Objective To investigate the effect of preoperative visit on reducing anxiety of patients undergoing carotid endarterectomy. Methods 120 cases of patients with carotid endarterectomy were randomly divided into the observation group and the control group with 60 patients in each group, in the control group, before surgery, the nurse of ward gave routine preoperative nursing care and health education.In the observation group, in addition to routine preoperative care and health education, there were preoperative visits by intensive care unit nurses, the anxiety level was compared 1 day before surgery and 2 to 3 days after surgery. Besides, the cooperation degree of patients was also compared. Results There was no significant difference in anxiety levels in the observation group, but there was significant difference in anxiety levels in the control group, there was significant difference in patients coordination degree between two groups. Conclusions Preoperative visits by intensive care unit nurses can reduce the anxiety level of patients, shorten hospital stay and promote early recovery of patients.

Objective:To provide better clinical treatment plan by grading and classifying four-dimensional ultrasound pelvic floor dynamic imaging primiparas pelvic floor dysfunction.Methods: 270 cases with pelvic floor functional disorders (bladder prolapse) of high-risk mothers were selected, from the beginning of the median sagittal plane and three-dimensional reconstruction of the surface at rest, to observe the bladder and urethra and pelvic diaphragm hiatus and anal status under Valaslva changes in the measurement parameters (bladder neck mobility, posterior horn of bladder and urethra, rotation angle of the urethra) and its Green typing.Results: There was no statistical difference between the mode of delivery cystocele resting corresponding BSD and posterior horn of bladder and urethra (t=1.133,t=1.165;P>0.05). Under Valsalva state, there were significant differences the two groups corresponding to BSD, the bladder neck mobility, posterior horn of bladder and urethra and rotation angle of the urethra (t=2.147,t=5.628,t=3.502,t=4.396;P<0.05). The incidence rate of type II and type III in vaginal delivery group is higher than that in cesarean section group. The incidence rate of type I in vaginal delivery group is less than that in cesarean section group. The differences were statistically significant (x2=6.080,P<0.05). Conclusion: The pelvic floor dynamic four-dimensional ultrasound imaging can clearly show the situation of pelvic floor before primiparas to understand the situation of maternal mode of delivery cystocele production. It can provide a more reliable basis for early clinical diagnosis of maternal pelvic floor dysfunction.

Objective:To use the perineum four-dimensional pelvic ultrasound stereo imaging for detecting injury situation of pelvic diaphragm hiatus and anal levator ani muscle. Understand abnormal classification of pelvic floor muscle. investigate the application of four-dimensional pelvic ultrasound stereo imaging in pelvic floor dysfunction (PFD) for primipara in order to provide more accurate data for clinical practice.Methods: 270 primiparas with pelvic floor dysfunction were divided into the vaginal delivery group (135 cases) and selective cesarean group (135 cases) as random number table; pelvic floor muscle strength, longitudinal diameter, transverse diameter, area of pelvic diaphragm hiatus and thickness of the anus levator were detected by the perineum four-dimensional pelvic ultrasound stereo imaging, respectively, and then to compare differences between the two groups. Results: In 270 cases, 162 cases (60%) were abnormalities in pelvic floor muscle strength, and 189 cases (70%) were abnormalities in vaginal pressure; the results of pelvic floor muscles fatigue grade situation revealed: 127 cases were abnormal muscle fiber strength ofⅠtype (47%), 30 patients were abnormal muscle fiber strength ofⅡ type (11%). There were no significant differences between the two groups in the abnormal rate of pelvic floor muscle strength, vaginal pressure and muscle fiber strength. Longitudinal diameter, transverse diameter and area of pelvic diaphragm hiatus in the vaginal delivery group were higher than that in the selective cesarean group, while thickness of anal levator were thinner than that in the selective cesarean group with significant differences (t=3.730,t=3.467, t=3.826,t=1.809;P<0.05).Conclusions: The perineum four-dimensional ultrasound diagnosis can intuitively and clearly show morphological characteristics of female pelvic diaphragm hiatus, therefore, it can quickly finish diagnosis, and provide the basis for clinical diagnosis and treatment evaluation of postpartum PFD.

Objective To evaluate the effectiveness of uterine arterial embolization (UAE) in the management of uterine fibroids (UF) and adenomyoma. Methods The UAE was carried out in 22 cases of UF and 2 cases of adenomyoma, including bilateral UAE in 23 cases and unilateral UAE in 1 case, by using polyvinyl alcohol (PVA) particles as embolic materials. Results The success rate of UAE in the study was 95 8% (23/24). No serious complications occurred. The uterine and UF volume decreased remarkably in size 6 months after the treatment ( t =2 391 and 3 990, respectively; P =0 022 and 0.000, respectively). In the patient who underwent unilateral UAE, the UF gradually increased in size and a hysterectomy was required. The 2 patients with adenomyoma experienced relief with this treatment but had a recurrence 4 months after the surgery. Conclusions UAE is a safe and effective method in the management of UF but its long-term effects remains a question to be answered through further observations . The efficacy of treatment of this method for adenomyoma is not apparent.

In this study, we constructed a yeast consortium surface-display expression system by using Flo1 as an anchor protein. Endoglucanase II (EGII) and cellobiohydrolase II (CBHII) from Trichoderma reesei, and β3-glucosidase 1 (BGLI) from Aspergillus aculeatus were immobilized on Saccharomyces cerevisiae Y5. We constructed the cellulose-displaying expression yeast consortium (Y5/fEGII:Y5/fCBHII:Y5/fBGLI = 1:1:1) and investigated the enzymatic ability and ethanol fermentation. The displayed cellulolytic enzymes was stabile during the 96-h fermentation. The yeast consortium produced 0.77 g/L ethanol from 10 g/L phosphoric acid swollen cellulose (PASC) within 96 h. The yield (in grams of ethanol produced per gram of carbohydrate consumed) was 0.35 g/g, which correspond to 68.6% of the theoretical yield.
Aspergillus ; enzymology ; Cellulase ; genetics ; Cellulose ; metabolism ; Cellulose 1,4-beta-Cellobiosidase ; genetics ; Enzymes, Immobilized ; genetics ; Ethanol ; metabolism ; Fermentation ; Glucosidases ; genetics ; Mannose-Binding Lectins ; metabolism ; Protein Binding ; Saccharomyces cerevisiae ; genetics ; metabolism ; Saccharomyces cerevisiae Proteins ; metabolism ; Trichoderma ; enzymology

Objective To obtain two-dimensional gel electrophoresis maps of the renal tissue proteins of normal and chronic intermittent hypoxia(CIH) rats for identifying the diferentially expressed proteins in the CIH rats.MethodsCIH rat models were established, and the proteins in the renal tissue underwent two-dimensional gel electrophoresis with immobiline pH gradientisoeleclricfocusingasthefirstdimensionandverticalSDS-PAGEasthesecond dimension.Analysis of 2-DE maps was used to determine differential expression of proteins between the two groups by ImageMaster 2D Platinum 5.0, and four protein spots expressed differently were picked up for further identification by MALDI-TOF-MS.Results Matched and compared with those of control group, 112 protein spots were determined with differently expressive levels in CIH group.By MALDI-TOF-MS, three protein spots of them were identified as ATP synthase delta subunit of mitochondrial precursor, catechol O-methyltransferase, apurinic/apyrimidinic endonudease.Conclusions There is obvious difference in expressive proteomes in renal tissue between normal and chronic intermittent hypoxia rats.The functions of those identified proteins are involved in cellular energy metabolism, apoptosis, signal transduction, anti-cell injury and hormone metabolism,so that proteomics can serve as a new approach in the study of obstructive sleep apnea-hypopnea syndrome to discover new therapeutic targets.

Objective To investigate the prognostic value of decreased vasopressin (VP)modulation in the late-phase of septic shock. Methods A prospective study was conducted. Fifty-five septic shock patients hospitalized in intensive care unit (ICU)of the First Hospital of Hebei Medical University from January 2012 to February 2014 were enrolled. All patients received 3% hypertonic saline solution infusion. Serum concentrations of sodium and VP were measured before and after hypertonic saline solution infusion. Patients with ratio of difference in sodium and VP before and after infusion of 3%hypertonic saline (△VP/△Na)≤0.5 pg/mmol were defined as non-responders,and who>0.5 pg/mmol were defined as responders. The levels of lactic acid,C-reactive protein (CRP),and vasoactive drug〔dopamine(DA)and norepinephrine(NE)〕usage between the two groups were compared. The 28-day mortality,live time in the dead,and ICU day in survivors were analyzed between the two groups. The receiver operating characteristic curve (ROC curve)was drawn to assess prognostic value of VP. Results There were 30 cases (54.5%) in non-responsive group,and 25 (45.5%)in responsive group. There were no significant differences in the age,acute physiology and chronic health evaluationⅡ (APACHEⅡ)score,central venous pressure (CVP),blood pressure, plasma albumin level,sodium level before and after hypertonic saline solution infusion between the two groups. The baseline level of VP in the non-responsive group was markedly lower than that of the responsive group (ng/L:10.66± 1.57 vs. 17.13 ±5.12,t=6.091,P<0.001). After hypertonic saline solution infusion,the VP level was also significantly decreased compared with that in the responsive group(ng/L:11.65±1.74 vs. 22.50±5.31,t=9.758,P<0.001). The non-responders showed higher lactic acid (mmol/L:3.04±0.55 vs. 2.28±0.38,t=-5.881,P<0.001) and CRP (mg/L:117.9±23.0 vs. 94.9±17.0,t=-4.143,P<0.001),and received larger dosage of vasoactive drugs〔DA(μg·kg-1·min-1):14.8±3.9 vs. 8.9±1.6,t=-5.725,P<0.001;NE(μg·kg-1·min-1):0.96±0.42 vs. 0.40± 0.09,t=-5.625,P<0.001〕for maintaining blood pressure compared with those in responders. The non-responsive group showed higher 28-day mortality(66.7%vs. 40.0%,χ2=3.911,P=0.048)and longer ICU day(days:9.9±2.3 vs. 6.7±1.7,t=-4.044,P<0.001),but the live time in the dead showed no difference between non-responsive group and responsive group(days:5.8±1.9 vs. 6.1±2.3,t=0.384,P=0.704). ROC curve showed that the area under ROC curve(AUC)forΔVP/ΔNa predicting the outcome was 0.828,and theΔVP/ΔNa threshold value of 0.5 pg/mmol had the sensitivity of 66.7%and specificity of 64.0%for prediction of the outcome(95%confidence interval:0.722-0.934). Conclusion Osmotic pressure-regulated VP secretion was impaired and decreased in the late-phase of septic shock, and made the sense in prognosis.

Objective To investigate the clinical curative effect and safety of Shenmai combined with meglu-mine adenosine cyclophosphate in the treatment of chronic heart failure.Methods 118 patients with chronic heart failure were selected as the research subjects.They were randomly divided into control group and observation group, 59 cases in each group.The patients in the control group received routine comprehensive treatment,the observation group was given intravenous Shenmai injection 50mL,1 /d,meglumine adenosine cyclophosphate injection 120mg, 250mL 5% glucose injection intravenous drip note,the 1 time /d,7d for a course of treatment.Two groups of patients received a total of 2 courses of treatment.Before and after treatment,left ventricular ejection fraction (LVEF)was detected by cardiac ultrasound,and the brain natriuretic peptide (BNP)level in patients was measured.The total effective rate of the two groups was analyzed.Results Before treatment,LVEF of the control group and the observa-tion group were (32.19 ±5.72)%,(32.50 ±6.01 )%.After treatment,LVEF of control group was (36.62 ± 4.13)%,LVEF indexes in the observation group was (42.09 ±5.52)%,LVEF increased significantly in the two groups,but that in the observation group was higher than that of the control group (t =-3.882,P =0.017),the difference was statistically significant.Before treatment,BNP index of the observation group and the control group were (485.16 ±206.15 )pg/mL,(489.11 ±178.96)pg/mL,after treatment,BNP level of the observation group was (159.29 ±93.62)pg/mL,BNP level in the control group was (322.36 ±156.58)pg/mL,BNP in the observation group was significantly lower than that of the control group(t =-7.443,P =0.000).24 cases in the observation group after treatment,effective in 30 cases,the total effective rate was 91.53%,which was significantly higher than 76.27% of the control group (χ2 =9.524,P =0.003).No obvious adverse reactions or allergic reaction etc.were observed in the observation group.Conclusion The therapeutic effect of combination of Shenmai injection and meglumine in the treatment of chronic heart failure is accurate,it can significantly improve cardiac function,and has high safety,and without adverse reaction reports,it is worthy of the clinical application and popularization.

Objective To evaluate the effect of palliative care in the treatment of pain and life quality in later period tumor patients.Methods 103 patients with advanced tumors in our hospital were selected and divided into group A(51 patients) and group B(52 patients) based on the methods of treatment.The patients in group A were given conventional treatment,and the patients in group B were given palliative care program on the basis of the treat-ment in group A.The effects of the groups A and B were observed and compared.Results The pain levels of group A and B before treatment had no statistically significant difference (P>0.05).The pain level score of group B after treatment was (26.41 ±3.55)points,which was lower than (32.56 ±7.12)points in group A,and the difference was statistically significant (t=6.430,P<0.05).The difference in life quality of the two groups before treatment was not significant (P>0.05).After treatment,the life quality score of group B was (66.85 ±6.75)points,which was higher than (53.39 ±6.74)points in group A,and the difference was statistically significant (P<0.05).Conclusion It is effective for palliative care to treat the patients with advanced tumors on their pain management and quality of life, which is worthy of clinical application.

Background and purpose: Recent literature has high lighted an important role of inflammation in promoting cancer. CRP (C reactive protein) is a way of building the bridge between inflammation and cancer. We aimed to explore correlations between CRP levels and clinical stages of nasopharyngeal carcinoma(NPC). Methods: We analyzed 108 cases, among which 68 cases were NPC, 20 cases were benign inflammatory diseases of nasopharynx, and another 20 were healthy volunteers as control. We detected the level of CRP using immunoturbidimetry (ITM), q test was calculated by SPSS. Results: The mean concentrations of CRP in NPC[(19.8±4.7) mg/L] were significantly increased compared to those in the control group[(6.2±1.8) mg/L], while they were significantly lower than those in benign inflammatory group[(45.6±7.9) mg/L]. In NPC, The mean concentrations of CRP in T4[(25.6±3.9) mg/L] were higher than those in T1[(17.4±5.8) mg/L], T2[(18.6±8.5) mg/L] and T3[(15.6±1.8) mg/L] respectively. The mean concentrations of CRP in N3[(28.0±7.1) mg/L] were higher than those in N0[(17.6±6.8) mg/L], N1[(21.3±5.1) mg/L] and N2[(18.6±5.6) mg/L] respectively. The mean concentrations of CRP in 1V[(25.7±5.5) mg/L] were higher than those in Ⅰ[(14.2±1.9) mg/L], Ⅱ[(16.1±3.9) mg/L] and Ⅲ[(23.0±7.7) mg/L] respectively (P<0.05). There were no statistic differences between the other groups. Conclusion: The serum CRP level is associated with the occurrence of NPC and benign inflammatory disease of nasopharynx. In NPC, the higher the CRP level is, the more advanced the TNM stage will be.