Objective:To evaluate the bactericidal effects of nano-silver against Enterococcus faecalis(E.faecalis) growing in multi-species biofilm.Methods:85 biofilms were established using MBECTM P&G Assay with E.faecalis together with Fusobacterium nucleatum and P.melaninogenica.Thereafter,10 specimens were used as the controls,75 were randomly divided into 3 groups(n=25),and treated with 0.1% nano-silver (12-15 nm) solution,0.1% nano-silver (100 nm) solution and 2% hypochlorite solution,respectively.Each sample was then separated into 2 different tubes.PMA was added to one of the tubes,and the other was left untreated.Then,DNA extraction and qPCR were performed.The cycle threshold(Ct) values between samples were compared by paired t test.Results:The Ct values of the samples treated with PMA were higher than that without PMA(P=0.000) in the group of 0.1% nano-silver solution(12-15 nm)was higher than that in the group of 0.1% nano-silver solution(100 nm)and 2% sodium hypochlorite solution.(P<0.05);the value in the group of 0.1% nano-silver solution(100 nm)was larger than that in 2% sodium hypochlorite solution(P<0.05).Conclusion:0.1% nano silver solution might have a strong bactericidal effect against against E.faecalis growing in multi-species biofilm.The bactericidal effect may be enhanced with the small size of silver particles.

ObjectiveTo study the self-choice right of the patients who visit psychology department in TCM hospitals and provide a reference for further TCM psychological treatment application.Methods Self-choice and visiting condition inquiry enacted by ourselves was used in the survey.It is an unregistered and on-sight investigation.The inquiries were distributed by doctor.Patients were instructed by their doctors in the process.Results64.35％ of patients in psychology department of TCM hospitals select treatment methods by themselves.TCM is the first choice among 66.96％ of patients in psychology department of TCM hospitals.44.35％ of patients visiting psychology department refuse western medicine due to their side effects.6.09％ of patients in psychology department of TCM hospital know a little about psychological treatment; however,some of them believe in psychological treatment.ConclusionThe research finds out the main methods of self-choice right among patients visiting psychology department of TCM hospital.It proposes that self-choice right should be respected,at the same time,doctors are responsible to guide patients to understand the etiology of diseases.These efforts will contribute to harmony relationship between doctors and patients and facilitate their recovery and rehabilitation.

Objective To study the influence factors for HBV reinfection following liver transplantation.Methods 92 cases of liver transplantation were enrolled for open non-randomized clinical study.Given conventional OLTx and immunosuppressive agents and antibiotics to prevent infection etc,patients are divided into lamivudine alone and HBIG combined with lamivudine group.Observation of postoperative liver function,HBV serum markers,HBV DNA in PBMC,YMDD and HBV S gene mutation,liver tissue IH etc.Results In 92 cases of liver transplantation with HBV-related liver disease,hepatitis B recurrence rate was 4.35%(4/92).In lamivudine group the HBV infection rate was 35%(7/20);In combined therapy group the HBV infection rate was 6.94%(5/72).With preoperatively negative HBV DNA negative the hepatitis B recurrence rate was 0;With preoperatively positive HBV DNA,the postoperative HBV infection rate was 17.39%(12/69),which had cases with S gene or YMDD mutation.In patients with negative HBV DNA before and after operation,the HBV re-infection rate was 11.11%(1/9);In 5 cases with preoperative HBV DNA positive,the HBV infection rate was 4/5 after LTx;before and after operation HBV DNA are positive,the HBV infection rate was 100%(3/3);the preoperative HBV DNA positive and postoperative HBV DNA negative,the HBV infection rate was 50%(1/2).Conclusion To prevent HBV infection after LTx,lamivudine group easily leads to HBV re-infection than HBIG combined with lamivudine group.Preoperative serum HBV DNA positive,preoperative and postoperative HBV YMDD and S gene mutation are the primary factors affecting the HBV re-infection after operation.HBV DNA positive in PBMC is the source of HBV re-infection,but also the factor of recurrence of hepatitis B.

Objective To investigate the scale of self-efficacy and the influencing factors among the elderly diabetic population in rural communities in Shanghai . Method The diabetic patients in the rural communities were involved in the study by questionnaire to analyze the patient′s self-efficacy and its influencing factors. Results The total score of self-efficacy was (77.48 ± 22.22), with the index score of 59.60%. By multiple stepwise regression analysis, the influencing factors were age, education level and annual income. Conclusions The self-efficacy of diabetic patients is at a low level. To improve their self-efficacy, we should strengthen the education to the diabetic patients with age of 40~49 or poor in education or lower in income.

Objective To investigate the efficacy of step decompression combined with decompressive craniectomy in treating severe traumatic brain injury (sTBI).Methods A retrospective case series study was conducted to analyze the clinical data of 192 patients with sTBI admitted to Changsha Traditional Chinese Medicine Hospital from January 2016 to April 2018.There were 149 males and 43 females,aged 11-79 years,with an average of 50.1 years.The Glasgow coma score (GCS) was 7-8 points in 57 patients,5-6 points in 45 patients,and 3-4 points in 90 patients.There were 55 patients with unilateral pupil dilation and 88 patients with bilateral pupil dilation.All patients were treated with step decompression and decompressive craniectomy.GCS and pupil sizes before and after operation,intraoperative diffuse brain swelling and acute encephalocele,intraoperative and postoperative delayed bleeding,secondary surgery,mortality during hospitalization,and Glasgow outcome score (GOS) 6 months after injury were recorded.Results At 24 hours after operation,the GCS was 7-8 points in 87 patients,5-6 points in 51 patients,and 3-4 points in 54 patients.The consciousness was significantly improved (P ＜ 0.01),and the pupil was reduced in 56 patients (P ＜ 0.0l).There were four patients with diffuse brain swelling during operation (2.1％),11 patients with acute encephalocele (5.7％),seven patients with delayed bleeding (3.6％),27 patients with postoperative delayed bleeding (14.1％),17 patients receiving secondary surgery (9.7％).Thirty-eight patients died during hospitalization (19.8％).The results of GOS follow-up of 6 months were as follows:there were 50 patients with good recovery (30.0％),36 patients with moderate disability (24.5％),15 patients with severe disability (10.2％),46 patients with persist vegetative states (31.3％),and seven patients died (4.8％).Conclusion For sTBI patients,step decompression combined with decompressive craniectomy can significantly reduce intraoperative diffuse brain swelling and encephalocele,intraoperative,and postoperative delayed bleeding,thus improving the prognosis.

Objective: To evaluate the outcomes of splenectomy in the treatment of relapsed/refractory autoimmune hemolytic anemia (AIHA). Methods: Retrospective analysis was performed in 30 cases with relapsed/refractory AIHA who were treated with splenectomy in our hospital. The pre- and post-operative blood routine indexes and responses were followed up. Results: Among the 30 relapsed/refractory AIHA patients, 20 were pure AIHA (including 13 patients with warm antibody AIHA, 2 with warm-cold double antibody AIHA and 5 with Coombs negative AIHA) and 10 were Evans syndrome. The short-term response was evaluated 10-14 days after operation, and the overall response rate (ORR) of short-term response was 90% [12 cases in complete response (CR), 6 cases in partial response (PR)] in 20 therapeutic evaluable cases. Among 13 patients with long-term follow-up data, except 3 patients with Evans syndrome died (2 cases were refractory to splenectomy, 1 case relapsed after surgery), the ORR of 10 patients with relapsed/refractory pure AIHA at 6 months and 12 months were 90% (9/10) and 70% (7/10), respectively, with a median follow-up of 14 (4-156) months. At the end of follow-up, 3 cases had maintained CR for more than 3 years. Conclusion The short-term response of splenectomy as a second-line treatment for relapsed/refractory AIHA is satisfactory, and long-term outcome of splenectomy is up to 70% at 1 year. Approximately one-third of patients could maintain sustained remission.

OBJECTIVETo compare the efficacy of laparoscopic versus open tension-free mesh repair using biologic mesh for inguinal strangulated hernia.

METHODSClinical data of 27 patients with inguinal strangulated hernia in the Shanxi Provincial People's Hospital between January 2012 and April 2014 were analyzed retrospectively. All the patients underwent one-stage tension-free repair using biological mesh, including laparoscopic(n=13) and open procedures(n=14).

RESULTSAs compared with the open group, the laparoscopic group had shorter operative time [(90.8±11.6) min vs. (130.8±32.5) min, P<0.01], lower rates of hematoma/seroma and wound infection[(7.7% vs. 42.9%) and (0 vs. 28.6%) respectively, both P<0.05], faster recovery of bowel function [(2.5±0.3) d vs. (3.8±1.4) d, P<0.01], and shorter hospital stay [(6.3±1.8) d vs. (9.8±3.2) d, P<0.01]. The mean follow-up was 5.7 months (ranged from 2 to 12 months), and no recurrence or serious complications occurred.

CONCLUSIONLaparoscopic tension-free hernia repair using biological mesh for inguinal strangulated hernia has significant advantage versus open operation.

Objective: To explore the new gene mutation and clinical manifestations of Caroli syndrome in 2 blood brother cases. Methods: The clinical data of the 2 brothers with clinical diagnosis of Caroli syndrome were analyzed, and the related genes were detected by second-generation sequencing technology. Results: The PKHD1 gene of both brothers had the mutation of c. 5059A>T(exon32). c. 4358(exon 32)delC shift mutation, neither of which has been reported in OMIM database. Conclusion After analysis, c. 4358(exon32) delC and c. 5059A>T(exon32) may be the new pathogenic mutation of this disease, with the same mutant genotype but completely different phenotype.

OBJECTIVE To establish a method for qualitative and quantitative analysis of Shangkeling spray ，which can be a certain foundation for the overall quality evaluation of Shangkeling spray . METHODS Eleven batches of Shangkeling spray were determined by high performance liquid chromatography （HPLC）.The separation was performed on Ultimate ® XB-C18 column with mobile phase consisted of acetonitrile -0.1% phosphoric acid （gradient elution ）at the flow rate of 1.0 mL/min. The detection wavelength was set at 210 nm，and column temperature was 35 ℃.Similarity Evaluation Software of Chromatographic Fingerprint of Traditional Chinese Medicine （2012 edition）was used for the establishment of HPLC characteristic chromatogram and similarity analysis；the chromatographic peaks were identified by comparing with the chromatogram of the reference substance . The contents of matrine ，oxymatrine，scopoletin and isoazinopyridine were determined by HPLC .RESULTS Totally 18 common characteristic peaks were demarcated for 11 batches of samples ，4 of them were identified ，i.e. peak 2（matrine），peak 3（oxymatrine），peak 6 （scopoletin），peak 7（isoazinopyridine）. The similarity between the characteristic chromatogram of 11 batches of samples and the control characteristic chromatogram R was ≥0.990. The results of content determination methodology conformed to the relevant requirements. The contents of matrine ，oxymatrine，scopoletin and isoazinopyridine in 11 batches of Shangkeling spray were 14.48-44.86，32.53-69.76，11.28-20.96 and 10.36-22.49 μg/mL，respectively. CONCLUSIONS HPLC characteristic chroma -togram and quantitative analysis method of 4 indicator components are successfully established in this study ，which can be used to evaluate the quality of this preparation .

BACKGROUND: Dysfunction of the gap junction channel protein connexin 43 (Cx43) contributes to myocardial ischemia/reperfusion (I/R)-induced ventricular arrhythmias. Cx43 can be regulated by small ubiquitin-like modifier (SUMO) modification. Protein inhibitor of activated STAT Y (PIASy) is an E3 SUMO ligase for its target proteins. However, whether Cx43 is a target protein of PIASy and whether Cx43 SUMOylation plays a role in I/R-induced arrhythmias are largely unknown. METHODS: Male Sprague-Dawley rats were infected with PIASy short hairpin ribonucleic acid (shRNA) using recombinant adeno-associated virus subtype 9 (rAAV9). Two weeks later, the rats were subjected to 45 min of left coronary artery occlusion followed by 2 h reperfusion. Electrocardiogram was recorded to assess arrhythmias. Rat ventricular tissues were collected for molecular biological measurements. RESULTS: Following 45 min of ischemia, QRS duration and QTc intervals statistically significantly increased, but these values decreased after transfecting PIASy shRNA. PIASy downregulation ameliorated ventricular arrhythmias induced by myocardial I/R, as evidenced by the decreased incidence of ventricular tachycardia and ventricular fibrillation, and reduced arrythmia score. In addition, myocardial I/R statistically significantly induced PIASy expression and Cx43 SUMOylation, accompanied by reduced Cx43 phosphorylation and plakophilin 2 (PKP2) expression. Moreover, PIASy downregulation remarkably reduced Cx43 SUMOylation, accompanied by increased Cx43 phosphorylation and PKP2 expression after I/R. CONCLUSION PIASy downregulation inhibited Cx43 SUMOylation and increased PKP2 expression, thereby improving ventricular arrhythmias in ischemic/reperfused rats heart.
Rats ; Male ; Animals ; Myocardial Reperfusion Injury/metabolism* ; Connexin 43/genetics* ; Sumoylation ; Down-Regulation ; Rats, Sprague-Dawley ; Arrhythmias, Cardiac/drug therapy* ; Myocardial Ischemia/metabolism* ; RNA, Small Interfering/metabolism*