Objective:To explore the application effect of seamless nursing in aged patients with coronary heart dis‐ease (CHD) .Methods :A total of 60 aged CHD patients ,who were hospitalized from Aug 2013 to Feb 2014 in our hospital ,were enrolled .The 60 patients were divided into seamless nursing group (n=30) and routine nursing group (n=30) .Seattle angina questionnaire (SAQ) was used to score all patients ;angina pectoris control condition and prognosis were compared between two groups .Results:Compared with routine nursing group ,there were significant rise in anginal stability [ (78.25 ± 9.42) scores vs .(89.14 ± 10.38) scores] ,anginal frequency [ (85.13 ± 11.57) scores vs .(93.24 ± 12.58) scores] and disease perception [ (58.52 ± 12.36) scores vs .(72.16 ± 14.57) scores] of SAQ scores in seamless nursing group , P<0.05 all;and significant reductions in incidence rates of adverse cardio‐vascular events ,including angina pectoris (20.0% vs .10.0% ) ,recurrent myocardial infarction (6.7% vs .0) and heart failure (10.0% vs .0) after discharge in seamless nursing group , P<0.05 all .Conclusion:Seamless nursing can provide continuous and scientific nursing service for patients with coronary heart disease ,which contributes to angina pectoris control and improving prognosis .

Objective To observe the ability of cultured dermal papilla cells(DPCs) to induce hair follicle regeneration and to sustain hair growth in vivo and in vitro. Methods The expression of basic fibroblast growth factor (bFGF), endothelin-1 (ET-1) and stem cell factor (SCF) in different passages of DPCs, and their possible effects on biologic behaviour of DPCs were measured by in situ hybridization and immunohistochemistry. Hair follicle regeneration induced by DPCs in hair follicle organotypic culture model and the model implantated into nude mice were studied. Results The expression of ET-1 and SCF in the early passages of cultured DPCs was strong, but became weak and even negative after 6 passages. Hair follicle-like structures were formed in the hair follicle organotypic cultures, composed of DPCs and hair follicle epithelium cells. When the hair follicle organotypic cultures were implanted into the subcutis of nude mice, relatively intact hair follicles were formed. Injection of the early passage DPCs mixed with hair follicle epithelial cells into the subcutis of nude mice resulted in the formation of hair follicle-like structures, while the structures were not formed after the injection of the mixture of hair follicle epithelial cells with dermal sheath fibroblasts or with scalp fibroblasts. There was a positive correlation between the expression levels of ET-1 and SCF in DPCs and the ability of DPCs to induce hair follicle regeneration . Conclusions Cultured DPCs can induce hair follicle regeneration and sustain hair growth in vivo and in vitro. Moreover, the expression levels of ET-1 and SCF are positively correlated with the ability of DPCs to induce hair follicle regeneration.

Objective To identify the clinical risk factors of refractory Mycoplasma pneumoniae pneumonia (RMPP) and their values in early diagnosis. Methods The retrospective analysis of clinical data was conducted in 142 children with Myco-plasma pneumoniae pneumonia (MPP) admitted to Changhai Hospital of Second Military Medical University from Jan. 2012 to Jan. 2014. All children were divided into two groups, RMPP group (n=112) and MPP group (n=30). The comparison was made between two groups in clinical data. The factors were analyzed by the multifactor logistic regression. Results As compared to MPP, RMPP had longer fever duration, the higher ratios of large consolidation shadows, extrapulmonary complications and in-creased CRP level (P<0.05). The results of logistic regression indicated that the clinical risk factors included large consolidation shadows (OR=6.57, 95%CI:2.10-20.56), extrapulmonary complications (OR=11.66, 95%CI:2.42-56.08) and CRP (OR=14.87, 95%CI:2.67-82.79) (P<0.01). Conclusions Large consolidation shadows, extrapulmonary complications and CRP are clinical risk factors of RMPP. CRP elevation and lung imaging changes are valuable in early diagnosis of RMPP.

Problem-based learning (PBL)was used in resident standardized training in depart-ment of pediatrics of Changhai Hospital. Attending doctors with authority were taken as leaders teach-ing group and 3-5 resident doctors as team members. Cases were set up according to the targets of resident standardization training and common clinical diseases in each system. According to the results of the questionnaire after the teaching , both teachers and students were satisfied with the teaching effect and expected targets were reached. Residents made great progress in handling clinical problems.

Objective To analyze the etiology and treatment of autoimmune hemolytic anemia. Methods The clinical data of 29 children with autoimmune hemolytic anemia during January 2013 to December 2015 were retrospectively analyzed. Results In 29 children, 10 cases were idiopathic 19 cases were secondary and 11 cases occurred after infections. The main clinical manifestations were pallor, jaundice, dark urine, and hepatosplenomegaly. 21 cases were Coombs test positive. In 29 children, 22 cases had a good response to adrenocortical hormone therapy while in 7 cases which had not response to adrenocortical hormone, good efficacy was achived after combined with the gamma globulin treatment. Conclusions The first line drug for autoimmune hemolytic anemia treatment is adrenocortical hormone. The gamma globulin can improve the efficacy.

Objective To explore the clinical characteristics and gene analysis of hexokinase deficiency (HKD). Methods Clinical symptoms, hemolysis, laboratory findings and gene analysis of a boy with HKD in our department were retrospectively analyzed, and the literatures of HKD were reviewed. Results The patient was a six months old boy presented with neonatal hyperbilirubinemia, nonspherocytic hemolyticanemia, and increased proportion of reticulocytes. Genetic testing found two compound heterozygous mutations in HK1: c.995+5G > A (intron 12) inherited from father and c.2216G C (exon 20) inherited from the mother. In the literature, clinical features of the HKD patients were mainly anemic, neonatal jaundice and hepatosplenomegaly, and the gene detection mainly includes point mutation in HK1 gene exon and intron nucleotide. Conclusions In the case with neonatal anemia, jaundice, increased indirect bilirubin, HKD should be considered. Gene analysis can be used for early diagnosis.

Objective:To explore the molecular mechanism of paraquat (PQ)-induced lung injuries.Methods:Male C57BL/6 mice aged 6 to 8 weeks were randomly divided into four groups. Mice in the experimental groups (three groups, nine rats in each group) were intraperitoneally injected with 40 mg/kg PQ to establish an infection model, and mice in the control group ( n=9) were intraperitoneally injected with the same dose of saline. Mice were sacrificed at day 2, 7 and 14 after PQ administration. Pathological changes of lung tissues from mice model were observed by Hematoxylin-eosin staining. The expression of different proteins in the lung tissues at different time points were detected and identified by tandem mass spectrometry tag technology (TMT), and the functional analysis was performed. Results:Compared with the control group, there were 91 (69 up and 22 down), 160 (103 up and 57 down) and 78 (45 up and 33 down) proteins in the PQ-2 d, 7 d, and 14 d groups, respectively, and there was significant difference of protein expression . The subcellular localization analysis showed that compared with the control group, the differentially-expressed proteins in the PQ-2 d and -7 d groups were mainly distributed in the extracellular space, while in the PQ-14 d group were mainly distributed in the nuclear. GO analysis showed that compared with the control group, the differentially-expressed proteins in the PQ-2 d and PQ-7 d groups were mainly involved in humoral immunity and coagulation-related reactions, while in the PQ-14 d group were mainly involved in chemotactic and regulatory responses such as neutrophil aggregation. The KEGG signaling pathway analysis showed that the complement and coagulation cascades was the most important pathway in the PQ-2d and PQ-7 d groups, while metabolism of xenobiotics by cytochrome P450 was the most important pathway in the PQ-14 d group.Conclusions:It is the first time that TMT was used to analyze PQ-induced lung injuries in mice model at different time points. This study demonstrates the molecular mechanism of PQ-induced lung injuries at protein levels, and elucidates that humoral immunity and complement-coagulation pathways charge the main role of PQ-induced lung injuries. This study may provide an important theoretical basis for further research and clinical treatment.

Background/Aims: Metabolic risk factors could accelerate hepatitis B virus (HBV)-related mortality; however, their impacts on disease severity in HBV-related acute on chronic liver failure (HBV-ACLF) patients remain unexplored. In this study, we assessed the effects of metabolic risk factors on the outcome of HBV-ACLF patients. Methods: This study retrospectively enrolled antiviral therapy naïve HBV-ACLF patients from a single center in China. Patients were evaluated according to Child-Turcotte-Pugh score, Model for End-Stage Liver Disease (MELD) score, 30-day, 90-day mortality and survival rate to estimate the prognosis of HBV-ACLF. The impacts of different metabolic risk factors were further analyzed. Results: A total of 233 patients, including 158 (67.8%) with metabolic risk factors and 75 (32.2%) without metabolic risk factors, were finally analyzed. Patients with metabolic risk factors had significantly higher MELD score (22.6±6.1 vs 19.8±3.8, p<0.001), 90-day mortality rate (56.3% vs 38.7%, p=0.017), and shorter median survival time (58 days vs 75 days: hazard ratio, 1.553; 95% confidence interval, 1.061 to 2.274; p=0.036) than patients without them. Moreover, metabolic risk factors were independently associated with patients’ 90-day mortality (hazard ratio, 1.621; 95% confidence interval, 1.016 to 2.585; p=0.043). Prediabetes/diabetes and hypertension were related to higher rates of infection and worse renal function in HBV-ACLF patients. Conclusions HBV-ACLF patients with metabolic risk factors, especially prediabetes/diabetes or hypertension, could have more severe disease and lower survival rates. In addition, the existence of metabolic disorder is an independent risk factor for HBV-ACLF patients’ 90-day mortality.

Objective To observe the effect of shRNA interference lentivirus vector targeting rat Sirt1 gene on the expression of Sirt1 in retinal ganglion cell (RGC). Methods Four short hairpin (sh) RNA interference sequences targeting rat Sirt1 gene were designed. The target sequences of Oligo DNA were synthesized and annealed to double strand DNA, which was subsequently connected with pGLV3 lentivirus vector to build the lentiviral vector. The positive clones were identified by polymerase chain reaction (PCR) and DNA sequencing. The lentiviral vector construct and lentiviral packaging plasmids were co-transfected into 293T cells, then the titer of lentivirus were determined. The RGC were divided into 6 groups including blank group, negative control group and si-Sirt1-1, si-Sirt1-2, si-Sirt1-3, si-Sirt1-4 groups. Real-time PCR and Western blotting were used to detect the expression of Sirt1 mRNA and protein in the RGC cells. Results PCR and DNA sequencing analysis confirmed that the shRNA sequence was successfully inserted into the lentivirus vector. The concentrated titer of virus suspension was 8×108 TU/ml after the recombinant lentiviral vector successfully transfected and harvested in 293T cells. Comparing with NC group, the expression of Sirt1 mRNA and protein were significantly decreased in the si-Sirt1-1, si-Sirt1-2, si-Sirt1-3 and si-Sirt1-4 groups (F=27.682, 1185.206; P=0.000, 0.000). The si-Sirt1-2 group had the strongest effect in reducing the expression of Sirt1 mRNA and protein. Conclusion The 4 lentiviral vectors harboring RNAi targeting rat Sirt1 gene can effectively down regulate the expression of Sirt1 mRNA and protein in RGC cells.

Objective To evaluate the CT features of small lung invasive adenocarcinoma with air?containing space and its relationship with pathological types, and to explore the pathological basis of air?containing space. Methods CT and pathological data of fifty patients with surgically proven lung invasive adenocarcinoma with air?containing space in our hospital from January 2012 to December 2017 were retrospectively reviewed. CT image analysis included image features of tumor and air?containing space. Pathological analysis included pathological subtype, differentiation degree. CT features of tumor and air?containing space were compared with regard to pathological types using chi?square test or Fisher exact text. Analysis of variance was used to compare quantitative data satisfying normal distribution, while those data not satisfying normal distribution were compared with Kruskal?Wallis test. In addition, Spearman correlation was used to analyze the correlation between nodule density and pathological types. Results (1) CT features of tumors: Tumors were predominantly located in peripheral lungs (46/50). Most of the tumors were subsolid nodules (37/50). Tumor?lung interface was generally clear (46/50). Tumors are often accompanied by malignant signs such as lobulation (37/50), spicule sign (27/50), air bronchogram sign (43/50), and pleural indentation (36/50). The mean diameter of nodules ranged from 7.50 mm to 18.12 mm, with an average of (12.91±2.85)mm. The nodule density ranged from-657.00 to 73.00 HU with an average of (-213.88±206.16) HU. (2) CT features of air?containing space:Air?containing spaces were commonly solitary (37/50) and were found to be mainly in an eccentric distribution (29/37). The maximum diameter of air?containing space ranged from 1.00 to 16.00mm, and the average diameter was (4.23±3.14)mm. Air?containing spaces less than 5mm were found in 35 cases (70%), and air?containing spaces more than 5mm were found in 15 cases. (3) Comparison of CT features and corresponding pathological types: Nodule density, number of air?containing space, and type of nodule density in different pathological types were statistically different (P<0.05). There was a correlation between nodule density and pathological subtypes (r=0.371, P=0.008). Differences of nodule density, short?dimension of nodule, type of nodule density, spicule sign, pleural indentation among different tumor differentiation degrees were significant (P<0.05). The degree of tumor differentiation was negatively correlated with nodule density (r=-0.451, P=0.001). Conclusion The detection rate of air?containing space in lung invasive adenocarcinomas is 12.7%. Most small lung invasive adenocarcinomas with air?containing space are presented as peripheral subsolid nodule, and there is a certain correlation between their CT features and pathological types. The pathological basis of air?containing space was supposed to be dilated distal bronchiole induced by check?valve mechanism and destruction of alveolar structure by tumor.