Nanomedicine offers great promise for early diagnosis and treatment of formidable diseases. The unique morphology and biology characteristics of bacteriophage provide unprecedented opportunity for such endeavor. The paper summarizes the application of bacteriophage in nanobiomaterials, nanomedicine, nanomedicine delivery and nanodiagnosis, especially the nano-imaging reagents and future direction concerning nanomedicine based on bacteriophage.

Objective To observe the developmental changes of projection and termination of proprioceptive afferent fibers in the mouse spinal cord. Methods Parvalbumin (PV) immunohistochemistry was used to label the proprioceptive afferents. Single and dual immunofluorescence histochemistry were used to examine the growth pattern of proprioceptive afferents and their relationships with motoneurons in the spinal ventral horn (VH). The stained sections were observed under a confocal laserscanning microscope. Results PV-like immunoreactive (LI) proprioceptive fibers first appeared in the dorsal column on embryonic (E) day 14, then entered the gray matter on El5 and reached the intermediate gray matter and VH more obviously on E16. The number and intensity of PV-LI proprioceptive afferent fibers and punctata increased in the VH with age and reached a maximum during earlier postnatal (P) period (P0-P7). After P14, the number and intensity of proprioceptive afferents gradually decreased. The proprioceptive terminals seemed to form close relationship with motoneurons from E17. Conclusion The present study indicates that the somatotopic organization of proprioceptive afferents in the spinal cord is established during the late embryonic and early postnatal stages. These results provide evidence for understanding the development of the reflex movements.

The present study was designed to examine the developmental changes in projection and termination of nociceptive and proprioceptive afferent fibers in the spinal cord by labeling those two fibers with calcitonion gene-related peptide (CGRP) and parvalbumin (PV)separately in mouse embryos and neonatal pups aged embryonic day 15 to posanatal day 3 (E15 -P3). CGRP-like immunoreactive (LI)nociceptive fibers first appeared in the superficial dorsal horn (DH) at E16. The afferent projections extended laterally to the DH and entered into the deep portions of the DH at E17 and E18. After birth, the projection pattern of CGRP-LI fibers remained unchanged but the intensity of afferent terminals increased in the superficial laminae and their branching patterns became more complicated. In addition,CGRP-LI collaterals that projected into the contralateral DH were also examined after E16. Around birth, the contralateral projections were also found originated from the lateral part of the DH. PV-LI proprioceptive afferents were first observed entering the gray matter at E15 and reached the intermediate gray matter (IG) and the ventral horn (VH) more obviously on E16. The number and intensity of PV-LI fibers increased in the the VH with age and reached a maximum during earlier postnatal period ( P0-P3 ). The proprioceptive terminals seemed to form close relationship with motoneurons in the VH from E17. Our results indicate that the somatotopic organization of nociceptive and proprioceptive afferents in the spinal cord both are established during the late embryonic and early postnatal stages. These results help to understand the development of the sensory transmission in more details.

Depending on the meaning and function of the liver in traditional Chinese medicine and modern medicine,this paper explores the important role of liver in the pathogenesis of DM (Diabetes Mellitus,DM).Combined with treatment based on syndrome differentiation and specific case report study,this paper has stressed the importance of treating DM from liver and so to set a sound basis for the systemic treatment based on syndrome differentiation from internal organs for DM.

Objective:Occult breast cancer (OBC) accounts for 0.3%-1.0%of all breast cancers. Because of the rarity of this dis-ease, its treatment and prognosis remain unclear. Our study evaluated the treatment outcomes and prognostic factors associated with OBC. Methods:A total of 82 patients diagnosed with OBC based on available criteria were treated at the Cancer Hospital of Chinese Academy of Medical Sciences, Beijing, China, between January 1968 and June 2014. Except for 16 patients who were treated by needle biopsy or excisional biopsy only and were subsequently excluded, all of the cases reported were included in the study. Of the remaining 66 patients, one was male. Patient data, tumor characteristics, and treatment and outcome variables were evaluated. Overall survival (OS) and disease-free survival (DFS) were analyzed. A unicentric retrospective review of 66 patients with OBC was performed. Re-sults:The median follow-up was 75.5 months (7.0-328.0). No significant differences in OS and DFS were observed between patients who underwent mastectomy plus axillary lymph node dissection (Mast+ALND) and those who underwent breast conservation surgery (P>0.05). Univariate analysis revealed that nodal status is a significant prognosis factor of DFS (P=0.031). Conclusion:No significant difference in treatment outcomes between mastectomy+ALND and breast conservation surgery was observed. Nodal status may be an independent predictor of poor outcomes in OBC patients.

Objective To observe the efficiency and safety of brachytherapy by CT-guided percutaneous paracentesis implantationof iodine-125 seed for lung cancer in elder patients.Methods 46 elder patients with lung cancer(65~81 years)were undergonebrachytherapy by CT-guided percutanepus paracentesis implantation of iodine-125 seeds with implanting needle(18-gauge). The effect of treatment according to observe the changes of tumors in size was evaluated after operation 1,2,3 and 6 months,respectively. Results There were totally 57 lesions in 46 cases,7 cases were undergone two times of implantation,and 1 case was undergone three times of implantation,totally the puncture accounted for 76. The effective rate (CR+PR) of treatment after one ,two, three, and six months was 8.77%(5/57), 40.35%(23/57),89.47%(51/57) and 96.49%(55/57),respectively. 5 patients(6.58%) accompanied by pneumathorax.Conclusion Brachytherapy by CT-guided percutaneous paracentesis implantation of iodine-125 seed is a safe, reliable and effective treatment for lung cancer, especially for elder patients.

Objective To investigate the level of the clinical nurses' critical thinking disposition and the competence about nursing ethical decision making,and analyze the relationship between them.Methods A total of 359 clinical nurses were recruited by stratified random sampling method.They were investigated with general situation questionnaire,critical thinking disposition inventory-Chinese version (CTDI-CV) and judgment about nursing decisiors(JAND).Results The total score of CTDI-CV was (285.06±26.79),the total score of JAND was(267.91±16.62).The influencing factors of clinical nurses' competence about nursing ethical decision making was education background,ways of obtaining occupational knowledge,training of nursing ethical decision.The clinical nurses' competence about nursing ethical decision making was positively correlated with critical thinking disposition.Conclusions The level of clinical nurses' critical thinking disposition and competence about nursing ethical decision making are medium,in order to improve the level of competence about nursing ethical decision making,both school education and the continue education among hospital should strengthen the training of nurses' critical thinking disposition.

Aim To explore the anti-apoptotic function of cardiac progenitor cells(CPCs)-derived exosome in vitro.Method CPCs were isolated from mouse heart using Magnetic Cell Sorting(MACS)system.Flow Cy-tometry(FC)determine the purity of stem cell surface antigen-1 positive(Sca-1 +)CPCs.Exosome was puri-fied from conditional medium,and confirmed by West-ern blot using CD63 as a marker,Nanoparticle Traffic-king Analysis(NTA)was used to detect the diameters and concentration of exosome.Then the cells were di-vided into control groups and CPC-exosome pre-protec-tion groups.H2 O2 was added into H9c2 cells to induce oxidative stress.Western blot was adopted to determine the expression of cleaved caspase-3.Results ① Im-munofluorescence showed that CPCs isolated by MACS were positively expressing Sca-1 protein;FC analysis showed that typical purity of Sca-1 +CPCs from the first
preparations was more than 95%.② WB demonstrated that CD63 of exosome isolated from CCMwas positively expressed,and NTA results showed that the diameters of exosome were (82.33 ±3.06)nm(n =3).Micro-scope detected PKH-26 labeled exosome appeared in the cytoplasma of H9c2 cells.③ Western blot showed the CPC-exosome pre-protection groups significantly down-regulated the levels of cleaved caspase-3 com-pared to the control groups(P <0.05).Conclusion CPC can secrete exosome which carries many important cargos,which can effectively gather in H9c2 cells. CPC-exosome can protect H9c2 cells from the oxidative stress induced by H2 O2 .Our results highlight a new perspective strategy for cardiac disease.

Objective To analyze the reasons of non-planned decannulation (NPD) of peripheraly inserted central catheter (PICC) and explore the applicable prevention strategies.Methods We retrospectively analyzed the clinical data of 432 patients who underwent PICC cannulations maintenance between July 2005 and June 2008.The reasons of 26 cases of NPD were analyzed.Results The main reasons of NPD included cannulation occlusion,cannulation ectopia or translocation,cannulation exfoliation,cannulation-related infections,mechanical phlebitis,and thrombus formation.The complications usually were caused by the poor cannulation material,incorrect fixation,top of canuulation not reaching superior vena cava,lack of management measures for outpatients,accidents,and others.Effective measures for preventing NPD included:use silica gel cannulation;ensure the top of canuulation reach the superior vena cava;and improve the communications between outpatients and nurses.Conclusion NPD of PICC may be caused by various reasons and effective prevention measures should be taken.

Objective To investigate whether amniocentesis may increase the risk for mother-tochild transmission of hepatitis B virus (HBV).Methods Totally 40 children born to HBV-infected mothers who had amniocentesis performed in Nanjing Drum Tower Hospital, Nanjing University Medical School from January 2010 to December 2013, were followed up and screened for HBV markers.Amniotic fluid samples were collected and stored at-80 ℃ were tested for HBV markers.Among the 40 carrier mothers, three (7.5％) were hepatitis B e antigen (HBeAg)-positive.Relevant data such as antiviral history, administration of hepatitis B vaccine and hepatitis B immunoglobulin (HBIG) in infants were collected.Chi-square test or Fisher's exact test was used for statistical analysis.Results The mothers were 21-41 years old, with a mean age of (31.5±5.5) years at the time of amniocentesis and mean gestational age of (21.2± 1.6) weeks (18.4-24.9 weeks).Indications for amniocentesis were mainly abnormal maternal serum alpha-fetoprotein levels (65.0％, 26/40)and maternal age over 35 years (10.0％, 4/40).None of the mothers received antiviral therapy and 14 (35.0％)underwent transplacental amniocentesis.Among 28 cases who had a store of amniotic fluid sample and were followed-up, one (7.1％) was positive for both hepatitis B surface antigen (HBsAg) and HBV DNA, and another was positive for HBsAg only.The average age of 40 children at follow-up was (2.0± 1.0) years (seven months to four years old), among which 23 were boys and 17 were girls.All of them received hepatitis B vaccine and HBIG.Positive rate of HBsAg and HBV DNA in HBeAg(+) mothers are higher than those in HBeAg(-) mothers [4.7％(2/43) vs 3/5, x2=14.705;0/43 vs 2/5, x2=17.948;both P ＜ 0.05].Thirty-seven children born to HBsAg(+)/HBeAg(-) mothers were negative for both HBsAg and hepatitis B core antibody (anti-HBc), and the other three born to HBsAg(+)/HBeAg(+) mothers were also negative for HBsAg and anti-HBc.Additionally, the positive rate of hepatitis B surface antibody in children was 90.0％ (36/40).Conclusions For those HBsAg(+)/HBeAg(-) mothers, amniocentesis does not elevate the risk for mother-to-child transmission of HBV, even performed transplacentally.However, further studies are needed for HBeAg-positive mothers.HBsAg or HBV DNA positive in amniotic fluid should be diagnosed as intrauterine infection of HBV.