The repair of massive bone defect is one of the challenges to clinical performance. The therapeutic efficacy of classic methods, such as repair with autograft, alograft and biomaterial-filling and so on, is not optimal and hinders its widely clinical use. Bone tissue engineering has provided a promising way to solve this problem, and has become one of the hotspots nowadays. However, the key technology of vascularization hasn’t been solved ideally yet. Obviously, the routine train of thoughts is faced up with big challenge in repaiering large bone defect. In order to find a clinically applicable bone tissue engineering approach, we brought forward and set up a microcirculation system of osteogenesis inducted by perfusion in vivo.

Objective To investigate the expression of GABA_A receptor in the process of activation of hippocampal neurons and explore the epileptogenesis. Methods The activated hippocampal neuron products (experiment group) and the serum-free-medium (control group) were injected into rat's lateral ventricle, respectively, then we observed the behaviors, electroencephalographic (EEG) and immunochemical changes of GABA_A receptor in rats. Results 10~30 min after administration of pentetrazole (PTZ)-activated hippocampal neuronal products, Ⅱ～Ⅲ class epileptic behaviors were found in the experiment group. EEG showed many short distance moderate amplitude sharp waves, sharp and slow wave complex. The behaviors of rats and EEG results were normal in the control group. GABA_A receptor positive cells extensively spread over cerebral cortex, hippocampal CA_1 and dentate gyrus in the control group, and the expression of GABA_A receptor significantly decreased in the experiment group.Conclusion Activated hippocampal neuronal products could induce epilepsy. One of its mechanisms might be related to the decrease of GABA_A content.

目的探讨药物注射配合强化训练对颅脑损伤患者运动功能的影响。方法将60例住院颅脑损伤患者随机分为治疗组(30例)和对照组(30例)。治疗组在常规综合康复治疗基础上加用针对性药物注射治疗及强化训练,而对照组单纯采用康复治疗。两个疗程(20天/疗程)后,采用Fugl- Meyer运动功能量表评定两组的治疗效果。结果两组患者的运动功能均有改善 ,但治疗组的改善程度明显优于对照组(P<0.01)。结论药物注射配合强化训练能够明显改善颅脑损伤患者的运动功能。

Objective To explore the effects of mirror therapy combined with Tongdu Xingshen acupuncture on the upper extremity function of stroke survivors.Methods Sixty stroke survivors were randomly divided into a mirror group (n =20),an acupuncture group (n =20) and a combined group (n =20).In addition to routine rehabilitation treatment,those in each group received mirror therapy,acupuncture or both for 4 weeks.Before the treatment and after 2 and 4 weeks of treatment,all of the patients were assessed using the Fugl-Meyer motor function assessment (FMA),Brunnstrom upper limb and hand staging (BSULH),the Barthel Index (BI) and in terms of the active range of motion in the wrist contralateral to their hemiplegia (AROM).The combined group was also evaluated using functional magnetic resonance imaging (fMRI) before treatment and after the 4 weeks.Results After 2 and 4 weeks of the treatment,the average BI,AROM,FMA and BSULH results had improved significantly compared with before the treatment.The improvements in the combined group were significantly greater than in the other groups after 2 and 4 weeks.The fMRI demonstrated that there were high-intensity signals in the primary motor area,the premotor area and the supplementary motor area on the affected side after 4 weeks of treatment.Conclusions Mirror therapy combined with Tungdu Xingshen acupuncture can improve the functional performance of the upper extremities of stroke survivors.

The therapeutic efficacy of large bone defects with traditional methods, such as autograft or allograft and biomaterial filling, is not favorable and hinders the widely clinical application. Bone tissue engineering has provided a promising way to solve this problem, and has become one of the hotspots nowadays. However, the key technology of vascularization has not been solved ideally yet. Obviously, the routine treatment has become a challenge in repairing large bone defect. In order to find a clinically applicable bone tissue engineering approach, we put forward and established a microcirculation system of osteogenesis inducted by perfusion in vivo. The "regulable osteoinduction microcirculation/microenvironment system in vivo (ROIMS)" has characteristics as follows: the culture conditions are controlled. For example, the release of a variety of growth factors can be controlled stably and quantitatively at bone defect site. Early nutrition and revascularization in the center of tissue-engineered bone can be effectively solved; some shortcomings resulted from construction of tissue-engineered bone in vivo, including secondary injury, high level technical requirements, and complex operation, can be avoided; vascularization and osteogenesis can be constructed simultaneously; simple safe and efficient operation. ROIMS perfectly combines in vitro construction and in vivo construction of tissue-engineered bone. Thereby, we can expect that this new type of technology of tissue engineered bone will be used in clinic in a near future and finally repair large segmental bone defects in clinic.

ObjectiveTo investigate the effect of individual donation-nucleic acid amplification test (ID-NAT) and minipool of 16 donations-NAT (P16-NAT) on the results of NAT of blood donors.Methods From February 2009 to June 2009,samples randomly collected from voluntary blood donors in Beijing were tested individually or in pooling of 16 donations by the PROCLEIX ULTRIO assay.For ID-NAT reactive samples with HBsAg,anti-HCV,or anti-HIV serologically unqualified,ID-NAT repeat reactive samples with serologically qualified,and P16-NAT reactive and followed resolution ID-NAT reactive samples,were performed for further discriminatory assays for HIV-1,samples and followed resolution ID-NAT reactive samples,were performed for further discriminatory assays for HBV,HCV and HIV-1discriminatory reagents.Samples which were HBV NAT + alone with serologically qualified were further quantified and confirmed of HBV DNA by Roche HBV quantitative PCR,analyzed by HBV serology and were diluted to simulate if they could be detected in P16-NAT.Results ( 1 ) Among 7613 samples tested by ID-NAT,26 were NAT positive,i.e.the ID-NAT positive rate was 0.34％ ( 26/7613 ). ( 2 ) Among 1004 P16 samples from 16 064 blood donations,27 were NAT positive,i.e.the P16-NAT positive rate was 0.17％ (27/16 064).(3)In serological qualified donations,ID-NAT yield rate (1 in 826,9/7438 ) was much higher than P16-NAT ( 1 in 7875,2/15 750) (x2 =11.880,P ＜ 0.05 ).All these 9 ID-NAT positive and 2 P16-NAT positive donations were discriminated as HBV NAT positive.There were no HCV NAT yield or HIV NAT yield samples. (4) Dilution assay showed only 2 of the 9 (22.22％ ) ID-NAT HBV yields were detected by P16-NAT.(5)Eight ID-NAT and 2 P16-NAT positive samples were quantified for HBV DNA and confirmed as HBV NAT yield,although the virus loads were very low:2 samples had HBV viral loads of 15 IU/ml and 472 IU/ml,6 samples ＜ 12 IU/ml,and 2 could not be detected in the original samples while had ＜ 12 IU/ml and 14.3 IU/ml in the 10 times concentrated samples.(6)Among 11 HBV NAT yield cases,3 (27.3％ ) were possible HBV window-period donors with all HBV seromarkers negative,the other 8 (72.7％ ) had occult HBV infections with anti-HBc or anti-HBe positive,however anti-HBc IgM negative.(7) The rate of initial P16-NAT reactive pools needed to be further tested by ID-NAT was 2.49％(25/1004).Initial P16-NAT reactive pools which caused by serologically qualified donations was 0.20％(2/1004).ConclusionsHBV NAT yield cases are detected at a higher frequency with ID-NAT than P16-NAT.In order to avoid samples with low viral loads would be undetected,NAT assay with high sensitivity should be selected and tested in minimized minipool donations or even with individual donation.

Objective To investigate the expression of CD40-CD154 co-stimulatory pathway in peripheral circulation and intestinal mucosa in patients with inflammatory bowel disease (IBD),the difference between the expression of CD40-CD154 in patients with IBD and that in healthy controls,and the correlation between CD40-CD154 levels and disease activity. Methods A total of 62 patients with Crohn's disease (CD),64 patients with ulcerative colitis (UC) and 56 healthy controls were enrolled. Enzyme-Linked Immuno Sorbent Assay (ELISA),SYBR-green real time PCR and immunohistochemical assay were respectively applied to evaluate expression of CD40-CD154 in plasma,mononuclear cells of peripheral blood and intestinal mucosa. Results Levels of CD40 (P=0. 000) and CD154 (P=0. 001) in plasma,mononuclear cells of peripheral blood and intestinal mucosa were significantly higher in patients with CD and UC than in healthy controls. However,no correlation between disease activity and CD40-CD154 expression in peripheral circulation or intestinal mucosa was detected (P ＞ 0. 05 ). Conclusion CD40-CD154 pathway activation is found in plasma,peripheral blood mononuclear cells and intestinal mucosa in patients with IBD,but is not correlated with disease activity.

Objective To investigate the effect of the typical task teaching method on nursing education in the department of cardiology .Methods Eighty-seven nurse interns in 2012 and ninety nurse interns in 2013 were selected and divided into the control group and the observation group .The control group was given the traditional teaching method and the observation group was given the typical task teaching method .According to the specialized subjects characteristic , the acute myocardial infarction , acute left heart failure , arrhythmia diseases combined with ECG monitoring , cardiopulmonary resuscitation and oxygen inhalation technique were identified as the typical work tasks for the department of cardiology .The “clinical ability of nursing students evaluation questionnaire” was used to analyze and compared the teaching effects of the two groups of nursing students.Results The scores of practice ability, communication ability, health education, nursing management, nursing scientific research and the total score in the observation group were (52.38 ±10.64), (42.52 ±8.54), (20.45 ±4.28), (35.22 ±8.35), (17.48 ±5.44) and (195.08 ±43.68), respectively, which were significantly higher than (41.57 ±10.50), (35.12 ±8.02), (14.49 ±3.36), (28.45 ±8.67), (12.16 ±3.84) and (156.02 ±39.42) in the control group ( t=6.801, 5.938, 10.336, 5.292, 7.493, 6.239, respectively;P<0.05).Conclusions The typical task teaching method can effectively improve the clinical ability of nursing students in the department of cardiology .It is necessary to be promoted in the nursing education .

Objective To explore the key points of preoperative emergency nursing in the patients with mechanical pros thetic valve dysfunction .Methods The clinical data from five patients with mechanical prosthetic valve dysfunction from March 2010 to November 2012 were retrospectively analyzed , and the key points of preoperative emergency nursing were summarized in the course of the disease .Results Four patients were recovered and discharged after they got the positive and effective rescue and accepted the valve replacement operation;one patient gave up further treatment because of serious condition .Conclusions The mechanical prosthetic valve dysfunction can lead to acute hemodynamic instability and eventually cause death of patients , and the valve replacement operation as the effective treatment should be carried out as early as possible .The preoperative intensive monitor and targeted emergency nursing can help patients to win the operative time and increase the chance of survival .

Objective To explore the impact of intensive follow-up visit in patients with nonvalvular atrial fibrillation taking Warfarin in process of anticoagulant therapy. Methods A total of 100 patients with persistent nonvalvular atrial fibrillation were randomly divided them into intensive follow-up group and regular follow-up group on average. We compared the treatment compliance, INR value, embolism and hemorrhage between two groups. Results The INR qualified rate was 86. 0% after 6 months taking medication in the intensive follow-up group and 72. 0% in the regular follow-up group (χ2 =4. 570,P<0. 05). The incidence rate of hemorrhage was 12% in the intensive follow-up group and 28% in the regular follow-up group (χ2 =4. 000,P<0. 05). Conclusions With the function of propaganda, education, supervision, promotion and attention on patients, follow-up visit makes patients taking Warfarin receive normative, effective anticoagulant treatment and improves the safety of medicine use, thus the effect of preventing stroke can be achieved.