Cas9 is a RNA-guided double stranded DNA nuclease that participates in the CRISPR/Cas9 system. Wide-type Cas9 directly silences the expression of target gene by gene splicing. The engineered dCas9 protein with the mutation at D10A and H840A lacks the Cas9' s endonuclease function but keeps its DNA binding activity. dCas9 can activate special genes by fusing with transcription activator. Meanwhile,it can inhibit the gene transcription by directly binding to the target gene and stop gene transcrip?tion. Combination of light sensitive structures and CRISPR can produce light-inducible CRISPR/Cas9 system for control of gene expres?sion. This system is able to activate or inhibit gene expression via the use of controlling blue light(470 nm). In this review,we mainly discuss the development of the light inducible CRISPR/Cas9 system as well as its application in the control of gene expression.

Objective To establish a kind of medical box for wound debriding and change dressing in sanitary train,which could be used to satisfy the requirements of natural and manmade disasters for medical service.Methods With tri-grade modularization theory,the medical box were divided into four functional sections,including disinfection cleaning solution section,debriding and change dressings common section,contaminated wound change dressings section and infected wound change dressing section.Through the four sections,the medical box could be provided 5 wound debirding and 50 change dressings.Results The medical box can satisfy all requirements for wound treatment with useful and convenient function.Conclusions The invented medical urgent box has so many advantages of modularization,complete functions and expansionary,which could satisfy all requirements for sanitary train.

Objective To study the biofilm-forming ability and the distribution of biofilm-related genes in Acinetobacter baumannii clinical isolates as well as antimicrobial resistance,to analyze their relationships with the bacterial resistance phenotype.Methods A prospective study was conducted.Biofilm models of 70 strains Acinetobacter baumannii collected in Chengwu County People's Hospital from October 2012 to October 2013 were constructed using 96-well polystyrene plate.In order to analyze the biofilm-forming ability,a qualitative and quantitative analysis was conduct by crystal violet staining assay.And the antimicrobial resistance of different biofilm-forming ability strains was compared including imipenem,amikacin,meropenem,cefepime,sulbactam cefoperazone,trimethoprim,levofloxacin,gentamicin,ciprofloxacin,cefotaxime,ceftizoxime,aztreonam,piperacillin,ceftriaxone,cefuroxime.In addition,the expressions of biofilm-related gene Bap,bfs and intI1 were tested with polymerase chain reaction (PCR) assay.Results Among 70 strains Acinetobacter baumannii,40 strains were multi-drug resistant (57.14％) and 6 strains were pan-drug resistant (8.57％); 68 strains had biofilm-forming ability (97.14％),14 of which were weakly positive,20 were positive and 34 were strongly positive.The antimicrobial resistant rate of Acinetobacter baumannii to imipenem,amikacin,meropenem and cefepime was decreased,it was 30.00％,32.86％,38.57％ and 41.43％,respectively.However,the antimicrobial resistant rates to other commonly used antibiotics were all higher than 50％.The drug resistance of Acinetobacter baumannii to levofloxacin (85.71％,45.00％,38.24％,x2=9.225,P=0.010),cefepime (71.43％,45.00％,29.41％,x2=7.222,P=0.027),gentamicin (78.57％,55.00％,38.24％,x2 =6.601,P=0.037) was significantly decreased when biofilm-forming ability reinforced (weakly positive,positive,hadro-positive).Bap gene positive rate of weakly positive,positive and strong positive biofilm-forming strains Acinetobacter baumannii was 50.00％,65.00％ and 79.41％ (x2=4.244,P=0.120),respectively.Bfs gene positive rate was 35.71％,65.00％ and 88.24％,respectively (x2=13.602,P=0.001) and intI1 gene positive rate was 42.86％,75.00％ and 91.18％,respectively (x2 =12.902,P=0.002).Moreover,the antimicrobial resistances of biofilm-related gene positive strains were higher than the negative,of which the drug resistance of intI1 positive group to amikacin was significantly higher than the negative group (40.38％ vs.11.11％,x 2=5.194,P=0.023).Conclusions The Acinetobacter baumannii collected from the hospital had strong multi-drug resistance as well as strong biofilm-forming ability.The drug resistance of Acinetobacter baumannii decreased when biofilm-forming ability reinforced.In addition,genes,such as Bap,bfs,and intI1,contributed to biofilm formation.

Obiective To evaluate the efficacy of health package for the nurse in train evacuation, Methods The self-manufactured new mobile health package for the nurses provides shortcut and completed equipment in various basic nursing care, therapic procedure, condition observation, emergency aid and treatment for nursing staff who performed transportation in train evacuation.Results The potable health package can play an important role in several medical support training and have special mission. Conclusion The health package has mobile applicability and operability, which is an important equipment for successful medical support training.

Objective To analyze the compliance and the influencing factors of the children with congenital hypothyroidism (CH).Methods 231 children with CH were collected for this study.The questionnaire survey and referring the case were used to collect relative factors.According to regular follow -up treatment,the children were divided into two groups,one group was good compliance and the other one was bad compliance.The results were ana-lyzed by two -independent sample t -test,2 -test and unconditioned logistic regression analysis.Results (1)Blood TSH(χ2 =59.870,P =0.00) and blood FT4 (χ2 =6.468,P =0.01) were normal,short distance from the hospital (χ2 =16.375,P =0.00),level of education of their mothers was high(χ2 =7.483,P =0.02),and regular compli-ance treatment of children with CH(χ2 =7.483,P =0.024) was good.(2) Logistic stepwise regression analysis showed that serum TSH value(OR =17.135),the short distance(OR =1.692) and diagnosis of CH(OR =4.028) were introduced into the logistic regression model (all P <0.05).Conclusion It is essential to take measures actively and reinforce the management of children with long distance,low -educated,and the diagnosis of TSH.More-over,enhancing the regular treatment compliance of children with CH is the key to improve the growth and develop-ment status of children with CH.

Objective: To observe the eff ect and mechanism of chronic high-fat diet on predation behavior in rats. Methods: Ten female SD rats with 4-week-old were randomly divided into a normal control group (NC group,n=5) and a chronic high-fat diet group (HF group,n=5). The rats in the NC group received the regular diet while rats in the HF group were fed with high-fat diet. Fitf een weeks later, the predation behavior of rats was evaluated by open if eld test and food foraging tests. At the end of experiments, the rats were killed and brain tissues were collected for evaluation of c-Fos protein expression in anterior cingulate cortex by immunohistochemical assay. Results: hT e predation behavior of rats in the HF group was signiif cantly impaired in the competitive or non-competitive food foraging test compared with the control rats (P<0.001). hT e c-fos protein expression in anterior cingulate cortex of rats from the HF group was signiif cantly decreased (P<0.001). Conclusion: Long time high-fat diet can aff ect the predation behavior of rats, which is related todysfunction of neuron in anterior cingulate cortex.

Objective To investigate the prognostic value of metabolic parameters of 18F-fluorodeoxyglucose positron emission tomography/computed tomography(FDG PET-CT)before radiotherapy in patients with esophageal cancer receiving radiotherapy. Methods We retrospectively analyzed the clinical data of 37 patients with stage Ⅱ-Ⅲ esophageal squamous cell carcinoma admitted to Anhui Provincial Hospital from 2010 to 2015,who underwent PET-CT scans within 4 weeks before radiotherapy. The following information was collected:age,sex,the location of primary lesion,clinical stage,and treatment regimen.The maximum standard uptake value(SUVmax), mean standard uptake value(SUVmean), metabolic tumor volume(MTV), PET tumor length(PTL),and total lesion glycolysis(TLG)were calculated. The optimal cut-off values of SUVmax, SUVmean,MTV,PTL,and TLG were determined by the receiver operating characteristic(ROC)curve. The Kaplan-Meier method was used to calculate survival rates,and the log-rank test was used for survival comparison and univariate prognostic analysis;the Cox model was used for multivariate prognostic analysis of significant variables. Results The area under the ROC curve suggested that MTV>TLG>PTL=0.713>0.679>0.670. The Kaplan-Meier survival analysis showed that patients had better survival time when MTV was less than 27.44 cm3,TLG was less than 166.2 g,and PTL was less than 36.74 mm(P<0.05).The Cox multivariate regression analysis showed that only MTV was an independent prognostic factor for radiotherapy in patients with esophageal cancer(P=0.000). Conclusions MTV, TLG and PTL have certain values in predicting the prognosis of patients with esophageal cancer before radiotherapy, and are helpful for selecting and adjust the clinical treatment regimen and improving the survival rate and prognosis.

Objective:To evaluate the consistency of individual iodine nutrition levels by serum iodine, plasma iodine and whole blood iodine, and to provide reference for iodine-related epidemiological investigation.Methods:Healthy adults aged 18 - 59 years were recruited from the Research Center of Environment and Health in Water Source Area of South-to-North Water Diversion of Hubei University of Medicine. Whole blood sample was collected and serum and plasma were separated. The content of iodine in serum, plasma and whole blood was determined by inductively coupled plasma mass spectrometry (ICP-MS), and the linear relationship, precision and accuracy of the standard curve of the detection method were evaluated. The difference of three kinds of blood iodine levels was analyzed by variance analysis of compatibility group design, and Passing-Bablok regression and Bland-Altman plot were used to evaluate the consistency between serum iodine and plasma iodine.Results:The linear range of iodine in serum, plasma and whole blood was 0.0 - 25.0 μg/L, and the correlation coefficients ( R2) were all > 0.999. The relative standard deviation of 8 mixed blood samples ranged from 1.9% to 4.3% ( n = 6), and the determination results of blood iodine certified standard substances were all within the reference range. The recovery rate of the added standard ranged from 99% to 106%. The iodine levels in serum, plasma and whole blood of 50 volunteers were (57.31 ± 8.06), (57.49 ± 8.50) and (33.89 ± 5.40) μg/L, respectively, and there was no statistically significant difference between serum iodine and plasma iodine ( P = 0.904). The results of Passing-Bablok regression showed that there was no statistically significant difference in bias between serum iodine and plasma iodine ( P = 0.538). The Bland-Altman plot indicated that the difference between serum iodine and plasma iodine was within the consistency limit. Conclusion:The results of plasma iodine and serum iodine are in good agreement, and plasma iodine can be used as an evaluation index of individual iodine nutrition level. But there is no consistency between whole blood iodine and serum iodine.

Objective:To investigate the clinical efficacy and safety of polymyxin B in the treatment of sepsis caused by extensively-drug resistant (XDR) Gram-negative bacteria.Methods:A retrospective analysis of 39 septic patients with XDR Gram-negative bacterial infection treated with polymyxin B in the department of critical care medicine of Xiangya Hospital of Central South University from June 2018 to September 2019 were enrolled. The clinical characteristics, bacterial culture, the sensitivity antibacterial drugs, types and courses of antibiotics, biochemical indexes, and acute physiology and chronic health evaluationⅡ(APACHEⅡ) before and after polymyxin B treatment were collected, to assess microbial clearance and efficacy, drug related adverse effects, and 28-day mortality in septic patients with XDR.Results:Of the 39 septic patients with XDR, 32 (82.1%) were male, with the mean age of (53.6±12.6) years old. The main infection site was pulmonary infection (51.2%), and the treatment courses of polymyxin B were ≥ 5 days. A total of 66 pathogenic bacteria were detected from 39 patients. Among them, with the high estrate of detecting Acinetobacter baumannii of 51.5% (34/66). After treatment with polymyxin B, the results showed that the clearance rate of microorganisms was 65.2% (43/66), the overall effective rate was 59.0% (23/39), and the 28-day all-cause mortality was 41.0% (16/39). There were no significant differences in clinical efficacy and microbial clearance among patients with different treatment groups of polymyxin B [< 10 days, 10-15 days, and > 15 days groups: effective rates were 56.5% (13/23), 54.5% (6/11), 80.0% (4/5), χ2 = 0.999, P = 0.728; the microbial clearance rates were 43.5% (10/23), 54.5% (6/11), and 80.0% (4/5), χ2 = 2.141, P = 0.393]. The effective and microbial clearance rates of the polymyxin B daily doses of 150 mg and 200 mg groups were significantly higher than those of the daily dose of 100 mg [effectiveness: 85.7% (6/7), 87.5% (7/8) vs. 41.7% (10/24); microbial clearance rate: 71.4% (5/7), 87.5% (7/8) vs. 33.3% (8/24), all P < 0.05], however, there were no significant differences in the length of intensive care unit (ICU) stay and mechanical ventilation time among different daily dose groups. The APACHEⅡscore after polymyxin B administration was significantly lower than before administration (all patients: 16.20±9.24 vs. 24.40±4.73, effective patients: 11.30±4.08 vs. 23.00±4.56, both P < 0.05). Four patients with renal injury had an increase in serum creatinine during the administration of polymyxin B, and recovered after discontinuation of the drug without other adverse reactions. Conclusion:Polymyxin B can be used as an effective treatment option for patients with severe infection of XDR Gram-negative bacteria.