Objective To explore the neuroprotective effect of dexmedetomidine ( Dex) in rats ex-posed to focal cerebral ischemia/reperfusion ( I/R) induced by middle cerebral artery occlusion ( MCAO) and the possible mechansims.Methods Adult male Sprague-Dawley rats were subjected to MCAO for 90 min followed by reperfusion for 24 h and Dex ( 15μg? kg-1 ) was infused through the left femoral vein im-mediately after the onset of MCAO.The PI3K inhibitor LY294002 ( LY,10 mM,10 μl) or eNOS inhibitor L-NIO ( 1 mg? kg-1 ,10μl) was intracerebroventricular administered before ischemia using a microinjecton. The neurological deficit score,brain edema,cerebral infarct volume,and neuron survivals were evaluated after 24 h of reperfusion.The expression of p-Akt ( Ser473) and p-eNOS ( Ser1177) in the ischemic hemicere-brum was detected by Western Blot.Results Compared with I/R group,the neurological deficit score,cere-bral infarct volume,and the degree of brain edema were significantly reduced in the rats treated with Dex ((2.3±0.4) vs (3.9±0.6),(19.3±3.5)%vs (40.5±5.4)%,(61.8±8.1)%vs (76.3±8.5)%,all P<0.05)re-spectively,and the number of survival neuron in the hippocampal CA1 and cortex was significantly increased ((136.5±15.8)/mm vs (53.5±7.9)/mm,(253.8±26.4)/mm3vs (112.5±14.6)/mm3,all P<0.01) respec-tively.The neuroprotection in DEX group was significantly inhibited by LY and L-NIO ( P<0.05) .In addi-tion,the expression of p-Akt and p-eNOS in the ischemic hemicerebrum was markly reduced in LY group compared with that in DEX group ((3.94±0.45) vs (0.85±0.21),(2.14±0.25) vs (0.79±0.29),all P<0.01) ,while there was no significant difference in the expression of p-Akt in the ischemic hemicerebrum be-tween L-NIO group and DEX group ((3.76±0.33) vs (3.94±0.45), P>0.05).Conclusion Dex can reduce cerebral injury in rats exposed to focal I/R,which is mediated by the activation of PI3K/Akt-eNOS pathway.

Objective To determine the relationships among the balance between nurse's work and family,the nursing practice environment and demission intention.Methods A total of 351 nurses were recruited from 5 hospitals in Zhengzhou by convenience sampling method.They were investigated using the Questionnaires for balance between nurse's work and family,the nursing practice environment and demission intention.Results The mean scores of the balance between nurse's work and family,the nursing practice environment and demission intention was (3.09±0.46),(2.86±0.48),(2.51 ±0.57).The predictors of demission intention of nurses were rational allocation of resources,age,work disturbs family,and family promotes work.Conclusions The levels of the balance between nurse's work and family,the nursing practice environment and demission intention are all in the medium.The balance between nurse's work and family and the nursing practice environment have direct positive influence on demission intention.

Objective To explore the relationship between homocysteine(HCY),glycosylated hemoglobin(HbA1c),lipids and posterior circulation ischemia and the clinical significance of their levels in the posterior circulation ischemic (PCI)diseases. Methods Difference between PCI were diagnosed in 140 examinees and a healthy control group,with fasting serum,HCY, HbA1c,total cholesterol (TC),triglyceride (TG),high density lipoprotein cholesterol (HDL-C)and low-density lipoprotein cholesterol (LDL-C)were detected.Results HCY and HbA1c were significantly higher,HDL-C was significantly lower in the patients with PCI,two independent sample t-test showed a significant difference between the test group and control group (P <0.001 and P =0.001),the remaining lipid indicators was not statistically significant.Spearman rank correlation analysis showed that HCY levels had significant positive correlation (P <0.001)and TG levels had significant negative cor-relation (P =0.013)with the subjects age,HCY levels had significant negative correlation with TG levels(P = 0.028), HbA1c levels had significant positive correlation with TG levels and LDL-C levels(P =0.001 and P =0.027).Conclusion High levels of HCY and HbA1c were closely associated with PCI,which HCY and HbA1c should be attached great impor-tance to the effective prevention and treatment and improve of PCI.

Objective To construct HaCaT cell lines stably expressing the wild type human GJB6 gene or its mutant by using a Tet-On lentiviral vector, and to lay an experimental foundation for studies on pathogenesis of hidrotic ectodermal dysplasia. Methods The wild-type human GJB6 gene and its mutant (A88V)were amplified by PCR, and then inserted into the Tet-on lentivirus plasmid to construct recombinant lentivirus vectors. The recombinants were identified by gene sequencing and enzymatic digestion. Cultured HaCaT cells were classified into three groups to be transfected with a negative control lentiviral vector (NC group), the lentivirus vector expressing the wild-type human GJB6 gene (WT group), or the lentivirus vector expressing the mutant human GJB6 gene (MU group). Puromycin was used to select HaCaT cell clones stably expressing the GJB6 gene which encodes the connexin 30 (Cx30)protein. The selected HaCaT cell clones were cultured with or without tetracycline for 48 hours, thereafter, real-time PCR(RT-PCR) was performed to detect GJB6 gene mRNA expression, Western-blot analysis to measure expressions of Cx30 and FLAG-tag proteins, and cell counting kit 8 (CCK8)assay to evaluate cellular proliferative activity. Results Enzymatic digestion and gene sequencing showed that recombinant lentivirus plasmids were successfully constructed. RT-PCR showed evidently increased mRNA expression of the GJB6 gene in stably transfected HaCaT cells. Moreover, the expression abundance of the GJB6 gene was 112.369 times higher in the WT group induced by tetracycline than in that without tetracycline treatment (P < 0.05), and 2.249 times higher in the MU group induced by tetracycline than in that without tetracycline treatment (P < 0.05). Western-blot analysis showed that Cx30 and FLAG-tag proteins were stably expressed in the WT group and MU group after induction with tetracycline, while neither of them was observed in the WT group or MU group without tetracycline treatment, or in the NC group. Significant differences were noted in cellular proliferative activity (expressed as the absorbance value at 450 nm)between the MU group with and without tetracycline treatment and between the WT group with and without tetracycline treatment at 4, 8, 12, 24, 36 and 48 hours (all P <0.05), but not between the NC group with and without tetracycline treatment at any of the above time points (all P >0.05). Conclusion HaCaT cell lines which stably express the wild-type GJB6 gene or its mutant(A88V)are successfully constructed.

Objective:To investigate the clinical characteristics and related factors of patients with chronic obstructive pulmonary disease (COPD) complicated by obstructive sleep apnea (OSA).Methods:The clinical data of 153 patients with COPD who received treatment in Xiangyang First People's Hospital from July 2018 to December 2019 were retrospectively analyzed. A total of 101 patients with complete data regarding pulmonary function and polysomnography who met inclusion criteria were selected. They were divided into simple COPD (COPD group, n = 33) and COPD + OSA (OS group, n = 68) groups according to whether they developed OSA. General clinical data, pulmonary function indexes and polysomnography indexes were compared between the COPD and OS groups. Logistic regression analysis was performed to analyze the degree of airflow limitation and the related factors of COPD combined with OSA. Results:There were more males than females in each group. In the OS group, the proportion of males, body mass index, forced expiratory volume in one second (FEV 1), forced expiratory volume in 1 second percent predicted (FEV 1%pred), the ratio of FEV 1 to forced vital capacity (FVC), apnea-hypopnea index and oxygen desaturation index in the OS group were 92.6%, 24.0 (23.4, 24.8) kg/m 2, 1.2 (1.2, 1.5) L, 50.0 (49.6, 59.4)%, 49.1 (46.9, 53.0)%, 15.4 (16.4, 25.3) times/h, 14.8 (17.3, 25.6) times/h, respectively, which were significantly higher than those in the COPD group [75.8%, 23.0 (21.6, 23.7) kg/m 2, 0.9 (0.9, 1.1) L, 41.0 (38.3, 49.1) %, 41.9 (39.5, 49.24)%, 1.9 (1.6, 2.4) times/h, 4.0 (3.7, 9.7) times/h, t or U = 4.246, 1 399.000, 1 544.500, 1 483.000, 1 407.000, 2 244.000, 1 915.000, all P < 0.05]. The lowest oxygen saturation at night in the OS group was significantly lower than that in the COPD group [81.5 (79.4, 82.6) % vs. 87.0 (80.2, 86.6) %, U = 758.500, P < 0.05]. There were no significant differences in age, smoking index and forced vital capacity between COPD and OS groups ( t = - 0.963, 1 150.000, - 1.954, all P > 0.05). Correlation and Logistic regression analysis revealed that the risk of severe or very severe airflow limitation was lower in the OS group than in the COPD group ( OR = 0.392, P < 0.05). BMI, FEV 1, FEV 1%pred were the risk factors of COPD combined with OSA ( OR = 1.185, 5.554, 1.034, all P < 0.05). BMI and FEV 1 were the independent risk factors of COPD combined with OSA ( OR = 1.168, 5.248, both P < 0.05). Conclusion:COPD and OSA are more common in males and in patients with higher BMI. OSA patients tend to develop lower degree of airflow limitation and more severe hypoxemia and apnea-hypopnea at night than COPD patients. Apnea-hypopnea index is the protective factor against airflow limitation in COPD. BMI, FEV 1 and FEV 1%pred are the risk factors of COPD combined with OSA. BMI and FEV 1 are the independent risk factors of COPD combined with OSA.

Objective: To examine the dose-response association between cardiorespiratory fitness ( CRF ) and the risk of cardiovascular and cerebrovascular diseases. Methods: A joint search was performed in Chinese and English electronic databases, including China National Knowledge Infrastructure ( CNKI ) , Wanfang Data, VIP, CBM, PubMed, Embase and Web of Science, to retrieve publications reporting the correlation between CRF and the risk of cardiovascular and cerebrovascular diseases until May, 2021. The pooled risk was estimated using the random effects model, and the dose-response association was evaluated using restricted cubic splines. The source of heterogeneity was assessed by subgroup analysis, and the stability of the results was tested by the trim-and-fill method, while the publication bias was assessed using funnel plots. Results: Totally 37 280 literatures were identified, and 23 eligible studies were finally included in the analysis, which covered 2 605 622 subjects. There were 22 publications identified as high-quality. Meta-analysis revealed that the pooled risk of cardiovascular and cerebrovascular diseases reduced by 42% in the highest CRF group relative to the lowest CRF group ( OR=0.58, 95%CI: 0.52-0.65 ), and a one metabolic equivalent ( MET ) increase in CRF caused a 10% reduction in the pooled risk of cardiovascular and cerebrovascular diseases ( OR=0.90, 95%CI: 0.88-0.92 ). There was a negative linear correlation between CRF and the incidence of cardiovascular and cerebrovascular diseases ( P=0.396 ). Subgroup analysis identified gender, sample size and study regions as possible sources of heterogeneity, and sensitivity analysis showed that the study results were stable. Conclusions There is a negative linear correlation between CRF and the risk of cardiovascular and cerebrovascular diseases, and an increase in CRF may reduce the risk of cardiovascular and cerebrovascular diseases.

Objective There is no quantization scheme for the early ambulation in patients with gastrointestinal tumor after operation of enhanced recovery .The aim of this study was to explore a suitable objective method of postoperative ambulation for gastro -intestinal tumor patients . Methods Sixty six gastrointestinal tumor postoperative patients were randomly assigned to two groups :ex-perimental group ( 33 cases ) and control group ( 33 cases ) .Enhanced recovery was adopted in the both groups afterthe operation . Wireless smart bracelets ( fitbit flex) were used in the experimental group , and the ambulation of patients was monitored by the hand of synchronous real time computer digital panel .At the same time, the patients was supervised for positive ambulation . Traditional quantitative methods of electronic pedometer were used in the control group.The postoperative ambulation , effect and compliance were compared between the two groups . Results Postoperative ambula-tion steps in the experimental group were increased compared with the control group on the days 1, 2, and 3postoperative, and the data were (208.70 ±45.76) vs (144.36 ±47.68), (560.73 ±148.67) vs (407.00 ±85.92), and (894.70 ±91.68) vs (674.00 ±73.06) steps (P<0.05).The first time of early ambulation, flatus, ca-tharsis, and compliance of ambulation showed significant difference in the two groups (P<0.05). Conclusion Wireless intelligent monitoring bracelet is objective and effective for monitoring and quantifying postoperative ambulation .It is superior to the traditional quantitative methods , and can improve the effect and compliance of the ambulation .Moreover , it can promote postoperative recovery in patient with enhanced recovery surgery .

Objective To summarize the methods of diagnosing and treating solid-pseudopapillary neoplasm of pancreas SPN so as to provide reference for its early clinical diagnosis.Methods We collected the clinical data of 62 patients with pathologically confirmed diagnosis of SPN treated in the First Affiliated Hospital of Xi'an Jiaotong University between Feb.2004 and Sep.2014.Then we retroactively analyzed and summarized the clinical characteristics,diagnosis and treatment of the disease.Results Among the 62 patients,55 were female and 7 were male;the mean age was (31.58±12.67) years old.The clinical features showed no specificity and the tumor was mostly detected upon physical check-up.The tumor was seen to be located mostly in the body and tail of the pancreas,and the average maximum diameter was (7.81±3.54)cm.We did not find obvious abnormality in routine pre-operative blood test results or liver and kidney functions.The imageological examination indicated tumor occupation in the pancreas.All the patients underwent surgical resection with no complications or death and had a good recovery after operation.Pathological diagnosis after operation was SPN without metastasis in lymph modes.Until the last time we followed up all the patients,we found relapse in two patients (3.2％).Conclusion SPN is a tumor that tends to affect young and middle-aged females.The malignancy grade of SPN is low,and patients with this disease show no specificity in clinical manifestation.The imageological examination is of vital importance in diagnosing SPN and surgical resection is an effective way to treat SPN.

Cystic lesions of the liver are classified into parasitic and non-parasitic lesions. Parasitic lesions mainly refer to hepatic cystic echinococcosis, and non-parasitic lesions can be further classified into benign, borderline, and malignant lesions. At present, there are still no comprehensive standard treatment of cystic space-occupying lesions in the liver. With reference to related literature in China and foreign countries, this article reviews the etiology, clinical manifestations, and diagnosis and treatment of hepatic cystic diseases, so as to improve the understanding of this disease.

A real-time polymerase chain reaction ( PCR ) micro total analysis system (μ-TAS ) integrated nucleic acid extraction, PCR amplification and real-time-fluorescent PCR detection on a same microfluidic chip was prepared for the fully automated and on-chip analysis of nucleic acid. The proposed method had the advantage such as low sample consumption, fast analysis and simple operation and so on. Micromachining technology was used to fabricate the anodic molds of integrated nucleic acid extraction microfluidic chip. A polydimethylsiloxane (PDMS) substrate with 3D channels was manufactured by a combination of molds and an injection molding method. The glass substrate and the chip were bonded together using a plasma treatment. The μ-TAS included a microfluidic control device whose micro fluidic velocity ( 0-10 mL/min ) could be adjusted, a TEC platform which the precision of temperature control was 0. 1℃ and a CCD detection module. The DNA of human blood was extracted by using a silica gel membrane method on the microfluidic chip. The processes of DNA extraction and detection were preset in the μ-TAS. Human blood lysate ( 20 μL ) were driven to the extraction chamber and was then washed. The fluidic drive speed was 2 mL/min. DNA and PCR reagents were mixed and then were driven into the PCR chamber. The fluidic drive speed was 1 mL/min. The GAPDH gene in extracted genome DNA was amplified by PCR and detected. The amplified product was verified by melting analysis. The results of nucleic acid extraction method on the chip were compared to those obtained using a standard manual centrifuge extraction method. The amplification curves were obvious. Ct values of the chip method were 25 . 3 and 26 . 9 . The denaturation temperature of all the melting was 89 . 9 ℃. The results validated that the chip-based method and device realized the extraction of nucleic acid, amplification and detection automatically.