Background Study confirmed that the active microglia may injure retinal ganglion cells (RGCs) in retinal ischemia reperfusion injury (IRI), and increased cx3cr1 expression is an important factor in microglial activation,and thus blocking the expression of cx3cr1 can inhibit microglial activation, which may be useful in neuronal protection.Objective This study was to analyze the protective effects of cx3cr1 antibody on retinal neuron in rat eyes with IRI.Methods Ninety SD rats were divided into 4 groups according to random number table.IRI models were established by perfusing normal saline solution into the anterior chamber.The cx3cr1 antibody of 1 μl (0.2 μg/μl) was intravitreally injected in the right eyes in the normal rats or model rats as the only cx3cr1 antibody injected group and the model cx3cr1 antibody injected group,respectively,and no any drug was injected in the rats of the normal control group and model control group.Retinal sections were prepared 48 hours after modeling, and apoptosis of retinal neutron was observed under the transmission electron microscope;the morphology of retinas was exmined and the number of survival RGCs was calculated by histopathologic method.The expression of CD68 in activated retinal microglial cells was detected by immunochemistry, and the relative expression levels of cx3cr1 mRNA,tumor necrosis factor-α (TNF-ct) mRNA and interleukin-1 β (IL-1 β) mRNA in the retinas were assayed by real time quantitative PCR.Results The cell nucleus of RGCs showed the round and ellipse in shape and there were abundant organelles in the cells.The mophology of photoreceptors was normal with abundant mitochondrions.Irregular cell shape, disrupture of outer segment membranous disc, proliferative microglial cells in RGC layer were seen in the model group.However,these findings were mild in the model cx3crl antibody group.The mean number of survival RGCs was (38.100 ± 3.929), (37.200 ± 5.266), (26.700 ± 2.584) and (31.700 ± 2.946)/field in the normal control group,only cx3cr1 antibody injected group, model control group and model cx3cr1 antibody injected group,showing significant differences between the model group and the normal control group, only cx3cr1 antibody injected group or model cx3cr1 antibody injected group (t =7.492,6.125,-4.607, all at P＜0.01).The expression levels (absorbance) of CD68 in rat retinas were significantly higher in the model group than those in the normal control group, only cx3cr1 antibody injected group and model cx3cr1 antibody injected group (t =-3.397 ,P =0.008;t =-6.207 ,P =0.000;t =3.494, P =0.007).The relative expression levels of cx3cr1 mRNA, TNF-α mRNA and IL-1 β mRNA in rat retinas were raised in the model group compared with the only cx3er1 antibody injected group and model cx3cr1 antibody injected group (all at P＜0.01).No significant differences were observed in these indicators between the normal control group and the only cx3crl antibody injected group (all at P＜0.05).Conclusions Intravitreal injection of cx3cr1 antibody to neutralize cx3cr1 levels in retinas can effectively inhibit the activation of retinal microglia,decrease the release of inflammatory factors, reduce the apoptosis of RGCs and thereby protect the retinal neutrons against IRI in SD rats.Intravitreal injection of cx3cr1 is safe and feasible.

From members in this local district from January 2011 to December 2013,a total of 150 patients with malignant cancer and chronic disease patients of lost of functions and their carers were recruited.A self-tailored interview was conducted via face-to-face communications.And according to 112 (74.7％) carers,as compared to hospitalization,the patients were more likely willing to be looked after at home.The 95 (63.3 ％) carers had a lack of professional caring knowledge and their caring techniques were insufficient.And 97 (64.7％) carers were willing receive professional training in nursing and protecting dying patients.In-house terminal care is indeed required by the patients.However its service is best supported by the following aspects.The supports from local medical services and resources; professional training organized by a local social (neighborhood) committee and providing the guidance of in-house caring techniques and information of the relevant disease management.Building up a mutual terminal care group and finalizing the caring standards as soon as possible are essentials.

[Objective] To discuss the efficacy of Telbivudine treating chronic hepatitis B.[Method] Randomly divide 164 cases into treatment group 85 and control one 79,respectively taking Telbivudine and Ramivudine for anti virus for 48 w,then observe their efficacy.[Result] The ALT normalization and HbeAg positive rates were separately 87.50% and 71.15% for both groups; HBV DNA reduction rates and HbeAg postive-5.3 and-4.2log10 copies/ml,negative-6.6 and-5.5 log10 copies/ml;HbeAg negative rates respectively 28.57% and 23.08%;HbeAg serum conversion rates 23.21% and 15.38%;resistance rates of HbeAg positive 3.57% and 11.53%,negative 3.45% and 14.81%;the difference was very obvious(P

Objective To explore the relationship between health-promoting lifestyle and work engagement in nurses of traditional Chinese medicine hospitals. Methods Totally 527 nurses from 3A level hospitals of the first, second, third affiliated to Zhejiang University of Traditional Chinese Medicine were investigated by the Chinese revision of Health-Promoting Lifestyle Scale, Chinese version of Utrecht Work Engagement Scale. Results M ultiple regression analysis showed that nurse health-promoting lifestyle had a significant correlation with work engagement, F = 8.987, P < 0.01. Among them, the self-realization dimension to the nurse work engagement most affected, t = 3.287, P < 0.01. Conclusions Improving nurses′health-promoting lifestyle can raise the level of work engagement and stabilize nursing staff and improve quality of care in traditional Chinese medicine hospitals.

Obj cetive A large number of recent studies show that sevoflurane anesthesia may cause learning and memory dysfunction.The aim of this study was to explore changes of learning and memory ability and hippocampal volume in infantile rats after neonatal interrupted and repeated inhalation of 2.6% sevoflurane through detecting the learning and memory ability by Morris water maze and the hippocampus volume by MRI.Method s Thirty two neonatal SD rats were randomly devided into two groups (n=16):experimental group and control group.Rats inhalated 2.6%sevoflurane in the experimental group and 1 L/min O2 +1 L/min Air in the control group at the postnatal days of 7, 14 and 21 (P7, P14, P21). The learning and memory ability was determined by the Morris water maze test from P31 to P37;The brains of rats were scanned by mag-netic resonance imaging ( MRI) machine under anesthesia with 1%sodium pentobarbital at P37, and the brain and bilateral hippocampal volumes were measured. Results ①In the place navigation test, the escape latency had no significant difference between the two groups (P>0.05).In the spatial probe test, the dwelling time, movement distance and number of entering times in platform quadrant decreased slightly in experimental group compared with those in the control group, while there was no significant difference (P>0.05).②The brain volume [(1.53 ±0.18) cm3 vs (1.60 ±0.13) cm3] and right hippocampal volume [(16.15 ±1.76)mm3 vs(16.46 ±1.71)mm3] had no significant difference between the two groups (P>0.05).The left hippocampal volume [(16.46 ±1.71)mm3] was decreased in the experimental group compared with the control group [(18.10 ±2.53)mm3](P<0.05). Conclusion The learning and memory ability has no significant changes in in-fantile rats after neonatal interrupted and repeated sevoflurane inhalation and MRI examination of hippocampal volume is not sufficient for the diagnosis of cognitive dysfunction.

Objective To explore the application of CT value in calculating the proton incident energy in proton treatment planning system. Methods Bethe-Block formula and the formula for calculating the proton range were analyzed to study the correlation of the range of proton beam ( 70-250 MeV ) between a variety of radiation equivalent material and water. Procedure of Monte Carlo SRIM2008 was used to verify the possibility of a constant proportional coefficient of range ( Ci ). The proportional coefficient ( Ci ) of range in radiation-equivalent material and the CT value were fitted by using Origin 8.0 software to study the functional relation of CT value and Ci. The actual range of proton was equivalent to a range of water and incident proton energy could be calculated. Results There was a constant range of Ci of proton beam (70-250 MeV) between a variety of radiation equivalent material and water. There was a functional relation between CT value and Ci ( r = 0.999). The actual range of proton in radiation equivalent material can be equivalent to a range of the water. Conclusions CT values and a range of proportional coefficient ( Ci ),and the actual required range of the tumor could be used to accurately calculate the water equivalent range,and the incident proton energy to the position of Bragg peak. A new exploration for using CT technology in proton treatment planning system could be obtained.

Objective To evaluate the feasibility and security of general anesthesia for elective surgery in infants with mild upper respiratory tract infections (URI). Methods A total of 169 cases of infants underwent general anesthesia for elective surgery, ASAⅠorⅡ, both sexes, aged 20 days to 36 months, were divided into URI group (n=41) and non-URI group (n=128), according to the preoperative symptoms of URI. The general data, the perioperative and postoperative respiratory-related complications were observed and recorded. Results (1) There was a higher incidence rate of breath holding during the operation in URI group than that of URI group. There were no significant differences in cough, sputum, blood oxygen saturation (SpO 2)<0.95, fever, glossoptosis between two groups. No fever was found in both groups. There was a higher incidence rate of sputum after operation in URI group. There were no significant differences in other complications including cough, SpO2<0.95, fever, glos?soptosis and incidence rate of breath holding between two groups. No laryngospasm and bronchospasm were found during operation and after operation in two groups. (2)The incidence of postoperative cough and fever increased, while the inci?dence rates of SpO2<0.95 and glossoptosis were lower after operation compared with those during operation in non-URI group. In URI group, the incidence rate of postoperative fever was higher,and SpO2<0.95 and breath holding was lower. There were no significant differences in other complications in URI group. Conclusion It is feasible and relatively safe to implement tracheal intubation general anesthesia for the infants with mild URI under thorough preoperative assessment and careful opera?tive management.

Objective To investigate the antimicrobial resistance of clinical isolates in Tongling People′s Hospital during 2013. Methods A total of 2 281 nonduplicate clinical isolates were collected.Kirby-Bauer disc diffusion method was employed to study the antimicrobial susceptibility.The data were analyzed with WHONET 5.6 software according to CLSI 2012 breakpoints. Results The top 5 most frequently isolated microorganisms were E.coli (479,21.0%),K.pneumoniae (360,15.8%),A. baumannii (271,11.9%),P .aeruginosa (240,10.5%),S.aureus (171,7.5%).Gram negative and gram positive microorganisms accounted for 76.5% and 23.5%,respectively.The prevalence of methicillin-resistant strains in S.aureus (MRSA)and coagulase negative Staphylococcus (MRCNS)was 38.6% and 73.1%,respectively.The resistance rates of MR strains to beta-lactams and other antimicrobial agents were much higher than those of MS strains.No staphylococcal strain was found resistant to vancomycin or teicoplanin.E.faecalis showed relatively lower resistance to penicillin,ampicillin and nitrofurantoin.E.faecium strains were more resistant than E.faecalis to most of the antibiotics tested.Approximately 50.5% of E.coli and 44.5% of Klebsiella isolates produced extended-spectrum beta-lactamases (ESBLs).The ESBLs-respectively.And 29.8% and 23.4% of the P .aeruginosa strains were resistant to imipenem and meropenem.Nearly all (94.0%)P .aeruginosa isolates were susceptible to amikacin.Conclusions There appears a trend of increasing resistance in the clinical bacterial isolates in this hospital,especially the carbapenem-resistant Enterobacteriaceae,which is of great concern.It is mandatory to take effective antibiotic policy and infection control measures.

Objective To investigate the clinical and pathologic features of small gastrointestinal stromal tumors (small GISTs,d ＜ 2.0 cm).Methods Medical records of 95 patients undergoing surgery (endoscopic surgery,thoracoscopic/laparoscropic surgery and open surgery)and diagnosed as having GISTs by pathology and immunohistochemistry in Nanfang hospital from October 2003 to June 2014 were retrospectively analyzed.Based on clinical and pathological results,correlation analyses between risk factors for endoscopic ultrasonography(EUS) and Mitotic count(MI),clinicopathologic parameter and NIH risk classification were performed.Results Among 95 cases (104 lesions),88 were single,while 7 were multiple;81.7％ (85/104) small GISTs arose from stomach,including 87.1％ (74/85)in middle-upper stomach;5 cases (5.3％) presented calcification of different degrees,3 cases(3.2％) presented local necrosis and 2 cases (2.1％) with arrangement of epithelioid cells;88 cases (92.6％) were very low grade of NIH risk classification,6 cases (6.3％) were intermediate risk and 1 case(1.1％) was high risk.Positive rates of CD34 and CD117 were 95.8％ (91/95) and 96.8％ (92/95) respectively.The risk factors (border,mucosal surface,echo and heterogeneity) of EUS had no correlation with mitotic count(P＞0.05).The correlation analysis between clinicopathologic features and NIH risk classification revealed tumors more than 1.5 cm had a striking correlation with NIH risk classification (P＜ 0.05).Conclusion Most small GISTs,single or multiple,located at middle-upper stomach,were of very low or low risk,and have a favorable prognosis.But it has worse biological behavior and a higher grade risk when the diameter is more than 1.5 cm,intervention should be recommended.

Objective To evaluate the effects of multiple exposures to sevoflurane anesthesia on the expression of apolipoprotein E (ApoE) in the hippocampus of neonatal rats.Methods Twenty-four pathogen-free Sprague-Dawley rats (12 males,12 females),aged 7 days,weighing 15-20 g,were randomly divided into 2 groups (n=12 each) using a random number table:control group (group Con) and multiple exposures to sevoflurane anesthesia group (group Sev).On postnatal day 7,14 and 21,2.6％ sevoflurane was inhaled for 2 h in group Sev,while the mixed gas of oxygen and air was inhaled instead of sevoflurane in group Con.Morris water maze test was carried out on postnatal day 31-37 to assess cognitive function.The rats were then sacrificed,and the hippocampus was removed to determine the expression of ApoE protein in hippocampal CA1,CA3 and DG regions (by immunohistochemistry) and the expression of ApoE mRNA (by fluorescent quantitative real-time reverse transcriptase polymerase chain reaction).Results There was no significant difference between the two groups in cognitive function (P＞0.05).Compared with group Con,the expression of ApoE protein in hippocampal CA1 and CA3 regions and ApoE mRNA was significantly up-regulated in group Sev (P＜0.05),and no statistically significant change was found in the expression of ApoE protein in hippocampal DG region in group Sev (P＞0.05).Conclusion Multipie exposures to sevoflurane anesthesia can up-regulate the expression of hippocampal ApoE and produce mild neurotoxicity without causing changes in cognitive function in neonatal rats.