Objective To evaluate the effect of sevoflurane preconditioning on intestinal injury in the patients undergoing resection for liver cancer.Methods Forty patients of both sexes,aged 20-60 yr,weighing 5075 kg,of ASA physical status Ⅱ or Ⅲ (liver function Child-Pugh grade A),undergoing resection for right liver cancer,were randomly divided into 2 groups (n =20 each):sevoflurane preconditioning group (S group) and control group (C group).Anesthesia was induced with target-controlled infusion of propofol and remifentanil.Tracheal intubation was facilitated with cisatracurium.Anesthesia was maintained with target-controlled infusion of propofol and remifentanil.S group inhaled sevoflurane with the end-tidal concentration of 2.0％ for 30 min starting from the end of intubation,followed by washout.Before induction (T0),immediately after hepatic portal was clamped (T1),at 1,3 and 6 h after occlusion of hepatic portal was released (T2-4) and at 24 h after operation (T5),arterial blood samples were obtained for determination of serum tumor necrosis factor-alpha (TNF-α),intestinal fatty acids binding protein (Ⅰ-FABP) and D-lactate levels.Results The concentrations of serum TNF-α and D-lactate started to rise at T2,peaked at T4,and started to decline at T5,and the serum Ⅰ-FABP concentrations started to rise at T2,peaked at T3,and started to decline at T4 in the two groups.The concentrations of serum TNF-α,Ⅰ-FABP and D-lactate were significantly lower in S group than in C group.Conclusion Sevoflurane preconditioning can inhibit inflammatory responses and reduce intestinal injury in the patients undergoing resection for liver cancer.

Objective To establish a stable HCV full-length genome replication cell model which is labeled with reporter gene and easyly to quantify intracellular HCV proteins and RNA level. Methodsneo gene was inserted into Luc-JC1 to make Luc-JC construct. Luc-JC RNA was obtained by in vitro transcription and then delivered into Huh7 cells by transfection. G418-resistant clones of Huh7 cells were obtained by selection. Clones of HCV full-length genome replication cell were confirmed by luciferase activity assay, Western blot and cleaveage of eYFP-MAVS by HCV NS3/4A protease. Then, HCV replication cell colonies were treated by different dose IFN-α in order to observe the change of luciferase activity, HCV protein and RNA level. Results At 3-4 weeks post-transfection, visible colonies were selected and stained by crystal violet. Luciferase activity and HCV NS3, NS5A protein were detected by luciferase activity assay and Western blot, respectively. Subcellular localization of eYFP-MAVS transferred from mitochondria to cytoplasms by cleavage of NS3/4A protease in cell colonies. Luciferase activity, HCV protein and RNA diminished obviously after IFN-α treatment. Conclusion A stable HCV full-length genome replication cell model labeled by reporter gene was successfully established and reporter activity can be used to indicate level of HCV proteins and RNA in cells. This cell model is a useful tool for the study on HCV pathogenesis and the screening of antiviral drugs.

Objective Congestive heart failure (CHF) is the final common pathway of various heart diseases.Calcineurin,a calcium/calmodulindependent phosphatase consisting of a catalytic subanit A (CnA) and a regulatory calcium-binding subunit B (CnB),is activated in heart failure.This study aimed to investigate the relationship between mRNA level of calcineurin in circulating T-lymphocyte and that in myocardium in patients with CHF. MethodsA total of 38 patients with CHF (aged from 29 to 62 years) were included in this study.The mRNA levels of alpha-and beta-isoform of CnA in left ventricular anterior papillary muscle and peripheral lymphocytes were determined by semi-quantitative reverse transcription polymerase chain reaction.Pearson linear correlation analysis was performed,and difference was considered statistically significant at a P value <0.05. ResultsCalcineurin mRNA levels in lymphocytes were positively correlated with those in myocardium (for CnA-alpha mRNA,r=0.820;for CnA-beta mRNA,r=0.875;both P<0.01).CnA-beta mRNA levels in both circulating lymphocytes and myocardium increased significantly with increasing NYHA class (r=0.877 for peripheral blood and r=0.805 for cardiac muscle;both P<0.01). ConclusionsThe mRNA level of CnA-beta in circulating lymphocytes is positively correlated with that in myocardium and is a promising marker for the severity of cardiac dysfunction in patients with CHF.

Objective To investigate the learning outcome of clinical scenarios discussion im-plemented in teaching medical students before clinical probation. Methods Using standardized pa-tients (SP) to simulate the clinical common difficult situation, all eight year program clinical medicine students (84) of Grade 2008 who were about to enter the clinical probation were given clinical commu-nication education guidance. Through five classification variables questionnaire and return visit, the teaching effect was evaluate. Epidata 3.0 was used to input data, and the SPSS 15.0 was used to make descriptive analysis of the questionnaire and proportion comparison. Results We found 35.4%(29) and 63.4%(52) of subjects liked and approval this training, respectively;90.2%(74) of the subjects thought the diffi-culty of this train was moderate; 77.3% (65) of subjects believed that it was necessary to set the clinical scenarios discussion before clinical probation. Conclusions The implementation of clinical scenarios discussion before clinical probation was effective on inducing the medical students to pay attention to the doctor-patient communication, and deep thinking about the communication notice mat-ters and cop-ing styles in clinical environment.

Objective To investigate the current situation of the pressure load of nurses in the dementia ward of a geriatric hospital, and to provide the intervention for nurses in alleviating the work and life stress of nurses in dementia wards, and in improving the work enthusiasm and the quality of nursing. Methods A total of 35 nurses in dementia ward and 36 nurses in non-dementia ward were surveyed by the questionnaire which the revised Chinese version of the stress load scale. Results The event load dimension score (27.60±6.57) and the individual vulnerability score (26.74±9.70) in the two dimensions of nurses' stress load of dementia ward were higher than those of non-dementia ward nurses, and the differences between the two groups were statistically significant (P<0.05). The top 3 of the stress load items for the dementia ward nurses were all in the event load dimension including "I felt too much pressure and responsibility", "I felt bound by various responsibilities" and "I felt too much to do, but had not enough time". Conclusions Nursing managers should pay attention to the pressure load of nurses in dementia ward, take active measures to intervene, promote the health of nurses and improve their work efficiency and nursing quality.

OBJECTIVETo evaluate the significance of traditional index on the identification of Bacillus anthracis and its correlation with pathogenic strains.

METHODSRoutine bacteriologic methods and PCR of virulence genes were used to determine the difference on traditional identification index between pathogenic and nonpathogenic Bacillus.

RESULTSThe characteristics of colony, with hemolysis and mobility both negative are the important interrelated characters of pathogenic strains of Bacillus anthracis.

CONCLUSIONTo judge the risk of anthrax, virulence of genes must be first defined. Some traditional methods for identification are still useful when molecular biological methods are not available.

Clinical data of 113 patients with non-alcoholic fat liver disease (NAFLD) diagnosed by liver biopsy from January 2015 to January 2017 in Taizhou People's Hospital were retrospectively reviewed . Patients all underwent transient elastographic ( TE) examination and the values of fat attenuation index (FAI) were obtained.The hepatocyt fatty changes in pathological examination were scored as 0 (＜5%, n＝40), 1 (5%-33%,n ＝27), 2 (34% -66%,n ＝28) and 3 (＞66%, n ＝18).There were significant differences in AST , Glu, TC and FAI among patients with hepatocyte fatty change scores 0, 1, 2 and 3, and the FAI was significantly correlated with the degree of fatty liver disease .The areas under the ROC curve (AUCs) of FAI in patients with hepatocyte fatty change scores 1, 2 and 3 were 0.78, 0.90 and 0.96, respectively.Logistic regression analysis showed that FAI was correlated with TG , TC and BMI.The results suggest that FAI in TE can be a non-invasive, rapid and objective evaluation method for patients with NAFLD.

As people are getting a better understanding of organism′s metabolism and the concept of disease treatment is being continuously updated, parenteral and enteral nutrition become an inter discipline subject that serves for the clinic and involves a number of disciplines. Just in the past five years, related guidelines at home and abroad have been published as much as more than 40. In order to better serve the clinical decision making, this text attempts to give a carding and interpretation from the three aspects of nutrition screening and assessment, the implementing of nutritional intervention and the progress of special nutrition support. It is observed that the standard clinical nutrition diagnosis and treatment process has been formed consensus. But in the practical application, there are still many details need to confirm and further study.

Exposure to cadmium (Cd) induces apoptosis in osteoblasts (OBs); however, little information is available regarding the specific mechanisms of Cd-induced primary rat OB apoptosis. In this study, Cd reduced cell viability, damaged cell membranes and induced apoptosis in OBs. We observed decreased mitochondrial transmembrane potentials, ultrastructure collapse, enhanced caspase-3 activity, and increased concentrations of cleaved PARP, cleaved caspase-9 and cleaved caspase-3 following Cd treatment. Cd also increased the phosphorylation of p38-mitogen-activated protein kinase (MAPK), extracellular signal-regulated kinases (ERK)1/2 and c-jun N-terminal kinase (JNK) in OBs. Pretreatment with the caspase inhibitor, N-benzyloxycarbonyl-Val-Ala-Asp-fluoromethylketone, ERK1/2 inhibitor (U0126), p38 inhibitor (SB203580) and JNK inhibitor (SP600125) abrogated Cd-induced cell apoptosis. Furthermore, Cd-treated OBs exhibited signs of oxidative stress protection, including increased antioxidant enzymes superoxide dismutase and glutathione reductase levels and decreased formation of reactive oxygen species. Taken together, the results of our study clarified that Cd has direct cytotoxic effects on OBs, which are mediated by caspase- and MAPK pathways in Cd-induced apoptosis of OBs.
Animals ; Apoptosis/*drug effects ; Cadmium/*toxicity ; Caspases/metabolism ; Environmental Pollutants/*toxicity ; Osteoblasts/*drug effects/metabolism ; Oxidative Stress/drug effects ; Rats ; Rats, Sprague-Dawley ; p38 Mitogen-Activated Protein Kinases/metabolism