Objective To investigate the effects on anti-expression of Osteopontin (OPN) by an antisense oligodeoxynucleotide (ASODN) targeting to low free energy region of OPN mRNA and its effects on the proliferation and apoptosis of human breast carcinoma cell line MCF-7. Methods Designing and synthesizing an ASODN based on minimum free energy algorithm in vitro,which targets to the low free energy region of OPN mRNA. Transfecting it into breast carcinoma cell line MCF-7 which expresses OPN in high level. The cell proliferation-inhibitory rate was determined by MTT method;The morphologic change was observed through transmission electron microscope (TEM);The OPN mRNA expression level was checked by RT-PCR method;Cell cycle and apoptosis rate were detected by flow cytometry (FCM) after transfection respectively. Results OPN ASODN inhibited the proliferation of the cells by a time and concentration dependent manner (P

Objective To investigate the value of cardiac troponin Ⅰ (cTn Ⅰ) in diagnosis of multi-trauma patients combined with myocardiac contusion.Methods A retrospective review was made on 98 cases of multi-trauma patients combined with blunt chest trauma.The groups were identified according to whether the patients were associated with myocardiac contusion or not,including myocardiac contusion group (n =48) and non-myocardiac contusion group (n =50).The detection and diagnosis of myocardiac contusion in the use of different cut-off points of cTn Ⅰ and creatine kinase MB isoenzyme/creatine kinase (CKMB/CK) or their combination were compared between groups.Results cTn Ⅰ ≥0.60 ng/ml had a specificity of 90.0％,a sensitivity of 64.6％ and a Youden index of 0.54 in diagnosis of myocardiac contusion,indicating a best diagnostic accuracy as a single parameter.As compared with the single use of cTn Ⅰ ≥ 0.60 ng/ml or CKMB/CK ≥ 6％ in diagnosis of myocardiac contusion,the combined use of two parameters presented a significantly higher diagnostic sensitivity (85.4％ vs 64.6％ ; 85.4％ vs 27.1％ respectively,both P ＜ 0.05),but no markedly lower specificity (84.0％ vs 90.0％ ; 84.0％ vs 88.0％ respectively,both P ＞0.05).cTn Ⅰ level was positively correlated with ISS score of the multi-trauma patients combined with myocardiac contusion (r =0.534,P ＜ 0.01).Mortality rate in patients with severely increased cTn Ⅰ was much higher than that in patients with mild-moderately increased cTn Ⅰ (P ＜ 0.01).Conclusions cTn Ⅰ ≥0.60 ng/ml presents a high sensitivity and preferable specificity for diagnosis of multiple trauma patients combined with myocardiac contusion.It can be served as a biomarker for diagnosis of MC and its combination with CKMB/CK≥6％ improves the diagnostic sensitivity.cTn Ⅰ can be used as an assessment indicator for the early risk stratification and outcome in multi-trauma patients combined with myocardiac contusion.

Objective To investigate the effects of colon dialysis on chronic renal failure(CRF).Methods 120 patients with CRF were randomly divided into two groups and they were given the same conventional therapy including alimentary control,blood pressure control,etc.The A group (colon dialysis group,n=60) was given colon dialysis,the B group (conventional therapy group,n=60) was given conventional therapy for 4 weeks.The serum creatinine(SCr),urea nitrogen,24 h proteinuria were observed in two groups.The therapeutic effects of colon dialysis were assessed by the changes of SCr.Results The colon dialysis and conventional therapy can decrease the SCr from (363.97±82.34) μmol/L to (280.87±87.52) μmol/L and (371.73±87.46) μmol/L to (339.90±68.59) μmol/L respectively.The former was more effective than the latter.The effects of colon dialysis in the renal function compensation stage and decompensation stage were more effective than in renal failure stage but no difference was detected between the former stages.Conclusions The colon dialysis has certain effects to CRF,especially to those with serum creatinine ＜443 μmol/L can get more benefit.

Objective To analyze the consistency of individual examination diagnosis with terminologies expressed in the conclusion report of physical examinations by the chief inspection physician. Methods Based on the clinical classifications used in the Guidelines on Prevention and Treatment of Blood Lipid Abnormality for Chinese Adults, and related terminology descriptions of Dyslipidemias that were actually used in four-item blood lipid examinations diagnosis, a lexicon database of Hyperlipidemias was constructed with 39 terms used in the four-item blood lipid examination diagnosis and chief physician conclusions. Totally 11953 electronic chief physician inspection reports from 8 health check-up institutions were included. We investigated the terms of lexicon database using word frequency analysis method, calculated the positive rate in the diagnosis of four single examinations of serum lipid and the positive rate in the chief physician's conclusion. Consistency of chief physician's conclusion with single examination diagnosis was analyzed by Kappa test. Results (1) Among the 39 terms of lexicon database, there are 18 nonstandard terms used in single examination diagnosis, accounted for 46％ of all terms; (2) In word frequency analysis, there are only 1％ of terms that corresponded to clinical classifications of Hyperlipidemias accurately;(3) The positive rate of Hyperlipidemias in serum lipid four single examinations diagnosis was 47％, the positive rate of physician diagnosis was 35％. The consistency analysis of chief physician conclusions with single examination diagnosis showed Kappa=0.71(P<0.01). Conclusions Although the final conclusion written by the chief physician was not using standard terms strictly, most of synonymous terminology expressed in the physician conclusion is normative, which enabled the construction of lexicon database and text mining. Whether the single examination diagnosis are consistent with physician conclusions can be an evaluation indicator to assess the quality of chief physician conclusions for physical examinations. Kappa>0.75 may be suggested as a favorable value.

Objective To investigate the protective effect of heat shock protein (HSP) 70 on the acute lung injury (ALI) of rats with heat stroke.Methods Sixty four rats were randomly (by employing a random number table) assigned into a sham-heated group (Sham group),heat stress group (HS group),and HS plus gluttamine treatment group (HS+GLN group) and HS plus quercet in treatment group (HS+QU group),16 each.All rats were housed in a artificial climate chamber,with the rats in the sham groups exposed to a temperature of 23 ℃ and humidity of 55％ ± 5％,while the rats of HS,HS+GLN and HS+QU groups to an ambient temperature of 39 ℃ and humidity of 65％.During heat stress or sham heating,rectal temperature (Tr),systolic blood pressure (SBP) and pulse rate (PR) were monitored to observe the difference in heat stress response among the groups.The time point at which the SBP started to drop from the peak level was taken as the point of HS onset.At the onset of HS,heat exposure was terminated,then the rats were immediately removed from the chamber,and returned to room temperature.The rats were scarified 0h and 6h after HS onset respectively.After bronchoalveolar lavage fluid (BALF) was collected,the lungs of all animals were harvested for pathological examination of lung injury.The concentrations of IL-1β,TNF-α and IL-6 in BALF and HSP70 in lung homogenate were measured by using an enzyme linked immunosorbent assay kit.Results Compared with HS and HS+QU groups,the rats in HS+GLN group required significantly greater heat load to induce HS (P＜0.001),and had longer survival time span after HS onset.Compared with Sham group,the concentration of HSP70 in lung homogenate in HS group increased in a time-dependent manner (P＜0.001).In comparison with HS group,the concentration of HSP70 in lung homogenate from HS+GLN group was significantly elevated at each time point (P＜0.001),while the treatment with QU significantly inhibited the expression of HSP70 (P＜0.001).The concentration of IL-1β,TNF-α and IL-6 in BALF significantly decreased in HS+GLN group compared with those in HS group and HS+QU group (P＜0.001).The pathological results showed that the lung injury was milder in HS+GLN group,while the opposite in HS+QU group.Conclusion HSP70 could protect HS rats against ALI by enhancing their thermo-tolerance and inhibiting inflammatory response.

Objective To investigate the role of oxidative stress in acute liver injury in a heat stroke model of conscious rats,and to explore its underlying mechanism.Methods Thirty-two rats were randomly (by using a random number table) assigned into a sham-heated control group (Sham group,n=8),a sham-heated group treated with NAC (Sham-NAC group,n=8),a heat stroke group (HS group,n=8) and a heat stoke group treated with NAC (HS-NAC,n=8).Rats were prepared with pre-warm chamber to initiate heat stoke.The change of rectum temperature (Tr),heart rate (HR) and systolic blood pressure (SBP) were monitored,and the time point of HS onset was recorded.Rats were sacrificed 12h after HS onset.ALT,serum TBIL,IL-6,IL-1β,TNF-α,MDA,T-SOD and GSH in the liver homogenates were measured.Liver tissues were harvested for determining the concentration of reactive oxygen species (ROS),neutrophil infiltration and the histological changes.Results During HS onset,no significant differences were observed in Tr,HR,SBP and heat exposure time between HS group and HS-NAC group (P＞0.05).However,the survival time was significantly longer in HS-NAC group than in HS group (P=0.039).12 hours after HS onset,the concentrations of ROS and MDA in the liver homogenates were significantly higher in HS group than in the other groups (P=0.000),while the concentrations of T-SOD and GSH were much lower than in the other groups (P=0.000).The serum concentrations of ALT and TBIL were significantly higher in HS group than in the other groups (P=0.000).Compare with HS group,the pathological injury was alleviated in HS-NAC group (P=0.000).The neutrophil infiltration level and the concentrations of IL-6,IL-1 β and TNF-α in liver tissue were significantly higher in HS group than in HS-NAC group (P=0.000).Conclusion Oxidative stress may play an important role in the pathogenesis of HS liver injury through its cytotoxic effect and by inducing inflammatory responses.

ObjectiveTo investigate the temporal features of renal injury in rats with severe heat stroke (SHS) and their relationship with inflammatory response.Methods Fifty-six male Wistar rats were randomly divided into normal control group and SHS for 0, 2, 6, 24, 48, 72 hours group (SHS-0, 2, 6, 24, 48, 72 h groups), with 8 rats in each group. Rats were placed in an artificial climate chamber [temperature (39.5±0.2)℃, humidity (60±5)%] to induce SHS model, and the criterion for successful model reproduction was the onset of lowering peak systolic blood pressure (SBP). Then the rats were transferred to room temperature (23.0±0.2)℃ after successful reproduction of the model. The rats of normal control group were kept in room temperature of (23.0±0.2)℃. Heart blood and renal tissue samples were harvested, and the levels of serum creatinine (SCr) and blood urea nitrogen (BUN) were determined by automatic biochemistry analyzer. The levels of myeloperoxidase (MPO), tumor necrosis factor-α(TNF-α) and interleukin-6 (IL-6) in renal tissue specimens were determined by enzyme linked immunosorbent assay (ELISA). The changes in histopathology in kidney were observed with light microscopy, and Paller scores were used to assess the degree of renal injury.Results Compared with normal control group, the levels of SCr and BUN in serum, and MPO, TNF-α and IL-6 in the renal tissue homogenate were significantly increased in SHS-6 h group [SCr (μmol/L): 174.0±27.0 vs.68.0±11.3, BUN (mmol/L): 12.6±2.3 vs. 4.3±1.2, MPO: (203.0±38.0)% vs. (100.0±1.4)%, TNF-α: (121.0±16.0)% vs. (100.0±1.4)%, IL-6: (118.0±19.0)% vs. (100.0±1.3)%, allP< 0.05], and they peaked at 24 hours [SCr (μmol/L): 489.0±96.0 vs. 68.0±11.3, BUN (mmol/L): 19.3±5.7 vs. 4.3±1.2, MPO: (511.0±41.0)% vs. (100.0± 1.4)%, TNF-α: (399.0±47.0)% vs. (100.0±1.4)%, IL-6: (473.0±56.0)% vs. (100.0±1.3)%, allP< 0.01], then declined to the normal levels at 72 hours. Under light microscopy, tissue edema and necrosis of renal tubules were found, and leukocyte infiltration was found to be most profuse at 24 hours, then they returned to normal levels at 72 hours. Paller scores in SHS-6 h group were significantly higher than those of the normal control group (75.45±9.70 vs. 14.23±3.26,P< 0.01), and it peaked at 24 hours (186.00±14.25 vs. 14.23±3.26,P< 0.01), followed by a gradual lowering, back to normal level at 72 hours.ConclusionThe results suggest that progressive renal damage occurred in the rats with SHS within 24 hours, and it was accompanied with elevated levels of MPO, TNF-α and IL-6 in the kidney homogenate, suggesting that inhibition of neutrophil activation and the release of IL-6, TNF-α may protect the SHS associated renal injury.

Objective To retrospectively investigate the distribution,molecular epidemiology and carbapenemases-encoding genes of carbapenem resistant K lebsiella pneumoniae(CRKP)in Zhejiang Province.Methods A total of 772 clinical isolates of K.pneumoniae isolated from 9 hospitals in Zhejiang Province in 2011 were selected,and antimicrobial susceptibility testings were carried out with disk diffusion or broth microdilution method.Polymerase chain reaction(PCR)was used to detect resistant genes,and molecular typing was performed by multilocus sequence typing(MLST)and pulsed field gel electrophoresis(PFGE).Results A total of 48 CRKP(6.2%)were screened in 9 hospitals. Carbapenemase-encoding genes were detected in 39 isolates by PCR,among which 37(77.1%)were identified as blaKPC-2and 2 were blaIMP-4.MLST showed that ST11 was the dominant ST type(30, 62.5%).Results of PFGE showed that 48 CRKP can be divided into 15 types.CRKP was found in 6 hospitals except hospitals in Wenzhou,Jiaxing and Shaoxing.Conclusions In 2011,CRKP is distributed in most areas of Zhejiang Province.The production of KPC-2 is the most important carbapenem resistance mechanism and ST11 is the most prevalent ST type.

Objective To monitor the susceptibility of clinical isolates to antimicrobial agents in tertiary hospitals in major regions of China in 2022.Methods Clinical isolates from 58 hospitals in China were tested for antimicrobial susceptibility using a unified protocol based on disc diffusion method or automated testing systems.Results were interpreted using the 2022 Clinical &Laboratory Standards Institute(CLSI)breakpoints.Results A total of 318 013 clinical isolates were collected from January 1,2022 to December 31,2022,of which 29.5％were gram-positive and 70.5％were gram-negative.The prevalence of methicillin-resistant strains in Staphylococcus aureus,Staphylococcus epidermidis and other coagulase-negative Staphylococcus species(excluding Staphylococcus pseudintermedius and Staphylococcus schleiferi)was 28.3％,76.7％and 77.9％,respectively.Overall,94.0％of MRSA strains were susceptible to trimethoprim-sulfamethoxazole and 90.8％of MRSE strains were susceptible to rifampicin.No vancomycin-resistant strains were found.Enterococcus faecalis showed significantly lower resistance rates to most antimicrobial agents tested than Enterococcus faecium.A few vancomycin-resistant strains were identified in both E.faecalis and E.faecium.The prevalence of penicillin-susceptible Streptococcus pneumoniae was 94.2％in the isolates from children and 95.7％in the isolates from adults.The resistance rate to carbapenems was lower than 13.1％in most Enterobacterales species except for Klebsiella,21.7％-23.1％of which were resistant to carbapenems.Most Enterobacterales isolates were highly susceptible to tigecycline,colistin and polymyxin B,with resistance rates ranging from 0.1％to 13.3％.The prevalence of meropenem-resistant strains decreased from 23.5％in 2019 to 18.0％in 2022 in Pseudomonas aeruginosa,and decreased from 79.0％in 2019 to 72.5％in 2022 in Acinetobacter baumannii.Conclusions The resistance of clinical isolates to the commonly used antimicrobial agents is still increasing in tertiary hospitals.However,the prevalence of important carbapenem-resistant organisms such as carbapenem-resistant K.pneumoniae,P.aeruginosa,and A.baumannii showed a downward trend in recent years.This finding suggests that the strategy of combining antimicrobial resistance surveillance with multidisciplinary concerted action works well in curbing the spread of resistant bacteria.