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 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.

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.

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 investigate the effect of using massage by finger pressing to prevent the enteroparalysis which caused by continue atropine injection. Methods Divided 60 patients with severe organophosphorus poisoning into experimental group and control group randomly, there were 30 cases in each group.Routine nursing cares were used in the control group, the massage by finger pressing was added in the experimental group.Compared the correlative indexes such as the time of first defecation, the times of defecation, the number of patients with enteroparalysis, the time of cholinesterase reactivation between the two groups. Results By the statistic test, all the indexes which have mentioned above had significant differences between 2 groups,P

Objective:To explore total hepatic ischemia-reperfusion(I/R)-induced lung injury in rats,its related mechanism and the protective effects of melatonin on lungs.Methods: This study was divided into 2 parts.In the first part,72 healthy male SD rats weighing 250-300 g were randomly divided into 2 groups: I/R group(ischemia-reperfusion,n=36) and sham-operation group(n=36).Total hepatic I/R was produced by occlusion of hepatic helium for 30 minutes,and the occlusion was then released for reperfusion.The animals were killed at 5 minutes prior to ischemia and 0 h,0.5 h,1 h,3 h and 6 h after reperfusion in sham-operation group and I/R group(n=6 at each time point),and the lung tissue was taken.Through comparisons of these two groups,we observed the dynamic changes of lung tissue after total hepatic I/R.In the second part,12 healthy male SD rats weighing 250-300 g were randomly divided into 2 groups: melatonin group(n=6) and vehicle group(n=6).Melatonin(0.5%,10 mg/kg)or vehicle of the same volume was injected via femoral vein 15 min before ischemia and 10 min before reperfusion,the animals were killed at 1 h after reperfusion,and the lung tissue was taken.Through comparisons of these two groups,we observed the effects of melatonin.Results:(1)Total hepatic I/R led to severe histological injury in lungs.Compared with those in sham-operation group,the MDA content and apoptotic index were increased,the SOD activity was decreased,the p-ERK/ERK ratio and PCNA-positive index were decreased respectively 0 h and 0.5 h after reperfusion,and then were increased gra-dually.Histological examination revealed that the alveolar architecture was destroyed with interstitial thickening and neutrophil infiltration in I/R group.Correlate analysis revealed that p-ERK/ERK ratio showed a positive correlation with PCNA-positive index(r=0.56,P

ObjectiveTo study the role of the myenteric plexus (ENS) nitrergic neurons in type 2 diabetic rats with gastroparesis.MethodsThiry male 8-week-SD rats were randomly divided into control group (CON),type 2 diabetic group (DM),insulin-treated group ( INS ) and insulin-lipoie acid group( LA ),each 15.The rats were sacrificed at 16 weeks after diabetic model established,the stomach relative residual rate of pigmented was measured and the protein content of neuronal nitric oxide synthase (nNOS) was evaluate,the level of malondialdehyde (MDA) and superoxide dismutase (SOD),were measured,the the morphological changes of gastric antrum nitrergic neurons was observed.ResultsCompared with CON group,gastric motility,gastric antrum nitrergic neuron count,T-SOD and CuZn-SOD,and were significantly decreased in DM group ( P ＜0.05).Compared with the CON group,DM group gastric antrum nitrergic neurons nNOS expression decreased,while MDA levels significantly increased ( P ＜ 0.05 ).Compared with DM group,INS group and LA group has significantly rapider gastric motility than that of DM group ( P＜ 0.05 ),the neuron counting markly increased in nitrergic neuron of gastic sinus ( P ＜ 0.05 ),increased expressions of nNOS in gastric sinus,while still lower than control group( P ＜0.05).compared with the INS group,antrum nitrergic neuron counts of LA group significantly increased ( P ＜ 0.05 ).Conclusion The gastrointestinal dyskinesis of type 2 diabetic rats might be associated with lesions of gastric myenteric plexus nitrergic neuron.Insulin intensive therapy and treated with alpha-lipoic acid as an antioxidant can inhibit the abnormally high levels of oxidative stress,protect gastrointestinal nitrergic neurons,delay the progress of diabetic gastrointestinal motility disorders.Insulin combined with a-lipoic acid treatment is superior to single-use insulin.

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.