Objectives:To evaluate the relationship between the activity of cholesteryl ester transfer protein(CETP) and cardiocerebrovascular diseases.　Methods:The CETP activity of 45 cases of coronary heart disease(CHD) and 26 cases of stroke were measured using the synthetic substrate of 14　C-radiolabeled discoidal bilayer particles as the cholesteryl ester donor and LDL as receptor.　Results:The CEPT activity(x±s) of CHD and stroke patients were(17.6±5.4)% and(15.2±3.8)%,while the healthy controls were(12.7±2.0)%.The CEPT activities in CHD and stroke patients were significantly higher than that in healthy controls(P<0.01).　Conclusions: CETP is related to the occurrence and development of atherosclerosis.

Objective To sift out the optimized electric pulse parameters for electroacupuncture treatment for lower limb myatrophy and explore the mechanism of its treatment.Method A model of lower limb myatrophy was made in 40 SD rats.The rats were then randomized to groups A (model group without electroacupuncture), B (a pulse duration of 0.5 ms and a frequency of 2 Hz), C (a pulse duration of 200 msand a frequency of 2 Hz) and D (a pulse duration of 200 ms and a frequency of 1/2/3 Hz).Points Zusanli(ST36)and Chengshan(BL57)were given electroacupuncture for four courses of treatment.Thesciaticfunction index (SFI),gastrocnemius muscle wet weight ratio (GW), gastrocnemius muscle fiber cross-sectional area ratio (GC),gastrocnemius muscle cell diameter ratio (GD)and gastrocnemius muscle cell apoptosis index (AI)were determined.Result SFI, GW and GC increased significantly and AI decreased significantly in groups C and D compared with group A (P<0.05). AI decreased significantly in groups C and D compared with group B (P<0.05). AI decreased significantly in groups D compared with group C (P<0.05). Conclusion Apulse duration of 200 ms and a frequency of 1/2/3 Hz are the optimizedelectric pulse parametersfor electroacupuncture delaying myatrophy.Its mechanism is related to inhibiting myocyte apoptosis.

Objectives:To compare the susceptibility of serum lipoproteins to oxidation and the effects of high-density lipoprotein on oxidative stress in patients with lipid turbulence.　Methods:VLDL, LDL and HDL were isolated using sequential ultracentrifugation from serum of patients with chronic renal failure (CRF) (n=45), myocardial infarction survivor (MIS) (n=33) , cerebral infarction(CI)(n=33) ,type 2 diabetes mellitus(DM)(n=53) and normal individuals (n=44). The degree of lipid peroxidation was estimated using the thiobarbituric acid-reactive substances (TBARS) value and the susceptibilities of lipoproteins to oxidation were assessed by measuring the increased absorbance value at 234 nm due to the conjugated dinene formation. Lipid levels and lipoprotein fractions were measured using standard methods.　Results: VLDL obtained from the patient groups showed significant increase in TBARS values, especially from the patients with MIS (compared with control group, P<0.001). In addition, LDL from MIS and DM groups and HDL from CI and DM groups also showed markedly increase in TBARS content. Significant decrease in lag time was observed in both VLDL and LDL fractions from the four patient groups. However, no change was found in the lag time in HDL fraction from the patient group compared with control group. In addition, HDL from the four patients exhibited significantly decreased inhibitory effects on in vitro oxidation of LDL, with the most significant decrease in HDL from CRF and MIS groups.　 Conclusions:The oxidative modification of lipoproteins in vivo in patients with serum lipid turbulence might be involved in the development of atherosclerosis in these patients.

Objective To sift and optimize pulse width for electroacupuncture prevention and treatment of muscular atrophy. Method A model of lower limb muscle atrophy was made in 40 rats. They were randomized into groupsⅠ (no electroacupuncture),Ⅱ (a pulse width of 0.5 ms and a frequency of 2 Hz), Ⅲ (a pulse width of 100 ms and a frequency of 2 Hz) and Ⅳ (a pulse width of 200 ms and a frequency of 2 Hz). Points Zusanli (ST36) and Chengshan(BL57) were given electroacupuncture. Sciatic function index (SFI), gastrocnemius muscle wet weight ratio (GW), the cross-sectional area of gastrocnemius muscle fibers (GC), gastrocnemius muscle cell diameter (GD) and gastrocnemius muscle cell apoptosis index (AI) were used as indicators of therapeutic effect. Result Compared with group Ⅰ, SFI and GW increased significantly in groups Ⅲ and Ⅳ (P<0.05). Compared with groupsⅠ and Ⅱ, AI on the affected side decreased significantly in groups Ⅲ and Ⅳ (P<0.05). Conclusion The therapeutic effect of electroacupuncture is related to its pulse width. The pulse widths of 100 ms and 200 ms are significantly more effective than a pulse width of 0.5 ms from a conventional electroacupuncture device in preventing and treating muscular atrophy.

Objective To develop nurses'knowledge,attitude and practice questionnaire on medication management for patients with dysphagia,and test its reliability and validity.Methods Based on the evidence-based summary of the best evidence of medication management for patients with dysphagia,guided by the the-ory of knowledge,attitude and practice,the basic dimensions and item pool of the questionnaire were deter-mined through group discussion,Delphi expert consultation and pre-investigation.In order to revise the ques-tionnaire,437 nurses from 10 tertiary hospitals in Jiangsu Province were conveniently selected for investigation,and the reliability and validity of the questionnaire were tested according to the survey results.Results The nurses'knowl-edge,attitude and practice questionnaire on medication management for patients with dysphagia included 43 items in three dimensions.The three dimensions were analyzed by exploratory factors,and six common factors with characteristic roots>1 were extracted.Two factors were extracted from the knowledge dimension,and the cumulative variance contribution rate was 74.958%,One factor was extracted from the attitude dimen-sion,and the cumulative variance contribution rate was 77.655%.Three factors were extracted from the prac-tice dimension,and the cumulative variance contribution rate was 72.274%.The factor load of each item was 0.618-0.902,Cronbach's α coefficient of the total questionnaire was 0.949,and the test-retest reliability was 0.909.The overall content validity coefficient of the questionnaire was 0.922,and the content validity coeffi-cient for each item was 0.800-1.000.Conclusion The nurses'knowledge,attitude and practice questionnaire on medication management for patients with dysphagia developed in this study has good reliability and validi-ty,and could be used as an effective tool to evaluate the status quo of nurses'medication management for pa-tients with dysphagia.

Objective:To review the clinical status based on the best evidence of drug administration in patients with dysphagia, systematically analyze the obstacle factors and promoting factors in the process of evidence transformation, and formulate reform strategies.Methods:Based on the evidence-based nursing research method and the guidance of the Ottawa Model of Research Use (OMRU), the review indicators were developed based on the best evidence. The current status of clinical practice behaviors of 223 patients and 75 nurses in the Neurology, Neurosurgery and Geriatric departments of the Affiliated Hospital of Jiangsu University were reviewed from July to December 2021.Based on the results of the review, qualitative interviews were conducted with 32 potential adopters, and content analysis was used to assess the barriers and contributing factors to the clinical translation of evidence in three aspects: evidence-based change, potential adopters and practice environment, so as to develop effective strategies.Results:Based on the 22 best evidence selected, the evidence-based team developed 25 review indicators to carry out clinical review, showing that the compliance rate of 16 indicators were less than 60%. By analyzing and summarizing the interview results of potential adopters, the main obstacles leading to the low compliance rate of nurses were analyzed as follows: evidence-based reform changed the traditional work mode, and the application of evidence was not convenient; at the level of potential adopters, nurses had poor knowledge and practice, heavy work burden, and low awareness of patients and caregivers; at the level of practice environment, there was lack of nursing norms and procedures for clinical transformation of evidence, and the channels of multi-disciplinary collaboration and communication were not smooth. The main promoting factors were the perfect supervision mechanism of evidence-based nursing projects, the evidence-based group had rich experience in evidence transformation, the management was willing to change, and the practitioners were good at innovation.Conclusions:There is still a large gap between the clinical practice and the best evidence of drug administration in patients with dysphagia. The promoting factors should be fully utilized to overcome the obstacles and implement improvements to promote the effective transformation of evidence into clinical practice.

OBJECTIVETo detect cholesteryl ester transfer protein (CETP) levels, frequencies of CETP D442G and I 14A mutations and characteristics of abnormal lipids in patients with cardio-cerebro vascular diseases.

METHODSNinety-four myocardial infarction (MI) patients, 110 stroke patients and 335 healthy controls were selected. The CETP concentration was determined using ELISA. The CETP activity was measured using a substrate of (14)C-radiolabeled discoidal bilayer particles. The CETP gene mutations were detected by PCR-RFLP.

RESULTSThe CETP concentrations in the MI and stroke group, were higher than those in the controls. The gene mutation frequencies of D442G in the MI, stroke and control group were 3.5%, 3.6% and 5%, respectively, and the frequencies of I 14A were 1.05%, 0.91% and 1%, respectively. One case of D442G homozygote was detected in the healthy group. The frequency of two CETP gene mutations showed no significant difference among the patients and controls. The CETP concentration and activity in subjects with CETP mutations were one-third of those in the control group. The level of HDL-C, apo-A1 increased in the mutation subjects, while the TG level decreased.

CONCLUSIONSThe CETP level increased significantly in patients with cardio-cerebrovascular diseases. The carriers of CETP deficiency had CETP and lipid abnormalities.

Carrier Proteins ; blood ; genetics ; Cholesterol Ester Transfer Proteins ; Glycoproteins ; Humans ; Lipids ; blood ; Male ; Middle Aged ; Mutation ; Myocardial Infarction ; blood ; genetics ; Stroke ; blood ; genetics