OBJECTIVE To investigate and analyze the prevalence rate as well as antibiotics usage in tumor hospital. METHODS The nosocomical prevalence rate of 350 cases in our hospital on 22 Apr,2008 were investigated through and case records. RESULTS Of total 350 cases,15 cases had nosocomial infection with an infection rate 4.3%,and 16 infected sites 4.6% existed.Of all the nosocomial infection cases,the respiratory infection was 40.0% and the urinary tract infection was 26.7%.The antibiotic use rate was 23.7%,from them 65.1% with a single antibiotic and 30.1% with two antibiotics combined. CONCLUSIONS By strengthening the surveillance of clinical departments and the management of antibiotic use the nosocomial infection control could be improved.

Objective To investigate the effects of microRNA-294 (miR-294) on tumor necrosis factor-α (TNF-α),interleukin-6 (IL-6) and high mobility group box 1 (HMGB 1) secretion in sepsis by targeting triggering receptor expressed on myeloid cell-1 (TREM-1).Methods miRNA-294 was predicted to regulate TREM-1 specially through bioinformatics analysis.Mice macrophage cell lines RAW264.7 were cultured in vitro,the cells were divided into non-inflammatory stage and inflammatory stage,and the cells in the two stages were subdivided into five groups as follows:normal control (NC),NC mimic transfection (NCm),NC inhibitor transfection (NCi),miR-294 mimic transfection (miR-294m) and miR-294 inhibitor transfection (miR-294i) groups.The ability of miR-294 was confirmed with dual-luciferase activity assay.At non-inflammatory stage,the cells were transfected with mimic or inhibitor of miR-294 or NC using TurboFectTM siRNA Transfection Reagent for 48 hours,mRNA expression of TREM-1 was detected by real-time reverse transcription-polymerase chain reaction (RT-PCR).At inflammatory stage,6 hours after stimulation by lipopolysaccharide (LPS,1 mg/L),the concentrations of TNF-α,IL-6 and HMGB1 were determined by enzyme linked immunosorbent assay (ELISA),the protein expression of TREM-1 was determined by Western Blot.Results ① Dual-luciferase activity assay demonstrated that TREM-1 was the target of miR-294.② In non-inflammatory stage,the expression of TREM-1 mRNA (2-ΔΔ~) in miR-294m group was significantly lower than that of the NC and NCm groups (0.673 ± 0.049 vs.1.000 ± 0.003,0.915 ± 0.039,t1=2.184,t2=5.421,both P＜0.001),the expression of TREM-1 protein (gray scale) was (50.00 ± 1.19)％ of NCm group (t=41.586,P＜0.001).③ In inflammatory stage,the concentrations of TNF-α (ng/L) in miR-294m group was significantly lower than that of the NC group (1 547.18 ±47.18 vs.2 702.11 ± 327.20,t=4.212,P=0.010),the concentrations of IL-6 (ng/L) was significantly lower than that of the NC and NCm groups (505.28 ± 33.33 vs.837.66 ± 69.43,918.72 ± 119.39,t1 =4.382,P1=0.015; t2=5.451,P2=0.021),the level of TREM-1 protein (gray scale) was (51.33 ±0.88)％ of NCm group (t=63.368,P＜0.001).Conclusion miR-294 reduce TNF-α and IL-6 secretion in LPS-induced RAW264.7 through inhibiting the expression of TREM-1 specifically.

Objective To study the sugical treatment of elderly patients with acute intestinal ob-struction caused by colorectal cancer. Methods The clinical data of 56 elderly patients of acute colonic ob-struction caused by colorectal cancer from Janury 2002 to Janury 2007 were analyzed retrospectively. There were 20 cases with right side coloniclesion,32 cases with left side coloniclesion and 4 cases with rectal lesion. All patients received emergency operation. One stage tumor resection and anastomosis was performed in 20 cases with right side coloniclesion and in 25 cases with left side coloniclesion,Hartmann operation in 4 cases,proximal colostomy in 3 cases were performed with left side coloniclesion. Dixon operation in 2 cases and proximal colostomy in 3 cases were performed with rectum cancer. Results Postoperative complications occurred in 18 cases,including wound infection,intraperitoneal sepsis and intestinal fistula. Fifty-five cases recovered,there was one perioperative death. Conclusions Positive operation should be taken when the diagnosis of acute obstructing colorectal cancer the elderly is made. The operative methods depended on the patient'conditions. The perioperative managment should be emphasized and selection of rational operation procedure is important for decreasing mortality and complications of acute obstructing colorectal cancer in the elderly.

Objective To evaluate the efficacy and safety of intra?articular injections of tranexamic acid (TXA) on perioperative blood loss and transfusion in primary unilateral total knee arthroplasty (TKA). Methods Primary TKA was per?formed on a total of 380 patients (380 knees) affected to various degrees by knee osteoarthritis. All the patients are divided into three groups according to different joint injection for 5 min at the end of surgery in which:120 patients received 1.5 g TXA injec?tion,136 patients received 0.5 g TXA injection, 124 patients no pharmacological intervention (control group). Blood loss, hidden blood loss, blood transfusion, drainage volume and limb circumference change after TKA were assessed. Results All the surger?ies were well performed. No complication including infection, necrosis, and fat liquefaction has been observed. The results indicat?ed no significant difference with pairwise comparisons in intra?operative time, intra?operative blood loss, hospitalization time, anes?thesia, and drainage volume and limb circumference change. The mean postoperative hidden blood loss (1.5 g TXA group 693.29± 377.91 ml, 0.5 g TXA group 835.41±481.97 ml, the control group 1 032.75±322.19 ml) and transfusion (1.5 g TXA group 7.5%, 0.5 g TXA group 13.2%, the control group 20.2%) requests were significantly different with pairwise comparisons among the three groups. Compared with the control group, both 1.5 g TXA group and 0.5 g TXA group showed better effects (P<0.05). Compared with the 0.5 g TXA group, 1.5 g TXA group showed better effects (P<0.05). Conclusion It can be concluded that intra?articular injection of TXA in patients undergoing unilateral TKA could significantly reduce postoperative hidden blood loss and blood trans?fusion, and did not increase the risk of phlebothrombosis. This efficacy demonstrated a concentration dependent effect. Compared with 0.5 g TXA, 1.5 g TXA performed a better efficacy.

Objective To detect biomarker proteins in relation to metastasis by comparing serum protein profiles of primary colorectal cancer patients with or without metastasis. Methods A total of 219 serum samples were analyzed using surface enhanced laser desorption ionization time of flight mass spectrometry(SELDI-TOF-MS).The samples were divided into two groups:the training group consisting of 57 primary colorectal cancer patients、63 metastatic colorectal cancer patients and 42 healthy controls,and the test group consisting of 26 primary colorectal cancer patients and 31 metastatic colorectal cancer patients.Samples in training group were analyzed to identify serum biomarker proteins which could differentiate colorectal cancer patients with or without metastasis.The sensitivity and specificity of biomarker proteins were examined by results from blind test group. Results In the m/z region of 2000～30000,31 proteins had statistically significant difference between primary colorectal cancer patients and healthy controls.The m/z of difierentiated proteins were respectively 3240.7、9289.3、5334.4、4596.1 and 4792.4 according to P value.38 proteins had statistically significant diffefence between metastatic colorectal cancer patients and healthy controls.The m/z of differentiated proteins were respectively 3240.7、9289.3、9184.4、3191.5 and 9340.9 according to P value.Only two protein peaks(9184.4 and 9340.9)were found of statistical difference between primary eolorectal cancer patients and metastatic colorectal cancer patients.The sensitivity and specificity of the combination use of the two biomarkers were respectively 90.3% and 88.5% in the test group. Conclusion SELDI-TOF-MS was helpful to find protein biomarkers with relation to metastasis in colorectal carcinoma patients.

Objective To investigate the correlation between cornexin37 (Cx37) CI019T polymorphism and ischemic stroke and its outcome.Methods Restriction fragment length polymorphism analysis was used to detect the distribution of Cx37 C1019T polymorphism in a ischemic stroke group and a control group.The modified Rankin scale (mRS) was used to evaluate the neurological outcome at 3 months after onset.Results A total of 235 patients in the control group,and 232 patients in the ischemic stroke goup were recruited.In the ischemic stroke group,210 had a good outcome (mRS ＜3) and 22 had a poor outcome (mRS≥ 3).The TT genotype (12.93％ vs.6.39％ ; x2 =10.087,P =0.006) and T allele (31.25％ vs.21.49％ ; x2 =11.466,P=0.001) frequency in the ischemic stroke group were significantly higher than those in the control group.Multivariatelogistic regression analysis showed that TT genotype (odds ratio [OR] 5.794; 95％ confidence interval [CI] 1.405-23.894; P =0.015) and T allele (OR 131.016,95％ CI 6.943 -2 472.477; P =0.001)signifkantly increased the risk of ischemic stroke.Univariate analysis showed that TT genotype (OR 0.650,95％ CI 0.144 - 2,934; P =0.575),CT genotype (OR 0.622,95％ CI 0.234 - 1.655; P =0.342),and CC genotype (OR 0.654,95％ CI 0.268 - 1.595; P =0.350) had no significant correlation with the outcome of ischemic stroke.Conclusions Cx37 1019TT genotype and T allele may increase the risk of ischemic stroke.T allele is one of genetic susceptibility factors for ischemic stroke; however,its gene polymorphism is not associated with the outcome of ischemic stroke at 3 months after onset.

Objective To evaluate percutaneous transluminal angioplasty ( PTA) for stenosed arteries of the lower extremities in patients with ischaemic diabetic foot. Methods We retrospectively analyzed the clinical and follow-up data of using PTA to treat diseased infrapopliteal arteries in diabetic patients who were hospitalized from Oct,2006 to May,2008. Results Technical success rate was 87% , procedure related complications developed in 8. 9% of patients, postoperative complications were 11. 1% , perioperative mortality was 2. 5% , limb salvage rate was 90% , pain symptom was significantly mitigated or relieved, ulcer healed well. The median hospitalstay was 10 days. Restenosis rates were 38. 1 % , 50% respectively at 1 year and 2 years. Rest pain and ulcer recurrence rates were 10% and 12% at 1 year and 2 years respectively; Amputation rates were 10% and 15. 3% at 1 year and 2 years. Restenosis ( or occlusion) , rest pain or ulcer recurrence and amputation rate in Fontain Ⅳ group is significantly poorer than that in Fontain Ⅰ - Ⅲ group (P ＜0. 05). Conclusions Percutaneous transluminal angioplasty (PTA) for critical limb ischeamia in patients with ischaemic diabetic foot are feasible, with minimal invasiveness, low complications. Fontain classification predicts PTA thrapeutic results.

Objective To establish a direct reverse transcription real-time fluorescence quantitative polymerase chain reaction ( RT-qPCR-D ) method for detecting serum circulating B cell-specific moloney murine leukemia virus integration site-1 (Bmi-1) mRNA, and analyze the levels of serum circulating Bmi-1 mRNA in colorectal cancer patients by using of this method for exploring its diagnosis value in colorectal cancer.Methods Methodology establishment.RNA was extracted from colorectal cancer HT 29 cell line, and detection standard curves of Bmi-1, ubiquitin C ( UBC), glyceraldehyde-3-phosphate dehydrogenase ( GAPDH) mRNAs were established , then the amplification efficiencies were calculated.Bmi-1 mRNA level was directly detected in serum and preparation buffer mixture , then the specificity of assay was evaluated by melting curve, and detection limit was observed through diluted serum samples.The serum circulating Bmi-1 mRNA levels were detected by ELISA in 158 cases with colorectal cancer , of which there were 26 cases of tumor node metastasis ( TNM)Ⅰstage, 53 cases of TNMⅡ, 47 cases of TNMⅢ, 32 cases of TNMⅣand 53 cases of controls with normal colonoscopy collected from January 2008 to January 2009 in Qilu Hospital of Shandong University.Comparisons of groups were determined by applying Mann-Whitney U test or Kruskal-Wallis test, and receiver operating characteristic ( ROC) curves were established to illustrate the diagnostic performance.Results The log values of Bmi-1, UBC and GAPDH showed good linear correlations with quantification cycle (Cq) values(R2 =0.990, 0.990, 0.991, all P <0.001), and the amplification efficiencies were 0.875, 0.917 and 0.935, respectively.Using the established RT-qPCR-D method, the peak of melting curve of Bmi-1, UBC and GAPDH mRNAs were single, the detection limit was up to 1.25μl.The levels of serum circulating Bmi-1 mRNA detected by RT-qPCR-D were 0.138 ( 0.078-0.228 ) in colorectal cancer stage Ⅰ patients, 0.163(0.067 -0.287) instage Ⅱ patients, 0.217(0.072-0.267) instage Ⅲpatients, 0.273(0.139 -0.419) in stage Ⅳ patients and 0.021(0.008 -0.029) in health controls, a significant difference was found among groups ( H =89.5, P <0.001 ).The levels of serum circulating Bmi-1 mRNA in each stage colorectal cancer were all significantly higher than that in control group(U=58.0, 287, 246, 72.5,all P<0.001).The levels in Ⅳstage patients were significantly higher than those in other stages patients (U=247, 590, 540,P=0.008, 0.020, 0.035), while no significant differences among Ⅰstage,Ⅱstage and Ⅲstage patients(U=633, 514, 1170,all P>0.05).ROC curve analysis showed area under the ROC curve ( AUC) for serum circulating Bmi-1 mRNA was 0.921(95%CI=0.876-0.953), which was significantly superior to the AUC of CEA (0.745, 95%CI=0.680-0.802, Z=4.697, P<0.001 ).When cutoff value was 0.034, the diagnostic sensitivity and specificity was 89.2%(141/158) and 90.6%(48/53), while 41.8%(66/158) and 73.6%(39/53) using CEA.The AUC for combination of circulating Bmi-1 mRNA and CEA was 0.933(95%CI=0.890-0.963 ) , which was no statistical significance when compared with the AUC of circulating Bmi-1 mRNA(Z=4.697, P>0.05).Conclusions The study establishes a higher sensitive, specific for detecting serum circulating Bmi-1 mRNA. Based on this method , serum circulating Bmi-1 mRNA is found to be increased in colorectal cancer , and is superior to traditional tumor marker CEA in diagnosis of colorectal cancer, which may become a potential detection index for early detection of colorectal cancer.

Objective:To analyze the alternative splicing (AS) events of patients with thyroid carcinoma (THYC) and explore the correlation between AS events and the prognosis of THYC.Methods:The clinical data and the Percent Splice In (PSI) value of AS events of THYC were downloaded from The Cancer Gene Atlas (TCGA) database and the TCGA SpliceSeq database respectively. The occurrence of seven kinds of AS events including AA, AD, AF, AP, ME, ES and RI in THYC was investigated and the matrix of AS events and survival data was constructed. Univariate Cox regression analysis was used to screen AS events related to prognosis of THYC. To avoid over-fitting, the least absolute shrinkage and selection operator (LASSO) regression analysis was performed. Then Multivariate Cox regression analysis was used to construct prognosis model. Kaplan-Meier curve and receiver operating characteristic (ROC) curve were performed to evaluate the prognosis ability of the risk model. We also used Pearson correlation analysis to select splicing factors (SF) which were correlated with survival associated AS events. Above SF genes were enrolled to gene ontology (GO) enrichment and KEGG pathway analysis.Results:A total of 10 447 genes and 45 150 AS events in 507 THYC patients were found in the present study. Among them, ES was the main type (38.84%) and ME was the type with the least frequency (0.51%). Totally 1 842 AS events associated with prognosis of THYC patients were identified. Three AS events including USHBP1-48249-AA、CACNB1-40626-AT and BEX5-89679-AP were selected to construct the prognosis model. The risk score of 0.807 was indicated as the best cut-off value of prognosis model. The patients were divided into high-risk group (240 cases) and low-risk group (241 cases) based on the risk score. The results demonstrated that the risk model could be used as a valuable prognostic factor for THYC ( P<0.001, AUC=0.929). The SF-AS network was constructed and several SF genes, including CDK12, RBM25, DDX39B, SRRM2 and DDX46 were identified as hub genes. Conclusions:The risk model based on 3-AS events was valuable prognosis predictor of THYC. The SF-AS network provided new insight for the exploration of tumorigenesis and development of THYC.

Tight-junction (TJ) is a complex supramolecular entity composed of complete membrane proteins, membranes and soluble cytoplasmic proteins, which is distributed in almost all barrier structures in the body. It can maintain the polarity of epithelial cells, close the intercellular space and prevent the overflow of materials in the epithelial space, and is a highly dynamic signaling entity. Occludin is one of the most representative members of TJ proteins, mainly responsible for sealing intercellular connections, maintaining intercellular permeability, and participating in maintaining the integrity of vascular endothelium. The integrity of occludin is related to the integrity of TJ, and the function of occludin is often associated with the barrier properties of various tissues, and the abnormal expression of occludin is related to the occurrence and development of various diseases. Occludin contains abundant Ser and Thr residues and has multiple phosphorylation sites. Phosphorylation is necessary for the combination of occludin and TJ, which can regulate the location of occludin, regulate the expression of occludin, and enhance the permeability and barrier function of TJ. Therefore, phosphorylation regulation is a mechanism that cannot be ignored in the regulation of occludin function. Occludin also interacts with many other proteins, such as co-forming the cytoskeleton with ZO-1, and is regulated by a variety of transcription factors. Studies have confirmed that in pathological conditions, a variety of signaling pathways can disrupt the integrity of cell barrier by regulating the expression and distribution of occludin. Myosin light chain kinase (MLCK) signal transduction pathway is one of the important ways to regulate the structure and function of TJ. It influences the expression of occludin by altering the cytoskeleton. MLCK mainly uses the phosphorylation of myosin light chain (MLC) as a medium to promote actin contraction, secondary decomposition of tightly binding proteins, resulting in increased or changed cellular barrier permeability, and increased MLC phosphorylation is also a biochemical marker of actomyosin contraction. Activation of MLCK causes Thr18 and Ser19 phosphorylation of MLC, which promotes the assembly of myosin II into myosin fibers and activates the hydrolysis of ATP, which relaxes the intercellular connections and reduces the ability of upper cortex to resist external invaders. Protein kinase C (PKC) plays an important role in the regulation of tightly connected signaling molecules, affecting the dynamic changes of paracellular permeability. PKC pathway is a key link in many cell signal transduction pathways, which influences all aspects of cell activities by catalyzing Ser/Thr residues phosphorylation of membrane proteins and many enzyme proteins. After PKC activation, it can regulate cellular barrier function by phosphorylating occludin and inducing its redistribution, and directly affect TJ action. Specific PKC subunits such as PKCα, PKCδ and PKCγ are activated and act on occludin molecules to promote their phosphorylation and cause the increase of TEER. The increase of TEER helps to regulate intercellular TJ and enhance the tightness of intercellular connections. Mitogen-activated protein kinases (MAPK) are usually activated by inflammatory factors, during which different signal transduction pathway subfamilies are formed to regulate occludin expression and affect tight junction and mucosal barrier functional integrity. Meanwhile, occludin is easily affected by various factors (such as cytokines and flora toxins), and abnormal expression of occludin will lead to structural damage of TJ and further damage of the intercellular barrier. Therefore, this paper summarizes the molecular structure and physiological function of occludin, and further summarizes its related signal regulation pathways and influencing factors, in order to provide theoretical support for maintaining the integrity of barrier function of occludin.