Objective To study the mechanism of insulin-stimulated glucose uptake in skeletal muscle cells. Methods The responses of GluT4 translocation and glucose uptake to the investigational drugs of SB203580 and Wortmannin as well as the effect of insulin on the drugs during differentiation were detected to study the insulin signal pathway. Results The GluT4 translocation and glucose transport were increased under insulin stimulation by 2.5±0.2 and 2.2±0.1 folds, respectively while compared with control; but t1/2 were 3.3 min and 6.0 min, and IC50 to wortmannin were 43 nmol/L and 3 nmol/L respectively.SB203580 inhibited 64% and 62% of insulin-stimulated glucose uptake and photolabelling of cell surface GluT4, respectively, but had no effect on GluT4 translocation.The fold increase of insulin-stimulated glucose uptake (1.7±0.1 fold vs control)was lower than that of GluT4 translocation (2.3±0.1 fold vs control) in myoblasts. Conclusions In skeletal muscle cells, two insulin signal pathways mediate GluT4 translocation and activation of GluT4, respectively.Insulin engages both of the pathways to stimulate the cells for maximum glucose uptake.

Objective To compare the status of nurses′cognition on children′s pain between the pediatric intensive care units (PICUs) and common wards .Methods Surveys were completed by the pediatric nurses through the WeChat platform ,3 283 quali‐fied surveys from department of nursing of 11 three level of first‐class hospital in central China ,were sent back and analyzed . Results There was no statistical difference in the age ,marital status ,professional title ,highest academic qualifications ,and the dis‐tribution of professional nursing service life between PICU nurses and common ward nurses(P>0 .05) .Statistical differences were found among the sex ,the positions ,the experiences of nursing and the pediatric nursing (P< 0 .05) .Significant differences were found between the total score of the PNKAS of the PICU nurses and that of common ward nurses(P<0 .05) .Among the four di‐mensionalities ,statistical difference was only found in the item of pharmacological analgesia between PICU nurses and common ward nurses (P<0 .05) .There were no statistical difference on the correct ratio of the top three correct answers and the top three wrong answers between PICU nurses and common ward nurses(P>0 .05) .Conclusion The knowledge of the PICU nurses and common ward nurses were both not optimistic .Specific training should be provided according to the different status of the PICU nurses and common ward nurses ,so that better pain management would be provided to the pediatric children .

Objective To investigate the accuracy and reliability of the image automatic matching using X-ray volumetric image (ⅩⅥ) system with the accelerator Elekta Synergy and to compare the matches with different methods and area.Methods A simulation plan using the head and neck phantom was designed and sent to ⅩⅥ system for CBCT scanning.During the scanning,the couch for certain distance was moved and the data of ⅩⅥ image automatic Matching in different matching methods and area was collected.Results The result of ⅩⅥ image automatic matching is consistent and correct to direction and distance which the couch had been moved (x:(0.11 ± 0.41) mm,y:(-0.04± 2.6) mm,z:(0.28 ± 0.74 mm)).There are not significant differences between the results that matching in different matching methods and different matching area.Conclusions The automatic image Matching of ⅩⅥ is accuracy and high reliability in recognition of offset error.But there are some significant differences on the automatic image Matching in different matching methods and different matching area.

AIM: To established an HPLC/MS/MS method for the study of pharmcokinetics of PMEA-Na (the mono-sodium salts of 9-[2-(phosphonomethoxy) ethyl] adenine) in beagle dogs. METHODS: PMEA-Na and internal standard 9-(3-phosphony-methoxypropyl) adenine were isolated from plasma by protein precipitation with methanol, and then analyzed adopting multiple reaction monitoring (MRM) mode. Using Xterra MS column, the mobile phases consisted of methanol:water:formic acid (25:75:0.5) at a flow rate of 0.25 ml·min-1. Beagle dogs received the intravenous dosage of PMEA-Na at 1.0, 3.0 and 6.0 mg·kg-1. Pharmacokinetic parameters were obtained from concentration-time curves by non-linear least-squares regression using the program DAS. RESULTS: The linear calibration curve was obtained in the concentration range of 0.02 to 20 mg·L-1 (r=0.999), and the limit of quantitition was 20 μg·L-1. The within-day and internal-day precisions (RSD) were less than 6.5% and 10.8%, respectively. The accuracy was 97.1%～107.3%. After a single dose studies in dogs the AUC were 2.3±0.5, 8.2±1.3 and 18.5±1.3 mg·L-1·h; the t1/2 were 3.9±1.8, 8.4±1.5 and 8.9±0.6 h; the CL were 0.44±0.09, 0.35±0.05 and 0.31±0.03 ml·h-1·kg-1 at the dose level of 1.0, 3.0 and 6.0 mg·kg-1 respectively. CONCLUSION: The analytical method is sensitive and specific for investigation the pharmacokintics of PMEA-Na in beagle dogs.

Objective To investigate an appropriate megavoltage computed tomography ( MVCT ) protocol to guide helical tomotherapy ( HT) for multiple metastases. Methods According to the location of target volume, 48 patients with multiple metastases undergoing HT were divided into head/chest group ( n=15), head/pelvis group (n=15), and chest/pelvis group (n=18). Each target volume received MVCT scans during the treatment. The obtained MVCT images were registered to CT images and the setup errors were recorded. The CTV?PTV margins were calculated. Comparison was made by paired t test. Results In the head/chest group, there was no significant difference in the setup error in x?axis between the head and chest (-0.15±1?25 vs. -0.21±2?34, P=0?71), while the head had significantly smaller setup errors in y?and z?axis than the chest (0.73±1?22 vs. 1.56±2?54, P=0?00;0.93±1?44 vs. 2.65±1?88, P=0?00). In the head/pelvis group, the head had significantly smaller setup errors in x?, y?, and z?axis than the pelvis (-0.16±1?31 vs. -1.29±3?72, P=0?00;0.81±1?34 vs. 3.20±3?90, P=0?00;1.24±1?75 vs. 5.49±2?80, P=0?00) . In the chest/pelvis group, there were no significant differences in setup errors in x?or y?axis between the chest and pelvis (-0.25± 2?90 vs. -0.22± 3?65, P=0?06;0.35± 3?60 vs. 0.38± 3?78, P=0?87), while the chest had a significantly smaller setup error in z?axis than the pelvis (1.95±2?81 vs. 3.35± 3?05, P=0?00) . In the three groups, the CTV?PTV margins of lower target volume were reduced in three dimensions after the correction of upper target volume, in which y?axis showed the largest reduction of CTV?PTV margins (5?13 vs. 4?01;9?17 vs. 8?30;8?52 vs. 7?13). Conclusions The setup error of individual target volume should not be used for correction of the overall setup error in HT for multiple metastases with isolated target volume. An MVCT protocol that provides image?based guidance for multiple target volumes is recommended.

Objective To construct S6K1 shRNA gene recombinant adenovirus(S6K1 Ax)and evaluate its gene silencing effects on mouse cell lines and C57 BL/6J mice level.Methods Three S6K1 shRNA gene sequences were designed and spliced from pcPUR plasmid,pcDNA3.1 plasmid to cosmid plasmid and transfected into adenovirus.S6K1 Ax which has best gene silencing effect was selected and proliferated in 293 cell.Silencing effect of S6K1Ax was checked on mice AML12,C2C12,3T3-L1 cell lines.C57BL/6J liver was obtained after S6K1 Ax was injected into mice tail vein six days later.S6K1 was evaluated by qRT-PCR and Western blot.Alanine transferanse(ALT)was examined before and after S6K1 Ax injected.Results S6K1Ax can silence S6K1 expression of mouse AML12,C2C12 and 3T3-L1 cell lines and liver of C57 BL/6J mice on Western blot.S6K1 mRNA expression of C57BL/6J liver were control group 1.39±0.21 vs S6K1Ax group 0.63±0.09,t=6.132.P<0.01.ALT of mice hepatic function did not change after S6K1Ax injected:before(15.15±4.43)U/L,after(17.32±4.22)U/L,t=1.451,P>0.05.Conclusion Construction of shS6K1 Ax can knockdown S6K1 gene on mice cell lines and C57BL/6J mice liver,it provides a good tool to study the function of S6K1.

Objective To explore the emergent nursing care of peritonsillar abscess in an infant. Methods The process of observation, treatment and nursing care of an infant with peritonsillar abscess were reviewed, and the nursing experiences were summarized. Results Through close observation of the rate, rhythm and depth of the respiration, the early signs of airway obstruction, guide parents with children right, keep the children quiet, open the airway, at the same time to prepare relevant emergency use objects to be prepared for emergency surgery, we saved time for the operation. Postoperative management of the airway and observation for the signs of bleeding in the area of incision were provided. The infant recovered well and was discharged after the treatment and nursing. Conclusions This case reminds nurses to pay attention to the airway obstruction while caring for the infants with peritonsillar abscess. The key points of nursing are observation and management of the airway obstruction, emergent preoperative preparation, postoperative monitoring, management of the airway and observation for the bleeding of the incision area.

Objective To detect the change and clinical significance of homocysteine (Hcy),hypersensitivity C response protein (hs-CRP) and hypersensitivity troponin I (hs-TnI) in patients with acute myocardial infarction (AMI).Methods Ninety-six cases of AMI were selected as the research group and 60 cases of coronary heart disease without AMI were enrolled in the control group.Blood samples were collected to measure the contents of serum Hcy,hs-CRP and hs-TnI.ROC curve was drawn and Logistic regression model was established to analyze the role of each index alone and combined detection in the diagnosis of AMI.Results The levels of Hcy,hs-CRP and hs-TnI in the research group were significantly higher than those in the control group (Hcy: (29.29±7.65) mol/L vs.(17.23±4.68) mol/L;hs-CRP: (15.47±5.01) mg/L vs.(9.21±3.15) mg/L;hs-TnI: (40.88±9.18) ng/mL vs.(7.34±2.12) ng/mL,t=2.78,8.66,34.36,P<0.05).The area under the ROC curve of Hcy,hs-CRP,hs-TnI were 0.802 (95%CI(0.729~0.874)),0.71(95%CI(0.62~0.792)),0.929 (95%CI(0.891~0.967)),respectively.The area under the combine detection curve was 0.971 (95%CI,0.950~0.992).The sensitivity of Hcy,hs-CRP and hs-TnI in the diagnosis of AMI were 79%,57%,87%,respectively,the specificity of the three groups were 72%,70%,90%,the sensitivity and specificity of combined detection were 96% and 88%.Conclusion Combined detection of Hcy,hs-CRP and hs-TnI plays a better role in the diagnosis of AMI than that of Hcy,hs-CRP,hs-TnI alone and has a high specificity and sensitivity in the diagnosis of AMI.

Objective To discuss the application value of DWI and ADC on predicting therapeutic effect of radiotherapy treatment in NPC. Methods Twenty four local recurrent cases and 38 non-recurrent cases after radiotherapy treatment in NPC were reviewed. MRI and DWI-MRI were performed at pre-radiotherapy and 3, 6, 12 months after treatment, the ADC values of the lesions were analyzed by SPSS 18.0 statistical software. ROC curves based on the ADC values were measured in 3, 6, 12 months after treatment plotted to analyze the threshold ADC value for confirming recurrence. Results The recurrent group and newly diagnosed group showed significantly high signal on DWI, while the non-recurrent group acquired low or mixed signal. The ADC values of the primary tumor in the recurrent group and the non-recurrent group were (0.709 ± 0.078) × 10-3 and (0.693 ± 0.089) × 10-3mm2/s, respectively, t=-0.717,P>0.05, respectively.The ADC values of the primary and recurrent tumor in the recurrent group were (0.730± 0.068) × 10-3mm2/s and (0.709 ± 0.078) × 10-3mm2/s, t=-1.000,P>0.05 , respectively.There were statistical differences between the recurrent group and the non-recurrent group for ADC in 3, 6, 12 months after treatment:(1.128 ± 0.179) × 10-3 and (1.358 ± 0.145) × 10-3mm2/s, t=5.567,P<0.01;(1.164 ± 0.174) and (1.450 ± 0.102) × 10-3mm2/s, t=7.310,P<0.01;(1.107 ± 0.180) × 10-3 and (1.584 ± 0.125) × 10-3mm2/s, t=11.189,P<0.01;respectively. Take 1.29 × 10-3 mm2/s,1.32 × 10-3mm2/s,1.37 × 10-3mm2/s respectively in 3, 6, 12months after treatment as the diagnostic threshold to predict tumor recurrence. The sensitive , specificity, and accuracy were (83.3%, 73.7%, 77.4%), (83.3%, 89.5%, 87.1%), (100.0%, 94.7%, 96.3%).Conclusions Both DWI and ADC value are important for diagnosing and predicting recurrent NPC after radiotherapy treatment, DWI and ADC can be used to regular follow-up after radiotherapy, to further improve the rate of early diagnosis of recurrent NPC.

OBJECTIVE:To evaluate the prophylactic use of antibiotics in perioperative period in our hospital. METHODS:The prophylactic use of antibiotics in 841 patients in our hospital in the first 3 months was analyzed statistically. RESULTS:841 patients have used antibiotics,and 74.04% of those patients with typeⅠ incision operation used antibiotics for 3 to 7 days. Cephalosporins and Fluoroquinolones were predominantly used for prophylactic purpose. Irrational use of antibiotics was seen in 714 cases. CONCLUSION:The prophylactic use of antibiotics in our hospital is far from rational,thus it is necessary to put "Guideline on Clinical Use of Antimicrobials" into practice.