Objective To investigate the in-vitro transdermal permeability of cyclovirobuxine D ethosomes.Methods Ethosomes,liposomes,saturated aqueous solution and 35.5% saturated alcohol solution of cyclovirobuxine D were prepared.The in-vitro transdermal permeability of different kinds of preparations of cyclovirobuxine D was studied by in-vitro permeation experiments.Results Cyclovirobuxine D ethosomes enhanced transdermal flux rate of cyclovirobuxine D and the enhancement ratio was 8.85,superior to liposomes and saturate alcohol.The dermatic hold-up amount of cyclovirobuxine D in 35.5% saturated alcohol solution,liposomes and ethosomes was in a decreasing sequence.Conclusion Compared with the liposomes,the ethosomes can enhance the transdermal flux rate of cyclovirobuxine D,which could increase the systematic action of the drug.

Objective To explore the nursing measures of patients with pure diffuse axonal injury (DAI)treated by multi-step sub-hypothermia therapy.Methods The nursing care of pure DAI patients treated by multi-step sub-hypothermia therapy,which included the traumatic condition evaluation before treatment,the nursing care during treatment,the nursing care after treatment but also in coma,and the nursing care after palinesthesia.Results The intracranial pressure and concentration and lactic acid in blood and cerebrospinal fluid alleviated.The forehead expanded.The disability rating scale(DRS)decreased.While the incidence of sub-hypothermia related complications did not increased.Conclusions The elaborative nursing care aiming at different pathogenetic conditions,different stages is the first guarantee in the treatment of pure DAI with multi-step sub-hypothermia therapy.

Objective To investigate the effects and mechanisms of the CXCR3-inhibitor genistein on the acute rejection reaction of pancreas transplantation in a rat model. Methods Three groups of rats underwent pancreas transplantation, group one: the syngeneic transplantation group; group two: heterogous transplantation group without genistein-treatment; and group three: genistein-treatment (10 mg/kg,i. p.×7d) transplantation group. The grafts of three groups were harvested at day 7 after operation for histopathology and immunohistochemistry analysis of CXCR3, the serum levels of IFN-γ, IL-2 were examined by ELISA. Results There was no acute rejection reaction of pancreas transplantation in group one and no expression of CXCR3 ,the serum levels of IFN-γ,IL-2 were (2.76±0.66) pg/ml and (11.83±1.86) pg/ml. In group two, there was significant acute rejection reaction and strong expression of CXCR3, the serum levels of IFN-γ, IL-2 were (32.64±2.52) pg/ml and (29.59±1.71 ) pg/ml, which were significantly higher than those in group one (P<0.05). Compared with group two, the damages of graft tissue in genistein-treatment group alleviated and the lymphocytes infiltration decreased, the expression of CXCR3 was weakly positive, the serum levels of IFN-γ, IL-2 were (15.94±1.95) pg/ml and (22.62±1.76) pg/ml, which were significantly lower than those in group two(P<0.05), but was higher than those in group one (P<0.05). Conclusions Genistein could mitigate the acute rejection of pancreas transplantation effectively through inhibiting CXCR3 expression.

Objective To investigate antimicrobial resistance of Escherichia coli (E.coli)and Klebsiella pneumoniae (K.pneumoniae),antimicrobial use density(AUD),as well as relation between antimicrobial resistance and AUD in a ter-tiary first-class hospital.Methods Antimicrobial resistance rates of clinically-isolated E.coli and K.pneumoniae,AUD of carbapenems and quinolones,as well as relation between resistance and AUD in 2013-2015 were statistically analyzed. Results Correlation analysis of antimicrobial resistance of bacteria and AUD showed that the decrease in resistance rate of E.coli to levofloxacin was related to the decrease in the use density of quinolones(r=0.61,P=0.03);increase in resist-ance rate of K.pneumoniae to imipenem was related to the increase in the use density of carbapenems(r=0.78,P<0.01). Conclusion Antimicrobial use is one of the causes of bacterial resistance,management on antimicrobial use needs to be strengthened to reduce the threat of bacterial resistance to human health.

Objective To explore the common pathogen of infantile convulsions associated with mild gastroenteritis, and to study the differences between the seizures caused by the two kinds of virus.Methods RT-PCR was used to detect Rotavirus (RV) and Norwalkvirus (NoV) in stool and cerebrospinal fluid of 30 cases with infantile convulsions associated with mild gastroenteritis. The differences between the frequency of seizures caused by two kinds of virus were analyzed by statistical methods (two-sample t-test).Results 17/30 (56. 7%) were RV-positive in stool and 3/17 (17. 7%) in cerebrospinal fluid; 6/30 (25.0%) were NoV-positive in stool and 1/6 (16. 7%) in cerebrospinal fluid. The seizure frequency with NoV infection was (4. 33 ± 1.75) times, and RV infection patients was (2. 53 ± 1.12) times (P ＜ 0. 01).The seizure frequency of CSF virus-positive children was (4. 75 ± 1.71) times compared to (2. 63 ± 1.21)times in virus-negative children (P ＜ 0.01). Conclusion The common pathogens causing infantile convulsions associated with mild gastroenteritis were RV and NoV. The degree of NoV infection affecting the central nervous system may be greater than RV. The presence of the virus in cerebrospinal fluid may lead to higher incidence of seizures,but their exact roles related to the occurrence of seizures remain to be further studied.

AIM: The goal of the present study was to evaluate the possibility about enterogenous endotoxemia in pathogenesis of hepatopulmonary syndrome. METHODS: The rat model of cirrhosis was prepared with compound factors. A small dose of lipopolysaccharide (LPS) was administered intraperitoneally once to aggravate endotoxemia of animal with cirrhosis. The normal rats injected with LPS or injected with LPS combined with glycine (LPS antagonist) were designed as controls. RESULTS: Hepatopulmonary syndrome of rats with cirrhosis had occurred in the end of eighth weeks. Pulmonary pathological changes of cirrhosis rats were exacerbated after administration of a given dose of LPS. Glycine sharply antagonized the biological effect of LPS in vivo and in vitro, inhibited the production of TNF-? by LPS and alleviated various pathological changes of hepatopulmonary syndrome. CONCLUSIONS: Enterogenous endotoxemia in cirrhosis rats might be an important mechanism in the development of hepatopulmonary syndrome. Endotoxin and its mediating effect by way of cytokines (TNF-?) may play a role in the pathogenesis of hepatopulmonary syndrome.

ObjectiveThis clinical study is aimed to investigate whether levetiracetam (LEV) can improve electrocorticogram (EEG) in epileptic children epilepsy patients with better clinical manifestation but abnormal EEG findings.MethodsTotally 39 children from our neurological clinic with partial or complex partial epilepsy seizure were included in present study and assigned equally into three groups receiving different treatment:control group,sodium valproate (VPA) group,and LEV group.Their clinical symptoms had been controlled for over one year by carbamazepine ( CBZ),but EEG results showed clearly abnormal.Epileptiform discharges were observed in routine EEG exams half a month before recruiting.After recruiting,they continued to receive CBZ alone (control group) or co-treated with VPA ( VPA group) or LEV (LEVgroup),respectively.Six months later,EEG was taken again and results were analyzed.ResultsImprovement rate were 9.1％ ( control group),23.1％ ( VPA group),and 66.7％ (LEV group),respectively;Overall statistical difference was reached among three groups ( P＜0.01 ) and between control group and LEV group( P＜0.012 5 ),but no statistical difference between control group and VPA group was reached ( P＞0.0125).ConclusionCo-treatment of LEV in child epilepsy patients receiving CBZ can significantly decrease abnormal EEG discharge frequency during interictal period.

Objective To learn the acceptance of rural community health workers (CHWs ) following the reform of rural health workers′team building in Pudong New Area.Methods 3 295 CHWs were surveyed with questionnaire for their acceptance of the incentive policies,and chisquare test analysis was used to analyze the differences among CHWs in individual areas.Results Over 80.0% of the CHWs reported that they were motivated by the incentive policies to improve their professional competence, medical service and organizational commitment;40.9% of them reported that the policies improved their social status;and 47.3% of them believed the policies could promote the rural areas to attract and retain talents.When a comparison was made of CHWs′feedbacks on different aspects,significant differences indicated that the proportion of CHWs′positive attitudes was the highest at remote rural communities. Conclusions The rural health workers′team building reform could promote incentive on the CHWs,yet with obvious regional differences.

Objective CD4 +IL-17 +cells are a group of newly discovered effector CD4 +T cells, which may play a key role in the pathogenesis of cancer.This study aims to investigate the expres-sion of CD4 +IL-17 +cells in pancreatic cancer and its correlation with the clinicopathological characteristics and prognosis of the dis-ease as well as the clinical significance of the cells in the microenvironment of pancreatic cancer. Methods We collected tumor tis-sue and tumor-adjacent normal tissue samples from 51 pancreatic cancer patients.We determined the expressions of CD34 and vascular endothelial growth factor ( VEGF) and measured the proportion of IL-17 +cells in the cancer tissue using immunohistochemistry and the fluorescence activated cell sorter, respectively, followed by analysis of their correlation with tumor angiogenesis, clinicopathological pa-rameters, and survival time of the patients. Results The percentage of CD4 +IL-17 +cells in tumor tissue was positively correlated with microvessel density (r =0.534, P<0.05) and the expression of VEGF in the tumor tissue (r=0.356, P<0.05).IL-17 +cells were expressed more highly in the tumorous than in the tumor-adjacent normal tissue (P<0.05), and the expression level was correla-ted with the stage of tumor, node, and metastasis (TNM) and lymph node metastasis (P<0.05), but not with the patients′gender or age, tumor size, tumor location, histological grade, or local invasion (P>0.05).Fifty (98.0%) of the patients were successfully followed up for 2-67 months, which revealed a median survival time of 16.6 ±4.8 months, significantly longer in those with a higher expression of intratumoral IL-17 +cells (P<0.05).Univariate analysis showed an association of the survival rate with the tumor size, TNM stage, lymph node metastasis, and level of intratumoral IL-17 +cells, while multivariate analysis showed the TNM stage to be an independent prognostic factor for the survival of the pancreatic cancer patients. Conclusion The expression of CD4 +IL-17 +cells in the tumor tissue is positively correlated with tumor angiogenesis, while that of IL-17 +cells with the clinicopathological parameters and survival time of the patients and therefore may serve as an important immune indicator for the prognosis of pancreatic cancer.

Six patients with factor Ⅴ deficiency were admitted in Shandong Provincial Hospital Affiliated to Shandong First Medical University from January 2006 to December 2022. All 6 patients presented with symptoms of coagulation dysfunction, 4 patients had recurrent nose bleeding, gingival bleeding, skin ecchymosis as the main manifestations, 1 patient had lower abdominal pain and ovarian active bleeding, and 1 patient had heavy menstruation. The prothrombin time and activated partial thromboplastin time were significantly prolonged, the factor Ⅴ level was significantly lower than normal, and the thrombin time was basically normal in all patients. Four patients received non-surgical treatment and transfusion of fresh frozen plasma; the bleeding symptoms were significantly relieved during hospitalization, and no aggravation of bleeding symptoms was found during follow-up. One patient with active ovarian hemorrhage underwent emergency surgical suture to stop bleeding, and fresh frozen plasma and prothrombin complex were given perioperatively; and no more bleeding occurred during follow-up. One patients with excessive menstruation underwent curettage plus hysteroscopic endometrial ablation, and the amount of menstruation was significantly reduced. It is suggested that the bleeding symptoms of coagulation factor Ⅴ deficiency vary in severity, which can be effectively alleviated by infusion of the fresh frozen plasma in most cases.