Objective:To develop evaluation index system of Knowledge, Attitude, and Practice Model of esophageal speech training for Otolaryngology nurse, which can provide an initial tool to evaluate the effect of esophageal speech training for Otolaryngology nurse.Methods:Based on the Knowledge, Attitude, and Practice Model and literature research, the initial dimensions and items were developed. The evaluation index system was completed by Delphi technique that 23 experts were invited to evaluate the importance of the dimensions and items in the consulting round. Then the weight value of the index system was computed through analytic hierarchy.Results:For the first and second rounds of the study, respectively, the recovery rates were 78.26% and 100.00%, the expert authority were 0.85 and 0.86, and the Kendall′s W were 0.16 and 0.19 ( P<0.05). Finally, the index system contained 3 dimensions and 30 items. Conclusions:The evaluation index system has the possible scientificity and reliability, and has the feasible thoery and content. In the future, the evaluation index system can be used to evaluate the effect of esophageal speech training for Otolaryngology nurse through the clinical practice improvement.

OBJECTIVEA high performance liquid chromatography (HPLC) method was developed to determine the concentration of nitidine chloride in plasma and successfully applied to study pharmacokinetics after i.v. administration in rabbits.

METHODTwelve rabbits, randomized into 2 groups , were given i.v. at the dose of 4, 6 mg x kg(-1) respectively. Chloramphenicol was used as an internal standard. Nitidine chloride was extracted from plasma with ion pair reagent, and was determined by HPLC.

RESULTThe calibration curves of nitidine chloride was linear in the range of 0.03-2.04 mg x L(-1). Its recoveries were more than 95%, intra-day and inter-day precisions were lower than 6%. The concentration-time curve of nitidine chloride in rabbits after i.v. of 4 and 6 mg x kg(-1) were shown to fit a two-compartment model, the main pharmacokinetic parameters showed no significant difference between the low and high dosage, and the AUC values are directly relative to doses. T1/2alpha were (5.46 +/- 0.89), (4.76 +/- 0.33) min respectively, T1/2beta were (263.33 +/- 16.4), (274.71 +/- 16.52) min respectively, AUC were (46.56 +/- 1.80), (69.19 +/- 2.30) microg x min(-1) x mL(-1) respectively.

CONCLUSIONIt is first time to establish the HPLC method to determine the concentration of nitidine chloride in rabbits plasma. The method is sensitive, accurate and reproducible. It is first time to study the pharmacokinetic characters of nitidine chloride in rabbits after i.v. administration, the elimination of nitidine chloride is linear pharmacokinetics.

Animals ; Benzophenanthridines ; administration & dosage ; blood ; pharmacokinetics ; Chromatography, High Pressure Liquid ; methods ; Drugs, Chinese Herbal ; administration & dosage ; pharmacokinetics ; Female ; Male ; Rabbits ; Random Allocation

ObjectiveTo investigate the clinical promoting effect of crossing nape electroacupuncture on the recovery of swallowing function and recovery from pulmonary infection in post-cerebral infarction patients with tracheotomy.MethodSixty post-cerebral infarction patients with cough reflex disorder and swallowing dysfunction associated with pulmonary infection receiving tracheotomy and tracheal intubation were subjects. They were allocated, using a random number table, to three groups, 20 cases each. In each group, the patients were enrolled in order of visits. The three groups were given the same basic treatment for fighting inflammation, resolving phlegm and improving blood supply. The crossing nape electroacupuncture group received bilateral points Fengchi (GB20), Yifeng (TE17), Dicang (ST4)-to-Jiache (ST6) and Lianquan (CV23) acupuncture with electrodes connected by left-right crossing. The acupuncture group received bilateral points Fengchi, Yifeng, Dicang-to-Jiache and Lianquan acupuncture without electrodes connected. The control group received basic treatment with Western drugs without acupuncture therapy. Observations were carried out using the Kubota’s water drinking test, the Toshima Ichiro Swallowing Assessment and the Clinical Pulmonary Infection Score. The clinical therapeutic effects were evaluated in the three groups.ResultThe therapeutic effects evaluated using the Kubota’s water drinking test and the Toshima Ichiro Swallowing Assessment were better in the crossing nape electroacupuncture group than in the acupuncture group and better in the acupuncture group than in the control group (P<0.05). The score of the Clinical Pulmonary Infection Score decreased in all the three groups. The promoting effect on recovery from pulmonary infection was marked in the crossing nape electroacupuncture group (P<0.01).ConclusionCrossing nape electroacupuncture has a marked improving effect on dysphagia in post-cerebral infarction patients with tracheotomy and tracheal intubation. It can promote recovery from pulmonary infection in post-cerebral infarction patients with cough reflex disorder receiving tracheotomy and tracheal intubation.

Objective To obverse the changes ofmacular choroidal thickness (CT) in patients with mild to moderate Alzheimer's disease (AD).Methods This was a case-control study.Twenty-one patients with mild to moderate AD confirmed by Neurology Department of Jinhua Central Hospital from November 2016 to June 2018 and 21 age-matched control subjects were concluded in the study.There was no significant difference in age (t=0.128),intraocular pressure (t=0.440) and axial length (t=1.202) between the two groups (P＞0.05).There was significant difference in mini-mental state examination score (t=8.608,P＜0.05).CT was measured by OCT with enhanced depth imaging technique in the subfoveal choroid,at 0.5 mm and 1.0 mm from the center of the fovea nasal (NCT0.5,1.0mm),temporal (TCT0.5,1.0mm),superior (SCT0.5,1.0mm),and inferior (ICT0.5,1.0mm).Independent-samples t test was used to compare the results obtained from these two groups.Results SFCT (t=2.431),NCT0.5,1.0 mm (t=3.341,2.640),TCT0.5,1.0 mm (t=3.340,2.899),SCT0.5.1.0 mm (t=3.576,3.751) and ICT0.5 (t=2.897,2.903) were significantly thinner in AD eyes than those in control eyes.Conclusion Compared with healthy subjects,patients with mild to moderate AD showed a significant reduction in CT.

Objective: To investigate the effect of bilirubin on inflammatory signaling pathway mediated by NOD-like receptor 2(NOD2) in premature infants. Methods: Fifteen cases of premature infants hospitalized at the Department of Neonatology, Children′s Hospital of Soochow University from April 2016 to January 2017, were selected, and 2 mL peripheral blood were collected from 15 cases of premature infants, and the mononuclear cells were isolated and divided into 6 groups, including blank control group (group A), muramyl dipeptide(MDP) group (group B), 102 μmol/L bilirubin group(group C), 102 μmol/L bilirubin+ MDP group (group D), 153 μmol/L bilirubin+ MDP group (group E), 255 μmol/L bilirubin+ MDP group (group F). Group A and group B were stimulated by buffer, group C, group D, group E and group F were stimulated by 102 μmol/L, 102 μmol/L, 153 μmol/L, 255 μmol/L bilirubin, respectively.The supernatant was discarded after 1 h, then the medium was added to group A and group C, and the rest of the 4 groups were agonisted with MDP, the cells were stimulated for 24 h, and then the cells and supernatant fluids were collected respectively, the expression levels of NOD2 mRNA in the cells were determinated by real time-PCR, and the expression levels interleukin-6(IL-6) and tumor necrosis factor-α(TNF-α) in the supernatant was determinated by enzyme linked immunosorbent assay. Results: The expression levels of NOD2 mRNA had no obvious changes after being stimulated by MDP or by different concentrations of bilirubin(7.16±3.08, 6.19±1.99, 7.02±4.04, 6.84±1.81) compared to those of the blank control group(7.46±3.70)(all P>0.05). After being stimulated by MDP, the expression level of IL-6 (5.13±2.36)was significantly higher than that of the blank control group(3.84±1.44), and the difference was statistically significant(P<0.05), but TNF-α had no obvious changes(4.85±2.47 vs.4.04±2.26, P>0.05). The expression levels of IL-6 and TNF-α had no obvious changes compared to those of the blank control group after being stimulated by 102 μmol/L bilirubin(3.26±1.06 vs.3.84±1.44, 3.45±1.84 vs.4.04±2.26, all P>0.05); but the expression levels of IL-6 and TNF-α were significantly lower after 153 μmol/L and 255 μmol/L bilirubin stimulation (IL-6: 2.58±1.33, 2.16±0.94; TNF-α: 2.32±1.49, 2.42±1.42)compared to those of the blank control group(3.84±1.44, 4.04±2.26), and the differences were statistically significant(all P<0.05). Conclusions Bilirubin have no obvious inhibitory effect on NOD2, and low concentration of bilirubin had no obvious inhibitory effect on IL-6 or TNF-α in this study, but high concentration of bilirubin can inhibit the expression levels of IL-6 and TNF-α, hyperbilirubin may inhibit the ability of anti-infection immune response in body by inhibiting inflammatory signaling pathway mediated by NOD2.

Background/Aims: Liver transplantation is the most effective treatment for the sickest patients with acute-on-chronic liver failure (ACLF). However, the influence of donor age on liver transplantation, especially in ACLF patients, is still unclear. Methods: In this study, we used the data of the Scientific Registry of Transplant Recipients. We included patients with ACLF who received liver transplantation from January 1, 2007, to December 31, 2017, and the total number was 13,857. We allocated the ACLF recipients by age intogroup I (donor age ≤17 years, n=647); group II (donor age 18–59 years, n=11,423); and group III (donor age ≥60 years, n=1,787). Overall survival (OS), graft survival, and mortality were com-pared among the three age groups and the four ACLF grades. Cox regression was also analyzed. Results: The 1-, 3-, and 5-year OS rates were 89.6%, 85.5%, and 82.0% in group I; 89.4%, 83.4%, and 78.2% in group II; and 86.8%, 78.4%, and 71.4% in group III, respectively (p<0.001).When we analyzed the different effects of donor age on OS with different ACLF grades, in groupsII and III, we observed statistical differences. Finally, the cubic spline curve told us that the relative death rate changed linearly with increasing donor age. Conclusions Donor age is related to OS and graft survival of ACLF patients after transplanta-tion, and poorer results were associated with elderly donors. In addition, different donor ages have different effects on recipients with different ACLF grades.

Background/Aims: Liver transplantation is the most effective treatment for the sickest patients with acute-on-chronic liver failure (ACLF). However, the influence of donor age on liver transplantation, especially in ACLF patients, is still unclear. Methods: In this study, we used the data of the Scientific Registry of Transplant Recipients. We included patients with ACLF who received liver transplantation from January 1, 2007, to December 31, 2017, and the total number was 13,857. We allocated the ACLF recipients by age intogroup I (donor age ≤17 years, n=647); group II (donor age 18–59 years, n=11,423); and group III (donor age ≥60 years, n=1,787). Overall survival (OS), graft survival, and mortality were com-pared among the three age groups and the four ACLF grades. Cox regression was also analyzed. Results: The 1-, 3-, and 5-year OS rates were 89.6%, 85.5%, and 82.0% in group I; 89.4%, 83.4%, and 78.2% in group II; and 86.8%, 78.4%, and 71.4% in group III, respectively (p<0.001).When we analyzed the different effects of donor age on OS with different ACLF grades, in groupsII and III, we observed statistical differences. Finally, the cubic spline curve told us that the relative death rate changed linearly with increasing donor age. Conclusions Donor age is related to OS and graft survival of ACLF patients after transplanta-tion, and poorer results were associated with elderly donors. In addition, different donor ages have different effects on recipients with different ACLF grades.

Background/Aims: Liver transplantation is the most effective treatment for the sickest patients with acute-on-chronic liver failure (ACLF). However, the influence of donor age on liver transplantation, especially in ACLF patients, is still unclear. Methods: In this study, we used the data of the Scientific Registry of Transplant Recipients. We included patients with ACLF who received liver transplantation from January 1, 2007, to December 31, 2017, and the total number was 13,857. We allocated the ACLF recipients by age intogroup I (donor age ≤17 years, n=647); group II (donor age 18–59 years, n=11,423); and group III (donor age ≥60 years, n=1,787). Overall survival (OS), graft survival, and mortality were com-pared among the three age groups and the four ACLF grades. Cox regression was also analyzed. Results: The 1-, 3-, and 5-year OS rates were 89.6%, 85.5%, and 82.0% in group I; 89.4%, 83.4%, and 78.2% in group II; and 86.8%, 78.4%, and 71.4% in group III, respectively (p<0.001).When we analyzed the different effects of donor age on OS with different ACLF grades, in groupsII and III, we observed statistical differences. Finally, the cubic spline curve told us that the relative death rate changed linearly with increasing donor age. Conclusions Donor age is related to OS and graft survival of ACLF patients after transplanta-tion, and poorer results were associated with elderly donors. In addition, different donor ages have different effects on recipients with different ACLF grades.

Background/Aims: Liver transplantation is the most effective treatment for the sickest patients with acute-on-chronic liver failure (ACLF). However, the influence of donor age on liver transplantation, especially in ACLF patients, is still unclear. Methods: In this study, we used the data of the Scientific Registry of Transplant Recipients. We included patients with ACLF who received liver transplantation from January 1, 2007, to December 31, 2017, and the total number was 13,857. We allocated the ACLF recipients by age intogroup I (donor age ≤17 years, n=647); group II (donor age 18–59 years, n=11,423); and group III (donor age ≥60 years, n=1,787). Overall survival (OS), graft survival, and mortality were com-pared among the three age groups and the four ACLF grades. Cox regression was also analyzed. Results: The 1-, 3-, and 5-year OS rates were 89.6%, 85.5%, and 82.0% in group I; 89.4%, 83.4%, and 78.2% in group II; and 86.8%, 78.4%, and 71.4% in group III, respectively (p<0.001).When we analyzed the different effects of donor age on OS with different ACLF grades, in groupsII and III, we observed statistical differences. Finally, the cubic spline curve told us that the relative death rate changed linearly with increasing donor age. Conclusions Donor age is related to OS and graft survival of ACLF patients after transplanta-tion, and poorer results were associated with elderly donors. In addition, different donor ages have different effects on recipients with different ACLF grades.

With the rapid development of organ transplantation in China,the donation after cardiac death (DCD) donor organs are widely used.However,the quality of these organs is relatively poor,so the way to preserve and maintain organ still remains a severe problem.Among them,ischemic reperfusion injury (IRI) impairs the organs severely.Acetaldehyde dehydrogenase 2 (ALDH2) protects organs from stress conditions,including ischemia-reperfusion injury,and the activation and autophagy inhibition also protects the organs from stress conditions as well.Recent studies showed that ALDH2 can regulate autophagy to inhibit the organ injury during ischemia-reperfusion.Our study aims to discuss the new findings in this mechanism.