Objective To explore the perioperative nursing points of 6 patients with true hermaphroditism. Method Six patients with true hermaphroditism from September 2009 to February 2014 were treated with surgeries , with perioperative nursing performed. Result All the operations were successful without serious complications and the wounds were on primary healing. Conclusions Perioperative nursing interventions over the patients with true hermaphroditism can alleviate role conflicts and help them overcome the psychological obstacles. Postoperative nursing including careful care to the perineum incisions and artificial vaginas, and health instruction can ensures postoperative rehabilitation.

This paper reviews studies on the relationship between health insurance and health status both at home and abroad. First, we put forward three viewpoints on their relationship;Second, based on different data, we review the studies from three different perspectives; Third, we review the recent studies at home. The paper draws the conclusion as following:(1) most studies on observational data prove that there is relationship between health in-surance and health status. To establish the causal relationship between them, we must overcome the endogeneity of health insurance. ( 2 ) Different studies have different conclusions, which are caused by different methodology and subjects. (3)The conclusions cannot be generalized to whole populations. Future studies should focus on the effect of different health insurance on different populations.

Ischemic stroke has become one of the leading causes of disability and death in China.A number of studies have confirmed that hypoalbuminemia is an independent risk factor for ischemic stroke.It affects the severity of ischemic stroke and outcomes.This article reviews the rehtionship between serum albumin and ischemic stroke,the cause of low albumin level,the effect of albumin on ischemic stroke,and how to supplement albumin in order to improve the clinician's attention for hypoalbuminemia in patients with ischemic stroke and supplement nutrition timely and reasonably.

Purpose To investigate the value of systemic abdominal ultrasonography in the diagnosis of acute abdominal diseases. Materials and Methods A total of 234 patients with acute abdominal diseases were enrolled consecutively in the study and randomly divided into the study group who received systemic abdominal ultrasonography and the control group who received traditional selective abdominal ultrasonography. The diagnose accordance rate and diagnose duration of two groups were compared with the results of pathology or clinical follow-up which served as the golden standard. Results The diagnose accordance rate in the study group (95.04%, 115/121) was significantly higher than that of the control group (86.73%, 98/113) (χ2=4.946, P<0.05);the ultrasound examination duration in the study group was statistically longer than that of the control group [(16.41±1.31) min vs (10.11±4.35) min, t=14.771, P<0.05], and the diagnose duration in the study group was significantly shorter than that of the control group [(2.00±1.30) h vs (2.65±1.72) h, t=3.301, P<0.05]. Conclusion Systemic abdominal ultrasonography can improve the diagnosis coincidence rate and shorten the duration in the diagnosis of acute abdominal diseases.

Objective To compare the roles of Toll-like receptor 4 (TLR4)/NF-κB signal pathway in acute lung injury (ALl) induced by blunt chest trauma and by blunt chest trauma-hemorrhagic shock and resuscitation (double hits) in rats.Methods Forty male Sprague-Dawley rats,aged 8 weeks,weighing 240-280 g,were randomly assigned into 3 equal groups (n =10 each) using a random number table:sham operation group (S group),blunt chest trauma group (T group),and blunt chest trauma and hemorrhagic shock and resuscitation group (group THSR).Lung contusion was induced in anesthetized rats by dropping a 300 g weight onto a precordial protective shield to direct the impact force away from the heart and toward the lungs.Blood was withdrawn via the femoral artery 5 min later until MAP was decreased to 35-45 mmHg within 15 min and maintained at this level for 60 min,followed by resuscitation.At 6 h after the model was established,the arterial blood samples were collected for blood gas analysis and detection of tumor necrosis factor-alpha (TNF-α) concentrations in serum.Oxygenation index (PaO2/FiO2) was calculated.The rats were then sacrificed and pulmonary specimens were obtained for determination of TLR4 expression and NF-κB ac tivity (by immunohistochemistry and Western blot) in lung tissues and for microscopic examination.Results Compared with group S,PaO2 and PaO2/FiO2 were significantly decreased,PaCO2 and TNF-α concentrations in serum were increased,TLR4 expression was up-regulated,and NF-κB activity was enhanced in T and THSR groups (P ＜ 0.05).Compared with group T,PaO2 and PaO2/FiO2 were significantly decreased,PaCO2 and TNF-α concentrations in serum were increased,TLR4 expression was up-regulated,and NF-κcB activity was enhanced in THSR group (P ＜ 0.05).The histopathological damage to lung tissues was aggravated in THSR group as compared with T group.Conclusion The role of TLR-4/NF-κB signal pathway in ALI induced by blunt chest traumahemorrhagic shock and resuscitation (double hits) is significantly stronger than that in ALI induced by blunt chest trauma alone in rats.

N-Acetylcysteine (NAC) protects rats administrated with gadolinium-based contrast agents from renal injury, however, the underlying mechanisms remain unclear.A 1H NMR-based metabolomics approach coupled with OPLS-DA (orthogonal projection to latent structure with discriminant analysis) was used to analyze the effect of NAC on urinary metabolic changes for Chronic Renal Failure Rats administrated with Gd-DTPA (Gd-Diethylenetriamine pentaacetic acid).Combined with univariate analysis of integral area, the significantly changed metabolites were selected to screen out the potential metabolic disturbances that induced by Gd-DTPA and NAC.These researches may attribute to study of the protective effect of NAC from renal failure induced by gadolinium-based contrast agents.The disturbance of energy metabolism, urea cycle and kynurenine metabolism were observed from the CRF group.Gd-DTPA caused the reduction of urinary choline, TMAO, o-HPA, p-HPA, hippurate, glycine, nicotinate and taurine accompanied with the elevation of allantoin.Metabonomic recovery in the NAC group was observed, which implied that NAC protects rats with chronic renal failure from Gd-DTPA induced disturbances of gut microbiota metabolism, liver mitochondria metabolism and kynurenine metabolism.The replenishment of glutathione in cells and the recovery of urea cycle that caused by NAC may protect rats from oxidative damage and renal injury.

Wistar rats were intragastrically administered with different doses (2, 5 and 10 g / kg body weight) of haematitum. 1H NMR-based metabonomic analysis coupled with multivariate statistical analysis (principal component analysis and partial least squares-discriminant analysis) was used to analyze the metabolic profiles of the urine samples collected from the treated rats. Univariate analysis on the 1H NMR spectra of urine (1 d before administration, 1-5 d post administration) was used to screen out the potential features of haematitum. Significant treatment related changes were observed for the levels of citrate, tuarine, creatinine,α-ketoglutarate, succinate and dimethylglycine, which could be used as potential features of haematitum. A trend of recovery in connection with dose levels was observed overtime. Such biochemical changes indicated that haematitum treatment at the dose of 2, 5 and 10 g / kg body weight affected the Krebs cycle and glucose metabolism, energy metabolism, choline metabolism and dimethylglycine metabolism in rats. These changes may attribute to the disturbances of hepatic function in 10 g / kg body weight group.

Objective To investigate the effects of penehyclidine hydrochloride on activities of nuclear factor kappa B (NF-kB) and activator protein-1 (AP-1) during actue lung injury induced by blunt chest trauma-hemorrhagic shock and resuscitation (HSR) in rats.Methods Thirty male Sprague-Dawley rats,aged 8 weeks,weighing 250-300 g,were randomly assigned into 3 equal groups (n =10 each) using a random number table:sham operation group (group S),blunt chest trauma-HSR group (group THSR) and penehyclidine hydrochloride group (group PHCD).The model of actue lung injury induced by blunt chest trauma-HSR was induced by dropping a 300 g weight onto a precordium in anesthetized rats.Blood was withdrawn via the femoral artery 5 min later until MAP was decreased to 35-45 mmHg within 15 min and maintained at this level for 60 min,followed by resuscitation.In PHCD group,PHCD 2 mg/kg was injected intravenously at 60 min after hemorrhagic shock.At 6 h after the model was established,blood samples were obtained for measurement of concentrations of tumor necrosis factor-alpha (TNF-α) in serum.The lungs were then removed for determination of lung water content,myeloperoxidase (MPO) activaty (by colorimetric assay),NF-κB and AP-1 activaties (using electrophoretic mobility shift assay) in lung tissues,and for microscopic examination of pathologic changes (under light microscope).The left lung was lavaged,and lung permeability index (LPI) was calculated.Results Compared with S group,lung water content,LPI,serum TNF-α level and activites of MPO,NF-κB and AP-1 were significantly increased in THSR and PHCD groups.Compared with THSR group,lung water content,LPI,serum TNF-α concentrations and activites of MPO,NF-κB and AP-1 were significantly decreased in PHCD group.The pathological damage to lung tissues was significantly reduced in PHCD group as compared with THSR group.Conclusion PHCD can inhibit activities of NF-κB and AP-1 in lung tissues,thus mitigating acute lung injury induced by blunt chest trauma-HSR in rats.

Objective To investigate the role of NRAGE subcellular localization in the EMT and radioresistance of esophageal cancer cells.Methods EMT model cells were established by the treatment of TE13 cells with TGF-β1.To verify the establishment of EMT model and the phenotype of EMT-like TE13R120 cells,EMT marker mRNA and protein were detected by Real-time PCR and Western blot,respectively.Real-time PCR was also used to detect the expression of NRAGE mRNA in three groups.Total NRAGE protein,cytoplasm protein and nuclear protein were measured by Western blot.Results It was found that TGF-β1 could induce morphological alterations of TE13 cells from epithelial to mesenchymal and change the expressions of EMT maker E-cadherin and vimentin (t =13.56,-232.84,P ＜ 0.05),indicating the successful establishment of EMT model cells.Similar expression trends of EMT makers were observed in TE13R120cells (t=15.84,-54.54,P＜0.05).NRAGE mRNA (t=-8.73,-5.62,P＜ 0.05) and total protein in both EMT model cells and TE13R120 cells were higher than that in TE13 cells,especially for the nuclear proteins.However,no differences in NRAGE cytoplasm protein expression were found among the three groups.In addition,there were also no difference of NRAGE mRNA (t =-0.88,P ＞0.05),cytoplasm and nuclear protein between TE13R120 cells and EMT model cells.Conclusions The radioresistant cell line TE13R120 has the EMT-like phenotype that may cause cell radioresistance by changing the subcelluar localization of NRAGE.