Objective To investigate the correlation between Presenilin 1 gene methylation (PSEN1) and sporadic Alzheimer's disease (SAD).Methods Massarray method was used to perform an analysis of DNA methylation in the promoters of PSEN1 gene in lymphocytes from 35 SAD patients,33 mild cognitive impaired (MCI)patients and 22 age-and gender-matched controls.Reporter gene plasmid of PSEN1 was built by genetic recombination methods,and then transiently transfected into the SH-SY5Y and HeLa cells.After that,cells were treated with several agents including serum deprivation,Aβ25-35,5-aza-2'-deoxycytidine (5-aza Cdr) and S-adenosyl-Lmethionine (SAM).A dual-luciferase reporter assay system was used to calculate the relative luciferase activity (RLA).Results Some CpG sites of PSEN1 (Cytosines at-173,95 and +76) showed hypomethylation patterns in SAD cases as compared with MCI and control group (P＜0.01).A dual-luciferase reporter assay showing significant differences in PSEN1 transcription activities were found in both cell lines under SAM treatment [SY5Y,SAM:(6.40±0.81),control:(9.13±1.67),P=0.000; Hela,SAM:(2.06±0.34),control:(2.99±0.59),P=0.000].Conclusions DNA hypomethylation of PSEN1 gene promoter is significantly associated with SAD susceptibility.PSEN1 may change the gene transcription level by methylation,further affecting the activity of amyloid protein-like γ-secretase,leading to the onset of AD.

Blood brain barrier is the main obstacle for drug delivery to the brain.To overcome the limited access of drugs to the brain,three methods have been developed at present:neurosurgical-based strategies,chemistry-based strategies to increase the lipid solubility of the drug,and biology-based strategies of endogenous BBB transporters-mediated drug delivery.PTD transport system to delivery drug across BBB is an emerging technology,which conveniently and efficiently deliver various molecules into spinal cord and brain via blood,intraperitoneally etc.PTD transport system offers a new approach to central nervous system disease with quick,convenient and safe charcteristics.

Objective To study the clinical features of traumatic mitral regurgitation and its surgical treatment methods and outcomes. Methods Clinical data of 16 patients with traumatic mitral regurgitation surgically treated from December 2000 to November 2008 were retrospectively analyzed. The cardiac thoracic ratio was 0.55 ±0.07 and the left ventricular ejection fraction (LVEF) was (51.2% ±23.2)%. According to the New York Heart Association (NYHA) functional classification, 10 patients were at grade Ⅰ - Ⅱ before operation. The surgical procedures consisted of mitral valvuloplasty in 14 patients and mitral replacement in two, when correction of other cardiac injuries was made at the same time.Of all, 14 patients obtained follow-up for (35.2 ± 25.7 ) months. Results The interval between trauma and appearance of mitral regurgitation was (23.3 ±50.90) months. Of 13 patients with echocardiography during follow-up, there were four patients with normal tricuspid hemodynamics, seven with trace tricuspid regurgitation and two with mild regurgitation. The value of LVEF was (66.8 ± 9.0)% at followup, significantly higher than preoperation (P ＜ 0. 05 ). There were 13 patients at grade Ⅰ - Ⅱ of NYHA,with a significant increase compared with preoperation ( P ＜ 0. 01 ). Conclusions Mitral regurgitation may emerge either immediately or several years after trauma. Traumatic mitral regurgitation patients can get satisfactory outcomes when comprehensive mitral valvuloplasty or mitral replacement is performed promptly.

Objective The paper proposed suggestions and measures for hospital scientific research management by statistical analyzing all the papers published from 2009 to 2013.Method By referring to research database of this hospital and by using Microsoft Excel,this research calculated the frequency distributions of different variables including quantity,publisher,disciplinary subject,and the author title as well as core author.Result 772 papers were published from 2009 to 2013,mainly in local periodicals.75.52％ of the title of first author are high-level or intermediate-level;86 core authors published 378 papers,account for 48.96％ of the total amount.Conclusion The number of research papers is increasing year by year.but the quantity and quality are still low.The research administorsshould take measures to encourage researchers to publish quality papers in periodicals with higher standards.

Core human resource serves as the principal capital of carrier of knowledge and skills of a hospital,which is the most decisive factor of a hospital' s competitiveness and adaptability for its initiative and creativity.Their stability and development plays a key role in hospital development.This study analyzed the characteristics and capacity demand of such human resource,and proposed that their management should differ from the rest,recommending reforms in their job description,development and training,performance appraisal,remuneration design and incentive mechanism.

Objective To investigate the relationship between the levels of serum glial fibrillary acidic protein (GFAP) ,ubiquitin carboxy-terminal hydrolase L1 (UCH-L1) ,CT findings and outcome in patients with severe traumatic brain injury .Methods En-zyme linked immunosorbent assay (ELISA) was conducted to detect the serum level of GFAP and UCH-L1 in 62 patients with se-vere traumatic brain injury at the time of 12 h and 36 h after the trauma .CT scans of the brain were obtained within 12 h of injury . Outcome was assessed by glasgow outcome scale (GOS) at 6th month .The relationship between GFAP ,UCH-1 ,CT findings and outcome were analyzed .56 healthy persons were selected as control group .Results The concentrations of serum GFAP and UCH-L1 of patients were significantly higher than those of the control group (P< 0 .05) ;GFAP levels were higher in patients with mass lesions than in those with diffuse injury while UCH-L1 levels were higher in patients with diffuse injury (P< 0 .05) ;the levels of GFAP and UCH-L1 of patients with unfavourable outcome(GOS 1 - 3 scores) were significantly higher than those of patients with favourable outcome(GOS 4 - 5 scores) ,and the concentrations of biomarkers were significantly negatively correlated with outcome . Conclusion Serum levels of GFAP and UCH-L1 are good predictors for severity and outcome in severe traumatic brain injury (TBI) .The levels of GFAP and UCH-L1 could reflect different injury pathways which were different in patients with mass lesions and diffuse injury remarkbly .GFAP and UCH-L1 could provide better characterization of subjects for specific types of cellular dam -age than that obtained with CT alone .

OBJECTIVE To emphasize the management of personnel and articles during operations with infective diseases,so to control the incidence of hospital infection.METHODS To establish an integrated and strict management of sterilization-isolation system,enhance the medical crew′s understanding of medical refuse′s harm during operations with infective diseases and intensify career training and supervising.RESULTS Hospital infection had been prevented effectively with procedure management and learning in operations with infective diseases.CONCLUSIONS The important procedures to prevent hospital infection are all medical crew take part in execution of perioperative antisepsis system strictly.

Objective To observe the therapeutic effect of porcine myocardium against porcine myocardial infarction (MI) by porcine myocardial infarction model with connexin-43/zonula occludens-1 (CX43/ZO-1) double gene induced pluripotent stem cells (iPS) transplantation.Methods Porcine myocardial infarction model was established by balloon occlusion.One week later,1640 culture medium,CX43 gene ips cells and CX43/ZO-1 gene ips cells were injected into the different coronary arteries.After 3 months,electron microscopy and color Doppler ultrasonography were used to evaluate the curative effect.Results Compared to ips group of CX43 and 1640 culture group,in CX43/ZO-1 gene ips group,electron microscope showed a large number of island-like cardiomyocytes,blood vessels and intact intercalated discs in the infarct area and normal myocardial junction area structure,color Doppler echocardiography showed left ventricular end diastolic diameter reduced,and ejection fraction was significantly increased (P ＜ 0.05).Conclusions Transfection of CX43/ZO-1 double gene ips cells can promote cardiomyocyte regeneration and cardiac function recovery in porcine myocardial infarction model.

OBJECTIVE:To provide reference for improving the clopidogrel rational use in cerebral infarction secondary preven-tion. METHODS:Medical cases of 471 patients with acute cerebral infarction in neurology department in a hospital from 2013 to 2014 were retrospective surveyed to collect the utilization rate of clopidogrel and the combination of clopidogrel with proton pump inhibitors(PPIs)and aspirin,and the rationality was analyzed. RESULTS:The utilization rate of clopidogrel in cerebral infarction secondary prevention was 93.84%;the combination rate with PPIs was 52.49%,of which,51.72% had no drug selection or com-bined treatment basis;the combination rate with aspirin was 40.72%,cardiogenic cerebral infarction accounted for only 3.9%, non-cardiogenic cerebral infarction accounted for 96.1%,and recurrence of cerebral infarction in high-risk patients accounted for 31.11%. CONCLUSIONS:Clopidogrel in patients with cerebral infarction secondary prevention is widely used in the hospital,has high combination rate with PPIs and aspirin and low guide compliance rate. Clopidogrel should be enhanced pharmacy services, comply with evidence based medicine and improve the rationality of medication.

The article reviews the current status of elder abuse from the perspective of epidemiology, characteristics of abuse, risk factors and nursing assessment and management, presenting the idea that nurses are playing a major role in the prevention,detection and resolution of elder abuse. It also introduces that nurse can screen out the situation of elder abuse timely by applying the proper assessment tool flexible and respond to the occurrence of elder abuse as well as avoid the elder abuse again by comprehensive application of nursing knowledge and management skills. Some advices about future research and mismanagement in elder abuse being given.