Objective To develop a scientific and objective risk factors evaluation index system for peri-operative hypothermia. Methods Based on literature review, the risk factors evaluation index system for peri-operative hypothermia was screened and identified by Delphi method,and the weight was identified through Hierarchy analysis. Results In two rounds of surveys, the rates of questionnaire retrieval were 94.4% and 100.0%, respectively. The authoritative coefficients were 0.83 and 0.84, the coordination coefficients were 0.586 and 0.601, respectively. The index system consisted of 2 first-level indexes and 21 second-level indexes. Conclusions A reliable and scientific risk factors evaluation index system for peri-operative hypothermia was developed. It can be utilized to provide theoretical foundation for the prevention of peri-operative hypothermia.

The "Lübeck disaster", twins studies, adoptees studies, and other epidemiological observational studies have shown that host genetic factors play a significant role in determining the host susceptibility to Mycobacterium tuberculosis infection and pathogenesis of tuberculosis. From linkage analyses to genome-wide association studies, it has been discovered that human leucocyte antigen (HLA) genes as well as non-HLA genes (such as SLC11A1, VDR, ASAP1 as well as genes encoding cytokines and pattern recognition receptors) are associated with tuberculosis susceptibility. To provide ideas for subsequent studies about risk prediction of MTB infection and the diagnosis and treatment of tuberculosis, we review the research progress on tuberculosis susceptibility related genes in recent years, focusing on the correlation of HLA genes and non-HLA genes with the pathogenesis of tuberculosis. We also report the results of an enrichment analysis of the genes mentioned in the article. Most of these genes appear to be involved in the regulation of immune system and inflammation， and are also closely related to autoimmune diseases.
Humans ; Genome-Wide Association Study ; Tuberculosis/genetics* ; Gene Expression Regulation ; Cytokines/genetics* ; Autoimmune Diseases ; Mycobacterium tuberculosis/genetics* ; Genetic Predisposition to Disease

Objective To investigate the clinical diagnostic evidences of pleural tuberculosis (PT).Methods One hundred and eighty patients with pleural effussion, whom were admited into our hospital from December 2007 to December 2009 ,were enrolled into this study. The clinical data of patients confirmed with PT ( n = 90) or Non-PT ( n = 90) were analyzed retrospectively. The likelihood ratios( LR), sensitivity, specificity,positive predictive value,and nagative predictive value of six indices including pleural ADA, IFN-γ, sIL-2R ,TB-antibody in blood and pleural effusion, age and fever status were calculated. Results The variable with the hightest LR+ was ADA optimal threshold, followed by TB-antibody, IFN-γ, age, sIL-2R, fever status, If all six variables reached the optimal threshold,the probabilities of PT exceeded 99.9%. However,if all variables didn't reached the optimal threshold, the probabilities of PT were less than 1%. Among all the six variables, any four or over four variables reached the optimal threshold, the probabilities of PT exceeded 97%. Conclusion The combination use of these six variables can aid the clinical analysis, early detection, and therapy instruction,complication prevention of PT.

Objective To discuss clinical effect of anti-inflammatory No.1 on prevention and treat-ment of chemotherapeutic phlebitis. Methods 200 patients undergoing peripheral venous chemotherapy were divided into the observation group and the control group with 100 patients in each group. The control group received routine nursing, the observation group was given local compression with gauze dipped with anti-inflammatory No.1 agents. The incidence of phlebitis was compared between the two groups and un-derwent χ2 test. Results The incidence of phlebitis in the observation group was lower than that of the control group. Conclusions Application of local compression with anti-inflammatory No.1 agents proves to be an effective method in prevention and treatment of chemotherapeutic phlebitis.

Objective To explore the role of Hippo pathway in the pathogenesis of autosomal dominant polycystic kidney disease (ADPKD),and find potential targets for drug therapy.Methods By means of immunofluorescence staining,Western blotting,Real-time PCR,the differences of sublocalization,expression and phosphorylation level about Hippo pathway molecules in Han:SPRD (cy/+) and ADPKD patients compared with the control were observed.Knockdown Yes kinaseassociated protein (YAP),transcriptional coactivator with PDZ binding motif (TAZ) and large tumor suppressor kinase1 (LATS1) in cystic lining epithelium cell line WT9-12 were took by siRNA interference,and then their effects on cell proliferation,apoptosis and cell cycle were assessed.Results In cystic lining epithelium of Han:SPRD(cy/+),decreased expression of LATS1 and increased expression of YAP were found compared with the control,and the immunofluorescence of YAP was distributed both in cytoplasm and nucleus,while distribution and expression level of TAZ were without significant variance.Abnormal mRNA expressions of Hippo pathway components in ADPKD patients were found (P ＜ 0.05).Down-regulation of LATS1 in WT9-12 cells could prohibit phosphorylation of YAP,and prompted proliferation and cell division.Knockdown YAP in WT9-12 cells could inhibited cell proliferation by arresting cell cycle in G0/G1 phase,but down-regulating TAZ showed no significant differences in proliferation and cell cycle.Conclusions Altered Hippo signaling exists in ADPKD,and YAP activation may be one leading cause of autosomal dominant polycystic kidney disease onset.In vitro,knockdown YAP in WT9-12 cells can inhibit cell proliferation by arresting cell cycle and depressing cell division,suggesting the expression level and activity of YAP are potential targets for ADPKD treatment.

Objective To investigate the correlation between chronic kidney disease (CKD) and long-term outcomes in a large cohort of unselected patients with acute cerebral infarction.Methods Consecutive acute cerebral infarction patients hospitalized in Department of Neurology,General Hospital of Jinan Military Region were prospectively recruited from August 2010 to November 2013.The baseline data including age,sex,the National Institute of Health Stroke Scale (NIHSS) scores,type of Oxfordshire Community Stroke Project (OCSP:total anterior circulation infarct,partial anterior circulation infart,posterior circulation infarct and lacunar infarct),serum creatinine were recorded.Estimated glomerular filtration rate (eGFR) was calculated according to CKD epidemiology collaboration (CKD-EPI) equation.CKD was defined as eGFR ＜ 60 ml · min-1 · 1.73 m-2 body surface area.Patients were divided into eGFR≥60 ml · min-1 · 1.73 m-2 group and eGFR ＜ 60 ml · min-1 · 1.73 m-2 group.Recovery was assessed by modified Rankin Scale (mRS) 180 days after stroke by telephone interview (mRS≤2 reflected good prognosis,and mRS ＞ 2 reflected unfavorable prognosis).Multinominal Logistic regression analysis,Kaplan-Meier curve and log rank test were used.Results Eight hundred and fifty-two patients were enrolled,among them 93 patients were with CKD.Compared to patients without CKD,acute ischemic patients with CKD were older ((70.56 ± 11.86) years vs (63.11 ± 12.15) years,t =5.60,P =0.000),more likely with NIHSS ≥7 (59.14％ (55/93) vs 32.54％ (247/759),x2 =25.61,P =0.000),more likely with hypertension (89.25％ (83/93) vs 77.34％ (587/759),x2 =6.99,P =0.007),more likely with atrial fibrillation (29.03 ％ (27/93) vs 9.5 ％ (72/759),x2 =30.82,P =0.000),more likely with congestive heart failure (13.98％ (13/93) vs 3.03％ (23/759),x2 =24.54,P =0.000),more likely with tumour (6.50％ (6/93) vs 2.24％ (17/759),x2 =5.59,P =0.031).CKD was a independent prognostic factor for long-term poor outcome (OR =2.034,95％ CI 1.194-3.468) and long term mortality (OR =2.657,95％ CI 1.450-4.870).Kaplan-Meier estimate of patients without CKD for cumulative 180 days survival function for all-cause mortality was higher than those with CKD (79.57％ (74/93) vs 93.54％ (710/759),Log rank test:x2 =23.602,P =0.000).Conclusions Acute ischemic stroke patients with CKD are with more comorbidities.CKD is a independent prognostic factor for long-term poor outcomes and long term mortality in patients with acute cerebral infarction.

Objective To understand the level of neonatal pain knowledge and attitudes of neonatal and obstetric department nurses, in order to supply the clinical basis for neonatal pain management. Methods Self-designed questionnaires to fill out on-site were distributed to 107 neonatal and obstetric department nurses (of which 40 were from neonatal department, 67 from obstetric department) for neonatal pain knowledge and attitudes. Results About question of neonatal pain, the average percentage of correct answers in the neonatal group was 75.5%, higher than 66.3% of the obstetric group, in the neonatal group, correct rate of seven questions was more than 80%,while in the obstetric group the correct rate of only one question was more than 80%, and 5 questions correct response rate was significantly lower than that of the neonatal group, the difference was significant. All nursing staff considered it essential or necessary to carry out the nursing knowledge of pain-related training. 95.0%(38/40) of neonatal nurses believed that they could properly assess the extent of neonatal pain, but only 83.6% (56/67) for the obstetric group, the difference between the two groups was significant. 97.5% (39/40) of neonatal nurses believed that they could make the right judgments on neonatal crying, and only 85.1%( 57/67) in the obstetric nurses, the difference between the two groups was significant.Conclusions Neonatal pain has gradually been recognized and paid attention to by the clinical front-line medical staff, they believe that it is necessary to receive training on neonatal pain, knowledge of neonatal pain of neonatal nurses is better than obstetric nurses.

OBJECTIVE:To standardized declaration of preparation registration in medical institutions. METHODS:With the combination of registration review of new varieties in the preparation registration in medical institutions in Liaoning province from 2010 to 2014,the existing problems in drug registration information of preparation in medical institutions were introduced,and the solutions and suggestions were proposed. RESULTS & CONCLUSIONS:The main problems of registration information of prepara-tion in medical institutions included non-standardized preparation name,unclear topic and writing,inappropriate instructions and la-bels,and imperfect preparation process,etc. To standardize the preparation registration authenticity and integrity of registration in-formation of medical institutions,it is suggested to increase on-site verification efforts,strengthen the five years clinical using his-torical inspection,improve the level of research and development of hospital preparations declaration units,and strengthen the idea that the medical institutions should be responsible for the quality and safety of preparations to ensure the safety and effectiveness.

AIM:To investigate the effects of brain-derived neurotrophic factor(BDNF)on extracellular proteolytic enzymes including matrix metalloproteinases(MMPs)and serine proteases,in particular,the urokinase-type plasminogen activator(uPA)-plasmin system in a human umbilical vein endothelial cell(HUVEC)model.METHODS:The HUVEC was activated with different doses of BDNF(25-200 ?g/L)for different time period(6-48 h).Reverse transcriptase-polymerase chain reaction(RT-PCR)was used to assay MMP-2,MMP-9,TIMP-1,and TIMP-2 mRNA in HUVEC.The cultured conditioned medium was analyzed for MMP and uPA activity by gelatin zymography and fibrin zymography,respectively.uPA,PAI-1,TIMP-1,and TIMP-2 were quantified by Western blotting analysis.RESULTS:The stimulation of serum-starved HUVECs with BDNF caused marked increase in MMP-2 and MMP-9 mRNA expression and induced the pro-MMP-2 and pro-MMP-9 activation without significant differences in proliferation.However,BDNF had no effect on TIMP-1 and TIMP-2 production.BDNF increased uPA and PAI-1 production in a dose dependent manner up to 100 ?g/L,while effects of 200 ?g/L were approximately equal to those of 100 ?g/L.BDNF stimulated uPA and PAI-1 production beyond that in control cultures from 12 h until 48 h after BDNF addition.Protease activity for uPA was also increased by BDNF in a dose dependent manner.CONCLUSION:BDNF activates MMP and uPA/PAI-1 proteolytic network in HUVEC.

PurposeTo explore the value of transesophageal echocardiography (TEE) monitoring mini-incision transthoracic occlusion of ventricular septal defect (VSD) with asymmetric ventricular defects occlude in preoperative selection of patients, intraoperative guidance monitoring and postoperative evaluation.Materials and MethodsForty-five cases of VSD undertook mini-incision transthoracic occlusion with asymmetric ventricular defects occlude were enrolled, their clinical data was analyzed retrospectively, preoperative transthoracic echocardiography (TTE) was applied for choosing appropriate cases. During surgery, TEE was employed for evaluating the VSD and in which perimembranous VSD was found in 21 cases, intracristal VSD in 15 cases and subpulmonic VSD in 9 cases, suitable eccentric type occluders were chosen, guide occluder was placed, and the occlusion effect was evaluated right after operation.ResultsThe procedures were completed successfully in 42 cases, with a successful rate of 93.3%, of which 21 cases had perimembranous VSD, 15 cases had intracristal VSD, and 6 cases had subpulmonic VSD. The diameter of the VSD ranged from 3 to 7 mm, averaging (4.5±0.7) mm, the diameter of occluders ranged from 4 to 8 mm, averaging (5.7±1.2) mm, there was a good positive correlation between size of VSD and occlude (r=0.87,P<0.05). All patients received follow-ups from 3 months to 24 months after operation, all the occluders located normally, with no more than mildly residual shunt, valve regurgitation or severe arrhythmia discovered.ConclusionMini-incision transthoracic occlusion of ventricular septal defect (VSD) with asymmetric ventricular defects occlude has high success rates, minimal injury, and lower complication rate. TEE can play a vital role by improving the success rate and safety of surgery.