8%, 12.3%) than in girls (12.8%, 7.6%), and in cities (16.1%, 11.8%) than in rural areas (13.3%, 7.9%)( χ 2=124.78, 245.43; 62.52, 166.23, P <0.01). PFI was negatively correlated with BMI( r= -0.23 , P <0.01). Age ( OR =1.01), urban and rural (rural s OR =1.21), gender (female s OR =1.11), over weight ( OR =1.94), obesity ( OR =4.85) were the influencing factors of physical fitness( P <0.05). Conclusion Age, residence, gender, overweight and obesity are the related factors of physical fitness. Controlling overweight and obesity can effectively improve students physical fitness.

Objective To investigate the relation between TMB and the efficiency of PD-1/PD-L1 inhibitors treatment for non-small-cell lung cancer. Methods Studies were searched from PubMed, Embase, Cochrane Library database, Chinese Biomedical Literature Database and Wanfang Database up to March 25, 2020. RevMan 5.3 software and STATA15.0 were used for analysis. Results Twelve literatures were involved, including 1209 patients. TMB significantly improved PFS (HR=0.54, 95%CI: 0.42-0.70, P < 0.001) but reduced the ORR (OR=4.41, 95%CI: 2.54-7.63, P < 0.001) of NSCLC patients treated with PD-1/PD-L1 inhibitors. The subgroup analyses showed that the predictive value of TMB was significant in non-small cell lung cancer treated by PD-1/PD-L1 inhibitors combined with anti-CTLA-4 therapy or chemotherapy. No significant publication bias was observed by the Begg's test and Egger's test. Conclusion High tumor mutation burden may predict the improved PFS of non-small cell lung cancer by PD-1/PD-L1 inhibitors treatment, but its predictive value for OS, ORR and long-term survival need more exploration.

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.