Objective:To find a better way to protect the security and interests of vulnerable groups by exploring the problem of protecting the vulnerable groups in drug clinical trial from the perspectives of ethics committees,organization and researchers.Methods:According to the relevant literature and the actual situation of the hospital,this paper analyzed the security issues of vulnerable groups comprehensively.Results:Only the ethics committees,organization and researchers work together,can it protect the security and interests of vulnerable groups to the greatest extents.Conclusion:Further research on the security of vulnerable groups not only promotes the development of human health,but also plays a decisive role in improving the protection of subjects in drug clinical trial.

BACKGROUND:To improve the survival rate of transplanted tissue, most scholars focus on cel therapy, particularly cel-assisted fat grafting.
OBJECTIVE:To analyze the effect of recombinant adenovirus-mediated hypoxia inducible factor 1alpha (HIF1α) mutant on survival rate of transplanted fat particles through transfection of adipose-derived mesenchymal stem cels.
METHODS:Recombinant adenovirus-mediatedtriple-mutantHIF1αwas inserted into an adenovirus pAdEasy-1 system, folowed by viral packaging and titer determination. Human adipose-derived mesenchymal stem cels were cultured, passaged and identified, and subsequently transfected with three kinds of viruses and blank vector (experimental group with transfection of the triple mutantof HIF1α;positive control group; negative control group; blank control group). Transfection efficiency was determined using enhanced green fluorescent protein labeling. Additionaly, MTT assay was used to detect cel proliferation.
RESULTS AND CONCLUSION:The recombinant adenovirus was successfuly constructed and packaged in line with transfection requirements. Moreover, adipose-derived mesenchymal stem cels were successfuly identified by adipogenic, osteogenic and chondrogenic induction and could be used asseed cels for subsequent experiments. RT-PCR results showed that HIF1α mRNA expression in the experimental group and positive control group was significantly higher than that in the other two groups (P< 0.05). Western blot analysis showed that the relative absorbance value in the experimental group was significantly higher than that in the other three groups (P< 0.05). A significant increase in the cel proliferation was found in the experimental group, significantly different from the other three groups (P<0.05). Therefore, our findings indicate that transfection of adenovirus-mediated triple-mutant HIF1α not only can sustain the expression of target protein in transfected adipose-derived mesenchymal stem cels under normoxic conditions, but also can promote the proliferation of transfected adipose-derived mesenchymal stem cels.

OBJECTIVE To investigate the status of nosocomial infection in community health services and offer a scientific basis for nosocomial infection control.METHODS Totally 5738 outpatients were investigated retrospectively for nosocomial infection in community.RESULTS The most frequently nosocomial infection sites were lower respiratory tract,and next upper respiratory tract and urinary tract(2131,1045 and 934,respectively).The major reasons of causing the nosocomial infection were irrational usage of antibacterial drugs(39.0%),invasive procedures(31.0%) and using glucocorticoids(10.0%).Most of the pathogenic bacteria of the nosocomial infection were Gram-negative and the next were Gram-positive and fungi.74.4% of the pathogens were resistant to most of antibioties.CONCLUSIONS Alzeimer′s disease patients in the community health centers are popular and susceptible to infection.

Objective To evaluate the features of bacterial spectrum and drug resistance in diabetic ulcer.Methods Excretion specimen of diabetic ulcer from 130 patients admitted into our hospital from Mar.2010 to Sep.2011 were collected for bacterial culture and drug sensitivity test.28 antibiotics were chosen from 35commonly used antibiotics to test antibiotic sensitivity to decide whether the antibiotic was sensitive (S),intermediate sensitive (I),or resistant (R).Results 19 strains were isolated from 130 cases.Staphylococcus aureus with 14.62 ％ (19 cases)rated the first,followed by escherichia coli with 13.85％ (18 cases),proteus mirabilis with 13.08％ (17 cases),staphylococcus epidermidis with 12.31％ (16 cases),enterococcus faecalis with 12.31％ (16 cases),acinetobacter baumannii with 10.77％ (14 cases).Antibiotics with high sensitivity to Gram-positive bacteria were tigecycline and vancomycin while with high sensitivity to Gram-negative bacteria were imipenem and amikacin.Conclusions Bacteria of diabetic ulcer are commonly resistant to antibiotics.It is of great importance for clinical rational drug use to know the distribution and resistance of commonly encountered bacteria.

Objective To investigate the relationship between interaction of peroxisome proliferators-activated receptor alpha (PPARα), cytochrome P450 oxysterol 7α-hydroxylase (CYP7B1) and estrogen receptor (ER) and intrahepatic cholestasis in pregnant rats. Methods Eighty clean SD pregnant rats were selected and divided into four groups randomly with 20 in each. Since the 13th day of pregnancy,rats in the control group was injected subcutaneously with refined vegetable oil 2.0 ml · kg-1 · d -1 , those in the low-dose, moderate-dose and high-dose groups received 17-α-ethynylestradiol (EE) 1.0 mg · kg-1 · d-1,1.25 mg · kg-1 · d-1 and 1.5 mg · kg-1 · d-1, respectively. All rats were sacrificed at the 21at day of pregnancy and maternal hepatic tissues were collected. The serum levels of alanine aminotransferase(ALT), aspartate transaminase (AST), total bile acid (TBA) and bilirubin (BIL) were determined by enzyme linked immunosorbent assay (ELISA). The mRNA expressions of PPARα, CYP7B1, Erα and Erβ in maternal rat livers were examined by real-time PCR. Results (1) Biochemical indicators: the serum levels of ALT,AST, TBA and BIL were significantly lower in the control group than in the rest 3 groups,respectively [ control group: (41.1 ± 2.8 ) U/L, (44.4 ± 3.6) U/L, (26.4 ± 5.6 ) μmol/L and( 2.8 ± 0.2)U/L;low-dose group: (48.2 ±3.4) U/L,(47.9 ±3.7) U/L,(36.4 ±4.2) μmol/L and (4.2 ±0.2) U/L;moderate-dose group: (70.4 ± 5.3 ) U/L, (68.4 ± 5.6) U/L, (64.3 ± 3.8 ) μmol/L and ( 6.2 ± 1.2)U/L; high-dose group: (72.4 ±7.6) U/L, (70.2 ±3.8) U/L, (72.4 ±7.8) μmol/L and (8.2 ±2.2)U/L, P<0.05], and those in the moderate or high-dose groups were higher than in the low-dose group (P<0.05). (2) mRNA expression of Erα and Erβ: the mRNA expression of Erα in pregnant rat livers increased in a dose-dependent manner, which were all significantly higher than that in the control group,respectively ( low-dose group: 0.76 ± 0.02 ); moderate -dose group: ( 0.99 ± 0.04; high-dose group:1.21 ±0.01 ;control group:0.65 ±0.01, P <0.05), but no difference was found among the 4 groups in the mRNA expression of Erβ ( P > 0.05 ). (3) mRNA expression of CYP7B1 and PPARα: the mRNA expression of CYP7B1 in pregnant rat livers increased from the low-dose group to the high-dose group, and were all higher than that of the control group ( low-dose group: 0.93 ± 0.01; moderate-dose group: 0.99 ±0.06; high-dose group: 1.22 ± 0.04; control group: 0.75 ± 0.02, P < 0.05 ). However, the mRNA expression of PPARα decreased from the low-dose group to the high-dose group, and were all lower than that of the control group (low-dose group: 0.83 ± 0.05; moderate-dose group: 0.71 ± 0.02; high-dose group:0.64 ± 0.03; control group: 1.35 ± 0. 05; P < 0.05 ) . Conclusions The down regulated mRNA expression of PPARα, caused by higher dose of estrogen, may increase the expression of CYP7B1 due to the ineffectiveness of the inhibition of PPARα on CYP7B1, which may further stimulate the Erα activity and then induce intrahepatic cholestasis. Abnormal expression of PPARα, CYP7B1 and ER may play a role in the pathogenesis of estrogen-induced intrahepatic cholestasis.

Hematopoietic Stem Cell Transplantation ; Humans ; Leukemia, Lymphocytic, Chronic, B-Cell ; surgery ; Transplantation, Homologous

Objective To study chemical ingredients and angiogenesis effects for different compatibility proportions ofDanggui Buxue Decoction.Methods For chemical components, HPLC was performed to study the ingredients (Ferulic Acid, Calycosin-7-glusosido, Calycosin, Formononetin) inDanggui Buxue Decoction. For angiogenesis effects, transgenosis zebrafish model was incubated with different proportions ofDanggui Buxue Decoction.Results With the raise of Astragali Radix content, the synthetic scores of four ingredients in different compatibility proportions increased. When the Astragali Radix content to Angelicae Sinensis Radix content was 8 to 2 and 5 to 1, the scores were the highest. For zebrafish vascular injury model, vessel recoveries in top three were 5:1, 6:1 and 2:1 (Astragali Radix: Angelicae Sinensis Radix).Conclusion From comprehensive analysis of chemical composition and angiogenesis, the best compatibility ratio of Astragali Radix to Angelicae Sinensis Radix is 5:1.

Objective To understand the cleaning status of hospital environment,and evaluate the effect of fluo-rescence labeling method plus feedback and training on hospital environmental cleaning effectiveness.Methods A total of 27 departments in a hospital were investigated,1 cleaning staff and 2 inpatients were selected from each de-partment,cleaning staff’s knowledge about cleaning and disinfection of environmental object surfaces,as well as cleaning status of inpatients’wards were surveyed,cleaning efficacy of hospital environmental object surfaces were detected with fluorescence labeling method,the surveyed results were performed timely feedback to clinical depart-ments,training on cleaning and disinfection knowledge was conducted,the effective cleaning rate of environmental object surface before and after the training was compared.Results A total of 27 cleaning staff were surveyed,the correct response rate for cleaning frequency was 96.30% ,awareness rate for section concept was 96.30% ,accuracy rate of cleaning order was 92.59% ,accuracy rate of post-cleaning immersion time of sanitary wares in disinfectant was 85.19% ,accuracy rates of replacing,drying,and repeated immersing wiping cloths were 81.48% ,48.15% ,and 25.93% respectively,rates of correct disinfectant formulating method and mop drying time were both 0. Among 54 investigated patients,bed units and ground of wards of 28 patients were cleaned both 1-2 times/day;bed units of 8 patients had never been wiped,18 patients in 9 departments cannot be conducted statistics due to completely in-consistent responses with the other patients of the same departments. The effective cleaning rates of environmental object surfaces before and after the training were 34.62% and 64.96% respectively,difference was significant(χ2=21.81,P<0.01).Conclusion Fluorescence labeling method plus feedback and training can improve cleaning efficacy of hospital environmental object surfaces.

Objective To explore the application of direct observation of procedural skills (DOPS) in anesthesia-related effects skills teaching. Methods Anesthesia students in the Department of Anesthe-siology, Clinical Medical College, Yangzhou University between June 2013 and June 2015, received an anesthesia-related DOPS examination at the mid-internship and pre-delivery. Through the DOPS assessment results, the analysis of teachers' and students' satisfaction degree on the evaluation results, the teaching effect of DOPS was evaluated. At the same time, the students were surveyed to find out the satisfaction degree of DOPS. SPSS 18.0 was applied to processing the date. Measurement data were expressed as mean plus or minus standard deviation, and t test was used in the comparison between groups. Results Interim assessment indicators for each individual average of more than four points , the individual departmental rotation examination scores were higher than the overall average score interim assessment results. Compared with interim assessment, satisfaction of teachers has made great progress in the end of assessment [(8.46 ± 0.32) vs. (8.14 ±0.60)], satisfaction of students was [(8.57 ±0.59) vs. (8.20 ±0.45)], satisfaction of the students was higher than the teachers [(8.57±0.59) vs. (8.46±0.32)], and the differences were statistically significant. Conclusion DOPS as an effective anesthesia-related skill of teaching and assessment method, can improve the level of anesthesia anesthesia-related skills of college students.

AIM: To understand the relationship between pentanucleotide repeat(PNR) polymorphism of the apolipoprotein(a) gene and lipoprotein natures of normal Han population. METHODS: The serum levels of TG, TC, LDL-C,HDL-C, apo AI, apo B and Lp(a) were measured and the polymorphism of the apo(a) PNR was studied by using PCR-SSCP in 153 random normal individuals in Hubei Han population respectively. RESULTS: The relative frequencies of apo(a) PNR allele were significantly different from western population. The apo(a) gene which copy number of PNR is 5 was associated with high Lp(a) levels. No marked differences in the levels of TG, TC,LDL-C, HDL-C, apo AI and apo B were found among the various genotype groups of apo(a) PNR in Hubei Han. CONCLUSION: The data of lipids and PNR polymorphism of the apo(a) gene from healthy Hubei Han were obtained. The apo(a) allele with 5(TTTTA)-repeats may be related to high serum Lp(a) levels in the Hubei Han population.