Risk factors of acute biliopancreatic complications in patients of pregnancy combined with gallbladder stone and construction of prediction model / 中华消化外科杂志

Objective:To investigate the risk factors of acute biliopancreatic complica-tions in patients of pregnancy combined with gallbladder stone and construction of prediction model.Methods:The retrospective case-control study was constructed. The clinical data of 98 patients of pregnancy combined with gallbladder stone who were admitted to the First Hospital of Lanzhou University from September 2011 to October 2022 and 53 patients of pregnancy combined with gallbladder stone who were admitted to Gansu Provincial Hospital May 2014 to October 2021 were collected. The age of 151 patients was 29(25,32)years. Observation indicators: (1) situations of patients of pregnancy combined with gallbladder stone; (2) risk factors of acute biliopancreatic com-plications in patients of pregnancy combined with gallbladder stone; (3) construction of prediction model for acute biliopancreatic complications in patients of pregnancy combined with gallbladder stone. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the independent t test. Measurement data with skewed distribution were represented as M( Q1, Q3), and comparison between groups was conducted using the Mann-Whitney U test. Count data were described as absolute numbers, and comparison between groups was conducted using the chi-square test. Comparison of ordinal data was conducted using the rank sum test. Univariate and multi-variate analyses were conducted using the Logistic regression model. Nomogram prediction model was conducted, and the receiver operating characteristic (ROC) curve was used to evaluate discri-mination of the nomogram predic-tion model. The calibration curve and clinical decision curve were used to evaluate calibration and net clinical benefit of the nomogram prediction model. Internal validation of the prediction model was performed by applying 10-fold cross-validation. Results:(1) Situations of patients of pregnancy combined with gallbladder stone. The total cholesterol, triglyceride, high density lipoprotein cholesterol, low density lipoprotein cholesterol, prepregnancy body mass index (<18.5 kg/m 2, 18.5?24.0 kg/m 2, >24.0 kg/m 2), gesta-tional period (early, mid, late), primipara (positive, negative), stone type (solitary, non solitary), diameter of stone (≤10 mm, >10 mm), gallbladder wall thickness (≥4 mm, <4 mm) were (4.9±1.4)mmol/L, 1.88(1.22,2.93)mmol/L, 1.48(1.22,1.83)mmol/L, (2.8±0.9)mmol/L, 13, 75, 58, 37, 45, 69, 86, 65, 37, 114, 89, 62, 38, 113 in the 151 patients of pregnancy combined with gallbladder stone. Of the 151 patients, the age, prepregnancy body mass index (<18.5 kg/m 2, 18.5?24.0 kg/m 2, >24.0 kg/m 2), primipara (positive, negative), stone type (solitary, non solitary), diameter of stone (≤10 mm, >10 mm), gallbladder wall thickness (≥4 mm, <4 mm) were 31(28,37)years, 3, 30, 36, 29, 40, 32, 37, 26, 43, 4, 65 in 69 cases without symptom, versus 27(24,31)years, 10, 45, 22, 57, 25, 5, 77, 63, 19, 34, 48 in 82 cases combined with acute biliopancreatic complications, showing significant differences in the above indicators between them ( Z=?3.636, ?2.385, χ2=11.544, 32.862, 23.729, 25.310, P<0.05). Five of the 82 patients of pregnancy combined with gallbladder stone missed data of prepregnancy body mass index. Of the 82 patients, there were 42 patients of simple acute cholecystitis, 40 patients of common bile duct stone and/or acute biliary pancreatitis including 18 cases of common bile duct stone, 13 cases of acute biliary pancreatitis and 9 cases of common bile duct stone combined with acute biliary pancreatitis. (2) Risk factors of acute biliopancreatic complications in patients of pregnancy combined with gallbladder stone. Results of multivariate analysis showed that primipara, non solitary stone, diameter of stone ≤10 mm, gallbladder wall thickness ≥4 mm were independent risk factors of acute biliopancreatic complications in patients of pregnancy combined with gallbladder stone ( odds ratio=3.102, 6.305, 3.674, 6.686, 95% confidence interval as 1.280?7.519, 1.886?21.080, 1.457?9.265, 1.984?22.528, P<0.05). Results of multivariate analysis in further analysis showed that primipara, non solitary stone, gallbladder wall thickness ≥4 mm were independent risk factors of simple acute cholecystitis in patients of pregnancy combined with gallbladder stone ( odds ratio=3.671, 8.905, 7.137, 95% confidence interval as 1.386?9.723, 2.332?34.006, 1.902?26.773, P<0.05), and age, non solitary stone, diameter of stone ≤10 mm, gallbladder wall thickness ≥4 mm were independent risk factors of common bile duct stone and/or acute biliary pancreatitis in patients of pregnancy combined with gallbladder stone ( odds ratio=0.883, 5.361, 5.472, 8.895, 95% confidence interval as 0.789?0.988, 1.062?27.071, 1.590?18.827, 2.064?38.325, P<0.05). (3) Construction of prediction model for acute biliopancreatic complications in patients of pregnancy combined with gallbladder stone. The nomogram prediction model for acute biliopancreatic complications in patients of pregnancy combined with gallbladder stone was constructed based on the clinical factors of age, primipara, stone type, diameter of stone and gallbladder wall thickness. The area under the curve (AUC) of ROC curve of prediction model was 0.869 (95% confidence interval as 0.813?0.923), indicating that the prediction model with good predictive ability. Results of Hosmer-Lemeshow test showed a good fit ( χ2=5.680, P>0.05), indicating that the prediction model with good calibration. Results of decision curve analysis showed the prediction model with high net clinical benefit. Results of internal validation of the prediction model based on 10-fold cross-validation showed the AUC of ROC curve for the cross-validation sample was 0.833, indicating that the prediction model with good stability. Conclusions:Primigravida, non solitary stone, diameter of stone ≤10 mm, gallbladder wall thickness ≥4 mm are independent risk factors of acute biliopancreatic complications in patients of pregnancy combined with gallbladder stone. The prediction model for acute biliopancreatic complications has good predictive ability.

The influence of glucose regulatory protein 78 on prognosis and tumor cell proliferation of hepatocellular carcinoma / 中华消化外科杂志

Objective:To investigate the influence of glucose regulatory protein 78 (GRP78) on prognosis and tumor cell proliferation of hepatocellular carcinoma.Methods:The experimental study and retrospective cohort study were conducted. Based on hepatocellular carcinoma tissue chip, in vitro culture of Huh7 and Hep3B hepatoma cells and LO2 normal hepatic cell, and combined with immunohistochemical staining, cell transfection, quantitative real-time polymerase chain reaction (qRT-PCR), Western blot detection, cell proliferation experiments, cell clone formation experiments and high-throughput transcription histological analysis, the GRP78 expression in hepatoma cells was analyzed. Huh7 and Hep3B hepatoma cells being transfected with the GRP78 gene-specific shRNA lentiviruses or the negative control shRNA lentivirus were set as the GRP78 gene-specific shRNA lentivirus group and the negative control shRNA lentivirus group respectively. Observation indicators: (1) GRP78 expression in hepatocellular carcinoma tissue and adjacent tissue and its correlation with the clinicopathological characteristics of hepatocellular carcinoma patients; (2) analysis of factors affecting the prognosis of hepatocellular carcinoma patients; (3) effects of inhibiting of GRP78 expression on the proliferation of hepatoma cells; (4) effects of inhibiting of GRP78 expression on the gene and protein expression of p53, p21, CDK2, CDK4, and CDK6 in hepatoma cells; (5) effects of HA15 on the proliferation and the gene and protein expression of p53, p21, CDK2, CDK4, and CDK6 in hepatoma cells. Measurement data of the normal distribution were expressed as Mean± SD, and comparison of groups was conducted using the t test or ANOVA. Repeated measurement data were analyzed using repeated ANOVA. Count data were expressed as absolute numbers, and comparisons between groups was conducted using the chi-square test. COX proportional hazards regression model was used for univariate and multivariate analysis. The Kaplan-Meier method was used to calculate the survival time and draw survival curve, and the Log-rank test was used for generative analysis. Results:(1) GRP78 expression in hepatocellular carcinoma tissue and adjacent tissue and its correlation with the clinicopathological characteristics of hepatocellular carcinoma patients: results of immunohistochemical staining of hepatocellular carcinoma tissue chip showed that GRP78 was low-expressed in 53 cases and high-expressed in 37 cases of the 90 hepatocellular carcinoma tissues. GRP78 was low-expressed in 84 cases and high-expressed in 6 cases of the 90 paracancerous tissues. There was a significant difference in GRP78 expression between hepatocellular carcinoma tissues and paracancerous tissues ( P<0.05). (2) Analysis of factors affecting the prognosis of hepatocellular carcinoma patients: all 90 patients were followed up for 5 to 56 months, with a median follow-up time of 49 months. The median overall survival time and median disease progression-free survival time were 56 months and 53 months in the 53 hepatocellular carcinoma patients with GRP78 as low-expressed, versus 32 months and 19 months in the 37 hepatocellular carcinoma patients with GRP78 as high-expressed, respec-tively, showing significant differences ( χ2=17.482, 12.097, P<0.05). Results of univariate analysis showed that alanine aminotransferase (ALT), tumor pathological grading and GRP78 expression were related factors affecting the 3-year overall survival rate and disease progression-free survival rate of hepatocellular carcinoma patients ( hazard ratio=2.317, 2.039, 3.740 and 2.194, 2.177, 2.927, 95% confidence interval as 1.150?4.671, 1.201?3.462, 2.116?6.612 and 1.048?4.593, 1.093?4.336, 1.492?5.742, P<0.05). Results of multivariate analysis showed that ALT >40 U/L, tumor pathological grading as Ⅲ-Ⅳ grade and GRP78 as high-expressed were independent risk factors affecting the 3-year overall survival rate and disease progression-free survival rate of hepatocellular carcinoma patients ( hazard ratio=2.438, 2.245, 3.223 and 3.046, 2.473, 3.307, 95% confidence interval as 1.114?5.334, 1.047?4.814, 1.396?7.440 and 1.337?6.940, 1.141?5.360, 1.399?7.819, P<0.05). (3) Effects of inhibiting of GRP78 expression on the proliferation of hepatoma cells: ①results of qRT-PCR showed that the relative expression of GRP78 messenger RNA (mRNA) in Huh7, Hep3B, and LO2 cells were 3.06±0.33, 4.42±0.60 and 1.00±0.02. There were significant differences in GRP78 mRNA expression between Huh7 and LO2 cells or Hep3B and LO2 cells ( t=6.19, 5.42, P<0.05). ②Results of Western Blot detection showed that the relative expression of GRP78 protein in Huh7, Hep3B, and LO2 cells were 1.65±0.01, 1.77±0.01 and 0.99±0.02. There were significant differences in GRP78 protein expression between Huh7 and LO2 cells or Hep3B and LO2 cells ( t=75.09, 108.10, P<0.05). ③Results of cell proliferation experiments showed that the growth rates in Hu7 GRP78 gene-specific shRNA lentiviruses group cells and Hu7 negative control shRNA lentivirus group cells at 24, 48, 72 and 96 hours were 111.51%±0.35%, 144.85%±0.68%, 188.71%±3.62%, 282.51%±5.25% and 190.08%±0.58%, 285.76%±2.69%, 459.51%±4.29%, 597.88%±12.25%, showing signifi-cant differences ( Fgroups=1 360.000, Ftime=668.500, Finteraction=197.600, P<0.05). The growth rates in Hep3B GRP78 gene-specific shRNA lentiviruses group cells and Hep3B negative control shRNA lentivirus group cells at 24, 48, 72 and 96 hours were 124.47%±0.25%, 153.25%±1.25%, 195.45%±3.19%, 282.51%±10.76% and 179.69%±0.33%, 322.67%±2.46%, 486.27%±5.82%, 622.35%±12.58%, showing significant differences ( Fgroups=1 222.000, Ftime=706.200, Finteraction=179.600, P<0.05). ④Results of the cell clone formation experiments showed that the number of cells in Hu7 GRP78 gene-specific shRNA lentiviruses group cells and Hu7 negative control shRNA lentivirus group cells were 125±3 and 435±17, showing a significant difference ( t=17.86, P<0.05). The number of cells in Hep3B GRP78 gene-specific shRNA lentiviruses group cells and Hep3B negative control shRNA lentivirus group cells were 138±3 and 388±7, showing a significant difference ( t=32.29, P<0.05). (4) Effects of inhibiting of GRP78 expression on the gene and protein expression of p53, p21, CDK2, CDK4, and CDK6 in hepatoma cells: results of high-throughput transcription histological analysis showed that the relative expression rates of p53, p21, CDK2, CDK4, and CDK6 were 19%, 334%, 398%, 41% and 49% in the Hu7 GRP78 gene-specific shRNA lentiviruses group cells comparing to the Hu7 negative control shRNA lentivirus group cells. ①Results of qRT-PCR showed that the relative expression of GRP78, p53, p21, CDK2, CDK4, and CDK6 mRNA were 0.17±0.03, 4.05±0.71, 3.73±0.47, 0.49±0.09, 0.48±0.06, 0.36±0.07 in the Hu7 GRP78 gene-specific shRNA lentiviruses group cells, versus 1.00±0.05, 1.03±0.17, 1.00±0.07, 1.01±0.09, 1.02±0.14, 1.00±0.03 in the Hu7 negative control shRNA lentivirus group cells, showing significant differences ( t=14.62, 4.17, 5.72, 4.26, 3.49, 8.82, P<0.05). The relative expression of GRP78, p53, p21, CDK2, CDK4, and CDK6 mRNA were 0.11±0.01, 4.28±0.43, 4.19±0.22, 0.44±0.01, 0.25±0.03, 0.68±0.04 in Hep3B GRP78 gene-specific shRNA lentiviruses group cells, versus 1.01±0.09, 1.02±0.15, 1.00±0.06, 1.01±0.09, 1.01±0.08, 1.15±0.02 in Hep3B negative control shRNA lentivirus group cells, showing significant differences ( t=10.19, 7.14, 13.79, 6.37, 9.42, 9.61, P<0.05). ②Results of Western Blot detection showed that the relative expression of GRP78, p53, p21, CDK2, CDK4, and CDK6 protein were 0.45±0.01, 1.98±0.05, 2.31±0.12, 0.75±0.03, 0.69±0.04, 0.82±0.03 in the Hu7 GRP78 gene-specific shRNA lentiviruses group cells, versus 1.01±0.05, 1.03±0.01, 1.00±0.02, 1.00±0.01, 1.01±0.02, 1.00±0.03 in the Hu7 negative control shRNA lentivirus group cells, showing significant differences ( t=11.07, 14.56, 11.30, 11.29, 10.55, 11.37, P<0.05). The relative expression of GRP78, p53, p21, CDK2, CDK4, and CDK6 protein were 0.61±0.03, 1.98±0.16, 2.55±0.12, 0.85±0.03, 0.78±0.01, 0.54±0.02 in Hep3B GRP78 gene-specific shRNA lentiviruses group cells, versus 1.00±0.03, 1.05±0.02, 1.05±0.01, 1.05±0.02, 1.00±0.02, 1.00±0.02 in Hep3B negative control shRNA lentivirus group cells, showing significant differences ( t=10.97, 13.40, 12.35, 11.06, 12.45, 13.78, P<0.05). (5) Effects of HA15 on the proliferation and the gene and protein expression of p53, p21, CDK2, CDK4, and CDK6 in hepatoma cells: results of 50% inhibiting concentration (IC50) test of HA15 showed that the IC50 of HA15 for Huh7 and Hep3B cells at 48 hours were 9.98 μmol/L and 13.70 μmol/L. ①Huh7 and Hep3B cells were treated with 9.98 μmol/L and 13.70 μmol/L of HA15. Results of cell proliferation experiments showed that the growth rates at 24, 48, 72, and 96 hours were 112.81%±0.27%, 154.71%±1.45%, 237.66%±16.77%, 294.40%±14.92% in the HA15-Huh7 cells, versus 133.67%±0.49%, 352.93%±2.31%, 557.17%±4.89%, 662.60%±13.31% in the normal Huh7 cells, showing a significant difference ( Fgroups=766.800, Ftime=518.200, Finteraction=133.300, P<0.05). The growth rates at 24, 48, 72, and 96 hours were 121.27%±2.32%, 203.85%±3.18%, 240.80%±3.02%, 286.50%±7.10% in the HA15-Hep3B cells, versus 239.14%±1.02%, 362.00%±5.44%, 539.37%±10.80%, 694.79%±17.13% in the normal Hep3B cells, showing a signifi-cant difference ( Fgroups=594.300, Ftime=317.900, Finteraction=78.600, P<0.05). ②Results of qRT-PCR showed that the relative expression of GRP78, p53, p21, CDK2, CDK4, and CDK6 mRNA were 0.27±0.05, 3.64±0.28, 4.13±0.41, 0.51±0.07, 0.39±0.03, 0.17±0.02 in the HA15-Huh7 cells, versus 1.02±0.14, 1.00±0.03, 1.00±0.05, 1.01±0.08, 1.01±0.09, 1.03±0.17 in the normal Huh7 cells, showing significant differences ( t=5.00, 9.25, 7.63, 4.73, 6.82, 5.01, P<0.05). The relative expression of GRP78, p53, p21, CDK2, CDK4, and CDK6 mRNA were 0.28±0.03, 3.49±0.78, 4.31±0.53, 0.38±0.05, 0.36±0.04, 0.24±0.03 in the HA15-Hep3B cells, versus 1.01±0.11, 1.03±0.18, 1.01±0.08, 1.00±0.06, 1.02±0.15, 1.00±0.06 in the normal Hep3B cells, showing significant differences ( t=6.26, 3.08, 6.21, 7.97, 4.26, 11.08, P<0.05). ③Results of Western Blot detection showed that the relative expression of GRP78, p53, p21, CDK2, CDK4, and CDK6 protein were 0.52±0.05, 1.94±0.08, 1.58±0.02, 0.89±0.00, 0.86±0.02, 0.74±0.01 in the HA15-Huh7 cells, versus 1.02±0.03, 1.00±0.03, 1.02±0.02, 1.04±0.03, 1.00±0.01, 1.01±0.02 in the normal Huh7 cells, showing significant differences ( t=11.54, 10.28, 11.03, 12.81, 13.67, 10.09, P<0.05). The relative expression of GRP78, p53, p21, CDK2, CDK4, and CDK6 protein were 0.57±0.02, 1.67±0.04, 1.41±0.04, 0.82±0.03, 0.70±0.02, 0.74±0.01 in the HA15-Hep3B cells, versus 1.03±0.01, 0.98±0.03, 1.00±0.03, 1.03±0.03, 1.01±0.01, 1.04±0.01 in the normal Huh7 cells, showing significant differences ( t=10.81, 11.54, 12.26, 13.62, 14.23, 10.17, P<0.05). Conclusions:High expression of GRP78 is an independent risk factor affecting the overall survival and disease progression-free survival of hepatocellular carcinoma patients. Inhibiting of GRP78 expression can reduce cell proliferation and the expression of p53, p21, CDK2, CDK4, and CDK6 mRNA and proteins in hepatoma cells.

Changes in academic performance in the online, integrated system-based curriculum implemented due to the COVID-19 pandemic in a medical school in Korea / 보건의료교육평가

Purpose@#This study examined how students’ academic performance changed after undergoing a transition to online learning during the coronavirus disease 2019 (COVID-19) pandemic, based on the test results of 16 integrated courses conducted in 3 semesters at Hanyang University College of Medicine in Korea. @*Methods@#For the 16 required courses that formed an integrated system-based curriculum running for 3 semesters, the major examinations’ raw scores were collected for each student. Percent-correct scores were used in the subsequent analysis. We used the t-test to compare grades between 2019 and 2020, and the Cohen D was calculated as a measure of effect size. The correlation of scores between courses was calculated using Pearson correlation coefficients. @*Results@#There was a significant decrease in scores in 2020 for 10 courses (62.5%). While most of the integrated system-based curriculum test scores showed strong correlations, with coefficients of 0.6 or higher in both 2019 and 2020, the correlation coefficients were generally higher in 2020. When students were divided into low, middle, and high achievement groups, low-achieving students consistently showed declining test scores in all 3 semesters. @*Conclusion@#Our findings suggest that the transition to online classes due to COVID-19 has led to an overall decline in academic performance. This overall decline, which may occur when the curriculum is centered on recorded lectures, needs to be addressed. Further, medical schools need to consider establishing a support system for the academic development of low-achieving students.

Exploring the preconception of the first year of medical students on medicine before entering medical school / 한국의학교육

Purpose@#First-year students can form a preconception based on life experiences before entering college and identifying learners’ existing characteristics can be useful foundation data for curriculum development. This study examines what preconceptions freshman students had about medicine before entering medical school. @*Methods@#A total of 110 first-year students were asked about what preconceptions they had about “medicine”. A total of 1,124 data were used in the content analysis method. @*Results@#The results were extracted into 5, and 12 twelve categories. On the theme of “scientific discipline”, the knowledge students had about general health was based on scant expertise and little evidence. Students perceived medicine as Western and scientific, considering Korean traditional medicine as unscientific. Students believed that “medical practice” should be a “disease treatment” and “patient-centered” approach rather than a “social responsibility”. In “the role of the doctor”, students were concerned about the doctor's being financially stable on the positive side, and about the high-intensity workload on the negative side. In “medical education”, students believed that studying medicine would be “hard and difficult” because of the “importance of memorizing” and “extensive study load”. In “specialty stereotype”, students had biases that were mostly concentrated on “psychiatry” and “surgery” @*Conclusion@#Perception of “medicine” has been revealed to a varied range of themes, but some have been inaccurate or unrealistic. These prejudices and groundless beliefs have a gap with the learning outcomes that students should achieve in the curriculum, and these preconceptions seem to have been influenced by South Korea’s unique cultural context.

Value of radiography with CO2 combined with contrast agents in endoscopic drainage for hilar cholangiocarcinoma / 中华消化内镜杂志

Objective To evaluate radiography with CO2 combined with contrast agents for endoscopic drainage of unresectable hilar cholangiocarcinoma. Methods Clinical data of 43 patients with unresectable hilar cholangiocarcinoma undergoing endoscopic drainage at the First Hospital of Lanzhou University from October 2010 to October 2015 were analyzed retrospectively. According to different contrast agents in radiography, patients were divided into the study group ( CO2 combined with contrast agent) and the control group ( contrast agent alone) . There were 23 cases in the study group and 20 cases in the control group. Total postoperative bilirubin(TBIL),white blood cell(WBC),procalcitonin(PCT)and the incidence of complications in the two groups were compared. Results The endoscopic procedure ranged from 50 min to 70 min. TBIL, WBC, PCT at 48 h and 72 h after operation in the study group were lower than those in the control group[48 h TBIL:(173. 42±66. 78) μmol/L VS (210. 81±78. 34) μmol/L,P=0. 025;72 h TBIL:(104. 64±56. 35) μmol/L VS (159. 33±59. 59) μmol/L, P=0. 023; 48 h WBC:(11. 51±7. 78)×109/L VS (15.83±6.67)×109/L, P=0.026; 72 h WBC:(10.92±5.64)×109/L VS (14.72±4.97)×109/L, P=0. 026; 48 h PCT:(0. 56±0. 18) ng/mL VS (1. 24±0. 73) ng/mL, P=0. 003; 72 h PCT:(0. 42± 0. 27) ng/mL VS (0. 90±0. 20) ng/mL, P=0. 001]. The incidence of postoperative cholangitis in the study group was lower than that in the control group [ 13. 0％( 3/23) VS 40％( 8/20) , P=0. 043] . Relatively low incidence of postoperative pancreatitis occurred in both groups, with no significant difference [ 4. 3％( 1/23) VS 10. 0％(2/20),P=0. 090]. Conclusion Radiography with CO2 combined with contrast agents during endoscopic drainage procedures for unresectable hilar cholangiocarcinoma is safe and effective, which could lower incidence of postoperative cholangitis.

Research progress of microRNA 222 in cardiovascular disease / 中国糖尿病杂志

MicroRNAs (miRNAs) are a class of endogenous;non-coding small RNA molecules;which can degradate target mRNA;or negatively regulate the expression of the corresponding target genes in the post transcriptional level through inhibiting target gene translation;inducing degradation and so on.MiRNAs exert important parts in the process of metabolism;cell growth;and development.MicroRNA 222 (miR-222) is an important member of microRNAs;which plays an important role in cell proliferation;differentiation;apoptosis and the development of a variety of biological tissues.Recent studies found that miR-222 could mediate a variety of physiological and pathological processes;and significantly influence the development of cardiovascular disease.MiR-222 has an important role in inflammatory response and apoptosis.Here;we reviewed the relationship between miR-222 and cardiovascular disease.

Interlukin-22 induces transforming growth factor -β1 high expression and the correlation with diabetic renal fibrosis / 中华内分泌代谢杂志

Objective To investigate the effects of interlukin-22 (IL-22) on diabetic renal fibrosis and its possible mechanisms. Methods C57 BL/ 6 mice were randomized to normal control group ( NC group), diabetic nephropathy control group ( DN group), recombinant interlukin-22 ( rIL-22) group, and interlukin-22 antibody (Anti-IL-22) group. 8 weeks after successful establishment of diabetes model, mice were injected intraperitoneally with 200 ng/ g rIL-22, Anti-IL-22 or equal 0. 1% bovine serum albumin (BSA) twice a week for 4 weeks. After the intervention, blood glucose, kidney function and 24 h urine microalbumin creatinine ratio were measured. Renal pathological changes and collagen deposition were observed under the light microscope, and semiquantitative assessment of renal sclerosis and fibrosis were evaluated at the same time. The mRNA expression of transforming growth factor ( TGF)-β1 was determined by realtime PCR. The protein expressions of α-smooth muscle actin (α-SMA), E-cadherin, and fibronetin (FN) were examined by Western blotting. The protein expressions of collagenⅢ were examined by immunohistochemical analysis. Results After 4 weeks of intervention, the 24 h urine microalbumin creatinine ratio decreased significantly in the Anti-IL-22 group ( P<0. 05). Renal tubular epithelial cells vacuolar degeneration, protein cast formation, and glomerular mesangial expansion were observed under the light microscope. And the lesions were more severe in the rIL-22 group, whereas improved in the Anti-IL-22 group. Meanwhile, the collagen deposition was in accordance with the tubular injury score. Moreover, TGF-β1 gene expression increased significantly in the rIL-22 group (P<0. 01). α-SMA and E-cadherin, epithelial-mesenchymal transition (EMT) markers, increased or decreased significantly in the rIL-22 group respectively (P<0. 05). FN and collagen Ⅲ, extracellular matrix ( ECM ) proteins, increased significantly in the rIL-22 group as well ( P <0. 05). Conclusions IL-22 may induce renal tubular epithelial cells TGF-β1 high expression. As a consequence, this contributes to EMT occurance and ECM accumulation, eventually accelerating the progression of diabetic renal fibrosis.

Interlukin-22 induces transforming growth factor -β1 high expression and the correlation with diabetic renal fibrosis / 中华内分泌代谢杂志

Objective To investigate the effects of interlukin-22 (IL-22) on diabetic renal fibrosis and its possible mechanisms. Methods C57 BL/ 6 mice were randomized to normal control group ( NC group), diabetic nephropathy control group ( DN group), recombinant interlukin-22 ( rIL-22) group, and interlukin-22 antibody (Anti-IL-22) group. 8 weeks after successful establishment of diabetes model, mice were injected intraperitoneally with 200 ng/ g rIL-22, Anti-IL-22 or equal 0. 1% bovine serum albumin (BSA) twice a week for 4 weeks. After the intervention, blood glucose, kidney function and 24 h urine microalbumin creatinine ratio were measured. Renal pathological changes and collagen deposition were observed under the light microscope, and semiquantitative assessment of renal sclerosis and fibrosis were evaluated at the same time. The mRNA expression of transforming growth factor ( TGF)-β1 was determined by realtime PCR. The protein expressions of α-smooth muscle actin (α-SMA), E-cadherin, and fibronetin (FN) were examined by Western blotting. The protein expressions of collagenⅢ were examined by immunohistochemical analysis. Results After 4 weeks of intervention, the 24 h urine microalbumin creatinine ratio decreased significantly in the Anti-IL-22 group ( P<0. 05). Renal tubular epithelial cells vacuolar degeneration, protein cast formation, and glomerular mesangial expansion were observed under the light microscope. And the lesions were more severe in the rIL-22 group, whereas improved in the Anti-IL-22 group. Meanwhile, the collagen deposition was in accordance with the tubular injury score. Moreover, TGF-β1 gene expression increased significantly in the rIL-22 group (P<0. 01). α-SMA and E-cadherin, epithelial-mesenchymal transition (EMT) markers, increased or decreased significantly in the rIL-22 group respectively (P<0. 05). FN and collagen Ⅲ, extracellular matrix ( ECM ) proteins, increased significantly in the rIL-22 group as well ( P <0. 05). Conclusions IL-22 may induce renal tubular epithelial cells TGF-β1 high expression. As a consequence, this contributes to EMT occurance and ECM accumulation, eventually accelerating the progression of diabetic renal fibrosis.

Aerobic exercise protects cardiac function of T2DM mice by activation of PI3K (p110α)/Akt signaling pathway / 中国病理生理杂志

AIM: To study the protective effect of aerobic exercise on cardiac dysfunction in mice and its mechanism, and to provide theoretical and practical basis for the exercise therapy of diabetic cardiac dysfunction .METH-ODS:The mice were divided into normal control non-exercise (NNC) group, normal control exercise (ENC) group, dia-betic non-exercise (NDM) group and diabetic exercise (EDM) group.At the end of the experiment , the cardiac function was evaluated by echocardiography .The pathological changes of the myocardial tissues and the development of fibrosis were observed.The mRNA expression of ANP, and the protein levels of PI3K (p110α) and Akt were determined.RESULTS:The decrease in cardiac function of diabetic mice was observed , and the cardiac function recovered after exercise interven-tion (P<0.05).Under light microscope with HE and Masson staining , the myocardial structure in NDM group was in ex-treme disorder , cell arrangement was not neat , and the degree of fibrosis increased , but the myocardial damage was im-proved in ENC group .Compared with NNC group , the mRNA expression of ANP in the myocardium of diabetic mice was up-regulated (P<0.05).The protein levels of PI3K (p110α) and Akt were decreased (P<0.05), and the cascade was inactivated.Compared with NDM group , the mRNA expression of ANP was down-regulated and the protein levels of PI 3K (p110α) and Akt were up-regulated in EDM group (P<0.05).CONCLUSION:Diabetes results in myocardial damage in mice, and reduces cardiac function .Exercise intervention alleviates the heart dysfunction induced by high glucose via activating PI3K( p110α)/Akt signaling pathway to protect the structure and function of the myocardium .

Effect and mechanism of exercise-induced miR-222 in the protection of myocardial damage in diabetic mice / 中华内分泌代谢杂志

Objective To investigate the protective effects of aerobic exercise and miR-222 expression in myocardium of diabetic mice. Methods C57BL/ 6 mice were divided into 4 groups: normal non-exercise group (SC), normal exercise group(EC), non-exercise diabetic group(SD), and exercise diabetic group(ED). After the diabetic model was established successfully, EC and ED underwent a swimming training for 5 weeks. By the end of the experiment, light microscope was used to observe the pathological changes of heart, RT-PCR for myocardial miR-222 expression, and Western blot for phosphatase and tensin homolog deleted on chromosome ten ( PTEN ), phosphatidylinositol 3-kinase (PI3K), and protein kinase B (Akt) protein expressions in myocardial tissue. Results (1) Under the light microscope, the diabetic mice had a significant change in myocardial structure, with great disorder in the cell arrangement. After exercise intervention, the lesion was alleviated. (2) MiR-222 expression was increased in the myocardium of normal mice and DM mice after exercise (all P<0. 05); (3) Compared with SC group, PTEN expression was increased and PI3K/ Akt expressions were inhibited in myocardium of diabetic mice(all P <0. 05). After exercise intervention, the expression of PTEN reduced( P < 0. 05) and PI3K/ Akt pathway was reactivated in myocardium of diabetic mice (all P<0. 05). Conclusion Exercise intervention may protect the myocardium under high glucose via inducing miR-222 and activating PI3K/ Akt signaling pathway.

Effects of Forsythiae Fructus on guinea pig ileum contractility in vitro / 中国中药杂志

<p><b>OBJECTIVE</b>To study contractility of guinea pig ileum in vitro,and analyze the mechanism of anti-emetic effects of Lianqiao.</p><p><b>METHOD</b>Using emesis-relating agonists as drugs, the inhibitory effects of Lianqiao on guinea pig ileum contractility in vitro were observed in organ bath.</p><p><b>RESULT</b>Lianqiao could inhibit guinea pig ileum spontaneous contractions, reducing the tone of contractions dose-dependently. Acetylcholine (Ach), histamine (His), 5-hydroxytryptamine (5-HT) stimulated contractions of the guinea pig ileum, enhanced the tone and amplitude. All the three doses (10, 5, 2 g x L(-1)) of Lianqiao could suppress the contractility, significantly reduced the tone and amplitude of ileum contractions stimulated by drugs but not the frequency. Dopamine could inhibit the spontaneous contraction tone and amplitude of ileum; Both the large doses (10, 5 g x L(-1)) of Lianqiao could antagonise the inhibitory effect of DA, enhance the tone and amplitude. Small dose(2 g x L(-1)) had additive effects on tone of ileum contractions with DA,but enhanced the amplitude not the frequency.</p><p><b>CONCLUSION</b>Lianqiao have an inhibitory effect on guinea pig ileum contractions,the mechanism might be blocking M receptor, H1 receptor, 5-HT receptor and D2 receptor or directly suppressed ileum smooth muscle. The mechanisms of anti-emetic effect of Lianqiao needs further study.</p>

A comparative study of the subjective well-being between students in junior high schools for the blind and the normal junior high school students / 中华行为医学与脑科学杂志

Objective To study and compare the present situation and the difference in subjective well-being between students in junior high schools for the blind and normal junior high school students, and provide basis for the construction of education mode for the well-being of the blind students. Methods By random sampling method, subjective well-being questionnaire was used to investigate the 155 blind students in five blind schools and 436 normal junior high school students in three junior high schools in Shandong Province. Results ( 1 ) The blind students had shown significant differences in many aspects of subjective well-being such as gender, family e-conomic status, sight and parents'education degree (P<0. 05) . (2) Blind school students'social confidence experience (4. 59 ±1.13) was significantly higher than that of the normal students (4.31 ±1.13), and had a significant difference (P<0.05). Blind students got significantly lower scores ((4. 38 ± 1.26) , (4.00 ± 1. 29) ,(3. 58 ± 1. 37) ,(3.89 ± 1. 35) ,(4.41 ± 1.04) , (4. 20 ± 1. 33) ) than normal school students( (4.68 ± 1. 19) , (4. 36 ±1.14),(3.88±1.27),(4.41 ±1.25),(4.61 ±0.99), (4. 52 ± 1. 18)) in target value experience, physical health experience, mental health experience, interpersonal adaptability experience self-acceptance experience, and emotional balance experience. Conclusion There exists a significant difference between the blind students and the normal junior high school students in the different aspects of subjective well-being.

Relationship among interpersonal relationship, coping style, self consistency and congruence for college students / 中华行为医学与脑科学杂志

ObjectiveTo provide evidence for the education on sychological health for the undergraduates by analyzing the relationship among interpersonal relationship, coping style, self consistency and congruence of local college students. Methods uestionnaires about interpersonal relationship, coping style, and self consis tency and congruence have been carried out on a stratified random sample of 1471 students from four local colle ges. And all the data of the questionnaire scales will be dealt with by the software SPSS15.0. Results①Total scores on interpersonal relationship and self consistency and congruence of male college students( (9.88 ±5.51 );(93.29 ± 13.48 ) respectively) were much higher than the scores of the female college students ( ( 8.84 ± 5.11 );(90.09 ± 12.60) respectively). Total scores of the above two items for the seniors( ( 10.26 ± 5.89 ); ( 96.79 ±12.93) respectively) were obviously higher than the total scores of students of other grades. For the engineering students, whose total scores on the two items( ( 10.26 ±5.86); (93.57 ± 12.83 ) respectively) were remarkably higher than the scores of students of other majors. Regarding the various factors of coping style, there are signifi cant differences in gender, grade and major( P ＜ 0. 01 ). ②Concerning the college students, there were conspicu ous relationship among their interpersonal relationship, coping style, self consistency and congruence ( P ＜ 0.01 ). ③ Self consistency and congruence could be effectively predicted by factors, i.e. total score of interpersonai rela tionship, remorse, problem-solving, rationalizing, fantasy, recoil, help-seeking and grade. ConclusionCollege students' ability of self consistency and congruence is affected by their coping style and interpersonal relationship. To improve the individual' s ability of self consistency and congruence and the condition of their psychological health, the most effective way is to cultivate the capability on interpersonal communication and apply the positively flexible coping style.

Study on carotid intima-media thickness and stiffness in type 2 diabetic patients / 中华内分泌代谢杂志

Objective To study the effect of blood glucose level and duration of type 2 diabetes mellitus on carotid intima-media thickness (CIMT) and quantitative carotid stiffness (QCS) in the patients with type 2 diabetes mellitus. Methods Two hundred and seventy-four type 2 diabetic patients (diagnosed according to the World Health Organization criteria) were involved in this study. The subjects were divided into three groups according to the HbAlclevels and duration of diabetes mellitus: 60 with duration ≤2 years (as newly diagnosed) , 96 with duration≥5 years and HbAlc <6.5%, and 118 with duration≥5 years and HbAlc≥6.5%. CIMT and QCS of the common carotid artery were assessed by the high-resolution B-mode ultrasound unit and an echo-tracking system integrated in an uhrasound unit respectively. Results (1) In categorical analyses, the mean level of CIMT was increased from 720 μm in subjects with a duration of diabetes mellitus ≤2 years to 770 μm in subjects with a duration of diabetes mellitus > 2 years and plasma HbAlc< 6.5% (P < 0.05), and to 800 μm in subjects with a duration of diabetes mellitus > 5 years and plasma HbAlc≥ 6.5 % (P < 0.01). The corresponding values for Q CS values were 4.5, 4.5 and 5.1 (P <0.05), respectively. (2) In multiple stepwise regression analyses, CIMT wassignificantly associated with the duration of diabetes mellitus, systolic blood pressure and serum concentration of total cholesterol, whereas QCS was significantly associated with age, duration of diabetes mellitus, smoking, HbAlc, systolic blood pressure (P < 0.05 or P < 0.01). Conclusion QCS is suitable in evaluating the impact of blood glucose on carotid artery, while CIMT is an appropriate tool for long-term follow-up of diabetic patients.