Objective To analyze the risk factors and prognosis of Clostridium difficile infection (CDI) among hospitalized patients with inflammatory bowel disease (IBD).Methods From March 2014 to February 2015,216 first-time hospitalized patients with IBD were enrolled.Once hospitalized,stool samples were obtained for Clostridium difficile culture immediately,and at the same time toxins of Clostridium difficile (tcd) A and tcdB were detected by polymerase chain reaction(PCR).The incidence and risk factors of CDI in enrolled patients were analyzed.Chi square test and nonparametric test were performed for statistical analysis.Results Among the 216 IBD patients,there were 73 patients with ulcerative colitis(UC) and 143 patients with Crohn's disease(CD).The positive rate of CDI was 13.9 ％ (30/216) in IBD patients.The positive rate of CDI was 24.7 ％ (18/73) in UC patients,which was higher than that of CD patients (8.4％,12/143),and the difference was statistically significant (x2 =10.690,P＜0.01).As the severity of the disease increased,the rate of CDI positive patients in UC patients increased.Among three patients at remission period,17 patients at mild active stage,23 patients at moderate active stage and 30 patients at severe active stage,the CDI positive patients were zero,two,five,11,respectively,and the difference was statistically significant (x2 =4.820,P=0.028).In UC patients,the incidences of patients with hospitalization history in other hospitals within three months before admission in CDI positive group and negative group were 6/18 and 7.3％ (4/55),respectively,and the difference was statistically significant (x2 =5.740,P=0.020).In 30 days before admission,the rates of patients with proton pump inhibitor (PPI) taking history of two groups were 7/18 and 7.3％ (4/55),and the difference was statistically significant (x2=8.270,P=0.004).The length of hospital stay in CDI negative UC patients was 7.0 d (5.0 d,12.0 d),which was shorter than that of CDI positive patients (10.5 d (8.8 d,18.2 d)),and the difference was statistically significant (U=277.000,P=0.005).The rate of patients underwent intestinal operation in CDI negative CD patients within three months after CDI examination was 10.7 ％ (14/131),which was significantly lower than that of CDI positive patients (5/12) (x2 =4.520,P=0.010).Conclusions The incidence of CDI in hospitalized IBD patients was high,especially in UC patients;the risk factors included disease severity,prior hospitalization history within three months before admission and PPI taking history within 30 days before admission.CDI was correlated with poor prognosis.

Objective To evaluate the therapeutic effect of bone marrow mesenchymal stem cells (BMSC) transplantation via renal artery in treating experimental rats with adriamycin-induced chronic nephro -pathy.Methods A total of 50 male Sprague-Dawley (SD) rats were used as experimental animals.Two rats were used for the isolation and culture of BMSC.Twelve rats were designed as blank control group (group N);in other 36 rats adriamycin was injected through caudal vein to establish rat models of chronic nephropathy,these 36 rats were randomly and equally divided into three groups with 12 rats in each group:control group (group C,n=12),BMSC transplantation via renal artery group (group A,n=12),and BMSC transplantation via caudal vein group (group V,n=12).For the rats of group N,the same amount of normal saline was injected through caudal vein.Results At each observation point,the levels of blood urea nitrogen,serum creatinine,24 h urinary protein and 24 h urinary microprotein in group A,V and C were remarkably higher than those in group N (P＜0.01).One and two weeks after BMSC transplantation,the 24 h urinary microprotein level in group A was significantly lower than that in group C (P＜0.01);the serum creatinine level in group A was significantly lower than that in group C and group V (P＜0.01).One week after BMSC transplantation,both the 24 h urinary protein level and 24 h urinary microprotein level in group A were strikingly lower than those in group V (P＜0.01),but two weeks after BMSC transplantation these differences between group A and group V became not statistically significant.Conclusion BMSC transplantation via renal artery can improve cell-homing efficiency and improve the repair of damaged tissue as well.

Objective To evaluate the short-term and mid-to-long-term clinical effectiveness of endovascular isolation technique with covered-stent in treating Stanford type B aortic dissection. Methods A total of 183 patients with Stanford type B aortic dissection, who were admitted to authors’ hospital during the period from January 2005 to December 2013 to receive endovascular isolation treatment with covered-stent under general anaethesia, were enrolled in this study. The clinical data, including post-operative symptoms, complications, retention time in ICU, hospitalization days, 30-day mortality, etc. were retrospectively analyzed. After discharged from hospital, the patients were followed up to check the situation, position and shape of the stent, the diameter of dissection false lumen, the internal leakage, etc. The survival rate and the quality of life were determined. Results Endovascular isolation procedure with covered-stent was successfully accomplished in all the 183 cases. The retention time in ICU was (3.08 ± 1.93) days, the mean hospitalization time was (3.08 ± 1.93) days, and the 30-day mortality was 1.09%. After discharged from hospital, the patients were followed up regularly, and no collapse or displacement of stent was observed, and the stent remained in its normal shape. No recurrence of dissection, rupture or reversal tear was observed. No long existing internal leakage could be detected. During the follow-up period 4 patients died, among them three died from cerebral infarction and one died of natural death. The 5-year survival rate was 97.82% and the patient’s quality of life did not become apparently worse. Conclusion For the treatment of Stanford type B aortic dissection, endovascular isolation therapy with covered-stent has excellent short-term effect and stable mid-to-long-term result.

Objective To investigate the role of scavenger receptor class B type 1 (SR-B1) signaling pathway in serum amyloid A (SAA)-induced angiogenesis in rheumatoid arthritis (RA).Methods The expression and location of SR-B1 in RA and osteoarthritis (OA) synovial tissues were observed by immunohistochemistry.And SR-B1 expression in the resting human umbilical vein endothelial cells (HUVECs) was detected by immunoflourescence.Wound repair assessement and tube formation assessement were employed to evaluate the effect on cell migration and tube formation stimulated by SAA and/or anti-SR-B1 antibody.The t-test and one-way analysis of variance (ANOVA) were used for statistical analysis.Results ① SR-B1 was significantly highly expressed in RA tissue samples (A=6 788±819) when compared to the minimal expression in OA (A =31 849±6 977,t=3.567,P＜0.01).Positive staining of SR-B1 was observed in RA synovial vascular endothelial cells and perivascular areas.② Strong staining for SR-B1 was observed in all HUVECs tested.③ Significant wound healing induced by SAA (MI=2.50±0.17) was found compared with the untreated controls (MI=1.00±0.09,q=14.38,P＜0.01),and the effects were inhibited in the presence of anti-SR-B1 antibody (MI=1.16±0.14,q=13.02,P＜0.01).④ Compared to the untreated group (branch point number:6.6±0.8),there was an enhanced formation of branched and capillary-hke tube structure followed by SAA stimulation (branch point number:19.0±1.1,q=25.04,P＜0.01) after culturing for 72 h,whereas,tube formation decreased markedly upon pre-treated with anti-SR-B1 antibody (branch point number:7.6±1.3,vs SAA,q =23.32,P＜0.01).Conclusion Our present study suggests that serum amyloid A may induce angiogenesis via SR-B1 signaling pathway in RA.

Objective To evaluate 16-SCT in diagnosing aeute appendicitis.Methods The CT findings of 34 cases were retrospectively analyzed.These cases were all proved acute appendicitis by surgical-pathology.Results 30 cases were confirmed by CT,with accuracy 88% (30/34).The diameter of 28 appendix was more than 6mm;2 collapsed with thickening wall.Periappendiceal fat stranding could be seen in 25 cases.Perforated appendicitis happened in 4 cases.Abscess performed in 2 cases.3 cases were missed,1 misdiagnosed.Conclusion 16-SCT could confirm acute appendicitis and its complication timely and accurately.

Objective To compare the repair effect on renal function between different times of bone marrow mesenchymal stem cells (BMSCs) transplant via renal artery route in experimental rats with adriamycininduced nephropathy.Methods Adriamycin-induced nephropathy model was established in 32 rats through injection of adriamycin though the caudal vein.Based on the scheduled times of BMSCs transplant,the experimental rats were randomly and equally divided into M0 group (zero time),M1 group (one time),M2group (2 times) and M3 group (3 times) with 8 rats in each group.Other 8 SD rats were used as normal control group (N group).Single dose of 0.5 rnl BMSC suspension (2×106 cells/ml) was transplanted to the rats of M0 group (zero time),M1 group (one time),M2 group (2 times) and M3 group (3 times),for the rats of the groups not receiving BMSC transplant a single dose of 0.5 ml L-DMEM culture medium,used as a placebo,was adopted to replace BMSC suspension.The transplant interval was one week.Before transplant as well as one and two weeks after last time of transplant,the serum urea nitrogen,serum creatinine,24 h urine protein and 24 h urine microprotein were tested,and one week after last time of transplant pathological sections were made for laser focusing microscope examination to observe renal pathological changes and the distribution of BMSC cells in the kidney.Results The values of serum urea nitrogen,serum creatinine,24 h urine protein and 24 h urine microprotein determined at each observation time point in M0 group,M1 group,M2 group and M3 group were significantly higher than those in N group (P＜0.001).The values of 24 h urine protein and 24 h urine microprotein determined at one week after last time of transplant in M2 group and M3 group were strikingly lower than those in M1 group (P＜0.05),but these differences between M2 group and M3 group were not statistically significant (P=0.063).Conclusion For the treatment of adriamycin-induced nephropathy in experimental rats,two times of using BMSCs transplant via renal artery route can achieve optimal curative effect.

Neurotrophic keratopathy is caused by a variety of factors that damage the corneal sensory nerves,resulting in hypoesthesia of cornea,corneal dystrophy and inflammatory changes.The manifestations of neurotrophic keratopathy are recurrent or persistent corneal epithelial defects,delayed corneal wound healing,corneal ulcers and even perforation.There are still some difficulties in therapy targeting to nerve plerosis.Substance P,as a neurotransmitter,is expressed in ophthalmic nerves and many cell types,including corneal epithelial cells,stromal cells and immunological cells,and exerts its biological functions by activating intracellular signaling pathways.Recently,with the increasing researches of substance P,the treatment of neurotrophic keratopathy is gradually changing.This paper retrospected the clinical features and pathogenesis of neurotrophic keratopathy,summarized the association between substance P and neurotrophic keratopathy from the perspective of infection,surgery and systemic disease,and the prospects of substance P application in neurotrophic keratopathy.

Objective To study current situation and influencing factors of health behavior among rectal cancer patients with intestine stoma after neoadjuvant chemotherapy. Methods Questionnaire investigation was conducted among 78 patients using health-promoting lifestyle profile-Ⅱ, general demographic data and related data of disease.And a statistical analysis was made on its investigation. Results The score of health behavior of rectal cancer patients with intestine stoma after neoadjuvant chemotherapy was 131.01 ± 24.47.The score ofeach dimensionin descending order were:nutrition, interpersonal relations, stress management, health responsibility, spiritual growth and physical activity. Multiple stepwise regression analysis indicates literacy, average mothly income, chemotherapy collateral injury and stoma complications were the significant factors of health behavior (P<0.05), which could explain 70％ of the variance in health behavior. Conclusion The level of health behavior of rectal cancer patients with intestine stoma afer neoadjuvant chemotherapy need to be improved. In the process of designing and implementing clinical nursing, great importance should be paid to the nursing of patients with chemotherapy collateral injury and stoma complications, to improve their health behavior, to help them establish and maintain a healthy lifestyle and to improve the quality of life.

Objective To explore the effect of adipose-derived stem cells (ADSCs) on inflammatory factors in rats with lipopolysaccharide (LPS)-induced acute lung injury (ALI) and the possible mechanism of anti-inflammatory. Methods Seventy male Sprague-Dawley (SD) rats were randomly divided into normal control group (n = 10), LPS model group (n = 30), and ADSCs intervention group (n = 30) by random number table. ALI model was reproduced by intraperitoneal injection of 8 mg/kg LPS, and the rats in ADSCs intervention group received tail vein injection of 300 μL ADSCs 30 minutes after the model reproduction, the samples of normal control group were harvested immediately without any intervention, and the specimens in remained two groups were taken at 6, 24, 72 hours respectively. Arterial partial pressure of oxygen (PaO2) and lactate level in femoral artery were determined. Enzyme-linked immunosorbent assay (ELISA) was used to detect the serum myeloperoxidase (MPO) and interleukin-10 (IL-10) in the blood of left ventricle. Lung wet/dry weight (W/D) ratio was detected by thoracotomy, and the pathological changes of lung tissue were observed under an optical microscope. Western Blot was used to detect the protein expression of nuclear factor-κB (NF-κB) in lung tissue of rats. Results Compared with the normal control group, the damage degree of lung tissue of LPS model group was significantly heavier from 6 hours, and lung W/D ratio, blood lactate, MPO, IL-10 and expression level of NF-κB in lung tissue were significantly increased respectively, while PaO2 was decreased significantly. Compared with LPS model group, the damage degree of lung tissue of ADSCs intervention group was significantly reduced from 6 hours, and lung W/D ratio, blood lactate, MPO, and NF-κB expression in lung tissue were significantly decreased, while PaO2 was increased significantly, and it became normal at 72 hours [lung W/D ratio: 5.33±0.29 vs. 5.77±0.42 at 6 hours, 5.14±0.46 vs. 5.43±0.38 at 72 hours; blood lactate (mmol/L): 3.6±1.0 vs. 5.7±1.1 at 6 hours, 3.1±1.0 vs. 3.8±1.2 at 72 hours; blood MPO (μg/L): 1.50±0.90 vs. 2.70±1.85 at 6 hours, 0.46±0.30 vs. 0.71±0.22 at 72 hours; NF-κB (gray value): 0.40±0.11 vs. 0.50±0.09 at 6 hours, 0.24±0.03 vs. 0.33±0.06; PaO2 (mmHg, 1 mmHg = 0.133 kPa): 78.0±4.1 vs. 74.5±3.2 at 6 hours, 89.3±9.4 vs. 81.9±3.4 at 72 hours; all P < 0.05]. The IL-10 level was significantly higher than that of LPS model group only at 24 hours (ng/L: 27.75±15.49 vs. 17.52±6.56, P < 0.05). Conclusion ADSCs can effectively relieve the inflammatory response of ALI induced by LPS, probably by inhibiting the expressions of NF-κB and blocking the release of inflammatory cytokines.

Objective: The purpose of the current study was to determinate the prevalence of dating violence perpetration and victimization and to examine its relationship with childhood abuse among medical college students. Methods: Cluster sampling survey was carried out among 3 727 freshmen and sophomores in two medical colleges from Anhui Province. Information with general demographic variables, childhood abuse and dating violence was obtained. Logistic regression was used to identify the relationship of different types of childhood abuse and dating violence after controlled for confounding factors. Results: The rate of dating violence perpetration and victimization was 37.8% and 27.8%, respectively. Female students had higher childhood emotional abuse experience (61.9%) than male students (51.6%), while male students had higher childhood physical and sexual abuse (28.2% and 19.4%) than females (24.3% and 10.5%) (χ2=33.84，6.33，52.97，P<0.01). Results showed that increased dating violence perpetration [OR(95%CI)=1.71(1.48-1.98),1.55(1.33-1.82),1.75(1.43-2.15)]and victimization [OR(95%CI)=1.84(1.43-2.16),1.59(1.34-1.87),1.62(1.32-2.00)](P<0.01) among individuals with physical, emotional and sexual abuse after controlling for confounding variables. No gender difference was found within other groups in the relationship between childhood abuse and dating violence(P>0.05). Conclusion Childhood abuse experiences are associated with higher risk of dating violence perpetration and victimization among college students. Reducing childhood abuse is beneficial to the prevention and control of dating violence among medical college students.