Objective To know the influence of health education on anxiety and respiratory function of patients with cardiothoracic surgery. Methods Divided 123 patients with cardiothoracic surgery into the observation group (60 cases)and the control group (63 cases)randomly, routine nursing cares was used in the control group, related health education was used in the observation group in addition. Compared the condition about anxiety, respiratory function, pains and master degree about cardiothoracic surgery related knowledge. Results After the nursing intervention, the anxiety condition in the observation group was significant better than control group and itself before the intervention, related knowledge master degree and the pains condition in the observation "group were also better than those of in the control group. Conclu-sions Health education can effective release the postoperative pains and anxiety for patients with cardio-thoracic surgery, and then promote the rehabilitation.

Objective To probe into the related factors and nursing of nosocomial infection for infectious diseases ward. Methods 2198 cases of patients in infectious diseases ward of our hospital were selected from February 2008 to December 2009, prospective monitoring and retrospective analysis were simultaneously adopted. Results In cases of nosocomial infection, mainly respiratory tract was the infection site, where the upper respiratory tract infection rate was 30.52%, lower respiratory tract infection rate was 28.57%, higher than other parts, there were significant differences. At the same time, nosocomial infection due to indwelling catheter and the irrational use of antibiotics led to higher rates of infection, 19.23%and 17.69%, there were significant differences. In addition, we could see from the age of nosocomial infection, ≤ 3-year-old children and elderly patients ≥ 60 years old had higher infection rate, 9.43% and 9.71%, there were significant differences. Conclusions According to elements features of infectious disease outbreak in hospital ward, to take effective care and prevention measures to reduce the infectious diseases room of the hospital infection will be of great clinical significance.

Forty rats were selected for the experiment, which were divided into three groups including experimental ulcer group, normal saline and normal control groups. The pancreatic tissue were prepared for immunohistochemical staining at 6th, 10th, 14th, and 21st day after operation. Sternberger's PAP method was used to show the glucagon cell (A cell) and insulin cell (B cell) in order to observe their changes during the experimental peptic ulcer. In normal control group, the percentage of A cells is 23.31?1.91 (X?SD) and that of B cells is 73.1?4.01. But in experimental ulcer group, the A cell percentage is raised up to 42.6?5.59 and the B cell percentage is lowered down to 57.5?4.55 on the 10th day after operation. Comparing with normal saline group and normal group their differences show statistical outstanding differences. The result may point out that both A and B cells of pancreatic islet take part in the body's natural resistance against the disease, especially A cells.

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Purpose To investigate the expression of Wnt-1 and β-catenin protein in cervical squamous cell carcinomas ( CSCC) and their relationship with invasion and lymph node metastasis. Methods Expression of Wnt-1 and β-catenin protein were examined on immunohistochemistry containing 78 specimens of CSCC and 30 specimens of normal cervical tissues. Results The positive rates of Wnt-1 and β-catenin protein in normal cervical tissues were 20.0% and 10.0% respectively. The positive rates of Wnt-1 andβ-cate-nin protein in CSCC were 56.4%, and 74.4% respectively. There was a significant difference between the two groups (P<0.001). The positive rates of Wnt-1 andβ-catenin protein in 33 cases with lymph node metastasis of CSCC were 72.7% and 90.9% respective-ly. The positive rates of Wnt-1 andβ-catenin protein in 45 cases with no lymph node metastasis of CSCC were 44.4% and 62.2% re-spectively. The expression of Wnt-1 andβ-catenin protein was significantly related with grades of tumors and depth of invasion and FI-GO stages (P<0.05), and there was no significantly difference between the expression of Wnt-1 andβ-catenin protein and CSCC pa-tients age (P>0.05). Spearman analysis showed that the expression of Wnt-1 protein was positive related to the expression ofβ-cate-nin protein (rs =0.490, P<0.001). Conclusion The abnormal expression of Wnt-1 and β-catenin may be involved in initiation, development, invasion, and metastasis of CSCC, and it is suggested that Wnt-1 and β-catenin be considered as potential markers for invasion, metastasis, and prognosis.

BACKGROUND:Articular cartilage injury is often complicated by subchondral bone damage to form osteochondral defects, and its treatment remains a pressing problem in orthopedics. Osteochondral composite grafts fabricated by tissue engineering technology provide a new way to repair osteochondral defects. OBJECTIVE:To explore the feasibility of fabricating osteochondral composite grafts in an independently designed double-chamber stirring bioreactor. METHODS: Goat bone marrow mesenchymal stem cels were seeded into β-tricalcium phosphate scaffolds. The cel/scaffold constructs were subjected to chondrogenic and osteogenic induction simultaneously in the double-chamber stirring bioreactor. According to the applied shear stress, they were divided into dynamic and static culture groups. The proliferation of bone marrow mesenchymal stem cels was detected by MTT test and scanning electron microscope examination. Osteogenesis and chondrogenesis related genes were detected by RT-PCR for the evaluation of chondrogenic and osteogenic differentiation. RESULTS AND CONCLUSION:The bone marrow mesenchymal stem cels in both dynamic and static culturegroups demonstrated satisfactory proliferation and differentiation. Better proliferation and differentiation ability were found in the dynamic culture group. Fabrication of osteochondral composite grafts in the independently.designed double-chamber stirring bioreactor is feasible, which is better under the mechanical stimulus environment than the static environment.

Objective To understand the clinical features of infant pulmonary hemorrhage of enterovirus 71 infection without skin rash, and to improve the diagnosis and treatment of this disease.Methods Six infants infected with enterovirus 71 and presented pulmonary hemorrhage but no skin rash between November 2007 and October 2008 were retrospectively reviewed. The clinical manifestations, clinical outcomes, treatments, laboratory data and chest imaging changes of the cases were analyzed. Results The 6 cases were all younger than 2 years old. The cases distributed throughout the whole year without peak season. Enterovirus 71 gene was detected by reverse transcription-polymerase chain reaction (RT-PCR) and real time polymerase chain reaction from throat swabs and secretions of the respiratory tract. All the cases began with fever, and 4 of which were accompanied with vomit, and 2 accompanied with cough. After 1 to 3 days, they all got sudden deterioration, manifested with pale and cyanosis, and 1 had hyperspasmia. After intubation, they all had pink frothy fluid from the endotracheal tube. They all had obvious hyperglycaemia, 4 had tachycardia, and 2 had hypertension. All the 6 cases died, and 4 died within 6 h after deterioration. Conclusions Pulmonary hemorrhage of enterovirus 71 infection without skin rash is seen in infants. It is sporadic throughout the whole year. The disease is fulminant and the case often dies in short period of time.

The pathogen of COVID-19 is 2019-nCoV, which belongs to the beta coronavirus. Angiotensin-converting enzyme 2 (ACE2) is the receptor of 2019-nCoV as the same of SARS-CoV. Most of the severe patients were the elderly with underlying diseases, which may be related to the decrease in the number of naive T cells. In addition to pulmonary symptoms, COVID-19 can also cause multiple organ dysfunction and even multiple organ failure (liver, nervous system, heart, kidney, etc.). Pathogenic mechanisms such as direct virus invasion, cytokine storm, endothelial cells damage, and down-regulation of ACE2 may play important roles in the severity of the disease.

Objective To analyze the heterogeneities of hepatitis B virus ( HBV ) reverse transcriptase domain (RT) gene mutations related to nucleos (t)ide analogues (NAs) resistance.Methods Blood samples from 2765 chronic hepatitis B patients with virological breakthrough or poor drug response treated in Ningbo No .2 Hospital and Ningbo Fourth Hospital from April 2011 to March 2018 were collected . According to the medication status , it was divided into LAM monotherapy group ( n =603 ) , LdT monotherapy group (n=147), ADV monotherapy group (n=68), ETV monotherapy group (n=10) and the sequential or combined drug resistance of NAs group (n=365).The resistance mutation sites and drug resistance patterns (pathways) of each group were analyzed .The SPSS 19.0 software was used to analyze the data.Results Among 2765 serum samples, the NAs-related HBV-RT resistance mutations were detected in 1193 cases with an overall mutation rate of 43.15％.The mutation rate of LAM monoclonal resistance group was 62.62％ (603/963) with 19 mutation types, the most common single point mutation was rtM204I/V (40.30％, 243/603).The mutation rate of LdT monoclonal resistance group was 45.51％(147/323), and there were 3 mutation types, with the single point mutation rtM204I/V being the most common (59.86％, 88/147).The mutation rate of the ADV monoclonal resistance group was 17.80％(68/382), mainly rtA181T single point mutation (64.71％, 44/68).The mutation rate of the ETV monoclonal resistance group was 4.06％(10/246), and the single point mutation of rtT184A/G/S/I/L/F was the most common one (80.00％, 8/10).The mutation rate of the sequential or combination therapy group was 41.91％ (365/871), among which the mutation rate of the LAM/LdT poor response or the resistance with the sequential ADV group was 63.39％(142/224), and the most single mutation point was rtA181V/T ( 35.21％, 50/142 );the mutation rate of LAM/LdT poor response or drug-resistant with combined ADV group was 42.19％ (54/128), and the most common mutation point was rtA181V/T (46.30％, 25/54);the mutation rate of LAM/LdT with poor response or resistance after sequential ETV 1.0 mg was 44.66％(117/262), and the most common mutation point was rtL180M+M204I/V+S202G/I (31.62％, 37/117);the LAM/LdT poor response or the drug-resistant ETV combined with ADV group had a mutation rate of 7.14％(5/70), all of which were multi-site mutations;the mutation rate of poor response to ADV or resistant with sequential ETV 0.5 mg group was 28.14％(47/167), all of which were multi-site mutations.Secondary ( compensation ) sites such as rtV173L, rtL180M, and rtV214A, and single-point mutations such as rtV207I/L/G, rtS213Tand rtN238T, which were not fully defined , were detected.The resistance patterns ( pathways ) of NAs monotherapy were relatively simple , and the resistance patterns ( pathways ) of NAs experienced patients ( sequential or combined treatment group ) were complex and diverse, and multiple resistance patterns (pathways) existed, along with NAs increasing in species.Non-first-line NAs-related resistance patterns ( pathways ) showed an overall downward trend sand ETV-related drug-resistant mutation showed an overall upward trend .Conclusion The NAs-related HBV resistance mutation sites ( patterns ) are complex and diverse , especially multi-site mutations , refractory drug resistance mutations, multidrug resistance mutations and cross-resistance mutations.Therefore, the optimization of antiviral treatment strategies and drug resistance management concepts need to be continuously updated .

In December 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused the outbreak of COVID-19 in Wuhan. It is a kind of enveloped positive-strand RNA virus, belonging to the subgenus Sarbecovirus of the genus Betacoronavirus. It is similar to other viruses of the subgenus Sarbecovirus in genomic structure and closely related to the bat coronavirus (RaTG13), indicating that its natural host is likely to be bat, but the intermediate host is still controversial. SARS-CoV-2 infects host cells with angiotensin-converting enzyme 2 (ACE2) as a receptor. At present, SARS-CoV-2 has undergone some mutations. This article reviewed the current research situation and progress in the etiology of COVID-19.