In order to understand the resistance against common antibiotics in clinic and macrolide antibiotic-resistant mechanism of Streptococcus pneumoniae (S.pneumoniae) isolates in Zhejiang area,both K-B slip method and E-test were applied to determine the sensitivity of 138 S.pneumoniae isolates to nine antibiotics,and the ermB and mefE genes in those isolates which associated with macrolide antibiotics-resistance closely were detected by PCR.Subsequently,correlation among ermB and mefE genes and the erythromycin resistance were analyzed.For these 138 S.pneumoniae isolates,93.5% (129/138) of the strains were resistant to erythromycin,but only 2.9%～4.3% strains were resistant to cefotaxim,cefuroxime,amoxicillin and levofloxacin.The positive rate of ermB gene in the isolates (91.3%,126/138) was significantly higher than that of mefE gene (33.3%,46/138) (P<0.05).Both of these two genes existed in 27.5 % (38/138) of the strains and all of the strains without ermB and mefE genes were sensitive to erythromycin.The erythromycin resistance rate (62.5%) of mefE gene positive strains was remarkably lower than that of the mefE&ermB gene positive strains (100%) and the ermB gene positive strains (97.7%) (P<0.05).All the data mentioned above demonstrated that erythromycin is not an appropriate antibiotic to treat the infectious diseases caused by S.pneumoniae.Moreover,ermB is the predominant erythromycin resistance gene in S.pneumoniae isolates and ermB gene could inspire stronger erythromycin resistance than mefE gene.

Objective To investigate the relation among clinical nurses′resilience, emotional, the pressure load and self-efficacy with the 10-item Connor-Davidson Resilience Scale. Methods A total of 449 nurse in Guangzhou were recruited to investigate by 10-item Connor-Davidson Resilience Scale (CD-RISC-10), Kessler 10 Scale (K10), General Self-Efficacy Scale (GSES), Chinese Stress Overload Scale (SOS). Results The average score was 23.6±6.7 for CD-RISC-10 , 24.4±8.2 for K10,24.7±5.7 for GSES , 63.3 ±16.6 for SOS ,and the individual vulnerability scoring was (31.2±10.0) points, events load was (32.0±7.5) points. High mental toughness of nurses in general self-efficacy scores higher than that of low mental toughness group (t=-8.53, P<0.01), in the K10 dated, S0S scores were lower than low mental toughness group (t=11.23, 7.70, P<0.01). Nurse relevant regression analysis results showed that gender, general self-efficacy, K10 dated, SOS as the main factors influencing nurses mental toughness, could explain 40%of variances. Conclusions The CD-RISC-10 can better reflect the level of clinical nurses′resilience, and the gender, self-efficacy were the main effects, as well as effectively predict the nurses′emotional distress and stress level. However how to improve the toughness of the clinical nurses need more research.

Objective To observe the protective effect of Xiaohuangdecotion against liver damage inα-naphthylisothiocyanate (ANIT)- induced cholestasis in rats and probe the potential mechanisms.Methods Male Wistar rats (40) were randomly divided into a normal group, a model group, aXiaohuangdecotion treatment group, and a UDCA control group (10 for each). Except for rats in the normal group, ANIT solution (6 ml/kg) was administered in other rats by gavages for cholestasis model. After ANIT treated 48 h, rats inXiaohuangdecotion group and UDCA group were treated withXiaohuangdecotion (1.73 g/kg) and UDCA (10 mg/kg) respectively for 1 week. And, rats in the normal group and the model group were given an equal volume of saline. At the end of the experiment, liver function rats were examined. Liver histology was examined by HE staining, and CD68 factor was tested by immunohistochemistry and Western blot.Results Compared with the model group, the content of ALT (164.6 ± 53.4 U/Lvs. 208.4 ± 28.5 U/L), AST (247.6 ± 76.1 U/Lvs. 341.8 ± 32.8 U/L), ALP (601.0 ± 101.1 U/Lvs. 720.6 ± 123.3 U/L), TBiL (96.5 ± 18.1μmol/Lvs. 149.6 ± 30.2μmol/L), DBiL (73.7 ± 16.6μmol/Lvs. 140.3 ± 28.6μmol/L) and TBA (93.4 ± 13.0μmol/Lvs. 146.5 ± 38.9μmol/L) were significantly reduced in the treatment group (P<0.01 orP<0.05). Compared with the model group, CD68 level (7.08 ± 0.19 vs. 17.42 ± 0.48)were significantly reduced by intervention ofXiaohuangdecotion (P<0.01).ConclusionsXiaohuangdecotion could improve liver functions and reduce CD68 expression, leading to a good hepatoprotective and jaundice-relieving effects.

Objective To evaluate the relationship between long non-coding RNAs (LncRNA) in tumor tissues and clinico-pathological features of hepatocllular carcinoma (HCC).Methods Using hepatocellular carcinoma gene database GSE36376,we conducted a study on eight LncRNAs which are associated with liver diseases and analyzed the correlation between these LncRNAs and HCC clinico-pathological characteristics.We also evaluated the potential effect of LncRNAs on HCC development.Results H19 was overexpressed in non-tumorous tissues of HCC (P ＜ 0.05),while MEG3,HOXA13,KCNQ1OT1 were all upregulated in tumorous tissues (all P ＜ 0.05).HULC level in HCC tumorous tissues was negatively correlated with AJCC staging,BCLC staging and tumor size (all P ＜ 0.05).UCA1 was positively correlated with BCLC staging (r =0.135,P ＜ 0.05).Univariate analysis and multivariate logistic analyses showed that UCA1 was a risk factor of intrahepatic metastasis of HCC (OR =6.054,95％ CI =1.429 ～ 25.642,P ＜ 0.05); in contrast,HULC overexpression in tumorous tissues played a positive role in HCC tumor size (OR=0.805,95％CI=0.678 ～0.956,P＜0.05).Conclusion HULC in tumorous tissues suppressed HCC proliferation,while UCA1 was a risk factor of HCC aggressiveness.

Hypoxic-ischemic brain damage is a serious complication of perinatal asphyxia. Enriched environment is the living condi-tions for the promotion of feeling, cognition and behavior. Enriched environment may promote the repairing of hypoxic-ischemic brain dam-age in term of praxiology, morphology and molecular biology, that enriched environment may regulate the secretion and release of various factors, and enhance synaptic plasticity, induce neuron regeneration, inhibit its apoptosis, and result in ethological and morphological recov-ery.

Objective To investigate the effect of exercise preconditioning on serum level of tumor necrosis factor α (TNF-α), interleukin (IL) -1β and IL-6 in rats after cerebral ischemia-reperfusion (I/R). Methods 24 male Sprague-Dawley rats were randomly divided into exercise preconditioning group (n=8), model group (n=8) and sham group (n=8). The middle cerebral arteries were occluded for 120 min and re-perfused. All the rats were evaluated with neurological deficit score 2 hours, 24 hours after I/R. The serum levels of TNF-α, IL-1β and IL-6 was detected with enzyme-linked immunosorbent, and the pathology was observed with HE staining 24 hours after I/R. Results The neurological deficit score decreased in the exercise preconditioning group compared with that in the model group, as well as the serum TNF-α, IL-1β and IL-6 (P<0.05) 24 hours after I/R. The pathological damage and interstitial edema alleviated in cerebral ischemia cortical, and the degeneration and necrosis of the neurons in the ischemic area significantly reduced in the exercise preconditioning group. Conclusion Exercise preconditioning may inhibit inflammatory response in I/R rats to protect neurological function from impairment.

Objective To study the effect of cluster needling of scalp acupuncture combined with rehabilitation on neurological function and expression of basic fibroblast growth factor (bFGF) and angiostatin (AS) in rats after focal cerebral ischemia. Methods 90 male Sprague-Dawley rats were randomly divided into sham operation group, model group, acupuncture treatment group, rehabilitation treatment group and acupuncture and rehabilitation treatment group, each group was further divided into 3 days, 7 days and 14 days subgroups (n=6). Permanent cerebral ischemia rat model was established according to Longa's method. The model group and the sham operation group accepted no treatment, the acupuncture treatment group was treated by cluster needling of scalp acupuncture, the rehabilitation treatment group received the treadmill training, the acupuncture and rehabilitation treatment group was treated by acupuncture and rehabilitation therapy. 3 days, 7 days, 14 days after operation, the neural function was evaluated with the modified Neurological Severity Score (mNSS), the expression levels of bFGF and AS proteins were detected by Western blotting. Results Compared with the model group, the acupuncture treatment group and the rehabilitation treatment group, mNSS decreased, the expression of bFGF protein increased, and the expression of AS protein decreased in the acupuncture and rehabilitation treatment group 3 days, 7 days, 14 days after operation (P<0.05). Conclusion Acupuncture and rehabilitation therapy can reduce the neurological function defect in rats with focal cerebral ischemia, which may be related to the upregulation of bFGF protein expression and down-regulation of AS protein expression.

Objective To analyze the treatment results of primary nasopharyngeal carcinoma(NPC)treated by four different external beam radiation therapy(EBRT)techniques in Sun Yat-sen University Cancer Center in the beginning of the 21 st century.Methods The data of 1093 hospitalized primary NPC patients treated in Sun Yat-sen University Cancer Center between December 2001 and June 2003 were retrospectively analyzed.The stage distribution(by AJCC/UICC,2002)was 63,439,358 and 233 patients in Stage Ⅰ,Ⅱ,Ⅲ and Ⅳa+Ⅳb.Definitive radiotherapy was given to all patients and the median total dose was 70 Gy.Four different EBRT techniques were used:812 patients with fluoroscopy simulation conventional radiotherapy(CR),155 patients with CT simulation conventional radiotherapy(CT-sim CR),69 patients with three dimensional conformal radiotherapy(3DCRT)and 57 patients with intensity modulated radiotherapv(IMRT). Results The 5-year local failure-free rate(LFFR),nodal failure-free rate(NFFR),and distant metastasis-free rate(DMFR)were 86.8%,95.3%and 83.2%,respectively.The 5-year progressionfree survival(PFS)and overall survival(OS)were 66.9%and 77.9%,respectively.Different EBRT techniques influeneed the OS and the LFFR of patients,the 5-year OS and LFFR of group CR,CT-sim CR,3DCRT and IMRT were 75.9%,83.5%,87.2%,86.6% and 84.5%,96.4%,91.0%,91.7%,respectively(P=0.014 and 0.006).The morbidity and severity of xerostomia and trismus were sigficantly lower in group 3DCRT and IMRT than in group CR and CT-sim CR(P=0.000 and=0.023). Conclusion The CT simulation technique,3DCRT and IMRT can improve the OS,LFFR and life qualitv of patients with primary NPC.

Objective To explore the effect of exercise preconditioning on apoptosis and expression of P53 protein in ischemic penum-bra in rats after cerebral ischemia-reperfusion. Methods Thirty-six Sprague-Dawley rats were randomly divided into sham group, model group and exercise preconditioning group, with twelve rats in each group. The middle cerebral artery occlusion (MCAO) model was estab-lished with modified Longa's method. TUNEL method was used to observe the apoptosis of neural cells in the ischemic penumbra. Western blotting was used to detect the expression of P53 protein in the ischemic penumbra. Results Twenty-four hours after cerebral ischemia-reper-fusion, the number of TUNEL positive cells was more in the model group than in the sham group (P<0.01), and was less in the exercise pre-conditioning group than in the model group (P<0.01). The expression of P53 protein was higher in the model group than in the sham group (P<0.01), and was lower in the exercise preconditioning group than in the model group (P<0.01). Conclusion Exercise preconditioning coud down-regulate the expression of P53 protein in the ischemic penumbra, and inhibit the apoptosis of cortical cells.

Objective To investigate the level of caregivers′burden and the coping style among parents of cancer children. Methods Totally, 229 parents of cancer children participated in the investigation by Chinese version of zarit burden interview (ZBI), Chinese version of coping health inventory for parents (CHIP) and self-designed general information questionnaire. The associations between caregivers′burden and coping styles were tested by Spearman correlation analysis. Results The caregiver′s burden on the parents was in the middle level with a total score of (30.50 ± 12.24). The coping style the parents took most frequently was to unite the family and keep a positive attitude and regard it as most effective. The caregiver′s burden was negatively associated with the positive coping style . Conclusion The parents of cancerous children suffer from middle level of burden . Nurses should assess the caregiver′s burden, provide targeted interventions to relieve it, help the to establish effective coping style and change their psychological and mental state and ultimately improve their quality of life.