IRF4-mediated Treg phenotype switching can aggravate hyperoxia-induced alveolar epithelial cell injury.

Bronchopulmonary dysplasia (BPD) is characterized by alveolar dysplasia, and evidence indicates that interferon regulatory factor 4 (IRF4) is involved in the pathogenesis of various inflammatory lung diseases. Nonetheless, the significance and mechanism of IRF4 in BPD remain unelucidated. Consequently, we established a mouse model of BPD through hyperoxia exposure, and ELISA was employed to measure interleukin-17 A (IL-17 A) and interleukin-6 (IL-6) expression levels in lung tissues. Western blotting was adopted to determine the expression of IRF4, surfactant protein C (SP-C), and podoplanin (T1α) in lung tissues. Flow cytometry was utilized for analyzing the percentages of FOXP3+ regulatory T cells (Tregs) and FOXP3+RORγt+ Tregs in CD4+ T cells in lung tissues to clarify the underlying mechanism. Our findings revealed that BPD mice exhibited disordered lung tissue structure, elevated IRF4 expression, decreased SP-C and T1α expression, increased IL-17 A and IL-6 levels, reduced proportion of FOXP3+ Tregs, and increased proportion of FOXP3+RORγt+ Tregs. For the purpose of further elucidating the effect of IRF4 on Treg phenotype switching induced by hyperoxia in lung tissues, we exposed neonatal mice with IRF4 knockout to hyperoxia. These mice exhibited regular lung tissue structure, increased proportion of FOXP3+ Tregs, reduced proportion of FOXP3+RORγt+ Tregs, elevated SP-C and T1α expression, and decreased IL-17 A and IL-6 levels. In conclusion, our findings demonstrate that IRF4-mediated Treg phenotype switching in lung tissues exacerbates alveolar epithelial cell injury under hyperoxia exposure.

A qualitative research on the responsibility understanding and difficult experience of respiratory nurses in the management of chronic obstructive pulmonary disease patients / 中国实用护理杂志

Objective:To explore the responsibilities of respiratory nurses in the management of chronic obstructive pulmonary disease (COPD) patient and the difficulties in disease management, so as to provide reference basis for formulating COPD management training strategies for respiratory nurses.Methods:Using phenomenological methodology, 14 nurses from the Department of Respiratory and Critical Care Medicine in the General Hospital of Ningxia Medical University and the First People′s Hospital of Yinchuan were interviewed in a personal semi-structured way from May to August 2021, and the data were sorted and analyzed according to Colaizzi 7-step analysis method.Results:Nurses′understanding of the responsibilities of COPD patient management could be summarized into five themes: dynamic monitoring and management of patients′ health, nursing decision-making of sudden changes in patients′ condition, implementation of patients′ out of hospital follow-up, promotion of improvement of patients′ self-management behavior, and cooperation among multidisciplinary team members. The difficult experience of nurses in the management of COPD patients abstracted five themes: lack of professional knowledge of COPD management, lack of clinical nursing decision-making authority, lack of human and financial support for follow-up, lack of communication skills with patients, and lack of multidisciplinary team formation in the hospital.Conclusions:Respiratory nurses have a clear understanding of the responsibilities of COPD patient management, but there are multiple difficulties in performing their responsibilities. We should pay attention to the responsibility positioning and difficulty support of nurses′ COPD management, and formulate targeted training strategies to promote the improvement of COPD nursing quality.

Investigation on nurses′cognition of oral care for hospitalized elderly patients in general ward / 中国实用护理杂志

Objective:To understand the current situation of nurses′ implementation of oral care for elderly patients, so as to improve oral care practice standard and quality of oral care constantly.Methods:Using convenient sampling method, 190 nurses in the general ward of the General Hospital of Ningxia Medical University were selected as the research object from September to November 2020. The self-designed questionnaire was used to investigate and analyze the implementation of oral care among elderly patients.Results:A total of 190 questionnaires were collected in this survey, 84.74%(161/190) of the nurses reported that the hospital or department had oral care practice standard; The proportion of nurses who evaluated the oral status of elderly patients by the oral care assessment tool was 17.89%(34/190).Only 14.74%(28/190) and 16.84%(32/190) of the nurses could always set the expected rehabilitation goals and formulate the corresponding nursing plans for the oral problems of elderly patients, respectively. When the elderly patients had special oral problems, 26.32% (50/190) of the nurses would proactively communicate with doctors or search literature; the oral knowledge and oral hygiene habits of the elderly patients would be known to nurses accounting for 5.26% (10/190).Conclusions:Nurses′ cognition of oral care for elderly patients is at a low level on the structure, process and outcome.Relevant nursing managers still need to further improve the oral care operation norms and the training of nurses′ knowledge and skills, so as to continuously promote the oral health of elderly patients.

Progress of pulmonary pericytes in lung development and lung diseases / 国际儿科学杂志

As a member of vessel extracellular matrix, pericytes have a close relationship with angiogenesis.Pericytes widely exist on the surface of microvascular all over the body, which are important to the stability of vessels.As a member in development of vascular structure, pericytes are located in the niches between the junction of lung vascular cells, and pericytes definitely play important roles in lung development and lung diseases.Based on the functional characters of pericytes, this article summarizes the relevant researches about the roles of pericytes in the lung development and lung diseases, and further study of pericytes will provide new insights into the mechanism of lung development and lung diseases.

Comparison of the predictive performance of Logistic regression, BP neural network and support vector machine model for the risk of acute exacerbation of readmission in elderly patients with chronic obstructive pulmonary disease within 30 days / 中华危重病急救医学

Objective:To compare the effectiveness of Logistic regression, BP neural network and support vector machine models in the prediction of 30-day risk of readmission in elderly patients with an exacerbation of chronic obstructive pulmonary disease (COPD) and to provide a scientific basis for the screening and prevention of high-risk patients with readmission.Methods:The COPD patient survey questionnaire was made, including the general data questionnaire, modified Medical Research Council dyspnea scale (mMRC), activities of daily living (ADL), the geriatric depression scale, the mini nutritional assessment-short form (MNA-SF) and COPD assessment test (CAT). Elderly COPD patients were selected from the department of respiratory medicine of 13 general hospitals in Ningxia from April 2019 to August 2020 by convenience sampling method, and they were followed up 30 days after discharge. To explore the risk factors of patient readmission, Logistic regression model, BP neural network model and support vector machine models were constructed based on the risk factors. According to the ratio of the training set to the testing set of 7∶3, the model was divided into the training set sample and the testing set sample. The prediction efficiency of the model was compared by the precision rate, recall rate and accuracy rate, F1 index and the area under the receiver operator characteristic curve (AUC).Results:A total of 1 120 patients were investigated, including 879 non-readmission patients and 241 readmission patients. Univariate regression analysis showed that there were statistically significant differences in age, education level, smoking status, proportion of diabetes and coronary heart disease, hospitalization times of acute exacerbation of COPD in the past 1 year, seasonal factors and long-term home oxygen therapy, regular medication, proportion of rehabilitation exercise, course of disease, ADL, depression status, mMRC, nutritional status between non-readmission patients and readmission patients. Binary Logistic regression analysis showed that education level, smoking status, coronary heart disease, hospitalization times of acute exacerbation of COPD in the past 1 year, seasonal factors, whether long-term home oxygen therapy, whether regular medication, nutritional status were the risk factors for 30-day acute exacerbation of readmission in elderly patients with COPD. The training set showed that the accuracy rate of Logistic regression model, BP neural network model and support vector machine models were 70.95%, 76.51% and 84.78%, respectively. The recall rates were 79.55%, 86.36% and 88.64%, respectively. The accuracy rates were 87.81%, 90.81% and 93.82%, respectively. F1 indexes were 0.75, 0.81 and 0.87, respectively. The AUC were 0.850, 0.893 and 0.921, respectively. The testing set showed that the precision rate of Logistic regression model, BP neural network model and support vector machine model were 78.38%, 80.65% and 88.57%, respectively. The recall rates were 70.73%, 60.98% and 75.61%, respectively. The accuracy rates were 85.82%, 84.40% and 90.07%, respectively. F1 indexes were 0.74, 0.69 and 0.82, respectively. The AUC were 0.814, 0.775 and 0.858, respectively.Conclusion:Comparing with Logistic regression and BP neural network, support vector machine model has better prediction effect, and can effectively predict the risk of acute exacerbation of readmission in elderly patients with COPD within 30 days.

Roles of type 2 innate lymphoid cells in lung development and lung injury / 国际儿科学杂志

As the first line of defense, innate immunity plays an important role in the defense of pathogens.ILC2s, a subset of innate lymphoid cells(ILCs)which is an important effector cell in the innate immune system, can produce a large number of type 2 cytokines and some tissue growth factors.ILC2s widely exist in various tissues of the body, of which lung mucosa is the main habitat.ILC2s are involved in lung development and may also be involved in lung injury and tissue repair induced by various factors.Further study of ILC2s will provide new insights into the mechanism of lung development and lung injury.

Performance of rapid tests for HIV-1 antibody detection in paired serum and urine specimens of men who have sex with men / 中华微生物学和免疫学杂志

Objective:To compare the performance of rapid tests for HIV-1 antibody detection in serum and urine specimens of men who have sex with men (MSM) for investigating suitable technology in the prevention and control of AIDS in Beijing.Methods:A total of 874 cases of MSM were recruited in the AIDS clinic of Beijing Center for Disease Prevention and Control. HIV-1/2 antibody rapid test kit (Kit A, Alere Determine), urine HIV-1 antibody rapid test kit (Kit B, Wantai Biological Pharmacy) and HIV-1/2 antibody Western blot kit (Kit C, IMT) were used for antibody detection. The sensitivity, specificity and consistency of the three rapid test kits for HIV-1 antibody detection in serum and urine specimens were analyzed.Results:Among the 874 cases of MSM, 447 were positive for HIV-1 antibody (51.14%) and 427 were negative. One false negative result occurred by using Kit A and 23 by using Kit B. Taking Kit C as reference, the sensitivity of Kit A and Kit B was 99.78% and 94.85%, respectively; the specificity of both was 100%; the overall consistency was 99.89% ( Kappa=0.998) and 97.37% ( Kappa=0.947), respectively. Conclusions:Although the sensitivity of urine rapid test kit was not as sensitive as serum rapid test kit, it was more suitable for self-test due to its convenience in sampling, high safety and high accessibility. It was suggested that urine rapid test kit should be popularized in MSM population for HIV-1 antibody screening.

Effects of marginal adaptation with different materials on restoring dental wedge-shaped defects / 中国基层医药

Objective To evaluate the effects of marginal adaptation with different materials on restoring dental wedge-shaped defects. Methods From January 2016 to July 2016,80 patients with 172 wedge -shaped defect teeth in Stomatological Hospital of Haishu District were chosen and randomly divided into three groups accord-ing to random number table method,26 patients with 55 defect teeth were treated with Fuji glass ionomer( group A) , 23 patients with 59 defect teeth were treated with Carey charismatic light-cured composite resin( group B) ,and the other 31 patients with 58 defect teeth were treated with beautifil flow plus reinforced polymer F03(group C). Marginal adaptation of three groups of different materials of the teeth were measured. Results The micro -leakage depth among the three groups had statistically significant difference(H=7. 036,P=0. 035). The micro-leakage depth of group A,B and C were (1. 10 ± 0. 05) mm,(0. 96 ± 0. 05) mm,(0. 78 ± 0. 06) mm,respectively. There was statisti-cally significant difference among the three groups(F=22. 371,P=0. 005). Conclusion The marginal adaptation of beautifil flow plus reinforced polymer F03 is superior to FujiⅡglass-ionome and Charisma composite resin,and has benefits for treatment of wedge-shaped defects.

Dynamic expression of CCAAT enhancer binding protein A and its significance in rat lung development / 中华实用儿科临床杂志

Objective To investigate the role of CCAAT enhancer binding protein A (C/EBPα) in lung development by analyzing the relationship between dynamic expression of C/EBPα protein and cell differentiation in rat lung tissue.Methods According to the histological stages of rat lung development,lung tissues were collected on 15.5 d (the late pseudoglandular period),17.5 d (the canalicular period),19.5 d (the early saccular period) of embryonic age and at 12 h (the middle saccular period),on 4 d (the late saccular period),7 d (the alveolar period,the alveolar stage),14 d (the alveolar period,the equilibrium stage) of postnatal age.The lung morphologic appearance was observed by using HE staining.Western blot was used to detect the expressions of C/EBPα and surfactant Protein (SP)-A,SP-B,SP-C,SP-D.Phosphatidylcholine (PC) assay kit was utilized to analyze the secretion of PC.Periodic acid-schiff (PAS) staining was used to evaluate the amcunt of glycogen in lung tissue.Results (1) C/EBPαt and SP-A began to express on 15.5 d of embryonic age (0.36 ±0.02,0.01 ±0.01),while SP-B,SP-C and SP-D started to express on 17.5 d of embryonic age (0.33 ±0.06,0.01 ±0.01,0.11 ±0.08).All of them increased with the development of lung,and C/EBPα,SP-A,SP-C reached the highest level at 12 h of postnatal age (3.48 ±0.05,3.24 ± 0.19,1.26 ± 0.21),and SP-D on the postnatal 4 d (1.48 ± 0.10),then gradually decreased,while the expression of SP-B continued to rise.The levels of C/EBPα and SPs maintained stable on postnatal 14 d.The C/EBPα protein level was positively correlated with SPs at embryonic age of 15.5 d,17.5 d,19.5 d and postnatal age 12 h (r =0.999,0.991,0.982,0.951,all P ＜ 0.05).(2) The level of PC was very low at embryonic age of day 15.5 [(60.50 ± 1.30) μg/g].With the development of lung,the secretion of PC increased gradually,but there was no significant correlation between the expression of PC and C/EBPoα(all P ＞ 0.05).(3) The level of glycogen was high in the late pseudoglandular stage (15.5 d) (585.50 ± 2.20),the content of glycogen decreased with the development of lung,especially on the canalicular (embryonic day 17.5) and during early saccular period (embryonic day 19.5),and then it became stable during the alveolar period (postnatal age 7 d).The expression of C/EBPα had negative correlation with the content of glycogen in fetal lung(r =-1.000,P ＜ 0.01).Conclusion C/EBPα plays an important role in rat lung development,as it may promote lung maturation by regulating the synthesis and secretionof SPs and PC.

We don't dare to tell her we don't know where to begin: Disclosure experiences and challenges among adolescents living with HIV and their caregivers in China.

BACKGROUND AND OBJECTIVES: With increasing access to antiretroviral therapy, HIV-infected youth are living longer, but are vulnerable as they navigate the transition to adulthood while managing a highly stigmatized condition. Knowing one's HIV status is critical to assuming responsibility for one's health. The process of disclosure to adolescents living with HIV is not well understood globally, even less so in China. To help address this gap, we explored practices for disclosure to adolescents living with HIV (ALHIV) among Chinese caregivers and clinicians, and the disclosure experiences of the adolescents themselves using qualitative methods. DESIGN AND SETTING: The study was conducted in 2014 at the Guangxi Center for Disease Control and Prevention ART (CDC-ART) clinic in Nanning, China. We used a qualitative design, incorporating in-depth interviews (IDIs) and focus group discussions (FGDs). PATIENTS AND METHODS: We conducted IDIs with 19 adolescent/caregiver dyads and five FGDs with adolescents and clinicians. Adolescent participants were aged 10-15 years, and had contracted HIV perinatally. Using NVivoTM software, we summarized major themes. RESULTS: Only 6/19 caregivers reported disclosing to their child; matched adolescents' statements indicate that 9/19 children knew their HIV status. Caregivers planned to disclose when children were 14 years or older. Concerns about stigma toward children and families were associated with reluctance to disclose. CONCLUSION: Disclosure to adolescents living with HIV in China was delayed compared with recommended guidelines. Culturally appropriate disclosure strategies should be developed, focused on supporting caregivers and de-stigmatizing HIV.

Evaluation on the effectiveness for respondent-driven sampling method among men who have sex with men in Beijing, 2017 / 中华流行病学杂志

Objective To evaluate the randomness and representativeness of respondent-driven sampling (RDS) tool in conducting the investigation in MSM population,in Beijing,2017.Methods RDS tool was used to recruit MSM population for a face-to-face interview with structured questionnaire and serological tests.Results A total of 600 MSM people were sampled and interviewed.The median number of personal network of seeds was 10,which was higher than other MSM people recruited.The numbers of recruitments by wave presented a skewed positive distribution and the highest number was in the fourth wave.It was also dramatically varied from different seeds.Three seeds had the longest chains and had recruited 184,113 and 92 MSM people,respectively.In contrast,five seeds recruited less than 10 MSM people.Two college students were the most non-generative seeds and each recruited only 1 MSM person.After five to nine waves of sampling,the major demographic characteristics reached equilibrium.Both convergence and bottleneck plots of major demographic characteristics reached convergence,although the plots on marriage and education did not.The homophiles of characteristics were all closed to 1,except for education.The HIV positive rate appeared as 7.9％ (95％CI:4.4％-11.4％). Conclusions Results from this study showed that RDS could be used as a feasible sampling method for the study on MSM population with major demographic characteristics reached equilibrium.The process of recruitment appeared controllable and reasonable,showing that this could represent the MSM population in Beijing,in some degree.

Validity and reliability of the Chinese Version Scale of Social Skill for Nursing / 中国心理卫生杂志

Objective:To test the validity and reliability of the Chinese Version Scale of Social Skill for Nursing(C-SSSN).Methods:The Japanese version SSSN was translated into Chinese according to Beaton's Translation Model.Totally 547 clinical nurses who met the criterion in a tertiary hospital in Yinchuan were selected for analyzing the items and investigating content validity,structure validity and internal consistency reliability.After 2 weeks,30 nurses were randomly selected for reassessment.Results:The content validity index (S-CVI) of C-SSSN was 0.87,the items content validities (I-CVI) varied from 0.86-1.00.Exploratory factor analysis was employed for extracting the 7 common factors and conformed 6 dimensions.The loads of items in the common factors were 0.43-0.88 correspondingly.The cumulative contribution rate was 60.38％.The Cronbach alpha coefficient of the scale was 0.89,the alpha coefficients of the 6 dimensions arranged 0.76-0.93.The retest reliabilities (r) were 0.83 for the total scale and 0.77-0.83 for the six dimensions.Conclusion:The Chinese Version Scale of Social Skill for Nursing has been proved to be reliable and valid which could be used to evaluate clinical nurses' social skill.

Relationship of serum ubiquitin carboxy terminal hydrolase L1 and glial fibrillary acidic protein with brain injury in preterm infants / 临床儿科杂志

Objective To explore the relationship of serum ubiquitin carboxy terminal hydrolase L1 (UCH-L1) and glial fibrillary acidic protein (GFAP) with brain injury in preterm infants. Methods A total of 130 premature infants with gestational age <34 weeks from August 2014 to October 2016 were recruited. Blood samples were collected at 6 h and 72 h after birth. The levels of serum UCH-L1 and GFAP were detected by ELISA method. According to the results of cranial ultrasound and MRI examination, the premature infants were divided into white matter damage (WMD) group, periventricular intraventricular hemorrhage (PVH-IVH) group, and no brain injury group. The levels of serum UCH-L1 and GFAP in preterm infants between the three groups, mild to severe brain injury were compared. Results At 6 h and 72 h after birth, the levels of serum UCH-L1 and GFAP among no brain injury group, PVH-IVH group and WMD group were significantly different (all P <0.001). The level of serum UCH-L1 and GFAP were the highest in the WMD group and the lowest in no brain injury group at both 6 h and 72 h after birth. The levels of serum UCH-L1 at 72 h after birth were significantly lower than those at 6 h after birth in PVH-IVH group and WMD group, while the levels of serum GFAP at 72 h after birth were significantly higher than those at 6 h after birth in both of the two groups (all P<0.05). The levels of serum UCH-L1 and GFAP in severe PVH-IVH group and severe WMD group were significantly higher than those in the mild group at 6 h and 72 h after birth (all P<0.05). Conclusions The levels of serum UCH-L1 and GFAP in preterm infants can be used as sensitive markers for early evaluation of brain injury, which can help determine the severity of brain injury in preterm infants.

Evaluation on the effectiveness for respondent-driven sampling method among men who have sex with men in Beijing, 2017 / 中华流行病学杂志

Objective To evaluate the randomness and representativeness of respondent-driven sampling (RDS) tool in conducting the investigation in MSM population,in Beijing,2017.Methods RDS tool was used to recruit MSM population for a face-to-face interview with structured questionnaire and serological tests.Results A total of 600 MSM people were sampled and interviewed.The median number of personal network of seeds was 10,which was higher than other MSM people recruited.The numbers of recruitments by wave presented a skewed positive distribution and the highest number was in the fourth wave.It was also dramatically varied from different seeds.Three seeds had the longest chains and had recruited 184,113 and 92 MSM people,respectively.In contrast,five seeds recruited less than 10 MSM people.Two college students were the most non-generative seeds and each recruited only 1 MSM person.After five to nine waves of sampling,the major demographic characteristics reached equilibrium.Both convergence and bottleneck plots of major demographic characteristics reached convergence,although the plots on marriage and education did not.The homophiles of characteristics were all closed to 1,except for education.The HIV positive rate appeared as 7.9％ (95％CI:4.4％-11.4％). Conclusions Results from this study showed that RDS could be used as a feasible sampling method for the study on MSM population with major demographic characteristics reached equilibrium.The process of recruitment appeared controllable and reasonable,showing that this could represent the MSM population in Beijing,in some degree.

Prevalence and related factors of HIV/HBV coinfection among HIV/AIDS patients / 中华流行病学杂志

Objective To reveal the prevalence and the related factors of hepatitis B (HepB) virus infection among HIV/AIDS patients.Methods We conducted a cross-sectional study in two HIV clinics,affiliated to local Centers of Disease Control and Prevention in Guangxi Zhuang Autonomous Regional.A face-to-face interview,with questionnaire was conducted to collect information on socio-demographic characteristics,drug use,and sexual behavior.Blood samples were used to test HBsAg.x2 test or Fisher's exact test and unconditional logistic regression models were used to identify the influencing factors.Results The prevalence of HBV and HIV co-infection was 13.85％ (113/816).Results from multivariate logistic regression analyses showed that age (25-45),family history of HBV and history of HepB vaccination were independent influencing factors for HBV and HIV coinfection,with OR (95％ CI) as 1.738 (1.031-2.931),2.898 (1.678-5.005) and 1.744 (1.052-2.892),respectively.Conclusion The prevalence of HBV among HIV/AIDS patients was significantly higher than that in general population.HIV/AIDS patients aged between 25 and 45 and with family history of HBV were more likely to be infected with HBV,while HepB vaccination was associated with the reduction of HIV/HBV coinfection.Specific comprehensive prevention and treatment programs on HIV/AIDS patients need to be set up.

Survival time of HIV/AIDS cases and related factors in Beijing, 1995-2015 / 中华流行病学杂志

Objective To analyze the survival time of HIV/AIDS cases and related factors in Beijing from 1995 to 2015. Methods A retrospective cohort study was conducted to analyze the data of 12874 HIV/AIDS cases. The data were collected from Chinese HIV/AIDS Comprehensive Information Management System. Life table method was applied to calculate the survival proportion, and Cox proportion hazard regression model were used to identify the factors related with survival time. Results Among 12874 HIV/AIDS cases, 303 (2.4%) died of AIDS related diseases; 9346 (72.6%) received antiretroviral therapy. The average survival time was 226.5 months (95%CI:223.0-230.1), and the survival rates of 1, 5, 10, and 15 years were 98.2%, 96.4%, 93.2%, and 91.9%respectively. Multivariate Cox proportion hazard regression model showed that AIDS phase (HR=1.439, 95%CI: 1.041-1.989), heterosexual transmission (HR=1.646, 95%CI: 1.184-2.289), being married (HR=2.186, 95%CI:1.510-3.164);older age (≥60 years) at diagnosis (HR=6.608, 95%CI:3.546-12.316); lower CD4+T cell counts at diagnosis (<350 cells/μl) (HR=8.711, 95%CI: 5.757-13.181); receiving no antiretroviral therapy (ART) (HR=18.223, 95%CI: 13.317-24.937) were the high risk factors influencing the survival of AIDS patients compared with HIV phase, homosexual transmission, being unmarried, younger age (≤30 years), higher CD4+T cell count (≥350 cell/μl) and receiving ART. Conclusion The average survival time of HIV/AIDS cases was 226.5 months after diagnoses. Receiving ART, higher CD4+T cell counts at the first test, HIV phase, younger age, being unmarried and the homosexual transmission were related to the longer survival time of HIV/AIDS cases. Receiving no ART, the lower CD4+T cell counts at the first test, AIDS phase, older age, being married and heterosexual transmission indicated higher risk of death due to AIDS.

A study on the protective mechanisms of lipoxin A4 for hyperoxia-induced pulmonary epithelial cells injury in mice / 中国新生儿科杂志

Objective To study the protective mechanisms of lipoxin A 4 ( LXA4 ) for hyperoxia-induced lung injury through modulation of let-7c/TGF-β1 signal pathway in mice.Method MLE-12 cells was transfected with let-7c mimic, mimic negative control ( NC) , let-7c inhibitor and inhibitor NC.The cells were assigned into hyperoxia group , LXA4 group, let-7c over-expression group, let-7c silence group, let-7c silence+LXA4 group, and all exposed to 85% oxygen.The mRNA level of the extracellular matrixα-smooth muscle actin (α-SMA) and collagen Ⅰ( COL-Ⅰ) , and the expression of related genes in TGF-β1 signaling pathway (Smad 2, Smad 3, Smad 4, TGF-βR1, TGF-βR2) were examined using qPCR.The protein expressions in TGF-β1 signaling pathway was examined using Western blot .Result The mRNA expressions of α-SMA, COL-Ⅰ, Smad 3, Smad 4, TGF-βR1 and TGF-βR2 in LXA4 group [(24.3 ±2.1), (14.6 ±0.2), (17.0 ±0.0), (14.9 ±0.1), (20.8 ±0.1), (9.0 ±0.0) ] and let-7c over-expression group [ ( 12.2 ±0.5 ) , ( 3.0 ±0.0 ) , ( 3.1 ±0.0 ) , ( 9.6 ±0.4 ) , ( 28.5 ±0.2 ) , ( 7.6 ± 0.1)] were decreased comparing with the hyperoxia group [(51.4 ±0.5), (32.0 ±0.1), (40.6 ±0.2), (16.3 ±0.1), (89.1 ±1.1), (19.3 ±0.2)].These expressions were increased in both let-7c silence group [(87.3 ±7.0), (38.5 ±0.3), (48.0 ±0.2), (56.5 ±0.2), (126.0 ±0.9), (33.1 ±1.0)] and let-7c silence +LXA4 group [(144.5 ±12.9), (86.3 ±3.0), (91.5 ±4.7), (86.5 ±3.3), (109.0 ±4.5), (45.6 ±1.6)].The protein levels of Smad 2, Smad 3, Smad 4, p-Smad 2, p-Smad 3 and TGF-βR1 of LXA4 group and let-7c over-expression group were decreased comparing with the hyperoxia group, while p-Smad 2, p-Smad 3 of let-7c silence+LXA4 group were increased(P<0.05).Conclusion LXA4 may play a protective role through let-7c /TGF-β1 signal pathway of lung epithelial cells for hyperoxia-induced lung injury in mice .

Effections of different ways of mechanical ventilation with pulmonary surfactant on respiratory mechanics of patients with neonatal acute respiratory distress syndrome / 实用医学杂志

Objective To investigate the respiratory mechanics and treatment outcomes of different types of mechanical ventilation for patients with neonatal acute respiratory distress syndrome(ARDS):the high frequency oscillation ventilation + pulmonary surfactant (HFOV+PS),conventional mechanical ventilation + pulmonary surfactant(CMV+PS),conventional mechanical ventilation(CMV). Methods Seventy-five cases with neonatal ARDS,25 cases in the HFOV+PS group,30 cases in the CMV+PS group,20 cases in the CMV group. Patients in the former two groups received 70 mg/kg PS at a time. PaO2,PaCO2,PaO2/FiO2,oxygenation index(OI)and respiratory index(RI)were detected at 0 h,12 h,24 h,48 h,72 h post-mechanical ventilation. Results At 12, 24,and 48 hours post-mechanical ventilation,patients in the HFOV+PS group had a significantly higher level of PaO2 and a significantly lower level of PaCO2 than those of patients in the CMV+PS group and the CMV group(P<0.05). At 12,24,48,and 72 hours post-mechanical ventilation,patients in the HFOV+PS group had a significantly higher level of PaO2/FiO2 and significantly lower level of OI and RI than those of patients in the CMV+PS group and the CMV group (P < 0.05,respectively). Patients in the HFOV+PS group also had significantly shorter durations of mechanical ventilation and oxygen usage than those of patients in the CMV+PS group and the CMV group (P < 0.05). No significant differences were observed in Gas leak,the incidence of intracerebral haemorrhage and cure rate among the three groups. Conclusions Application of HFOV with PS therapy for patients with neonatal ARDS can timely improve the oxygenation,shorten the time of mechanical ventilation and the usage of oxygen,without increasing complications.

Protective effect of lipoxin A4 on hyperoxia injury of mouse lung epithelial cells / 中华实用儿科临床杂志

Objective To investigate the protective effects of lipoxin A4 (LXA4) on the lung epithelial cells (MLE-12) in mice with hyperoxia injury.Methods MLE-12 cells were cultured in vitro and divided into air group,air + LXA4 group,hyperoxia group and hyperoxia + LXA4 group.The receptor of LXA4 (ALX) was verified by using reverse transcription-polymerase chain reaction (RT-PCR).MLE-12 cells were exposed to hyperoxia (＞ 850 mL/L oxygen concentration) for 12 h followed by pretreatment of 1 nmol/L,10 nmol/L and 50 nmol/L LXA4 for 1 h,6 h,12 h and 24 h.Quantitative real-time PCR (qRT-PCR) was applied to analyze the heme oxygenase 1 (HO-1) expression to determine the optimal concentration and the optimal pretreatment time of LXA4.The cell morphology was observed by using inverted microscope.The survival rates and cell viability were determined by using Trypan Blue stain and cell counting kit-8 (CCK-8).The superoxide dismutase (SOD) level was determined by using hydroxylamine method.The expressions of mRNA and protein of HO-1 were measured by using qRT-PCR,western blot and immunofluorescence assay,respectively.The interleukin-6 (IL-6) and monocyte chemotactic protein 1 (MCP-1) were determined by using enzyme-linked immunosorbent assay.Results ALX was expressed in MLE-12 cells.The optimal intervention concentration and time of LXA4 was 10 nmol/L for 12 h.Compared with air group [(84 ± 5) ％,1.22 ± 0.27,(5.33 ± 1.16) kU/L],the cell survival rate,viability and SOD level of hyperoxia group [(66 ± 8) ％,0.67 ± 0.21,(2.38 ± 0.65) kU/L] decreased,and the differences were significant (t =3.98,2.55,4.86;P =0.01,0.03,0.00);compared with the hyperoxia group,the cell survival rate,viability and SOD level of hyperoxia + LXA4 group [(88 ± 5) ％,1.43 ± 0.05,(6.50 ± 0.19) kU/L] significantly increased,and the differences were significant (t =4.83,3.52,6.78;P =0.01,0.02,0.00).The HO-1 mRNA and protein expression of hyperoxia group (0.57 ± 0.03,1.31 ± 0.11) increased as compared to air group (0.13 ± 0.03,0.24 ± 0.10),and the differences were significant (t =8.00,10.10;all P =0.00);the HO-1 expression of hyperoxia + LXA4 group (0.78 ± 0.08,1.82 ± 0.09) significantly increased as compared to hyperoxia group,and the differences were significant (t =3.94,8.82,all P=0.00).The levels of MCP-1 and IL-6 of hypemxia group [(1 025.18 ±35.51) rig/L,(1 136.65 ±160.01) ng/L] significantly increased as compared to air group [(467.63 ± 13.69) ng/L,(470.03 ± 118.22) ng/L],and the differences were significant (t =16.51,7.48;all P =0.00);the MCP-1 and IL-6 of hyperoxia + LXA4 group [(640.25 ± 61.03) ng/L,(655.48 ± 88.57) ng/L] significantly decreased as compared to hyperoxia group,and thedifferences were significant (t =11.40,5.40,all P =0.00).Conclusions LXA4 can attenuate hyperoxia-induced injury in MLE-12 cells.The protective role of LXA4 in the hyperoxia-induced cell injury is related to the up-regulation of HO-1 expression and down-regulation of IL-6 and MCP-1 levels.

Effects of galactooligosaccharide on the intestinal flora in premature rats / 重庆医学

Objective To explore the effects of galactooligosaccharide on the intestinal flora in premature rats.Methods Premature Sprague-Dawley rats were randomly divided into GOS group and control group.Premature rats in GOS group were feeding with GOS according 4 g/kg by dropper for 14 d.At 7 d and 14 d after feeding,the mental state and weight of rats were observed and recorded,the fresh feces in terminal rectum were collected to culture and count the number of colonies of bifidobacteria,lactobacillus,enterobacteria and enterococcus.Results Rats in GOS and the control group were normal growth during the administration period,mental state was not abnormal.Compared with the same time point of the control group,there was no significant difference in weight gain between the GOS group(P＞0.05).After feeding GOS for 7 d,there was no statistically significant difference between the number of colonies of bifidobacteria,lactobacillus,enterobacteri.a and enterococcus (P＞0.05).After feeding GOS for 14 d,the number of colonies of bifidobacteria and lactobacillus increased significantly(P＜0.05),while the number of enterobacteria and enterococcus decreased significantly (P ＜ 0.05).Conclusion Galactooligosaccharide could promote the proliferation of bifidobacterium and lactobacillus,inhibit the growth and reproduction of enterobacteria and enterococcus,so regulate the balance of intestinal flora.