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 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.

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 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 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.

ObjectiveTo investigate the clinical characteristics and pathogenic microorganisms in culture-positive sepsis, to identify its risk factors, and evaluate the prognosis on polymicrobial infection in intensive care unit (ICU).Methods A descriptive retrospective study was conducted. Clinical data of patients aged≥ 18 years, diagnosed as culture-positive sepsis, and admitted to six ICUs of Guangdong General Hospital from October 12th, 2012 to December 1st, 2014 were enrolled. Based on the number of isolated pathogens, patients were divided into polymicrobial infection group (≥two pathogens) and monomicrobial infection group (one pathogen) to investigate the clinical characteristics of patients with culture-positive sepsis and the causative pathogens. Multiple logistic regression was conducted to identify the risk factors for polymicrobial infection. Kaplan-Meier curve was plotted to analyze a 90-day survival rate from the onset of positive blood culture.Results 299 patients with positive blood culture were enrolled. A total of 450 strains of pathogens were isolated including 246 gram-positive cocci (54.67%), 167 gram-negative bacilli (37.11%) and 37 fungi (8.22%). Ninety-one patients had polymicrobial infection, and 208 with monomicrobial infection. Compared with monomicrobial infection group, patients suffering from polymicrobial infection had more advanced age (years: 73.19±18.02 vs. 60.83±18.06,t = -5.447,P = 0.000), also with higher incidence of cerebrovascular diseases [39.56% (36/91) vs. 17.79% (37/208),χ2 = 16.261,P = 0.000] or chronic renal insufficiency [15.38% (14/91) vs. 7.21% (15/208),χ2 = 4.828,P = 0.028], higher incidence of recent hospital stay (≥2 days) within 90 days [73.63% (67/91) vs. 61.54% (128/208),χ2 = 4.078,P = 0.043], longer mechanical ventilation duration [days: 4 (0, 17) vs. 1 (0, 6),U = 7 673.000,P = 0.006], longer length of hospital stay before blood was drawn for culture [days: 21 (7, 40) vs. 9 (3, 17),U = 6 441.500,P = 0.006], and higher incidence of pre-admission intravenous use of antibiotics [84.62% (77/91) vs. 66.83% (139/208),χ2 = 9.989,P = 0.002]. Multiple logistic regression analysis showed that advanced age [odd ratio (OR) = 1.032, 95% confidential interval (95%CI) = 1.015-1.050,P = 0.000], cerebrovascular diseases (OR = 2.247, 95%CI = 1.234-4.090,P = 0.008), prolonged mechanical ventilation (OR =1.041, 95%CI = 1.014-1.069,P = 0.003), and recent hospital stay (≥2 days) within 90 days (OR = 1.968, 95%CI =1.079-3.592,P = 0.027) were the independent risk factors for polymicrobial infection. In the polymicrobial infection group, the length of ICU stay [days: 46 (22, 77) vs. 13 (7, 22),U = 3 148.000,P = 0.000] and hospital stay [days:81 (47, 118) vs. 28 (17, 46),U = 3 620.000,P = 0.000] were significantly longer, and the ICU mortality [65.93%(60/91) vs. 43.75% (91/208),χ2 = 12.463,P = 0.000] and hospital mortality [68.13% (62/91) vs. 45.67% (95/208),χ2 = 12.804,P = 0.000] were significantly higher, and on the other hand the 90-day survival rate was significantly lower than that in the monomicrobial infection group (χ2 = 8.513,P = 0.004).Conclusions The most common pathogen of ICU sepsis is gram-positive cocci. Independent risk factors for polymicrobial infections were found to be advanced age, occurrence of cerebrovascular disease, prolonged mechanical ventilation, and recent hospitalization. Polymicrobial infection is associated with longer length of ICU and hospital stay, as well as higher mortality.

Objective To investigate skin manifestations and comorbidities of chronic arsenicosis due to conta?minated drinking water, and to explore their possible risk factors. Methods Data about demographic characteristics, skin manifestations and comorbidities were collected from 95 patients with chronic arsenicosis due to contaminated drinking water in Inner Mongolia, and retrospectively analyzed. A logistic regression model was established to analyze associations of skin manifestations and comorbidities with patients′ gender, age, age at onset of drinking of arsenic?contaminated water, arsenic concentrations in water and duration of arsenic exposure. Results Among the 95 patients, 77 had hyperpigmentation, 75 hypopigmentation, 93 palmoplantar keratoderma, 27 skin cancer, and 8 multiple skin cancer. Five patients were complicated by tuberculosis, 15 by hypertension, 2 by rheumatoid arthritis, 4 by cerebral infarction, 7 by coronary heart diseases, 3 by internal malignancy, 6 by hepatic cirrhosis and 2 by anemia. Logistic regression analysis revealed a significant correlation between hyperpigmentation and arsenic concentrations in water(OR=0.32, 95%CI=0.10-0.98;ORadjusted=0.27, 95%CI=0.08-0.90), between occurrence of hepatic cirrhosis and arsenic concentrations in water (OR=24.67, 95%CI=2.69-226.57;ORadjusted=22.51, 95%CI=2.38-213.11), and between occurrence of coronary heart diseases and duration of arsenic exposure(OR=6.41, 95%CI=1.09-37.88;ORadjusted=8.55, 95%CI=1.21-60.41). Conclusions There is a high incidence of aberrant pigment metabolism, palmoplantar keratoderma and skin cancer in patients with chronic arsenicosis due to contaminated drinking water. Different arsenic concentrations in water and duration of arsenic exposure seem to have different influences on the human body.

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