The mechanisms of increased expression of toll-like receptor 4 (TLR-4) during the formation of foam cells were explored. Low density lipoprotein (LDL) was prepared by density gradient ultracentrifugation and oxidized by incubation with CuCl2. The human monocytic leukemia cell line (THP-1) was cultured in RPMI1640. The differentiation of THP-1 cells into macrophages (MPs) was induced by using myristate acetate (PMA) for 48 h. The macrophages were then incubated with oxidized LDL (ox-LDL) to generate foam cells (FCs). The mRNA and protein expression levels of human TLR-4 were detected by immunocytochemistry, Western blotting and reverse transcription polymerase chain reaction (RT-PCR). The results showed that the TLR-4 mRNA and the protein expression levels were significantly increased during the differentiation of monocytes into macrophages (P＜0.05) as well as during the formation of lipid-laden foam cells (P＜0. 05). It was concluded that the upregulation of human TLR-4 gene expression during the differentiation of monocytes into macrophages and the differentiation of macrophages into foam cells could increase TLR-4 protein synthesis dramatically, which may enhance the ability of foam cells inflammation reaction in atherosclerosis.

To investigate the effects of leptin on expression of acyl-coenzymeA: cholesterol acyl-transferases-1 (ACAT-1) in monocyte-macrophage differentiation, human monocytic cells (THP-1) were cultured in RPMI 1640 and made to differentiate into macrophages under the incubation with phorbol myristate acetate (PMA) for 48 h. The cells were divided into 4 groups according to different intervention factors as follows: MCs cultured in RPM11640 medium with 10% FBS for 48 h served as MC group (control group), MCs cultured in medium with serum-free RPM11640 containing 5% BSA, 100 nmol/L PMA for 48 h as MP group, MCs cultured in RPMI1640 medium with 10% FBS, 10 micromol/ml leptin for 48 h as leptin-MC group, and MCs cultured in medium with serum-free RPMI1640 containing 5% BSA. 100 nmol/L PMA, and 10 micromol/ml leptin for 48 h as leptin-MP group. Immunocytochemistry, reverse transcription polymerase chain reaction (RT-PCR) and Western blot were performed, respectively, to observe the effects of leptin on expression of ACAT-1 in the monocyte-macrophage differentiation. Our results showed that expression of ACAT-1 protein and mRNA in MP-group is two times that in MC-group (P<0.05), and the expression of ACAT-1 protein and mRNA increased by up to 4 folds in leptin-MP group-as compared with that of MC group (P<0.01). Thus, our results support the idea that expression of ACAT-1 increases more in cultured human macrophages than in monocytes, and leptin can significantly promote ACAT-1 expression. It was concluded that high expression of ACAT-1 may accelerate the development of human atherogenesis, and leptin might participate in atherogenesis by increasing expression of ACAT-1.
Atherosclerosis ; enzymology ; Cell Differentiation ; Cells, Cultured ; Humans ; Leptin ; pharmacology ; Macrophages ; cytology ; enzymology ; Monocytes ; cytology ; enzymology ; Sterol O-Acyltransferase ; biosynthesis ; genetics ; Tetradecanoylphorbol Acetate

Objective To be good for the different working age midwives to carry out the same evaluation of the pregnant woman,we build and use the Episiotomy Evaluation Form for reducing the rate of episiotomy with ensuring the safety of mother and baby.Methods Consult relevant literature,combine clinical practice,discuss,report to the hospital ethics committee many times and at last it was made after approval.The details included:perineal lesions,perineum elasticity,perineal length,maternal coordination,gestational age,age,fetal distress degree,amniotic fluid situation,the weight of fetus estimated,the second time of labor and so on,to score by 0,1,3,5,20.A total of 600 patients with low risk of natural childbirth were randomly divided into observation group and control group according to method of random number table with 300 cases each.The observation group was graded according to the perineal incision evaluation and we operated according to its use method.The control group was judged according to the experience of midwife and subjective cognition.At last compared the effects on the mother and baby.Results The rates of lateral episiotomy and Ⅰ degree laceration were 15.00％ (45/300) and 63.00％ (189/300) in the observation group and 48.33％ (145/300) and 21.67％ (65/300) in the control group,respectively.The difference between the two groups was statistically significant (x2=16.238,21.507,P ＜ 0.05).There was no statistical difference in the perineal intact rate,median perineal incision rate,perineal Ⅱ degree laceration rate,severe perineal laceration,second stage of labor,postpartum hemorrhage 2 hours,neonatal asphyxia rate,incidence of neonatal birth injury (brachial plexus injury,clavicle fracture,etc.) and pelvic floor muscle strength of 42 days after delivery between the two groups (P ＞ 0.05).Conclusions By using the episiotomy evaluation form,we can improve the accuracy and homogeneity of the midwife's assessment about the episiotomy which is benefit to reduce rate of episiotomy.It is worth promoting in clinical practice but we should ensure the safety of maternal and child.

Objective To observe the application effects of scenario simulation combined with guided feedback teaching method in the teaching of endocrinology nursing interns.Methods A total of 180 nursing students who interned in the endocri-nology department of Southern Medical University Shenzhen Hospital from January 2020 to January 2023 were selected as the re-search subjects.Using a digital randomization method,the students were divided into a control group(90 cases)and an observa-tion group(90 cases).The control group received conventional teaching,while the observation group received scenario-based teaching combined with guided feedback teaching method.The intern performance,satisfaction of teaching instructors toward students,and students'satisfaction with teaching instructors were compared between the two groups.Results The intern per-formance of the observation group was higher and showed a greater improvement after training,with statistically significant differ-ences(P＜0.05).Both the students'satisfaction with teaching instructors and the teaching instructors'satisfaction with students in the observation group were higher than those in the control group,with statistically significant differences(P＜0.05).Conclusion The application of scenario simulation combined with guided feedback teaching method in the teaching of endocri-nology nursing interns can significantly improve students'intern performance,providing a more scientific basis for nursing intern-ship teaching.

Objective    To evaluate the degree of psychological pain for cancer patients undergoing surgical treatment and analyze the contributory factors to provide the theoretical basis for psychological intervention for cancer patients with surgical treatment. Methods    The clinical data of 455 cancer patients who received surgeries in our hospital from November 2020 to January 2021 were retrospectively analyzed, including 225 males and 230 females aged 53.80±13.50 years. By applying the method of convenient sampling, a cross-sectional survey was carried out by gathering the general information of the patients and evaluating their mental condition with the distress thermometer. The contributory factors were discussed by logistic regression analysis. Results    The score for the psychological pain of the patients was 4.11±2.49 points. The main factors contributing to the psychological pain were physical problems, emotional problems and family matters. The logistic regression analysis showed that the main factors related to the degree of psychological pain were cancer types (P=0.023), religious belief (P=0.046), number of niduses (P=0.016), respiratory status (P=0.004), medical expense (P=0.007), grief (P=0.001) and anxiety (P=0.040). Conclusion    Nearly half of the patients have been subjected to apparent psychological pain, and emotion and physical problems are the main factors. It is crucial to pay attention to the patients’ mental problems, seek convenient tools for psychological evaluation, and take actions to deal with the psychological problems and physical symptoms.

AIM: To compare the efficacy of intravitreal injection of ranibizumab(IVR)and intravitreal injection of conbercept(IVC)in children with retinopathy of prematurity(ROP).METHODS: Retrospective study. A total of 1 100 eyes with ROP treated with intravitreal anti-VEGF at our hospital from January 2015 to June 2023 were included. According to the different therapeutic drugs, the children were divided into two groups: IVR group and IVC group. According to the degree of ROP, the patients were divided into three groups: aggressive ROP(A-ROP), Zone Ⅰ type 1 ROP and Zone Ⅱ type 1 ROP. The reactivation and retreatment between the two groups were compared after propensity score matching(PSM)analysis, and they were followed-up for at least 3 mo after surgery.RESULTS: In Zone Ⅱ type 1 ROP, there was a statistically significant difference in the rates of reactivation and retreatment between the IVR and IVC groups(P<0.05); however, in A-ROP and Zone I type 1 ROP, there were no statistically significant differences in the rates of reactivation and retreatment between the two groups(P>0.05). The risk of reactivation and retreatment of Zone I type 1 ROP was higher than the Zone II type 1 ROP. Furthermore, the use of drugs and corrected gestational age of first treatment were influencing factors of lesion recurrence and retreatment.CONCLUSION: There is a significant difference in the initial cure effect between the two drugs in Zone II type 1 ROP, with the reactivation and retreatment rates of the IVC group being much lower than those of the IVR group.