Objective To explore the effect of nursing clinical pathway in percutaneous coronary intervention(PCI)for patients with acute myocardial infarction(AMI).Methods Sixty AMI patients were randomly divided into nursing clinical pathway(NCP) group and control group equally by their registration sequence.Patients in the control group received routine nursing care,while patients in NCP group received nursing according to the nursing clinical pathway.Results Compared with the conventional group, the time of preoperative preparation,bed rest and hospitalization was obviously shortened.The incidence of complications and hospital costs were both declined,and meanwhile the quality of care and patient satisfaction improved significantly(P<0.05). Conclusions The application of nursing clinical pathway in patients with AMI can be timely and effective in the treatment of PCI, lower the mortality and complications and moreover improve nurses' working enthusiasm.

G protein- coupled receptors (GPCRs), also known as seven- transmembrane domain receptors, constitute the largest superfamily of cell surface receptors. By coupling to heterotrimeric G proteins, arrestins and other signaling molecules, GPCRs modulate diverse signal transduction pathways under physiological and pathological conditions. Recent studies have revealed crucial roles of GPCRs in tumorigenesis and development of cancer metastasis. This review summarizes roles of GPCRs, particularly the roles of those coupled to chemokines, prostaglandin, lysophosphatidic acid, endothelin, catecholamine and angiotensin in proliferation, invasion, metastasis and angiogenesis of hepatoma cells and development of hepatocellular carcinoma. The potential of GPCRs- based therapeutics being used for hepatocellular carcinoma is also highlighted.

Objective In order to investigate the comlex course of electricity and mechanism of erosive gastritis(EG) and its relative factors,and to extract gastric motility feature indexes.Methods 30 volunteers of erosive gastritis were selected.The signal processing device was designed by Chongqing University of Posts and Telecommunications.By the means of spectrum analysis technic,the signals could be classified according to the dominant power and dominant frequency.Some indexes such as frequency of EGG and IGM,signal power spectrum and dynamic spectrum,the rates of rhythm and power for the normal EGG and IGM and so on could also be calculated.Results The power ratio in 2~4 cpm was 59.2?4.4,the frequency ratio was 70.4?25.5,the frequency instability coefficient was 0.182?0.059,and the power instability coefficient was 1.576?0.481.The parameters changed signifcantly between health adult and patient(P0.05).Conclusion The results of the experiments show that the method based on the synchronous measurement of EGG and IGM can provide a non-invasive way to investigate and evaluate erosive gastritis corresponding to gastrointestinal physiology and pathology conditions.

Objective To explore the protective effects and the mechanisms of peritoneal dialysis (PD) on multiple organs induced by acute organophosphoms pesticide poisoning(AOPP)in order to get a scientific basis for the application of PD to treat AOPP patients. Method The model of AOPP rabbits was made by intragastric administration of 25 mg/kg(0.5LD50)40% omethoate, and the symptoms of poisoning such as myosis, salivating and muscular tremor were observed. Eighteen male Japanese rabbits were randomly divided into control group and peritoneal dialysis group (PD group). Pralidoxime chloride and atropine were given by intra-muscular injection to rabbits of control group (re = 9). Rabbits of PD group ( n = 9) had a tube inserted into peritoneal cavity and peritoneal dialysis was given for 10 times after administration of pralidoxim chloride and atropine. Serum TNF-α,CK-MB (M.B. isoerizyme of creatine kinase), ALT, creatinine, and amylase were observed dynamically. The dialysate of peritoneal dialysis was remained in the peritoneal cavity for testing the nature of intoxicant by using Varian 3900/ Saturn 2100T GC/MS device. All data were analyzed with SPSS version 12.0 software. Statistical comparison between two groups was carried out by using student t-test and analysis of variance(ANOVA) followed by Dunnett-ttests before and after intoxication. The pearson correlation analysis was used for determination of the relationship between TNF-α and other biomarkers. Results After intoxication, serum TNF-α, CK-MB, ALT and amylase increased except creatinine, but the serum levels of those biomarkers in PD group were significantly lower than those in control group.The level of TNF-a had positive correlations with CK-MB ( r = 0.470), ALT ( r = 0.649), and amylase ( r = 0.517). The omethoate was detected in the dialysate of peritoneal dialysis. Conclusions Organophosphorus pesticides can lead the cardiac muscle, liver, kidney and pancreas to the injury through several mechanisms,and the inflammatory mediators play important role in the development of MODS induced by AOPP. Peritoneal dialysis can clean up intoxicants slowly and continuously and in turn lower down the level of inflammatory mediators resulted in protecting multiple organs from AOPP.

Objective To evaluate the effectiveness of applying simulation based medical education (SBME) in critical care medicine PBL teaching. Methods Totally 46 undergraduates in medical college of Shanghai JiaoTong University , who participated in critical care medicine PBL teaching in our Hospital from 2012 to 2013 were chosen as research objects. These students were divided into two groups: PBL group (2009 grade, n=24) and SBME-PBL group (2010 grade, n=22). The teaching effectiveness was evaluated by questionnaire survey, theoretical exam, direct observation of procedural skills (DOPS) and mini-clinical evaluation exercise (Mini-CEX). Data were analyzed by SPSS 17.0 software. The data of questionnaire survey were expressed as percentage and the assessment results were expressed as x±s. Chi-square and t test were used to do statistical analysis. P<0.05 signi-fies for statistically significant differences . Results ①The results of questionnaire survey showed that:there was no significant difference between two groups in study interests(P=0.665, 0.937, 0.746) and study ability(P=0.937, 0.665). But regarding collaboration ability, SBME-PBL group performed better than PBL group (P=0.019, 0.038, 0.024). ②These was no significant difference in the theo-retical knowledge exam between PBL and SBME-PBL group(P=0.743). But the DOPS scores of car-diopulmonary resuscitation (P=0.000), endotracheal intubation (P=0.023), defibrillation (P=0.002) and central venous catheterization(P=0.047) were all significantly higher in SBME-PBL group than in PBL group. ③In Mini-CEX, there was no statistical difference in physical examination skills (P=0.790) and clinic judgment(P=0.426) between the two groups. However, SBME-PBL group performed better in medical interviewing capacity(P=0.002), humanistic care (P=0.001), counseling skills(P=0.017), organization efficiency(P=0.029) and overall clinical competence(P=0.024) than PBL group. Conclusions SBME can promote the students' team work spirit, basic clinical skills and comprehen-sive clinical capacity in critical care medicine PBL teaching and can improve the teaching quality of critical care medicine.

To extract sub-signal of heart period signal (HPS), a new statistical signal processing approach, namely independent component analysis (ICA) was addressed. Electrocardiosignal (ECS) was acquired from ten volunteers. ECS was sampled 8 minutes when the volunteer was in supine position, and then when the same volunteer was in erect position. HPS was extracted from ECS. According to time-delay, HPS was divided into five groups as mixed signals. Five signals were reconstructed into two groups by ICA. The rebuilt signals were transformed by Fourier transformation. One centralized in low frequency (called IC1); the other did in high frequency (called IC2). The power of IC1 was significantly increased (P<0.01) while that of IC2 showed no significant change (P>0.05), and the ratio of IC1 to total power also significantly increased with the change from supine position to erect position. Comparsion between the two postural results reveals that IC1 may express sympathetic activity, and IC2 represents parasympathetic activity. Sympathetic and parasympathetic nervous functions can be evaluated respectively and quantitatively by use of data and graphs from the two decomposed components.
Autonomic Nervous System ; physiology ; Electrocardiography ; Heart Rate ; physiology ; Humans ; Parasympathetic Nervous System ; physiology ; Signal Processing, Computer-Assisted

OBJECTIVETo study the changes in activity of phosphatidylinositol 4 kinase (PI 4 kinase), phosphatidylinositol 4 phosphate 5 kinase (PIP 5 kinase) and protein kinase C (PKC) during myocardial ischemia and elucidate the relationship between phosphatidylinositol signal pathways and prolonged myocardial ischemia.

METHODSIn vivo an ischemic rat model was used. Activity of PI 4 kinase, PIP 5 kinase and PKC were measured at different times in postischemic heart cells using isotope analysis.

RESULTSThe activity of PI kinase, PIP kinase and PKC in the myocardium increased to peak at 1 hour postischemia, with activities 6.1, 3.0 and 4.0 fold over control levels, respectively. Their activities declined to normal levels with time.

CONCLUSIONThe phosphatidylinositol signal pathway is involved in prolonged myocardial ischemia, but its mechanism needs further study.

1-Phosphatidylinositol 4-Kinase ; metabolism ; Animals ; Male ; Myocardial Ischemia ; enzymology ; Phosphotransferases (Alcohol Group Acceptor) ; metabolism ; Protein Kinase C ; metabolism ; Random Allocation ; Rats ; Rats, Wistar ; Signal Transduction

Objective To study in the correlation of the laboratory markers of coagulation,fibrinolysis and thrombosis in patients with sepsis and SOFA score,the procalcitonin (PCT) concentration and seven-day survival rate.Methods From February 2017 to March 2018,119 patients with sepsis admitted in ICU and another 119 patients with non-sepsis undergoing selective surgery were enrolled as control in this study.APTT (activated partial thromboplastin time),PT-INR (prothrombin time-international normalized ratio),FIB (fibrinogen),AT-Ⅲ (antithrombin Ⅲ),D-Dimer,FDP (fibrinogen degradation products),sTM (soluble thrombomodulin),TAT (thrombin antithrombin complex),PIC (plasmin-a2 plasminogen inhibitor complex) and t-PAI-C (tissue plasminogen activator and its inhibitor complex),were simultaneously monitored at admission.The correlation between the given laboratory markers mentioned and SOFA score,the PCT concentration and seven-day survival rate were analyzed with the Spearman correlation analysis.Results (① In the patients with sepsis,a positive correlation between SOFA score and sTM,t-PAI-C,TAT respectively was found,and a negative correlation between SOFA score and PLT (platelet count) was observed,and no correlation between SOFA score and PIC was noticed.(②) A positive correlation between PCT and sTM,t-PAI-C respectively was significant,a negative correlation between PCT and PLT was marked,and no correlation between PCT and AT-Ⅲ,TAT,PIC respectively was found.(③) A negative correlation between seven-day survival rate and sTM,t-PAI-C and TAT respectively was obvious,a positive correlation between seven-day survival rate and AT-Ⅲ,PLT respectively was occurred,and no correlation between seven-day survival rate and PIC was determined.Conclusions Soluble thrombomodulin (sTM),thrombin-antithrombin (TAT),antithrombin Ⅲ (AT-Ⅲ) and tissue plasminogen activator inhibitor complex (t-PAI-c) were good clinical monitoring indicators of coagulation disorder in patients with sepsis,which were the representative of the endothelial cell damage with highly activated coagulation,relatively insufficient anti-coagulation function and poor fibrin degradation ability.These were good adjuvants to PLT,INR and APTT for core diagnostic criteria of coagulation disorder in sepsis.

Objective:To explore the significance of digital orthopedic technology in surgical plan for spinal tumor and the preliminary outcomes of 3D printed vertebral bodies in spinal tumor surgery.Methods:The clinical data of 2 patients were retrospectively analyzed who had had a 3D printed vertebral body implanted at Center of Orthopaedics, Shenzhen Hospital from June 2018 to December 2019. One was a 32-year-old male, diagnosed with cervical neurinoma; the other was a 27-year-old female, diagnosed with giant cell tumor of lumbar bone. 3D virtual reconstruction of tumor and surrounding structures was established via Mimics software for surgical plan. Virtual osteotomy was simulated, their disease models and guide templates were 3D printed, and their metal artificial vertebral bodies were 3D printed after personalized design of the vertebral body diameter, porosity and procedures of reconstruction and fixation. Lesion resection and prosthesis implantation were carried out in accordance with the preoperative plan. After operation, the motor function of cervical or lumbar vertebrae, tumor recurrence, and spinal stability reconstructed were regularly observed.Results:Resections and reconstructions went uneventfully in both cases. The 2 patients were followed up for 21 and 13 months respectively. Their postoperative images showed that their 3D printed vertebral bodies fitted the neighboring vertebral bodies well. The spinal stability was reconstructed without any loosening or periprosthetic osteolysis, and the tumors were removed completely with no recurrence in both cases. Their spinal motor function was satisfactory.Conclusions:Digital orthopedic technology can offer accurate guidance in the treatment of spinal tumors. It is necessary to consider local physiological anatomy in personalized design of a metal vertebral body 3D printed. Clinical application of 3D printed metal vertebral bodies is a new strategy for spinal reconstruction following spinal tumor resection.

Objective: To explore cyberbullying and risk factors of middle school students, and to provide a reference for cyberbullying prevention in school settings. Methods: A stratified cluster random sampling method was used to select 12 940 students from three junior high schools and four senior high schools in Yixing City of Jiangsu Province, China, to conduct a questionnaire survey from March 1 to May 31, 2019. The Chi -square test was performed to compare differences in the prevalence of cyberbullying among groups with different sociodemographic characteristics, and the multivariate Logistic regression model was employed to analyze the risk factors. A risk predictive nomogram model was constructed and then verified. Results: Middle school students were found to be victims of cyberbullying at a rate of 12.3%. The Logistic regression results showed that alcohol use ( OR =1.93), lack of emotional management ( OR =1.30), feeling unsafe ( OR =1.70), not trusting people ( OR =1.66), increased daily online time ( OR =1.39), higher frequency of using social software or websites ( OR =2.24), poor relationships with family members ( OR =1.46), parental neglect ( OR =1.50), class leadership ( OR =1.30) and poor relationships with classmates ( OR =1.34) were risk factors for middle school students who were victims of cyberbullying ( P <0.05). Based on these 10 independent risk factors, the nomogram prediction model, had good discrimination ( AUC =0.73). Conclusion Cyberbullying is common among middle school students. Internet use, parental neglect and class leadership all have an impact on cyberbullying.