As an important member of Tim gene family,T cell immunoglobulin domain and mucin domain protein (Tim) - 1 mainly expressed in T cell surface and adjust T cells immune response.Recent studies have found that Tim-1 gene polymorphisms may be linked with allergic diseases,autoimmune diseases and infection diseases.The review of relationship between Tim-1 polymorphism and diseases will have profound and long-term impact to expound the pathogenesis,providing new method to prevent and treat diseases.

OBJECTIVE To analyze and review the antibiotics utilization for the perioperative inpatients in our orthopedics department,and to evaluate the rationality of the utilization.METHODS Totally 267 cases of inpatients receiving operations from Sep to Nov,2008 were selected in our orthopedics department,then the methods of drug use review and drug frequency analysis were applied to analyze and review the effects of antibiotics utilization with retrospective statistics.RESULTS All of the 267 inpatients have taken antibiotics,of which the cephalosporins were the most frequently used.The antibiotics commonly used were cefminox,cefmetazole,and cefuroxime.The antibiotics of the highest daily defined dose(DDD) costs and total costs were cefamandole,flomoxef,etc.The average days of antibiotics utilization for clean operations,clean-contaminated operations,and contaminated operations were 7 days,8 days,and 9 days,respectively and 86% of the patients were antibiotic combination usage.CONCLUSIONS There is inappropriateness in the antibiotics utilization during perioperations of orthopedics.Guidelines of drug use must be followed to improve the drug usage.

OBJECTIVE:To provide reference for rational use of antibiotics in the clinic. METHODS:The study quarterly count the dosage of carbapenems,the department distribution of cultured K. pneumonia (271 strains) during Oct. 1st 2013-Sept. 30th 2014,and it’s resistant rates to carbapenems and then investigate the correlation of dosage of carbapenem and drug-resistance of K. pneumoniae. RESULTS:Carbapenem drugs are mainly used in these departments,such as neurosurgery department,ICU and the departments of transplantation and respiratory. Carbapenem-resistant K. pneumonia was also detected in these departments. More-over,with the usage of carbapenem increased by from 64.24% to 360.63%,and the resistant rates of K. pneumonia increased by nearly 10%. CONCLUSIONS:The resistance rates of K. pneumonia is positively related to the amount of carbapenem;the amount control of carbapenems can delay the generation of K. pneumonia.

Background Radiation-induced optic neuropathy (RION) is a severe complication after radiotherapy for head and neck cancer,which threatens the visual acuity and quality of life of patients.Till now,there is no recognized treatment for RION.It is of great significance to study the natural progression of the RION,and to prevent and treat RION.Objective This study was to establish an ideal radioactive optic nerve injury animal model.Methods Healthy 8-week SD rats with hygiene grade were randomly divided into normal control group and model group,with 6 rats in each group.The total 30 Gy dose of radiation with 3 portions was used to irradiate the head model group rats;ELISA was performed to analysis the changes of endothelin-1 (ET-1) and Von Willebrand factor (vWF) concentrations in blood 2,4 and 8 weeks after irradiation.Hematoxylin-eosin staining and transmission electron microscope were performed to observe the changes of optic structure.The use and care of the experimental animals complied with the ARVO statement.Results The concentrations of ET-1 in the model group were (23.18± 0.11),(27.98 ±0.22),(33.90 ±0.1 1),(65.25 ±0.38) and (43.82 ± 0.09) pg/ml before irradiation,1 day,2,4,6 weeks after irradiation,those in the normal control group were (22.65 ± 0.14),(23.18 ± 0.19),(23.68 ± 0.15),(24.23±0.12) and (23.58±0.16)pg/ml.The concentrations of vWF in the model group were (63.16±2.21),(88.32± 2.06),(123.38 ± 1.36),(191.40 ± 0.61) and (141.69 ± 0.82) pg/ml before irradiation,1 day,2,4,6 weeks after irradiation,those in the normal control group were (62.82 ± 1.56),(63.35 ±2.06),(64.12 ± 1.76),(63.52±2.02) and (63.48 ± 1.55)pg/ml.There were significant differences of ET-1 and vWF concentrations among different groups and time points (ET-1:Fgroup =32.160,P =0.012;Ftime =21.180,P =0.023.vWF:Fgroup =73.110,P=0.001;Ftime =46.180,P =0.002).The nerve fiber bundles was swelled with disordered arrangement and vacuolization 8 weeks after irradiation.Axon swell and atrophy,axons with myelin sheath layer plate separation were obtained.The rates of axon demyelination in the normal control group and model group were (1.35 ±0.79) ％ and (14.44±2.32)％,respectively.There was a statistically significant difference between the two groups (t =14.07,P＜0.01).Conclusions The total 30 Gy dose of radiation on the head of rats can make stable radioactive optic nerve injury model.This model making method is simple,cheap and practical,which is worth further study.

Objective To construct evaluation standards for pediatric nursing responsibility. Methods With the method of expert enquiry for Delphi, coefficient of variation of each index through expert grading and Kendall W′s coordination coefficient were used to test the coordination degree in opinions among experts. After the coefficient of larger variation and lower weight were removed , the elements of nursing duty were ranked based on the weight by using hierarchy analysis method. Results The established practical pediatric nurses responsibility evaluation standard consisted of 3 modules, with 11 dimensions and 33 items. The Cr expert authority coefficient was between 0.77~0.90, with an average of 0.88. The variation coefficient of each index was low, ranging between 0.013 0.135 (<0.25). The Kendall W′s coordination coefficients of the primary, secondary and tertiary indicators were 0.482, 0.552 and 0.438, respectively, with significant differences in the coordination coefficient (P<0.001). Conclusion The experts are active and authoritative in participating in the standard establishment and they highly agreed on the standard , which indicates that the established the standard is reliable in a higher degree.

Objective:To explore therapeutic effect of felodipine combined atorvastatin on aged patients with isolated systolic hypertension (ISH).Methods:A total of 176 aged ISH patients were selected from our hospital from Mar 2012 to Jan 2014. They were randomly and equally divided into felodipine group (only received felodipine and other routine therapy)and combined treatment group (received atorvastatin based on treatment of felodipine group),both groups were treated for 12 weeks.Levels of systolic blood pressure (SBP),diastolic blood pressure (DBP),pulse pressure (PP),fore brachial artery endothelium dependent diastolic-systolic function (FMD),nitric oxide (NO), high sensitive C reactive protein (hsCRP)and interleukin (IL)-6 were measured and compared between two groups before and after treatment.Results:Compared with before treatment,after treatment there were significant reductions in levels of SBP,PP,hsCRP and IL-6,and significant rise in FMD and NO level in both groups (P<0.01 all).Compared with felodipine group after treatment,there were significant reductions in levels of SBP [(134.64 ±9.64)mmHg vs.(130.86±9.75)mmHg],PP [(68.57±6.01)mmHg vs.(57.84±5.79)mmHg],hsCRP [(11.94±2.95)mg/L vs.(7.47±1.97)mg/L]and IL-6 [(10.64±3.85)mg/L vs.(5.84±3.11)mg/L],and sig- nificant rise in DBP [(72.64±7.95)mmHg比 (77.94±8.13)mmHg]and FMD [(9.75±2.56)% vs.(12.54± 4.65)%]and NO [(53.74±8.65)μmol/L vs.(86.48±6.84)μmol/L]in combined treatment group,P<0.05 or<0.01. Conclusion:Felodipine combined atorvastatin possesses good therapeutic effect in aged patients with isolated systolic hypertension.It' s help to recovering vascular function and lower inflammatory reactions.

Aim To investigate the expression of G protein-coupled receptor TGR5 and its effects on FN and TGF-β1 expression cultured under high glucose condition in rat glomerular mesangial cells , and then to explore the role of TGR5 in diabetic nephropathy. Methods INT-777 and TGR5 plasmid were used to activate TGR5 under high glucose(HG,30 mmol·L - 1 glucose ) condition, and anti-TGR5 small interfering RNA(TGR5 siRNA) was used to knock down TGR5. The protein expression of FN and TGF-β1 in rat me-sangial cells was detected by Western blot. Results TGR5 could be detected in rat glomerular mesangial cells. Both FN and TGF-β1 protein levels could be in-creased by high glucose compared with control group(P < 0. 05),and be inhibited by activiation of TGR5(P <0. 05). On the other hand,knockdown of TGR5 could increase FN and TGF-β1 protein to abnormal levels(P< 0. 01,P < 0. 05). Conclusion TGR5 suppresses HG-induced FN and TGF-β1 expression in rat glomer-ular mesangial cells,suggesting a protective role in the process of diabetic nephropathy.

Objective To identify the genetic mechanism of fetuses with short limbs deformity.Methods From Aug.2008 to Aug.2011,ten fetuses with obvious short limbs were found in ultrasound screening performed at 18-24 and (or) 30-32 gestational weeks and underwent artificial induced labor with the patient' consent.Amniotic fluid or cord blood of the fetuses was collected for karyotyping analysis and detection of mutation point of fibroblast growth factor receptor 3 (FGFR3)gene by polymerase chain reaction and gene sequencing.One fetus (case 3) who presented with achondrogenesis underwent sequencing of SLC26A2 and Trip11 gene meanwhile.Results Among the 10 fetuses with short limbs deformity,five cases were found during second trimester and five during third trimester.Nine cases were identified as normal karyotype and one was chimera (46,XY/45,XY,- 18).One fetus carried a rare FGFR3 mutation of c.1108G＞T (G370C) and was diagnosed as thanatophoric dysplasia at 21+3 weeks.Three fetus carried c.1138G＞A (G380R) mutation and were diagnosed as achondroplasia.These four families had low recurrent risk because no gene mutations were found in the parents.Three mothers of these four fetuses were pregnant again and had normal neonates now.No mutations were found in all gene sequencing in case 3.Conclusions Karyotyping analysis and sequencing of FGFR3 gene could find causative gene mutations and provide genetic counselling and prenatal diagnosis for some fetuses with short limbs deformity.In the third trimester,achondroplasia is the most possible diagnosis when short limbs fetus is found by ultrasound.

Objective To evaluate the preventive effect of orifices-dredging and stasis-removing therapy on retinal vascular endothelium and optic nerve damage induced by radiation in rats. Methods Thirty-six SD rats were randomly divided into 3 groups, namely blank control group, model group and therapy group. Rats in the model group and therapy group were exposed to X-ray radiation once a week for three weeks. Two weeks before the radiation, therapy group was pretreated with intraperitoneal injection of Astragalus injection ( 4.0 g/kg) , Ligustrazine Hydrochloride injection ( 15 mg/kg) and Xingnaojing injection ( 2.5 mL/kg) once a day, blank control group and model group were given intraperitoneal injection of same volume of saline once a day. Before radiation, one day, and 2, 4 and 6 weeks after radiation, we detected the blood concentrations of endothelin-1 ( ET-1) and Von willebrand factor (vWF) in all of the rats by enzyme-linked immunosorbent assay (ELISA) , and analyzed the dynamic changes and intergroup difference. Demyelination of optic nerve was observed under transmission electron microscope, and demyelination percentage was counted 2, 4, and 6 weeks after irradiation. Results Compared with the blank control group, the blood concentrations of ET-1 and vWF in model group were increased after irradiation (P<0.05) , and the peak value appeared on the fourth week after irradiation. Compared with the model group, the blood concentrations of ET-1 and vWF in the therapy group were decreased weeks 2 after irradiation ( P<0.05) . The demyelination percentage of optic nerve was significantly higher in the model group than that in the blank control group (P<0.05) 2, 4, and 6 weeks after irradiation. Compared with the model group, the demyelination percentage of optic nerve in therapy group showed insignificant changes 2 and 4 weeks after irradiation (P>0.05) , but was decreased obviously 6 weeks after irradiation (P<0.05) . Conclusion Pretreatment with orifices-dredging and stasis-removing therapy can decrease the blood concentrations of ET-1 and vWF in the radiation-induced retinal damage rats, and can reduce the demyelination of optic nerve in irradiated rats.

BACKGROUND:The transplanted bone marrow stem cells (BMSCs) survive,migrate to the injury site and differentiate into neurons and astrocytes.Transplantation of BMSCs following spinal cord injury (SCI) may improve the recovery of spinal function and may be an effect way for treating spinal cord injury.The treatment of spinal cord injury by autologous BMSCs mobilization and surgical transplantation has a wide prospect of clinic application.However,it is still unclear whether outcomes and mechanisms of them are different.OBJECTIVE:To compare the efficacy of treating SCI in rats by mobilization and surgical transplantation of autologous BMSCs,and assess the two methods by qualitative indexes.DESIGN,TIME AND SETTING:A randomized controlled animal experiment was conducted at the Henan Province People's Hospital from June 2007 to April 2008.MATERIALS:A total of 90 healthy Sprague Dawley rats aged 10 wees old,half male and half female,weighing (240±10) g,were subjected to make spinal cord injury models.MATHODS:After 3 days injection with bromodeoxyuridine 50 mg/kg per day,BMSCs were isolated from bone marrow of healthy rats.All the rats were underwent spinal cord injury by NYU impactor.All 90 rats were randomly divided into 3 groups,with 30 for each group.Rats in the mobilization group were subcutaneously injected with grenulocyte-colony stimulating factor for 7 days,20 mg/kg per day.In surgical transplantation group,a total of 0.3 mL (1×10~(10)/L) BMSCs were transplanted into injured area of spinal cord.Rats in control group were given the same volume of saline (0.3 mL) into injured area of spinal cord.All the rats were injected with 50 mg/kg bromodeoxyuridine daily at day 3 before surgery for 10 days in each group.MAIN OUTCOME MEASURES:The Basso-Beattie-Brasnahan (BBB) locomotor score was used to evaluate functional recovery in rat hindlima at 3 days,1,2,4 and 8 weeks after SCI.Motion evoked potential (MEP) and somatosensory evoked potential (SEP) tests were performed to defect the neural pathway so as to evaluate recovery of injured spinal cord.The cell structural changes and the expression and distribution of Brdu,glial fibrillary acidic protein (GFAP),and neuron specific enolase (NSE) were observed by pathological and immunohistochemical methods.and 8 weeks after injury (P ＜ 0.05),but there was no significant difference between the mobilization group and surgical was increased in the mobilization group and surgical transplantation group compared with the control group (P ＜ 0.05-0.01),but Histopathology showed that there were less empty,necrosis and GFAP-positive glial scar tissue,more Brdu-positive cells and NSE-positive cells in the mobilization group and surgical transplantation group than in the control group.CONCLUSION:Autologous BMSCs mobilization transplantation and surgery transplantation could significantly reduce the degree of SCI,and promote the recovery of the spinal cord function after injury for treating SCI.Compared between the two,mobilization of autologous BMSCs are more convenient,non-invasive,more likely to seize the opportunity to treatment.