Objective: To construct a lentiviral vector of RNA interference(RNAi) of TGF-?1 gene. Methods: Three target sequences were selected according to TGF?1 mRNA sequence firstly,then three pairs of oligonucleotide sequences according to these target sequences and one pair of negative control oligonucleotide sequence were designed and synthesized. The annealed oligonucleotide fragments were subcloned into pRNA-U6/Lenti plasmid. After identified by restriction enzyme digestion and sequencing ,these plasmids were cotransfected along with ViraPowerTM Lentiviral Packaging Mix into 293FT cells for the package of lentiviral particles. Then the lentiviral vector particles were transfected into Hela cells and TGF-?1 expression in the transfected cells was assayed by Real-Time PCR and ELISA. Results: It was confirmed by digestion and sequencing that lentiviral vectors had the correct structure and could express high titer of virus. After transfected into Hela cells,TGF-?1 expression was decreased significantly by two of these lentiviral vectors at both the protein and mRNA level and the first vector had the best interefence efficiency. Conclusion: The lentivirus RNAi vector of TGF-?1 was constructed successfully.

Intervention measures of a nursing student with hepatitis B carrier and situational mental disorder are reported,including inducing emotional release,helping nursing students appropriately recognize and deal with diseases,and searching effective social and family support.Related issues are also reflected on these interventions,such as to implement in-time mental nursing,stress hepatitis B related health education,deal with the conflict and balance between right of privacy and informed consent,and widespread related laws.

Objective To explore the application value of blood lipid,blood glucose,liver function and serum uric acid in the diagnosis of fatty liver in elderly patients.Methods A total of 62 elderly patients with fatty liver in our hospital from April 2016 to October 2016 were selected as study group,and 62 healthy persons were selected as control group.All the subjects were drawn fasting venous blood 4 mL.Rate method was used to detected liver function indexes of total bile acid(TBA),gamma glutamyltranspeptidase(GGT) and aspartate aminotransferase(AST),alanine aminotransferase(ALT),total bilirubin(TBIL) levels.The hexokinase method was used to detected blood lipid indexes,including very low density lipoprotein cholesterol(VLDL-C),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),cholesterol(TC),triglyceride(TG) levels.The peroxidase colorimetric method was used to detected blood glucose index including glycated hemoglobin(HbA1c) and fasting blood glucose(FBG) levels.MINDRAY BS-400 automatic biochemical analyzer produced in Shenzhen MINDRAY company was used to detect the serum uric acid level.Value of blood lipid,blood glucose,liver function,serum uric acid in diagnosis for fatty liver were made statistical comparison.Results The levels of TBA,GGT,AST,ALT and TBIL in the study group were higher than those in the control group,the level of VLDL-C,LDL-C,TG,TC in the study group were higher than those in the control group,the HDL-C level was lower than that in the control group,the levels of FBG and HbA1c in the study group were higher than those in the control group,the level of serum uric acid in the study group[(447.12±91.03)μmol/L] was higher than that in the control group [(353.41±70.32)μmol/L],the differences were all had statistically significant(P<0.05).The sensitivity(80.65%,79.03%,82.26%,77.42%) and accuracy(90.32%,88.71%,90.32%,88.71%) of blood lipids,blood glucose,liver function,blood uric acid alone in diagnosis of fatty liver were lower than the combined diagnosis(95.16%,96.77%),the differences were statistically significant(P<0.05).Conclusion Fatty liver patients have abnormal blood lipids and blood glucose,liver function and blood uric acid level,combined with the above indexes for diagnosis can improve the sensitivity and accuracy of fatty liver,and provide guidance for the intervention,is worthy of promotion.

OBJECTIVE:To investigate the revenue and expenditure in PIVAS of our hospital,and to provide data for the es-tablishment and operation of PIVAS in other hospitals. METHODS:A statistics was undertaken for the revenue and expenditure of PIVAS in 2014,and partial influential factors were analyzed comprehensively. RESULTS:In 2014,under the premise of only long-term doctor's advice for the morning,760611 groups of intravenouse drugs had been administered in PIVAS of our hospital. The revenue was about 2197439 yuan and the expenditure was about 1872598 yuan;the cost of human resource was the main cost part,which took 77.92%. CONCLUSIONS:The revenue of PIVAS almost covers the cost of pharmacy in our hospital at pres-ent;the data of cost-effectiveness can be reference for other hospitals.

Objective To observe the effect on serum inflammatory factors and immune function of Shiwei Longdanhua particles in elderly patients with acute bronchitis.Methods 120 cases of elderly patients with acute bronchitis from November 2014 to October 2016 were selected and randomly divided into the observation group and the control group with 60 cases in each group, according the order of single and double number.The control group was given conventional treatment, and the observation group was given Shiwei Longdanhua particles based on the control group.Treatment for seven days, to observe the differences of serum inflammatory factors (hs-CRP, TNF-αand IL-6, IL-1) and immunologic function indexes (CD3 +, CD4 +, CD8 +, CD4 +/CD8 +and IgM, IgG, IgA) between the two groups.Results After treatment, hs-CRP, TNF-αand IL-6, IL-1 of the two groups decreased with before treatment, the difference was statistically significant (P<0.05), and all indexes of the observation group were lower than those of the control group, the difference was statistically significant ( P<0.05 ) .After treatment, CD3 +, CD4 +, CD4 +/CD8 + of the two groups increased with before treatment except CD8 +decreased, the difference was statistically significant (P<0.05), there was no significant difference between the control group and before treatment, there was significant difference between the two groups after treatment (P<0.05).After treatment, IgM, IgG and IgA of the two groups decreased with before treatment, the difference was statistically significant (P<0.05), and all indexes of the observation group were lower than those of the control group, with significant differences, the difference was statistically significant (P<0.05).Conclusion Shiwei Longdanhua particles has the effects of inhibiting inflammatory reaction and improving the immune status in the treatment of elderly patients with acute bronchitis .

Objective To explore the effect and mechanism of osteoprotegerin on apoptosis in human umbilical vein endothelial cells(HUVECs) induced by triiodothyronine(T3) with different concentrations.Methods HUVECs were cultured in control group (0 nmol/L T3),low-concentration group (0.1 nmol/L T3),physiologicalconcentration group(1 nmol/L T3),high-concentration group(10 nmol/L T3) with OPG for 48 h.The cell apoptosis was measured by cytometry and Hoechst 33258.The expressions of p-IκKβ,lκKβ,p-TSC2,TSC2,p-S6K,S6K,p-AKT,AKT,Bcl-2,and Bax were analyzed by Western blot.Results (1) After OPG pretreatment and being cultured in control group、low-concentration group and high-concentration group,the HUVEC apoptosis was decreased significantly(P＜0.05) as compared with groups without OPG pretreatment.There was no difference in physiological concentration group before and after intervention of OPG.(2) The expression of p-IκKβ,p-S6K,and Bax in other groups were higher than those in physiological concentration group ; however,the expressions of p-TSC2,p-AKT,and Bcl-2 were lower than those in physiological concentration group(P＜0.05).After OPG pretreatment in control group,low-concentration group,and high-concentration group,the expressions of p-IκKβ,p-S6K,and Bax decreased significantly (P＜0.05)and the expression of p-TSC2,p-AKT,and Bcl-2 increased significantly (P＜ 0.05) ; there were no differences in the expressions of p-IκKβ,p-S6K,p-TSC2,p-AKT,Bcl-2,and Bax in physiological concentration group before and after intervention of OPG.Conclusions Low and high concentrations of T3 increase apoptosis of HUVECs by way of activation of IκKβ/mTOR pathway.Osteoprotegerin is able to protect HUVECs from apoptosis induced by low and high concentration of T3 via the way of inhibiting the IκKβ/mTOR pathway.

Objective To explore the feasibility and value of ultrasonography during choledocholithotomy with fibroptic choledochoscope. Methods Fifty-one cases of intrahepatic bile duct stones after cholecystomsy as diagnosed by pre-operative examination with ultrasound, CT, magnetic resonance imaging from Jan. 2007 to Dec. 2008, underwent conventional lithotomy through fibroptic choledochoscope first, and then high-frequency probing with ultrasonography was done directly over the surface of liver to detect the existence of any residual stone in the bile duct. The position of residual stone, if there was any, was then accurately determined and removed through fibroptic choledochoscope under the guidance of ultrasonography. Results Of 51 patients who had undergone lithotomy through fibroptic choledochoscope, 12 patients were found to have residual stones in their bile ducts after operation. The rate of complete calculus removal was 76.5%, and of residual stones was 23.5%. Of the 12 patients with residual stones, 7 patients were found to have residual stones in their intrahepatic bile ducts complicated with deformed bile duct, 5 patients were found to have residual stones in their intrahepatic bile ducts complicated with stricture of bile duct. All residual stones in intrahepatic bile ducts of 12 patients were accurately located and then completely removed under the guidance of operative ultrasonography through fibroptic choedochoscope without any complications. Conclusions The difficulties of residual stones after lithotomy may be overcome by localization with ultrasonography and removal under the guidance of atfrasonography, so the technique is of practical value in clinical application.

Objective To evaluate the feasibility and value of percutaneous transhepatic multiple biliary drainage introduced under ultrasound guidance in treatment of advanced portal cholangiocarcinoma. Methods Thirty-two patients were accurately diagnosed as advanced portal cholangio carcinoma according to preoperational examination of ultrasound,enhanced computed tomography,nuclear magnetic resonance or endoscopic retrograde cholangiopancreatography (ERCP) in the hospital from Jan. 2006 to Dec. 2008. After making a reasonable therapeutic plan,3 or 4 drainage-tubes were successfully inserted in intrahepatic bile duct in turn using Seldinger technique under ultrasound guidance. Thus,retained bile was effectively drained from intrahepatic bile ducts. The changes in jaundice index after treatment and complications were observed,follow-up was performed during the patients' surviving period,and therapeutic effect was evaluated comprehensively. Results Of the 32 patients drained through multiple bile drainage-tubes,19 received 3 draining tubes simultaneously,and 13 with 4 bile drainage-tubes,with a total of 109 bile drainage-tubes inserted into all the patients. Bile drainage-tubes were inserted into all target bile ducts successfully in a 100% successful rate. 4-8 weeks after operation,the jaundice disappeared completely in 28 cases and decreased significantly in 4 cases. For all the cases,complication occurred in only 2 patients,and it disappeared after symptomatic treatment. The shortest survival time was 4 months,and the longest was for 15 months after operation. Conclusions For those patients with advanced portal cholangiocarcinoma,and the tumor could not be surgically resected,percutaneous transhepatic multiple biliary drainage is correct option,which is effective and safe,and it was valuable in relieving malignant obstructive jaundice.

The article introduced the recent progress of tissue-engineered trachea.The problems encountered in the field and the study direction in the future are also mentioned.

Objective To discuss the clinical characteristics and surgical treatment for gastric cancer in the elderly.Methods Related literatures were reviewed to summarize the characteristics of elderly patients with gastric cancer,thus to evaluate the feasibility and strategy of surgical treatment for elderly patients with gastric cancer.Results Elderly gastric cancer patients often had one or more comorbidities,but most patients could accept gastrectomy and had a good prognosis.Conclusions Age is not the contraindication for surgery.Dealing with comorbidities in elderly patients,preventing the complications and performing the appropriate surgical method can result in a good therapeutic effect.