Objective To study the mechanism of Ulinastat’s enhancement for antibiotics’curative effects in sepsis Children caused by bacteria. Methods Children with sepsis caused by bacteria were treated with Ulinastat combined with antibiotics (UTI group) and antibiotics only (CON group), The curative effects, GSC scores and APACHEⅡscores in two groups were observed and compared, pre-and post-therapy serum procalcitonin and inlfammatory factors were detected and compared. Results The efifciency rate and GSC score in UTI group were signiifcantly higher than in CON group (P<0.05), but lower in mortality and APACHEⅡscore (P<0.05). hs-CRP, TNF-α, IL-6 and IL-8 of UTI group in one week, two weeks and three weeks post-therapy were signiifcantly lower than in CON group (P<0.05), while IL-10 was higher(P<0.05). Conclusion The Ulinastat can signiifcantly increases antibiotics’curative effects for sepsis Children caused by bacteria though lowering down serum PCT, hs-CRP, TNF-α, IL-6 and IL-8 and increasing IL-10.

Objective In order to understand the students' experience and satisfaction in community nursing practice and the factors that influence them,to provide a basis for improving the quality of teaching in community practice.Methods The students were invited to compete the questionnaire that consisted of preceptors,the length of clinical practice time in hospital,practice items and satisfaction,opinions and harvest to community practice after completing 3-week practice in a designated community placement.Results 327 nursing undergraduates participated in the survey,and the average practice items were (9.7±2.0).The satisfaction of students was (3.89±0.58) points.There were significant differences of practice items and the scores among different preceptors,duration of students practice in hospital ahead,and the length of community conducting the practice teaching.There was a positive correlation between practice items and the satisfaction of students.Conclusions It is time to improve the quality of preceptors,strengthening the practice management in late stage,and promote students self-improvement.

Objective To investigate the effect of Xuesetong Dripping Pills combined with alprostadil intervention on serum brain natriuretic peptide in elderly patients with chronic congestive heart failure.Methods In 74 patients with chronic congestive heart failure, were randomly divided into observation group and control group, 37 cases in each group.Control group received conventional method.The observation group received Xuesetong Dripping Pills combined with alprostadil on the basis of conventional therapy.Compared the efficacy, the heart function level, walking test and level of serum brain natriuretic peptide between two groups after 15 days’ treatment.Results The total efficiency of observation group was 94.59%, which was higher than 75.68% in the control group, the difference was statistically significant(P<0.05).After treatment, the heart function level improvement in the observation group was better than the control group, the difference was statistically significant(P<0.05).After treatment, 6 min walking test in the observation group(316.4 ±20.7) m, was better than the control group(303.5 ±28.1) m, the difference was statistically significant(P<0.05).The level of serum brain natriuretic peptide in the observation group(608.9 ±158.1)ng/L, was lower than that of the control group(792.7 ±179.4) ng/L, the difference was statistically significant ( P <0.05 ) .Conclusion Xuesetong Dripping Pills combined with alprostadil has good curative effect in the treatment of chronic congestive heart failure,can relieve the abnormal increase of serum brain natriuretic peptide, improve blood circulation and heart function.

Objective To investigate the distribution characteristics and clinical features of familial aggregation hemangioma to improve the level of the diagnosis and treatment.Methods Total 1202 cases of vascular disease were treated in this department from June 2006 to June 2011.The clinical data and family distribution characteristics in 36 cases of familial aggregation hemangioma were analyzed and their effects of laser treatment were evaluated.Results 36 cases were familial aggregation hemangioma,whose incidence was 2.99 ％ in 1202 cases of vascular disease cutis; and the ratio of male to female was 1 ∶ 1.There were 9 cases of parents suffering from hemangioma.But the incidenceof the next generation suffering from vascular disease was 28.5 ％.Among these 36 cases of familial aggregation hemangioma,33 cases underwent the long pulse 1064 nm Nd ∶ YAG laser and optimized pulse light combination therapy.The effective rate was 100 ％.Conclusions There may be a genetic predisposition in hemangioma.The application of long pulse 1064 nm Nd ∶ YAG laser and optimized pulsed light treatment to hemangioma cutis can obtain satisfactory results.The intervention should be taken in early stage.

Objective To investigate the effect of STAT3 knockdown on the sensitivity of breast cancer cells with drug-resistant to adriamycin (MCF-7/ADR). Methods Levels of STAT3 and p-STAT3 in MCF-7/ADR and MCF-7 cells were detected by Western Blot. The MCF-7/ADR cells were infected with lentivirus expressing STAT3-shRNA and the negative control vectors in the STAT3-RNAi group and NC group, respectively, wihle the cells in the blank group received no treatment. The transfection efficiency was observed with fluorescence microscope, the mRNA level of STAT3, protein levels of STAT3 and p-STAT3 were detected by qRT-PCR and Western Blot, respectively. MCF-7/ADR cells were treated with different concentrations of adriamycin for 48 hours, cell proliferation was detected by MTT assay and cell apoptosis was detected by flow cytometry. Results Levels of STAT3 and p-STAT3 in MCF-7/ADR cells were significantly higher than those in the MCF-7 cells (P < 0.05). The levels of STAT3 mRNA, STAT3 and p-STAT3 in the STAT3-RNAi group were significantly lower than those in the Con group and the NC group (P<0.05, respectively). The Adriamycin IC50 in the Con group, NC group and STAT3-RNAi group was (56.1 ± 3.00)ug/mL,(54.9 ± 11.9)ug/mL and (7.6 ± 0.2)ug/mL, respectively. The flow cytometry results showed that the cell apoptosis in the Con group, the NC group and the STAT3-RNAi group was (10.5+0.7)%, (11.7+0.7)%and (34+3.1)%, respectively. Conclusion LV-shRNA-STAT3 can significantly inhibit STAT3 expression and enhance the sensitivity of breast cancer cells to adriamycin, and the underlying mechanism may be related to cell apoptosis.

Objective To investigate the effects of ligustrazine (TMP) combined with salvia miltiorrhiza on the progression of chronic allograft nephropathy (CAN) in rats and the action mechanism.Methods Fischer 344 rats and Lewis rats were used as renal transplant recipients and donors for ortlotopic kidney transplantation. The CAN model was established.By using random number table,the kidney transplant recipients were divided into five groups:cyclosporine A (CsA) group (A),TMP + CsA group (B),Salvia + CsA group (C),TMP + Salvia + CsA group (D) and blank control group (E,receiving no treatment).At 2nd,4th,6th,8th and 12th week after operation,5 mice in each group were sacrificed,and the transplanted kidney was removed for examination of renal histopathological changes. The immunohistochemistry was used to detect the expression of transforming growth factor β1 (TGF-β1) in the renal allograts,and by using fluorescent quantitative polymerase chain reaction,TGF-β1 mRNA expression in the renal allograts assayed.Results In blank control group,the survival time was no more than two weeks.In group A,the CAN pathological changes occurred at 4th week postoperation,those in group B and group C occurred later than in group A,and latest in group D with mild pathological lesions.In all groups after operation,Banff scores showed an upward trend,and at the same time point,those in group A were significantly higher than groups B,C and D ( P＜0.05 and P＜0.01 ).and those in group D was significantly lower than in group B and group C (P＜0.05),but no significant difference was found between group B and group C (P＞0.05).With time over,the TGF-β1 expression intensity showed an increasing trend.At the same time point,TGF-β1 expression intensity in group A was strongest among groups A,B,C and D (P＜0.05 and P＜0.01 ),and that in group D was significantly lower than in group B and group C (P＜0.05),but no significant difference was found between group B and group C (P＞00.05).The changes of TGF-β1mRNA expression pattem in each group showed the same trends as TGF-β1 protein expression.Conclusion TMP or salvia miltiorrhiza can delay the progression of CAN in kidney transplant rats by down-regulating the TGF-β1 expression,and the combined use of them exerts synergic effects.

Objective To investigate the relationship between chest radiographic changes and clinical manifestations in patients with scrub typhus in Guangdong area.MethodsA total of 148 cases of scrub typhus admitted to First Affiliated Hospital of Ji′nan University,Guangzhou Eighth People′s Hospital and the Second People′s Hospital of Yuebei between 1999 and 2010 was retrospectively reviewed.The patients were divided into two groups based on the findings of the chest X-rays (with or without radiographic abnormalities).Furthermore,the clinical characteristics and prognosis in two groups were compared.The statistical analysis was done using t test,chi-square test or Fisher′s exact test.ResultsChest X-rays showed abnormalities in 66 (44.6％) cases,and the chest X-ray features were diverse.The incidences of cough,severe thrombocytopenia,hypoalbuminemia,shock,acute respiratory failure,jaundice and acute renal failure were all significantly increased in group of patients with chest X-rays abnormalities compared with the other group of patients without chest X-rays abnormalities (χ2 =18.193,6.872,17.138,5.608,4.318,7.982 and 7.932,respectively; all P＜0.05).The hospitalization day was longer in patients with chest X-rays abnormalities compared with the patients without chest X-rays abnormalities,but there was no statistical difference [(11.7±7.1)d vs (9.9±5.0)d,t=1.717; P=0.088)],while the mortality was higher(6.1 ％ vs 0; Fisher′s exact test,P =0.038).Conclusions The clinical manifestations of the patients with scrub typhus are diverse,and the presence of abnormal chest X-rays is shown to be associated with the disease severity.Physicians should have the awareness of scrub typhus to make the diagnosis and treatment properly.

Objective To determine the pathogen of a local dengue fever outbreak in Shenzhen city in 2010,and to analyze the molecular characteristics of the epidemic dengue virus strain as well as explore the possible origin.Methods The serum samples collected from the suspect dengue fever cases were detected for IgM, IgG by enzyme-linked immunosorbent assay ( ELISA ),immunochromatography and dengue virus nucleic acid by real-time polymerase chain reaction (PCR).Serum samples from patients with early stage dengue fever were used to isolate virus with C6/36 and BHK-21 cell lines.The type of isolated virus strain was determined by RT-semi-nested-PCR and realtime PCR.E gene of isolated virus strain was amplified by RT-PCR and sequenced.Homology and phylogenetic tree of E gene of Shenzhen dengue virus with the strains isolated from other areas were constructed.Results IgM,IgG and RNA of type 1 dengue virus were detected in serum samples from dengue fever suspected patients.Type 1 dengue virus named DEV1-SZ1029 was successfully isolated from the serum sample.The homology of nucleotide sequence of E gene of SZ1029 strain with standard type 1 dengue virus HAWAII 45,Fj231/04,GD14/97 and GD05/99 were 94.8％,99.6％,97.7％ and 98.5 ％,respectively.The phylogenetic tree indicated that SZ1029 had the greatest similarity with the D1/Malaysia/36000/05 strain,SG(EHI)DED142808 strain and Fj231/04 strain and they lied in the same branch of the phylogenetic tree.The isolated dengue virus type 1 belonged to genetype Ⅰ with GZ/80,Taiwan87,All patients lived in a certain construction site in Shenzhen and had no recent travel history outside the area in one month before infection.Conclusions The virological,serological and molecular features all identify that the local dengue fever outbreak in Shenzhen in 2010 is caused by type 1 dengue virus and SZ1029 strain may be transferred from Southeast Asian region,and there may be a plague focus in Shenzhen.

Objective To investigate the relationship between spontaneous miscarriage and embryonic chromosome abnormalities,and to evaluate the clinical application of karyotype analysis by chorionic villus cell culture. Methods The chorionic villus karyotype of 1983 cases of miscarriage from January 2010 to July 2016 in Guangzhou Women and Children′ s Mecical Center were analyzed retrospectively. The miscarried chorionic villi were obtained by curettage under sterilized condition. The chromosome specimens were prepared after chorionic villus cell culture. Karyotype analysis was performed by G-banding technique. Results In the 1983 samples, successful karyotype analysis was performed in 1770 cases, with the successful rate of 89.98%. Chromosomal abnormalities were found in 1038 cases (58.64%,1038/1770). Chromosomal structural abnormalities were found in 37 cases. The numeral abnormalities were more common than structural abnormalities, and most of the numeral abnormalities were aneupoidies. In turn, they were trisomy 16, 45,X, trisomy 22, trisomy 2, trisomy 21, trisomy 15. The most common structural abnormality was balanced translocation, including Robersonian translocation. Female embryoes accounted for 61.02%(1080/1770) miscarriages and for 57.4%(596/1770) of chromosomal abnormalities, while male embroyes acoounted for 61.02%(1080/1770),57.4%(596/1770)respectively. The proportion of female embryoes was higher than male embryoes. The median age of the patients was 30 years old(16-46 years old). As the maternal age increased, the proportion chromosomal abnormalities increased. The incidence of chromosomal abnormalities in the advanced age group (≥35 years) was 68.38%(240/351), which was significantly higher than that in the younger group (56.24% ,798/1419; χ2=17.10, P<0.01). Conclusions Embryonic chromosomal abnormalities are the most common cause of early spontaneous miscarriage. The abnormalities centralize in some karyotypes. There is certain relationship between maternal age and the incidence of miscarriage, as well as the embryonic gender. Chorionic villus cell culture and karyotype analysis are helpful in finding the cause of miscarriage and counsel the patients.

Objective To compare the 18F-FDG PET metabolic characteristics and VHRCT morphological characteristics between invasive and non-invasive adenocarcinoma presenting as pure ground-glass nodules(pGGN).Methods Fifty-one patients with pGGN from October 2010 to June 2016 were retrospectively enrolled in this study.There were totally 52 lesions with sizes of no more than 30 mm and were grouped depending on pathological and follow-up diagnosis (31 lesions in the invasive adenocarcinoma group and 21 lesions in the non-invasive group).Clinical and imaging features were analyzed including age,gender,lesion location,size,density,SUVmax T/N,spiculation,lobulation,pleural indentation,vascular connection signs,vacuole sign and the air bronchogram.T test or x2-test was used in the comparison of different manifestations between the two groups.Logistic regression analysis on clinical parameters was applied.The ROC curve was used to find the cutoff of T/N.Results In the invasive adenocarcinoma group,T/N,SUV density and size were 1.97±0.71,1.16±0.54,-(431±104)HU,(18.48±5.65)mm,respectively.In the non-invasive group,T/N,SUVmax density,size were 1.20±0.28,0.64±0.20,-(533± 109)HU,(12.05±5.04)mm,respectively.The differences of T/N,SUVmax density and size had statistical significance between the two groups (t=-5.40,-4.87,-3.39,-4.21,P＜0.05).Lobulation and vascular connection signs in the invasive adenocarcinoma group were found in 21 and 13 cases respectively,while in the non-invasive group,they were present in 2 and 1 case,respectively,which showed significant differences between the two groups(x2=17.85,7.01,P＜0.05).T/N,lobulation,and vascular connection signs were the independent factors for the differentiation of benign and malignant lesions.The ORs were 52.547,8.375,72.206,respectively.When T/N=l.62,the area under the ROC curve was 0.885.The sensitivity,specificity and accuracy were 77.42％,90.48％,82.69％,respectively.Conclusions Pulmonary pGGNwith T/N no less than 1.62,lobulation and vascular connection sign indicates an invasive adenocarcinoma.