Objective To investigate the changes of stress response on inhalation-intravenous general anesthesia during pericystectomy for Liver hydatid cyst. Methods Thirty ASA I-II patients with liver hydatidosis for pericystectomy were studied. The blood from right jugular vein were collected for measurement of serum cortisol (Cor) concentrations and glucose (BG) levels, and MAP, HR and BIS were observed and recorded at different point-times: pre-intubation for 1 min, post-intubation for 3 min, pre-incision for 1 min, post-incision for 3 min, post-incision for 10 min, post-surgical exploration 10 min. The data of pre-intubation and pre-incision served as controls. Results The levels of Cor concentration of post-incision for 10 min were decreased than those of pre-intubation and pre-incision (P<0.05); MAP of post-incision for 10 min and post-surgical exploration for 10 min were increased than those of pre-intubation and pre-incision (P < 0.01); For HR, the data of post-surgical exploration 10 min was much quicker compared with pre-incision (P < 0.01), which is slower than that of pre-intubation(P<0.01). Conclusion Inhalation-intravenous general anesthesia may inhibit the stress response during intubation,incision and surgical exploration for liver hydatidosis pericystectomy. Hemodynamic changes during incision may reflect the trend of stress response in advance.

Objective To investigate the protective effect of protocatechuic acid(PCA)on the PC12 cell model of Alzheimer’s disease(AD)and to explore its mechanism . Methods Amyloid beta peptide 1-42(Aβ1-42)fiber polymers were identified by immunofluorescence. After PC12 cells were stimulated with the Aβ1-42 fiber polymers, the cellular morphology was observed at different time points of hour 0, 3, 6, 9, 12, 24 , and the cellular viability was tested by methyl thiazolyl tetrazolium(MTT)assay to monitor the modeling condition. The effect of PCA on PC12 cells was detected after PC12 cells were pretreated with the different contentions of PCA. Autophagy-related marker Beclin1 protein level was detected by Western blotting method to investigate the protective mechanism of PCA. Results Aggregated white Aβ1-42 mass was stable at hour 12 and 24, and showed no significant difference between the two time points, the cell damage rate being 40%. Therefore, we defined culturing time being 12 and 24 hours as the modeling condition of AD model. The cell viability was increased with 200-800 μmol/L of PCA after culturing for 24 hours(P<0.01) , and the Western blotting results showed that the Beclin1 protein expression was up-regulated by PCA. Conclusion PCA prevents PC12 cells from Aβ1-42-induced toxicity, the mechanism being related with the increase of cellular autophagy.

Aim To study the mechanism of andrographolide(AD) on the proliferation and apoptosis induction in human esophageal cancer Ec9706 cells.Methods The spectrometry was used to detect the activity of caspase-3 in human esophageal cancer Ec9706 cells treated with or without AD for 6 h,12 h and 18 h,and to detect the activity of caspase-8 and caspase-9 in human esophageal cancer Ec9706 cells treated with or without AD for 6 h.The influence of AD on the proliferation of Ec9706 cells after treatment with or without Z-VAD-FMK(a broad-spectrum caspase inhibitor) was determined by MTT method and the result was compared.The changes of gene expression levels of bcl-2 were determined by immunohistochemical method.Results The expression level of bcl-2 gene was obviously lower in the cells treated with AD(30 mg?L-1,P

Objective To explore the effect of 5M1E quality analysis tool-based hand hygiene(HH) comprehensive intervention measures on pediatric healthcare-associated infection(HAI).Methods HH status of 29 health care workers(HCWs) in the pediatric department of a hospital was monitored, April-June 2015 was baseline survey stage, 5M1E quality analysis tool was adopted to analyze various factors affecting the compliance rate of pediatric HH, intervention measures began to be taken in June 2015, and compared with HH in July 2015-March 2016.The occurrence of HAI between July 2014-March 2015 and July 2015-March 2016 was compared.Results HH compliance rate of HCWs increased from 30.86% in April-June 2015 to 81.94% in January-March 2016;HH correct rate increased from 68.14% to 93.75%;HH compliance rate and correct rate of HCWs gradually increased(X2=2 608.626, 630.798,respectively, both P<0.001).Qualified rate of detection of HCWs' HH sampling increased from 20.69% in April-June 2015 to 89.66% in January-March 2016(X2=31.957,P<0.001).Incidence of HAI decreased from 7.74% in July 2014-March 2015 to 3.62% in July 2015-March 2016(X2=46.717,P<0.001).Conclusion Application of 5M1E quality analysis tool in the investigation, analysis, and comprehensive intervention in HCWs' HH in pediatric department has greatly enhanced HCWs' HH compliance rate, and reduced the incidence of HAI in pediatric patients.

Objective: To make long-term comparison of drug-eluting stent (DES) implantation betweenleft internal mammary artery (LIMA) graft and native vessel in patients with previous coronary artery bypass grafting (CABG).
Methods: A total of 151 patients with anterior wall ischemia because of previous CABG induced LIMA graft lesion who received percutaneous coronary intervention (PCI) in our hospital from 2004-07 to 2012-12 were retrospectively studied. The clinical, coronaryangiography (CAG) and follow-up conditions for DES implantation were analyzed;according to the target vessel, the patients were divided into 2 groups:LIMA group, n=40 and Native vessel (NV) group, which meant all segments of left main to left anterior descending arteries, n=111. Primary end points included target lesion revascularization (TLR), target lesion failure (TLF) as cardiac death, target vessel related non-fatal MI with the composition of TLR and major adverse cardiovascular events (MACE).
Results:The median follow-up time was 30 (10-100) months. The rates of TLR and TLF were similar between 2 groups:(15.0%vs 11.7%, log-rank P=0.65) and (17.5%vs 13.5%, log-rank P=0.63). MACE occurrence in LIMA group was higher than NV group (35.0%vs 18.0%, log-rank P=0.043) which was mainly presented by new non-target vessel revascularization as right coronary artery, left circumlfex and saphenous vein graft(17.5%vs 4.5%, log-rank P=0.014). Cox multivariate analysis indicated that target lesion stent length was the only independent predictor for both TLR (HR=1.03, 95%CI1.00-1.06, P=0.01) and TLF (HR=1.03, 95%CI1.00-1.05, P=0.02);whereas, LIMA-PCI was the only independent predictor for MACE occurrence (HR=3.09, 95%CI1.28-7.60, P=0.012).
Conclusion: The chances of TLR and TLF were similar inpatients with previous CABG by either LIMA or NV, while MACE occurrence was higher in LIMA patients which should be further investigated.

Objective To survey on the smoking status among people with disabilities in Shanghai Jing′an District.Methods A cross-sectional questionnaire survey on smoking status among people with disabilities was conducted from July to December 2015 in 5 communities of Shanghai Jing′an District. Results Total 1 815 valid questionnaires were collected.Among all participants,278 were smokers with an overall smoking rate of 15.3%(278/1 815); the smoking rate in males was 28.1%(265/944)and in females was 1.5%(13/871).The disables people aged 45 -60 years had the highest smoking rate (23.4%,141/602).The nicotine dependence rate in regular smokers accounted for 74.6%(182/244). The nicotine dependence was mainly mild to moderate, and the average of Fagerstrom Test of Nicotine Dependence(FTND)score was 3.75 ±1.97.Most participants(90.8%,238/262)were aware of the harm of smoking to health,but the awareness rate of health hazards of second-hand smoke was only 59.5%(156/262).The awareness rates of tobacco-related diseases were all lower than 70%.The rate of quitting was 33.5%(93/278),but only 17.2%(16/93)succeeded;66.0%(173/262)of the smokers did not intend to quit,only 15.3%(40/262)started to quit or to reduce the smoking;and 83.6%(219/262)of current smokers thought that it was impossible to quit smoking.Conclusion The smoking rate in people with disabilities is lower than that in the general population,the awareness of the harm of second-hand smoke is low and there is lack of knowledge of tobacco related diseases;the intend of quitting is low but the success rate of smoking cessation is high among people with disabilities in Shanghai Jing ′an District.

Objective To study the possible causes of ST-elevated acute myocardial infarction (STEAMI) occurring one month after percutaneous coronary intervention (PCI). Methods One hundred and ninety two patients aged from 40-79 years who had a successful previous PCI and also received primary PCI due to STEAMI in this hospitalization were included in this study. The AMI-related lesions and previous angiographic findings such as the number of lesions, the degree of the stenosis, the type of stents and the acute results of last PCI, etc. were recorded in detail. If the AMI-related lesion was localized in-stents or at the edge of stents (distance from the edge ≤5 mm), it was defined aslate thrombosis, otherwise it was regarded as an AMI induced by new-lesion. Results New lesions, as the cause of STEAMI, were found in 144 cases (Group A, 75%), and late thrombosis in 48 patients (Group B, 25%). There was a significant difference in the average time from previous PCI to AMI (30.1±12.4 vs. 20.3±11.9 months) between the two groups. Diabetes mellitus (DM) and drug-eluting stents (DES) utilization were associated with markedly higher morbidity of late thrombosis in adjusted logistic regressionanalysis [hazard ratio (HR) 3.387, 95% CI 1.053-10.898 and HR 5.311, 95% CI 1.066-26.464]. Conclusions STEAMI occurred 1 month after PCI are more likely to be developed from previous insignificant lesions than from late thrombosis in stents. Moreover, DM and DES are associated with a high incidence of late thrombosis, which may indicate that intensive antiplatelet therapy should be considered in diabetic patients receiving PCI.

Objective: To evaluate the impact of primary percutaneous coronary intervention (PPCI) with pre-operative intra-aortic balloon pump (P-IABP) implantation on short and long term prognosis in octogenarian patients of ST-segment elevation myocardial infarction (STEMI). Methods: We performed aretrospectively study in octogenarian STEMI patients treated in our hospital from 2004-01 to 2014-08. The patients were divided into 2 groups: P-IABP group,n=24 and PPCI group,n=73 including 12 patients who received rescue IABP (R-IABP) because of intra- or post-procedural hemodynamic collapse as a subgroup.Major end point events included 1 month and 1-, 2-year post-operative death; major adverse cardiac and cerebral events (MACCE) included 1 month post-operative cardiac shock, new or worsening heart failure (HF), re-infarction and stroke. The predictors causing different endpoint events were identiifed by Cox proportional hazard model analysis. Results: 1 month and 1-, 2-year post-operative death were similar between 2 groups (8.3% vs 16.4%), (16.7% vs 24.7%), (25.0% vs 30.1%) respectively; MACCE incidence was also similar (20.8% vs 30.1%), allP>0.05. Death rates between P-IABP group and R-IABP subgroup were similar at different time points,P>0.05; while MACCE incidence in P-IABP group was lower than R-IABP subgroup (20.8% vs 66.7%),P=0.005 and it was mainly presented by reduced HF occurrence (8.3% vs 41.7%),P=0.003. Coxproportional hazard model analysis indicated that post-operative TIMI lfow<3 grade was the independent predictor for 1 month death (HR=4.79, 95% CI1.59-14.39,P=0.005), complicating diseases as chronic obstructive pulmonary disease, kidney impairment and anemiawere themain independent predictors for 2-year death (HR=3.0, 95% CI 1.37-6.56,P=0.006). Conclusion: PPCI and P-IABP had no signiifcant differencefor short and long term survivalin octogenarianSTEMIpatients. Compared with R-IABP, P-IABP patients had the lower MACC Eincidence at 1 month post-operation .

【Objective】 To explore the model of "One Core, Multiple Elements" emergency blood donation volunteer team (referred to as the Model) . 【Methods】 The Nanjing City Voluntary Blood Donation Joint Meeting serves as the core, with diverse entities including party committees, government departments, district governments, social organizations, enterprises, blood donors, etc. Following the principles of "emergency response in emergencies, wartime readiness, combining regular and wartime efforts," and adhering to the framework of the Model, the emergency blood donation volunteer team system in Nanjing was constructed. 【Results】 1) After the construction of the Model (2018—2022), the total number of emergency blood donation volunteers in Nanjing City increased by 191% compared to the pre-construction period (2013—2017), with an average annual blood donation of 20 929, showing significant differences (P<0.05). 2) After the construction of the Model, the number of emergency blood donation during the winter and summer increased by 206% and 185%, respectively, compared to the pre-construction period, demonstrating significant differences (P< 0.05) .3) Prior to the construction of the Model, Nanjing lacked a relatively stable emergency volunteer team. After the construction, Nanjing established a total of 5 relatively stable volunteer teams, with the district-level government and township personnel accounting for the highest proportion (52.96%), followed by medical personnel (23.95%), enterprise team (11.10%), State-owned Assets Supervision and Administration Commission team (7%), and Nanjing municipal government team (4.98%). 4) Following the Model, during the COVID-19 pandemic, Nanjing successfully initiated two Level Ⅱ blood emergency responses, with emergency blood donations reaching 23 041. 【Conclusion】 The Model can effectively ensure the blood supply in Nanjing region during emergencies.

Selenylation modification of polysaccharides from the extract residue of Sarcandra glabra(Thunb.) Nakai was operated with sodium selenite as modification agent and barium chloride as the catalyst.The synthesis conditions were optimized by orthogonal experiment with the yields and contents of selenium as indicators.Then, the purity,molecular weight,infrared spectroscopy,thermophysical properties and antitumor activity of the seleny-lated polysaccharides were determined.Results showed that the optimum conditions for preparing selenylated polysaccharides from the extract residue of S.glabra(Thunb.)Nakai were at 70 ℃ for 7 h with 1.0％ nitric acid using 1.5 g barium chloride as catalyst.Under the optimum condition,the physicochemical properties of the derivatives were measured and the results showed that the total carbohydrate content was(94.89 ± 0.83)％,the yield was(21.93 ± 0.85)％,the content of selenium was(944.54 ± 13.91)μg/g,the molecular weight was 1 339 kD. In vitro antitumor activity indicated that exposure of HepG2 cells to the increasing concentrations of the crude polysaccharide from the residue of S.glabra(Thunb.)Nakai and its selenylated products decreased cell viability in dose-dependent and time-dependent manner.The selenium polysaccharide demonstrated a better antitumor activity compared with the raw polysaccharide,which could be explored as a potential antitumor drug from abandoned extracted residue for the functional foods and pharmaceutical industries.