Objective To explore the transmission route of Legionella pneumophila in central air-conditioning system. Methods The environmental samples collected from four public places of Nanjing city were detected by nested-PCR and analyzed by phylogenetic analysis. Results The positive rate of Legionella pneumophila in sediment, cooling water, aerosol near cooling tower, dust in duct surface and indoor air were 100%(9/9),78.6% (11/14),25.4% (17/67),16.7% (2/12) and 17.3% (13/75), respectively. The nucleotide sequence similarities of Legionella pneumophila in cooling water and indoor air was more than 92%. Conclusion The main pollution source of Legionella pneumophila is cooling water and Legionella pneumophila can be transmitted to indoor air through central airconditioning system.

Objective To explore the impacts of high temperature on health in summer in different cities of China.Methods The ettects of high temperature on health in different cities were analyzed through metereological data collecting and questionnaire survey on health of residents in Guangazhou,Nanjing and Harbin cities,300 cases respectively.Results Guangzhou,Nanjing and Harbin locat in different latitudes and have deifferent climates.Guangzhou had the high temperature all the year,with little daily temperature difference.Nanjing had cold winter and hot summer.Harbin's temperature all the year round and large daily temperature difference.In summer of 2003,the utilization rate of air-condition was 85%,75% and 12%,(respectively in Guangzhou,Nanjing and Harbin),the insomnia rate was 21.6%,38.3% and 12.9%,the occurrence rate of fatigue was 21%,25.1% and 15.2%,the occurrence rate of aggravation of existing diseases was 5.0%,7.3% and 6.1%,the incidence rate of heatstroke was 21.6%,38.3% and 12.9%,respectively.Conclusion High temperature in summer can lead to not only heat stroke,but also insomnia,fatigue,aggravation of existing diseases,et al.The residents in different cities have different tolerance to high temperature.The continual climate warming will threat human health in different latitude cities in difterent latitudes.

Objective To explore the value of the ultrasound contrast agent in conjunction with advanced contrast imaging techniques in the evaluation of the renal cortical perfusion. Methods The animal model was established with ligating renal artery to cause the renal cortical perfusion decrease of rabbits. Real-time harmonic gray scale imaging was performed to visualize the contrast enhancement of the renal cortex. After bolus injection of contrast agent SonoVue, dynamic image was observed and recorded during the first three minutes. According to the time-intensity curve (TIC), accelerating time (AT),Peak intensity (A), time to half of peak intensity (T), difference between peak and base (PBD), slope rate of the curve (β) and the product of A and β (A·β) were obtained before and after the renal artery operation. The t test and correlation analysis was used to examine the above parameters. Results Before the renal artery operation, renal cortex enhanced rapidly and obviously, the way of the enhancement was renal artery-cortex-pyramids. After ligation of renal artery, AT prolonged evidently (P<0.001), A decreased obviously (P<0.001), T obviously shortened (P<0.001), PBD decreased markedly (P<0.001), while the decline of βinduced (P<0.002) and A·βobvious dropped(P<0.001). AT, BPD and A·βcorrelated with stenosis level of renal artery. Compared with 31%－69% group, AT prolonged evidently (P<0.001). A decreased obviously (P<0.029), PBD decreased obviously (P<0.001), A·β was dropped markedly (P<0.02) in 70%-93% stenosis group. Conclusions Contrast agent combining with developed contrast specific imaging is able to detect changes of renal cortical microcirculation sensitively with the help of analysis of TIC.

Objective To identify anal canal structures by dual plane transrectal ultrasound. Methods One anorectal specimen was observed by ultrasonography when needles were placed in different anal muscle layers respectively. Fifty patients with no anorectal or perianal diseases were examined by transrectal ultrasound to verify the sonographic features of anal canal, meanwhile the inner and outer sphincters and longitudinal combination muscle were measured. The ultrasound images of anal canal were compared with MR images. Fifty patients were divided into three groups according to the age: 25- 40 years old, 41 -55 years old,and ＞55 years old. Results The sonographic features of anal canal structures by transrectal ultrasound were identified. Anal canal sonographic images and MR images had consistency. The thickness of inner sphincter in each group was (0.19 ± 0.03)cm, (0.22 ± 0.02)cm, (0.24 ± 0.03)cm respectively,while outer sphincter (0.44 ± 0.03)cm, (0.49 ± 0.04)cm, (0.52 ± 0.04)cm, and longitudinal combination muscle (0.10±0.02)cm,(0.11 ± 0.02)cm,(0.11 ± 0.02)cm. Conclusions Transrectal ultrasound is a simple,efficient and non-invasive method to examine anal canal which can identify anal canal structures clearly.

Objective: To investigate the effects of silk fibroin on the immobilization of thrombin. Methods: The immobilized thrombin was prepared using silk fibroin as the carrier and glutaraldehyde as the crosslinking agent. With activity yield as the index, the process conditions of silk fibroin immobilized thrombin were determined by an orthogonal test. Results:The optimum process con-ditions of immobilized thrombin treated with silk fibroin were as follows:the immobilization time was 6 h, the enzyme dosage was 2 400 NIH·g-1 casein, the temperature was 25℃ and pH was 7. 6. The activity recovery of immobilized thrombin was 67. 22%. Conclu-sion:Silk fibroin has the positive immobilization effect on thrombin.

BACKGROUND: Integrin α5β1 has been shown to be related to acetabular cartilage degeneration due to developmental dysplasia of the hip.OBJECTIVE: To investigate the expression of integrin α5β1 in differently degenerated cartilage tissues of the knee after knee osteoarthritis.METHODS: Seventy-five degenerated articular cartilage specimens at the weight-bearing surface of femoral lateral and medial condyles were removed from patients with knee osteoarthritis who underwent total knee replacement, and were then allotted to four groups based on Mankin's grading system: normal (n=6), mild degeneration (n=24), moderate degeneration (n=26) and severe degeneration (n=19) groups. The expression of integrin α5β1 in each group was detected using real-time PCR, immunohistochemistry and western blot assay.RESULTS AND CONCLUSION: The detected results were consistent in the three kinds of assays, and the expression level of integrin α5β1 was ranked as follows: severe degeneration group > moderate degeneration group > mild degeneration group > normal group (P < 0.05). To conclude, differential expression levels of integrin α5β1 are found in different degenerative degrees of articular cartilage in knee osteoarthritis. Furthermore, the expression level of integrin α5β1 is increased with the degenerative severity.

Traumatic craniocerebral injury has been paid close attention by neurosurgeons at home and abroad due to its high morbidity and mortality.Cerebral contusion and intracranial hematoma caused by various injury mechanisms are the main causes of increased intracranial pressure in the acute stage of traumatic brain injury.As a classic surgical method,standard decompressive craniotomy,often together with intracranial hematoma evacuation,brain debridement and internal decompression,has become the main surgical treatment in the acute stage of traumatic brain injury,saving the lives of many patients with severe cerebral injury,the importance of this procedure is irreplaceable.In long-term clinical practice,through the unremitting efforts of first-line neurosurgeons and neuroscientists,a large number of studies have been conducted on the relationship between the details,norms and prognosis of craniotomy,so as to better regulate the treatment of traumatic brain injury and reduce the death and disability rate of patients with severe brain injury.This article systematically reviews and analyzes the pathophysiological mechanism of intracranial hypertension and the mechanism,development history,surgical methods,indications and contraindications,prognosis and prospects of the intracranial hypertension.Through this article,the author hope to have some guidance and suggestions for future clinical work.

Thyroid cancer is the most common malignant tumor of the endocrine system, and the incidence is increasing year by year, which seriously threatens people's health. Autophagy is a programmed mode of death that can be used as a potential target for anti-tumor therapy and plays an important regulatory role. Leucine-rich repeat kinase 2 (LRRK2) is a protein kinase encoded by PARK8 gene. The recent studies have confirmed that autophagy is closely related to thyroid cancer. This paper analyzes the possible regulatory mechanism of LRRK2 affecting thyroid cancer through autophagy, providing new ideas for basic research and clinical diagnosis and treatment of thyroid cancer.

Objective To clarify the relationship between intracranial pressure monitoring and prognosis of patients with traumatic brain injury after decompressive craniectomy.Methods From December 2015 to December 2017,48 head-injured patients in Affiliated Suzhou Hospital of Nanjing Medical University were enrolled,who were underwent decompressive craniectomy in this retrospective study.The patients were subdivided into 2 groups based on whether postoperative was monitored (n =19) or not (n =29).The prognosis was evaluated by Glasgow Outcome Scale score,with 1 point of prognosis death,2 to 3 points of poor prognosis,and 4 to 5 points of good prognosis.Count data were expressed as a percentage (％).Count data were expressed as percentage (％).The chi-square test was used to compare the difference in the rate of good prognosis and mortality between the two groups.Results The mortality of monitoring group (10.5％) was significantly lower than that of control group (37.9％) (x2 =4.365 5,P =0.036 7) during hospitalization,The rate of good prognosis in the monitoring group (68.4％) and the control group (44.8％) was not statistically significant (x2 =2.573 8,P =0.108 6).Condusion The study showed that continuous monitoring in patients with severe craniocerebral injury could reduce the mortality of patients during hospitalization,but had no significant effect on the improvement of prognosis.

Platelets have long been known to play critical roles in hemostasis by clumping and clotting blood vessel injuries. Recent experimental evidence strongly indicates that platelets can also interact with tumor cells by direct binding or secreting cytokines. For example, platelets have been shown to protect circulating cancer cells in blood circulation and to promote tumor metastasis. In-depth understanding of the role of platelets in cancer progression and metastasis provides promising approaches for platelet biomimetic drug delivery systems and functional platelet-targeting strategies for effective cancer treatment. This review highlights recent progresses in platelet membrane-based drug delivery and unique strategies that target tumor-associated platelets for cancer therapy. The paper also discusses future development opportunities and challenges encountered for clinical translation.
Animals ; Antineoplastic Agents ; chemistry ; pharmacology ; Biomimetic Materials ; chemistry ; Blood Platelets ; cytology ; Drug Carriers ; chemistry ; Humans ; Models, Animal ; Nanomedicine ; methods ; Nanostructures ; chemistry ; Neoplasms ; drug therapy