Objective To compare the timeliness, success and mortality rates between the modified carotid artery puncture method ( MCAPM) and standard suture method ( SSM) in the establishment of rat model of a middle cerebral ar?tery occlusion ( MCAO) . Methods Thirty?two male rats were randomly and equally assigned into MCAPM group and SSM group. The MCAO models were established by inserting a thread into the common carotid artery ( CCA) . 24 h after modeling, the rats of the two groups were evaluated with Bederson neurological scores, and the modeling success rate and mortality rate were analyzed. Results The suture insertion times, success rates and mortality rates of the MCAPM vs. SSM groups were (82?3 ±17?4) s versus (164?6 ± 22?0) s (P<0?01), 87?5% versus 68?75% (P>0?05), and 6?25% versus 18?75% (P>0?05). Conclusions MCAPM can be used to establish the rat model of MCAO due to its simplicity, mild wound and feasibility.

Objective To explore the impact of nursing intervention on quality of life of blood dialysis patients.Methods 60 cases of hemodialysis patients were selected and divided into the experimental group and the control group with 30 patients in each group.The control group was given conventional nursing,while the experimental group was given systematic health education and psychological nursing.The differences in life quality before and after the intervention in the experimental group was evaluated with self-designed questionnaire.The changes in motor function,psychological function,social function,and material life were compared before and after the intervention between two groups.Results After the intervention,the score of motor function,psychological function and total evaluation of the experimental group were higher than those of the control group.Conclusions Nursing intervention can effectively alleviate the discomfort feeling of patients,reduce their mental pressure,increase their quality of life.Nursing intervention is closely related with quality of life.

Objective To observe the regulatory role of long non-coding RNA HIF1A-AS1 on the autophagy of pancreatic cancer PANC1 cells induced by hypoxia.Methods The pancreatic cancer PANC1 cells were cultured in a three-gas incubator filled with hypoxic gas mixture (94% N2,5% CO2,1% O2) for 3, 6, 12, 24, 36 and 48 h.HIF1A-AS1 overexpression and low expression PANC1 cells were obtained by the infection of recombinant adenovirus carrying HIF1A-AS1 and the transfection of HIF1A-AS1 targeting siRNA by liposome, and routinely cultured PANC1 cells served as control.The expression of HIF1A-AS1 of PANC1 cells was detected by real-time quantitative PCR after being cultured in hypoxia-induced condition for 24 h.The apoptosis rate was detected by flow cytometry.The autophagy related proteins Beclin 1 were detected by western blot.Results The expression of HIF1A-AS1 in hypoxic cells was increased as the hypoxic time increased since 6 h and peaked at 36 h, which was significantly higher than that in control group (P<0.01).HIF1A-AS1 relative expression in HIF1A-AS1 overexpression and low expression PANC1 cells was 4.49±0.53 and 0.49±0.07, which were normalized to that of control group with the relative expression of 1.Control group had lower HIF1A-AS1 expression than HIF1A-AS1 overexpression PANC1 cells but higher HIF1A-AS1 in HIF1A-AS1 low expression PANC1 cells, and the differences were statistically significant (P<0.01).The cell apoptosis rate of control, HIF1A-AS1 overexpression and low expression PANC1 cells was (8.27±1.28)%, (6.56±1.49)% and (19.9±2.34)% after 24 h hypoxic culture.Control group had higher HIF1A-AS1 expression than HIF1A-AS1 overexpression PANC1 cells but lower HIF1A-AS1 in HIF1A-AS1 low expression PANC1 cells, and the differences were statistically significant (P<0.01).The expression of Beclin 1 protein was protein 1.05±0.11, 1.29±0.19 and 0.38±0.18, respectively.Control group had lower Beclin 1 expression than HIF1A-AS1 overexpression PANC1 cells but higher Beclin 1 in HIF1A-AS1 low expression PANC1 cells, and the differences were statistically significant (P<0.01).Conclusions HIF1A-AS1 can promote autophagy of pancreatic cancer PANC1 cells induced by hypoxia and participate in the pathogenesis and metastasis of pancreatic cancer.

Objective To evaluate the clinical efficacy of small endoscopic sphincterotomy combined large-bal-loon dilation in treatment of common bile duct stones 1.0~2.5 cm in diameter. Methods 426 patients with large common bile duct (CBD) stones 1.0~2.5 cm in size were reviewed in our hospital between June 2010 and June 2014. They were randomized underwent small endoscopic sphincterotomy combined large-balloon dilation (SESPLBD) (n=218) or endoscopic sphincterotomy (EST) ( n= 208) for lithotripsy. The therapeutic outcome and complications were reviewed and compared. Results SESPLBD had higher complete duct clearance in one session (95.41 % vs. 93.75%), but there was no statistical significant difference. Bleeding was much less occurred in SESPLBD than in EST (2.29 % vs. 7.69 %, P= 0.025), especially when the stones were bigger than 1.5 cm in diameter. Mechanical lithotripsy was performed less in SESPLBD (13.76%vs 25.96 %, P=0.002), especially when the stones were 1.5 ~2.0 cm in diameter. There was no statistical significant difference in the incidence rate of post-ERCP pancreatitis (9.17 % vs. 6.73 %,P = 0.452), hyperamylasemia (19.72 % vs. 18.27 %,P = 0.796), perforation and death. Conclusions SESPLBD could be a safe method for large bile duct stones 1.0~2.5 cm in size. Compared with routine EST, it had less bleeding rate and mechanical lithotripsy requirement without increasing the incidence rate of post-ERCP pancreatitis or hyperamylasemia.

Objective To investigate the antimicrobial resistance mechanisms and genetic homogeny of Salmonella from community acquired infections in Shenzhen,China.Methods Ninety-three of Salmonella were isolated from 2002 to 2007 at Shenzhen People's Hospital,China.PCR and DNA sequencing were used to investigate the mutation in QRDR of the gyrA,gyrB,parC and parE.Plasmid mediated quinolone resistance genes including qnr and aac(6')-Ib-cr,β-lactamase genes including blaTEM,blaSHV,blaOXA, blaCTX-M, and class 1 integron were detected. All isolates were typed by PFGE. Results S. enterica typhi and S. enterica paratyphi A were susceptible to ampicillin, chloramphenicol, trimethoprim/sulfamethoxazole, ceftriaxone and ciprofloxacin, with the susceptible rate of 96%-100%. Fifty-two percent (13/25) of S. enterica typhi and 95% (61/64) of S. enterica paratyphi A were resistant to nalidixic acid. Twenty-four percent (6/25) of nalidixic acid-resistant S. enterica typhi and 94% (60/64) of nalidixic acid-resistant S. enterica paratyphi A showed decreased susceptibility to ciprofloxacin (MIC of 0. 125-1 μg/ml).All nalidixic acid-resistant (susceptible to ciprofloxacin ) Salmonella (NARS) isolates had a single substitution in the QRDR of GyrA, and 91% (68/75) of these isolates carried the substitution Ser83Phe in GyrA. Two mutations in the QRDR of GyrA were detected in both of two ciprnfloxacin-resistant Salmonella,with the additional one mutation in the QRDR of parC. Plasmid mediated quinolone resistance genes including qnr and aac(6')-lb-cr were not detected in any isolate. The blaCTX-M-14 gene was detected in a ceftriaxoneresistant isolate of S. enterica paratyphi A, with ISEcpl located on the upstream of it. Three muhidrugresistant strains of Salmonella all carried one 1 900 bp classⅠ integron gene cassette dhfrⅫ-orfF-aadA2,with the additional one β-lactamase gene of blaTEM-1, or blaOXA-30. Twenty-two distinct PFGE patterns were observed among twenty-five S. enterica typhi. The PFGE patterns of sixty-four S. enterica paratyphi A showed limited genetic diversity (average similarity of 91% ). Ninety investigated inpatients were infected in the community. Six patients infected by S. enterica paratyphi A had a travel history before infection. Conclusions Nalidixic acid-resistant S. enterica typhi and S. enterica paratyphi A are highly prevalent in Shenzhen,China. The mutation in the QRDR of GyrA is the prevalent mechanism responsible for the resistance to nalidixic acid in Slmonella. The great genetic similarity among S. enterica paratyphi A isolates indicates endemic disease from the presence of a single clone over 6-year period.

Objective To explore the relationships among nurses’intent to stay,occupational commitment and managers’ leadership styles in emergency department.Methods A total of 130 nurses in emergency department were recruited by convenience sampling method from three tertiary hospitals in Guangzhou.They were investigated by using Nurses’Intent to Stay Questionnaire, Nurses’Occupational Commitment Questionnaire and Multifactor Leadership Questionnaire(MLQ).Results The score of nurses’ intent to stay and occupational commitment were(20?19±3?74)and(76?16±12?13),respectively;both were at medium levels and occupational commitment,transformational leadership style were positively correlated with nurses’intent to stay(P<0?05).Nurses perceived their managers as transformational leaders more often than transactional leaders.Conclusions Both the current nurses’ intent to stay,occupational commitment were at medium levels.The influential factors of nurses’intent to stay in emergency department included emergency work experience,emotional commitment and normative commitment.In order to increase nurses’retention and stabilize the healthy development of nursing personnel,nurse managers should improve the level of nurses’occupational commitment.

Objective:To evaluate the clinical value of the transcutaneous neuromodulation (TN) in improving gastrointestinal function after gastrointestinal tumor operation.Methods:From April 2019 to June 2020, at The Affiliated People′s Hospital of Ningbo University, 100 patients who underwent gastrointestinal tumor surgery were included. The 100 patients were randomly divided into treatment group(receiving TN treatment, 50 cases)and control group (receiving sham TN treatment, 50 cases). The clinical data of the two groups was compared to evaluate the recovery of gastrointestinal function, which included the time of first defecation, time of first flatus, time of first ambulation, time of resuming diet, the incidence of nausea and vomiting within 3 d after operation and pain score (0 to 10). Heart rate variability (HRV) was compared between two groups to analyze the possible mechanism of TN improving gastrointestinal function after gastrointestinal tumor surgery. Independent sample t test and Chi-square test were used for statistical analysis. Results:Among 100 patients, there were 63 male and 37 female patients, the age was (67.0±11.3) years old, ranged from 28 to 92 years old. Compared with the control group, the time of first defecation, first flatus, first ambulation and resuming diet of treatment group reduced by 31.0%, 39.8%, 38.0% and 32.4% ((72.1±3.0) h vs.(104.5±2.9) h, (49.4±5.7) h vs.(82.1±3.1) h, (3.1±0.7) d vs.(5.0±0.9) d, (4.8±0.9) d vs. (7.1±0.8) d)), respectively; the pain scores on the day 2 and day 3 after operation and incidence of nausea and vomiting within 3 d after operation decreased by 50.0%, 65.5%, 26.0%(1.5±0.6 vs. 3.0±0.7, 1.0±0.6 vs. 2.9±0.6, 16.0%, 8/50 vs. 42.0%, 21/50), respectively, and the differences were statistically significant ( t=54.28, 35.72, 11.67, 13.66, 12.00 and 14.90, χ2=8.21, all P<0.01). The results of HRV analysis showed that the high frequency on day 3 was higher than that on day 1 of treatment group, and the ratio of low frequency to high frequency after operation was lower than that before operation of treatment group (0.5±0.1 vs. 0.4±0.1, 1.2±0.7 vs. 1.9±1.0), and the differences were statistically significant( t=-4.81 and 4.26, both P<0.01), which indicated TN could enhance vagal activity. Conclusions:TN promote the recovery of gastrointestinal function after gastrointestinal tumor operation, and can be used as an adjuvant therapy to accelerate the recovery of gastrointestinal function after gastrointestinal tumor operation.

Epilepsy is one of the common diseases of nervous system, and its pathogenesis is complex. More and more attention has been paid to the role of glucose metabolism disorder in seizures. In recent years, the related researches are in the ascendant. In this paper, we summarize the different biochemical mechanisms that contribute to the disturbance in glucose metabolism in epilepsy patients, including glucose transport, glycolysis, aerobic oxidation of glucose, synthesis and decomposition of glycogen and glycolism.

Objective To investigate the effect of first aid nursing path under the center of chest pain on the diagnosis and treatment of patients with ST-segment elevation myocardial infarction (STEMI). Methods A total of 79 cases of STEMI patients who had been selected for emergency treatment after the establishment of the chest pain center were as the experimental group. The patient's first aid nursing path was used in the center of chest pain. A total of 159 cases of STEMI patients before the establishment of the chest pain center were as the control group, Application of traditional clinical pathway. Compared to the diagnosis and treatment effect of two groups of patients. Results The rate of completed the project within 10 min for the experimental group: the completion of electrocardiogram examination (91.1% vs 84.9% ), oral aspirin, clopidogrel, or lindinda (81.0% vs 75.5%), and laboratory medical order (79.7% vs 69.8%) were higher than those in the control group, and the difference was statistically significant (χ2=2.31, 1.68, 2.06, P < 0.05). The day of hospitalization in the experimental group was less than that of the control group (6.48±3.82 vs 9.76± 4.32), and the difference was statistically significant (t=-9.80, P < 0.05). The mortality rate during hospitalization was lower than that of the control group (5.66% vs 3.8% ), and the difference was statistically significant (χ2=-2.24, P<0.05). Conclusion The first aid nursing path in the center of chest pain can shorten the time of diagnosis and treatment of STEMI patients and improve the diagnosis and treatment effect of STEMI patients.

Objective To study the effect of acupuncture combined with clean intermittent catheterization in the treat-ment of neurogenic bladder. Methods A total of 46 patients were randomly divided into test and control groups. There were 23 patients in the each group. The clean intermittent catheterization only used in the control group. However inte-grated acupuncture and clean intermittent catheterization were used in the test group. Final the residual urine volume and the incidence of bacteriuria were researched after 5 months. Results There were 17 cases restored the micturating function in the test group, however only 7 cases in the control group. There were 3 cases suffered bacteriuria in the test group, but there were 11 cases suffered bacteriuria in the control group. The difference between the two groups was sta-tistical ly significantly (P<0.05). Conclusion Combined acupuncture with clean intermittent catheterization can effi-ciently maintain the normal function of bladder, decrease the residual urine volume, and reduce the incidence of bac-teriuria.