Objective To research the tissue structure changes of vessels wall in the patients with liver cirrhotic portal hypertension and to investigate the role of inducible nitric oxide synthase (iNOS) in development process of liver cirrhosis.Methods The left portal vein,left hepatic artery and left hepatic vein (n=27) were collected from the patients with liver transplantation as the case group and the corresponding vessels of traumatic hepatectomy were collected as control group (n=15).HE staining and Masson staining were performed respectively.The hepatic arteries were stained with elastic fibers and immunized with anti-human iNOS polyclonal antibody.Results Compared with the control group,the portal vein intima and tunica media in the case group were thickened,the smooth muscle cells of tunica media were hyperplasia and hypertrophy,partial smooth muscle cells protruded into the intima;the irregular proliferation of hepatic arterial intima,arterial luminal stenosis,internal elastic membrane flatten,and even fracture,the tunica media smooth muscle hyperplasia to the intima were also observed;no obvious structural changes were observed in the hepatic vein wall.The higher expression of iNOS was found in the cytoplasm of hepatic artery smooth muscle cells (P<0.01).Conclusion The walls of liver artery and portal vein in the patients with liver cirrhosis would secondarily develop the tissue structure reconstruction,which is the results of human body′s own compensatory mechanism,the higher expression of iNOS accelerats the occurrence and development of the tissue structure reconstruction.

Objective: To study the effect of intervention aiming at parents on development of behavioral problem of children aged 2 years. Methods: Using retrospective design, 310 parents in project communities wore investigate with Achenbach children's behavior checklist (CBCL, China urban version) and correlating background questionnaire. The control group contains 191 parents from those communities with the same social economic status and health care service. Results: The prevalence of behavioral problem of toddlers in project communities was 48. 7% , which was lower than that in control ones (62. 8% , X2= 9. 49, P

Objective:Performance appraisal of large-scale medical equipment has a significant impact on hospital management. Process equipment performance evaluation of digital is an important part of digital medical&hospital. How to fully utilize the large number of advanced medical equipment resources, how to monitor and manage equipment are focuses that hospital administrators pay much attention to. Methods: The effective performance appraisal of large-scale medical equipment can promote the resource allocation optimization, accurate and scientific management, reasonable and benign application, and then allows large-scale medical equipment fully and effectively applied to clinical practice. Results: Collecting basic data is the basis for performance appraisal of large-scale medical equipment; its instant validity, accuracy, and scientific can enhance the operability and the scientific accuracy of the performance appraisal for large-scale medical equipment. Conclusion:The acquisition of basic data has few specialized research in previous studies, the rules set up for basic data acquisition of large-scale medical equipment in this paper can improve the timeless, accuracy and normalization of the basic data using in the performance appraisal of large-scale medical equipment.

BACKGROUND:Creation of a precise finite element model is an important basis for the finite element mechanical analysis of the spine. The reports on the precise finite element model are less.
OBJECTIVE:To create L 3-L 5 lumbar three-dimensional finite element model and validate this model with normal CT data.
METHODS:A 39-year-old male healthy volunteer with the height of 175 cm and weighted 65 kg was selected, then the L 3-L 5 lumbar spines were scanned with 16 row spiral CT to obtain 101 CT images with the thickness of 1.25 mm. Solid geometric model was established with Geomagic9.0 software, then determined the unit type,
divided the finite element mesh, and established the finite element model for loading and calculating.
RESULTS AND CONCLUSION:A L 3-L 5 lumbar three-dimensional finite element model was established. It
included 213 736 nodes and 799 779 elements. The ranges of motion of L 3-L 4 and L 4-L 5 segments of the model were consistent with cadaveric biomechanical testing results, verified the effectiveness of the model, so the
model could be used for experimental research.

Objective To investigate the effects of different DO2-directed hemodynamic man-agement on postoperative prognosis of orthotopic liver transplantation (OLT)patients with different degrees of liver function insufficiency.Methods Seventy patients (male 48 cases,female 22 cases, aged 37-66 years,ASA grade Ⅲ or Ⅳ)scheduled non veno-venous bypass OLT were divided into two groups (n = 35 each ).The oxygen delivery (DO2 )maintained respectively between 350 ml·min-1 ·m-2 and 500 ml·min-1 ·m-2 (group control)and more than 500 ml·min-1 ·m-2 (group study).After induction of anesthesia,the left radial artery was cannulated,allowing continu-ous blood pressure monitoring as well as serial blood sampling,then the Swan-Ganz catheter was in-serted via the right internal jugular vein to continuously monitor CI and S-vO2 .After anesthesia induc-tion and before operation (T1 ),10 min before anhepatic phase (T2 ),30 min after onset of anhepatic phase (T3 ),30 min after neohepatic phase (T4 )and the end of surgical procedure (T5 ),the SaO2 , PaO2 ,Hb,CI and S-vO2 were recorded to calculate the DO2 ,VO2 and ERO2 .Postoperatively,ICU and hospital length of stay,quality of life (QOL)and 1-5 year survival rate were recorded.Results In the two groups,CI,DO2 and VO2 declined at T3 to a statistically significant degree in comparison with T1 (P <0.05).CI,DO2 and VO2 in group study significantly higher than those of group control (P <0.05).ERO2 in group study was lower than that of group control significantly (P <0.05).ICU and hospital length of stay were significantly shorten in group study in comparison with group control (P <0.05).Survival rate and QOL in group study tended to be slightly higher than those of group control until the end of study period,but there was no significant difference.Conclusion The DO2-directed hemodynamic management can improve prognosis with enhanced DO2 in OLT patients with different degrees of hepatic insufficiency.It has a positive impact on their outcome of shortening ICU stay and the hospitalization days.

Objective To understand the homology of clinical isolates from patients with carbapenem-resistant Klebsiella pneumoniae(CRKP)infection and isolates from environment in a medical institution.Methods One CRKP strain isolated from a patient in this hospital and 4 strains of Klebsiella pneumoniae(K.pneumoniae)isolated from patient's surroundings were collected,susceptibility of 5 strains to commonly used antimicrobial agents was detected,production of carbapenems in 5 strains were detected by modified Hodge testing and carbapenem inactivation method(CIM),homology analysis was performed by pulsed-field gel electrophoresis(PFGE).Results Antimicrobial susceptibility testing results showed that 5 strains of K.pneumoniae(1 from patient,4 from the patient's ward surroundings,including hands of nursing aides,solution bottle opening,handle for lifting and dropping bed,and bedrail)were all resistant to other antimicrobial agents except to cephamycin and aminoglycosides.The modified Hodge testing and CIM confirmed that 5 strains all produced carbapenemases;PFGE results showed that electrophoretogram of CRKP isolated from solution bottle opening of ward,bedrail,and handle for lifting and dropping bed were the same as CRKP isolated from patient,while electrophoretogram of CRKP isolated from hands of nursing aides had 2 different bands,there was a close relationship between the strains.Conclusion The same type of CRKP were isolated from patient and his surroundings,it is necessary to implement healthcare-associated infection(HAI)control system,isolate infected patient,and strengthen environmental cleaning and disinfection,so as to avoid the outbreak of HAI.

Objective:To explore the relationship between the lipid accumulation product index (LAP) and the risk of carotid atherosclerosis in different gender groups.Methods:The data of 2 740 employees of Dalian municipal government and institutions, including 1 583 males and 1 157 females, who had underwent physical examination in Dalian Municipal Central Hospital Affiliated of Dalian Medical University from January to June 2018 were analyzed retrospectively. The general data, laboratory indexes and carotid ultrasound data of the population were collected, and the body mass index (BMI) and LAP value were calculated. According to carotid intima-media thickness (IMT), the subjects were divided into carotid atherosclerosis group (IMT ≥ 1.0 mm) and carotid normal group (IMT<1.0 mm). The clinical indicators between the two groups were compared. Independent risk factors for carotid atherosclerosis were analyzed by binary Logistic regression, and the cutoff point for predicting carotid atherosclerosis by LAP was calculated by receiver operating characteristic (ROC) curve.Results:The age, waist circumference (WC), hip circumference (HC), LAP, BMI, total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), fasting plasma glucose (FPG), systemic blood pressure (SBP), diastolic blood pressure (DBP) and the prevalence of hypertension and diabetes in the male and female population carotid atherosclerosis groups were significantly higher than those in the normal group ( P<0.05). The results of binary Logistic regression analysis showed that after adjusting age, BMI, HC, WC, smoking, drinking, hypertension, diabetes, TC and LDL-C, the risk of carotid arteriosclerosis still increased 1.316 times with each quartile interval of LAP in women ( OR= 1.316, 95% CI 1.063 to 1.629, P = 0.012). In men, after adjusting for these factors, the independent effect of LAP on the risk of carotid atherosclerosis disappeared. In women, the area under curve (AUC) of LAP in predicting carotid atherosclerosis was 0.713, significantly higher than that of BMI (AUC 0.614) and WC (AUC 0.654), and the differences were statistically significant ( P<0.05). But there was no significant difference among the three indexes in the male population in predicting carotid atherosclerosis. According to ROC curve, the best cut-off value of LAP for predicting carotid atherosclerosis was 32.13 cm·mmol/L in men and 33.70 cm·mmol/L in women. Conclusions:LAP is an independent risk factor for carotid atherosclerosis in female population, and its predictive ability for carotid atherosclerosis is higher than that of body mass index and waist circumference. LAP ≥ 33.70 cm·mmol/L can be used as the best cut-off value for screening carotid atherosclerosis in female population.

Objective To observe the effect of intra-articular injection of sodium hyaluronate (Na-HA) on mRNA expression of inducible nitric oxide synthase (iNOS) in cartilage of osteoarthritis (OA). Methods Sixteen white rabbits were underwent unilateral anterior cruciate ligament transection and were divided into 2 groups randomly 5 weeks after transection. Experimental group rabbits received 0.3 ml of intra-articular 1% Na-HA injection once a week. Animals in control group were treated with the same conditions using normal saline. All animals were sacrificed 10 weeks following surgery. The aritcular cartilage degeneration of medial femoral condyle was evaluated at mascroscopically and microscopically. The mRNA expression of iNOS in cartilages was analyzed by reverse transcription-polymerase chain reaction (RT-PCR). Results Cartilage degradation in experimental group was significantly less severe than that in control group. No significant difference of iNOS mRNA expression in cartilage was found between the experimental group and the control group. Conclusion Na-HA can significantly reduce the severity of cartilage degradation of OA. Na-HA dose not show definite effect on iNOS expression in cartilage during early stage of OA.

Objective To investigate paclitaxel and ezrin-siRNA therapy for metastatic liver cancer.Methods Human metastatic liver cancer cells MHCC97-H were divided into four groups in vitro and in vivo,including control cells,exposure to paclitaxel alone,ezrin-siRNA alone,and the combination of paclitaxel and ezrin-siRNA.Nude mice lung lesions were formed by tail vein injection of tumor cells.The tumor cells'apoptosis rate,wound healing ability,the ability to cross an artificial membrane,and the numbers of metastatic lung lesions were measured.Results The apoptosis rate in normally cultured MHCC97-H tumor cells was 2.52％,compared to the other three groups at 11.66％,2.35％,7.38％ respectively.The wound healing ability was best in the negative control and weakest in cells treated with combination paclitaxel and ezrin-siRNA.The numbers of cells which could cross the artificial membrane in the negative,paclitaxel,ezrin-siRNA,and combination paclitaxel and ezrin-siRNA group were 52.5 ± 3.9,32.2 ± 3.2,26.6 ± 2.4,and 19.4 ± 1.1 respectively.The numbers of metastatic lung lesions in the nude mice (n =40) were 12.5 ±2.4,8.2 ± 1.5,7.0 ± 1.3,and 3.8 ± 0.3 respectively.Conclusions The ezrin-siRNA combined with paclitaxel therapy demonstrated a greater efficacy over single agent therapy for depressing liver cancer growth,motility,aggression,and metastasis in vitro and in vivo.

Objective To summarize the application of ATP bioluminescence assay in surveillance of terminal disinfection of effects ,so as to provide the basis for intervention of disinfected effects .Methods ATP bioluminescence assay were employed to randomly test the surfaces of operating objects in therapeutic rooms and beside tables in wards ,total 144 object surfaces ,of each clinical departments in the whole hospital .The values of ATP bioluminescence assay were read on‐site ,0-250 RLU was recognized as qualification ,while disqualification when >250 RLU .The disqualified object surfaces were performed on‐site intervention that all of them were re‐disinfected ,the results were compared .Results Both the surfaces of operating objects and beside tables were dis‐qualified before disinfection ,and the values of ATP bioluminescence assay were 780 ± 10 .34 RL and 853 ± 13 .29 RLU respectively . The pass rates of ATP bioluminescence assay was 61 .97% of operating surfaces and 79 .45% of beside table surfaces the first dis‐infection .The disqualified sites were retested following on‐site intervention .The values of ATP bioluminescence assay were 431 .02 ± 0 .53 before intervention and 1 .43 ± 0 .59 after intervention ,and the difference was statistically significant .Conclusion ATP bi‐oluminescence assay can get more immediately ,simple and timesaving in evaluating the effect of disinfection and estimate the effi‐ciency of disinfection timely ,which can also provide the scientific basis on on‐site intervention so as to improve the execution power of hospital infection management .