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 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 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 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 investigate the analgesic efficacy and spinal neurotoxicity of intrathecal (IT) different doses of dexmedetomidine in rats. Methods Sixty male SD rats weighing 180-220 g were randomly divided into 5 groups ( n = 12 each): groupnormal control (group C); group IT normal saline (group N); different doses of dexmedetomidine groups received IT dexmedetomidine 0.75, 1.50 and 3.00 μg/kg respectively (groups D1.3). Paw withdrawal threshold to mechanical stimulation (PWMT)with yon Frey filaments and tail flick latency (TFL) to a thermal nociceptive stimulus were measured before (To, baseline) and at 30 or60 rin after IT dexmedetomidine or normal saline administration (T1, T2 ) and the percentage of the maximum possible effect ( MPE ) was calculated. Lumbar segment of the spinal cord ( L4-6 ) was removed for microscopic examination and determination of c-Fos expression (by immuno-histochemistry) at 7, 24 and 48 h after IT dexmedetomidine or normal saline administration. Results PWMT, TFL and the percentage of MPE were significantly increased after IT dexmedetomidine as compared with the baseline values at T0 in groups D1-3 ( P ＜ 0.05). PWMT was significantly higher at T1 and TFL and the percentage of MPE were higher at T2 in groups D1-3 than in groups C and N,and in group D3 than in groups D1,2 ( P ＜ 0.05). At 7,24 h after IT dexmedetomidine c-Fos protein expression was significantly higher in group D3 than in groups C and N( P ＜ 0.05). There was no significant difference in c-Fos expression at 48 h after IT dexmedetomidine between group D3 and groups C and N ( P ＞ 0.05 ). At 24 h after IT dexmedetomidine c-Fos protein expression was significantly higher in group D3 than in other 4 groups( P ＜ 0.05). Slight spinal cord injury was observed at 24 h after IT dexmedetomidine in group D3. Conclusion IT dexmedetomidine has antinociceptive effect. High dose dexmedetomidine IT can produce transient reversible toxicity to the spinal cord.

Objective To evaluate the changes in the expression of DJ-1 protein during myocardial ischemia-reperfusion (I/R) in diabetic rats.Methods Fifty male Sprague-Dawley rats,weighing 220-280 g,were used in this study.Type 1 diabetes mellitus was induced by intraperitoneal streptozotocin 65 mg/kg and confirmed by fasting blood glucose ＞ 16.7 mmol/L.Forty animals with type 1 diabetes mellitus were randomly divided into 3 groups:diabetes group (group D,n =10),diabetic sham operation group (group DS,n =15) and diabetic I/R group (group DIR,n =15).Another 10 non-diabetic rats in which citrate buffer 6 ml/kg was injected intraperitoneally were served as control group (group C).Myocardial I/R was produced by occlusion of the anterior descending branch of left coronary artery for 30 min followed by 120 min reperfusion in group I/R.At 120 min of reperfusion,5 rats were sacrificed and myocardial specimens were c(on)tained for determination of infarct size in groups DS and DIR,and 10 rats were sacrificed and myocardial specimens were obtained for microscopic examination and for determination of cell apoptosis,malondialdehyde (MDA) content,superoxide dismutase (SOD) activity and expression of DJ-1 and phosphatase and tensin homologue (PTEN) protein.Apoptotic index (AI) was calculated.Linear correlation between the expression of DJ-1 protein and MDA content,SOD activity,AI and expression of PTEN protein was analyzed.Results Compared with group DS,the myocardial infract size was significantly increased in group DIR (P ＜ 0.05).Compared with group C,MDA content and AI were significantly increased,SOD activity was decreased,the expression of DJ-1 was down-regulated,and the expression of PTEN protein was up-regulated in groups D,DS and DIR (P ＜ 0.05).Compared with groups D and DS,MDA content and AI were significantly increased,SOD activity was decreased,the expression of DJ-1 was down-regulated,and the expression of PTEN protein was up-regulated in group DIR (P ＜ 0.05).There was no significant difference in the parameters mentioned above between groups D and DS (P ＞ 0.05).There was linear correlation between the expression of DJ-1 protein and MDA content,SOD activity,AI and expression of PTEN protein and the correlation coefficients (r) were-0.734,0.593,-0.818,and-0.812 in turn.Conclusion Down-regulation of DJ-1 protein expression is involved in myocardial I/R injury in diabetic rats via decreasing anti-oxidative stress responses and upregulating PTEN protein expression.

Objective To investigate the expression of NKG2D and related signaling molecules adaptor protein(DAP10) and extracellular signal-regulated kinase(ERK) in the inflammatory cells of gastric adenocarcinoma and para-carcinoma tissues,the effects of vasoactive intestinal peptide(VIP) on the expression of NKG2D,DAP10 and ERK in natural killer(NK) cells of healthy volunteers.Methods The expression of NKG2D,DAP10 and ERK in the inflammatory cells of 36 gastric adenocarcinoma and para-carcinoma tissues were detected by immunohistochemistry.The peripheral blood NK cells of healthy volunteers were isolated and purified with CDC method.The expressions of NKG2D,DAP10 and ERK in NK cells were determined by immunocytochemistry and reverse transcription-polymerase chain reaction(RT-PCR) methods before and after VIP intervention.The ttest was used for comparison between two groups and rank transformation nonparametric test (Kruskal-Wallis H test) for count data analysis.Results The expression levels of NKG2D,DAP10 and ERK in the inflammatory cells of gastric adenocarcinoma were significantly lower than those of para-carcinoma tissues (H=30.640,24.910,20.320,all P＜0.01).The expression levels of NKG2D,DAP10 and ERK were much lower in poorly differentiated gastric adenocarcinoma (H =4.049,11.830,8.118),at stage Ⅲ-Ⅳ (H=4.275,11.560,7.686),and the expression levels of NKG2D,ERK were lower with lymph nodes metastasis (H=6.513,6.064,all P＜0.05).The expression levels of NKG2D,DAP10 and ERK in gastric adenocarcinoma tissues and inflammatory cells were not correlated with gender,age and the location of lesions (all P＞0.05).The expression levels of NKG2D,DAP10 and ERK in NK cells was decreased after VIP intervention (protein:H=12.438,4.798,13.745,mRNA:F=337.640,638.579,1055.015,all P＜0.05).Conclusion Gastric adenocarcinoma may downregulate the expression of NKG2D,DAP10 and ERK in NK cells through VIP secretion,which may be involved in the immune escape of gastric cancer.

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.