BACKGROUND:Studies have shown that mitochondrial oxidative stress has an important role in the development of knee osteoarthritis,and Hemin can regulate the expression of mitochondria-related proteins. OBJECTIVE:To study the regulatory effect of Hemin on oxidative stress in mouse chondrocytes and its interventional effect and mechanism in knee osteoarthritis. METHODS:(1)In vitro cell experiment:Primary chondrocytes from C57BL/6 mice were extracted and induced with 10 ng/mL interleukin-1β to construct an in vitro chondrocyte model of osteoarthritis.The optimal concentration of Hemin(0,1,10,20,40,80,and 160 μmol/L)for the intervention in mouse chondrocytes was determined by cell counting kit-8 method.Chondrocytes were randomly divided into control group,model group(interleukin-1β)and Hemin group(interleukin-1β+Hemin).Reactive oxygen species,mitochondrial membrane potential and apoptosis of chondrocytes in each group were detected.(2)In vivo experiment:Adult C57BL/6 mice were randomly divided into normal group,model group(osteoarthritis)and Hemin group(osteoarthritis+Hemin),with eight mice in each group.After 4 weeks of Hemin treatment,the behavioral test and histopathological observation of the knee joint were performed in each group.Changes in extracellular matrix-related protein expression and apoptosis in chondrocytes and the expression level of Nrf2/HO-1 protein in cartilage tissue were detected. RESULTS AND CONCLUSION:In vitro experiment:the optimal concentration of Hemin on primary chondrocytes was 40 μmol/L.Compared with the model group,the level of reactive oxygen species was significantly reduced,the mitochondrial membrane potential was significantly improved,and the apoptosis of chondrocytes was reduced in the hemin-treated interleukin-1β-induced chondrocytes.In vivo experiment:After 4 weeks of treatment,compared with the model group,the lower limb function of mice in the Hemin group was significantly improved,the histopathological score was significantly improved,and the apoptosis of knee chondrocytes was significantly reduced.All these findings indicate that Hemin can alleviate oxidative stress,restore mitochondrial function and reduce apoptosis in mouse chondrocytes induced by interleukin-1β.Hemin can improve extracellular matrix degradation,promote chondrocyte anabolism,reduce catabolism and reduce chondrocyte apoptosis in knee osteoarthritis.It may act by activating the chondrocyte Nrf2/HO-1 signaling pathway in the inflammatory environment.

Objective Triple-negative breast cancer(TNBC)poses a significant challenge for treatment efficacy.CD8+T cells,which are pivotal immune cells,can be effectively analyzed for differential gene expression across diverse cell populations owing to rapid advancements in sequencing technology.By leveraging these genes,our objective was to develop a prognostic model that accurately predicts the prognosis of patients with TNBC and their responsiveness to immunotherapy. Methods Sample information and clinical data of TNBC were sourced from The Cancer Genome Atlas and METABRIC databases.In the initial stage,we identified 67 differentially expressed genes associated with immune response in CD8+T cells.Subsequently,we narrowed our focus to three key genes,namely CXCL13,GBP2,and GZMB,which were used to construct a prognostic model.The accuracy of the model was assessed using the validation set data and receiver operating characteristic(ROC)curves.Furthermore,we employed various methods,including Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway,immune infiltration,and correlation analyses with CD274(PD-L1)to explore the model's predictive efficacy in immunotherapeutic responses.Additionally,we investigated the potential underlying biological pathways that contribute to divergent treatment responses. Results We successfully developed a model capable of predicting the prognosis of patients with TNBC.The areas under the curve(AUC)values for the 1-,3-,and 5-year survival predictions were 0.618,0.652,and 0.826,respectively.Employing this risk model,we stratified the samples into high-and low-risk groups.Through KEGG enrichment analysis,we observed that the high-risk group predominantly exhibited enrichment in metabolism-related pathways such as drug and chlorophyll metabolism,whereas the low-risk group demonstrated significant enrichment in cytokine pathways.Furthermore,immune landscape analysis revealed noteworthy variations between(PD-L1)expression and risk scores, Conclusion Our study demonstrates the potential of CXCL13,GBP2,and GZMB as prognostic indicators of clinical outcomes and immunotherapy responses in patients with TNBC.These findings provide valuable insights and novel avenues for developing immunotherapeutic approaches targeting TNBC.

Objective:To construct a humanistic care intervention program for stroke patients after discharge and evaluate the implementation effect.Methods:Through preliminary research, literature review and expert consultation, the humanistic care program for stroke patients after discharge based on Watson's humanistic care theory was constructed and integrated into clinical practice intervention program and implemented. By convenience sampling method, stroke patients discharged from the Neurology Department of Shanghai Pudong New Area People's Hospital in June 2019 were selected as the control group, and patients discharged in July 2019 were selected as the intervention group. The control group received routine follow-up, and the intervention group received humanistic care intervention program after discharge. The scores of the WHO Quality of Life-BREF (WHOQOL-BREF) , limb function improvement, and the General Well-Being Schedule were compared between the two groups before and after the intervention.Results:After the intervention, the WHOQOL-BREF total score of the intervention group was (55.74±4.88) , and the total score of the General Well-Being Schedule was (72.06±8.02) , which was higher than (48.49±5.77) , (65.09±3.45) of the control group. The differences were statistically significant ( P<0.05) . After the intervention, the limb function improvement score of the intervention group was (3.52±0.71) , which was not significantly different from that in the control group (3.20±0.63) . Conclusions:Through the construction and application of humanistic care program for stroke patients after discharge, it can effectively improve the quality of life, and happiness of COPD patients.

Objective:To explore the influence of patient participation-based dietary intervention on nutritional status for patients with severe burn.Methods:From September 2017 to January 2019, 60 severe burn patients hospitalized in the department of burn and plastic surgery of Qingdao Municipal Hospital were recruited and divided into the experimental group ( n=30) and the control group ( n=30) according to the random number table method. The control group received a regular diet. While the experimental group received a patient participation-based dietary intervention(PPDI), The wound healing time and the value of nutritional status index, such as height, body mass index(BMI), serum albumin, serum prealbumin, in the two groups on admission, at 2 weeks after intervention, 4 weeks after intervention were compared. The nutritional knowledge questionnaire of burn patients and "3-day diet diary" were used for investigation. Results:The score of nutritional knowledge showed no significant difference between the two groups before intervention. After intervention, the score of nutritional knowledge in the experimental group was 21.40±2.42, significantly higher than that in the control group (19.00±2.26) ( t value was 3.975, P<0.01). For time effect and between-group effect, there were significant difference in serum albumin between two groups ( F values were 9.232, 4.651, P<0.05); the time effect and between-group effect of serum prealbumin were statistically significant ( F values were 11.592, 6.228, P < 0.05). The wound healing time in the experimental group was significantly lower than that in the control group ( t value was -3.801, P<0.01). Conclusions:Patient participation-based dietary intervention can effectively enhanced the level of nutritional knowledge, improved nutritional status, shortened wound healing time among patients with severe burn.

Cervical cancer is the second most common female reproductive system tumor in developing countries and ranks second among female cancer deaths worldwide. In recent years, with the continuous optimization and popularization of cervical cancer screening and preventive measures, the overall incidence rate of cervical cancer has decreased. But the incidence rate of cervical cancer in China is younger and differentiated. It continues to threaten the fertility, reproduction, mental health and life safety of women in China. In view of the current difficulties, precision medicine initiative (PMI) has opened a new chapter in the individualized prevention and treatment of cancer. Chinese medical workers need to learn from the beneficial results of international research organizations on early screening and prevention of cervical cancer, and explore the appropriate early screening and prevention strategies for cervical cancer in China.

Objective To investigate the current situation of medical students' individual career management and its educational status.Methods Self-made questionnaire was used to investigate the present situation of individual career management and education of medical students in a medical college in November 2016.SPSS 20.0 was used for analyzing descriptive statistical analysis,t test and rank test in questionnaire data.From April to May 2017,30 students were randomly selected for interviews to explore the current situation of medical students' individual career management.Result 900 questionnaires were issued and 816 valid questionnaires were collected,and the recovery rate was 90.67％.Whether medical students accept the relevant education had significant difference in their career management ability (P＜ 0.05),30.15％ of the students who received the relevant education (246) had a higher total score of their own career management than those who had not received,which was reflected in social work environment cognition level,participation in extracurricular activities,consideration of graduation and stage goals setting.It is learned from the interview that most medical students lack clear self-awareness and professional goals are vague,and they fail to form a good personal career management atmosphere.Conclusion Individual career management education promotes the cognitive level of social work environment of medical students and then develops their self-awareness.At the same time,it urges medical students to participate in extracurricular activities,to consider the whereabouts after graduation,to set phased goals,and to carry out targeted self-improvement.The comprehensive development of self-cognition and self-improvement finally make the medical students' individual career management ability continuously improved.

Objective To compare the trigger delay and work of trigger between neurally adjusted ventilatory assist (NAVA) and pressure support ventilation (PSV) in acute exacerbation of chronic obstructive pulmonary disease (AECOPD) patients with intrinsic positive end-expiratory pressure (PEEP) during mechanical ventilation. Methods AECOPD patients with intrinsic PEEP (PEEPi) greater than or equal to 3 cmH2O (1 cmH2O=0.098 kPa) were enrolled during invasive mechanical ventilation. Subjects were ventilated with low, medium and high pressure under either NAVA or PSV mode. Servo Tracker software continuously recorded the waveform of ventilator and respiratory mechanics indexes (including respiratory frequency, inspiratory tidal volume (Vti), minute ventilation volume (VE), peak airway pressure (PIP), inspiratory time), and calculated trigger and expiratory conversion delay time, work of trigger and total work of breath. Results A total of 14 AECOPD patients were enrolled with the average PEEPi (4.3±1.3) cmH2O. PSV inspiratory trigger delay time was positively correlated with PEEPi (r=0.913, P<0.05). Compared with PSV, NAVA significantly decreased trigger delay time in low, medium and high pressure level groups [(48±17) ms vs. (167±86) ms, (63±65) ms vs. (247±240) ms, (63±49) ms vs. (342±192) ms,respectively all P<0.05]. Similar results were shown as to work of trigger [(0.92±0.36) μV?s vs. (1.22±0.70) μV?s, (1.08±0.51) μV?s vs. (1.62 ± 1.25) μV?s, (1.20 ± 0.96) μV?s vs. (2.29 ± 1.02) μV?s, all P<0.05]. Trigger delay time increased according to the increase of pressure level in PSV mode.Conclusion The presence of PEEPi in AECOPD patients leads to obvious trigger delay under PSV mode, which is positively correlated with PEEPi level. NAVA significantly reduces trigger delay time and work of trigger compared with PSV mode.

Objective To investigate the influence of occupational aluminum exposure on cogmtive function and its relationship with tri-methyl histone H3 lysine residues 4 points (H3K4me3) and brain-derived neurotrophic factor (BDNF) levels.Methods By cluster random sampling method,a total of 235 cases of male workers selected from a Shanxi aluminum factory were recruited in the study in September 2015.Used the occupational epidemiological investigation questionnaire,which included Mini-Mental State Examination (MMSE),Clock Drawing Test (CDT),Digit Span Test (DST,including forward test DSFT and backward test DSBT),Fuild Object Memory Evaluation (FOME) and Verbal Fluency Test (VFT),to collect workers' basic information and assess their cognitive function score.Detected the concentration of aluminum in plasma by graphite furnace atomic absorption spectrometry.Workers were divided into three groups by the 25 percentile and 75 percentile of the aluminum content,such as low,middle and high aluminum concentration groups.The concentrations of H3K4me3 in lymphocyte and BDNF in plasma were determined by enzyme-linked immunosorbent assay.Results The levels of aluminum in plasma was 134.36 (100.14,178.96) μg/L.The scores of MMSE,DSFT,DSBT,DST of high aluminum concentration group were lower than low aluminum group (27.98±1.25 vs 28.83±1.54,9.19±2.00 vs 10.64±2.87,6.08±1.63 vs 7.19±3.07,15.27±3.11 vs 17.81±4.72,all P＜0.05),the scores of CDT,FOME,VFT among three groups had no statistical significance (all P＞0.05).The expression levels of H3K4me3 and BDNF of high aluminum concentration group were lower than the low group [(18.45±9.81) ng/μg Pro vs (23.76±9.89) ng/μg Pro,(26.07±10.18) ng/ml vs (31.66±9.24) ng/ml,all P＜0.05].Multiple correlation analysis showed that aluminum concentration were negatively correlated to H3K4me3,BDNF,MMSE,DSFT,DST,respectively (rs =-0.307、-0.214、-0.252、-0.197,-0.181,all P＜0.01).Conclusion Exposure to occupational aluminum for a long time may change cognitive function,which go along with the decreasing of H3K4me3 level in lymphocyte and BDNF protein expression in plasma.

Objective To investigate the influence of occupational aluminum exposure on cogmtive function and its relationship with tri-methyl histone H3 lysine residues 4 points (H3K4me3) and brain-derived neurotrophic factor (BDNF) levels.Methods By cluster random sampling method,a total of 235 cases of male workers selected from a Shanxi aluminum factory were recruited in the study in September 2015.Used the occupational epidemiological investigation questionnaire,which included Mini-Mental State Examination (MMSE),Clock Drawing Test (CDT),Digit Span Test (DST,including forward test DSFT and backward test DSBT),Fuild Object Memory Evaluation (FOME) and Verbal Fluency Test (VFT),to collect workers' basic information and assess their cognitive function score.Detected the concentration of aluminum in plasma by graphite furnace atomic absorption spectrometry.Workers were divided into three groups by the 25 percentile and 75 percentile of the aluminum content,such as low,middle and high aluminum concentration groups.The concentrations of H3K4me3 in lymphocyte and BDNF in plasma were determined by enzyme-linked immunosorbent assay.Results The levels of aluminum in plasma was 134.36 (100.14,178.96) μg/L.The scores of MMSE,DSFT,DSBT,DST of high aluminum concentration group were lower than low aluminum group (27.98±1.25 vs 28.83±1.54,9.19±2.00 vs 10.64±2.87,6.08±1.63 vs 7.19±3.07,15.27±3.11 vs 17.81±4.72,all P＜0.05),the scores of CDT,FOME,VFT among three groups had no statistical significance (all P＞0.05).The expression levels of H3K4me3 and BDNF of high aluminum concentration group were lower than the low group [(18.45±9.81) ng/μg Pro vs (23.76±9.89) ng/μg Pro,(26.07±10.18) ng/ml vs (31.66±9.24) ng/ml,all P＜0.05].Multiple correlation analysis showed that aluminum concentration were negatively correlated to H3K4me3,BDNF,MMSE,DSFT,DST,respectively (rs =-0.307、-0.214、-0.252、-0.197,-0.181,all P＜0.01).Conclusion Exposure to occupational aluminum for a long time may change cognitive function,which go along with the decreasing of H3K4me3 level in lymphocyte and BDNF protein expression in plasma.

Aim To investigate the regulatory effects of baicalin on apoptosis induced by virus H1 N1 in hu-man pulmonary carcinoma cell A549 . Methods The chips were used to screen the RNA samples in virus-in-fected A549 cells. Differentially expressed genes were selected in the pathway of apoptosis. The mRNA ex-pressions of caspase-3 and -8 were verified by Real-Time PCR. Results With the DNA microarray, the functions of differentially expressed genes involved in apoptosis biological pathways were analyzed by Kyoto Encyclopedia of Genes and Genomes ( KEGG ) Path-way databases. caspase-3, -7, -8, -10, TRAIL, MYD88 , IL1 A and IL1 B were up-regulated in virus-in-fected group. Oseltamivir could down-regulate gene ex-pressions of caspase-3 ,-4 and-8 . High-dose of baica-lin could down-regulate gene expressions of caspase-3 ,-4,-6 and -8. Except gene expressions of above, low-dose of baicalin could also down-regulate gene expres-sions of IL1RAP and Cn. Real-Time PCR experiments showed that baicalin could significantly decrease mR-NA expression of caspase-3 , -4 , -6 , -8 , IL1 RAP and Cn ( P < 0. 01 ) , compared with the virus-infected group. The results also figured that the interference ef-ficacy of low-dose baicalin was better than that of high-doses. As expected, real-time PCR data were in good agreement with the microarray assay. Conclusions Baicalin can be detected in their suppression effect of caspase-3,-4,-6, and -8 mRNA expression, so it re-sists against the apoptosis to fight against influenza vi-rus in vitro.