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Objective To evaluate the effects of leptin on brain injury and long-term cognitive function in rats undergoing orthotopic liver transplantation. Methods Ninety clean-grade male Sprague-Dawley rats, aged 3 months, weighing 200-250 g, were divided into 3 groups by a random number table method: sham operation group ( S group) , liver ischemia-reperfusion ( I∕R) group ( I∕R group) and lep-tin group ( L group) , with 18 rats in each group. Orthotopic liver transplantation was performed to estab-lish the model of liver I∕R injury in I∕R and L groups. Leptin 1 mg∕kg was intraperitoneally injected at the onset of ischemia in L group, and the equal volume of normal saline was given instead of leptin in S and I∕R groups. Twelve rats in each group were sacrificed at 3 days after operation, and brains were removed for ex-amination of the pathological changes in hippocampal CA1 region ( with a light microscope) and for determi-nation of apoptosis in hippocampal neurons ( by TUNEL assay) and expression of aquaporin 4 ( AQP4) and protein kinase C ( PKC) in the hippocampus ( by Western blot) . The apoptosis rate was calculated. The remaining 6 rats in each group underwent a Morris water maze test at 30 days after surgery to evaluate long-term cognitive function. Results Compared with S group, the apoptosis rate of hippocampal neurons was significantly increased, the expression of AQP4 and PKC was up-regulated, the escape latency was pro-longed, and the time of staying at the platform quadrant was shortened in I∕R and L groups (P<0. 05). Compared with I∕R group, the apoptosis rate of hippocampal neurons was significantly decreased, the ex-pression of AQP4 and PKC was down-regulated, the escape latency was shortened, and the time of staying at the platform quadrant was prolonged in L group (P<0. 05). Conclusion Leptin can reduce the brain damage in rats undergoing orthotopic liver transplantation, the mechanism may be related to down-regulating the expression of PKC and AQP4, and leptin can also improve long-term cognitive function after orthotopic liver transplantation in rats.

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Objective To investigate the effect of dexmedetomidine (DEX) on brain injury and long-term cognitive dysfunction in rats after orthotopic liver transplantation ischemia/reperfusion and its mechanism. Methods Fifty-four male Sprague-Dawley (SD) rats were randomly divided into sham-operated group (n=18), orthotopic liver transplantation ischemia/reperfusion group (I/R group, n=18) and DEX pre-administration group (DEX group, n=18). The orthotopic liver transplantation ischemia/reperfusion models were established in I/R group and DEX group. Rats of the DEX group were intraperitoneally injected with DEX 100 μg/kg 30 min before the incision, and an equal volume of normal saline was injected into rats of the sham-operated group and I/R group at the same time. Twelve rats in each group were sacrificed 3 d after operation and brain tissues were taken. The pathological changes of the hippocampus were observed under light microscope. Terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) was used to detect neuronal apoptosis index of the hippocampus. Western blotting was used to detect the protein levels of aquaporin 4 (AQP4) and protein kinase C (PKC) in the hippocampus. The remaining 6 rats accepted Morris water maze test to evaluate the long-term cognitive function 30 d after surgery. Results As compared with those in the sham-operated group, rats in the I/R group and DEX group had hippocampus edema and disordered cell arrangement; as compared with sham-operated group, I/R group and DEX group had significantly increased neuronal apoptosis index, significantly increased protein levels of AQP4 and PKC, significantly shorter quadrant retention time of the platform, and statistically longer escape latency (P<0.05). As compared with those in the I/R group, the pathological damage of hippocampal neurons was significantly alleviated, the neuronal apoptosis index was significantly decreased, the protein levels of AQP4 and PKC were statistically decreased, and the residence time of the quadrant in the platform was significantly prolonged, and the escape latency was statistically shorter in DEX group (P<0.05). Conclusion Pre-administration of DEX may reduce the brain damage and improve long-term cognitive dysfunction in rats after orthotopic liver transplantation ischemia/reperfusion, which may be related to down-regulating the AQP4 and PKC expression levels and reducing neuronal apoptosis.

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Objective To investigate the effect of dexmedetomidine (DEX) on platelet activating factor (PAF) levels in the plasma and hippocampus of mice with postoperative cognitive dysfunction (POCD).Methods A total of 30 specific pathogen free C57BL/6J mice were randomly divided into three groups (n=10):sham-operated group,POCD group and DEX intervention group.Mice in sham-operated group only received anesthesia but not partial hepatectomy surgery;the POCD models of POCD group and DEX intervention group were established by partial hepatectomy surgery under anesthesia;DEX (25 μg/kg) was given to mice from the DEX intervention group by intraperitoneal injection 30 min prior to partial hepatectomy surgery;normal saline of the same volume was injected intraperitoneally prior to partial hepatectomy surgery in sham-operated group and POCD group.Behavioral test was performed via fear conditioning tests (FCS),and the percentage of freezing time was recorded on the 3rd d of POCD modeling.The PAF levels in the blood and hippocampus were measured by enzyme-linked immunosorbent assay (ELISA).Results (1) As compared with the sham-operated group,POCD group had significantly lower percentage of freezing time in audible alerts on FCS (57.3％±9.1％ vs.30.0％±5.4％,P＜0.05);as compared with the POCD group,DEX intervention group had significantly higher percentage of freezing time in audible alerts on FCS (30.0％±5.4％ vs.46.5％±6.6％,P＜0.05).(2) The PAF levels in the plasma and hippocampus of POCD group were significantly increased as compared with those in the sham-operated group ([0.5±0.3] ng/mL vs.[22.5±2.2] ng/mL;[5.7±1.0]ng/mL vs.[9.8±1.4] ng/mL],P＜0.05);the PAF levels in the plasma and hippocampus of DEX intervention group were significantly increased as compared with those in the POCD group ([22.5±2.2] ng/mL vs.[14.6±1.6] ng/mL;[9.8±1.4] ng/mL vs.[7.4±1.2] ng/mL,P＜0.05).Conclusion DEX can improve early POCD in mice after partial hepatectomy surgery by reducing PAF levels in the plasma and hippocampus.

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Objective To investigate the effect of dexmedetomidine (DEX) on mammalian target of rapamyein (mTOR) signaling pathway in the hippocampus of mice with postoperative cognitive dysfunction (POCD).Methods A total of 64 specific pathogen free (SPF) adult C57BL/6J mice were randomly divided into four groups (n=16):sham-operated group,POCD group,DEX-L group (giving low dose of DEX) and DEX-H group (giving high dose of DEX).Mice only received anesthesia but not partial hepatectomy surgery in sham-operated group;mouse models of POCD in POCD group were established by partial hepatectomy surgery under anesthesia;DEX (25 μg/kg or 50 μg/kg) was given by intraperitoneal injection 30 min prior to partial hepatectomy surgery,and then,the mouse models of POCD were established in DEX-L group and DEX-H group;normal saline of the same volume was injected intraperitoneally prior to partial hepatectomy surgery in sham-operated group and POCD group.Behavioral test was performed via Fear Conditioning Test (FCS) one d before surgery and 3 d after surgery for training and behavioral testing,and the percentage of freezing time was recorded.Enzyme linked immunosorbent assay (ELISA) was used to detect the protein levels of beta amyloid protein 42 (Aβ-42) and phosphorylated(p)-tau-181 in cerebrospinal fluid of mice 3 d after surgery.The hippocampus tissues of mice were collected 3 d after surgery,and the mRNA expressions of mTOR,Tau,nuclear factor-κB (NF-κB) and tumor necrosis factor-α (TNF-α) in hippocampal tissues were tested by reverse transcription-polymerase chain reaction (RT-PCR).The protein expressions ofmTOR,p-tau (pS396 Tau protein),NF-κB and TNF-α in hippocampal tissues were tested by Westem blotting.Results (1) As compared with that in sham-operated group,the percentage of freezing time in conditioning FCS in POCD group was statistically lower (P＜0.05);as compared with that in POCD group,the percentage of freezing time in conditioning FCS in DEX-L group and DEX-H group was significantly higher (P＜0.05).(2) The protein levels of Aβ-42 and p-tau-181 in cerebrospinal fluid of POCD group,DEX-L group and DEX-H group were significantly higher than those in sham-operated group (P＜0.05);the protein levels of Aβ-42 and p-tau-181 in cerebrospinal fluid of DEX-L group and DEX-H group were significantly lower as compared with those in POCD group (P＜0.05);DEX-H group had significantly lower protein levels of Aβ-42 and p-tau-181 in cerebrospinal fluid as compared with DEX-L group (P＜0.05).(3) The mRNA and protein expressions of mTOR,NF-κB p65 and TNF-α,Tau mRNA expression,and pS396 Tau protein expression in the hippocampus of the POCD group were significantly higher as compared with those in the sham-operated group (P＜0.05);the mRNA and protein expressions ofmTOR,NF-κB p65 and TNF-α,Tau mRNA expression,and pS396 tau protein expression in the hippocampus of the DEX-L group and DEX-H group were significantly lower as compared with those in the POCD group (P＜0.05);those in the DEX-H group were significantly lower than those in the DEX-L group (P＜0.05).Conclusion DEX can improve early POCD in mice,and the mechanism may be related to down-regulation of mTOR signaling pathway.

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Objective To explore the zero cited fund papers in clinical nursing in China,in order to provide evidence for improving the academic quality and cite rate of nursing papers.Methods Bibliometric statistical analysis was used to summarize zero cited papers published in 12 nursing core journals from 2012 to 2014.Indicators collected including the distribution of time,journals,funding number,funding sources,research methods,research design type,statistics method,number of cooperative people,nature of the authors' organizations,as well as the conditions of cited papers and the distribution of themes.Results The overall zero cited rate of clinical nursing zero cited fund papers was 74.64％.Affiliated hospital of colleges account for a large proportion of 42.53％,and the zero cited rate in the national disease research center and the affiliated hospital of army colleges was the highest (100.00％ and 80.52％).The oncology nursing,disease and symptoms care proportion was 13.94％ and 23.10％.The output of TCM care and rehabilitation care fund paper accounted only 3 and 8 respectively,and none was cited.The zero cited rates of social support,care coordination,treatment and care attitude and evidence-based research were 96.3％,94.12％,91.67％,90.32％.Strengthened their awareness of research applications,managers focused on research papers in the number of outputs at the same time and paid attention to the paper quality,and promoted scientific research into nursing,and promoted the development of nursing discipline.Conclusions The current paper-citing situation in clinical nursing was not optimistic,nursing research personnel should correct the attitude of scientific research,strengthen their own sense of scientific achievement applications.The management personnel should pay more attention to the paper quality,and promote nursing research outcome transformation,promote the development of nursing discipline.

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Objective To investigate the effects of dexmedetomidine pre-treatment on pneumonocyte apoptosis and CCAAT/enhancer binding protein homologous protein (CHOP) in acute lung injury (ALI) induced by ischemia/reperfusion (I/R) during orthotopic liver transplantation in rats.Methods Forty adult male Sprague-Dawley (SD) rats were randomly divided into four groups by random number table method: sham operation group, I/R model group, dexmedetomidine low dose group and dexmedetomidine high dose group, 10 rats per group. Hepatic artery was ligated and cut off by two cuff method, and the portal vein was completely opened after donor liver transplanted into the recipient, thus, a hepatic I/R model was established. The perihepatic ligaments of rats were just separated after laparotomy in sham operation group and no other special treatment was performed. One hour prior to I/R, dexmedetomidine at a dose of 2.5μg·kg-1·h-1 and 5.0μg·kg-1·h-1, respectively, were pumped intravenously and finished within 1 hour in the rats of low dose group and high dose group. After experiment, the lung tissue was taken, and the lung wet/dry weight (W/D) ratio was determined. Pathological changes of lung tissue were observed and alveolar damage index of quantitative assessment (IQA) was tested by light microscope, and changes of ultrastructure of lung tissue were observed by transmission electron microscope. The mRNA and protein expressions of CHOP were detected respectively by reverse transcription-polymerase chain reaction (RT-PCR) and Western Blot. The apoptosis in lung tissue was determined by terminal-deoxynucleotidyl transferase mediated nick end labeling (TUNEL) method and apoptosis index (AI) was calculated.Results Compared to sham operation group, the lung W/D ratio (4.94±0.84 vs. 2.29±0.54), IQA [(40.52±5.15)% vs. (4.55±1.85)%] and AI [(36.57±5.85)% vs. (2.85±0.95)%] in I/R model group were significantly higher (allP < 0.01); remarkable injury of lung tissue was confirmed by light microscope and transmission electron microscope in the I/R model group. Compared to I/R model group, the W/D ratio (3.29±0.85, 2.68±0.78 vs. 4.94±0.84), IQA [(23.69±2.62)%, (15.86±3.61)% vs. (40.52±5.15)%] and AI [(25.73±3.71)%, (14.66±2.61)% vs. (36.57±5.85)%] in dexmedetomidine low and high dose groups were markedly lower (allP < 0.01); under light and transmission electron microscopes, the injury of lung tissue in these two dose groups was notably alleviated. There was a large amount of apoptotic cells of pulmonary vascular endothelium and alveolar epithelium in I/R model group, while the cell apoptosis was distinctly decreased in dexmedetomidine low and high dose groups compared to that in model group. Compared to sham operation group, the expressions of CHOP mRNA [absorbance (A) value: 0.96±0.18 vs. 0.43±0.08] and protein (gray scale: 2.79±0.74 vs. 1.02±0.27) were significantly higher in I/R model group (bothP < 0.01). Compared to I/R model group, the expressions of CHOP mRNA (A value: 0.69±0.13, 0.56±0.12 vs. 0.96±0.18) and protein (gray scale: 1.96±0.58, 1.34±0.49 vs. 2.79±0.74) were significantly lower in dexmedetomidine low and high dose groups, the decrease in dexmedetomidine high dose group being more marked (allP < 0.01).Conclusion The pretreatment of dexmedetomidine can protect lung tissue against I/R injury during liver transplantation in rats, and the mechanism may be related to the suppression of CHOP activation and alleviation of lung tissue cell apoptosis.

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Objective To investigate the role of AcrAB-TolC efflux pump in fluoroquinolones resistance by Shigella. spp and to explore the significance of AcrAB-TolC efflux pump on mutation of acrR, soxS and marOR as well as on drug re?sistence. Methods Drug resistant bacteria were selected by Kirby-Bauer disk diffusion test. After addition of efflux pump inhibitor carbonylcyanide-m-chlorophenylhydrazone (CCCP), change of minimal inhibitory concentration (MIC)s of nilidixic acid, Levofloxacin, ofloxacin, ciprofloxacin and Norfloxacin were examined. The DNA binding region of acrA, acrB, soxS, acrR and marOR gene in these mutants were amplified by PCR and sequenced. Results Among the 159 clinical isolates of Shigella,11 strains are resistant to fluoroquinolone. After the addition of CCCP, MICs of 2 fluoroquinolone resistant strains decreased; the MICs of 7 fluoroquinolone resistant strains did not change; MICs of 2 fluoroquinolone resistant strains in?creased. The corresponding nucleotides C, A, T, T on the 36th to 39th of marOR gene were missing, showing by sequencing, in fluoroquinolone resistent strains which might be regulated by the efflux pump gene AcrAB-TolC. Conclusion Efflux pump inhibitor could restrain the activity of efflux partially. The mutations of marOR might play an important role in fluoroquino?lone resistent by shigella.

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Objective To explore carrying rates of class 1, class 2 integrons as well as ISCR1 in Shigella isolates and their connection with drug resistance. Methods Antibiotic sensitivities were detected by K-B disk diffusion in 159 clinical isolates. Total bacteria DNA was prepared through boiling the isolates and the DNA was then used as template for PCR am?plification. PCR, ZSCR1 and sequencing analyse of integrons were applied to all of them. Results were compared by Blast and GenBank. Results Antibiotic sensitivity results showed that in the S. flexneri strains the incidence of resistance to tet?racycline and streptomycin were 88.68%and 81.13%in the S. flexneri strains while the incidence of resistant to chloram?phenicol and trimethoprim-sulfamethoxazol were both 56.60%, and the incidence of multidrug drug resistance was 77.36%. In the sonnei strains, the incidence of resistance to ampicillin, trimethoprim-sulfamethoxazo were 97.17% and 95.28%, 83.96%and 76.42%respectively, and the incidence of multidrug resistance was 98.11%. Among all isolates, 118 were class 1 integron positive , 70 were class 2 integron positive and 89 were double positives. For those 118 isolates that are positive of class 1 integron, 23 were typical while 95 weres atypical. The gene cassettes of typical class 1 integrons contains aadA2, aa?dA1, dfrⅠ, blaoxa-10 and blaoxa-1. IntI1, aadA, blaoxa-1 and IS1 were included in the gene cassetes of the atypical class 1 integrons. Class 2 integrons positive isolates carried gene cassttes which include dfrA1, satl and aadA1. No ISCR1 was found in any isolate. Integron carriage strains were closely associated with higher rate of multiple antibiobic resistance com?pared with the organisms without integrons (90.65%,50%, P<0.05). Conlusion Class 1 and class 2 integrons were widely existence in Shigella isolates and were related to the multidrug resistance.

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Objectiv e To evaluate clinical application effect of the self-developed usableness and fully functional fuming-washing appliance used for limb rehabilitation.Methods 200 cases of patella fracture patients with knee joint stiffness were divided into the observation group and the control group with 100 cases in each group.The observation group used fuming-washing appliance for limb rehabilitation,the control group chose traditional clinical method.The clinical effect was compared between two groups.Results After 2 weeks,87 cases received excellent result,10 cases with good result,3 cases with fair result.The effective rate reached 97％ in the observation group,which was higher than that of the control group.Conclusions The fuming-washing appliance used for limb rehabilitation has definite clinical effect and good security,it can effectively promote the nursing quality and save rehabilitation nursing resources,meanwhile it can make use of the advantages and ef-fecfiveness of traditional Chinese medicine in the department of traumatology rehabilitation treatment.

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Objective To investigate the clinical pathologic significance of lymphangiogenesis in in colorectal cancer. Methods New lymphatic-specific markers D2-40 was used immunohistochemically to detect the lymphatic vessel density(LVD) in the intratumoural and peritumoral areas, and in normal tissue from 96 cases of colorectal cancer, which were analyzed with clinical pathologic parameters of those colorectal cancer. Results Significandy higher LVD was found in the intratumoural area(14.5±2.4), when compared with normal(5.9±1.1)and peritumoural areas(6.7±1.2) (P<0.01). LVD of the peritumoural area was higher than normal area (P< 0.01). However, peritumoural LVD was associated with both depth of invasion and liver metastasis (r=0.71,0.78 P<0.05), but not associated with tumour size, macroscopic type and lymph-node metastasis (P>0.05). Intratu-moural LVD was not correlated with tumour size, macroscopic type, the depth of invasion,lymph-node metastasis, and liver metastasis(P>0.05). Conclusion Lymphangiogenesis in the peritumoural area may be helpful in evalution of liver metastasis and prognosis.

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To explore the role of mechanosensitive potassium channel TREK-1, Western blot analysis was used to investigate the expression changes of TREK-1 in left ventricle in acute mechanically stretched heart. Forty Wistar rats were randomly divided into 8 groups (n=5 in each group), subject to single Langendorff perfusion for 0, 30, 60, 120 min and acute mechanical stretch for 0, 30, 60, 120 min respectively. With Langendorff apparatus, an acute mechanically stretched heart model was established. There was no significant difference in the expression of TREK-1 among single Langendorff perfusion groups (P>0.05). As compared to non-stretched Langendorff-perfused heart, only the expression of TREK-1 in acute mechanically stretched heart (120 min) was greatly increased (P<0.05). This result suggested that some course of mechanical stretch could up-regulate the expression of TREK-1 in left ventricle. TREK-1 might play an important role in mechanoelectric feedback, so it could reduce the occurrence of arrhythmia that was induced by extra mechanical stretch.

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To explore the role of mechanosensitive potassium channel TREK-1, Western blot analysis was used to investigate the expression changes of TREK-1 in left ventricle in acute mechanically stretched heart. Forty Wistar rats were randomly divided into 8 groups (n=5 in each group),subject to single Langendorff perfusion for 0, 30, 60, 120 min and acute mechanical stretch for 0, 30,60, 120 min respectively. With Langendorff apparatus, an acute mechanically stretched heart model was established. There was no significant difference in the expression of TREK-1 among single Langendorff perfusion groups (P＞0.05). As compared to non-stretched Langendorff-perfused heart, only the expression of TREK-1 in acute mechanically stretched heart (120 min) was greatly increased (P＜0.05). This result suggested that some course of mechanical stretch could up-regulate the expression of TREK-1 in left ventricle. TREK-1 might play an important role in mechanoelectric feedback,so it could reduce the occurrence of arrhythmia that was induced by extra mechanical stretch.

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OBJECTIVE:To establish a microbial limit test method for povidone iodine solution.METHODS:Validation on methodology of the microbial limit test of povidone iodine solution was performed using plating method(Ⅰ),culture agent dilution method(Ⅱ),membrane-filter procedure method(Ⅲ)and sodium thiosulfate neutralization in combination with membrane-filter procedure method(Ⅳ).RESULTS:The recovery rates of all of the test organisms in method Ⅰ and method Ⅱ approached zero,less than 70% in method Ⅲ but above 85% in method Ⅳ.The growth of the control bacteria was abnormal in method Ⅱand method Ⅲ,but normal in method Ⅳ.CONCLUSION:It is advisable to adopt the method Ⅳ for microbial limit test of povidone iodine solution.

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OBJECTIVE To determine the value of acidic electrolyzed oxidizing water (EOW) for disinfecting endoscopes in the children's hospitals. METHODS The detection methods of field sampling were used for monitoring the effect of EOW disinfection. Washed after-use endoscopes were disinfected by EOW for 3-5min. Bacteriological tests on samples of pre-and post-disinfection made for 30 samples of laryngoscopes,30 examples of gastroscopes and 16 samples of enteroscopes,which were selected randomly. RESULTS Through EOW disinfection,the bacteria were not found on the laryngoscopes. The total number of bacteria on digestive endoscopes was conformed to the Standards of Disinfection Techniques and no pathogenic bacteria were detected. CONCLUSIONS Applying EOW to disinfection of endoscopes for clinical purpose can fulfill the State Standards completely. EOW has strongly germicidal activity,also with characteristic aslo act rapidly,securely and environment friendly,and without any irritant odor. These rusults indicate a widely potential use of EOW as in children's hospitals,especially,with a positive significance in health care of pediatric patients.