Objective To study the effect of early mechanical ventilation in treatment of patients with severe acute pancreatitis(SAP).Methods Fifty-two patients with SAP admitted in the First People's Hospital of Zhaoqing from January 2010 to January 2015 were randomly allocated into two groups (n =26),early mechanical ventilation group(observation group) and conventional mechanical ventilation group(control group).Patients in the observation group treated with early lung protective ventilation when PaO2 ＜ 13.3kPa.Patients in the control group treated without mechanical ventilation untill PaO2 ＜ 8kPa.The symptoms,the extent of inflammatory reaction,the severity of lung lesions and the mortality of two groups were compared through monitoring vital signs,abdominal circumference,APACHE Ⅱ score,bladder pressure,oxygenation index (PaO2/FiO2),C reactive protein (CRP),procalcitonin (PCT),hospital stay and mortality.Results No statistically significant differences in the APACHE Ⅱ score,bladder pressure,oxygenation index,CRP and PCT in two groups before treatment were observed(P ＞ 0.05).The APACHE Ⅱ score (12.8 ± 7.6) points,bladder pressure (14.9± 7.9) cmH2O,CRP (48.8 ± 30.1) rmg/L,PCT (1.25 ± 0.55) μg/L,mortality (3.84％) of the observation group after treatment were significantly lower than those of the control group (t =2.057,2.091,3.252,2.697,x2 =4.305,all P ＜ 0.05),while the oxygenation index in the observation group [(300.0 ± 34.9) mmHg] was significantly higher than that in the control group [(278.1 ± 32.8) mmHg],the difference of the two groups was statistically significant (t =3.322,P ＜ 0.05).Conclusion Early lung protective ventilation is safe and effective for treatment of the patients with SAP.

Objective To investigate the association between 5-hydroxytryptamine 2A receptor (HTR2A)gene T102C locus polymorphism and schizophrenia,and to provide basis for evidence-based medicine for the genetic background of schizophrenia.Methods PubMed,EMbase,CNKI,WanFang and Vip information databases were used to search full text of all the relevant studies about the association between HTR2A gene T102C locus polymorphism and schizophrenia,which were published during 2003 to 2012.Based on reviewing full text,the data were selected, evaluated and accessed. RevMan 5.1 and Stata 1 2.0 were used to perform the statistical analysis of those studies that were in accordance with the inclusive criteria. According to the different ethnicities, the obj ects were divided into two subgroups as European and Asian to analyze respectively. Also, depending on different inheritances, the obj ects were divided into five patterns including C/T allele, CC/TT, CC/CT+TT, CC+CT/TT and CC+ TT/CT genotypes to analyze respectively, including heterogeneity inspection, effect consoliating and publication bias assessment. Results A total of 11 studies were available for this analysis, including 2 443 schizophrenia patients and 2 469 controls.The Meta-analysis results showed that the allele of all people were OR=1.12,95%CI=0.96-1.31,P>0.05;CC/TT of all people were OR=1.11,95%CI=0.80-1.53,P>0.05;CC/CT+TT of all people were OR=1.13,95%CI=0.99-1.30,P>0.05;CC+CT/TT of all people were OR=1.18, 95%CI=0.93-1.50,P>0.05;CC+TT/CT of all people were OR=0.95, 95%CI=0.84-1.06,P>0.05.Conclusion Current evidence is insufficient to show that HTR2A gene T102C locus polymorphism may be associated with schizophrenia, suggesting that the gene polymorphism has no significantly genetic association with schizophrenia.

Objective:To evaluate the role of DNA methyltransferase in acute lung injury in septic mice.Methods:Forty-eight healthy male C57BL/6 mice, aged 6-8 weeks, weighing 20-25 g, were divided into 4 groups ( n=12 each) using a random number table method: sham operation group (group Sham), sham operation+ DNA methyltransferase inhibitor group (group Sham+ 5-Aza), sepsis group (group Sepsis) and sepsis+ DNA methyltransferase inhibitor group (group Sepsis+ 5-Aza). Sepsis model was developed by cecal ligation and puncture (CLP) in anesthetized mice.Mice were sacrificed at 24 h after CLP, and lung tissues were obtained, DNA was extracted to determine the global DNA methylation by colorimetry, and RNA was extracted to detect the expression of DNA methyltransferase (DNMTl, DNMT3a, DNMT3b) mRNA by real-time fluorescent quantitative polymerase chain reaction, the wet/dry lung weight ratio (W/D ratio) was measured, the histopathological changes of lung tissues were determined by HE staining, the contents of interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), high-mobility group box 1 protein (HMGB1) and malondialdehyde (MDA) and activities of superoxide dismutase (SOD) and catalase were measured by enzyme-linked immunosorbent assay. Results:Compared with group Sham, the global DNA methylation was significantly increased, the expression of DNMT1 and DNMT3a mRNA was up-regulated, the lung injury score, W/D ratio, and contents of IL-6, TNF-α, HMGB1 and MDA were increased, and activities of SOD and CAT were decreased at 24 h after CLP in group Sepsis and group Sepsis+ 5-Aza ( P<0.05), and no significant change was found in the indexes mentioned above in group Sham+ 5-Aza ( P>0.05). Compared with group Sepsis, the global DNA methylation was significantly decreased, the expression of DNMT1 and DNMT3a mRNA was down-regulated, the lung injury score, W/D ratio, contents of IL-6, TNF-α, HMGB1 and MDA were decreased, and the activities of SOD and CAT were increased in group Sepsis+ 5-Aza ( P<0.05). Conclusions:DNA hypermethylation mediated by DNMT1 and DNMT3a is involved in the process of acute lung injury in septic mice.

Objective: To investigate the causes of peripheral vascular thrombosis in patients with paraquat poisoning. Methods: The patients with paraquat poisoning who were admitted to our department in recent two years were observed to screen out the patients with large vessel thrombosis. The data on toxic exposure history, clinical features, and treatment were collected to analyze the causes of thrombosis in the patients with paraquat poisoning. Results: Three patients had typical lower limb thrombosis. There was one case of right common femoral vein thrombosis, one case of bilateral calf muscle vein thrombosis, and one case of right calf superficial vein thrombosis and right calf muscle vein thrombosis. Conclusions After paraquat poisoning, the blood is in a hypercoagulable state and prolonged bed rest may increase the risk of thrombosis.

Magnetic working environment can improve job satisfaction and nursing quality of nurses. Therefore, this article summarizes the concept, development history, core connotation and measurement tools of magnetic hospitals, and discusses related factors that affect the magnetic level of hospitals, aiming to understand the current situation of magnetic hospitals in China and provide reference basis for improving the magnetic level of domestic hospitals, nurse retention rate and nursing quality through the intervention of influencing factors.

Objective:To compare the myocardial protection in pediatric patients undergoing living-donor liver transplantation (LDLT) performed under propofol- versus desflurane-based anesthesia. Methods:Sixty American Society of Anesthesiologists Physical Status classification Ⅲ or Ⅳ pediatric patients of both sexes, aged 5-24 months, weighing 5-15 kg, scheduled for elective LDLT under general anesthesia, were divided into 2 groups ( n=30 each) using a random number table method: propofol group (group P) and desflurane anesthesia group (group D). During anesthesia maintenance, propofol 5-10 mg·kg -1·min -1 was intravenously infused in group P, desflurane 0.65 MAC-1.30 MAC was inhaled in group D. At 5 min after induction of anesthesia, at 1 h of reperfusion, at the end of surgery, at 1, 2, 3, 7 and 14 days after surgery, and on the day of discharge, the concentrations of serum high-sensitivity cardiac troponin I, creatine kinase isoenzyme, N-terminal pro-B-type natriuretic peptide were determined by enzyme-linked immunosorbent assay, the occurrence of nausea and vomiting, agitation, and shivering, postoperative tracheal extubation time, intensive care unit stay time, and postoperative length of hospital stay were recorded within 24 h after surgery. Results:Compared with group P, the concentrations of serum high-sensitivity cardiac troponin I and creatine kinase isoenzyme were significantly decreased after surgery, the extubation time and intensive care unit stay time were shortened ( P<0.05), and no significant change was found in serum N-terminal pro-B-type natriuretic peptide concentrations, postoperative length of hospital stay and incidence of postoperative adverse effects at each time point in group D ( P>0.05). Conclusions:Desflurane has better myocardial protection than propofol in pediatric patients undergoing LDLT, which is helpful for early prognosis.

Objective:To explore the predictive value of the prognostic nutritional index (PNI) in concurrently infected patients with acute-on-chronic liver failure (ACLF).Methods:220 cases with ACLF diagnosed and treated at the First Affiliated Hospital of Xi'an Jiaotong University from January 2011 to December 2016 were selected. Patients were divided into an infection and non-infection group according to whether they had co-infections during the course of the disease. Clinical data differences were compared between the two groups of patients. Binary logistic regression analysis was used to screen out influencing factors related to co-infection. The receiver operating characteristic curve was used to evaluate the predictive value of PNI for ACLF co-infection. The measurement data between groups were compared using the independent sample t-test and the Mann-Whitney U rank sum test. The enumeration data were analyzed using the Fisher exact probability test or the Pearson χ2 test. The Pearson method was performed for correlation analysis. The independent risk factors for liver failure associated with co-infection were analyzed by multivariate logistic analysis. Results:There were statistically significant differences in ascites, hepatorenal syndrome, PNI score, and albumin between the infection and the non-infection group ( P ?

Objective:To evaluate the effect of dexmedetomidine on the expression of DNA methyltransferases in septic mice with acute lung injury.Methods:Forty-eight clean-grade healthy male C57BL/6 mice, aged 6-8 weeks, weighing 20-25 g, were divided into 4 groups ( n=12 each) using a random number table method: sham operation group (group Sham), sham operation + dexmedetomidine group(group Sham+ DEX), sepsis group (group Sepsis) and sepsis + dexmedetomidine group(group Sepsis+ DEX). Sepsis model was established by cecal ligation and puncture(CLP)in anesthetized mice. At 30 min before model preparation, dexmedetomidine 0.05 μg/g (in 0.5 ml of normal saline) was administered in Sham + DEX and Sepsis + DEX groups, and normal saline 0.5 ml was given instead in Sham and Sepsis groups. The mice were sacrificed at 24 h after CLP, and the lung tissue was taken to determine the wet to dry lung weight ratio, contents of interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α) and high mobility group box-1 (HMGB-1), activities of superoxide dismutase (SOD) and myeloperoxidase (MPO), and content of malondialdehyde (MDA) (by enzyme-linked immunosorbent assay), global DNA methylation (by colorimetric assay), and expression of DNA methyltransferases (DNMTl, DNMT3a, DNMT3b) (by Western blot) and to examine the histopathological changes of lung tissues (by HE staining) which were scored. Results:Compared with group Sham, the lung injury score, wet/dry lung weight ratio, contents of IL-6, TNF-α and HMGB1 and MDA, MPO activity and global DNA methylation were significantly increased, SOD activity was decreased, and the expression of DNMT1 and DNMT3a was up-regulated in group Sepsis and group Sepsis+ DEX ( P<0.05), and no significant change was found in the aforementioned indexes in group Sham+ DEX ( P>0.05). Compared with group Sepsis, the lung injury score, wet/dry lung weight ratio, contents of IL-6, TNF-α and HMGB1 and MDA, MPO activity and global DNA methylation were significantly decreased, SOD activity was increased, and the expression of DNMT1 and DNMT3a was down-regulated in group Sepsis+ DEX ( P<0.05). Conclusions:The mechanism by which dexmedetomidine reduces acute lung injury is related to inhibition of up-regulation of DNMT1 and DNMT3a expression in septic mice.

Objective : To explore the effects of microRNA-155 (miR-155) on apoptosis of chronic myeloid leukemia ( CML) cells，and the influence of miRNA-155 regulating the expression of heat shock proteins ( HSP) 27， HSP60，HSP70． Methods : Reverse transcription-quantitative real-time PCR ( RT-qPCR) was used to detect the expression levels of miR-155 in CML-resistant imatinib (IM) cell line K562-G and CML cell line K562 ．K562-G cells were infected with the lentivirus carrying miR-155 or the negative control lentivirus ，and they were named miR-155 group and control group．The effect of miR-155 on the proliferation of drug-resistant cells was detected by cell counting kit-8 ( CCK-8) method. RT-qPCR and Western blot were used to detect the effect of miR-155 on the expression of heat shock proteins HSP27，HSP60，HSP70．Flow cytometry was used to detect the percentage of cell apoptosis in miR-155 group and control group. Results : ompared with K562 cells，miR-155 showed low expres- sion in K562-G cells (P ＜0. 05) ．The proliferation of miR-155 group cells decreased significantly from the 36th hour (P＜0. 05) ．Compared with the control group，in the miR-155 group，HSP60 and HSP70 increased (P < 0. 05) ，while HSP27 decreased (P＜0. 01) ．The apoptosis rate of miR-155 group was higher than that of control group (P＜0. 05) ． Conclusion miR-155 promotes the apoptosis of chronic myeloid leukemia cells，increases the expression of HSP60 and HSP70，and decreases the expression of HSP27 .

Objective : To detect the low⁃affinity penicillin⁃binding protein drug resistance , pbp4 gene , and multi⁃ locus sequence typing (MLST) of clinically isolated E. faecalis . Methods : 78 clinical isolates of E. faecalis were collected , and their drug resistance was detected by automated instruments ; the mutation of pbp4 gene mutation was analyzed by PCR amplification and MLST . Results : 78 strains of E. faecalis were highly resistant to ciprofloxacin , levofloxacin , rifampicin , erythromycin , tetracycline and high concentration of gentamicin , and were resistant to penicillin and gentamicin . The ampicillin resistance rate was 10. 3% , and no strains were found to be resistant to nitrofurantoin , vancomycin , teicoplanin and linezolid ; 8 strains of 78 E. faecalis had amplified TEM genes , and all of them were resistant to penicillin and ampicillin resistance , with a positive rate of 10. 3% ; the allelic profiles and sequence types of 78 strains of E. faecalis which were divided into 16 sequence types , of which ST179 and ST16 were the most , with 21 and 21 strains , respectively . 20 strains , accounting for 26. 9% and 25 . 6% , the rest were ST6 type 8 strains (10. 3% ) , ST4 type 7 strains (9 . 0% ) , ST585 type 6 strains (7 . 7% ) , ST480 type 4 strains (5 . 1% ) , ST28 strains 3 strains (3 . 8% ) of the ST type were detected , and only 1 strain was detected for the oth⁃ er ST types . The analysis of the relationship between ST types and drug resistance showed that E. faecalis with the same ST type had similar drug resistance profiles . Conclusion The resistance mechanism of E. faecalis to β ⁃lactam antibiotics is mainly caused by the production of β⁃lactamase mediated by TEM gene , which is not necessarily related to the mutation of pbp4 gene . The isolates of E. faecalis are mainly CC16 ( including ST16 and ST179) clones and drug resistance is serious . It is necessary to guide clinical medication and strengthen nosocomial infection monitoring according to its characteristics .