Objective:To observe the changes of 5-HT1B and D1DR expression in nucleus of SNr/GPi-VL-SMA pathway in pre and post-exhaustive exercise,and investigate the central mechanism of SNr/GPi-VL-SMA pathway modulating the occurrence and development of exercise-induced fatigue.Method:Twenty-four male Wistar rats were randomly divided into control group (CG),immediately after exhaustion group (EG),and 90min after recovery group (RG),each consists of 8 rats.The expression level of 5-HT1B and D1DR receptors in each group were observed with the immunohistochemistry technique.Result:Compared with CG,the positive cell area/scanning area value (R value) and the average optical density value (AOD value) of 5-HT1B receptor in SNr and GPi of the EG and RG rats both decreased significantly (P ＜ 0.05),while the R value and AOD value of D1DR both increased significantly(P＜ 0.05).The R value and AOD value of 5-HT1B receptor in VL of EG and RG rats increased significantly(P＜0.05,P＜0.01).In SMA,the R value and AOD value of 5-HT1B receptor of EG and RG rats increased significantly (P＜ 0.05),while,the R value and AOD value of D1DR receptor decreased significantly (P ＜ 0.05).Conclusion:Changes of 5-HT1B receptor and D1DR receptor expression in the nuclei of ‘SNr/GPi-VL-SMA'pathway caused the changes of the neurotransmitters release,thus affecting the excitability of the electrical activity of neurons,this might be one of the important ways for ‘SNr/GPi-VL-SMA'pathway modulating the exercise-induced fatigue and exercise performance.

Objective To describe surgical nurses' learning motivation of attending continuing nursing education (CNE) and to analyze influencing factors of learning motivation.All of these would be reference for managers of hospitals and administrative department to improve the quality of CNE and make related policy.Methods 140 surgical nurses from one general hospital were recruited to fill a questionnaire of demographic data of participants and revised Education Participation Scale (EPS).Results The score of EPS of surgical nurses was (89.26±13.67),the first dimension was professional advancement,followed by serving society,learning interest,social relation,external expectations and escape/stimulation.The score of EPS of nurses who were younger than 35 years old,single,no administrative posts was higher than nurses who were older than 35 years old,married or in administrative position.Education level,working life,professional ritle,financial resources and numbers participating in CNE in recent 1 year made some differences for EPS score.Conclusions The score of EPS of surgical nurses was at middle level,factors affecting EPS were different.The managers should take interventions to improve the motivation of attending CNE according to nurses' characters in order to increase the professional level and nursing quality of nurses.

This paper explores the social care for HIV-infected people and patients in Shanxi Province,detailed as two parts including medical assistance and living assistance.And the purpose of this paper is to reflect the status of comprehensive prevention and treatment of AIDS in Shanxi Province,and find out the emerging priorities and challenges in work to provide references for relevant research.

Objective To explore the effects of excise-induced fatigue on the microloop plasticity of prefrontal cortex through observing the expression of parvalbumin positive neurons in prefrontal cortexes of rats induced by exhaustive exercise,so as to find out the possible mechanism of the central regulation of exercise-induced fatigue by measuring the expression of NMDAR2B receptors.Methods Thirty-six Wistar rats were randomly divided into an exhausted group (E),a repeated exhaustion group (RE) and a control group (CG),each of 12.For group E,the adjusted Bedford incremental load of treadmill exercise program was employed:the initial treadmill speed was 8.2 m/min,lasting for 15 minutes,then increased to 15 m/min for another 15 minutes,and finally increased to 20 m/min till exhaustion.For RE group,they were given continuous treadmill exercises to exhaustion for consecutive 7 days.The immunofluorescence technique was used to observe the expression of PV+ interneurons after exhausted treadmill running.The Western blotting technique was used to determine the expression of NMDAR2B in the tissue of the prefrontal cortex.Results After the exhausted treadmill running,the expression of PV+ interneurons in the prefrontal cortexes of both E and RE groups increased significantly compared with the control group(P＜0.01).The immunofluorescence results indicated that NMDAR2B positive neurons were seen in group E,but not obviously in group CG and RE.The Western blotting showed that compared with CG group the protein expression of NMDAR2B in prefrontal cortexes of group E was relatively high,and that of group RE was relatively low,but without significant difference (P＞0.05).The running distance and prefrontal cortex NMDAR2B expression were found negatively correlated (P＜ 0.01).Conclusions Exhaustive exercises have an impact on the plasticity in rats' prefrontal cortex neural network through regulating the local loop of PV positive neurons.This plasticity of the prefrontal cortex is involved in the regulation of central fatigue.The present study might provide morphological basis for the research of central mechanism of the exercise-induced fatigue.

Objective To observe the local field potential activity of dorsomedial and dorsolater striatal (STR) neurons in rats with exercise-induced fatigue,so as to explore the regional characteristics of those neurons.Methods Thirty-six male Wistar rats were randomly divided into a control group(CG),a single fatigue group(SFG)and a repeated fatigue group(RFG),each of 12.The exercise-induced fatigue model was established according to a load-increasing treadmill running protocol.The CG did not do any treadmill running,SFG finished one-time exhaustive exercise while the RFG repeated exhaustive exercise 6 times.The extracellular glass microelectrode technique was used to record the spontaneous firing of dorsomedial(n=6)and dorsolateral(n=6)STR neurons in vivo to observe the discharging frequency,characteristics and types.Results (1)Spontaneous firing frequencies of striatal neurons in SFG were significantly higher than those of CG(P＜0.01),while those of RFG were significantly lower than SFG.(2) After repeated fatigues,there were significant decreases in the irregular firing pattern and significant increase in the explosive firing of striatal neurons compared with CG(P＜0.05).(3)After the single fatigue and repeated fatigue,the discharging frequency of dorsomedial medium spiny-like neurons increased significantly(P＜0.05),and that after repeated fatigue significantly higher than that of the dorsolateral(P＜0.01).The discharge frequency of the dorsomedial and dorsolateral fast-spiking neurons decreased significantly after repeated fatigues.The discharge frequency of dorsolateral large aspiny-like neurons of RFG was significantly higher than SFG,while that of the latter was significantly lower than CG(P＜0.05).Conclusions (1)Striatal neurons mediate exercise-induced fatigue and present regional characteristics,which might be due to dorsomedial and dorsolateral striatal neurons receiving different types of projection neurons.(2) Striatal fast-spiking neurons may play an important role in mediating the exercise-induced fatigue.

Objective To analyze and assess the major functions of medical APP by investigating its application in self management of chronic diseases. Methods The 3 major functions of APP were analyzed, including data record and condition assessment, medical consultation, and life therapy. Results The medical APP possesses its basic functions for chronic diseases management. However, it lacks of practicality and convenience and its homogenization is severe. Conclusion The APP +hardware +cloud medical management model should be promoted by making use of the Internet + medical technology, the supervision of mobile medical APP should be strengthened, the mobile information management mechanisms of chronic diseases should be perfected, and the self management efficiency of patients with chronic diseases should be improved.

Objective To study the safety and efficacy of fast track program in anorectal surgery perioperative period. Methods One hundred and sixty-nine cases of rectal cancer were divided into the study group of 86 patients with fast track program, and the control group of 83 patients with traditional programs by random digits table. Both groups were compared from the time out of bed, the first intestinal discharge time,intravenous fluids stopping time,length of hospital stay,total cost of treatment and the incidence of postoperative complications. Results The study group compared with the control group: the first intestinal discharge time [(33.6 ± 12.9) h vs. (81.7 ± 20.1) h], intravenous fluids stopping time [(4.5 ±1.3) d vs.(7.4 ± 1.6) d],and length of hospital stay [(5.6 ± 1.2) d vs.(8.9 ±2.7) d],the total cost of treatment [(15 000 ± 3000) yuan vs. (16 000 ± 4000) yuan], the differences were statistically significant (P ＜ 0.01 or ＜ 0.05),and had less incidence of postoperative complications in study group than that in control group [5.8% (5/86) vs. 16.9% (14/83)], the difference was statistically significant (P ＜ 0.05).Conclusions Fast track program in anorectal surgery perioperative period is safe and effective, beneficial,conducive to rehabilitation of patients.

Objective To understand the basic situation of healthcare-associated infection(HAI)management and prevention and control of multidrug-resistant organism(MDRO)infection in medical institutions in Hubei Province.Methods Questionnaires were used to investigate the basic situation of HAI management and MDRO infection in 47 tertiary and secondary hospitals in Hubei Province.Results 47 hospital were enrolled in this study,HAI management full-time staff was allocated with a median of 0.90/250 beds;in 2015,the isolation rates of methicillin-resistant Staphylococcus aureus,carbapenem-resistant Enterobacteriaceae,carbapenem-resistant Pseudomonas aeruginosa,carbapenem-resistant Acinetobacter baumannii,and vancomycin-resistant Enterococcus were 39.13%,4.13%,19.44%,63.60%,and 2.77%respectively.47 hospitals all carried out surveillance on MDROs,28(59.57%)hospitals were installed HAI monitoring system software,could directly obtain data through collecting with the laboratory system.The diagnosis of MDRO infection was mainly based on the combined diagnosis by HAI full-time personnel and clinicians(26 hospitals,55.32%).44(93.62%)hospitals regularly convened coordination meeting on prevention and control of MDROs,in 2015,hand hygiene compliance rate were 10.0%-89.2%by self-inspection;42(89.36%)hospitals routinely prescribed isolation orders for patients with MDRO infection,33(70.21%)hospitals conducted environmental clean and disinfection twice a day,24(51.06%)hospitals performed personal protection by using complete set of protective equipment.Conclusion This investigation is helpful for understanding the general situation of HAI management in medical institutions,as well as the detection and control of MDROs in this area,and make continual improvement on the problems and weakness found in the investigated project,so as to promote the development of HAI management in this area.

BACKGROUND:Most bone marrow mesenchymal stem cel s are infused intravenously and have very low efficiency of homing to the bone marrow. However, cel infusion via the femoral approach is little reported. OBJECTIVE:To explore the distribution of luciferase gene modified red fluorescent protein transgenic bone marrow mesenchymal stem cel s in vivo through different infusion routes. METHODS:Luciferase gene modified bone marrow mesenchymal stem cel s at different gradients (5×106, 1×106, 1×105, 1×104) were seeded or injected into the in vitro pore plate or free femurs to observe the fluorescence imaging and select the best concentration of cel s. Luciferase gene modified bone marrow mesenchymal stem cel s at the best cel concentration were injected into the mice via the femur and the tail vein, respectively. The distribution of fluorescence and cel number in the mice were explored by using bioluminescence, pathological examination, flow cytometry and quantitative PCR. RESULTS AND CONCLUSION:Ex vivo fluorescence intensity of luciferase gene modified bone marrow mesenchymal stem cel s was positively correlated with the cel concentration;fluorescent cel s in vivo appeared in the femur first and then quickly spread to the lungs in the femur group, while fluorescent cel s in the tail vein group spread to the lungs quickly after cel infusion. Fluorescent cel s could be seen in the spleen, liver and other organs 24 hours later in the two groups. The distribution and migration of cel s in mice could be observed successful y by bioluminescence;5 minutes after cel infusion, the lungs of mice in the two groups began to emit fluorescence that could spread to the liver, spleen and other tissues 24 hours later, and the fluorescence intensity reached its peak after 15 minutes. The distribution of bone marrow mesenchymal stem cel s in mice had no significant difference between the femur group and the tail vein group. To conclude, cel injection through the bone marrow cavity and tail vein fails to promote the homing of bone marrow mesenchymal stem cel s to the bone marrow.

Objective To investigate the molecular characteristic of fluoroquinolone resistant Streptococcus agalactiae (GBS) isolates in Suzhou.Methods Totally 46 fluoroquinolone resistant GBS strains were collected,and then subjected into PCR and two resistance genes were sequenced and their high frequency mutation sites,gyrA and parC were analysed.Results Among these isolates,the most frequent gyrA mutation was gyrA_S81L (TCA→TTA),which displayed 93.4％ (43/46) with substituted at No.81 site of amino acid from Ser to Leu.However,the most frequent parC mutation was mutated at No.79 site of amino acid from Ser to Tyr orPhe,with two mutations parC_S79Y (73.9％,34/46) and parC_S79F(17.4％,8/46).The analysis showed that the major mutation patterns are gyrA_S81L with parC_S79Y (73.9％,34/46),gyrA_S81L with parC(13.0％,6/46).Conclusion The most frequent mutations of fluoroquinolone resistant gene in Suzhou are gyrA and parC and the major mutation patterns are gyrA_S81L/parC_S79Y and gyrA_S81L/parC_S79F.