Objective To explore the risk factors of nosocomial infection during the trauma intensive care unit stay and provide reference for clinical prevention.Methods 983 cases of trauma ICU patients were selected, whose clinical data were retrospectively analyzed.And 983 patients were divided into infection group and non-infection group according to their infection status,univariate factors such as age were analyzed aimed at all patients.Infection group was divided into mild traumapatients ( ISS<16 ) and severe trauma patients ( ISS≥16 ) , multivariate factors analysis were carried out aimed at infection group patients and severe trauma patients respectively.Results Independent risk factors of nosocomial infection in infection group patients were age≥60 years ( OR =1.70,95% CI 1.05 ~2.69),time length of ICU stay≥2 weeks (OR=1.59,95% CI 1.06~2.49),tracheacannula(OR=2.69,95% CI 1.80~4.20),ISS score≥16(OR=2.20,95% CI 1.20~3.91),central venousmonitoring(OR=4.31,95% CI 2.81~6.52);independent risk factors of nosocomial infection in severe trauma patients were time length of ICU stay≥2 weeks,trachea cannula,central venous monitoring.Conclusion More than one independent risk factor are related to ICU trauma patients,standardized treatment means,shortening the treatment time and other means should be carried out to control the infection status.

Objective To investigate the differences in the inhibition of return (IOR) capacity of attention between expert and novice pilots.Methods Compared the capacity of IOR of 10 expert pilots and 10 novice pilots under the conditions of adjacent and spaced clueing positions by experiment and by means of simultaneous cueing processes.Results These data suggested that in simultaneous cueing processes,no matter that the clueing positions were adjacent or spaced,the reaction time of expert pilots( adjacent:(428.01 ± 64.89) ms,spaced:(425.24 ± 63.94 ) ms) was slower novice pilots ( adjacent:( 363.05 ± 38.95 ) ms,spaced:( 360.61 ± 41.70 ) ms )(P ＜ 0.01 ) ; the capacity of IOR in no matter that the clueing positions were adjacent or spaced.The expert pilots showed IOR at only one location when the 5 clues all appearance in simultaneous cueing processes (P＜ 0.05 ),and no IOR could be see in the other locations.The novice pilots showed IOR when the from 3 to 5 of clues appearance in simultaneous cueing processes,the disparity was significantly predominance(P＜ 0.01 ).Conclusion The expert pilots of stability of capacity of IOR is better than novice pilots,and show solidly and highly efficient space searching ability.

Objective To evaluate the preoperative nutritional status of the patients which were preparing for cardiac valves replacement using nutrition risk screening 2002 (NRS2002),and analyze the evaluation effect and bring forward the corresponding nursing interventions.Methods 226 patients who would carry out cardiac valves replacement in the context of extracorporeal circulation were evaluated by NRS2002 preoperatively.88 patients had nutrition risk.Those elective 88 patients were randomly assigned into the experimental group and the control group,each had 44 cases.Then different nursing measures were implemented in each group and the clinical outcome was contrasted in the two groups.Results In the patients who were preparing for cardiac valves replacement,88 cases had preoperative nutrition risk score ≥3 points and 138 cases ＜ 3 points.Preoperative nutrition risk score had positive correlation with heart function grade.Difference of the experimental group and the control group in length of stay,length of mechanical ventilation after surgery and incidence rate of general complications had statistical significance.Conclusions It is effective to analyze the preoperative nutritional status of the patients with cardiac valves replacement by NRS2002.It may improve prognosis effectively by providing preoperative nursing interventions for patients with nutrition risk.Besides,it provides theoretical basis for further studying the relation between nutrition support and clinical outcome of patients with nutrition risk.

The concept of epigenetics was first proposed by Waddington in 1942,referring to phenotypic changes that are not related to the underlying DNA sequence,yet alterations in the level and function of gene expression can be heritable,such as DNA methylation,histone modifications,microRNA interference,etc.Phenotype changes while genotype remains unchanged,this controlled mechanism can be kept stable throughout cell division,proliferation,and subsequent process of development.This process thus may cause corresponding changes in the pathophysiology,which are correlated with the occurrence of cancer,immune disorder,cardiovascular disease,metabolic syndrome and so on.Diabetes mellitus is the third heaviest chronic diseases in the world,and does serious harm to human health,especially the diabetic vascular diseases.Even if the blood glucose level is controlled in an ideal state,vascular inflammation still persists,indicating the existence of metabolic memory.Studies have suggested that the pathogenesis can be elucidated at the level of epigenetics.This paper mainly focuses on DNA methylation,histone modifications,and is an overview of epigenetics research progress in diabetic vascular diseases.

Adenocarcinoma ; metabolism ; secondary ; surgery ; Anal Canal ; chemistry ; pathology ; surgery ; Anus Neoplasms ; metabolism ; pathology ; surgery ; Carcinoembryonic Antigen ; analysis ; Diagnosis, Differential ; Humans ; Immunohistochemistry ; Keratin-20 ; analysis ; Male ; Middle Aged ; Mucin-1 ; analysis ; Paget Disease, Extramammary ; metabolism ; secretion ; surgery ; Skin Neoplasms ; metabolism ; secretion ; surgery

This study is to investigate the effect of hydroxyethylpuerarin on the expression of tumor necrosis factor-alpha (TNF-α) and activity of nuclear factor kappa B (NF-κB) after middle cerebral artery occlusion (MCAO) in rats. Rats were subjected to cerebral ischemia-reperfusion injury induced by MCAO. Hydroxyethylpuerarin (10, 20, 40 mg·kg-1, iv) was administered just 30 min before occlusion and immediately after reperfusion. After a 24 h reperfusion following 2 h of MCAO, the number of viable neurons in hippocampal CA1 region was counted by hematoxylin and eosin (HE) staining. TNF-α protein and its mRNA expression were examined with radioimmunoassay (RIA) and reverse transcriptase-polymerase chain reaction (RT-PCR) respectively. NF-κB activity was observed by electrophoretic mobility shift assay (EMSA), and inhibition of NF-κB α (IκBα) protein expression was evaluated by Western blotting analysis. Animals treated with hydroxyethylpuerarin had a significant increase in neuronal survival in comparison with vehicle-treated group. Hydroxyethylpuerarin significantly reduced the protein and mRNA expression of TNF-α following 2 h of ischemia with 24 h of reperfusion. NF-κB DNA binding activity and the degradation of IκBα in the cytoplasm also decreased by hydroxyethylpuerarin treatment. The protective effects of hydroxyethylpuerarin against ischemia-reperfusion injury may be mediated by decreasing the expression of TNF-α and the activity of NF-κB in rats.

Objective:To investigate the feasibility of transradial artery approach for coronary angiography and for bilateral carotid angiograohy at the same time.Methods:There vdere 39 patients(remale 18 and male 21)with a mean age of 65 years(range 49-72).Transradial artery approach for coronary angiography was performed,at the same time,selective bilateral carotid angiography was performed with Simmons catheter.Results:Thirty-seven patients completed the selective coronary angiography and bilateral carotid angiography successfully,and 2 failed.The success rate was 94.5%,and no complications occurred.Comlmiom:Transradial artery approach for selective bilateral carotid angiograohy is safe and feasible.

Objective:To investigate the effects of ovarian cancer ascites-derived exosomes on the stem cell properties and invasion ability of ovarian cancer stem-like cell (OCS-LC).Methods:(1) A2780 cells were induced into OCS-LC in serum-free medium, and authenticating their stem-like properties by sphere-forming test, differentiation test and CD 133 marker detection. (2) Exosomes from ascites and A2780 cell were extracted by ultracentrifugation, then authenticating them. The morphology of exosomes was observed by the transmission electron microscope, exosome particle size was measured by nanoparticle tracking analysis (NTA). The expressions of heat shock protein 70 (HSP-70), CD 63 and CD 9 were detected by western blot. (3) The exosomes from ovarian cancer ascites and tumor cell supernate were co-cultured with OCS-LC. The groups were divided into control group, ascites-derived exosomes (ADE) group (ADE+OCS-LC group), and cells-derived exosomes (CDE) group (CDE+OCS-LC group). The sphere-forming ability was evaluated by sphere-forming cycle, maximum sphere diameter and sphere-forming rate of each group; the expression of CD 133 was detected by immunofluorescence staining under microscope; quantitative real-time (qRT)-PCR was used to detected the expression levels of octamer-4 (Oct-4), Nanog mRNA of the signature genes in the stem cells of each group; the metastasis ability of each group was measured by transwell assay. Results:(1) Identification of OCS-LC: sphere-forming experiment showed that the suspension of OCSC single cells was grown in serum-free medium in secondary sphere-forming. Differentiation function experiment showed that OCS-LC were differentiated into adherent A2780 cells by changing the growth mode in serum containing medium. Flow cytometry showed that the proportion of CD 133 positive ( CD133+) cells in OCS-LC group was (18.9±0.9)%, significantly higher than that of control group (0.6±0.5)% ( t=38.570, P<0.01). (2) Under transmission electron microscope, clear lipid bilayer structure was observed in ADE and CDE, and one side presented a concave hemispheric or cup like structure. NTA showed that the diameter of exosomes mainly ranged from 30 to 100 nm, with an average diameter of 67.2 nm. Western blot analysis showed that the specific protein molecules HSP-70, CD 63 and CD 9 were positive. (3) Three groups′ OCS-LC could continue to grow into spheres, and the group of ADE+OCS-LC showed two growth modes, most of the cells continued to grow into spheres, while a small part of cells grew in adherent differentiation. The sphere-forming rate of OCS-LC in the control group, ADE+OCS-LC group, and CDE+OCS-LC group were (1.05±0.20)%, (4.15±0.10)%, and (10.45±0.25)%, the sphere-forming cycle of OCS-LC in the three groups were (15.3±1.5), (10.3±0.6), and (6.7±0.6) days, and the maximum diameters of OCS-LC were (100.3±3.2), (145.2±5.1) and (170.0±2.1) μm, respectively. And the differences were statistically significant (all P<0.05). After co-culture of exosomes with OCS-LC, the sphere-forming ability of cells in the group of CDE+OCS-LC was prior to ADE+OCS-LC group (all P<0.05). Immunofluorescence staining showed that the number of CD 133 green fluorescent chromophore cells in OCS-LC groups [(46.2±2.1)%, (58.4±2.2)%] was significantly higher than that in the control group [(26.6±1.5)%] after the addition of exosomes in co-culture, the positive rate of CD 133 was higher than that in the control group( F=187.588, P<0.05). The qRT-PCR results showed that the expression levels of Oct-4 mRNA in ADE+OCS-LC and CDE+OCS-LC groups were 3.46±0.24, 4.03±0.31, compared with that in control group (1.04±0.12), the differences were statistically significant ( F=134.932, P<0.05). The mRNA expression levels of Nanog were 1.57±0.32, 2.66±0.15, which were significantly higher than that in the control group (1.00±0.07), and the differences were statistically significant ( F=49.329, P<0.05). And the expression of both in CDE+OCS-LC group increased more significantly than ADE+OCS-LC group (all P<0.05). The number of invasive cells in the three groups of OCS-LC were: control group 30±5, ADE+OCS-LC group 102±4, CDE+OCS-LC group 210±7, and there were statistically significant differences among three groups ( F=820.800, P<0.05). Compared with the control group, the number of invaded cells in the co-culture group were significantly increased ( P<0.05), and the CDE+OCS-LC group had the higher cell invasion ability then the ADE+OCS-LC group ( t=23.202, P<0.05). Conclusions:Exosomes derived from ovarian cancer ascites could enhance and maintain the stemness of OSC-LC, and promote the invasion of tumor cells. Moreover, CDE is superior to ADE.

Objective To study the expression of interleukin-17 (IL-17) in diabetic rat aorta and the effect of intervention with resveratrol,meanwhile,to explore the potential mechanisms of IL-17 induced diabetic vascular diseases and the protective role played by resveratrol in the epigenetic field.Methods The experiment was carried out in 4 groups:normal control group(NC),normal interventional group(NB),diabetic group(DM),and diabetic interventional group(DB),NB and DB groups were intervened with resveratrol.Immunohistochemistry was used to observe the histological localization of IL-17 and to measure the thickness of rat abdominal aorta.Western blotting,real-time PCR,and methylation-specific PCR were used respectively to compare the expression of IL-17 protein and mRNA,as well as DNA methylation in 4 groups.Results IL-17 mainly expressed in arterial intima of diabetic rats,the abdominal aorta in DM group was obviously thicker than that in NC and DB groups(P＜0.05).IL-17 protein and mRNA expressions in DM group were significantly higher than NC group(P＜0.05),and were reduced in NB and DB groups compared with NC and DM groups respectively.While DNA methylation levels of IL-17 in DM group were significantly lower than NC group(P＜0.01),however,the levels in NB and DB groups were elevated accordingly as compared with corresponding groups.Conclusions The increased levels of IL-17 in aorta of diabetic rats suggests that IL-17 is involved in the process of inflammatory responses to diabetic macrovascular diseases,while resveratrol could inhibit the expression,it may play a role in protecting aorta,and the regulation of IL-17 gene promoter DNA methylation levels may be the potential mechanism underlying these two phenomena.

Objective To analyze the sequences of two component signaling system PhoP/PhoQ encoding genes of Pseudomonas aeruginosa strains sensitive or resistant to aminoglycoside antibiotics and to determine the correlation between the PhoQ/PhoP and the resistance. Methods The segments of entire pimQ and phoP genes of P. aeruginosa were obtained by PCR and then sequenced after T-A cloning. Two prokaryotic expression systems of phoQ and phoP genes were constructed and the target recombinant expres-sion products rPhoQ and rPhoP were extracted by Ni-NTA chromatography. Rabbits were intracutaneoualy immunized with rPhoQ and rPhoP to obtain antisera and double immunodiffusion test was used to detect the titers of antisera. The phoQ genes of aminloglycoside antibiotics-resistant P. aeruginosa strains were knocked out by using Red recombination system, and phoQ mutants were identified by PCR plus sequencing and Western blot assay. Tube dilution method was applied to determine MIC values of wild and mutant strains of P. aeruginosa to four different aminoglycoside antibiotics. Results In comparison with the corresponding sequences in GenBank, the similarities of nueleotide and putative amino acid sequences of the cloned phop and phoQ genes were 98.7%-99.6% and 98.7%-100% , and 98.4%-99.8% and 99.1%-100%, respec-tively. Both rPhoQ and rPhoP were successfully expressed using pET-42a and E. coil BL21 DE3 system, and their rabbit antisera with 1 : 4 and 1 : 8 double immunodiffusion titers were also obtained. The deletion of phoQ genes and absence of the products in the two phoQ mutants were confirmed by PCR, sequencing and West-ern blot assay. MIC values of the four different aminoglycoside antibiotics to the two mutants were 1/512-1/2048 as those of their wild strains. Conclusion PboQ/PhoP is a sequence conserved two component sig-naling system of P. aeruginosa, and this system mediates resistance of the microbe to aminoglycoside antibiotics.