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 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.

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 evaluate the effects of perioperatively administrated enteral immunonutrition in gastrointestinal cancer patients on immune and inflammatory responses,nutrition states and postoperative morbidity.Methods:Sixty patients with gastrointestinal cancer were divided randomly into two groups.Two groups perioperatively(from preoperative day 5 to postoperative day 7) received an supplemented diet with arginine,RNA,and ?-3fatty acids(immunonutrition group;n=30) or an isoenergetic and isonitrogenous standard diet (standard-nutrition group;n=30).All variables of immune and inflammatory responses,nutrition states and postoperative morbidity were measured on preoperative day 5 and postoperative day 1,4 and 8.Results:On postoperative day 4 and 8,most immune variables and prealbumin in the immuno-group were significantly higher than those in the standard-group(P0.05),and inflammatory variables as CRP in the immunonutrition group were significantly lower than those in the standard group.In the immunonutrition group,there were significantly fewer patients who experienced postoperative complications and shorter days of hospital stay compared with standard group(P0.05).Conclusion:The perioperative administration of enteral immunonutrition in gastrointestinal cancer patients can significantly modulate the postoperative immunosuppressive and inflammatory responses at the early postoperative day,can significantly decrease the occurrence of infectious and overall postoperative complications as well as the length of hospital stay.

0.05). The major toxic reactions in the two groups was tolerable myelo-suppression. The average cost of one patient for two therapeutic cycles was (23664?384.7) and (8519.94?369.1) respectively. Escalation of 1 % of response rate costed (485.02?34.65) and (185.62?23.77) respectively. Prolongation of 1 month of median survival duration costed (2211.59?59.1) and (946.66?43.3) respectively.TTP in group GP is longer than that in group NP(P

This paper discussed that how to cultivate high-quality medical talents by the use of basic education,medical moral education and psychologic education etc.