Objective To study the effects of lung recruitment maneuvers (RM)with different duration combined with low tidal volume (TV)ventilation in acute respiratory distress syndrome (ARDS) with pulmonary and extra-pulmonary origin(ARDSp / ARDSexp). Methods Twenty-six ARDS patients with ventilation were selected including 10 patients of ARDSp (ARDSp group) and 16 patients of ARDSexp(ARDSexp group). All patients were given intermittent high-positive end expiratory pressure (PEEP) combined with low tidal volume RM in the base of usual ventilation. Effects of different duration of RM were evaluated and compared in the patients of ARDSp / ARDSexp. Results MAP decreased and HR increased when sustaining time of RM was above 60 seconds. Significant differences were showed compared with that before treatment. MAP and HR returned to normal after RM stopped.Compared with the state before RM,Pplat and Crs increased immediately after RM (P<0.05). When RM lasted above 60 seconds, Pplat increased significantly compared with that when RM continue lasted 40-59 seconds.But Crs,OI and SpO2 didn't increase obviously. Treatment effects of RM in patients of group ARDSexp were more obviously than those in patients of ARDSp group. There were 1 case of pneumothorax and 3 cases of pneumoderma in ARDSp group and 2 cases of pneumoderma in ARDSexp group when RM lasted above 60 seconds. Conclusions RM with intermittent high-PEEP on low TV is effective to ARDS and best duration is 40～59 seconds. The patients of ARDSexp, with pulmonary interstitial edema as the main pathology, respond better to RM than patients in ARDSp with pulmonary consolidation.

Objective To explore the significance of complement split product C4d in monitoring chronic rejection of renal allografts in rats.Methods Healthy closed population rats were used as donors and SD rats as recipients. The Wistar to SD model of graft rejection was developed. All the 42 recipients were randomly divided into 2 groups: group A receiving nothing except CsA (5mg?kg~ -1 ? d~ -1 ) in the first 10 days after operation, and group B receiving MMF (10 mg/kg) and CsA after operation. On the 3rd, 5th and 10th week, all the allografts were tested by light microscopy and immunofluorescence. Pathological changes of the kidneys and the expression of C4d in allograft tissue were observed.Results From the 3rd week, the rats in group A showed light pathological changes of chronic rejection and they became more and more obvious as time increased. Pathological changes occurred in group B at the 5th week and lighter than in group A. At the same time, C4d deposition in PTC was obviously observed on the 3rd week in group A, and on the 10th week C4d widespread deposition in allografts.Conclusion The deposition of complement split product C4d in allografts appears earlier than pathological change of chronic rejection, which can be regarded as a significant indicator to predict chronic rejection of renal allografts.

Objective:To determine the fluorine content in enamel before and after besmearing fluoride varnishes or fluorinated bubbles. Methods:Thirty patients whose deciduous central incisors will be extracted were divided into group a and b randomly. For the same patient, a pair of mandibular deciduous central incisor were chosen. For group a: one tooth was removed, and the other one besmeared with fluoride varnishes and removed 24 h later. For group b: one tooth was removed, and the other one besmeared with fluorinated bubbles and removed 24 h later. The fluorine contents in the enamel of every tooth were determined by neutron activation method and analyzed statistically. Results:For group a: the fluorine content in the experimental group was (142.78?42.25) ?g/g, and that in the control group was(119.62?38.62) ?g/g. For group b: (162.36?31.36) ?g/g and (126.56?38.42) ?g/g respectively. The fluorine content in the enamel of tooth besmeared with fluoride varnishes or fluorinated bubbles was higher than that in the control group(P

Objective To investigate the influence of Qiliqiangxin capsule on the exercise tolerance in patients with chronic heart failure. Methods 86 patients with chronic heart failure were selected and recruited into a control group and an observation group randomly. The patients in the control group were given angiotensin-converting enzyme inhibitor, diuretic,carvedilol or metoprolol and dixina. The patients in the observation group were given Qiliqiangxin capsule on the basis of the control group. The change of exercise tolerance and left ventricular ejection fraction in all patients were detected after 4 weeks.Results The distance of walking in 6 minutes increased for all patients after 4 weeks' treatment(P＜0.05), while the observation group increased more significantly than the control group(P＜0.05). The left ventricular ejection fraction increased for all patients after therapy 4 weeks (P＜0.05), while the observation group increased more obviously than the control group (P＜0.05). The total excellent rate and effective rate in the observation group were both higher than the control group (P＜0.05). Conclusion Qiliqiangxin capsule can increase the clinic curative effect by increasing the exercise tolerance and improving the heart function of patients with chronic heart failure.

Objective Bone morphogenetic protein 4 ( BMP4) induces rat myocardial hypertrophy in H9c2 cells, but the spe-cific mechanism remains unclear .The study aimed to elucidate the role of autophagy in myocardial hypertrophy and its relationship with extracellular signal regulating kinase ( ERK1/2) signal transduction pathway . Methods H9c2 cardiomyocytes were randomly divided into 4 groups:control group, BMP4 group, BMP4+PD98059 (ERK1/2 signal pathway inhibitor) group and BMP4+3MA (autophagy inhibitor) group.With PD98059(50μmol/L) and 3MA(5mmol/L) blocking for 30min, BMP4 (50μg/L) were added.Expressions of tiny tube related proteins 1 light chain 3 (LC3) and p-ERK1/2 were detec-ted after culturing for 30min.48h later, measurements were made on cell surface area , average protein content and α-smooth muscle actin (α-SMA ) protein expression level .Cell morphology and size were measured respectively by inverted microscope and Image J software .Total protein content was detected by BCA , and western blot was used to measure the expressions of LC3, ERK1/2, p-ERK1/2 and α-SMA. Resul ts 30min later, the expressions of LC3 and p-ERK1/2 were significantly higher in BMP4 group than in control group [(1.54 ±0.05) vs (1.95 ±0.11),(0.94 ±0.04) vs (1.33 ± 0.06),P<0.01] and no significant difference was found in other two groups .Compared with BMP4 group, significant decrease was found in BMP4+PD98059 and BMP4+3MA [(1.95 ±0.11) vs (1.59 ±0.08), (1.36 ±0.02);(1.33 ±0.06) vs (0.87 ±0.05), (0.95 ±0.15), P<0.01], while no significant difference was found between BMP 4+PD98059 group and BMP4+3MA group.48h lat-er, the cell area, protein content and α-SMA protein expression level are significantly lower in control group than in BMP 4 group [(644.1 ±15.01)μm2 vs (745.6 ±14.43)μm2,(240.0 ±7.26)pg/cell vs (347.1 ±5.4)pg/cell,(1.22 ±0.06 vs 1.99 ±0.03),P<0.01], while the corresponding indexes were significantly higher in BMP 4+PD98059 and BMP4+3MA compared with BMP4 group [(745.6 ±14.43)μm2 vs (645.0 ±12.63)μm2, (647.7 ±13.89)μm2;(347.1 ±5.4)pg/cell vs (239.7 ±3.39)pg/cell , (241.1 ± 8.56)pg/cell;(1.99 ±0.03) vs (1.13 ±0.05);(1.12 ±0.02), P<0.01].No significant difference was found as to the indexes be-tween BMP4+PD98059 group and BMP4+3MA group(P>0.05). Conclusion Autophagy may participate in BMP4-induced rat myo-cardial hypertrophy in H9c2 cells through ERK1/2 signal transduction pathway .The clinical treatment of myocardial hypertrophy may benefit from the blocking of autophagy or ERK 1/2 signal transduction pathway .

Objective To establish a quantitative SYBR GreenⅠreal-time PCR method for detection of Metadherin (MTDH) gene expression level in breast cancer, and to investigate the relationship between MTDH mRNA expression level and the clinicopathological characters. Methods Real-time PCR was employed to determine the expression level of MTDH mRNA in peripheral blood of 80 specimens of breast cancer patients and normal females. Results In the 80 specimens, MTDH mRNA was positively expressed in the peripheral blood of 61 cases of breast cancer patients while negatively expressed in the 19 cases of normal females. Among the 61 breast cancer patients, MTDH mRNA showed high expression in 34 cases, accounting for 55.7%, and showed low expression in 27 cases, accounting for 44.3%. Both of the differences in expression rate has statistic significance (Ratio = 2.02 ± 0.81, P<0.05). MTDH expression relative to GAPDH expression in the peripheral blood of breast cancer patients was 1.15 ± 0.36. MTDH mRNA expression has no connection with age, estrogen and progesterone receptors , as well as HER-2.(P＞0.05). There is statistical difference for MTDH mRNA expression level between the group with lymph node metastasis and the group without lymph node metastasis (Ratio=2.02 ± 0.81,P<0.05). MTDH mRNA expression level changed between clinicopathological stage I, II and III, IV. Conclusion The established SYBR Green Ⅰ quantitative real-time PCR method can successfully detect the expression level of MTDH mRNA, which may be closely related to the occurrence and development of breast cancer.

Objective To observe the morphology, quantity and migration of Langerhans cells in normal or HPV-infected skin treated with localized hyperthermia. Methods Tissue specimens obtained from 16 patients with condyloma accuminatum (CA) and 15 normal controls were divided into three equal parts, and irradiated by a self-made hyperthermia equipment at 37℃, 42℃ and 45℃ respectively for 30 minutes. Immunohistochemistry and flow cytometry were applied to detect the morphology, quantity and migration of Langerhans cells (LCs), respectively, in these treated specimens. Results With a rise in temperature, the number of LCs in epidermis decreased, the dendrites shortened, decreased in number or even disappeared. After exposure to hyperthermia at 37℃, 42℃ and 45℃, the number of LCs was 782.40±114.8, 649.44±119.40 and 510.88±118.64 per square millimeter respectively, in normal tissue, 646.04±135.67, 489.38±118.19 and 387.93±110.15 per square millimeter respectively in HPV-infected skin tissue.The percentage of migratory LCs expressing CD1a was 0.19%±0.18%, 0.89%±0.19% and 1.59%±0.28% in normal skin tissue treated with hyperthermia at 37℃, 42℃ and 45℃ respectively, 0.62%±0.31%,2.31%±0.54% and 6.33%±0.98%, respectively, in HPV-infected skin tissue; the differences were significant among these different temperatures. Furthermore, the migration of LCs from tissue into culture was enhanced by the treatment with hyperthermia. Conclusions Hyperthermia can promote the migration of LCs, and accordingly enhance the antigen presenting effect of these cells in immune response.

Objective To analyze the current situation and influence factors of ordinary medical college undergraduates' contact with scientific research at early stage in order to provide references for scientific research.Methods Totally 1940 students majoring in clinical medicine,imaging,traditional Chinese medicine and nursing (2008 -2010 grade) in China Three Gorges University were enrolled to do questionnaine and SPSS 17.0 was used to do statistical analysis.Results Totally 1653copies of questionnaires were collected from 1940 students,the recovery rate was 85.21％.Two hundred and nineteen students ( 13.25％ ) participated in scientific research,65.28％ students thought college propaganda to be ordinary,95.43％ students got benefits from scientific research.The main influence factors of scientific research were lack of time (23.73％),insufficient knowledge reserves (22.03％) and researchers' own problems (39.73％).Conclusions Medical school should expand the range of scientific research and strengthen propaganda.Medical students should arrange research time and constantly improve their comprehensive ability so as to achieve good results.

Objective: To explore the relationship among social support, self-efficacy, peer pressure and physical exercise behavior and to provide a reference for subjective initiative of college students in physical exercise. Methods: Questionnaire survey regarding social support, peer pressure and self-efficacy, as well as physical exercise behavior was administered among 1 189 students from 3 colleges and universities in Henan Province during August to October 2019. Results: Peer pressure score was (18.72±4.02), subjective support score was (14.76±3.46), objective support score was (10.98±2.53), utilization score for support was (11.20±3.12), self-efficacy score was (36.79±8.00), physical exercise behavior score was (21.72±4.75). Subjective support, objective support, utilization of support, peer pressure, self-efficacy and college students ’ physical exercise behavior were significantly positively correlated(P<0.05). Structural equation model showed that subjective support, objective support, utilization of support, peer pressure, and self-efficacy significantly positively associated with physical exercise behavior,with standardization coefficients of 0.08, 0.12, 0.13, 0.40, 0.90(P<0.05), respectively. Self-efficacy has significant mediating effect on peer pressure, subjective support, objective support, utilization of support and physical exercise behavior of college students used, with standardized effect quantities being 55.36%, 90.73%, 85.88%, 87.92%, respectively. Conclusion College students’ physical exercise behavior is closely related to social support, peer pressure and self-efficacy. Social support has a significant impact on college students’ physical exercise behavior, and self-efficacy, while self-efficacy and peer pressure all have a positive effect on college students’ physical exercise behavior.