ObjectiveTo investigate the effect of activation of RIG-Ⅰsignaling pathway by leucine rich repeat containing23(LRRC23)on replication of influenza virus.MethodsOverexpression and knock-down of LRRC23 were performed in A549 cells to investigate its effect on influenza virus replication. A549 cells were transfected with pcLRRC23 plasmid or siLRRC23(small interfering LRRC23)for 24 h and then infected with influenza virus A/jingfang/1/86(H1N1). The virus titer and HA protein expression level in the cell supernatant were determined by plaque assay and ELISA respectively.The expression of LRRC23,RIG-Ⅰ,MAVS,M1 and HA at gene and protein levels were determined by qRT-PCR and Western blot respectively. The interactions between LRRC23 and RIG-Ⅰwere analyzed by co-immunopre-cipitation(Co-IP)and immunofluorescence assay(IFA). IFN-β-luc and NF-κB-luc activities were determined by dual-luciferase reporter assay.ResultsThe LRRC23 overexpression significantly decreased the influenza virus titer and inhibited the expression of HA protein in the supernatant of A549 cells,while enhanced the NF-κB and IFNβ activations by activation of RIG-Ⅰ-MAVS signaling pathway,resulting in the inhibition of expressions of M1 gene and HA protein. Conversely,the knock-down of LRRC23 increased the protein expression level of HA in the supernatant of A549 cells,up-regulated the relative expression level of M1 gene and down-regulated those of RIG-ⅠmRNA and MAVS mRNA.ConclusionLRRC23 plays an essential role in innate antiviral response by inhibiting influenza virus replication through activation of RIG-Ⅰsignaling pathway.

Objective To investigate the levels of creatine kinase (CK-MB), brain natriuretic peptide (BNP), and neu-ropeptide Y (NPY) in severe pneumonia pediatric patients combined with heart failure (HF). Methods Pneumonia pediatric patients admitted from December 2010 to December 2014 had been enrolled and divided into pneumonia group (P) (n=32), se-vere pneumonia group (SP) (n=20) and severe pneumonia combined HF group (HF) (n=36). Twenty healthy children served as control group (C). Serum level of CK-MB was detected by enzyme rate method and were measured by ELISA. BNP and NPY were measured again during the recovery period in 18 cases in HF group. Results The serum levels of CK-MB, BNP and NPY were signiifcantly different among the four groups, (F=25.19~277.94, P<0.01). The serum levels of CK-MB, BNP and NPY were signiifcantly higher in HF group than in SP, P and C group (P<0.05). The serum level of CK-MB was signiifcantly higher in SP group than that in P and C group (P<0.05) and there was no difference between P and C group (P>0.05). The serum levels of BNP and NPY were not statistically signiifcant between SP and P and C group (all P>0.05). In HF group, the serum levels of CK-MB, BNP, and NPY were signiifcantly decreased in 18 cases after treatment. The serum level of BNP was positively correlat-ed with CK-MB and NPY (r=0.681, 0.525, all P<0.01) and the NPY and CK-MB levels were also positively correlated (r=0.545, P<0.01). Conclusions The Detection of the serum levels of CK-MB, BNP and NPY can help diagnose severe pneumonia com-bined with HF. The BNP maybe the most sensitive indicator.

Objective To observe the application effect of mind mapping in the nursing teaching of higher vocational nursing students. Methods A total of 120 nursing students from 2014 four vocational nursing classes. First class and second class were observation group (60 cases), third classes and fourth classes were control group (60 cases). Nursing students in observation group unfold nursing teaching with mind mapping teaching method. Nursing students in control group unfold nursing teaching with traditional teaching method. The test results and teacher satisfaction with nursing students at the end of the period were assessed. And the evaluation of nursing students on mind mapping teaching method was compared. Results The scores of the instruments and materials, the performance of the operation steps, the technique and the achievement scores were (9.85 ± 0.40), (64.67 ± 1.64), (17.37 ± 1.25) points in the observation group and (9.22±0.64), (58.68±2.21), (14.18±2.23) points in the control group, the differences were significant(t =-8.440,-18.539,-10.881, P<0.05). The satisfaction degree of the control group was 78.3%(47/60) and the satisfaction degree of the observation group was 95.0%(57/60), and there was significant difference (χ2=5.550, P<0.05). Nursing students in observation group of mind mapping teaching hold a higher rating (t =11.32-5.25, P<0.01). Conclusions Mind mapping teaching method allows nursing students quickly master the nursing skills, improve teaching effectiveness, improve teaching nursing students′satisfaction, enhance clinical thinking and critical thinking skills.

Objective To observe the role of mulberry flavone on the expression of insulin receptor substrate(IRS)in HepG2 cells with insulin resistance, and to explore the possible molecular mechanism that mulberry flavone improves insulin resistance. Methods HepG2 cells were cultured to establish insulin-resistance cell model in high concentration of insulin, and then incubated with mulberry flavone. Effect of mulberry flavone on the HepG2 cell model of glucose incorporation rate was observed. Western blot was used to observe the variety of IRS protein expression. Results Mulberry flavone increased the glucose incorporation rate of (33. 9 ± 1.0)higher than that of Conclusions Mulberry flavone can improve insulin resistance. Furthermore, IRS protein expression increasing is the possible molecular mechanism that mulberry flavone improves insulin resistance.

Objective To analyze the effects of Ileus tube (IT) along with somatostatin (SS) used for treatment of patients with severe acute pancreatitis (SAP).Methods Under conventional treatment,75 patients with SAP were divided into three groups as per different additional treatments,namely group A (IT and SS),group B (nasogastric decompression tube and SS),and group C (IT alone),and the therapeutic efficacies of those treatments were evaluated in respects of improvement of physical signs and symptems,dynamic changes in decompression drainage and prognosis.Results Therapeutic efficacy was 100％ in group A,84％ in group B and 80％ in group C.The difference between group A and B was x2 =8.26 (P ＜0.01) ; group B vs.C was x2 =0.38 (P ＞ 0.05).The physical signs and symptoms in group A were improved more rapid than those in group B and C (P ＜ 0.05),but there was no significant differences in those signs and symptoms between group B and group C (P ＞ 0.05).In comparison of decompression drainage,the t value of group A vs.group B was 2.14,group B vs.group C was 3.83,and group A vs.group C was 2.23 (P ＜ 0.05).As cure rate of patients with SAP in hospital on the 14th day,rate of transferring to surgical treatment as a last resort and mortality in group A were compared with group B and C,the differences were statistically significant (P ＜ 0.05),while group B vs.C,the difference was not statistically significant (P ＞ 0.05).Conclusions Application of IT combined with SS can significantly improve the condition of patients with SAP,thereby reducing the operation rate,shortening hospital stay,lowering mortality and improving the outcome,and it is worthy of clinical popularization.

Objective To evaluate the reliability and validity of three-district and four-level triage standards in adult emergency department.Methods A randomized sampling cross-sectional study was conducted. A total of 1106 emergency adult patients admitted to the Second Xiangya Hospital of Central South University in Hunan Province from December 2015 to April 2016 were enrolled. The triage was independently performed by 12 nurses according to the emergency triage criteria. Based on the shift style, 2 nurses were assigned to each shift as the triage guider and assistant respectively, who did the triage for every patient independently. The clinical data were recorded as follows: the demographic data, emergency information (triage time, emergency way, complaints, vital signs, and conscious state), triage information (triage level, admitted department), waiting time, treatment time, destination and outcomes. The reliability of three-district and four-level triage standards was analyzed by Spearman correlation, and the receiver operating characteristic curve (ROC) was plotted to evaluate its validity.Results ① A total of 254 patients were enrolled for reliability evaluation in the first 2 weeks of the study. The overall internal consistency rate ofthe triage instructors and the triage assistants was 72%, the total Kappa value was 0.686 [95% confidence interval (95%CI) = 0.608-0.757,P < 0.001]. ② Validity analysis showed that in the 1125 emergency patients collected during the study, a total of 1106 patients were finally enrolled in the analysis excluding the patients who refused to accept the treatment, whose data was incomplete and who was diagnosed as prehospital death. With the increase of three-district and four-level triage level, a significant increase was showed in the waiting time of patients, the treatment time, and the retention rate; on the contrary, the salvage rate, the hospitalization rate, hospitalization time, emergency mortality, in-hospital mortality and total mortality rate were decreased [the waiting time of patients from triage level 1 to 4 (minutes) was 1.00 (1.00, 1.75), 1.00 (1.00, 5.00), 8.00 (2.00, 23.00), 10.00 (4.50, 28.00), the treatment received time (minutes) was 1.00 (1.00, 10.00), 6.00 (1.00, 23.00), 48.00 (25.00, 105.00), 87.00 (41.00, 140.00), the retention rate was 4.76%, 10.94%, 55.91%, 42.86%, the salvage rate was 95.24%, 87.94%, 20.81%, 0%, the hospitalization rate was 57.14%, 70.98%, 53.62%, 20.41%, the hospitalization time (days) was 19.50 (9.75, 28.00), 11.00 (8.00, 17.00), 12.00 (8.25, 17.00), 10.50 (8.75, 15.25), the emergency mortality was 19.05%, 6.92%, 1.41%, 0%, the in-hospital mortality was 16.67%, 15.09%, 6.25%, 0%, and the total mortality rate was 28.57%, 17.63%, 4.76%, 0%, allP < 0.05]. ROC curve analysis showed that the area under ROC curve (AUC) of three-district and four-level triage standards for identifying patients needed an immediate intervention (triage level 1 to 2) was 0.854 (95%CI = 0.831-0.878), and the sensitivity and specificity were 78.62% and 89.89%, respectively, the misdiagnosis rate was 10.11%, and the missed diagnosis rate was 21.38%.Conclusion The three-district and four-level triage standards were proved to be a reliable and valid instrument, which can distinguish the severity of the disease and help nurses to triage patients correctly.

With the development of detection technology, circulating tumor DNAs have broad application prospects in early diagnosis, prognosis evaluation and curative effect and tumor load monitoring. The application of circulating tumor DNAs in breast cancer has also become a hotspot in recent years, especially in the early diagnosis of breast cancer, tumor burden and drug resistance. At the same time, chemotherapy, targeted therapy, and endocrine therapy for breast cancer will be more individualized and targeted. The existing imaging and clinical tests provide limited individualized information for comprehensive treatment of breast cancer. The advantage of circulating tumor DNA detection is likely to change the existing treatment strategies of breast cancer and provide more precise treatment for patients.

Objective To investigate the recent efficacy and safety of autologous bone marrow stem cells transplantation in treatment of early spinal cord injury. Methods 51 cases of early spinal cord injury admitted to Liaocheng People Hospital from 2007.11 to 2009.8 were enrolled in this study. In transplantation group, 24 patients were treated by subarachnoid space injection with autologous bone marrow stem cell transplantation. The patients who were not transplanted in the same period of hospitalization were selected as control group. Motor and sensory function ( AISA score) was assessed at 1, 3, 6 months before and after transplantation in two groups patients. And blood routine, clotting mechanisms, biochemical items andtunor markers were determined in followed up. Results After one month of transplantation, two groups ofpatients had recovered in motor and sensory function to some degree. After three months of transplantation,there was significant different between transplantation group and control group in sensory function recovery (P < 0. 05 ). After 6 months of transplantation, there were significant different between transplant group and control group in motor and sensory function recovery (P<0.05). Blood examination results did not show markedly abnormal in followed -up patientsConclusion The safety and recent effect of autologous bone marrow stem cells transplantation in treatment of early spinal cord injury were satisfied, but the long - term effect was still unclear.

Objective To investigate the curative effect of bronchoalveolar lavage with fiberoptic bronchoscopy combined with vibration sputum drainage in the treatment of severe pneumonia patients undergoing mechanical ventilation (MV).Methods A prospective randomized controlled trial was conducted. 286 severe pneumonia patients undergoing MV admitted to intensive care unit (ICU) of Hunan People's Hospital from January 2014 to July 2016 were enrolled, and they were divided into control group and observation group according to random number table, with 143 patients in each group. Patients in both groups received sensitive antibiotics for anti-infection, etiological treatment, and calefacient and humidifying treatment. The patients in the control group received bronchoalveolar lavage with fiberoptic bronchoscopy, and those in the observation group received bronchoalveolar lavage combined with vibration sputum drainage. The parameters of respiratory function and inflammation before and after treatment, curative effect, and prognosis were compared between the two groups.Results ① There were no significant differences in respiratory function parameters between the two groups before treatment, 2 hours after treatment, the parameters were improved in both groups. Moreover, oxygenation index (PaO2/FiO2) in observation group was significantly higher than that of control group [mmHg (1 mmHg = 0.133 kPa): 379.1±20.2 vs. 351.8±24.7], and arterial partial pressure of carbon dioxide (PaCO2) and airway resistance (Raw) were significantly lower than those of the control group[PaCO2 (mmHg): 36.5±5.8 vs. 45.3±6.9, Raw (cmH2O, 1 cmH2O = 0.098 kPa): 12.9±0.6 vs. 13.1±0.8, allP < 0.01]. ② There were no significant differences in inflammation parameters between the two groups before treatment, 24 hours after intervention, which were significantly decreased in both groups. Moreover, white blood cell count (WBC), procalcitonin (PCT) and C-reactive protein (CRP) in the observation group were significantly lower than those of the control group [WBC (×109/L): 8.2±1.7 vs. 12.8±3.7, PCT (μg/L): 15.4±2.4 vs. 21.8±3.1, CRP (mg/L): 37.1±6.1 vs. 67.2±7.2, allP < 0.01]. ③ Compared with the control group, the treatment efficiency of observation group was improved [95.1% (136/143) vs. 87.4% (125/143)], the quantity of sputum excretion was increased (mL: 49.2±12.5 vs. 36.9±11.0), duration of MV and length of ICU stay were significantly shortened (days: 6.4±3.6 vs. 9.4±2.1, 8.6±5.7 vs. 12.4±4.6, bothP < 0.01), however, there was no significantly statistical difference in 28-day mortality between control group and observation group [2.8% (4/143) vs. 2.1% (3/143),P > 0.05].Conclusion Compared with bronchoalveolar lavage with fiberoptic bronchoscopy alone, the treatment of bronchoalveolar lavage combined with vibration sputum drainage is more effective in sputum excretion for severe pneumonia patients undergoing MV, which could improve the respiratory function, reduce infection, shorten the duration of MV and the length of ICU stay, and improve the recovery.

BACKGROUND:With the development of sports medicine and research of radiologic imaging techniques, Blumensaat line (the radio-opaque line at the roof of the intercondylar notch) has been paid increasing attention. Blumensaat line is considered as measurement indexes of knee diseases. Taking advantage of the Blumensaat line, many surgeons and radiography physicians are trying to diagnose some knee diseases. OBJECTIVE:According to the knowledge about Blumensaat line in auxiliary diagnosis of knee disease, we hoped that it wil have a wide application in clinic. METHODS:A computer-based online search of CBM, CNKI, Wangfang Database and PubMed between 2000 and 2015 was performed for articles addressing Blumensaat line. We summarized its application as different diagnostic indicators. The key words were patel a alta, Blumensaat line, anterior cruciate ligament (ACL) injuries and ACL reconstruction. Thirty-nine studies were accorded with the inclusion criteria. RESULTS AND CONCLUSION:Blumensaat line represents the tangential y hit part of the roof in the intercondylar fossa. The line can be used for diagnosing ACL injuries and directing ACL restruction. (1) Blumensaat line and patel a alta:Patel a heights can be measured with the use of Blumensaat method, modified Blumensaat method and modified Blumensaat ratio. Modified Blumensaat ratio was found by Japanese researchers in 2014 and it is efficient. (2) Blumensaat line and ACL injuries:Blumensaat angle is formed by Blumensaat line and ACL. If this angle is negative or it is greater than 15°, we can draw a conclusion that the ACL was hurt. (3) Harner’s method can be used for choosing an accurate isometric point and a perfect bone tunnel’s angel in ACL reconstruction.