Objective:To detect the expression of microchromosome maintenance protein 6 (MCM6) in bladder cancer tissues, and to explore the relationship between MCM6 and the clinical prognosis of bladder cancer. To explore the possibility of MCM6 as a potential biomarker for bladder cancer.Methods:Bioinformatics methods were used to analyze the mRNA levels of MCM6 in bladder cancer tissues and adjacent normal tissues, and to analyze the relationship between its expression and the survival rate of bladder cancer patients. The clinicopathological data of 83 patients with bladder cancer underwent surgical treatment were retrospectively analyzed. Immunohistochemical method was used to detect the expression level of MCM6 protein in bladder cancer tissue and normal tissue adjacent to the cancer, and analyze its relationship with clinicopathological characteristics of bladder cancer patients.Results:The results of bioinformatics analysis showed that MCM6 mRNA was significantly highly expressed in bladder cancer tissues and was significantly correlated with the overall survival rate ( P=0.036) and disease-free survival rate ( P=0.01) of the patients. The results of immunohistochemistry showed that the expression of MCM6 in bladder cancer tissue was significantly higher than that in normal tissues adjacent to the cancer, and high expression of MCM6 in bladder cancer tissue was related to tumor stage ( P=0.025), but had nothing to do with age, gender and tumor grade (all P>0.05). Conclusions:The expression of MCM6 in bladder cancer tissue is significantly high and indicates a poor prognosis, and its expression level is related to the tumor stage of bladder cancer patients. MCM6 may serve as a new potential biomarker for bladder cancer.

Objective To investigate the distribution and drug resistance of pathogenic bacteria in children with blood stream in-fection(BSI) in Beihai area .Methods The clinical data of children with blood stream infection from January 2013 to June 2016 were retrospectively analyzed .Results 95 .3% of BSI children patients were community acquired infection .The proportions of Gram-pos-itive cocci and Gram-negative bacilli were 53 .5% and 46 .5% respectively .The resistance rates of vancomycin and linezolid to Gram-positive cocci all were 0% ;which of piperacillin ,piperacillin/tazobactam ,cefepime and meropenem to Gram-negative bacilli were 9 .3% ,0 .0% ,9 .1% and 5 .0% respectively .Conclusion The proportion of Gram-positive cocci and Gram-negative bacilli is basical-ly consistent .Vancomycin and linezolid can be used as the empiric medication of Gram-positive cocci BSI ;piperacillin ,piperacillin/tazobactam ,cefepime and meropenem and can be used as the empiric medication of Gram-negative bacilli BSI .

Objective To establish an optimization model of hospital medical equipment purchase based on cost-benefit analysis to enhance equipment purchase demonstration.Methods An integer programming model for the types and amount of purchased hospital medical equipment was constructed with the cost benefit parameters based on market survey and the hospital annual purchase plan. LINGO optimization software was used to determine the optimal purchase scheme.Results The model acquired was applied to medical equipment purchase demonstration in some hospital, so that the purchase scheme was formed rapidly as desired.Conclusion The model may promote hospital medical equipment purchase demonstration and provide references for equipment selection.

Objective To investigate the clinical significance of serum chemokine and hs-CRP levels in patients with type 2 diabetes mellitus with asymptomatic subclinical atherosclerosis.Methods The clinicpathological and follow-up data of 55 patients with Type 2 diabetic from 2012.1 to 2015.12 were collected and reviewed.At the same time,55 patients with non type 2 diabetes were taken as control.Determination of FPG,HbA1c,HDL-C,TC,TG,LDL-C,INS and other indicators by automatic biochemical analyzer,the application of color Doppler ultrasound equipment measurement C-IMT.Correlation using Pearson correlation analysis,risk factor analysis using multiple linear stepwise regression analysis.Results Compared with the control group,the two groups in BMI,WHR,systolic blood pressure,ankle brachial index,FPG,HbA1c,HDL-C,hsCRP,C-IMT,HOMA2-IR and serum chemokines were significantly different,with statistical significance (t =-6.31 ～5.79,P≤0.01 ～ 0.03).In 110 cases of experimental group and control group,the levels of serum chemokines were positively correlated with WHR,HOMA2-IR,C-IMT and hs-CRP (r=0.24～0.29,P=0.01～0.04).C-IMT and age,WHR,systolic blood pressure,diastolic blood pressure,FPG,HbA1c,diabetes duration,hs-CRP was positively correlated (r=0.15 ～0.68,P≤0.01～0.0.04),and the ankle brachial index was negatively correlated (r=-0.32～0.29,P≤0.01).Hs-CRP was positively correlated with HbA1c,HOMA2 IR,serum chemokine,C-IMT (r=0.25～0.32,P≤0.01～0.04),and was negatively correlated with TC and HDL-C (r=-0.27～-0.25,P all 0.02).Cox proportional hazard regression model for multivariate analysis showed that high serum chemokines,hs-CRP and HbA1c were the risk factors of C-IMT (β=0.026～0.658,SE=0.015～0.033,t=2.532～3.421,P≤0.01～0.04).Conclusion High serum levels of chemokines and hs-CRP are the risk factors of C-IMT,and it has important clinical significance for the diagnosis of asymptomatic subclinical atherosclerosis in patients with type 2 diabetes mellitus.

Objective To compare the effect of postoperative intercostal nerves cryoanalgesia and patient controlled epidural analgesia (PCEA) in patients undergoing thoracic surgery. Methods From April 2006 to May 2008,89 patients undergoing thoracic surgery were randomly divided into intercostal nerves cryoanalgesia group (group A,47 cases) and PCEA group (group B,42 cases). The scores of pain, use of pain medication and time of out-of-bed activity after the operation were used to evaluate the effect of pain between two groups. Results The scores of pain in group A and group B were (1.49 ± 0.80) and (2.43 ± 1.21) scores respectively. There were significant differences in the scores of pain. The use of pain medication [(1.28 ± 0.62) times vs (2.02 ± 1.05) times]and time of out-of-bed activity after the operation [(43.15 ± 12.22) h vs (64.10 ± 14.25) hi were significant difference between the two groups(P< 0.05). Conclusions For reducing the post- thoracotomy pain,intercostal nerves cryoanalgesia is superior to PCEA. Intercostal nerves cryoanalgesia can provide satisfactory analgesia after thoracic surgery.

Objective To observe the analgesic effect of COX-2 inhibitors combined with PCA in treatment of the pain after total knee arthroplasty(TKA)and explore novai method for pain control after TKA. Methods This study was,a double blind,controlled,randomized,placebo-controlled,parallelgroup and single center study and obtained the consent of the Medical Ethics Committee of Chongqing Medical University.Inclusion criteria:the patients with severe trauma or degenerative knee,at age of 58-75 vears.ASA Ⅰ or Ⅱ, tolerance of the intravenous anesthesia.The same solvent formula of PCA was routinely prepared based on body weight after TKA.Intravenous injection of 40 mg Parecoxib plus 2 ml normal saline or injection of only 2 ml normal saline was done when closing the incision.which was recorded and prescribed by the researcher A.The same reagent waft,used continually every other 12 hours till48 hours.Celecoxib or placebo capsules was not usod orally at 72 hours until two weeks later.The knee ioint function was observed preoperatively and at days 3,7 and 15 after TKA. Results The study was completed in 60 patients including 30 patients in the group treated with Parecoxib and Celecoxib sequential therapy and 30 patients in placebo-control group.There was no statistical difference in aspects of general condition in both groups(P>0.05).There was no statistical difference in aspect of preoperative knee score between two groups(P>0.05).The analysis showed statistical difference in the knee function score at days 3.7 and 15 after operation(P<0.05 or0.01).Conclusions The COX2 inhibitors combined with PCA has definite analgesic effect on the pain after TKA,which positively correlates with early modified HSS evaluation of TKA.

Objective: To reconstruct adenovirus vector of breast eukaryotic initiation factor 4E and to observe its effect on the metastasis ability of breast cancer cell line MCF-7. Methods: eIF-4E gene was constructed into adenovirus vector pAD-X by gene recombination technique, which was transformed into 293 packaged cell for high titer adenovirus. Real-time PCR was applied to detect eIF-4E gene expression. eIF-4E siRNA was applied and then transwell cabin assay was used to observe changes of invasion and motor ability of MCF-7 cells transfected with reconstruction adenovirus. Result:The finding of digestion was coincided with expected. eIF-4E gene over-expression was detected in transfected MCF-7 cells with real-time PCR. And the invasion and motor abilities of transfected MCF-7 cells were more significantly inhibited in transwell cabin assay (respectively p

Objective To explore the effect of health education path on rehabilitation training of patients with total knee arthroplasty (TKA).Methods One hundred and eighty TKA patients were divided into experiment group and control group equally according to the sequence of admission.In the control group routine rehabilitation training was adopted,while in the experiment group the training was done on the instruction of health education path.The two groups were compared in terms of training accuracy,scores on health education, satisfaction with nursing and training efficiency after 12 months.Result Training accuracy,scores on health education,satisfaction with nursing and training efficiency after 12 months of the experiment group were significantly higher than those of control group(all P<0.05).Conclusion The application of health education path in rehabilitation training of TKA patients can improve the training efficiency and is good for patients’recovery.

Objective To investigate the effect of propofol exposure on neuroapoptosis in pri-mary cultured cortical neurons and its mechanisms.Methods Cortical neurons were primarily cultured for seven days,then divided into two groups:control group (treated with equal volume of 20% in-tralipid),propofol-treated group (treated with 500 μmol/L propofol).The neurons were treated for 12 h.The neuron viability was determined by MTT.Neuroapoptosis was identified by Hoechest 33 258 dying.Mitochondrial membrane potential was measured by the fluorescent dye rhodamine 123 (Rh123).Western blot was performed to detect the level of cyt-c and cleaved-caspase-3.Results Neu-rons survival rate (54.4%±6.4%)in the propofol group was significantly lower than that of control group (99.8% ± 4.1%) (P < 0.05 ), the rate of neuronal apoptosis (46.5% ± 5.3%) was significantly higher than that of control group (7.2%±0.9%)(P <0.05),mitochondrial membrane potential (59.6%±4.3%)was significantly lower than that of the control group (99.9% ± 5.7%) (P <0.05 ),cyt-C protein level (0.38 ± 0.03 )was significantly higher than that of control group (0.1 5±0.02)(P < 0.05 ),level of cleaved-caspase-3 protein level (0.46 ± 0.04)was significantly higher than that of control group (0.13±0.02)(P <0.05).Conclusion Propofol induces neuroapo-tosis in primary cultured cortical neurons,which is associated with the decreased level of MPP and the increase levels of cyt-c and cleaved-caspase-3.

Objective To investigate the status quo of transformational leadership,psychological empowerment,team psychological safety and team effectiveness,and test whether the supposed structural equation is tenable.Methods Totally 380 nurses completed the Transformational Leadership Questionnaire,Psychological Empowerment Questionnaire,Team Psychological Safety Questionnaire and Team Effectiveness Questionnaire,structural equation model was used to verify the relationship of the above,Bootstrapping confidential interval and product of coefficient were used to test the mediating effect.Results Significant correlations were found between transformational leadership,psychological empowerment,team psychological safety and team effectiveness (P ＜ 0.01),transformational leadership played indirect effect on team effectiveness (Z=6.195,P ＜ 0.05),psychological empowerment and psychological safety had a totally mediation effect.Conclusions Healthcare workers should make psychological empowerment and team psychological safety as the breakthrough point,fully play the advantages of transformational leadership on team effectiveness in order to increase the working ability of nurses and make them complete the clinical work effectively and with high quality.