In order to carry out subject librarian service and improve electronic literature service in hospital libraries, the utilization of electronic literature databases in 240 clinical nurses of class A and B hospitals in Jinan, Qingdao and Jining was investigated with questionnaire, which showed the new features of clinical nurses in awareness and utilization of electronic literature databases under the new turn of hospital class evaluation.

Biomass is a renewable resource, which can be transformed into useful chemical products. The effects of dilute hydrochloric acid on the hydrolysis of steam explosion pretreatment of corn straw were studied. This article developed the application research of ergosterol using corn straw hydrolysates as fer- mentation substrates. The results showed that when corn straw was hydrolyzed with 1.5% hydrochloric acid, temperature at 90?C, hydrolysis for 3 h and the corresponding solid to liquid ratio at 10%, the reducing sugar content can reached up to 53.3% and cellulose conversion efficiency was 79%. The optimal fermental pa- rameters were as follows: 6.0 oBx of corn straw hydrolysates, corn concentration steep water at 4%, pH 7.5, 10% of inoculation, 28?C cultivated for 32 h. Under these conditions, the yeast biomass up to 8.5 g/L and the ergosterol content up to 2.35%. The infrared spectrometer and the X-ray diffract meter used to characterize of crystallite structure.

Objective To explore the diagnosis,treatment,risk factors and prognosis factors of postpancreaticoduodenectomy hemorrhage (PPH).Methods The retrospective case-control study was adopted.The clinical data of 703 patients who underwent pancreatoduodenectomy at Hospital 401 of the People's Liberation Army from January 2008 to July 2013 were collected.Standard pancreatoduodenectomy was carried out for the malignant tumors of the head of pancreas or ampulla,pylorus-preserving pancreatoduodenectomy was operated for the benign tumor or the duodenal papilla tumor.The corresponding treatment was adopted for PPH.The observation indicators included:(1) the surgical situation (surgical method,operation time and the volume of intraoperative blood loss),(2) diagnosis of PPH,(3) treatment of PPH,(4) univariate and multivariate analyses for the risk factors affecting the occurrence of PPH,(5) univariate and multivariate analyses for the risk factors affecting prognosis of PPH patients.The measurement data with normal distribution were represented as x ± s.The measurement data with skewed distribution were represented as M (range).The chi-square test or Fisher exact probability was used for univariate analysis.Logistic regression model was used for multivariate analysis.Results (1) The surgical situation:among 703 patients,409 patients underwent standard pancreatoduodenectomy and 294 underwent pylorus-preserving pancreatoduodenectomy,including 1 combined with right hemihepatectomy,27 with portal vein reconstruction and 2 with hepatic artery reconstruction.Pancreaticojejunostomy was applied to 658 patients using mucosa anastomosis of the pancreatic duct to jejunum and 45 patients using invagination anastomosis.Supporting tube was routinely deposed in the pancreatic duct,598 patients had internal drainage and 105 patients had external drainage.The end-to-side anastomosis between common bile duct and jejunum was used for choledochojejunostomy.The 409 patients received the gastrojejunostomy using side-to-side anastomosis of gastric part and jejunum and 294 patients using end-to-side anastomosis of duodenum and jejunum.Operation time and volume of intraoperative blood loss were (324 ± 54) minutes and (428 ± 118) mL.(2) The diagnosis of PPH:among 703 patients after pancreatoduodenectomy,62 patients had PPH,the hemorrhage reasons of 38 patients had been identified,and the hemorrhage reasons of 24 patients had not been identified (A level in 5 patients,B level in 17 patients,C level in 2 patients).① The site of hemorrhage:the hemorrhage outside the cavity were detect in 27 patients,the hemorrhage inside the cavity in 28 patients,and the hemorrhage from both outside and inside part of the cavity in 7 patients.② The time of hemorrhage:early-stage hemorrhage were detected in 5 patients and the delayed hemorrhage in 57 patients.③The volume of postoperative blood loss was (885 ± 253)mL,30 patients had mild hemorrhage and 32 patients had severe hemorrhage.④ The clinical classification of PPH:5,32 and 25 patients were detected in level A,B,C,and 19 patients combined with sentinel hemorrhage.(3) The treatment of PPH:①5 patients with PPH in A level were given clinical observation,blood volume supplement and other treatment,then the symptoms gradually turned better.② Among 32 patients with PPH in B level,15 patients became better after symptomatic and supportive treatments,6 patients received successful hemostasis after guglielmi detachable colis embolization,4 patients received successful hemostasis under gastroscopic hemostasis,7 patients received emergency exploratory laparotomy.Thirty-two patients were improved and then out of hospital after treatment,without occurrence of death.③ Among 25 patients with PPH in C level,4 patients received successful hemostasis after guglielmi detachable colis embolization,17 patients received hemostasis by emergency exploratory laparotomy,4 patients with undiscovered bleeding points received the treatment of fluid infusion,blood volume supplement and antacid.Among 25 patients after corresponding treatment,10 patients were improved and 15 patients were dead.(4) The result of univariate analysis showed that the combined hypertension,vascular resection and reconstruction,postoperative pancreatic leakage and postoperative intraabdominal infection were risk factors affecting the occurrence of PPH (x2 =4.950,5.300,7.568,5.505,P ＜ 0.05).The results of multivariate analysis showed that the combined pancreatic leakage and postoperative intraabdominal infection were independent risk factors affecting the occurrence of PPH [OR =2.761,2.216,95％ confidence interval (CI):1.389-5.489,1.198-4.101,P ＜ 0.05].(5) The risk factors affecting the prognosis of PPH patients:the results of univariate analysis showed that postoperative sentinel hemorrhage,postoperative pancreatic leakage,site,degree and level of hemorrhage were risk factors affecting the prognosis of PPH patients (x2 =8.022,4.448,11.853,18.551,28.285,P ＜ 0.05).The results of multivariate analysis showed that postoperative sentinel hemorrhage and site of hemorrhage (outside and inside part of the cavity) were independent risk factors affecting the prognosis of PPH patients (OR =5.550,0.233,95％ CI:1.595-19.314,0.086-0.635,P ＜ 0.05).Conclusions Pancreatic leakage and intraabdominal infection are independent risk factors after pancreatoduodenectomy.The treatment effect of the early-stage hemorrhage is better than that of the delayed hemorrhage,and angiographic embolization is the first choice of diagnosis and treatment for the delayed hemorrhage.Sentinel hemorrhage could result from aneurysm or continuous arterial hemorrhage of vascular erosion,it is the independent risk factor affecting the death of hemorrhage after pancreatoduodenectomy.

Objective To explore the effect of implementation of prevention and control measures on reducing the incidence of multidrug-resistant organisms(MDROs)healthcare-associated infection(HAI)rate.Methods Imple-mentation of prevention and control measures on MDROs were strengthened in a hospital in 2012,the relationship between implementation status and change in MDROs infection in the whole hospital were analyzed statistically. Results Through continuous monitoring and tracking,the implementation of prevention and control measures on MDROs continued to be improved,MDRO HAI rate of the second half year was significantly lower than the first half year ([0.29%,119/41 579]vs[0.49%,186/38 252])(χ2 =20.95,P <0.01).Conclusion Continuous monito-ring and tracking of MDROs is helpful for implementing the prevention and control measures on MDROs infection, as well as reducing the incidence of HAI caused by MDROs .

Objective: To investigate the genotype and phenotype of children with KCNA2 gene related developmental and epileptic encephalopathy (DEE). Methods: Clinical data including the manifestations and electroencephalogram of 8 children with KCNA2 variants treated in the Department of Pediatrics, Peking University First Hospital from March 2017 to June 2019 were collected and analyzed retrospectively. Results: Among the 8 epileptic patients with KCNA2 variants, 5 were males and 3 were females. The age of onset was from 1 day to 11 months. The age at last follow-up ranged from 4 months to 86 months. Two variants including c.1214C>T (loss-of-function) and c.1120A>G (gain-and loss-of-function) were identified. The variant of c.1214C>T was found in six patients (case 1-6). For these patients, the age of onset was from 5 to 11 months and they were characterized by multiple seizure types. All had focal seizures and had normal development before seizure onset with developmental regression after seizure onset. The first electroencephalogram showed epileptic discharges in Rolandic region in two, epileptic discharges in Rolandic region combined with generalized discharge in one, generalized discharge with posterior predominance in two (combined with or transferred to Rolandic region during the course) and epileptic discharges in posterior region combined with generalized discharge in one. And in 5 of them the Rolandic discharges developed into epileptic electrical status (ESES) during sleep. All the six patients were still treated with a combination of multiple antiepileptic drugs. Two of them had seizure controlled at 80 months and 68 months, respectively. The variant of c.1120A>G were identified in two of eight patients (case 7 and 8) and they had seizure onset on the 1st day after birth. Their epileptic seizures were frequent and difficult to control. They had remarkably developmental delay and microcephaly since birth. One case (case 8) had a wide forehead. They had frequent seizures up to the last follow-up. In case 7, the early electroencephalogram showed epileptic discharges in temporal region, and interictal electroencephalogram at 3 months of age showed multifocal discharge with posterior and temporal region predominance. In case 8, the early electroencephalogram was normal and electroencephalogram showed burst suppression at 2 months of age, and it developed epileptiform discharge in posterior region at 1 year of age. Conclusions KCNA2 gene variants can lead to DEE with multiple seizures types. Among them, loss-of-function c.1214C>T is the most common, and these patients have seizure onset at infancy with Rolandic discharges tended to develop into to ESES pattern. The variant of c.1120A>G is a gain-of- and loss-of-function variant, patients with c.1120A>G have seizure onset in neonatal period, the phenotype overlaps with the former but is more severe.

OBJECTIVETo study the inhibitory effect and mechanism of Ganoderma lipsiense extract (GLE) on the growth of triple-negative breast cancer (TNBC) cell line MDA-MB-231-HM in a mouse model.

METHODSThe mouse model of TNBC was established by subcutaneous injection of 1.5 x 10(6) of MDA-MB-231-HM cells into BALB/c-nu mouse. Twenty successfully modeled mice were divided into the GLE group and the negative control group according to random digit table, 10 in each group. GLE (0.2 mL 100 mg/mL) was peritoneally injected to mice in the GLE group, while equal dose of normal saline was peritoneally injected to mice in the negative control group. The medication was administered once per 3 days and discontinued after 45 days. The CD34 expression was detected using immunohistochemical assay for counting microvessels. Meanwhile, expressions of thrombospondin 1 (TSP-1) and cyclin D1 were detected using immunohistochemical assay.

RESULTSThe average weight was obviously lower in the GLE group than in the negative control group [(0.33 ± 0.16) g vs (0.68 ± 0.37)g, P < 0.05]. The tumor inhibition rate was 51.4% in the GLE group. The volume of transplanted tumor was obviously lesser in the GLE group than in the negative control group (P < 0.05). Results of immunohistochemical staining showed, the microvessel density (MVD) under every field was (20.7 ± 2.1), TSP-1 positive cell count was (66.2 ± 9.2), cyclin D1 positive cell count was (33.8 ± 16.4) in the GLE group, and they were 34.0 ± 2.0, 24.0 ± 6.6, and 168.2 ± 32.6, respectively in the negative control group. There was statistical difference in all indices between the two groups (P < 0.05).

CONCLUSIONGLE could inhibit malignant proliferation of tumor cells by suppressing angiogenesis of blood vessels in tumor tissues and regulating cell cycles, thereby inhibiting TNBC.

Animals ; Biological Products ; pharmacology ; Cell Line, Tumor ; Cyclin D1 ; metabolism ; Disease Models, Animal ; Ganoderma ; chemistry ; Humans ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; Microvessels ; Neoplasm Transplantation ; Neovascularization, Pathologic ; prevention & control ; Random Allocation ; Thrombospondin 1 ; metabolism ; Triple Negative Breast Neoplasms ; drug therapy

Objective To analysis the cause of injury of traumatic optic neuropathy and explore the main factors affecting the prognosis of visual acuity. Methods We retrospectively collected clinical data of 104 cases (108) of traumat-ic optic neuropathy from January 2007 to December 2012 in the Renhe Hospital of Three Gorges University. We then ex-amined the cause of injury and analyzed risk factors for poor prognosis of visual acuity in traumatic optic neuropathy us-ing multivariate Logistic regression analysis. Results The mean age of patients was 33.6 ± 12.8 years and 95 cases (91.3%) were males. The injury was mainly caused by non-motor vehicle and motor vehicle accidents (84 cases, 80.8%). Most of the patients came to the hospital within 3 days after the injury (81 cases, 77.9%). Overall efficacy rate of treat-ment was 45.4%(49/108). The effective rate was 29.9%(20/67) for visual acuity without light perception and 70.7%(29/41) for visual acuity with light perception, respectively. Logistic regression analysis showed that the time to treatment≥24h, orbital hemorrhage or orbital fracture, ethmoid or sphenoid sinus bleeding and no light perception vision were an in-dependent prognostic factors. Conclusion Time to treatment time and severity of injury are the independent risk factors for poor visual prognosis of traumatic optic neuropathy whereas controlling these risk factors has important clinical signifi-cance to the treatment and prognosis of traumatic optic neuropathy.

AIM:To investigate the risk factors of diabetic retinopathy(DR)in diabetic patients and the influence on the biological structures of anterior segment.

METHODS: This was a cross-sectional study. Patients with type 2 diabetes who had been treated in ophthalmology department of Shanghai Tongren Hospital were invited to participate in this study during January 2018 to September 2018. To evaluate clinical characteristics, each subject completed diabetes related history questionnaire, laboratory examination(blood glucose, glycosylated hemoglobin, blood lipid), eye examination(vision, intraocular pressure, slit lamp examination, corneal topography, fundus photography, OCT). According to the severity of retinopathy, patients were classified to three groups: group 0: none DR, group 1: mild and moderate NPDR, group 2: severe NPDR and PDR. Chi-square test, t-test and variance analysis were used to analyze the differences between groups, and risk factors of DR were studied through Logistic regression analysis. Then analyzed whether these risk factors would affect the biological structures of the anterior segment, such as refractive index, corneal thickness, corneal curvature and anterior chamber depth.

RESULTS: Totally 219 diabetic patients participated in the survey, and 56 patients(25.6%)were diagnosed with DR. The age of DR patients \〖(66.84±15.13a)(group 1)/(65.45±12.83a)(group 2)\〗 was higher than that of patients without DR(59.59±14.61a)(P<0.05). The course of diabetes in DR patients \〖(13.69±10.22a)(group 1)/(15.23±8.22a)(group 2)\〗 was higher than that in patients without DR(9.21±7.92)a(P<0.05).The proportion of diabetic nephropathy in DR patients \〖(28.0%)(group 1)/(32.3%)(group 2)\〗 was higher than that those without DR(14.1%)(P<0.05).The proportion of DR patients treated with insulin \〖(64.0%)(group 1)/(83.9%)(group 2)\〗 was higher than those without DR(44.2%)(P<0.05). Logistic regression analysis showed that the course of diabetes, diabetic nephropathy and insulin were the risk factors of DR(OR>1, P<0.05). All of the above risk factors will significantly reduce the corrected vision of DR patients.The corneal thickness of patients with DR(550.82±34.73)μm was greater than those without DR(542.37±33.32)μm(P<0.05). The anterior chamber depth of patients with diabetes over 10a(2.49±0.43)mm was less than those with diabetes less than 10y(2.68±0.40)mm(P<0.05).

CONCLUSION: The course of diabetes, diabetic nephropathy and insulin use were the risk factors for DR. Patients with long duration of diabetes had a shallower anterior chamber depth.

Multi-channel recording is now a widely used tool in neuroscience research that makes it possible to study the activity of neuron population. The data collected from multiple neurons indicate important information of neural coding rules and brain functional mechanism, which requires advanced computational techniques to decode. Here we reviewed the methods for multi-channel neural data analysis and gave brief introduction of their typical application for studying different kinds of neural data.
Animals ; Brain ; cytology ; physiology ; Database Management Systems ; Humans ; Models, Neurological ; Nerve Net ; physiology ; Neurobiology ; methods ; Neurons ; physiology ; Signal Processing, Computer-Assisted

Cooperation hydrogen production was carried out using Rhodopseudomonas sp. DT and Enterobacter aerogenes. The effects of the initial ratio of Rhodopseudomonas sp. DT and E. aerogenes, culture temperature, and carbon source on the cooperation hydrogen production were investigated. The results suggested that cooperation hydrogen production rate was highly affected by the initial ratio of Rhodopseudomonas sp. DT and E. aerogenes. The mixed bacteria of Rhodopseudomonas sp. DT and E. aerogenes with 1:1 initial ratio benefited to the cooperation hydrogen production, which led the hydrogen production rate and duration of gas production to 3.1 mol H2/mol glucose and 81 h, respectively. The pH dynamics analysis of culture medium further discovered that the pH of the mixed bacteria with 1:1 initial ratio changed from 6 to 7 smaller than other conditions, which was probably fitted to produce hydrogen. Furthermore, the mixed bacteria with 1:1 initial ratio had the higher hydrogen production efficiency at temperatures of 28?C and 37?C than at 20?C, and without any hydrogen production at temperature of 50?C. The carbon sources of glucose, succinate acid, malic acid could be used to produce hydrogen by the mixed bacteria. Even the soluble starch, unused by Rhodopseudomonas sp. DT, was also decomposed by the mixed bacteria to produce hydrogen with the conversion efficiency of 8.22%. The glucose was the optimal carbon resource, and the conversion efficiency could reach to 36.11%. The results, further, implied that the cooperation hydrogen production could enlarge the use of the carbon sources.