OBJECTIVE:To prepare silybin liposomes(SLBL)coated by N-trimethyl chitosan(TMC)(TMC60-SLBL),and to optimize the formula. METHODS:The effects of 3 kinds of preparation methods on encapsulation efficiency of SLBL were com-pared,including film dispersion method,multiple emulsion method and reverse evaporation method. The formula of TMC60-SLBL was optimized by orthogonal test using encapsulation efficiency as index with the concentration of phospholipid,ratio of phospholip-id to cholesterol,ratio of silybin to lipids,hydration temperature as factors. The stability of TMC60-SLBL by optimal formula at 4 and 25℃within 30 d,the particle size and Zeta potential of TMC60-SLBL and SLBL were all compared. RESULTS:The encapsu-lation efficiency of TMC60-SLBL prepared by the film dispersion method was the highest,without statistical significance in encap-sulation efficiency before and after cutting (P>0.05). The optimal formula was with the concentration of phospholipid 6 mg/ml;the ratio of phospholipid to cholesterol 40∶1;the ratio of silybin to lipids 1∶30;the temperature of hydration medium 45 ℃;the encapsulation efficiency were(82.08±2.6)%,RSD=3.17%(n=3). The preparation was stable at 4℃;the mean diameter of SL-BL and TMC60-SLBL were(131.9±1.9)nm and(161.2±2.0)nm,and Zeta potential respectively were(-23.18±1.14)mV and (36.73 ± 2.84) mV. CONCLUSIONS:TMC60-SLBL is prepared successfully,and its formula is simple and practicable with high encapsulation efficiency.

A retrospective analysis was carried out in 220 cases of nonfunctional pituitary adenoma (NFA).The diagnosis was based on negative immunohistochemical staining,no elevation of plasma hormone level,and no symptom caused by increased hormone level.Incidence of NFA was the highest(33.13％) among the pituitary tumors.It was more common in males than in females (132 ∶ 88).The highest prevalence resided in the elder group.N FA often caused pituitary apoplexy,and mainly presented as compression symptoms including visual field abnormalities (85.00％),headache (80％),hypopsia (68.66％),and other symptoms of hypopituitarism (44.04％).Imaging features showed tumor size usually within 2-4 cm (71.82％),and aggregated degree Ⅲ or Ⅳ (83.64％).

Objective To investigate the clinical features of anterior pituitary hypofunction.Methods A retrospective analysis was carried out on the data of 117 patients with anterior pituitary hypofunction during 1994-2010.Results There were 60.68％ male and 39.32％ female patients respectively.The onset age was from 13 to 79 years,with 79.12％ of the patients more than 40 years old.There were 57 cases with sellar tumors ( 40.17％ ),in which 55 cases( 96.49％ )were operated and (or) treated with radiotherapy.35 cases were operated via the frontal approaches( 66.04％ ) and 18 cases underwent transsphenoidal surgery ( 33.96％ ).There were 108 cases with hyponatremia with the first symptoms of weakness,anorexia,nausea,and vomiting induced by ACTH deficiency (92.31％ ).There were 23 cases accompanied with central diabetes insipidus( 19.66％ )and 82 cases with coronary heart disease( 70.09％ ).Conclusion Owing to the difference in etiological factors,the incidence,early symptoms,and the hormones involved are greatly different.The main cause is pituitary tumor,which occured more in aged person,more in males than females.

Objective To evaluate the prognestic effect of thrombus aspiration combined tirofiban in patients of acute myocardial infarction. Methods 372 patients with acute ST segment elevation myocardial infarction were randomly divided into the observation group (n=183) and the control group (n=189). Patients in the observation group received thrombus aspiration combined tirofiban additional to conventional treatment, and cases in the control group received routine treatment. The curative effect, postoperative complications and adverse reactions were compared between the 2 groups. Results The postoperative TIMI classⅢperfusion was achieved in 152 cases (83.1%) in the observation group and 140 cases (74.1%) in the control group (P < 0.05). The left heart ejection fraction of the observation group on 7 and 30 days after surgery was (60.4±6.1)%and (64.3±5.6)%respectively which was higher than the control group with (52.4±5.9)% and (55.4±5.7)% on 7 and 30 days respectively (P < 0.05). Bleeding events were recorded in 36 cases(19.7%) in the observation group rensus 26 versus (13.8%) in the control group (P>0.05). MACE reorded within 30 d post operation was 10 cases(5.5%) in the observation group and 22 cases (11.6%) in the control group (P < 0.05). No thrombocytopenia recorded in both groups. Conclusions Thrombus aspiration combined tirofiban for patients with acute myocardial infarction during PCI can improve the postoperative coronary artery perfusion, left ventricular ejection function and reduce the incidence of MACE within 30 days.

Objective To analyze the epidemiological characteristics of pituitary apoplexy and investigate the changes and features of endocrine hormones caused by pituitary apoplexy.Methods A retrospective analysis of the clinical and laboratory data of pituitary tumor and pituitary apoplexy was carried out.Results (1) The incidence of pituitary apoplexy was 31.78％,patients were 15-75 (47.5 ± 11.7) year old,most patients were female.(2)Diabetes,coronary heart disease,menopausal hormone therapy,radiotherapy,surgery,and bromocriptine administration may be related to pituitary apoplexy.(3) There was high incidence of apoplexy in nonfunctioning adenoma.(4) According to the relationship between apoplexy and pituitary tumor,cases with pituitary apoplexy were divided into 5 types.(5) Pituitary apoplexy was associated with low serum creatinine,hypernatremia,hyperchloremia,hypoeosinophilia,and hypobasophilia.(6) 61.61％ of the patients had pituitary hormone deficiency,especially the GnH deficiency.(7)98.10％ of the patients were treated by surgery.Conclusion Pituitary apoplexy has its own clinical characteristics,and more attention should be paid in clinical practice.

Objective To investigate the effects of dexmedetomidine (DEX) on the mRNA expression of triggering receptor expressed on myeloid cells 1 (TREM-1) in peripheral blood mononuclear cells of rats with acute obstructive suppurative cholangitis (AOSC).Methods Sixty healthy male Wistar rat models of AOSC induced by complete common bile duct ligation and injection of E.coli into the bile duct through an intubation tube were replicated successfully.After modeling,the peripheral blood was collected and mononuclear cells were isolated and cultured.According to random number table method,the mononeuclear cells were divided into model group (no drug added in culture of mononuclear cells) and low,medium and high dose DEX groups (final concentrations 0.4,0.8,1.2 μg/L DEX were in low,medium and high DEX mononuclear cell cultures,respectively).After the mononuclear cells were cultured for 24 hours,the levels of tumor necrosis factor-α (TNF-α),interleukins (IL-1 and IL-6) in the supernatant of the cultured mononuclear cells were detected by enzyme linked immunosorbent assay (ELISA).The level of C-reactive protein (CRP) was detected by immunity transmission turbidimetry.The expression of TREM-1 mRNA in the mononuclear cells was detected by reverse trantscription-polymerase chain reaction (RT-PCR).Results Compared with the model group,the levels of TNF-α,IL-1,IL-6,CRP were decreased,the TREM-1 mRNA expressions were down-regulated in the different DEX dose groups,and the degrees of descent in medium and high dose groups were more significant than those in low dose group [TNF-oα (ng/L):95.5±8.6,88.9±5.3 vs.131.1 ± 14.2;IL-1 (ng/L):53.5±8.3,48.3 ± 6.7 vs.73.7 ± 12.8;IL-6 (ng/L):266.9±26.2,252.1 ± 17.7 vs.349.9±40.4;CRP (ng/L):4.3 ± 1.1,3.9 ±0.7 vs.5.6 ± 1.7;TREM-1 mRNA (A value):0.43 ± 0.18,0.39 ± 0.16 vs.0.65 ±0.25,all P ＜ 0.05].Conclusion DEX can down-regulate the expression of TREM-1 mRNA and inhibit the formation and secretion of inflammatory factors TNF-α,IL-1,IL-6 and CRP in peripheral blood mononuclear cells of rats with ASOC.

Objective To explore serum caspase-3 activity in pulmonary tuberculosis patients.Methods 38 tuberculosis pa-tients in Infectious Disease Department in the First Affiliated Hospital of Guangxi Medical University were recruited and the peripheral venous blood was collected in December,2010.Among them,sputum smear-positive patients which were first treated were 13,sputum smear-negative patients which were first treated were 15,10 cases were drug resistance.In addition, 22 unrelated healthy individuals from a routine health survey were enrolled as controls.Spectrophotometry was used to de-tect serum caspase-3 activity in tuberculosis patients,which was absorbancy-A of 4-nitroaniline generated by caspase-3.Re-sults The activity of caspase-3 in sputum smear-positive patients,sputum smear-negative patients,drug resistance patients, and healthy controls were 37.15±5.06,50.38±6.29,45.32±3.32 and 23.89±2.29,respectively.The caspase-3 activity was significantly different from each other (F=10.68,P<0.01).Compared with the healthy controls,the caspase-3 activity in sputum smear-positive patients (q=3.51,P=0.016),sputum smear-negative patients (q=7.5,P<0.001),drug resist-ance patients (q=5.34,P=0.001)was significantly different.There was no statistical difference among sputum smear-posi-tive patients,sputum smear-negative patients and drug resistance pulmonary tuberculosis patients (P>0.05).In the same way,there was no significant difference in male/female ratio[χ2=0.38 (DL=3),P=0.94]and mean age (F=0.82,P=0.49)among the four group.Conclusion Caspase-3 closely associated with the development of tuberculosis occurrence, which might promote apoptosis of cells through the activation of caspase-3 and produce the body immune process of tubercu-losis.

Objective To discuss the effect of in vitro fertilization ( IVF) and mouse sperm cryopreservation , to establish a simple and economic frozen system for the genetically engineering mice preservation .Methods Sperm from genetically engineering mice were cryopreserved , IVF was performed using post-thawed sperm, then embryo transfer, to compare the effects of cryopreservation medium、age of male mice and sperm preincubation medium .Results Using CPA as sperm cryopreservation medium , when PM was used thawed-sperm preincubation in IVF , the fertility rates were from 82.49%to 91.43%, when HTF was used thawed-sperm preincubation in IVF , the fertility rates were from14.46%to 27.38%, there was a signification difference between PM and HTF sperm preincubation medium;10 to 35 weeks male genetically engineering mice sperm were succeed cryopreservation , and positive mice were procreated after 2-cell embryos were transferred;R18S3、CPM and CPA was used to freeze sperm , the fertility rates were 75.85%、88.89%to 94.27%, positive mice were procreated after 2-cell embryos were transferred;2-cell embryos after IVF were freezed , then thawed and positive mice were procreated after 2-cell embryos were transferred .Conclusion Using CPA as sperm cryopreservation medium , when PM was used thawed-sperm preincubation in IVF , genetically engineering mice sperm were succeed cryopreservation .

To discuss clinical diagnosis and treatment of cow’s milk protein allergy and cow’s milk protein-induced FPIES (food protein induced enterocolitis syndrome). Methods We retrospectively analyzed clinical data of one infant with milk protein allergy-induced FPIES. Results A 67 days old female on mixed breast and formula feeding developed recurrent diarrhea, abdominal distension, vomiting, mucousy and bloody stools, feeding dififculty, anemia, and failure to thrive since 2 weeks after birth. Laboratory studies showed anemia, increased CRP level and elevation of peripheral white blood count and eosinophil proportion. Milk-speciifc IgE was negative. She was previously hospitalized 4 times, all with admitting diagnosis of“necrotizing enterocolitis”. We treated her with milk protein elimination for 4 weeks and all symptoms were resolved. Milk protein re-challenge test was positive, consistent with clinical features of cow’s milk protein allergy-induced infant FPIES. Conclusions Cow’s milk protein allergy and cow’s milk protein-induced FPIES can present with non-speciifc and variable clinical symptoms and signs, and should be considered in the differential diagnosis.

ObjectiveTo explore the in-depth cognition and experience of nursing procedure in the course of clinical practice in undergraduatenursing interns. MethodsBy purposive sampling, 15 undergraduate nursing interns who were at the late stage of clinical practice in a ClassⅢ Grade A general hospital in Shanghai were selected from March to May in 2018. Semi-structured interview was adopted to interview them and Colaizzi seven-step method was used to analyze the data. ResultsTotally four themes were extracted, namely, the gradual dilution of theoretical knowledge of nursing procedures, the different understanding of the role of nursing procedures, different views on whether nursing procedures are applied in nursing work, and various deficiencies in the application of nursing procedures in nursing work. ConclusionsStrengthening nursing students＇ study of theoretical knowledge of nursing process,clarifying the important role and application of nursing process,encouraging nursing students to apply nursing procedures in a coordinated and standardized manner ,strengthening the holistic concept of nursing students and improving the consistency of nursing students＇ learning and application of nursing process in different departments are the key points for the continuous improvement of clinical intern teaching.