As the most important gap junction protein, connexin 43 ( Cx43 ) is the most important connexin in the mammalian heart.Recent studies suggest that it plays an important role in heart development, cardiac electrophysiological activity and cell repair after myocardial ischemia.Cx43 abnormity is an important cause of many cardiovascular diseases including congenital heart disease, ischemic heart disease, arrhythmias and hypertension.The expression of Cx43 is regulated by various factors, including methylation, histone modification and non-coding RNA regulation, etc. These abnormal regulations may be important for the development of diseases.

Objective To observe the application effect of nursing intervention in the risk management of emergency department,and provide theoretical basis for subsequent work.Methods From January to December,2010,nursing intervention concepts were introduced to risk management in the emergency department and relevant work was carried out,1268 patients were admitted during this period.754 patients before nursing intervention from January to December,2009 were selected.The results were analyzed and compared before and after nursing intervention was implemented.Results The satisfaction degree after nursing intervention was 98.00％,significantly higher than 80.00％ before the nursing intervention.The nursing error or fault was 1 case after nursing intervention,and was 10 cases before the nursing intervention.The annual theoretical examination score was (76.48 + 12.14) and (86.44 + 10.43) before and after nursing intervention,the difference was statistically significant.Condusions The application of nursing intervention in the risk management of the emergency department can improve patients' satisfaction degree,reduce the nursing error and negligence,improve the ability of nursing staff,so it has certain application value.

Objective Previous studies have found that micheliolide(MCL) could improve the sensitivity of breast cancer cells to chemotherapeutic drugs such as cisplatin and induce the apoptosis of breast cancer cells.This article aims to study the proliferation inhibition effect of micheliolide on lung cancer cells H460 and its underlying mechanism.Methods Human lung cancer cell line H460 was treated with different concentrations of micheliolide(30,60,90μmol/L).Then the cell proliferation was measured by-CCK8 and plate colony formation assays.The apoptosis and the cell cycle were detected by flow cytometry.Western blot was used to determine the mechanism of how MCL affecting cancer cell H460.Results Compared with the control (275.00±7.21), the clone numbers after 30μmol/L,60μmol/L and 90μmol/L MCL treatment(199.00±5.66,166.00±1.41, 90.00±7.81) were significantly decreased (P<0.05).Meanwhile, the CCK-8 results showed that compared to the control group, A value was significantly increased after 30μmol/L MCL treatment for 72h and 96h, and 60μmol/L or 90μmol/L MCL treatment for 48h,72h and 96 h (P<0.05).Compared with the control apoptotic ratio [(2.90±0.03)％], the ratio of early and late apoptotic cells after 30μmol/L, 60μmol/L and 90μmol/L MCL treatment [(5.23±0.76)％, (9.06±0.47)％, (19.00±0.64)％] were significantly increased (P<0.05).Compared with the control group, the ratio of G2/M phase cells[(12.52±0.88) ％ ,(17.22±0.43)％, (19.84±0.31)％] was gradually increased after 30μmol/L, 60μmol/L and 90μmol/L MCL treatment, and there was statistically significant difference after 60μmol/L and 90μmol/L MCL treatment (P<0.05).The ratio of S+G1/G0 phase cells[(87.53±1.06)％ ,(82.94±0.67)％ ,(79.79±0.21)％] was gradually decreased after 30μmol/L, 60μmol/L and 90μmol/L MCL treatment, and there was statistically significant difference after 60μmol/L and 90μmol/L MCL treatment (P<0.05).The expression level of notch4 was significantly decreased after 30μmol/L, 60μmol/L and 90μmol/L MCL treatment (P<0.05), while the expression level of cleaved caspase3 was significantly upregulated (P<0.05).Conclusion MCL exerted an inhibitory effect on lung cancer cell H460.

Objective To investigate the impact of cerebral microbleeds (CMBs) on cognitive function in ischemic stroke patients.Methods A total of 268 acute ischemic stroke patients recruited in the Ningbo First Hospital from January 2014 to June 2015 were divided into CMBs group (199 patients) and non-CMBs group (69 patients) according to whether complicated with CMBs by susceptibility-weighted imaging (SWI).According to the microbleed number, CMBs group patients were divided into 2 grades: grade 1 (1-5 CMBs) and grade 2 (≥6 CMBs). Montreal Cognitive Assessment (MoCA) was used to evaluate and compare the global cognitive function and cognitive domains of the patients. Results The total MoCA score and the scores of visuospatial/executive, attention domains in CMBs group were 20.95±4.53, 2.53±1.09, 3.83±0.97, while those in non-CMBs group were 26.82±1.25, 3.16±1.24 and 4.91±0.84. The total MoCA score and the scores of visuospatial/executive, attention domains were significantly lower in CMBs group than those in non-CMBs group (t=16.59, P<0.01;t=3.75, P<0.01;t=8.83, P<0.01). The total MoCA score and the score of attention domain in grade 1 CMBs group were 21.53±4.61 and 4.11±0.91 , which were significantly lower than those in non-CMBs group (t=14.09, P<0.01;t=14.23, P<0.01). Whereas the total MoCA score and the scores of visuospatial/executive, attention, orientation domains in grade 1 CMBs group were 21.53±4.61, 2.88±1.06, 4.11±0.91, 4.96±0.40, which were significantly higher than those in grade 2 CMBs group (18.58±3.08, 2.23±0.95, 3.63±1.01, 3.85±0.39, respectively;t=2.85, P<0.01;t=2.54, P<0.05;t=5.63, P<0.01;t=2.58, P<0.01). Multivariate regression analysis showed that independent risk factors of MoCA scores in ischemic stroke patients included CMBs (OR=3.15, 95% CI 1.28-5.12, P=0.005) and the number of CMBs (OR=1.73,95% CI 1.08-2.32,P=0.031). Conclusions CMBs and the number of CMBs were independently associated with cognitive impairment in ischemic stroke patients. And with the increasing of the microbleed number, the impairments of certain cognitive domains were more obviously.

Sepsis is essentially a result from immunological dissonance provoked by severe insults such as fulminant infection,severe trauma and extensive burns.It originates from excessive inflammatory responses and develops into immune paralysis or immunosupression.It has been demonstrated that cellular immune response plays a vital role in the pathogenesis of sepsis.In the stage of excessive inflammation,several kinds of immune cells are activated by pathogen-associated molecular patterns (PAMPs) or damage-associated molecular patterns (DAMPs) and subsequently produce a vast number of pro-inflammatory cytokines,while during the stage of immune paralysis,excessive apoptosis could result in decrease of immune cells with functional compromise.Inhibitory or regulatory immune cell subsets eventually dominate the direction of immune response and the production of inhibitory cytokines is enhanced.For clinical practice,surveillance of changes and shift in overall immune function is a basis for immunotherapy,especially to immunomodulation therapy.However,there is still a lack of adequate indexes or markers for integral evaluation of host immune state in the development of sepsis.

Objective To investigate the distribution of pathogenic bacteria in children with chronic rhinosinusitis (CRS) and their susceptibility to commonly used antibacterial drugs .Methods 95 cases of CRS complicating adenoidal hypertrophy were per-formed adenoidectomy .The secretion of maxillary sinus ostium and posterior ethmoid sinus ostium was collected during endoscopic adenoidectomy by the disinfected cotton swab for conducting the bacterial culture and the drug sensitivity test .Results 89 speci-mens showed the bacterial growth ,the positive rate of bacterial culture in all culture specimens was 93 .7% ,86 strains of aerobic bacteria ,28 strains of anaerobic bacteria .Among 95 patients ,81 cases of aerobic infection ,52 cases of anaerobic infection ,44 cases of mixed infection .The drugs susceptibility test in vitro displayed that amoxicillin and clavulanate potassium had the higher antibacte-rial activity to aerobic bacteria and metronidazole had the higher antibacterial activity to anaerobic bacteria .Conclusion Children CRS is dominated by the aerobic bacterial infection .The bacterial infection plays a larger role in children CRS .Antibacterial drugs have better effect for treating CRS .

Objective:To study the effects of somatostatin on portal pressure and operative complications in patients of portal hypertension treated with porta-azygous disconnection. Methods:Twenty patients with portal hypertension were treated with azygoportal disconnection. The severity of liver disease according to the Child-Pugh's grade was B in all patients. The patients were divided into two groups. The patients in group A were treated with intravenous infusion of somatostatin (6 mg/24 h) one day before operation and five days after operation. The patients in group B were treated with azygoportal disconnection without the use of somatostatin. The portal pressure, the volume of bleeding during operation, and the ascites and complications after operation were evaluated. The serum concentration of GLU, NO and ET-1 were determined. Results:The portal pressure and GLU concentration in patients of group A were lower than those in patients of group B. There were no differences of NO, ET-1 in patients between group A and group B. The volume of bleeding, ascites and complications in patients of group B were higher than in patients of group A. Conclusion:The use of somatostatin before and after porta-azygous disconnection can decrease portal pressure. It is beneficial in reducing the volume of bleeding in operation, ascites and complications after operation.

Communicable Disease Control ; Humans ; Influenza, Human ; prevention & control ; World Health Organization

Objective:To describe antipsychotic medication prescription patterns and estimate the associated costs for patients with schizophrenia in Tianjin,China. Methods:Data were 30%random sampling from the Tianjin Urban Employee Basic Medical Insurance (UEBMI)database. Adult patients with≥ 1 diagnosis of schizophrenia, antipsychotics prescribed at the first diagnosis of schizophrenia (index date),and 12-month continuous enrollment after the first antipsychotic prescription (follow-up period)between 2008 and 2010 were included. The classes and number of antipsychotics patients prescribed at index date and patterns of antipsychotics patients maintained/changed during the study period were described. The total direct medical costs were also estimated. Results:Among 2125 patients with schizophrenia,1739 (81. 8%)prescribed with antipsychotic medication prescriptions were in-cluded. At the index date,1461 (84. 0%)of the patients prescribed with one antipsychotic medication,278 (16. 0%)with more than two antipsychotics,and 747 (43. 0%)were prescribed with first-generation antipsychot-ics,813 (46. 8%)with second-generation antipsychotics and 179 (10. 2%)with both. During the following 12 months,1387 (79. 8%)patients remained on the index antipsychotic class. The total cost for 1739 patients was (12498. 9 ±14575. 2)CNY. The total direct medical cost was significantly lower for patients only prescribed with second-generation antipsychotics compared with ones only with first-generation antipsychotics [(9064. 1 ±13209. 8) CNY vs. (1 1928. 6 ±13767. 4)CNY,P<0. 001 ]. In addition,the cost for patients prescribed with first-generation and second-generation antipsychotics was 18821. 8 ±15702. 7 CNY. Conclusion:Majority of patients are prescribed with monotherapy,and tend to stay with one antipsychotic medication class. The total medical cost for patients with second-generation antipsychotic medications is lower than first-generation ones.

Objective To investigate the possibility of tumor abnormal protein ( TAP) ,as index of diag-nosis and prediction of prognosis in gastrointestinal tumors (GITs).Methods The outpatients and inpatients as well as healthy physical examinees in our hospital were chosen as objects in the present study .The patients were divided into GIT group(120 cases),high-risk GIT group(123 cases)and normal group(117 cases).TAP ex-pression was detected in three groups.These study objects were followed up for one and a half years .Then the re-lationship between TAP expression and the occurrence or recurrence of tumors was analyzed .Rseults There were significant differences(P<0.001)among the three groups on the positive TAP with critical expression rate .TAP detections to GITs diagnosis sensitivity ,specificity ,positive predictive value ,negative predictive value and Youden index were 88.33%,85.83%,75.71%,93.64% and 0.74 respectively.TAP positive non GITs crowd tumori-genesis proportion (23.53%)was significantly higher than that of TAP -negative(0.49%)(P<0.001).GITs TAP positive patients relapse rate(33.33%)was significantly higher than negative ones (6.90%)(P<0.001). Conlcusion TAP can be an index for diagnosis ,early prevention ,monitoring of treatment effect and prediction of prognosis of gastrointestinal tumor .