As the most common pathogen for healthcare -associated infection in European and American countries, Clostridium difficile has become increasingly popular in China and has posed a great threat to public health.Based on evidences retrieved from the PubMed and CNKI databases , this article reviews biological characters and dissemination patterns of C.difficile, epidemiology, burden and risk factors of C.difficile infection, and the surveillance, contact precaution, hand hygiene, antimicrobial stewardship, environment cleaning, use of probiotics and vaccine for the prevention of C.difficile infection.

Purpose To study the expression of zeb-1 and c-jun in gastric cancer and its influence of occurrence and development of tumor. Methods The expression zeb-1, c-jun and E-cadherin were assessed in 100 specimens of gastric cancer and their tissue adja-cent to cancer by immunohistochemistry. Results The positive rates of zeb-1,c-jun and E-cadherin expression in gastric cancer were 81%, 70%, 35%, and in tissue adjacent to cancer were 17%, 25%, 100%. The expression of zeb-1 and c-jun in gastric cancer were higher than those in their tissue adjacent to cancer (P<0. 05). zeb-1 expression was closely correlated with the degree of tumor differentiation, depth of invasion, lymph node metastasis and TNM stage (P<0. 05), which were not correlated with patient s age, sex and tumor size. c-jun expression was closely correlated with the degree of tumor differentiation (P<0. 05), which were not correlated with other pathological features. The expression of zeb-1 was negatively correlated with the expression of E-cadherin and was positively correlated with the expression of c-jun in gastric cancer. Patients with high expression of zeb-1 and c-jun had lower five-year survival rate than patients with negative expression. Conclusion zeb-1 and c-jun are closely correlated with occurrence and development of gastric cancer. They can be a index of judging prognosis of gastric cancer.

Objective: To conduct systematic evaluation on the dermatologic toxicity caused by targeted anti-cancer drugs in children and teenager to provide reference for future studies and clinical practice.Methods: Pubmed(http:∥www.ncbi.nlm.nih.gov/pubmed/), American Society of Clinical Oncology Annual Meetings' Online Abstracts Database(http:∥www.asco.org/) and ClinicalTrials.gov(http:∥www.clinicaltrials.gov) were searched for the clinical trials on the use of targeted anti-cancer drugs (single or combination) in children and teenager complicated with dermatologic toxicity.Methodological quality assessment was performed for the included studies, using Cochrane's risk of bias assessment tool for randomized controlled trials and methodological index for non-randomized studies (MINORS).Meta-analysis was performed for the outcomes including adverse event rate of skin rash, xerosis, pruritis and mucositis.Results: A total of 24 studies with 960 patients were included in this study.Various solid tumors and leukemia were investigated in the studies.The quality assessment revealed that the majority of included studies were with high quality.According to the results of meta-analysis, the pooled event rate and 95% confidence interval were 0.19[0.12-0.28],0.24[0.06-0.51],0.12[0.04-0.24] and 0.21[0.07-0.39] for skin rash, xerosis, pruritis and mucositis, respectively.Publication bias analysis indicated potential reporting bias for skin rash (Egger's P=0.007).Conclusion: Dermatologic adverse events occur in a part of children and teenager with cancer treated with targeted therapy, which may cause impaired quality of life and disability.Adequate attention should be paid to these events during clinical trials and real life practice.

Objective To study the content changes of ET and CGRP in MID patients and investigate the effect of cluster needling on scalp point about intelligence of MID patients. Methods Sixty MID patients were divided into cluster needling group and medicine group which was treated by hupperzine. HDS,ADL,MMSE score and ET,CGRP content was assayed before and after treatment. Results After treated for 8 weeks,CGRP content of cluster needling group was increased and ET was decreased significantly compared with medicine group (P

Objective To assess the efficacy and safety of co-administration of aspirin and low-dose clopidogrel in patients undergoing percutaneous coronary intervention (PCI) after 1 year.Methods From March 2004 to September 2010,a total of 3366 patients with successful drug-eluting stents implantation after 1 year were divided into group A (aspirin combined with low-dose clopidogrel,n=1682) and group B (aspirin alone,n=1684).The average follow-up period was (29.5±16.3) months (19 months-76 months).The major adverse cardiovascular and cerebrovascular events and clinical complications were evaluated.Results Rates of cardiovascular death were 0.1 ％(2 cases) in combination group and 0.9％ (15 cases) in aspirin group,the risk ratio (HR) was 0.154 [(95％ CI:0.035 0.675),P＜0.05].Myocardial infarction occurred in 9 patients (0.5％) in group A and 27 patients (1.6％) in group B,the risk ratio (HR) was 0.036 [(95％ CI:0.153-0.741),P＜0.01].Rates of stroke were 0.4％ (7 cases) in group A and 1.6％ (27 cases) in group B,the risk ratio (HR) was 0.301 [(95％ CI:0.131 0.693),P ＜ 0.01].Recurrent ischemia with rehospitalization occurred in 152 patients (9.0％) in group A and 274 patients (16.3％) in group B,the risk ratio (HR) was0.601 [(95％ CI:0.491-0.735),P＜0.01].The cumulative survival rate in patients died of cardiac causes was significantly better in group A than in group B (P＜0.01).The cumulative incidence of major adverse cardiovascular and cerebrovascular events was significantly lower in group A than in group B (P＜0.01).There were no significant differences in total number of deaths,target vessel revascularization,stent thrombosis,incidences of severe bleeding,mild bleeding,leukopenia and thrombocytopenia between the two groups (all P＞0.05).Conclusions In patients with PCI after 1 year,the co-administration of aspirin and low-dose clopidogrel reduces the risks of major adverse cardiovascular and cerebrovascular events,and does not increase the risks of bleeding and cytopenia.

Triple-negative breast cancer (TNBC) is a heterogeneous disease.It has distinct risk factors,molecular biology features,clinical presentations and prognosis.TNBC recurrence is common after resection,and the survival rate is low and available treatment options are few after recurrence.To date,chemotherapy is the main treatment strategy for TNBC.There is a great need for new molecular predictive marks and drug targets for improving the efficacy of TNBC treatment.

Patients with ischemic stroke is often accompanied by inflammtory response. Studies have suggested that toll-like receptor 4 (TLR4) has induced the occurrence,development and of ischemic stroke and secondary brain injury. This article reviews the toil-like receptor 4 signal transduction pathway and its roles in ischemic stroke in order to provide certain basis for the development of TLR4-targeted medication.

Objective To investigate the pathological significance of expression of IL-23 in colon tissues of patients with steroid-dependent uncreative colitis at remission.Methods Expression of IL-23 was measured by means of Western Blot and immunohistochemistry SABC in inflammation repairing areas from 15 patients with steroid-dependent ulcerative colitis at remission, 30 patients with common ulcerative colitis at remission (15 treated with SASP and 15 with prednisone) and 10 normal colon tissues.The results were analyzed by SPSS 16.0.Results Compared with normal control, expression of IL-23 in patients of SASP maintenance therapy and prednisone with common ulcerative colitis were slightly increased ( P > 0.05), which was significantly lower that of steroid-dependent specimens ( P < 0.01).Conclusion Over-expression of IL-23 may plas a key role in the pathogenesis of steroid-dependent ulcerative colitis.

Nerve agents (NAs) belong to the class of organic phosphorus compounds which are acetylcholinesterase ( AChE) inhibitors, including soman, sarin, tabun,VX, etc.NAs are extremely toxic and considered as the most danger-ous chemical warfare agents.The current standard treatment for poisoning by nerve agents consists of the combined adminis-tration of anticholinergic drugs such as atropine sulphate, AChE reactivators such as pralidoxime, obidoxime and HI-6 and diazepam for anticonvulsant effects, but oximes are therapeutic antidotes against nerve agent intoxications which exert the therapeutic purposes primarily by reactivating the NAs-inhibited AChE.In this paper, the mechanism of nerve agents, the main working procedure of anti-NAs drugs, the chemical structure of classic reactivator, the corresponding antitoxic action, in vivo and in vitro effects and metabolic kinetics are reviewed.

Objective Stem cell therapy has been extensively used in clinical practice. However ,the methods available are unable to non‐invasively detect the distribution of cells in vivo. This study was aimed to establish a novel molecular imaging probe for stem cell labeling ,which would monitor cells via fluorescence imaging. Methods 1‐iodododecane was used to modify polyethyleneimine (PEI) to form amphiphilic macromolecules. These macromolecules encapsulated the hydrophobic quantum dots by self‐assembly to form imaging probes. Results Strong fluorescence signals of the probe occurred at 630 nm ,and the probe could be effectively endocyted by mesenchyme stem cells. In vivo imaging showed that significant optic signals occurred in probe‐labeled mesenchyme stem cells compared with the control cells (blank group:1.47e8 [p/s/cm2/sr]/[μW/cm2 ];test group:2.78e8 [p/s/cm2/sr]/[μW/cm2 ]). Conclusion The nanoprobes have good optic imaging effects ,and can be used to la‐bel cells.