AIM: To explore the nursing cooperation highlights of eight osteopetrosis patients underwent optic nerve decompression via transsphenoidal microsurgical approach instead of routine pathway, and to improve the quality of nursing cooperation. ·METHODS: We enrolled 8 cases ( left eye in 3 cases, right eye in 5 cases ) of osteopetrosis patients referred from the Eye Hospital of Wenzhou Medical University during February 2012 to November 2016. Patients received ophthalmic examinations including visual acuity and diagnostic imaging tests in pre-operation and post -operation. All eyes were performed surgical optic nerve decompression through endoscopic approach in assist of image guidance system. We retrospectively analyzed the clinical data and surgical cooperation procedure of these cases and summarized nursing cooperation experience. ·RESULTS:The operations of 8 patients were completed successfully without massive hemorrhage. Mean visual acuity improved from pre-operation (2. 5±2. 1) to post-operation (3. 4±1. 9). Cerebrospinal fluid leakage occurred in 1 patient and was instantly repaired during the operation. We performed the nursing strategy as postural drainage, condition monitoring and conscious assessment intra-and post-operation. ·CONCLUSION: It is the critical for this kind of surgery that both circulating nurse's high-skilled cooperation to the connection and operation of the navigation system, to treat with complication during the surgery, and scrub nurse's sufficient preparation of surgical instruments and consumables, proficient equipment delivery, meticulous management, use and maintenance of equipment.

Lactic acid production and antagonistic property of five strains of LAB isolated from piglet intestine were investigated. The results showed that among all strains L5 exhibited the most rapid production and highest amount of lactic acid in the culture. Consequently, the pH in L5 culture showed the fast decline, with the final value significantly lower than those of other cultures. Strain L1 showed the least production of lactic acid and highest pH among all strains. Culture supernatants of the five strains showed different degrees of antagonistic effect against pathogenic E. coli K88, K99, 987P, O141, E1, and S. aureus. When taking out the effect of the acid, the culture supernatants still showed 22%～53% inhibitory effect, suggesting that the bacteria produced other inhibitory substances apart from lactic acid. The inhibitory effect of the culture supernatant was above 92% after heat treatment and above 85% when treated with proteases.

Objective:To observe the expression of the tumor suppressor gene (P53),apoptosis signal receptor (Fas),tumor necrosis factor alpha ( TNF-α) and Cyclin E ( Cyclin E) in serum and cancer tissues with papillary thyroid cancer patients ,and explore their relationship with the clinical pathology characteristics of thyroid papillary carcinoma .Methods:The puncture diagnosis in patients with papillary thyroid carcinoma as the experimental group (n=74),physical examination of healthy people as the normal control group (n=26).The two groups were fasting venous blood samples ,the experimental group in postoperative specimens from cancer tissue , adjacent normal tissue and 7 days after the fasting venous blood was sampled again.Protein content of P53,Fas,TNF-αand Cyclin E was detected by ELISA in serum , cancer adjacent normal tissue and cancer tissue;using real-time fluorescent quantitative assay to observe the gene expression of P53,Fas,TNF-αand Cyclin E in thyroid papillary carcinoma and adjacent normal tissues ; protein expression by immunohistochemical methods in papillary thyroid carcinoma and adjacent normal tissues P 53,Fas,TNF-αand Cyclin E analysis;the clinical expression with papillary thyroid cancer staging , pathological Type and has no relationship to lymph node metastasis.Results:The protein concentration in serum of patients with papillary thyroid carcinoma P 53 , Fas and TNF-αwere significantly lower than that of the normal control group ,Cyclin E protein content was significantly higher than that of normal control group ,the differences were statistically significant (P<0.01);thyroid papillary carcinoma P53,Fas and TNF-αprotein content,protein expression strength and gene expression levels were significantly lower than the normal tissues adjacent to cancer ,protein content ,Cyclin E protein expression and gene expression intensity was significantly higher than that in normal tissues ,the difference was statistically significant (P<0.05).Conclusion:The expression of p53,Fas and TNF-αin papillary thyroid carcinoma lower and expression level of Cyclin E increase ,may play an important role in papillary thyroid cancer invasion and metastasis.Combined detection of the four can be used as markers for early diagnosis of papillary thyroid cancer ,enhance the rate of early diagnosis of thyroid papillary carcinoma.

Objective To explore the effects of first aid green channel on the emergency patients with severe traumatic brain injury.Methods One hundred and thirty patients with severe traumatic brain injury were chosen and randomly divided into two groups,each with 65 cases.The observation group received first aid green channel model of care,and the control group received the traditional nursing method of emergency medical cure.The time to save patients,mortality rate and patient satisfaction were compared between the two groups.Results The mortality rate was 15.2％ in the observation group,and was lower than 40.6％ in the control group; the time to save patients was (12.6 ±2.9) min,and was shorter than (16.1 ±2.0) min in the control group; the patient satisfaction was 100.0％ in the observation group,and was better than 78.1％ in the control group,and the differences were statistically significant (x2/t =4.22,3.03,5.97,respectively; P ＜ 0.05).Conclusions First aid green channel can improve nursing procedures,enhance the medical and nursing staffs' awareness of first aid,shorten the treatment of space and time,improve the treatment success rate,and patients or their families to the satisfaction of the quality of care.

Objective To investigate the effects of cholinergic pathway on acute renal tubular cell injury induced by acute oxygen and glucose deprivation. Methods Rat kidney macrophages were isolated and cultured for constructing macrophages and renal epithelial cells co-cultivating model of oxygen-glucose deprivation (OGD), and the model cells were divided into three groups: OGD alone group, acetylcholine (ACh 100μmol/L)+OGD group and ACh + galantamine (Gal 10μmol/L)+OGD group. The cells underwent OGD treatment for 1 hour, and normally cultured for 24 hours. The expressions of TNF alpha, IL-1 beta, and IL-10 in supernatant fluid were detected by ELISA, the renal tubular cell viability was determined by MTT assay, the expression of acetylcholine esterase (AChE) mRNA and protein were determined by RT-qPCR and Western blotting. The activity of AChE was determined by colorimetric method. Results The expressions of TNF alpha (pg/ml) in OGD, Ach+OGD group, Ach+Gal+OGD groups were 140.2±44.81, 119.46±4.42 and 103.31±1.62 respectively (P<0.05), those of IL-1β (pg/ml) were 172.26±13.51,144.34±5.53 and 119.37±11.42 respectively (P<0.05), and those of IL-10 (pg/ml) were 181.47±16.01, 173.62±10.12 and 188.36±8.73 respectively (P>0.05); The values of renal tubular cell proliferation were 55.02%±6.28%, 66.65%±6.47%, and 79.75%±4.22% respectively (P<0.01); the expressions of AChE mRNA in macrophages were 4.07±0.03, 4.22±0.15 and 3.98±0.29 respectively in the three groups (P>0.05); those of AchE protein were 0.66±0.07, 0.74±0.04 and 0.67±0.06 respectively (P>0.05); The activity of AChE (kU/L) was 0.51±0.02, 0.35±0.05 and 0.32±0.04 respectively (P=0.001, 0.001 and 0.368). Conclusions ACh and Gal could inhibit the secretion of inflammatory mediators and cholinesterase activity and can reduce the acute hypoxic renal tubular cell injury. The modulation of the cholinergic pathway in macrophages may be the important treatment method for acute renal injury in the future.

The myocardial viability after myocardial infarction was evaluated by intravenous myocardial contrast echocardiography. Intravenous real-time myocardial contrast echocardiography was performed on 18 patients with myocardial infarction before coronary revascularization. Follow-up echocardiography was performed 3 months after coronary revascularization. Segmental wall motion was assessed using 18-segment LV model and classified as normal, hypokinesis, akinesis and dyskinesis. Viable myocardium was defined by evident improvement of segmental wall motion 3 months after coronary revascularization. Myocardial perfusion was assessed by visual interpretation and divided into 3 conditions: homogeneous opacification; partial or reduced opaciflcation or subendocardial contrast defect; contrast defect. The former two conditions were used as the standard to define the viable myocardium. The results showed that 109 abnormal wall motion segments were detected among 18 patients with myocardial infarction, including 47 segments of hypokinesis, 56 segments of akinesis and 6 segments of dyskinesis. The wall motion of 2 segments with hypokinesis before coronary revascularization which showed homogeneous opacification, 14 of 24 segments with hypokinese and 20 of 24 segments with akinese before coronary revascularization which showed partial or reduced opaciflcation or subendocardial contrast defect was improved 3 months after coronary revascularization. In our study, the sensitivity and specificity of evaluation of myocardial viability after myocardial infarction by intravenous real-time myocardial contrast echocardiography were 94.7% and 78.9%, respectively. It was concluded that intravenous real-time myocardial contrast echocardiography could accurately evaluate myocardial viability after myocardial infarction.
Angioplasty, Transluminal, Percutaneous Coronary ; Cell Survival ; Coronary Artery Bypass ; Echocardiography/*methods ; Models, Statistical ; Myocardial Infarction/*pathology ; Myocardial Infarction/*ultrasonography ; Myocardial Revascularization ; Myocardium/*pathology ; Perfusion ; Time Factors

Objective To investigate key bonding point and existing problems of clinical doctor-nurse collaboration,in order to improve the collaboration and provide reference for seamless cooperation between doctors and nurses.Methods Open questionnaires were used to find out the bonding point of doctor-nurse collaboration and its problems.Questionnaire on existing problems of doctor-nurse collaboration ( doctor volume and nurse volume) was also designed for further analysis.247 nurses and 211 doctors in a third class A hospital in Shanxi province were included in this investigation,to work out the collaboration between nurses and doctors and the cause of existing problems.Results The score rates in 8 doctor - nurse bonding point were 30.35％ ～84.5％ in nurse volume and 31.3％ ～ 84.3％ in doctor volume.The highest score in both nurse and doctor volume was doctor' s operating dimension,which accounted for 84.5％ and 84.3％.Among 10 worst doctornurse collaboration items,people who scored more than or equal to 3 accounted for 63.97％ ～ 100.00％.Among 5 items which were the highest in both nurse and doctor volume,ward management accounted for 40％.82.94％ doctors who scored more than or equal to 3 believed that junior nurses' ability to cooperate was poorer.Conclusions Nurse performed poorly in cooperation during doctors' operation.Most problems lie in ward management.Problems in medical order handling and execution are most intractable.And junior nurses lack standardized training and competence evaluation.Therefore,establishing reasonable flow path and responsibilities is necessary to improve doctor-nurse collaboration.

OBJECTIVETo explore the association between G614T single nuclear polymorphism (SNP) of the alpha-adducin gene and the antihypertensive effect of hydrochlorothiazide (HCTZ) in essential hypertensive (EH) patients.

METHODSEight hundred twenty nine EH patients were given 12.5 mg HCTZ/d for six weeks. Alpha-adducin gene G614T SNP in the tenth exon was determined by PCR-RFLP in 754 patients with complete records. All the patients were grouped according to TT, GT and GG genotypes.

RESULTSAfter 6 weeks of HCTZ treatment, the decreases in DBP and MAP of patients carrying 614T allele of alpha-adducin were significantly greater than that of those carrying GG homozygotes (P < 0.05). The decreases in SBP and MAP were significantly greater in patients with the TT genotype as compared with GT or GG genotype (P < 0.05). The effective rate of BP fall by HCTZ was higher in patients with TT genotype than those with GT or GG genotype (P < 0.05). Multivariate stepwise regression analysis showed that the TT genotype and the baseline SBP were the two major predictors affecting the decrease in SBP.

CONCLUSIONThe present study suggests that the alpha-adducin G614T polymorphism is associated with the antihypertensive effect of HCTZ, which is more effective in patients with TT genotype.

Adult ; Aged ; Aged, 80 and over ; Antihypertensive Agents ; therapeutic use ; Blood Pressure ; Calmodulin-Binding Proteins ; genetics ; Female ; Humans ; Hydrochlorothiazide ; therapeutic use ; Hypertension ; drug therapy ; genetics ; Male ; Middle Aged ; Polymorphism, Single Nucleotide ; Single-Blind Method ; Treatment Outcome

OBJECTIVETo study the inhibitive effects of gastric cancer cell-dendritic cell fusion vaccine on tumor cells of proliferation cycle.

METHODSPeripheral blood mononuclear cells were separated from gastric cancer patients and co-cultured with granulocyte macrophage colony stimulating factors(GM-CSF), interleukin-4(IL-4) and tumor necrosis factor-alpha(TNF-alpha) to generate mature dendritic cells. The dendritic cells and SGC7901 cells were fused by polyethylene glycol, and the pure fusion cells were screened out by selective culture systems. The inhibitive effects of gastric cancer cell-dendritic cell fusion vaccines on tumor cell proliferation cycle in vivo and in vitro were detected by flow cytometry.

RESULTSTreated with the fusion vaccine in vitro, the percentages of G(0)/G(1), S and G(2)/M cells of tumor cells were (76.77+/- 4.38)%, (16.50+/- 2.90)% and (6.73+/- 1.59)% respectively. There were significant differences in the percentages of different cell cycle tumor cells between the tumor cells treated with the fusion vaccine and those co-cultured with dendritic cell or T cells alone(P< 0.01). The proliferative index of the tumor cells treated with the fusion vaccine was 23.34+/- 3.51, significantly lower than those co-cultured with dendritic cell and controls (P< 0.05).

CONCLUSIONSFusion vaccines can affect cell cycle of the tumor cells, thus inhibit tumor cell proliferation and growth.

Cancer Vaccines ; immunology ; pharmacology ; Cell Cycle ; drug effects ; Cell Fusion ; Cell Proliferation ; drug effects ; Dendritic Cells ; immunology ; Humans ; Stomach Neoplasms ; immunology ; Tumor Cells, Cultured

OBJECTIVETo study the effects of methionine and choline on the expression levels of CaMKII and CREB mRNA and proteins in hippocampus of rats exposed to lead.

METHODSMale SD rats were divided into five groups. (1) control group, (2) group exposed to lead+2 by drinking water with 0.40 g/L lead acetate, (3) group exposed to methionine and choline (1:1, 400 mg/kg), (4) group exposed to 0.40 g/L lead acetate plus methionine and choline (1:1, 100 mg/kg), (5) group exposed to 0.40 g/L lead acetate plus methionine and choline (1:1, 400 mg/kg). In 8 weeks after exposure, all rats were killed. Then CREB mRNA and CaMK II mRNA expression levels in hippocampus were detected by real-time PCR, CREB and CaMK II protein expression levels in hippocampus were measured by western blot assay.

RESULTSThe expression levels (0.743 ± 0.185 and 0.729 ± 0.199) of CaMKII mRNA and CREB mRNA in the hippocampus of lead group were significantly lower than those (0.950 ± 0.238 and 0.901 ± 0.232) of control group (P < 0.05), also the expression levels (0.271 ± 0.045 and 0.212 ± 0.058) of CREB protein and pCREB protein in the hippocampus of lead group were significantly lower than those (0.319 ± 0.058 and 0.506 ± 0.125) of control group (P < 0.05). The expression levels (1.014 ± 0.210 and 1.126 ± 0.379) of CaMKII mRNA and the expression levels (1.029 ± 0.335 and 0.932 ± 0.251) of CREB mRNA in the hippocampus of 2 groups exposed to lead acetate plus methionine and choline were significantly higher than those of lead group (P < 0.05). The expression levels (0.407 ± 0.951 and 0.563 ± 0.178) of CREB protein and pCREB protein in the hippocampus of group exposed to lead acetate plus 400 mg/kg methionine and choline were significantly higher than those of lead group (P < 0.05).

CONCLUSIONMethionine and choline could decrease the inhibition effects of lead on the expression of CaMKII and CREB mRNA or CREB and pCREB proteins in the hippocampus of rats.

Animals ; Calcium-Calmodulin-Dependent Protein Kinase Type 2 ; metabolism ; Choline ; pharmacology ; Cyclic AMP Response Element-Binding Protein ; metabolism ; Hippocampus ; drug effects ; metabolism ; Lead ; toxicity ; Male ; Methionine ; pharmacology ; RNA, Messenger ; genetics ; Rats ; Rats, Sprague-Dawley