Objective:To investigate the therapeutic effect of exosomes derived from remote ischemic conditioning on neurological dysfunction after cardiopulmonary resuscitation in a rat model of cardiac arrest and the relationship with glycocalyx protection.Methods:Exosomes were isolated from the blood of healthy adult male Sprague-Dawley rats using ultracentrifugation after undergoing remote ischemic conditioning for use as intervention drugs. Nanoparticle tracking analysis technology was used for exosome detection. Thirty-six adult male Sprague-Dawley rats were randomly assigned to 3 groups ( n=12 each) :Sham group, Control group and Exosome group. Cardiac arrest was induced by asphyxia for 7 min in the Control and Exosome groups. Placebo or exosomes (1×10 10 Particles) were infused intravenously at 5 min after the rats had returned of spontaneous circulation. Neuropsychological deficit score (NDS), open field test, Y maze and Morris water maze were used to assess neurological outcomes. The levels of plasma Hyaluronic acid (HA) and syndecan-1 (Sdc-1) were detected by Elisa. The expression levels of matrix metalloproteinase-2/9 (MMP-2/9) in hippocampal CA1 region were detected by Western blot. Results:After undergoing remote ischemic conditioning, the plasma levels of exosomes were elevated in rats compared to normal rats. Compared with the control group, the behavioral experiment of rats in the exosomes group were significantly improved, as evidenced by an increase in horizontal locomotor distance (5.86±2.89 vs. 17.53±5.51, P< 0.05), an increase in the correct rate of spontaneous alternation (13.29±15.07 vs. 42.63±10.25, P< 0.05), and a shortening of avoidance latency (25.83±8.54 vs. 13.49±4.55, P< 0.05). Plasma HA and Sdc-1 levels were significantly lower 24 h after resuscitation (HA: 26.34±9.83 vs. 14.84±6.26, P< 0.05; Sdc-1: 0.05±0.03 vs. 0.02±0.02, P<0.05), along with significantly lower MMP-2/9 levels in hippocampal tissue. Conclusions:Exosomes extracted from the plasma of rats undergoing remote ischemic conditioning can improve neurological dysfunction after cardiac arrest in rats, and the mechanism may be related to the inhibition of metalloproteinases and the reduction of endothelial glycocalyx degradation.

Objective To obsOrvO thO safOty and OffOct of intraopOrativO cOll salvagO and autologous blood transfusion during cOsarOan sOction with cOntral placOnta prOvia.Methods From April 2015 to March 2016, 25 prOg-nants with cOntral placOnta prOvia diagnosOd by MRI and ultrasound and undOrwOnt sOlOctOd caOsarOan sOction in thO POoplO′s Hospital of WOnzhou wOrO includOd. WhOn thO amount of blood in thO rOcovOry tank was 450 mL or thO obstOtrician rOquirOd, thO wash and rOtransfusion dOvicO was startOd-up. Hb and Hct wOrO mOasurOd bOforO and aftOr thO parturiOnt, and thO blood was rOcovOrOd. ThO blood loss, rOcovOry of blood, blood transfusion, allogOnOic RBC infusion and thO sidO OffOcts aftOr transfusion and 42 d of postpartum wOrO rOcordOd.Results No sOrious complica-tions wOrO rOcordOd in all prOgnants. FivO casOs(20% ) wOrO only rOcovOrOd and thO autologous blood transfusion and transfusion of thO allogOnOic RBC wOrO not carriOd out. In 14 casOs(56% ),only thO autologous blood was rOturnOd to thO puOrpOra. ThO volumO of blood transfusion was 705 mL(430,1 535). Six casOs(24% ) had massivO blOOding during thO opOration,3690 mL(1 900,8 750),and thO autologous blood transfusion volumO was 2939 mL(1 167, 4 206),and thO allogOnOic RBC transfusion was 3.5U(1.5,11.5).Conclusion Autologous blood transfusion can bO usOd safOly in thO caOsarOan sOction of thO cOntral placOnta prOvia, and can rOducO thO allogOnOic RBC transfusion.

Objective To investigate the effect of Astragalus injection combined with low molecular weight heparin and nifedipine on levels of related indexes and pregnancy outcomes in patients with preeclampsia.Methods A total of 60 patients with preeclampsia from March 2013 to December 2016 in Cixi Municipal Maternal and Child Care Hospital were selected and randomly divided into the study group and control group, with 30 cases in each group.All patients were given spasmolysis, diuretic and other conventional treatment.The control group were treated with low molecular weight heparin and nifedipine while the study group were additionally treated with Astragalus injection.The blood pressure, blood coagulation and other laboratory indicators in the two groups were monitored before and after treatment , and the incidence of pregnancy complications and pregnancy outcomes in the two groups were statistically analyzed.Results There was no significant difference in blood pressure, human chorionic gonadotropin (β-hCG), alpha fetoprotein (AFP) and blood coagulation function indexes in the two groups before treatment .After treatment, the blood pressure,β-hCG, AFP, platelet count (PLT), prothrombin time (PT), activated partial thromboplastin time (APTT), plasma fibrinogen (FIB) and D-dimer (D-D) were significantly improved, the difference was statistically significant ( P<0.05).After treatment, the diastolic and systolic blood pressure, β-hCG, AFP, PLT, FIB and D-D levels in the study group were significantly lower than those in the control group, the difference was statistically significant ( P<0.05), PT and APTT were significantly longer than those in the control group, the difference was statistically significant (P<0.05).The incidence rates of pregnancy complications ( uterine inertia, premature rupture of membrane, fetal distress, placental abruption) and adverse pregnancy outcomes (cesarean section, neonatal asphyxia) in the study group were significantly lower than those in the control group, the difference was statistically significant (P<0.05).Conclusion The application of Astragalus injection combined with low molecular weight heparin and nifedipine in the clinical treatment of patients with preeclampsia can effectively control the blood pressure level and other parameters , reduce pregnancy complications and improve pregnancy outcomes.

Most of the current experiments are obsolete and verified,the students are not interested in and the experiments are out of touch with the actual work.These are the common problems in the experiment teaching of occupational health and occupational medicine.By taking the students who majored in preventive medicine as the subjects,this study aimed to explore the effects of independent designed experiment teaching mode,which was based on dividing the groups before class,choosing the projects by students themselves,deciding the design of the program via the discussion of teacher and students and doing the experimental reports and sharing the experience.The results showed that,in the premise of the preliminary master of the theory and basic skills of occupational health and occupational medicine,carrying out independent designed experiments in the last three weeks of semester,to a certain extent,could arouse students' interest in learning,cultivate their abilities of independent thinking,practice,problem analysis and solution,and team cooperation.However,restricted by lack of teachers,inadequate equipment and high cost and other factors,this teaching mode is only suitable for small class.

Objective:To investigate the effects of Mor-platin, a novel mitochondrial platinum complex, on proliferation and migration of human hepatoma carcinoma HepG2 cells. Methods:Cell counting kit-8 (CCK-8) assay was used to analyze cell proliferation of Mor-platin and classic anticancer drugs, particularly cisplatin, in HepG2 cells. A laser confocal microscope was used to observe whether Mor-platin can target mitochondria. The morphological changes in cellular mitochondria after treatment with Mor-platin were ob-served on a transmission electron microscope. Cell apoptosis was measured by flow cytometry, and cell invasion was evaluated by three-dimensional tumor spheroid model. Results:Mor-platin can inhibit cell proliferation and is dose dependent. The half inhibitory concentration (IC50) of Mor-platin is lower than that of cisplatin. Laser confocal images showed that Mor-platin can target cell mito-chondria and enrich cell mitochondria. Transmission electron microscopy images showed that cell mitochondrial morphology changed after Mor-platin treatment. Furthermore, cell mitochondrial membrane is incomplete and mitochondrial cristae are reduced. Cell apoptosis caused by Mor-platin is dose dependent. The three-dimensional tumor spheroid model showed that the cell areas of the group subjected to Mor-platin treatment are smaller than those of the control group. Conclusion:Mor-platin can target cell mitochon-dria, change the cell mitochondrial morphology, inhibit cell proliferation, and thus promote cell apoptosis. It also showed better anti-cancer effects than cisplatin. Furthermore, Mor-platin can inhibit three-dimensional tumor spheroid invasion. These results suggest that Mor-platin is a potential antitumor drug.

Objective To investigate the effect of deltaNp63(ΔNp63) silencing on the proliferation of pancreatic cancer PANC1 cells.Methods ΔNp63 mRNA level in 23 pairs of pancreatic cancer and adjacent tissue specimen was detected by real-time PCR, andΔNp63 protein in human normal pancreatic ductal cell line HPDE6-C7 and pancreatic cancer cell line PANC1, CFPAC1 and BXPC3 was detected by Western blot. PANC1 cells were transfectedΔNp63 specific siRNA (ΔNp63-siRNA ) and scramble siRNA ( Con-siRNA ) using liposome, and untransfected cells served as control.ΔNp63 mRNA and protein was detected by real-time PCR and Western blot to validate the silencing ofΔNp63 expression.MTT assay and BrdU method were used to detect the proliferation and DNA synthesis of transfected PANC1 cells.Results TheΔNp63 mRNA expression in pancreatic cancer tissues and matched adjacent normal tissues was 0.99 ± 0.07 and 0.70 ±0.07, respectively.ΔNp63 mRNA expression in pancreatic cancer tissue was significantly up-regulated compared with that in the normal tissue (P=0.0034).TheΔNp63 protein expression in HPDE6-C7, PANC1, CFPAC-1 and BxPC3 cells was 0.97 ±0.09,3.06 ±0.16,2.57 ±0.11 and 2.45 ±0.08, respectively.TheΔNp63 protein level in pancreatic cancer cells were higher than that in HPDE6-C7 cells (P<0.001).ΔNp63 mRNA level in control, Con-siRNA and ΔNp63-siRNA group was 0.97 ±0.07,0.97 ±0.07 and 0.28 ±0.03, respectively, andΔNp63 protein expression level was 0.97 ±0.06,1.00 ±0.10 and 0.26 ±0.03.The expression ofΔNp63 mRNA and protein inΔNp63-siRNA group were significantly down-regulated comparing with those in Con-siRNA group (P<0.01).Significant inhibition on cell proliferation was observed in ΔNp63-siRNA group, which was statistically different from that in control and Con-siRNA group.The A490 value (DNA synthesis) of control, Con-siRNA andΔNp63-siRNA group was 0.55 ±0.04, 0.56 ±0.01 and 0.55 ±0.00 at 24 h after transfection, and 0.84 ±0.05,0.87 ±0.07 and 0.71 ±0.05 at 48 h after transfection.The DNA synthesis inΔNp63-siRNA group was significantly down-regulated compared with that in control and Con-siRNA group (P<0.05).Conclusions Knockdown ofΔNp63 could greatly inhibit the proliferation and DNA synthesis of pancreatic cancer PANC1 cells.

To improve the quality of experimental teaching,investigating the independent design experiments are carrying out in preventive medicine by public health experimental teaching center in our school.We take preventive medicine professional as an example,and besides the classical basis experiments,some experiments are verification project at present,in which students are not strongly interested.On the basis of the integration of the classic experiments,according to the national standard of the experimental method,we are trying to carry out part of the independent design experiments to meet the needs of students learning.The effect of those independent design experiments shows that it is appropriate carrying out independent design experiments on the basis of the existing classical experimental project in preventive medicine experimental teaching,to a certain extent,which will stimulate students' learning interest and enhance their sense of achievement.This study is conducive to the cultivation of medical students' innovation,independent thinking,analysis and problem-solving ability,practical ability and teamwork spirit.

Objective To explore the effect of Yi Xuesheng Jiaonang combined with Iron Sucrose Injection on anemia in pregnancy on serum transferrin receptor and pregnancy outcome.Methods 78 patients with anemia in pregnancy form December 2014 to December 2015 of the third people’s Hospital of Cixi were collected and randomly divided into control group and treatment group,each had 39 cases.Control group was given 200 mg Iron Sucrose Injection with 100 mL 0.9%sodium chloride injection intravenous infusion,2 times a week; experiment group were treated on the base of control group with 4 pills of Yi Xuesheng Jiaonang,3 times daily.The course was 28d,and two groups all with a course treatment.After the end of treatment,clinical curative effect,serum transferrin receptor level,liver and renal function and the incidence of adverse pregnancy outcome were observed and compared. Results Serum transferrin receptor levels were increased in two groups after treatment (P<0.05),compared with control group,serum transferrin receptor level of treatment group was even higher (P<0.05), alanine aminotransferase (ALT),aspartate aminotransferase (AST),serum creatinine (Cr) and urea nitrogen ( BUN) and other indicators of liver and kidney function of experiment group had no statistical significance.Adverse pregnancy outcome rate betwen two groups was not statistically significant.Conclusion Yi Xuesheng Jiaonang combined with Sucrose Iron Injection therapy for patients with anemia of pregnancy can significantly increased serum transferrin receptor levels,has higher safety and low adverse pregnancy outcomes rate.

Beta2 adrenergic receptor (β2 AR) is one member of G protein coupled receptors (GPCRs), which is a key pharmaceutical target in the treatment of asthma. Evolutionary trace (ET) method was employed to analyze AR sequences and 44 conserved residues were identified. Then molecular dynamics (MD) simulation of the β2 wild-type receptor, D130N active mutant and D79N inactive mutant were carried out and tried to explore the structural/dynamic features characterizing functionally different states of the receptor,by means of investigating ET identified conserved basic residues in the wild-type receptor and its two mutants. Particularly, it was found that the departing of D130 from R131 of DRY motif and approaching to K149 are highly correlated with the receptor activation,and the movement of helix 2, 4 and 6 upon receptor activation is inferred from the observation that R151 and K270 interact with other residues in the receptor active state on the basis of little change of the side chain orientations. The results might provide further insights into the activating mechanism of β2 AR mutants, as well as the molecular bases of the diseases induced by the mutations of the receptor.

Objective To study on imagination features of tumor thrombi in the portal vein of primary liver cancer (PLC). Methods We established a new type system of tumor thrombi, with Ⅰ 0 to Ⅳ, a total of 5 types and 8 sub-types in the portal vein of PLC based on normal intrahepatic portal vein anatomy and growing features of the tumor thrombi. The relationship between the types and the imaging diagnosis of 130 PLC cases with tumor thrombi in the portal vein was studied. Results 85%(110/130) cases of PLC with tumor thrombi in the portal vein belongs to type Ⅱ or Ⅲ when being first diagnosed in the hospital. The resectability rates for type Ⅰ, Ⅱ, Ⅲ, Ⅳ were 62%(5/8), 16%(10/62), 10%(5/48), 0 (0/12), respectively, and chemoembolization therapy (TACE) was given in 38%(3/8), 40%(25/62), 27%(13/48), 16%(2/12), respectively. Conclusions The new types of tumor thrombi are helpful for diagnosis and treatment of PLC with tumor thrombi in the portal vein.