Objective To explore the role of JNK signaling pathway in epithelial mesenchymal transition (EMT)process of human alveolar epithelial cells A549 induced by TGF‐β1 in vitro.Methods Human alveolar epithelial cells (A549)cultured in vitro were divided randomly into three groups :normal group ,TGF‐β1 group ( treated by TGF‐β1 with 10 ng/mL)and inhibitor group (treated by 10 ng/mL TGF‐β1 and 20 μmol/L Sp600125).Morphological observation on the cells was performed under light microscope after culturing in 3% serum medium for 72 h. The expression of E‐cadherin (E‐cad ,a epithelial cell marker) ,α‐smooth muscle actin (α‐SMA ,a mesenchymal cell marker)and Collagen fibers Ⅰ(ColⅠ ,a mesenchymal cell marker)were tested by RT‐PCR.The level of JNK phosphorylation (p‐JNK)was detected through Western blot.All experiments were repeated three times at least.Results The normal human alveolar epithelial cells (A549)cultured invitro were arranged closely like peb‐bles.E‐cad expressed at a certain level ,while the expression ofα‐SMA ,ColⅠand p‐JNK was weakly detected.In TGF‐β1 group , the cells were spindle‐shaped ,the expression of E‐cad was reduced ,while the expression ofα‐SMA ,ColⅠand p‐JNK was signifi‐cantly increased 72 h after treatment of TGF‐β1. However ,compared with TGF‐β1 group ,spindle‐shaped cells in the inhibitor group were recovered after 72 h being treated by TGF‐β1 and Sp600125 ,the expression of E‐cad was increased and the expres‐sion levels of α‐SMA ,ColⅠand p‐JNK were significantly decreased 72 h after treatment with TGF‐β1 and Sp600125 in inhibitor group. As compared with normal group ,the shape of the cells in inhibitor group was prolate ,and the expression of E‐cad ,α‐SMA ,ColⅠand p‐JNK was not significantly different.Conclusion JNK signaling pathway is related to the process of EMT of human alveolar epithelial cells induced by TGF‐β1. Sp600125 ,a special inhibitor of JNK ,could validly restrain the process.

Objective To assess the prevalence and severity of burnout in medical staffs,and investigate associated demographic,perceived social support and job burnout.Methods Totally 618 medical staffs form Sichuan province people's hospital were selected by the systematic sampling method,and were tested by general state questionnaire,job burnout questionnaire and perceived social support scale.Results ①The prevalence of job burnout was 75.6％,including mild job burnout (36.1％),moderate (32.2％),severe (7.3％).②The scores of emotional exhaustion in the female medical staffs(20.50±8.35) was higher than the male medical staffs (19.07±7.76,P＜0.05).Divorced medical staffs had higher scores(18.28±7.13) than that of single and married medical staffs (15.05±5.00) in low personal accomplishment (P＜ 0.01).The medical personnel of different ages were statistically significant difference in total job burnout scores,emotional exhaustion and depersonalisation (F=4.475,3.061,3.942,all P＜0.05).The medical personnel of different post,professional title and working years were statistically significant difference in total job burnout scores and emotional exhaustion (F=6.920,13.968; 3.506,3.391;3.190,3.300,all P＜ 0.05).The medical personnel of different educational attainment were statistically significant difference in total job burnout scores,emotional exhaustion and low personal accomplishment(F=6.218,2.837,2.850,all P＜0.05).)Correlation analysis found that emotional exhaustion,depersonalisation,low personal accomplishment and total job burnout respectively with family support,friend support,and other support and total social support was significantly negative correlation (r=-0.126～-0.403,P＜0.01).④Regression analysis showed that education,family and friends support were protective factors for total job burnout(OR=-0.248,95％ CI =0.625-0.975 ; OR=-0.084,95％ CI =0.862-0.980 ; OR=-0.091,95％ CI =0.860-0.968 ; all P＜0.05).Conclusion The prevalence of job burnout is high in medical staffs.The medical staffs of different sex,age,title,jobs,education,working years,marital status are showed the differences job burnout scores,which is closely related to the perceived social support.

Objective To study the clinical and prognostic value of CK19 mRNA-positive circulating tumor cells in early breast cancer patients. Methods We analyzed the peripheral blood in 50 patients with early breast cancer after surgery and before the initiation of any adjuvant treatment for the presence of CK19 mRNA-positive circulating tumor cells using a nest reverse polymerase chain reaction assay. All patients were followed up. Results CK19 mRNA-positive cells were detected in 40.0 %(20/50) of patients with early breast cancer, 12.5 %(3/24) of patients with breast benign lesions, but 5 %(1/20) in healthy individuals (P =0.017,P =0.004); 11 to 20 of them relapsed during the follow-up period (P =0.002). There was no significant association between the detection of CK19 mRNA-positive cell and the patients' menstrual status, tumor stage, tumor size, etc (P ＞0.05). Detection of peripheral-blood CK19 mRNA-positive cells was associated with reduced median relapse-free interval in early breast cancer patients (P =0.007). Conclusion CK19 mRNA is one of the molecular markers for the detection of circulating tumor cells in early breast cancer. Detection of peripheral blood CK19 mRNA-positive cells might be an important predictive value as a marker of relapse in early breast cancer patients.

Objective:To explore the association between dopamine-β-hydroxylase (DβH), norepinephrine transporter (NET) gene polymorphisms and panic disorder(PD).Methods:The structured clinical interview for the diagnostic and statistical manual of mental disorders fourth edition (DSM-Ⅳ) axis Ⅰ disorders was administered by trained clinical psychiatrist, 139 patients with PD(PD group) and 196 healthy controls(control group) were enrolled in the study.Single nucleotide polymorphism(SNP) genotyping was performed using an improved multiplex ligation detection reaction technique.SPSS 16.0 and PLINK softwares were used to compare the allele frequency and genotype distribution.Results:(1)Compared with control group, PD group carried more G allele(76.3% vs 68.4%) and fewer A allele(23.7% vs 31.6%) in NET rs5569, and the difference was significant(χ 2=4.986, OR=0.67, 95% CI: 0.47-0.95, P<0.05). However, the correlation was no longer significant after adjusting for Bonferroni’s multiple testing( P>0.05). (2)The additive model of NET rs5569 showed a association with PD ( OR=0.68, 95% CI: 0.48-0.96, P<0.05). And the recessive model of DβH rs1611114 showed a association with PD( OR=0.42, 95% CI: 0.18-0.96, P<0.05). However, these correlations were no longer significant after adjusting for Bonferroni's multiple testing( P>0.05). (3)No matter allele or genotype, there were no significant differences in DβH (rs129882, rs1611114, rs1611115) and NET (rs2242446, rs28386840) gene polymorphisms between panic disorder group and control group(all P>0.05). Conclusion:The present study indicates that there is no significant association of DβH and NET gene polymorphisms with PD.

Objective To discuss the effect of comfort nursing on physiological and psycho-logical therapeutic efficacy for COPD patients.Methods A total of 120 patients diagnosed COPD were randomly divided into experimental group and control group,all the patients were given the same clinical therapeutic measures and the control group was given routine nursing while the experi-mental group was given comfort nursing on the basis of routine intervention,physiological and psy-chological therapeutic efficacy were compared in two groups.Results BMI,MMRC and CAT in the experimental group were lower than that in the control group and higher than patients in the control group,FEV1% predictive values in the experimental group was higher than that in the con-trol group,the difference was statistically significant (P <0.05).Anxiety scores and depression scores in the experimental group was lower than that in the control group,subjective well being in the experimental group was higher than that in the control group,the difference was statistically significant (P <0.05).Conclusion Comfort nursing can improve the physical and psychological therapeutic efficacy,improve quality of life and patients’satisfaction,and enhance the doctor-pa-tient relationship as well as overall health level.

Objective To discuss the effect of comfort nursing on physiological and psycho-logical therapeutic efficacy for COPD patients.Methods A total of 120 patients diagnosed COPD were randomly divided into experimental group and control group,all the patients were given the same clinical therapeutic measures and the control group was given routine nursing while the experi-mental group was given comfort nursing on the basis of routine intervention,physiological and psy-chological therapeutic efficacy were compared in two groups.Results BMI,MMRC and CAT in the experimental group were lower than that in the control group and higher than patients in the control group,FEV1% predictive values in the experimental group was higher than that in the con-trol group,the difference was statistically significant (P <0.05).Anxiety scores and depression scores in the experimental group was lower than that in the control group,subjective well being in the experimental group was higher than that in the control group,the difference was statistically significant (P <0.05).Conclusion Comfort nursing can improve the physical and psychological therapeutic efficacy,improve quality of life and patients’satisfaction,and enhance the doctor-pa-tient relationship as well as overall health level.

Objective To explore the mediating effects of security on the severity of panic disorder and life events.Methods Security Questionnaire(SQ),life event scale(LES)were used to investigate 97 cases of patients with panic disorder and 108 cases of normal control group. The severity of panic disorder was assessed by panic disorder severity scale(PDSS).And the correlation and hierarchical regression analy-sis were used.Results ①The panic disorder patients' positive life stimulation(7.95±6.00)were less than that the normal control group's(18.06± 13.60),negative life stimulation and total life events stimulation ((36.64±29.98),(44.59±31.24))were higher than that of the normal control group(respectively(10.19± 7.89),(28.25±14.51)),the differences were statistically significant(all P<0.05).Panic disorder patients' interpersonal security certainty in control and total score(respectively(18.89 ± 8.66),(17.88 ± 7.58), (36.76±13.47))were lower than that the normal control group(respectively(26.64±9.33),(24.34±8.33), (50.98±15.31)),the differences were statistically significant(all P<0.01).②Severity of panic disorder and positive life events were negatively related to positive events,the total score of security,interpersonal securi-ty,certainty in control(r=-0.262--0.392);severity of panic disorder were positively related to the negative life stimulation and total life event(r=0.346,0.280)(all P<0.01).③Security played a partial mediating role between the negative life events and the severity of panic disorder(beta value decreased from 0.346 to 0.253).Conclusion The patients with panic disorder have more negative life events,lower security.And negative life events and lower security are related to the severity of panic disorder.And security plays a partial mediating effect between the negative life events and the severity of panic disorder.

Objective To explore the association between monoamine oxidase A (MAOA) variable number tandem repeat (VNTR) polymorphism and panic disorder,and then to compare panic disorder(PD) severity patient with different MAOA VNTR genotypes.Methods The structured clinical interview for the diagnostic and statistical manual of mental disorders fourth edition (DSM-Ⅳ) Axis I Disorders (SCID-1) was administered by a trained clinical psychiatrist,135 patients with PD and 195 healthy controls were recruited.MAOA-VNTR polymorphism were measured by fluorescent tags amplification product length polymorphism technology,Chi-square test was used to compare the distribution difference between each genotype and the allele frequency distribution.Results ①Whether male or female,there was no statistically significant difference between case group and healthy control group in the genotype and allele frequencies of MAOA-VN-TR polymorphism (x2=1.574,1.894,3.588;all P＜0.05).② There was no statistically significant difference between genotypes and panic disorder severity in the male with panic disorder ((14.46± 3.53),(14.15 ± 4.02);t=-0.247,P＞0.05).③)However,there was significant difference between genotypes and panic disorder severity in the female with panic disorder((13.15±3.47),(16.57±4.34),(15.27±4.91);F=4.222,P＜ 0.05).MAOA VNTR-L/L carriers experienced more serious panic (16.57 ± 4.34) than the patient with MAOA VNTR-H/H (13.15±3.47) (P＜0.01) by LSD multiple test.Conclusion No association between MAOA-VNTR polymorphism and panic disorder is found in Chinese Han population,but low activity homozygous genotype may be related to the severity of panic disorder in female patient with panic disorder.

Objective To explore the influencing factors of type 2 diabetes mellitus(T2DM)merging with diabetic peripheral neuropathy(DPN),and to construct and verify a prediction model based on random forest algorithm.Methods 512 T2DM patients who were hospitalized in our hospital from January 2019 to December 2021 were divided into simple T2DM group(n=292)and T2DM combined with DPN group(DPN,n=220)based on whether or not DPN was present.The general data and biochemical indicators of the two groups were compared.Logistic regression analysis was conducted to identify the influencing factors of DPN in T2DM patients.A random forest model was constructed.Results Compared with the T2DM group,the DPN group showed an increase in weight loss rate,incidence of diabetic retinopathy(DR),WBC and HbA1c(P<0.05),with decrease in DM duration≥10 years,TG and HDL-C(P<0.05).Logistic regression analysis showed that age≥60 years,HbA1c,TG,HDL-C,rate of weight loss,DR were influencing factor for T2DM combined with DPN.The random forest model showed that when the number of trees was 387,the error rate was the lowest.The importance ranking of the influencing factors of T2DM combined with DPN were the rate of weight loss,TG,DR,HDL-C,HbA1c and age≥60 years.Conclusions Age≥60 years,HbA1c,TG,HDL-C,rate of weight loss and DR are influencing factors for T2DM combined with DPN,that can be used for early clinical diagnosis and treatment.

Objective To understand the serum gonadal hormone level of female patients with panic disorder(PD),and to analyze its relationship with the disease severity.Methods The chemiluminescence method was adopted to detect serum gonadal hormone level in 57 female patients with panic disorder and 74 healthy subjects,the panic disorder severity scale (PDSS),Hamilton anxiety scale (HAMA) and Hamilton depression scale (HAMD) were simultaneously used to conduct the investigation.Results The serum pituitary prolactin (PRL) level in the female patients with PD had lower level was higher than that in the control group,the difference was statistically significant (P＜0.05);the luteinizing hormone (LH) and follicle-stimulating hormone (FSH) levels were lower than those in the control group(P＜0.05).The difference of the serum testosterone,estradiol and progesterone levels between the female patients with panic disorder and control group was not statistically significant (P＞0.05).The correlation analysis found that serum T level in the female patients with PD was negatively correlated with the disease severity of panic disorder,HAMD total score,retardation factor and sleep disorder factor (P＜0.05).Serum LH and FSH were positively correlated with the anxiety somatic factor of HAMA (P＜0.05).Serum FSH level was positively correlated with anxiety somatization and the sleep disorder factor of HAMD (P＜0.05).Conclusion The disorder of gonadal hormone levels may exist in the female patients with PD,and the serum T level is correlated with the PD severity and depressive symptoms.