Objective To investigate the changes of excitatory amino acids (EAAs) of cerebrospinalfluid (CSF) in patients with delayed encephalopathy after acute carbon monoxide poisoning(DEACMP).Method The EAAs levels of CSF including glutamate (Glu) and aspartate (Asp) in 24 patients with DEACMP and 20 controls with migraine were measured by high performance liquid chromatography( HPLC ).Results Glu and Asp levels in patients with DEACMP were significantly higher than those of the controls [(3.76 ± 1.52) μmol/L vs ( 1.55 ± 1.03 ) μmol/L, (0.73 ± 0.44) μmol/L vs (0.38 ± 0.33 ) μmol/L, P all <0.01]. Glu and Asp levels in moderate and severe DEACMP patients were higher than those in mild DEACMP patients. Conclusion It suggests that EAAs participated in the pathogenesis of DEACMP. The Glu and Asp levels in CSF may be regarded as indicator of DEACMP.

Objective To study the clinical feature of ciguatera fish poisoning.Methods Thirty-nine patients with ciguatera fish poisoning were observed.Results The clinical symlptoms of ciguatera poisoning usually began to appear 2～10 hours after eating a poisonous fish and could be classified into three broad groups:neurological,gastrointestinal cardiovascular symptoms.Gastrointes tinal symptoms were the most common complaint.Neurological symptoms generally stayed for 1～2 weeks.The clinical picture was characterized by temperature reversal.Conclusion Ciguatera poisoning can be differentiated by unique features affecting the neurological system.

Objective To explore the effects of cleaning staff's hygienic management intervention on the infection of staphylococcus aureus (SAU) in hospitalized patients. Methods Totals of 450 hospitalized patients from January to August 2016 in each department were selected. Starting from May 2016, the cleaning staff in charge of the departments were involved in the management of hand hygiene. The changes of hand hygiene awareness and infection control knowledge of the cleaning staff before and after the intervention were compared. Staphylococcus aureus infection was monitored in real time, and compared before and after the intervention. Results Before the intervention, the hygiene awareness of the cleaners was (39.81±3.28), and the hand hygiene rate was 60.15%. After the intervention, the hygiene awareness was (45.22±4.83), and the hand hygiene rate was 84.28%. The differences before and after intervention were statistically significant (t=2.219, χ2=4.463; P< 0.05). The average score of infection control knowledge before and after the intervention were (39.3±5.6) and (82.8±6.4) respectively, with a statistical difference (t=2.139, P=0.037). There were 112 cases of staphylococcus aureus infectoin in all departments before the intervention, and 71 cases after the intervention, with a statistical difference (χ2=2.983, P=0.027). Conclusions To strengthen the management of hand hygiene can effectively improve the hospitalization environment and reduce staphylococcus aureus infection.

Objective To study the resting-state functional connectivity( FC) changes of anterior cingulate cortex(ACC) and amygdala in adolescent patients with medication-naive first-episode major de-pressive disorder(MDD).Methods Medication-naive first-episode MDD adolescents( n＝30) and pair-wise matched healthy controls(HCs,n＝29) underwent resting-state functional magnetic resonance images(fM-RI).To study whether there were different in FC changes between amygdala and ACC and whole brain re-gions,and whether abnormal FC was related to clinical characteristics.Results Compared with HCs,the ado-lescent MDD patients showed decreased FC between the left amygdala and right thalamus( MNI x,y,z:15,－21,18)(t＝－2.85)and increased FC between the left amygdala and the bilateral temporal middle gyrus,left occipital gyrus,right medial prefrontal cortex(MPFC)(MNI x,y,z:9,66,15) ( t＝2.80).The right amygdale showed decreased FC with bilateral middle frontal gyrus,left caudate(MNI x,y,z:－15,－9,21)(t＝－2.53), right thalamus(MNI x,y,z:12,－36,12)(t＝－3.01),right cerebellum(MNI x,y,z:3,－84,－33)(t＝－2.45) and increased FC with right temporal middle gyrus,right MPFC( MNI x,y,z:6,69,12) ( t＝2.41).The left ACC showed decreased FC with left cerebellum( MNI x,y,z:12,－87,－24) ( t＝－2.36),left frontal inferior triangle gyrus,right frontal inferior orbital gyrus and increased FC with right frontal middle orbital gyrus.The right ACC showed decreased FC with left caudate(MNI x,y,z:－15,21,6)(t＝－2.29),right temporal middle gyrus,right MPFC(MNI x,y,z:9,54,36)(t＝－2.29),right frontal inferior orbital gyrus,right angular(MNI x,y,z:45,－51,21)(t＝－3.01),left dorsolateral prefrontal cortex(MNI x,y,z:－21,33,36) ( t＝－2.61).The increased FC between the left amygdale and bilateral temporal middle gyrus showed positive correlation with the score of HAMD(r＝0.50,P＜0.05;r＝0.45,P＜0.05).And the FC between the right amygdale and right middle frontal gyrus was positive correlation with duration of disease( r＝0.63,P＜0.05).Conclusion There is widespread FC disorder in amygdala and ACC in adolescents patients with first-episode depression.Abnor-mal FC changes may be the neuropathological mechanism of depression.

Central serous chorioretinopathy (CSC) is a common macular disease, which can lead to the loss of central vision in young patients. Although the disease is self-limited to some extent, there is no shortage of patients with prolonged course and recurrent attacks, eventually leading to irreversible visual impairment. Therefore, taking reasonable treatment in a certain period is particularly important for the visual prognosis of patients. Although thermal laser photocoagulation of leakage points and photodynamic therapy (PDT) have achieved good effects, there are risks of retinal damage and retinal pigment epithelium atrophy. Subthreshold micropulse laser (SMLP) is a kind of subthreshold short pulse laser, which does not cause visible damage to the retina and is safer. In the era of lack of PDT drugs, SMLP has gradually become an important means of clinical treatment for CSC, especially for patients with no obvious leakage point or subfoveal leakage point. An in-depth understanding of the mechanism of action of SMLP and its efficacy and safety in the treatment of CSC is helpful for the promotion and application of SMLP in the clinical treatment of CSC.

Objective:To provide reference for the development of a more intelligent and systematic nursing clinical decision support system based on the concept of precision nursing and data sharing, the nursing plan module of clinical decision support system.Methods:An evidence-based knowledge base was constructed based on the nursing process and the standardized nursing terminologies; the nursing plan module was designed according to clinical needs, and the logical reasoning rules were formulated from the generation, sequencing and stopping of nursing problems, objectives, measures and activities, and finally the nursing plan module of clinical decision support system was formed.Results:The nursing plan module of clinical decision support system included the basic information of patients, positive evaluation items and weight values, nursing problems, objectives, measures and activities, etc. the module could automatically deduce the nursing plan according to the patient's individual characteristic index (positive evaluation item), and sort the nursing problems and corresponding measures and activities according to the generation time, weight value and correlation degree. It could automatically distinguish nursing problems, goals, measures and the time of activity stop, and realize intelligent decision-making.Conclusion:The interface of nursing plan module of this system is clear and logical reasoning rules are rigorous. It breaks through the bottleneck of nursing decision-making based on personal professional knowledge and experience in clinical situation for a long time, which can ensure the homogeneity of nursing plan and improve the correctness of decision-making.

OBJECTIVETo develop a high-performance liquid chromatography (HPLC) method for the simultaneous determination of rutin, hyperoside, isoquercetin, astragulin, quercetin, and kaempferol in Apocynum venetum and its extracts.

METHODThe separation was carried out on a Shim pack ODS (4.6 mm x 250 mm, 5 microm) colum eluted with in mobile phases of water containing 0.2% phosphoric acid and acetonitrile containing 0.2% phosphoric acid in acetonitrile gradient mode. The column temperature was 40 degrees C, and the flow rate was 1.0 mL x min(-1). The detection wavelength was set at 360 nm.

RESULTThe good seperation of six flavonoids was achieved within 40 min, with the relative standard deviations (RSD) of intra- and inter-day precision < or = 2.0%. Calibration curves of rutin, hyperoside, isoquercetin, astragulin, quercetin, and kaempferol showed good linear relationship (R2 > 0.999 7, n = 6). The average recoveries of the six flavonoids were within 97.30% - 105.8% (RSD 2.6%). Three batches of A. venetum and 2 batches of its extracts were determined.

CONCLUSIONThe developed method is simple, accurate, and repeatable, and can be readily used as a powerful tool for the quality control of A. venetum and its extracts.

Objective:The therapeutic effect of less polar ginsenosides on rats with rheumatoid arthritis was studied, and the metabolic pathway that produce anti-inflammatory effect of less polar ginsenosides was identified.Methods:Rats were randomly divided into the control group, the model group, methotrexate treatment group, and high dose, medium dose, and low dose less polar ginsenosides groups. After 30 days of oral administration, less polar ginsenosides reduced the disease activity significantly in rats with rheumatoid arthritis. Blood and ankle synovial tissue metabolisms were measured by ultra performance liquid chromatography (UPLC) tandem mass spectrometry (MS) to explore the mechanism of less polar ginsenosides.The resulting data were subjected to principal component analysis and orthogonal partial least squares discriminant analysis(OPLS-DA).Results:Compared with the model group, erythrocyte sedimentation rate and RF decreased significantly in the high dose of less polar ginsenosides ( P<0.01). Metabolomics showed that R2X and R2Y of serum OPLS-DA were 0.626 and 0.904 respectively. The R2X and R2Y of synovial OPLS-DA were 0.429 and 0.689 respectively. Major differential metabolites were identified in the model group of rats, including arachidonic acid, valine, linoleic acid, and guanine nucleoside, etc. The main differential metabolites were identified in rats in the high dose group of less polar ginsenosides, including linoleic acid, betaine, eicosapentaenoic acid, alanine, methionine sulfoxide, isoleucine, etc. Conclusion:The metabolic spectrum has shown that inflammation is associated with linoleic acid metabolism, valine, leucine and isoleucine degradation, arachidonic acid metabolism. Less polar ginsenosides regulatethe linolenic acid metabolism, methionine metabolism and glucose alanine cycle.

Porcine circovirus type 2(PCV2)mainly damages the immune cells of pigs,causing lym-phocyte depletion and immune suppression.Interleukin(IL)-15 regulates immune functions wide-ly,and plays an important regulatory role in the survival,proliferation,differentiation and immune function of a variety of immune cells such as natural killer(NK),CD8+T cells and NKT cells.In this study,in order to determine the effect of PCV2 on IL-15 expression,4-week-old piglets(n=4)were infected with PCV2 and the negative control group(n=4)was set up.On day 7 post-infec-tion,the inguinal lymph nodes of the infected and control groups were collected,and porcine cyto-kine antibody microarray(QAP-CYT-1)was employed to quantify the expression of cytokines in the tissues,screen for differential cytokines,and GO and KEGG enrichment analysis for IL-15 were conducted.Real-time quantitative fluorescent PCR(qPCR)and ELISA were used to verify the level of IL-15 mRNA and protein,and those in porcine peripheral blood mononuclear cells(PBMC)and serum were simultaneously detected.Compared with the negative control group,the expression lev-el of IL-15 was significantly reduced in the infected group(P＜0.05);IL-15 was mainly involved in cytokine-cytokine receptor interactions,immune responses,cellular activation,and the regulation of JAK-STAT and TNF signaling pathways.The levels of IL-15 mRNA and protein in inguinal lymph nodes in the infected group were significantly lower than those in the control group(P＜0.05),which was consistent with the detection results of QAP-CYT-1.However,there was no significant difference in IL-15 mRNA and protein levels in PBMC and serum.These results indicate that PCV2 can inhibit IL-15 in the inguinal lymph node microenvironment of piglets.This study can provide important information for further revealing the immunosuppressive mechanism of PCV2.

Based on the transcriptome analysis data of a Bacillus licheniformis, a novel bidirectional promoter was identified from the strain and its transcriptional strength was analyzed. The expression level of a Bacillus clausii derived alkaline protease gene driven by the bidirectional promoter was studied by using the known strong constitutive promoter pShuttle-09 as a control. Three recombinant expression vectors and the corresponding recombinant bacteria were constructed. Under the control of the new promoter pLA and its reverse promoter pLB, the alkaline protease expression level respectively reached 164 U/mL and 111 U/mL. The results indicated that the transcription strength of pLA was significantly higher than that of pShuttle-09 and pLB, and both the pLA and pLB promoters could initiate the expression of the alkaline protease. Thus, it provides a new expression element for the heterogenous genes in Bacillus sp. and a new idea for the co-expression of two genes in one prokaryotic strain.
Bacillus subtilis ; Promoter Regions, Genetic