RT-PCR, Western blot, and immunofluorescence were used to examine secreted protein acidic and rich in cysteine(SPARC)mRNA and protein expression in adipose tissue of rats. The results showed that the expression levels of SPARC mRNA and protein in adipose tissue of insulin resistant rats were higher than those of the normal ones(all P＜0.01). SPARC may play a role in the negative feedback regulation duning the development of insulin resistance.

Melioidosis is a endemic infectious disease caused by Burkholderia pseudomallei, and is considered one of the major causes of fatal pneumonia and sepsis.This paper reports diagnosis and treatment course of one case pulmonary melioidosis, and reviews the related literatures, so to improve clinical workers'' understanding towards melioidosis, avoid misdiagnosis and missed diagnosis.

Objective To investigate the role of vitamin D in the synthesis and degradation of aggrecan in rat articular chondrocytes at cellular level. Methods Rat articular chondrocytes were stimulated by IL-1α, IL-1β and TNF-α, respectively. Normal and inflammatory chondrocytes were treated with different doses of vitamin D, respectively. CCK8, Flow cytometry, real time-PCR and western blot analysis were used to examine the proliferation activity and apoptosis level of chondrocytes, and the expression of aggrecan, ADAMTS-4 and ADAMTS-5 at both mRNA and protein levels. Results IL-1α,IL-1β and TNF-α significantly decreased the proliferation activity and increased the apoptosis level of the chondrocytes. Furthermore, IL-1α, IL-1β and TNF-α significantly decreased the expression of aggrecan, and increased the expressions of ADAMTS-4 and ADAMTS-5 at both mRNA and protein levels in the chondrocytes. 1α,25 (OH)2D3supplementation significantly increased the proliferation activity and decreased the apoptosis level of chondrocytes stimulated by IL-1α, IL-1β and TNF-α in a dose-dependent manner, but not affected the normal chondrocytes. Meanwhile, 1α,25(OH)2D3also significantly increased the expression of aggrecan, and decreased the expressions of ADAMTS-4 and ADAMTS-5 at both mRNA and protein levels in the chondrocytes under inflammatory conditions. Conclusions Vitamin D may promote the anabolism of aggrecan and inhibit aggrecanase activity in chondrocytes under inflammatory conditions, which may impact overall protection for articular cartilage.

Objective To analyze influence of nursing intervention on the psychological status and the incidence of restlessness in the operation room during resuscitation period of general anesthesia.Methods A total of 120 patients with general anesthesia after laparoscopic surgery in our hospital were randomly divided into conventional group and intervention group,with 60 cases in each group,given traditional management and high quality nursing based on traditional management,respectively.The rate of heart rate,blood pressure,restlessness rate and the index of general anesthesia in the two groups were compared.Results There was significant difference in restlessness score distribution in intervention group compared with conventional group (P ＜ 0.05),and the incidence of restlessness was significantly lower than that of the conventional group (P ＜ 0.05).The systolic blood pressure,diastolic blood pressure and heart rate were significantly increased compared with that of the first preoperative day before intervention,but heart rate and blood pressure of the intervention group were significantly lower than the conventional group(P ＜0.05).Anxiety score before and after 12 h of operation in the intervention group was significantly lower,and resuscitation time was shorter than the conventional group (P ＜ 0.05).Conclusion High quality nursing intervention can improve psychological status,reduce the incidence of restlessness for patients with general anesthesia,maintain stability of the blood pressure and heart rate and safety of resuscitation period of general anesthesia,so it is worthy of clinical promotion.

Objective To analyze influence of nursing intervention on the psychological status and the incidence of restlessness in the operation room during resuscitation period of general anesthesia.Methods A total of 120 patients with general anesthesia after laparoscopic surgery in our hospital were randomly divided into conventional group and intervention group,with 60 cases in each group,given traditional management and high quality nursing based on traditional management,respectively.The rate of heart rate,blood pressure,restlessness rate and the index of general anesthesia in the two groups were compared.Results There was significant difference in restlessness score distribution in intervention group compared with conventional group (P ＜ 0.05),and the incidence of restlessness was significantly lower than that of the conventional group (P ＜ 0.05).The systolic blood pressure,diastolic blood pressure and heart rate were significantly increased compared with that of the first preoperative day before intervention,but heart rate and blood pressure of the intervention group were significantly lower than the conventional group(P ＜0.05).Anxiety score before and after 12 h of operation in the intervention group was significantly lower,and resuscitation time was shorter than the conventional group (P ＜ 0.05).Conclusion High quality nursing intervention can improve psychological status,reduce the incidence of restlessness for patients with general anesthesia,maintain stability of the blood pressure and heart rate and safety of resuscitation period of general anesthesia,so it is worthy of clinical promotion.

Objective To probe into the clinical nurse′s ethical cognition of Kazakh Medicine Hospital of Altay Region in Xinjiang,so as to provide basis for improving the level of nursing ethical cognition in minority area.Methods The self-designed questionnaire was used to investigate 51 clinical nurses of Kazakh Medicine Hospital of Altay Region in Xinjiang,and the result of investigation was used nonparametric statistics method and was analyzed by software SPSS 16.0.Results The overall level of ethical cognition in 51 clinical nurses maintained low level,with lowest score 30 and highest score 51 and median score 37;there were 21 nurses acquired score range from 30-36,and 30 nurses acquired over 36.The differences were statistically significant in comprehensive ethical cognition score of different departments′nurses (H=16.916,P <0.05).Conclusions The overall level of ethical cognition in 51 clinical nurses was low,so we should pay attention to its education,encourage multi-channel learning,strengthen ethics training,establish ethical norms,narrow the gap among each departments′nurses ethical cognition,improve the overall quality of nurses,and provide quality service for patients.

Infectious bone defect is bone defect with infection or as a result of treatment of bone infection. It requires surgical intervention, and the treatment processes are complex and long, which include bone infection control,bone defect repair and even complex soft tissue reconstructions in some cases. Failure to achieve the goals in any step may lead to the failure of the overall treatment. Therefore, infectious bone defect has been a worldwide challenge in the field of orthopedics. Conventionally, sequestrectomy, bone grafting, bone transport, and systemic/local antibiotic treatment are standard therapies. Radical debridement remains one of the cornerstones for the management of bone infection. However, the scale of debridement and the timing and method of bone defect reconstruction remain controversial. With the clinical application of induced membrane technique, effective infection control and rapid bone reconstruction have been achieved in the management of infectious bone defect. The induced membrane technique has attracted more interests and attention, but the lack of understanding the basic principles of infection control and technical details may hamper the clinical outcomes of induced membrane technique and complications can possibly occur. Therefore, the Chinese Orthopedic Association organized domestic orthopedic experts to formulate An evidence-based clinical guideline for the treatment of infectious bone defect with induced membrane technique ( version 2023) according to the evidence-based method and put forward recommendations on infectious bone defect from the aspects of precise diagnosis, preoperative evaluation, operation procedure, postoperative management and rehabilitation, so as to provide useful references for the treatment of infectious bone defect with induced membrane technique.