Objective To establish a high-throughput screening system to obtain key Staphylococcus aureus (S.aureus)secretory proteins which required for S.aureus survival in macrophages.Methods Based on our validated eukaryotic expression vector library of S.aureus secretory proteins,DNA transfection was used to obtain an RAW264.7 macrophage array expressing S.aureus secretory proteins.After the RAW264.7 cells were infected with S.aureus,the extracellular bacteria were removed to observe the intracellular surviving situation of S.aureus.Finally,the screening results were validated by the overexpression and knockout S.aureus of corresponding secretory proteins.Results The optimal transfection dose (1.0 μg/well)of plasmids for RAW264.7,multiplicity of infection (MOI,1 .0 ),and infection time (4 h after removing extracellular bacteria of S.aureus ) were established respectively.To validate the screening results,the corresponding overexpression and knockout strains were constructed.And hypothetical protein and Serine protease E were found to promote the survival of intracellular S.aureus.Conclusion We successfully construct a screening system for key secreted secretory proteins which required for S.aureus surviving in macrophages,which may advance the study of the intracellular surviving mechanism of S.aureus.

Objective To explore the mechanism which drives nimbolide(NIM)in treating acute pneumonia caused by Staphylococcus aureus(S.auteus).Methods A mouse model of acute pneumonia caused by S.auteus was constructed through endotracheal intubation.After NIM treatment,the survival rate was observed,the amount of bacteria in the lung was tested by plate culture,and the expression of inflammatory cytokines in the lung tissues was detected with ELISA.After primary cultured peritoneal macrophages(PM)were infected with S.auteus,the effect of NIM on the expression of inflammatory cytokines and activation of inflammatory pathway were studied with ELISA and Western blotting,respectively.The effect of RNF114 knockdown by lentiviral shRNA infection on inflammation responses in PM was explored with ELISA and Western blotting.Results Acute infection of S.auteus in the lung could cause acute death in the mice,while NIM treatment significantly improved the survival rate and down-regulated the levels of inflammatory cytokines in the lung.However,it had no effect on the lung colonization of S.auteus in the short term.The results of in vitro experiments indicated that NIM may regulate RNF114 function to down-regulate the phosphorylation level of ERK,inhibit the activation of MAPK pathway,and thus suppress the expression of inflammatory cytokines.Conclusion NIM may inhibit the activation of MAPK pathway by regulating the function of RNF114,and thus suppress the expression of inflammatory cytokines in the lung,and finally inhibit the death of mice with acute pulmonary hyperinflammation caused by S.auteus.

To summarize the nursing experience of a patient with schizophrenia complicated by severe neurodeptic malignant syndrome.Nursing points include:to emphasize monitoring of antipsychotic medications to detect the onset of neurodeptic malignant syndrome as early as possible;to leverage the multidisciplinary team for rapid initiation of acute phase management interventions;to combine multimodal cooling to help rewarm the patient;to implement the stepwise intervention program to promote recovery of bowel function;to emphasize family supportive therapy to restore social functioning;to continue case management by developing a multidisciplinary follow-up plan.After careful management and care by the multidisciplinary team,the patient was successfully discharged from the hospital after a total stay of 47 days.After 3 months of follow-up,the patient's daily life was basically back to normal.

Objective To discussion the effect of endoscopic single nostril transsphenoidal pituitary tumor resection on improving clini-cal symptoms and related quality of life of patients. Methods Selected 114 cases of patients with pituitary tumors in our hospital from August 2013 to August 2015, and randomly divided them into the nasal endoscopic group and the microscopic group according to the random number table,with 57 patients in each group. Patients of the 2 groups were treated with nasal endoscopic and microscopic single nostril transsphenoi-dal pituitary tumor resection respectively. The operation situation,hormone decline,incidence of complications after surgery and SNOT-20 and VAS score of the two groups were compared. Results Operative time of nasal endoscopic group was significantly higher than that in the mi-croscopic group,whlie the blood loss,length of hospital stay in endoscopic group was significantly lower than the microscopic group,and the difference was statistically significant (P<0. 05). The total resection rate of pituitary tumor of the two groups were of no statistically signifi-cance (P>0. 05). One week after operation,cerebrospinal fluid cell count,cerebrospinal fluid protein,adrenocorticotropic hormone,serum chloride,sodium, growth hormone,and prolactin levels of the nasal endoscopic group were lower than the microscopic group (P<0. 05). The complication rate was 14. 9% in the nasal endoscopic group,which was obviously lower than 59. 6% in the microscopic group (P<0. 05). One week after operation,the SNOT-20 scores and VAS scores were increased in both of the two groups,but the microscopic group increased more significantly (P<0. 05). Conclusion Endoscopic single nostril transsphenoidal pituitary tumor resection surgery cost longer operation time,but it lead to less trauma and less postoperative complications,which may delay the decline of patients’ quality of life and promote the improvement of prognosis.

Objective To discuss the efficacy and safety of endoscopic endonasal transsphenoidal surgery for sympatomatic Rathke' s cleft cysts.Methods The clinical manifestations, imaging features, surgical methods, pathology features, postoperative complications, postoperative recurrence and outcomes of 24 patients with Rathke's cleft cysts, admitted to our hospital from January 2007 to December 2014, were reviewed retrospectively.Results Total resection was achieved in 0 patient and subtotal resection was achieved in 24 patients.In the 16 patients with headache, 4 got relief and 12 achieved cure.In the 9 patients with hypopsia, 3 recovered to normal, 5 got improvement and one enjoyed no obvious changes.In the 21 patients with endocrine function disorder, 2 recovered to normal, 2 got improvement and one had transient diabetes insipidus.One patient appeared transient diabetes insipidus.Nine patients had transient decreased thyroid hormones, and those patients with progesterone, follicle stimulating hormone, luteinizing hormone, growth hormone and prolactin disorders recovered to normal;one patient got postoperative recurrence and accepted surgery for the second time.Conclusion Endoscopic endonasal transsphenoidal surgery is a rational choice for sympatomatic Rathke' s cleft cysts, which can effectively perform the cyst drainage and resection of the capsule wall, enjoying small trauma, safety and low postoperative recurrence rate.

Objective To study the application effect of weekly dose of docetaxel combined with cisplatin and concurrent radiotherapy in the downstaging treatment of patients with esophageal carcinoma at at stage of ⅢA andⅢB.Methods 90 patients with locally advanced esophageal squamous cell carcinoma were the research object ,and they were divided into control group (PF group)45 cases and observation group (DP group)45 cases by using random number table method , then the clinical effect , adverse reaction rates and serum tumor markers before and after the treatment of two groups were analyzed ,and the analysis results were compared .Results The clinical effect of obser-vation group(64.44%)was better than those of control group (46.67%)(χ2 =3.97,P<0.05),and the serum tumor markers were lower than those of control group (t=4.11,3.84,3.29,all P<0.05),there were all significant differ-ences,while the various adverse reaction rates of two groups had no significant differences (all P>0.05).Conclusion The application effect of weekly dose of docetaxel combined with cisplatin and concurrent radiotherapy in the down -staging treatment of patients with esophageal carcinoma at at stage of ⅢA andⅢB is better ,and the safety is worth af-firmation.

Objective To investigate pulmonary heart disease acute exacerbation of changes in the characteristics of thyroid function and significance. Methods Pulmonary heart disease with acute exacerbation of 200 cases as the observation group,in the same period 200 cases of healthyas control group, observation euthyroid sick syndrome (euthyroid sick syndrome, ESS) occurred, compared the observe and control groups, observer group in the survival group died with the group,ESS thyroid hormone treatment before and after the test results,ESS and death. Results Pulmonary heart disease with acute exacerbation of ESS incidence of 42. 5% (85/200) ;section observe the admission T3 ,FT3 lower than the control group;observer group in the survival group died and TSH group no significant difference,the group died T3 ,FT3 ,T4 ,FT4 were lower than the survival group( P＜0. 05 ) ;improvement in the treatment of primary disease, thyroid hormone, or return to near normal ; ESS mortality occurred in 30. 59% higher than a change of 13.04% mortality rate. Conclusion Serum thyroid hormone levels to reflect changes in the pulmonary heart disease in patients with acute exacerbation of the state of the body and severity of the dynamic serum levels of thyroid hormone can observe the development of pulmonary heart disease and prognosis.

OBJECTIVE:To observe the therapeutic effect of Shenfu Injection in combination of rougui for oxaliplatin-induced neurotoxicity.METHODS:A total of 73 cases with malignant tumor were randomly divided into control group and treatment group:the control group was treated with chemotherapy alone,in which oxaliplatin was included;the treatment group was treated intravenously with Shenfu Injection 40～60ml for 7～10d plus orally with 3g Rougui decoction prior to chemothera_py.RESULTS:Incidences of neurotoxicity for the treatment group and the control group were 13.5% and 55.6%,respectively.Significant differences were noted between 2 groups(P