Objective To explore the differences of serum expression of cystatin C,macrophage migration inhibitory factor (MIF)and matrix metalloproteinase-1 (MMP-1)in elderly patients with coronary artery disease.Methods 120 cases of senile cor-onary heart disease patients in the department of cardiovascular medicine from July 2010 to August 2012 were selected and divided into the control group (n=30),stable angina pectoris group(SAP group,n= 34),unstable angina group (UA group,n=28)and a-cute myocardial infarction group (AMI group,n=28)according to the results of coronary arteriography combined with the electro-cardiogram and myocardial enzyme spectrum test.The serum levels of cystatin C,MIF,MMP-1 and C reactive protein (hs-CRP) were compared among the four groups,and correlations of the four indicators were analysed as well.Results There were significant differences in the serum levels of cystatin C,MIF,MMP-1 and hs-CRP among the four groups(P <0.05).The serum levels of cys-tatin C,MIF and MMP-1 were gradually increased with the progression of disease,and significant differences were found between any two groups(P <0.05).There were significant differences in the levels of hs-CRP between the AIM group and the other three groups(P <0.05).While among the control group,SPA group and UA group,no significant differences were found in the levels of hs-CRP between any two groups(P >0.05).The significant positive correlations were observed among cystatin C,MIF and MMP-1.Conclusion The serum levels of cystatin C,MIF and MMP-1 have a gradually increasing trend with disease progression in pa-tients with coronary heart disease,which could be important indicators of disease evaluation.

OBJECTIVE:To study the contents changes of polysaccharide and 5-HMF in Polygonati rhizoma from different pro-ducing areas after different processing,and provide reference for the development of processing technology of Polygonati rhizoma from different producing areas and the quality standard of different processing products. METHODS:UV spectrophotometry and HPLC were conducted to respectively determine the contents of polysaccharide and 5-HMF,and compare the content differences of polysaccharide and 5-HMF in Polygonati rhizoma from different producing areas [Shaanxi Lueyang County,Shaanxi Huangling County,Yunnan Fumin County (genuine producing areas),Shaanxi Taibai County] by fresh-cutting,dry-cutting,steaming and steaming with wine. RESULTS:Polysaccharide of sample from Yunnan Fumin County showed the highest content in fresh-cut sam-ples(13.4%),no 5-HMF(0)was detected;polysaccharide contents were respectively 10.8%-13.4%,8.9%-10.8%,5.5%-6.9%, 5.6%-6.5% after fresh-cut,dry-cut,steamed and steamed with wine,5-HMF contents were 0,0,0.21%-0.50%,0.25%-0.72%. Compared with no processing samples (fresh-cut),polysaccharide contents in Polygonati rhizoma were decreased in turn after dry-cut,steamed and steamed with wine,5-HMF contents were increased in turn after steamed and steamed with wine. CONCLU-SIONS:It is suggested to consider origin factor in developing processing technology of Polygonati rhizoma from genuine and non-genuine producing areas. 5-HMF content determination index should be added into quality standard of processing products after steamed and steamed with wine.

Objective To explore the continuous improvement to reduce the suctioning pediatrics lumen instruments return-cleaning rate of the first time washing, improve work efficiency and reduce the cost by applying root cause analysis. Methods Using causal analysis of fishbone diagram to analysis and verify the main reason of leading to high lumen instruments return-cleaning rate. According to the three terminal factors of continuous quality improvement, quality control group was set up, lumen instruments cleaning quality control standards was made, water flow mode of lumen instruments cleaning was changed, selected the appropriate cleaning tools and real picture show, synchronize quality control measures of publishing the quality and safety board. Compared before and after return-cleaning rate of three different detection methods and the different parts of the same suction lumen instruments. Results Before carrying out eye-measurement, cotton swab to wipe, ATP bioluminescence back washing rate was 0.89% (2/225), 7.11%(16/225), 27.11%(61/225), respectively after implementation of 0, 0.44%(1/226), 3.98%(9/226), visual observation before and after the return rate of washing was no statistically significant difference (χ2=2.018, P>0.05);Cotton swab to wipe, ATP bioluminescence back washing rate difference was statistically significant (χ2=13.820, 45.999, P<0.01). The lumen instruments total return-washing rate was decreased from 35.11% (79/225) to 4.42% (10/226). Among them, the return- washing rate of the inside surface of lumen instruments was decreased from 32.89% (74/225) to the 3.10% (7/226) and the difference was statistically significant(χ2=67.028, 67.915,P<0.01). By contraries, the thread interface and the outside surface of lumen instruments return- cleaning rate before and after the implementation has no statistical significance (P>0.05). Conclusions ATP bioluminescence assay has fine effects to detect the return-washing rate of the inner wall of the lumen instruments. The Root Cause Analysis method significantly reduced the return-washing rate of the inside surface of the suction lumen instruments, improve the efficiency, save the medical cost and reduce the hospital infection.

Objective To compare the effects of equivalent dose sufentanil,remifentanil or fentanyl on hemodynamic and cardiac output in the elderly patients during induction of general anesthesia.Methods Ninety elderly patients(ASA Ⅰ ～ Ⅱ) undergoing elective abdominal surgery under general anesthesia were randomly divided into sufentanil group(group S),remifentanil group(group R) and fentanyl group(group F),30 patients in each group.Patients in group S,group R and group F received sufentanil 0.2μg/kg,remifentanil 2μg/kg and fentanyl 2μg/kg Ⅳ,respectively,using an blind method before intubation.SBP,DBP,MAP,HR,CO,CI and SVR were recorded before of anesthesia (T0),immediately after induction (T1),1,3 minutes after tracheal intubation (T2,T3).Changes of SBP and HR during observation were also recorded.Results The MAP and HR in three groups at T1 were significantly lower than those at T0 and decreased significantly in group R than those in group F and S(P ＜0.05).The MAP and HR in group F significantly increased at T1 than T0.The MAP and HR in group R were significantly decreased after tracheal intubation.Compared with the baseline,the MAP and HR in group S at T1,T2,remained unchanged.In group R,there were two patients whose HR were under 50 bpm.In group F,the MAP at T1,T2 were significantly higher than those at T.In group S,there were no significant changes in CO,CI,SVR which were all within normal range (P ＞ 0.05).Conclusion Both sufentanil and remifentanil effectively inhibit the stress response during induction of general anesthesia.At the same time,sufentanil has better hemodynamic stability.

[ABSTRACT]AIM:Toinvestigatetheeffectofsilencingisocitratedehydrogenase2(IDH-2)genebysmallinter-fering RNA (siRNA) on the biological characteristics of human small cell lung cancer cell line NCI -H446.METHODS:IDH-2 expression was knocked down in human small cell lung cancer cell line NCI -H446 by siRNA-IDH-2.The expression level of IDH-2 was determined by real-time PCR and Western blotting .The cell proliferation was measured by CCK-8 as-say , the protein expression of MAPK p 42 was detected by Western blotting , and the cell cycle was analyzed by flow cytome-try.The migration was observed using Transwell cell migration system .BALB/c nude mice were subcutaneously injected on the back with NCI-H446 cells transfected with siRNA-IDH-2/negative control siRNA or non-transfected cells to study the tumor growth .RESULTS:siRNA-IDH-2 remarkably down-regulated the expression of IDH-2 and MAPK p42 in the NCI-H446 cells.siRNA-IDH-2 inhibited both the proliferation and migration abilities of NCI-H446 cells, and the cell cycle was arrested in S phase as compared with negative control group .Additionally, the volume of xenograft tumors in siRNA-IDH-2 group was significantly decreased as compared with control group .CONCLUSION:siRNA-IDH-2 down-regulates the expres-sion of IDH-2 in NCI-H446 cells, reduces the cell migration efficiency and inhibits the tumor growth in vitro and in vivo.

Objective To explore the key points of graded nursing care to rectal cancer patients with radioactive proctitis induced by preoperative neoadjuvant chemoradiotherapy.Methods The clinical data of 162 rectal cancer patients undergoing neoadjuvant chemoradiotherapy were analyzed retrospectively. The experience of grading nursing care for patients with radioactive proctitis induced by neoadjuvant chemoradiotherapy was summarized.Results Of 162 patients,radioactive proctitis occurred in 110 patients(67.9%).Among the 110 patients with proctitis,62(38.3%)were grade I radioactive proctitis,29(17.9%)gradeⅡand 19(11.7%)gradeⅢ.The graded nursing was done to the patients with radioactive proctitis and achieved good effect.Conclusions Radioactive proctitis has a high incidence in rectal cancer patients with preoperative neoadjuvant chemoradiotherapy and graded nursing care can reduce the distress of patients with radioactive proctitis effectively and promote wound healing,thus to improve their quality of life.

Objective To detect circulating antigen (Cag) for diagnosing neurocysticercosis. Method ELISA was performed with monoclonal antibody 4B6 against the cyst fluid antigen of Cyticercus cellulosae for detecting Cag in serum and/or cerebrospinal fluid (CSF) of patients with neurocysticercosis or with other diseases. Results In the group of 82 cases of neurocysticercosis, the positive rate of serum Cag was 79.2% (65/82) and the positive rate of CSF Cag was 100% (26/26). After chemotherapy for 20 cases with positive serum Cag, the titer of serum Cag in 17 cases dropped to zero(85% ). Cag could not be detected in specimens from patients with other diseases. Conclusion These results indicate that the determination of Cag, especially of the CSF Cag, is useful for the diagnosis of neurocysticercosis and the drop in serum Cag is a good parameter for the evaluation of the effectiveness of chemotherapy.

Objective To establish axenic cultivation of Pneumocystis carinii (P.c). Methods The organisms of P.c were isolated from the bronchoalveolar lavage fluid (BALF) of the rats with Pneumocystis carinii pneumonia (PCP) and cultured in a medium which was based on IMDM (GIBCO) supplemented with S-adenosyl-L-methionine, putrescine, N-acetyl glucosamine, putrescine, L-cysteine and L-glutamine, and newborn calf serum. The organisms cultured in the system were identified by observing the morphology of cysts in smears stained with Gomori's methenamine silver nitrate stain (GMS). Ultrastructure of the cysts/trophozoites was examined by transmission electron microscopy. The sequences of mitochondria] large ribosomal DNA subunit of the cutured organisms were compared with the Pneumocysti carinii f.sp. ratti variant isolate (GenBank No U20173) and Pneumocystis carinii f.sp.hominis (GenBank No M58605). Results Five isolates of P.carinii received from BALF of 8 rats with PCP were cultured axenically and continuously in the system. The cultured organisms could be stored in frozen condition and used to reinitiate culture, and were amplified by 19-22 times within 72 h. The morphology, ultrastructure and gene sequencing of the cultured organisms confirmed that the isolated organisms were P.carinii. Conclusion Five continuously and axenicly cultured isolates of P.carinii have been received.

Objective To investigate the adverse reactions by stereotactic body radiation therapy(SBRT)for advanced hepatocellular carcinoma and summarize nursing experience.Methods Forty-one patients with advanced hepatocellular carcinoma from the radiation department of Sun Yat-sen University Cancer Center from July 2010 to May 2012 were enrolled in this retrospective study.The adverse reactions were closely observed and the patients were given pertinent nursing.Results The effectiveness rate was 56.2%.During the therapy,36 patients developed nausea/vomiting of grade 1-2,taking up 87.8%,18 had grade 1-3 elevation of liver enzymes,taking up 43.9%,16 had grade 1-2 decrease of white blood cells,taking up 39.0%,8 had grade 1 anemia,taking up 19.5%and 21 had grade 1-2 decrease of blood platelet,taking up 51.2%.The adverse reactions were contained satisfactorily through careful observations and pertinent nursing.Conclusions The toxic reactions by SBRT are nausea,vomiting,enzymes elevation and decrease of whole blood cell.Therefore,nurses need to observe these toxic reactions carefully and give pertinent care to the patients so as to prevent the complications,especially radiation-induced liver injury.

Objective To investigate the correlation between cytomegalovirus infection and heart rate variability (HRV) in elderly patients with atherosclerosis.Methods 160 patients with coronary heart disease who met World Health Organization diagnostic criteria for coronary heart disease in 1979 were collected.According to the IMTHCMV PP65 antigen test results,patients were divided into positive group (observation group,n=103) and negative group (control group,n=57).We detected the levels of of HRV,metalloprotease-9 (MMP 9) and tumor necrosis factor α (TNF-α) in the two groups in order to access the plaque stability.Results The all sinus standard deviation of RR interval (SDNN),standard deviation of the average NN interval (SDANNI),mean value of sinus standard deviation of RR interval (SDNNI) were lower in observation group than in control group (P ＜0.05).There were no significant differences in square root of the mean squared differences of successive NN intervals (RMSSD) level and percentage of differences exceeding 50ms between adjacent normal number of intervals (PNN50) between the two groups (P＞0.05).The levels of total cholesterol and low density lipoprotein were higher and the levels of MMP 9 AND TNF α were lower in observation group than in the control group (all P＜0.05).Compared with control group,the plaque stability was decreased in observation group [20.4％ (21/103) vs.61.4％ (35/57),x2=4.273,P=0.015].Conclusions Patients with atherosclerosis combined with cytomegalovirus infection have a greater heart rate variability and poorer plaque stability.