BACKGROUND:The level of peripheral erythrocytes in rats is significantly increased under hypoxia exposure,and the proliferation of nucleated erythrocytes in the bone marrow may be one of the direct causes of the increase in peripheral erythrocytes.Previous studies have focused on the effects of factors such as erythropoietin and hypoxia-inducible factor,but little research has been done on related factors such as inflammation and immunity.OBJECTIVE:To study the expression of interleukin-18 in bone marrow nucleated erythrocytes,bone marrow supernatant and peripheral blood of rats after hypoxia exposure,and to explore the possible role of interleukin-18 in the pathogenesis of chronic mountain sickness.METHODS:Sixteen healthy male SD rats were randomly divided into two groups:the experimental group was kept in a hypobaric oxygen chamber at a simulated altitude of 5 000 m for 28 days,and the control group was kept in a laboratory at an altitude of 2 260 m for 28 days.The blood routine tests of the two groups of rats were performed.The proportion of CD71+nucleated erythrocytes in the bone marrow of the two groups of rats was determined by flow cytometry.The expressions of interleukin 18 mRNA and protein in CD71+nucleated erythrocytes in the bone marrow of the two groups of rats were determined by RT-qPCR and western blot assay.The expressions of interleukin 18 protein in the sternum of the two groups of rats were determined by immunofluorescence.The levels of interleukin 18 in the peripheral blood and bone marrow supernatant of the two groups of rats were determined by ELISA.RESULTS AND CONCLUSION:(1)The indexes of erythrocyte count,hemoglobin,hematocrit,and mean hemoglobin content in peripheral blood of the experimental group were higher than those of the control group(P＜0.05).(2)The proportion in bone marrow CD71+erythroblasts was significantly higher in the experimental group than that in the control group(P＜0.05).(3)RT-qPCR results showed that the expression of interleukin 18 mRNA in CD71+nucleated erythrocytes in the bone marrow of rats in the experimental group was significantly higher than that in the control group(P＜0.05).(4)Western blot assay results showed that the expression of interleukin 18 protein in CD71+nucleated erythrocytes in the bone marrow of rats in the experimental group was significantly higher than that in the control group(P＜0.05).(5)The immunofluorescence results showed that the expression of interleukin 18 protein in the sternum of rats in the experimental group was significantly higher than that in the control group(P＜0.05).(6)ELISA results exhibited that the level of interleukin 18 in the serum of rats of the experimental group was higher than that in the control group(P＜0.05),but the level of interleukin 18 in the bone marrow supernatant of rats in the experimental group was lower than that in the control group(P＜0.05).The results indicate that the increased expression of interleukin 18 in bone marrow CD71+erythroblasts and peripheral blood of rats under hypobaric hypoxia may be involved in the proliferation of erythroblasts in bone marrow.

BACKGROUND:The level of peripheral erythrocytes in rats is significantly increased under hypoxia exposure,and the proliferation of nucleated erythrocytes in the bone marrow may be one of the direct causes of the increase in peripheral erythrocytes.Previous studies have focused on the effects of factors such as erythropoietin and hypoxia-inducible factor,but little research has been done on related factors such as inflammation and immunity.OBJECTIVE:To study the expression of interleukin-18 in bone marrow nucleated erythrocytes,bone marrow supernatant and peripheral blood of rats after hypoxia exposure,and to explore the possible role of interleukin-18 in the pathogenesis of chronic mountain sickness.METHODS:Sixteen healthy male SD rats were randomly divided into two groups:the experimental group was kept in a hypobaric oxygen chamber at a simulated altitude of 5 000 m for 28 days,and the control group was kept in a laboratory at an altitude of 2 260 m for 28 days.The blood routine tests of the two groups of rats were performed.The proportion of CD71+nucleated erythrocytes in the bone marrow of the two groups of rats was determined by flow cytometry.The expressions of interleukin 18 mRNA and protein in CD71+nucleated erythrocytes in the bone marrow of the two groups of rats were determined by RT-qPCR and western blot assay.The expressions of interleukin 18 protein in the sternum of the two groups of rats were determined by immunofluorescence.The levels of interleukin 18 in the peripheral blood and bone marrow supernatant of the two groups of rats were determined by ELISA.RESULTS AND CONCLUSION:(1)The indexes of erythrocyte count,hemoglobin,hematocrit,and mean hemoglobin content in peripheral blood of the experimental group were higher than those of the control group(P＜0.05).(2)The proportion in bone marrow CD71+erythroblasts was significantly higher in the experimental group than that in the control group(P＜0.05).(3)RT-qPCR results showed that the expression of interleukin 18 mRNA in CD71+nucleated erythrocytes in the bone marrow of rats in the experimental group was significantly higher than that in the control group(P＜0.05).(4)Western blot assay results showed that the expression of interleukin 18 protein in CD71+nucleated erythrocytes in the bone marrow of rats in the experimental group was significantly higher than that in the control group(P＜0.05).(5)The immunofluorescence results showed that the expression of interleukin 18 protein in the sternum of rats in the experimental group was significantly higher than that in the control group(P＜0.05).(6)ELISA results exhibited that the level of interleukin 18 in the serum of rats of the experimental group was higher than that in the control group(P＜0.05),but the level of interleukin 18 in the bone marrow supernatant of rats in the experimental group was lower than that in the control group(P＜0.05).The results indicate that the increased expression of interleukin 18 in bone marrow CD71+erythroblasts and peripheral blood of rats under hypobaric hypoxia may be involved in the proliferation of erythroblasts in bone marrow.

The research focus of diabetes, a common chronic metabolic disease, has shifted from individual factors to environmental factors at the population level. Epidemiological studies suggest an association between exposure to environmental pollutants and the risk of diabetes. Major environmental pollutants include organochlorine pesticides, polychlorinated biphenyls, phthalates and their metabolites, and arsenics, which primarily enter the human body through the skin, respiratory tract, and digestive system. Long-term exposure to these pollutants can affect the pathology of diabetes through various mechanisms, such as promoting insulin resistance, causing insulin secretion deficiencies, inducing oxidative stress-induced glucose metabolism disorders, and affecting DNA methylation. However, the potential damaging mechanism of the impact of environmental pollutants on diabetes remain unclear. Limitations such as insufficient sample sizes, uncertainties regarding exposure time and dosage, and differences between single and co-exposures. In the future, it is necessary to focus on exploring and analyzing the mechanisms of environmental pollutant exposure on diabetes to develop effective prevention strategies, control and reduce the incidence and development of diabetes, and provide new insights into its diagnosis and treatment.

Objective Summarize the key difficult problems faced by national regional medical centers,create a checklist of crucial issues,and propose strategic recommendations to support future development.Methods It employed a combination of literature review,field research,and in-depth interviews to develop an initial draft of the checklist for key issues in national regional medical centers.Additionally,two rounds of Delphi method consultation were conducted with experts from local government,exporting and supporting hospitals.The data gathered from the questionnaires in both rounds were analyzed,and essential questions were identified.Results The questionnaires achieved response rates of 99%and 100%in the two rounds,and the expert authority coefficients were 0.83 and 0.90.The final checklist for key issues in national regional medical centers encompassed a total of 6 problems.These included 3 challenges related to establishing sound management systems and mechanisms,1 challenge concerning human resource management improvement,1 challenge focusing on elevating medical service levels,and 1 challenge pertaining to other aspects of progress.Conclusion Currently,the development of national regional medical centers encounters crucial challenges,including the enhancement of management mechanisms,overall human resource management,and medical capabilities.The government should reinforce leadership assurance,coordination,and supervisory responsibilities.Exporting hospitals should enhance management systems and operational mechanisms.Supporting hospitals should focus on effective party building guidance and cooperation while consistently promoting the uniform development of national regional medical centers.

Objective Summarize the key difficult problems faced by national regional medical centers,create a checklist of crucial issues,and propose strategic recommendations to support future development.Methods It employed a combination of literature review,field research,and in-depth interviews to develop an initial draft of the checklist for key issues in national regional medical centers.Additionally,two rounds of Delphi method consultation were conducted with experts from local government,exporting and supporting hospitals.The data gathered from the questionnaires in both rounds were analyzed,and essential questions were identified.Results The questionnaires achieved response rates of 99%and 100%in the two rounds,and the expert authority coefficients were 0.83 and 0.90.The final checklist for key issues in national regional medical centers encompassed a total of 6 problems.These included 3 challenges related to establishing sound management systems and mechanisms,1 challenge concerning human resource management improvement,1 challenge focusing on elevating medical service levels,and 1 challenge pertaining to other aspects of progress.Conclusion Currently,the development of national regional medical centers encounters crucial challenges,including the enhancement of management mechanisms,overall human resource management,and medical capabilities.The government should reinforce leadership assurance,coordination,and supervisory responsibilities.Exporting hospitals should enhance management systems and operational mechanisms.Supporting hospitals should focus on effective party building guidance and cooperation while consistently promoting the uniform development of national regional medical centers.

Objective Summarize the key difficult problems faced by national regional medical centers,create a checklist of crucial issues,and propose strategic recommendations to support future development.Methods It employed a combination of literature review,field research,and in-depth interviews to develop an initial draft of the checklist for key issues in national regional medical centers.Additionally,two rounds of Delphi method consultation were conducted with experts from local government,exporting and supporting hospitals.The data gathered from the questionnaires in both rounds were analyzed,and essential questions were identified.Results The questionnaires achieved response rates of 99%and 100%in the two rounds,and the expert authority coefficients were 0.83 and 0.90.The final checklist for key issues in national regional medical centers encompassed a total of 6 problems.These included 3 challenges related to establishing sound management systems and mechanisms,1 challenge concerning human resource management improvement,1 challenge focusing on elevating medical service levels,and 1 challenge pertaining to other aspects of progress.Conclusion Currently,the development of national regional medical centers encounters crucial challenges,including the enhancement of management mechanisms,overall human resource management,and medical capabilities.The government should reinforce leadership assurance,coordination,and supervisory responsibilities.Exporting hospitals should enhance management systems and operational mechanisms.Supporting hospitals should focus on effective party building guidance and cooperation while consistently promoting the uniform development of national regional medical centers.

Objective Summarize the key difficult problems faced by national regional medical centers,create a checklist of crucial issues,and propose strategic recommendations to support future development.Methods It employed a combination of literature review,field research,and in-depth interviews to develop an initial draft of the checklist for key issues in national regional medical centers.Additionally,two rounds of Delphi method consultation were conducted with experts from local government,exporting and supporting hospitals.The data gathered from the questionnaires in both rounds were analyzed,and essential questions were identified.Results The questionnaires achieved response rates of 99%and 100%in the two rounds,and the expert authority coefficients were 0.83 and 0.90.The final checklist for key issues in national regional medical centers encompassed a total of 6 problems.These included 3 challenges related to establishing sound management systems and mechanisms,1 challenge concerning human resource management improvement,1 challenge focusing on elevating medical service levels,and 1 challenge pertaining to other aspects of progress.Conclusion Currently,the development of national regional medical centers encounters crucial challenges,including the enhancement of management mechanisms,overall human resource management,and medical capabilities.The government should reinforce leadership assurance,coordination,and supervisory responsibilities.Exporting hospitals should enhance management systems and operational mechanisms.Supporting hospitals should focus on effective party building guidance and cooperation while consistently promoting the uniform development of national regional medical centers.

Objective Summarize the key difficult problems faced by national regional medical centers,create a checklist of crucial issues,and propose strategic recommendations to support future development.Methods It employed a combination of literature review,field research,and in-depth interviews to develop an initial draft of the checklist for key issues in national regional medical centers.Additionally,two rounds of Delphi method consultation were conducted with experts from local government,exporting and supporting hospitals.The data gathered from the questionnaires in both rounds were analyzed,and essential questions were identified.Results The questionnaires achieved response rates of 99%and 100%in the two rounds,and the expert authority coefficients were 0.83 and 0.90.The final checklist for key issues in national regional medical centers encompassed a total of 6 problems.These included 3 challenges related to establishing sound management systems and mechanisms,1 challenge concerning human resource management improvement,1 challenge focusing on elevating medical service levels,and 1 challenge pertaining to other aspects of progress.Conclusion Currently,the development of national regional medical centers encounters crucial challenges,including the enhancement of management mechanisms,overall human resource management,and medical capabilities.The government should reinforce leadership assurance,coordination,and supervisory responsibilities.Exporting hospitals should enhance management systems and operational mechanisms.Supporting hospitals should focus on effective party building guidance and cooperation while consistently promoting the uniform development of national regional medical centers.

Objective Summarize the key difficult problems faced by national regional medical centers,create a checklist of crucial issues,and propose strategic recommendations to support future development.Methods It employed a combination of literature review,field research,and in-depth interviews to develop an initial draft of the checklist for key issues in national regional medical centers.Additionally,two rounds of Delphi method consultation were conducted with experts from local government,exporting and supporting hospitals.The data gathered from the questionnaires in both rounds were analyzed,and essential questions were identified.Results The questionnaires achieved response rates of 99%and 100%in the two rounds,and the expert authority coefficients were 0.83 and 0.90.The final checklist for key issues in national regional medical centers encompassed a total of 6 problems.These included 3 challenges related to establishing sound management systems and mechanisms,1 challenge concerning human resource management improvement,1 challenge focusing on elevating medical service levels,and 1 challenge pertaining to other aspects of progress.Conclusion Currently,the development of national regional medical centers encounters crucial challenges,including the enhancement of management mechanisms,overall human resource management,and medical capabilities.The government should reinforce leadership assurance,coordination,and supervisory responsibilities.Exporting hospitals should enhance management systems and operational mechanisms.Supporting hospitals should focus on effective party building guidance and cooperation while consistently promoting the uniform development of national regional medical centers.

Objective Summarize the key difficult problems faced by national regional medical centers,create a checklist of crucial issues,and propose strategic recommendations to support future development.Methods It employed a combination of literature review,field research,and in-depth interviews to develop an initial draft of the checklist for key issues in national regional medical centers.Additionally,two rounds of Delphi method consultation were conducted with experts from local government,exporting and supporting hospitals.The data gathered from the questionnaires in both rounds were analyzed,and essential questions were identified.Results The questionnaires achieved response rates of 99%and 100%in the two rounds,and the expert authority coefficients were 0.83 and 0.90.The final checklist for key issues in national regional medical centers encompassed a total of 6 problems.These included 3 challenges related to establishing sound management systems and mechanisms,1 challenge concerning human resource management improvement,1 challenge focusing on elevating medical service levels,and 1 challenge pertaining to other aspects of progress.Conclusion Currently,the development of national regional medical centers encounters crucial challenges,including the enhancement of management mechanisms,overall human resource management,and medical capabilities.The government should reinforce leadership assurance,coordination,and supervisory responsibilities.Exporting hospitals should enhance management systems and operational mechanisms.Supporting hospitals should focus on effective party building guidance and cooperation while consistently promoting the uniform development of national regional medical centers.