Objective To observe the therapeutic effects of ganciclovir(GCV)with differentInjection methods on experimental acute retinal necrosis(ARN).Methods The right eyes of 41pigmented rabbits were infected by herpes simplex virus(HSV-1)(COS strain)to establish ARN animalmodel.After 24 and 72 hours,GCV was given by intravitreal injection(10 eyes),intravenous injection(11 eyes)and the intravitreal+intravenous injection(10 eyes);intravitreal injection of GCV anddexamethasone(6 eyes)was also included.Four eyes were not treated as the control.The dosage of GCVin intravitreal and intravenous injection was 800 μg and 5 mg/kg weight,respectively.Retina necrosis wasobserved and the grade was recorded 1-21 days after injection according to the grade standard ofretinopathy.The maximum grades of retinal necrosis in different groups were compared.Results Thegrade of retinal necosis was 3.8 in the control group,and 0.2,0.4,0.8,and 2.2 in intravitreal iniection,intravitrcal+intravenous injection,intravitreal injection with GCV and dexamethasone,and intravenousrejection,respectively,24 hours after the model was set up.The effects of the first 3 groups wereobviously better than the Iast group(P=0.003,0.011,0.045);while the difference among the first 3groups were not significant(P=0.881,0.054,0.107).Seventy-two hours after the mode J was set up,thegrades of retinal necrosis were above 1.4 in 4 groups,and the differences among the 4 groups were notapparent(P=0.214).Conclusions In the animal model of ARN,intravitreal injection with GCV caneffectively decrease the grade of retinal necrosis.The difference among intravitrealinjection,intravitreal+intravenous injection,intravitreal injection with GCV and dexamethasone,and intravenous injection is notsignificant.

Objective To explore the relationship among psychological satety climate,proactive personality and self-efficacy.Methods Psychological safety climate scale,proactive personality scale,and self-efficacy scale were used to investigate a total of 228 registered nurses from two tertiary hospitals of Tianjin City from October to December,2013.Results The average points of nurses psychological safety climate was (3.05±0.53),average points of proactive personality was (2.70±0.48),average points of self-efficacy was (2.74±0.45),all were in the medium level.Both psychological safety climate and proactive personality could positively influence nursing self-efficacy directly(r=0349～0.472,P ＜ 0.01),and psychological safety climate could also indirectly influence nursing self-efficacy through the mediation of proactive personality (3 decreased from 0.472 to 0.352,P ＜ 0.01).Conclusions Hospi-tal should make concerted efforts to improve psychological safety climate and proactive personality so as to in-crease nurses' self-efficacy.

Based on the body height and weight of the Chinese young men, 975 from the north and 921 from the south of China, actually measured, a calculating formula for the ideal body weight of young men both of north and south listed blow was established. The Northener's ideal body weight (kg) = [height (cm) - 150] ? 0.6 +50; the Southener's ideal body weight(kg) = [height (cm.) - 150] ? 0.6 +48. The formula later checked by another data of body height and weight of 783 young men from north and 883 from south has been proved to be reliable. It also showed that the ideal body weight of 1464 young men from north and 2264 from south calculated according to the formula seemed to be more reasonable than the another's formula used previously.

PurposeVon Hippel-Lindau (VHL) syndrome is a rare autosomal dominant diseases involved multiple organs. This paper aims to explore the clinical and imaging features of VHL syndrome for the improvement of early diagnosis and treatment of this disease.Materials and Methods The clinical and imaging data, as well as their history of 5 patients with VHL syndrome were retrospectively studied. Follow-up was performed and the related literature was also reviewed.Results Among the 5 patients, 4 were found with angioreticulomas. One out of four patients simultaneously suffered from multiple angioreticulomas in brainstem, and another one had multiple cervical cord angioreticulomas. The typical MRI showed multiple cystic and solid mass with mixed intense signals, and the enhanced MRI displayed obvious enhancement in the solid part of the mass. Three patients were diagnosed with renal clear cell carcinomas. The typical CT scan showed equidensity or slightly low density signals, and the enhanced CT scan noted heterogeneous enhancement. Besides, bilateral epididymis cystadenoma occurred in one case. The ultrasonography presented heterogeneous echo and rich blood vessels. The follow-ups had been conducted till January 2015. According to the Glasgow outcome scale, three patients were in good conditions, while the other two died from renal clear cell carcinomas.Conclusion Patients with VHL syndrome usually have an unsatisfactory prognosis and most may die from renal carcinoma. Genetic test and investigation of family history should be performed as early as possible on patients with highly suspected or confirmed VHL Early treatment, life-long follow-up and periodic imaging examinations may be helpful in the prognosis.

ObjectiveToinvestigatetheriskfactorsforunfavorableoutcomeinpatientswithminor ischemic stroke. Methods Patients with minor ischemic stroke were enroled prospectively. The modified Rankin Scale ( mRS ) w as used to assess the clinical outcome at day 90 after onset, and mRS 0-2 w as defined as favorable outcome. The demographic data, vascular risk factors, clinical data, imaging data, stroke etiologic subtypes, laboratory test results, and treatment methods in the favorable outcome group and unfavorable outcome group w ere compared. Multivariate logistic regression analysis w as used to identify the independent risk factors for early poor outcome in patients w ith minor ischemic stroke. Results A total of 516 patients with minor ischemic stroke were enroled. At day 90 after onset, 90 patients (17.44%) had unfavorable outcome and 426 (82.56%) had favorable outcome. Multivariate logistic regression analysis showed that age (odds ratio [OR] 1.045, 95% confidence interval [CI] 1.017-1.074; P=0.002), heart diseases (OR 2.021, 95%CI 1.063-3.841; P=0.032), baseline National Institutes of Health Stroke Scale (NIHSS) score (OR 1.662, 95%CI 1.177-2.347; P=0.004), limb movement disorder ( OR 2.430, 95%CI 1.010-5.850; P=0.048), ataxia (OR 2.929, 95%CI 1.188-7.221;P=0.020), early neurological deterioration ( OR 50.994, 95%CI 17.659-147.258; P<0.001), infarct diameter ( OR 1.279, 95%CI 1.075-1.521; P=0.005), non-responsible vascular stenosis ( OR 2.518, 95%CI 1.145-5.536;P=0.022), and large artery atherosclerotic stroke ( OR 2.010, 95%CI 1.009-4.003; P=0.047) w ere the independent risk factors for unfavorable outcome in minor ischemic stroke. Conclusions The early poor outcome of minor ischemic stroke is closely associated w ith age, heart diseases, baseline NIHSS score, limb movement disorder, ataxia, early neurological deterioration, infarct diameter, non-responsible vascular stenosis, and large artery atherosclerotic stroke. The relevant examinations need to be improved early, the etiologic subtype should be identified, and the correct clinical treatment should be guided.

Objective To investigate the role and the mechanism of Apr-1 gene on cholangiocarcinoma QBC939 cell lines proliferation and cell cycle regulation. Methods Apr-1 gene was transfected into QBC939 cells by using liposomes to establish a QBC939 cell model ( QBC939-Apr-1 ) stably expressing Apr-1 gene. Apr-1 mRNA expression and the changes in cell cycle and cell growth of QBC939 cells were analyzed by RT-PCR, flow cytometry ( FCM ) and growth curve before and after transfection. The regulatory effect of Apr-1 gene on the expression of cell cycle-related genes was investigated in QBC939 cells before and after Apr-1 transfection using cell cycle gene microarrays. Results Significant suppression of cell growth was observed with the cell model stably expressing Apr-1 gene. Apr-1 over-expression caused cell arrest from 9% to 13% (P ＜0. 01 ) increase in G2 population. Cell cycle gene microarrays demonstrated that the expression of Skp2 、UBE1 was up-regulated, while the expression of MRE11A 、CKS2 、CDK8 、CDC45 was down-regulated by more than 3 folds. Conclusions Apr-1 gene suppresses QBC939 cell proliferation in vitro, QBC939 cells presented with differences in the expression of cell cycle-related genes after Apr-1 gene transfection.

Objective Anti-calcification and surface modification of the transcatheter heart valve is the priority research area and development direction of bioprosthesis heart valve.In present study,the Arginine-Glycine-Aspartic acid(RGD) coating technology and anti-calcification with epoxy chloropropane(EC) treatment were applied to investigate surface modification property of the transcatheter heart valve compared to the traditional anti-calcification method with glutaraldehyde (GA) treatment to demonstrate the improvement of structure and surface biological properties of the transcatheter heart valve.Methods Morphological characteristics of mesenchymal stem cells(MSCs) seeded on the transcatheter heart valve with the various anticalcification treatments were observed by scanning electron microscopy and the apoptosis rates of MSCs seeded on the transcatheter heart valve with the various anti-calcification interventions were studied by TUNEL staining.The cell adhesion and expression of the cytoskeletal protein,Vinment of MSCs treated as described were analyzed by cell-counting method and fluorescence immunohistochemical method respectively.Results The apoptosis rate of MSCs was markedly decreased while the expression of vinment and the cell adhesion strength of MSCs were elevated in the groups of GA-EC and RGD-EC treatments.The biological indices of RGD-EC group has significant difference(P ＜ 0.05) compared with GA group.Conclusion Biological properties of the surface of transcatheter heart valve can be remarkably improved by GA-EC and RGD-EC anti-calcification treatments.

Objective To investigate the operative techniques of microsurgery treatment of M1 segment of middle cerebral artery (MCA) aneurysms via pterional approach in 132 cases.Methods Retrospectively analyzed the clinical manifestation,angiograms,and surgical operation data of 132 patients with M1 segment of MCA aneurysms who underwent microsurgery through pterional approach.Results Preoperative digital subtraction angiography (DSA) was conducted in 121 cases to identify the size,shape,orientation and relationship with blood vessels around the MCA aneurysms.The other 11 cases underwent emergency operation.Among the 132 cases,72 patients were discharged in good condition according to Glasgow Outcome Scale; 41 patients were in poor condition; 19 cases were dead or in predying state.Postoperative CT showed that49 cases occurred new infarction and 7 cases developed hydrocephalus or enlargement of ventricles.Ventriculoperitoneal shunt was conducted in 2 cases.Intraoperation rupture and bleeding of aneurysms occurred in 17 cases.Conclusion The aneurysms in M1 segment of the middle cerebral artery are mostly located in the bifurcation of M1 segment.Most branches and perforating arteries stem from middle cerebral artery trunk.Patients with Hunt-hess grade Ⅰ-Ⅲ MCA aneurysms or with Hunt-hess grade Ⅳ,Ⅴ should be treated with microsurgery as soon as possible.Inside Sylvian fissure approach is the most frequently adopted in microsurgery via pterional approach.It is key for the success of the operation to preoperatively understand the anatomy surrounding the aneurysms,have good microsurgical skills and employ correct methods of preventing and managing of rupture of aneurysm.It can relieve the secondary cerebral vasospasm to clear up hematocele in the cisterns or to wash the cisterns or use adhesive wound dressing on blood vessels during operation using papaverine.

Objective To investigate status quo of handover evaluation of nurses and analysis the related factors. Methods Study was administered to 505 nurses, using Handover Evaluation Scale, Perceived Organizational Support Scale, General Self-Efficacy Scale, Maslach Burnout Inventory and Nurse′s Work Pressure Sources Scale. Results The handover evaluation of nurses was in a high level (6.35±0.74)points,quality of information(6.39±0.89)points,interaction and support(6.23±0.88)points, efficiency (6.43 ± 0.69) points. Education background were influence factors of handover evaluation (F=31.97-53.65, P<0.01). Handover evaluation, organizational support and self-efficacy were positive correlation(r=0.263, 0.139, P<0.01). Handover evaluation, burnout and work pressure were negative correlation (r=-0.270,-0.257, P<0.01). Conclusions Nursing administrators should take effective measures to improve nurses′organizational support and self-efficacy level,decrease burnout and burnout for enhancing nurses′handover evaluation.

Objective To investigate the reasons of HOXA5 overexpression in GBM and the molecular mechanism of miR-128-3p regulating the proliferation, invasion and apoptosis of glioblastoma multiforme. Methods After increasing and decreasing miR-128-3p expression in U87 cell lines by lentivirus transfection, the changes of HOXA5 expression were detected by Western blot, to explore the correlation between miR-128-3p and HOXA5 in GBM. The dual-luciferase reporter tests were performed to detect the target interaction of miR-128-3p with HOXA5. Through CCK-8 test, Transwell test, flow cytometric assay and tumor cell xenograft in nude mice, we verified molecular mechanism of miR-128-3p regulating the proliferation, invasion and apoptosis of GBM in vitro and in vivo. Results The expression level of HOXA5 was decreased in U87 cell line after miR-128-3p upregulation. In addition, the expression level of HOXA5 was increased in U87 cell line after miR-128-3p downregulation (P < 0.05). The expression level of HOXA5 was correlated negatively with the expression of miR-128-3p in U87 cell lines. MiR-128-3p targetedly interacted with 3'UTR of HOXA5 and inhibited the expression of HOXA5. The proliferation, invasion and anti-apoptosis of U87 cells were significantly decreased in the miR-128-3p+control group. Conclusion MiR-128-3p regulates negatively the proliferation, invasion and anti-apoptosis of GBM cells by targeting HOXA5. The overexpression of HOXA5 is induced by downregulation of miR-128-3p in GBM.