Bone remodeling is an ordered process of coupling of bone resorption and bone formation. Cytokines secreted by different bone cells and membrane molecules expressed by bone cells are involved in regulation of coupling of bone resorption and bone formation. To reveal the mechanism of bone coupling is of great significance in the study and diagnosis of osteoporosis and other metabolic bone diseases. In the present review, we summarize the progression of mechanisms by which cytokines and the related membrane molecules are regulating the coupling of bone resorption and bone formation.

Objective To investigate the distribution and drug resistance of pathogens of ventilator-associated pneumonia(VAP) in general intensive care unit(ICU).Methods Statistical methods were used to analyze retrospectively the data of pathogens and drug resistance of VAP in general ICU from 2004 to 2006.Results Totally 347 pathogens were isolated from deep-part secretion of lower respiratory tracts of 302 VAP in general ICU.The main pathogens included Pseudomonas aeruginosa(32.3%),Acinetobacter baumanii(31.1%),Staphylococcus aurous(16.7%),Klebsiella(7.5%) and Coagulase-negative Staphylococci(6.1%).Gram-negative bacillus showed a high resistance to piperacillin and Cefotaxime but high susceptibility to carbapenems and the enzyme inhibitor antibiotics.Gram-positive coccobacteria showed a high resistance to Penicillin,Clindamycin and Erythromycin but high susceptibility to Vancomycin and Quinolone.Conclusion Gram-negative bacillus was the main pathogen of VAP in general ICU,multidrug resistance was serious.The rate of methicillin-resistant staphylococcus aurous(MRSA) and methicillin-resistant coagulase-negative staphylococci(MRCNS) was high,with serious drug resistance.According to the data of the bacteria pathogen and antibiotics susceptibity,we can select antibiotics reasonably to control the infection and delay the emergency of new drug-resistant bacteria.

Objective To compare the distribution and drug resistance of isolates between sterile body fluid and non‐sterile body fluid in the hospital in 2014 .Methods By adopting the retrospective analysis method ,we used BD phoenixTM 100 to conduct bacteria identification and drug susceptibility testing ,the Whonet5 .6 software and SPSS19 .0 software to statistically analysize the drug re‐sistance of the bacteria .Results E .coli ranked the top in sterile body fluid isolates(43% ) while the highest rate in non‐sterile body fluid was P .aeruginosa .E .coli(21% ) .Isolates from sterile body fluid had lower drug resistance rate to 11 kinds of antibacterials such as ampicillin ,chloramphenicol ,ciprofloxacin and aztreonam than the strains isolated from non‐sterile body fluid(P<0 .05) .S . aureus ,isolated from sterile body fluid ,had lower drug resistance rate to 6 kinds of antibacterials such as amikacin ,amoxicillin/cla‐vulanicacid ,ciprofloxacin than the strains isolated from non‐sterile body fluid .P .aeruginosa ,isolated from sterile body fluid ,had lower drug resistance rate to aztreonam than the srains isolated from non‐sterile body fluid .K .pneumoniae ,isolated from sterile body fluid ,had lower drug resistance rate to 6 kinds of antibacterials such as ampicillin/sulbactam ,sulfamethoxazole ,chlorampheni‐col than the strains isolated from non‐sterile body fluid(P<0 .05) .Conclusion There is significant difference between sterile body fluid and sterile body fluid in strain distribution and drug resistance ,so it is vital to enhance the bacterial resistance surveillance of sterile body fluid .

Objective To establish programs of home healthcare service by investigation and analyzing the current status of the elderly requirements towards community nursing in yunnan province.Methods A self-administrated questionnaire which includes functional status,living situations,and home healthcare demands was distributed in 105 community elderly around Yunnan Province by professional staff. Results 76.20% of the community elderly people had different home care nursing service demands. The highest needs for community elderly is daily medical and nursing care.Conclusion Developing home healthcare can effectively improve the self- care consciousness of aged people, and also improving the quality of life in elderly has important significance for healthcare insurance of elderly.

Objective To establish biological detection method for Fuzheng Xiaoji capsule.MethodsTaken Radix astragali,Hedyotis diffusa Willd, Fructus Polygoni orientalis and rhubarb in Fuzheng Xiaoji capsule as targets, the antimicrobial activity of the single fried mixture of Radix astragali,Hedyotis diffusa Willd,Fructus Polygoni orientalis and rhubarb to 4 kinds of standard strains(Staphylococcus aureus, Salmonella, Escherichia coli and Bacillus subtilis) were inspected.The standard curve by susceptible strains of the inhibition zone diameter and logarithm of the concentration was established,and this test also determined the biological potency of different batches of Fuzheng Xiaoji capsule according to the dose-response curve.ResultsThe single fried mixture of Radix astragali,Hedyotis diffusa Willd, Fructus Polygoni orientalis and rhubarb have strong anti-bacterial effect to the above four standard strains.There was a good linear relationship between logarithmic dose and response effect when the concentration in the range of 0.029-0.136g/mL(r=0.9583).ConclusionBiological potency detection method can be combined with traditional analysis methods to control the quality of Fuzheng Xiaoji capsule.

Objective To investigate the effects of acetylated HMGB1 on cognitive function in rats with sepsis associated encephalopathy (SAE) and the effect of HMGB1 inhibitor.Methods Forty-eight males mice were randomly assigned to three groups (n=16): sham group (group S),cecal ligation puncture group (group C),cecal ligation puncture+sodium butyrate group (group B).Cecal ligation puncture was applied to establish the SAE model,and group S received sham operation.Rats in groups S and C were injected with normal saline 5 ml/kg 30 min and 4 h after CLP,respectively.The rats in group B were intraperitoneally injected with sodium butyrate 500 mg/kg 0.5 h and 4 h after CLP,respectively.All animals were performed Morris water maze test on 4th day after operation,and the exploring time of space exploration experiments were assessed on 7th day after CLP surgery.IL-6,BDNF,HMGB1 and acetylated HMGB1 expression in hippocampus of all rats were determined by Western Blot.Results Compared with group S,the latency of rats in group C was longer and the exploring time was shorter (P<0.05).Compared with group C,the latency of rats in group B was shorter and the exploring time was longer (P<0.05).Compared with group S,the expression of IL-6,HMGB1 and acetylated HMGB1 in group C increased (P<0.05) and the level of BDNF decreased (P<0.05).Compared with group C,the expression of IL-6,HMGB1 and acetylated HMGB1 in group B decreased (P<0.05) and the level of BDNF increased (P<0.05).Conclusion HMGB1 inhibitor sodium butyrate can inhibit the expression of acetylated HMGB1 in the hippocampus of SAE rats,and reduce the cognitive impairment induced by sepsis.

Objective To investigate the role of hippocampal cyclophilin D (CypD) in sepsis-associated encephalopathy in rats.Methods A total of 36 adult male Sprague-Dawley rats,aged 3-4 months,weighing 300-400 g,were randomly divided into 3 groups (n =12 each) using a random number table:sham operation group (Sham group),sepsis group (S group),and sepsis + CypD inhibitor cyclosporin A group (CsA group).Sepsis was induced by cecal ligation and puncture (CLP).Cyclosporin A 6 mg/kg was injected intraperitoneally at 30 min before CLP in group CsA.All the animals underwent Morris water maze test on 4th day after CLP.The animals were sacrificed after the test,and the hippocampus was isolated for determination of the expression of cytochrome c (Cyt c),CypD,caspase-3,brain-derived neurotrophic factor (BDNF),phosphorylated protein kinase A (p-PKA),and phosphorylated cyclic adenosine monophosphate response element-binding protein (p-CREB).Results Compared with group Sham,the escape latency was significantly prolonged,the space exploration time was shortened,the expression of Cyt c,CypD,caspase-3,p-PKA and p-CREB was up-regulated,and the expression of BDNF was down-regulated in S and CsA groups (P＜0.05).Compared with group S,the escape latency was significantly shortened,the space exploration time was prolonged,the expression of Cyt c,CypD,caspase-3,p-PKA and p-CREB was down-regulated,and the expression of BDNF was up-regulated in group CsA (P＜0.05).Conclusion Hippocampal CypD may be involved in the pathophysiological mechanism of sepsis-associated encephalopathy,and the downstream mechanism is probably related to promotion of activation of PKA/CREB signaling pathway in rats.

Objective To explore the inhibitory effect of 24 pseudomonas aeruginosa(PA) on pathogenic fungi ,such as candida albicans ,candida tropicalis ,candida glabrata ,candida parapsilosis ,candida krusei ,mucous spore bacterium (MSB) etc .Methods 24 PA isolates were collected from clinical specimens and identified by Gram′s stain ,oxidase production and the API 20NE system(bi-oMerieux ,France) .Cross-streaking method and sterilizing filter paper-disk method and co-cultured method were applied to observe the inhibitory effect of PA .Sodium dodecyl sulfate-polyacrylamide gel electrophoresis(SDS-PAGE) analyzed the difference of bacte-rial proteins of PA .Results The results showed that some strains of 24 PA had strong inhibitory effect against pathogenic fungi , some strain had partial effect and others had no effect .Co-cultured test showed that PA could inhibit the growth of fungal hyphae . SDS-PAGE displayed the significant difference in secretive proteins between the PA strains which had strong effect and no effect . Conclusion PA have inhibitory effect upon common pathogenic fungi and and this might be related to inhibit fungal hyphae forma-tion ,various protein secretion and inhibit the growth of fungi .

Objective To investigate the changes of serum C-X-C motif ligand 13 (CXCL13) concentration in senior patients undergoing total hip replacement and its role in post-operative dys-function(POCD).Methods Eighty consecutive senior patients aged 65-80 years with BMI 18.4-27.3 kg/m2,ASA physical status Ⅱ or Ⅲ,were recruited and scheduled to undergo hip joint replacement operation.Neuropsychological test was performed 1-5 d after operation and patients were divided into POCD group and non-POCD group.Serum C reactive protein (CPR),procalcitonin (PCT),IL-6, TNF-α,CXCL13 concentration were detected 1 d before and 1,2,3,4,5 d after operation. Results A total of 21 (26%)patients developed POCD 1-5 d after operation (recruited in POCD group),and the other 59 patients were recruited in non-POCD group.Compared with the time point of 1 d before operation,serum CRP,PCT,IL-6,TNF-αand CXCL13 concentration were higher 1-5 d after operation in all patients (P<0.05).The concentrationsof these factors were higher in patients from POCD group than in those from non-POCD group 1-5 d after operation (P < 0.05). Conclusion The CXCL13 concentration insenior patients undergoing total hip replacement who devel-oped POCD were higher than in those who did not developed POCD.Whether it is correlated with POCD remains further study.

Objective To explore the drug resistance mechanism and characteristics of carbopenem-resistant pseudo-monas aeruginosa(CRPA)in our hospital.Methods BD phoenix 100 automatic bacterial identification and drug sensitivity an-alyzer was used to identify and detect the drug sensitivity of the strains.The minimum inhibitory concentration(MIC)of ceftazi-dime/acibactam was detected by micro broth dilution method.The modified carbapenem inactivation method(mCIM)and colloi-dal gold immunochromatography were used to detect the carbapenemase phenotype of the strains.The whole genome sequencing was used to detect the carbapenemase resistance gene and ST typing of the screened positive strains.Results A total of 22 strains of clinically isolated CRPA were collected,of which the antibacterial drugs with the lowest resistance rate were ceftidine/avibatan(22.7% ),followed by gentamicin and amikacin(27.3% ),pyracillin/tazobactam(59.09% ),cefuroxime(63.6% ).Ceftazide and aminotransferrane(77.27% ),ciprofloxacin(86.36% ),levofloxacin(95.45% ).There are a total of 5 strains(22.7% )of carbapenems in 22 CRPA by phenotypic detection.The whole genome sequencing results show that 4 strains of ST549 CRPA carry metal β-lactamase IMP-45 and serine β-lactamase OXA-1,OXA-50,one strain is ST245 CRPA carries metal β-lactamase NDM-1,that is,all five CRPA strains produce metal β-lactamase.Conclusion The resistance rate of CRPA to ceftazidime/avibactam is low in our hospital.Carbapenemase-producing is not the main mechanism of CRPA resistance to car-bapenems,while metal β-Lactamase-producing is the main mechanism of CRPA resistance to ceftazidime avibactam.