Integration of Volunteer Service and Humanistic Quality of Medical Students / 中国医学伦理学

The long-term development of volunteer service depends on the level of humanistic quality of par-ticipants, the improvement of humanistic quality needs the practical support of volunteer service, and the integra-tion of volunteer service and humanistic quality of medical students has its theoretical rationality. "Caring for peo-ple"is its common cultural foundation,"subjectivity" is its common ideological foundation, and"group nature" is the common practice foundation for both. At present, the integration of volunteer service and medical students' hu-manistic quality is mainly facing the development issues including medical students and those who are served misun-derstand the volunteerism, the lack of medical students' humanistic spirit leads to instrumental tendency of volun-teer service behavior and the limited channels of volunteer service objectively limit the enhancing effect of humanis-tic quality of medical students. It should promote the organization of volunteer service for medical students and cul-tivate the humanistic spirit of medical students;promote the professionalization of medical students' volunteer service and enhance the self-education ability of medical students;promote the normalization of medical students' volun-teer service and enhance the social responsibility of medical students to provide reference for the integration and de-velopment of volunteer service and medical humanistic quality.

The Application of Educational Narrative in Medical Ethics Education / 中国医学伦理学

Educational narrative is the application of narratology in the field of education.This paper introduced the definition of educational narrative and its characteristics of life,situationality and reflexivity,and then discussed the applicableness of the application of educational narrative in the medical ethics education.Based on this,it proposed the effectiveness means,namely that to improve theory quality and enhance the ability of narration,clarify the narrative theme and select material carefully,take care of medical students' growth and listen to their voice.

Retinoid X receptor agonist inhibits TGF-β1-induced collagen synthesis in cardiac fibroblasts by repressing Smad2 activation / 中国病理生理杂志

AIM:To investigate the effect of activation of retinoid X receptor (RXR) on transforming growth factor β1 (TGF-β1) induced collagen synthesis under hypoxic environment in rat cardiac fibroblasts (CFs) and underlying molecular mechanisms .METHODS: CFs were cultured using myocardial tissue with dry method .Hypoxic environment was established for CFs by continuous nitrogen supplement .Type I and type III collagens in supernatants were detected by ELISA.Nuclear and cytoplasmic extractions were prepared using NE-PER nuclear and cytoplasmic extraction reagents .The protein levels of Smad2 and p-Smad2 were determined by Western blot and immunocytochemical staining .RESULTS:Un-der hypoxic condition , TGF-β1 (0.01~10 μg/L) increased the synthesis of type I and type III collagens in a dose-de-pendent manner in the CFs .At the concentration of 5μg/L, the synthesis of collagen I and III was significantly increased as compared with control group (P<0.01).RXR agonist 9-cis-retinoic acid (9-cis-RA;10 -9 ~10 -6 mol/L) decreased TGF-β1 (5μg/L)-induced synthesis of type I and III collagens in a dose-dependent manner in the CFs under hypoxic con-dition.The synthesis of type I and type III collagens was significantly inhibited by 9-cis-RA (P<0.01).Smad2 inhibitor ( 20 nmol/L) showed similar inhibitory effect on the synthesis of type I and III collagens induced by TGF -β1 under hypoxic condition.Compared with TGF-β1 intervention group, the cytoplasmic level of p-Smad2 in the CFs was significantly in-creased in TGF-β1+9-cis-RA group, but the nuclear p-Smad2 level was significantly decreased (P<0.05).CONCLU-SION:Retinoid X receptor agonist 9-cis-RA inhibits TGF-β1-induced synthesis of type I and type III collagens in the CFs by repressing p-Smad2 nuclear translocation under hypoxic condition .

Effects and related mechanism of retinoid X receptor agonist bexarotene on atherosclerosis progression in diabetic apoE(-/-) mice / 中华心血管病杂志

<p><b>OBJECTIVE</b>To explore the effect of retinoid X receptor (RXR) agonist bexarotene on atherosclerosis and the potential mechanism in streptozotocin (STZ) induced diabetic apolipoprotein E knockout (apoE(-/-)) mice.</p><p><b>METHODS</b>Eight C57BL/6 mice served as control, 46 apoE(-/-) mice were randomized into 4 groups: apoE(-/-) group (n = 10), STZ+apoE(-/-) group (n = 12), STZ+apoE(-/-)+Bex 10 (10 mg×kg⁻¹×d⁻¹)group (n = 12), STZ+ apoE(-/-)+Bex 30 (30 mg×kg⁻¹×d⁻¹) group (n = 12). Diabetic apoE(-/-) animal model was established by intraperitoneal injection of STZ. Blood glucose was determined by glucose oxidase method. Patch area in thoracic aorta was measured by HE staining. Western blotting was used to determine the RXR and gp91(phox) protein level in thoracic aorta. Reactive oxygen species (ROS) level in blood and thoracic aorta homogenates was detected by Fenton and Griess method.</p><p><b>RESULTS</b>(1) Patch areas of thoracic aorta were larger in apoE(-/-) group than in C57BL/6 group [(38.40 ± 8.95)µm² vs. (0.10 ± 0.01) µm², P < 0.01], further increased in STZ+apoE(-/-) group [(94.06 ± 8.04)µm², P < 0.05 vs. apoE(-/-) group] and significantly reduced in STZ+apoE(-/-)+Bex 10 group [(78.72 ± 4.62)µm², P < 0.05 vs. STZ+apoE(-/-) group] and further educed in STZ+apoE(-/-)+Bex 30 group [(46.13 ± 7.56)µm², P < 0.05 vs. STZ+apoE(-/-)+Bex 10 group]. (2) Blood glucose level, TG, TC, LDL-C, thoracic aorta gp91(phox) protein level and ROS level in blood and thoracic aorta homogenates were significantly higher in STZ+apoE(-/-) group than in apoE(-/-) group (all P < 0.05). Blood glucose level and TG, TC, LDL-C levels were similar between STZ+apoE(-/-)+Bex10 and STZ+apoE(-/-) group. Thoracic aorta gp91(phox) protein level and ROS level in blood and thoracic aorta homogenates were lower in STZ+apoE(-/-)+Bex 10 group than in STZ+apoE(-/-) group (P < 0.05). Blood glucose level, TG, TC, LDL-C levels, gp91(phox) expression in thoracic aorta, ROS level in blood and thoracic in STZ+apoE(-/-)+Bex 30 group were lower than in STZ+apoE(-/-) group (all P < 0.05).</p><p><b>CONCLUSION</b>Bexarotene treatment could attenuate arteriosclerosis progression in STZ induced diabetic apoE(-/-) mice, the underlying mechanism might be related to suppressing oxidative stress and decreasing blood glucose level and improving lipids metabolism.</p>

Atorvastatin inhibits atherogenesis by RXRα-mediated depressing oxida-tive stress in STZ-induced diabetic ApoE-/-mice with fat-rich diet / 中国病理生理杂志

AIM:To explore the effects of atorvastatin (Atorv) on atherosclerosis in streptozotocin (STZ)-in-duced diabetic apolipoprotein E knockout ( ApoE-/-) mice with fat-rich diet and the possible mechanism .METHODS:C57 mice served as control.ApoE-/-mice (n=34) fed with high-fat diet were randomly divided into ApoE-/-group, STZ-ApoE-/-group and STZ-ApoE-/-+Atorv group.Intraperitoneal injection of streptozotocin was performed to create di-abetic animal model .Blood glucose was determined by glucose oxidase method .Blood lipid levels were detected by enzymic method or selective homogeneous method .The plaque area in the thoracic aorta was measured by HE staining .The protein level of nicotinamide-adenine dinucleotide phosphate ( NADPH) oxidase subunit gp91phox in the thoracic aorta was deter-mined by Western blotting .The levels of reactive oxygen species ( ROS) in blood and thoracic aorta homogenates were de-tected by Fenton reaction and Griess reagent .Human umbilical vein endothelial cells ( HUVECs ) were isolated from healthy umbilical cords by collagenase I and cultured .ROS production was detected by flow cytometry .NADPH oxidase ac-tivity was measured using lucigenin assay .Effects of retinoid X receptor α( RXRα) on inhibition of oxidative stress by ator-vastatin were evaluated by RNA interference and plasmid transfection .RESULTS: (1) Compared with C57 group, the plaque areas of the thoracic aorta in ApoE-/-group were increased .No difference of the fasting glucose between the 2 groups was observed.The levels of triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), thoracic aorta gp91phox protein and ROS in blood and thoracic aorta homogenates were higher in ApoE-/-group than those in C57 group.(2) Compared with ApoE-/-group, the plaque areas of the thoracic aorta in STZ-ApoE-/-group were further enlarged [(314.13 ±35.72) μm2 vs (215.88 ±34.19) μm2, P<0.05].The levels of blood glucose, TG, TC and LDL-C, thoracic aorta gp91phox protein and ROS in blood and thoracic aorta homogenates were higher in STZ-ApoE-/-group than those in ApoE-/-group (P<0.05).(3) Compared with STZ-ApoE-/-group, the plaque areas of the thoracic aorta in STZ-ApoE-/-+Atorv group were reduced [(217.47 ±24.56) μm2 vs (314.13 ±35.72) μm2, P<0.05].The levels of blood glucose , LDL-C, TC, HDL-C and TG showed no significant difference between the 2 groups.Thoracic aorta gp91phox protein level and ROS production in blood and thoracic aorta homogenates were lower in STZ -ApoE-/-+Atorv group than those in STZ-ApoE-/-group (P<0.05).(4) High glucose-induced increases in NADPH oxidase activity and gp91phox expression were significantly inhibited by atorvastatin (10-6 mol/L) in HUVECs.The inhibitory effects of atorvasta-tin on high glucose-induced ROS production and NADPH oxidase activation were largely impaired when the cells were trans -fected with RXRαsiRNA.However , the effect of atorvastatin was significantly strengthened when RXRαwas over-expressed in the HUVECs transfected with RXRαplasmid.CONCLUSION: Atorvastatin inhibits atherogenesis by depressing high glucose-induced oxidative stress in diabetic ApoE-/-mice with fat-rich diet.The anti-oxidative stress effect of atorvastatin is mediated by RXRα.

Regulatory effect of RXR/VDR agonists on atherosclerosis and NF-κB ex-pression in diabetic ApoE knockout mice / 中国病理生理杂志

[ABSTRACT]AIM:ToexploretheeffectofretinoidXreceptor(RXR)agonistbexarotene(Bex)andvitaminD receptor (VDR) agonist calcitriol (Cal) on the expression of nuclear factor-kappa B (NF-κB) and the development of atherosclerosis in streptozotocin-induced diabetic apolipoprotein E knockout ( STZ-ApoE-/-) mice.METHODS: Male mice were treated for 12 weeks as follows:(1) C57+vehicle;(2) ApoE-/-+vehicle;(3) STZ-ApoE-/-+vehicle;(4) STZ-ApoE-/-+Bex (10 mg· kg-1· d-1);(5) STZ-ApoE-/-+Cal (10 μg/kg, twice a week);(6) STZ-ApoE-/-+Bex (10 mg· kg-1· d-1) +Cal (10 μg/kg, twice a week).Intraperitoneal injection of STZ was performed to establish the diabetic animal model .Western blotting and immunohistochemical method was used to detect NF-κB level in the thorac-ic aorta.Plaque area in the thoracic aorta was measured using HE staining .RESULTS:Compared with the C57 mice, the fasting blood glucose in the ApoE-/-mice was not remarkably changed .The levels of total cholesterol ( TC) and low-densi-ty lipoprotein ( LDL) were greatly increased .The fasting blood glucose and lipid levels in STZ-ApoE-/-group were much higher than those in ApoE-/-group.Compared with STZ-ApoE-/-group, the fasting blood glucose and lipid levels in Bex group and Cal group were not significantly changed .Compared with the C57 mice, the protein expression of NF-κB in the ApoE-/-mice and the STZ-ApoE-/-mice was remarkably increased .Compared with STZ-ApoE-/-group, the levels of NF-κB in Bex group, Cal group and combination group were greatly decreased .Compared with STZ-ApoE-/-group, the thoracic artery plaque areas in Bex group and Cal group were inhibited (both P<0.05).Compared with Bex group, the plaque area of the thoracic artery in combination group was significantly decreased (P<0.05).CONCLUSION:Bexaro-tene or calcitriol decreases the development of atherosclerosis in streptozotocin -induced diabetic ApoE-/-mice.Bexarotene combined with calcitriol affords greater protection than monotherapy .The mechanism may be involved in down-regulating the expression of NF-κB.

A comparison of the outcomes of two rehabilitation protocols after simultaneous stage I bilateral total knee replacement / 中华物理医学与康复杂志

Objective To study the outcomes of 2 rehabilitation protocols after simultaneous stage Ⅰ bilateral total knee replacement (TKR). Methods One hundred and twenty patients admitted for stage Ⅰ bilateral TKR were assigned randomly to receive alternative or traditional rehabilitation therapy. Rehabilitation training was administered in both alternative and traditional groups before and after operation. In alternative group, each rehabilitation action was designed to be done on one side and the other side alternatively. In traditional group, each training session was designed to be done on one side and then followed by the other side in succession. Visual analogue scale (VAS)scores were evaluated for 2 weeks after operation and deep vein thrombosis (DVT) complications were recorded for 3 months after operation. The range of motion ( ROM), American hospital special surgery (HSS) knee scores and SF-12 scores were recorded at 1 d before operation and the 1st, 3rd, 6th and 12th month after operation, Results One hundred and fifteen patients completed all training sessions and assessments. Compared with traditional group, alter-native group had significantly lower VAS scores in the early postoperation stage and significantly better knee function scores and SF-12 scores at the 1 st and 3rd month postoperation (P <0. 005). Conclusion The alternative protocol can speed up rehabilitation and lead to decrease VAS scores in the early postoperation stage, and improve knee func-tion and physical and mental health after TKR.

Association Between Metabolic Syndrome and the Increased Risk of Atrial Fibrillation in Essential Hypertension Patients / 中华高血压杂志

Objective To investigate the effect of metabolic syndrome(MS) on the atrial fibrillation(AF) in patients with essential hypertension(EH).Methods A cross-sectional study was conducted in a cohort of 1810 hospitalization essential hypertension patients,which were divided into EH+non MS group(n=1155) and EH+MS group(n=655) according to MS criteria.Results Incidence of AF in EH+MS group was higher than that in EH+non MS group(14.4% vs 8.3%,P

Serum Uric Acid and Ischemic Stroke in Patients with Essential Hypertension / 中华高血压杂志

Background Whether serum uric acid are related with ischemic stroke in essential hypertension (EH) is controversial. Objective To delineate the relationship between serum uric acid and ischemic stroke in EH. Methods A retrospective study was conducted in a cohort of 729 EH patients. Patients were classified into four groups according to serum uric acid level. The odds ratio for ischemic stroke was calculated with the lowest quartile as the reference. Results The prevalence of ischemic stroke in EH with quartile 4 of uric acid was higher than that in EH with quartile 1(37.9% vs 17.6%,P

Left Atrial Diameter Enlargement Aggravates the Risk of Ischemic Stroke in Essential Hypertensive Patients / 中华高血压杂志

LAD(OR=1.209). Conclusion Left atrial diameter was independent risk factor for ischemic stroke in hypertensive patients.

Effect of micronised fenofibrate on lipotoxicity and insulin sensitivity in spontaneously hypertensive rats treated with high-fat diet / 中国病理生理杂志

AIM:To observe the effect of micronised fenofibrate(lipanthyl)on lipotoxicity and insulin sensitivity(IS)in spontaneously hypertensive rats(SHR)with high-fat diet.METHODS:Twenty-seven SHR were randomly divided into three groups:normal chow group(n=9),high-fat diet group(n=9)and micronised fenofibrate treatment group(n=9).Micronised fenofibrate 100 mg?kg-1?d-1 was given orally to SHR,which diet on high-fat diet for three months.Intramuscular lipids were observed and lipids accumulation index(LAI)was calculated.Nonesterified fatty acid,glucose and insulin were determined in all rats.RESULTS:(1)Compared to SHR in normal chow diet group,body weight and the level of serum TG and TC increased significantly and the level of HDL-C decreased significantly in SHR fed with high-fat diet(P