The interaction between genetic and environmental factors influences the onset,development and prognosis of cerebral ischemia.Recently,epigenetic regulation is increasingly becoming a research focus on cerebral ischemia,and there has been great progress in research on DNA methylation,histone modification and miRNA network.Epigenetic regulation provides a new idea for identifying potential therapeutic targets of cerebral ischemia.

Objective To investigate the dynamic changes of metallothionein(MTs)gene expression and explore the important significance of MTs during hepatocarcinogenesis.Methods One hundred and twenty-five SPF 5 -8-week old male C57BL/6J mice were randomly divided into control group and model group.Diethylnitrosamine (DEN) was given to the mice at a dose of 100 mg/kg, ip, and 50 mg/kg, ip, in the first and next week, respectively.The mice were given ethanol (53%, 5 mL/kg/day, 5 days/week) from the third week of experiment till 35 weeks.At 1, 3, 9, 13, 24 and 35 weeks of the experiment, liver samples were taken for histopathological examination of liver damages and incidence of HCC. The liver index and malondialdehyde (MDA) of liver homogenate were determined.All liver tissue samples were examined by histopathology using hematoxylin and eosin (HE), Masson and reticular fiber staining.Real-time RT-PCR was used to analyze the mRNA expression level of liver metallothionein-1 /2 (MT-1 /2) in different periods.Results Progressive liver damages in model group mice were identified in different periods.Hepatocytes abnormal tission and abnormal liver plate structure, architecture often characteristic of HCC could be seen in approximately 50% of mice at 35 weeks.In addition to these, a higher liver index also were seen at 35 weeks.Increased MDA levels in the mouse liver tissues were observed in each stage.Real-time RT-PCR analysis showed that significantly increased transcription of MT-1 and MT-2 at 1, 3 and 9 weeks, then gradually declined and even below the normal level.Conclusions MTs gene expression levels in mouse liver tissues are changed from significantly increased in the early stage of injury to decreased expression combined with distinct fibrosis. Our findings further demonstrate that the down-regulation of MTs level is closely correlated with hepatocarcinogenesis.

AIMTo investigate the effects of ovarian hormone on th e expression of 5-HT 3 receptors in the rats colon. METHODS24 adult female SD rats were randomly divided into three groups:sham operation(Sham ) group;ovariectomy(OVX) group and ovariectomy with estrogen and progesterone(OV X+E 2+P) group. The 1 hour fecal pellets and the time of glass pellets output w ere observed 4 weeks after operation;and the expression of 5-HT 3 receptors mR NA in the colon tissues was studied by RT-PCR. RESULTSIn contra st with the Sham group and OVX+E 2+P group,OVX group showed increase in the fec al pellets output and decrease in the time of glass pellets output(P

Objective To understand the drug resistance situation of clinical common bacteria in hospital.Methods VITEK-2 was adopted to perform the identification and antimicrobial susceptibility test.The drug resistance data were analyzed by adopting the WHONET 5.5 software.Results 13 841 strains of bacteria isolated for the first time from the patient were collected from Jan-uary 2009 to December 2012,in which Gram positive bacteria accounted for 29.3% and Gram negative bacteria accounted for 70.7%.Meticillin-resistant Staphylococcus aureus (MRSA)and meticillin-resistant coagulase-negative staphylococci (MRCNS) accounted for 78.3% and 88.4% of staphylococci aureus and coagulase-negative staphylococci,respectively.No vancomycin and tigecycline resistant strains of staphylococci were found.4.3% of enterococcus faecalis and 7.5% of enterococcus faecium were re-sistant to vancomycin.The detection rates of E.coli and Klebsiella spp (Klebsiella pneumoniae +Klebsiella bacteria producing acid )producing extended spectrum beta-lactamases (ESBLs)were 58.5% and 24.4%,respectively.Enterobacteriaceae strains were still more sensitive to carbapenem antibiotics.The resistance rates of pseudomonas aeruginosa and Acinetobacter spp strains to imipenem were 24.9 % and 42.6%,respectively.Conclusion Bacterial drug resistance still constitutes a serious threat to the clini-cal anti-infection therapy.So the antibacterial agents should be rationally used for reducing the bacterial drug resistance.

The paper discusses the experimental teaching reform of biochemistry by referring to the characteristics of biochemical development and special feature.The reform increases effectually the interests of medical students,and may contribute to their creative competence and the abilities of scientific research.

With the internationalization of nursing education,one major project facing higher nursing education is to foster lots of high quality nursing specialists,with properties of international vision,development prospect,and adaptation to international nursing positions.Chongqing Medical University engaged in reforming and implementation of talents culturing and yielded significant effect along with the main competency ideology of humanistic caring,critical thinking,evidence-based nursing,practicing and international competition.

Objective To build a complete medical capability evaluation system for hospital's clinical departments,based on the data of a public general hospital in Beijing,using simplified DRGs-related indexes as a risk-adjustment tool.Methods Select with literature review,corresponding medical capacity evaluation indexes to build a primary index data base,and establish the evaluation index system of clinical medical indexes of a hospital based on DRGs analysis using Delphi method and AHP method.Conduct the sequence comparison and paired t test using the evaluation method mentioned above as well as the traditional evaluation method.Results Establishing the evaluation system of medical ability for clinical departments composed of 3 first level indexes and 12 two level indexes based on DRGs related indicators The 3 composing first level indexes are productivity,efficiency and quality whose corresponding weighting coefficients were 0.363,0.479,0.158 respectively.Outcomes of the sequence comparison from both this method and the traditional method are basically the same,and the paired t test shows no significant difference between the two.Conclusion This evaluation system facilitates data collection and accurately indicate the medical capacity of a hospital's clinical department,making it an ideal tool for hospital's day-to-day management.

Objective To investigate the prognostic value of fever burden in traumatic brain injury (TBI) patients.Methods A retrospective analysis of 355 TBI patients admitted to the emergency department and intensive care unit from November 2010 to October 2012 was performed,and the Glasgow outcome scale (GOS) was followed-up 6 months after the injury.The patients were divided into two groups according to the GOS:good outcome group (4 to 5) and poor outcome group (1 to 3).Relevant clinical findings were studied by statistical description,logistic regression analysis,Spearman correlation analysis and ROC curve analysis.Results Fever burden level was continuously increased with the decrease of GOS from score 5 to 2,except for score 1 of GOS,which was corresponding to a significant lower fever burden.There were significant differences in age,pupil reactivity,Glasgow coma scale (GCS) and fever burden between two groups (P ＜ 0.05).Compared to the good outcome group,the poor outcome group was featured with more advanced average age (P =0.000),poorer pupil reactivity (P =0.000),lower GCS score (P =0.000) and higher fever burden level (P =0.000).Univariate logistic regression analysis suggested that age,GCS,pupil reactivity and fever burden level (OR 1.166,95％ CI:1.117-1.217) were associatedwith poor outcome.The fever burden level and the other independent prognostic predictors as age,GCS and pupil reactivity were further included in the multivariate logistic regression model,and the adjusted OR of fever burden level was 1.098 (95％ CI:1.031-1.169,P =0.003).ROC curve analysis showed the respective AUC for fever burden was 0.713 (95％ CI:0.663-0.760).The relevant analysis revealed a significant negative correlation between the fever burden and the GOS score (r =-0.376,95％ CI:-0.462--0.283,P =0.000).Conclusions Fever burden can be considered as an independent predictor of poor outcome of patients with TBI.The TBI patients with early onset of high levels of fever burden will have increased poor outcome risk.

Objective To explore the effects of high-dose ambroxol hydrochloride (Mucosolvan) on pulmonary protection and anti-inflammatory in traumatic brain injury patients treated by mild hypothermia.Methods From June 2008 to June 2012,40 elderly traumatic brain injury patients aged 60-70 years treated by mild hypothermia in our hospital were selected.Patients were randomly divided into two groups:low-dose ambroxol hydrochloride group and high dose ambroxol hydrochloride (n=20,each).Patients in low-dose ambroxol hydrochloride group were treated with ambroxol 30 mg plus saline infusion,3 times/day; while patients in high-dose ambroxol hydrochloride group were treated with ambroxol 300mg plus saline infusion,3 times/day; both groups were treated for 7 days.The changes of characteristic and quantity of sputum,PaO2and PaO2/FiO2,and serum TNF α level were analyzed at day 1,3,7.Duration of mechanical ventilation,tracheotomy proportion,and mortality were compared between the two groups 3 months after treatment.Results At day 3-7 after the intervention,the sputum got thinner and less,and more easy to suck in highdose group than in low-dose group (thin sputum proportion:75％ vs.40％,P =0.025; clean proportion by once suction:65％ vs.25％,P=0.011).The improvement of PaO2,PaO2/FiO2 were more significant in high dose group than in low dose group (PaO2 ∶ 3d,(92.3±12.3) mm Hg vs.(83.3±15.2) mm Hg,P=0.046;7d,(95.9±12.5) mm Hgvs.(87.1±11.7) mm Hg,P=0.028;PaO2/FiO2∶3d,(290.8± 15.8) mmHgvs.(221.8± 16.4) mm Hg,P=0.000;7d,(296.3±16.9)mm Hg vs.(238.4±15.0) mm Hg,P=0.000).Serum concentrations of TNF α was lower in highdose group than in low dose group [3d,(54.1± 4.9) ng/L vs.(71.4± 5.6) ng/L,P=0.000;7d,(35.1± 2.7) ng/L vs.(63.3±4.3) ng/L,P 0.000].Duration of mechanical ventilation was shorter and tracheotomy proportion was lower in high dose group than in low dose group [(116.8±18.7) hrsvs.(178.4±35.5) hrs,P=0.000; 25％ vs.60％,P=0.025].There was no significant difference in mortality between groups 3 months after treatment.Conclusions The application of high dose ambroxol can improve respiratory function,decrease duration of mechanical ventilation and tracheostomy proportion,and reduce the systemic inflammatory response in elderly traumatic brain injury patients treated by mild hypothermia,but without long-term survival benefit.

Disasters ; Earthquakes ; Emergency Medical Services ; manpower ; organization & administration ; Liability, Legal ; Public Health Practice