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 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 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 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 investigate the value of arthroscope in the diagnosis and treatment of knee synovitis. Methods 50 cases of knee synovitis diagnosed by arthroscopy and treated by endoscopic synovectomy were studied. There were 10 cases with rheumatoid arthritis, 11 cases with pigmented villonodular synovitis,5 cases with chronic infection of knee joint,12 cases with chronic non-specific synovitis,5 ca-ses with tuberculous synovitis of the knee,4 cases with meniscus injury,3 cases with unknown cause. The efficacy of the treatment was recor-ded. Results All these cases were clearly diagnosed by microscopic examination combined with synovial pathological examination,and 10 cases were corrected with clinical diagnosis post-operation. All cases received primary healing without serious complications. All cases were followed up,and 6 cases of pigmented villonodular synovitis,2 cases of rheumatoid arthritis,1 case of chronic non-specific synovitis and 1 case of tuberculous synovitis of the knee had recurred. The total effective rate was 80. 0%. Conclusion The application of arthroscopy and syno-vial biopsy was effective in diagnosis. Arthroscopic synovectomy had good effect on treatment with less trauma and complications.

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 study the significance of expression of Cyclin E in hepatocellular carcinoma (HCC). Methods Cyclin E expressions were examined in 45 specimens of HCC and 30 specimens of paracancer tissues, and the relationship between Cyclin E with the clinico-pathological parameters was determined.Among the 45 patients ,19 were poor encapsulatic; 12 patients had portal vein thrombus; 11 had extrahepatic metastasis;12 had intrahepatic metastasis.Any patient had one or more of 4 conditions mentioned above was considered as invasion and metastasis. Results The overexpression of Cyclin E in HCC tissues was seen in 16 cases (35.6%) ,but not seen in paracancer tissues. Cyclin E overexpression occurred more frequently in HCC patients with poor differentiation and portal vein thrombus ( P 0.05). Conclusions Expression of Cyclin E is related with HCC carcinogenesis; differentiation , invasion and metastasis, detection of expression of Cyclin E may be helpful in the diagnosis, treatment and prediction of the prognosis of patients with HCC.

Objective:under the protective medical system,health care professional incline not to disclose the medical information to vulnerable patients in order to protect them from any unpleasant stimuli which might worsen their illness condition.This study aims to understand how patients' perceived illness severity and prognostic awareness impact on their will to live and healthcare expectations.Participants & Methods:twenty newly admitted patients,6 men and 14 women,with confirmed diagnosis of metastasis cancer in a hospice ward in Shanghai participated in the study.Semi-structured interviews were used to illicit the patients' view and experience.The interview questions include the patients' understanding of their illness condition,concerns in different aspects of life and expectation on treatment and care.Audio-recorded interviews were verbatim transcribed and analyzed using vanKaam's method of controlled explication.Result:although the patients did not learn their illness directly from others,they were able to capture their illness severity by observing the reaction of doctors or family members.Among them,9 patients actively sought evidence to confirm their illness condition.Although all 20 patients considered themselves gravely ill,their will to live ranged form very strong to very weak,which can be categorized into three major kinds of responses: struggling for life,letting-it-to-happen and pleading for death.The patient's level of prognostic awareness did not have a strong association with their will to live,but the will to live was associated with their expressed quality of life concerns.The patients with more negative emotion,weaker family ties and more physical discomforts had weaker will to live.The patients who had unfinished business such as young children had the strongest will to live.The letting-it-go-happen patients were complacent that they had fulfilled their life responsibilities.Both patients who struggled for life and who pleaded for a hastened death had unrealistic healthcare expectations.The former hoped the medical staff could cure their illness whilst the latter preferred the medical staff to end their life.This is inconsistent to the concept of hospice care as dying should be treated as a natural process.Conclusion: This study shows that empathetic and open interactions with terminally cancer patients are possible.No untoward emotional reactions were noted after the interviews.The patients could receive better psychological support form the health care providers,and their needs were more realistically addressed.Furthermore,it can facilitate the family and healthcare providers to fulfill patients' last wishes and help them to pass their last days in peace,comfort and dignity.

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.