Objective As members of CNEDERT, we were trusted to take the mission of medical rescue in April of this year in Yushu area of Qinghai province. As soon as we heard of the news of earthquake with shock of 7.1 on Richter scale happened on 14th April 2010, our team of 32 members from the General Hospital of Armed Police Force rapidly rushed to get there at 19 o'clock on 14th April. It is a cold plateau with 4000 meters in average above sea level. Of course, they would face many difficult problems and some of them could not be figured out in advance. It was really a new and big challenge. First of all, we had to bear the very low barometric pressure,threatening lives of team members. In order to fulfill the mission of medical rescue, and to prevent the acute mountain sickness (AMS) ,we monitored the physiological changes of every member. Method A total of 32 members aged from 27 - 42 years old with average age of (33.26 + 12.54) years, 6 male and 6 female, gathered at Peking, 50 meters above sea level, 6 hours ahead of getting to Yushu and received physical examination with measurements of SaO2, HR, Hb and breath holding test. The team worked in Yushu area for 13 days and returned back to Peking on 27th April at 13 o'clock. The measurements of SaO2, HR and He were kept on from 14th April to 4th May, 21 days in total. The occurrence of AMS was surveyed by questionnaire from 18 to 48 hours after arrival,and the AMSA was diagnosed and scored according to the Lake Louise consensus on the definition and quantification of altitude illness. When the score was equal or above 3, it was considered to be AMS. Our work activities included searching the victims under the collapsed building, carrying out treatment and operation as soon as possible in the mobile hospital, doing medical round visiting, public health and disease prevention, work of joint rescue of multiple professions and psychological counseling. Results Of them 26 (81.25%) members suffered from AMS of various severities and few of them had pulmonary edema and hematuria, and those with SaO2 below 60% were sent down to the plain of low level above sea. The average level of SaO2 at Peking was ( 98.21 + 2.63) %, and it suddenly dropped to (66.31 ± 4.24)% on the first day of entering Yushu area, and from the 2nd day on, it gradually increased to (84.80 ± 4.20)% on the 13th day of stay in Yushu. On the 14th day, we returned back to Peking, the average SaO2 gradually went up from ( 85.57 + 2.73) % to (85.70 + 3.11 ) % on the 15th day,(87.93±2.63)% on the 17th day, (92.21 ±3.62)% on the 18th day, and (98.2333 ± 1.78)% On the 21st day (5th May ). At plain the average HR was (78 ± 11 ) beats/min, and it went up abruptly to ( 121 ± 18) beats/min on the first day of arrival to Yushu, and from the 2nd day on, it slowly lowered down to (99± 12) beats/min at the end day of stay in Yushu area. When we got back to Peking, the average HR gradually normalized from (91± 18) beats/min to (77 + 16) beats on the 5th May. The average Hb in Peking was ( 118 ± 32) g/L, and it gradually increased to ( 137 ± 18) g/L on the 5th day and to ( 161 ± 27) g/L on the 11th day after arrival, and it gradually dropped to (127:± 13) g/L on the 17th day and to (120± 13) g/L on the 21st day. Various measures were taken to treat and prevent the AMS with Chinese herbal medicines such as hongjingtian (Rholiola sacra [Prain ex Hamet] Fu), droplet-sized pill of danshen (salva miltiorrhiza Bge), slice of xiyangshen (Panax quinquefolium L)for lozenge which had some effect of minimizing the symptoms of AMS, and with easily digestible diet catered for in less amount of food in each meal and more meals every day, and diet was composed of mainly carbohydrate and vitamins. Large amount of fluid was required at least 4000 - 6000 mL daily guided by the number of urination at least once or twice a day. For the severe case with shortness of breath and sense of oppression over chest, the oxygen inhalation and intravenous glucose saline with small dose of hydrocortisone were given. Conclusions There were great changes in SaO2, HR and Hb of individuals rushed into high altitude area from plain of low level above sea in a short length of time. But those individuals had the capability of adaptation to ameliorate bit by bit those changes day by day until 13 days of stay, the end of stay at high altitude. On that day, the levels of SaO2, HR and He were still far away from normal. And those changes took 6 days to resume the original levels after the members retumed to the plain. Of them, 81.25% (26/32) members suffered from AMS of various severities. Various measures taken to treat and prevent the AMS are very important. In addition, working at high altitude area, the medical equipment and facilities should be miniaturized for easy portability on the rugged and narrow footpath in order to preserve the energy of medical members.

BACKGROUND:Stem cell transplantation provides a new approach to treat chronic renal disease.Specific marking and in vivo tracing of stern cells are the basis of studies in this field.However,the marking methods appropriate for all cells remain uncertain.OBJECTIVE:To observe the in vivo location and differentiation of 4',6-diamidino-2-phenylindole (DAPI) and green fluorescence protein (GFP)-Iabeled cells in adriamycin nephrosis rats so as to explore an efficient labeling and tracing method for metanephric mesenchymal cells (MMCs) derived from embryonic rats.DESIGN,TIME AND SETTING:Grouping comparative observation was performed at the Second Xiangya Hospital of Central South University from April to December 2007.MATERIALS:A total of 60 female SD rats,weighing 180-220 g,of dean grade,were used to establish models of adriamycin nephrosis.METHODS:DAPI and MMCs infected with GFP and DAPI were respectively injected into addamycin nephrosis via the tail vein.DAPI and GFP distribution in the frozen sections was detected at 1,3,and 5 weeks,postoperatively.In addition,GFP expression in renal tissues was detected by ABC immunoenzymatic staining method.MAIN OUTCOME MEASURES:DAPI and GFP-labeled Cell grafts in adriamycin nephrosis rats were compared.The changes of GFP-transfected MMCs at different time points were observed.RESULTS:DAPI positive cells were observed in tubular structures after 1 weeks of injection of DAPI-labeled cells and DAPI alone,and remained existing at 5 weeks,but the florescence was reduced with time.GFP-transfected MMCs were able to survive and integrate into tubular structures after 1 week,and remained existing at 5 weeks.Moreover,the fluorescence was not reduced.ABC immunoanzymatic staining showed that only a few GFP-positive MMCs appeared in glomerular tufts,and mainly distributed in cytoplasm.Semi-quantitative evaluation of GFP show that the positive cell rate in rats with early application was greater than that with advanced application,and the positive rate was increased with time.CONCLUSION:Liposome mediated GFP gene transfer was an efficient labeling in vitro and suitable tracing method for cell differentiation experiment in vivo,suitable for short-term tracing and observation of transplanted cells.

Objecfive To detect the functional repair of metanephric mesenchymal cells (MMCs) transplantation in adriamycin (ADR)-induced glomerulopathy rats. Methods A total of 90 Sprague-Dawley female rats were randomly divided into three groups:ADR group (n=40,rats were injected via the tail vein with O.25 mg ADR/100 g body weight on days 1 and 21),ADR- MMCs group(n=40,rats were injected via the tail vein with 5×10~6-7×10~6 MMCs 8 weeks after the second ADR administration),control(n=10).All the rats were scarified 8 weeks after MMCsinjection.Pathology and collagen IV expression in renal tissue were examined.Moreover,matrix metalloproteinases 2 (MMP-2) and matrix metallopmteinases 9 (MMP-9) expression in the renal tissue were also detected with immunohistochemistry,and quantity analysis of protein and gene was further demonstrated with Westem blot and RT-PCR analysis,respectively. Results There were no significant differences in tubulointerstitial injury score and glomerulosclerosis degree between ADR group and ADR-MMCs group(P>0.05).Compared with ADR group,collagen Ⅳ and MMP-2 expression decreased, MMP-9 expression incrased in renal tissue of ADR-MMCs group, and the difference was significant (P<0.05). Conclusion MMCs transplantation may have potentially therapeutic effect on renal tissue fibrosis of adriamyein-induced glomerulopathy in rats, and the signaling pathways of MMPs appear to be involved in these processes.

Objective To explore the relationship and clinical significance of Gli1 expression in peripheral blood and cancer tissues of gastric.Method 95 gastric cancer patients were recruited as surgery group,and 40 recurrent gastric cancer patients were recruited as recurrent group.50 normal subjects were recruited as control group.Paraffin specimens of gastric cancer tissues and gastric mucosa adjacent to cancer were collected to test expression of Gli1 protein.ELISA was applied to test Gli1 in peripheral blood.Results Levels of Gli1 in peripheral blood of preoperative surgery group were higher than in control group [(9.21 ± 1.37) ng/ml vs.(0.79 ±0.18) ng/ml,t =43.193,P ＜0.001].Post-up Gli1 decreased significantly to the level of control group (t =0.722,P =0.472).Levels of Gli1 in peripheral blood of recurrent group were higher than that in preoperativesurgery group (t =14.575,P ＜ 0.001).Gli1 protein in cancer tissues was higher than that in adjacent gastric mucosa (t =33.471,P ＜0.001),and Gli1 protein in cancer tissues of surgery group was higher than that in cancer tissues of recurrent group (t =8.808,P ＜0.001).Conclusion In postoperative gastric cancer patients increased Gli1 level in peripheral blood and cancer tissues predicts recurrence.

Objective To establish a mini-pool nucleic acid testing (NAT) assay using multiplex RT-nested PCR for the detection of HIV RNA, and apply it in screening for acute HIV infection among MSM. Methods Frozen EDTA plasma samples collected between Oct. 2008 and Mar. 2009 from 3 HIV infectors during window-period, a total of 30 HIV chronically infected individuals and 97 healthy subjects were used to develop the NAT assay. Plasma samples from 10 cases were pooled into one tube and centrifuged at high speed for the collection of viruses. HIV RNA was extracted. Two pairs of primers were designed according to two conserved regions of HIV RNA ( HXB2 nt 5783-nt 6228 and nt 1235-nt 2012).Multiplex RT-PCR and nested PCR were performed. Individual NAT-reactive samples were confirmed by commercially available NAT assays. The sensitivity and performance efficacy were also evaluated. The assay was then applied to 1 005 plasma specimens from MSM with negative or uncertain HIV antibody test results.These were collected in the same period as the other samples. Results ( 1 ) Two fragments of HIV were amplified successfully with the low detection limit of 162 copies/ml plasma; (2) Results of the mini-pool HIV NAT validation with samples from 3 HIV infectors during window-period were consistent with the expected values; (3) All 30 plasma samples from MSM with positive HIV antibody, which were tested by multiplex RT nested PCR, were found to be HIV RNA positive; (4) One out of 1 005 plasma samples was found to be HIV RNA positive, for this case acute infection was followed-up and sero-conversion was found. Conclusion Mini-pool NAT has good sensitivity, and may be applied to screening HIV RNA among MSM during window-period.

Objective To study the relationship between aquaporin 9 (AQP 9) gene and brain edema in neonatal rats of hypoxic-ischemic brain damage (HIBD) and the therapeutic mechanism of mannitol.Method Healthy and 7-day-old SD rats were randomly assigned into three groups:sham-operated group,HIBD group and mannitol group.Both HIBD and mannitol group were established on HIBD model.The mannitol group was given mannitol intraperitoneally at 0,24,48 h of HIBD.2 ml/kg of 2％ Evans blue (EB) were injected intraperitoneally before sacrifice.0,6,12,24,48 and 72 h after HIBD,the outcomes were analyzed including the brain water content,the expression of AQP 9 mRNA measured using RT-PCR and immunofluorescence staining methods,and the permeability of blood-brain barrier (BBB) measured with EB.Result In HIBD group,the brain water content was higher comparing with sham-operated group at 0 h after HIBD(P ＜ 0.05),and gradually increased over time,reaching peak at 48 h (89.3％ ± 1.9％) and then decreased.In mannitol group,brain water content started to decrease from 1 h after mannitol administration to the bottom at 12 h (86.5％ ±0.6％),then increased to peak at 72 h (87.2％ ± 1.7％),and brain water content were decreased during 0 ～ 48 h comparing with HIBD group.HIBD group's EB were higher than sham-operated group (P ＜ 0.05);Mannitol group's EB were decreased comparing with HIBD group (except 0 h,P ＜ 0.05).AQP 9 mRNA expression in the HIBD group was decreased at 0 h,and reached the bottom at 48 h (0.09 ± 0.07).Comparing with sham-operated group,it was higher in the HIBD group at0,6,72 h,and lower (P＜ 0.05) at 12,24,48 h.Higher AQP 9 mRNA expression were detected in mannitol group than HIBD group and sham-operated group at each time point (with the exception of 48 h) (P ＜ 0.05).AQP 9,which was closely related to water metabolism,were widely found in the pia mater and ependyma using immunofluorescence staining.After ischemia and hypoxia insult,an increasedecrease-increase pattern of AQP 9 expression was found.Conclusion AQP 9 is widely existed in various parts of the brain,influencing brain edema through a variety of pathways.AQP 9 also plays a role in alleviating brain edema in mannitol therapy.

Objective To apply the concept of evidence-based nursing to the practice of non-invasive ventilation,and to introduce the method of using self-made pressure-resistant cap cotton cover and its application effect.Methods Fifty patients on non-invasive ventilation admitted to intensive care unit (ICU) of Harrison International Peace Hospital Affiliated to Hebei Medical University from September 2017 to April 2018 were enrolled as observation group.By retrieved the relevant literature at home and abroad to look for clinical evidence,the concept of evidence-based nursing care program was formulated and implemented,and self-made pressure-resistant cap cotton cover was used to prevent facial pressure sores in patients on non-invasive ventilation.Forty non-invasive ventilation patients admitted from January to August in 2017 were enrolled as the historical control group,and conventional nursing was conducted by using traditional hydrocolloid dressings to prevent pressure ulcers.The incidence of facial pressure ulcers,ocular complications,dressing replacement time and cost were compared between the two groups.Results All patients were enrolled in the final analysis.The incidence of pressure ulcers in the observation group was significantly lower than that in the control group [4.0％ (2/50) vs.22.5％ (9/40),P ＜ 0.05],and the incidences of ocular complications such as eyelid swelling [2.0％ (1/50) vs.5.0％ (2/40)],conjunctival congestion [2.0％ (1/50) vs.5.0％ (2/40)] and irritant keratitis [0％ (0/50) vs.7.5％ (3/40)] were also significantly lower than those in the control group (P ＜ 0.05).Because the pressure-resistant cap cotton cover made by ourselves was easy to be replaced at any time,the interval time of dressing change in the observation group was significantly shorter than that in the control group (minutes:1.5 ± 0.5 vs.2.0 ± 0.5,P ＜ 0.05).In addition it could be cleaned,used alternately,and the cost was low,so the dressing cost in the observation group was significantly lower than that in the control group (Yuan:30±10 vs.123±20,P ＜ 0.01).Conclusion The application of self-made pressure-resistant cap cotton cover could obviously reduce the occurrence of complications such as facial pressure sores in patients on non-invasive ventilation.

OBJECTIVETo develop and evaluate a mouse model of nonalcoholic steatohepatitis (NASH) induced by a high-fat and high-fructose (HFHFr) diet.

METHODSSix-week-old C3H mice were randomly divided into groups for HFHFr diet experimental modeling, high fat-only (HF) diet controls, high fructose-only (HFr) diet controls, and standard chow (SC) diet controls. The standard HFHFr diet was modified so that it consisted of 76.5% standard chow, 12% lard, 1% cholesterol, 5% egg yolk powder, 5% whole milk powder, and 0.5% sodium cholate, along with 20% fructose drinking water. At the end of experimental weeks 4, 8, and 16, measurements were taken for the NASH-related parameters of body mass, serum levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST), lipid profile, and wet liver weight (upon sacrifice). In addition, histological changes in the liver were evaluated by hematoxylin-eosin (HE) and oil red O staining. The significance of differences between groups was assessed by statistical analysis, using the

METHODSof t-test, Wilcoxon rank sum test, x2 test, F test or Fisher's test as appropriate.

RESULTSAs compared to the mice in the SC group at the corresponding time points, the mice in the HFHFr and HF groups showed significantly higher body mass and wet liver weight, as well as more extensive and robust lipid disposition in hepatic tissues as evidenced by oil red O staining. However, HE staining indicated that the HFHFr and HF groups had different degrees of macrosteatosis accompanied with intralobular inflammatory foci, with the former showing more remarkable NASH-related histological changes. Analysis at the end of week 16 showed that about 80% of the mice in the HFHFr group had developed NASH [nonalcoholic fatty liver disease (NAFLD) activity score (NAS): less than 5]. The levels of low-and high-density lipoprotein (LDL and HDL) cholesterol, as well as the levels of ALT and AST, were increased from the end of week 4 to the end of week 8 for the HFHFr and HF groups. At the end of week 16, the two groups differed in the extent of increase in total cholesterol and LDL and HDL cholesterol, with only the HFHFr group showing statistically significant changes. Specifically, at the end of week 16, the HFHFr group showed ALT levels of 108.5 +/- 93.34 U/L (F=5.099, P =0.005 vs. HF group: 44.30 +/- 35.71 U/L, HFr group: 46.70 +/- 17.95 U/L, SC group: 24.70 +/- 6.57 U/L), AST levels of 316.30 +/- 208.98 U/L (F=6.654, P=0.001 vs. HF: 132.12 +/- 75.43 U/L, HFr: 143.30 +/- 38.53 U/L, SC: 122.60 +/- 12.76 U/L), total cholesterol levels of 5.18 +/- 0.58 mmol/L (F=72: 470, P =0.000 vs. HF: 3.94 +/- 0.75 mmol/L, HFr: 2.30 +/- 0.50 mmol/L, SC: 2.02 +/- 0.24 mmol/L), HDL cholesterol levels of 3.05 +/- 0.49 mmol/L (F=25.413, P =0.000 vs. HF: 2.65 +/- 0.54 mmol/L HFr: 1.77 +/- 0.47 mmol/L, SC: 1.58 +/- 0.16 mmol/L), LDL cholesterol levels of 1.11 +/- 0.23 mmol/L (F =83.297, P =0.000 vs. HF: 0.72 +/- 0.17 mmol/L, HFr: 0.27 +/- 0.04 mmol/L, SC: 0.20 +/- 0.05 mmol/ L).

CONCLUSIONThe present study suggests that a mouse model of NASH can be successfully induced by a 16-week modified HFHFr diet.

Objective:To investigate the effect of motion correction (MC) on the calculated values of myocardial blood flow (MBF) and myocardial flow reserve (MFR) based on cadmium-zinc-telluride SPECT (CZT SPECT) images.Methods:Twenty-eight consecutive patients (10 males, 18 females, age: (60.75±11.62) years) with suspected or known coronary artery disease who underwent myocardial perfusion imaging (MPI) with dynamic CZT SPECT between June 2019 and August 2019 in TEDA International Cardiovascular Hospital were retrospectively analyzed. The MBF and MFR during rest imaging and stress imaging were quantitatively analyzed. Corridor 4DM software was used to calculate the stress MBF (sMBF) and MFR of the coronary artery branches and left ventricular (LV) before and after MC. The paired t test and Pearson correlation were used for data analysis. Results:The sMBF and MFR of LV before MC were (0.82±0.49) ml·min -1·g -1 and 1.69±0.68 respectively. After MC the two parameters increased to (1.05±0.64) ml·min -1·g -1 and 2.12±0.77 respectively ( t values: -4.87, -6.01, both P<0.001). The sMBF and MFR in left anterior descending (LAD), left circumflex (LCX), right coronary artery (RCA) and LV before MC were correlated with those after MC ( r values: 0.69-0.96, all P<0.001). If MFR <2.0 was used as the reference of impaired MFR, data before MC showed 19 patients (67.9%, 19/28) had impaired MFR, while 13 patients (46.4%, 13/28) had impaired MFR based on MFR values after MC. Conclusion:For MPI quantitative imaging with CZT SPECT, the calculated values of sMBF and MFR after MC is higher than those before MC, suggesting that MC is helpful to reduce the false positive results which may be caused by the " creep" effect of the heart.

【Objective】 To investigate the protection of astragaloside IV from high glucose induced podocyte injury and mitochondrial dysfunction and its molecular mechanisms. 【Methods】 The model of podocyte injury induced by high glucose (30 mmol/L glucose) was established, and the model cells were treated with low, medium and high doses of astragaloside IV respectively; cell activity was detected by CCK-8. Apoptosis was detected by TUNEL staining. Mitochondrial membrane potential was detected by JC-1 fluorescence probe. ATP content was detected by the kit. The expression levels of apoptosis and podocyte injury related proteins and Notch pathway related proteins were detected by Western blotting. 【Results】 Compared with the control group, cell activity was decreased, apoptosis level was increased (P<0.05), anti-apoptotic protein (Bcl2) expression was decreased, and apoptosis protein (Bax, cleaved-caspase 9, cleaved-caspase 3) expressions were increased (all P<0.05) in HG group. Compared with HG group, HG+AS-IV improved cell activity and apoptosis level induced by high glucose (P<0.05), increased expression of anti-apoptotic protein (Bcl2), and decreased expressions of apoptotic protein (Bax, cleaved-caspase 9, and cleaved-caspase 3) (all P<0.05). Compared with the control group, mitochondrial dysfunction occurred in HG group, JC-1 monomer content increased, and ATP content decreased (all P<0.05). Compared with HG group, HG+AS-IV improved mitochondrial dysfunction, increased JC-1 polymer content and ATP content (P<0.05). In addition, compared with the control group, the expression of Notch pathway-related protein was decreased in HG group (P<0.05). Compared with HG group, Notch pathway-related protein expression was increased in HG+AS-IV group (all P<0.05). Molecular docking results showed that AS-IV could bind Notch1. 【Conclusion】 Astragaloside IV can improve podocyte injury and mitochondrial dysfunction induced by high glucose, possibly by inhibiting Notch pathway activation.