Objective To explore how Vibrio vulnificus (Vv) invades dendritic cells (DC) and induces acute necrosis of DC via toll-like receptor (TLR) 2 and 4 pathways.Methods Vv 1.1758 strain and DC 2.4 mixed culture model was established,observed the infection rates of DC with optical microscope,the location of Vv and structural changes of DC by transmission electron microscope.The expression levels of TLR2 and TLR4 mRNA were determined by real-time quantitative reverse transcription polymerase chain reaction (RT-qPCR) and tumor necrosis factor-α (TNFα) protein titers were measured by enzyme-linked immunosorbent assay (ELISA).DNA ladder qualitative test was used to detect cell apoptosis,while flow cytometry was used to quantify cell apoptosis and necrosis rates.Statistical analysis was done by chi-square test and one-way ANOVE.Results The infection rates of DC after 0.5,1,2,4 and 6 h of mixed culture were (7.8±0.8) ％,(13.9± 1.1) ％,(34.6±4.9) ％,(77.8± 10.2)％ and (95.8 ± 13.1)％,respectively.Vv was generally located in the internal cell membrane of DC 2.4.After 2 h co-culture,nuclear chromatins of DC became active and intranuclear apoptosis bodies appeared.After 4 h,cytoplasmic vacuoles appeared,chromatin gathered,and cell membranes were seriously damaged.After 6 h,mitochondria was highly swelled and distorted,and cell apoptosis and necrosis occurred.TLR2 and TLR4 mRNA levels reached peak values after co-culture for 0.5 h; TNF-α level began to increase at 1 h (P＜0.05) and reached peak values at 2 h.DNA Ladder electrophoresis presented scouring necrosis after 2 h culture and apoptotic bands appeared between 720 bp and 900 bp after 4 to 5 h culture.Early apoptosis rates of DC after 2,4 and 6 h culture were (3.1±3.8)％,(7.8±4.7)％ and (12.7±8.2)％,and necrosis rates of DC were (16.7±12.5)％,(41.6±25.9)％ and (75.5±33.6)％,higher than that of control group (all P＜0.05).Conclusions Vv infects DC and induce DNA degradation through up-regulated expression of TLR2 and TLR4 and increasing of TNF-α inflammatory mediators.During cell degradation,apoptosis and necrosis coexist,while necrosis is predominant.

Objective:To explore the effect of active ruminant thinking training on improving the self-perceived burden and quality of life of patients with end-stage renal disease undergoing hemodialysis.Methods:Using the convenient sampling method, a total of 106 patients with end-stage renal disease undergoing hemodialysis who were treated in Yantai Yuhuangding Hospital from January to December 2019 were selected as the research objects. The patients were divided into the control group and the intervention group by random number table, with 53 cases in each group. The control group received conventional treatment and nursing care, while the intervention group received active rumination thinking training on this basis. The scores of self-perceived burden, perceived stress and self-efficacy were compared between the two groups before and after intervention.Results:After the intervention, the total scores of body burden, emotional burden and self-perceived burden of the intervention group were lower than those of the control group, and the differences were statistically significant ( P<0.05) . The score of perceived stress of the intervention group was lower than that of the control group, and scores of emotional control, reasonable rest, self-care, management of compliance with medication and health problems in the self-efficacy of patients were higher than those of the control group, and the differences were statistically significant ( P<0.05) . Conclusions:The application of active rumination thinking training in hemodialysis patients with end-stage renal disease can reduce the self-perceived burden and perceived pressure of patients and improve the self-efficacy level.

OBJECTIVE: To observe the therapeutic effect of work intensive training on workers with musculoskeletal injury(MSI). METHODS: A convenience sampling method was used to select MSI patients as research subjects. Patients were randomly divided into control group(179 cases) and experimental group(188 cases). On the basis of the conventional comprehensive rehabilitation treatment, the control group received the routine occupational rehabilitation intervention, and the experimental group received the work intensive training intervention. The intervention period was 4 weeks in both groups. We used the Post-Traumatic Stress Disorder(PTSD) Self-Rating Scale, the Fear-Avoidance Beliefs Questionnaire(FABQ) and the General Self-efficacy Scale(GSES) to assess the recovery of MSI patients. The statuses of return to work of patients were followed up by telephone after six months of discharge from hospital. RESULTS: Compared with the same group before intervention, the scores of PTSD, FABQ-P and FABQ-W in the control group and the experimental group decreased, and the score of GSES increased(P<0.01). After the intervention, the scores of PTSD, FABQ-P and FABQ-W in the experimental group were lower than those in the control group(P<0.01), and the score of GSES was higher than those in the control group(P<0.01). The rate of returning to work in the experimental group was higher than that in the control group(80.9% vs 59.2%, P<0.01). CONCLUSION: Work intensive training has curative effect on self-efficacy, physical activity, subjective pain, and post-traumatic stress disorder, and can improve the rate of resuming to work in patients with MSI.