Epidemiological studies have shown that human papillomavirus (HPV) infection is the main cause of cervical cancers and cervical intraepithelial neoplasia(CIN).And different types of HPV have different carcinogenicity,different cervical cancer pathological types and prognoses of cervical cancer.The effective way to decrease the cervical cancer morbidity is to detect and classify the high-risk HPV infection in early time,and carry out intervention therapy in early time.Therefore,detecting HPV subtypes in clinic will have great significance in prevention and treatment of cervical cancer and cervical precancerous.

Objective To investigate the protective effect of N-acetylcysteine(NAC) on the development of myocardial hypertrophy in diabetic rats induced by streptozotocin. Methods Male SD rats were randomly divided into normal control (NC), control treatment (NCT), diabetic (DM) and diabetes treatment (DMT) groups. NAC was administered at dose of 1.4～1.5g·kg~(-1)·d~(-1) to NCT and DMT groups in the drinking water for 8 weeks. At termination the rats were surgically prepared for hemodynamic measurement, such as systolic blood pressure, heart rate, the rate of left ventricle relaxation (-dp/dt) and the time to maximum relaxation (T). Subsequently, the hearts were removed to assay relative ratio of left ventricle weight versus body weight (LVW/BW) and cardiomyocyte cross sectional areas.Plasma glucose, insulin, 15-F_(2t)-isoprostane(15-F_(2t)-Isop) concentration and superoxide dismutase (SOD) activity were analyzed. Results The LVW/BW ratio and cardiomyocyte areas were significantly attenuated by NAC treatment as compared to DM group (P＜ 0.05). Increases in -dp/dt and SOD activity and the decreases in glucose, 15-F_(2t)-Isop T (P＜ 0.05) were found at the same time. Conclusions NAC can effectively prevent the development of myocardial hypertrophy and improve diastolic function in diabetic rats, which may be related to its antioxidant capacity.

Objective To explore the effect of Shen-Fu injection(SFI,参附注射液) on expressions of heme oxygenase-1(HO-1) and inducible nitric oxide synthase(iNOS) in renal failure induced by intestinal ischemia-reperfusion injury(IRI) in rats and its possible mechanism in the protection of kidney.Methods The model of intestinal IRI was induced by clamping superior mesenteric artery(SMA) for 1 hour and then releasing the arterial clamp for 6 hours.Thirty-six male Wistar rats were randomly divided into three groups: IRI model group,SFI pretreatment group and sham operation group.In the SFI pretreatment group,10 ml/kg of SFI was pumped in at constant rate 30 minutes before the ischemia,the SMA was clumped for 1 hour and then released,while in the IRI model group,an equal volume of normal saline was pumped in continuously 30 minutes before the ischemia.The serum creatinine(SCr) and blood urea nitrogen(BUN) were observed respectively.Expressions and distributions of HO-1 and iNOS in the rat kidney tissue were detected by immunohistochemitry and morphometry computer image analysis.The histological changes of kidney were observed under light microscope.Results The expressions of HO-1 and iNOS were markedly higher,and the levels of SCr and BUN were also significantly higher in intestinal IRI model group than those in the sham operation group(all P

Objective To analyze the pathogen distribution and drug resistance of candida isolated from children with blood infections in our hospital,and to provide reference for clinical effective prevention and treatment.Methods The blood specimens of pediatric patients were collected between January 2009 and December 2015,and were cultured using BacT/ALERT 3D and BD9140 instruments.The candida were separated with Sobaurandps agar culture medium,and identified with chromogenic medium,API 20CAUX test strips or VITEK-2 compact YST card.The minimal inhibitory concentration of 5 drugs were determined by ATB FUNGUS 3 system.Results In 176 cases,92 strains (52.3％) were from neonatal ward,and 46 strains (26.1％) were from PICU.In newborn group,85 strains were isolated from premature,which contained the low and very low birth weight infants (37 strains),pneumonia(20 strains),neonatal respiratory distress syndrome(9 strains).In PICU,the strains were commonly isolated from children with severe infection.Among 176 strains of candida,71 strains (40.3％) were C.albicans,62 strains (35.2％) were C.parapsilosis,16 strains(9.1％) were C.glabrata,9 strains(5.1％) were C.tropicalis,and 18 strains(10.2％) belonged to other candida.Conclusion Candida blood infections can happen at all age of chlidren.The most common strains detected from blood were C.albicans,followed by C.parapsilosis.Most of these strains are susceptible to antifungal drugs,such as fluconazole,except C.glabrata.The sensitive rates to commonly used antifungal drug are more than 93％.The selection of antifungal drugs should be based on the species of strains.

Objective To improve the cleaning quality of reusable medical instruments continuously through root cause analysis,reduce healthcare-associated infection(HAI)and the wear and tear of instruments.Methods The major factors influencing the cleaning quality of instruments were analyzed and clarified by fishbone diagram,contin-uous quality improvement was carried out based on 5 terminal factors,the rate of rusting,stain,repeated cleaning, damage,and clinical department satisfaction before and after the implementation of continuous improvement were compared.Results The qualified rate of instrument clean increased from 94.24% before implementing measures to 97.60% after implementing measures,the rate of rusting,stain,repeated cleaning,damage decreased from 3.39%, 2.37%,5.76%,and 2.08% to 1 .55%,0.85%,2.40%,and 0.48% respectively,there were significant difference among different groups(all P <0.001 );the score of satisfaction rate to central sterile supply department elevated from(93.87±3.87)before implementing measures to (98.08 ±0.59)after implementing measures(t =6.80,P <0.001).Conclusion Root cause analysis is important in improving cleaning quality of reusable instruments continu-ously,as well as reducing HAI and the wear and tear of instrument,it can save medical cost.

BACKGROUND: Reperfusion injury and inadequate perfusion exist,causing the injury of intestinal mucosa during shock / resuscitation.OBJECTIVE: To investigate protective effect of shenfu injection (SFI) in equal dosage for human effect on intestinal mucosal pH (PHi) of sigmoid colon, the contents of nitric oxide (NO), malonialdehyde(MDA) and Ca2+ of intestinal mucosa, activity of serum diamine oxidase(DAO of rabbits during shock/resuscitation.DESIGN:A randomized controlled trial with experimental animals as the subjects.SETTING: DepartmentofAnesthesiology, Renmin Hospital of Wuhan University MATERIALS: The experiment was performed in the Research Institute of Anesthesiology, Renmin Hospital of Wuhan University from August to October in 2003. Twenty-four adult healthy white rabbits were randomly divided into 3 groups with 8 animals for each: Shenfu injection group (SFI group), shock/resuscitation group and control group .INTERVENTIONS: Hemorrhagic shock was induced by blood withdrawal from femoral artery at a rate of 2 mL/kg per minute until MAP dropped to 40 mmHg. MAP was maintained at this level for 60 minutes,then the collected auto-blood and the same volume of balanced salt solution was transfused to the animal for preparing shock/resuscitation model. In SFI group: the animals were given 2.1 mL/kg SFI together with the auto-blood transfusion and followed by a continuous infusion of 5mL/kg SFI per hour.MAIN OUTCOME MEASURES: Intestinal mucosal pH (PHi) of sigmoid colon, NO, MDA and Ca2+ contents of intestinal mucosa, activity of serum DAO were detected before shock (So), 1 hour after shock (S1), 1 hour (R1) and 3 hour (R3) following resuscitation.the R1 reperfusion (7.171±0.102) , and R3 reperfusion (7.194±0.106) of the SFI group were higher than those of the shock/ resuscitation group (6.920±0.155,6.971±0.165,P ＜ 0.05,P ＜ 0.01) and those of the contents of the reperfusion R1 (35.090±1.184) μkat/L and R3 (32.440±2.884) μkat/L of the SFI groups were significantly higher than those of the shock/resuscitation group [(50.994±2.684),(52.377±1.217) μkat/L,P＜ 0.01] and of the control group [(15.970±1.734), (16.620±0.767)μkat/L,Pgroup were significantly lower than those in the shock/resuscitation group [ (61.8±5.3,72.2±5.8 ) μmol/g , (68.2±4.9,96.9±8.5) μmol/L ,P＜ 0.05]. Ca2+ content of intestinal mucosa at reperfusion 3 hours in the SFI group [(2.43±0.27)μmol/L] was lower than that in the shock/resuscitation group [(2.93±0.34)μmol/L,P ＜ 0.05] and higher than that in the control group [(2.26±0.31 )μmol/L, (P ＜ 0.05)].CONCLUSION: SFI in equal dosage for human effect could protect intestinal mucosa from shock/resuscitation injury through improving perfusion and oxygenation, inhibit the activity of NO, reduce oxygen free radical and calcium overload, with a good protective effect on intestinal mucosa during shock/resuscitation.

Objective To evaluate the outcome of patients with low ejection fraction undergoing coronary artery bypass grafting.Methods One hundred and twenty-eight consecutive patients with left ventricular ejection fraction (LVEF) ≤35％,who underwent Off-pump caronary bypass surgery or Cardiopulmonary coronary artery bypass between December 2000 and Novomber 2010 were studied.The outcome of early complication,mortality,LVEF were analyzed.Results LVEF and LVEDD were significantly increased in early postoperation (P ＜ 0.05 ).Use of Intra-aotric balloon counterpulsation(IABP) can decrease early mortality,and postopertive respiratory tract infections,renal insufficiency were found to be the main complications.Conclusions Preoperative low ejection fraction has no relationship with postoperative early mortality.using medicine to adjust heart function,strcity control blood pressure,blood glucose,heart rate preoperation,positive use of IABP postoperativon are key point to decrease early mortality.

Objective To investigate the effect of micro-ecological agent on the intestinal flora of patients with posterior lumbar spine surgery.Methods Seventy-two patients with lumbar spine surgery were selected as our subjects.Of them,42 patients with occurred the intestinal flora dysfunction were served as experimental group (group A),other 30 patients were as control group (group B).The levels of plasma endotoxin,plasma tumor necrosis factor-α (TNF-α),Interleukin 6 (IL-6) were detected before and after operation.The patients in group A were treated with micro-ecological agent Jinshuangqi.Collected stool samples at preoperative,postoperative first natural defecation (after 1-4 d),and compared intestinal flora difference and Bifidobacterium (B)/Enterobacteriaceae (E) value of two groups patients.Results The levels of plasma endotoxin in group A were (1.82 ±0.12),(2.29 ±0.15),(1.91 ±0.08) ng/L at before surgery,the 2nd and 7th day after surgery,and that in group B were(1.91 ±0.21),(2.35 ±0.16),(2.26 ±0.24) ng/L The TNF-α level in group A were (275 ±51),(309 ±45),(276 ±34) ng/L and that in group B were (269 ±48),(318±67),(297 ±53) ng/L at before surgery,the 2nd and 7th day after surgery.The IL-6 levels in group A were (138 ± 22),(159 ± 15),(137 ± 17) ng/L and that in group B were (159 ± 16),(187 ± 19),(174 ± 21) ng/Lat before surgery,the 2nd and 7th day after surgery.The repeated measured repeated measures analysis of variance showed that among three indexes of plasma endotoxin,TNF-α,IL-6 levels,differences of between group and interaction were statistically significant (P ＜ 0.05),but there was no significant difference within groups (P＞ 0.05).The levels of plasma endotoxin,TNF-α,IL-6 decreased after surgery ware gradually decreasing with hospitalization prolonged.There was significant difference between before surgery and at the 2nd,7th day after surgery(P ＜ 0.05),and there was significant difference between the 2nd and the 7th day after surgery(P＜ 0.05).At the 2nd day after surgery,there was significant difference between group A and group B in terms of the level of plasma endotoxin,TNF-α,IL-6.At the 7th day,the levels of plasma endotoxin,TNF-α,IL-6 were slowly decreased in group A,and there were significant difference compared to group B (P ＜ 0.05).The numbers of intestinal Bifidobacterium,Bacteroides,and B/E values of group A were decreased after surgery compared to group B((9.17 ±0.54) lg cfu/g vs.(10.01 ± 0.75) lg cfu/g,(9.23 ± 0.47) lg cfu/g vs.(10.09 ± 0.81)lg cfu/g,(1.01 ± 0.16) vs.(1.20 ± 0.11)),and the difference was significant (P =0.031,0.042,0.029respectively).The levels of Enterobacter and Enterococcus in group A were (9.11 ± 1.02) lg cfu/g,(7.80± 1.02) lg cfu/g,higher than that of group B ((8.81 ± 0.89) lg cfu/g,(7.29 ± 0.98) lg cfu/g(P =0.037,0.043)).There was no significant difference between two groups in terms of small clostridium and lactobacillus (P ＞ 0.05).After treated with micro-ecological agent Jinshuangqi,the levels of intestinal Bifidobacterium,Bacteroides,and B/E value at was increased compared to before treated in group A (Bifidobacterium:(13.01±0.87) lg cfu/g vs.(9.17 ±0.54) lg cfu/g; Bacteroides:(14.12 ±0.75) lg cfu/g vs.(9.23 ±0.47)lg cfu/g; B/E value:(1.28 ± 0.45) vs.(1.01 ± 0.16) ;P =0.045,0.034,0.038 respectively).No significant difference was seen in terms of the levels of Enterobacter,Enterococcus,small clostridium and lactobacillus between two groups(8.71 ±0.91) lg cfu/g vs.(9.11 ± 1.02) lg cfu/g,(7.01 ±0.54) lg cfu/g vs.(7.80± 1.02) lg cfu/g,(5.23 ± 1.04) lg cfu/g vs.(5.15 ± 0.89) lg cfu/g,(6.71 ± 1.04) lg cfu/g vs.(6.53± 0.86) lg cfu/g respectively; P ＞ 0.05).Conclusion Posterior lumbar operation patients with intestinal dysbacteriosis often associated with endotoxemia and inflammatory reaction,the levels of bifidobacteria,Bacteroides intestinal Enterobacteriaceae decrease while Enterococcus,opportunistic pathogens increase,and intestinal microbial colonization resistance decrease.Micro-ecological agent Jinshuangqi treatment can ease the body's endotoxemia and inflammatory response,improved lumbar surgery intestinal flora after surgery,and beneficial to rebuild the intestinal microflora balance.

Objective To study the effects of serum of the Zhuartgguqiang jin tablets on the proliferation and osteogenic differentiation of bone marrow stromal stem cells (BMSCs) of aged rats.Methods The BMSCs were obtained from male SD rats of 18 months.The cell surface markers CD34,CD31,CD29 were detected by flow cytometry.The proliferation of BMSCs treated by different concentration of medicated serum (2.5％,5％,10％) at 24,48,72hours was detected by CCK-8 method.The BMSCs were divided into 4 groups,which were osteogenic induction group,the Chinese medicated osteogenic induction group,Chinese medicine group,the blank group.After the BMSCs were cultured for 7 days,alkaline phosphatase (ALP) vitality was detected.After the BMSCs were cultured for 14 days,the BMSCs were stained by alizarin red,the mRNA of ALP and osteocalcin(OC) was detected.Results The expressionof CD29 was positive,and the expression of CD31 and CD34 were negative.2.5％,5％ of the medicated serum could promote cell proliferation.The ALP vitality of osteogenic induction group[202.76 ± 15.44(U/gprot)],the Chinese medicated osteogenic induction group [240.48 ± 18.55 (U/gprot)],Chinese medicine group [178.87 ± 17.29 (U/gprot)]were significantly higher than that of blank group [111.24 ± 20.71 (U/gprot)] (t =22.50,7.985,3.535,all P ＜0.01).The ALP activity of Chinese medicated osteogenic induction group was higher than that of osteogenic induction group (t =3.103,P ＜ 0.05).The ALP gene relative OD value of osteogenic induction group (0.40 ± 0.20) and Chinese medicated osteogenic induction group (0.60 ± 0.06) were higher than the blank group (0.09 ± 0.03) (t =2.372,9.547,all P ＜0.01).The ALP gene expression of Chinese medicated osteogenic induction group was obviously higher than that of the osteogenic induction group(P ＜0.05).The OC gene relative OD value of osteogenic induction group(0.58 ± 0.09) and Chinese medicated osteogenic induction group(0.76 ± 0.11) were higher than the blank group(0.41 ± 0.02) (P ＜ 0.05,P ＜ 0.01).The OC gene expression of Chinese medicated osteogenic inductiongroup was obviously higher than that of the osteogenic induction group(t =2.673,P ＜ 0.05).Conclusion Medicated serum of Zhuangguqiangjin tablets can promote the proliferation and osteogenic differentiation of BMSCs of aged rats,which may be the mechanism of prevention senile osteoporosis.

Objective:To evaluate the effects of esketamine on myocardial injury and the relationship with nuclear factor-erythroid 2-related factor 2 (Nrf2) heme oxygenase-1 (HO-1) signaling pathway in septic rats.Methods:Thirty-two SPF healthy adult male Sprague-Dawley rats, weighing 200-230 g, were randomized into 4 groups ( n=8 each) using a random number table method: control group (group C), control plus esketamine group (group CE), sepsis group (group S) and sepsis plus esketamine group (group SE). Lipopolysaccharide (LPS) 10 mg/kg was intraperitoneally injected to establish the sepsis model.At 30 min after LPS or normal saline intraperitoneal injection, esketamine 10 mg/kg was intraperitoneally injected, and administration was repeated 12 h later in group SE and group CE.At 24 h after LPS injection, left ventricular ejection fraction (LVEF) was measured (using echocardiography), and serum cardiac troponin I (cTnI), brain natriuretic peptide (BNP), lactate dehydrogenase (LDH), creatine kinase-MB (CK-MB), tumor necrosis factor alpha (TNF-α) and high mobility group box-1 (HMGB1) concentrations were determined (by enzyme linked immunosorbent assay). Myocardial tissues were obtained for examination of pathological changes (by hematoxylin-eosin staining) and for determination of expression of Nrf2, HO-1 and transcription factor Bach 1 (BTB-CNC allogeneic 1). Results:Compared with group C, LVEF was significantly decreased, concentrations of cTnI, BNP, LDH, CK-MB, TNF-α and HMGB1 in serum were increased, expression of Nrf2 and HO-1 was down-regulated, and expression of Bach 1 was up-regulated ( P<0.05), and the significant pathological changes of myocardial tissues were found in S and SE groups.No significant change was found in the parameters mentioned above in group CE ( P>0.05). Compared with group S, LVEF was significantly increased, concentrations of cTnI, BNP, LDH, CK-MB, TNF-α and HMGB1 in serum were decreased, expression of Nrf2 and HO-1 was up-regulated, and expression of Bach 1 was down-regulated ( P<0.05), and the pathological changes of myocardium were significantly attenuated in group SE. Conclusion:Esketamine can reduce myocardial injury, and the mechanism may be related to activating Nrf2/HO-1 signaling pathway in septic rats.