Due to low autoimmune function, imperfect development of various organs, coupled with a variety of invasive operations and other factors, premature infants are high-risk groups of invasive fungal infection.Invasive candida infection in premature infants accounts for more than 80% of invasive fungal infection. The main infection rate of invasive candida albicans was candida albicans. However, in recent years, the infection rate of non-candida albicans such as candida albicans, tropical candida, smooth candida and other non-candida albicans showed a gradual upward trend.In addition to blood culture, the latest diagnostic methods such as plasma (1-3)-β-D-glucan test and candida polymerase chain reaction are helpful for the diagnosis of invasive fungal infection. At the same time, attention should also be paid to prophylactic antifungal therapy and empirical antifungal therapy in premature infants.

Objective:To investigate the role of epidermal growth factor receptor (EGFR)in the regulation of B[a]P-induced silent information regulator 1 (SIRT1 ) activation in the human bronchial epithelial cells (BEAS-2B),and to clarify the relationship between EGFR/SIRT1 signal transduction pathway and the occurrence and development lung cancer.Methods:The prediction analysis of transcriptional factor binding sites of SIRT1 was performed by MOTIF SearchTM software.The primary cultivated BEAS-2B cells were divided into control group (without B[a]P exposure)and B[a]P groups (the cells were exposed to B[a]P for 6,12,24,48 h).RT-PCR and Western blotting method were carried out to detect the EGFR mRNA and protein expression levels.The BEAS-2B cells transfected with SIRT1 promotor luciferase reporter gene plasmid were treated with human epidermal growth factor (hEGF)and Genistein (tyrosine protein kinase inhibitor)for 24 h,the morphology of BEAS-2B cells was observed by inverted microscope, and luciferase reporter assay was used to test the SIRT1 transcriptional activity.The human lung tissue biopsies were acquired and the immunohistochemical analysis was used to determine the EGFR protein expression level.Results:The transcriptional factor binding sites of SIRT1 contained EGF, 2Fe-2S and vWF.Compared with control group,the expression levels of EGFR mRNA in B [a]P groups were increased in a time-dependent manner,and reached the peak at 12 h (P < 0.05);the EGFR protein expression levels were also increased (P <0.05).The SIRT1 luciferase activity in hEGF group was increased compared with control group (P <0.05);when hEGF and B[a]P worked together,the SIRT1 luciferase activity was increased even further (P <0.001). The cells showed arrangement and morphologic changes gradually when the B[a]P concentration was above 30 μmol · L-1. Genistein (30 μmol · L-1 )inhibited the increase of SIRT1 luciferase activity induced by B [a]P ,and there was significant difference compared with control group (P <0.05).The immunohistochemistry results showed that EGFR expression level in lung cancer tissue was higher than that in normal lung tissue (P < 0.001).Conclusion:EGFR can regulate the B [a]P-induced SIRT1 expression in BEAS-2B cells,and to cause lung chronic inflammation;EGFR/SIRT1 signal transduction pathway may play a role in the occurrence and development of lung cancer.

Objective To explore the clinical effect of the radial artery perforator flap on repairing soft tissue defect after palm postoperative scar contracture. Methods Eighteen patients with palm scar contracture were selected. The palm soft tissue defect was repaired by radial artery perforator flap after the operation of scar removal and soft tissue release. The areas of soft tissue ranged from 5 cm × 3 cm to 8 cm × 5 cm. The area of donor flap exceeds 20%of the wounds area, and wounds were repaired by free skin grafting. Six months after operation, the hand function was compared with that before operation. Results All the patients were followed up for 6-15 months (mean 10.8 months), all flaps survived with good shape, and flap donor site wounds were healed by skin grafting. The patients were evaluated 6 months after operation according to the Chinese Medical Hand Surgery Society of upper part of functional assessment criteria: excellent in 11 cases, good in 5 cases and general in 2 cases, but preoperative functional evaluation was excellent 0 case, good in 3 cases, general in 7 cases and poor in 8 cases. Compared with that before operation, the postoperative function was significantly improved. Conclusions It is a commendable approach of repairing soft tissue defect after postoperative palm scar contracture by radial artery perforator flap, because it can provide reliable blood supply, and significantly improve hand function with exactly clinical effect.

Objective:To explore the effects of medical support program on local diagnosis,treatment and prognosis of acute myocardial infarction(AMI).Methods:Department of Cardiology,Zhongshan Hospital,Fudan University launched medical support program for Fuyuan People′s Hospital in Mar 2010.A total of 103 AMI patients admitted to Fuyuan People′s Hospital during Mar 2010 and Apr 2014 were enrolled.And 5 1 patients admitted during Mar 2010 and Nov 2012 were allocated to group A,while 52 patients admitted during Dec 2012 and Apr 2014 were allocated to group B.The treatment strategy,hospital stay, medication and prognosis were compared between the two groups.Results:Among the 103 AMI patients,male smoking pro-portion was significantly higher than female one(P <0.05).Only 21 patients with ST segment elevation myocardial infarction (STEMI)arrived hospital within 12 h.The thrombolytic therapy rate of patients with STEMI in group B was higher than that in group A(P <0.05).The usage rate of adenosine diphosphate(ADP)receptor antagonist(clopidegrel)during hospitalization in group B was higher than that in group A (P <0.05 ).Only 57 patients were followed up.And only 1/3 of these patients re-ceived consecutive coronary angiography and percutaneous coronary intervention(PCI).After discharge from hospital,the pre-scription rates of ADP receptor antagonist,β-receptor blockers and angiotension converting enzyme inhibitor (ACEI)all de-creased obviously and there was no significant difference between the two groups(P >0.05).There was no significant difference regarding the incidence rates of endpoint events between the two groups(P >0.05).Conclusions:Medical support program im-proves the rates of diagnosis and standardized treatment of AMI during hospitalization.However,the delay before admission has not been shortened yet.Furthermore,there was no standardized secondary prevention and treatment after discharge.Thus,apart from improving the ability of diagnosis and treatment during hospitalization,more attention should be paid to the health education for patients and the training for primary medical staff,and enhance the regional cooperation.

Objective To construct a multi-gene recombinant pcDNA3-HBsAg-p30-ROP2 expression vector and identify it preliminarily. Methods According to recombinant pcDNA3-p30-ROP2 restriction sites,HBV HBsAg gene sequences of primers were designed and synthesized to amplify target fragment,and then cloned into pcDNA3-HbsAg-p30-ROP2 expression vector. Af-ter sequencing,it was identified finally by restriction enzyme digestion and other molecular biology techniques. Results HBV HBsAg gene segment was amplified by PCR and the multi-gene recombinant pcDNA3-HBsAg-p30-ROP2 expression vector was constructed and identified to be correct as theoretical values. The PCR and restriction enzyme digestion results showed that HBsAg and p30-ROP2 gene in recombinant plasmid were confirmed by DNA sequencing. Conclusion The multi-gene recombinant pcD-NA3-HBsAg-p30-ROP2 expression vector is successfully constructed.

Six years' English teaching in department of obstetrics and gynecology in Wenzhou Medical College were reviewed. Language and cultural differences are the main reasons hindering teaching quality. Rational use of a variety of teachers,preparing for lessons adequately,adoption of English image data,supplying and revising English teaching materials,using network auxiliary teaching and forming ef-fective education mode are conducive to improving English teaching quality in department of obstetrics and gynecology for foreign students.

Objective To investigate the influence of vertebral artery (VA) dominance in basilar artery (BA) curvature and pontine or cerebellar infarction occurring around the vertebrobasilar junction.Methods Radiological data (infarction laterality,VA dominance,BA curvature and their directional relationships)were analyzed in 86 patients with acute unilateral pontine or posterior inferior cerebellar artery (PICA) territory infarction.Multiple Logistic regression analysis was performed to predict the moderate to severe BA curvature.Results The dominant VA frequently happened on the left side (69.8％,60/86).The BA curvature frequently happened to be right lateral flexion (74.4％,64/86).In 86 patients,71 patients had negative direction relationship between VA dominance and BA curvature.The diameter grade of VA had significant relationship with hypertension,moderate and severe BA curvature and right diameter of VA (P ＜ 0.05 or ＜ 0.01).The diameter of VA was the only independent predictor for moderate and severe BA curvature (OR =2.81,95％ CI:1.33-6.09).Conclusions VA dominance is an important predictive factor of BA curvature,and BA curvature is usually opposite to the side of VA dominance.VA dominance and BA curvature caused by VA dominance increase the incidence of vertebrobasilar junctional infarction.

Objective To investigate the expression of RECK gene in placentas of patients with preeclampsia and its correlation with MMP-2 activation,and explore the possible roles of RECK gene in the placental trophoblast invasion mechanism.Methods RT-PCR and Western blot were used to detect the expression of RECK mRNA and protein respectively in the placental tissues of normal late pregnant women (normal pregnant group,22 cases) and pre-eclamptic patients(22 mild cases and 20 severe cases).Gelatinase zymography was used to determine MMP-2 activation ratio.Results The expression levels of RECK mRNA and protein from placenta tissues in mild,severe pre-eclamptic group were both significantly higher than those in nomal pregnant group.Moreover,the expression levels of RECK mRNA and protein in severe pre-eclamptic group were obviously increased as compared with those in mild pre-eclamptic group.There was significant difference among the three groups (all P<0.01).MMP-2 activation ratio in mild,severe pre-eclamptic group was significantly lower than that in normal pregnant group.MMP-2 activation ratio in severe pre-eclamptie groups was obviously reduced as compared with mild pre-eclamptic group.There was significant difference among the three groups(all P<0.01).The expression leVels of RECK mRNA and protein were significantly negatively correlated with MMP-2 activation ratio (both P<0.01).Conclusion The abnormal high expression of RECK and inhibition of MMP-2 activation in placentas of pre-eclamptic patients may participate in the process of placental trophoblast shallow invasion.

Objective To compare the clinical effects of 3i nternal fixation devices,130?comp res-sion-plate,Richards screw-plate system and Gamma locking nail,in tre atment of intertrochanteric fractu res of femur in order to provide evidence fo r clinical choice.Methods The 3different internal fixation devices were statistically compared in terms of t heir surgery time,volume of operative bleeding,hospitalization time,postop-erative complications,as well as excellent and good rate of function in t reatment of intertrochanteric frac tures of femur.Results Compared with the other two treatmen t groups,the Gamma locking nail grou p presented the best therapeutic effects.Its posto perative complications were significantly lower and its excellent and f ine rate of function was significantly higher t han those of the other two groups.Conclusion Gamma locking nails are a kind of effective internal fixation device for the treatment of intertro chanteric fractures in elderly patients,because it has better biomechanical properties which facilitate fracture healing and recovery of hip joint function.[

Objective To study the value of three internal fixation devices (interlocking intramedullary nail, cloverleaf type intramedullary nail ,compression plate) in treatment of fractures of femural shaft. Methods All the patients were divided into three groups randomly. 32 patients were treated with the interlocking intramedullary nail , 67 patients with the cloverleaf type intramedullary nail, and 47 patients with the compression plate. Results After the three internal fixation devices were used in the fractures of femural shaft. All the patients were followed up for 6 months to 144 months. The total rates of postoperative deformity healing and delayed healing and nonunion were 3.1%, 6.0%and 10.6%respectively. The rates of the internal fixation failure were 0%, 4.5%and 17.0%respectively. The rates of excellent function recovery of lower limbs were 81.3%, 70.1%and 59.6%. Conclusions The data show that the curative effects of the interlocking intramedullary nail is better than those of the cloverleat type intramedullary nail and the plate in treatment to fracture of femural shaft.