Objective To unravel the relationship between artefiM blood lactate (ABL) level and is1et β-cell secretion constituents in stress hyperglycemia(SHG)setting of critical illness,and analyze the effect of inadequate tissue perfusion on islet β-cell function.Method According to ABL level,68 critically ill patients with SHG were divided into three groups,namely,group A(ABL≤1.5 mmol/L),group B (ABL 1.6～4.4 mmol/L)and group C(ABL≥4.5 mmol/L).Another 25 healthy volunteers served as insulin (IRI) were measured.The homeostasis model assessment for secretion index of islet beta-cell (HOMA-β)was calculated.The relationship among the above B-c3eH secretion constituents were analyzed.Results The TI level of group C was significantly lower than that of group A(P<0.01).The PI levels of group B and C were significantly higher than those of group A and control group(P<0.05).The C-P level of group C was significantly higher that of group A and control group(P<0.05).The HOMA-β of group C was significant lower than that of group A and B and control group(P<0.05).The ABL had positive correlation with PI and C-P(r=O.322,P=O.015;r=0.513,P=0.000),and the ABL had negative correlation with TI and HOMA-β(r=-0.353,P=0.007;r=-0.294,P=0.002).Conclusions The worse tissue perfusion was in SHG of critical illness,the higher PI and C-P were,the lower TI was, Inadequate tissue perfusion setting could lead to islet beta-cell paracrisis and deceleration.

Objective To explore how to apply SWOT analysis method for analysis in nursing management in special wards,to develop individualized measures,and to evaluate the clinical quality of care. Methods Using SWOT analysis method to investigate the internal strengths factors,internal weaknesses factors,external opportunities factors,and external threats factors and arranged as a matrix in accordance with a certain order,and used systems analysis methods to analyze the factors matching each other,to dr aw the appropriate conclusions,and to develop appropriate countermeasures.30 patients before and 40 patients after the application of SWOT analysis method were selected for effect comparison. Results After the implementation of SWOT analysis method primary care,I-level care,health education quality,satisfaction degree of patients and ward management score were better than those before the implementation. Conclusions SWOT analysis method was intuitive and simple to use.It possesses balance and systematieness,which is suitable for clinical care management.

Objective To measure the mRNA expression of immediate-early gene c-fos in endothelial cells by the use of different intermittent hypoxia (IH) protocols. Methods A gas control delivery system was homemade, which pro-duced IH/re-oxygenation(ROX) environmental exposure. The endothelial cells were exposed to IH/ROX cycles, and were di-vided into three groups (A, B and C). There were five sub-groups in each group. Group A included intermittent normoxia group, standard incubator control group, continuous hypoxia group (CH), 1.5%O2 IH group and 10%O2 IH group. There were different frequency IH of 1.5%O2 and 10%O2 sub-groups in group B and group C. Hypoxia time was 15 s. The intermittent hypoxia cycle was 60 and the ROX time was different. The total cycle time was different, including 1.5 h group, 3 h group, 5 h group, 6.5 h group and 9.5 h group. The mRNA expression of immediate-early gene c-fos was measured by real-time PCR. Results There was no significant difference in the level of c-fos mRNA between intermittent normoxia group and CH group. The expression of c-fos mRNA was significantly higher in 1.5%O2 IH group and 10%O2 IH group than that of intermit-tent normoxia group, and there was a higher expression level of c-fos mRNA in 1.5%O2 IH group than that of 10%O2 IH group (P＜0.01). It was found that the mRNA expression of c-fos increased gradually at first, and then gradually decreased. The expression of c-fos mRNA was significantly higher in 5 h group than that of other groups (P＜0.01). Conclusion The mRNA expression of immediate-early gene c-fos is increased after exposing to IH/ROX in endothelial cells, which is closely related with IH extents and frequencies.

The clinical features, electroneurophysiology, neuroimaging and gene characteristics of one case of early adult-onset dentatorubral-pallidoluysian atrophy (DRPLA) with an onset of epilepsy were reported. The female patient had the onset manifestation of epilepsy. Whereafter, she progressively developed marked cerebellar ataxia, mental retardation and choreic movement. Electroencephalography showed that there were multiple complex slow waves in the whole brain cortex. Magnetic resonance imaging showed the patient had marked atrophies in the cerebral cortex, brainstem and cerebellum. Atrophin-1 gene detection revealed that the numbers of CAG repeats were 15/65 (the patient) and 14/54 (her father) respectively. Her father had no clinical manifestations until now. The mother and brother were normal. DRPLA has diverse clinical presentation,heterogeneous phenotypic spectrum, early adult-onset DRPLA is rare, and the specific gene detection can be helpful for a definitive diagnosis.

Objective To investigate the cell-type-specific enhancer (CTSE) in HPV16 and its variation in cervical carcinoma. Methods CTSEs were detected by polymerase chain reaction (PCR) in 58 cervical carcinoma from Shaanxi province; in addition variation of CTSEs was analyzed through single-strand conformation polymorphisms (SSCP). Results HPV16 CTSEs were detectable in 34 of 58 (57%) specimens and mutant rate was 41%(14/34) and the main mutations of chosen randomly variant CTSE (CTSEv) happened at YY1 binding sites in addition to glucocoticoid response elements (GRE). Conclusion CTSE in some specimens of Shaanxi province was obviously different from that in HPV16 wild type and variant CTSE might affect the transcriptional regulation of LCR on viral P97, which regulates over-expression of viral oncogenes in cervical carcinoma.

Objective To explore the factor structure of the anxiety imagery characteristics questionnaire.Methods Through the literature review and expert group discussion,the initial anxiety imagery features questionnaire was created.The first questionnaire contained 49 items of anxiety imagery,which was answered by 106 imagery dialogue psychotherapists.After analysis of the items and exploratory factors,the formal questionnaire that contained 20 items of anxiety imagery characteristics was formed.The formal questionnaire was measured by 115 imagery dialogue psychotherapists,then,exploratory and confirmatory factor analyses were made.Results The exploratory factor analysis showed that four factors whose Eigen value were more than 1 were extracted from l0 items,including emotional panic,uneasy,tense muscles,and motor restlessness.Those four factors explained 54.39％ of the total variance.Confirmatory analysis showed that x2/df was 2.142 ; root mean square error of approximation (RMSEA) was 0.059 ; and comparative fit index (CFI),goodness-of-fit index (GFI),non-normed fit index (NNFI) and RSMEA was 0.912,0.935,0.896,and 0.057,respectively.Conclusions The four-factor structure was constructed by 10 items of anxiety imagery characteristics questionnaire.

Objective To observe the correlation of serum aquaporin 4 (AQP4) antibodies and condition and visual prognosis in patients with severe neuromyelitis optica spectral disorders (NMOSD). Methods Fifty NMOSD patients with visual acuity of 20/200 or worse in at least one eye were enrolled in this retrospective analysis. There were 12 males and 38 females. The age ranged from 17 to 65 years, with the mean of (39.86±2.02) years. The patients were divided into two groups according to the serum AQP4-IgG status. The ophthalmologic examination, serum anti-nuclear antibodies (ANA), myelin oligodendrocyte glycoprotein (MOG) antibody detection and vision prognosis were compared and analyzed. Glucocorticoid therapy was delivered to 46 patients who were within 1 month of onset. The visual acuity of the patients after treatment was divided into complete recovery, partial recovery, stabilization and reduction, and the visual acuity of the two groups were analyzed. Results Among 50 patients, there were 30 (60%) seropositive patients (positive group), 20 (40%) seronegative patients (negative group). The positive group had significantly higher ratio of female to male (P=0.004), and more binocular optic neuritis (ON) (P=0.010) compared with the negative group. More recurrence ON were also found in the positive group, but without statistic difference between two groups (P=0.167). There was no difference of age, course, and vision damage degrees and abnormal orbital MRI scanning between two groups (P>0.05). Among 24 patients who underwent serum ANA detection in the positive group, 8 patients were positive. All of 18 patients who underwent serum ANA detection in the negative group were negative. The difference of the ratio of serum ANA positive patients between two groups was significant (P=0.030). Serum MOG antibody detection in the positive group was negative (0/10). Sixteen patients who underwent MOG antibody detection in negative group, 4 patients were positive. After treatment, there were 23.3%, 23.3%, 53.3% patients with vision of complete recovery, partial recovery and reduction in the positive group; 25.0%, 30.0%, 25.0% patients with vision of complete recovery, partial recovery and reduction in the negative group, respectively. There was no difference in proportion of vision with complete recovery and partial recovery between two groups (P=0.163, 0.607), but significant difference was observed in proportion of vision with stabilization and reduction between two groups (P=0.021, 0.048). Conclusions The positive serum AQP4 antibody is common in patients with severe NMOSD. The patients with AQP4 antibody in the serum are more likely combined with immunological serological markers and poor vision prognosis.

In this study, a novel technique for the preparation of (125)I-5-trimethylstannyl-1-(2-deoxy-2-fluoro-beta-D-arabinofuranosyl) urail (FIAU) was developed, (125)I-FIAU biodistribution profile was detected in Kunming mice and the possibility of using FTAU radio-labeling for reporter gene imaging was explored. 5-trimethylstannyl-1-(2-deoxy-2-fluoro-beta-D-arabinofuranosyl) urail (FTAU) was labeled with radioiodine ((125)I). A rotary evaporation method was used to remove excess methanol. The reactant was purified through a Sep-Pak C18 reversal phase column. The radiochemical purity and in vivo stability were determined using silica gel thin layer chromatography (TLC). The biodistribution of (125)I-FIAU in Kunming mice was also detected. The results showed that (125)I-FIAU could be radiolabeled effectively with FTAU, with mean labeling rate being (81±0.38)% (n =5). The mean radiochemical purity of (98.01±0.40)% (n=5) was achieved after a reversal phase Sep-park column purification. (125)I-FIAU was stable when incubated in normal human serum or in saline at 37°C, with a radiochemical purity >96% during a 0.5-24 h time period. Biological experiments exhibited rapid clearance of (125)I-FIAU from the blood pool. (125)I-FIAU was mostly excreted by kidneys. (125)I-FIAU in myocardium dropped conspicuously after 8 h and there was hardly retention at 24 h. We were led to concluded that the new method of radioiodinization of FTAU for the preparation of (125)I-FIAU is easy, highly effective and stable in vivo. The biodistribution of (125)I-FIAU in Kunming mice showed it can serve as an imaging probe for myocardial reporter genes.

Objective To study the effect of postoperative rehabilitation of meditation training on repeat cesarean section patients. Methods A total of 86 cases of repeat cesarean section from October 1st, 2014 to October 1st, 2016 were collected. The patients were divided into the observation group (43 cases) and the control group (43 cases) by random digits table method. The observationgroup received meditation therapy by a well-trained nurse based on the routine treatment. The control group was treated with routine treatment. The two groups were compared by postoperative pain score, anxiety and depression scores, the first breastfeeding time, the first urination time and satisfaction. Results After intervention, the postoperative pain visual scores of the observation group and the control group were 3.21 ± 1.51 and 5.41±1.45 respectively, the difference was statistically significant (t=3.817, P<0.01). After intervention, the scores of Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD) of the observation group were 10.86±1.95,9.22±2.76, and 16.88±2.09,14.02±3.79 in the control group, the differences were statistically significant (t=11.518, 6.317, P<0.01). The first out-of-bed time of the observation group were as follows:<4 h:9.30%(4/43), 4-6 h:88.37%(38/43),>6 h/failure:2.32%(1/43). While the data of the control group were <4h: 18.60%(8/43), 4-6 h: 67.44%(29/43), >6 h/failure: 13.95%(6/43), the differences were statistically significant (t=6.114, P<0.05). The satisfaction of the observation group and the control group were 98.47% (42/43) and 91.69% (39/43) respectively, the difference was statistically significant. (χ2=7.679, P<0.01). ConclusionsMeditation can effectively reduce the postoperative pain, reduce the incidence of anxiety, shorten the first time of breastfeeding and urination, and improve patients′satisfaction.

Objective To discuss the presentations, pathologic features, diagnosis and treatment of primary synovial sarcoma of the kidney. Methods One case of primary synovial sarcoma of the kidney was reported and the relevant literature was reviewed. A 55-year-old man was admitted with complaint of right abdomen and flank pain for 5 h. Computerized tomography revealed a 12.5 cm × 11.0 cm × 9. 0 cm mass located at the middle and lower pole of the right kidney. The patient was taken radical nephrectomy. Results The diagnosis of primary synovial sarcoma of the kidney in the patient was confirmed by postoperative pathology. Under microscope, tumor was typically mitotically active, monomorphic spindle cells growing in intersecting fascicles or in solid sheets with epithelial differentiation. In some areas a haemangiopericytoma-like pattern was found. Immunohistochemical staining showed that the tumor cells were positive for the markers Vimentin, CD99 and Bcl-2, but CK was negative. The patient died of local recurrence and multi-metastasis at 8 months after surgery. Conclusions Primary synovial sarcoma of the kidney is extremely rare with a high grade of malignancy,and its prognosis is poor. The diagnosis depends on pathological features, Immunohistochemical studies and RT-PCR detection. Radical resection combined with chemicaltherapy is considered to be the most reliable treatment so far.