Objective To evaluate pulmonary vascular remodeling,right ventricular function,intestinal barrier integrity,and inflammatory factor expression in rat models of pulmonary hypertension(PH)induced by normobaric hypoxia(NH)and hypobaric hypoxia(HH).We also aimed to compare modeling method and establish an experimental basis for understanding the pathogenesis of PH and for developing appropriate treatment strategies.Methods From June 2024 to December 2024,eighteen 6-week-old male SPF Sprague-Dawley rats were assigned randomly to three groups:normobaric normoxia(Control),NH,and HH groups.Mean pulmonary artery pressure(mPAP)was measured by right heart catheterization.Right ventricular function was assessed using echocardiography and right ventricular hypertrophy index(RVHI).Pulmonary vascular remodeling and intestinal mucosal barrier damage were evaluated via hematoxylin/eosin staining.Colon permeability was quantified by colon ligation followed by fluorescein isothiocyanate-dextran injection.Expression levels of inflammatory factors in lung and colon tissues were analyzed by enzyme-linked immunosorbent assays.Results Right heart function assessment revealed that mPAP was significantly increased(P＜0.05),pulmonary artery acceleration time(PAAT)was shortened,and RVHI and right ventricular free wall thickness(RVFW)were significantly elevated(P＜0.05)in rats in NH and HH groups compared with Control group.Rats in NH group demonstrated a prolonged pulmonary ejection time(PET)and reduced PAAT/PET ratio compared with HH group,indicating more pronounced right heart dysfunction.Pulmonary vascular morphology demonstrated that percentage of medial area percentage(MA％)and percentage of wall thickness percentage(WT％)of pulmonary vessels were significantly higher in NH and HH groups compared with Control group(P＜0.05).Moreover,MA％was markedly increased in the NH group relative to the HH group(P＜0.05),suggesting more severe pulmonary vascular remodeling in NH group.Regarding intestinal injury,rats in NH and HH groups exhibited shorter colon length,increased mucosal damage,and significantly increased permeability compared with Control group(P＜0.05),while rats in HH group showed more prominent inflammatory cell infiltration compared with NH group,confirming intestinal mucosal barrier damage in both groups.In terms of inflammation,expression levels of interleukin(IL)6,IL1β,and IL 17a were significantly elevated in lung and colon tissues from rats in NH and HH groups compared with Control group(P＜0.05).Notably,expression levels of IL6 and IL1 β in lung tissue and IL17a in colon tissue were significantly higher in NH group compared with HH group(P＜0.05),while IL6 expression in colon tissue was relatively lower(P＜0.05),indicating local inflammation in lung and colon tissues in both groups.Conclusions There are phenotypic differences between PH rat models induced by NH and HH,with respect to pulmonary vascular remodeling,right heart function,intestinal mucosal barrier injury,and the expression of inflammatory factors in lung and intestinal tissues.These result demonstrate that air pressure contributes to the pathogenesis and progression of PH.Different air pressures may affect the development of PH via distinct mechanisms,thereby offering critical insights into the pathological changes of PH,potential therapeutic strategies to mitigate disease progression,and the elucidation of inflammatory mechanisms underlying PH based on the lung-intestine axis.

Objective To evaluate pulmonary vascular remodeling,right ventricular function,intestinal barrier integrity,and inflammatory factor expression in rat models of pulmonary hypertension(PH)induced by normobaric hypoxia(NH)and hypobaric hypoxia(HH).We also aimed to compare modeling method and establish an experimental basis for understanding the pathogenesis of PH and for developing appropriate treatment strategies.Methods From June 2024 to December 2024,eighteen 6-week-old male SPF Sprague-Dawley rats were assigned randomly to three groups:normobaric normoxia(Control),NH,and HH groups.Mean pulmonary artery pressure(mPAP)was measured by right heart catheterization.Right ventricular function was assessed using echocardiography and right ventricular hypertrophy index(RVHI).Pulmonary vascular remodeling and intestinal mucosal barrier damage were evaluated via hematoxylin/eosin staining.Colon permeability was quantified by colon ligation followed by fluorescein isothiocyanate-dextran injection.Expression levels of inflammatory factors in lung and colon tissues were analyzed by enzyme-linked immunosorbent assays.Results Right heart function assessment revealed that mPAP was significantly increased(P＜0.05),pulmonary artery acceleration time(PAAT)was shortened,and RVHI and right ventricular free wall thickness(RVFW)were significantly elevated(P＜0.05)in rats in NH and HH groups compared with Control group.Rats in NH group demonstrated a prolonged pulmonary ejection time(PET)and reduced PAAT/PET ratio compared with HH group,indicating more pronounced right heart dysfunction.Pulmonary vascular morphology demonstrated that percentage of medial area percentage(MA％)and percentage of wall thickness percentage(WT％)of pulmonary vessels were significantly higher in NH and HH groups compared with Control group(P＜0.05).Moreover,MA％was markedly increased in the NH group relative to the HH group(P＜0.05),suggesting more severe pulmonary vascular remodeling in NH group.Regarding intestinal injury,rats in NH and HH groups exhibited shorter colon length,increased mucosal damage,and significantly increased permeability compared with Control group(P＜0.05),while rats in HH group showed more prominent inflammatory cell infiltration compared with NH group,confirming intestinal mucosal barrier damage in both groups.In terms of inflammation,expression levels of interleukin(IL)6,IL1β,and IL 17a were significantly elevated in lung and colon tissues from rats in NH and HH groups compared with Control group(P＜0.05).Notably,expression levels of IL6 and IL1 β in lung tissue and IL17a in colon tissue were significantly higher in NH group compared with HH group(P＜0.05),while IL6 expression in colon tissue was relatively lower(P＜0.05),indicating local inflammation in lung and colon tissues in both groups.Conclusions There are phenotypic differences between PH rat models induced by NH and HH,with respect to pulmonary vascular remodeling,right heart function,intestinal mucosal barrier injury,and the expression of inflammatory factors in lung and intestinal tissues.These result demonstrate that air pressure contributes to the pathogenesis and progression of PH.Different air pressures may affect the development of PH via distinct mechanisms,thereby offering critical insights into the pathological changes of PH,potential therapeutic strategies to mitigate disease progression,and the elucidation of inflammatory mechanisms underlying PH based on the lung-intestine axis.

Objective:To explore the clinical application value of Bodyfix fixation device in stereotactic body radiotherapy (SBRT) for elderly patients with lung cancer.Methods:The clinical data of 63 elderly patients with lung cancer who received SBRT in Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology from January to October 2021 were retrospectively analyzed. According to different fixation methods, the patients were divided into Bodyfix combined with vacuum bag fixation device group (Bodyfix group, 20 cases) and 4D respiratory gating technology combined with vacuum bag fixation device group (vacuum bag group, 43 cases). Cone beam CT (CBCT) was used for position verification before each treatment, linear and rotational errors in the horizontal (X), head-to-foot (Y), front-to-back (Z) directions were recorded.Results:The linear errors of Bodyfix group in the X, Y and Z directions were 1.7 mm (1.3 mm, 3.0 mm), 4.6 mm (4.3 mm, 5.3 mm) and 1.3 mm (0.8 mm, 2.8 mm), and the rotational errors were (0.46±0.04)°, (-0.48±0.05)° and 0.64°(0.38°, 1.07°); the linear errors of vacuum bag group in the X, Y and Z directions were 2.1 mm (1.6 mm, 3.3 mm), 2.8 mm (1.8 mm, 3.7 mm) and 3.0 mm (2.3 mm, 3.8 mm), and the rotational errors were (0.69±0.04)°, (-0.70±0.04)° and 0.64° (0.42°, 0.86°). The differences in linear errors in the Y and Z directions and rotational errors in the X and Y directions between the two groups were statistically significant ( P values were <0.001, <0.001, 0.003 and 0.007). Conclusions:Compared with the 4D respiratory gating technology, the Bodyfix fixation device has smaller rotational errors in the X and Y directions and linear errors in the Z direction. It can be used as an effective method of postural fixation for SBRT in elderly patients with lung cancer.

BACKGROUND:Previous studies have found that electroacupuncture can delay articular cartilage degeneration mediated by JAK-STAT signaling pathway through upregulating the expression level of transforming growth factor β1 as well as mRNA expression levels of STAT3, Smad3 and LepR. In the meanwhile, electroacupuncture can inhibit the mRNA expression of p38 and Fas mRNA mediated by MAPK signaling pathways, further inhibiting the apoptosis of chondrocytes. OBJECTIVE: To explore the effect of electroacupuncture on the degeneration of articular cartilage in rats with knee osteoarthritis based on Ras-Raf-MEK1/2-ERK1/2 signaling pathway. METHODS:120 male healthy Sprague-Dawley rats aged 2 months olds were selected and randomly divided into normal, model, 15-minite electroacupuncture and 30-minute electroacupuncture groups (n=30 per group). The rats in the latter three groups received the intra-articular injection of 4% papain bilaterally, and the remaining rats received no intervention. At 2 weeks after modeling, the latter two groups were respectively given 15- and 30-minute electroacupuncture, five times weekly for consecutive 12 weeks. The morphology of the cartilage was observed by hematoxylin-eosin staining, the expression level of interleukin-1β in the synovium was detected by ELISA assay, and the protein expression levels of Ras, Raf, MEK1/2, ERK1/2, C-MYC, C-FOS, and C-JUN were detected by western blot analysis. RESULTS AND CONCLUSION: Hematoxylin-eosin staining showed that: in the model group, the cartilage surface was rough, the cartilage layer became thinner, and the cartilage structure was damaged with incomplete tidal line; in the 15- and 30-minute electroacupuncture groups, the cartilage structure was complete with clear layers and complete tidal line. ELISA showed that the expression level of interleukin-1β in the model group was significantly higher than that in the normal group (P< 0.01), and the level in the 15- and 30-minute electroacupuncture groups was significantly lower than that in the model group (P < 0.05). Western blot assay found that compared with the normal group, the protein expression levels of Ras, Raf, MEK1/2, ERK1/2, C-MYC, C-FOS, and C-JUN were increased in the model group. However, all above protein levels except ERK1/2 in the 15- and 30-minute electroacupuncture groups were significantly lower than those in the model group (P < 0.01,P < 0.05). To conclude, electroacupuncture inhibits the degeneration of articular cartilage in osteoarthritisvia Ras-Raf-MEK1/2-ERK1/2 signaling pathway and downregulating the expression level of interleukin-1β.

Objective To analyze the prevention condition of skin tears of inpatients in level-III hospitals, so as to provide basis for making prevention strategies.Methods 14 level-III hospitals were involved in the cross-section survey. Within the same time period, using the same research tools, methods and procedure, 964 trained nurses inspected patients from head to toes, who were selected by convenience sampling, with hospital stay ≥24 h, with age≥18 years old, and with signature on the informed consent documents, and also investigated implementation of prevention measures. Results A total of 18 806 effective cases were obtained, with 238 locations of skin tears in 199 patients found. Incidence of hospital-acquired skin tears was 1. 06%. Implementation rate of risk assessment and nutrients and water supplement was 3. 92% and 10. 35%. Implementation rate of prevention of falling and falling down from bed was 51. 58% and 47. 20%. Usage of assistant tools and emollients accounted for 28. 23% and 2. 69%. Adopting suitable moving techniques and wearing long sleeves, trousers or long stockings accounted for 8.07% and 6.95%. Differences of incidence rate, risk assessment and implementation of prevention measures of skin tears among teaching hospitals, comprehensive hospitals and specialty hospitals were statistically meaningful ( P < 0. 05 for all ) . Conclusions Risk assessment and prevention of skin tears in these 14 level-III hospitals were not satisfactory. Prevention measures vary from different types of the hospitals. In future, nurses should be trained to strengthen awareness of risk assessment and prevention, and implementation rate and consistency of preventive measures should be improved.

Objective To evaluate the combination of the mortality in emergency department sepsis (MEDS) score with blood lactate level in the risk stratification of patients with severe sepsis in the emergency department (ED).Methods 665 adult patients with severe sepsis admitted from May 2011 to December 2012 in ED were found to be eligible for the study.MEDS score,acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score,and arterial blood lactate was determined,and the outcomes in 28 days were recorded.Logistic regression analysis was used to evaluate the relationship between each predictive factor score and prognosis.Each predictive factor was compared with the areas under the receiver operating characteristics (ROC) curve (AUC).Results The mortality in 28 days was 34.6％ in 665 patients.The mortality in group of MEDS score 12-27 was significantly higher than that group of MEDS score＜12 [51.0％ (156/306) vs.20.6％ (74/155),x2=28.414,P=0.000].In the meantime,APACHE Ⅱ score and blood lactate level were also significantly higher in group of MEDS score 12-27 than those in group with MEDS score＜12 [APACHE Ⅱ score:26.4 ± 10.6 vs.21.7 ± 8.1,t=-3.555,P=0.002; lactate (mmol/L):4.9 (2.3,9.9)vs.3.9 (1.5,8.9),Z=-2.352,P=0.023].Kaplan-Meier survival analysis showed significantdifference in the two groups (the Log Rank test 36.71,P ＜0.01).The levels of 3 predictive factors were predominantly higher in non-survivors than survivors [MEDS score:14.1 ± 6.7 vs.8.2 ± 4.5,t=-6.929,P=0.000; APACHE Ⅱ score:28.1 ±7.1 vs.22.2± 11.3,t=-6.472,P=0.000; lactate (mmol/L):5.4 (2.9,11.0) vs.3.8 (1.2,9.1),t=-6.472,P=0.004].The AUCs were 0.813,0.706 and 0.727 for MEDS score,APACHE Ⅱ score and blood lactate respectively.The predictive ability for 28-day mortality of MEDS score was better than blood lactate (P=0.008) and APACHE Ⅱ score (P=0.005).The AUC of MEDS score combined with lactate was 0.865,and 28-day mortality prediction was better than MEDS score (AUC 0.865 vs.0.813,P＜0.001).The sensitivity (83.1％),specificity (93.2％),positive prediction value (PPV,62.4％),and negative prediction value (NPV,92.1％) for MEDS score combined with lactate were highest among all predictors.Conclusion MEDS score combined with lactate is a good risk stratification tool for emergency patients with severe sepsis,and its prognostic capability is better than either MEDS score,APACHE Ⅱ score or blood lactate.

Objective To investigate whether the combination of glipizide-XL with glucophage was more rational in insulin resistance and insulin secretion in patients with type 2 diabetes mellitus(T2DM).Methods The changes of insulin resistance and insulin secretion were evaluated from variations of IAI(insulin sensitivity index),IR(insulin resistance index.),IS(insulin secretion index)and HBCI(B-ce1l function index)in cases treated with glipigide-XL and glucophage or either for 18 weeks.Results IAI\IR standing for insulin resistance were higher significantly,and IS & HBCI standing for insulin secretion were lower significantly in patients with T2DM than in normal group(P