Objective To investigate changes in the expression of prepro-orexin and orexin receptor-1 ( OX1R) following permanent middle cerebral artery occlusion ( MCAO ) with or without preconditioning through electrical stimulation of the cerebellar fastigial nucleus (FNS). Methods Wistar rats were subjected to permanent MCAO and randomly divided into 5 groups: a sham-operated control group (PO), an FNS preconditioning + shamoperated control group (FNS-PO) , an ischemia group, an FNS preconditioning + ischemia group (FNS-PI) and a cerebellar fastigial nucleus injury + FNS preconditioning + ischemia group (FNL-FNS-PI). Each group was divided into 5 subgroups according to the time at which the animals were sacrificed after the MCAO ( 1, 3, 6, 12 and 24 h).RT-PCR was used to detect expression of OX1R mRNA, and ELISA to measure the levels of orexin-A in the hypothalamus and plasma. Results The immunoreactivity of prepro-orexin decreased significantly in the PI groups, with further decreases over time. At the 12th h after MCAO, the immunoreactivity of prepro-orexin reached a minimum.There were significant differences between the rats in the PO and FNS-PO groups. On the contrary, the immunoreactivity of OX1R increased significantly in the PI groups, with further increases continuing over time, peaking at 12 h after the MCAO. There were significant differences between the PO and FNS-PO groups. In the rats with FNS preconditioning (PI-FNS) , the decrease in prepro-orexin and the increase in OX1R were significantly inhibited compared to the PI subgroups at the 6th and 12th hour. There was no significant difference between the FNL-PIFNS group and the PI group. The expression of OX1R mRNA increased significantly in the PI group, with further increases continuing over time, peaking at 24 hours. The plasma levels of orexin-A were not significantly different among the groups, but the levels of orexin-A in the hypothalamus decreased significantly in the PI and FNL-PI-FNS groups, with further decreases continuing over time. At the 12th h after the MCAO the levels were significantly different compared with the PO and PO-FNS groups. While in the rats with FNS preconditioning (PI-FNS) , the decrease in orexin-A level was reversed and there was no significant difference compared with PO and PO-FNS groups. Conclusions The orexinergic system is altered following cerebral ischaemia. FNS preconditioning may be able to regulate these changes.

Objective To evaluate the application and efficacy of 6S quality management methods in drug clinical trials of oncology department.Methods By using 6S (Seiri,Seiton,Seiso,Seiketsu,Shitsuke,Safety) quality management methods,quality about mastering level of good clinical practice (GCP) knowledge,sample collection and drug management etc.were controlled,and efficacy after the quality control was evaluated.Results After implemention of 6S quality management,rate of achieving GCP certificate was increased to 77.80％,accuracy rate of sample collection and accuracy rate of medicine preparation were increased to 100.00％,and the rate of relearning study protocol was increased to 100.00％,and subjects' satisfaction was improved significantly.Conclusion The implementation of 6S quality management methods could effectively enhance the quality of drug clinical trials in oncology department.

Objective To observe the effects of melatonin (MT) on the expression of heme oxygenase-1 (HO-1),phosphorylated adenine dinucleotide quinone oxidoreductase-1 (NQO-1) and nuclear factor erythroid-2-related factor 2 (Nrf2),so as to explore the mechanism of MT's action in the Nrf2-ARE signaling pathway.Methods A total of 72 Sprague-Dawley rats were randomly divided into a control group,an injury group and a melatonin group,each of 24.T11-T12 acute SCI was induced in the injury and melatonin groups using the modified Allen's method.Ten minutes after the injury,equal amounts of absolute ethyl alcohol and melatonin were intraperitoneally injected into the rats in the injury and melatonin groups.For the control group,the vertebral plate was cut to expose the T11-T12 spinal cord without any injury of the nerves.Six rats from each group were randomly selected for sacrifice at 6,12 and 24 hours after the operation,and T11-T12 spinal cord specimens were collected.The spinal cord injury and inflammatory response were observed using haematoxylin eosin staining.The expression of HO-1,NQO-1 and Nrf2 was examined using immunofluorescence,while the expression of HO-1,NQO-1 and Nrf2 protein and mRNA were detected using RT-PCRs.Results The neuronal cells in the spinal cords of the control rats were of normal shape,without edema,necrosis or obvious hemorrhagic foci.Hemorrhagic foci,significantly more inflammatory cells and some spinal cord neurons with edema and necrosis were observed in the injury group.However,significantly fewer hemorrhagic spots and cells with edema were found in the melatonin group compared with the injury group.The average expression of HO-1,NQO-1 and Nrf2 protein and mRNA was significantly higher in the melatonin group than in the other two groups.The levels in the injury group were also significantly higher than in the control group 12 and 24 hours after the experiments.Immunofluorescence showed that the greatest number of cells with HO-1,NQO-1 and Nrf2 was found in the melatonin group,followed by the injury group and then the control group,with significant differences among all 3 groups.Conclusion Melatonin can promote the expression of HO-1,NQO-1 and Nrf2 in rats with acute spinal cord injury,which might be related with its activating the Nrf2-ARE signaling pathway.

This paper reviewed the common ethical issues in oncology drug clinical trials implementation of one hospital, such as the auditing and implementation of research protocols were not strict, the quality of research-ers needed to be improved, the hardware facilities for drug clinical trial was lacking, the informed consent signature was not standard, and the professional quality control was lacking. After corresponding countermeasures had been taken, such as the strict examination of research programs, strengthening the research team construction, taking the focus of GCP and SOP training, equipping hardware facilities for drug clinical trials, standardizing of ICF signa-ture, and the joint implementation of the quality control in hospital and departments, the researchers′ professional quality was further improved, which established a good foundation for better implementation of the drugs clinical tri-als and protection of the participants′interests.

Objective To compare the differences between a new type of pillow for nasal drops and traditional pillow in alleviating nasal congestion, nasal pus, sneezing and headache in patients suffering from acute sinusitis, and to select a better nasal dropping equipment for clinical nursing. Methods In total 86 acute sinusitis patients in hospital were randomly divided into the observation group and control group ( for each group, n= 43 ) . Patients in both groups were treated with intravenous cephalosporin, and arcelor thiazole and levofloxacin by nasal dropping. Our new type of pillow for nasal drops and the traditional pillow were applied in the observation group and control group respectively. We compared the differences of treatment effect in five days later between two groups by the SNOT-20 scale, pain assessment, and visual analogue scale. Results The scores of a stuffy nose, discharging, sneezing, headache, decreased smell, taste and unable to sleep, and night sleep of the patients in the observation group were significantly lower than those in the control group ( P <0. 05). The comfort score of the observation group was significantly higher than that of the control group (P<0. 05). Conclusions By using the new pillow for nasal drops, drugs are able to reach the nasal sinus cavity accurately, so the symptoms of patients with acute sinusitis are relieved better.

Objective To explore the influence of social-economic factors on self-care ability and general well-being in adolescents with type 1 diabetes mellitus (T1DM). Methods Totally 75 adolescents with T1DM who were treated in Endocrinology Department of the First Affiliated Hospital of Zhengzhou University from January 2014 to January 2016 were selected as the research objects, and the social-economic factors of their families were collected, which included education degree, career situation, yearly household income and citizenship. The levels of self-care ability and general happiness in adolescents with T1DM were researched by Diabetes Self-Care Scale (DSCS) and Memorial University of Newfoundland Scale of Happiness(MUNSH), and the correlation between the social-economic factors and self-care ability, general happiness were analyzed by multiple linear regression analysis. Results In this study, the score of self-care ability of adolescents was (80.66±8.57), in which 19 cases got good scores, 35 cases got general scores and 21 cases got poor scores; the score of general happiness was (34.02±4.99), in which 23 cases got low scores, 26 cases got medium scores and 26 cases got high scores. The differences in parents' education degree, father's career situation, and yearly household income among T1DM adolescents with different self-care ability levels were statistically significant (P<0.01); the differences in parents' education degree, parents' career situation and yearly household income among T1DM adolescents with different general happiness levels was statistically significant (P< 0.05). Multiple linear regression showed that parents' education degree, father's career situation and yearly household income were influence factors of self-care ability in adolescents with T1DM (P< 0.01); parents' education degree, parents' career situation and yearly household income were influencing factors for general well-being in adolescents with T1DM (P< 0.01). Conclusions The levels of self-care ability and general well-being in adolescents with T1DM are at medium level; their parents' education degree and yearly household income are the main influencing factors.

OBJECTIVE: To analyze the clinical phenotype and genetic characteristics of a patient with Alport syndrome. METHODS: A patient with Alport syndrome who had visited the First Affiliated Hospital of Zhengzhou University in November 2020 was selected as the study subject. Clinical data of the patient were collected. High-throughput sequencing was carried out to detect potential variant of the COL4A3, COL4A4 and COL4A5 genes, and Sanger sequencing was carried out for verification of candidate variants in the family. RESULTS: The main clinical manifestations of the patient included hematuria, proteinuria, and impaired hearing. Audiometric testing suggested symmetrical cochlear sensory neural hearing loss on both sides. Renal biopsy revealed mild mesangial proliferative glomerulonephritis. Genetic testing revealed that the patient has harbored compound heterozygous variants of the COL4A4 gene, namely c.940G>A (p.Gly314Ser) and c.3773G>A (p.Gly1258Asp), which were respectively inherited from her father and mother. Neither variant has been reported before, and were predicted to be pathogenic based on the guidelines from the American College of Medical Genetics and Genomics. CONCLUSION The c.940G>A (p.Gly314Ser) and c.3773G>A (p.Gly1258Asp) compound heterozygous variants of the COL4A4 gene probably underlay the Alport syndrome in this patient. Above finding has enriched the mutational spectrum of the COL4A4 gene.
Female ; Humans ; Nephritis, Hereditary/genetics* ; Hematuria ; Genetic Testing ; Genomics ; Hearing ; Collagen Type IV/genetics*

Objective:To translate and revise the Arteriovenous Fistula Assessment Scale (AVF-AS), test the reliability and validity of the Chinese version of AVF-AS.Methods:The modified Brislin translation model was used to translate, back translate and cross culture adjust AVF-AS, forming the Chinese version of AVF-AS. Using the convenient sampling method, 220 hemodialysis patients from the First Affiliated Hospital of Zhengzhou University were selected for investigation from July to September 2022. Two weeks later, 30 patients were randomly selected for retesting. The valid data were used for project analysis and reliability and validity evaluation.Results:The Chinese version of AVF-AS consisted of 3 factors and 18 items. Consistency level between evaluators was 0.94, the item level content validity index was 0.83-1.00, average scale level content validity index was 0.94, and the calibration validity was 0.68.Three common factors(autogenous arteriovenous fistula blood flow, stenosis and ischemia, puncture location) were extracted from exploratory factors, and the cumulative variance contribution rate was 75.255%. The total scale's Cronbach α was 0.946, the half reliability of each dimension was 0.826 - 0.898, and the test-retest reliability was 0.907.Conclusions:The Chinese version of AVF-AS has good reliability and validity, and can be used as an effective tool to evaluate the autogenous arteriovenous fistula functional status of hemodialysis patients in China.

Objective? To explore the effect of staged continuous nursing mode on self-care ability of arteriovenous fistula among hemodialysis patients. Methods? A total of 120 patients with arteriovenous fistula in Blood Purification Center at the First Affiliated Hospital of Zhengzhou University were enrolled in the study by convenience sampling methods from January to December in 2017. Patients were divided into control group and observation group by random numeral table method. The control group received routine nursing and health education. On the basis of these, the observation group was given a phased continuous nursing intervention. The intervention was divided into 3 stages. The Exercise of Self-care Agency Scale (ESCA) was used to evaluate patients before and after the intervention. Complications of arteriovenous fistula were observed and compared in two groups. Results? There was no significant difference in self-concept, knowledge and information seeking, passiveness, motivation, and self-care scores between two groups before intervention. After intervention, the observation group patients' self-concept, knowledge and information seeking, passiveness, motivation, and self-care scores were higher than the control group, and the differences were statistically significant (P＜ 0.05). After intervention, the result of comparing the occurrence of obstruction of internal fistula, thrombosis, infection, and hemorrhage/hematoma in two groups showed that those in control group was higher than observation group with statistical differences (P＜ 0.05). Conclusions? The staged continuous care model improves the self-care ability of arteriovenous fistula among hemodialysis patients, and reduces the occurrence of related complications.

Objective:To explore the effect of nursing intervention based on Donabedian quality theory in blood purification patients undergoing vascular access.Methods:From July 2017 to May 2019, convenience sampling was used to select 120 hemodialysis patients undergoing vascular access who were admitted to the First Affiliated Hospital of Zhengzhou University. All patients were divided into control group and observation group with the method of random number table, with 60 cases in each group. Control group carried routine nursing, and observation group implemented nursing intervention based on Donabedian quality theory, both of which were treated for three months. The composition ratio of vascular access, nutritional status before and after nursing intervention, urea clearance index (Kt/V) and urea decline rate (URR) , incidence of recirculation, and incidence of vascular access complications after nursing intervention were compared between two groups.Results:The proportion of central venous catheter access in observation group (10.00%, 6/60) was lower than that in control group (25.00%, 15/60) , and the difference was statistically significant ( P<0.05) . After intervention, the albumin, hemoglobin, and prealbumin levels of two groups were higher than those before intervention, and the albumin, hemoglobin and prealbumin levels of observation group after intervention were higher than those of control group, and the differences were statistically significant ( P<0.05) . After intervention, post-dialysis Kt/V and URR of observation group were higher than those of control group, and the incidence of recirculation (10.00%, 6/60) was lower than that of control group (21.67%, 13/60) , and the incidence of vascular access complications (5.00%, 3/60) was lower than that of control group (16.67%, 10/61) , and the differences were statistically significant ( P<0.05) . Conclusions:Nursing intervention based on Donabedian quality theory applied to blood purification patients undergoing vascular access can improve the nutritional status and coagulation function of patients, reduce the incidence of complications which is worthy of popularization.