OBJECTIVE Learned through the seeing about the infection management of the Japanese Oita Medical University affiliated hospital and analyzed our hospital infection management′s status,to understand the dynamic management of hospital infection.Moreover these suggested that we attach importance to the management of hospital infection and constantly explore new ways of hospital infection management.METHODS According to the comparative presentation of these two hospitals′ awareness and practices of infection management from China and Japan,this paper probed into the direction of our hospital infection management development.RESULTS Hospitals in every country of the world have attached great importance to their infection management,but their specific practices were different.CONCLUSIONS By comparing inspection,every hospital should maintain the individualized characteristics and learn from each others′ strong points to offset their own weakness in order to gain continuous improvement of hospital infection management.

AIM: To study the difference in main chemical composition and content between(Radix et Rhizoma Rhei;Rhizoma Coptidis;Radix Scutellariae) dispensing granules and standard decoction. METHODS: 3D-HPLC was used with MeOH(A)、0.1%H_3PO_4-H_2O(include 0.02 mol/L KH_2PO_4,pH=3)(B) gradient elution,the fingerprint chromatogram of Xiexintang Dispensing Granules and standard decoction were set up. RESULTS: 30 peaks were indicated,the relative retention time and relative peak area were obtained. CONCLUSION: (The) difference between Xiexintang Dispensing Granules and standard decoction is obvious,the contents of the former are higher.

The teaching methods in anesthesiology practice to traditional Chinese medicine students was discussed.Watching for the first step, then simulation and manipulation on patients should be abided by. Paying more attention to patients’ safety and avoiding any fault to patients should be emphasized . The one to one and hand by hand teaching method should also be used to train the students' clinic thought and practical ability.

Objective To explore the mechanism of tripterygium wilfordii polyglycoside tablets for elderly patients with relapsing refractory immune thrombocytopenic purpura (ITP),and to seek the theoretical basis for Chinese medicine treatment of this disease.Methods The clinical data of 79 patients with relapsing refractory ITP were retrospectively analyzed.According to whether the combined use of tripterygium wilfordii polyglycoside,they were divided into the control group (35 cases) and the observation group (44 cases).The control group was treated with platelet and tranexamic acid,sulfasalazine,sulforaphane sodium,hemagglutinin and other symptomatic hemostasis treatment.The observation group in symptomatic hemostasis support on the basis of treatment with tripterygium wilfordii polyglycoside tablets.The CD4+/CD8+ ratio and CD4+ CD25+ Treg expression were compared between the two groups.Results The CD4+/CD8+ ratio,CD4+ CD25+ Treg and platelet count in the control group before treatmentwere (0.96 ± 0.36),(1.21 ± 0.67) ％,(13.14 ± 6.92) × 109/L,respectively,which of the observation group were (0.92 ± 0.37),(1.19 ± 0.59) ％,(11.51 ± 6.21) × 109/L,respectively,there were no statistically significant differences between the two groups (all P ＞ 0.05).The CD4+/CD8+ ratios in peripheral blood of the observation group at 2 weeks,3 weeks and 4 weeks after treatmentwere (1.04 ±0.56),(1.55 ±0.34),(1.59 ±0.41),respectively,there were statistically significant differences between the two groups (t =9.994,9.797,all P ＜ 0.05).The CD4+ CD25+ Treg proportions in the observation group at 2 weeks,3 weeks and 4 weeks after treatmentwere (1.01 ± 0.61) ％,(1.06:±:0.57) ％,(5.92 ± 0.65) ％,respectively,there was statistically significant difference between the 4 weeks after treatment and before treatment(t =5.378,P ＜ 0.05).The CD4+/CD8+ ratios in the peripheral blood of the control group were (1.01 ±0.60),(0.89 ±0.50) and (0.96 ±0.51),respectively,and the CD4+ CD25+ Treg in control group at 2 weeks,3 weeks and 4 weeks after treatment proportions were (0.99 ±0.72)％,(1.15 ±0.66)％,(1.22 ±0.56)％,respectively,there were no statistically significant differences between before and after treatment (all P ＞0.05).There were statistically significant differences in the CD4+/CD8+ ratio and CD4+ CD25+ Treg expression between the observation group and control group at 4 weeks after treatment (t =8.589,P ＜ 0.01;t =2.369,P ＜ 0.05).There was no statistically significant difference in the platelet count between the two groups(P ＞ 0.05),but the symptoms of bleeding of the observation group was lighter at 3 weeks after treatment.Conclusion Tripterygium wilfordii polyglycoside improves the expression of CD4+/CD8+ and CD4+ CD25+ Treg in peripheral blood of elderly patients with relapsed or refractory ITP.It is an ideal drug for the treatment of relapsed and refractory ITP in the elderly,it is worth further study.

Objective To explore the effect and potential mechanism of Huayu Mingmu Recipe(HMR)-containing serum on high glucose-induced angiogenesis of human retinal microvascular endothelial cells(HRMECs).Methods CCK-8 method is used to screen the optimal sugar concentrations,as well as volume fraction of drug-containing serum.A model of high glucose-induced HRMECs dysfunction was established.The HRMECs were divided into 6 groups such as normal control group which was treated with normal ECM culture medium(containing 5.5 mmol·L-1 glucose)and 10%blank serum,the mannitol control group and the high glucose model were given 19.5 mmol·L-1 mannitol and 19.5 mmol·L-1 D-glucose on the basis of the treatment of normal control group,respectively.The low-,medium-,and high-dose groups of HMR were given 10%low-,medium-,and high-dose medicated serum(without blank serum)on the basis of the model group.The colony experiment was used to detect the number of cell colonies.Transwell experiment was used to test the number of cell migration,and tube formation experiment was used to determine the forming of tubes.Immunofluorescence,Western Blot and RT-PCR were used to detect levels of protein and mRNA expression of FactorⅧ,platelet endothelial cell adhesion molecule-1(CD31),cell differentiation factor(CD34),vascular endothelial growth factor A(VEGFA),vascular endothelial growth factor receptor 2(VEGFR2).Results Compared with the normal control group,the model group could promote colony formation of HRMECs(P＜0.01),cell migration(P＜0.01),and lumen formation(P＜0.01).The levels of protein and mRNA expressions of Factor VIII,CD31,CD34,VEGFA,VEGFR2 were significantly increased(P＜0.01)in model group.Compared with the model group,low-,medium-and high-dose HMR-containing serum groups could inhibit colony formation of HRMECs(P＜0.05,P＜0.01),cell migration(P＜0.01),and lumen formation(P＜0.05,P＜0.01).The levels of protein and mRNA expressions of Factor VIII,CD31,CD34,VEGFA,VEGFR2 were significantly reduced(P＜0.05,P＜0.01)in HMR-containing serum groups.There was no statistically significant difference in results of various tests between the normal control group and the mannitol control group(P＞0.05).Conclusion HMR-containing serum can inhibit the proliferation,migration,and tube formation of HRMECs induced by high glucose,and then prevent or reduce angiogenesis.The mechanism may be related to the regulation of VEGFA/VEGFR2 signaling pathway.

Objective To study the changes and significance of 11β-HSD1 and 11β-HSD2 gene and protein expression in pla-centa of patients with gestational diabetes mellitus .Methods Thirty pregnant women with gestational diabetes mellitus (GDM ) and normal glucose tolerance (NGT ) were selected .Chemiluminescence was used to determine the serum cortisol ,neonatal cord blood cortisol and fasting insulin ect .Immunohistochemistry was used to detect the expression location of 11β-HSD1 and 11β-HSD2 in the placenta .The differential expression of 11β-HSD1 and 11β-HSD2 genes and proteins were detected by real-time PCR and Western blot .Results Compared with NGT group ,fasting insulin ,HOMA-IR ,insulin secretion index and maternal serum cortisol level were significantly increased in GDM group [(19 .95 ± 1 .05) mU/L vs .(12 .93 ± 1 .50) mU/L ,4 .54 ± 0 .67 vs .2 .87 ± 0 .43 , 80 .55 ± 6 .18 vs .53 .15 ± 5 .58 ,(1110 .00 ± 40 .91) nmol/L vs .(934 .1 ± 45 .92) nmol/L ,P<0 .05)] ,but there were no significant differences were found in fasting blood glucose and cord blood cortisol (P>0 .05) .The distribution of 11β-HSD1 in the placenta was distributed in the outer layer of villous syncytiotrophoblast ,villous interstitial and dry villi .The expression of 11β-HSD2 was con-centrated in the outer layer of villous syncytiotrophoblast .Real time-PCR and Western blot results showed that the expression of 11β-HSD1 mRNA and protein in placenta of GDM group was significantly lower than that of NGT group (0 .56 ± 0 .09 vs .1 .36 ± 0 .36 ,0 .27 ± 0 .07 vs .1 .00 ± 0 .01 ,P< 0 .05 ) ,11β-HSD2 mRNA was significantly higher than NGT group (5 .17 ± 1 .02 and 1 .21 ± 0 .34 respectively ,P<0 .05) ,but no significant difference was found in protein level (P>0 .05) .Conclusion The differenti-al expression of 11β-HSD1 and 11β-HSD2 in placenta of gestational diabetes mellitus can avoid the maternal poor pregnancy envi-ronment ,but will cause long-term harm to the fetus .

Objective To study the relationship of microRNA-145(miR-145) and CD44 in the hepatocellular carcinoma(HCC).Methods 13 clinical samples of HCC tissues and corresponding normal liver tissues were collected at department of General Surgery,Second Affiliated Hospital of Fujian Medical University from October 2015 to June 2016.The patients with positive expression of CD44 were studied.The expression levels of miR-145 and CD44 in HCC tissues and corresponding normal tissues were detected by real-time quantitative PCR.Western blot was performed to detect the expression of CD44 in HCC cells Hep G2 and SNU423.Biological information methods predicted whether miR-145 and CD44 have a targeted relationship.CD44 expression levels were detected after high expression of miR-145 in HCC cell line with positive expression of CD44.The vector and luciferase reporter genes were constructed to verify the interaction between miR-145 and CD44.The effects of miR-145 on proliferation in HCC cell lines with positive and negative CD44 expression were examined by tetramethylazoazole salt (MTT) assay.Results 8 of the 13 patients showed positive CD44 expression in HCC tissues.Compared with normal liver tissues,the relative expression of miR-145 in HCC tissues was significantly lower (0.998±0.010 vs.0.503±0.046,P＜0.05),and the relative expression of CD44 was higher (0.996±0.005 vs.1.878±0.108,P＜0.05).Bioinformatics suggested that miR-145 had a targeted relationship with CD44.High expression of miR-145 can significantly reduce the expression level of CD44 mRNA in HCC cell SNU423 (0.941±0.010 vs.0.515±0.021,P＜0.05) and down-regulate the expression of CD44 protein.Confirmed by luciferase reporter assay,CD44 is the target gene of miR-145.After transfection with miR-145 mimics,the proliferation of CD44 positive cell SNU423 was significantly inhibited (P＜0.05).Conclusions miR-145 can affect the proliferation of CD44 positive HCC cells by regulating the expression of CD44,which may be one of the pathogenesis of HCC.