BACKGROUND: Epoxyeicosatrienoic acids (EETs), which are metabolites of arachidonic acid catalyzed by cytochrome P450 epoxygenase, are degraded into inactive dihydroxyeicosatrienoic acids by soluble epoxide hydrolase (sEH). Many studies have revealed that sEH gene deletion exerts protective effects against diabetes. Vascular calcification is a common complication of diabetes, but the potential effects of sEH on diabetic vascular calcification are still unknown. METHODS: The level of aortic calcification in wild-type and Ephx2-/- C57BL/6 diabetic mice induced with streptozotocin was evaluated by measuring the aortic calcium content through alizarin red staining, immunohistochemistry staining, and immunofluorescence staining. Mouse vascular smooth muscle cell lines (MOVAS cells) treated with β-glycerol phosphate (0.01 mol/L) plus advanced glycation end products (50 mg/L) were used to investigate the effects of sEH inhibitors or sEH knockdown and EETs on the calcification of vascular smooth muscle cells, which was detected by Western blotting, alizarin red staining, and Von Kossa staining. RESULTS: sEH gene deletion significantly inhibited diabetic vascular calcification by increasing levels of EETs in the aortas of mice. EETs (especially 11,12-EET and 14,15-EET) efficiently prevented the osteogenic transdifferentiation of MOVAS cells by decreasing nidogen-2 (NID2) expression. Interestingly, suppressing sEH activity by small interfering ribonucleic acid or specific inhibitors did not block osteogenic transdifferentiation of MOVAS cells induced by β-glycerol phosphate and advanced glycation end products. NID2 overexpression significantly abolished the inhibitory effect of sEH gene deletion on diabetic vascular calcification. Moreover, NID2 overexpression mediated by adeno-associated virus 9 vectors markedly increased insulin-like growth factor 2 (IGF2) and phospho-ERK1/2 expression in MOVAS cells. Overall, sEH gene knockout inhibited diabetic vascular calcification by decreasing aortic NID2 expression and, then, inactivating the downstream IGF2-ERK1/2 signaling pathway. CONCLUSIONS sEH gene deletion markedly inhibited diabetic vascular calcification through repressed osteogenic transdifferentiation of vascular smooth muscle cells mediated by increased aortic EET levels, which was associated with decreased NID2 expression and inactivation of the downstream IGF2-ERK1/2 signaling pathway.
Animals ; Mice ; Vascular Calcification/metabolism* ; Mice, Inbred C57BL ; Epoxide Hydrolases/metabolism* ; Diabetes Mellitus, Experimental/genetics* ; Male ; Gene Deletion ; MAP Kinase Signaling System/genetics* ; Cell Line ; Immunohistochemistry ; Muscle, Smooth, Vascular/metabolism* ; Signal Transduction/genetics* ; Mice, Knockout

Objective:To investigate the current situation of satisfaction with graduate education among recent medical graduates in China, and analyze the differences between different populations, and to propose countermeasures and suggestions.Methods:From June to July 2023, a self-made questionnaire was used to survey 16 903 medical graduates who had recently earned a post-graduate degree from 78 institutions about their satisfaction with curriculum sessions, practical sessions, research training, tutoring, and institutional management. The degrees of satisfaction with education among different populations were compared through the t test and analysis of variance with the use of SPSS 26.0. Results:The scores of satisfaction of the graduates with tutoring, curriculum sessions, practical sessions, institutional management, and research training were 4.44, 4.03, 4.02, 3.90, and 3.82, respectively. Satisfaction scores for individual dimensions were significantly higher for males, doctors, non-transfers, comprehensive universities, non-agricultural household registration, moderate-to-high annual household income per capita, parents with high educational levels, and parents with mid- or senior-level occupations ( P<0.05). Conclusions:There is room for improvement in students' satisfaction with medical graduate education. To improve the quality of medical graduate education, attention should be paid to key populations, education policies, school management, and tutoring to provide appropriate education for different students.

Objective To compare the safety and effectiveness of two different flow diverter devices between Tubridge flow diverter(TFD)and Surpass Streamline flow diverter(SFD)in the treatment of unruptured intracranial aneurysms.Methods A retrospective analysis from August 2020 to December 2023 was performed on the clinical data of 62 cases of unruptured aneurysms in the Department of Interventional Radiology(Shinan Branch),the Affiliated Hospital of Qingdao University treated with flow diverter.According to the type of implanted stents,they were divided into TFD group(32 cases)and SFD group(30 cases),general information about patients was collected,including age,sex,and past history(hypertension,diabetes,coronary heart disease),hospitalization time,surgical time(anesthesia start to anesthesia awakening time)and aneurysm location(anterior circulation,posterior circulation),type(giant aneurysm:maximum diameter ≥ 25 mm,large aneurysm:maximum diameter 15-＜25 mm,medium aneurysm:maximum diameter 5-＜15 mm,small aneurysm:maximum diameter＜5 mm),aneurysm morphology(saccular aneurysm,simple fusiform aneurysm,dissecting aneurysm),aneurysm maximum diameter,aneurysm neck,parent artery diameter,aneurysm wall enhancement in preoperative high-resolution MRI scan.Different types of flow diverters were selected according to the results of Surpass intracranial aneurysm embolization system pivotal trial to treat large or giant wide neck aneurysms(SCENT)and intracranial aneurysms managed by parent artery reconstruction using Tubridge flow diverter study(IMPACT).If"ejection sign"was found at the aneurysm neck on angiography immediately after the release of flow diverters,appropriate amount of coils were packed.Tamponade until there is no contrast filling in the aneurysm body on cerebral angiography,at which time the operation is terminated.If there is no"ejection sign"immediately after the release of the flow diverter,the procedure is terminated.Angiography was performed immediately after operation to evaluate the parent artery stenosis(patency[stenosis rate ≤50％],stenosis[stenosis rate＞50％]or occlusion[stenosis rate 100％])degree of aneurysm occlusion.O'Kelly-Marotta(OKM)classification was used to evaluate the degree of aneurysm occlusion.Effectiveness evaluation:DS A follow-up was performed≥1 month after operation,and the final angiographic result was taken as the final follow-up result to evaluate the postoperative aneurysm occlusion(OKM grade D:complete aneurysm occlusion,other grades:incomplete aneurysm occlusion),parent artery stenosis or occlusion.Safety evaluation:the clinical efficacy of patients at the last postoperative follow-up was evaluated by modified Rankin scale(mRS)score(mRS score 0-2:good clinical prognosis,mRS score 3-6:poor clinical prognosis),and perioperative(≤2 weeks after surgery)complications(ischemic complications,bleeding complications and other complications)were counted.The clinical effects and complications of the two groups were compared.Results A total of 62 aneurysms in 62 patients were included in the study.All patients were treated with a single flow diversion device.There were 28 males and 34females,aged 32 years to 76 years,with an average of(57±10)years.There were 39 anterior circulation aneurysms and 23 posterior circulation aneurysms.Among 62 patients,43 patients had saccular aneurysm,4 patients had simple fusiform aneurysm and 15 had dissecting aneurysm.Among them,38 saccular aneurysms were located in the anterior circulation and 5 in the posterior circulation;1 simple fusiform aneurysm was located in the anterior circulation and 3 in the posterior circulation;all dissecting aneurysms were located in the posterior circulation.The maximum diameter of the aneurysm ranged from 2.0 mm to 27.0 mm,with a median of 7.0(5.0,12.0)mm,and the aneurysm neck ranged from 2.0 mm to 18.5 mm,with a median of 5.0(4.0,6.7)mm.(1)There were statistically significant differences in aneurysm location and shape distribution between TFD group and SFD group(both P＜0.05),but there were no statistically significant differences in other general data(all P＞0.05).(2)The incidence of perioperative complications was 6.3％(2/32)in TFD group and 10.0％(3/30)in SFD group,and there was no significant difference between two groups(P=0.940).The good clinical outcome rate of both groups were 100.0％at the last follow-up.(3)All patients were followed up with DS A after operation.The follow-up time ranged from 55 d to 1 150 d,with a median follow-up time of 205.0(108.0,360.0)d.There was no significant difference in OKM classification distribution immediately after operation(P=0.607)and complete occlusion rate at the last follow-up(53.1％[17/32]vs.63.3％[19/30],P=0.416)between two groups.At the last follow-up,no parent artery stenosis or occlusion occurred in either group.Conclusions TFD has comparable efficacy and safety as SFD in the treatment of unruptured intracranial aneurysms.The results of this study need to be further verified by prospective large sample study.

Objective To compare the safety and effectiveness of two different flow diverter devices between Tubridge flow diverter(TFD)and Surpass Streamline flow diverter(SFD)in the treatment of unruptured intracranial aneurysms.Methods A retrospective analysis from August 2020 to December 2023 was performed on the clinical data of 62 cases of unruptured aneurysms in the Department of Interventional Radiology(Shinan Branch),the Affiliated Hospital of Qingdao University treated with flow diverter.According to the type of implanted stents,they were divided into TFD group(32 cases)and SFD group(30 cases),general information about patients was collected,including age,sex,and past history(hypertension,diabetes,coronary heart disease),hospitalization time,surgical time(anesthesia start to anesthesia awakening time)and aneurysm location(anterior circulation,posterior circulation),type(giant aneurysm:maximum diameter ≥ 25 mm,large aneurysm:maximum diameter 15-＜25 mm,medium aneurysm:maximum diameter 5-＜15 mm,small aneurysm:maximum diameter＜5 mm),aneurysm morphology(saccular aneurysm,simple fusiform aneurysm,dissecting aneurysm),aneurysm maximum diameter,aneurysm neck,parent artery diameter,aneurysm wall enhancement in preoperative high-resolution MRI scan.Different types of flow diverters were selected according to the results of Surpass intracranial aneurysm embolization system pivotal trial to treat large or giant wide neck aneurysms(SCENT)and intracranial aneurysms managed by parent artery reconstruction using Tubridge flow diverter study(IMPACT).If"ejection sign"was found at the aneurysm neck on angiography immediately after the release of flow diverters,appropriate amount of coils were packed.Tamponade until there is no contrast filling in the aneurysm body on cerebral angiography,at which time the operation is terminated.If there is no"ejection sign"immediately after the release of the flow diverter,the procedure is terminated.Angiography was performed immediately after operation to evaluate the parent artery stenosis(patency[stenosis rate ≤50％],stenosis[stenosis rate＞50％]or occlusion[stenosis rate 100％])degree of aneurysm occlusion.O'Kelly-Marotta(OKM)classification was used to evaluate the degree of aneurysm occlusion.Effectiveness evaluation:DS A follow-up was performed≥1 month after operation,and the final angiographic result was taken as the final follow-up result to evaluate the postoperative aneurysm occlusion(OKM grade D:complete aneurysm occlusion,other grades:incomplete aneurysm occlusion),parent artery stenosis or occlusion.Safety evaluation:the clinical efficacy of patients at the last postoperative follow-up was evaluated by modified Rankin scale(mRS)score(mRS score 0-2:good clinical prognosis,mRS score 3-6:poor clinical prognosis),and perioperative(≤2 weeks after surgery)complications(ischemic complications,bleeding complications and other complications)were counted.The clinical effects and complications of the two groups were compared.Results A total of 62 aneurysms in 62 patients were included in the study.All patients were treated with a single flow diversion device.There were 28 males and 34females,aged 32 years to 76 years,with an average of(57±10)years.There were 39 anterior circulation aneurysms and 23 posterior circulation aneurysms.Among 62 patients,43 patients had saccular aneurysm,4 patients had simple fusiform aneurysm and 15 had dissecting aneurysm.Among them,38 saccular aneurysms were located in the anterior circulation and 5 in the posterior circulation;1 simple fusiform aneurysm was located in the anterior circulation and 3 in the posterior circulation;all dissecting aneurysms were located in the posterior circulation.The maximum diameter of the aneurysm ranged from 2.0 mm to 27.0 mm,with a median of 7.0(5.0,12.0)mm,and the aneurysm neck ranged from 2.0 mm to 18.5 mm,with a median of 5.0(4.0,6.7)mm.(1)There were statistically significant differences in aneurysm location and shape distribution between TFD group and SFD group(both P＜0.05),but there were no statistically significant differences in other general data(all P＞0.05).(2)The incidence of perioperative complications was 6.3％(2/32)in TFD group and 10.0％(3/30)in SFD group,and there was no significant difference between two groups(P=0.940).The good clinical outcome rate of both groups were 100.0％at the last follow-up.(3)All patients were followed up with DS A after operation.The follow-up time ranged from 55 d to 1 150 d,with a median follow-up time of 205.0(108.0,360.0)d.There was no significant difference in OKM classification distribution immediately after operation(P=0.607)and complete occlusion rate at the last follow-up(53.1％[17/32]vs.63.3％[19/30],P=0.416)between two groups.At the last follow-up,no parent artery stenosis or occlusion occurred in either group.Conclusions TFD has comparable efficacy and safety as SFD in the treatment of unruptured intracranial aneurysms.The results of this study need to be further verified by prospective large sample study.

Objective To investigate the effects of microRNA497 (miR-497) on the metastasis of gastric cancer and its possible molecular mechanism. Methods SGC-7901 gastric cancer parent cells were cultured in an ultra-low adhesion environment, and the anoikis resistance model of SGC-7901 cells was created after re-adhesion. Clone formation assay, flow cytometry, Transwell^TM test and scratch healing test were used to detect the differences of biological behavior compared with their parent cells. Fluorescence quantitative PCR was performed to detect the expression of miR-497. Western blot analysis was used to detect the changes of key proteins of Wnt/β-catenin signaling pathway and epithelial mesenchymal transformation (EMT) related proteins such as vimentin and E-cadherin. Parent cells and anoikis resistant SGC-7901 cells were transfected with miR-497 inhibitor or miR-497 mimic, and CCK-8 assay was used to detect the proliferation activity. Transwell^TM invasion assay was performed to detect the invasion ability of cells. Transwell^TM migration test and scratch healing assay was used to determine the migration ability. Western blot analysis was used to detect the expressions of Wnt1, β-catenin, vimentin and E-cadherin. By transfecting miR-497 mimic into the anoikis resistance SGC-7901 cells and inoculating them subcutaneously in nude mice, the changes in the volume and mass of tumor tissues were measured and recorded. Western blot analysis was used to determine the expressions of Wnt1, β-catenin, vimentin and E-cadherin of tumor tissues. Results Compared with the parent cells, the anoikis resistance SGC-7901 gastric cancer cells had faster proliferation rate, stronger colony formation, lower apoptosis rate, stronger invasion and migration ability. The expression of miR-497 was significantly decreased. After down-regulation of miR-497, the proliferation ability, invasion and migration ability were significantly enhanced. The expressions of Wnt1, β-catenin and vimentin increased significantly, while E-cadherin decreased notably. The results of up-regulation miR-497 were the opposite. The tumor growth rate, tumor volume and mass of miR-497 overexpression group were significantly lower than those of control group. The expressions of Wnt1, β-catenin and vimentin decreased significantly, while the expression of E-cadherin increased significantly. Conclusion The expression of miR-497 is low in the anoikis resistance SGC-7901 cells. miR-497 can inhibit the growth and metastasis of gastric cancer cells by blocking Wnt/β-catenin signaling pathway and EMT.
Animals ; Mice ; Humans ; beta Catenin/metabolism* ; MicroRNAs/metabolism* ; Vimentin/metabolism* ; Stomach Neoplasms/pathology* ; Anoikis/genetics* ; Wnt Signaling Pathway/genetics* ; Mice, Nude ; Cell Proliferation/genetics* ; Cadherins/genetics* ; Cell Line, Tumor ; Epithelial-Mesenchymal Transition/genetics* ; Cell Movement/genetics*

ObjectiveTo explore the effect of repetitive peripheral magnetic stimulation on upper limb motor function rehabilitation of stroke patients after contralateral seventh cervical nerve transfer (CC7). MethodsFrom May, 2020, to May, 2022, 34 stroke patients with hemiplegia underwent CC7 in Jing'an District Centre Hospital of Shanghai were randomly divided into control group (n = 17) and observation group (n = 17). Both groups received conventional rehabilitation. The observation group accepted repetitive peripheral magnetic stimulation, and the control group received sham stimulation, for eight weeks. They were assessed with Fugl-Meyer Assessment-Upper Extremities (FMA-UE) and Hua-Shan Grading of Upper Extremity (H-S grading) before and after treatment. ResultsTwo cases dropped down in each group. There was difference in gender between two groups (χ² = 6.136, P < 0.05). After treatment, the scores of FMA-UE and H-S grading significantly improved in both groups (t > 4.000, P < 0.01), and the improvement was better in the observation group than in the control group (t > 2.362, P < 0.05). ConclusionRepetitive peripheral magnetic stimulation could improve the motor function of upper limb and hand of stroke patients with hemiplegia after CC7.

Objective: To compare body composition of girls aged 10 to 15 years with or without onset of menarche in Nanyang, and to provide a reliable basis for effective adolescent health care. Methods: From August to December 2020 and from March to October 2021, cluster random sampling was adopted in 13 areas of Nanyang City to select 1 523 girls. Questionnaire survey and body composition (Japan Bailida MC-180) were conducted. Results: BMI, body fat percentage, trunk fat percentage, muscle mass and bone mass of girls aged 10 to 15 years in Nanyang City gradually increased with age, the water content in the body decreased with age. BMI, fat percentage, trunk fat percentage, muscle mass and bone mass in girls experienced menarche were higher, while water content in the body was lower than those without menarche. Significant difference in BMI between the menarche and without menarche of girls were found in those aged 11 to 15 years( t =2.07, 2.03, 2.43, 2.45, 2.52, P <0.05). Significant differences in fat rate, trunk fat rate, muscle mass and bone mass between the menarche and without menarche were found in girls aged 12 to 15 years fat percentage, trunk fat percentage muscle mass bone mass( P <0.05). Among girls aged 10, 14 and 15 year old, significant difference in body water percentage were observed in the two groups of girls with or without menarche( t =2.75, 2.35, 2.37 , P <0.05). Average age at menarche showed significant urban rural differences among girls aged 10, 11 and 14 year old ( χ 2=4.34, 3.45, 6.73, P <0.05). Conclusion Changes in body composition including BMI, body fat percentage, muscle mass, bone mass and body water percentage during the transition to menarche in girls is helpful to predict menarche in girls. Age of menarche is related to nutritional status, BMI, physical exercise, snack and beverage intake.

According to 'National Standard of Undergraduate Teaching Quality for Nursing Science', the mode of community nursing practice was explored and implemented by the School of Nursing in Tianjin Medical University. Focus on competency, the syllabus of community nursing practice was revised. Optimizing the management system of community nursing practice, developing the team of high-quality teachers, building standardized community nursing practice bases, and improving the evaluation system of community nursing practice aimed to enhance comprehensive quality of nursing undergraduates and the quality of community nursing practice. Within the concept of "big health", our school is exploring the new mode of combining community nursing practice with health management-oriented nursing personnel training, which lays an important foundation for training applied nursing talents to meet the needs on development of community health services.

Objective To explore the predictor of invalid conservative treatment of acute calculous cholecystitis (ACC) in pregnant women.Methods A total of 107 pregnant patients with ACC in a tertiary hospital from Jan.2010 to Jun.2017 were studied retrospectively.Results Univariate analysis revealed that body temperature ＞ 37.3 ℃ (x2 =4.721,P ＜ 0.05),gallbladder dilation (x2 =4.764,P ＜ 0.05),TBiL (t=-2.518,P＜0.05),ALT (t=-2.860,P＜0.05),AST (t=-3.014,P＜0.05),hospital stay (x2 =9.769,P ＜ 0.05),rate of pregnancy termination (x2 =7.349,P ＜ 0.05) were all significantly higher in conservative therapy failure group than those in the conservative therapy success group.Multivariate analysis showed that gallbladder dilation,TBiL,body temperature ＞ 37.3 ℃,AST were the independent risk factors predicting invalid conservative management.Conclusion Gallbladder dilation,body temperature ＞ 37.3 ℃,high level of TBiL and AST are the early predictors for the invalid conservative management for ACC in pregnant women.

OBJECTIVETo explore the safety and efficacy of pegylated recombinant human granulocyte colony-stimulating factor (PEG-rhG-CSF) in preventing chemotherapy-induced neutropenia in patients with breast cancer and non-small cell lung cancer (NSCLC), and to provide the basis for clinical application.

METHODSAccording to the principle of open-label, randomized, parallel-group controlled clinical trial, all patients were randomized by 1∶1∶1 into three groups to receive PEG-rhG-CSF 100 μg/kg, PEG-rhG-CSF 6 mg, or rhG-CSF 5 μg/kg, respectively. The patients with breast cancer received two chemotherapy cycles, and the NSCLC patients received 1-2 cycles of chemotherapy according to their condition. All patients were treated with the combination chemotherapy of TAC (docetaxel+ epirubicin+ cyclophosphamide) or TA (docetaxel+ epirubicin), or the chemotherapy of docetaxel combined with carboplatin, with a 21 day cycle.

RESULTSThe duration of grade 3-4 neutropenia in the PEG-rhG-CSF 100 μg/kg and PEG-rhG-CSF 6 mg groups were similar with that in the rhG-CSF 5 μg/kg group (P>0.05 for all). The incidence rate of grade 3-4 neutropenia in the PEG-rhG-CSF 100 μg/kg group, PEG-rhG-CSF 6 mg group, and G-CSF 5 μg/kg group were 69.7%, 68.4%, and 69.5%, respectively, with a non-significant difference among the three groups (P=0.963). The incidence rate of febrile neutropenia in the PEG-rhG-CSF 100 μg/kg group, PEG-rhG-CSF 6 mg group and G-CSF 5 μg/kg group were 6.1%, 6.4%, and 5.5%, respectively, showing no significant difference among them (P=0.935). The incidence rate of adverse events in the PEG-rhG-CSF 100 μg/kg group, PEG-rhG-CSF 6 mg group and G-CSF 5 μg / kg group were 6.7%, 4.1%, and 5.5%, respectively, showing a non-significant difference among them (P=0.581).

CONCLUSIONSIn patients with breast cancer and non-small cell lung cancer (NSCLC) undergoing TAC/TA chemotherapy, a single 100 μg/kg injection or a single fixed 6 mg dose of PEG-rhG-CSF at 48 hours after chemotherapy show definite therapeutic effect with a low incidence of adverse events and mild adverse reactions. Compared with the continuous daily injection of rhG-CSF 5 μg/kg/d, a single 100 μg/kg injection or a single fixed 6 mg dose of PEG-rhG-CSF has similar effect and is more advantageous in preventing chemotherapy-induced neutropenia.

Antineoplastic Agents ; adverse effects ; therapeutic use ; Antineoplastic Combined Chemotherapy Protocols ; Breast Neoplasms ; drug therapy ; Carboplatin ; administration & dosage ; adverse effects ; Carcinoma, Non-Small-Cell Lung ; drug therapy ; Cyclophosphamide ; administration & dosage ; adverse effects ; Epirubicin ; administration & dosage ; adverse effects ; Female ; Granulocyte Colony-Stimulating Factor ; therapeutic use ; Humans ; Incidence ; Induction Chemotherapy ; Lung Neoplasms ; drug therapy ; Neutropenia ; chemically induced ; epidemiology ; prevention & control ; Polyethylene Glycols ; Recombinant Proteins ; administration & dosage ; Taxoids ; administration & dosage ; adverse effects