Objective:To construct recombinant expression vector of human augmenter of liver regeneration(ALR)and study its protective effect on liver function.Methods:ALR cDNA was synthesized and inserted into expression vector pET28a+.The recombinant plasmid was tranformed into BL21 and the expression of ALR was induced by isopropyl-?-D-thio- galactoside(IPTG).MTT method was used for cell proliferation assay;the protective effect of recombinant product on liver function was observed in CCl_4-induced acute toxic mouse model.Results:Recombinant expression plasmid of ALR was con- firmed correct by restriction enzyme digestion and sequencing.The purified expression product had strong stimulatory effect on hepatocyte proliferation.Low and medium dodges of expression product decreased aminotransferase level in acute chemical injury mouse model.Conclusion:The recombinant expression vector of ALR has been correctly constructed and the expressed rALR can simu- late hepatocyte regeneration.

Objective To explore the value of combined detection of carbohydrate antigen 125(CA125),human epididymis secre-tory protein 4 (HE4)and plasma D-dimer in early diagnosis of ovarian cancer.Methods Fifty-six patients with ovarian cancer and 50 patients with benign ovarian tumors in the gynecology department of our hospital from January 2014 to June 2016 were selected. Contemporaneous 50 women undergoing healthy physical examination were selected.The chemiluminescence method was adopted to determine serum CA125 and HE4 levels,and the immune turbidimetry method was adopted to detect plasma D-dimmer level.Their early diagnostic values for ovarian cancer were comparatively analyzed.Results The serum CA125 and HE4 levels and plasma D-di-mer level in the cancer group were significantly higher than those in the control group with statistical difference(P<0.05),moreo-ver HE4 had higher sensitivity(89.28%)and higher specificity (88.00%)for detecting ovarian cancer.In the 3-index combined de-tection,sensitivity and specificity were greatly improved.Conclusion The combined detection of CA125,HE4 and plasma D- dimer can improve the accuracy of early diagnosis of ovarian cancer.

Three problems of treatment based on syndrome differentiation, TBSD are discussed here. Firstly, in allusion to the diversity of the concept of TBSD, the due medical concept of it are discussed and analyzed. Hence, the actual difference and sameness, the due relationship as well as the principle of management between syndrome differentiation and disease differentiation are fully compared. Finally, the concrete operation procedure of syndrome differentiation and disease differentiation are expounded. The author detailedly introduced particular cognition to standardized operation of TBSD attained from Yao Hesheng, a famous physician in Jiangxi Province.

In view of the contradictory phenomenon between yingfen dominating the interior when suffering exogenous epidemic febrile disease and ying disease dominating the exterior in cold pathogenic diseases,the authors revealed the misunderstanding of yingfen dominating the interior in epidemic febrile disease by a systematical analysis on the headstream of the theory,the connotation for diagnosis and treatment and logical relation. Based on the requirement of the theory guiding the clinical effectively,at the same time,the authors put forward a new opinion on classification of diagnosis and treatment on wei,qi,ying,blood system by the theory of the cold integrating the warm,which was a courageous exploration for the purpose of seeking unity of thinking on syndrome differentiation and treatment of external infection diseases.

In view of the contradictory phenomenon between yingfen dominating the interior when suffering exogenous epidemic febrile disease and ying disease dominating the exterior in cold pathogenic diseases,attemping to get the logical demonstration that cold pathogenic diseases and exogenous epidemic febrile diseases can be integrated by yingfen diseases,the authors made a systematic classification and comparison on basis of the collection of related diagnosis and treatment in respective yingfen diseases of cold pathogenic diseases and exogenous epidemic febrile disease. It was of vital importance to connecting cold pathogenic diseases with exogenous epidemic febrile diseases in classification of diagnosis and treatment in wei,qi,ying,blood system.

Objective To explore the effects of nicorandil on cardiac function and clinical outcomes in patients with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI). Method Sixty-six patients with AMI were randomized into a control group and nicorandil group (n = 33 for each group). In the nicorandil group, nicorandil (4 mg as a bolus injection followed by constant infusion at 8 mg/hour for 24 hours) was administered immediately after admission. Reactive oxygen species (ROS) formation was assessed by measuring urinary excretion of 8-epi-prostaglandin F2α (PGF2α) and compared between the two groups; cardiac function and cardiac events were also compared. Results Urinary 8-epi-PGF2αexcretion was increased 2-fold at 60 to 90 minutes after PCI in the control group, whereas it was unchanged in the nicorandil group (P < 0.001). Left ventricular ejection fraction and cardiac index immediately after PCI and at 6 months were greater in the nicorandil group than in the control group(P < 0.05). Rates of total inhospital cardiac events and rehospitalization were lower in the nicorandil group than in the control group (P<0.05). Conclusions Nicorandil improves cardiac function and clinical outcomes in patients with AMI undergoing primary percutaneous coronary intervention. Suppression of ROS formation may be involved in the potential mechanism.

Objective To discuss nursing care of patients underwent corneal Descemet stripping endothelial keratoplasty to treat bullous keratopathy. Methods 22 patients who underwent corneal Descemet stripping endothelial keratoplasty to treat bullous keratopathy accepted strengthened psychological care, perfect preoperatively preparation, to sleep in face-up supine position, meanwhile complications were observed and treated carefully. Results 22 patients could persist in sleeping in face-up position for 4days postoperatively. Graft shift occurred in two cases. And after gas reinjection the grafts adhered very well. Intraocular pressure rose in 7 cases .After timely treated these 7 patients were cured and discharged. Conclusions Careful preoperative evaluation and preparation could reduce postoperative complication. Strict measures to keep patients sleeping in face-up supine position, timely observation and treatment of complications should be important to ensure the success of the operation.

OBJECTIVE:To understand the prophylactic antibiotics use in general surgeries performed in the hospital where the authors work.METHODS:500copies of discharge record of common surgical cases written between Jul.2005and Feb.2006were checked randomly,and the questionnaires about the general data and medication of the patients were filled out.Then the collected data were analyzed statistically.RESULTS:The prophylactic drug use rate in TypeⅠincision operations reached up to98.8%,of which58.5%cases lacked clear indications of medication.The high rate of prophylactic drug use,improper time of drug use,and the prolonged continuous drug use were among the problems that existed in TypeⅠand TypeⅡincision operation.CONCLUSION:There remain many problems in the use of prophylactic antibiotics in the general surgeries performed in our hospital,which requires the strengthening of standardized administration of prophylactic antibiotic use.

Objective: To investigate of e-cigarette use among middle school students in Hainan Province, so as to provide insights into tobacco control among adolescents. Methods: Students were randomly sampled using a multistage stratified cluster random sampling method from three junior high schools, two high schools and one vocational high school in Hainan Province from July to October, 2021. Participants' basic features, use of e-cigarettes, e-cigarette advertising exposure were collected using the Questionnaire on Tobacco and Alcohol Prevalence among Chinese Adolescents in 2021 prepared by Chinese Center for Disease Control and Prevention. Following data weighting, students' use of e-cigarettes and exposure to e-cigarette advertisements were descriptively analyzed, and factors affecting current use of e-cigarettes were identified using a multivariable logistic regression model. Results: A total of 8 561 questionnaires were allocated, and 8 538 valid questionnaires were recovered, with an effective recovery rate of 99.73%. The respondents included 4 470 boys (52.35%) and 4 068 girls (47.65%), and there 4 367 junior high school students (51.15%), 3 482 high school students (40.78%), and 689 vocational high school students (8.07%). The rate of e-cigarette use was 25.01% and the rate of current e-cigarette use was 4.68%. There were 2 728 respondents with exposure to e-cigarette advertising during the past 30 days, and the number of weighted individuals were 210 932 (32.60%). The route of e-cigarette advertising exposure mainly included point-of-sale (21.59%), stores (13.61%), and shopping websites (9.01%). Multivariable logistic regression analysis identified region (OR=0.610, 95%CI: 0.482-0.772), males (OR=1.332, 95%CI: 1.062-1.669), high school students (OR=0.376, 95%CI: 0.259-0.545), companion smoking (OR=6.645, 95%CI: 4.935-8.948) and advertising exposure (OR=3.229, 95%CI: 2.581-4.040) as factors affecting current use of e-cigarettes. Conclusions The use of e-cigarettes among middle school students is higher in Hainan Province than the national level, and exposure to e-cigarette advertisements may facilitate use of e-cigarettes. It is necessary to strengthen the supervision of e-cigarettes, strictly restrict e-cigarettes advertisements and promotions.

Objective To investigate the colonization of Gram-negative bacilli carrying mcr-1 gene in intestinal tracts of inpatients and people having physical examination for further elucidating the molecular and epidemiological features of mcr-1 gene. Methods A total of 1263 and 750 fecal specimens were col-lected from inpatients in the First Affiliated Hospital of Guangzhou Medical University and people having physical examination in the Kingmed Physical Examination Centre, respectively. Drug-resistant bacteria were isolated using Maconkey agar supplemented with colistin. PCR was performed to detect the bacteria carrying mcr-1 gene. Multilocus sequence typing ( MLST) and enterobacterial repetitive intergenic consensus-PCR ( ERIC-PCR) were used for homology analysis. The transferability of mcr-1 gene was verified by plasmid transfer assays. Plasmids of mcr-1-carrying strains were typed by PCR-based replicon typing techniques. Twelve virulence-related genes were also detected by PCR. Results Ninety-two colistin-resistant strains were isolated from the 1263 samples from inpatients(7. 3％, 92/1263) and two of them were positive for mcr-1 gene ( one strain also carried the blaNDM-5 gene) . Thirty-six colistin-resistant strains were isolated from the 750 samples of physical examination group (4. 8％, 36/750) and one of them carried the mcr-1 gene. MLST analysis showed that three mcr-1-carrying Escherichia coli strains ( minimum inhibitory concentration of colistin:8 μg/ml) belonged to three different sequence types. Moreover, they exhibited different banding patterns in ERIC-PCR analysis. All of the mcr-1-carrying isolates could transfer mcr-1 gene to the recipient strains successfully. Six types of incompatibility plasmids were detected in the mcr-1-carrying isolates ( IncFⅡ, IncX2, IncHI2, IncFIB, IncX4 and IncX1). Virulence-related genes fimH, iutA and fyuA were detec-ted in all mcr-1-carrying Escherichia coli strains. Conclusions Colistin-resistant strains and mcr-1 gene are prevalent in inpatients and people having physical examination, which brings potential risk for the control of clinical infections.