Objective To study the effect of exploratory environment on behavioral recovery and the expression of neurogranin (Ng) in rats after unilateral local cerebral infarction. Methods 70 male Sprague-Dawley rats were adopted. After making the model of MCAO with electric coagulation, 60 rats were randomly divided into exploratory group (n=30, living in maze cages) and control group (n=30, living in large standard cages). Other 10 rats as the sham group lived in standard cage. 10 rats were chosen randomly from the groups for Berderson test, manual muscle and balancing test on the 1st, 7th, 14th, 28th day after operation, and 5 rats were sacrificed separately in exploratory group and control group at the same time. 5 rats in sham group were randomly sacrificed separately on the 7th, 28th day after operation. The expressions of Ng in the peri-ischemic cortex were detected with immunohistochemistry stain. Results The scores of behavior in exploratory group improved compared with that in control group (P<0.05) from 14 d after operation. The number of Ng positive cells increased in exploratory group compared with that in control group (P<0.01) from 7 d after operation. Conclusion Exploratory environment can facilitate the functional recovery and the Ng expression in rats after unilateral local cerebral infarction.

Objective To explore the application effect of de-escalation thinking shift mode in emergency condition of morning shift meeting. Methods Guided by the de-escalation thinking, critical ill patients transfer tables were established in the emergency department, patients admitted into the emergency resuscitation room were selected from January 2015 to December 2015, and divided into the observation group (329 cases) and the control group ( 310 cases) . Patients in the control group applied the traditional oral shift meeting mode by the bed to check the patient; patients in the observation group applied the de-escalation thinking shift mode of morning shift meeting, followed by the specification of morning shift process and content; additionally, the cooperation of nursing staff, the transfer of nursing adverse events, nurses awareness of the patient′s condition, the patient satisfaction survey were counted before and after the implementation, respectively. Results Chinese version of Nursing Assessment Shift Report (NASR) was used to evaluate the cooperation status between the two sides of nursing staffs, and the mean scores of nursing staffs were 60.50±1.80 and 78.20±2.50 in the control group and the observation group, respectively, showing statistical significance (t=14.23, P<0.01);before application, corresponding statistical results regarding the shift meeting related nursing adverse events showed that there were 5 cases of infusion prolapse/leakage, 2 cases of pressure ulcer, 3 cases of pipe extrusion, and 2 cases of delayed drug delivery;after application, there were 2 cases of infusion prolapse/leakage, 0 case of pressure ulcer, 1 case of pipe extrusion, and 1 case of delayed drug delivery;comparison results showed significantly statistical difference (χ2=1.76-6.74, P<0.05). Before application, assessment results regarding the mean scores of nurses awareness of the patient's condition showed that mean scores of patients′ state of illness, test results, current treatment, potential risk, and nursing focus were 3.83 ± 0.62, 3.16 ± 0.64, 4.17 ± 0.36, 3.47 ± 1.26, and 3.64 ± 1.10, respectively;and after application, mean scores of patients′state of illness, test results, current treatment, potential risk, and nursing focus were 4.71 ± 0.27, 4.53±0.66, 4.89 ± 0.10, 4.50 ± 0.61, and 4.72 ± 0.43, respectively;the differences were statistically significant (t=-8.86--3.35, P<0.05). Furthermore, patient satisfaction with nursing staff in emergency department was improved from 91.6%(284/310) to 96.0%(316/329)(χ2 =25.74,P<0.05). Conclusions The application of de-escalation thinking shift mode in emergency condition of morning shift meeting may contribute to the specification of the transfer process, improvement of nursing work efficiency, and finally result in the promotion of patients′safety and teamwork.

Objective To evaluate early and mid-term results in infants,weighing less than 2 500 g,who underwent early cardiac surgery on cardiopulmonary bypass (CPB).Method Since November 2003 to December 2007,28 consecutive infants of less than 2 500 g underwent early cardiac surgery on CPB in Children's Hospital Affiliated to Fudan University.Sixteen infants were male,and 12 infants were female.The mean pregnancy period was 34 weeks (30 to 41 weeks) ,and 14 patients were premature,and the mean birth weight was 2 010 g(1 370-2 500 g).Mean age at operation was 27.46 d (range 1～61 d),and mean weight was 2 391 g (range 1 500～2 500 g).Deep hypothermia circulatory arrest was used in 9.Indications for surgery were:ventricular septal defect (10 infants),transposition of great arteries (6 iofants),totally anomalous pulmonary venom return (5 infants),pulmonary atresia with intact ventricular septum(2 infants),coarctation of aorta (1 infants) ,interrupted aortic arch (1 infants),cortriatriatum(1 infants),abnormal original of fight pulmonary artery (1 infants).Resuits Two (7.14%) infants died after operation at early phase.Mean duration of mechanical ventilation and intensive care unit stay were 113.9 h and 14.4 d,respectively.During follow-up (mean 16.87 months),one died.Two patients needed reintervention.About 84.4% infants didn' t need reintervention at the end of 12-month followup.Conclusions If medicine is aseless,infants woth low birth weight and congenital heart defect can obtain satisfactory outcome after CPB.Perioperative proration for virtual organs should be payed attention to.

Objective We aimed to assess the sedative effects by intravenous injection of fentanyl on neonates with mechanical ventilation. Methods We divided 142 neonates with mechanical ventilation into the observation group (92 cases) and the control group (50 cases). The observation group received intravenous injection of fentanyl, while the control group was given no sedative medication. The pain and sedation was assessed before ventilation, 1 and 2 hours after ventilation and later every 4 hours by adoption of NPASS evaluation inventory. Results The scores of pain at different time points 2 hours after medication in the observation group were lower than those in the control group, especially 24 hours after medication. The mean airway pressure and oxygen concentration required by the observation group was lower than those of the control group. But no difference was seen in blood oxygen saturation between the two groups. Conclusions Intravenous injection of fentanyl was proper in the application of sedative treatment for neonates with mechanical ventilation. N-PASS inventory could effectively assess the pain and sedation condition and ensure the safe medication.

Objective To investigate the inhibitory effect of dauricine on the growth of human bladder cancer T-24 cell and its mechanism.Methods The T-24 cells were treated with dauricine(Dau) at different concentrations.The proliferation of T-24 cells was assayed with MTT colorimetric method.The apoptosis of T-24 cells induced by Dau was studied by fluorescent staining,flow cytometry(FCM) and DNA agarose gel electrophoresis.Results Dau effectively inhibited the proliferation of T-24 cells in a concentration dependent manner.A characteristic DNA ladder was observed in Dau treated groups.Dau at the concentration of 5-30 ?g/ml induced the apoptosis of T-24 cells and the apoptosis rate increased in a time-dependeut manner.Cell cycle was arrested at G_0/G_1 phase.The expression of bcl-2 was inhibited and the expression of bax was up-regulated.Conclusion Dauricine significantly inhibits the growth of bladder cancer cells.Cell cycle arrest and apoptosis might be the functional mechanisms.

Objective Compare the analgesia effects of using different intervention method among neonatal infants, and then find out the most effective method. Methods Divided 120 neonatal infants into the control group, the NNS group and the position group, there were 40 cases in every group. Using the N-PASS scale evaluated the pain degree at the points of 1 and 5 minutes respectively after stimulation among the 3 groups. Results There was significant difference between the 3 groups on the pain degree,P

Objective A retrospective study was undertaken to evaluate the outcomes of the newborns with pulmonary atresia with intact ventricular septum(PAIVS),in order to delineate strategies for the optimal management of PAIVS. Methods From July 2003 to July 2008,17 neonates with PAIVS underwent surgical treatment.The mean age at operation was(1 5.6±8.6)d and the mean weight was(3.54±0.44)kg.Initial surgical treatment included:Blalock-Taussig shunt (BT shunt)in 2 cases,closed pulmonary valvotomy and BT shunt in 1 case,right ventricular outlet tract reconstruction(RVOTR)in 2 cases,RVOTR and BT shunt in 11 cases. Results The mean duration of mechanical ventilation and intensive care unit stay were(35.5±35.1)h and(8.7±5.9)d,respectively.Two early deaths were reported inside the hospital(2/17,11.8%).Multivariable analysis demonstrated that mechanical ventilation before surgery was the risk factor for in-hospital mortality(r=1.02,P<0.01).The rest 15 cases were followed up with the average time of 19 months(2 months to 5 years)and no death was reported. Conclusions Neonates with PAIVS should be operated early.Individualized treatment strategy and regular follow-up are helpful to achieve better short-term outcome.

Objective To compare the efficacy of inhaled Iloprost and nitric oxide( NO)in infants with moderate or severe pulmonary hypertension(PH)after congenital heart disease surgery. Methods This was a prospec-tive randomized study in Children's Hospital of Fudan University from January 2011 to January 2014,including 40 in-fants who suffered from moderate to severe PH after heart surgery. Their ages ranged from 1 to 24 months. Their weight ranged from 3. 2 to 11. 0 kg. They were randomly allocated to inhale NO( NO group,n = 20)or Iloprost( Iloprost group,n = 20). Iloprost group was given Iloprost with 50 ng/(kg·min)for 10 min and then combined with NO 20 × 10 - 6 for 10 min;NO group was first given 20 × 10 - 6 of NO for 10 min,then combined with Iloprost 50 ng/(kg·min) for 10 min. Heart rate,systolic blood pressure,pulmonary artery pressure(PAP)and central venous pressure were recor-ded continuously. At the same time,the concentration of nitrogen dioxide and methemoglobin after inhaling NO was de-tected. Results Inhaled Iloprost and NO caused significant reduction in PAP(t = 4. 670,P = 0. 009;t = 3. 762,P =0. 004)and pulmonary - to - systemic pressure ratio(Pp/ Ps)(t = 16. 974,P = 0. 000;t = 9. 682,P = 0. 000)but signifi-cant increase in oxygen index separately. The combination had no additional effect compared with single application. In term of the reduction of PAP,there was no significant difference between inhaled Iloprost and NO(F = 2. 742,P =0. 129). The levels of nitrogen dioxide and methemoglobin were not above the normal limits. Conclusions Moderate to severe PH after cardiac surgery was significantly reduced by inhaled NO and Iloprost. They had similar effects. However, the combination of both vasodilators failed to prove more potent than either substance alone. Compared with the potential toxicity of NO,the individual differences and the complex transmission,Iloprost may be more reasonable and feasible for the postoperative treatment of PH.

ObjectiveTo study the effect of exercise on expression of p38 after cerebral infarction in rats.MethodsThe right middle cerebral artery was occluded(MCAO) with electric coagulation in Wistar rats,and then were divided into three groups at random 48 hours later: training group which were given wheel-running exercise everyday(n=20);control group(n=20) and sham group(n=10).The expression of p38 in cortex of the three groups were detected on 7th,14th,21th and 28th day after the MCAO.ResultsIn the cortex around the infarcted focus,the expressions of p38 elevated much significantly after cerebral infarction(P<0.05).The expression of p38 in training group were higher than those in control group(P<0.05) on the 21th and 28th day.ConclusionThe cerebral infarction could induce the expression of p38.The exercise could enhance its expression.

Objective To investigate the effect of transcranial direct current stimulation (tDCS) on aphasia recovery after stroke. Meth-ods From April, 2012 to January, 2013, 20 aphasic patients after stroke were enrolled in an A-B experiment design. During phase A, ten times of sham tDCS and language training (five days a week) were implemented, then ten times language training combined with tDCS (five days a week) were implemented in phase B. The treatment lasted for four weeks. Picture naming was measured for all patients before and af-ter treatment both in phase A and phase B. Results The D-value scores of picture naming before and after treatment were significantly more in phase B than in phase A in both treatment items and non-treatment items (t>3.030, P<0.05). Conclusion tDCS could raise the accuracy of picture naming in patients with aphasia after stroke.