Objective To explore a layered nursing intervention based on risk assessment strategies application effect in elderly patients with hip replacement. Methods Chosen during January 2013 to December 2014 rows of orthopaedic trauma treated 224 patients of senile hip replacement as the research objectto divide into observation group and control group 112 caseseach according to admission time.Observation group applied based on risk assessment strategy stratification nursing intervention, the control group used conventional care. Compared two groups of patients with postoperative pain degree, hip function, complications, and patient satisfaction. Results For 24 h, 48 h, 72 h after the operation, Visual Analog Scale (VAS) scores of observation groupwere 2.25 ± 0.35, 2.01 ± 0.31, 1.92 ± 0.23, which were significantly lower than 3.53 ± 0.51, 2.84±0.45, 2.70±0.35 of the control group (t=21.900, 16.075, 21.900, P<0.01);3 months and 12 months after the surgery, the index of the Harris hip score observation group was 71.32 ± 7.45, 93.44 ± 9.65, which were obviously higher than 60.47 ± 6.65, 83.75 ± 9.21 of control group (t=11.498, 7.688, P<0.01);8.04%(9/112) incidence of complications such as infection of incision, increase of observation group was obviously lower than 20.54%(23/112) of the control group(χ2=7.146, P<0.05);97.32%(109/112) satisfaction was significantly higher than 78.57% (88/112) of the control group (χ2= 18.572, P < 0.05). Conclusions Stratified nursing intervention based on risk assessment strategy can help to alleviate the degreeof pain, improve hip function, reduce postoperative complications and improve patient satisfaction.

OBJECTIVE: As a part of the whole skeleton,oral maxilloficial bone can also be affected by the risk factors of systemic osteoporosis. This paper reviewed literature on the possible correlation of systemic osteoporosis with oral alveolar bone resorption,periodontal disease,healing of implanted denture and temporomandibular joint disease that result from oral maxillofacial osteoporosis.DATA SOURCES: Literature in English between January 1999 and December 2003 were searched with the computer in Medline Database by the following key words: osteoporosis,alveolar trophy,periodontitis,implanted denture and tempororomandibular joint with; meanwhile literature was also searched in Chinese Periodical Database and Wanfang Database of the same period by the same key words in Chinese.STUDY SELECTION: Literature involving treatment group and control group were screened in the first trial. Then those non-randomized clinical trials were excluded and the others were looked up for full text. Inclusion criteria: randomized controlled clinical trial(RTC) . Exclusion criteria: repeated study.DATA EXTRACTION: A total of 27 articles of randomized or non-randomized studies on the possible association of systemic osteoporosis with oral alveolar bone atrophy, implanted denture and temporomandibular joint disease were collected,and 18 trials met the inclusion criteria.DATA SYNTHESIS: All subjects in the 18 studies were confirmed of having osteoporosis according the diagnostic standards. Changes of oral maxillofacial bone in systemic osteoporosis were explored by observing bone density,residual teeth, the height of alveolar ridge so as to make comparative and correlation analysis.CONCLUSION: In systemic osteoporosis, mandible bone may also have rarefaction changes.

BACKGROUND: There are about 20 millions people suffering from mental retardation in China and about 200 thousands newborns of mental retardation are born every year. Mental retardation in children is a result of multiple factors.OBJECTIVE: To explore the popular causes of mental retardation in order to provide scientific evidence for effectively preventing mental retardation.DESIGN: An observational case study taking children with mental retardation as the subjects.SETTING: Population and family plan institute of a hospital.PARTICIPANTS: Totally 1 336 disabled children in 6 counties of Tai' an city diagnosed by family planning authority from January 1998 to December 2001 were selected. Inclusive criteria: intelligence quotient(IQ) < 55 and met the condition of disabled children, aged over 4 years old, those whose parents requested to give birth to the second baby due to mental retardation of the first children. Exclusive criteria: Disabled children with diseases of other systems. A total of 613 disabled kids met the above standards, aged from 4 to 14 years old, including 509 boys and 104 girls with the ratio of boy to girl of 4.9 to 1.INTERVENTIONS: All the children with mental retardation were examined by professional pediatrists and experts of family planning medical appraisal and conducted IQ test by using Chinese Wechsler Intelligence Scale for Children(C-WISC). Uniform survey was made according to all the data and processed by SPSS10. 0.MAIN OUTCOME MEASURES: The main factors caused mental retardation in kids.RESULTS: Among the 1 336 disabled kids in Tai' an city, the incidence rate of mental retardation was 45.88%. There were 112 mild cases and 501 severe cases with mental retardation among the 613 disabled kids. The component ratio of etiological classification on prenatal, perinatal and postnatal factors was 36.7%, 29.85% and 13.21% respectively, and 20. 23% of them were caused by unclear reasons.CONCLUSION: It is the key mean to prevent the occurrence of mental retardation by reinforcing maternal health, improving obstetric quality, preventing acquired disease and paying attention to early education.

OBJECTIVE: Factors that result in systemic osteoporosis will also affect maxillofacial bones for the latter is a component of skeleton. Present studies are being focused on how is the effect of the drugs that are used to treat systemic osteoporosis on maxillofacial bones. In this article we reviewedclinical and experimental studies about the drugs that acts on maxillomandibular and alveolar bone loss in order to find treatment for maxillofacial bone loss.DATA SOURCES: Medline was searched from January 1999 to October 2001 for English literatures with the searching words of "osteoporosis,mandible, bisphosphonates, herb, estradiol." And Chinese journal database was also searched from January 1995 to December 2004 for Chinese literatures with the searching words of "osteoporosis, mandible, bisphosphonates,herb estradiol"DATA SELECTION: The literatures of therapeutic and controlled studies were chosen, from which the non-random trials and repeated ones were excluded. The full texts of the remaining literatures were found and those of random and controlled trials were included in this review.DATA EXTRACTION: Seventeen literatures that were about random trials on the treatment of maxillofacial bone loss were collected. Thirteen of these 17 were included in this review and 4 of repeated trials were excluded.DATA SYNTHESIS: The subjects in the 17 literatures were all patients with osteoporosis that were in compatible with diagnosis standard. Drugs that act by inhibiting bone resorption, increasing bone mass and ameliorating bone quality were used. The effects of the drugs were compared and analyzed in perspective of the density, mass and strength of bone.CONCLUSION: Medicines for systemic osteoporosis are effective in ameliorating maxillomandibular bone structure, delaying alveolar bone resorption and promoting new bone formation.

0.05).Conclusion The peptide growth factors can activate the Akt kinase by phosphorylation.This process depends on the production of H2O2 and the presence of PTEN.

Objective To study the diagnostic value of AFP,AFU and the combined detection of AFU and AFP in PHC.Methods To analyse the detection results of AFP,AFU and AFP and AFU from 80 PHC patients and 40 healthy controls by ROC curve.Results AFP and AFU were significantly different between them (P

Objective To explore the effect of miniAd-ATP7B-GFP on the copper metabolism of skin fibroblasts of Wilson′s disease ( WD ) patients under high concentration copper medium.Methods Firstly, mini-adenovirus carrier containing human ATP7B gene was built and the mutations of 8 WD patients were detected.Fibroblasts from primary culture of skin of WD patients and normal human were cultivated 72 h in basic medium and medium with the copper concentration of C1(22.3μmol/L), C2(89.2μmol/L), C3 (156.1 μmol/L), C4 (245.3 μmol/L).Then the concentration of copper and protein was detected and copper/protein ratio was calculated.Secondly, miniAd-GFP ( miniAd-GFP group) and miniAd-ATP7B-GFP ( miniAd-ATP7B-GFP group ) were added into WD patients skin fibroblasts respectively, Wilson non-transfection group and normal group were set up as control, and C4 medium was used to culture the cells of four groups for 72 h and 96 h.Then the concentration of copper and protein was detected and copper/protein ratio was calculated.Results Five kinds of mutations were detected from 8 WD patients.The copper/protein ratio of WD patients and normal human in basic medium and the C1 -C3 groups had no statistically significant difference, but in C4 group (WD (1 871.6 ±209.2) ng/mg, normal group (1 267.2 ±188.3) ng/mg) the difference was statistically significant (t=6.075, P<0.01).C3((816.3 ±113.9) ng/mg) and C4 groups had statistically significant difference compared with the basic medium group ( ( 159.2 ± 38.6) ng/mg;WD:χ2 =31.493, normal group:χ2 =30.708, both P<0.01).The copper/protein ratio of 96 h group was higher than 72 h group.Compared with WD non-transfection (96 h:(2 731.2 ±188.7) ng/mg,72 h:(1 901.7 ±219.5) ng/mg) and normal groups, miniAd-ATP7B-GFP group had statistically significant difference both in 96 h ( ( 2 071.0 ±171.8 ) ng/mg ) and 72 h groups ( ( 1 495.5 ±161.4 ) ng/mg;72 h:F=20.130, 96 h: F=51.496,P<0.01).Conclusion MiniAd-ATP7B-GFP has partial improvement on copper metabolism of skin fibroblasts of WD patients under high concentration copper medium.

Objective:To screen out the potential key genes of endotoxin tolerance (ET), and to provide theoretical and experimental evidence for treatment and prognosis of sepsis.Methods:①Experiment 1 (gene chip and bioinformatics analysis): ET related data set GSE47783 was downloaded from the Gene Expression Omnibus (GEO). The data set was obtained from lipopolysaccharide (LPS) stimulated mouse macrophages to establish sepsis model (LPS group) and ET model (ET group). IDEP 0.92 software was used to screen differential expressed gene (DEG) between the two groups, analyze gene ontology (GO), and locate the main functions and signaling pathways of differential genes. The protein-protein interaction (PPI) network of DEG was constructed by the Search Tool for the Retrieval of Interacting Genes Database (STRING) to screen core genes hepatitis A virus cell membrane protein receptor 2 (HAVCR2) for following up validation study. ②Experiment 2 (reproduction of mouse macrophage RAW264.7 model): RAW264.7 cells were cultured in vitro, the ET model (ET group, cells were cultured with 10 μg/L LPS for 24 hours and then with 100 μg/L LPS for 4 hours) and sepsis model (LPS group, cells were cultured with 100 μg/L LPS for 4 hours) were reproduced by LPS stimulation. Phosphate buffer saline (PBS) group was given equal volume of solvent PBS for 4 hours. The mRNA and protein expressions of HAVCR2 were detected by real-time fluorescence quantitative polymerase chain reaction (RT-qPCR) and Western blotting. ③Experiment 3 (RAW264.7 cells transfected with HAVCR2 lentiviral vector): to further clarify whether HAVCR2 was involved in the formation of ET, after knockdown of HAVCR2 in RAW264.7 cells by lentiviral short hairpin RNA (shRNA) technology, the ET model (HAVCR2 --ET group) was constructed again, and the control group (ET group) without knockdown of HAVCR2 was set up. RT-qPCR method was used to detect the mRNA expressions of macrophage polarization key proteins [arginase 1 (ARG1), CD206, tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), nitric oxide synthase 2 (NOS2)] in cells. Results:①Experiment 1: a total of 1 013 DEG were identified, compared with LPS group, 521 genes were up-regulated and 492 genes were down-regulated in ET group. The function of these DEG was to increase biosynthesis and reduce inflammatory reaction. Signal pathways were mainly enriched in Janus kinase/signal transducers and activators of transcription (JAK/STAT) , NOD like receptor, Toll-like receptor (TLR), TNF, hypoxia inducible factor-1 (HIF-1). The first up-regulated HAVCR2 in the ET group was selected as the target of the study. ②Experiment 2: the results of in vitro experiment showed that the mRNA expression of HAVCR2 after high-dose LPS stimulation was down-regulated as compared with PBS group, and the mRNA expression of HAVCR2 in ET group was significantly higher than that in LPS group (2 -ΔΔCT: 1.10±0.10 vs. 0.60±0.10, P < 0.05). The results of Western blotting were consistent with RT-qPCR results. ③Experiment 3: the mRNA expressions of ARG1 and CD206 in HAVCR2 --ET group were significantly lower than those in ET group [ARG1 mRNA (2 -ΔΔCT): 0.50±0.10 vs. 1.00±0.10, CD206 (2 -ΔΔCT): 0.73±0.10 vs. 1.00±0.10], and the mRNA expressions of TNF-α and IL-1β were significantly higher than those in ET group [TNF-α mRNA (2 -ΔΔCT): 2.20±0.10 vs. 1.00±0.10, IL-1β mRNA (2 -ΔΔCT): 9.00±0.10 vs. 1.00±0.10), with significant differences (all P < 0.05). There was no significant difference in the expression of NOS2 mRNA between the two groups. Conclusion:HAVCR2 is involved in the regulation of inflammatory factors downstream of sepsis and the formation of ET, which is expected to become a new therapeutic target of sepsis.

OBJECTIVE To investigate the mechanisms for carbapenem resistance in clinical isolates of Pseudomonas aeruginosa from surgical intensive care unit(SICU).METHODS The minimal inhibitory concentrations(MICs) of various antibiotics were detected with agar dilution method;their ?-lactamases were extracted,types of their enzymes were identified and then their physical and chemical characteristics were studied by three dimentional extract test and isoelectric focusing(IEF) electropheresis;primers specific to IMP and VIM genes were utilized to amplify the metallo-?-lactamase genes.The levels of outer membrane protein OprD2 were measured by Western blot.RESULTS Forty one strains were resistant to imipenem from 49 strains of P.aeruginosa isolated from SICU during 3 years.Among them,34 isolates were found to produce high level of AmpC enzymes.Eight produced extended-spectrum ?-lactamases(ESBLs) at the same time.2 produced ESBLs only.No metallo-?-lactamases were detected.The activity of enzymes in the imipenem resistant group(74.32?53.42) was statistically different from the sensitive one(8.7?16.16,P

objective To investigate the immunophenotype of Chinese patients with acute lymphoblastic leukemia(ALL)and its association to cytogenetics and clinical features.Methods In this study.a total of 113 Chinese patients with ALL were immunophenotyped by flow cytometry using a panel of monoclonal antibodies.50 000 cells were acquired and analyzed with Cell Quest and abnormal populations were recognized by CD_(45)/SSC gating.Among the 113 patients enrolled in this study,bone marrow cells of 74 patients were cultured for 72 hours to prepare for conventional chromosome detection.and karyotype was analyzed with R-banding technique.Results Of 113 ALL patients,14.2%(16/113)were identified as TALL,85.8%(97/113)as B-ALL Among the 106 out of 113 ALL cases,myeloid antigen(MyAg)expression was documented in 34.9%(37/106)and CD_(13) was the most commonly expressed MyAg in ALL patients(23.6%,25/106).MyAgs were more frequently associated with T-ALL(46.2%,6/13)than with B-ALL(33.3%,31/93)but there was no significant difieFence(X~2=0.825,P＞0.05)between the two groups.MyAg positivity in adult ALL patients(47.6%,20/42)was higher than that in children(26.6%,17/64).There was a significant difference between the two groups(X~2=4.948,P＜0.05).Abnormal karyotypes were detected in 39 out of 74(52.7%)patients.It showed that percentage of patients with high WBC count(＞50×10~9/L)in MyAg~+(48.6%,18/37)was higher than that in MyAg~-ALL types (20.3%,14/69).There was a significant difference between the two groups(X~2=9.191,P＜0.01).CD34 expression was found in 83.8%(31/37)of MyAg~+ and 53.6%(37/69)of MyAg~-cages.There was a significant difference between the two groups(X~2=9.527,P＜0.05).In addition,the percentage of adult ALL patients in MyAg~+ group(54.1%,20/37)was higher than that in MyAg~-group(31.9%,22/69).There was a significant difference between the two groups(X~2=4.948,P＜0.05).Conclusion lmmunophenotype analysis is useful for ALL diagnosis and classification and the immunophenotype has relevance to the abnormal cytogenetic changes and clinical features in ALL patients.