Objective To observe the free radicals level in Toufeng disease,also named migraine,so to explore the pathogenesis of the Toufeng disease,as well as to provide an effective treatment for migraine with integration of traditional Chinese and western medicine.Methods The free radicals(SOD,MDA) level in the Toufeng disease onset group(100 cases) were tested and compared with the healthy group(100 cases).The free radicals(SOD,MDA) of the patient group were tested in 4 hours after headache onset while that of the healthy group were tested as soon as taken in.Serum SOD was assayed with xanthine oxidase and MDA with TBA(thiobarbituric acid).Results Compared with the healthy group,the level of SOD was significantly decreased(P

Capsular warning syndrome (CWS) is a subtype of recurrent stereotyped transient ischemic attacks that heralds a subsequent stroke.The mainly presumed mechanism is repeated bursts of ischemia in the region of penetrating arteries,since the structural changes of large arteries is rare in series of imaging examinations.The majority of the infarct is located in the internal capsule or pontine.CWS is usually therapeutically resistant to simple traditional antithrombotic treatment,while combined antiplatelet treatment,thrombolysis,endovascular intervention and antiepileptics may protect part of the patients from developing into permanent infarcts.

Aim Toresearchthemolecularmecha-nisms of adriamycin-induced cardiomyocyte apoptosis based on β-adrenoceptor signaling pathway during de-velopmentofheartfailure.Methods SeventymaleSD rats were assigned randomly into two groups:the con-trol group(CON,n=30)and the ADR-induced cardio-toxicity group (ADR,n =40 ).ADR was administered intraperitoneally in five equal injections (each contai-ning 3 mg·kg-1 )over a period of two weeks,with a total cumulative dose of 15 mg · kg-1 body weight. Age-matched rats injected with saline were used as controls.The general condition of all rats was observed, and transthoracic echocardiography was performed im-mediately following the final ADR injection,and then every other week.Serum and myocardial tissue were harvested at W2,W4 and W6 separately.The serum contents of brain natriuretic peptide(BNP)and cardiac troponin-T(cTn-T)were analyzed by euzymelinked im-munosorbent assay (ELISA ).The pathological change and apoptosis were determined by HE,Masson and ter-minal deoxyribonucleotide transferase-mediated dUTP nick end labeling (TUNEL).The protein expressions ofβ1-AR,β2-AR,PKA and CaMK Ⅱ were detectedbyWesternblot.Results FollowingthefinalADRin-jection,cardiac systolic function and SV declined, which was accompanied by marked atrophy of the heart,low levels of cardiomyocyte fibrosis and apopto-sis,significantly increased serum BNP and cTn-T and decreased β1-AR,PKA and CaMK Ⅱ protein expres-sion.However,cardiac systolic function was improved with the extension of time but remained depressed as compared to CON group.The serum BNP and cTn-T concentration kept on rising.The gradual aggravation apoptosis and concomitant fibrosis in the ADR group heart were observed following ADR withdrawal.β1-AR protein expression was continuously down-regulated,β2-AR protein expression unchanged.Expression of PKA and CaMKⅡ proteins in hearts from ADR-injec-ted rats gradually increased.Conclusion β-AR/PKA/CaMKⅡ signaling pathway mediates cardiomyo-cyte apoptosis during the progress of ADR-induced car-diac dysfunction and pathological remodeling and apop-tosis.

Objective To analyze the risk factors of bile duct injuries in laparoscopic cholecystectomy.Methods The clinical data of 11 243 patients who underwent laparoscopic cholecystectomy between October 1992 and December 2013 in the Xianyang Center Hospital were studied retrospectively.The risk factors of bile duct injuries were analyzed using the Chi-square test to determine the independent risk factors of bile duct injuries.Results Univariate analysis showed that bile duct injuries were associated with male,age ≥65 years,BMI ≥25 kg/m2,staging of inflammation,gallbladder atrophy on ultrasonography,thickness of gallbladder wall on ultrasonography,anatomy of Calot 's triangle and operator's experience (all P ＜ 0.05).Multi-factor and non conditional Logistic regression analyses showed that the independent risk factors of bile duct injury were old men,gallbladder atrophy,anatomy of Calot's triangle and operator's experience (All P ＜ 0.05).Conclusion Old men,gallbladder atrophy,anatomy of Calot's triangle and operator's experience were independent risk factors of bile duct injuries.

Objective To investigate the expression of AIF, CYT C, PAF-1, caspase-3, and XIAP in Sprague-Dawley rats with spontaneous mammary neoplasms.Methods One-hundred and thirty 3-4-week old SPF Spargue-Dawley rats (♀∶♂=1∶1) were fed in a specific pathogen free (SPF) breeding barrier for 60 weeks.The occurrence of spontane-ous breast tumors was recorded and histopathology was performed to identify the types of tumors.The rats were divided into 3 groups:rats with normal breast tissue ( group I) , with benign tumors ( group II) and with malignant tumors ( group III) . The expression of AIF, CYT C, APAF-1, caspase-3 and XIAP proteins and mRNAs were detected by immunhistochemistry ( IHC) and RT-PCR assay.Results Among these 130 SD rats, 14 rats were observed having spontaneous mammary neo-plasms with the incidence rate of 10.77%(14/130).In these neoplasm cases, 7 cases were mammary fibroadenomas, 7 cases of breast carcinoma, both with an incidence rate of 5.38%.Immunohistochemistry showed that, compared with the group I, the positive expressions of AIF, APAF-1, caspase-3 were decreased significantly (P<0.01), and the CYT C and XIAP expressions were significantly increased in the group II.The positive expression of all genes except XIAP was de-creased in the group III(P<0.01).Compared with the group II, APAF-1 and XIAP were significantly higher in the group III (P<0.01), and the positive expression of AIF, Cyt C, and caspases-3 were significantly decreased (P<0.01).In the results of RT-PCR assay, except APAF-1 which showed significant correlation with the results of immunohistochemistry ( P<0.05 ) , all the others showed an extremely significant correlation with immunohistochemical results ( P <0.01 ) . Conclusions Mammary tumors are most common spontaneous neoplasms in SD rats.Abnormal expression of mitochondrial apoptotic pathway-related factors AIF, CytC, APAF-1, caspase-3, and XIAP are correlated with the carcinogenesis and de-velopment of breast tumors.

Objective To explore the effect of the clinical scenario-based simulation communication education based on Calgary-Cambridge Guide for undergraduate nursing students.Methods Totally 87 undergraduate nursing students were enrolled and divided into the experimental group (n=44) and the control group (n=43).The experimental group received clinical scenario-based simulation communication education based on Calgary-Cambridge Guide for communication.The control group received traditional class-based education for communication.The chnical communication skills questionnaire and Communication Observing Questionnaire were administered before and after the training.The testing results of both groups were compared.Results After participating in the education project,six dimensions of clinical communication competence and the total score were significantly improved after training compared with those before training in the experimental group.After training,the experimental group was better than the control group in establishment of harmonious relationship,confirming patients' problems,efficient information transfer,validation experience and communication competence,t values were 2.64,2.32,2.19,2.20 and 4.36,P＜ 0.05.In testing of integrated cases,scores of six aspects such as case design,information collection,explaining behavior,relationship development,conflict coordination and service behavior in the experimental group were significantly higher than those of the control group,t values were 2.15,2.10,3.26,2.84,2.14 and 2.61,P＜0.05.Conclusions The clinical scenario-based simulation education based on the Calgary-Cambridge Guide can improve communication competence of nursing students.

Aim To optimize the traditional method of right catheterization in rats and establish a rapid , stable and reliable method of the right heart catheter guided intubation to measure pulmonary artery pressure. Methods Nighty male wistar rats were used to optimize the method of detection of pulmonary arte-rial pressure. Three catheter namely PE50, PU I, and PU II were used for choosing the best intubation. The new technology of right catheterization was established and used for the research of pulmonary arterial hypertension. Results The PU I catheter was obviously better than PE50 and PU II catheter in the success rate and measurement time ( P <0. 05 ) . The method of right heart catheter guided intubation was significantly superior to the traditional right heart direct intubation (P<0. 05 or P<0. 01). After improving the right catheterization, the detection of hemo-dynamic indexes in PAH-model rat was successful with regular pressure curve and reliable experimental data. Conclusions The right heart catheter guided intubation method has a high suc-cess rate and it can detect the pulmonary artery pressure quick-ly, easily, and can help other researchers to complete experi-ment as efficiently as possible.

Objective: To explore the value of parameters obtained by dual-pulse wave Doppler to predict the recurrence of atrial fibrillation (AF) after radiofrequency catheter ablation(RFCA) and the value of the technology to evaluate the left ventricular diastolic function of the AF. Methods: Sixty-seven AF patients who were subjected to ablation were selected as the case group, and 47 patients with sinus rhythm were matched as control group. The general clinical data of the case group and the control group was collected, routine ultrasound examination and dual-pulse wave Doppler examination were performed to all of them. A 24-hour Holter examination was performed at 3, 6 and 12 months after radiofrequency catheter ablation in the case group, the patients were divided into two groups with and without recurrence according to the results. Dual-pulse wave Doppler parameters included: ①the time interval between the onset of early transmitral flow velocity (E) and that of early diastolic mitral annular velocity (e′) (TE-e′); ②peak early diastolic transmitral flow velocity (E) and tissue Doppler septal (S) mitral annular early diastolic velocity (e′), peak early diastolic transmitral flow velocity (E) and tissue Doppler lateral (L) mitral annular early diastolic velocity (e′), E/e′(S) and E/e′(L). The differences between the case group and the control group, and between the recurrent and the non-recurrent group were compared. The factors influencing the recurrence of AF after RFCA were analyzed with univariate and multivariate Logistic regression. Results: ①The parameters E/e′(S), E/e′(L) and TE-e′ of case group were higher than those of control group (all P<0.05); ②During follow-up examinations after the ablation, 21 (31.34%) patients recurred. TE-e′ of the recurrence group was higher than that in the nonrecurrence group (P<0.001). The parameters E/e′(S) and E/e′(L) in the recurrence group had no difference compared with those in nonrecurrence group without recurrence(all P>0.05); ③Univariate and multivariate Logistic regression suggested that TE-e′ was an independent predictor for the recurrence of AF patients after the ablation(P=0.001). Conclusions Dual-pulse wave Doppler can evaluate left ventricular diastolic function of atrial fibrillation, TE-e′ is an independent predictor for the recurrence of AF patients after radiofrequency catheter ablation.

Objective To compare two different regimens of ultrasound-guided Continuous ad-ductor canal block (CACB)for postoperative analgesia and early ambulation after total knee arthro-plasty (TKA).Methods Sixty-seven patients scheduled for unilateral TKA undergoing spinal anes-thesia,13 males and 54 females,aged 18-85 years,BMI 18-30 kg/m2,ASA physical status Ⅰ-Ⅲ, were randomly divided into the continuous infusion group A (n=34)and the intermittent boluses group B (n=33).After the operations,ultrasound-guided CACB were administered and 20 ml of 0.2% ropivacaine was given as the loading dose.From then on,patients in both groups used electronic analgesic pumps containing 240 ml of 0.2% ropivacaine for postoperative analgesia.5 ml/h of 0.2% ropivacaine was continuously infused for 48 hours in the group A.5 ml of 0.2% ropivacaine was automated injected every 60 minutes in the group B.All infusion pumps were setted at a bolus dose of 5 ml,with a lock time of 30 minutes.The total consumptions of analgestic pum solution and dezoine, quadriceps muscle strength, active range of knee flexion, ambulation distance and occurrences of adverse reactions such as nausea and vomiting,dizziness,drowsiness,extravasating and errhysis were recorded at different time points postoperatively.Results The total consumptions of analgestic pum solution at 12,24 h postoperatively of group B were significantly reduced than that of group A (P<0.05).The 48 h total dezoine consumption of group B was significantly reduced than group A (P<0.05).Active range of knee flexion at 24,48 h and ambulation distance at 48,72 h of group B were significantly higher than group A (P<0.05).There was no statistical difference in quadriceps muscle strength between group A and group B.The incidence of nausea and vomiting in group A was significantly higher than that in group B,and there were no statistical difference in other adverse reactions between group A and group B.Conclusion Compared with the continuous infusion group,the intermittent bolus group for CACB after TKA can provide better analgesic effect and de-crease opioid use postoperatively,with little effect on motor nerve,promoting early ambulation.

Anxiety disorders,dopaminergic neurons and ventral tegmental area(VTA)are related closely.VTA dopaminergic neurons play an important role in the regulation of anxiety.Numerous research results in animals indicated that the VTA dopaminergic neurons,involving in multiple neural pathways,respectively regulate anxiety-like behavior in physiological or pathological condition.Dopamine,the main neurotransmitters in VTA regulates anxiety through dopamine D1 and D2 receptors.In addition,the VTA glutamate,GABA and acetylcholine also play directly or indirectly roles in regulating anxiety.The clinical imaging research showed that the integrity of dopaminergic VTA structural of anxiety disorder group is lower than healthy control.Current researches of VTA dopamine neurons involving in the regulation of anxiety-like behavior is developing at a high speed and deserving further exploration,which will further elucidate the pathogenesis and provide new ideas for prevention and treatment of anxiety disorders.