Bacterial cellulose,as a new material,due to its unique nano-fiber mesh structure with good purity,physical and chemical properties such as mechanical strength and water holding capacity,biocompatibility and adaptability,has been widely used in medicine,food,paper,textile,acoustical materials and other industries.In medical field,especially,it has been rapidly developed in recent years.This review discusses the current bacterial cellulose and its performance optimization products which relates to the medical applications.

OBJECTIVE:To study the influence of calcineurin gene polymorphism on the efficacy of cyclosporine A (CsA). METHODS:The blood samples of patients treated with CsA were collected. The trough blood concentration of CsA was detected by EMIT. The genotype of PPP3CA and PPP3CB was assayed by RFLP-PCR method. The expression of NFAT-regulated gene IL-2, IFN-γand GM-CSF were measured by RT-qPCR,which were used to define the index of indirect efficacy of CsA. The relationship of gene polymorphism with CsA efficacy was study by relationship analysis and multiple factor regression method,etc. RESULTS:A to-tal of 100 blood samples were collected. There was no significant correlation between the expression of CsA efficacy-related NFAT-reg-ulated gene GM-CSF and trough concentration of CsA(rGM-CSF=-0.04,P=0.238);the expression of IL-2 and IFN-γ were negatively correlated with trough concentration of CsA significantly(rIL-2=-0.384 3,P<0.001;rIFN-γ=-0.335 4,P<0.001). Using the average value of mRNA expression of IL-2 and IFN-γas indirect efficacy index,the polymorphism of PPP3CB rs3763679 site significantly in-fluenced the efficacy of CsA(P<0.05),but PPP3CA rs3804358 had no any effect on it(P>0.05). Stratified analysis showed that among patients with immune disease underwent renal transplantation,efficacy of patients with PPP3CB rs3763679 genovariation(TC+TT) were better than those with wild-type gene (CC)(P<0.05). After the efficacy was normalized by CsA trough concentration, multivariate analysis showed that normalized efficacy of CsA was negatively correlated with gender,PPP3CB rs3763679,lactate dehy-drogenase and creatinine significantly,but positively correlated with PPP3CA rs3804358,leucocyte count,usea nitrogen,glycerin trilaurate,etc. CONCLUSIONS:PPP3CB rs3763679 gene polymorphism influence the efficacy of CsA;among patients with immune disease underwent renal transplantation,efficacy of patients with PPP3CB rs3763679 TT+TC is better than that of CC type. At the same time,gender,PPP3CA rs3804358,leucocyte count,usea nitrogen,glycerin trilaurate and other factors all can influence the nor-malized efficacy of CsA to different extent. Multiple factors should be considered when using CsA.

Objective To explore the indications, superiority and surgical technique of periareolar approach in the management of benign breast diseases. Methods 132 patients with benign breast disease (91 cases of Fibroadenoma, 12 cases of limited gland hyperplasia, 8 cases of cyst, 2 cases of benign phyllodes tumor and 6 cases of male gynecomastia) underwent operation through areolar incision. Results All patients were followed up for 1-10 months. 107 cases were satisfied with their treatment,19 cases were not quite satisfied with the relatively long incision, and 6 cases were not satisfied with the front incision. The one-month-later reexamination showed that 117 cases feel good and 15 cases had partial numbness of the nipple (15/132, 11.36%). All but two patients wound healing delayed because of local hematoma (2/132, 1.52%). Neither necrosis nor infection was found. Conclusions With the advantages of fewer complications and cosmetic effect, periareolar approach can be applied in management of various benign breast diseases. Factors such as indications, anatomical layer, postoperative molding, appropriate drainage, pressure dressing should be taken into consideration for the success of operation.

ObjectiveTo investigate the expressions of folate receptor alpha (FOLR1) in 40 esophageal cancerous tissues and its relevance of ABO blood group.MethodsABO blood groups were analyzed in 40 patients.Immunohistochemistry (IHC) and real-time quantitative reverse transcription PCR detection were used to detect the expression of folate receptor in cancer and adjacent tissues.Results20％of esophageal cancer was suspected positive (+), 50％ of cancer adjacent tissue was suspected positive (+), 10％ were positive (+), the difference was statistically significant (x2 = 14.48, P ＜0.01).Real Time RT-PCR analysis showed FOLRI low expression in esophageal cancer and adjacent tissues, compared to normal esophageal mucosa, the differences were statistically significant (F1 =53.247, F2 = 116.500, P ＜0.01).ABO blood type and FOLRi in esophageal cancer patients were not significant correlated (P =0.647, P ＞0.05).ConclusionsFOLRI expression was decreased in the esophageal lesions compared with adjacent tissues.Detection of FOLRl expression level in esophageal cancerous tissues and the paired adjacent tissues was helpful for judging the extent of disease and guiding surgery treatment.The FOLRI expression level in esophageal carcinoma tissues had no relationship with ABO blood types.

Objective To observe the poet-operative clinical inpact on cervical intraepithelial neoplasia surgery by Loop elcctrosurgical excision procedure(LEEP),gelatin paste to improve the healing of the Cut,prevent the post-operative bleeding,and find out effective methods of preventing LEEP complications.Methods 100 patients with cervical intraepithelial neoplasia underwent LEEP in clinic.Divide them into two groups randomly,60 patients were adopted gelatin paste post-LEEP ag the cure group.while 40 patients were adopted as control group.Observation Vaginal bleeding,infection and cervical rear in short-term.Results In 60 patients of cure group,never patients with vaginal bleeding,infection and the cut healing in the short time.In 40 patients of control group,three patients with vaginal bleeding,two patients with infection,and three patients with bad healing.The different between two group with vaginal bleeding,infection and the cut healing time was significant(P＜0.05).Condusion gelatin paste can reduce bleeding.infection and cervical repair bad cmpllcations after cervical intraepithelial neoplasia surgery by LEEP.

This article is to explore the practical application of concept maps in nursing teaching practice to make it as a learning tool to promote undergraduates to make a meaningful study. Besides, the results is applied in research on improving the teaching method so as to provide an effective teaching policy and evaluation tools to promote the scientific research and clinical practice in nursing care.

Objective To examine the reliability and validity of the Chinese version of Moral Distress Scale for nurses.Methods Cross-cultural adaptation process was applied to translate and develop the Chinese version of Moral Distress Scale for nurses.238 nurses were selected to answer the scale to evaluate the reliability and validity of the scale.Results Content validity index of the Chinese version of Moral Distress Scale for nurses was 0.909.Construct validity of validity analysis:exploratory factor analysis of the items identified that the scale had 4 factors,explaining 54.583％ of the total variance.Reliability analysis:The Cronbach' α coefficients for the MDS-R dimensions were 0.846、0.724、0.738 and 0.566,and 0.879 for the total scale.The test-retest reliability coefficient for MDS-R was 0.802.Conclusions The Chinese version of Moral Distress Scale-Revised for nurses has good reliability and validity in the measurement of Chinese nurses.

Objective:To investigate the role of anaphylatoxin C 5 a in patients with asthma .Methods:A prospective study was performed between September 2006 and February 2007.A total of 33 patients with acute exacerbation of asthma and 13 healthy subjects were recruited into the study .The patients with acute exacerbation of asthma were also studied when they returned to the remission state .Levels of lung function, levels of C5a in induced sputum and cell differential count in induced sputum were determined . Results:The level of C5 a in induced sputum was significantly higher in patients with acute exacerbation of asthma [0.85(0.68-2.13) μg/L] than that in patients with stable asthma [0.45(0.26-0.88)μg/L, Z=-2.193, P=0.013];Sputum C5a levels in stable asthma patients were significantly higher than those in healthy controls [0.14(0.06-0.45) μg/L, Z=-2.141, P=0.015].The level of C5a in patients with severe exacerbation [2.21(1.27 -9.0) μg/L] was significantly higher than those in patients with mild exacerbation [0.34(0.17-0.63) μg/L] and moderate exacerbation [0.85(0.55-1.67) μg/L,χ2 =12.330, P=0.001].The level of C5a in induced sputum was positively correlated with the number of total cells count (r=0.797, P=0.004), neutrophils (r=0.504, P=0.032) and macrophages ( r =0.424, P=0.036 ) in acute exacerbation of asthma .Conclusion: C5a levels in induced sputum could be identified as an important prognostic biomarker , which involved in asthma ’ s pathogenesis .

Objective To investigate the effect of over-expression of human ribonuclease inhibitor suppresses invasion and migration of transplanted bladder cancer .Methods The T24 cells were stably transfected with pIRES2-EGFP-RI and pIRES2-EG-FP plasmid respectively .Using the cell transfected with pIRES2-EGFP and untransfected cell as controls .and the positive clones were screened by G418 ,respectively ;Tumor cells of the three groups at 2 × 106 were respectively injected into the back of BALB/C nude mice to establish the xenograft models .Change of micro-blood vessels in tumor tissue and expression of CD31 were detected by Immunohisto-chemical and HE staining .Immunohisto-chemical assay was used to detect the expression of RI ,MMP-2 ,MMP-9 ,E-cadherin ,N-cadherin ,Vimentin ,Snail ,Slug ,Twist in the tumors .Results Animal experiment showed that the T24-RI cells group significantly inhibited the growth of bladder cancer compared with the other two control groups .Compared with the T24 and T24 vector cells groups ,the microvessel density in tumor tissue of T24-RI group was notably reduced and the expressions of MMP-2 , MMP-9 ,N-cadherin ,Vimentin ,Snail ,Slug ,Twist significantly were decreased simultaneously ,while the expressions of RI and E-cadherin were increased .Conclusion up-regulation RI can inhibit the growth of transplanted bladder cancer in nude mice by decrea-sing the expression of invasion protein and EM T protein .

Objective To investigate the combination of Oxycodone and Morphine Hydrochloride Injec-tion in cancer pain and breakthrough cancer pain (BtCP).Methods This study included 78 patients with moder-ate or severe cancer pain ,which was titration with Oxycodone and Morphine Hydrochloride Injection .All data were obtained from diagnosed malignant tumors and followed up in the people ′s hospital of Jiangmen city between Jan 2011 and Dec 2015.Results The first 5 days of the titration with a total Morphine Equivalent Dose (MED)be-tween 156~1 491 mg(426.46 ±286.00 mg),and a total dose of IV morphine hydrochloride injection between 2~57 mg(20.96 ±13.25 mg).The mean dose used in the treatment of BtCP was 2.23 ±2.50 mg in Phase B(8 pm~8 am)and 1.96 ±2.14 mg in Phase A(P<0.05).When the treatment begun Numerical Rating Scale (NRS)showed a significant decrease .All the patients were less likely to experience any severe side -effects. Conclusion The titration by Oxycodone and Morphine Hydrochloride Injection is a simple , safe and efficient method,with less side-effect,significantly improve the living quality .It′s a good choice in the titration of moder-ate or severe cancer pain .