Objective To investigate the potential role of estrogen in the formation of granulation tissue hyperplasia-induced tracheal stenosis in rats.Methods Twenty-four female SD rats were ran-domly divided into three groups(n=8)using a random number table method:sham group(n=8),ovariectomized(OVX)group(bilateral ovariectomy,n=8),and ovariectomized+estrogen(OVX+E2)group(bilateral ovariectomy followed by exogenous estrogen intervention,n=8).Four weeks af-ter establishment of the Sham and OVX rat models,a granulation tissue hyperplasia-induced tracheal stenosis model was constructed in all rats using the oral nylon brush scraping method.On the first day of modeling,rats in the OVX+E2 group were administered 17β-E2 at a dose of 300 μg/kg via intrap-eritonealinjection daily,while rats in the other two groups were given the same volume of normal saline.After 7 consecutive days of administration,tracheal specimens were obtained.Hematoxylin and eosin(HE)staining was used to observe the pathological changes of tracheal granulation tissue hyperplasia in each group and calculate the tracheal stenosis rate.Masson staining was employed to analyze the collagen fibers in the tracheal granulation tissue and calculate the relative collagen deposition area.Immunohistochemical(IHC)staining was used to detect the protein expression levels of transforming growth factor-beta 1(TGF-β 1),vascular endothelial growth factor(VEGF),alpha-smooth muscle actin(α-SMA),and collagen type Ⅰ(COL-Ⅰ)in the tracheal granulation tissue,and the average optical density(AOD)was calculated.Results HE staining revealed granulation tissue hyperplasi-a and tracheal lumen stenosis in the tracheal walls of all three groups.The stenosis rate was the highest in the OVX+E2 group,followed by the sham group,and the lowest in the OVX group,with statistically significant differences(P＜0.05).Masson staining showed that the collagen fibers in the sham group were thicker and denser with more collagen deposition compared to the OVX group.In contrast,the OVX+E2 group had even thicker and denser collagen fibers with more collagen dep-osition than the sham group.IHC staining demonstrated that the protein expression levels of COL-Ⅰ,TGF-β1,VEGF,and α-SMA in the tracheal granulation tissue were the lowest in the OVX group,fol-lowed by the sham group,and the highest in the OVX+E2 group.Conclusion Estrogen can acceler-ate tracheal granulation tissue hyperplasia by upregulating the protein expression levels of COL-Ⅰ,TGF-β1,and VEGF,as well as promoting fibroblast activation,leading to aggravated tracheal stenosis.

ObjectiveTo investigate the current status of cognition and attitude towards hospice care among medical staff in Liaocheng，analyze the related influencing factors，and to provide reference for further development of hospice care services. MethodsUsing the method of convenient sampling，404 medical staff from all levels of hospitals in Liaocheng were selected as the research subjects from January to June 2022 to conduct a questionnaire survey on the cognition and attitude towards hospice care.Statistical methods were used to analyze the related influencing factors. ResultsThe knowledge score of hospice care among medical staff in Liaocheng was （13.02 ± 4.10），with an average score rate of 65.10%.The score of attitude was （38.67 ± 5.64），with an average score rate of 64.50%.Age （41~50 years old），having received education and training，treated or cared for patients in the middle and late stages，and understanding ethics and morality，as well as cultural customs were significantly positively correlated with knowledge scores.Age （> 50 years old），professional title （deputy senior professional title），position （medical treatment），and experience in treating or caring for patients in the middle and late stages were positively related to attitude scores. ConclusionThe cognition and attitude towards hospice care among medical staff in Liaocheng were at a moderate level.Strengthening the construction of a standardized hospice care system is helpful to improve the cognition and attitude level towards hospice care among medical staff.

Objective To explore the influence of impulsivity on digital addiction tendencies in patients with Wilson disease(WD)and its related factors.Methods A total of 66 patients with WD were included in the study which were divided into neurological WD group(42 cases)and hepatic WD group(24 cases)according to clinical manifestations.Sixty-six WD patients were included as the study subjects,including 24 cases of hepatic WD and 42 cases of neurological WD.The Chinese version of the Barratt impulsiveness scale(BIS-11-C)was used to assess patients'impulsiveness.Mobile phone addiction index(MPAI)evaluates the degree of dependence on mobile phone use.Cranial MRI was used to examine the location and cumulative frequency of the diseased brain region.Results Among the 66 WD patients,45 cases(68.2% )had the tendency of digital addiction,including 35 cases(53.0% )in the neurological WD group and 10 cases(15.2% )in the hepatic WD group.There was a statistically significant difference in the proportion of the two types of WD patients(P=0.001).The scores of BIS-11-C and MPAI scales in neurological WD group were higher than those in hepatic WD group(P<0.05).The out-of-control score in the MPAI scale is positively correlated with the attention impulsivity score(r=0.499,P=0.001),motor impulsivity score(r=0.553,P=0.001),unplanned impulsivity score(r=0.535,P=0.001),and impulse control score(r=0.653,P=0.001)in the BIS-11-C scale.Linear regression analysis showed a correlation between attention impulsivity score and frontal lobe lesions(B=-1.634,P=0.018).There was a correlation between loss of control score and frontal lobe lesions(B=-3.609,P=0.023).The withdrawal score was associated with the thalamus lesions(B=-5.047,P=0.007)and frontal lobe lesions(B=-2.204,P=0.024).Avoidance score was associated with parietal lobe lesions(B=-1.867,P=0.032).The low efficacy score was associated with the putamen lesions(B=-1.789,P=0.016)and frontal lobe lesions(B=-1.592,P=0.044).Conclusion Neurological WD patients have higher tendency of digital addiction than hepatic WD patients and the tendency of digital addiction is related to impulsivity.The digital addiction tendency of WD patients may be related to impulse control disorders caused by lesions in multiple brain regions such as the putamen,thalamus,and frontal lobe.

Objective:To investigate the interfering factors in the determination of creatinine(Cr) using the American Clinical Laboratory Standards Association (CLSI) EP7-A3 document.Methods:According to the CLSI EP7-A3 document, fresh serum (no hemolysis, lipemia, and jaundice) was used on the day of the experiment and confirmed the interfering substances through the pairing difference experiment and the point-to-point analysis method was used in the dose effect experiment to clarify the difference of interfering substances.Results:Triglyceride (16.94 mmol/L), dobutamine hydrochloride (4.01 μmol/L), ascorbic acid (298 μmol/L) did not interfere with the determination of Cr. Free bilirubin (684 μmol/L), conjugated bilirubin (684 μmol/L), calcium hydroxybenzene sulfonate (144 μmol/L) and hemoglobin (10 g/L) were used as the maximum concentrations of interferences for the dose effect test, the results showed that the above interferences had negative interference on the determination of Cr.Conclusion:According to EP7-A3, it is valuable to evaluate the interference factors of creatinine determination.

[Objective]To compare the clinical outcomes of fresh embryo transfer of the in vitro fertilization/intracytoplasmic sperm injection and embryo transfer(IVF/ICSI-ET)in different age groups as well as in different responders using gonadotropin-re-leasing hormone agonist(GnRH-a)long protocol or GnRH antagonist(GnRH-ant)protocol.[Methods]A retrospective analysis was performed on 737 IVF/ICSI cycles,including 386 cycles of GnRH-a long protocol(group A)and 351 cycles of GnRH-ant protocol (group B),from August 28,2015 to December 31,2016. Then all the cycles were divided into sub-groups by ages and retrieved oo-cyte numbers:group a1(<38 years),group a2(≥38 years);group b1(n≤5),group b2(6≤n≤15),group b3(n>15). The basic information of patients and clinical outcomes were compared.[Results](1)Comparable results were obtained from group A and group B in these following variables such as fertilization rate,normal fertilization rate,biochemical pregnancy rate and miscarriage rage. But the stimulation period,the total gonadotropin(Gn)dosage,estradiol(E2)level and endometrial thickness on the day of human chorionic gonadotropin(hCG)administration,number of oocytes retrieved and mature oocytes,ovarian hyperstimulation syn-drome(OHSS)rate,implantation rate and clinical pregnancy rate were significantly higher in group A than group B(P<0.05),and significantly higher cancellation rate of fresh embryo transfer was observed in group B(P<0.001).(2)When divided by ages,no mat-ter in sub-group a1 or sub-group a2,the implantation rate was slightly lower in GnRH-ant protocol than in GnRH-a long protocol, although they failed to reach significant difference(sub-group a1:32.6%vs 39.8%,P=0.067;sub-group a2:9.7%vs 17.9%,P=0.066). The clinical pregnancy rate was comparable using these two protocols in sub-group a1(54.8%vs 50.4%,P=0.429),but it was significantly lower by using GnRH-ant protocol than GnRH-a long protocol in sub-group a2(19.6%vs 39.1%,P=0.021).(3) When divided by numbers of oocytes retrieved,the implantation rate was significantly lower when using GnRH-ant protocol in sub-group b1(13.1%vs 26.0%,P=0.026),but we failed to observe significant differences in other two sub-groups. The clinical preg-nancy rates were comparable in all sub-groups ,whereas differed considerably in sub-group b1 (36.6% vs 19.3%,P = 0.056).[Conclusion]Overall,the implantation rate and clinical pregnancy rate were higher in GnRH-a long protocol than those in GnRH-ant protocol. Nevertheless,GnRH-ant protocol could reduce the dosage of Gn,shorten the treatment duration,and effectively reduce the occurrence of OHSS. There were similar pregnancy outcomes in two protocols for normal responders and high responders ,while for advanced patients or other poor responders,the implantation rate and clinical pregnancy rate were higher in GnRH-a protocol.

Objective To observe the inhibitory effect of the extracts of Nidus Collocaliae on avian influenza A H5N1 virus in vitro. Methods Nidus Collocaliae water extract, artificial gastric juice digestion products of Nidus Collocaliae water extract, and artifitial intestinal juice digestion products of Nidus Collocaliae water extract were prepared for the experimental study. 293T cells transfection in vitro was carried out. The effects of 3 kinds of Nidus Collocaliae extracts on H5N1 pseudovirus and VSV-G pseudovirus were determined by luciferase detection kit. Blood clotting response to erythrocyte hemagglutinin subtypes H5, H7, H9 antigens and the inhibitory effects of 3 kinds of Nidus Collocaliae extracts were observed. The effects of 3 kinds of Nidus Collocaliae extracts on neuraminidase activity were determined by neuraminidase inhibitor screen kit. Results The 3 kinds of Nidus Collocaliae extracts had inhibitory effects on H5N1 avian influenza pseudovirus, the effects being enhanced with the increase of the concentrations of Nidus Collocaliae extracts. Of the 3 extracts, artificial intestinal digestion products had the strongest inhibitory effect, while Nidus Collocaliae water extract had the weakest effect. However, Nidus Collocaliae extracts had no obvious effect on VSV-G pseudovirus. The concentration of H5, H7 antigen for positive blood clotting response was 1 ∶ 128, and that of H9 antigen was 1 ∶ 256. The 3 kinds of Nidus Collocaliae extracts at certain concentrations could inhibit blood clotting response to H5, H7, H9 antigen, but had no obvious effect on neuraminidase. Conclusion The anti-H5N1 virus effect of Nidus Collocaliae extracts has been achieved probably through resisting hemagglutinin.

Objective To study effect of positive liver soup on serum leptin (LEP), adiponectin (ADP) and insulin resistance (IR) in patients with hepatitis B cirrhosis.Methods 68 cases of hepatitis B patients with cirrhosis according to randomized divided into the control group (34 cases) and treatment group (34 cases).Oral treatment administered to the control group (Inosine Tablets and vitamin C),treatment group in the control group based on liver soup treatment, treatment for 3 months, serum leptin (LEP),adiponectin (ADP) and insulin resistance (IR) index before and after treatment were detected.Results Before treatment, there was no significant difference between ADP and LEP in the control group and the treatment group.After 3 months of treatment, there was no significant difference between ADP and LEP level in control group, while the level of ADP and LEP in treatment group were significantly decreased (P<0.05), and were significantly lower than that in control group (P<0.05).There was no significant difference in FPG, fasting insulin level and IRS index between the control group and the treatment group before treatment.After 3 months of treatment, the control group FPG, fasting insulin level and IRS index were not significantly different.FPG, fasting insulin and IRS index in the treatment group were significantly decreased (P<0.05), and were significantly lower than those in the control group (P<0.05).Conclusion Positive liver soup can reduce serum LEP, ADP level, and improve IR in treatment of hepatitis B liver cirrhosis.

ObjectiveTo investigate the degree of acceptance of Emergency Medicine and the abilities of first aid in senior medical students, and study the methods of how to improve their abilities and skills.MethodsA random sample survey methodology.ResultsA total of 146 medical students of clinical medicine were surveyed.99.32％ of student believed that emergency medicine was essential and necessary in their learning process.The knowledge of first aid would play important role for their future work.55.48％ of students considered that there were partial overlaps in teaching content in emergency medicine and internal medical and surgery.Senior medical students accessed to knowledge mainly through books,followed by the Internet,television and newspapers and their first aid knowledge and skills were poor.ConclusionEmergency medical teaching should be focused on highlighting its characteristics.The visualization of the operation and standardized assessment will help to strengthen students' mastery of first-aid knowledge and skills.

Objective To observe the tendency of the plasma concentration of plasminogen activator inhibitor type-1 (PAI-1) and thrombin activatable fibrinolysis inhibitor (TAFI) before and after thrombolytic treatment of acute ST elevation myocardial infarction (STEMI) and to explore their recanalization predictive value of PAI-1 and TAFI for acute myocardial infarction patients with thrombolytic treatment.Methods Sixty patients,who received thromobolytic treatment from January 2007 to March 2009,were prospectively recruited.The blood sample were collected within 2 hours of thromobolytic treatment ( 0,0.5 h,1 h,1.5 h and 2 h).The plasma concentration of TAFI and PAI-1 were test by ELISA.16 healthy people were recruited as control group.Results The plasma levels of PAI-1 in STEMI patients before thrombolytic treatment were higher than those of Control group ( P ＜0.01 ),however the same significant change of TAFI level was not seen.The levels of TAFI were no significant difference before and after thrombolytic therapy during whole observation periods.However,the level of PAI-1 increased at 1.5 h and 2 h after thrombolytic therapy (P ＜ 0.01 ).The plasma PAI-1 levels of no - revascularigation group at 2 h after thrombolytic therapy were significant higher than that in revascularization group ( P ＜ 0.05 ).The levels of TAFI were not significantly different between two groups (P ＞ 0.05).Conclusions The decrease of plasma PAI-1 from high level within 2 hours after thrombolysis treament may be exploring the predictive value for revascularization.The tendency of TAFI can' t forecast the result of revascularization.

BACKGROUND: Some experiments indicated that applying rosiglitazone on diabetic animals lacking of insulin could not increase insulin and lower blood glucose obviously, which showed that rosiglitazone did not stimulate the excretion of rosiglitazone. The action of rosiglitazone in improving insulin resistance and the effects on the functions of liver and kidneys need more investigations.OBJECTIVE: To investigate whether rosiglitazone can improve the insulin resistance of rats with hyperlipemia, and analyze the possible mechanism.SETTINGS: Guangzhou Hospital of Traditional Chinese Medicine; Guangzhou Institute of Traditional Chinese Medicine and Materia MedicaDESIGN: A stratified randomized controlled animal trial.MATERIALS: Sixty-four Sprague-Dawley (SD) rats (Batch No. 2002A024), SPF grade, half male and half female,weighing 150 to 180 g, aged 6 to 8 weeks were purchased from Guangdong Medical Experimental Animal Center.Normal feed (total quantity of heat 6.9 kJ/g) was enriched with 23% protein, 53% carbohydrate and 5% fat. High fat emulsion (total quantity of heat 15.5 kJ/g) was enriched with 200 g/L lard, 200 g/L cholesterol, 10 g/L bile salt ox,200 g/L propylene glycol, 200 g/L tween-80. High fat and sugar feed (total quantity of heat 21.0 kJ/g) was enriched with 15% protein, 51% carbohydrate and 30% fat after adding 100 g/L glucose, 200 g/L lard and 100 g/L yolk powder then mixing and baking. Rosiglitazone was from GlaxoSmithKline Co Ltd. (Tianjin) (5 mg/tab, Batch No.02110012). Gliclazide was from Servier International and Tianjin Hua Jin Pharmaceutical Factory (100 mg/tab, Batch No.00232).METHODS: The experiment was carried out in Guangzhou University of Traditional Chinese Medicine from April to July in 2003. ① Sixty-four Sprague-Dawley rats, 16 of which were randomly sampled as the normal control group and had been fed with normal feed for 6 weeks. The others were modeled after medical literatures, each one was administered with high fat emulsion (10 mL/kg) by gavage once a day for 14 days. Rats whose FBG≥6.1 mmol/L or 2hBG≥7.8 mmol/L were selected, randomized into 3 groups according to body mass and blood glucose, i.e., negative control (model)group, rosiglitazone group and gliclazide group, there were 16 rats in each group. Except the normal control group, rats in the rosiglitazone group and gliclazide group were gavaged with rosiglitazone for 5 mg/kg and gliclazide for 100 mg/kg respectively, and those in the model group were gavaged with distilled water. All of the rats were fed with high-fat feed once a day for 28 days. From the 21st day, high fat emulsion was added once a day for 7 days. After fasting for 18 hours from the last administration, all the rats were recorded for FBG and administered dextrose 2.78 mol/10 mL .kg or dextrose and drug mixture 10 mL/kg by body mass. Two hours'later, 2hBG was recorded. ② Blood samples were collected from orbital plexus and serum was prepared for detecting the biochemical indexes and immunological indexes in serum, i.e., fasting serum glucose(FSG), total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), alanine aminotransferase (ALT), aspartate aminotransferase (AST),blood urea nitrogen (BUN), creatinine (Cr), tumor necrosis factor alpha (TNF-α) and fasting insulin (FINS). The insulin sensitivity index (ISI) was calculated: ISI=ln [1/ (FINS content×FBG content)]. After the rats were killed, their liver suspension was prepared for measuring the levels of TG, superoxide dismutase (SOD), glutathione (GSH) and malondialdehyde (MDA).MAIN OUTCOME MEASURES: ① FBG and 2hBG; ② FSG, blood lipids, TNF-α, FINS and ISI in serum; ③ TG, GSH, SOD and MDA in liver cells; ④ ALT, AST, BUN and Cr in serum. RESULTS: ① Results of FBG and 2hBG: The FBG and 2hBG in the rosiglitazone group [(3.2±0.3), (6.3±1.2) mmol/L]were lower than those in the modelcontrol group [(3.8±0.5), (8.1±2.1) mmol/L, P ＜ 0.01]. The FBG in the gliclazide group [(3.3±0.7) mmol/L] was lower than that in the model control group. ② Results of FSG, blood lipids, TNF-α, FINS and ISI: The FSG, TNF-α and FINS in the rosiglitazone group were (4.2±1.2) mmol/L, (246±45) μg/L and (133±45) pmol/L respectively, which were lower than those in the model control group [(6.6±1.5) mmol/L, (294±65) μg/L, (264±76) pmol/L,P ＜ 0.05-0.01], whereas ISI was higher than that in the model control group (-6.33±0.46, -7.46±0.95, P ＜ 0.01). The FSG and TNF-α in the gliclazide group [(4.1±1.1) mmol/L, (251±62) μg/L] were lower than those in the model control group (P ＜ 0.05-0.01). ③ Results of TG content, GSH deposit, SOD activity and MDA content in liver cells: The TG and MDA contents in liver cells in the rosiglitazone group [(1.00±0.38), (40±17) mmol/g] were lower than those in the model control group [(2.40±0.60), (171±63) mmol/g, P＜ 0.01], the GSH deposit and SOD activity [(51±14) mg/g, (583.45±50.01 ) nkat/g] were higher than those in the model control group [(2.40±0.60) mg/g, (450.09±66. 68) nkat/g, P ＜ 0.05-0.01].The TG and MDA contents in the gliclazide group [(1.20±0.38), (100±30) mmol/g] were lower than those in the model control group, whereas the GSH deposit [(46±15) mg/g] was higher than that in the model control group. ④ Results of ALT, AST, BUN and Cr in serum: The serum contents of BUN and Cr in the rosiglitazone group [(14.3±3.8) mmol/L,(33±9) μmol/L] were lower than those in the model control group [(19.2±5.6) mmol/L, (45±13) μmol/L, P ＜ 0.05].CONCLUSION: Both rosiglitazone and gliclazide can improve the insulin resistance induced by high fat feed.Rosiglitazone is superior to gliclazide in decreasing the high insulin level, decreaseing serum levels of BUN and Cr,improving reduced GSH deposit and enhancing SOD activity.