Objective To evaluate emergency nursing methods to permanent pacemaker patients with severe complication and acute hemodynamic changes during implantation. Methods The emergency nursing methods were analyzed retrospectively in 9 of 2 027 patients over 6 years, who had serious complication occurred during the pacemaker implantation Results There were 4 patients with pneumothorax, 2 with pericardial tamponed, 1 with ventricular fibrillation and 2 with acute left ventricular failure in 9 patients (0.4%). Observed the changes of symptoms and signs carefully,found the severe complications at the first time and performed the specific nursing based on different kinds of conditions and improved the prognosis of these patients. Conclusions The serious complications during the implantation of permanent pacemaker were life-threatening, and the specific nursing scheme to different types of complications could increase the successful rate of emergency service.

Objective To investigate the memory monitoring ability in patients with hepatolenticular degeneration(HLD) and explore the mechanism of their memory impairment.Methods The feeling-of-knowing (FOK) paradigm of episodic memory(EM) and semantic memory(SM)were established and subsequently applied to 30 HLD patients and 30 healthy control(HC) participants who were matched in age and educational level.Results Compared with healthy control group (FOK-EM recall (64.17 ± 29.21) ％ ; FOK-SM recall (84.72 ± 11.44)％),the FOK-EM recall((26.55±20.92)％) and FOK-SM recall((53.93±28.42)％) in HLD patients were significantly lower(t=-5.140,P＜0.01 ; t=-5.123,P＜0.01).The positive judgment and correct recognition of FOK-EM ((50.64±29.43) ％) and the negative judgment and correct recognition of FOK-EM((12.80± 18.32) ％) in the HLD group were significantly different from the HC group (the positive judgment and correct recognition of FOK-EM:(75.15±31.73)％ and the false judgment and correct recognition of FOK-EM:(1.81±5.41)％; t=-2.693,P＜0.05 ; t=3.026,P＜0.01).Most importantly,the stroop effect was positively correlated with the negative judgment and correct recognition of FOK-EM in HLD group(r=0.601,P＜0.01).Conclusion The results show that the HLD group underestimate their memory performance on episodic FOK,and the impairment of memory monitoring is positively correlated with the deficit of executive function,indicating that the prefrontal impairment can be an influential factor of memory disorder in HLD,whereas the unimpaired semantic metamemory FOK indicates the episodic and semantic metamemory monitoring may depend on different neural network.

Objective To investigate the ability of decision making under risk condition in patients with Parkinson' s disease (PD),and to explore the neural relationship between basal ganglia and the decision-making ability.Method Twenty-five PD patients and 25 healthy controls (HC) were investigated by Game of Dice Test (GDT) with explicit probability.Results PD patients performed poorly in the entire task,selecting more risky options ( PD:10.88 ± 5.58 ; HC:5.72 ± 3.69 ; t =3.86,P ＜ 0.01 ),compared with healthy controls.In general,the final asset of PD group was negative while the result of HC group was always profitable and the difference was significant ( PD:- 3748.00 ± 3923.87 ; HC:684.00 ± 1764.62 ; t =-5.15,P ＜ 0.01 ).The most frequent choice made by PD patients was one number,which is the most risky one.Accordingly,the most frequent choice made by HC group was three numbers (one number:PD:6.48 ±5.81;HC:1.00 ± 1.44;t =4.58,P ＜0.01; three numbers:PD:2.64 ±2.14;HC:7.04 ±2.54;t =-6.62,P ＜ 0.01 ).The frequency of choosing the risky options was correlated with the rate of using negative feedback( r =-0.59,P =0.003 ),and the result of Stroop test( r =0.55,P =0.004).Conclusion Present study has shown that PD patients have significant impairments in decision-making under risk condition,and the impairments are correlated with executive function and negative feedback.

Through the suvey, we find that freshmen are generally suited for college physics studies. ln this paper, high school and college students’ interest in Learnig, their initiatives, the change of their study methods and the teachers’ teaching methods are discussed.

This study explored the role of apoptosis of alveolar wall cells of chronic obstructive pulmonary disease (COPD) patients with pulmonary emphysema in the pathogenesis of emphysema. The subjects were divided into three groups: COPD patients with pulmonary emphysema (COPD group), asymptomatic smokers and non-smokers. Lung tissues were harvested and histologically assessed. TUNEL assay was employed to determine the apoptotic cells. The expression of PCNA, Bax and SP-C in the lung alveolar wall cells were immunohistochemically determined. SP-C immunofluorescence staining was used to identify type II alveolar cells in the TUNEL-positive cells. The mean linear interval (MLI), mean alveoli number (MAN) and mean alveoli area (MAA) in COPD group were significantly different as compared with those in asymptomatic smokers and non-smokers, respectively (P<0.01). The proliferation index (PI), apoptosis index (AI) and the percentage of Bax-positive cells in COPD group were significantly greater than those of asymptomatic smokers and non-smokers (P<0.01). However, the percentage of SP-C-positive cells was significantly lower in COPD group than in asymptomatic smokers and non-smokers (P<0.01). Most of the TUNEL-positive cells expressed SP-C. In COPD group, the apoptosis of alveolar wall cells, especially apoptosis of type-II cells, may take part in the pathogenesis of emphysema. Up-regulation of Bax expression may be responsible for the apoptosis of alveolar wall cells in the COPD patients with pulmonary emphysema.

Objective To investigate the effects of dopaminergic medication on decision-making un-der ambiguity in patients with early Parkinson's disease( PD) . Methods Using Iowa Gambling Task ( IGT) for 24 early non-medication idiopathic PD patients( Hoehn and Yahr Scale≤Ⅱlevel) ,24 early idiopathic PD patients with regular dopaminergic medication and also for 24 healthy controls( HC) whose age,gender,and education match to PD patients to test their ability of decision-making under ambiguity. Results The results showed non-medication PD group showed impairments on digtal span and verbal fluency and decision-making task. There was significant difference in IGT task scores among the three groups(F=6.024, P=0.004) . The total net scores of advantageous choices in IGT were significantly lower in non-medication PD group( (-4.50 ±22.19) scores) than medication PD group((8.83±23.24)scores) and healthy group((15.92±15.77) scores) . The difference of net scores in block1 to block5 between non-medication PD group and medication PD group was gradually increased,and the difference of net scores in block5 was significant(P<0.05) . There was no significant difference in total net scores and net scores in block1 to block5 between medication PD group and healthy group(P>0.05) . As the game processing,medication PD group gradually shifted their se-lections toward the advantageous choices. But non-medication group did not exhibit this shift pattern and the performance was much poorer. Meanwhile, the study also indicated the total net scores of advantageous choices for non-medication PD group was positive correlation to the MoCA scores ( r=0.614, P=0.001). Conclusion The present study has shown that non-medication PD group has impairment in decision-making under ambiguity risk condition and prefer to choose risky options. when exogenous complement dopaminergic medication,the risk decision-making ability of medication PD group has been improved.

OBJECTIVE: To explore the correlation between postmortem interval (PMI) and five RNA markers of rat's skin--β-actin, glyceraldehyde-3-phosphate dehydrogenase (GAPDH), 18S ribosomal RNA(18S rRNA), 5S ribosomal RNA (5S rRNA), and microRNA-203 (miR-203), at different temperatures. METHODS: Eighteen SD rats were randomly divided into three environmental temperature groups: 4 °C, 15 °C and 35 °C, respectively. Skin samples were taken at 11 time points from 0 h to 120 h post-mortem. The total RNA was extracted from the skin samples and the five RNA levels were detected by real-time fluorescent quantitative PCR. Proper internal reference was selected by geNorm software. Regression analysis of the RNA markers was conducted by GraphPad software. RESULTS: 5S rRNA and miR-203 were most suitable internal references. A good linear relationship between PMI and RNA levels (β-actin and GAPDH) was observed in two groups (4 °C and 15 °C), whereas the S type curve relationship between the expression levels of the two markers (β-actin and GAPDH) and PMI was observed in the 35 °C group. The partial linear relationship between 18S rRNA and PMI was observed in the groups (15 °C and 35 °C). CONCLUSION Skin could be a suitable material for extracting RNA. The RNA expression levels of β-actin and GAPDH correlate well with PMI, and these RNA markers of skin tissue could be additional indice for the estimation of PMI.
Actins ; Animals ; Autopsy ; Glyceraldehyde-3-Phosphate Dehydrogenases/genetics* ; Postmortem Changes ; RNA ; RNA Stability ; RNA, Ribosomal, 18S ; Rats ; Real-Time Polymerase Chain Reaction ; Regression Analysis ; Skin ; Temperature

Objective To investigate the clinical features, operation procedures and clinical outcomes of cervical spondy-lotic myelopathy with different imageological characteristics. Methods Two hundred and twenty one cervical myelopathy with different imageological characteristics patients between November 2011 and October 2013 were involved in this retrospective study. Patients were distributed into three groups, namely mild group (A), moderate group (B) and severe group(C), based on severi-ty of complexity by imageological variables (severity of cervical spine degeneration, the number of spinal cord compression, severi-ty of spinal cord compression and difficulty in operation). Preoperative and postoperative Japanese Orthopaedic Association (JOA) score and mean recovery rate were collected to evaluate the postoperative clinical effects. Demographic data and imageological characteristics were recorded;Univariate analysis or analysis of variance was conducted to analyze the correlation between post-operative JOA recovery rate with gender, age, course of disease, severity of spinal cord compression, the number of segment with spinal cord compression, severity of disc degeneration, MRI T2 increased signal intensity, cervical instability, cervical kyphosis, developmental cervical spinal stenosis and ossification of posterior longitudinal ligament. Results There was no significant differ-ence in gender between three groups. There was significant difference in age, preoperative JOA score and improvement rate be-tween group A and group B (C). All patients received decompression and reconstruction by anterior or posterior approach. The ra-tio of anterior approach in group A, B and C was 91.1%(72/79), 79.8%(71/89), 35.8%(18/53). The last follow-up JOA recovery rate of group A, B and C was 75.4%±6.4%、67.7%±8.7%、62.8%±10.4%. The last follow-up JOA recovery rate was correlated with duration of disease, the number of spinal cord compression and severity of spinal cord compression. Age, duration of course, preop-erative JOA score, degree of cord compression, the number of segment with cord compression, degree of disc degeneration, MRI T 2 increased signal intensity, cervical instability, cervical kyphosis, developmental cervical spinal stenosis and OPLL. Conclusion Patients suffering from cervical myelopathy with different imageological have good prognosis by appropriate operation procedure.

Objective To insestigate the pathophysiological mechanisms of spontaneous transient hyperperfusion after cerebral ischemia-reperfusion in rats.Methods Fifty-two SD rats were randomly allocated into sham-operation(group A),cerebral ischcmia 2-hour(group B), and cerebral ischemia 6-hour(group C)groups.Group B were redivided into 0-,0.5-,1-,2-,4-,6-,and 24-hour subgroups according to the reperfusion time;group C were redivided into 0-,0.5-,1-,2-,and 24-hour subgroups according to the reperfusion time (n=4 in each subgroup). Multislice spiral CT perfusion imaging(CTPI)was performed at different time points after ischemia-reperfusion in each group.After completing the scanning.the rats were sacrificed immediately for optical and electron microscopy examinations.Results In group A,compared to the contralateral sides.there were no significant differences in the relatise value of the cerebral blood flow parameters and the results of optical and electron microscopy in the sham-operated regions. In group B, the relative cerebral blood flow (rCBF) and relative cerebral blood volume (rCBV) in the ischemic core area were increased gradually with the extension of reperfusion time. The relative mean transit time (rMTT) and the relative time to peak (rTTP) were decreased gradually, There were no significant differences compared to group A at 6-hour after reperfusion. The optical and electron microscopy revealed that neuronal density in the ischemic core area in group B were decreased, part of the cell volume enlarged and showed vacuolated changes, and part of the neuronal cell bodies and nuclei shrinked, rCBF in the ischemic core area still maintained lower level with the extension of reperfusion time in group C. The ischemic core area showed the increased transient rCBV and rCBV at 0.5 hour after reperfusion in group B and C. The optical and electron microscopy showed that the ischemic core area presented a large number of necrotic and apoptotic cells, and inflammatory cell infiltration. At 6 hours after reperfusion in group B, the increased blood density was observed under the electron microscope in the ischemic core area, showing capillary engorgement and increased pressure. Conclusions The dynamic changes of CTPI in the process of rat middle cerebral artery occlusion and reperfusion have a certain correlation with the pathological mechanisms of injury. The ultra-early spontaneous and transient hyperperfusion after cerebral ischemia-reperfusion in rats is associated with the transient inflammatory hyperemia after reperfusion injury.

Objective To review the experience with mini-percutaneous nephrolithotomy (MPC NL) in early children and discuss its safety and indications. Methods Between Dec 2005 and Apr 2009, 34 boys and 22 girls aged 7 months to 36 months underwent MPCNL for upper urinary tract calculi. Clinical data were analyzed retrospectively. Results The mini-percutaneous renal access of 12 - 16 F was successfully established in 56 patients under realtime colour ultrasound guidance and immediate lithotripsy was performed. Average accessing time was 2. 9±0. 6 min, and stone management time was 13. 9±3. 2 min. No severe complication occurred. Stone free rate was 92. 5%. Conclusions MPCNL was highly effective to treat stone disease in this population. The indications for MPCNL in early children include large upper tract stone burden ( greater than 1. 5 cm ) , multiple renal calculi, staghorn calculi, stones with high-grade obstruction, and those could not be cleared by EWSL or other treatment conservatively.