LIN28 is an RNA binding protein with important roles in early embryo development, stem cell differentiation/reprogramming, tumorigenesis and metabolism. Previous studies have focused mainly on its role in the cytosol where it interacts with Let-7 microRNA precursors or mRNAs, and few have addressed LIN28's role within the nucleus. Here, we show that LIN28 displays dynamic temporal and spatial expression during murine embryo development. Maternal LIN28 expression drops upon exit from the 2-cell stage, and zygotic LIN28 protein is induced at the forming nucleolus during 4-cell to blastocyst stage development, to become dominantly expressed in the cytosol after implantation. In cultured pluripotent stem cells (PSCs), loss of LIN28 led to nucleolar stress and activation of a 2-cell/4-cell-like transcriptional program characterized by the expression of endogenous retrovirus genes. Mechanistically, LIN28 binds to small nucleolar RNAs and rRNA to maintain nucleolar integrity, and its loss leads to nucleolar phase separation defects, ribosomal stress and activation of P53 which in turn binds to and activates 2C transcription factor Dux. LIN28 also resides in a complex containing the nucleolar factor Nucleolin (NCL) and the transcriptional repressor TRIM28, and LIN28 loss leads to reduced occupancy of the NCL/TRIM28 complex on the Dux and rDNA loci, and thus de-repressed Dux and reduced rRNA expression. Lin28 knockout cells with nucleolar stress are more likely to assume a slowly cycling, translationally inert and anabolically inactive state, which is a part of previously unappreciated 2C-like transcriptional program. These findings elucidate novel roles for nucleolar LIN28 in PSCs, and a new mechanism linking 2C program and nucleolar functions in PSCs and early embryo development.
Animals ; Cell Differentiation ; Embryo, Mammalian/metabolism* ; Embryonic Development ; Mice ; Pluripotent Stem Cells/metabolism* ; RNA, Messenger/genetics* ; RNA, Ribosomal ; RNA-Binding Proteins/metabolism* ; Transcription Factors/metabolism* ; Zygote/metabolism*

Clostridioides difficile is a key pathogen of antibiotic related diarrhea and hospital associated infection, causing several outbreaks in Europe and North Americans and resulting in severe disease burden. However, the standardized diagnostic principle and detection specifications in C. difficile infection (CDI) survey are limited in China, and the infection rate and disease burden of CDI in China are unclear. Therefore, National Institute for Communicable Disease Control and Prevention,National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, together with another 11 institutions, draft the group standard entitled "Diagnosis of Clostridium difficile infection (T/CPMA 008-2020)" of Chinese Preventive Medicine Association. Based on the principle of "legality, scientificity, advancement, and feasibility", this standard clarifies risk factors, diagnosis principles, diagnoses and differential diagnoses in order to improve the accuracy of CDI diagnosis in clinical practice, guide the surveillance for CDI, and understand the infection rate and disease burden of CDI in China .

Objective To investigate the prevalence rate of healthcare-associated infection(HAI)in Xiangya Hospital,and provide reference for preventing and controlling HAI.Methods The cross sectional surveys on preva-lence rates of HAI,cross-sectional antimicrobial use,and bacterial detection among all hospitalized patients on the given days in 2000-2014 (except 2006)were carried out by combination of bedside investigation and medical record reviewing.Results The prevalence rates of HAI in 2000-2014 decreased from 6.30% to 3.91%,difference was statistically significant (χ2 = 35.14,P < 0.001 );prevalence rates of community-associated infection(CAI)were 15.61%-15.76%,there was no significant difference among each year.General intensive care unit (ICU)had the highest prevalence rate;respiratory tract was the most common site of both HAI and CAI;urinary catheterization rate showed a decreased tendency,arteriovenous catheterization rate showed a increased tendency,difference were both significant(χ2 = 5.21,96.24,respectively,both P <0.001).In 2008 - 2014,pathogenic detection rates for specimens from patients receiving therapeutic antimicrobial agents were 36.37%-44.51%,from patients with HAI were 34.00%-44.99%,detection rate of pathogens causing HAI were 41.57%-68.48%,all showed a increased tendency,difference was significant (χ2 = 22.78,10.03,26.49,respectively,all P < 0.001 ).Gram-negative bacteria were the main pathogens causing infection;both cross sectional and combination antimicrobial usage rates declined (P < 0.05 ).Conclusion Prevention and control of HAI,and antimicrobial management has achieved preliminary success,prevalence rate of HAI and cross sectional antimicrobial usage rate declined obviously,the main pathogen is gram-negative bacteria,and the major infection site is lower respiratory tract.

Objective To explore the direct economic loss caused by healthcare-associated infection(HAI)in general hospitals in China.Methods 68 hospitals were selected,a retrospective 1:1 matched survey was conducted to compare the direct medical cost in patients with and without HAI between January 1,2015 and December 31,2015. Results A total of 2 123 pairs of patients with and without HAI were included in the survey.The average cost of hospitalization in HAI and non-HAI groups were ￥25 845.30 and ￥12 006.14 respectively,￥13 839.16 on average was increased due to HAI.The average economic loss in provincial and ministerial levels of hospitals were￥21 409.83.The average economic loss in different regional hospitals were ￥9 725.42-￥18 909.59,and north China ranked the first.Economic loss caused by bloodstream infection and lower respiratory tract infection were more than other sites,which were ￥23 190.09 and ￥18 194.50 respectively.Conclusion HAI resulted in considerable direct economic loss.Prevention and control of HAI,especially bloodstream infection and lower respiratory tract infection should be paid more attention.

Monoclonal immunoglobulin deposition disease is rare in medical practice. The light and heavy chain deposition disease is characterized by deposition of monoclonal antibodies in the basement of membrane. Kidney is the most frequently involved organ. There was a male patient diagnosed as light and heavy chain deposition disease in department of Nephrology of the Second Xiangya Hospital, Central South University by renal biopsy. After treatment by oral prednisone, melphalan and thalidomide, the patient's proteinuria and serum creatinine decreased. The retrospective analysis of this case provides a guide for doctors to understand the light and heavy chain deposition disease. Early diagnosis and treatment could improve the prognosis.
Antibodies, Monoclonal ; adverse effects ; Basement Membrane ; physiopathology ; Biopsy ; Creatinine ; blood ; Heavy Chain Disease ; diagnosis ; drug therapy ; Humans ; Immunoglobulin Light Chains ; Kidney ; physiopathology ; Male ; Proteinuria

Objective To realize basic status of occupational exposure among medical postgraduates,and provide theoretical evidence for making occupational precaution measures.Methods Data about occupational exposure among medical postgraduates in a teaching hospital between January 2011 and December 2013 were analyzed retro-spectively.Results A total of 3 362 medical postgraduates were monitored,56 (1 .67%)sustained occupational ex-posure.The most common occupational exposure sites were left hand thumbs(n=15,26.79%),occupational expo-sure most frequently occurred during operation(n=29,51 .79%),a total of 40(71 .43%)occupational exposure oc-curred during the process of operation and invasive procedure,all were sharp injuries.46(82.14%)exposure sources were with bloodborne-transmitted diseases.Surgery students accounted for 66.07%(n =37)of students sustained occupational exposure,exposure rate in master’s candidates was higher than doctoral candidates(2.31 % vs 0.28%,χ2 =18.325,P <0.001 ).After timely treatment and preventive medication,none of the students were infected. Conclusion It is necessary to strengthen the occupational safety education for medical postgraduates,improve pre-caution awareness,standardize all kinds of procedures,and implement standard precaution;timely and effective treatment after exposure is important for reducing occupational injury among medical postgraduates.

BACKGROUNDThe objective of this study was to analyze the trend in the publication of systematic reviews on hip fractures through a bibliometric approach.

METHODSLiterature including systematic reviews or meta-analyses on hip fractures was searched from the ISI Web of Science citation database. The search results were analyzed in terms of geographical authorship and frequency of citation by country, institution, author, and periodical distribution.

RESULTSA total of 654 published systematic reviews from 1995 to 2013 in 48 countries or regions were retrieved. The United States (171) was the predominant country in terms of the number of total publications, followed by the United Kingdom (149), Canada (120), Australia (76), and China (54). The number of systematic reviews significantly increased during the last 6 years, especially in China. The production ranking changed in 2012, at which time the United States and China were the leaders in the yearly production of systematic reviews on hip fractures. The amount of literature (27 publications) from China contributed almost one-quarter of the total literature (109 publications) in 2012. However, the average number of citations of each article from China was still low (6.70), while the highest number of citations of each article was from Sweden (193.36). The references were published in 239 different journals, with 15 journals contributing to 41.3% of the systematic reviews on hip fractures. The two journals that contributed the most were Osteoporosis International (10.6%) and the Cochrane Database of Systematic Reviews (7.6%). The predominant institution in terms of the number of publications was McMaster University (36) in Canada.

CONCLUSIONSThe best evidence in the field of hip fractures has attracted increasing attention. Systematic reviews on hip fractures from China have been increasingly more frequent during the past 6 years, particularly in 2012.

Objective To investigate the current situation of healthcare-associated infection(HAI)management in grassroots medical institutes in a province.Methods Forty-six grassroots medical institutes in 13 cities of the prov-ince were selected randomly for the survey,questionnaires about the current situation of HAI management in grass-roots medical institutes were filled out,and related data were analyzed.Results Forty-four qualified questionnaires were adopted for analysis,and 2 unqualified questionnaires from public hospitals were excluded.HAI management in 44 medical institutes (100.00%)was in the charge of major leaders in medical institutes.Only 2 institutes(4.55%) set up independent HAI management departments,and 10 institutes(22.73%)established basic regulations and po-sition responsibilities of HAI management,38.67% of medical institutes established regulations of HAI prevention and control in key departments and responsibilities for key positions.The score for the establishment of basic regu-lations and position responsibilities of HAI management in village clinics was lower than the other medical institutes (F =5.762,P <0.01 ).Except aseptic technique,the core regulations of HAI management weren’t implemented well in village clinics compared with the other institutes(P <0.05).Conclusion Organizational settings,HAI man-agement of key departments,and core regulations of HAI management are not performed well in grassroots medical institutes in this province.Village clinics perform the worst in HAI management among all types of grassroots med-ical institutes.More measures,including education and surveillance,should be taken to improve HAI management in grassroots medical institutes.

ObjectiveTo disuss the effect of clinical nursing pathway on rehabilitation effect,hospitalization cost and satidaction degree of patients with acute stroke.Methods100 cases of acute cerebral stroke patients in our hospital from December 2009 to June 2010 were divided into the observation group and the contro group with 50 cases in each group.The control group was given conventional nursing,while the observation group was given clinical nursing pathway.Nursing effect was compared between two groups.ResultsNeural function defect score,daily life ability improvement hospitalization time and cost,the compliance rate of health education content,satisfaction degree with nursing quality in the observation group were significantly better than those in the control group.ConclusionsClinical nursing pathway for patients with acute stroke can shorten hospitalization time,reduce hospitalization cost and improve the rehabilitation effect.

Objective To evaluate antiangiogenic therapeutics effect with contrast-enhanced gray-scale ultrasound.Methods Kun-min mouse with subcutaneously implanted H22 mice hepatoma were treated with thalidomide or placebo by oral gavage over 7 days, starting at clay 2 post-implantation.Contrast-enhanced gray-scale ultrasound was performed on day 8.The tumor maximum cross-sectional area and non-enhanced area in ultrasound imaging were measured on the ultrasound machine.The percent of non-enhanced area from contrast-enhanced gray-scale ultrasound was calculated.Immediately after imaging, minces were euthanized and tumor tissue removed for fixation in a 10% formalin solution.The section equivalent to ultrasound imaging plane was stained with Hematoxylin and Eosin(HE) to allow for assessment of maximum cross-section area and necrotic area.The percent of necrotic area from HE stained section was calculated.Results The difference of maximum cross-sectional area measured in ultrasound and pathology slice was not significant between control and treated tumors (P >0.05).Ultrasound measurement of the tumor non-enhanced area and the percent of non-enhanced area were significantly larger in treated tumors than in control tumors (P <0.001).The necrotic area and the percent of necrotic area measured from HE stained section were also significantly larger in treated tumors than in control tumors (P < 0.001).The maximum cross-sectional area determined by the two methods was well corrected (r = 0.815, P < 0.001).There was good correlation between the non-enhanced area in contrast-enhanced gray-scale ultrasound and the necrotic area in pathology slides (r = 0.909, P <0.001).The percent of non - enhanced area calculated from ultrasound highly correlated with necrotic area estimated by pathology slides (r = 0.910, P <0.001).Conclusions Contrast-enhanced gray-scale ultrasound can detect the intratumoral necrosis and changes of tumor perfusion caused by antiangiogenic treatment before apparent change in tumor volume.