Objective To investigate the impact of isoniazid (INH)-resistant Mycobacterium tuberculosis (Mtb) on the prevalence and dissemination of multi-drug resistant tuberculosis (MDR-TB).Methods A total of 251 patients diagnosed with tuberculosis in designated hospitals of Guanyun,Jiangsu and Deqing,Zhejiang from 2010 to 2011 were included in the study.The drug susceptibility tests (DST) were performed on all the Mtb isolates available from the sputum cultures.Mycobacteral interspersed repetitive units-variable number tandem repeats (MIRU-VNTR) was conducted for genotyping for all available Mtb isolates.Chi-square test,Fisher exact test,ANOVA and non-conditional Logistic regression modelling were applied for data analysis.Results Among 251 patients with Mtb isolates and DST results available,72 (28.7％) were resistant to INH,including 13 were INH mono-drug resistant.Of the remaining 59 INH-resistant Mtb,34 (13.5％) were resistant to rifampin TB and 25 were resistant to streptomycin and/or ethambutol.The clustering analysis based on MIRU-VNTR genotyping revealed 29 clustered genotypes (including 105 isolates) and 146 unique genotypes (including 119 isolates).Twentyfive clusters contained drug resistant Mtb and 16 clusters of them comprised by 37 INH-resistant isolates and 20 MDR-TB isolates,which accounted for 51.4％ of the INH-resistant isolates and 58.8％ of the MDR-TB isolates.Single factor analysis showed that sex,age,previous tuberculosis treatment history and sputum smear results were all related to INH-resistant tuberculosis and MDR-TB (all P ＜ 0.05).Multiple factors analysis showed that previous tuberculosis treatment history was risk factor of MDR-TB (OR=8.40,95 ％CI:3.342-21.105),while the risk factors of INH-resistant tuberculosis were previous tuberculosis treatment history (OR=3.52,95％CI:1.570-7.910),pulmonary caviry (OR=2.27,95％CI:1.075-4.799) and sputum smear results (OR=0.50,95％CI:0.275-0.892).Conclusions That INH-resistant strain may evolve to the MDR-TB after recent transmission is a possible trend.Patients with previous treatment history and advanced age are at high risk of INH-resistant tuberculosis and MDR-TB.

Objective To study the effects of exercise on hemodynamic parameters and cardiovascular humoral factors in the elderly patients with hypertension. Methods The modified Bruce assessment (MBA) was employed in an essential hypertension (EH) group (group 1, n =34) composed by elderly EH patients and a control group (group 2, n =31) composed of normal subjects. Heart rate (HR),systolic and diastolic blood pressure (SBP、DBP), and the quantum and duration of exercise (QE, DE) were explored, while the serum concentrations of nitric oxide (NO), endothelin 1(ET1), atrial natriuretic factor (ANF) and AngiotensinⅡ(AngⅡ) were measured at 3 min before and after treatment. Results There were no significant differences between groups 1 and 2 with regard to HR, SBP, DBP, total DE and peak QE before and after treatment, in addition, at the peak of exercise ( P 0.05). Pretreatment SBP and DBP were significantly and positively correlated with those at the peak of and after treatment ( r =0.648,0.630, P

Enterovirus 71 (EV71) is a neurotropic pathogen that can induce hand, foot and mouth disease in children. There is an appreciable mortality rate after EV71 infections. The mechanism of action of EV71 replication is not known. Recent work has identified some of cell factors of the host that participate in the synthesis of the RNA and proteins of EV71 (e.g., hnRNP K, reticulon 3 (RTN 3)). In that work, researchers used a competitive assay to show that hnRNP K can interact with EV71 5' UTR, which is required for efficient synthesis of viral RNA. Using a yeast two-hybrid system, other researchers demonstrated that RTN 3 interacts with the N-terminal domain of EV71 2C, which is crucial for replication of viral RNA. Here, we discuss recent work focusing on the molecular mechanisms of hnRNP K and RTN 3 in the synthesis of the RNA and proteins of EV71.
Animals ; Carrier Proteins ; genetics ; metabolism ; Enterovirus A, Human ; genetics ; physiology ; Enterovirus Infections ; genetics ; metabolism ; virology ; Heterogeneous-Nuclear Ribonucleoprotein K ; Host-Pathogen Interactions ; Humans ; Membrane Proteins ; genetics ; metabolism ; Nerve Tissue Proteins ; genetics ; metabolism ; Ribonucleoproteins ; genetics ; metabolism ; Viral Proteins ; genetics ; metabolism ; Virus Replication

AIM and METHODS: A study of radioimmunoimaging was carried out on Kcnming mice - uterine cervical cancer (U14) using 99mTc labeled monoclonal Au14-1 with a modified Schwartaz method. RESULTS: The bio - distribution showed that radioactivity accumulated in tumor tissue at 12h after 99mTc - Au14- 1 injection in tail vein. The uptake by tumor was 4. 12 % ID/g at 2h and 8. 79 % ID/g at 24h respectively. The tumor/non - tumor (T/NT) radiocativity ratios for organs except kidneys were ranged from 2.02 to 6.71 at 24h post - injection. The image of tumor showed at 12h and clearer at 24h after injection. CONCLUSION: The quality of tumor image was relevant to the T/NT radioactivity ratios. It was demonstrated that 99mTc- Au14-1 has a good capability of localization for tumor.

Objective To analyze the risk factors of post-ERCP pancreatitis (PEP) and to evaluate the relationship between cannulation time and PEP.Methods The data of cannulation time in 1 625 patients who underwent ERCP from 2010 to 2012 were retrospectively studied.The risk factors associated with PEP were analyzed by univariate and multivariate Logistic regression analysis.The effect of different cannulation time on PEP was evaluated.Results The incidence of overall PEP was 4.6％ (75/1 625) including 4.1％ (67/1 625)of mild and 0.5％ (8/1 625)of moderate-to-severe.Univariate analysis revealed that diabetes mellitus (P =0.02),choledocholithiasis (P =0.02),malignant biliary stenosis (P =0.007),duodenal stenosis (P =0.029),precut (P＜0.01),cannulation time ≥ 8 min (P＜0.01),blood platelet count ≥ 180× 109/L(P =0.089),alkaline phosphatase ≥ 120 U/L (P =0.083) and total bilirubin ≥ 17.1 μmol/L (P =0.094)were associated with PEP.Multivariate analysis revealed that precut (OR=1.93,95％CI:1.10-3.39,P=0.022),cannulation time ≥8 min (OR =3.50,95％CI:2.00-6.13,P＜0.01) and duodenum stenosis (OR=2.92,95％CI:1.08-7.86,P=0.034) were independent risk factors of PEP.Within 30 min of cannulation,longer cannulation time was accompanied with higher PEP rate.Conclusion The cannulation time is an independent risk factor of PEP.Overall PEP is increased when cannulation time is more than 8 min.

Objective To study and summary the treatment of talus fracture. Methods Fifteen patients with talus fracture were treated by limited cut off reduction by leverage and hollow lag screw under C arm X-Ray machine January 2008 to November 2014, of whom there were 11 males and 4 females, aged 15-61 years old. Seven patients sufferred from talus fracture because of traffic accidents, 4 patients because of falls, 2 patients because of crush injury, and 2 patients because of sprains. Hawkins typing:Ⅰtype in 1 patient, Ⅱ type in 6 patients, Ⅲ type in 6 patients of Ⅲ type, and Ⅳ type in 2 patients. Results Followed up for 6 months to 4 years (mean 1.5 years), fracture healed better. Hawkins grading standard:9 patients showed excellent (1 patient ofⅠtype, 5 patients ofⅡtype, 3 patients ofⅢtype), and two patients showed good (Ⅲtype). The excellent and good rate was 11/15. Necrosis of talus occurred in one patient, and degenerative joint disease occured in one patient. Conclusions Minimally invasive internal fixation with hollow lag screw under C arm X-Ray machine in the treatment of talus fracture has a small injury to the periosteum and the blood supply of small soft tissue. It can fix reliably and can pressurize the fracture fragments, and is conducive to fracture healing.

Objective To summarize the nursing methods and experience for the elderly hi-atal hernia patients complicated with a variety of basic diseases so as to the quality of nursing. Methods 12 esophageal hiatal hernia patients complicated with multiple basic diseases were given comprehensive nursing intervention.Results 12 esophageal hiatal hernia patients were diagnosed timely and clearly.There was no aspiration pneumonia,malnutrition and adverse drug reactions in hospital.And 10 patients discharge after recovery and the other 2 patients with mechanical ventila-tion should be hospitalized for a long time.Conclusion Accurate and effective nursing measures is very important to the hiatal hernia elderly patients complicated with a variety of basic diseases.

Objective To summarize the nursing methods and experience for the elderly hi-atal hernia patients complicated with a variety of basic diseases so as to the quality of nursing. Methods 12 esophageal hiatal hernia patients complicated with multiple basic diseases were given comprehensive nursing intervention.Results 12 esophageal hiatal hernia patients were diagnosed timely and clearly.There was no aspiration pneumonia,malnutrition and adverse drug reactions in hospital.And 10 patients discharge after recovery and the other 2 patients with mechanical ventila-tion should be hospitalized for a long time.Conclusion Accurate and effective nursing measures is very important to the hiatal hernia elderly patients complicated with a variety of basic diseases.

Objective: To assess the effectiveness in optimizing resources and shortening critical children′s waiting time in pediatric emergency department (PED) with five-level pediatric emergency triage system (PETS). Methods: This retrospective study was conducted in the First Affiliated Hospital of Xiamen University after PETS was applied. The data of patients who visited the pediatric emergency department from January 2015 to December 2017 were collected and analyzed, including age, sex, diseases, visiting time, triage rate and destination. Results: A total of 375 985 patients were included, among whom males were 225 308 (59.9%) and females were 150 677 (40.1%), all younger than 14 years of age. The number of critical cases (level Ⅰ, level Ⅱ and level Ⅲ) was increased from 4 719 (3.7%) in 2015, 12 209 (10.2%) in 2016 to 16 188 (12.7%) in 2017. The number of non-critical patients (level Ⅴ) decreased year by year, as from 98 213 (76.8%) in 2015 to 75 210 (62.6%) in 2016 and 78 857 (61.7%) in 2017. The patients who classified as level Ⅰ or levelⅡaccording to the PETS were seen immediately by physician (n=1855, 0.5%). Overall, 119 738 patients (98.3%) who were classified as level Ⅲ or level Ⅳ could be seen by physician in a timely manner according to triage guidelines, while 2 112 patients (1.7%) could not. The mean waiting time was 9.09 min in level Ⅲ, 17.7 min in level Ⅳ, and 55.76 min in level Ⅴ patients, respectively. The critical cases admitted to the intensive care units were 175 (36.2%) in 2015, 350 (62.8%) in 2016 and 374 (66.2%) in 2017. The etiologies were respiratory diseases (73.3%), gastrointestinal diseases (15.8%) and infectious diseases (3.1%). Conclusion The application of PETS could optimize emergency resources and shorten the waiting time of critically ill children.

course of Internal Medicine and Surgery Nursing. Methods From September 2014 to July 2016, the Grade 2013 nursing students at the Sino American cooperative nursing class in the Nursing College of Wenzhou Medical University were selected as the experimental group by convenient sampling method, with a total of 59 people. The Grade 2012 nursing students in the Sino American cooperative nursing class were selected as the control group, with a total of 60 people. The nursing students in the control group received traditional teaching methods and the nursing students in the experimental group received the self participating teaching method. We compared students' self-learning ability, theoretical knowledge and comprehensive practical ability between the two groups. Results The total score of self-learning ability and the scores of all dimensions of experimental group were higher than those in the control group after class, and the differences were statistically significant (P< 0.05). The scores of theoretical knowledge and comprehensive practice ability of the experimental group were higher than those of the control group, and the differences were statistically significant (P< 0.05). Conclusions Self participation teaching method is a teaching method that helps teachers play a leading role in giving play to students' main body status. It helps to promote the development of nursing students' independent learning ability, and improve their theoretical level and nursing practice ability.