Objective To explore the effect of risk management on the perioperative nursing of elderly patients undergoing cardiovascular surgery. Method Sixty-two elderly patients undergoing cardiovascular surgeries were managed by management, which included establishing risk management team, identity and evatuating risk factors, applying risk manadement. Result There was no nursing risk events among them. Conclusion For elderly patients with cardiovascular surgery, risk management can enhance nurses′ability of discerning, assessing and managing the nursing risks so that it is effective in avoiding possible risks, reducing nursing adverse events during perioperative period, improving nursing quality and ensuring the safety of surgery.

The neurotransmitter plays an important role in the neurologic functional recovery of animals and patients with spinal cord injury. This article reviews the neurotransmitters in spinal cord injured of rats and the effect of some therapy on them.

Objective To study the effect of computerized pressure hemostat on lower limb deep vein thrombosis in high-risk elderly patients.Methods From September to December 2013,36 orthopedic hospitalized patients who received operations were divided into the hemostat group and the non-hemostat group with 18 patients in each group.D-dimer changes and lower limb deep vein thrombosis were observed in both groups.Results D-dimer was significantly increased in both groups compared with that before operation,but the extent of elevation in the non-hemostat group was lower than that in the hemostat group.D-dimer and cases of lower limb deep vein thrombosis in the hemostat group was higher than those in the non-hemostat group after operation,which showed significant difference.Conclusions The use of computerized pressure hemostat will increase the risk of lower limb deep vein thrombosis in elderly patients,so the technical operation procedures should be strictly enforced accompany with safely use of computerized pressure hemostat.

Objective To explore neural plasticity around an injured region of the spinal cord and the effects of step training on functional recovery after incomplete spinal cord injury (SCI). Methods Adult female Sprague-Dawley rats ( n = 24) were induced with spinal cord contusion at T10 and divided into a step training group and a control group ( 12 rats in each). Training started from the 7th day post-injury and lasted for (20 ± 10)min per day, 5 days per week, for 9 weeks. Treadmill speeds were 3 m/min at the beginning, and adjusted daily according to each rat's tolerance up to 11 m/min or more. The functional recovery was measured weekly with the open-field locomotor rating scale of Basso, Beattie and Bresnahan (BBB score). The expression of glial fibrillary acidic protein (GFAP), neurofilament protein (NF) and growth-associated protein-43 (GAP-43) in the spinal cord around the injured region were detected. Results After 70 days of step training, the average BBB score of the step training group reached ( 12.86 ± 0.94 ), significantly higher than that of the control group ( 10.71 ± 0.95 ). The expression of NF and GAP-43 around the injured region increased significantly more in the step training group than among the controls. Conclusions Step training can promote functional recovery and neural plasticity in rats after incomplete SCI.

Objective To describe the true feelings and needs in oncology professional nurses training, so as to provide evidences for improving training content and patterns, orientating the career development. Methods Phenomenological methodology of qualitative study was adopted in this research. In-depth interview were conducted on 1-5 session specialized nurse in Zhejiang tumor base. Data was analyzed by Colaizzi analysis. Results Oncology professional nurses teaching effect was good, there were quite abundant harvest. Nurses′ professional attitudes were positive. Their training pressure was bigger, but there were good external support ways to cope. They had increased theory class time, improve the effect of theory course, refine the training content, and strengthening clinical practice teaching needs. Conclusions The training of tumor specialized nurse has certain necessity, and the nurses′ability has great advanced. Respondents were optimistic to the career prospects. However, the training patterns and content should be continuously perfected and updated, in order to improve the training effect.

Objective To study the diagnostic value of air plethysmography (APG) in deep venous valvular incompetence of lower limbs and the relationship between deep venous reflux and calf muscular pump function. Methods Sixty-five varicose cases (89 limbs) were detected by APG in alterations of venous filling index (VFI), ejection fraction(EF), residual volume fraction(RVF) and outflow fraction(OF). Of 89 limbs, 18 limbs were in GradeⅠ of deep venous reflux, 24 in Grade Ⅱ, 18 in Grade Ⅲ and 12 in Grade Ⅳ. Integrated vectors analysis (Hotelling T 2test) was done with these index. Venography was performed in all patients. Results There were statistical differences in VFI between each two Grades of deep venous reflux except for between Grade Ⅰ and Ⅱ. There were also statistical differences in EF,RVF and OF between Grade Ⅳ and the other Grades. Hotelling T 2test showed significant testing efficiency of APG. ConclusionsDeep venous valvular insufficiency of lower limbs can be assessed by APG. VFI is a reliable quantitative index for evaluating the degree of deep venous reflux. There may be an exponent relation between deep venous reflux and calf muscular pump function.

Objective:To elucidate the clinical effect of xingxiong sodium chloride injection on vertebralbasilar insufficiency.Method:98 patients with vertebralbasilar nsufficiency were randomly divided into two groups,(therapy group with 50 cases treated with xingxiong sodium chloride injection and the controlled group with 48 treated with danshen injec- tion.After 14 days,their clinical symptom change and haemodynamics parameters change were evaluated and detected by transcranial Doppler (TCD).Result:In the therapy group,45 cases (90%) were cured and in the controlled,30 cases (62.5%) were cured.The two groups presented a statistical significance (P

Taxa-4(5),11(12)-diene is the precursor for paclitaxel biosynthesis. The diterpenoid paclitaxel (marketed as Taxol), a plant secondary metabolite isolated from yew, is an effective drug widely used in the treatment of numerous cancers. However, further application of taxol has been restricted due to its low yield in plants and the difficulties in extraction. To increase the intact isoprene flux, we constructed the fusion gene plasmid pBgGGTS and individual cassette plasmid pBgGGgTS to enhance the expression levels of geranylgeranyl diphosphate synthase gene (ggpps) and a taxadiene synthase gene (ts) in Coprinopsis cinerea. These two plasmids were separately transformed into C. cinerea LT2 strain, resulting in several putative transformants. Putative transformants were determined by PCR technique, indicating that 5 out of 13 putative transformants transformed by pBgGGTS and 6 out of 13 putative transformants transformed by pBgGGgTS, respectively. Additionally, the Southern blotting analysis of these 10 transformants confirmed that both ggpps and ts gene were stably integrated into the genome of C. cinerea. Crude extracts from each of the transformants were analyzed. There is no difference in the mycelium extracts among the wild-type LT2 and two types of transformants. However, analysis of culture filtrates indicated that an additional GC peak was found at the retention time of 16.762 min which was absent in the wild type control. The mass fragmentation pattern of this peak had the same diagnostic ions with taxa-4(5),11(12)-diene. According to peak area, the amounts of taxa-4(5),11(12)-diene in each fermented broth were 44 ng/L (transformed with pBgGGgTS) and 30 ng/L (transformed with pBgGGTS), respectively. In conclusion, co-expression of the ggpps and ts gene could increase the taxadiene production in C. cinerea.
Agaricales ; metabolism ; Alkenes ; metabolism ; Diterpenes ; metabolism ; Farnesyltranstransferase ; genetics ; metabolism ; Genetic Engineering ; Isomerases ; genetics ; metabolism ; Paclitaxel ; Plasmids

Objective To explore the effect of olfactory ensheathing cell (OEC) transplantation combined with walking training on neurofunction recovery in rats after spinal cord contusion. Methods Forty adult female rats aged (75 ± 1 ) days were subjected to experimental spinal cord contusion at the T10 level using a New York University impactor at a height of 25 mm. They were then divided into 4 groups: ( 1 ) an OEC transplantation combined with walking training (OEC-walking training) group, (2) an OEC transplantation (OEC) group, (3) a walking training combined with Dulbecco's modified Eagle medium injection (DMEM) (walking training-DMEM) group, and (4) aDMEM injection (SCI-DMEM) group. The OEC transplants and DMEM injections were performed 2 weeks post-injury. Walking training began at the 7th day post-injury and consisted of daily sessions (once daily, 5 days a week for 10 weeks) of quadrupedal treadmill training, starting from 15 min and gradually increasing to 30 min daily, at speeds starting from 3 m/min and gradually increasing in accordance to the condition of the rats. Locomotor function recovery of the rats' hindlimbs was evaluated weekly using the Basso, Beattie and Bresnahan (BBB) locomotor rating scale.The expression of tyrosine hydroxylase ( TH ) was detected in the injured region of the lumbar spinal cord. Results The BBB scores of rats in the OEC-walking training group and the walking training-DMEM group improved significantly from the 4th week post-injury compared to the SCI-DMEM injection group. Rats in the OEC transplantation group had a significant improvement in BBB scores at the 5th to 8th weeks post-injury. At the end of the 11th week post-injury, the average BBB scores were 13.14 ± 0.24 in the OEC-walking training group, 11. 64 ± 0.56 in the OEC transplantation group, 12.29 ±0.64 in the walking training-DMEM group and 11.07 ± 0.84 in the SCI-DMEM group.The OEC-walking training group scored significantly higher than the other 3 groups. Although the number of TH-positive neurons in the lumbar spinal cord was not significantly different among the groups, the morphology of TH-positiveneurons in the OEC-walking training group and the walking training-DMEM group was different from those in the OEC transplantation group and the SCI-DMEM group. Conclusions OEC transplantation combined with walking training can effectively promote the functional recovery of the hindlimb. The plasticity of the descending TH system and of motoneurons of the ventral horn of the lumbar spinal cord might mediate the changes.

Objective To explore diagnostic value of multi-slice spiral CT imaging features with respect to pancreatic neuroendocrine tumors (pNET) of different histological grades. Methods A retrospective analysis of preoperative abdominal plain CT and dual-phased contrast-enhanced CT was performed in 21 patients (median age, 47 years;12 males and 9 females) with pathologically proven pNET. age, gender, endocrine function, location and size of lesion, cystic change or necrosis, completeness of capsule, calcification, dilation of pancreatic duct were evaluated.CT attenuation-related parameters (plain CT value, relative density index, and CT value, CT value difference, enhanced percentage and enhancement index on arterial and portal phase) of each tumor were measured or calculated. All tumors were pathologically classified into three histological grades (G1, G2 and G3) based on mitotic count and ki-67 index. Kruskal-Wallis test was performed to compare differences of age, gender, endocrine function, morphological features among different grades. CT attenuation-related parameters were evaluated using Kruskal-Wallis or one-way analysis of variance (ANOVA). Results Twenty four pNET foci [grade G1 (n=13), G2 (n=7) and G3 (n=4)] were seen in the 21 patients. The difference of age, gender among different grades demonstrated no statistical significance (P>0.05). Nine lesions of G1 and 1 lesion of G2 demonstrated endocrine function, and the difference of endocrine function among three grades was statistically significant (χ2=8.355,P=0.012). For G1, G2 and G3, 11, 5 and 2 lesions were seen in uncinate process, pancreatic head and neck, respectively while 2, 2 and 2 lesions in pancreatic body and tail, respectively. The median maximum diameter of pNET of G1, G2 and G3 was 1.5, 2.5 and 6.7 cm, respectively;For G1, G2 and G3, 13, 4 and 0 lesions demonstrated intact capsule, respectively while 2, 3, and 3 lesions cystic degeneration and necrosis, respectivel; 0, 2 and 2 lesions calcification,respectively, 0, 1 and 2 lesions dilation of pancreaticobiliary duct, respectively, 0, 1 and 4 lesions sign of malignancy, respectively. The difference of size of lesion, completeness of capsule, calcification, and dilation of pancreatic duct showed statistical significance (P< 0.05). The difference of location of lesion and cystic change or necrosis displayed no significance (P>0.05). In addition, pNET of different grades demonstrated similar density and relative density index on plain CT. Regarding CT value, CT value difference, enhanced percentage and enhancement index on arterial and portal phase, the pNET of G2 showed highest value, while pNET of G3 lowest value, however, the difference about CT attenuation-related parameters among three grades showed no significant difference (P>0.05). Conclusion pNET of different histologic grades have some specific CT imaging features, which can facilitate an accurate diagnosis of pNET prior to therapy.