Objective To investigate the spatio-temporal distribution characteristics of syphilis epidemic in Main-land China in 2005-2011.Methods Geographic information system was established based on the data of syphilis epidemic and demographic information from online reporting system of 3 1 provinces,municipalities and autonomous regions of Mainland China from 2005 to 2011,global indication of spatial autocorrelation(GISA),local indication of spatial autocorrelation (LISA),and spatial-temporal cluster analysis were conducted by GeoDa 0.95i and SaTScan 9.1 .1 software,high risk areas of spatial-temporal distribution of syphilis were determined.Results The number of syphilis in Mainland China in 2005-2011 were 1 841 217 cases,annual incidence was 20.07/100 000,suggesting a sign of obvious cluster distribution.Except 2011,GISA coefficient Moran’s I were statistically different.Accord-ing to LISA analysis,Jiangsu,Shanghai,Zhejiang and Fujian lay in high-high region in 2005-2009,Chongqing lay in high-low region in 2006-2008,and in 2011,no area was found in high-high region.Spatio-temporal cluster anal-ysis showed that the most likely cluster was in Shanghai and Zhejiang (2009-2011);the secondary cluster distribu-ted in five areas,including Guangdong,Guangxi and Hainan (2009-2011),Xinjiang (2009-2011),Liaoning and Jilin (2010-2011),Gansu,Ningxia,Shaanxi,Sichuan,Chongqing,Shanxi and Inner Mongolia (2011),Beijing and Tianjin (2008-2010).Conclusion Significant spatio-temporal cluster pattern is found for the distribution of syphilis in mainland China,which can be meaningful for pertinent control.

Objective To study the expression of P57kip2 and its clinical significance in hilar bile duct adenocarcinoma.Methods The expressions of P57kip2 in hilar bile duct adenocarcinoma tissues (37 cases) and normal bile duct tissues (32 cases) were determined by immunohistochemical SP methods.The relations between the expression levels of P57kip2 with clinicopathologic parameters were analyzed.Results The positive rate of P57kip2 was 43.2％ (16/37) in bile duct adenocarcinoma,while it was 87.5％ (28/32) in normal duct tissues (P ＜0.01).The expression level of P57kip2 in adenocarcinoma showed no significant association with gender,age or CA19-9 level (P ＞0.05),but they were significantly related with lymph node metastasis,invasion and degree of differentiation (P ＜ 0.05).Conclusions P57kip2 is associated with the occurrence and development of hilar bile duct adenocarcinoma.It may play an important role in invasion and metastasis of hilar bile duct adenocarcinoma.The P57 protein can be used as an index to diagnose hilar bile duct adenocarcinoma.

Objective To investigate the effects of angiotensin receptor blocker (ARB)losartan on the glomerular protein expression profile of spontaneous type 2 diabetic KKAy mice by two-dimensional differential gel eleetrophoresis and MALDI-TOF mass spectrometry.Methods 8-week-old spontaneous type 2 diabetic KKAy mice were randomly divided into losartan (10 mg·kg-1·d-1 given in drinking water) treatment group and non-treatment group.Eight-week-old C57BL/6 mice were used as normal control.The glomeruli were separated by magnetic bead perfusion through thoracic aorta at age of 20 weeks,then glomerular protein was extracted.The glomerular protein expression profile was investigated by CyDyes minimal fluorescence labelling,two-dimensional differential gel electrophoresis and MALDI-TOF mass spectrometry.Results KKAy mice developed higher body weight and blood glucose,higher urinary microalbumin creatinine ratio at age of 20 weeks than C57BL/6 mice at the same age (all P＜0.05).Losartan treatment markedly reduced urinary microalbumin creatinine ratio [(539.71 ±100.23)mg/g vs (728±177.19) mg/g],attenuated mesangial expansion and the thickening of glomerular basement membrane,but had no effect on the blood glucose.By DeCyder 2-D differential analysis software,62 protein spots of differential expression were found in glomeruli between losartan treatment and non-treatment KKAy mice at age of 20 weeks.Among them,41 proteins were identified by peptide mass fingerprinting.The expressions of 28 proteins were up-regulated by losartan treatment,including glycerokinase,sulfite oxidase,glycine amidinotransferase,adenosylhomocysteinase,etc.The expressions of 13proteins were down-regulaled by losartan treatment,including 3-mercaptopyruvate sulfurtransferase,ATP synthase subunit d,60 000 heat shock protein,stress-70 protein (alternative name 75 000glucose-regulated protein,GRP75),etc.Six differcntially expressed proteins were found in glomeruli between non-treatment KKAy mice and C57BL/6 mice,and the differential expressions were suppressed by losartan treatment,including dihydrolipoyllysine-residue acetyltransferase component of pyruvate dehydrogenase complex,succinyl-CoA ligase (GDP-forming) subunit beta,mitochondrial,ATP synthase subunit d,GRP75,nucleoside diphosphate-linked moiety X motif 19 and seleniumbinding protein 1.Conclusions Losartan significantly reduces the urinary protein excretion rate and renal pathological lesion of spontaneous type 2 diabetic KKAy mice,and suppresses the differential expression of mitochondrial ATP synthase subunit d,GRP75,selenium-binding protein 1,etc in glomeruli.Losartan may play a renoproteetive role by reducing glomerular mitochondrial reactive oxygen species genesis and inhibiting oxidative stress.

Objective To investigate the effect of follow-up frequency on the dialysis quality of patients undergoing continuous ambulatory peritoneal dialysis (CAPD). Methods 298 CAPD pa-tients were selected for retrospective analysis from December 2005 to April 2007. All patients were di-vided into two groups according to different follow-up frequency: group A (shorter than 3 months),group B (longer than 3 months). The dialysis quality of the two groups was compared. Results The levels of hemoglobin, albumin and transferrin of group A were (112.19±20.62)mmol/L, (40.45±4.50) retool/L, (2.43±0.29) mmol/L,which were significantly higher than those of group B, (99.63±20.69) mmol/L, (38.01±5.02)mmol/L,(2.29±0.36) mmol/L (P＜0.05). In addition, edema level, life self-care,work capacity, median duration of dialysis, education level and address in group A were significantly different from those of group B (P ＜ 0.05). Conclusion Shortening follow-up frequency plays an im-portsnt role in improving the dialysis quality of CAPD patients.

Objective To identify susceptible miRNAs for the pathogenesis of diabetic nephropathy (DN) and the molecular targets of losartan treatment. Methods The 8-week age KKAy mice were divided into losartan treatment group (10 mg· kg-1· d-1) and non-treatment group,C57BL/6 mice were used as the control group.At age of 20 weeks,body weight,random blood glucose,urinary albumin and urinary creatinine were tested,and kidney morphology was observed.Glomeroli were separated by magnetic beads perfusion,and total RNA were extracted.MiRNAs expression profiles were analyzed by the Affymetrix GeneChip miRNAs arrays. Results At age of 20 weeks,KKAy mice developed higher body weight,higher blood glucose and higher urinary microalbumin creatinine ratio than C57BL/6 mice,and the glomerular basement membrane thickened,mesangial matrix widened.Losartan treatment markedly improved the level of urinary albumin creatinine ratio [(539.71±100.23) mg/g vs (728±177.19) mg/g,P＜0.05)] and pathological lesion of KKAy mice.The miRNA array analysis showed that there were 22 miRNAs differentially expressed between KKAy non-treatment mice and C57BL/6 mice glomeruli at age of 20 weeks.Among them,10 miRNAs were up-regulated,and 12 miRNAs were down-regulated.The expression of 4 miRNAs was down-regulated in glumeruli of KKAy mice treated by losartan compared with that of non-treatment mice.The expressions of miRNA-503 and miRNA-181d were significantly up-regulated in the glumeruli of KKAy mice and inhibited by losartan treatment, Conclusion The expressions of miRNA-503 and miRNA-181d are significantly up-regulated in the glumeruli of KKAy mice and inhibited by losartan treatment,which may be new therapeutic targets of DN.

Objective:To apply enhanced recovery after surgery (ERAS) to patients with pelvic floor dysfunction during perioperative period and evaluate its application effect.Methods:A retrospective research method was used to select inpatients who were admitted to department of gynecology in Peking University People's Hospital from July 2016 to June 2018. The 117 patients enrolled from July 2016 to June 2017 were the routine group, and the 156 patients enrolled from July 2017 to June 2018 were the ERAS group. The routine group was given conventional nursing measures, while the ERAS group was given perioperative management by using ERAS concept. The differences of the indwelling catheter time, pain score, average length of stay, complications and hospitalization expenses between the two groups were compared.Results:The postoperative indwelling catheter time (2.28±1.15) d, average length of stay (7.00±2.33) d and pain score (2.08±2.02) of the ERAS group were lower than those of the routine group, and the differences were statistically significant ( P<0.05) . Conclusions:The application of ERAS in the perioperative period of patients with pelvic floor dysfunction disease can shorten the duration of indwelling catheter, alleviate the pain of patients, shorten the average length of stay in hospital, thus saving medical resources. It is suggested to carry out during the perioperative period of pelvic floor dysfunction disease.

[ ABSTRACT] AIM:To investigate the depressant effect of FK228 combined with rapamycin on the human breast cancer cell line MCF-7 and MDA-MB-435.METHODS:FK228, a new histone deacetylase inhibitor, and rapamycin, the specific inhibitor of the mammalian target of rapamycin ( mTOR) protein, were used in the study.MCF-7 cells and MDA-MB-435 cells were exposed to different concentrations of FK228 and rapamycin.The inhibitory rate of cell growth was de-termined by SRB assay.Combination index ( CI) was used to evaluate the interaction between FK228 and rapamycin.The expression of the apoptotic proteins, cycle proteins and nucleic acid proteins were detected by Western blotting.The cell cycle was analyzed by flow cytometry.RESULTS: Both FK228 and rapamycin showed growth inhibitory effects on the breast cancer cell lines in a time-and dose-dependent manner.CI of the 2 drugs was less than 1 when the inhibitory rate of the cell growth was 50%effective dose (ED50)~ED70, indicating a synergistic effect.The combination therapy of FK228 with rapamycin increased the apoptotic proteins, and induced the down-regulation of phosphorylated Akt and over-expres-sion of caspase-3 compared with a single use of the drugs.The combination therapy of FK228 with rapamycin reduced the cycle proteins, and the cell cycle was arrested in G2/M.The levels of phosphorylated H2AX and acetylated H3 were ob-viously increased after combination therapy.CONCLUSION:The combination therapy of FK228 with rapamycin inhibits the cell proliferation and increases apoptosis with a synergistic effect, which may become a new trend for treating endometri-al cancer.

Objective To observe the effect of detail nursing in prevention of falls in patients with fracture of lower limbs.Methods A total of 142 cases in our hospital were selected as research objects,and 71 patients were selected as control group given conventional nursing,and another 71 patients included in the study group given detail nursing,nursing effect and fall prevention condition were compared.Results The incidence of falls,awareness rate of health knowledge,nursing satisfaction were better than the control group,the difference was statistically significant (P ＜ 0.05).The average length of stay,nursing quality score of the study group were better than that of the control group,the difference was statistically significant (P ＜ 0.05).Conclusion Detail care for patients with lower limb fracture can improve the quality of life and nursing,and avoid complications.

Objectives To investigate the relationship between the expression of hENT1 protein in pancreatic cancer and the efficacy,adverse reactions and prognosis of gemcitabine.Methods The tissues of 83 patients with pancreatic cancer diagnosed in Department of Hepatobiliary and Pancreatic Surgery of Jiaxing Second Hospital and Jiaxing City Hospital of Traditional Chinese Medicine from June 2013 to January 2016 were collected by endoscopic fine needle aspiration biopsy.The expression of hENT1 protein was detected by immunohistochemistry,which was divided into hENT1 low expression group and high expression group.According to the curative effect of chemotherapy,it was divided into gemcitabine effective group and drug resistance group.The clinicopathological parameters,adverse reaction rate,median survival,and progressionfree survival (PFS) were compared between the two groups.Results Of the 83 pancreatic cancer tissues,37 (44.6％) had high expression of hENT1 and 46 (55.4％) had low expression.There were no significant correlations of the efficacy of gemcitabine chemotherapy with gender,age,clinical symptoms,primary tumor location,tumor size,TNM staging,CA19-9 level,CEA level,presence or absence of liver metastasis,but gemcitabine resistance rate in high expression group was significantly higher than the low expression group (78.1％ vs 50.0％),and the difference was statistically significant (P =0.010).Both groups were able to tolerate adverse reactions of gemcitabine chemotherapy and no chemotherapy-related death was observed,but the incidence of leucopenia and thrombocytopenia in hENT1 low expression group was significantly higher than those in bENT1 protein high expression group (63.0％ vs 21.6％,47.8％ vs 16.2％),the differences was statistically significant (all P ＜ 0.05).The median survival and 1-year PFS of hENT1 protein low expression group were significantly lower than those of high expression group (11 months vs 15 months,19.4％ vs 50％),and the differences were statistically significant (P ＜0.05).Conclusions Decreased hENT1 protein expression in pancreatic cancer tissue could reduce the efficacy of gemcitabine chemotherapy,increasing the incidence of leucopenia and thrombocytopenia.

Objective To establish the screening condition of psychological intervention for patients in department of chest surgery and to explore the effect of psychological intervention on mental status and quality of life of patients undergoing operation. Methods Firstly, 30 healthy citizens and 30 patients undergone thoracic surgery were selected used simple random sampling method from October 2015 to December 2016. The Quality of Life Assessment Table (SF-36) and 90 Symptom Self-assessment Tables (SCL-90) were used respectively to obtain the ROC curve analysis of each total score. The respective values of them were obtained. Secondly, according to the cut-off value, 90 eligible patients were selected and randomly divided into control group and observation group, 45 cases in each group. The control group was given general care, and the intervention group received positive psychological intervention nursing for 2 weeks. Before and after intervention, all patients underwent SF-36 and SCL-90 scores, and the nursing satisfaction survey was done before the end of the study. Results The ROC curve analysis showed that the patients with SF-36 total score less than 570.55 had poorer quality of life, and the patients with SCL-90 total score more than 13.21 had poor mental status. After the intervention, the SF-36 score in emotional function, social function, the overall health of the two groups had no statistical difference (P>0.05), other indicators of the intervention group were better than the control group, and there were statistical differences (P<0.05); the SCL-90 score of patients in obsessive-compulsive symptoms, depression, psychotic were no significant difference (P>0.05), other indicators of the intervention group were better than the control group, and there were statistical differences (P<0.05). Conclusions The patients undergoing chest surgery with SF-36 total score less than 570.55 and SCL-90 total score more than 13.21 need positive psychological nursing intervention, and positive nursing intervention has a positive impact on the quality of life and psychological status of such patients.