Objective To establish a microbial limit test for levofloxacin hydrochloride gel. Methods Ca2+ was added to neutralize the antibacterial activity of quinolone,and to form the insoluble precipitate by binding with carbomer, therefore destroying the stability of macromolecules in the gel. The microbial limit test for levofloxacin hydrochloride gel was confirmed combining with membrane filtration and plate methods. Results The normal plate counting was used in detecting the mold and yeast colony in the gel, the recovery was more than 70%.Simultaneously neutralization centrifugation and membrane filtration were used in bacterial count,with recovery less than 70%,and controlling bacteria test. Conclusion The method is accurate and practical for microbial limit test of levofloxacin hydrochloride gel, but is risky for bacterial counting and needs further risk assessment.

Objective To investigate the influence of psychological intervention on the physical and psychomotor development of children born of assisted reproductive technology. Methods 329 cases of ART born children in our hospital were set as the experimental group,the parturients were given pertinent psychological intervention.254 cases of children of spontaneous pregnancy were selected as the control group.The two groups were given follow-up for 24 months.Their physical condition at birth and psychomotor development during follow - up period were compared. Results Compared with the control group,length of infants at birth,body mass of the experimental group were significantly lower,and the incidence rate of premature birth,low birth weight,NICU stay during neonatal stage were higher.But there were no differences in psychomotor development between two groups. Conclusions ART born children of 24-month old show normal psychomotor development,but there are still more unfavorable physical factors,therefore,pertinent nursing intervention should be given based upon psychological intervention in clinic.

Based on their inherent relationship,some independent and verifying experiments of medical immunology were intergrated into a series of comprehensive and open experiments,which was embodied in the preparations of antiserum.so as to set up a new experiment teaching system emphasizing the training of student comprehensive capability.Achievements in training students'scientific research capacity,innovative motivation and practical working ability have been obtained and the results could provide valuable experience for innovation and reform of medical immunology experiment teaching model and method.

Objective To evaluate the value of positive 99Tcm-MIBI tumor imaging for thyroid cancer diagnosis. Methods Fifty four suspected thyroid cancer patients underwent 99Tcm-O4 and 99Tcm-MIBI combined imaging procedure. The imaging data were confirmed by pathological findings. Results All the 54 cases had single throid nodules, and 25 of which were pathologically malignant. Fifty two cases of nodules were detected by the 99Tcm O4 thyroid static imaging, including 2 hot nodules,4 warm nodules, 10 cool nodules and 36 cold nodules;2 cases were negative by the imaging. Of the 25 malignant thyroid nodules, 16 nodules were visible by 99Tcm-MIBI uptake and were cold nodules;29 exhibited benign thyroid nodules,of which 15 could be seen by 99Tcm-MIBI uptake,including 1 warm nodules,2 cool nodules and 12 cold nodules. The sensitivity, specificity of the combined imaging of 99Tcm O4 and 99Tcm-MIBI were 64. 00% ( 16/25 ) and 48. 28% (14/29). No significant difference was found for the positivity between benign nodules and malignancy nodules by 99Tcm-MIBI tumor imaging ( χ2 = 0. 83, P ＞ 0. 05 ). Conclusion 99Tcm-MIBI tumor imaging is not specific for the diagnosis of thyroid malignancy.

Objective To analyze the pathogenic features and risk factors of hospital-acquired pneumonia in patients with acute spontaneous intracerebral hemorrhage (sICH) in intensive care unit (ICU).Methods The clinical data of 110 patients with sICH admitted in ICU during January 2015 and February 2017 were collected.Patients were divided into hospital-acquired pneumonia group (HAP group,n =66) and non-HAP group (n =44).Multivariate Logistic regression was used to study the risk factors of HAP,and pathogen distribution and drug susceptibility were analyzed.Results Multivariate Logistic regression demonstrated that long-term mechanical ventilation (OR =1.028,95％ CI 1.012-1.044,P ＜ 0.01),lower score of glasgow coma scale (GCS) (OR =1.550,95％ CI 1.148-2.093,P ＜ 0.01),prolonged hospital stay (OR =1.131,95％ CI 1.046-1.224,P ＜0.01) and underlying diseases more than two forms (OR =9.793,95％ CI 1.012-1.044,P ＜ 0.01) were the independent risk factors of HAP,while high plasma albumin level was protective factor for HAP (OR =0.897,95％ CI O.811-0.992,P ＜ 0.05).One hundred and eighty-three bacterial strains were isolated from 66 patients,the top 4 pathogens were Acinetobacter baumannii (28.96％,53/183),Klebsiella pneumonia (15.85％,29/183),Pseudomonas aeruginosa (13.11％,24/183) and Staphylococcus aureus (12.02％,22/183).Acinetobacter baumannii,Klebsiella pneumoniae and Pseudomonas aeruginosa were highly resistant to the majority of antibiotics,some of which even reached 100％.Staphylococcus aureus showed high resistance to macrolides,fluoroquinolones and β-lactam antibiotics.Conclusions There is high incidence of HAP in patients with sICH,and the pathogenic bacteria are mainly gram-negative bacteria.Effective prevention and treatment measures should be taken to reduce the incidence of HAP for patients with sICH in ICU.

OBJECTIVETo explore the correlation of pulmonary expressions of fibroblast growth factor receptors (FGFR1-4) with lung fibrosis and aging.

METHODSReal-time fluorescence quantitative PCR was used to detect the expression levels of FGFR1-4 in the lung tissues, and lung fibrosis was observed by HE and Masson staining in mice at different ages.

RESULTSThe 4 subtypes of FGFR showed different expression levels in the lung tissues of mice, and FGFR2 had the highest expressions. The expression levels of all the 4 FGFR subtypes in 8-month-old mice were significantly lower than those in 5-week-old mice. The 8-month-old mice tended to present with histological changes of lung fibrosis.

CONCLUSIONFGFR expressions is down-regulated with aging in mice. Among the FGFR subtypes, FGFR2 is expressed at the highest level. The occurrence of lung fibrosis with aging is probably associated with down-regulated FGFR expression. FGF/FGFR signaling may participate in the aging process and regulation of lung fibrosis.

Aging ; physiology ; Animals ; Lung ; metabolism ; pathology ; Male ; Mice ; Mice, Inbred C57BL ; Pulmonary Fibrosis ; metabolism ; pathology ; physiopathology ; Receptors, Fibroblast Growth Factor ; classification ; metabolism ; Signal Transduction

Acute myocardial infarction (AMI) and acute massive pulmonary embolism can be characterized by no pulse electrical activity. Patients of cardiac arrest (CA) with no pulse electrical activity have a high mortality rate before the cause was corrected. Extracorporeal membrane oxygenation (ECMO), as a kind of artificial heart-lung support organ, provides treatment for CA patients. A case of massive pulmonary embolism similar to AMI was treated in the Third Central Hospital of Tianjin, who received interventional thrombolysis assisted by ECMO. Through the review of the overall development of the case, we aim to broaden the diagnosis and treatment of CA patients with no pulse electrical activity, and to improve the understanding of the complications secondary to ECMO.

The nursing students of Grade 2009 to Grade 2016 were selected.Their skills,midterm,usual and final performances as well as comprehensive scores of normal human morphology course were analyzed by one-way ANOVA in combination with different stages of curriculum integration in order to compare the teaching effect between traditional teaching mode + evaluation system and mixed teaching mode + formative evaluation in the course of normal human morphology.Statistical analysis by SPSS 17.0 showed that the average score of formation stage (traditional teaching mode) was 67.55 ± 12.72,the average score of integration stage (mixed teaching mode) was 72.79 ± 10.93 and the average score of development stage (formative evaluation +mixed teaching mode) was 83.94 ± 9.58.After making comparisons,the P values of ANOVA of the course of normal human body morphology in all stages were all less than 0.001,having statistical significance.The results showed that the overall development of the curriculum is becoming mature and the new teaching model can help students who usually do not like to review.

OBJECTIVETo explore the molecular mechanism in the formation of unstable plaques.

METHODSThe cDNA microarray E-MTAB-2055 was downloaded from ArrayExpress database to screen the differentially expressed genes in 24 ruptured plaques against 24 stable plaques. Functional enrichment analysis was conducted to define the biological processes and pathways involved in disease progression. The protein-protein interaction network was constructed to identify the risk modules with close interactions. Five pairs of carotid specimens were used to validate 3 differentially expressed genes of the risk modules by real-time PCR.

RESULTSA total of 439 genes showed differential expression in our analysis, including 232 up-regulated and 207 down-regulated genes according to the data filter criteria. Immune-related biological processes and pathways were greatly enriched. The protein-protein interaction network and module analysis suggested that TYROBP, VCL and CXCR4 might play critical roles in the development of unstable plaques, and differential expressions of CXCR4 and TYROBP in carotid plaques were confirmed by real-time PCR.

CONCLUSIONOur study shows the differential gene expression profile, potential biological processes and signaling pathways involved in the process of plaque rupture. TYROBP may be a new candidate disease gene in the pathogenesis of unstable plaques.

Adaptor Proteins, Signal Transducing ; genetics ; Disease Progression ; Down-Regulation ; Gene Expression Profiling ; Humans ; Membrane Proteins ; genetics ; Oligonucleotide Array Sequence Analysis ; Plaque, Atherosclerotic ; genetics ; Protein Interaction Maps ; Real-Time Polymerase Chain Reaction ; Receptors, CXCR4 ; genetics ; Transcriptome ; Up-Regulation ; Vinculin ; genetics

Objective:To explore the incidence of secondary hemophagocytic lymphohistiocytosis (sHLH) in elderly patients with severe SARS-CoV-2 infection, and to analyze and summarize its clinical features and risk factors for early identification of high-risk groups.Methods:A retrospective cohort study was conducted. From January to May 2020, No. 960 Hospital of People's Liberation Army, the Second Hospital Affiliated to Cheeloo College of Medicine of Shandong Province, the First Rehabilitation Hospital of Shandong Province, the Public Health Clinical Center Affiliated to Shandong University, and Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine received 248 patients over 60 years old who were diagnosed with severe SARS-CoV-2 infection during their assistance to Hubei or support for diagnosis and treatment of SARS-CoV-2 infection in Shandong Province. The clinical data of patients were collected. According to the hemophagocytic lymphohistiocytosis diagnosis scoring (HScore) criteria, the patients were divided into sHLH group (HScore > 169) and non-sHLH group (HScore < 98). The demographic data, clinical features, laboratory results, the proportion of organ failure and 60-day mortality of patients were collected and compared between the two groups. The risk factors of sHLH and 60-day death were evaluated through binary multivariate Logistic regression analysis in elderly patients with severe SARS-CoV-2 infection. The receiver operator characteristic curve (ROC curve) was plotted to analyze the diagnostic value of indicators only or combined for sHLH.Results:Among 248 elderly patients with severe SARS-CoV-2 infection, 82 patients with incomplete data and untraceable clinical outcomes, and 35 patients with HScore of 98-169 were excluded. Finally, 131 patients were enrolled in the final follow-up and statistics, including 25 patients in the sHLH group and 106 patients in the non-sHLH group. Compared with the non-sHLH group, plasma albumin (ALB), hemoglobin (Hb), lymphocyte count (LYM), platelet count (PLT), fibrinogen (Fib) and prealbumin (PAB) in the sHLH group were significantly reduced, while alanine aminotransferase (ALT), aspartate aminotransferase (AST), blood urea nitrogen (BUN), MB isoenzyme of creatine kinase (CK-MB), serum creatinine (SCr), C-reactive protein (CRP), D-dimer, ferritin (Fer), lactate dehydrogenase (LDH), procalcitonin (PCT), cardiac troponin I (cTnI), triglycerides (TG), interleukin-6 (IL-6), total bilirubin (TBil) were significantly higher. The fever and fatigue in the sHLH group were more severe than those in the non-sHLH group, and the patients in the sHLH group had higher rates of shock, acute kidney injury, liver dysfunction, and cardiac injury than the non-sHLH group. The 60-day mortality of patient in the sHLH group was significantly higher than that in the non-sHLH group [84.0% (21/25) vs. 40.6% (43/106), P < 0.01]. Binary multivariate Logistic regression analysis showed that high Fer [odds ratio ( OR) = 0.997, 95% confidence interval (95% CI) was 0.996-0.998], D-dimer ( OR = 0.960, 95% CI was 0.944-0.977), LDH ( OR = 0.998, 95% CI was 0.997-0.999) and TG ( OR = 0.706, 95% CI was 0.579-0.860) were independent risk factors for sHLH in elderly patients with severe SARS-CoV-2 infection (all P < 0.01), while elevated Fer ( OR = 1.001, 95% CI was 1.001-1.002), LDH ( OR = 1.004, 95% CI was 1.002-1.005) and D-dimer ( OR = 1.036, 95% CI was 1.018-1.055) were independent risk factors for 60-day death of patients (all P < 0.01). The death risk of the sHLH patients was 7.692 times higher than that of the non-sHLH patients ( OR = 7.692, 95% CI was 2.466-23.987, P = 0.000). ROC curve analysis showed that a three-composite-index composed of LDH, D-dimer and TG had good diagnostic value for sHLH in elderly patients with severe SARS-CoV-2 infection [area under the ROC curve (AUC) = 0.920, 95% CI was 0.866-0.973, P = 0.000]. Conclusions:Elderly patients with severe SARS-CoV-2 infection complicated by sHLH tend to be critically ill and have refractory status and worse prognosis. High Fer, LDH, D-dimer and TG are independent risk factors for sHLH, and are highly suggestive of poor outcome. The comprehensive index composed of LDH, D-dimer and TG has good diagnostic value, and can be used as an early screening tool for sHLH in elderly patients with severe SARS-CoV-2 infection.