OBJECTIVE: To test the hypothesis that the inhibition of endoplasmic reticulum (ER) stress-induced apoptosis in oxidized low-density lipoproteins (ox-LDL)-induced human aortic-vascular smooth muscle cells (HA-VSMCs) was associated with suppression of the protein kinase RNA-like ER kinase (PERK)-eukaryotic translation initiation factor 2α (eIF2α)-activating transcription factor 4 (ATF4)-CCAAT/enhancer binding protein homologous protein (CHOP) signaling pathway by Pollen Typhae total flavone (PTF). METHODS: Primary HA-VSMCs were cultured and identified. The cultured HA-VSMCs were randomized into 5 groups, including a normal control group, an ox-LDL group (70 μg/mL high ox-LDL), an HPTF group (70 μg/mL high ox-LDL+500 μg/mL PTF), an MPTF group (70 μg/mL high ox-LDL+250 μg/mL PTF), and a LPTF group (70 μg/mL high ox-LDL+100 μg/mL PTF) in the first part; and a normal control group, an ox-LDL group (70 μg/mL high ox-LDL), an MPTF group (70 μg/mL high ox-LDL+250 μg/mL PTF), a shRNA group (transducted with PERK shRNA lentiviral particles), a scramble shRNA group (transducted with control shRNA lentiviral particles), an MPTF+ox-LDL+shRNA group (250 μg/mL PTF+70 μg/mL high ox-LDL+PERK shRNA lentiviral particles) and an ox-LDL+shRNA group (70 μg/mL high ox-LDL+PERK shRNA lentiviral particles) in the second part. The protein expression levels of ER-associated apoptosis proteins were detected by Western blot, and their mRNA expression levels were detected by quantitative real-time reverse transcription-polymerase chain reaction. The 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay was applied to test cell viability, and the level of apoptosis was monitored by flow cytometry. RESULTS: The MTT assay and flow cytometry showed that the ox-LDL group had a significant increase in apoptosis, which was attenuated in PTF treatment groups and shRNA groups. Moreover, the ox-LDL group had increased protein and mRNA levels of binding immunoglobulin protein and ER-associated apoptosis proteins, such as PERK, eIF2α, ATF4 and CHOP, which were attenuated in PTF treatment groups and shRNA groups. CONCLUSIONS The apoptosis induced by ox-LDL had a strong relation to ER stress. The protective effect of PTF on ER stressinduced apoptosis was associated with inhibition of the PERK-eIF2α-ATF4-CHOP pathway, which might be a potential therapeutic strategy for enhancing the stability of atherosclerotic plaques.

Objective To investigate the effect of intra-articular tumor necrosis factor (TNF) inhibitor injection in patients with moderate to severe rheumatoid arthritis (RA) and values of power Doppler ultrasonography in evaluating effect of intra-articular injection.Methods RA patients with arthritis in knee and/or elbow and/or ankle referred to the Department of Rheumatology in the First Affiliated Hospital of Xi'an Jiaotong University were enrolled to receive intra-articular injection with 50 mg or 25 mg of recombinant human tumor necrosis factor-α receptor Ⅱ:IgG Fc fusion protein (TNFR:Fc) for injection after synovial fluid aspiration.Evaluation of visual analogue scale for pain of the involved joints,erythrocyte sedimentation rate (ESR),C reactive protein (CRP) and 28-joint disease activity score (DAS28) were performed before and after intra-articular TNFR:Fc injection.Synovial hypertrophy,power Doppler signal and joint effusion were analyzed and graded by ultrasound before and after intra-articular TNFR:Fc injection.Comparisons of continuous data between groups was made by t test.The data that were not normally distributed was analyzed by Mann-Whitney U rank sum test.Results Fifty-four patients with RA [6 men and 48 women,mean age (52±11) years,mean duration of disease (7±3) years] were included in this study.A significant decrease in visual analogue scale for pain of the involved joints (t=2.630,P=0.018;t=2.160,P=0.043),ESR (t=2.094,P=0.030;Z=-2.242,P=0.030),CRP (Z=-2.199,P=0.030;Z=-3.337,P=0.001) and DAS28 (t=3.579,P=0.002;t=5.538,P=0.000) were observed after one month of injection of 50 mg or 25 mg of TNFR:Fc.Synovial hypertrophy (t=2.175,P=0.036;t=2.280,P=0.030) power Doppler signal (t=2.500,P=0.020;Z=-2.504,P=0.013) and joint effusion (Z=-1.790,P=0.042;t=2.230,P=0.027) were reduced significantly after one month of intra-articular TNFR:Fc injection in knee.Synovial hypertrophy (t=2.180,P=0.034;t=2.480,P=0.030) and power Doppler signal (t=2.681,P=0.020;t=5.482,P=0.000) were also reduced significantly after one month of intra-articular TNFR:Fc injection in elbow and ankle.Conclusion Intra-articular TNFR:Fc injection is an effective and safe treatment in RA patients with monoarthritis.Ultrasound may be an objective and valid method in evaluating the effect of intraarticular TNF inhibitor injection in RA patients.

Objective To explore the effect of nursing intervention on the efficacy and complication of heart valve replacement combined with radiofrequency ablation.Methods A total of 110 patients underwent heart valve replacement combined with radiofrequency ablation were selected and were randomly divided into observation group and control group, with 55 patients in each group.The control group was given routine care, and observation group was given comprehensive care, the incidence of complications, cardiac ultrasound changes and nursing after surgery were observed.Results The ablation time, aorta block time, ICU stay, extracorporeal circulation bypass time and postoperative hospital stay were significantly shorter in the observation group than in the control group (P<0.05).After nursing, diameter of left atrial in two groups was reduced, but observation group reduced more than the control group (P<0.05).After nursing, the EF and FS in observation group were (63.45±6.90)%,(38.78±6.78)%, which were significantly lower than (53.48±7.02)%, (34.12±6.06)% of the control group (P<0.05).After nursing, the incidence of complications such as arrhythmia, infection, cerebral embolism, low cardiac output syndrome and renal failure in the observation group was significantly lower than that in the control group (P<0.05).Conclusion Appropriate nursing intervention can effectively prevent complications of heart valve replacement and radiofrequency ablation, and improve the patient′s cardiac function.

Objective To research the effect of meticulous nursing intervention on clinical effect and prognosis of patients with chronic ulcerative colitis.Methods A total of 134 patients with chronic ulcerative colitis treated by retention enema in our hospital were divided into the observation group and the control group according to the order of admission.The control group was given routine nursing intervention and the observation group was given meticulous nursing intervention.The prognosis, quality of life and the occurrence of related adverse reactions of the two groups were compared.Results The weight gain degree of the observation group was higher than that of the control group, and the stool forming time and hospitalization time were lower than the control group (P<0.05).After 20 days of treatment, the scores of quality of life in the observation group were significantly higher, the incidence of adverse reactions were significantly lower than that in the control group, the differences between two groups were statistically significant (P<0.05).Conclusion Meticulous nursing intervention can help patients with chronic ulcerative colitis to quickly establish the normal intestinal function, reduce the incidence of adverse reactions, improve the quality of life of patients after treatment, and enhance the clinical effect and prognosis.

Objective To explore the effect of nursing intervention on the efficacy and complication of heart valve replacement combined with radiofrequency ablation.Methods A total of 110 patients underwent heart valve replacement combined with radiofrequency ablation were selected and were randomly divided into observation group and control group, with 55 patients in each group.The control group was given routine care, and observation group was given comprehensive care, the incidence of complications, cardiac ultrasound changes and nursing after surgery were observed.Results The ablation time, aorta block time, ICU stay, extracorporeal circulation bypass time and postoperative hospital stay were significantly shorter in the observation group than in the control group (P<0.05).After nursing, diameter of left atrial in two groups was reduced, but observation group reduced more than the control group (P<0.05).After nursing, the EF and FS in observation group were (63.45±6.90)%,(38.78±6.78)%, which were significantly lower than (53.48±7.02)%, (34.12±6.06)% of the control group (P<0.05).After nursing, the incidence of complications such as arrhythmia, infection, cerebral embolism, low cardiac output syndrome and renal failure in the observation group was significantly lower than that in the control group (P<0.05).Conclusion Appropriate nursing intervention can effectively prevent complications of heart valve replacement and radiofrequency ablation, and improve the patient′s cardiac function.

Objective To research the effect of meticulous nursing intervention on clinical effect and prognosis of patients with chronic ulcerative colitis.Methods A total of 134 patients with chronic ulcerative colitis treated by retention enema in our hospital were divided into the observation group and the control group according to the order of admission.The control group was given routine nursing intervention and the observation group was given meticulous nursing intervention.The prognosis, quality of life and the occurrence of related adverse reactions of the two groups were compared.Results The weight gain degree of the observation group was higher than that of the control group, and the stool forming time and hospitalization time were lower than the control group (P<0.05).After 20 days of treatment, the scores of quality of life in the observation group were significantly higher, the incidence of adverse reactions were significantly lower than that in the control group, the differences between two groups were statistically significant (P<0.05).Conclusion Meticulous nursing intervention can help patients with chronic ulcerative colitis to quickly establish the normal intestinal function, reduce the incidence of adverse reactions, improve the quality of life of patients after treatment, and enhance the clinical effect and prognosis.

Objective To investigate the mechanical properties of both artificial cartilage and host cartilage by establishing the in vitro model of tissue engineered cartilage for repairing defects. Methods The agarose gel as an artificial cartilage was implanted in a deep cartilage defect connected with biological adhesive to set up the in vitro model of tissue engineered articular cartilage defects. Under the compression load, the instant mechanical behavior of the repair area was studied using the digital image correlation technology. Results There was no cracking phenomenon occurred at the interface during the compression process. The Strain distributions at middle layer of the repair area were obtained when the cartilage thickness appeared changes with 3.5%, 5.6%, 7.04% and 9.0% by the compression, respectively. When the compressing change increased from 3.5% to 9%, the maximum compressive strain of host cartilage was increased by 75.9%, and the maximum tensile strain of artificial cartilage was increased by 226.99% in the vertical direction of cartilage surface. In the direction parallel with cartilage surface, the maximum tensile strain at the interface was increased by 116.9%, and the increment was far more than that at the host cartilage area and artificial cartilage area. For shear strain at the repair area, the direction of shear strain at the interface changed oppositely with the compression increasing. Conclusions The repair effect of tissue engineered cartilage was uncertain due to the mechanical environment of the repair area. After the tissue engineered cartilage was implanted in the defect, the repair area was under the influence of complex strain states. The strains changed greatly at the interface both with the host cartilage and artificial cartilage as the compression increasing. The strain in the vertical direction of cartilage surface at the interface might change from compressive stain to tensile strain, which was significantly increased in the direction parallel with cartilage surface. The strain direction at the interface could even be changed oppositely, and the shear strain appeared rapidly increase. The complex strain states lead to such great changes in mechanical environment of the defect area, and may cause cracking at the interface, and even further affect the repair process. Therefore, attention should be given to this complex mechanical environment during cartilage defect repair process in clinical treatment.