Objective To investigate the correlation of postoperative cognitive dysfunction (POCD)and the preoperative he-moglobin (HbA1c)in elderly patients with type 2 diabetes mellitus (T2DM).Methods 82 patients with T2DM who were underwent non-cardiac surgery were included in this study,group A had 37 patients with POCD after surgery,group B had 45 patients with non POCD,the patients in two groups used the same anesthesia method,compared the general data and pre-operative HbA1c,fasting blood glucose levels of two groups,compared the incidence of POCD in patients with HbA1c in dif-ferent levels.Results There was no significant difference in gender composition,age,body mass index,preoperative MMSE score,hypertension rate,operation time and bleeding volume in operation,and there was no significant difference in fasting blood glucose of patients in two groups.Fasting blood-glucose (FBG)of two groups were 7.1±2.6 and 6.7±1.8 mmol/L (t=0.821,P=0.424),it was no significant difference;HbA1c of two groups were (7.2±1.3)% and (6.3±1.0)%,the group A was higher than the group B (t=3.543,P=0.001),there was significant difference.The incidence rate of POCD of the group AH was 58.1%(25/43),while the group AL was 30.8% (12/39),the group AH was higher the group AL(χ2=5.131,P=0.024),there was significant difference.Conclusion Preoperative determination of HbA1c in elderly patients with T2DM after surgery has forecast values for the occurrence of POCD,to control HbA1c in the low level can reduce the occurrence of POCD in elderly patients with T2DM.

It is urgent to construct the integrity of medical students on campus.Students of the first and fifth grade which are also the two special stages are investigated in the survey,According to the comparison of the honor credibility knowledge and behavior,the article summarized the effectiveness of contemporary medical education,and discussed the dialectical relationship between the integrity education of the medical students and medical integrity,to give full play to the clinical practice teaching as a significant role of the integrity education of medical students.

Objective To rapidly construct hepatitis B virus(HBV)adefovir(ADV)‐resistant strain(RT A181T)infectious clone by using SOE‐PCR ,to observe the expression of recombinant plasmids in Huh7 cells and to establish the in vitro cell model of HBV ADV‐resistant strain(RT A181T) .Methods The conservative primers were designed ,the full‐length HBV genome was amplified from serum in the patients with ADV‐resistant chronic hepatitis B .Then ,the 1 .3‐fold genome‐length infectious clone pHBV1 .3 was constructed by using the SOE‐PCR technique ,which was transfected into human hepatoma cells Huh7 cell line .ELISA ,Western Blot and Real‐time PCR were adopted to detect infectious cloning replication and expression ,meanwhile the antiviral drugs lamivu‐dine(LAM ) and ADV were used to verify the infectious clone copy and inhibition of expression .Results The HBV ADV‐resistant infectious cloning plasmids pHBV1 .3 was successfully constructed .This plasmid could be effectively replicated ,transcripted and ex‐pressed in Huh7 cell lines .LAM could effectively inhibit the replication and expression of the infectious clone ,while ADV could not inhibit the replication and expression of the infectious clone .Conclusion The constructed infectious clone plasmids pHBV1 .3(RT A181T ) of HBV ADV‐resistant strain can efficiently replicate and express protein in vitro ,its transfected cells can be used in the study of HBV replication mechanism and antiviral study .

Objective: To investigate the effects of hepatitis B virus (HBV) X protein (HBx) on the expression of tumor necrosis factor-α (TNF-α) in glomerular mesangial cells (GMCs) and the underlying intracellular signal pathways. Methods: The plasmid pCI-neo-X that carries the X gene of hepatitis B virus was transfected into cultured GMCs. HBx expression in the transfected GMCs was assessed by Western-blot. TNF-α protein and mRNA were assessed by ELISA and semi-quantitative RT-PCR, respectively. Three kinase inhibitors-U0126, an inhibitor of extracellular signal-regulated kinases (ERKs);lactacystin, an inhibitor of nuclear factor-κB (NF-κB);and SB203580, a selective inhibitor of p38 MAP kinase (p38 MAPK) were used to determine which intracellular signal pathways may underlie the action of HBx on TNF-αexpression in transfected GMCs. Results:A significant increase in HBx expression in pCI-neo-X transfected GMCs was detected at 36 h and 48 h, which was not affected by any of those kinase inhibitors mentioned above. A similar increase in the expression of both TNF-αprotein and mRNA was also observed at 36 h and 48 h, which was significantly decreased in the presence of U0126 or lactacytin, but not SB203580. Conclusions:HBx upregulates TNF-αexpression in cultured GMCs, possibly through ERKs and NF-κB pathway, but not p38 MAPK pathway.

Objective To observe the effects of silencing IGF-1 receptor on the expression of Caspase12 , a endoplasmic reticulum specificity apoptosis protein of the peroxidation damage in L02 cells. Methods Four the recombined plasmids expressing short hairpin RNA (shRNA) specific for sileincing IGF-1R gene were constructed and these shRNAs were potentially targeted on different mRNA sequences of the IGF-1 receptor gene (Sh-H-IG1R- 1108, Sh-H-IGF1R-2797, Sh-H-IGF1R-3215 and Sh-H-IGF1R-3787). These constructs were classed as the experimental group. Another two constructs containing an irrespective sequence and no sequence were defined as a positive control group a negative control group , respectively. All these constructs were transfected into the L02 cells by Lipefectamine 2000. The interference effect was detected by RT-PCR after 24 h and the plasmid stably silencing the expression of IGF-1 receptor was selected for further analysis which was divided into four groups: the blank control group(Group A), the peroxidation damage group(Group B), the negative plasmid transfection group (Group C) and the positive plasmid transfection group (Group D). The expression of Caspase12 was detected by Westen Blot after 12 h. Results The amplification folds of experimental groups were statistically significantly lower than those of the Sh-H-IGF1R-V1 group and Sh-H-IGF1R-V2 group (P < 0.05). The silence effect of the Sh-H-IGF1R-3215 group (0.02 ± 0.01) and the Sh-H-IGF1R-3787 group (0.05 ± 0.05) were most stable and the repeatability of the later was better. The expressions of Caspase12 in Group B (2.41 ± 0.03), Group C (2.45 ± 0.02) and Group D (3.60 ± 0.06) were higher than Group A (0.34 ± 0.02) (P < 0.01). The Group Cexpression was higher than that of the Group B (P > 0.05). The Caspase12 expression in Group D was higher than that in Group B and C (P < 0.01). Conclusion (1) Of all the four constructs in this study, Sh-H-IGF1R-3787 is the most suitable for silencing IGF-1 receptor. (2) Silencing IGF 1R expression using shRNA plasmids can aggravate the L02 cells apoptosis, suggesting that the IGF-1/IGF 1R signal pathway might be involved in regulating the activation of apoptosis in L02 cells with peroxidation damag via endoplasmic reticulum stress.

Ischemic reperfusion is the common mechanism of some chronic diseases such as type 2 diabetes,coronary heart disease,hypertension,and so on.Previous studies of insulin resistance is mainly focused on the relationships of these chronics,while now,in recent years,the research between the insulin resistance and ischemic reperfusion has gradually become one of the new and hot points,closely related to the patient's prognosis.In this paper,we will review the insulin resistance and ischemic reperfusion according to the reported literature review.

Objective To analyze the subject frequency and score proportion of the national unified examination papers of Nursing Research according to the topic content,in order to offer proposals for the reformation and optimization of the examination,and provide self-test-takers with references of improving learning methods and results.Methods The papers of the subject of Nursing Research during October 2008 to January 2013 had been statistically analyzed following the syllabus.Results Comprehensive coverage of knowledge point existed in the papers of the recent five years.The theme of measurement of research tools (5.8％) and basic procedures of nursing research (7.0％) took a smaller proportion compared with nursing research design (16.0％) and nursing papers writing(16.3％).Conclusions The contents of the 10 papers of the past 5 years concentrate high attentions and emphasis on the comprehension and application of the basic theory and methods,which accord with the goals and requirements of this subject in the training of the research ability.

Infection is one of the most familiar complications in children with idiopathic nephrotic syndrome.Although vaccination is an effectual measure in prevention of secondary infections, it still faces many problems.On the one hand, children′s own immune status (immune system dysfunction, administration with immunosuppressants, etc.) lends additional uncertainties to whether the immune system can produce sufficient protective antibodies after vaccination.On the other hand, potential risks (recurrence of nephrotic syndrome and induction of vaccine related diseases) need to be comprehensively assessed at the time of vaccination.In this paper, the safety, effectiveness and timing of va-ccination in children with nephrotic syndrome in the post-COVID-19 period were summarized, and possible problems of vaccination against severe acute respiratory syndrome Coronavirus 2(SARS-CoV-2) were discussed.

During the installation of a pipe pile, the soil around the pile will be squeezed out. This paper deals with this squeezing effect of open-ended pipe piles using the cylindrical cavity expansion theory. The characteristics of soil with different tension and compression modnli and dilation are involved by applying the elastic theory with different moduli and logarithmic strain. The closed-form solutions of the radius of the plastic region, the displacement of the boundary between the plastic region and the elastic region and the expansion pressure on the external surface of the pipe piles are obtained. When obtaining these solutions, the soil ping in the open-ended pipe pile is considered by employing an incremental filling ratio to quantify the degree of soil plugging. Moreover, the effects of the ratio of tension and compression moduli, angle of dilation and incremental filling ratio on the radius of the plastic region and the expansion pressure on the external surface of the pipe pile are investigated. The parametric analyses show that it is necessary and important to consider the difference between the tension modulus and compression modulus, dilation angle and incremental filling ratio for studying the squeezing effect of open-ended pipe pile installation. It is concluded that the analytical solutions presented in this paper are suitable for studying the squeezing effect of open-ended pipe piles.

Objective To explore the influence of preoperative chemotherapy (POCT) on telomerase activity(TA) of breast cancer and its mechanism. Methods TA was detected in 40 primary breast cancer specimens. Forty patients were divided into two groups: (1)POCT group. 32 patients, who underwent POCT using CMF scheme; (2) control group . 8 patients, who did not receive any POCT or radiotherapy. Results TA in POCT group(TA=0.499) was significantly lower than that in control group (TA=1.018). TA in patients received one , two or three times of POCT was 0.812,0.492 and 0.280 respectively. The difference of TA in patients received 1 time POCT and receive ≥ 2 times POCT was significant (P