Objective To study the effect of blood biqing1 injection on patients with septic shock in peripheral blood red cell distribution width,inflammatory mediators and APACHEII score.Methods 90 patients with septic shock in our hospital from May 2014 to May 2015 were randomLy divided into observation group and control group,each of 45 cases,the control group was treated with conventional treatment of septic shock,blood in patients in the observation group on the basis of routine treatment of septic shock biqing1 injection,before and after comparison two groups of red cell distribution width and inflammatory mediators(IL-2,IL-4,IL-6)level and APACHEII score.Results Two groups of patients before treatment,IL-2,IL-4 and IL-6 levels compared to no difference after treatment,the observation group were IL-2,IL-4,IL-6 levels were(23.5±2.3),(21.7 ±3.6),(22.5±3.4),significantly lower than the control group patients,two groups of patients before treatment,red cell distribution width,APACHEII score comparison showed no difference in treatment of 2D two groups of patients after the red cell distribution width and APACHEII score compared to no difference after the treatment of 5D,observation group distribution in red blood cell width(％),APACHE II score were(9.8±1.7),(10.4±1.9),significantly lower than the control group patients,two groups were CO,CI,SVR,EVLWI compared to no difference before treatment.After the treatment of 2D patients in the two groups CO,CI,SVR,EVLWI compared to no difference after the treatment of 5 days patients in the observation group,CO,CI were(8.9±1.4),(9.3±2.1),significantly higher than the control group,while the level of SVR and EVLWI were(865±104.5),(5.7±0.9),significantly lower than the control group.Conclusion Will the blood injection can reduce septic shock in patients with peripheral blood red cell distribution width and the levels of inflammatory mediators,reduce the score of APACHEII.

Objective To evaluate the effect of miR‐335 regulate cell proliferation by targeting survivin in breast cancer cells MCF‐7 .Methods (1)Chose breast cancer tissue and para‐carcinoma tissue ,and used RT‐PCR or Western blot to detect the expres‐sion of miR‐335 and survivin protein .(2)Chose breast cancer cells MCF‐7 ,respectively transfected miR‐335 mimic and mimic con‐trol .The expression of miR‐335 and survivin protein were detected by RT‐PCR or Western blot .(3)Chose breast cancer cells MCF‐7 ,respectively co‐transfection wild type survivin 3′‐UTR(survivin‐wt)or mutant type urvivin 3′‐UTR(survivin‐Mut)and miR‐335 mimic or negative control(NC)to breast cancer cells MCF‐7 .The cell luciferase activity were detected by dual‐luciferase report gene experiment .(4)Chose breast cancer cells MCF‐7 ,respectively transfected mimic control ,miR‐335 mimic and miR‐335 mimic+ sur‐vivin .The cell proliferation activity of each group were detected by MTT method .Results (1)Compared with para‐carcinoma tis‐sue ,the miR‐335 expression of breast cancer tissue significantly decreased(P<0 .05) ,and the survivin protein expression of breast cancer tissue significantly increased(P<0 .05) .(2)Compared with transfection mimic control ,transfection miR‐335 mimic can made the miR‐335 expression of MCF‐7 increased(P<0 .05) ,and made the survivin protein expression of MCF‐7 decreased(P<0 .05) . (3)Compared with transfection NC ,co‐transfection miR‐335 mimic and survivin‐wt can made luciferase activity of MCF‐7 signifi‐cantly decreased(P<0 .05) ,but the luciferase activity of MCF‐7 was not significantly changes after co‐transfection miR‐335 mimic and survivin‐Mut (P>0 .05) .(4)Compared with transfection mimic control ,the MCF‐7 proliferative activity significantly decreased after transfection miR‐335mimic(P<0 .05) .Compared with transfection miR‐335 mimic ,the MCF‐7 proliferative activity signifi‐cantly increased after transfection miR‐335 mimic+survivin(P<0 .05) ,but still lower than transfection mimic control(P<0 .05) . Conclusion In breast cancer tissue ,the miR‐335 show low expression ,and survivin show high expression .miR‐335 can target sur‐vivin to inhibit the proliferation activity of breast cancer cells MCF‐7 .

Objective To investigate the association between diabetes mellitus and risks of kidney cancer.Methods The cohort and case-control studies on the association between diabetes mellitus and risk of kidney cancer were analyzed by searching PubMed database within the time limit of Jan.1990 to Oct.2011.Data were selected according to the inclusion and exclusion criteria,and the meta-analysis was performed by using the Cochrane Collaboration's RevMan 5.0 software.Results A total of 14 studies(8 cohort studies and 6 case-control studies) involving 6,645,516 participants met the inclusion criteria.Meta analysis showed that patients with diabetes had a higher risk of kidney cancer compared with the control group without diabetes(OR =1.28,95％ CI 1.10 ～ 1.48,P ＜ 0.05).Stratification study showed that diabetes was associated with an increased risk of kidney cancer in cohort studies(OR =1.32,95％ CI 1.14-1.53,P ＜0.05),but this association was not found in casecontrol studies (OR =1.21,95 ％ CI 0.79-1.84,P ＞ 0.05).Conclusion This meta-analysis indicates a positive association between diabetes and risk of kidney cancer,however,future researches are needed to identify whether diabetes mellitus is an independent risk factor for kidney cancer.

Objective To evaluate the therapeutic effects of autolngous bone marrow mesenchymal stem cells transplantation in the early phase of acute renal ischemia-reperfusion(I/R)injury in rabbits and their impact on tubular epithelial cell apoptosis.Method Bone marrow mesenchymal stem cells(MSCs)were isolated and cultured in vitro.Thirty rabbits were divided randomly into transplanted group,control group and sham-operated group,10 in each group.Rabbits of transplanted group were induced acute renal I/R injury by clamping bilateral renal arteries for 90 minutes,then transplanted MSCs labeled with BrdU immediately after the resumption of circulation in kidney.The rabbits of control group were induced acute renal I/R injury and then infused with saline instead.The sharn operated rabbits were transplanted autologous MSCs labeled with BrdU after sham operation.Fortyeight hours after transplantation,all rabbits were sacrificed.Renal functional and structural damage were evaluated.MSCs derived BrdU positive cells were determined by immunostalning.Tubular epithelial cell apoptosis was arialyzed by usign TUNEL.The SPSS version 11.3 Software was used for statistical analysis.ANOVA were used to ana lyze the data of renal function and tubular epithelial cell apoptesis.Data of renal structure darnage were analyzed by using the nonparametric Kruskal-Wallis test.Results Compared with control group,the renal functional and struc tural darnage were significantly ameliorated(24 h,BUN:F=7.483,Ser:F:15.091;48 h,BUN:F:17.741.Scr:F=61.865;P<0.05),tubular epithelial cell apoptods Wsa reduced significantly in transplanted group(F=135.495,P<0.01).MSCs derived BrdU positive cell were detected in the renal tissues of transplanted rabbits.Conelusiu Autologous bone marrow mesenchymal stern cells transplantation is curative for acute renal I/R injury in rabbits.Bone marrow MSCs might ameliorate renal I/R injury by reducing tubular epithelial cell apoptosis.

Objective To evaluate the efficacy of metformin(MTF) in treatment of clomiphene (CC)-resistant patients with polycystic ovary syndrome (PCOS).Methods The published articles of randomized controlled trial (RCT) of comparison of MTF combined with CC and CC alone in treatment of CC-resistant PCOS were searched in PubMed,EMBASE,OVID,EBSCO databases and Cochrane Library,and these studies were screened under inclusion and exclusion criteria.The quality of included studies and extract data of comparison of ovulation rates and pregnancy rates were evaluated.And the Meta-analysis using statistic software RevMan 5.0 was completed.ResultTotal of 333 patients in total 8 trials were included.Meta analysis showed that MTF plus CC led to a significantly higher clinical ovulation rate ( OR =7.31,95 ％ CI:2.57 - 20.76,P ＜ 0.05 ) and pregnancy rate ( OR =7.93,95 ％ CI:2.45 - 25.63,P ＜ 0.05 ) than that of CC alone.Conclusion MTF can increase ovulation and pregnancy rates of CC-resistant PCOS women.

Objective To investigate the effects of different tidal volume mechanical ventilation on pulmonary function and inflammatory factors in gynecologic laparoscopic surgery.Methods 45 patients undergoing gynecological laparoscopic surgery without lung disease,ASA Ⅰ-Ⅱ,aged 20-45 years old,weight 45-65 kg,operation time 2-3 hours,were randomly divided into A,B,C three groups,15 cases in each group.Mechanical ventilation with different tidal volume of the three groups,A group,B group and C group were 8mL/kg,9mL/kg,10mL/kg.Blood gas analysis was performed before anesthesia (T0),30 minutes (T1),(T2),PA-aDO2 (60 minutes) (T3),and 120 min (T4),respectively,and the peak airway pressure and mean pressure were recorded.IL-6,TNF-α and IL-10 levels in plasma by radial artery blood sampling were simnultaneously determined.Results Comnpared with A group,the concentrations of Ppeak and Pmean were increased in B group at T1-T4 (t =5.13,4.78,6.54,5.32 and t =7.54,4.88,5.37,4.95;all P ＜ 0.05),the concentration of Ppeak and Pmean in C group at T1-T4 increased (t =7.76,8.87,7.23,8.99 and t =6.42,7.38,7.62,9.86;all P ＜ 0.05).Compared with B group,the concentrations of Ppeak and Pmean were increased in C group at T1-T4 (t =4.76,5.87,4.23,3.99 and t =4.76,3.99,6.06,4.52;all P ＜ 0.05).Compared with A group,the A-aDO2 values of B group and C group were increased at T1,T2,T3 and T4 (t =5.32,5.48,4.88,5.69 and t =7.85,7.32,8.45,6.67;all P ＜ 0.05).Compared with B group at the same time point,the A-aDO2 value of C group increased at four times of T1-T4 (t =5.62,4.38,6.94,4.22,P ＜0.05).Compared with group A,the concentration of A-aDO2 in C group was higher than that in B group at the same time point (t =4.45,4.87,5.32,4.79 and t =7.68,7.59,7.44,8.38;all P ＜ 0.05).The levels of IL-6 and TNF-α in C group were significantly higher than those in the control group (t =4.78,5.56,7.62,8.03 and t =3.98,4.52,5.46,6.23;all P ＜ 0.05).Compared with T0,IL-6 and TNF-α concentrations AT T2-T4 in A group had no statistically significant differences (all P ＞ 0.05).Compared with B group,the levels of IL-6 and TNF-α in C group were significantly higher (t =4.58,4.99,6.53,4.77 and t =5.62,7.89,6.43,4.52;all P ＜ 0.05).Compared with T0,IL-6 and TNF-α concentrations at T2-T4 in A group had no statistically significant differences (all P ＞0.05).There was no significant difference in IL-10 concentration among the thrce groups.Conclusion Laparoscopic surgery according to the end tidal carbon dioxide partial pressure (PetCO2) ventilation frequency,8 mL/kg tidal volume mechanical ventilation has no effect on the IL-6,TNF-alpha,IL-10 and other inflammatory factors,mechanical ventilation tidal volume is more appropriate.

Objective To understand the present situation of safety organizing and quality of nurse work life in pediatric intensive care unit(PICU),and to discuss the relationship between safety organizing and quality of nurse work life.Methods A total of 279 PICU nurses in eight hospitals in Zhejiang were selected by the safety organizing scale (SOS)and quality of nursing work life(QNWL).Results The score of SOS was (45.23 ±10.88)points,and the score of QNWL was (159.46 ±33.60)points.There was a positive correlation between safety organizing and quality of nurse work life(r =0.256,P <0.05).Conclusion The nurse managers should improve the level of quality of nurse work life by safety organizing.

Objective To summarize the characteristics of nosocomial infections in the patients treated in intensive care unit (ICU).Methods The incidence of nosocomial infections was monitored in ICU from March 2012 to August 2012.The incidence rate of infection was adjusted with Average Severity of Illness Score (ASIS)score and analyzed in relation to three invasive pro-cedures.Pathogen distribution of nosocomial infections in ICU was also analyzed.Results Nosocomial infection was identified in 357 of the 3 700 ICU patients (9.65%).The overall daily infection rate was 30.34‰,specifically,49.10‰ for ventilator asso-ciated pneumonia (VAP),13.86‰ for catheter-related bloodstream infections (CRBSI),and 1.09‰ for catheter-associated urinary tract infections (CAUTI).Of the 688 bacterial isolates,gram negative bacteria accounted for 82.70%.The top three bacterial species were Acinetobacter baumanii ,Pseudomonas aeruginosa ,and Klebsiella pneumoniae .Conclusions ICU is the focus for surveillance of nosocomial infections.Objective investigation is critical for nosocomial infection surveillance.

Abstract: Objective To investigate the impact of SARS-CoV-2 virus infection on the risk of thrombosis in COVID-19 outpatient patients with mild and regular symptoms. Methods Outpatient patients during the SARS-CoV-2 large-scale infection period after the policy adjustment for COVID-19 in Beijing in 2022 were selected as the observation group, and the dynamic zero-clearing period before the policy adjustment and outpatient patients during the 2022/2021/2020 period were taken as the three control groups. The patients with physiological factors that may increase the risk of coagulation, such as thrombotic diseases, malignant tumors, female pregnancy and other physiological factors, were excluded. Pediatric patients under 14 years old were also excluded. Age was expressed as median (interquartile). The changes in blood routine, fibrin/fibrinogen degradation products, and D-Dimer in Beijing outpatient patients were studied with statistical method and data analysis techniques. Results Compared with the control groups, the observation group showed a statistically significant decrease in red blood cells (RBC), hemoglobin (Hb), and hematocrit (HCT) levels, and an increase in monocytes (MONO) and platelet (PLT) counts, all showed statistically significant differences (P<0.0001). The proportion of fibrinogen degradation product (FDP) and D-Dimer of observation group exceeding the range increased significantly. Compared with the three control groups, the number of outpatient fibrinogen degradation products (FDP) in the observation group of patients aged 50 years and verage number of patients under 50 years old in the observation group with D-Dimer exceeding the threshold increased by more than 48.98%, and the monthly average number of patients with D-Dimer exceeding the threshold in patients aged 50 or older increased by 346%-998%. Conclusions The results of this study suggest that outpatient patients with mild or regular SARS-CoV-2 infection are also at risk for thrombotic events, and monitoring blood coagulation indicators such as D-dimer is recommended to avoid the sudden onset of thrombosis-related fatal complications .

Objective To explore a novel strategy to repair traumatic soft tissue defects in the head and face by tissue expansion in the early stage.Methods Eighteen patients with traumatic soft tissue defects were treated with thorough debridement leaving the wound unclosed or simply closed with thin split-thickness scalp skin grafting,and adjacent expander implantation in the early stage and expanded flap transposition in the second stage.Results There were 11 male patients and 7 female patients ranging in age from 3.5 to 40 years [mean,(19.4±12.2) years],with average 15 months follow-up (range,3-67 months).The average expansion time was 74.3 days (range,53-96 days).The total of 18 patients with 22 expanders were treated with satisfactory results.All the flaps survived and the skin color,texture and contour well matched to those of the peripheral tissue.Only one complication of infection happened in the 18 cases (5.56％) and total 22 expanders (4.55％),which was similar to the rate reported in the literature.There were no any other complications related to the expander.Conclusions Debridement and tissue expansion in the early stage have been proved a more effective strategy to repair traumatic soft tissue defects in the head and face,which can not only achieve satisfactory color,unbulky and well matched texture similar to normal,but also can avoid unnecessary donor site injuries and does not increase the infection rate of tissue expansion.