This study examined the relationship between PDGF-induced proliferation of vascular smooth muscle cells (VSMCs) and Nur77 expression and the effect of atorvastatin on VSMC proliferation and Nur77 in PDGF-treated VSMCs. Rat VSMCs were isolated and cultured. After incubation with atorvastatin or Nur77 siRNA, the cells were stimulated with PDGF and detected for BrdU incorporation to measure the proliferation of the VSMCs. Quantitative PCR and Western blotting were used to determine the Nur77 protein and the CREB phosphorylation level, to observe their relations with PDGF-induced VSMC proliferation. Our results showed that PDGF increased the BrdU incorporation in VSMCs, suggesting that it induced the proliferation of the cells. The VSMC proliferation was associated with increased Nur77 expression and elevated CREB phosphorylation. Atorvastatin inhibited the PDGF-induced VSMC proliferation, suppressed Nur77 expression. After silencing of Nur77 gene, the PDGF-induced VSMC proliferation was decreased. It was concluded that PDGF-induced VSMC proliferation was related to the Nur77 expression and CREB phosphorylation. Atorvastatin reduced the Nur77 expression and, at the same time, inhibited the VSMC proliferation.

In this paper, five different methods were carried out for DNA extraction directly from soil. The result shows that all five methods could generate DNA with more than 15 kb in size. They were subsequently used as templates for PCR amplification with success, using primers of the bacterial 16S rRNA gene and Shiva-1 gene encoding an antibacterial peptide. However, method 5 is more suitable for DNA extraction directly from a small amount of soil sample as it produced a good yield of DNA in high integrity with reliable reproducibility.

Objective To evaluate the indications and intraoperative management of nephron-spar- ing surgery (NSS) for renal cell carcinoma (RCC).Methods A total of 53 patients (32 men and 21 women;age range,21 -76 years) with unilateral RCC and a normal contralateral kidney underwent NSS.The disease course ranged from 1 week to 13 months.The unilateral RCCs were detected by B-uhrasonography. Partial nephrectomy was performed on 38 cases of polar RCC and wedge nephrectomy was performed on 15 cases of central RCC.Both renal vein and artery were blocked for 10 - 15 min,and unclamped for 1 -2 min if necessary.The resections were finished within 7 -21 min (mean,12 min).No inosine and regional hypo- thermia were used during operation.Absorbable hemostatic gauze and terylene flake were used to suture renal wound surface.After operation all patients were treated with interferon hypodermic injection of 5 000 000 U every other day for 3 months.Results The diagnosis of RCC with negative cutting margin was confirmed by pathological examination in all patients.The greatest dimension of the renal cancers were＜4 cm except for one of 6 cm.The clinical stage was T_1N_0M_0 in all patients.During the follow-up of 6 -48 months,all pa- tients were alive without recurrence and had normal renal function.Conclusions NSS can be rapidly per- formed for T_1 stage renal cancer＜4 cm or single clearly localized cancer＞4 cm in diameter.The follow-up results are satisfactory.

Objective To compare the efficacy and safety of 1.9 μm thulium laser with transurethral resection of bladder tumor(TURBT) for the treatment of superficial bladder cancer.Methods We reviewed 53 patients with superficial bladder cancer,who were divided into 1.9 μm laser (n =25) and TURBT groups (n =28) from January 2013 to December 2015.The operation time,blood loss volume in operation,catheter indwelling time,hospital stay time,and complications,cumulative recurrence rate were compared between the two groups.Results Compared to TURBT group,1.9 μm laser group showed significantly lower rate of blood loss volume in operation (21.6 ± 4.6) min,catheter indwelling time (22.4 ± 6.4) h,hospital stay time (2.2 ± 0.7) d,less complications (12％)and recurrence(16％) (P ＜ 0.05).Conclusions 1.9 μm thulium laser is safe and effective for the treatment of patients with superficial bladder cancer.The approach has less complications than TURBT.

Objective To explore the expressions of cyclooxygenase-2 (COX-2), phosphatase and tensin homolog deleted on chromosome ten (PTEN) in hepatobiliary calculus associated with cholangiocarcinoma (HCWC) and their clinical significance. The relationship between the expressions of COX-2, PTEN and the onset and progression of HCWC was investigated to form an experimental base for the prevention and treatment of HCWC. Methods Thirty seven patients with tumor tissues of HCWC (group C), thirty patients with tissues of bile duct surrounding intrahepatic calculus (group B), and ten patients with normal tissues of bile duct from operations of hemangiomas of liver or liver trauma as the control (group A) were sampled and collected. A two-step immunohistochemistry (SP method) was employed to detect and statistically analyze the expressions of COX-2 and PTEN in each of the 3 groups. Results In groups A, B, C, the positive rate of the expression of COX-2 was 10%,33.3%, and 70.3%, respectively. The positive rates of expression of COX-2 in the carcinoma tissues of HCWC was significantly higher compared with the control group (P＜0. 01). In groups A, B, C the positive rates of the expression of PTEN was 90. 0%, 80. 0%, and 35.0%, respectively. The positive rate of expression of PTEN in the carcinoma tissues of HCWC was significantly lower than the control group (P＜0. 01). The expression of COX-2 was followed by a low expression of PTEN in the tissues of HCWC. Kendall's related analysis showed a strong negative correlation between the expression of COX-2 and PTEN in HCWC (r=-0. 323, P＜0. 05). Conclusions A high expression of COX-2 was related to HCWC. There was a negative correlation between the expressions of COX-2 and PTEN in HCWC. A high expression of COX-2 and a low expression of PTEN suggested a high chance of HCWC in extrahepatic or lymphatic metastasis.

Objective To evaluate the effect of bundle intervention measures on preventing ventilator-associated pneumonia (VAP).Methods Patients who were admitted to an intensive care unit(ICU)of a hospital from January 2012 to December 2013 were monitored,patients from January to December 2012 were as control group,while from January to December 2013 were as intervention group (bundle intervention measures were implemented).Usage rate of ventilators and incidence of VAP between two groups were compared.Results A total of 4 560 patients were mo-nitored,2 608 in intervention group and 1 952 in control group.Usage rate of ventilators in intervention group was lower than control group (53.95% vs 61 .17%;χ2 =65.756,P <0.01).Incidence of VAP per 1 000 ventilator days in intervention group was lower than control group (13.00‰ vs 19.56‰;χ2 =4.649,P =0.031 ).Percentage of late-onset VAP per 1 000 ventilator days in tervention group was higher than control group(41 .82‰ vs 24.59‰). Conclusion Bundle intervention measures are helpful for reducing the incidence of VAP in ICU patients.

Objective : To evaluate the effectiveness of interventions for human papillomavirus ( HPV ) vaccine hesitancy among female university students based on the precaution adoption process model (PAPM), so as to provide the evidence for improving the coverage of HPV vaccine in this population. Methods : HPV vaccine hesitant female students were selected using a cluster sampling method from Zhejiang Chinese Medical University, and randomly assigned to the PAPM group and control group. Students in the PAPM group received PAPM-based interventions for HPV vaccine hesitancy, while students in the control group were given routine interventions. The HPV-related knowledge, HPV vaccine-related knowledge and HPV vaccine hesitancy scores were collected from both groups prior to interventions ( T0 ), 0 ( T1 ), 1 ( T2 ) and 3 months post-interventions ( T3 ), and the effectiveness of interventions was evaluated using analysis of variance for repeated measures. Results : There were 147 students in the PAPM group and 141 students in the control group. In the PAPM group, 36.73% of the students majored in medical sciences, and 48.23% were freshmen; in the control group, 39.72% majored in medical sciences, and 50.35% were freshmen. The mean scores of HPV- and HPV vaccine-related knowledge were significantly greater in the PAPM group than in the control group, respectively ( T1, 5.29 vs. 4.91; T2, 4.27 vs. 4.22; T3, 4.22 vs. 4.04; P<0.05 ); however, no significant differences were detected in the HPV vaccine hesitancy scores between the two groups, respectively ( T1, 2.98 vs. 2.95; T2, 3.07 vs. 3.07; T3, 3.08 vs. 2.97; P>0.05 ). The mean scores of the confidence dimension ( T1, 3.37 vs. 3.23; T2, 3.48 vs. 3.40; T3, 3.38 vs. 3.25 ) and the dimension of influence by others ( T1, 3.44 vs. 3.33; T2, 3.42 vs. 3.37; T3, 3.46 vs. 3.27 ) were significantly greater in the PAPM group than in the control group (P<0.05), while the mean scores of the complacency dimension were significantly lower in the PAPM group than in the control group ( T1, 1.98 vs. 2.03; T2, 2.06 vs. 2.20; T3, 2.18 vs. 2.15; P<0.05 ). Conclusions PAPM-based interventions for HPV vaccine hesitancy may effectively improve the awareness of HPV and HPV vaccines, reduce complacency, and enhance the influence by others among female university students.

Objective:To compare the clinical efficacy of the Simultaneous three scopes combined surgery [laparoscopic cholecystectomy(LC)+ choledochoscopy exploration + choledochectomy and removal of the common bile duct + primary suture of the common bile duct + endoscopic guided nasobiliary duct placement] and staged two scopes surgery[endoscopic retrograde cholangiopancreatography (ERCP) combined with LC] in the treatment of choledocholithiasis and cholecystolithiasis.Methods:From January 2018 to June 2020, we retrospectively analyzed the clinical data of 83 patients with choledocholithiasis and choledocholithiasis, who underwent minimally invasive treatment in our center. According to the different surgical procedures, the patients were divided into three-mirror group ( n=42) and two-mirror group ( n=41). All patients in the three-mirror group underwent three-scopy combined surgery. The patients in two-mirror group received endoscopic retrograde cholangiopancreatography (ERCP) combined with laparoscopic cholecystectomy (LC). In this study we compared the relevant clinical indicators of the two groups, in terms of the operation time, intraoperative blood loss, one-time stone clearance rate, postoperative exhaust time, postoperative defecation time, total hospitalization cost, incidence of postoperative acute pancreatitis, postoperative stone recurrence rate, incidence of postoperative cholangitis, and incidence of postoperative biliary fistula, total hospitalization time, postoperative bile duct stricture rate. Use SPSS 26.0 software to statistically analyze various indexes such as intraoperative, postoperative, follow-up, etc. Normally distributed measurement data were described by the mean±standard deviation ( Mean± SD), the comparison between groups was by t test, and measurement data with skewed distribution were destribed as M( P25, P75), Pairwise comparisons were analyzed using nonparametric test. The comparison of count data between groups was by the chi-square test. Results:No death was observed in both two groups. The operation time, intraoperative blood loss, one-time stone clearance rate, postoperative exhaust time, and postoperative defecation time of the three-mirror groupwere (167.98±47.37) min, 50(50, 100) mL, 100%(42/42), (2.10±0.76) days, 3(3, 4) days, the two-mirror group were (143.80±34.47) min, 50(50, 50) mL, 85.4%(35/41), (1.53±0.99) days and 2(1, 3) days. Compared with the two groups, the three-mirror group was higher than the two-mirror group, and the difference was statistically significant ( P<0.05). The total hospitalization expenses, postoperative acute pancreatitis incidence, and postoperative calculus recurrence rate in the three-mirror group were (3.46±0.77) ten thousand yuan, 0(0/42), 2.38%(1/42), the two-mirror group were (4.22±1.50) ten thousand yuan, 9.8%(4/41), 19.5%(8/41). Compared with the two groups, the three-mirror group was lower than the two-mirror group, and the difference was statistically significant ( P<0.05). No postoperative cholangitis or biliary fistula occurred in the two groups. There was no statistically significant difference in the total hospital stay and incidence of postoperative bile duct stenosis between the two groups ( P>0.05). Conclusions:For choledocholithiasis combined with cholecystolithiasis patients, simultaneous three-scopes combined surgery and elective LC after ERCP are safe and effective, and each has its own advantages. It should be selected reasonably according to the patient′s condition and combined with the technical advantages of the treatment team.

Abstract: Objective　To investigate the clinical characteristics and diagnosis key points of brain abscess caused by Nocardia asiatica, and provide a clinical basis for diagnosing and treating intracranial infection caused by Nocardia. Methods　A case of pulmonary Nocardia asiatica complicated with brain abscess diagnosed at the Second Affiliated Hospital of Hainan Medical University was selected to analyze the clinical manifestations, cerebrospinal fluid characteristics, pulmonary and cranial imaging features, and treatment plan, and to summarize the diagnosis and treatment experience. Results　The patient was an elderly woman with a history of diabetes, dry cough was the first symptom without fever or headache. At the beginning of the course, it was diagnosed as pulmonary infection and tuberculosis in the local hospital, and received conventional antimicrobial and anti-tuberculosis therapies, but showed no improvement. The patient developed progressive limb weakness, followed by consciousness disorders, and coma. Cerebrospinal fluid (CSF) adenosine deaminase and lactate dehydrogenase were not abnormal, CSF pressure, protein and white blood cells were high, mainly with multiple nuclear cells. CSF glucose and chloride were normal in the early stage of the disease, but decreased significantly in the later stage. Metagenomic analysis of cerebrospinal fluid indicated Nocardia asiatica with a specific sequence number of 537. Lung CT showed exudation, abscess, and cavity in the right lung. Skull MRI scan + enhancement suggested multiple scattered abscesses in both cerebral hemispheres. The abscesses were of different sizes and showed ring enhancement, with extensive surrounding edema, and ventricular compression. After treatment with meropenem, linezolid, and compound sulfamethoxazole tablets, the cerebrospinal fluid recovered, and the lesions in the lungs and intracranial structures improved. Conclusions　Brain abscess caused by Nocardia asiatica is similar to the tuberculous brain in clinical symptoms, cerebrospinal fluid examination, craniocerebral imaging, so we should be alert to the possibility of Nocardia infection in patients with diabetes. At the same time, metagenomic testing of the cerebrospinal fluid can help confirm the diagnosis. The mortality and disability rates of brain abscess caused by Nocardia are high. Early diagnosis and treatment can improve the prognosis.

This study examined the relationship between PDGF-induced proliferation of vascular smooth muscle cells (VSMCs) and Nur77 expression and the effect of atorvastatin on VSMC proliferation and Nur77 in PDGF-treated VSMCs.Rat VSMCs were isolated and cultured.After incubation with atorvastatin or Nur77 siRNA,the cells were stimulated with PDGF and detected for BrdU incorporation to measure the proliferation of the VSMCs.Quantitative PCR and Western blotting were used to determine the Nur77 protein and the CREB phosphorylation level,to observe their relations with PDGF-induced VSMC proliferation.Our results showed that PDGF increased the BrdU incorporation in VSMCs,suggesting that it induced the proliferation of the cells.The VSMC proliferation was associated with increased Nur77 expression and elevated CREB phosphorylation.Atorvastatin inhibited the PDGF-induced VSMC proliferation,suppressed Nur77 expression.After silencing of Nur77 gene,the PDGF-induced VSMC proliferation was decreased.It was concluded that PDGF-induced VSMC proliferation was related to the Nur77 expression and CREB phosphorylation.Atorvastatin reduced the Nur77 expression and,at the same time,inhibited the VSMC proliferation.