BACKGROUND:Preliminary studies of our research group mainly focus on the role of nucleus of solitary tract in gastric noxious stimulation and acupuncture point, while dorsal nucleus of vagus nerve, nucleus of solitary tract and area postrema are the necessary component for vagus nerve complex, and dorsal nucleus of vagus nerve plays a crucial role in the regulation of gastric functions. OBJECTIVE:To observe the effect of acupuncture at Zusanli, Neiguan, Pishu and Shenshu acupoints on the gastric-related neurons in dorsal motor nucleus of the vagus nerve. METHODS:The gastric related neurons in dorsal motor nucleus of the vagus nerve of gastric distension rats were identified using extracellular recording technique, according to neuroelectrophysiology method. Acupuncture stimulation was given to Zusanli, Neiguan, Pishu and Shenshu for 15 seconds. The effect of body stimulation on the gastric distension related neurons in dorsal motor nucleus of the vagus nerve of rats was recorded. RESULTS AND CONCLUSION:Among the involved 24 rats, 90 neurons at paraventricular hypothalamic necleus exhibited discharge. Among the discharged neurons, 54 neurons were related to gastric distension. After acupuncture stimulation at Zusanli, Neiguan, Pishu and Shenshu, there were 44, 39, 38, 27 neurons giving a response, the reaction rate was 82%, 72%, 70%and 50%, respectively. Acupunture at different nerve segment acupoints can activate the dorsal motor nucleus of the vagus nerve to different degrees, which is involved in the regulation of gastric motility.

BACKGROUND:Previous studies concerning neuromechanism of acupuncture for regulating gastric function mainly focused on peripheral nerve, involving in central nervous system. In particular, there are few studies addressing higher central nervous system.
OBJECTIVE:To explore the effects of acupuncture at Neiguan (PC6) and Zusanli (ST36) on gastric-related neurons in the hypothalamic paraventricular nucleus.
METHODS:Using microelectrode extracellular recording technique, gastric related neurons in the paraventricular nucleus were found in gastric distension rats. Stimulation was conducted for 30 seconds by hand acupuncture at Neiguan and Zusanli. The effects of acupuncture on gastric-related neurons in the paraventricular nucleus were observed.
RESULTS AND CONCLUSION:The discharge of 109 neurons in the hypothalamic paraventricular nucleus of 60 rats was recorded. A total of 56 gastric-related neurons of the 109 neurons were observed. The number of neurons response to acupunctures at Zusanli, Neiguan, Pishu (BL20) and Weishu (BL21) were respectively 44, 47, 29, and 33, with the reaction proportion of 78.57%, 83.47%, 51.79%and 58.93%. Results suggested that there exist gastric distension stimulation and acupuncture stimulations from neurons soma to visceral reaction in the hypothalamic paraventricular nucleus, which simultaneously participates in the regulation of acupuncture on the gastric function.

Objective To investigate the association of single nucleotide polymorphisms (SNPs) in COX-2 with aspirin resistance in Chinese cerebral infarction patients. Methods A total of 150 Chinese cerebral infarction patients were recruited. Platelet aggregation response was measured by light transmission aggregometry method and four SNPs located in COX2 gene were genotyped by sequencing method. Results Sixty patients of the total were classified as aspirin non-responders. For clinical variables , concentrations of high homocysteine and the frequency of recurrence cerebral infarction were significantly higher in aspirin non-responders when compared with aspirin responders. Univariate analysis of SNPs showed that rs20417 , rs689465 and rs689466 were significantly associated with aspirin resistance. Multivariate analysis indicated that after adjusting other SNPs and clinical risk factors, rs20417 and rs689466 were still significantly associated with aspirin resistance. Conclusions Rs689466 is significantly associated with aspirin resistance in Chinese cerebral infarction patients even after the adjustment of rs20417. By combining rs689466 , rs20417 and other clinical risk factors , we may better classify the aspirin non-responders from aspirin responders.

AIM:Chronic heart failure (CHF), caused by ischemic cardiomyopathy (ICM) and nonischemic cardiomyopathy (NICM), is among the leading causes of mortality and morbidity worldwide .Low-density lipoprotein receptor-related protein 6 (LRP6) plays a criti-cal role in regulating Wnt signaling .Dysregulated Wnt signaling contributes to high incidence of arrhythmias .Thus, there might be an association between genetic variations of LRP6 and sudden cardiac death ( SCD) .The objective of the study was to examine the associ-ation between common variants of LRP6 and prognosis of CHF patients .METHODS:From July 2005 to December 2009, patients with CHF referred from 10 hospitals and participants without structural heart disease in China were undergone a prospective study .The sin-gle-nucleotide polymorphism rs 2302684 was selected to evaluate the effect of LRP6 polymorphisms on the survival of the patients .RE-SULTS:A total of 1 887 patients (1 437 with CHF and 450 in the control group)were finally enrolled for the analysis.During a medi-an follow-up of 61 months, a total of 546 (38.00%) patients died, including 201(36.81%) cases with SCD and 345 (63.19%) ca-ses with NSCD.No end point event occurred in the control group .Patients carrying A allele of rs2302684 had increased risks of all-cause death (P<0.01) and SCD (P<0.01).After adjusted for the other risk factors , the associations remained significant in all-cause death (P<0.01) and SCD (P<0.01).In patients with CHF caused by ICM , those carrying A allele of rs2302684 also had in-creased risks of all-cause death (P<0.01) and SCD (P<0.01).After adjusted for the other risk factors , the associations remained significant in all-cause death (P<0.01) and SCD (P<0.01).However, there was no association between A allele of rs 2302684 and prognosis in patients with CHF caused by NICM .CONCLUSION:The SNP rs2302684 T>A in LRP6 is associated with an increased risk of all-cause death and SCD in patients with CHF in Chinese Han population , and the association is more prevalent in patients with CHF caused by ICM.Thus, LRP6 might be added as a novel predictor of SCD and could provide an attractive and direct therapeutic target in SCD prevention .

Objective To explore the effects of isokinetic training on muscle endurance and the ambulatory capacity of patients with incomplete lumbar spinal cord injury ( SCI ) . Methods Sixty patients were randomly divided into a control group and a treatment group, each of 30. Both groups were given conventional rehabilitation, while the treatment group was additionally provided with isokinetic muscle strength and muscle endurance training for 3 months. The endurance ratio ( RO) of the quadriceps and hamstrings, the mean power frequency of the rectus femo-ris (RF-MPF) and the biceps flexor cruris (BF-MPF), and distance covered in the 6-minute walk test (6MWT) were evaluated before and after the treatment. An index of functional community ambulation was also compared be-tween the 2 groups. Results After the treatment significant differences were observed in all of the measurements compared to before the treatment for both groups. The average RO improvement of the quadriceps and hamstrings, the BF-MPF, the RF-MPF and the 6MWT distance of the treatment group were all significantly higher compared with the control group. After the treatment, 25 patients of the treatment group could demonstrate functional community ambula-tion, significantly better than that of 20 of the control group. Conclusion Isokinetic training can improve muscle endurance and the walking capacity of persons with an incomplete lumbar spinal cord injury.

Objective:To compare and explore the effects of needling acupoints at different nerve segmentson the oxytocin (OT) neurons in the paraventricular nucleus of hypothalamus (PVN) and the intragastric pressure, and discuss the possible mechanisms. Methods: Thirty-two healthy adult Sprague-Dawley (SD) rats were numbered and divided into 4 groups according to the random number table, a Zusanli (ST 36) group, a Neiguan (PC 6) group, a Weishu (BL 21) group and a control group, with 8 rats in each group. Except the control group, rats in the other three groups received acupuncture at the corresponding acupoints. To observe the differences in double-labeled OT neurons and c-fos neurons of the hypothalamic PVN and the intragastric pressure after acupuncture among the three groups of needling acupoints at different nerve segments. Results:Compared with the control group, the numbers of double-labeled cells in the PVN of the Zusanli (ST 36) group and the Neiguan (PC 6) group decreased significantly, while the intragastric pressure increased significantly (allP<0.05), and the inter-group differences were statistically significant (P<0.05). The intragastric pressure in the Weishu (BL 21) group decreased significantly, and the inter-group difference was statistically significant (P<0.05). Compared with the Weishu (BL 21) group, the numbers of OT/c-fos double-labeled cells in PVN of the Zusanli (ST 36) group and the Neiguan (PC 6) group decreased significantly, and the intragastric pressure increased significantly, the inter-group differences were statistically significant (allP<0.01). Conclusion:Acupoints at different nerve segments have different regulation effects on intragastric pressure. The difference may be related to the different nerve conduction pathways by acupoints at different nerve segments in regulating the intragastric pressure. The PVN may be one common integration center for the regulation of gastric function in the three acupoints [Zusanli (ST 36), Neiguan (PC 6) and Weishu (BL 21)] at different nerve segments.

Objective To understand the knowledge and attitude of clinical pipeline nursing in nurses and provide evidence for carrying on aimed pipeline nursing training. Methods By convenience sampling, 91 surgery nurses were investigated with questionnaire. Results The average score of nurses in clinical pipeline nursing were (32.47 ±4.66), one-way ANOVA results showed that age, seniority, job title and the years they have been working for in the department were related to the nurses' knowledge and attitude about pipeline nursing. Conclusions Nursing managers should strengthen young nursing staff' s training and retraining of the knowledge about clinical pipeline nursing, especially the new knowledge of pipeline nursing, new developments,and should get the main points and carry on systematically.

Objective To explore intervention effect of palliative treatment of pancreatic cancer patients and their families to implement the same period nursing. Methods 48 cases of patients with pancreatic cancer were divided into intervention group and control group by odd and even numbers in hospital, each group was 24 cases, the intervention group implemented the same period nursing to the patients with pancreatic cancer and their families, the control group took the whole patient-centered nursing intervention, Before and after the intervention, the questionnaire survey was conducted to the patients by Hamilton Depression Rating Scale and the Perceived Social Support Scale, Patients were evaluated for depression and social support. Results After the nursing intervention to palliative treatment of patients with pancreatic cancer and their families to implement the same period nursing, patients with depression had significantly improved than that of the control group, the difference was significant [(10. 17 ± 2.41) vs (14.46 ± 1. 25), t = -7. 750, P ＜ 0. 01]; Intervention group in improving the perception of social support group was better than that in the control group [61.79±7.40) vs (51.08 ±4.94) ,t =5. 894,P ＜0. 0l]. Also it found, the control group scores after the intervention to support the family has declined compared with that before intervention, the intervention group scores after the intervention to support the family has increased compared with that before intervention, and differences were statistically significant (P ＜0. 01). Conclusions The methods of palliative treatment of patients with pancreatic cancer and their families to implement the same period nursing were feasible, help alleviate depression in patients and improve their quality of lives.

Objective: To investigate the application of coronary angiography (CAG) in children with Kawasaki disease complicated with coronary artery lesion (CAL). Methods: A total of 139 patients (115 boys and 24 girls, age (48±42) months) with Kawasaki disease complicated with CAL underwent CAG between June 2006 and June 2018 in Children′s Hospital of Fudan University. CAL in all children were at grade Ⅲ and above assessed by echocardiography and underwent CAG under general anesthesia with parental consent. A retrospective analysis was performed to identify the safety and complication of CAG, degree of satisfaction of image, distribution of CAL, and the treatment and follow-up management according to the result of CAG. Results: All the 139 patients underwent CAG, and 17 patients received CAG twice. In these cases, there was a total of 309 CAL with an average of 2.22 CAL per patient. After CAG, children were re-graded as grade Ⅲ in 33 cases, grade Ⅳ in 56 cases, grade Ⅴa in 33 cases and grade Ⅴb in 17 cases according to the clinical severity. Ten patients (7.2%) had only aortic root angiography and 129 (92.8%) patients had selective left or right CAG. Among these, 27 cases (19.4%) showed thrombosis in coronary aneurysm, 23 cases (16.5%) showed coronary artery stenosis, 4 cases (2.9%) showed recanalization after occlusion in right coronary artery. All the patients obtained satisfied images, and no complication was found. Eight of the grade Ⅴb patients underwent coronary artery bypass grafting (CABG). One patient died during the surgery due to severe heart failure, and the other seven patients received CABG successfully and recovered well during a long-term follow up (18 to 108 months). Conclusions CAG is safe for children with Kawasaki disease with CAL, and the images of CAG are satisfied. Patients who were graded according to CAG and received the corresponding surgical treatment could get satisfied effect in the medium and long-term follow-up.

Objective To investigate the pharmacokinetics of cyclosporine(CsA) in type 1 diabetes of rats.Methods Rats with type 1 diabetes were induced by intraperitoneal administration of 65 mg· kg-1 streptozotocin (STZ).Pharmacokinetics of CsA (10 mg· kg-1) was compared between diabetic and normal rats on the 5 weeks after STZ injection.Concentration of CsA in whole blood was measured by enzyme multiplied immunoassay technique.Results Type 1 diabetes rats were successfully induced as the fasting blood glucose levels exceeded 11.1 mmol · L-1 after STZ injection for 1 week.Beside glucose,total cholesterol (TC) and triacylglycerol (TG) in serum of diabetic rats were significantly higher than those in normal rats after STZ injection for 5 weeks.Unlike normal rats,the pharmacokinetics of CsA in diabetic rats exhibited a double peak after oral administration.The Tmax and Cmax were lower in diabetic rats than normal rats,although without statistical differences as follows:Tmaxwas (3.3±1.6),(3.2 ±2.5) h,Cmax was (579.0±208.5),(453.0 ± 104.8) ng· mL-1 in normal and diabetic rats.Compared with normal rats,AUC and t1/2 of CsA in diabetic rats decreased significantly,which were 0.51 and 0.70 times those of normal rats,respectively;AUC was (7343.2 ± 2333.7),(3729.7 ± 1106.6) h ·ng · mL-1,t1/2 was (8.5 ± 1.5),(6.0 ± 0.9) h in normal and diabetic rats.Conclusion The oral pharmacokinetics of CsA was significantly different in type 1 diabetic rat model compared to normal controls,which should be taken into consideration in clinical medication.