Objective To elucidate the function and regulatory mechanism of LyGDI involved delayed cell death in the human K562 cells and HL-60 cells induced by 60Co γ-rays. Methods Erythrosine B cells staining was used to count the apoptosis rate. PI staining and flow cytometry were applied to check the cell cycle. The expression of LYGDI and Rac1 was resolved by Western blot by using monoclonal antibody of LyGDI and Racl. The distribution of Racl protein in cells was observed with immunofluorescence by using the confocal microscope. Results The K562 cells showed G2/M phase arrest and the percent age was 71.3%. The apoptosis rate was very low at early post-irradiation stage in the K562 cells. The apoptosis rate was 14% in the K562 cells at 24 h post-irradiation with 8 Gy of γ-rays, and delayed cell apoptosis was present. LyGDI was cleaved in the K562 cells irradiated by 4 Gy 60 Co γ-rays after 24 hours post-irradiation. The expression of Racl protein was not altered at all, but the distribution was changed in the irradiated cells while the Racl protein moved to cell membrane and a little in cell nucleus. The Racl was activated with the losing the binding affinity with the LyGDI. Conclusion LyGDI could promote the delayed cell apoptosis, which is through the activation of the Rac1.

Objective To investigate the risk factors of premature atherosclerotic three-vessel coronary artery dis?ease (CHD), and the association between single nucleotide polymorphism (SNP) of CD36 rs3211956, rs7755 and premature CHD. Methods Patient with premature three-vessel coronary artery disease (n=102) which were confirmed by consecutive coronary angiogram (lesion group) and patients (n=72) without CHD (control group) were enrolled in the study. Conventional CHD risk factors were compared between the two groups as well as SNPs of CD36 rs3211956 and rs7755 to disclose inde?pendent risk factor for CHD, which were measured by mass spectrometry. Results Among the conventional CHD risk fac?tors, male, HBP, high LDL-C, low HDL-C were independent risk factors of premature CHD. The GT genotype proportion of rs3211956 was significantly lower (χ2=8.042,P=0.005) in the lesion group than that in control group while the TT genotype proportion is significantly higher in lesion group compared with that in control group (χ2=6.191,P=0.014). Patients with the TT genotype have higher score of BMI than patients with GG or GT genotype (P=0.037). The G allele proportion of rs7755 in the lesion group was significantly higher than control group (χ2=3.636, P=0.047). Patients of the GG genotype have higher scores of BMI but lower level of HDL-C than those with AA or AG genotype (P<0.001). Logistic regression analysis re?vealed that after excluding a number of confounding factors, GG and TT genotype of rs3211956 and GG and GA genotype of rs7755 were respectively one of the independent risk factors for premature CHD. Conclusion The SNPs of CD36 rs7755 and rs3211956 may be the independent risk factors of premature coronary heart disease and might affect the the onset of CHD by affectting BMI and HDL-C.

OBJECTIVE To investigate the clinical distribution and drug resistance of clinical Pseudomonas aerugilosa isolates,and offer reasonable experimental data for clinical therapy.METHODS P.aerugilosa was identified by ATB Expression system,and its drug resistance was determined by Kirby-bauer and ATB Expression method.RESULTS The main departments in which frequently P.aerugilosa infection accurred were Intensive Care Unit(41.2%) and Respiration Departments(19.3%).The common site of P.aerugilosa infection was respiratory tract(68.2%).The sensitive rate of P.aerugilosa to polymyxin E and cefoperazone/sulbactam was the highest(95.1% and 91.4%),while to meropenem and imipenem was 77.5% and 70.6%.The highest resistant rate of P.aerugilosa to trimethoprim/sulfamethoxazole,ampicillin/sulbactam was 97.1% and 95.1%.The resistunce to ciprofloxacin,ticarcillin and piperacillin,were 64.9%,63.3% and 56.3%.CONCLUSIONS P.aeruginosa is major pathoge in our hospital.It is important to select antibiotics correctly according to the results of susceptibility tests.

This paper analyzed and discussed on the importance of doctor-patient communica-tion skills and the differences between foreign countries and China. Meanwhile, it pointed out the drawbacks of doctor-patient communication skills training for medical students in China and proposed some countermeasures including finding out influence factors, searching for reference books, provid-ing guide for doctor-patient communication theory and skills, formulating teaching pattern, building evaluation mechanism, and establishing a communication platform of doctor-patient communication skills for medical students.

Objective To establish an HPLC method for the content determination of protodioscin and diosgenin in Dioscoreae Hypoglaucae Rhizoma from different habitats.Methods The chromatographic separation was performed on an Agilent C18 column (4.6 mm×150 mm, 5μm) with mobile phase of acetonitrile-water solution with gradient elution at the flow rate of 0.8 mL/min; the detection wavelength was 208 nm; the column temperature was 30℃; the injection volume was 20μL.Results Protodioscin showed a good linear relationship among the range of 1.73–8.64 μg (r=0.999 6), with the average recovery of 101.98% (RSD=1.53%); Diosgenin showed a good linear relationship among the range of 1.03–8.20μg (r=0.999 1), with the average recovery of 101.60% (RSD=2.41%). The contents of protodioscin and diosgenin in Dioscoreae Hypoglaucae Rhizoma from 10 different habitats were in the range of 0.89%–2.24% and 0.75%–3.22%, respectively.Conclusion The method is simple, accurate and with repeatability, which can be used as quality control method of Dioscoreae Hypoglaucae Rhizoma.

Objective To analyse the nutrients of Acaudina leucoprocta and explore its hypolipidemic effect. Method The nutrients constituents of Acaudina leucoprocta were analyzed by high-performance liquid chromatography,and was compared with Apstichopus japonicus. The hyperlipidemia model was estabolished by feeding SD male mice with high fat feed. The change of liver index and fat coefficient as well as the effects on serum lipid,antioxidant capacity of serum in rats were observed. Results The fat content of Acaudina leucoprocta was only 0.43%,significantly lower than that of Apstichopus japonicus. The content of amino acids in Acaudina leucoprocta was higher than that of Apstichopus japonicus. Acaudina leucoprocta would decrease the liver index,fat coefficient and TC,TG,LDL-C,LDL-C/HDL-C in serum significantly,and increase HDL-C and HDL-C/TC. MDA and NEFA contents were effectively reduced. GSH-Px activitives were enhanced. Conclusion Acaudina leucoprocta is very rich in protein,and low in fat content. It has hypolipidemic and antioxidative effects,and may reduce the oxidative damage caused by high fat diet. Acaudina leucoprocta may be used as a functional food.

Objective To optimize the enzymolysis condition for Acaudina leucoprocta to research lencoprocta the antioxidant activity of its hyoholysate in vivo.Method Response surface methodology (RSM) was employed to optimize the hydrolysis conditions with protamex.The ICR mice were given ig the hydrolysate of Acaudina lencoprocta obtained under optimal conditions.The activity of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) and the content of MDA in blood serum and liver in mice were analyzed.Results and Conclusion The best hydrolysis conditions were:the amount of enzyme was 2.02%;enzymolysis temperature was 51.18 ℃;enzymolysis time was 127.81min,hydroxyl radical scavenging rate was 73.10%.The activities of SOD,GSH-Px in hydrolysate were significantly enhanced and the content of MDA was significantly lower,which showed that this hydrolysate had remarkable antioxidation activity.So the enzymolysis technology for Acaudina leucoprocta was optimal.

Objective_To investigate the effect of ginsenoside Rg1 on the spleen structure and function of aging rats and its relative mechanism.Methods_Forty SD rats were randomly divided into normal control group, aging model group (D-galactose 120 mg/kg,qd ×42 d), Rg1 intervention group(D-galactose 120 mg/kg,qd ×42 d and Rg1 20 mg/kg, from day 15th,qd ×28 d) and Rg1 control group.After finishing injections the spleen index was meas-ured, paraffin sections were then made to observe spleen microscopic structure.Senescence-associatedβ-Galactosi-dase( SA-β-Gal) stain was used to detect aging splenocytes.The proliferative capacity of splenocytes stimulated with Concanavalin A (ConA) was measured by CCK-8.The content of IL-2,IL-6 and advanced glycosylation end products(AGEs) was detected by ELISA.The level of ROS was analyzed by flow cytometry(FCM).Malondialde-hyde(MDA), superoxide dismutase (SOD) were detected by enzymatic assay.The expression of senescence-associ-ated protein P53,P21 and RB were detected by Western blot analysis.Results_Comparing the Rg1 intervention group with the aging model group, spleen index, splenic white pulp area proportion, the proliferative capacity of splenocytes were significantly increased (P<0.05);The secretory capability of IL-2 and IL-6, the active content of SOD were obviously increased(P<0.01);The percentage of SA-β-Gal positive splenocytes, the productions of ROS and MDA were significantly decreased (P<0.01);The production of AGEs was decreased (P<0.05);The expressions of P53,P21 and Rb were also significantly down-regulated ( P<0.01) .Conclusions_Ginsenoside Rg1 relieves injure of the spleen in aging rats induced by D-galactose.It is suggested that the mechanism may be Rg1 in-hibiting oxidative stress and down-regulating P53-P21-RB signaling pathway.

Objective To investigate the situation about cognitive performance of critical care staffs in nutrition therapy for mechanical ventilated chronic obstructive pulmonary disease (COPD) patients in county hospitals.Methods A chart of questionnaire about nutrition therapy was formulated according to the current guidelines.Critical care staffs from 12 hospitals of county-level of Hang Zhou city were enrolled.The role of staffs in management of nutritional therapy for patients was observed to assess their cognitive performance and influence factors were analyzed according logistic analysis.Results A total of 137 staffs were enrolled.Almost all of the staffs thought that nutrition therapy for ventilated COPD patients was very important.About 90％ of the staffs never heard about the use of NRS2002 (nutritional risk screening 2002)to evaluation COPD patients but the rate of using it was higher among senior staffs (OR =1.08,95％ CI:1.01-1.16,P =0.04).Most of staffs assess the nutritional status of patients according to biomarkers and other methods.However,doctors might assess nutritional status more often according to their experience.The majority of staffs did choose enteral nutrition for patients especially seen in doctors and senior staffs (OR =3.10 and1.13,95％ CI:1.27-7.55 and 1.03-1.23,both P =0.01).For those without malnutrition,senior staffs did not choose parenteral nutrition (OR =0.14,95％ CI:0.04-0.57,P =0.01).Besides,senior staffs did not continue the enteral nutrition in patients with unstable haemodynamics (OR =1.10,95％ CI:1.03-1.16,P =0.002).Most of staffs considered that the head piece of bed was raised up to 30-45 degree and gastric residual volume monitoring was very important.However,compared with nurses,the cognitive performance of doctors was poorer (OR =0.39,95％ CI:0.18-0.83,P =0.01).Most of staffs thought that the nutrition therapy implementation checklist was necessary but it was used in only 20％ institutions.The understanding and demand for nutritional knowledge was more urgent among doctors than nurses (OR =3.13 and 5.33,95％ CI:1.45-6.75 and 1.13-25.02,P =0.004 and 0.03).Conclusions Nutrition therapy was important for ventilated COPD patients,but the staffs were not very familiar with nutritional knowledge.The cognitive performance of medical staffs was influenced by their profession and experience of practice.

Objective:To screen risk factors for delirium and its duration in intensive care unit (ICU)patients.Methods:1 200 patients admitted to ICU of the Second Hospital of Shanxi Medical University from May 2017 to May 2019 were enrolled. The gender, age, anesthesia mode, duration of mechanical ventilation and hypoxia, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score, sedative drug use, and length of ICU stay were recorded. The occurrence and duration of ICU delirium were recorded. Multivariate Logistic regression analysis and multiple linear regression analysis were used to analyze the factors with statistical significance differences between the groups for screening the risk factors for delirium and its duration in ICU patients.Results:397 of 1 200 patients developed delirium, the incidence of ICU delirium was 33.1%. The duration of delirium in 189 patients (47.6%) was 1.0 day, and the duration of delirium in 397 delirium patients was 2.0 (1.5, 2.5) days. ① Analysis of risk factors for delirium: univariate analysis showed that there was no significant difference in the incidence of ICU delirium among patients with different genders or ages. The incidence of ICU delirium in patients with duration of mechanical ventilation or hypoxia 4-9 days and ≥ 10 days was higher than that in patients with ≤ 3 days. The incidence of ICU delirium of general anesthesia and internal medicine patients was higher than that of patients with lumbar anesthesia. The incidence of ICU delirium in patients with APACHEⅡ score ≥ 20 was higher than that in patients with ≤ 10 and 11-19. The patients with length of ICU stay > 9 days had a higher ICU delirium incidence than those ≤ 8 days. Increased incidence of ICU delirium in sedative patients was found as compared with those who did not use sedatives. Multivariate Logistic regression analysis showed that APACHEⅡ score [odds ratio ( OR) = 5.491, 95% confidence interval (95% CI) was 4.361-6.913, P < 0.001], the length of ICU stay ( OR = 2.679, 95% CI was 1.822-3.941, P < 0.001) and the use of sedatives ( OR = 2.479, 95% CI was 1.821-3.374, P < 0.001) were risk factors for ICU delirium. ② Analysis of risk factors of ICU delirium duration: univariate analysis showed that there was no significant difference in ICU delirium duration in patients with different genders or ages. The duration of ICU delirium in patients with duration of mechanical ventilation or hypoxia ≥ 10 days was longer than that in patients with ≤ 3 days and 4-9 days. The duration of ICU delirium in general anesthesia and non-surgical patients was higher than that in patients with spinal anesthesia. The ICU delirium duration in patients with APACHEⅡ score ≥ 20 was longer than that in patients with ≤ 10 and 11-19. The duration of ICU delirium in patients with the length of ICU stay > 9 days was longer than that in patients with ≤ 8 days. The duration of ICU delirium in patients on sedatives was longer than those not taking sedatives. Multiple linear regression analysis showed that the duration of ICU delirium increased by an average of 0.061 days (β = 0.061, 95% CI was 0.032-0.090, P < 0.001) for each additional day of hypoxia (hypoxia duration was divided into three grades of ≤ 3, 4-9 and ≥ 10 days). For every one increase in APACHE Ⅱ score (APACHE Ⅱ score was divided into three grades of ≤ 10, 11-19 and ≥ 20), duration of ICU delirium extended an average of 0.058 days (β = 0.058, 95% CI was 0.048-0.068, P < 0.001). ICU delirium duration increased by an average of 0.065 days in patients with length of ICU stay > 9 days as compared with those ≤ 8 days (β = 0.065, 95% CI was 0.056-0.075, P < 0.001). On average, the duration of ICU delirium was prolonged by 0.362 days in patients on sedatives as compared with those who did not use sedatives (β = 0.362, 95% CI was 0.234-0.490, P < 0.001). Conclusions:APACHEⅡ score, the length of ICU stay and the use of sedatives were common risk factors for ICU delirium and its duration. The hypoxic duration was risk factors for ICU delirium duration.