Objective To observe the expression of neural nicotinic acetylcholine receptor subunit α3 (α3nAChR) and extracellular regulated protein kinases (ERK1/2),c-Jun N-terminal kinase (JNK),p38 kinases of mitogen-activated protein kinase (MAPK) pathway in human neuroblastoma cell line SH-SY5Y overexposed to fluoride,and try to investigate the molecular mechanism of cell damage caused by overexposure of fluoride.Methods The SH-SY5Y cell with low expression of α3nAChR suppressed by silence interference RNA served as α3nAChR silence group;the normal SH-SY5Y cell served as control group,and the effect of silencing of αt3nAChR gene in SHSY5Y was detected by Western blotting and real-time PCR;SH-SY5Y cell was treated with different concentrations of fluoride (0.000,0.005,0.050,0.500,1.000,2.500,5.000 mmol/L),the safe concentration of fluoride in SHSY5Y cell was detected by 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2-H-tetrazolium bromide (MTT) assay;the SH-SY5Y cell of control group and α3nAChR silence group were treated with 4.000 mmol/L fluoride for 0,4,8,12,24,36,48 h according to the results of MTT assay;the expression of ERK1/2,JNK,p38 kinases of MAPK pathway in SH-SY5Y at protein levels was measured by Western blotting.Results The expression of α3nAChR mRNA (0.04 ± 0.03) and protein (12.0 ± 2.5) in α3nAChR silence group was decreased significantly compared with those of control group (1.00 ± 0.11,100.0 ± 11.3,t =24.58,28.80,all P ＜ 0.05).The viability of SH-SY5Y cell treated with 5.000 mmol/L fluoride (0.53 ± 0.15) was decreased significantly compared with that of SH-SY5Y cell treated with 0.000 mmol/L fluoride (1.05 ± 0.05,P ＜ 0.05).The increased expression of phospho-ERK1/2 was found in α3nAChR silence group and control group incubated with fluoride with time prolonged,and the expression of phospho-ERK1/2 increased significantly at time points 24,36 and 48 h (188.33 ± 7.33,200.00 ± 10.01,213.33 ± 11.55;125.33 ± 5.69,136.00 ± 4.52,155.33 ± 6.51) compared to 0 h in the same groups (100.00 ± 0.00,100.00 ± 0.00,all P ＜ 0.05),and the expression of phospho-ERK1/2 was higher significantly in α3nAChR silence group than those of control group (t =9.26,7.63,5.72,all P ＜ 0.05);no change of expression of total-ERK1/2 in the two groups was found with the passage of time.The gradually increased expression of phospho-JNK was found in α3nAChR silence group and control group,among which,the expression of phospho-JNK in o3nAChR silence group at time points 12,24,36 and 48 h (154.00 ± 6.25,149.00 ± 5.57,156.00 ± 6.08,141.67 ± 2.52) and in control group at 8,12,24,36,48 h (133.33 ± 10.69,173.00 ± 4.00,175.00 ± 11.79,200.67 ± 11.93,200.33 ± 18.58) was compared to those at 0 h in the same groups (100.00 ± 0.00,100.00 ± 0.00),and the difference was significant (all P ＜ 0.05);the higher expression of phospho-JNK was found in α3nAChR silence group other than control group at 8,12,24,36,48 h (t =-4.28,-5.02,-2.89,-8.33,-6.18,all P ＜ 0.05);no change of expression of total-JNK was found in the two groups (P ＞ 0.05).The increased expression of phospho-p38 was detected in control group at time points 24,36 and 48 h (120.33 ± 4.51,122.00 ± 7.55,119.67 ± 7.57) compared to 0 h in the same groups (100.00 ± 0.00,all P ＜ 0.05),and the expression of phospho-p38 was significantly higher than that in α3nAChR silence group at the same time points (93.33 ± 9.61,94.00 ± 5.01,98.33 ± 5.69,t =-4.01,-6.73,-5.59,all P ＜ 0.05);no change of expression of total-p38 was found in the two types of SH-SY5Y cells treated with fluoride (P ＞ 0.05).Conclusion When SH-SY5Y cells are exposed to fluoride;activation of ERK1/2 may be not depend on α3nAChR;α3nAChR may have protected the cell from apoptotic injury caused by activation of JNK pathway,and the activation of p38 may be depend on nAChRα3.

Objective To investigate the changes of C- reactive protein( CRP ) and homocysteine ( Hcy)in the type 2 diabetes with depression,and its clinical significance and potential mechanism. Methods One hundred and twenty-four cases with type 2 diabetes were divided into the depression group(63 cases)and non-depression group( 61 cases ) according to the Self-Rating Depression Scale and verified by Self-Rating Anxiety Scale. The information including age,sex,education degree,body mass index,course of disease and the number of complications were recorded. The levels of CRP,Hcy,fasting plasma glucose( FPG ),glycosylated hemoglobin(HbA1c)and blood lipid were measured. The depression group was divided into mild,medium and heavy group to compared the changes of Hcy and CRP. Results The levels of Hcy,HbA1c and the number of complications in depression group were 11. 5( 8. 6,15. 6 )μmol/L,( 10. 13 ± 2. 17 )%,and 2( 1,3 ) respectively,higher than that of non-depression group(8. 6(7. 4,11. 2)μmol/L,(9. 33 ± 2. 20)%,1(0,2)), while the education degree of depression group((9. 75 ± 3. 36)years)was lower than that of non-depression group((11. 56 ± 3. 73)years),and the differences were significant( t/Z = -3. 537,0. 952,-2. 339,0. 228 respectively;P ﹤0. 05). The levels of Hcy in mild,medium and heavy depression group were(8. 75(7. 45, 10. 45)μmol/L,12. 2(8. 90,14. 40)μmol/L,19. 50(14. 33,28. 03)μmol/L respectively and the difference was significant(F =25. 963,P =0. 000). No significance difference was found in terms of CRP level(2. 35 (1. 10,4. 92)mg/L,3. 25(1. 11,5. 68)mg/L,2. 32(1. 27,5. 41)mg/L;F=0. 194,P=0. 907). There was significant correlation between depression scores and Hcy( r=0. 615,P=0. 000). Conclusion Type 2 diabetes with depression is associated with the level of blood glucose,education degree and the course of disease. Hcy,not CRP is an independent risk factor of type 2 diabetes with depression.

Objective:To investigate the satisfaction levels of the rural elderly in Dafeng district of Yancheng, Jiangsu province with the contracted family doctor services, and to identify the factors that influence their satisfaction.The findings of this study will provide valuable insights for improving the quality of the contracted family doctor services offered to the rural elderly population.Methods:The study utilized the stratified cluster sampling method to select elderly individuals aged 60 years and above from Dafeng district, Yancheng city for a questionnaire survey.Specifically, the study focused on elderly individuals who had participated in contracted family doctor services for more than six months.The survey aimed to gather information on the elderly population's general situation, as well as their understanding, utilization, and satisfaction with contracted family doctor services.The satisfaction of contracted family doctor services was analyzed using the chi square test and multivariate Logistic regression to identify the influencing factors.Results:The study surveyed 385 elderly individuals from rural areas who had contracted family doctor services.The results showed that 88.3%(340/385)of respondents were satisfied with the services they received.Additionally, 99.2%(382/385)of those surveyed were aware of the contracted family doctor services, and 81.8%(315/385)had received basic medical services from their signed-up doctors.The results of a multifactor analysis that examined the factors influencing the overall satisfaction of elderly patients with their contracted family doctor services revealed several significant factors.Specifically, being female( OR=2.557, 95% CI: 1.122-5.830, P=0.026)and unmarried( OR=7.355, 95% CI: 1.850-29.237, P=0.005), supporting the contracted family doctor services system( OR=18.442, 95% CI: 1.732-195.973, P=0.016), believing that the contracted medical institutions had excellent hardware facilities( OR=9.918, 95% CI: 2.313-42.526, P=0.002)and providing high-quality health services for the elderly( OR=8.723, 95% CI: 1.556-48.908, P=0.014), as well as experiencing improved health status after signing the contract( OR=5.006, 95% CI: 1.764-14.201, P=0.002)were all significant factors influencing their satisfaction.These findings suggest that these factors are important considerations for improving the satisfaction of elderly patients with their contracted family doctor services. Conclusions:The contracted family doctor services provided in Dafeng district, Yancheng city have been well received by the rural elderly population.Factors such as gender, marital status, attitude towards the contracted family doctor services system, improvements in health status after contracting the service, quality of the hardware facilities at the contracted medical institution, and availability of health services specifically tailored for the elderly all play a role in determining the level of satisfaction among the contracted elderly population.To better serve the elderly population, it is crucial that we prioritize their needs.This can be achieved by improving the level of "suitable aging" in the contracted services and enhancing the satisfaction of family doctors who provide these services.

Objective:In order to develop an appropriate care service system and care security system for the elderly in urban communities, it is necessary to gain a comprehensive understanding of their needs and utilization of care services, as well as the cost of care and the factors that influence it.This will provide a theoretical basis for developing effective countermeasures.Methods:A stratified random cluster sampling method was utilized to conduct a questionnaire survey on individuals aged 60 and above in the Xuzhou urban community.The survey aimed to gain insight into the needs, utilization, and expenditure of care services for the elderly.To analyze the factors influencing care expenditure, a single factor χ2 test and Tobit regression model were employed. Results:In our survey of 1 623 elderly individuals, it was found that 32.4%(526 people)had been bedridden for more than one day in the past year and were unable to care for themselves.Of the elderly who are bedridden, 393 individuals(74.7%)have received care services from professional institutions, with a focus on medical care(312 people, 79.4%)and rehabilitation care(95 people, 24.2%).In terms of financial expenditures, 91.7% of respondents(1 489 people)reported spending zero yuan in the past year, while 6.0%(96 people)spent between 1 and 4 999 yuan.Only 1.0%(17 people)reported spending between 5 000 and 9 999 yuan, and 1.3%(21 people)spent 10 000 yuan or more.The findings from the univariate analysis revealed that various factors, including marriage, age, medical expenses, and life satisfaction had a significant impact on the care expenses of the elderly(all P<0.05).Furthermore, the Tobit regression model demonstrated that certain variables were particularly influential in determining care expenses.Specifically, elderly individuals with higher monthly income(Me=3.114), advanced age(Me=3.458), knowledge of care insurance(Me=7.647), disability(Me=10.998), no spouse(Me=14.387), and dementia(Me=20.473)had significantly higher care expenses. Conclusions:The survey conducted in Xuzhou suggests that the demand for care services is high, yet the utilization rate remains low, leading to a significant burden of care costs.To address these challenges, we must prioritize the care needs of disabled, mentally retarded, and advanced-age elderly individuals.We should also focus on enhancing medical and rehabilitation care services, improving the overall quality of elderly care, and promoting the development of a comprehensive elderly care service system and care security system that caters to the specific needs and financial constraints of the elderly population.