Dendritic cells are the most powerful cells to induce T cell immune reaction. DC derived from leukemia also possess the ability of the antigen processing and presentation. DC pulsed with tumor antigen can effectively initiate T cell immune reaction and induce T cell to cytotoxic T lymphocytes in vitro and in vivo. In this text, we introduce the advanced development of the biological character of DC, tumor immunology, the mechanism of tumor cell escaping immune surveillance and DC in leukemia immunotherapy.

Objective To investigate the application value of methylene blue excretion test in early reasonable nutritional support for severe traumatic brain injury.Methods One hundred and thirty-three cases of severe traumatic brain injury admitted to hospital from January 2010 to June 2012 were chosen as treatment group,while the 127 cases of similar patients admitted to hospital from January 2007 to December 2009 were chosen as control group.Patients in treatment group underwent methylene blue excretion test in 3 days,8 days,15 days after injury,and the nutritional support ways were determined according to the elimination time of methylene blue in patients' urine.The control group conventionally receive enteral nutrition support therapy firstly,after 15 days if they still cannot be tolerant of the enteral nutrition,then parenteral nutrition therapy were adopted.The weight,serum albumin and hemoglobin circumstances of the two groups were determined and the complications were recorded.Glasgow coma score (GCS) of 3 months after injury were followed up.Results There was no significant difference on the average body weigh between these two groups before treatment.The average body weight of the treatment group was significantly higher than that of control group after 3 months treatment((56.3 ± 5.5) kg vs.(52.6 ± 5.3) kg,t =5.93,P ＜ 0.01).The serum albumin and hemoglobin of 14 d,21 d after injury were significantly higher than those of the control group (serum albumin of 14 d:(32.7 ±3.4) g/L vs.(28.8 ±3.1) g/L; serum albumin of 21 d:(34.3 ±3.8) g/L vs.(30.7 ±3.3) g/L;hemoglobin of 14 d:(113.4±12.5) g/L vs.(102.2 ±11.6) g/L;hemoglobin of 21 d:(118.5 ±13.3) g/L vs.(106.7 ± 12.4) g/L.Nutritional status of treatment group was significantly better than that of the control groupall P ＜ 0.05).After three months,the effective rate of treatment group (93.23％ (124/133)) was significantly higher than that of the control group (84.25％ (107/127)),the difference was statistically significant (x2 =5.29,P ＜ 0.05).Conclusion Determining the early reasonable nutrition support ways for patients with severe traumatic brain injury according to the elimination time of methylene blue in the urine,can provide comprehensive nutrition to patients,enhance their body resistance,reduce the incidence of complications,and create an important clinical value for improving prognosis.

Objective To sum up the clinical characteristics and the diagnostic and therapeutic principle of severe hypertensive intracerebral hemorrhage complicated with gastroparesis.Methods The clinical data of 51 patients with severe hypertensive intracerebral hemorrhage complicated with gastroparesis were retrospectively analyzed.Results Of the patients who died,3 died of over-severe hemorrhage,and 1 died of acute respiratory distress syndrome caused by aspiration,as well as one died of respiratory failure resulting from pulmonary infection after aspiration.None died of digestive tract complication.Twenty-one patients(41.18％) needed feeding via naso-intestinal tube.Thirty patients (58.82％) were recovered within two weeks and 14 patients (27.45％) were recovered within the third week,and those who recovered beyond three weeks accounted for 3.92％ (n =2).Conclusion The gastroparesis complicating severe hypertensive intracerebral hemorrhage is considered as a functional disorder rather than mechanical obstruction.It is mainly on the basis of symptoms and signs in combination with gastroscopy or radiography that the diagnosis can be made.The conservative treatment (including nasal feeding in some patients) should be applied to the disorder.

Acute myocardial infarction (AMI) is an acute, dangerous, and serious disease. Scholars at home and abroad are constantly exploring ways to reduce its first-aid time, improve the treatment efficiency and the prognosis. Multidisciplinary collaboration is one of the keys to emergency treatments in AMI, and nurses play an important role in this process. However, no clear criteria for emergency care procedures for AMI have been found at home and abroad. Through comprehensive analysis of related research, this paper attempts to find the shortcomings of emergency care procedures for AMI and propose the direction for its future development. This article reviews the status quo of emergency care procedures for AMI at home and abroad in order to provide reference for nursing staff.

This paper summarized the work of nursing acute chest pain pre-examination and triage from the following 4 aspects: the general situation of the work of nursing acute chest pain pre-examination and triage at home and abroad, the factors influencing the decision-making of nurses' chest pain triage, the mode of acute chest pain pre-examination and triage, and the tools of acute chest pain pre-examination and triage, so as to provide reference for improving the quality of nursing pre-examination and triage.

The inherent evolvability of promiscuous enzymes endows them with great potential to be artificially evolved for novel functions. Previously, we succeeded in transforming a promiscuous acylaminoacyl peptidase (apAAP) from the hyperthermophilic archaeon Aeropyrum pernix K1 into a specific carboxylesterase by making a single mutation. In order to fulfill the urgent requirement of thermostable lipolytic enzymes, in this paper we describe how the substrate preference of apAAP can be further changed from p-nitrophenyl caprylate (pNP-C8) to p-nitrophenyl laurate (pNP-C12) by protein and solvent engineering. After one round of directed evolution and subsequent saturation mutagenesis at selected residues in the active site, three variants with enhanced activity towards pNP-C12 were identified. Additionally, a combined mutant W474V/F488G/R526V/T560W was generated, which had the highest catalytic efficiency (k (cat)/K (m)) for pNP-C12, about 71-fold higher than the wild type. Its activity was further increased by solvent engineering, resulting in an activity enhancement of 280-fold compared with the wild type in the presence of 30% DMSO. The structural basis for the improved activity was studied by substrate docking and molecular dynamics simulation. It was revealed that W474V and F488G mutations caused a significant change in the geometry of the active center, which may facilitate binding and subsequent hydrolysis of bulky substrates. In conclusion, the combination of protein and solvent engineering may be an effective approach to improve the activities of promiscuous enzymes and could be used to create naturally rare hyperthermophilic enzymes.
Aeropyrum ; chemistry ; enzymology ; Archaeal Proteins ; genetics ; metabolism ; Binding Sites ; Biocatalysis ; Caprylates ; metabolism ; Cloning, Molecular ; Dimethyl Sulfoxide ; chemistry ; Escherichia coli ; Hot Temperature ; Industrial Microbiology ; methods ; Kinetics ; Laurates ; metabolism ; Molecular Dynamics Simulation ; Mutagenesis, Site-Directed ; methods ; Peptide Hydrolases ; genetics ; metabolism ; Protein Binding ; Protein Conformation ; Recombinant Proteins ; genetics ; metabolism ; Solvents ; chemistry ; Substrate Specificity

Objective To explore the effect on family members′ cardiopulmonary resuscitation ( CPR) training and improving psychological state of patients after percutaneous coronary intervention ( PCI ) . Methods We selected 94 patients after PCI surgery and their family members from September 2013 to August 2014 in the Department of Cardiology, they were randomly divided into experimental group ( 49 cases ) and control group (45 cases). The patients of control group were implemented conventional coronary heart disease health education, while patients and their families in the observation group were to be trained with coronary heart disease health education and CPR. The SAS, SDS scores were collected compared at the time before training, three days after training, and training after three months between two groups. Results Before the training, the scores of SAS and SDS of two groups had no significant differences (P>0. 05). At the three months and three days after the training, the scores of SAS in the observation group and control group were statistically significant compared with scores before training (P<0. 05). In the observation group and control group, three days and three months after traing, the scores of SAS and SDS were statistically significant compared with the scores before training (P<0. 05). Conclusions CPR training plays an active role in patient′anxiety psychology, but it still needs to strengthen the duration of training. The way of CPR training for the family members is worth of promotion.

Objective To develop multi-functional suction tubes used in neuroendoscope assisted pituitary tumor surgery via endonasal transsphenoidal pathway and investigate their application value.Methods The experiments included 145 pituitary tumor patients,recruited in our hospital from March 2014 to March 2015.Self-regulating multi-functional curve and detachable suction tubes were used in neuroendoscope assisted pituitary tumor resection,which could do suction,electrical coagulation and stripping together.The efficacy of them was analyzed.Results There were 101 total tumor resection,26 subtotal resection and 18 partial resection in the 145 pituitary tumor patients.The average operative blood loss was 41.52 mL with application of the multifunctional suction tubes.The shortest time in operation was 28 min,and the average operation time was 76.55 min.Patients were discharged 3-5 days after surgery and the prognosis were good.Conclusion As a safe and effective novel endoscopic neurosurgery instrument,the multifunctional curve and detachable suction and stripping tubes with electrical coagulation could significantly improve surgery effectiveness and reduce operative blood loss when used in pituitary tumor resection through endonasal transsphenoidal pathway.

Objective:To explore the status quo of self-stigma in diabetic patients and analyze its correlation with self-compassion.Methods:In this cross-sectional study, from December 2020 to January 2021, totally 240 diabetic patients admitted at the Department of Endocrinology in two ClassⅢ Grade A hospitals in Hangzhou, Zhejiang Province were selected by convenient sampling and investigated with the general information questionnaire, Self-Stigma Scale (SSS) , and Self-Compassion Scale (SCS) . Hierarchical regression analysis was used to explore the relationship between self-stigma and self-compassion in diabetic patients. A total of 240 questionnaires were issued, and 225 valid questionnaires were recovered. The effective response rate was 93.75% (225/240) .Results:The total SSS score of the 225 diabetic patients was (56.47±16.72) , and the average score of all items was (2.01±0.60) ; the total SCS score was (86.46±12.79) , and the average score of all items was (3.33±0.49) . Pearson correlation analysis showed that the total SSS score of diabetic patients was negatively correlated with the total SCS score ( P < 0.01) . Hierarchical regression analysis revealed that self-compassion was an influencing factor of self-stigma in diabetic patients ( P< 0.01) , which could independently explain 13.1% of self-stigma (Δ R2=0.131, P<0.001) . Conclusions:Self-stigma of diabetic patients is at a moderate level, and self-compassion is an influencing factor of self-stigma of diabetic patients. Nursing staff can reduce patients ' self-stigma by improving their self-compassion.

Objective:To summarize the best evidence for non-pharmacological interventions for patients with perimenopausal sleep disorders and to provide an evidence-based basis for improving sleep disorders and quality of life in perimenopausal women.Methods:All the evidence of sleep disorder in perimenopausal period in databases were searched by the computer in UpToDate, BMJ Best Clinical Practice, Cochrane Library, Joanna Briggs Institute Database, National Guideline Cleaninghouse, National Institute for Health and Clinical Excellence, Scottish Intercollegiate Guidelines Network, Wanfang Database, CNKI, et al. The evidences includes guidelines, expert consensus, evidence summary, systematic evaluation, best practice information book, randomized controlled trial, etc. The search deadline was from database establishment to October 15, 2022. Finally, methodological quality evaluation was conducted on relevant literature to extract and integrate the best evidence.Results:A total of 22 literatures were included, including 6 guidelines, 1 position statement, 4 systematic reviews and 11 randomized controlled trials. A total of 21 pieces of evidence were collected from 5 aspects, including sleep assessment, psychological intervention, physical intervention, traditional Chinese medicine intervention and exercise intervention.Conclusions:Regular evaluation should be conducted on the sleep status of perimenopausal women, and appropriate and feasible individualized intervention measures should be provided based on the actual situation to improve their sleep quality. When applying evidence, it should be combined with the clinical environment to transform it into localized evidence to guide best practice.