The aging trend is intensifying currently,but there is still a lack of standardized diagnosis and treat-ment schemes for severe infections in elderly people.This paper focuses on the recommendations for immune-related clinical diagnosis and treatment routes as well as the idea of risk stratified diagnosis and treatment for elderly peo-ple,aiming to effectively prevent infectious diseases in elderly people and perform stratified management through systematic and scientific means of immune function monitoring and regulation,so as to enhance the standardized level of diagnosis and treatment as well as clinical treatment effect of infection in elderly people.

The aging trend is intensifying currently,but there is still a lack of standardized diagnosis and treat-ment schemes for severe infections in elderly people.This paper focuses on the recommendations for immune-related clinical diagnosis and treatment routes as well as the idea of risk stratified diagnosis and treatment for elderly peo-ple,aiming to effectively prevent infectious diseases in elderly people and perform stratified management through systematic and scientific means of immune function monitoring and regulation,so as to enhance the standardized level of diagnosis and treatment as well as clinical treatment effect of infection in elderly people.

Chronic inflammation induced by Helicobacter pylori is considered to be one of the main causes of gastric cancer,and CagA is a main virulence factor of H.pylori.The study aimed to investigate the role and mechanism of CagA in host inflammatory response.Mass spectrometry was used to identify the interacting proteins of CagA in AGS cells.By immunoprecipitation and immunofluorescence,the interaction was validated.Pathway expression was detected by immunoblotting after knockdown by using siRNA,and mRNA levels of inflammatory cytokines were detected by quantitative PCR.CagA-induced inflammatory responses were detected in clinical samples using hemoglobin-eosin staining(H&E).Data showed that CagA interacted with SHARPIN.And CagA activated the NF-κB signaling pathway and upregulated the mRNA and protein levels of the inflammatory cytokines IL-6,IL-8,and TNF-α,as compared with the CagA knockout strain(all P<0.05).Knockdown of SHARPIN by siRNA reduced inflammation levels and partially inhibit NF-κB signaling.In clinical samples,CagA-positive samples exhibited stronger inflammatory responses.To sum up,CagA promoted the host inflammatory response,and CagA-induced inflammatory response was reduced when SHARPIN was partially inhibited,suggesting that CagA activates the NF-κB signaling pathway through binding to SHARPIN.

Objective? To explore the effects of systematic construction of clinical specialized nursing safety in pressure injury nursing of neurosurgery patients. Methods? The specialized nursing safety system was completed step by step in Beijing Tiantan Hospital, Capital Medical University on January 2018. Totally 174 neurosurgery patients hospitalized between January and October 2018 were selected and included in the observation group, while another 183 neurosurgery patients hospitalized from January to October 2017 (before the systematic construction of specialized nursing safety) was included in the control group. The percent correct in the pressure injury care safety risk scale and the incidence rate of in-hospital pressure injuries were compared between the two groups. Results? After the systematic construction of specialized nursing safety, the percent correct in the pressure injury care safety risk scale of the observation group was 96.6% (168/174), while that of the control group was 90.2% (165/183), (χ2=5.804,P＜ 0.05). The incidence rate of in-hospital pressure injuries of the observation group was 0, whereas that of the control group was 0.5% (1/183),(P＞ 0.05). Conclusions? Systematic construction of clinical specialized nursing safety system can enhance the awareness of nursing safety and improve the percent correct in pressure injury risk assessment among the nursing staff.

Objective To investigate the correlation between Helicobacter pylori (HP) infection-associated gastritis and the ap-optotic genes in gastric mucosa .Methods Forty-five patients with chronic gastritis were registrated in our study from November 2013 to December 2014 .HP infection status in the patients was detected by using urease test and 13C-urea breath test .The degree of gastritis in the gastric mucosa with HP infection was confirmed via histopathology .qRT-PCR was used to measure the mRNA ex-pressions of Bax ,Bak and Bcl-2 in the gastric mucosa with HP infection and matched normal gastric mucosa .Person analysis was used to assess the correlation between the HP infection-associated gastritis and the mRNA expressions of Bax ,Bak and Bcl-2 in the gastric mucosa .Results Forty-five patients with HP infection in antrum and 45 patients (100% ) with chronic antrum gastritis were identified ,including 28 patients (62 .2% ) with light gastritis ,16 patients (35 .6% ) with moderate gastritis ,1 patient (2 .0% ) with severe gastritis .9 patients (20 .0% )with metaplasia ,5 patients(11 .1% ) with low grade intraepithelial neoplasms .The urease tests were negative in the gastric body of 45 patients ,6 patients (13 .3% )were mild chronic gastritis in the body ;Patient with meta-plasia and intrapithelial gastritis was not found .The Bax expression in the HP-infected gastric mucosa was markedly increased when compared with the normal gastric mucosa (P< 0 .01) ,and positively correlated with the degree of gastritis (P< 0 .01) , whereas the expressions of Bak and Bcl-2 have no significantly deferences bttween two groups(P>0 .05) .Conclusion HP infec-tion-associated gastritis positively correlated with the expressions of apoptotic genes in gastric mucosa ,suggesting that HP infection might result in increasing the Bax expression and further enhancing the cell apoptosis .

Objective To isolate and purify VacA protein secreted by Helicobacter pylori or recombinant VacA , and to investigate the effect of VacA-induced cell vacuolar change and apoptosis .Methods VacA proteins were separated and pu-rified from the culture supernatant of H.pylori ( ATCC26695 ) or from the split products of genetically engineered bacteria (pQE30-VacA-E.coli M15) expressing recombinant VacA.The VacA protein obtained was acidified and then incubated with AGS cells for 24 h at different final concentrations of 5 and 10 ng/ml before the vacuolar change and apoptosis of AGS cells were detected via microscopy and flow cytometry assay , respectively .Results H.pylori-secreted VacA and recombi-nant VacA were successfully separated and purified .The H.pylori-secreted VacA significantly induced the vacuolar change and apoptosis of AGS cells (P<0.01) while the recombinant VacA did not.Conclusion H.pylori-secreted VacA protein can effectively induce cell vacuolar change and apoptosis, but recombinant VacA can not, suggesting that the purified VacA protein secreted by H.pylori can be used to explore VacA-induced pathogenesis.

Objective To investigative the relationship of personality and coping style with subjective well-being in nurses.Methods 140 nurses were invited randomly to answer the questionnaires.123 questionnaires out of 140 were selected,with 17 papers excluded because of un-complete answer.Personality,coping style and subjective well-being were respectively estimated with Eysenck Personality Questionnaire(EPQ),Simplified Coping Style Questionnaire(SCSQ) and General Well-Being Scale(GWB).The resuits were compared with the national norm.Correlation analysis was performed in term of the correlation of personality and coping style with subjective well-being.Results Subjective well-being of nurses was associated with personality and coping style.Conclusions Personality and coping style can predict subjective well-being.The research can provide theoretical basis for psychological care to the nurse group.

ObjectiveTo establish a practical and effective clinical pathway (CP) for the etiological diagnosis of acute biliary pancreatitis.MethodsA total of 2216 patients enrolled were randomly divided into control group (n =1120) and CP group (n =1096) according to different etiological diagnosis methods including following doctor's established experiences and habits and the designed CP in our study.ResultsThere was no significant difference in baseline data between the two groups.The etiology of acute pancreatitis was determined in 91.1％ (999/1096) of cases in the CP group which was significantly higher than the control group (65.5 ％,734/1120),P ＜ 0.05.The enhanced etiological determination of CP group was mainly consisted of the increased detection of biliary stones,duodenal diseases as well as pancreas divisum,P ＜ 0.05.The positive etiological determination of magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography in the CP group were 59.1％ (273/462) and 86.0％ (98/114),respectively.ConclusionsThe CP established in this study significantly enhances the biliary etiological determination of acute pancreatitis. It is easy to be conducted and may be of importance to improve the quality of etiological diagnosis of acute pancreatitis.

OBJECTIVE: To summarize our experiences on surgical saving of the cervical opening wound. METHOD: Retrospectively analyze 43 cases with cervical opening wound in department of otolaryngology, suizhou central hospital from 1992-2010. RESULT: Forty-one among 43 cases healed with no complications, 1 case died of obstruction of air way and hemorrhagic shock, and 1 case occurred secondary laryngostenosis and resulted in fine prognosis af ter treating with laryngotracheoplasty in higher hospital. CONCLUSION It is very important to give the appropriate treatment on the injuries of large cervical vessels, nerves, laryngeal cartilages, throat mucosa and complications. It is important to repair the wounds primarily. Correct diagnosis and treatment at first time, and well nursing are crucial for good prognosis.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Neck Injuries ; surgery ; therapy ; Retrospective Studies ; Treatment Outcome ; Young Adult