Objective To evaluate the effect of SYNTAX score in the emergency revascularization strategy selection in ST‐segment elevation myocardial infarction patients with multi‐vessel disease(MVD) and to analyze the patient′s prognosis and influen‐cing factors .Methods A total of 144 patients with STEMI complicating MVD verified by coronary arterial angiography in the Xin‐qiao Hospital of Third Military Medical University from August 2010 to March 2012 were collected and divided into the once com‐plete revascularization group (CR group) ,staged complete revascularization group (SR group) and incomplete revascularization group (IR group) according to different emergency PCI strategies .The basic clinical conditions and coronary arterial SYNTAX score were recorded .The occurrence rate of major adverse cardiovascular events (MACCE) during 12 months follow up period was performed the statistics .The results of coronary arterial angiography were collected .The effect of different strategy on prognosis and the risk factors affecting prognosis were analyzed .Results There was no statistically significant difference in the all‐cause mor‐tality between the IR group with the CR and SR groups (P>0 .05) ,while the cerebrovascular event ,repeat revascularization during hospitalization ,AMI and total MACCE occurrence rate had statistical difference between the IR group with the CR and SR groups (P<0 .05) .The main influence factors of MACCE were complicating diabetes mellitus ,type C lesions ,SYNTAX score ,D‐B time , myocardial infarction area ,TIMI score in PCI ,no reflow existence and cardiac shock (P<0 .05) .According to the SYNTAX score , the occurrence rate of MACCE in mild or severe lesions had no statistical difference among 3 groups(P> 0 .05) ,while which in moderate lesion had statistical difference among 3 groups(P<0 .05) ,the CR group had the highest occurrence rate of MACCE . Conclusion For the patients with STEMI complicating MVD ,the SYNTAX score can be used as the evidence for selecting reperfu‐sion strategies and applied in emergency PCI .

Objective To assess the subgenotypes of pathogenic Cryptococcus gattii isolates from China and to elucidate the epidemiological links between these domestic isolates and those from other parts of the world. Methods DNA was extracted from 9 clinical isolates of Ctyptococcus gattii from China. The partially variable regions of the three unlinked loci, namely IGS1, PLB1 and GEF1, were amplified and sequenced, and the bioinformation at these loci was obtained from GenBank for multi-locus sequences alignment and phylogenetic analysis. Results Of these 9 clinical isolates, 8 were genotype VG Ⅰ and mating type α with the same sequences at the tested regions as the reference strain WM276, which was a representative isolate of an independent subgenotype; 1 was of genotype VG Ⅱ and mating type α, which was the first report in China, with the tested sequences consistent with those of the referrence strain R272. Sequencing and phylogenetic analysis of GEF1 gene, which was located at mating type locus, successfully identified the genotypes and mating types of all the Cryptococcus gattii isolates involved here. Conclusions Multi-locus sequence analysis shows that causative Cryptococcus gattii isolates of genotype VG Ⅰ in China carry similar sequences at the tested loci in IGS1, PLB1 and GEF1 genes, to a widely distributed subgenotype in the world, and the sequences of the first VG Ⅱ genotype isolate from China resemble the less virulent subgenotype VG Ⅱ b found in Vancouver islands.

Objective To study the correlation between 2007 modified TOAST classification and OCSP classification.Methods Totally 177 patients were classified based on the 2007 modified TOAST and OCSP criteria.Analyze whether there was any correlation between the two typing.Results TACI and LACI had significant deviation on distribution of modified TOAST subtype(P

Objective To analyze the working stress related factors of nurses in intensive care unit (ICU), and put forward the corresponding counter measures.Methods During January to March 2016, a questionnaire survey was conducted with a commonly used nurses working pressure source scale on 110 ICU nurses in three People's Liberation Army (PLA) 3A grade hospitals in Beijing. The questionnaire survey involved 35 items within 5 main categories, including nursing professional issues, nursing workload and time allocation, working environment and resources, special care for critical patients and inter-personnel relationships between the head of nurses and other nurses. The correlations between the ICU nursing working stress and alternative factors were analyzed.Results Ninety-six nurses said the job was stressful, and 88.5% of them expressed that the degree of pressure was more than medium. The correlation analysis showed that ICU nurse working stress was correlated with 29 items in the survey scale (allP < 0.05), of which the top 6 items the mostly closely related were the frequent working shift (r = 0.58,P = 0.000), low nursing social status (r = 0.54,P = 0.000), less promotion opportunities (r = 0.54,P = 0.000), less opportunities to pursue further study (r = 0.53, P = 0.000), nurse low salary (r = 0.52,P = 0.000) and excessive workload (r= 0.50,P = 0.000).Conclusions ICU nurses face a lot of pressure in their work, the management departments should pay more attention to them, and actively energetically improve the nurse system construction, raise ICU nurses' pride, enhance the quality of nurse care and promote the healthy development of nursing profession.

Objectives To learn about current public health education for undergraduate clinical students and to provide some references for developing suitable teaching way in the further.Methods Public health education for undergraduate clinical students in 11 medical colleges and universities and teachers' opinions on it were surveyed with the self-made questionnaire.Quantitative data were analyzed with descriptive statistic method.Results All the surveyed colleges and universities opened public health curriculum for undergraduate clinical students and 10 colleges and universities made public health course to be compulsory.The teaching contents were varied in different colleges and universities.Teachers who gave the public health courses proposed some suggestions on its reform.Conclusions Public health education for clinical students in different colleges and universities has both unity and diversity.It should develop new teaching model based on the training goal of public health education for undergraduate clinical students.

Objective:To analyze the distribution, clinico-pathologic features, and survival status of different subtypes in axillary lymph node-negative invasive breast cancer patients. Methods:In this study, data of 183 patients were included and retrospectively ana-lyzed in terms of age distribution, clinico-pathologic features, disease-free survival (DFS), and overall survival based on different sub-types (luminal, basal-like, and HER-2 over-expression). Results:No significant differences in age, tumor size, and TNM stage was ob-served among different subtypes. The relapse rates of luminal, basal-like, and HER-2 over-expression subtypes were 3.9% (4/102), 20.4% (10/49), and 6.3% (2/32), respectively (P=0.002). The death rates of luminal, basal-like, and HER-2 over-expression subtypes were 2.0%(2/102), 6.1%(3/49), and 3.1%(1/32), respectively (P>0.05). Kaplan-Meier analysis showed that the DFS of basal-like sub-type was much lower compared with that of the luminal and HER-2 over-expression subtypes (P=0.002). Cox analysis showed that the subtype was an independent prognostic indicator (P=0.001). Conclusion:In node-negative invasive breast cancer, no significant differ-ences in age distribution, tumor size, and TNM stage was observed among different subtypes. The basal-like subtype has the worst prog-nosis. Therefore, subtype is an important independent prognostic indicator.

Objective Through the cell block technique to detect the expression of P16 protein in the liquid-based cytology with atypical squamous cells of undetermined significance (ASCUS) and high degree of cervical intraepithelial lesions (HSIL),to explore the significance of P16 protein in ASCUS re-evaluate.Methods Collected in our hospital in 2012 cervix liquid based cytology specimens of 45 patients,including of 15 ASCUS,11 HSIL cases,low in 11 cases of epithelial lesions (LSIL) and 2 cases of squamous cell carcinoma,2 cases of atypical glandular cells,4 cases of normal cells as a control.Immunocytochemical analysis of P16 protein control analysis,cytology and histology results.Results The expressing of P16 protein in normal cells,ASCUS,LSIL,HSIL,squamous cell carcinoma,atypical glandular cells in the positive expression rates were 0,20％,27.2％,63.6％,100％,100％.Cytology and biopsy results,cytologic diagnosis of ASCUS 15 cases,biopsy:12 cases of cervicitis,CIN Ⅱ-Ⅲ in 3 cases; cytology the in LSIL11,biopsy:5 cases of cervicitis,CIN Ⅰ 6 cases ; the cytological diagnosis HSIL11 cases,biopsy:cervical four cases of intlammation,CIN Ⅱ-Ⅲ ; cytologic diagnosis of atypical glandular cells in 2 cases,biopsy:adenocarcinoma; cytologic diagnosis of squamous cell carcinoma in 2 cases,biopsy:squamous cell carcinoma.Conclusion Detection of P16 protein on the cell block can be used for ASCUS classification ASCUS reassessment.

Objective To identify risk factors associated with the severity of acute kidney injury (AKI) in-duced by crush syndrome and whether the patient required hemodialysis (HD). Method A retrospective study was designed. Within 19 days after the Chinese Wenchuan earthquake (May 12, 2008), 63 victims (33 men, 30women) of 2139 cases were hospitalized at Mianyang Central Hospital (Siehuau, China) because of crush syn-drome caused by crush injuries. The patients with renal dysfimcfion before the earthquake were excluded. Totally 63 patients with AKI associated with crush syndrome were included in this study and were divided into two groups: group 1, 25 patients, requiring HD (when urine volume <250 mL/d;serum potassium> 6 mmol/L) ; and group 2, 38 patients, without HD. The following data were collected retrospectively for all patients: (1) epidemiological parameters: age, gender, race, time under the rubble, liquid treatmem before being rescued; (2) clinical param-eters: blood pressure, body area crushed, amputation, fasciotomy, blood transfusion, quantity of fluid infusion, urine output in the first 24 hours; (3) initial laboratory data: complete blood count, urine analysis, serum chem-istry, arterial blood gas analysis. Comparisons between the two groups were made using SPSS 10.0. The quantita-tive data and categorical data were analyzed using t tests and χ2 tests, respectively. P -values < 0.05 were consid-ered to indicate significant differences. The significant variables were entered into logistic regression models to de-termine the risk factors for the severity of AK1 in patients with crush syndrome and whether the patient required HD. Results Four significant risk factors with P -values < 0.05 were identified: fasciotomy, cystatin C (Cys C)level, myoglobin (MB) level and lactic acidosis. The odds ratios (95% confidence intervals) were 8.641 (3.027～76.479), 6.956 (3.027～76.479), 5.379 (3.027～76.479) and 4.833 (2.569～32.764), respectively. Conclusions In addition to urine output and potassium levels, we found that four risk factors, namely faseiotomy, Cys C and MB levels, and lactic acidosis, were significanfly associated with the severity of AKI and whether the patient required hemodialysis.

Objective To investigate the prottective effect of ulinstatin on lung of rats with sepsis and its mechanism of ameliorating cell apoptosis. Method A total of 40 female SD rats were randomly (random number)divided into the control group and the therapy group (ulinastatin 300 000 u/kg). The rat models of sepsis were produced by the classical method of cecal ligature and puncture (CLP), and the designed doses ulinastatin were given intra-peritoneally to the rats of the ulinastatin group and the same amounts of PBS (phosphate buffered solution) instead of ulinastatin were administered intra-peritoneally to the rats of the control group when the sepsis symptoms appeared usually in 3 hours after modeling. In 12 hours after treatment, lung tissues of rats in two groups were taken for observation under the transmission electron microscopy and detecting the levels of Bcl-2 and Bax protein in lung tissues by using immunohistochemical technique. The levels of the integrated optical density(IOD)of Bcl-2 and Bax protein were detected by using Image-pro plus software and the ratio of Bcl-2/Bax was calculated. Results Transmission electron microscope showed that lung tissue in control group had inflmmatory changes such as severe congestion and consolidation, and those changes in ulinastatin treatment group (300 000 u/kg)were significantly slighter. There were significant differences in the levels of antiapoptotic protein Bcl-2 in lung tissue of rats between two groups(P＜0.01), and the level of protein Bcl-2 in ulinas tatin group were higher than those in control group. The level of pro-apoptotic protein Bax in control group were higher than that in ulinastatin group (P＜0.01). The ratio of Bcl-2/Bax in ulinas tatin group was higher than that in control group (P ＜ 0.05).Conclusions Ulinastatin has protective effect on lung tissue in septic rats, and it may inhibit the inflammatory response and in the same time plays a role in inhibiting cell apoptosis.

Purpose　To explore the possibility and the effect of therapeutic bronchial asthma by antisense oligonucleotid.　Methods　Based on the IL-5 cDNA sequence of mouse,a segment of antisense oligonucleotid was designed and synthetized.5′-labeling of antisense oligonucleotid was signed by T4 PNK in order that the efficiency of stearylamine liposome in transfe-ting antisense oligonucleotid can be evaluated. Astham model was duplicated with ovalbumin (OVA) absorbed to aluminum hydroxide. T lymphocytes of mice were separated by nylon fiber method,then T lymphocytes transfected a different content of antisense oligonucleotid with stearylamine phys. positive liposome were cultured respectively in order to observe the effect of antisense oligonucleotid on IL-5 produced by T lymphocytes. IL-5 levels in the supernatants of T lymphocytes culture were determined by ELISA.　Results 　Stearylamine liposome could markedly increase the efficiency of antisense oligonucleotid transfection. The efficiency of antisense oligonucleotid transfection was the best at 1∶15 m/m(antisense oligonucleotid and SA liposome) and it was increased approximately 12 times.In healthy and asthma Balb/c mice, IL-5 was not detected in the supernatants of T lymphocytes culture without challenge with OVA.However,IL-5 was increased markedly in the supernatants of T lymphocytes culture challenged with OVA. After transfecting a different concentration antisense oligonucleotid, IL-5 levels in the supernatants of T lymphocytes culture were significantly lower than those in control cells without antisense oligonucleotid transfection. IL-5 levels decreased from (44.60±6.23) to (30.70±7.362),(17.20±6.181) and(8.16±2.34)pg/ml respectively. And IL-5 synthesis was inhibited by 31.17% , 61.43% and 81.7% respectively. 　Conclutions　IL-5 synthesis could be obviously inhibited by antisense oligonucleotid and showed a markedly relation between quantitative and effect. It is supported that the production of IL-5 be inhibited through preventing the transcription of IL-5 from T lymphocytes. The study provides foundation for antisense gene therapeutic asthma.