【Objective】 To establish an enzyme-linked immunosorbent assay (ELISA) method for the determination of residual human coagulation factor Ⅺ in human prothrombin complex and validate the method. 【Methods】 Human factor Ⅺ was reacted with the capture antibody coated on the microtiter plate. After appropriate washing steps, biotinylated primary antibody was bound to the captured protein. Excess primary antibody was washed away and bound antibody was reacted with horseradish peroxidase conjugated streptavidin. TMB substrate was used for color development at 450 nm. The dilution reliability, accuracy, specificity, repeatability, intermediate precision, linearity, range and durability were verified. 【Results】 The verification results showed that the accuracy and specificity of this method met the experimental requirements, with an average recovery rate of 109.2% and RSD of 6.93%. The repeatability RSD was 6.78%, and the intermediate precision RSD was 6.75%, indicating good precision. The linear regression correlation coefficient of standard curve was 0.999 9, showing good accuracy and precision within the linear range. The durability was verified by the incubation time and the validity period of reagent kit opening. The results showed that the RSD of the incubation time change was 6.62%, indicating that the incubation time of this detection method was controlled between 28 to 32 minutes, and there was no significant impact on the results. The RSD of the detection results before and after the reagent kit was opened and stored under conditions for 7 days was 3.84%, indicating that the preservation of the reagent kit according to the conditions for 7 days after opening has no effect on the FⅪ detection results. Both indicated that the method had good durability. The dilution reliability results showed that there was a "hook" effect in the detection of FⅪ residue in human prothrombin complex, which could be solved by diluting 100 to 200 times. 【Conclusion】 This method can be used for the determination of FⅪ residues of human prothrombin complex in laboratory.

Objective:To investigate the risk factors for tumor recurrence after radical resection of stage Ⅱ-Ⅲ colon cancer, and application value of a nomogram prediction model.Methods:The retrospective case-control study was conducted. The clinicopathological data of 228 patients with stage Ⅱ-Ⅲ colon cancer who underwent radical resection in the First Affiliated Hospital of Xi′an Jiaotong University from January 2013 to June 2016 were collected. There were 118 males and 110 females, aged from 25 to 87 years, with a median age of 62 years. All patients underwent open or laparoscopic-assisted radical resection of colon cancer. Observation indicators: (1) postoperative tumor recurrence; (2) risk factors analysis for tumor recurrence after radical resection of stage Ⅱ-Ⅲ colon cancer; (3) development and evaluation of a nomogram prediction model for tumor recurrence after radical resection of stage Ⅱ-Ⅲ colon cancer. Follow-up using outpatient examination and telephone interview was performed to detect postoperative 3-year tumor recurrence up to June 2019. Measurement data with skewed distribution were represented as M (range). Count data were described as absolute numbers, and comparison between groups was analyzed using the Pearson chi-square test or Fisher exact probability. Multivariate analysis was performed using Logistic stepwise regression analysis. The independent risk factors were included into R 3.6.1 software to construct a nomogram prediction model. The receiver operating characteristic curve (ROC) was drawed, and the area under curve (AUC) was used to evaluate discrimination of the nomogram prediction model. The calibration chart with R software was used to evaluate consistency of the nomogram prediction model. Results:(1)Postoperative tumor recurrence: 53 of 228 patients had postoperative tumor recurrence including 19 cases with locoregional recurrence and 34 cases with distant metastasis. Of the 34 patients with distant metastasis, there were 14 cases with liver metastasis, 7 cases with lung metastasis, 4 cases with brain metastasis, and 9 cases with multiple metastasis or isolated metastasis in other sites. The time to recurrence was 12 months (range, 6-19 months). (2) Risk factors analysis for tumor recurrence after radical resection of stage Ⅱ-Ⅲ colon cancer:results of univariate analysis showed that bowel obstruction, preoperative carcinoembryonic antigen (CEA) level, ascites, vascular invasion were related factors for tumor recurrence after radical resection of stage Ⅱ-Ⅲ colon cancer ( χ2=4.463, 13.622, 10.914, 5.911, P<0.05). Pathological N stage was also a related factor for tumor recurrence after radical resection of stage Ⅱ-Ⅲ colon cancer ( P<0.05). Results of multivariate analysis showed that preoperative CEA level >5 μg/L, ascites, vascular invasion and pathological N stage as stage N1 or N2 were independent risk factors for tumor recurrence after radical resection of stage Ⅱ-Ⅲ colon cancer ( odds ratio=3.129, 3.071, 7.634, 3.439, 15.467, 95% confidence interval as 1.328-7.373, 1.047-9.007, 1.103-52.824, 1.422-8.319, 3.498-68.397, P<0.05). (3) Development and evaluation of a nomogram prediction model for tumor recurrence after radical resection of stage Ⅱ-Ⅲ colon cancer: based on preoperative CEA level, ascites, vascular invasion and pathological N stage of multivariate analysis, a nomogram prediction model for tumor recurrence after radical resection of stage Ⅱ-Ⅲ colon cancer was developed using R 3.6.1 software. The nomogram score was 41.7 for preoperative CEA level >5 μg/L, 41.0 for ascites, 74.2 for vascular invasion, 45.1 and 100.0 for pathological N stage as stage N1 and N2, respectively. The total of different scores for risk factors corresponded to the probability of postoperative recurrence. The ROC of nomogram for recurrence after radical resection of stage Ⅱ-Ⅲ colon cancer was drawed,with the AUC of 0.805(95% confidence interval as 0.737-0.873, P<0.05). The calibration chart showed a good consistency between the probability of recurrence after radical resection of stage Ⅱ-Ⅲ colon cancer predicted by nomogram and the actual probability of postoperative recurrence. Conclusions:Preoperative CEA level >5 μg/L, ascites, vascular invasion and pathological N stage as stage N1 or N2 are independent risk factors for tumor recurrence after radical resection of stage Ⅱ-Ⅲ colon cancer. The nomogram prediction model contributes to prediction of the recurrent risks after radical resection of stage Ⅱ-Ⅲ colon cancer.

Objective To evaluate the role of spinal cord tumor necrosis factor receptor-associated factor 6 (TRAF6)/nuclear factor kappa B (NF-κB)signaling pathway in the development of diabetic neuropathic pain (DNP)in rats.Methods Clean-grade healthy adult male Sprague-Dawley rats,aged 2 months,weighing 180-230 g,in which IT catheters were implanted,were used in this study.Streptozotocin 60 mg/kg was intraperitoneally injected after IT catheterization to establish the model of DNP.Twelve DNP rats were divided into 2 groups (n =6 each) by a random number table method:DNP group and DNP plus TRAF6 inhibitor group (group DTR).Another 6 age-matched Sprague-Dawley rats were used as normal control group (group NC).The rats in group DC and group DTR received IT injection of dimethyl sulfoxide 10 μl and TRAF6 inhibition 10 μg,respectively,once a day for 7 consecutive days starting from day 21 after establishing the model.The mechanical paw withdrawal threshold (MWT) was determined before establishing the model (T1),on 7,14 and 21 days after establishing the model (T2-4),and on 1,4 and 7 days after IT injection (T5-7).The rats were sacrificed after the last MWT measurement,and the L3-5 segments of the spinal cord were removed for determination of the expression of TRAF6 and NFκB p65 by Western blot.Results Compared with group NC,the MWT at T3-7 in group DC and at T3-6 in group DTR was significantly decreased,and the expression of spinal TRAF6 and NF-κB p65 was up-regulated in DC and DTR groups (P＜0.05).Compared with group DC,the MWT was significantly increased at T6-7,and the expression of spinal TRAF6 and NF-κB p65 was down-regulated in group DTR (P ＜ 0.05).Conclusion Spinal cord TRAF6/NF-κB signaling pathway is involved in the development of DNP in rats.

Objective: To make a preliminary assessment on the immunogenicity of a quadrivalence recombinant human papillomavirus (HPV) vaccine (6, 11, 16 and 18 types) (Hansenulapolymorpha) in healthy women aged 18-45 years in phaseⅠclinical study. Methods: It was a single-center, double-blind, randomized, placebo-controlled phaseⅠ clinical study. Women aged 18-45 years were randomized (2∶1) to receive HPV vaccine (n=60) or placebo control (n=30) at months 0, 2 and 6. Antibodies against HPV6/11/16/18 were detected by pseudovirus-based neutralisation assay in serum samples collected at 0 d, 180 d and 210 d. Seroconversion rates and geometric mean titres (GMT) of antibodies against the four types of antigens were calculated. Results: Seroconversion rates of the vaccination group at 180 d (before the third dose) and 210 d (one month after the third dose) were generally similar and between 85%-100% for all types of antibodies. The GMT of antibodies at one month after the last dose improved significantly compared with those before immunization. Conclusions These results showed that the HPV vaccine had good immunogenicity in the population of healthy women aged 18-45 years. Higher antibody titers were elicited by the vaccine compare with the tites before the first dose and in the placebo control group.

Objective: To investigate the effects of micronutrient supplementation for the elderly on plasma homocysteine level and cognitive function in institutional older adults. Methods: A total of 98 older adults with the score≤11 by mini nutritional assessment short-form aged 65-100 years were enrolled and assigned to either intervention group or control group (n=49 each), with either a package of micronutrient pack or placebo daily, for three months. Fasting blood samples were collected both at baseline and the end of study to detect serum vitamin B₁₂, folate and plasma homocysteine (Hcy) concentrations. Global cognitive function was assessed using the mini-mental state examination (MMSE). The paired t test was used to compare the continuous variables between the two groups after intervention. The relationship between changes in MMSE score and changes in plasma Hcy concentrations was examined by least-squares linear regression. Results: Eighty-two patients completed the study, and 17 patients withdrew from the study due to diarrhea and hospital discharge with the drop rate of 17.3%. Compared to the control group, concentrations of serum vitamin B₁₂ (128.8±34.8 vs 13.3±16.0 pmol/L, P=0.003) and folate (21.1±1.6 vs 0.6±0.5 nmol/L, P<0.01) significantly increased in the intervention group over 3-month supplementation, while plasma Hcy levels were remarkably reduced (-5.3±0.7 vs 1.7±0.3 μmol/L, P<0.01). The incidences of deficiency of folate, deficiency of serum vitamin B₁₂and high Hcy all decreased in intervention group. Although individual item scores in MMSE were not changed markedly, change of total MMSE score in intervention group were higher than that in the control group (1.2±3.0 vs -0.2±2.5, P<0.05). Conclusions The supplementation of the micronutrient pack in long-term care facilities can reduce the incidence of hyperhomocysteinemia, and improve the total MMSE score.

Objective To evaluate Chinese nurses' perception of the nursing work environment and to compare the differences among the eight economic regions in mainland China.Thus,policy-makers and nursing managers can optimize and coordinate resources based on the results of this study.Methods Chinese version of Nursing Working Environment Scale was used in the study.A total of 19,000 nurses from 31 provinces and municipalities in mainland China were investigated.Descriptive analysis,cluster analysis and nuclear density estimation were conducted.Results The average score of the nursing work environment was 4.1 points,which means nurses were somewhat satisfied with their work conditions.Specifically,nurses were most dissatisfied with the basic safeguard dimension (3.4 points),followed by sufficient manpower (3.9 points),career development (4.0) and leadership and management(4.0)dimensions.In addition,the eight economic regions could be divided into three categories(P＜0.01)according to the differences of the nursing work environment.The first category included the northeast,northern coastal and middle reaches of the Yellow River economic zone;the second category included eastern coastal economic zone;and the third category included the southern coast,the middle reaches of the Yangtze River,southwest and northwest economic zone.Conclusion The development of the nursing work environment in the vast majority of mainland China is unbalanced and the regional differences are obvious.

Objective To investigate the relationship between lipid fluctuations of daily diet and insulin resistance in patients with type 2 diabetes mellitus(T2DM) with normal fasting lipid profile. Methods One hundred and ninety?eight cases patients with T2DM who were treated in the Endocrinology Department of the General Hospital of Benxi Iron and Steel Group Corporation from October 2012 to September 2014 were selected. Patients were divided into three groups according to fasting and postprandial 4 h triglyceride( TG4 h)
level,the group with normal fasting TG and normal TG4 h with 38 cases,the group with normal fasting TG and rising TG4 h with 78 cases,the group with rising fasting TG and rising TG4 h with 82 cases. The control group was composed of healthy volunteers with 20 cases. The patients followed daily diet habits to eat,blood glucose, insulin and lipid level of fasting and 2 h,4 h after lunch were monitored. Homeostasis model insulin resistance index( HOMA?IR) was used as an index to evaluate insulin resistance,and the correlation analysis was carried out with fasting and dietary intake of postprandial lipid metabolism. Results (1)HbA1c,FPG,HOMA?IR,TG and insulin level in the patients of the group with normal fasting TG and normal TG4 h,the group with normal fasting TG and rising TG4 h,the group with rising fasting TG and rising TG4 h were higher than the control group (HbA1c:(8. 4±1. 9)%,(8. 2±2. 4)%,(7. 8±1. 8)% vs. (4. 3±0. 6)%);FPG:(8. 98±1. 93) mmol/L, (8. 62±1. 33) mmol/L,(8. 28±1. 26) mmol/L vs. (4. 82±0. 63) mmol/L;,HOMA?IR:11. 07±0. 11,6. 98 ±0. 08,3. 83±0. 09 vs. 1. 24±0. 16;TG:0 h TG:(2. 35±1. 85) mmol/L,(1. 60±0. 41) mmol/L,(1. 58±0. 46) mmol/L vs. (0. 82±0. 25) mmol/L;2 h TG:(3. 97±2. 96) mmol/L,(2. 98±1. 49) mmol/L,(1. 83±0. 62) mmol/L vs. (1. 22±0. 31) mmol/L;4 h TG:(4. 24±1. 57) mmol/L,(3. 15±1. 63) mmol/L,(1. 92±0. 53) mmol/L vs. (1. 16±0. 24) mmol/L;insulin(0 h insulin:(26. 51±3. 65) mU/L,(18. 18±6. 24) mU/L,(10. 31 ±2. 38) mU/L vs. (5. 87±1. 62) mU/L;2 h insulin:(59. 15±8. 34) mU/L,(43. 75±9. 83) mU/L,(34. 27 ±1. 61) mU/L vs. (25. 24±1. 98) mU/L;4 h insulin:(51. 22±6. 79) mU/L,(40. 06±7. 51) mU/L,(31. 06 ±1.77) mU/L vs. (13.36±1.37) mU/L;P<0.05). (2)WHR(0.90±0.08 vs.0.72±0.06),HOMA?IR, insulin level of fasting and 2 h,4 h after lunch,TG of 2 h,4 h after lunch in the group with normal fasting TG and rising TG4 h were higher than the group with normal fasting TG and normal TG4 h ( P<0. 05 ) . ( 3 ) BMI ((27. 3±3. 3) kg/m2 vs. (23. 1±1. 5) kg/m2),WHR(0. 96±0. 10 vs. 0. 72±0. 06),HOMA?IR,TG and insulin level of fasting and 2 h,4 h after lunch in the group with rising fasting TG and rising TG4 h were higher than the group with normal fasting TG and normal TG4 h( P<0. 05) . HOMA?IR,TG and insulin level of fasting and 2 h, 4 h after lunch in the group with rising fasting TG and rising TG4 h were higher than the group with normal fasting TG and rising TG4 h( P<0. 05) . ( 4) HOMA?IR was positively correlated with BMI,WHR,and fasting TG levels in the groups with diabetes(r=0. 297,0. 376,0. 326,P<0. 05). HOMA?IR was significantly positively correlated with TG of 2 h,4 h after lunch in the groups with diabetes( r=0. 529,0. 693,P<0. 05) . HOMA?IR was significantly positively correlated with BMI and WHR in the control group(r=0. 617,0. 728,P <0. 05). HOMA?IR was not significantly correlated with fasting and postprandial TG in the control group. Conclusion Postprandial lipid metabolism disorder after daily diet is in some of patients with T2DM with normal fasting lipid profile. Postprandial lipid metabolism disorder after daily diet is significantly positively correlated with insulin resistance in patients with T2DM. Insulin resistance may be one of the pathogenesis of postprandial dyslipidemia in patients with type 2 diabetes.

BACKGROUND:Moxibustion products produced in moxibustion, such as moxa smoke, are one of hotspots in moxibustion research. Metabonomics can be used to more comprehensively and systematicaly study the effects of moxibustion products on the body.
OBJECTIVE:To investigate the efect of diferent concentrations of moxibustion products on urine metabonomics of rats.
METHODS:Forty Sprague-Dawley rats were randomly divided into normal control group, low-dose moxibustion products group, middle-dose moxibustion products group, high-dose moxibustion products group, high-dose moxibustion products recovery group. In the latter four groups, rats from each group were exposed to the mixture of moxibustion products and pure gas at ratios of 0.4:2.0, 0.8:2.0, 1.6:2.0, 1.6:2.0, respectively, 4 hours daily, 5 days weekly, totaly for 60 days. After 60-day high-dose moxibustion products stimulation, rats in the high-dose moxibustion products recovery group were raised in normal air for 21 days. Rats in the normal control group were raised in normal air for 60 days without any moxibustion products. Then we analyzed the changes of urine metabonomics in al group rats.
RESULTS AND CONCLUSION: Totaly 108 metabolites were identified in the urine of rats using gas chromatography/time-of-flight mass spectrometry, and 64 metabolites were verified by standard library. There were some positive correlations between changes of typical metabolites and moxibustion product concentrations. The metabolites in the urine were most different between the high-dose moxibustion products group and normal control group. Twenty-two differential metabolites, such as glucuronic acid and vitamin C were mainly involved in 15 sugar and amino acid metabolic pathways, such as ascorbate and aldarate metabolism. These findings indicated that energy metabolism, detoxification and anoxidation increased in rats stimulated by moxibustion products.

Objective To analyze the risk factors of nosocomial infection in patients with postpartum hemorrhage and the distribution of common pathogens, and to provide basis for reducing the infection incidence in patients with postpartum hemorrhage.Methods 134 patients with postpartum hemorrhage admitted from Jan. 2011 to Dec.2013 in our hospital were studied.The incidence of infection was observed in patients, and clinical data of patients were analyzed by univariate and multivariate Logistic regression.The risk factors of infection were was observed and blood samples from infected patients were analyzed to observe the distribution of common patho-gens.Results Among the 134 cases, 42 cases had puerperal infection, accounting for 31.34%, and 4 cases had obstetric wound infection, accounting for 2.99%.Univariate analysis showed that advanced maternal age, high-risk pregnant women, midwifery or cesarean section, invasive treatment, and long hospital stay were risk factors for infection.Logistic regression analysis showed that high-risk pregnant women, midwifery or cesarean section, invasive treatment, and long hospital stay were independent risk factors for infection.52 pathogens were detected from 46 patients.28 Gram-positive bacteria were identified, of which 15 cases of were staphylococcus aureus, accounting for 28.85%and 22 Gram-negative bacteria were identified, of which 11 were escherichia co-li, accounting for 21.15%.Conclusions Gram-positive bacteria are the majority in patients with postpartum hemorrhage and infection.High-risk pregnant women, midwifery or cesarean section, invasive treatment, and long hospital stay are independent risk factors for infection.Puerperal infection also need to be noted when post-partum hemorrhage occurs.

Objective To investigate the relationship between family burden and support for maintenance hemodialysis ( MHD) patients. Methods Family APGAR index scale ( APGAR scale) and disease family burden scale ( FBS) were used to investigate among 126 MHD patients ( selected by convenient sampling method) from July 2012 to December 2013 in one Beijing level three class A hospital. Results The score of family burden was (36. 01 ± 7. 52) presented at 3 aspects of family economic burden, family daily life and family entertainment activities. The total score of family support was (7. 71 ± 3. 01), in which the good family function was 92 cases (73. 1%), family slightly obstacles 14 cases (11. 1%), and family serious obstacles 20 cases (15. 8%). The burden score of family having MHD patients had negative correlation with the score of family support (r= -0. 426, P<0. 05). Conclusions MHD patients′family support has significant influence on family burden. Therefore, the nursing staffs should strengthen the concept of holistic nursing care, pay more attention to the patients′family burden as well as nursing care, so as to perfect the family function, enhance the family support and comprehensively enhance the quality of care for patients.