目的 研究母代不同孕期巨细胞病毒（CMV）感染对自身精神及行为的影响。方法 72只BALB/c雌鼠随机分为12组（A1、A2、A3、B1、B2、B3、C1、C2、C3、D1、D2、D3,每组6只）,A为孕期再感染、B为既往感染、C为孕期原发感染、D为空白对照,1为孕早期、2为孕中期、3为孕晚期。母鼠腹腔注射小鼠CMV（murine CMV,MCMV）Smith株建立播散性感染模型,或注射无菌生理盐水建立对照模型。母鼠产仔后同笼合养,产后22 d分笼;母鼠做行为学试验。试验结束,每组随机处死3只母鼠;测量子宫、肝、脑脏器重量系数及唾液腺中MCMV含量。结果 A、B、C组母鼠产后次日体质量均低于D组（均P<0.05）,其中C2、C3组母鼠低体质量情况持续至产后22日（均P<0.05）。A、B、C组母鼠唾液腺组织均测出MCMV。与D组母鼠相比,A1、C1组母鼠活胎率降低（均P<0.05）,A、C组母鼠的子宫、肝、脑脏器系数升高（均P<0.05）且脑组织有病损表现。产后6天时,A3、B3、C组母鼠水平运动总距离和直立次数减少（均P<0.05）,糖水偏好量降低（均P<0.05）,悬尾不动时间延长（P<0.05）;其中,C2、C3组母鼠以上行为退缩情况至产后22天仍存在,且有逃避潜伏时间延长（均P<0.01）,穿越原平台位置次数减少（均P<0.01）情况。结论 孕期CMV感染损害母代身心健康,有可能增加子代不良抚养的风险。

Objective To investigate the effects of cytomegalovirus（CMV）infection in different stages of maternal pregnancy on its own spirit and behavior．Methods A total of 72 female BALB/c mice were randomly divided into 12 groups（each group had 6 mice）：A1-A3,B1-B3,C1-C3,D1-D3（group A had re-infection,group B had previous infection,group C had primary infection,group D was blank control,group 1 was in early pregnancy,group 2 was in middle pregnancy,group 3 was in late pregnancy）．The disseminative infection model was established by intraperitoneal inoculation of murine CMV（MCMV）Smith strain,and the blank control model was established by intraperitoneal inoculation of 0.9% sterile saline（NaCl）．After 21 days of parturition,the mothers and offspring were reared in separate cages,mothers were selected for the behavior experiments．At the end of all the behavior tests,3 mothers in each group were killed randomly．Weighed and calculated the organ coefficients of the uteri,livers and brains,and detected the expression levels of MCMV in salivary gland．Results On the first day after delivery,the weights of mothers in groups A,B and C were lower than those in group D（all P<0.05）,the low body weight of mice in C2 and C3 groups lasted to the 22th day（all P<0.05）．The MCMV in salivary gland tissue were found in groups A,B and C,but not in group D．The live fetus rates of groups A1 and C1 were significantly lower than that of group D．The organ coefficients of uteri,livers and brains in groups A and C were higher than those in group D（all P<0.05）．And the lesions of brain tissues in groups A and C were more serious than in the other groups．On the 6th day,compared with the other groups,the mothers of groups A3,B3 and C were significantly abnormal in the open field test,the tail suspension test and the sugar preference test（all P<0.05）．But on 22th day,only the mothers of groups C2 and C3 were significantly abnormal in those tests（all P<0.01）,and even in the water maze test（all P<0.01）．Conclusions Maternal CMV infection in different stages pregnancy have impacts on mother mice's physical and mental health．Those bad situations may bring poor parenting to the offspring．

目的 探讨与分析推拿联合补肾祛瘀针刺法治疗慢性腰肌劳损恢复期患者对腰部疼痛及表面肌电图的影响。方法 选择2019年9月—2022年4月我院收治的72例慢性腰肌劳损恢复期患者为研究对象,根据随机1∶1数字表法,分为联合组与对照组各36例。对照组给予推拿治疗,联合组在此基础上,给予补肾祛瘀针刺法治疗,2组均治疗并观察4周,评价腰部疼痛及表面肌电图变化情况。结果 治疗后联合组与对照组的总有效率分别为97.2%和75%,联合组高于对照组（P<0.05）;治疗前,2组患者的视觉类比疼痛评分法（VAPS）和下腰痛失能问卷（OPDG）评分比较差异无统计学意义,治疗后,2组患者的VAPS和OPDG评分均降低,且联合组低于对照组（P<0.05）;2组治疗后的腰椎前屈力度都高于治疗前（P<0.05）,且联合组更高（P<0.05）;2组治疗后的表面肌电图神经根振幅和潜伏期均低于治疗前（P<0.05）,且联合组更低（P<0.05）。联合组与对照组治疗后的血清5-HT含量均高于治疗前（P<0.05）,联合组更高（P<0.05）。结论 推拿联合补肾祛瘀针刺法在慢性腰肌劳损恢复期患者中的应用具有良好的安全性,有效改善患者的腰椎功能,缓解患者疼痛,提高整体治疗效果,也能改善患者的表面肌电图状况,促进血清5-HT的释放。

Objective To explore and analyze the effects of massage combined with kidney tonifying and blood stasis removing acupuncture on lumbar pain and surface electromyography in patients with chronic lumbar muscle strain in the recovery period．Methods From September 2019 to April 2022, 72 cases of patients in the recovery period of chronic lumbar muscle strain treated in our hospital were selected as the research objects, and were divided into the combined group and the control group with 36 cases in each group by the random 1∶1 number table method．The control group were given massage therapy, and the combination group were given kidney tonifying and stasis removing acupuncture additionally．Results After treatment, the total effective rates of combined group and control group were 97.2% and 75%, respectively, and the combined group was significantly higher than the control group（P<0.05）．Before treatment, there was no significant difference in the visual analogue pain scale（VAPS）and Oswestry low pain & disability questionnaire（OPDG）scores between the two groups, but after treatment, the scores of the two groups were significantly decreased, and the combined group was significantly lower than the control group（P<0.05）．The lumbar flexion intensity after treatment was significantly higher in both groups than before treatment（P<0.05）, and higher in combination group（P<0.05）．The amplitude and latency of surface electromyogram nerve roots after treatment were significantly lower in both groups than before treatment（P<0.05）, and even lower in combination group（P<0.05）．The serum 5-HT content in combination group and control group after treatment was significantly higher than that before treatment（P<0.05）, and that in combination group was higher（P<0.05）．Conclusions The application of massage combined with kidney tonifying and blood stasis removing acupuncture in patients recovering from chronic lumbar muscle strain has good safety, which can improve the lumbar function of patients, relieve the pain of patients, improve the overall therapeutic effect, improve the surface electromyography of patients and promote the release of serum 5-HT．

目的 比较单纯康复训练和在此基础上结合苍龟探穴针法对脑卒中后肩手综合征I期的临床疗效差异。方法 选择响水县人民医院疼痛康复科收治的卒中后出现肩手综合征I期患者60例,按随机数字表法分为治疗组（n=30）和对照组（n=30）。治疗组患者行与苍龟探穴中医针法结合康复训练,先由具备针灸专业主治资格的临床医师对所选取的部分穴位使用苍龟探穴中医传统针法实施治疗后,再由具有5年以上工作经历的康复治疗师实施治疗,而其他患者则单纯接受康复训练,并观察2组患者在治疗前和治疗后的视觉模拟评分（VAS）、肿胀程度、简式上肢运动功能（Fugl-Meyer）评估以及临床疗效。结果 本次研究临床治疗进程中,2组无不良反应情况出现,因疫情和不能配合治疗而出现5例脱落病例（治疗组2例,对照组3例）。①治疗后,2组患者的VAS和肿胀程度评分低于治疗前（P<0.01）,治疗组患者2项评分高于治疗前（P<0.05）;②治疗后,2组患者的Fugl-Meyer评分高于治疗前（P<0.01）,治疗组患者评分高于对照组（P<0.01）;③治疗组的有效率高于对照组,组间比较差异有统计学意义（P<0.05）。结论 苍龟探穴中医传统针法结合康复训练可减少患者水肿和酸痛情况,明显改善患者上肢运动能力,有良好的临床效果。

Objective To compare the clinical efficacy of rehabilitation training alone and the combination of Cangguitanxue acupuncture on post-stroke stage I shoulder-hand syndrome．Methods A total of 60 patients from the Department of Rehabilitation Medicine of Xiangshui County People's Hospital who met the diagnosis（stroke followed by stage I shoulder-hand syndrome）were selected, and they were randomly divided into treatment group（n=30）and control group（n=30）according to the random number table method．Patients in the treatment group underwent a combination of rehabilitation training with the Cangguitanxue acupuncture Chinese medicine acupuncture method, and were first treated by a clinician qualified in acupuncture using the Cangguitanxue acupuncture Chinese medicine traditional acupuncture method on selected acupoints, and then by a rehabilitation therapist with more than five years of experience, while other patients received rehabilitation treatment alone．Results In the clinical treatment process of this study, there were no adverse reactions in the two groups, but there were five cases of dropout due to the epidemic and the inability to cooperate with the treatment（two cases in the treatment group and three cases in the control group）．After treatment, the visual analogue scale（VAS）and swelling degree scores of the two groups were significantly lower than those before treatment（P<0.01）, and the performance of the patients in the treatment group was better than that before treatment（P<0.05）．After treatment, the score of simplified upper limb motor control function（Fugl-Meyer）score in the two groups was significantly higher than that before treatment（P<0.01）, and the score of patients in the treatment group was higher than that of the control group（P<0.01）．The effective rate of the control group was inferior to that of the treatment group, and the difference was statistically significant（P<0.05）．Conclusions The traditional acupuncture method combined with rehabilitation training can significantly reduce edema and soreness in patients, significantly improve upper limb motor ability, and have good clinical effects．

目的 探讨基于中药熏蒸配合穴位按摩的健康管理对稳定期肺肾气虚型慢阻肺的疗效。方法 选取2020年1月—2021年1月在我院接受治疗的稳定期肺肾气虚型慢阻肺患者120例为研究对象,随机分为对照组和干预组。对照组采用西医常规干预,干预组在此基础上实施为期1年的中药熏蒸配合穴位按摩的健康管理,比较干预前后2组患者肺功能、血氧指标以及生活质量的差异。结果 干预前,2组患者第1秒用力肺活量（FEV₁）、第1秒用力肺活量占预计值百分比（FEV₁%）、用力肺活量（FVC）、第1秒用力肺活量占用力肺活量的比值（FEV₁/FVC%）等指标比较差异无统计学意义（P>0.05）,干预后,2组患者的FEV₁、FEV₁%、FVC、FEV₁/FVC%明显上升,且干预组患者优于对照组（P<0.05）;实施相关干预前,干预组和对照组患者的血氧指标比较差异无统计学意义（P>0.05）,干预后,2组患者的PaO₂、和SpO₂上升,PaCO₂下降,且干预组的变化幅度大于对照组（P<0.05）;干预前2组患者在圣乔治问卷（SGRQ）生活质量评分比较差异无统计学意义（P>0.05）,干预后2组患者的SGRQ生活质量评分降低,且干预组患者的SGRQ生活质量指标评分更低（P<0.05）。结论 中药熏蒸配合穴位按摩应用于稳定期肺肾气虚型慢阻肺患者中,能够提高患者的肺功能,改善血氧指标,提高患者的生活质量。

Objective To explore the effect of health management based on traditional Chinese medicine fumigation combined with acupoint massage on stable chronic obstructive pulmonary disease（COPD）with lung-kidney deficiency．Methods A total of 120 patients with stable COPD and lung-kidney deficiency who received treatment in our hospital from January 2020 to January 2021 were selected as the study objects and randomly divided into control group and intervention group．The control group received conventional Western medicine intervention,and the intervention group received 1-year traditional Chinese medicine fumigation combined with acupoint massage on the basis of Western management．The differences of lung function,blood oxygen index and quality of life between the two groups were compared before and after intervention．Results Before intervention,there were no significant differences in forced expiratory volume in one second（FEV₁）,the first second forced vital capacity percentage of expected value（FEV₁%）,forced vital capacity（FVC）,the ratio of the first second forced vital capacity of forced vital capacity（FEV₁/FVC%）between the two groups（P>0.05）,but after intervention,the FEV₁,FEV₁%,FVC,FEV₁/FVC% of the two groups increased significantly,and those in the intervention group were better（P<0.05）．Before the implementation of relevant intervention,there was no difference in blood oxygen index between the two groups（P>0.05）．After the intervention,PaO₂ and SpO₂ of the two groups were significantly increased,while PaCO₂ was significantly decreased,and the change in the intervention group was significantly greater（P<0.05）．Before intervention,there were no significant differences in the quality of life scores of St George’s Respiratory Questionnaire（SGRQ）between the two groups（P>0.05）．After intervention,the scores of SGRQ of the two groups were significantly decreased,and the scores of the intervention group were significantly lower（P<0.05）．Conclusions Traditional Chinese medicine fumigation combined with acupoint massage can significantly improve lung function,blood oxygen index and life quality of stable COPD patients with lung-kidney deficiency．

目的 观察LACE风险模型下的护理干预策略在心脏瓣膜置换术后患者中的应用效果。方法 选取我院2021年3月—2022年3月心脏瓣膜置换术后患者82例作为研究对象,以患者入院顺序编号分为对照组、观察组,各41例。对照组予以常规护理,观察组予以LACE风险模型下的护理干预。比较2组出院时、干预后的自我管理能力及负性情绪;干预期间的术后并发症发生率、再入院率、用药依从性。结果 干预后观察组自我管理环境、自我管理行为、自我管理认知评分高于对照组（P<0.05）;观察组术后并发症发生率7.32%（3/41）、再入院率4.88%（2/41）均低于对照组24.39%（10/41）、21.95%（9/41,P<0.05）;观察组用药依从率97.56%（40/41）高于对照组78.05%（32/41,P<0.05）;干预后观察组汉密尔顿抑郁量表评分、汉密尔顿焦虑量表评分低于对照组（P<0.05）。结论 心脏瓣膜置换术后患者进行LACE风险模型下的护理干预后,患者的自我管理能力及用药依从性明显改善,同时其并发症发生率和再入院率有效降低,焦虑、抑郁等负性情绪得到缓解,具有良好护理效果。

Objective To observe the effect of nursing intervention strategy under LACE risk model in patients after heart valve replacement．Methods From March 2021 to March 2022,82 patients with heart valve replacement were enrolled as the study objects．The patients were divided into control group and observation group according to the order of admission,with 41 patients in each group．The control group was given routine nursing,and the observation group was given nursing intervention under LACE risk model．The self-management ability and negative emotions at discharge and after intervention were compared between the two groups．The incidence of postoperative complications,readmission rate and medication compliance during the intervention period were also compared．Results After intervention,the scores of self-management environment,self-management behavior and self-management cognition in the observation group were higher than those in the control group（P<0.05）．The postoperative complication rate of 7.32%（3/41）and readmission rate of 4.88%（2/41）in the observation group were lower than those of 24.39%（10/41）and 21.95%（9/41）in the control group（P<0.05）．The compliance rate of the observation group（97.56%）was higher than that of the control group（78.05%,P<0.05）．After intervention,the scores of Hamilton Depression Scale and Hamilton Anxiety Scale in the observation group were lower than those in the control group（P<0.05）．Conclusions After nursing intervention under LACE risk model for patients after heart valve replacement,the self-management ability and medication compliance of patients have been significantly improved,the incidence of complications and readmission rate have been effectively reduced,and negative emotions such as anxiety and depression have been alleviated,which has good nursing effect．

目的 分析近年来2型糖尿病自我管理水平的研究进展,讨论其自我管理水平的影响因素及给出相应的建议。方法 通过中国知网、万方医学、迈特思创外文期刊等检索工具,搜索“2型糖尿病”“自我管理”等关键词,收集2000年—2022年相关文献资料,采用文献研究方法进行分析。结果 共检索相关文献1 053条,通过阅读文献以及文献引文,共筛选出重要文献35篇。结论 归纳总结介绍了近年来有关2型糖尿病自我管理水平的研究进展、自我管理的各个方面,包括概念、评估工具、影响因素、与糖尿病并发症的关系及提升方法等,最后文章的总结部分提出了未来研究的方向和挑战。

Objective To analyze the research progress on self-management levels of type II diabetes in recent years,discuss the influencing factors of self-management levels,and provide corresponding suggestions．Methods This article collected relevant literature from 2000 to 2022 by searching tools such as CNKI,Wanfang Medical and Medline for keywords such as “type II diabetes”and“self-management”,and analyzed the literature using a literature research method．Results A total of 1,053 relevant literature were retrieved,and 35 important literature were selected through reading literature main body and citation．Conclusions This article summarizes the research progress on self-management levels of type II diabetes in recent years,including various aspects of self-management such as concepts,evaluation tools,influencing factors,the relationship with diabetic complications,and improvement methods．The conclusion part of the article proposes directions and challenges for future research．

目的 应用锥形束CT比较改良颈肩体热塑膜和传统颈肩体热塑膜体位固定装置在颈胸段食管癌患者放射治疗中的摆位差异,分析两种固定方式对锁骨上下区摆位误差的影响。方法 分析2021年6月—2022年10月在南京医科大学第一附属医院行放射治疗的29例食管癌患者的临床资料。将患者分为改良颈肩体热塑膜组（改良组）和光板颈肩体热塑膜组（对照组）,对比分析2组病例不同配准区域的摆位误差。结果 改良组在X（左右）方向的平移误差及Rz（冠状面）方向的旋转误差小于对照组,差异有统计学意义（P<0.05）。改良组锁骨上下区在X（左右）方向的平移误差以及Rx（矢状面）方向的旋转误差小于对照组,差异有统计学意义（P<0.05）。改良组的整体靶区外放范围在X、Y方向上均小于颈肩体组,改良组在锁骨上下区的X方向靶区外放范围也更小。结论 对于颈胸段食管癌需行锁骨上下区放疗的患者,应用改良颈肩体热塑膜可减少平移误差,控制旋转角度,减少靶区外放范围。

Objective To compare the set-up errors between the modified neck-shoulder body thermoplastic film and the traditional neck-shoulder body thermoplastic film fixation device in the radiotherapy of patients with cervical and thoracic esophageal cancer by cone beam CT,and to analyze the influence of the two fixation methods on the positioning error of the upper and lower clavicular region．Methods The clinical data of 29 patients with esophageal cancer who underwent radiotherapy in the First Affiliated Hospital of Nanjing Medical University from June 2021 to October 2022 were analyzed．The patients were divided into two groups：the modified neck-shoulder body thermoplastic film group（the modified group）and the smooth neck-shoulder body thermoplastic film group（the control group）,the positioning errors in different regions of the two groups were compared and analyzed．Results The translation error in the X（left and right）direction and the rotation error in the Rz（coronal plane）direction of the modified group were smaller than those of the control group,and the differences were statistically significant（P<0.05）．The translation error in the X（left and right）direction and the rotation error in the Rx（sagittal plane）direction of the superior and inferior clavicular region in the modified group were smaller than those in the control group,and the differencs were statistically significant（P<0.05）．The overall target area of the modified group was smaller in X and Y directions than that of the neck-shoulder body group,and the target area of the improved group in X direction was also smaller in the upper and lower clavicle area．Conclusions For patients with cervical and thoracic esophageal cancer who need radiotherapy in the upper and lower clavicular region,the application of modified neck shoulder body thermoplastic film can reduce the translation error,control the rotation angle and reduce the external radiation range of the target region．

目的 探讨精细化管理模式对消毒供应中心风险事件发生率的影响。方法 选取2020年6月—2022年5月为研究阶段,抽取本院消毒供应室1 000件医疗器械作为研究对象,随机分为对照组和研究组,各500件。对照组采用常规管理模式,研究组采用精细化管理模式,对比2组医疗器械不良事件发生率,观察30名工作人员分别在不同管理模式下发生职业风险暴露人数的变化,并进一步比较工作效率的不同。结果 研究组发生数量不等、物品过期、标签错误、型号错误、零部件差错等不良事件发生率均低于对照组（P<0.05）。研究组工作人员利器损伤和血制品污染者发生率低于对照组（P<0.05）,研究组工作人员工作效率评分高于对照组（P<0.05）。结论 精细化管理模式可有效减少消毒供应室医疗器械不良事件,降低工作人员职业暴露风险事件发生率,提高工作人员工作效率,改善管理工作质量。

Objective To explore the influence of refined management mode on the incidence of risk events in disinfection supply center. Methods From June 2020 to May 2022,1 000 pieces of medical devices were selected from the disinfection supply room of our hospital as the research object,and were randomly divided into control group and research group,with 500 pieces in each group. The control group adopted the conventional management mode,while the research group adopted the refined management mode. The incidence of adverse medical device events in the two groups was compared,and the changes in the number of 30 staff exposed to occupational risks under different management modes were observed,and the differences in work efficiency were further compared. Results The incidences of adverse events involving unequal quantities,expired items,mislabeling,modeling errors and parts errors were lower in the study group than in the control group(P<0. 05). The number of sharps injuries and blood product contamination among the staff in the study group was significantly lower than that in the control group(P<0. 05),and the staff efficiency scores of the study group were higher than those of the control group(P<0. 05). Conclusions Refined management mode can effectively reduce the adverse events of medical devices in disinfection supply room,reduce the number of occupational exposure risk events of staff,improve the work efficiency of staff and improve the quality of management.

目的 探讨特殊健康儿童预防接种评估及不良反应处理。方法 选取2018年1月–2022年12月经预防接种门诊主动筛选的出生日期在2004年6月1日—2022年6月1日的特殊健康儿童,收集临床资料,以此进行预防接种评估建议,随访不良反应。结果 本研究共纳入944例特殊健康儿童,其中精神发育迟滞231例（24.47%）、脑性瘫痪440例（46.61%）、先天愚型115例（12.18%）、癫痫74例（7.83%）、先天性心脏病54例（5.72%）、唐氏综合征30例（3.18%）。其中男、女分别有519例（54.98%）、425例（45.02%）。在特殊健康儿童中,建议可正常接种疫苗918例（97.25%）,建议接种灭活疫苗但避免接种减毒活疫苗8例（0.85%）,建议暂缓接种所有疫苗18例（1.91%）。建议接种疫苗的特殊健康儿童中,已接种疫苗926例（98.09%）,接种灭活疫苗842例（89.19%）,接种减毒活疫苗612例（64.83%）;926例儿童共接种疫苗8 480剂次,其中灭活疫苗6 770剂次、减毒活疫苗1 770剂次;62例儿童进行68剂次疫苗接种后出现不良反应（包括局部反应15例次、全身反应53例次）,总发生率为8.02‰（68/8 480）,其中灭活疫苗、减毒活疫苗发生率分别为6.79‰（46/6770）、1.29%（22/1 710）。所有不良反应案例经处理,除口干1例处理后好转外,其他均达治愈,治愈率达98.53%（67/68）。结论 特殊健康儿童经医学评估后大多可接种疫苗,接种后不良反应发生风险在可控范围内。

Objective To discuss the evaluation of vaccination and treatment of adverse reactions in healthy special children. Methods From January 2018 to December 2022,healthy special children with birth dates from June 1,2004 to June 1,2022 who were screened by the vaccination clinic were selected. Clinical data were collected to conduct vaccination assessment recommendations and follow up adverse reactions. Results A total of 944 healthy special children were included in this study,including 231 cases(24. 47%)of mental retardation,440 cases(46. 61%)of cerebral palsy,115 cases(12. 18%)of congenital foolishness,74 cases(7. 83%)of epilepsy,54 cases(5. 72%)of congenital heart disease and 30 cases(3. 18%)of Down syndrome. There were 519 males(54. 98%)and 425 females(45. 02%). Among the healthy special children,918 cases(97. 25%)were recommended to get vaccinated normally,8 cases(0. 85%)were recommended to be vaccinated with inactivated vaccine but avoid to be vaccinated with attenuated live vaccine,and 18 cases(1. 91%)were recommended to suspend all vaccination. Among the special healthy children recommended for vaccination,926(98. 09%)had been vaccinated,842(89. 19%)had been vaccinated with inactivated vaccine,and 612(64. 83%)had been vaccinated with live attenuated vaccine. A total of 8 480 doses of vaccines were administered to 926 children,including 6 770 doses of inactivated vaccines and 1 770 doses of attenuated live vaccines. Adverse reactions occurred in 62 children after 68 doses of vaccination(including 15 cases of local reactions and 53 cases of systemic reactions),with a total incidence of 8. 02 ‰(68/8480). The incidences of inactivated vaccine and attenuated live vaccine were 6. 79 ‰(46/6 770)and 1. 29%(22/1710),respectively. All cases of adverse reactions were treated and basically cured,with a cure rate of 98. 53%(67/68),except for the case of dry mouth. Conclusions Most of the healthy special children can be vaccinated after medical evaluation,and the risk of adverse reactions after vaccination is controllable.

目的 采用体外试验的方法,研究弱酸性培养对人正常食管内皮细胞（HEEC）活力的影响及潜在的调控机制。方法 细胞培养液的pH值分别设为（6.0~6.5）和（7.0~7.4）。以中性培养组为对照。利用CCK8实验,检测弱酸培养条件下,不同时间点食管内皮细胞活力的变化。采用蛋白免疫印迹法检测p38和磷酸化p38（p-p38）的表达。利用酶联免疫吸附剂测定法检测培养基上清液中IL-1β和IL-8的表达水平,并检测加入p38激酶活性抑制剂SBS 203580后两者浓度的变化。结果 弱酸环境下,细胞活力下降。培养1 h时,弱酸组细胞活力为（96.4±8.0）%,培养3 h和6 h时分别为（88.7±6.2）%和（87.7±7.4）%。细胞中p38的水平与培养基的pH值无关。弱酸培养可以促使细胞内p-p38的含量增加。基线时,弱酸组p-p38的灰度值比值为（0.37±0.02）,在培养2 h和6 h时分别为（0.64±0.09）、（0.84±0.11）,差异显著（P<0.01）。弱酸刺激诱导食管内皮细胞表达更多的IL-8和IL-1β。基线时弱酸组上清液中IL-8和IL-1β的浓度分别为（8.64±1.31）pg/mL,（3.35±0.49）pg/mL。培养6 h后,二者的浓度分别上升至（36.85±2.02）pg/mL和（19.19±1.60）pg/mL,差异显著（P<0.01）。加入SBS 203580后,IL-8和IL-1β的浓度明显下降（P<0.05）。结论 弱酸刺激可以降低食管内皮细胞的活力。p38 MAPK可能通过调控IL-8和IL-1β的表达参与该调节过程。

Objective To study the effect of weak acidic culture on the viability of normal human esophageal endothelial cells(HEEC)and the potential regulatory mechanisms. Methods The pH values of cell culture medium were set at(6. 0-6. 5)and(7. 0-7. 4),respectively. The group in neutral medium was set as control. CCK8 experiment was used to detect the change of cell viability at different time points. The expressions of p38 and phosphorylated p38(p-p38)were detected by Western Blot experiment. Enzyme linked immunosorbent assay was used to detect IL-1β and IL-8 concentration in the medium supernatant before and after adding p38 activity inhibitor(SBS 203580). Results HEEC viability was decreased under weak acidic conditions. After 1 hour of cultivation,the HEEC viability was(96. 4±8. 0)%,after 3 and 6 hours,it decreased to(88. 7±6. 2)% and(87. 7±7. 4)%,respectively. The level of p38 in cells was independent of culture medium pH values. Weak acidic stimulation could promote an increase of p-p38 in HEEC. At baseline,the gray value ratio of p-p38 in the weak acidic group was(0. 37±0. 02),and after 2 and 6 hours of culturing,it increased to(0. 64±0. 09)and(0. 84±0. 11),respectively,which differences were significant(P<0. 01). More IL-8 and IL-1β were expressed after weak acidic stimulation. At baseline,the concentrations of IL-8 and IL-1β in the medium supernatant of weak acidic group were(8. 64±1. 31)pg/mL and(3. 35±0. 49)pg/mL. After 6 hours of culturing,they increased significantly to(36. 85±2. 02)pg/mL and(19. 19±1. 60)pg/mL(P<0. 01),while the concentrations were decreased after adding SBS 203580(P<0. 05). Conclusions The HEEC viability was reduced by weak acidic stimulation,p38 MAPK may participate in the process by regulating the expression of IL-8 and IL-1β.