Objective To investigate the intracellular signal transduction pathway of insulin promoting stem cell factor (SCF) expression in colonic smooth muscle cells (SMCs).Methods Colonic SMCs from SD rats were isolated and cultured, which were identified by α-actin immunofluorescence cytochemistry staining.SMCs were divided into 3 groups for experiment. ①Insulin concentration gradient group:Adding different insulin concentrations (0,2.5,5,20,40 and 80 mg/L) into SMCs culture and cultured for 16 hours; ② Insulin time point group:SMCs were cultured with insulin (40 mg/L) for different time durations (0,8,16,24 hours); ③ Signal pathway blocking group:SMCs were pretreated with LY-294002 or PD-98059,and then induced with insulin (40 mg/L) for 16 h.The proliferation of SMCs was examined by MTT method.The change of SCF expression was determined by Western blot and RT-PCR.Results ① Insulin at concentration of 5 mg/L remarkably promoted SMCs proliferation,and there was no significant difference in its effect with insulin concentrations at 20,40,80 mg/L (all P＜0.05).② Compared with no insulin adding group,low and medium dose of insulin (2.5,5,20 mg/L) already had a role in promoting SCF mRNA and SCF protein expression (all P ＜ 0.05). It reached maxium effect when insulin concentration was at 40 mg/L(P＜0.05),and there was no significant difference between insulin concentration at 40 mg/L and 80 mg/L (P＞0.05).③ Compared with time 0 hour,the expression of SCF increased after insulin worked on SMC (40 mg/L) for 8 hours (P＜0.05),and reached the peak after 16 hours (P＜0.05),and there was no significant difference between 24 hours and 16 hours (P＞0.05).④ Compared with blank control group and solvent control group,both insulin-induced SCF expression reduced after pretreated with LY-294002 or PD-98059 (all P＜0.05).Conclusions Insulin can promote SMCs proliferation,and in certain range the induction of SCF synthesis in colon SMCs is in dose and time dependent manners.The effect may be related to PI3K and MAPK signal pathway.

Objective To build a core competence evaluation index system for new nurses which was scientific and comprehensive. Methods 23 nursing experts was consulted by a two-round Delphi method, and finally determined the index system and the weight of each index. Results The core competence evaluation index system for new nurses consisted of 6 first-level indicator, 20 second-level indicator, 66 third-level indicator. The coefficient and authoritative coefficient were 0.370, 0.84. Conclusions The formation of the core competence evaluation index system for new nurses is scientific and reliable, which can provide objected and quantitative standards for assessment, training and evaluation of new nurses.

Objective Previous study showed that the histopathological basis of visual function damage caused by optical nerve injury is apoptosis of retinal ganglion cells(RGCs). This procedure is regulated by P53, bax and caspase 3 genes. Present study aimed to observe the expression of bax, P53 and caspase 3 mRNA in RGCs after traumatic optic nerve damage in the rats by SYBR green I fluorescence quantitative PCR method. Methods The animal model of optic nerve injury was established in the right eyes of 56 adult Wistar rats by a fluid percussion brain injury device (FPI) . Animal were killed on days 1, 3, 5, 7, 9, 14, 28 days separately after injury. Other 16 Wistar rats were divided into normal control group and sham operation group. The total RNA was isolated from rat fresh retina tissue by Trizol method and was treated by reverse transcription to cDNA using 01igo(dt) 18 as primer and then amplified. The target fragments of bax, P53 and caspase 3 cDNA were linked with carrier pTZ57 R/T to construct recombined plasmids which were transformated to E. Coli DH5α by T/A clone method. Recombined plasmids were extracted with alkaline lysis method and the plasmids were selected in white colonies by ampicillin screening, EcoR I restrictive enzyme analysis, and their specificity was evaluated using DNA sequencing. The standard curves were created by plasmid DNA and the precise expression level of target genes in samples were determined using software. The results were expressed as the ratios of target gene mRNA to GAPDH mRNA. Results The standard curve drawn by pTZ57R/T and target gene presented a good linear tendency with the higher sensitivity and specificity. The expression of P53 and bax mRNA began to increase on the third day after the injury of optic nerve and peaked on the fifth day and started to decline on the seventh day. The expression of caspase 3 mRNA increased from the fifth day through the ninth days after injury and declined on the fourteenth day. The significant differences were found in the expression of P53, bax and caspase 3 between model group and control group (P ＜ 0. 05) . Conclusion The pro-apoptotic protein P53, bax and caspase 3 play an important role in RGCs apoptosis.

OBJECTIVE To investigate the tendency of bacterial distribution and drug resistance of pathogens in department of respiratory medicine,then instruct clinical application of antibiotics reasonably.METHODS By the retrospective methods,we analyzed the pathogens isolated from the sputa of the hospitalized patients with lower respiratory tract infection in the department of respiratory medicine from Jul 2007 to Jun 2009 and their drug resistance.RESULTS A total of 1508 strains of pathogens were isolated,Gram-negative bacilli were 47.3%,The most common pathogens of them were Pseudomonas aeruginosa(15.6%).The rate of the ESBLs-producing strains of Escherichia coli and Klebsiella pneumoniae were 41.0% and 35.8%,respectively.Fungi were 44.1%.And all the fungi were sentive to amphotericin B,fluconazole and ketoconazole.Gram-postive cocci accounted for 8.6%.The most common pathogen of Gram-postive cocci was Staphylococcus.Meticillin resistant strains of Staphylococcus aureus accounted for 62.4%.CONCLUSIONS The drug-resistance of pathogenic bacteria due to nosocomial infection and community-acquired infection in respiratory medical ward is increasing year-by-year.It is necessary to continuously monitor drug-resistance and rationally use antibiotics.

OBJECTIVE To investigate the tendency of bacterial distribution and resistance of hospitial infections,and to provide the reference for the clinical treatment and infection control in hospital.METHODS Bacteria isolated from patients in our hospital from Jan 2004 to Dec 2005 were identified by ATB expression,and bacterial susceptibility tests were performed on strains using Kirby-Bauer method.RESULTS A total of 3066 pathogens strains were isolated,among them 927 strains were Gram-positive cocci(30.2%).The most common pathogens of them were Staphylococcus.Meticillin resistant strains of Staphylococcus aureus and coagulase negative Staphylococcus(CNS) accounted for 69.0% and 77.6%,respectively.In our data,no vancomycin resistant S.aureus were isolated.There were 2134 strains of Gram-negative bacilli(69.6%),the most common pathogens of them were Pseudomonas aeruginosa,Escherichia coli,Klebsiella pneumoniae,Acinetobacter baumannii and Enterobacter cloacae.The ESBLs producing strains of E.coli and K.pneumoniae accounted for 30.1% and 40.1%,respectively.The highest susceptible to Gram-negative bacilli was carbapenem,then were cefoperazone/sulbactam,piperacillin /tazobactam and cefepime.Mainly pathogenic bacteria were multi-resistant to some antibiotics.CONCLUSIONS Drug resistance of the nosocomial infection bacteria is a serious problem.It's important and urgent to carry out surveillance of bacterial resistance for appropriate using of antibiotics and effective controlling nosocomial infections.

Background Visual electrophysiology is a sensitive index for the evaluation of visual function.It has an important value in the assessment of traumatic optic neuropathy.Rabbit is an ideal animal model of traumatic optic neuropathy,and it is simple for the record of flash visual evoked potential(F-VEP)in rabbits.ObjectiveThe present study is to establish the animal model of traumatic optic neuropathy with or without lens injury and observe the repairing procedure using F-VEP. MethodsModels of traumatic optic neuropathy associated with lens injury were established in the right eyes and only traumatic optic neuropathy were created in the left eyes of 64 healthy SPF Chinese white rabbits using fluid percussion brain injury device(FPI).F-VEP was recorded based on the Proposal of International Visual Electrophysiology on 1,2,4,7,10,14,21,28 days after injury of optic nerves.Experimental animals were sacrificed in above time points for the histopathological examination.Macrophages were labeled by ED-1 antibody and survival retinal ganglion cells (RGCs)were stained by Nissl method.Results At the first day after injury,the latencies of P_(100) in both group were longer,and the amplitudes of P_(100) in both group were lower than before injury,showing statistically significant differences among different time points(P<0.05),but no significant difference was seen between the two groups(P>0.05).The duration of latency in traumatic optic neuropathy associated with lens injury group was shorter than that in only traumatic optic neuropathy group(P<0.05).The restore of latency in traumatic optic neuropathy associated with lens injury group was much faster than that in only traumatic optic neuropathy group(P<0.05).The numbers of macrophages were significantly increased and numbers of survival RGCs were considerably decreased with lapse of injury time (P<0.05).The abnormalities of VEP P_(100) and RGCs were obviously improved in 28 days after injury in both groups. ConclusionThis animal model can be established successfully by FPI.The result of retinal histopathological examination confirms F-VEP findings in this model.

OBJECTIVETo investigate the effect of different length and diameters on the stability of mini implant and to select optimal length and diameter using continuous variation of parameters.

METHODSTo perform 3-dimensional finite element analysis, finite element models of a maxilla, and mini implants with length of 6-12 mm and diameters of 1.2-2.0 mm were generated. Load of two different forces were applied to the head of mini implant. One type was horizontal force (HF), the other was composite force (CF). The maximum equivalent stress (Max EQV) in maxilla and the maximum displacement (Max DM) of mini implant were evaluated.

RESULTSThe Max EQV in maxilla and Max DM of mini implant decreased as length and diameter increased. When length was more than 9 mm, the evaluation indexes were small and had a less change. Datas indicated that diameter played a more important role in reducing target, and was a more effective parameter in reducing Max EQV when CF was loaded.

CONCLUSIONFrom biomechanical point of view, the choice of the length should not be more than 9 mm. When CF is loaded using the mini implant, diameter exceeding 1.2 mm are optimal design for mini implant.

AIM: To investigate the effect of sitagliptin on the autopaghy and the expression of extracellular matrix in mesangial cells induced by advanced glycation end products (AGEs).METHODS: The cells were divided into 5 groups: control group, AGE group, and sitagliptin (5, 10 and 20 μmol/L) groups.After 48 h, the cell viability was measured by MTT assay, and the content of collagen (Col) Ⅳ in the supernatant of the cell culture was detected by ELISA.The protein levels of beclin-1, adenosine monophosphate-activated protein kinase (AMPK), p-AMPK, p70S6K and p-p70S6K were determined by Western blot.RESULTS: Compared with control group, the viability and the expression of Col IV induced by AGEs in the cultured mesangial cells were significantly increased (P<0.01).Sitagliptin decreased the viability and the expression of Col IV induced by AGEs in the mesangial cells in a dose-dependent manner.AGEs significantly inhibited the protein levels of beclin-1 and p-AMPK, but significantly increased the protein level of p-p70S6K.Compared with AGE group, sitagliptin significantly reversed the above results in a dose-dependent manner.CONCLUSION: Autophagy may mediate the protective effect of sitagliptin on mesangial cells induced by AGEs.

Objective: To explore the night sleep quality of shift nurses and the current situation of their daytime tiredness, sleepiness, and to provide evidence for nursing administrators and managers to allocate human resources reasonably and prevent adverse events. Methods: The cross-sectional method was utilized to conduct a questionnaire survey among shift nurses in a tertiary teaching hospital in Shandong Province from March to May inclusive, 2017. Results: There was a total of 233 valid questionnaires returned. The prevalence of sleep disorder, daytime tiredness and sleepiness was 45.92%, 16.31% and 13.30%, respectively. The differences of the nurses' sleep quality at night between different ages, marriages, educational backgrounds and professional titles were statistically significant (P<0.05) , while the differences of daytime burnout and sleep state between different shift systems were statistically significant (P<0.01) . Night sleep quality was positively correlated with daytime tiredness and sleepiness (P<0.05) . The results of multiple linear regression analysis showed that age, marriage, educational background and professional title had an impact on nurses' sleep quality at night (P<0.05) . Shift system had an impact on nurses' daytime burnout and sleep apnea (P<0.01) . Conclusion There was a high prevalence of night sleep disorder, daytime tiredness and sleepiness among the shift nurses. Nursing administrators and managers should pay more attention to the night sleep quality of nurses who aged over 30 years old, married, without a bachelor degree and those with a lower professional rank. Furthermore, the current situation of daytime tiredness and sleepiness among two-shift only nurses was worrisome.

Objective To study the clinical effect of total parathyroidectomy (TPTX) on treatment of secondary hyperparathyroidism (SHPT) in patients with chronic renal failure.Methods 24 patients undergoing TPTX in Mianyang Central Hospital from Jan.2014 to Nov.2016 were retrospectively analyzed.The preoperative,postoperative and follow-up intact parathyroid hormone (iPTH),serum calcium,serum phosphorus and calciumphosphorus product were statistically analyzed.The postoperative complications and recurrence were observed.Results For preoperative,1 week after operation,3 months after operation,6 months after operation,12 months after operation,24 months after operation and 36 months after operation,the mean values of iPTH were (1771.7± 244.5) pg/ml,(70.2±18.2) pg/ml,(106.5±35.3) pg/ml,(114.3±31.3) pg/ml,(122.1±27.8) pg/ml,(128.1±12.5) pg/ml and (113.8±24.9) pg/ml.The mean values of serum calcium were (2.6±0.4) mmol/L,(1.9±0.4) mmol/L,(2.1±0.3) mmol/L,(2.1±0.2) mmol/L,(1.8±0.2) mmol/L,(1.8±0.2) mmol/L and (1.8±0.3) mmol/L.The mean values of serum phosphorus were (2.1±0.7) mmol/L,(1.4±0.6) mmol/L,(1.3±0.4) mmol/L,(1.4±0.3) mmol/L,(1.3±0.3) mmol/L,(1.5±0.2) mmol/L and (1.4±0.4) mmol/L.The mean values of calcium-phosphorus product were (61.9±17.0) mg2/dl2,(34.6±19.4) mg2/dl2,(37.4±14.4) mg2/dl2,(40.4±12.3) mg2/dl2,(29.2±5.3) mg2/dl2,(35.0 ±7.1) mg2/dl2 and (32.4 ± 11.3) mg2/dl2,respectively.Compared with those before operation,postoperative iPTH,serum calcium,serum phosphorus and calcium-phosphorus product decreased significantly at 1 week after operation,3 months after operation,6 months after operation,12 months after operation,24 months after operation and 36 months after operation,and the differences had statistical significance (all P＜0.05).Temporary injury of recurrent laryngeal nerve was found in one patient (4.2％).Early postoperative hypocalcemia rate was 91.7％ (22/24).No recurrence developed after operation.Conclusion TPTX is safe and effective in treatment of SHPT in patients with chronic renal failure,with low recurrence rate and satisfactory treatment outcome.