Objective To study the hemodynamic characteristics of autologous arteriovenous fistula(AVF)and provide a theoretical basis for reducing its stenosis rate.Methods Bidirectional fluid-structure interaction(FSI)simulations were conducted on a modified AVF model.Flow field and wall shear stress(WSS)distributions in the internal fistula at different periods and angles in a cardiac cycle were analyzed for retrograde flow(confluence)and anterograde flow(shunt)modes in models with varying anastomosis angles.Results Under confluence modes,the WSS＜1 Pa area in the 60° anastomosis angle model was the smallest(7.027 mm2),while the 45°,60°,and 90° models showed no significant differences in eddy current size and intensity.Under shunt modes,the 45° anastomosis angle model had the smallest WSS＜1 Pa area(9.079 mm2),but the 60° model exhibited the lowest eddy current intensity and distribution area.In addition,the difference in the WSS＜1 Pa area between the 60° and 45° models was only 2.661 mm2.Conclusions Under both confluence and shunt flow modes,establishing an AVF with 60° anastomosis angle is conducive to reducing the risk of vascular stenosis in arteriovenous fistula.

Objective To study the hemodynamic characteristics of autologous arteriovenous fistula(AVF)and provide a theoretical basis for reducing its stenosis rate.Methods Bidirectional fluid-structure interaction(FSI)simulations were conducted on a modified AVF model.Flow field and wall shear stress(WSS)distributions in the internal fistula at different periods and angles in a cardiac cycle were analyzed for retrograde flow(confluence)and anterograde flow(shunt)modes in models with varying anastomosis angles.Results Under confluence modes,the WSS＜1 Pa area in the 60° anastomosis angle model was the smallest(7.027 mm2),while the 45°,60°,and 90° models showed no significant differences in eddy current size and intensity.Under shunt modes,the 45° anastomosis angle model had the smallest WSS＜1 Pa area(9.079 mm2),but the 60° model exhibited the lowest eddy current intensity and distribution area.In addition,the difference in the WSS＜1 Pa area between the 60° and 45° models was only 2.661 mm2.Conclusions Under both confluence and shunt flow modes,establishing an AVF with 60° anastomosis angle is conducive to reducing the risk of vascular stenosis in arteriovenous fistula.

Objective To establish an allogeneic rat model of endometriosis and to evaluate the effects of gonadotropin-releasing hormone (GnRH) agonist GenSci006 on experimental rat endometriosis. Methods Endometrium from SPF grade donor female SD rats were transplanted onto the abdominal wall of recipient female rats to construct an allogeneic endometriosis model. The rats undergoing sham surgery were divided into the sham group. Three weeks later, the length, width and height of the ectopic endometrium were measured, and the volume of the endometrium (V₁) was calculated before drug administration. The modeling rats were randomly divided into four groups: model group, triptorelin group (0.25 mg/kg), GenSci006-1 group (0.125 mg/kg) and GenSci006-2 group (0.25 mg/kg). Each group had 16 rats and received a single dose of the corresponding drug. The sham group and model group were administered an equal volume of solvent. Three weeks after administration, ectopic endometrium was measured to calculate the volume V₂ and inhibition rate. The effect of GenSci006 on rat uterus and ovarian tissues was assessed by comparing organ coefficients and changes in pathological sections. Enzyme-linked immunosorbent assay (ELISA) was used to measure the levels of serum estradiol (E₂), progesterone (P₄), follicle stimulating hormone (FSH), and luteinizing hormone (LH). Real-time fluorescent quantitative PCR was used to detect the expression of GnRH receptor (GnRHR) mRNA in the hypothalamus and pituitary. Western blot was used to detect the expression of estradiol receptor alpha (ERα), beta (ERβ) and progesterone receptor (PR) in ectopic endometrium. Results Three weeks after administration, compared with the model group, the body weight of rats in the triptorelin and GenSci006-2 groups significantly increased (P < 0.05), while the volume of ectopic endometrium significantly decreased (P < 0.05). Compared with the sham group, the model group showed no significant changes in uterine and ovarian organ coefficients or endometrial thickness (P > 0.05). Compared with the model group, the uterine organ coefficients and endometrial thickness were significantly reduced in the triptorelin and GenSci006-2 groups (P < 0.05). Compared with the sham group, the serum levels of E₂, P₄, FSH and LH in the model group showed no significant changes (P > 0.05). Compared with the model group, the ovarian organ coefficient and serum P₄ levels of rats in the Triptorelin, GenSci006-1, and GenSci006-2 groups were significantly reduced (P < 0.05), while the serum LH levels of rats in the GenSci006-1 group were significantly increased (P < 0.05). However, there were no significant changes in serum E₂ and FSH levels in each group (P > 0.05). Compared with the model group, the expression levels of GnRHR mRNA in the pituitary tissue of rats in the triptorelin and GenSci006-2 groups were significantly downregulated (P < 0.05), with no significantly changes in the hypothalamus (P > 0.05). There were no significant changes in the expression level of GnRHR mRNA in the hypothalamus or the protein levels of ERα, ERβ and PR in the ectopic endometrial tissue in any group (P > 0.05). Conclusion The allogeneic endometriosis rat model is a suitable animal model for screening and evaluating drugs for treating endometriosis. The volume of ectopic endometrium, inhibition rate, uterine and ovarian organ coefficients, and serum E₂ levels may serve as indicators for detecting drug efficacy.

Objective:To explore the effects of consecutively repeated application of emergency contraception pills (ECPs) containing levonorgestrel (LNG) on the female fertility and the health outcomes of F1 generation rats.Methods:Female SPF rats were intragastric administered with LNG-ECPs consecutively for 3 (P-3), 6 (P-6) and 12 (P-12) estrous cycles (three times in each estrous cycle), respectively. Under each administration schedule, rats were randomly divided into 2 groups according to body weight stratification using random numbers generated in Excel, i.e. LNG-ECPs group and solvent control group, administered with 0.12 mg/kg LNG-ECPs and corresponding volumes of 0.5% CMC-Na, respectively. Four hours after the last dosing, half of the animals (12-18) in each group were allotted randomly for dissection (6-9) and mating (6-9), respectively. The remaining half (12-18) were recovered for 3 estrous cycles, and then were randomly allocated for dissection (6-9) and mating (6-9). Organ coefficients were calculated. Serum levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol, progesterone, testosterone, anti-Müllerian hormone (AMH) and free thyroid hormone 3 (fT3) were examined by enzyme linked immunosorbent assay (ELISA). Ovarian tissues were sectioned and stained with hematoxylin and eosin (HE) for follicle counting. In addition, the pregnancy rate and litter size of the female rats were recorded, and the growth indexes and behavioral parameters of the cubs were measured. Moreover, RNA sequencing (RNA-seq) of the ovarian tissues was performed to establish the differential expression gene profile of ovarian injury induced by LNG-ECPs. Then gene ontology (GO) function and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment were analyzed.Results:1) After consecutive administration for 3 and 6 estrous cycles, LNG-ECPs showed no significant impact on the serum hormone levels and female fertility (all P>0.05), and the growth indexes and behavioral parameters of the F1 generation (all P>0.05). 2) After consecutive administration for 12 estrous cycles, the serum levels of FSH [(0.21±0.17) U/L], LH [(0.27±0.08) U/L] and progesterone [(0.68±0.23) μg/L] in LNG-ECPs group decreased significantly compared with those in solvent control group [(1.00±0.82) U/L, P=0.043; (1.00±0.50) U/L, P=0.006; (1.00±0.20) μg/L, P=0.027], while the level of estradiol [(2.24±1.03) μg/L] and testosterone [(1.25±0.25) μg/L] increased noticeably compared with those in solvent control group [(1.00±0.35) μg/L, P=0.019; (1.00±0.07) μg/L, P=0.044]. The number of primordial follicles (4.88±2.36) lost distinctly, while the number of atretic follicles (24.38±5.01) increased markedly in LNG-ECPs group compared with those in solvent control group (16.13±9.36, P=0.005; 19.13±2.30, P=0.018). In addition, the weight-loaded swimming (WLS) time of the F1 generation rats from the LNG-ECPs group [(157.13±32.29) s] reduced obviously compared with those from the solvent control group [(198.06±40.01) s, P=0.003]. Moreover, after recovering for 3 estrous cycles, LNG-ECPs significantly increased the levels of FSH [(2.48±1.18) U/L], LH [(1.60±0.41) U/L], testosterone [(1.37±0.23) μg/L] and the ratio of FSH/LH (1.61±0.41) compared with those in solvent control group [(1.00±0.67) U/L, P=0.024; (1.00±0.27) U/L, P=0.014; (1.00±0.18) μg/L, P=0.011; 1.00±0.49, P=0.042], respectively. Additionally, the serum levels of estradiol [(0.49±0.15) μg/L] and AMH [(0.79±0.15) μg/L] were significantly lower than those in solvent control group [(1.00±0.37) μg/L, P=0.011; (1.00±0.10) μg/L, P=0.016]. In addition, the number of primordial follicles in rats of LNG-ECPs group (6.25±5.06) were obviously less than that in solvent control group (12.00±5.56, P=0.048). Furthermore, the total distance in open field [(89.85±36.98) m] and the swimming time in WLS [(112.00±29.52) s] in rats treated with LNG-ECPs both decreased distinctly compared with those in solvent control group [(147.55±23.13) m, P<0.001; (137.69±25.85) s, P=0.014]. 3) According to transcriptomic analysis, Cd5, Cxcr1, Lexm, Fga, Mybphl and Gstm5 were the significant differential expressed genes (DEGs) in the ovarian tissues of rats. These DEGs were involved in pathways related to steroid hormone biosynthesis, including terpenoid backbone biosynthesis, ovarian steroidogenesis, cortisol synthesis and secretion. Additionally, these genes were involved in metabolic processes, such as carbon metabolism, butanoate metabolism, cysteine and methionine metabolism. And the genes were also involved in immunoregulatory processes including cytokine-cytokine receptor interaction, viral protein interaction with cytokine and cytokine receptors. Conclusion:Consecutively repeated administering LNG-ECPs to the female rats in a short-term period (<12 cycles) did not demonstrate significant adverse effects on female fertility and the growth and development and the behaviors of their F1 generation cubs. However, long-term repeated treatment with LNG-ECPs (12 cycles) caused ovarian injury on female rats and showed negative impacts on the health of the F1 generation cubs, and no significant improvement was observed after recovering for 3 estrous cycles.

Objective:To explore the effects of consecutively repeated application of emergency contraception pills (ECPs) containing levonorgestrel (LNG) on the female fertility and the health outcomes of F1 generation rats.Methods:Female SPF rats were intragastric administered with LNG-ECPs consecutively for 3 (P-3), 6 (P-6) and 12 (P-12) estrous cycles (three times in each estrous cycle), respectively. Under each administration schedule, rats were randomly divided into 2 groups according to body weight stratification using random numbers generated in Excel, i.e. LNG-ECPs group and solvent control group, administered with 0.12 mg/kg LNG-ECPs and corresponding volumes of 0.5% CMC-Na, respectively. Four hours after the last dosing, half of the animals (12-18) in each group were allotted randomly for dissection (6-9) and mating (6-9), respectively. The remaining half (12-18) were recovered for 3 estrous cycles, and then were randomly allocated for dissection (6-9) and mating (6-9). Organ coefficients were calculated. Serum levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol, progesterone, testosterone, anti-Müllerian hormone (AMH) and free thyroid hormone 3 (fT3) were examined by enzyme linked immunosorbent assay (ELISA). Ovarian tissues were sectioned and stained with hematoxylin and eosin (HE) for follicle counting. In addition, the pregnancy rate and litter size of the female rats were recorded, and the growth indexes and behavioral parameters of the cubs were measured. Moreover, RNA sequencing (RNA-seq) of the ovarian tissues was performed to establish the differential expression gene profile of ovarian injury induced by LNG-ECPs. Then gene ontology (GO) function and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment were analyzed.Results:1) After consecutive administration for 3 and 6 estrous cycles, LNG-ECPs showed no significant impact on the serum hormone levels and female fertility (all P>0.05), and the growth indexes and behavioral parameters of the F1 generation (all P>0.05). 2) After consecutive administration for 12 estrous cycles, the serum levels of FSH [(0.21±0.17) U/L], LH [(0.27±0.08) U/L] and progesterone [(0.68±0.23) μg/L] in LNG-ECPs group decreased significantly compared with those in solvent control group [(1.00±0.82) U/L, P=0.043; (1.00±0.50) U/L, P=0.006; (1.00±0.20) μg/L, P=0.027], while the level of estradiol [(2.24±1.03) μg/L] and testosterone [(1.25±0.25) μg/L] increased noticeably compared with those in solvent control group [(1.00±0.35) μg/L, P=0.019; (1.00±0.07) μg/L, P=0.044]. The number of primordial follicles (4.88±2.36) lost distinctly, while the number of atretic follicles (24.38±5.01) increased markedly in LNG-ECPs group compared with those in solvent control group (16.13±9.36, P=0.005; 19.13±2.30, P=0.018). In addition, the weight-loaded swimming (WLS) time of the F1 generation rats from the LNG-ECPs group [(157.13±32.29) s] reduced obviously compared with those from the solvent control group [(198.06±40.01) s, P=0.003]. Moreover, after recovering for 3 estrous cycles, LNG-ECPs significantly increased the levels of FSH [(2.48±1.18) U/L], LH [(1.60±0.41) U/L], testosterone [(1.37±0.23) μg/L] and the ratio of FSH/LH (1.61±0.41) compared with those in solvent control group [(1.00±0.67) U/L, P=0.024; (1.00±0.27) U/L, P=0.014; (1.00±0.18) μg/L, P=0.011; 1.00±0.49, P=0.042], respectively. Additionally, the serum levels of estradiol [(0.49±0.15) μg/L] and AMH [(0.79±0.15) μg/L] were significantly lower than those in solvent control group [(1.00±0.37) μg/L, P=0.011; (1.00±0.10) μg/L, P=0.016]. In addition, the number of primordial follicles in rats of LNG-ECPs group (6.25±5.06) were obviously less than that in solvent control group (12.00±5.56, P=0.048). Furthermore, the total distance in open field [(89.85±36.98) m] and the swimming time in WLS [(112.00±29.52) s] in rats treated with LNG-ECPs both decreased distinctly compared with those in solvent control group [(147.55±23.13) m, P<0.001; (137.69±25.85) s, P=0.014]. 3) According to transcriptomic analysis, Cd5, Cxcr1, Lexm, Fga, Mybphl and Gstm5 were the significant differential expressed genes (DEGs) in the ovarian tissues of rats. These DEGs were involved in pathways related to steroid hormone biosynthesis, including terpenoid backbone biosynthesis, ovarian steroidogenesis, cortisol synthesis and secretion. Additionally, these genes were involved in metabolic processes, such as carbon metabolism, butanoate metabolism, cysteine and methionine metabolism. And the genes were also involved in immunoregulatory processes including cytokine-cytokine receptor interaction, viral protein interaction with cytokine and cytokine receptors. Conclusion:Consecutively repeated administering LNG-ECPs to the female rats in a short-term period (<12 cycles) did not demonstrate significant adverse effects on female fertility and the growth and development and the behaviors of their F1 generation cubs. However, long-term repeated treatment with LNG-ECPs (12 cycles) caused ovarian injury on female rats and showed negative impacts on the health of the F1 generation cubs, and no significant improvement was observed after recovering for 3 estrous cycles.

Objective:To investigate the effects of early hyperbaric oxygen combined with piracetam on hepatic and renal function and myocardial enzyme spectrum in patients with acute carbon monoxide poisoning (ACOP).Methods:A total of 103 patients with ACOP treated in the Emergency Department of Affiliated Hospital of Jining Medical University from January 2015 to January 2019 were selected and divided into control group (53 cases, hyperbaric oxygen treatment) and observation group (50 cases, hyperbaric oxygen combined with piracetam treatment). The changes in the renal function, myocardial enzyme spectrum, superoxide dismutase (SOD), and the hepatic function, as well as the clinical efficacy, and the incidences of adverse reactions were compared between the two groups.Results:The total effective rate of the observation group (98.00%) was significantly higher than that of the control group (79.25%), and there was a statistically significant difference ( P<0.05). After treatment, the levels of blood urea nitrogen (BUN), creatinine (Cr), uric acid, β2 microglobulin (β2-MG), creatine kinase (CK), creatine kinase isoenzyme (CK-MB), α-hydroxybutyrate dehydrogenase (α-HBDH), lactate dehydrogenase (LDH), alkaline phosphatase (ALP), alanine aminotransferase (ALT), and aspartate aminotransferase (AST) in the observation group were lower than those in the control group, while the level of SOD in the observation group was higher than that in the control group, and there were statistically significant differences ( P<0.05). In terms of the incidences of delayed encephalopathy, acute cerebral infarction, rhabdomyolysis, and pressure ulcer, there was no statistically significant difference between the two groups ( P>0.05). Conclusion:The early hyperbaric oxygen combined with piracetam has a significant clinical efficacy in treating patients with ACOP. It can alleviate the myocardial damage caused by hypoxia, and plays a positive role in protecting hepatic and renal function.

Objective:To investigate the effects of early hyperbaric oxygen combined with piracetam on hepatic and renal function and myocardial enzyme spectrum in patients with acute carbon monoxide poisoning (ACOP).Methods:A total of 103 patients with ACOP treated in the Emergency Department of Affiliated Hospital of Jining Medical University from January 2015 to January 2019 were selected and divided into control group (53 cases, hyperbaric oxygen treatment) and observation group (50 cases, hyperbaric oxygen combined with piracetam treatment). The changes in the renal function, myocardial enzyme spectrum, superoxide dismutase (SOD), and the hepatic function, as well as the clinical efficacy, and the incidences of adverse reactions were compared between the two groups.Results:The total effective rate of the observation group (98.00%) was significantly higher than that of the control group (79.25%), and there was a statistically significant difference ( P<0.05). After treatment, the levels of blood urea nitrogen (BUN), creatinine (Cr), uric acid, β2 microglobulin (β2-MG), creatine kinase (CK), creatine kinase isoenzyme (CK-MB), α-hydroxybutyrate dehydrogenase (α-HBDH), lactate dehydrogenase (LDH), alkaline phosphatase (ALP), alanine aminotransferase (ALT), and aspartate aminotransferase (AST) in the observation group were lower than those in the control group, while the level of SOD in the observation group was higher than that in the control group, and there were statistically significant differences ( P<0.05). In terms of the incidences of delayed encephalopathy, acute cerebral infarction, rhabdomyolysis, and pressure ulcer, there was no statistically significant difference between the two groups ( P>0.05). Conclusion:The early hyperbaric oxygen combined with piracetam has a significant clinical efficacy in treating patients with ACOP. It can alleviate the myocardial damage caused by hypoxia, and plays a positive role in protecting hepatic and renal function.

Objective: To analyze the characteristics of changes in serum cholesterol level in sepsis patients, and to explore its correlation with prognosis. Methods: A retrospective analysis was conducted. Two hundred and six patients with sepsis admitted in the Third People′s Hospital of Dalian from February 2015 to February 2019 were enrolled (observation group), and 206 patients without sepsis hospitalized in the same period were served as control group. The basic clinical data of the two groups were collected, and the results of total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C) and biochemical parameters were compared. The patients with sepsis were divided into death group and survival group, and risk factors influencing the prognosis of patients with sepsis were analyzed with Logistic regression analysis. Results: Compared with control group, the levels of serum TC [(2.49 ± 1.14) mmol/L vs. (3.40 ± 1.26) mmol/L, t=6.240] and HDL-C [(1.66 ± 0.89) mmol/L vs. (2.49 ± 0.81) mmol/L, t=5.532] in observation group were significantly lower (P<0.05), and that of LDL-C showed no statistically significant difference [(1.96 ± 0.91) mmol/L vs. (2.10 ± 0.72) mmo/L, t=0.940, P>0.05]. In observation group, the patients in death group (85 cases) were older than those of the survival group (121 cases)[(75.6 ± 8.6) years vs. (62.5 ± 6.0) years, t=4.565], serum creatinine (SCr) was higher than that of survival group [(246.2 ± 34.6) μmol/L vs. (165.4 ± 35.6) μmol/L, t=5.420], and the levels of serum TC [(2.15 ± 0.59) mmol/L vs. (2.89 ± 1.02) mmol/L, t= 5.475], HDL-C [(1.40 ± 0.42) mmol/L vs. (1.94 ± 0.52) mmol/L, t=4.856] and LDL-C [(1.73 ± 0.56) mmol/L vs. (1.97 ± 0.72) mmol/L, t=4.261] were significantly lower than those of survival group (P<0.05). Logistic regression analysis showed that age was the risk factor of death in sepsis patients (OR=1.256, 95% CI 1.006 -1.056, P=0.012), and TC was the protective factor for the prognosis of sepsispatients (OR=-0.758, 95%CI 0.579-0.867, P=0.014). Conclusions The levels of TC, HDL-C in sepsis patients are significantly lowered, and the levels of TC, HDL-C, LDL-C in death group are significantly lower than those in survival group. TC may be used as a clinical indicator to assess the outcome of sepsis patients.

Objective:To observe ulcer characteristics of Crohn's disease under double balloon enteroscopy,and to evaluate the correlation between endoscopic severity and clinical manifestations.Methods:A prospective,observational study from July 2015 to December 2016 in the Third Xiangya Hospital,Central South University,we selected 45 patients with positive double-balloon enteroscopy (DBE) and confirmed Crohn's disease.Two digestive internal physician observed the ulcer characteristics of Crohn's disease under double balloon enteroscopy,and gave a simple endoscopic score for CD (SES-CD).We analyzed the correlation between SES-CD and Crohn's disease activity index (CDAI).Results:DBE indicated 24 patient ulcers (53.33％) locating at the end of the ileum,5 (11.11％)locating at ileocolon,16 (35.56％) locating at upper gatrointestinal tract and they did not affect the end of the ileum.Among them,8 cases (17.78％) affected only jejunum.Thirty-two patients with longitudinal ulcers in Crohn's disease,accounting for 71.11％.There was no correlation between SES-CD score and CDAI score (r=0.237,P=0.136).Conclusion:The ulcerative appearance in Crohn's disease were diverse under double balloon enteroscopy.Crohn's disease could only affect the upper gastrointestinal tract or jejunum.The unwounded ileum and ileocecal valve couldn't be a sign to exclude Crohn's disease.CDAI score couldn't fully assess the prognosis of Crohn's disease.

Objective To explore the value of mast cell tryptase and brain natriuretic peptide(BNP)in the differential diagnostic of sudden death due to hypersensitivity and coronary atherosclerotic heart dis-ease.Methods Totally 30 myocardial samples were collected from the autopsy cases in the Department of Forensic Pathology, Shanxi Medical University during 2010—2015. All samples were divided into three groups:death of craniocerebral injury group, sudden death of hypersensitivity group and sudden death of coronary atherosclerotic heart disease group, 10 cases in each group. Mast cell tryptase and BNP in myocardium were detected by immunofluorescence staining and Western Blotting.Results Immunofluo-rescence staining showed that the positive staining mast cell tryptase appeared in myocardium of sudden death of hypersensitivity group and coronary atherosclerotic heart disease group. Among the three groups, the expression of mast cell tryptase showed significantly differences through pairwise comparison(P<0.05); The expression level of BNP in sudden death of coronary atherosclerotic heart disease group were significantly higher than the sudden death of hypersensitivity group and death of craniocerebral injury group(P<0.05). The difference of the expression level of BNP between the sudden death of hypersensitivity group and the death of craniocerebral injury group had no statistical significance(P>0.05).Conclusion The combined detection of the mast cell tryptase and BNP in myocardium is expected to provide help for the forensic differential diagnosis of sudden death due to hypersensitivity and coronary atherosclerotic heart disease.