Objective Explore the expression of intercellular adhesion molecule-1(ICAM-1) and Pselectin in the healing process for possible application in timing of incised wounds. Method An immunohistochemical study on the expression of ICAM-1 and P-selectin was performed on rats vital skin incised wounds (5min～7d)using postmortem incisions(5～30min)as control.Results In the vital skin incisions,positive stain of ICAM-1 was observed on epidermis began from 1h and lasted till 3d, while the P-selectin stain was observed on vascular endothelium as early as 10min after incision and lasted 5h; in addition, the expression of ICAM-1 was also found in the inflammatory cells and fibroblasts,the lasting period varied from group to group (groupⅠ 5min～1h,groupⅡ 3～7h,group Ⅲ 9～12h,groupⅣ 1d,groupⅤ 3d,groupⅥ 5～7d.).The positive ratios of ICAM-1 among the cells were very low in group Ⅰ(0.41?0.73%),and increased considerably in group Ⅱ(9.79?3.74%) and group Ⅲ(23.33?1.10%),maximized in group Ⅳ(30.58?2.65%),then decreased in group Ⅴ and Ⅵ.There were no changes of ICAM-1 and P-selectin in the postmortem incision group. Conclusion ICAM-1 and P-selectin are considered potentially useful markers for wound age determination in forensic practice.

Objective To explore the influence of PUMA on radiosensitivity of pancreatic cancer AsPC-1 cells after Slug gene inhibition by transfected short interferencing RNA(siRNA). Methods The AsPC-1 cells were infected with MOI 10,50,100 for 72 h, respectively. The expression of Slug and PUMA was analyzed by Western blotting and immunohistochemistry methods. The transfected and control cells were exposed to 4 Gy γ-rays. The cells inhibition rate was examined by MTT, Hoechst 33342 and IP double staining. DNA ladder and Giemsa staning was used to observe apoptosis. Results The relative value of Slug expression was 0.831 ±0.14,0. 546 ±0.12 and 0.178 ±0.08 after AsPC-1 was infected with Slug-siRNA ( MOI 10,50,100) for 72 h, significantly lower than that of control group ( F = 4. 992,P ＜ 0.05 ).The relative value of PUMA was 0. 325 ±0. 07,0. 593 ±0. 11 and 0. 978 ±0. 12, after AsPC-1 was infected with Slug-siRNA ( MOI 10,50,100) for 72 h, significantly higher than that of control group ( F = 4. 324,P ＜ 0. 05 ). The cell proliferation rate was ( 78.76 ± 9. 36 ) % in transfection combined with radiosensitivity group, significantly higher than that of transfection group [ ( 43.68 ± 6.71 ) % ] and radiosensitivity group alone [( 19.25 ± 3.72)% ] (F = 5.056, P ＜ 0.05). The apoptosis of transfection combined with radiosensitivity group was significantly higher than that of others. Conclusions Slug gene targeting siRNA could inhibit the expression of Slug, and consequently increase the activation of PUMA expression, and so enhance the radiosensitivity to γ-rays.

ObjectiveTo explore the in-hospital mortality and its determinants for very eldly (80 + years of age) patients with acute myocardial infarction (AMI).MethodsA retrospective cohort method was used.The 499 study subjects were very eldly patients with newly diagnosed AMI consecutively admitted into our department between January 1,2002 and February 22,2010.ResultsNinety-seven out of 499 patients died during hospitalization period,with total in-hospital mortality of 19.4％.Multivariable logistic regression analysis showed the independent determinants for mortality of very elderly AMI patients were cardiac Killip grades,complete A-V block,renal dysfunction,stent implant,and the type of AMI.Conclusions The independent determinants for mortality of elderly AMI patients are as following,cardiac Killip grade,complete A-V block,renal dysfunction,stent implant,and the type of MAI.Urgent PCI is safe and effective for some very elderly with AMI,which could improve their survival rate within hospitalization period.

Objective: To study the clinical outcomes of stent-thrombosis (ST) at different times in patients after drug-eluting stent (DES) implantation.
Methods: A total of 131 coronary angiography conifrmed ST patients in our hospital from 2005-01 to 2015-04 were studied. According to the time of ST occurrence, the patients were divided into 2 groups: Early ST group, ST occurred ≤30 days,n=42 and Late ST group, ST occurred >30 days,n=89. The in-hospital and follow-up information was collected; clinical outcomes were compared between 2 groups.
Results: The in-hospital MACE occurrence rate in Early ST group was higher than that in Late ST group (16.7% vs 4.5%),P=0.04. There were 123 patients survived to discharge and they were followed-up for the median of 38.00 (15.00, 62.00) months. Kaplan-Meier analysis estimated that the MACE-free survival was similar between 2 groups (41.9% vs 36.3%), P=0.43.
Conclusion: In-hospital MACE occurrence was higher in early ST patients, while the long term prognosis was similar between the early and late ST patients for whom with DES implantation.

Physical restraint is a complex and dynamic process in which nurses are the main decision makers and implementer. This article is to review the factors influencing the implementation of physical restraint in ICU nurses, and summarize from 4 aspects: nurses' own factors, environmental factors, promotion measures of rational use of physical restraint and ethical factors, so as to provide a basis for the effective clinical intervention measures in the future.

Objective To investigate the clinical pathological characteristics, diagnosis and treatment of breast rhabdomyosarcoma, and to enhance the awareness of malignancy infiltration to bone marrow (BM). Methods The data of one case of Rhabdomyosarcoma of breast were analyzed retrospectively. BM aspirate and biopsy, morphology, immunology, cytogenetics, molecular biology (MICM) in different parts of BM, peripheral blood smear, fine puncture of breast mass, final biopsy of breast mass by Mammotome System and whole body PET-CT were performed. The immunochemistry stain of specimen of breast mass was used. Results The peripheral blood smear of this patient showed immature erythrocytes, leucocytes and classification of unknown cells which were consistent with BM morphology. The results of BM aspirate and biopsy depicted a hypercellular specimen with disseminated unknown cells infiltration. Unknown cells were positive for CD56 and negative for any hematopoietic markers by flow cytometry. The whole body PET-CT showed that uptake of 18F-FDG of bilateral breast and whole BM was increased, whereas the mass of breast was not presented by CT. PET-CT suggested a probable malignant hematologic disease. The enough specimen of breast mass got from Mammotome System showed embryonal rhabdomyosarcoma, and the tumor cells were positive for MyoD1, Vimentin and Desmin. Conclusions It is a challenge for early diagnosis of solid sarcoma with unknown origin which diffusely infiltrating into BM. Negative expression of hematopoietic markers by flow cytometry plays a role on differential diagnosis in this setting, whereas PET-CT only provides a valuable reference. Enough specimen and immunohistochemical staining could provide solid evidences of diagnosis.

Objective:To evaluate the clinical value of endoscopic release therapy for fecal impaction in the colorectal diverticulum.Methods:Data of patients with fecal impaction in the colorectal diverticulum who received endoscopy in Shantou Central Hospital from January 2018 to September 2020 were included in this study. Among them, 85 patients treated with endoscopic release therapy were assigned to the observation group (2 patients were excluded from the observation group due to acute appendicitis), and 43 patients receiving no treatment were assigned to the control group. The relief of abdominal symptoms was used as an index to evaluate the clinical value of endoscopic release therapy for fecal impaction in the colorectal diverticulum.Results:In the observation group, 42.2% (35/83) were successfully released at one time. The successful comprehensive measures accounted for 25.0% (12/48) of the first release failure, and the total success rate was 56.6% (47/83). There were no complications related to endoscopy in the observation group. One week after the treatment, patients in the observation group were followed up by telephone. Among the 45 patients who were successfully released, positive symptoms of 30 patients disappeared or significantly improved with the effective rate of 90.9% (30/33). Among the 38 patients who failed to release the fecal impaction, 19 had positive symptoms and 16 improved in varying degrees with the effective rate of 55.2% (16/29). The overall effective rate of the observation group was higher than that of the control group [55.4% (46/83) VS 7.0% (3/43)], showing significant difference( χ2=23.354, P<0.01). The effective rate were significant differences in the successful release group [65.2% (30/46)], unsuccessful release group [29.7% (11/37)] and the control group [7.0% (3/43), χ2=33.792, P<0.01]. By pairwise comparison, the effective rate of the successful release group was the highest, followed by the unsuccessful release group, and that of the control group was the lowest with significant difference ( P<0.017). Conclusion:The endoscopic release therapy for fecal impaction in the colorectal diverticulum is relatively simple, which can relieve and reduce related symptoms, avoid complications, missed diagnosis and misdiagnosis, and show definite curative effects. When colorectal diverticulum with fecal impaction is found in the process of endoscopy, it is of great practical significance to release the incarcerated feces by means of different methods.

Objective:To understand the occupational health examination of graphene workers in a certain enterprise and provide evidence for occupational disease prevention and treatment.Methods:In September 2019, the physical examination data of 54 workers exposed to graphene dust in an occupational health examination of a graphene enterprise from January to August 2019 were collected, and the differences of various physical examination indexes of each group were examined by χ 2 test. Results:The company had a total of 54 graphene workers, and 15 cases of occupational health examination abnormalities, and the abnormal rate was 27.8%. 7 of which had abnormal central functions, and 11 cases of abnormal pulmonary function. 3 of them had abnormal heart function and abnormal lung function. With the increase of age and working age, the abnormal rates of cardiac and pulmonary functions were increased (χ 2=0.042, P<0.05) . Conclusion:With the development and mass production of graphene, the opportunities for workers to expose to graphene are increasing, and the health of workers is also threatened. Therefore, the occupational disease prevention work of staff should be emphasized.

Objective:To understand the occupational health examination of graphene workers in a certain enterprise and provide evidence for occupational disease prevention and treatment.Methods:In September 2019, the physical examination data of 54 workers exposed to graphene dust in an occupational health examination of a graphene enterprise from January to August 2019 were collected, and the differences of various physical examination indexes of each group were examined by χ 2 test. Results:The company had a total of 54 graphene workers, and 15 cases of occupational health examination abnormalities, and the abnormal rate was 27.8%. 7 of which had abnormal central functions, and 11 cases of abnormal pulmonary function. 3 of them had abnormal heart function and abnormal lung function. With the increase of age and working age, the abnormal rates of cardiac and pulmonary functions were increased (χ 2=0.042, P<0.05) . Conclusion:With the development and mass production of graphene, the opportunities for workers to expose to graphene are increasing, and the health of workers is also threatened. Therefore, the occupational disease prevention work of staff should be emphasized.

China has entered an aging society,fall in the elderly often causes their physical and mental damage and even be life-threatening.Literature reviews studying on fall prevention in the elderly discovered that the improvement of the lower-extremity muscle strength can reduce the fall incidence in the elderly.This paper summarized the current researches on the methods for elderly people's lower-extremity muscle strength improvement.In addition,this paper also gave an analysis of both advantages and disadvantages of these methods,in order to provide a theoretical evidence and reference for the future study in improving the lower-extremity muscle strength.