Objective To observe the early rehabilitation effect of mild hypothermia on patients with herpes simplex viral encephalitis (HSE). Methods A total of 58 patients with HSE were randomized into two groups, a mild hypothermia therapy group (30 cases) and a normothermia control group (28 cases). Their rectal temperatures were controlled to (34±1)℃ and (37.0±0.5)℃ respectively. Serum levels of neuron specific enolase (NSE) were determined through radio-immunoassay (RIA). Soluble intercellular adhesion molecule-1 (sICAM-1) was measured with ELISA before and 1, 3, 5, and 7 d after treatment. The outcome was evaluated using the Glasgow Outcome Scale (GOS) 30 days after treatment. Results Compared with the normothermia control group, the mild hypothermia group's serum levels of NSE and sICAM-1 decreased quickly and significantly during the early stage of treatment and remained better 30 d later. Conclusion Mild hypothermia therapy can dramatically reduce inflamma-tion and facilitate the rehabilitation of damaged neurons, provide protective effects and improve the outcome for pa-tients with SHE.

Background and purpose:Triple-negative breast cancer (TNBC) possesses high risk of relapse and metastasis. Clinically, there are no speciifc targeted-therapies to TNBC except chemotherapy. Therefore, studying the mechanism of relapse and metastasis has signiifcance to improve the patients’ survival rate. This experiment aimed to study the effect of MAPK activation on migration and invasion of triple-negative breast cancer cells. Methods:Difference of migration and invasion between lung-high metastasis breast cancer cell line 231-HM and its parental cell line 231-p were first examined by cell scratch and transwell;Then, metastasis-associated proteins and MAPK-associated molecules were detected by Western blot; Last, 231-p cells were treated with P38/MAPK inhibitor and used to determine cell migration, invasion, and metastasis-associated proteins thereafter. Results:Compared with the parental cell line 231-p, 231-HM cells displayed obviously higher ability of migration and invasion. With the increased expression of Caveolin-1and β-catenin, the phosphorylation of MAPK-associated molecules including P38, Erk1/2, and MEK was highly decreased. Treatment of 231-p cells with low concentration (10 μmol/L) of the P38/MAPK inhibitor SB202190 increased the migration and invasion of 231-p cells, and the expression of Caveolin-1 andβ-catenin. Conclusion:Activation of MAPK signaling inhibits the migration and invasion of triple-negative breast cancer.

Objective This investigation was to define the occupational security-related factors in community nurses and effective strategies to improve their service awareness and occupational protection ability.Methods A questionnaire was used for 1702 community nurses in Guangzhou to learn occupational security-related factors and occupational protection skills.Results Self-report results found that 21.3% (362/1702) nurses fully understood the occupational security-related factors,12.0% (204/1702) nurses knew the requirement for occupational security,and 12.3% (209/1702) nurse could provide occupational protection.Conclusions These results suggested that most community nurses showed poorer occupational protection awareness and ability.Thus,occupation safety management regulations,standardized performance procedure and emergency response plan should be put forward,and further community nurse training programme need to be initiated.

Objective To compare the effect on preserving rat amputated extremities during the cold preservation between the UW solution and HTK solution.Methods Thirty healthy adult Wistar rats were randomly divided into 3 groups (10 rats in each group) for producing the models of amputated limbs of rats.The three groups were separately irrigated the amputated limbs with UW solution,HTK solution and saline from femoral artery.After irrigation,the extremities were preserved in the refrigerator at 4 ℃.Samples of skeleton muscle tissue were taken for pathological and biochemical examination every 6 hours since the amputation.Results After perfusion,HE:changes of organizational structures of skeletal muscle were lighter in experimental groups than in control group (saline-perfusion group) at the same time.While samples in UW solution-perfusion group has lighter changes of organizational structure than those in HTK solution-perfusion group.TEM:at 12 h,all the three groups have shown the mitochondria edema.At 24 h,the myofibril in saline-perfusion group become fragments.Biochemical examination:at 24 h,indexes in salineperfusion group,HTK solution group and UW solution group were:ALP (U/L) 3.62 ± 1.32,3.37 ± 0.84 and 2.68 ± 1.59,respectively;ALT(U/L) 542.25 ± 129.36,521.82 ± 97.32 and 462.53 ± 74.18,respectively;AST (U/L) 2200.12 ± 687.61,2002.20 ± 632.27 and 1742.87 ± 396.09,respectively;CK(U/L) 313190.83 ± 42041.32,283173.50 ± 31488.87 and 271319.67 ± 41147.52,respectively;LDH (U/L) 32409.50 ± 4253.20,30382.50 ± 2337.18 and 30047.83 ± 4628.78,respectively;GLU(mmol/L) 0.242 ± 0.041、0.240 ± 0.044 and 0.252 ± 0.049,respectively;LAC (mmol/L) 1.790 ± 0.160,1.792 ± 0.196 and 1.993 ± 0.366,respectively;SOD(U/mL) 80.82 ± 9.46,91.62 ± 14.97 and 73.71 ± 10.60,respcctively.There were statistical difference among the UW solution-perfusion group and centrol group in ALP and GLU (P ＜ 0.05).UW solution-perfusion group has better results than HTK solution-perfusion group in SOD (P ＜ 0.05).Conclusion Amputated limbs irrigated with organ preservation solution as a way to protect skeletal muscle had great effects on lightening tissue damage and keeping tissue active.Between the two usual organ preservation solution,UW solution had a stronger protective effects on the amputated limbs than HTK solution.

OBJECTIVE To investigate the current situation and rationality of clinical usage of antibacterial drugs in our hospital and to find out corresponding supervision measures. METHODS According to the same method and criterion,3343 medical records of discharged patients in 14 departments were investigated retrospectively by utilizing the designed questionnaire. RESULTS The total application rate of antibacterial drugs was 60%,and the rate of preventive usage took up 41% of the total application rate,the application rate of cephalosporins was the highest,and that of quinolones was the next.For the combined usage of drugs,1 150 patients were treated with one drug,730 were treated with two drugs,and 99 were treated with more than three drugs.The treatment period of 1 086 patients was less than 7 days. CONCLUSIONS The usage of antibacterial drugs should be supervised more intensively and the training for medical personnel be strengthened to improve their knowledge of using antibacterial drugs,in order to achieve the rational usage of antibacterial drugs.

Objective To investigate the security and effect of endovascular stents placement in treating atherosclerotic stenosis of the iliac arteries.Methods 15 cases with iliac arterial stenosis caused by atherosclerosis were treated by a big amount of thrombolysis in combination with iliac arterial stent placement.The length of lesions was from 4.3 cm to 9.5 cm(mean of 6.7 cm),the claudicant distance was from 100 m to 300 m(mean of 185 m).Clinical follow-up included CT angiography,color Doppler sonography and clinical evaluation with the ankle-brachial index(ABI).Results Eighteen stents were placed in 18 limbs of 15 patients.The technical successful rate was 100%.The clinical symptoms(claudication or the rest pain)were improved,and ABI increased from 0.25?0.18 to 0.85?0.15 after stent implantation in all cases.All the patients were followed up for 3~47 months,one patient was death during the follow-up periods because of brain stem ischemic stroke.All patients maintained uninterrupted stent patency until the final follow-up.Conclusion Iliac arterial stent placement is a safe treatment with favorable long term patency for treating arterial stenosis caused by atherosclerosis.

BACKGROUND: To determine the non-or collapsed osteonecrosis of the femoral head (ONFH) and degree of collapse, can help surgeons design reasonable treatment strategy for patients with ONFH. In China, articular cartilage collapse less than or greater than 2 mm, is a basis for choosing palliative surgery or hip replacement. However, the measurement of collapsed ONFH before replacement has not yet been confirmed. OBJECTIVE: To predict the collapse of femoral head before replacement by CT and X-ray examinations, and to compare with the intraoperative excised femoral head specimens.METHODS: This was a single-center, open-label and diagnostic trial, which was finished at the Third Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, China. Eighty-six patients with unilateral ONFH undergoing total hip replacement were recruited, and allocated into three groups, such as X-ray, CT and specimen groups. The X-ray group underwent X-ray examination at anteroposterior pelvic (bilateral hips) at 1 week before surgery, the CT group received CT scan at bilateral hips at 1 week before surgery, and the specimen group was subjected to the removal of affected femoral head, and then directly measured using ruler and vernier caliper. Primary outcome was the sensitivity of thesethree methods for measuring collapsed femoral head. Secondary outcomes were the specificity, positive predictive value,negative predictive value, positive likelihood ratio, and negative likelihood ratio of these three methods for the diagnosisof collapsed femoral head and the diagnostic accuracy; the diagnostic consistence of CT and X-ray examinations; the height of the lateral, middle and external femoral head measured by three methods. The study was approved by the Ethics Committee of the Third Hospital of Hebei Medical University, China, and will be performed in accordance with the guidelines of the Declaration of Helsinki, formulated by the World Medical Association. Written informed consent will be obtained from all participants prior to the trial. DISCUSSION: In this study, the height of femoral head was measured and analyzed in all-dimensional and multi-anglemanner based on intraoperative removed specimens, so as to make an accurate prediction for collapsed femoral head, thus providing imaging reference for surgeons prior to choosing an appropriate operative scheme

Objective To evaluate analgesic effect of bupivacaine infiltration in trocar incision after laparoscopic surgery.Methods 90 patients were randomly divided into 3 groups after laparoscopic cholecystectomy.In group 10.25% bupivacaine 20 ml(50 mg) injection, in group 2 sterile NS 20 ml infiltrated in the muscular fasciae of the trocars, in group 3 patient-controlled intravenous analgesia(PCIA) was used.In 2, 6, 12 and 24 hours after the intervention, the pain intensity was recorded with the use of a Visual Analogue Scale ( VAS), time of flatus passing was recorded as well.Results Patients with bupivacaine or PCIA had statistically significant in pain score compared with patients with NS especially within 12 hours after the surgery (t2h = 8.475; t6h = 5.356; t12h = 3.496, P ＜ 0.05) while the difference was not statistically significant between the 3 groups at 24 hours.The time of passing flatus in group 1 patients with bupivacaine was earlier than with PCIA ( x224h = 5.406, P ＜ 0.05 ) .Conclusions Bupivacaine infiltrated in trocar incision after laparoscopic surgery reduced postoperative pain, and did not disturb peristalsis reflex recovery of the intestines.

ObjectiveTo investigate the roles of Toll-like receptor (TLR) 3 and 9 in herpes zoster (HZ).Methods Venous blood samples were collected from 40 patients with HZ and 16 normal human controls. Flow cyometrywas usedto detect the expressionsof TLR3and TLR9inperipheralblood mononuclear cells(PBMCs) from these subjects.ResultsThe percentages of PBMCs expressing TLR3 and TLR9 were significantly higher in patients than in normal human controls(both P ＜ 0.01).The expression levels of TLR3 and TLR9 in PBMCs were negatively correlated with the age of onset(r =-6.23,-5.88respectively,both P ＜ 0.01 ),but uncorrelated with gender or age.There was a significant difference in the expression levels of TLR3 and TLR9 in PBMCs between different age groups ( ＜ 40 years,40-50 years,＞ 50 years) of patients with HZ(F =3.410,P ＜ 0.01 ),with the strongest expression observed in patients younger than 40 years.ConclusionTLR3 and TLR9 may participate in the pathogenesis of HZ.