Objective To observe the curative effect of traditional Chinese medicine (TCM) Gubiao Pixie prescription on the prevention of nosocomial infection in elderly patients with susceptible factors.Methods A prospective observational study was conducted. The elderly patients aged over 70 years admitted to the Department of Integrated TCM and Western Medicine of Tianjin First Center Hospital from March 2015 to March 2016 were enrolled. The patients were divided into experiment group and control group by random number table. The patients in control group were given conventional treatment without special intervention; and those in experimental group were given Gubiao Pixie prescription particles (prescription composition:Radix Astragali 30 g,Bran fried Rhizoma Atracylodis 20 g,Raidix Saposhnikoviae 12 g,Radix Scutellariae 10 g,Fructus Tsaoko 6 g) on the basis of conventional treatment. The Gubiao Pixie prescription particles were taken in warm water 300 mL, twice a day in morning and evening respectively, taking half an hour after meals, and were increased or decreased according to the disease condition. The changes in immune function parameters before and after treatment, as well as the incidence of nosocomial infection, the abnormal increase rate of body temperature, white blood cell (WBC), and C-reactive protein (CRP) after 10 days of treatment in the two groups were observed.Results A total of 110 elderly patients with susceptible factors during hospitalization were included. After the exclusion of vomiting, abdominal distension and failure to conform the trial requirements, hospitalization time less than 10 days of patients, a total of 100 patients were enrolled in the analysis finally, with 50 patients in control group and in experimental group respectively. There were no significant differences in immune function parameters including IgA, IgG, IgM before treatment between the two groups. After 10 days of treatment, the immune function parameters showed no significant improvement in control group, and those in experiment group were improved significantly, and IgA (g/L: 1.59±0.32 vs. 1.29±0.29), IgG (g/L: 12.07±2.37 vs. 10.23±1.91), and IgM (g/L: 1.01±0.29 vs. 0.88±0.24) were significantly increased as compared with those of control group (allP < 0.01). Compared with the control group, the incidence of nosocomial infection (20% vs. 38%) and the abnormal increase rate of body temperature (24% vs. 44%), WBC (28% vs. 52%), and CRP (28% vs. 50%) 10 days after treatment in experimental group were significantly decreased (allP < 0.05).Conclusions TCM Gubiao Pixie prescription has a role in enhancing immune function and antibacterial and bactericidal effect. It has certain preventive effect on nosocomial infection in susceptible people.

A New Combination membrane was prepared by chitosan and polyvinyl alcohol (PVA).The gas permeability and water content of the membrane are all improved better than that of simple chitosan membrane.

Objective To evaluate the changes of physical activity status of residents in Beijing Yayuncun(Asian Games Village)Community.Methods A total of 1765 permanent residents over 15 from 600 families living in Yayuncun Communities since 2000 were selected in this prospective study.Thebaseline survey was carried out with the Questionnaire for Residents of Beijing Typical Community in 2004 and 2005.From 2006 to 2008,same questionnaire was used for the follow-up survey,and 1412 residents were responded to the questionnaire.Results The knowledge levels related to physical exercise of Yayuncun residents elevated(P＜0.01).The source of knowledge gain from Olympics Games promotion,specialized community lectures and intemet increase significantly(P＜0.01),that from other media decreased(P＜0.01).The exercise rate in community was higher than in other sites(P＜0.01)and increased significantly (P＜0.05);while doing exercise in charged sites decreased(P＜0.05).Logistic regression analysis showed that regular physical exercise was related to age,BMI,exercise-related knowledge,exercise sites,attitude for sport facilities and chronological order.Conclusion During the preparation for the Beijing Olympic Games.the status of physical exercise of residents in Yayuncun Community presented the positive trends.

Objective To establish a high resolution melting based method for the rapid identifica-tion of functional class 2 integron.Methods Nighty-nine non-repetitive Proteus spp.strains positive for genes encoding class 2 integrase were isolated from August, 2011 to August, 2012.The genomic DNAs were extracted and used as templates to amplify 60 base pair fragments containing the mutated point in class 2 in-tegrase gene by PCR.The high resolution melting analysis was conducted to identify the functional class 2 in-tegrons that were further compared by sequence analysis.Results There were remarkable differences with the high resolution melting curves between the functional class 2 integrons and the ordinary class 2 integrons. The results of high resolution melting analysis were consistent with those by using sequence analysis.Con-clusion High resolution melting analysis could be used for the rapid and accurate identification of functional class 2 integron.

Objective To investigate the clinical features and treatment of residual gallbladder lesions after cholecystectomy.Methods The retrospective cross-sectional study was conducted.The clinicopathological data of 83 patients with residual gallbladder lesions after cholecystectomy who were admitted to the Affiliated Hospital of Inner Mongolia Medical University between January 2009 and April 2016 were collected.Among the 83 patients,74 had residual gallbladder (41 combined with bile duct stones and 33 with simple residual gallbladder)and 9 had simple residual bile duct stones.Patients received laboratory and imaging examinations,and then selected suitable surgery according to residual lesions.Observation indicators included:(1) clinical features:medical history,clinical manifestation,features of laboratory and imaging examinations;(2) surgical and postoperative situations:surgical procedure,operation time,volume of intraoperative blood loss,time of drainagetube removal,postoperative complications and duration of postoperative hospital stay;(3) postoperative pathological examination;(4) follow-up situation.Follow-up using outpatient examination and telephone interview was performed to detect survival of patients and recurrence of lesions using abdomen color Doppler ultrasound up to October 2016.Measurement data with normal distribution were represented as ~ ±s.Results (1) Clinical features:① medical history:all the 83 patients had histories of cholecystectomy,including 57 with emergency operation and 26 with selective operation.② Clinical manifestation:initial clinical manifestation occurred at 1-324 months postoperatively,with an average time of 96 months.Of 83 patients,49 had right upper abdominal colic associated with right shoulder or back rediating pain,fever,nausea and vomiting,24 had jaundice as the main symptoms,8 had gradually worse conditions,with right upper quadrant abdominal pain,chills and fever associated with jaundice in the advanced stage and 2 had abdominal discomfort associated with incomplete intestinal obstruction.③ Laboratory examination:elevated alanine transaminase (ALT) and aspartate transaminase (AST) levels were detected in 48 patients,elevated total bilirubin (TBil) level in 28 patients and elevated serum and urinary amylase level in 4 patients,respectively.④ Imaging examination:of 83 patients,77 had positive results of magnetic resonanced eholangio-pancreatography (MRCP),43 had positive results of abdominal color Doppler ultrasound and 39 (4 combined with pancreatitis) had positive results of abdominal computed tomography (CT).(2) Surgical and postoperative situations:all the 83 patients underwent surgery.Of 74 patients with residual gallbladder,72 underwent residual gallbladder resection (of 41 combined with bile duct stones,35 undergoing residual gallbladder resection + bill duct exploration and removing the stone + T-tube drainage,6 initially undergoing endoscopic sphincterotomy for removing bile duct stones and then residual gallbladder resection and 31 undergoing simple residual gallbladder resection),1 combined with residual gallbladder cancer underwent residual gallbladder resection + common bile duct resection + hepatic duct-jejunum internal drainage and 1 combined with residual gallbladder cancer and common bile duct space-occupying lesion underwent palliative biliary-enterostomy.Nine patients with simple residual bile duct stones underwent endoscopic sphincterotomy for removing bile duct stones.Operation time,volume of intraoperative blood loss,time of drainage-tube removal and duration of postoperative hospital stay were (92±39)minutes,(63±12)mL,(5±4)days and (9±5)days in 74 patients with residual gallbladder,respectively.There was no severe postoperative complication.Operation time,volume of intraoperative blood loss and duration of postoperative hospital stay were (57±33)minutes,(25±9)mL and (5 ± 3) days in 9 patients with simple residual bile duct stones,respectively.No severe complication was occurred in 9 patients.(3) Postoperative pathological examination:the length of residual cystic duct in 74 patients with residual gallbladder was (2.8 ± 1.0) cm,combining with stones.Of 74 patients,simple hyperplasia of residual gallbladder were detected in 54 patients,dysplasia in 14 patients,tumor-like hyperplasia and benign tumor in 4 patients and adenocarcinoma in 2 patients.(4) Follow-up situation:all the 83 patients were followed up for 6-71 months,with a median time of 33 months.Eighty-one patients were healthy survival,without recurrence of lesions.One patient had recurrence of bile duct stones at 34 months postoperatively,and then was cured by choledochojejunostomy,without recurrence up to the end of follow-up.One patient with residual gallbladder cancer complicated with common bile duct space-occupying lesion died at 9 months postoperatively.Conclusions Patients have recurrent right upper abdominal colic associated with right shoulder or back rediating pain,fever and jaundice after cholecystectomy,and lesions of residual gallbladder or bile duct stones should be considered.Reoperation is safe and feasible for patients,with a good clinical outcome.

Exosomes are extracellular microbubbles related to intercellular communication, which have the ability to transport and transfer biological macromolecules. Pain will lead to a sharp decline in the quality of life of patients, and will give patients and society a heavy medical burden. More and more evidences show that the exosomes plays an important role in the pathological process of pain related diseases.Summarizing the exosomes and the biomolecules carried by them under different pain conditions, and identifying the specific exosomes related to the pain state will be helpful for early diagnosis and treatment of pain related diseases. In addition, the ability of exosomes to transmit information and its widespread characteristics in the body indicate that they have broad prospects as a new diagnosis and treatment tool in the field of pain. A better understanding of the relationship between the exosomes and pain will provide a novel and promising treatment for patients with pain.

Osteosarcoma is the most common malignant bone tumor disease in young children and young people. It usually has strong invasiveness, and conventional treatment cannot achieve the expected results. Therefore, studying the mechanism of tumor cell death and exploring more effective treatment methods is of great significance. As a new form of cell death, ferroptosis has been found to have three main regulatory pathways closely related to tumor cell molecular mechanisms, genes, etc. This provides a theoretical basis for the application of ferroptosis in the treatment of osteosarcoma. This article reviews recent research on the interaction between ferroptosis and osteosarcoma in regulating molecules, genes, and other factors, as well as the application of ferroptosis in the treatment of osteosarcoma.

Objective: To investigate the independent predictors of inguinal lymph node metastasis (LLM) in patients with penile squamous cell carcinoma (SCCP), and to establish a nomogram for predicting individual LLM risk. Methods: The data of patients with SCCP diagnosed at the department of urology, Xijing Hospital from July 2009 to June 2019 were analyzed retrospectively. A total of 101 patients were included in this study, with age of 55 (26-84) years. There were 25 (24.8%) and 76 (75.2%) patients with and without palpable inguinal lymph node enlargement, respectively. There were 47 cases (46.5%), 40 cases (39.6%) and 14 cases (13.9%) in T₁, T₂ and T₃ stages, respectively; there were 67 cases (66.3%), 21 cases (20.8%) and 13 cases (12.9%) in Broder 1, 2 and 3, respectively. The average value (or median) of fibrinogen was 2.84 (1.72-5.00)g/L; alkaline phosphatase was 80(32±214)U, hemoglobin was 147(81-180)g, platelet count was (193.74±65.68×10⁹/L, absolute value of neutrophils, monocytes and lymphocytes were 3.98(1.19-11.85)×10⁹/L, 0.44(0.17-1.90)×10⁹/L and 1.68(0.58-4.13)×10⁹/L, respectively. The average (or median) value of PLR, NLR and LMR were 113.38(18.80-418.42), 2.42(0.59-10.22) and 3.84 (1.08-9.89), respectively. There were 26 cases (25.7%) with LLM and 75 cases (74.3%) without LLM. The independent predictors of LLM were identified by univariate and multivariate logistic regression analyses. The R software was used to establish the nomogram by integrating all independent predictors, and the bootstrap method was used to internally validated our nomogram, where the value of AUC (area under the ROC curve) was calculated and the calibration plot was drawn. Results: Clinical inguinal lymph node status (P<0.006), T stage (P<0.021), Broder grade (P<0.017) and absolute neutrophil value (P<0.043) were independent predictors of LLM. The accuracy of our nomogram was 0.875 (AUC=0.875, 95%CI 0.859-0.891); Moreover, the risk of LLM predicted by nomogram was in good consistency with the actual LLM rate, and the errors of the nomogram-predicted LLM risks were all within 10%. Conclusions Clinical inguinal lymph node status, T stage, broder grade and absolute value of neutrophils were identified as independent predictors of LLM in patients with SCCP on the basis of single center data. A generic nomogram predicting LLM risk for Chinese patients was developed, which would be helpful to screen SCCP patients who need prophylactic inguinal lymph node dissection.

Objective To analyze the structures of atypical class 1 integrons in clinical Proteus isolates. Methods This study included 26 class 1 integron integrase gene-positive clinical Proteus isolates, from which the variable regions of class 1 integrons could not be amplified. Six isolates were chosen from them to amplify the flanking DNA segments of class 1 integron integrase gene using inverse PCR. The se-quences of PCR products were analyzed with BLAST to identify the target homologous sequences as well as their accession numbers in GenBank. Primers for overlap PCR were designed according to the flanking se-quences. Then the 26 clinical Proteus isolates were analyzed with overlap PCR and sequencing analysis. Re-sults The variable regions of class 1 integrons in 25 out of the 26 clinical Proteus isolates were completely or partly identified by using inverse PCR,overlap PCR and sequencing analysis. A gene cassette array of estX-psp-aadA2-cmlA1-aadA1a-qacI-tnpA-sul3 was detected in 22 isolates. The variable regions of class 1 integrons in the other three isolates were identified to be estX-psp-aadA2-cmlA1,dfrA14 and IS26,respectively. All of the 25 isolates lacked the 3'conserved segements in class 1 integron. Conclusion Inverse PCR can be used to analyze the structures of atypical class 1 integrons. Gene cassette psp and gene cassette arrays of estX-psp-aadA2-cmlA1-aadA1a-qacI-tnpA-sul3 and estX-psp-aadA2-cmlA1 in clinical Proteus isolates are reported for the first time.