AIM:To observe the effects and mechanisms of hydroxyethylstarch (HES) 130/0.4 on no-reflow phenomenon after myocardial ischemia-reperfusion in rats.METHODS: SD rats were randomly divided into 4 groups:sham operation group , ischemia-reperfusion ( IR, treated with normal saline ) group, normal saline ischemia-reperfusion (NS-IR, treated with NS) group and HES ischemia-reperfusion (HES-IR, treated with HES) group.Myocardial infarct size and no-reflow range were determined by staining methods , and the activities of myocardial enzymes ( CK-MB, cTnI and MPO) were measured .Meanwhile , cardiac microvascular endothelial cells of the rat were cultured and divided into 4 groups:control group, hypoxia/reoxygenation (H/R) group, NS-H/R group and HES-H/R group.Acute ischemia reper-fusion models were simulated , and the concentration of calcium ions was measured .The relative cell activity was evaluated by CCK-8 assay, and the apoptotic rate was detected by flow cytometry .RESULTS:In HES-IR group, the myocardial in-farct size, the no-reflow zone, CK-MB, cTnI and MPO activity were all significantly lower than those in IR group ( P<0.05).In microvascular endothelial cells , the concentration of calcium ions and the apoptotic rate in HES-H/R group were significantly decreased, while the relative cell activity increased compared with H/R group (P<0.05).CONCLUSION:HES reduces no-reflow in acute myocardial ischemia-reperfusion .The mechanism may be involved in the inhibition of both the infiltration of neutrophils and the calcium overload of endothelial cells .

AIM: To observe the changes of adengl cyclase(AC) and phosphodiesterase(PDE) activities of at different time point in hypothalamus of rats with fever and hypothermia. METHODS: Radioisotope method was used to measure the activity of AC and PDE. RESULTS:The fresh yeast caused rats fever after subcutaneous injection 4h( P

AIM: To observe the changes of AC activity and content of cAMP at different time point in hypothalamus of rats with fever and hypothermia. METHODS: Radioisotope method was used to measure the enzymatic activity of AC and the content of cAMP. RESULTS:(1)The fresh yeast caused fever after making model 4 h( P

Objective Summary the first group of robotic bypass surgery on the beating heart and stent placement in distinct hybrid session in China. Methods 163 cases patients accepted selective operation of robotic coronary bypass grafting on the beating heart form April 2007 to January 2011. 12 cases had multi coronary vessels stenosis accepted stent placement after robotic surgery in a hybrid manner. The average age of patients was ( 56. 0 ± 9.74 ) years old. 3 case was female and 9 cases were male. All the patients had a medical history of angina. The coronary arterioangiography showed sever left anterior descend ing or diagonal branch stenosis in all patients. And 4 cases had myocardial infarction history. All the patients had good lung function and had no medical history of pleurisy. Without sternotomy, through 3 ports about 1 cm in left thorax, the left internal mammary artery was obtained and simultaneously single vessel coronary artery bypass grafting through small thoracotomy or totally endoscopic coronary bypass (TECAB) was performed on beating heart. The bridge patency and revascularization was accessed by arterioangiography. Results All cases successfully accepted robotic bypass surgery on the beating heart and stent placement in distinct hybrid session without complication. Conclusion Hybrid coronary artery revascularization enable adequate revascularization of patients with multivessel coronary artery disease without sternotomy and with the advantage of the most durable option.

Objective As the first robotic da Vinci S surgical system(Intuitive Surgical,Inc,CA) in China,atrial septal de- fect repair(ASD) were performed in 15 patients using the robotic da Vinci S surgical system.Prespectively,we evaluated safety and efficacy in performing both simple and complex ASD repairs.Methods Eligible patients had ASD with mild to moderate pulmonary hypertension.Operative techniques included peripheral cardiopulmanary perfusion,a 2 cm working port only in the forth intercostal space,transthoracic aortic occlusion,and antegrade blood cardioplegia.Transesophageal echocardiograms(TEE) were done intraoper- atively with three-dimensienal reconstructions.Successful repairs were defined.Results Enhanced three-dimensional visualization of ASD allowed safe,dexterous intracardiac tissue manipulation.All patients had successful repairs including direct suturing in 10 cases, as well as pericardial patching in 5 cases.There were no operative deaths,strokes,or device-related complications.One patient was reexplored for bleeding.There were no incisional conversions.The mean cardiopulmonary bypass times and aortic crossclamp times were (109.5?12.6) minutes and (41.2?11.7) minutes.Both robotic repair and total operating times decreased significantly re- spectively.Total ICU length of stay for patients was 1 to 2 days.Conclusion This study shows that the da Vinci S surgical system (intuitive Surgical,lnc) has no limitations in performing ASD repairs.Articulated wrist-like instruments and three-dimensional visual- ization enabled precise tissue telemanipulation.

Objective To explore the application of the model centering on organ system teaching in experimental diagnostics and evaluated its teaching effect.Methods A total of 185 clinical medical undergraduates of grade 2012 and 2013from School of Basic Medical Science in Tianjin Medical University joined the integrated curriculum of laboratory diagnostics for liver disease (abbreviated as integrated group).All of the teachers from varied professional fields were reconstituted into integrated teaching group.Training lecture was unified according to the new integrated teaching material.In order to make a contrast,180 clinical medical undergraduates of the grade 2010 and 2011 were involved in traditional laboratory diagnostics curriculum (abbreviated as traditional group).The results of terminal test of the integrated group and traditional group were analyzed with SPSS 21.0 software and Excel 2007.Glossary items,multiple choice,were indicated by scoring rate,and the objective items and subjective items total scores were indicted by real scores.Results Significant difference was found in the scoring rate of the glossary items,objective items,subjective items and the total scores between the two groups (P＜0.01).The records of students were [75.00％ (50.00％,100.00％)],(72.28 ± 22.63),(90.70 ± 22.36),(79.96 ± 18.59) in the integrated group and [66.67％ (33.33％,83.33％)],(61.43 ± 28.85),(72.92 ± 22.14),(69.10 ± 17.95) in the traditional group.The scoring rate in the integrated group was higher than that in the traditional group (P＜0.01).But the records of multiple choice were [100.00％ (0.00％,100.00％)] in the traditional group and [66.67％ (66.67％,100.00％)] in the integrated group.Conclusions The model centering on organ system teaching model is much more reliable and it may improve the teaching quality.

Objective:To review the scope of research on the application of managing cancer and living meaningfully (CALM) in cancer patient populations, and provide reference for follow-up research and clinical promotion and application.Methods:Using the research method of scope review, two evidence-based trained researchers independently conducted a blind literature search. A total of 12 databases were searched, including CNKI, Wanfang, VIP, China Biomedical Literature Database, Cochrane Library, PubMed, Web of Science, CTNAHL, Embase, Scopus, Medline and EBSCO. The search time limit was from database establishment to September 26, 2022. Collected relevant literature on the application of CALM therapy to cancer patients, extracted data included in the literature, summarize and report research results.Results:A total of 2 089 articles were retrieved, and 13 were eventually included through the inclusion criteria, including 8 randomized controlled studies, 2 quasi experimental studies and 3 qualitative studies. The results showed that CALM therapy included 4 themes, 3 to 8 separate psychotherapy sessions, each lasting for 3 to 6 months for 30 to 60 minutes. It was a short and flexible evidence-based personalized psychotherapy method that was easily accepted by patients, could alleviate the negative emotions of patients with advanced cancer, and promote their mental health. There was no literature reports on the occurrence of adverse events related to CALM therapy.Conclusions:CALM therapy has a positive impact on cancer patients, with safety and feasibility. In the future, it is necessary to construct a specific, standard, and localized CALM therapy program, conduct large sample, high-quality research to verify the application effect of CALM therapy in cancer patients, and provide evidence-based basis for formulating the best CALM therapy program for cancer patients.

Objective To understand the genotyping of human immunodeficiency virus (HIV) co-infected hepatitis C virus (HCV) patients in Yunnan Province, and to analyze the differences in viral load, biochemical indicators, and blood routine indicators among different genotypes, in order to provide a laboratory basis for the diagnosis and clinical treatment of HIV/HCV co-infected patients. Methods From November 2022 to June 2023, the serum samples and basic information of patients diagnosed with HIV/HCV co-infection were collected in the antiviral outpatient clinic of Yunnan Provincial Hospital of Infectious Diseases. The HCV viral load was detected by one-step qRT-PCR amplification, the positive samples were sequenced, and genotyping was determined based on NS5 gene sequence. The differences in biochemical and blood routine indexes between HIV patients co-infected with different HCV genotypes and low/high viral loads were analyzed. Results A total of 126 HIV/HCV co-infected patients were collected, including 20 HCV genotype 1 (15.9%), 91 HCV genotype 3 (72.2%), and 15 HCV genotype 6 (11.9%). The maximum and minimum viral load of the three HCV genotypes were as follows: HCV type 1 (1.0×108, 4.8×104 IU/mL), HCV type 3 (2.2×108, 2.9×102 IU/mL), and HCV type 6 (8.1×107, 6.8×104 IU/mL). The results showed that there was no significant difference between HIV co-infection with different genotypes of HCV and three HIV treatment schemes, including nucleoside reverse transcriptase inhibitors+integrase strand transfer inhibitors (NRTIs+INSTIs), nucleoside reverse transcriptase inhibitors+non-nucleoside reverse transcriptase inhibitors (NRTIs+NNRTIs) and nucleoside reverse transcriptase inhibitors+protease inhibitor (NRTIs+PLs), and the viral load of patients (P>0.05). The analysis of biochemical indexes such as total bilirubin (TBIL), direct bilirubin (DBIL), alanine aminotransferase (ALT), aspartate aminotransferase (AST), creatinine (CREA), and blood routine indexes such as white blood cell (WBC), red blood cell (RBC), hemoglobin (HGB), platelet (PLT), mean corpuscular hemoglobin (MCH) and mean corpuscular hemoglobin concentration (MCHC) among different HCV genotypes and low/high viral loads showed that there was no significant difference in biochemical indexes and blood routine indexes between low/high viral loads of HIV co-infected HCV patients (P>0.05); however, the biochemical indicators TBIL, IBIL and MCHC were significantly different statistically between patients with genotype 3 HCV infection and those with genotype 1 HCV infection (P<0.05), while other biochemical and blood routine indexes were not statistically different among different HCV genotypes (P>0.05). Conclusions There are six subtypes of HCV co-infection in HIV patients in Kunming, Yunnan Province, including three genes of genotype 1, 3, and 6. Among them, genotype 3 HCV is the main prevalent genetic virus among HIV co-infected populations. The TBIL, IBIL and MCHC values of HIV patients co-infected with HCV type 3 are different from those infected with HCV type 1.

Lupus nephritis(LN)is an immune-complex nephritis caused by renal involvement in systemic lupus erythemato-sus(SLE).It is one of the main causes of death in SLE and the end-stage renal disease(ESKD).Early diagnosis,effective treatment and reduction of recurrence are important means to delay LN entering ESKD.Renal biopsy is the"gold standard"for diagnosis and determination of LN typing and activity,but it is invasive and not easy to repeat.Therefore,there are still some clinical indicators that can accurately monitor the degree of kidney damage at an early stage,effectively reflect the histological type,disease activity,and judge the curative effect and prognosis.This article reviews the studies on urine biomarkers related to LN,in order to provide ideas for basic research and clinical treatment of LN.

Objective:To further understand the real experience of the nurse in the rotation of NICU in neurosurgery.Methods:Qualitative research method was used to analyze the reflective diary of 26 nurses and the semi-structured interview data of 8 nurses.Results:Three primary themes and 11 secondary themes were extracted from the real experience of rotation of nurses in the neurointensive care unit: department integration and mental process, role competency and influencing factors, career expectations and coping strategies.Conclusions:At present, the integration process of the nurses in the neurointensive care unit is slow. Influenced by many factors, it is difficult to change their roles. It is the direction that nursing managers should pay attention to establish a diversified discipline training system and create a better organizational commitment