Objective:To explore the effect of Shenfu Injection (SFI) on expression of Heme oxygenase-1 (HO-1) and iNOS (inducible nitric oxide synthase) in renal failure rats induced by intestinal ischemia-reperfusion (IR) and its possible mechanism. Methods:The model of intestinal ischemia-reperfusion was induced by clamping superior mesenteric artery for one hour and then releasing the arterial clamp for six hours. Wistar rats were randomized into three groups:IR+normal saline group,IR+SFI group and control group (C group). The serum creatinine and blood urea nitrogen were observed respectively. Expression of HO-1 and iNOS in rat kidney tissue was detected by immunohistochemitry and morphometry computer image analysis. The histological change of kidney was observed under light microscope. Results:①Compared with C group,expression of HO-1 and iNOS increased markedly in IR+ normal saline group (P

Objective To study the chemical constitutents of Fomes officinalis and their inhibiting (effect) on thrombin. Methods Compounds were separated by column chromatography with silica gel and polyamide, whose structures were elucidated by spectral analysis and chemical evidence. Results Seven compounds were isolated from the chloroform extract. Their structures were identified as: 3-keto-dehydrosulfurenic (Ⅰ), dehydroeburicoic acid (Ⅱ), eburicoic acid (Ⅲ), sulphurenic acid (Ⅳ), dehydrosulphurenic acid (Ⅴ), dehydroeburiconic acid (Ⅵ), versisponic acid D (Ⅶ). The inhibitory rate of compound Ⅶ on thrombin was 45.36% but others were not obvious. Conclusion Compounds Ⅴ, Ⅶ are isolated from the fungus for the first time. Compound Ⅶ is effective to anti-thrombin at higher concentration, while the remainders are not obvious.

The training of professional postgraduates is one mode of medical postgraduate training,which more emphasizes the cultivation of clinical practice and ability.The problems existing in the training of professional degree postgraduates in dermatology are analyzed in this article,such as weak foundation of scientific research foundation,lack of supervision and evaluation,and the challenges from dermatology characteristics.The solutions including the training objectives,project design,the optimization of teaching process and evaluation,the training of comprehensive ability will be discussed in this article.The purpose is to improve the quality of training,to give some advice for providing high quality professional degree postgraduates.

Objective To analyze the correlation between the resistance of Acinetobacter baumannii and the utilization of antimicrobial agents in the hospitalized patients of Beijng Chuiyangliu Hospital,and provide the basis for clinical rational use antimicrobial agents.Methods A retrospective analysis was conducted for the drug resistance rate and specimen source of the 2 194 strains of Acinetobacter baumannii from 2010 to 2014 in the hospital and DDDs/DUI of antimicrobial agents was analyzed by Pearson correlation.Results The resistance rate of Acinetobacter baumannii was positively correlated with the DDDs and DUI of imipenem/cilastatin(r=0.991,0.994,all P<0.01), and was positively correlated with the DDDs of cefepime(r=0.934,P=0.020).The resistance rate of Acinetobacter baumannii to amikacin was positively correlated with the DDDs of etimicin(r=0.931,P=0.022).The resistance rate of Acinetobacter baumannii was negatively correlated with the DUI of levofloxacin(r =-0.986,P =0.002). Conclusion The resistance rate of Acinetobacter baumannii was high and there was correlation between the drug resistance and the utilization of some antimicrobial agents.

Objective:To explore the application effect of action learning for nursing ethic teaching in operating room.Methods:Total 94 nursing students were divided into two groups to compare the testing scores and the inci-dence of hidden security events .The control group underwent the traditional teaching method , and the experimental group taken Action learning .Results:The testing scores and the accurate rates of case analysis problem of the ex-perimental group were higher than those in the control group (P<0.05).While the rate of hidden danger events of the experimental group was significantly lower than that in the control group ( P <0 .05 ) .Conclusion: Action learning can stimulate students′learning potential , improve the effect of learning , and reduce the incidence of secu-rity events.

Objective To explore independent risk factors of ventilator associated pneumonia (VAP) on severe craniocerebral injury patients, and propose nursing intervention measures to reduce occurrence of VAP. Methods A retrospective analysis was conducted on 73 severe craniocerebral injury patients with VAP postoperatively from January 2013 to June 2015, and 80 severe craniocerebral injury patients underwent mechanical ventilation without VAP postoperatively at the same time were selected as the control group. Through literature review, questionnaire was designed to collect potential impact factors of VAP in both two groups, the single factor analysis and Logistic regression analysis were applied to explore the VAP independent risk factors, and nursing intervention countermeasures were proposed to improve VAP clinical prevention. Results VAP incidence rate of severe craniocerebral injury patients postoperatively was 23.0%(73/317) , from which 81 strains were detected, the first three strains of strain spectrum were Klebsiella pneumonia (21.0% ), Bauman Acinetobacter (17.3% ) and pseudomonas aeruginosa bacteria (14.8% ). Single factor analysis showed there were significant differences on composition of two groups in age, preoperative Glasgow Coma Scale (GCS) score, operation times, artificial airway type, postoperative mechanical ventilation time, daily airway humidification frequency, daily sputum suction frequency compound injury, daily oral care times (χ2=1.809-11.936, P < 0.01 or 0.05). Logistic regression models showed duration of mechanical ventilation (OR≥7d=3.013; OR≥14d=3.695), secondary surgery (OR =3.111) , preoperative GCS score (OR =2.989), daily airway humidification frequence (OR =2.280), age (OR=2.237) had remarkable influence on occurrence of postoperative VAP (P<0.01 or 0.05). Conclusions The incidence rate of VAP in severe craniocerebral injury patients is higher, age, mechanical ventilation duration, preoperative GCS score, airway humidification degree, second surgery are the independent risk factors of VAP.

Objective To compare the clinical effect of pantoprazole and omeprazole in the treatment of elderly patients with peptic ulcer.Methods 200 patients with peptic ulcer were selected as study subjects,and they were randomly divided into two groups.The control group (100 cases) was orally given clarithromycin,amoxicillin and omeprazole triple therapy.The observation group (100 cases) was given clarithromycin,amoxicillin and pantoprazole triple therapy.The clinical efficacy,clinical symptoms disappeared time and adverse reactions occurred in the two groups were compared.Results The total effective rate of the observation group was 96％,which of the control group was 94％,the difference between two groups was not significant (x2 =0.421,P ＞ 0.05).The disappear time of abdominal pain,belching,burning and bleeding in the observation group after treatment were significantly shorter than those of the control group(t =35.545,56.680,98.896,61.109,all P ＜ 0.05).The incidence rate of adverse reaction of the observation group(5.0％) had no significant difference compared with the control group(7.0％) (x2 =0.354,P ＞ 0.05).Conclusion There is no significant difference in efficacy and safety between pantoprazole and omeprazole in the treatment of elderly patients with peptic ulcer,but the effect of pantoprazole on relieving symptoms is better than omeprazole.

Objective To establish a rapid and sensitive method for detection of urinary protein.Methods In B-R buffer solution with pH 4.2,the signals of resonance light scattering by Poncesu S (PS) combined with protein in ?ex=?em=306nm were detected.Results There was a linear relation between the scattering signals of resonance light,and the protein concentration ranged from 0 to-1500 mg/l. The regression equation was ?I=2.24c-0.41,r=0.999 and the detection limit was 1.48 mg/l. The average recovery was 102.8% and the between-and within-subject coefficients of variation were 2.09% and 5.40% respectively.No significant difference was found compared with the method of PS.Conclusion The established method in this study is a simple,rapid and high sensitive method for determination of urinary protein.

Objective To investigate the level of human cytomegalovirus(HCMV)specific CD8+ T lymphoeytes in peripheral blood and the immune reaponae of HCMV reactivation after kidney transplantation.Methods Thirty-eight HCMV seropesitive HLA-A*0201 kidney transplant recipients(9 with HCMV infection and 29 without HCMV infection)and 54 healthy individuals were enrolled.The levels of total HCMV specific CD8+ T cells were measured using HLA-A2 pentamer folded with HCMV-peptide NLVPMVATV.The levels of IFN-γ secreting CD8+ T cells were measured by intracelluhr IEN-γ staining pulsed with the same peptide.Results The median levels of pentamer stained CD8+ T cells were 1.19%(0-19.42%),1.20%(0-18.40%)and 3.2%(0.51%-18.90%)in healthy group,negative HCMV group and positive HCMV group(H=5.34,P＞0.05),respectively.The median levels of IFN-γ secreting CD8+ T cells were 0.72%(0-0.70%),0.47%(0-5.61%)and 0.67%(0.07%-4.00%),respectively(H=0.58,P＞0.05).However,the mean proportions of IFN-γ secreting pentamer stained T cells relative to total HCMV specifc CIL were(60.18±19.16)%,(39.19±17.22)% and(20.02±13.26)%,respectively.There were significant differences among the groups(P＜0.01).Condusiorm There was no significant difference of levels of HCMV specific CD8+ T lymphocytes in peripheral blood between the kidney transplant recipients and healthy individuals.However,the proportion of HCMV-specific IFN-γ producing CD8+ T cells in pentamer stained cells was reduced in the kidney transplant recipients especially in those with active HCMV infection,which may contribute to the inability to control HCMV reactivation.

Objective To evaluate the role of by NO in reduction of myocardial ischemia-reperfusion (IR)injury by ginsenoside Rb1 preconditioning in diabetic rats. Methods Forty healthy adult male SD rats weighing 220-280 g were used in this study. Diabetes mellitus was induced by intraperitoneal streptozotocin 65 mg/kg and confirmed by fasting blood glucose ＞ 16.7 mmol/L. The animals were randomly divided into 4 groups ( n = 10each): sham operation group (group S), group IR, ginsenoside Rb1 group (group R) and L-NAME + ginsenoside Rb1 group (group LR). IR was produced by occlusion of the anterior descending branch of left coronary artery (LAD) for 30 min followed by 120 min reperfusion in group IR, R and LR. In group S, LAD was exposed but not occluded. In group LR, L-NAME 10 mg/kg was injected iv 25 min before ischemia. In group R and LR, ginsenoside Rb1 40 mg/kg was injected iv 10 min before ischemia. In group S and IR, eaqual volume of normal saline was injected instead of ginsenoside Rb1. The blood sample was taken from carotid artery at 120 min of reperfusion for determination of serum activities of creatine kinase (CK) and lactate dehydrogenase (LDH). Then the animals were sacrificed and myocadial tissues were obtained for determination of infarct size, endothelial nitric oxide synthase (eNOS) expression, MDA and NO contents, SOD activity and microscopic examination. Results The serum activities of CK and LDH were significantly increased and the myocardial infarct size was enlarged in group IR, R and LR, and eNOS expression was significantly down-regulated, MDA content was increased, and SOD activity and NO content was significantly decreased in group IR and LR compared with group S ( P ＜ 0.05). The serum activities of CK and LDH, and MDA content were significantly decreased, the myocardial infarct size was reduced, the expression of eNOS was up-regulated and the activity of SOD was increased in group R compared with group IR and LR ( P ＜ 0.05). There was no significant difference in the indices mentioned above between group IR and LR ( P＞ 0.05). Conclusion Ginsenoside Rb1 preconditioning can attenuate myocardial IR injury in diabetic rats via activation of eNOS, increase in NO production, and inhibition of the lipid peroxidation reaction.