Objective To explore the operative cooperation of the intra-extra cranial bypass operation of the intracranial giant aneurysms. Methods A retrospective analysis of 7 patients who had intracranial giant aneurysm and received the intra-extra cranial bypass operation from October 2014 to June 2016. All preoperative and intraoperative nursing points of operative cooperation were analyzed. Results The post-operative digital subtraction angiographies of 7 patients without any perioperative nursing complications showed enough flow in the bypass arteries. Conclusions Operative multi-incision managing, positive temperature intervening, special instruments using and thrombosis preventing play very important roles in the nursing points of the successful operative cooperation.

Aim To study the relationship between the vasodilatation effects of daidzein and M-receptor in the endothelial cell, extracellular Ca2+ and intracellular Ca2+.Methods Measurement of isometric force of rabbit thoracic aortae rings was performed. Results Dai(3～100 ?mol?L-1 ) significantly inhibited the contractive response of phenyleohrine dependent on intracellular Ca2+ release and extracellular Ca2+ inflow;a shift was produced to the right of the concentration-effect curve of KCl and the maximum response was depressed by Dai(10～100 ?mol?L~ -1 ); Dai(10,30,100 ?mol?L-1 ) enhanced the relaxing effect induced by acetylcholine in a concentration-dependent manner,but the relaxing effect was inhibited after using atropine to block the M-receptor. Conclusion The relaxing effect of Dai was related to the inhibition of the receptor-mediated Ca2+ -influx and Ca2+-release;Dai induced direct relaxing effect by activating the M-receptor in the endothelium and releasing EDRF, which was similar to ACh, and this effect was endothelium-dependent.

Objective:To study the effect of Snyder's hope theory nursing on the scores of psychological stress, quality of life and neurological function in patients with acute hypertensive cerebral hemorrhage.Methods:From June 2017 to December 2018, 100 patients with acute hypertensive cerebral hemorrhage in the Second Affiliated Hospital of Xi′an Jiaotong University were selected as the study object. According to the random number table, the patients were divided into observation group (50 cases) and control group (50 cases).The patients in the control group were given routine rehabilitation nursing mode, and the patients in the observation group received Snyder′s hope theory nursing on the basis of the control group. The rescue time, the recovery time and the incidence of complications of the two groups were compared. The degree of anxiety and depression, neurological function, quality of life of the patients were evaluated by Self-rating Anxiety Scale(SAS), Self-rating Depression Scale(SDS), National Institutes of Health Stroke Scale(NHISS), Glasgow Coma Scale(GCS) and SF-36.Results:The rescue time and recovery time were (58.13±10.36) min, (12.7±5.3) d in the observation group, and (85.71±8.30) min, (21.1±3.3) d in the control group, and there were significant differences between the two groups ( t values were 14.691, 10.646, P < 0.05).There was no significant difference in SAS, SDS, NIHSS, GCS, SF-36 score before intervention between the two groups ( P> 0.05).The scores of SAS, NIHSS, GCS after intervention were (40.56±1.72), (11.23±2.85), (13.12±4.11) points in the observation group, and (46.56±1.62), (14.97±4.55), (11.13±3.15) points in the control group, and there were significant differences between the two groups ( t values were 17.956, 4.926, 3.212, P<0.01). There were significant differences in SF-36 after intervention between the two groups( t values were 7.124-13.014, all P<0.01). The incidence of complications was 8.0%(4/50) in the observation group, and 24.0%(12/50) in the control group, and there was significant difference between the two groups( χ2 value was 4.762, P<0.05). Conclusions:Snyder's hope theory nursing has a significant effect on the improvement of anxiety and depression in patients with acute hypertensive cerebral hemorrhage, which is worth popularizing.

Objective To study changes in serum homocysteine(Hcy) and its correlation with serum levels of folic acid and high sensitivity C-reactive protein(hs-CRP)in Tibetan patients with mildto-moderate Alzheimer's disease at various high altitude areas,so as to direct the clinical diagnosis and treatment of AD in plateau hypoxia environment Method 108 cases were divided into four groups:23 AD Tibetan patients at middle altitude(AD/middle altitude group)and 23 healthy Tibetan subjects (healthy/middle altitude group) in Qinghai-Tibet Plateau Xining region,altitude at 2,260 m,31 AD Tibetan patients (AD/high altitude group)and 31 healthy Tibetan elderly subjects (healthy/high altitude group)in Yushu region at altitude of 3,800 m.Among the total study subjects,half are males,aged from 60 to 85 years.The levels of serum Hcy,Vitamin B12 and folic acid(FA)were measured by the Fluorescence Polarization Immunoassay(FPIA).Serum hs-CRP,triglyceride(TG)and low density lipoprotein cholesterol(LDL-C)were measured by automatic biochemistry analyzer.Correlation of Hcy with FA and hs-CRP was analyzed.Result Both high altitude and middle altitude group showed the levels of Hcy and hs-CRP were significantly higher in AD Tibetan patients than in healthy control at the same altitude(allP＜0.05).The levels of Hcy,LDL-C and hs-CRP of subjects were higherat high altitude than at middle altitude(P＜0.05).In contrast,folic acid levels in AD and control groups were lower at the high altitude than at middle altitude(P＜0.05).The levels of vitamin B12 and TG were not significantly different among all four groups.Multiple logistic regression analysis showed that altitude,folacin and hs-CRP were the risk factors for Hcy in patients with AD at plateau(OR =0.351,2.794,3.021,P=0.045,0.037,0.016).Conclusion Along with increased altitude,serum level of Hcy is significantly increased in AD Tibetan patients living in high altitude area.High altitude,high hs-CRP and lower folacin may be the risk factors for hyper-homocysteine in AD Tibetan patients with high altitude,and their combined effects are involved in the occurrence and development of AD.

Objective To investigate the effects of selenium and iodine deficiency on the contractibility of rat thoracic aorta and probe into its mechanisms.Methods Isolated vascular methods were used to study the effects in different groups.Results The contraction of rat thoracic aorta of the groups with selenium and iodine deficiency was less than that of the normals(P(0.05));sodium selenite(0.1mol/L) had no effect on rat aortic contraction,but was significantly synergic with the contraction induced by KCl combined with NE(P

Objective To construct protective immunity to Mycobncterium tuberculosis latent infection, a novel fusion protein consisting of HspX, the 190 to 198 peptide of Mpt64 and Ag85B, which were confirmed to be the effective protective antigens mainly expressed in the dormancy and exponential phase of growth, was constructed and its immunogenicity was investigated. Methods Ag85B and Mpt64190-198-HspX sequences were amplified by PCR and cloned into plasmids pET-28a. The fusion protein, Ag85BMpt64190-198-HspX (AMH) was expressed in E. coli BL21 and purified with Ni-NTA resins. C57BL/6 mice were immunized three times at 2-week intervals subcutaneously with AMH formulated with the adjuvant composed of dimethyl-dioctyldecyl ammonium bromide (DDA) and BCG polysaccharide nucleic acid (BCGPSN). Humoral and cell-mediated immunity responses were analyzed at five weeks after the last injection. Results AMH was expressed stably in E. coli and could be purified well by Ni-NTA affinity chromatography. C57BL/6 mice immunized with AMH subunit vaccine generated specific cellular and humoral immunologic response to the stimulation of Ag85B, Mpt64190-198 and HspX. Conclusion It suggested that AMH was a promising candidate antigen of tuberculosis subunit vaccine.

Objective:To retrospectively compare the clinical efficacy of two PDE3 inhibitors, oplinone and Milrinone, in order to evaluate which drug has better effects on the improvement of cardiac function, protection of renal function and adverse effects of arrhythmia.Methods:A total of 41 neonates with congenital heart disease after biventricular treatment under cardiopulmonary bypass in the Department of Cardiothoracic Surgery at Soochow University Children's Hospital during 2018-2022 were collected. The experimental group was divided into two groups: Oprilinone(25 cases) and Milinone(16 cases). A retrospective study was conducted on the incidence of renal function, cardiac function improvement and arrhythmia in the children.Results:On the first day after operation, EF in both groups decreased significantly compared with that before operation( P<0.01); On day 4 after surgery, EF in the oprilinone group was significantly higher than that on day 1 after surgery( P<0.01), Milrinone group was slightly higher than that on day 1 after surgery( P<0.05), and EF in oprilinone group was significantly higher than that in Milinone group during the same period( P<0.01); EF in Milinone group continued to increase on day 7 compared with day 4( P<0.01), but there was no significant difference between the two groups. Long-term follow-up showed that there was no significant difference in EF value in the oprilinone intervention group on day 7 after surgery( P<0.05), and the long-term EF in Milinone group was higher than that at 7 days after surgery( P<0.05). The creatinine level in the oprinone intervention group continued to decrease on the 4th and 7th day after surgery( P<0.01; P<0.05); The creatinine level of Milinone group on day 4 after surgery was significantly lower than that on day 1 after surgery( P<0.01), the decrease was not significant on the 7th day after surgery compared with the 4th day after surgery; The creatinine level in the oprilinone group was lower than that in the Milrinone group on day 7 after surgery( P<0.05). The rate of arrhythmia in children was slightly decreased in the intervention group of olplinone. There was no change in the Milinone group. Conclusion:Oplinone improved cardiac function better than Milrinone, and the recovery time to normal cardiac function was shorter. In terms of renal function protection, oplinone was stronger than Milrinone, and the protective effect of oplinone on kidney lasted longer. No significant abnormalities were found with respect to adverse reactions, such as the incidence of arrhythmia.

Objective:To investigate the factors affecting the accuracy of electronic portal imaging device (EPID)-based in vivo dose verification in radiotherapy for patients with lung and esophageal cancers, and to recommend the workflow and specifications for the application of the in vivo dose verification. Methods:This study randomly selected 32 patients who received radiotherapy for esophageal and lung cancers at the Department of Radiation Oncology, Jinhua Municipal Central Hospital from May to August 2022, including 14 lung cancer cases and 18 esophageal cancer cases. Using a uRT-linac 506c linear accelerator, these patients were treated according to the dynamic intensity-modulated radiotherapy (dIMRT) and EPID-based In vivo dose verification ( In vivo EPID) plans developed with the uRT-TPOIS planning system. The In vivo dose verification performed during the treatment included 238 fractions of In vivo EPID and 80 fractions of image-guided radiotherapy (IGRT) for the lung cancer cases, as well as 414 fractions of In vivo EPID and 105 fractions of IGRT for the esophageal cancer cases. The 2D γ passing rate for each irradiation field was obtained according to the set threshold value. Furthermore, fractioned irradiation fields with γ-passing rates below the threshold value were analyzed, and primary factors decreasing the γ-passing rate were further analyzed by combining the online CT images and 3D reconstruction-derived dose. Results:For lung and esophageal cancers, the mean γ-passing rates were 95.1% ± 5.7% and 96.5% ± 4.5%, respectively at 3 mm/5%; 91.5% ± 8.4% and 92.2% ± 4.9%, respectively at 3 mm/3%, and 79.1% ± 14.7% and 83.7% ± 8.2%, respectively at 2 mm/2%, indicating no statistically significant differences between two cancers ( P > 0.05). The average γ passing rate for beam orientations near 0°/180° (Group A) was higher than those near 90°/270° (Group B) 3 mm/5%: Z = -25.4, P < 0.05; 3 mm/3%: Z = -26.8, P < 0.05). The IGRT correction of setup errors significantly improved the γ passing rates (96.3% ± 5.1% and 96.4% ± 4.9%, respectively at 3 mm/5%, Z = -5.50, P < 0.05; 92.3% ± 8.0% and 91.3% ± 7.7%, respectively at 3 mm/3%, Z = -9.54, P < 0.05). The results of In vivo dose verification were affected by changes in the volumes and motion of tumors and normal tissues, radiotherapy positioning, and adequacy of pre-treatment preparation. Conclusions:EPID-based In vivo dose verification during radiotherapy can avoid incorrect irradiation. However, it is necessary to standardize the workflow of the EPID-based In vivo dose verification to avoid the decrease in the γ passing rate caused by artificial factors.

Objective To evaluate the risk factors and sonographic findings of pregnancies complicated by placenta increta or placenta percreta. Methods Totally, 2219 cases were retrospectively analyzed from 20 tertiary hospitals in China from January 2011 to December 2015. The data were collected based on the original case records. All cases were divided into two groups, the placenta increta (PI) group (79.1％, 1755/2219) and the placenta percreta (PP) group (20.9％, 464/2219), according to the degree of placental implantation. The risk factors and sonographic findings of placenta increta or percreta were analyzed by uni-factor and logistic regression statistic methods. Results The risk factors associated with the degree of placental implantation were age, gravida, previous abortion or miscarriage, previous cesarean sections, and placenta previa (all P<0.05), especially, previous cesarean sections (χ2=157.961) and placenta previa (χ2=91.759). Sonographic findings could be used to predict the degree of placental invasion especially the boundaries between placenta and uterine serosa, the boundary between placenta and myometrium, the disruption of the placental-uterine wall interface and loss of the normal retroplacental hypoechoic zone(all P<0.01). Conclusions Previous cesarean sections and placenta previa are the main independent risk factors associated with the degree of placenta implantation. Ultrasound could be used to make a prenatal suggestive diagnosis of placenta accreta spectrum disorders.