Exploration and practice of the blended teaching model based on BOPPPS classroom reconstruction in Diagnostic Radiology / 中华医学教育探索杂志

Objective:To investigate the feasibility and effectiveness of the blended teaching model for diagnostic radiology based on BOPPPS classroom reconstruction, i.e., bridge-in, objective, pre-assessment, participatory-learning, post-assessment, and summary.Methods:The undergraduate students in the classes of 2017 and 2018 in Department of Medical Imaging were selected as research subjects. The students in the class of 2018 were established as observation group and received the innovative blended teaching model based on BOPPPS classroom reconstruction, and those in the class of 2017 were established as control group and received teaching with traditional theoretical lectures. At the end of the course, 80 students were randomly selected from the observation group and the control group for performance analysis and teaching evaluation. SPSS 26.0 was used to perform the t-test. Results:The observation group had a total score of (82.66±6.18), while the control group had a total score of (76.47±5.42), and compared with the control group, the observation group had significantly higher scores of homework score, course discussion, and final examination ( P<0.05). Compared with the control group, the observation group had significantly higher scores of "understanding of the basic knowledge of imaging", "improvement of comprehensive diagnostic thinking ability", "stimulating the interest in learning and expanding horizons", and "cultivating clinical competence" in the self-evaluation survey ( P<0.05). Conclusion:The blended teaching model based on BOPPPS classroom reconstruction is suitable for the teaching of radiology diagnostics. It not only enriches teaching means and methods and enhances classroom participation and interaction, but also expands teaching space and teaching content.

Artesunate alleviates hypoxic-ischemic brain damage in neonatal rats by inhibiting NLRP3 inflammasome activation and inflammatory cytokine secretion / 细胞与分子免疫学杂志

Objective To investigate the protective effect of artesunate on hypoxic-ischemic brain damage (HIBD) and its mechanism in neonatal rats. Methods 7-day-old neonatal SD rats were randomly divided into sham operation group, model group, artesunate 5 mg/kg group, artesunate 10 mg/kg group, artesunate 20 mg/kg group and dexamethasone 6 mg/kg group, with 18 rats in each group. HIBD models were established in groups except for the sham operation group. The sham operation group only needed to separate the left common carotid artery without ligation and nitrogen-oxygen mixed gas ventilation. Each group was injected with drug intraperitoneally right after surgery and the rats in the sham operation group and the model group were injected with an equal volume of normal saline (once a day for a total of 5 times). One hour after the last injection, the rats in each group were scored for neurological defects. After the rats were sacrificed, the brain water content was measured and the pathological changes of the brain tissues of rats were observed. Terminal-deoxynucleotidyl transferase mediated nick end labeling (TUNEL) was used to detect the neuronal cell apoptosis, and ELISA was applied to detect the levels of IL-1β, IL-6 and TNF-α in brain tissues and peripheral blood of each group of rats. Western blot analysis was adopted to detect the protein expression levels of NLR family pyrin domain containing 3 (NLRP3), apoptosis-associated speck-like protein containing CARD (ASC) and caspase-1 in the rats brain tissues of each group. Results Compared with the model group, the neurological deficit score was decreased; the pathological damage of brain tissues was relieved; the brain water content was significantly reduced; the apoptosis number of hippocampal neurons was decreased significantly; the levels of IL-1β, IL-6 and TNF-α in brain tissues and peripheral blood were significantly reduced; the protein expression levels of NLRP3, ASC and caspase-1 were significantly lowered in the middle-dose and high-dose artesunate groups and the dexamethasone group. Conclusion Artesunate can improve the neurological function, relieve the brain damage, and alleviate the brain edema in neonatal rats with HIBD. It can protect the HIBD, which may be related to the inhibition of NLRP3 inflammasome activation and reduction of inflammatory cytokine secretion.

The application and value of imaging cloud platform in medical imaging practice teaching / 中华医学教育探索杂志

Objective:To explore the impact of applying the imaging cloud platform to medical imaging practice teaching on diagnostic thinking ability and learning experience of students.Methods:Eighty-eight students of Batch 2016 from the Department of Medical Imaging of Chongqing Medical University were randomly divided into two groups, with 44 students in each group. The experimental group was taught by the imaging cloud platform, and the control group was taught by traditional practice. Differences in diagnostic thinking ability and learning experience were compared between the two groups after 4 weeks. SPSS 22.0 was used for t-test. Results:The total score of the diagnostic thinking ability test in the experimental group was higher than that in the control group [(80.63±6.10) vs. (70.36±8.09)], and the difference was statistically significant ( P<0.05). There were statistically significant differences in the scores of three items: description of signs, differential diagnosis and key points, and new progresses and recommendations ( P<0.05). For the five aspects of the learning experience in the questionnaire survey, the scores of the experimental group were higher than those of the control group, and all the differences were statistically significant ( P<0.05). Conclusion:The application of imaging cloud platform in imaging practice teaching has important value in improving diagnostic thinking ability and learning experience of students, and it is worthy of practice and promotion.

Role and regulatory mechanism of triggering receptor expressed on myeloid cells 2 in mice lung ischemia/reperfusion injury / 中华危重病急救医学

Objective:To investigate the role and regulatory mechanism of triggering receptor expressed on myeloid cell 2 (TREM2) in mice lung ischemia/reperfusion injury (LIRI).Methods:Thirty-six healthy male C57BL/6 mice were divided into six groups according to the random number method ( n = 6): normal control group, and LIRI 2, 6, 12, 24, 48 hours group. Mice LIRI models were established by clamping the left hilum. The wet/dry weight ratio (W/D) of left lung tissue was measured. Lung injury was observed and evaluated by hematoxylin-eosin (HE) staining and electron microscopy. The levels of interleukins (IL-1β, IL-18) in lung tissue were detected by enzyme linked immunosorbent assay (ELISA). The mRNA expressions of TREM2 and caspase-1 were determined by polymerase chain reaction (PCR). The protein expressions of TREM2, caspase-1, Gasdermin-D (GSDMD) were determined by Western blotting. Results:At 2 hours after LIRI, lung injury began to appear, the lung ultrastructure changed, and the lung injury score increased; at 6 hours, the degree of lung injury was the most serious; after 12 hours, the lung injury gradually reduced and the lung injury score gradually decreased. Compared with the normal control group, lung W/D ratio and lung injury score of LIRI 2, 6, 12, 24, 48 hours groups were significantly higher, the differences were statistically significant (lung W/D ratio: 7.06±0.52, 8.34±0.17, 6.42±0.35, 5.34±0.25, 5.59±0.45 vs. 4.69±0.23; lung injury score: 5.50±0.54, 9.75±0.89, 5.88±0.84, 3.63±0.74, 4.13±0.64 vs. 1.13±0.35, all P < 0.05). Compared with the normal control group, the levels of IL-1β and IL-18 in lung tissue were significantly increased at 2 hours after LIRI, reached a peak at 6 hours [IL-1β (ng/L): 502.76±12.25 vs. 56.50±8.07, IL-18 (ng/L): 414.02±10.75 vs. 81.63±5.29, both P < 0.05], then decreased gradually, and were still significantly higher than the normal control group at 48 hours. The PCR and Western blotting showed that the expression of TREM2 was significantly lower than that in the normal control group at 2 hours after LIRI, and reached a valley at 6 hours [TREM2 mRNA (2 -ΔΔCt): 0.47±0.05 vs. 1.02±0.05, TREM2/GAPDH: 0.23±0.13 vs. 0.48±0.17, both P < 0.05], then gradually increased, and reached the peak at 24 hours [TREM2 mRNA (2 -ΔΔCt): 3.98±0.15 vs. 1.02±0.05, TREM2/GAPDH: 0.71±0.17 vs. 0.48±0.17, both P < 0.05]. The trend of expression of caspase-1 and GSDMD were opposite to that of TREM2, which increased at first and then decreased, and reached a peak at 6 hours after reperfusion [caspase-1 mRNA (2 -ΔΔCt): 2.20±0.13 vs. 1.01±0.02, caspase-1/GAPDH: 0.64±0.02 vs. 0.20±0.06, GSDMD/GAPDH: 1.23±0.01 vs. 0.87±0.02, all P < 0.05]. Conclusions:TREM2 might be involved in LIRI in mice. The mechanism may be related to the effect of TREM2 on caspase-1-mediated pyroptosis.

Case report of congenital complete heart block in premature twins and literatures review / 中华实用儿科临床杂志

Objective:To investigate the pathogenesis, precaution and treatment of neonatal congenital complete heart block (CCHB) in twins.Methods:The clinical data of a case of premature twins with neonatal CCHB from the Department of Neonatology, the First Affiliated Hospital of Xinxiang Medical University were retrospectively analyzed and related literature was reviewed.Results:(1)Case review: the 37-year-old gravida had no symptoms.Fetal ultrasound cardiogram(fUCG)at 23 weeks of gestation indicated bradycardia and CCHB.Then, the mother was diagnosed with undifferentiated connective tissue disease.After treatment with human immunoglobulin, dexamethasone and hydroxychloroquine, fUCG at 31 weeks of gestation still suggested CCHB.An emergency cesarean section was performed on the diagnosis of threatened preterm labor.With weakly positive neonatal antinuclear antibody (ANA), and positive Ro60 and Ro52 autoantibodies, twins were diagnosed with CCHB by 24 hour-Holter monitors.One of the twins was discharged with CCHB (ventricular rate of 80-90 times/min) after systemic therapy, but the weight increased to 2 200 g. The other one of the twins suffered from the sudden decrease of heart rate and blood pressure and finally died of sudden cardiac arrest.(2) Literature search: two cases in Chinese and 9 cases in English were reviewed.Among them, 9 cases were sjogren syndrome type A (SSA)/Ro and sjogren syndrome type B(SSB)/La related CCHB, and 2 cases were idiopathic CCHB.Conclusions:The placental transfer of anti-SSA or anti-SSB is an important mechanism of neonatal CCHB in twins, and other factors may also be involved.Current treatments are unsatisfactory.Most patients need pacemaker implantation.Early diagnosis and prenatal management can improve the prognosis.

Effects of Yuanzhi San on Ethology and Cerebral Acetylcholinesterase Activity of Memory Disorder Mouse Model Induced by Scopolamine / 广州中医药大学学报

Objective To observe the effects of Yuanzhi San (YZS) on the ethology and cerebral acetylcholinesterase(AchE) activity of mouse model of memory disorder induced by scopolamine. Methods Sixty mice were randomly divided into six groups, namely blank control group, model group, positive medicine group, and low-dose, middle-dose and high-dose YZS groups. Except for the blank control group and model group were given the normal saline, the mice in other groups were administered with the corresponding drugs for 10 days. And then, mice in the medication groups were given subcutaneous injection of scopolamine in the dose of 3mg/kg to induce memory disorder model. Morris water maze test and step-down test were adopted for the observation of the learning-memory ability of the mice, and at the end of the tests, the activity of AchE in mouse cerebral cortex was measured by a biochemical method. Results Compared with the model group, escape latency was decreased, and retention time and swimming distance in the effective area in Morris water maze test were prolonged in YZS groups (P0.05). Conclusion YZS exerts certain effect on improving learning-memory ability of memory disorder mice induced by scopolamine , and the mechanism might be related with the inhibition of AchE activity in the cerebral cortex of model mice.

Application of ATP bioluminescence assay in survey of cleanliness of hos-pital environmental object surfaces and health care workers’hands / 中国感染控制杂志

Objective To investigate cleanliness of hospital environmental object surfaces and hands of health care workers(HCWs).Methods The adenosine triphosphate (ATP)bioluminescence assay was used to detect object surfaces and hands of HCWs in a hospital,on-the-spot intervention was conducted.Results The qualified rates of hospital environmental object surfaces and ventilator-relevant object surfaces were 58.14% (200/344)and 69.88%(116/166)respectively,the qualified rate of ventilator tracheal intubation site was low (29.17%);the qualified rate of telephone surfaces was the lowest (27.27%).The qualified rates of ventilator-relevant object surfaces used con-tinuously for ≥48h and <48 h were 56.70%(55/97)and 88.41 %(61/69)respectively,there was significant differ-ence between the two(χ2 =19.26,P <0.01).The qualified rates of HCWs’hands before and after intervention were 34.18% and 85.58% respectively,relative light unit (RLU)values were (1 033.46±106.20)and (80.46±10.68) respectively,the qualified rates and RLU before and after intervention were both significantly different (both P <0.01).Conclusion Contamination of object surfaces and hands’of HCWs in hospital dynamic environment is seri-ous,ATP bioluminescence detection and on-the-spot intervention is helpful for improving cleanliness of hospital en-vironment object surfaces and HCWs’compliance to hand hygiene.

Effects of estrogen on the apoptosis of human umbilical vein endothelial cells / 医学研究生学报

Objective Recent researches find that endoplasmic reticulum is a new target for the treatment of cardiovascular disease and its stress response plays an important role in the hypertension-induced cardiovascular remodeling.The study built up the apoptosis model of endoplasmic reticulum stress ( ERS) in human umbilical vein endothelial cells ( HUVECs) and investigated the im-pact of 17β-estradiol ( E2) on the ERS apoptosis of HUVECs induced by tunicamycinand(TM)/dithiothreitol(DTT). Methods HUVECs incubated for 10 h in 10μmol/L TM or 8 h in 2 mmol/L DTT were the best concentration and time for ERS apoptosis.E2 of 10-8 mol/L was prominent in protecting ERS.According to the application of TM/DTT, E2, estrogen antagonists (ICI182, 780 and G15), there were 6 groups:control group, TM/DTT group, TM/DTT+E2 group, TM/DTT+E2 +G15 group, TM/DTT+E2 +ICI+G15 group.Western blot was applied to detect the expressions of biomarkers for ERS in-duced apoptosis (GRP78, cleaved caspase-12 and CHOP).Hochest staining was used to observe the changes of the apoptosis cell number. Results Compared with control group, the expressions of GRP78, caspase-12 and CHOP significantly increased(P<0.05).In comparison with TM group, the expressions of GRP78, caspase-12 and CHOP in TM+E2 group significantly decreased (6.80 ±1.07 vs 4.01 ±0.46, 1.54 ±0.32 vs 0.88 ±0.10, 1.91 ±0.37 vs 0.91 ± 0.02, P<0.05).In comparison with TM +E2 group, the CHOP expression in TM +E2 +ICI group increased(0.91 ±0.02 vs 0.96 ±0.02, P<0.05), and the expressions of GRP78 and caspase-12 in TM+E2 +G15 group increased(4.01 ±0.46 vs 5.25 ± 0.80, 0.88 ±0.10 vs 1.02 ±0.07, P<0.05), and the expressions of GRP78, caspase-12 and CHOP in TM+E2 +ICI+G15 group increased (P<0.05).Compared with DTT group, the expressions of GRP78 and CHOP in DTT+E2 group decreased (1.81 ± 0.08 vs 1.30 ±0.14, 1.00 ±0.13 vs 0.51 ±0.01, P<0.05).In comparison with DTT+E2 group, the expressions of GRP78 and CHOP in DTT+E2 +ICI group decreased(P <0.05), and the expression of GPR78 in DTT+E2 +G15 group increased(P<0.05), and the expressions of GRP78, caspase-12 and CHOP in DTT+E2 +ICI+G15 group increased(P<0.05).The change of the apop-tosis cell number observed by hochest staining was in consistence with the result of western blot. Conclusion E2 can protect human endothelial cells from ERS induced apoptosis caused by TM and DTT.Estrogen maintains homeostasis by regulating ERS estrogen re-ceptors, thereby protecting the cardiovascular system.

Current situation of off-label drug use in China and abroad and its inspirations / 中华医院管理杂志

This article discussed characteristics of current off-label drug use in China and other countries,and analyzed the current administration and future development,making valuable reference for off-label drug use.

Feasibility evaluation of real-time quantitative PCR with small reaction volume / 西安交通大学学报(医学版)

Objective To evaluate the feasibility of real-time quantitative PCR (RtPCR) with small volume regarding the stability, efficiency and reliability of amplification, and determine the optimal quantity of cDNA template suitable for small PCR volume. Methods The experiment was carried out in 3 groups with 10, 15 and 20μL reaction volume, respectively. In each group, rat β-actin mRNA was detected by RtPCR with 0.1, 0.2, 0.3 or 0.4μL rat cDNA as template, respectively. The amplification curve and melting curve were used to evaluate the reaction stability. The fitting of a curve of gradient templates against threshold cycle numbers was to show the reaction efficiency and the linear correlativity was to estimate the suitability of the template quantity. In addition, in order to estimate reliability, pristane-induced arthritis (PIA) rat model was established, and spleen TNF-α mRNA expression was detected by RtPCR with the selected reaction volumes. Results The amplification of rat β-actin mRNA was specific and stable in 10μL, 15μL and 20μL PCR volume, and had a high efficiency. Furthermore, the standard curves fitted by 0.1-0.4μL gradient templates showed a significant linear correlation in each volume group. When the 10μL and 20μL PCR volumes, and 0.2μL cDNA templates were chosen, the TNF-α mRNA expression in PIA rat spleen showed significant upregulation in both two volume groups as anticipated. Conclusion The experiment shows that it is feasible in the RtPCR amplification to use the small reaction volume of 10μL and 15μL, which has good stability and reliability. And 0.1-0.4μL templates are all suitable for the reaction system. PCR with small volume can not only save the reagents and template, especially rare clinical specimens, but also is helpful for the realization of high-throughput reaction.

Comparison of effects of sufentanil and fentanyl combined anesthesia on stress response in pediatric patients undergoing surgical repair of congenital cardiac defect with cardliopulmonary bypass / 中华麻醉学杂志

Objective To compare the effects of snfentanil and fentanyl combined anesthesia on stress responses in pediatric patients undergoing surgical repair of congenital heart defect with cardiopulmonary bypass (CPB) .Methods Twenty-four pediatric patients aged 2-6 yr undergoing surgical repair of congenital heart defect were randomized into 2 groups (n=12 each): sufentanil combined anesthesia group (group S) and fetanyl combined anesthesia group (group F). The patients were premedicated with intramuscular morphine 0.2 mg/kg, scopolamine 0.01 mg/kg and ketamine 5 mg/kg. Anesthesia was induced with midazolam 0.1 mg/kg and snfentanil 0.7 μg/kg (in group S) or fentanyl 5 μg/kg (in group F). Tracheal intubation was facilitated with vecuronium 0.15 mg/kg. The patients were mechanically ventilated. P<ET>CO_2 was maintained at 35-45 mm Hg. Anesthesia was maintained with propofol infusion at 6-9 mg·kg~(-1)·h~(-1) and intermittent in boluses of midazolam,vecuronium and 3 doses of sufentanil (0.7, 1.5, 1.5 μg/kg) or fentanyl (5, 10, 10 μg/kg). Arterial blood samples were taken after entering the operation room, at 1 min after tracheal intubation, 1 min after splitting of sternum, immediately after rewarming, 10 min after termination of CPB and 24 h after operation for determination of plasma ACTH, cortisol, glucagon, lactic acid and blood glucose. Results The MAP and HR were maintained in the normal range during operation in both groups. The plasma concentrations of ACTH, cortisol, glucaon and lactic acid were significantly lower in group S than in group F. Plasma ACTH cortisol, glucagon, lactic acid and blood glucose increased significantly during operation as compared with the baseline before anesthesia in both groups. Conclusion Sufentanil combined anesthesia can inhibit stress response in pediatric patients more effectively during surgical repair of congenital cardiac defect performed under CPB.

The Investigation and Analysis on the Status of Websites Construction in Jiangsu Hospital / 医学信息学杂志

The paper analyzes the status of hospital websites construction in Jiangau province, which would provide useful evidence for further development. Surfing on the hospital wehaites covering both third and second class hospital in Jiangsu province, it reveals that the websites of third-class hospital are much better than the second-class ones. However, both of them have problems on contents, domain names and interactive parts. The paper suggests that we should constantly explore the methods and ways to solve those existing prob-lems, focus on strengthening informafization construction in hospital and play its advantages.

Pathogen Distribution after Incision of Trachea and Correlation Factors / 中华医院感染学杂志

0.0125) incision of trachea,and oral and pharyngeal portion,but no correlation with hands of nurse and external environment(P

MRI diagnosis of arrhythmogenic right ventricular cardiomyopathy / 第三军医大学学报

Objective To discuss the utility of MRI in evaluating arrhythmogenic right ventricular cardiomyopathy(ARVC).Methods Nine patients of ARVC who received treatment in our hospital from January 2005 to May 2008,were retrospectively analyzed.They all underwent MRI by using GE signa 1.5 Tesla CV/I MR system.White blood technique(Fast cine sequence) were performed in short axis view,four-chamber view,and long axis view of two ventricles.Black blood techniques(Double IRFSE and Triple IRFSE) were performed in short axis view and long axis view of the right ventricle.Results MRI displayed thinning of the right ventricular(RV) wall(9 cases),dilatation of the RV(8 cases),fat signal intensity of the RV wall in DIRFS and irregular insula or continuity breaking in TIRFSE(3 cases),dilatation of the left ventricle(LV)(2 cases),a bit thickening of ventricular septum(1 case),enlargement of the outflow of the RV(2 cases),and ventricular wall aneurysm formation(2 cases).Their positions involved apex of the right ventricle(6 cases),facies diaphragmatica(4 cases),anterior ventricle(4 cases),infundibulum(4 cases) and the papillary muscle of the RV(1 case).Conclusion Cardiac MRI is the most specific and sensitive examination technique in diagnosing of ARVC,which can present structural and functional changes and the quality,degree,range of the disease.We recommend cardiac MRI if ARVC is suspected.

Effects of ulinastatin on cytoldnes and respiratory index during open heart surgery with CPB / 中华麻醉学杂志

Objective To investigate the effects of ulinastatin on pro- and anti-inflammatory cytokines and respiratory index during open heart surgery under CPB. Methods Twenty ASA Ⅱ- Ⅲ patients of either sex (9 males, 11 females) scheduled for elective valve replacement under CPB were randomly divided into two groups of 10 each : control group (C) and ulinastatin group (W) . Patients with hepato-renal dysfunction or taking glucocorticoid were excluded. The patients were premedicated with intramuscular phenobarbital 0.1 g and scopolamine 0.3 mg. Anesthesia was induced with midazolam 0.1 mg?kg-1 , fentanyl 10?g?kg-1 and vecuronium 0.1mg?kg-1 . After tracheal intubation anesthesia was maintained with midazolam and fentanyl. The patients were mechanically ventilated. VT was set at 8-12 ml?kg-1 , RR 10-12 bpm and I: E 1:2. PETCO2 was maintained at 35-45 mg. In ulinastatin group, the patients received ulinastatin 12 000 U?kg-1 of which half was given i.v. before CPB and half was added to the priming fluid, while group C received normal saline instead of ulinastatin. Blood samples were taken from radial artery for determination of plasma TNF-?, IL-6, and IL-10 concentrations and blood gas analysis before operation (T1 ) , 30 min after initiation of CPB (T2), 1 h (T3 ) , 4 h (T4 ) and 24 h (T5 ) after CPB. Respiratouy index (PA-aDO2/ PaO2) was calculated at T1-5 .Results There were no significant differences in sex, age, weight, height, duration of CPB, and aortic cross-clamping time between the two groups. In group C the plasma levels of TNF-?, IL-6 and IL-10 were significantly higher than the baseline values (T1 ) during and after CPB (P

Effect of ulinastin on the gastrointestinal circulation and systemic inflammatory response during cardiopulmonary bypass / 中华麻醉学杂志

Objective To investigate the effect of ulinastin on the gastro-intestinal circulation and systemic inflammatory response during open heart surgery with cardiopulmonary bypass( CPB) .Methods Thirty adult patients undergoing valve replacement with mild hypothermic CPB were randomly divided into two groups: ulinastin group (U ,n = 15) and control group (C , n = 15). In ulinastin group patients received ulinastin 6000 IU?kg-1iv after induction of anesthesia and another 6000 IU?kg-1 was added into the priming solution. In control group patients received equal volume of normal saline, instead of ulinastin. The patients were premedicated with morphine 0.2 mg?kg-1 and scopolamine 0.06 mg?kg-1 .Ranitidine 1 mg?kg-1 was given iv before induction of anesthesia. Anesthesia was induced with midazolam 0.1 mg?kg-1 , fentanyl 10?g?kg-1 and vecuronium 0.1 mg?kg-1 and maintained with fentanyl 50-60?g?kg-1, midazolam, isoflurane and vecuroinum. The patients were intubated and mechanically ventilated. PET CO2 was maintained at 35-45 mm Hg during operation. Gastric intramucosal PCO2 (PiCO2 ) was measured (pHi was calculated) and blood concentrations of TNF-?and IL-6 were determined before CPB (T0), 30 min after aorta was cross-clamped (T1), 60 min after termination of CPB(T2 ) and 6 h after operation (T3 ) .Results The two groups were comparable with regard to age, sex, body weight, ejection fraction, duration of CPB and cross-clamping time. (1) pHi decreased significantly at T1-2 as compared with the baseline value at T0 (P