Objective To investigate the effects of dexmedetomidine (Dex) on the neuronal apoptosis in spinal dorsal horn in a rat model of chronic neuropathic pain.Methods Seventy-two adult male SD rats weighing 180-220 g were randomly divided into 3 groups ( n =24 each):sham operation group (group S) ; chronic constrictive injury (CCI) group; Dex + CCI group (group D).Two ligatures were placed on right sciatic nerve at 1 mm intervals with 4-0 silk thread in groups CCI and D.In group D Dex 50 μg/kg was injected intraperitoneally once a day starting from the end of operation until the animals were sacrificed.Paw withdrawal threshold to mechanical stimulation with yon Frey filament (PWT) and paw withdrawal latency to thermal stimulation (PWL) were measured at one day before (T0,baseline) and on the 3rd,7th and 14th day after operation (T1,2,3).Six animals were sacrificed at each time points (T1,2,3) after the measurement of PWT and PWL.Their lumbar segments (L4,5)were removed for examination with transmission electron microscope and detection of Bcl-2 and caspase-3 expression (by immune-histochemistry).Results CCI significantly decreased PWT and PWL,increased Bcl-2 and caspase-3 expression at T1,2,3 and induced apoptosis in spinal dorsal horn neurons in group CCI as compared with group S.Intraperitoneal Dex significantly attenuated CCI-induced mechanical and thermal hyperalgesia and neuronal apoptosis in group D as compared with group CCI.Dex injected intraperitoneally further increased Bcl-2 expression but decreased caspase-3 expression in group D as compared with group CCI.Conclusion Reduction in neuronal apoptosis in spinal dorsal horn is involved in the attenuation of neuropathic pain by Dex.

Objective To investigate the effect of dexmedetomidine on the expression of purinergic P2X4 receptor (P2X4R) mRNA and p38 mitogen-activated protein kinase (p38 MAPK) mRNA in spinal cord in a rat model of neuropathic pain (NP).Methods Seventy-two male SD rats weighing 180-220 g were randomly assigned into 3 groups ( n =24 each):sham operation group (group S),group NP and dexmedetomidine group ( group DEX).The animals were anesthetized with intraperitoneal 10％ choral hydrate 350 mg/kg.NP was induced by chronic constrictive injury (CCI).The right sciatic nerve was exposed and 4 ligatures were placed on sciatic nerve at 1 mm intervals with 4-0 silk thread in groups NP and DEX.In group S,the right sciatic nerve was only exposed but not ligated.Dexmedetomidine 50μg/kg was injected intraperitoneally daily staring from the end of operation,while the equal volume of normal saline was injected in groups S and NT.The mechanical paw withdrawal threshold (MWT) and thermal paw withdrawal latency (TWL) were measured on day 1 before operation and on day 1,3,7 and 14 after operation.Six animals were sacrificed after MWT and TWL measurement on day 1,3,7 and 14 after operation in each group,the L4～6 segment of spinal cords was removed for determination of P2X4 R mRNA and p38 MAPK mRNA expression by RT-PCR.Results Compared with group S,MWT and TWL were significantly decreased and the expression of P2X4 R mRNA and p38 MAPK mRNA was significantly up-regulated after operation in groups NP and DEX ( P ＜0.05).Compared with group NP,TWL and MWT were significantly increased and the expression of P2X4 R mRNA and p38 MAPK mRNA was significantly down-regulated after operation in group DEX ( P ＜ 0.05 ).TWL and MWT were significantly higher and the expression of P2X4 R mRNA and p38 MAPK mRNA was significantly lower on day 1,3 and 14 after operation than on day 7 after operation in groups NiP and DEX ( P ＜ 0.05).Conclusion The mechanism by which dexmedetomidine attenuates NP is related to inhibition of the expression of P2X4 R mRNA and p38 MAPK in rats.

Ergosterol is an economically important metabolite produced by yeast. To improve the production of ergosterol by Saccharomyces cerevisiae YEH56 (pHXA42) from molasses, a cheap and regenerative material, different strategies were applied. First, Plackett-Burman design and central composite design were applied to screen the significant factors in fermentation medium using ergosterol yield (g/L) as the response value. Ergosterol yield reached 371.56 mg/L by using the optimal fermentation medium in shake-flask culture (total sugar in molasses 40 g/L, KH2PO4 1 g/L, K2HPO4 1.86 g/L, CuSO4 x 5H2O 17.5 mg/L, FeSO4 x 7H2O 13.9 mg/L, MgSO4 x 5H2O 12.3 mg/L, corn steep liquor 10 mL/L), which was increased by 29.5% compared with the initial culture. Second, ergosterol yield was increased by 62.1% using a pH-control strategy in a 5-L bioreactor. Third, ergosterol production was improved further by using molasses feeding strategy. After 38 h fermentation, ergosterol yield reached 1 953.85 mg/L, which was 3.2 times of that in batch fermentation. Meanwhile, ergosterol production rate was increased by 42.7% compared with that in the batch culture.
Culture Media ; Ergosterol ; biosynthesis ; Fermentation ; Industrial Microbiology ; Molasses ; Saccharomyces cerevisiae ; genetics ; growth & development ; metabolism

Objective To investigate the effect of targeted monitoring on the control of central venous catheter associated infection, study the difference of CVC?RI infection rate and the distribution of pathogenic bacteria in the general hospital and the maternal and child hospital, and analyse the main pathogenic bacteria drug resistance characteristics. Methods From January 2013 to December 2014,685 cases patients with central venous catheterization in the Port Hospital of Hebei Port Group Company Limited,and four cooperative hospitals ( Affiliated Hospital of North China University of Science and Technology, People′s Hospital of Tangshan, Tangshan Port Economic Development District Hospital, Maternal and Child Health Care Hospital of Laoting County) were selected as the research objects. The difference of infection rate before and after the targeted monitoring in 2014 was compared. The tip of the catheter and the peripheral blood were cultured in the patients with suspected infection,bacterial identification and drug sensitivity test were carried out using Compact VITEK2 automatic bacteria identification/drug sensitivity analyzer. Results The infection rate of CVC?RI of five hospitals was 18. 75%( 60/320 ) in 2013, 11. 51%( 42/365 ) in 2014, the difference of infection rate was statistically significant before and after the implementation of the target monitoring(χ2=7. 059,P<0. 05) . The CVC?RI infection rate was 15. 52%(81/522) in the general hospital,12. 88%(21/163) in the maternal and child hospital,the difference was not statistically significant(P>0. 05). In 102 cases of CVC?RI,105 bacterial strains were detected in 91 cases,gram positive bacteria accounted for 51. 43%( 54/105) ,gram negative bacilli accounted for 40. 95%( 43/105) ,fungi accounted for 7. 62%( 8/105) . There was no significant difference in the proportion of pathogenic bacteria in the general hospital and the maternal and child hospital(P>0. 05). Grampositive cocci were mainly staphylococcus aureus and coagulase negative staphylococci,they were completelysensitive to linezolid, quinupristin/ dalfopristin, tigecycline, and vancomycin. They were high sensitivity torifampicin,while highly resistant to gentamicin, tetracycline, penicillin; Gram negative bacilli were mainlypseudomonas aeruginosa and escherichia coli,they were high sensitivity to meropenem,imipenem,while resistantto multiple antimicrobia1s. Conclusion Adhere to the implementation of targeted monitoring help to reduce theoccurrence of CVC?RI. The isolation of pathogenic bacteria from multiple drug resistance should be paid moreattention.

Objective To discuss the effect of self- care education at the early time of postoperation and the use of nursing packages during the later period on non- throat patients. Methods 40 patients having un-dergone total laryngectomy were divided into the control group and the experimental group according to the surgery date with 20 cases in each group. The control group received conventional nursing, while the experi-mental group was given the system intervention by specialized nurses. The intervention content included self-care education at the early time of postoperation and the use of nursing packages during the later period. The questionnaire survey was carried out 15 days and 3 months after operation.The coping style,self-care ability and survival quality were compared between the two groups. Results The comparison of coping style showed re-markable difference in the two groups. The comparison of self- care ability and level of health knowledge showed significant difference 15 days after operation except two other items,but the four items demonstrated significant difference 3 months after operation. Difference also existed in the total scorn of survival quality. Conclusions Early system serf- care education after operation and the use of nursing package during the later period can impel the patients to cope positively, enhance self-care ability and survival quality.

Objective To investigate the expression of SOX4 and C/EBPα mRNA in chronic myeloid leukemia (CML) and their clinical significances. Methods Bone marrow samples from 68 cases of CML including 57 newly diagnosed patients and 11 patients treated with imatinib were collected, and peripheral blood mononuclear cells from 30 healthy people were collected as healthy control. The expression of SOX4 and C/EBPαmRNA and protein levels were detected by RT-PCR and Western blot, respectively. The relations between the expression of SOX4 and C/EBPα and the influences of imatinib on SOX4 and C/EBPα were analyzed. Results The expression level of SOX4 mRNA was increased in newly diagnosed CML patients compared with that of normal control group (6.545 5±1.495 2 vs. 0.059 6±0.018 8, t=3.139, P=0.002 3), but the expression level of C/EBPαmRNA was significantly decreased (0.238 8±0.033 8 vs. 0.810 5±0.056 2, t=9.240, P<0.000 1). The expression levels of SOX4 and C/EBPαmRNA had no significant correlation with age, gender, white blood cell count (WBC) and bcr-abl of newly diagnosed patients (all P>0.05). The expression level of SOX4 mRNA in 5 patients treated with imatinib was decreased (0.120 6 ±0.044 9 vs. 0.557 9±0.144 8, t=2.885, P=0.020 4), and the expression level of C/EBPαmRNA was increased (0.330 3±0.042 4 vs. 0.150 5±0.046 5, t=2.855, P=0.021 3). The expression level of SOX4 mRNA in 6 patients who developed blast phase during the treatment of imatinib was increased (0.469 9±0.123 0 vs. 0.050 2±0.036 6, t=2.370, P=0.039 3), and the expression level of C/EBPα mRNA was decreased (0.197 9 ±0.064 7 vs. 0.378 7±0.042 9, t=2.327, P=0.042 3). The expression of SOX4 mRNA was negatively correlated with C/EBPα mRNA (t=-0.554 6, P=0.002 8). Conclusions In newly diagnosed CML, the expression level of SOX4 is increased, C/EBPα is decreased compared with that of healthy control, and both have negative correlation. In the patients in blast phase after imatinib treatment, SOX4 gene is up-regulated, and C/EBPα is down-regulated. C/EBPα-SOX4 axis may play a role in the occurrence and development of CML. SOX4 may be a new molecular target for the treatment of CML.

Objective To explore the clinical nursing of patients with bronchial obstruction caused by Y stent implantation.Methods A total of 12 atelectasis cases with bronchial obstruction treated by Y stent were selected,clinical nursing pathway was applied and included psychological nursing,preoperative preparation,postoperative nursing and postoperative nursing,complications of treatment,discharge guidance and follow-up nursing,clinical performance and satisfaction were observed.Results The blood oxygen saturation after treatment was significantly higher than treatment before,and the difference was statistically significant (P ＜ 0.05).After 3 d nursing,oxygen saturation was significantly higher than treatment before (P ＜ 0.05).Seven patients (58.3％) were quite satisfied,4(33.3％) were satisfactory,1 (8.3％) were general satisfied,and there was no unsatisfactory patients,and overall satisfaction were 96.7％.Conclusion Clinical nursing pathway for Y stent placement in the treatment of pulmonary congestion caused by bronchial obstruction can improve the clinical efficacy and satisfaction,and enhance the relationship between nurses and patients.

Objective To explore the clinical nursing of patients with bronchial obstruction caused by Y stent implantation.Methods A total of 12 atelectasis cases with bronchial obstruction treated by Y stent were selected,clinical nursing pathway was applied and included psychological nursing,preoperative preparation,postoperative nursing and postoperative nursing,complications of treatment,discharge guidance and follow-up nursing,clinical performance and satisfaction were observed.Results The blood oxygen saturation after treatment was significantly higher than treatment before,and the difference was statistically significant (P ＜ 0.05).After 3 d nursing,oxygen saturation was significantly higher than treatment before (P ＜ 0.05).Seven patients (58.3％) were quite satisfied,4(33.3％) were satisfactory,1 (8.3％) were general satisfied,and there was no unsatisfactory patients,and overall satisfaction were 96.7％.Conclusion Clinical nursing pathway for Y stent placement in the treatment of pulmonary congestion caused by bronchial obstruction can improve the clinical efficacy and satisfaction,and enhance the relationship between nurses and patients.

Objective:To analyze the clinicopathological characterization of primary esophageal benign tumor (EBT). Methods:A total of 1,058 EBTs were enrolled from 500,000 cases in an esophageal and cardiac tumor biological sample and clinical information data-base of Henan Key Laboratory for Esophageal Cancer Research (1973-2015) in the First Affiliated Hospital of Zhengzhou University. SPSS 21.0 software was applied for data analysis. Results:In this database, 1,058 cases with primary EBTs among the 249,246 esopha-geal tumor patients with detailed clinical and pathological information were identified with an incidence of 0.42%(1,058/249,246). A total of 544 patients were male with an average age of 50±11 years old, whereas 514 patients were female, with an average age of 52± 11 years old. Among the 10 types of EBTs, leiomyoma was the most common type (84.50%, 894/1,058), followed by papilloma (6.90%, 73/1058). Adenoma (0.38%, 4/1,058) was the rarest type. Leiomyoma, gastrointestinal stromal tumor, and neurofibroma mainly oc-curred in male patients. By contrast, lipoma, granulosa cell tumor, schwannoma, and hemangioma mainly occurred in female patients.All five cases of hamartoma occurred only in female patients. Given the incidence of≥50%as the common standard, the common EBT in sequence in young male patients was leiomyoma and gastrointestinal stromal tumor, whereas that in young female patients was granulosa cell tumor and lipoma. The common EBT in sequence in older male patients was papilloma, gastrointestinal stromal tumor, and leiomyoma, whereas that in older female patients was schwannoma, papilloma, leiomyoma, gastrointestinal stromal tumor, and hamartoma. Additionally, lipoma, hemangioma, neurofibroma, and adenoma in male patients and neurofibroma in female patients oc-curred in older patients. The different ages of patients with EBTs (P=0.034) and leiomyoma (P=0.004) had a statistical significance. In these EBTs, leiomyoma, papilloma, gastrointestinal stromal tumor, and schwannoma mainly occurred in the middle esophagus, where-as lipoma mainly occurred in the lower esophagus. The major treatment for EBT in the present study was surgery (57.54%, 492/855), which was followed by endoscopic resection (38.01%, 325/855) and others (4.45%, 38/855). Conclusion:The incidence of EBT is low, with a couple of different histological types. Gender, age, and predilection sites are different depending on the histological types of EBTs. Surgery and endoscopic resection are the major treatment methods.

The uniqueness of the location of large general hospitals in urban areas determines that the contradiction between space constraints and medical expansion has become a problem of management bottleneck.The situation that expert visits are too concentrated on a certain working day morning has been significantly improved by carrying out peak load shifting in the visiting arrangements and visiting units of large general hospitals through the Total Quality Management theory and continuous improvement of work mode,greatly alleviating public transportation congestion around the hospital.Through the internal construction of the quality of outpatient clinics,it can effectively improve the patients'sense of access to health care.