Endoscopes ; Humans ; Nasal Septum ; surgery ; Nose Deformities, Acquired ; surgery

The incidence of candidiasis caused by Candida albicans has increased dramatically in recent years. With the widespread use of antifungal agents, the emergence of drug resistant strains pose a major challenge to drug treatment. The overexpression of membrane proteins functioning as drug efflux pumps is one of the main mechanisms for multidrug resistance of Candida albicans. Membrane transporters associated with drug resistance in Candida albicans are reviewed in this article.

Cap1p, encoded by CAP1, is a basic region-leucine zipper (bZip) transcription factor in Candida albicans. It has been proven to play important roles in both drug resistance and oxidative stress. Within the AP-1 family, Cap1p belongs to the same subgroup which also includes Yap1p, Yap2p, and Pap1p. The function of Cap1p is regulated by a nuclear localization mechanism. In recent years, some target genes of Cap1p have been discovered and the differences as well as similarities between Cap1p and Yap1p have been revealed. However, the role of Cap1p in the drug resistance of Candida albicans still needs to be further investigated. Currently drug resistance and oxidative stress are the 2 focuses in the research of fungal pathogens, making Cap1p very important in the future study. The authors have been involved in Cap1p research for a long time and this review introduces the current progress in the area.

Objective To evaluate recombinant adenovirus microspheres encapsulated with antisense MRP(as-mrp) on reversion of hepatocellular carcinoma.Methods The rats were divided randomly into 5 groups:control group;hepatic arterial injection of normal saline group,microspheres carrying no viruses group,rAdV carrying as-mrp group,and microspheres with encapsulation of as-mrp rAdV(MER) group.The theraputic effect were observed.Results The tumor growth inhibition and the mean life time in MER group were superior to than of other 4 groups(P

Older people generally had low health literacy, age related cognition decline and some even progress into dementia, burden on society was aggravating. Cognition decline of the elderly could lead to the decrease of health literacy. Meanwhile, higher level of health literacy was a protective factor against cognition decline in the elderly. This paper aimed to explore the relationship between health literacy and cognitive function in the elderly population without dementia, and to provide a theoretical basis for improving the health literacy and cognitive function of the elderly.

Abstract Socioeconomic status is an important factor affecting all-cause mortality. Income, education and occupation alone or in combination have been employed as a measure of socioeconomic status; however, the study results vary in measures. Material mechanism, lifestyle mechanism, psychological mechanism and community neighborhood mechanism have been accepted as the main intermediate mechanisms for the impact of socioeconomic status on all-cause mortality; however, the contribution of these mechanisms remains controversial. Based on the international and national publications pertaining to the association between socioeconomic status and all-cause mortality from 2012 to 2021, this review summarizes the relationship between socioeconomic status and all-cause mortality in different metrics and the intermediate mechanism of the impact of socioeconomic status on all-cause mortality, so as to provide insights for further studies.

Objective To evaluate the clinical outcomes of different flaps for repairing the soft tissue defects of heels.Methods A total of 26 patients with soft tissue defects around the heel treated modified propeller perforator flap,medialis pedis flap,or anterolateral thigh flap from March 2012 to June 2016 were analyzed retrospectively.There included 19 males and 7 females,aged 4-64 years (mean,38.1 years).There were 9 patients with posterior heel defect,3 with weight-bearing defect,6 with posterior medial defect and 8 with posterolateral defect.The wound areas were from 6.0 cm × 4.0 cm to 12.0 cm × 9.5 cm,while the flap areas were from 7.0 cm × 5.0 cm to 13.5 cm × 10.5 cm.According to the principle of flap selection,the pedicled skin flap instead of free skin flap was selected in order to minimize damage to the donor site area.Modified propeller perforator flap was applied in 13 patients,medialis pedis flap in 3 patients and anterolateral thigh flap in 14 patients.The flap donor site was directly sutured in 23 patients and a simultaneous skin graft was applied in 3 patients.The survival rate,appearance,texture and feeling recovery of flaps,complications,walking ability,and the status of donor sites were compared.Besides,postoperative functions of all cases were estimated according to foot scoring scale of American Orthopaedic Foot and Ankle Society (AOFAS).Results All flaps survived well in 26 patients.The wounds of flaps and flap donor sites were healed at Ⅰ stage.A total of 24 patients were followed up for 12-36 months (average 16 months).The appearance,color and texture of the flaps were good.There was no ulcer in flaps or flap donor sites.The protective feeling of flaps was recovered and the feeling of distinguishing two points was 6-13 mm.Modified propeller perforator flap donor site was directly sutured,the wound of which showed a linear healing.There was no fat deformity or obvious scar formation around ankle.The skin graft of the medialis pedis flap donor site was healed well,without scar hyperplasia,rupture,or deformity of arch.The anterolateral thigh flap was healed linearly without scar,and the anterolateral skin felt slightly depressed.The muscle strength of the four biceps femoris muscle was 4.According to AOFAS score,the feet's functions were evaluated as excellent in 5,good in 16,fair in 4,and poor in 1,with excellence rate of 81％.Conclusions For different soft tissue defects of the heels,propeller perforators flap,medial plantar flap or anterolateral thigh flap can not only attain appearance reconstruction of the defects and good functional recovery,but also minimize the injury of flap donor site.

Objective To evaluate the reliability and validity of the Chinese version of the Newest Vital Sign(NVS). Methods The NVS was translated and back-translated. Cultural adaption of scale was performed by Delphi expert consultation and pilot study. The reliability and validity of the Chinese version of the NVS was tested in 451 Chinese residents. Results Chinese version of the NVS consisted of 6 items with Pearson correlation between item and total score of scale ranging from 0.50 to 0.71. Two factors were abstracted by exploratory factor analysis and explained 61.51% of total variance. Confirmatory factor analysis showed that the fitness of the model was acceptable:comparative fit index was 0.96, Tuker-Lewis index was 0.92, standardized root mean square residual was 0.04, root mean square error of approximation was 0.077. Cronbach α coefficient was 0.71, retest reliability was 0.92. Conclusions Chinese version of the NVS has good reliability and validity, which can be used to test the health literacy of residents in China.

Objective To investigate the intermediary and regulating effect of self?esteem on per?ceived stress and training burnout among accelerated plateau soldiers. Methods A total of 700 accelerated plateau soldiers were investigated which were chosen by a random cluster sampling method,and assessed by the Perceived Stress Scale, Self?esteem Scale and Self?compiled Soldiers' Training Burnout Questionnaire. Results ( 1) The total score of training burnout,the score of physical and mental exhaustion and the score of training alienated among soldiers who had a history of training injury (27.85±5.80,14.89±3.46 and 6.89± 2.26,respectively) were significantly higher than those of soldiers who didn't have a history of training injury (25.05±5.12,12.68±3.25 and 6.16±2.78,respectively),and the differences were significant ( t= 4.321, 5.764,2.825,all P<0.01). The total score of training burnout,the score of physical and mental exhaustion and the score of training alienated among soldiers who had a high training expectation were higher than those of soldiers who didn't have a high training expectation,and the differences were significant (P<0.01). (2) Among accelerated plateau soldiers,training burnout showed significantly positive correlation with perceived stress ( r=0.323, P<0.01),and significantly negative correlation with self?esteem ( r=-0.409, P<0.01). (3) The intermediary role of self?esteem between perceived stress and training burnout was remarkable (P<0.01) ,which accounted for 33.8% of the total effect,and self?esteem also had a regulating effect (P<0.05) . Conclusion Radical plateau soldiers have remarkable differences due to the history of training injury or training expectations,and self?esteem has partial intermediary and regulating effect between perceived stress and training burnout.

Objective To evaluate the prognostic effect of different ratios of fresh frozen plasma (FFP) to packed red blood cells (PRBC) in massively transfused trauma patients.Methods A retrospective cohort study was conducted for 210 trauma patients who received more than 10 units of PRBC during the initial 24 hours from January 2007 to June 2015.The patients were divided into four groups:Group A(PRBC:FFP ≤1,n=41),GroupB (1 ＜PRBC:FFP≤1.5,n=63),GroupC(1.5＜PRBC:FFP≤2,n=30) and Group D (PRBC:FFP ＞2,n =76).At 24 hours after admission,blood transfusion amount,blood transfusion ratios,post-transfusion adverse reactions (allergy,non-hemolytic febrile transfusion reaction,hemolysis,congestive heart failure,pulmonary edema,etc) and coagulation changes [hemoglobin (Hb),platelet count (PC),prothrombin time(PT),activated partial thromboplastin time(APTT),international normalized ratio (INR),etc] were compared among groups.Prognostic markers including sequential organ failure assessment(SOFA),hospital stay,ICU stay,30-day mortality and causes of death were also evaluated.Results Use of PRBC was decreased significantly in Group A than in other groups (P ＜ 0.01),and there were no differences in blood transfusion adverse reactions among all groups (P ＞ 0.05).The coagulation indices (PT,APTT and INR) in Groups A and B were significantly decreased compared to Group D after transfusion (P ＜ 0.05).There were no differences in length of hospital stay and ICU stay among all groups (P ＞ 0.05).Group D was associated with higher SOFA and higher 30-day mortality than other groups(P ＜0.01),but no differences were found in Group A,B and C (P ＞0.05).Meanwhile,ratio of patients died of massive hemorrhage in Group D was also higher than other groups (P ＜0.01).Kaplan-Meier survival analysis showed the survival interval was the shortest in Group D,while the longest in Group B and C.Conclusions Modest transfusion ratios (1.5 ＜ PRBC:FFP ≤2)within 24 hours can substantially improve outcomes in trauma patients.Aggressive ratios may improve coagulation indices and reduce use of PRBC,with no more benefit to the outcomes.