Embryonic stem cells detached from inner cell mass(ICM),can maintain self-renewal undifferentiation status and differentiate into almost every type of cells.Lots of genes take part in the regulation of embryonic stem cell's proliferation and differen-tiation.In this paper,we reviewed the related genes about embryonic stem cell's proliferation and differentiation,meantime draw off questions which need to be further illuminated.

Objective: To explore the possible mechanism of statins improving endothelial function via observing the effect of a high single dose atorvastatin on endothelial dysfunction and peripheral blood leucocyte Rho kinase activity in patients with unstable angina (UA). Methods: A total of 78 consecutive UA patients admitted in our hospital from 2012-08 to 2014-02 were enrolled. The patients received a single dose of atorvastatin 80 mg on the day of admission. Flow-mediated vasodilation (FMD) of brachial artery was examined by high-resolution ultrasound at before and 12 hours after medication. Protein expression of phospho-speciifc Thr853-MYPT1 (p-MYPT1Thr853) and MYPT1 was measured by Western blot analysis; peripheral blood leukocyte Rho kinase activity was assayed by the proportion of phospho-Thr853 in myosin binding subunit of light chain phosphatase (MYPT1). Results: Compared to prior medication, with atorvastatin 80 mg for 12 hours, FMD was increased 28.15% as (6.50 ±1.68) % vs (8.33 ± 1.93) %,P<0.001 and peripheral blood leucocyte Rho kinase activity was decreased 32.78% as (58.91 ± 5.22) % vs (39.6 ± 3.85 ) %,P=0.002. Conclusion: High dose atorvastatin could rapidly improve vascular endothelial dysfunction in UA patients. inhibiting of RhoA/Rho kinase pathway may involve in the effect of statins improving endothelial function.

Objective To explore the efficacy and safety of dexmedetomidine combined with propofol on double-balloon enteroscopy.Methods Forty cases of patients ASA Ⅰ-Ⅱ grade who underwent double-balloon enteroscopy were divided into dexmedetomidine combined with propofol group (combine group) and propofol group by random digits table with 20 cases each group.Combine group was given load 0.7 μg/kg (intravenous infusion for 10 min) before induction and 0.2 μg/ (kg·h) continuous infusion during the surgery.All the patients were used propofol by target concentration with 2.5-4.0 mg/L for target-controlled infusion heart rate (H R),mean arterial pressure (MAP),respiratory rate (RR),peripheral oxygen saturation (SpO2) were recorded before examination(T0),eye lash reflex time(T1),during the perform (T2),the end of check (T3),sedation score,induction time,recovery time,total propofol amount,rates of adverse reaction and satisfaition were recorded.Results The induction time,recovery time was no statistically significant difference between two groups (P ＞ 0.05).The RR,SpO2 was no statistically significant difference between two groups at different time points (P ＞0.05).The HR at T1,T2 in combine group was significantly lower than that at T0 and in propofol group same period[(65.8 ± 7.3),(68.6 ± 8.2) times/min vs.(84.6 ± 7.1) and (77.6 ± 7.2),(89.6 ± 8.4) times/min,P ＜ 0.05].The MAP at T1 in combine group was significantly higher than that at T0 and in propofol group same period [(88.9 ± 9.4) mm Hg (1 mm Hg =0.133 kPa) vs.(81.3 ± 4.5) and (73.5 ± 6.8) mm Hg,P ＜ 0.05],at T2 was significantly lower than that in propofol group [(80.6±6.6) mm Hgvs.(88.5 ±7.6) mm Hg,P＜0.05].Sedation score 1 score 18 cases,2 scores 2 cases in combine group; 1 score 3 cases,2 scores 17 cases in propofol group,the difference was statistically significant (P ＜ 0.05).Combine group apnea two cases,moving,choking three cases,propofol group were eight cases and seven cases,the difference was statistically significant (P ＜ 0.05).The total propofol amount in combine group was significantly lower than that in propofol group [(421 ± 76) mg vs.(638 ± 89) mg,P ＜ 0.05].Conclusion Dexmedetomidine composite target controlled infusion of propofol used for double-balloon enteroscopy can produce good narcotic analgesic which is safe and effective anesthesia.

Anesthesia plays an essential role in clinical operations. Guiding anesthesia by EEG signals is one of the most promising methods at present and it has obtained good results. The analysis and process of the EEG signals in anesthesia can provide clean signal for further research. This paper used variance threshold method to remove the mutation fast and large interfering signals; and used notch filter to remove frequency interference, smoothing filter to remove baseline drift and Butterworth low-pass filter to remove high frequency noise at the same time. In addition to this, the translation invariant wavelet method to remove interference noise on the signals which was after the classical filter and retained non-stationary characteristics was used to evaluate parameter calculation. By comparing the calculated parameters from treated signal using this paper's methods and untreated signal and standard signal, the standard deviation and correlation has been improved, particularly the major parameters BetaR, which provides better signal for integration of multi-parameter to evaluate depth of anesthesia index for the latter.
Anesthesia ; methods ; Humans ; Signal Processing, Computer-Assisted

Objective To assess the value of 18 F-FDG PET imaging in the localization of epileptic foci.Methods 18 F-FDG PET were performed in 22 patients with medically intractable epilepsy (15 males,7 females,mean years:19.0 years,mean duration:8.2 years). The open skull operations were undergone in 21 patients according to the results of 18 F-FDG PET, combining with scalp EEG and CT or/and MRI. 1 patient was refered for stereotactic operation. During operation,EcoG was detected for identifying the site of epileptogenic focus and lobectomy was performed . All specimens were examninated with the pathological tests. All patients were followed up for the curative effects. Results PET showed abnormalities in 21 patients(95.5%). Among them,single or multiple focal hypometabolisms were found in 20 patients and focal hypermetabolism in 1 patient. The scalp EEGs showed abnormalities in 17 patients(77.3%),but 8 of them did not showed clear latreralizing manifestations.The abnormalities were found on MR or/and CT in only 5 cases (22.7%).The epileptogenic foci detected by PET were consistent well with EcoG in 18cases(85.7%), consistent approximately in 2 cases and not consistent in 1 cases .Among 19 patients with abnormal PET findings , the pathological abnormalities were found in 18 cases (94.7%).No pathological abnormality was found in the patients with nomal PET imaing. After the open skull operations, 9 patients (42.9%) becomed seizure free . 9 patients (42.9%) had more than 50% seizure reduction and 3 patients (14.3%)showed no improvement. The patient treated with stereotactic operation also showed no significant improvement.Conclusion 18 F-FDG PET imaging is a sensitive and accurate modality to localizate the epileptic foci and has important clinical value in surgical therapy.

Formative evaluation is a medical education evaluation form used to correct its own track in the course of activities so as to get better effect. In the medical education, it can significantly improve the medical students' ability such as active learning ability, relearning ability, ability to master and apply know l edge, ability of scientific thinking and debating, ability of innovation and analysis, ability of association and communication, and so on.

Objective This study aimed to construct an index system for nurse performance appraisal based on the quantity,quality,efficiency and technology in holistic nursing mode.Methods Expert interviews and Delphi expert enquiry were used to complete the construction of index system,and SPSS17.0 was used to do data statistics and reliability analysis.Results The nurse performance appraisal index system was constructed which contained 4 level-Ⅰ indicators such as level coefficient,nursing workload scores,nursing quality scoring rate and reward amount and 12 level-Ⅱ indicators.The calculation method of each part was also established.The expert positive coefficients were 94.3％ and 100.0％ respectively,the authority coefficients were 0.83 and 0.84,the importance and feasibility mean scores of every index were 4.27-5.00 and 4.26-4.94,and coefficients of variation were 0.00-0.26 and 0.05-0.26 in 2 rounds of enquiry.The importance of level-Ⅰ or level-Ⅱ indicators and operability coordination coefficients were 0.13-0.43,the significance test showed P ＜ 0.05.Conclusions The design of each dimension of the index system gives full consideration to nurse post management,hierarchical using,the nurse in charge of the patient,grading nursing care and many other factors.Representative of key indicators is strong,and it can reflect the distribution concept that more payment for more contributions,best's best reward and rewarding the good and punishing the bad.

Objective To evaluate the therapeutic effects of capsule Huoluoshugan on schistosomal hepatocirrhosis.Methods Ninety-six patients with schistosomal hepatocirrhosis were selected and divided randomly into three groups:Huoluoshugan group,interferon-?(IFN-?)group and control group,and treated with capsule Huoluoshugan,IFN-? and routine therapy,respectively.The course of treatment was 6 months in all groups.Before and after the treatment,the symptoms,physical signs,indexes of liver function and hepatic fibrosis,and changes of B-type ultrasonic images were detected for all the patients.Results The indexes of liver function,hepatic fibrosis and B-type ultrasonic image of the patients in Huoluoshugan group improved obviously compared with the control group after the treatment(P0.05).In addition,there was no obvious adverse reactions during the treatment in the patients of Huoluoshugan group.Conclusion Capsule Huoluoshugan can reduce the indexes of hepatic fibrosis and improve the liver function in patients with schistosomal hepatocirrhosis.

Objective To construct the assessment index system for general nursing goals management based on the performance structure theory. Methods Expert interviews and Delphi expert enquiry were used to complete the construction of index system, and SPSS17.0 was used to do data statistics and reliability analysis. Results The assessment index system for general nursing goals management was constructed which contained 6 level-Ⅰindicators such as nursing quality, nursing safety, nursing service, teaching and training, the contribution of department and the communication skills and 22 level- Ⅱ indicators. The department monthly examination scores calculation method and feedback mechanism were also established. The expert positive coefficients were 97.6%and 98.8%respectively, the authority coefficients were 0.85 and 0.86, the importance and feasibility mean scores of every index were 3.86-4.98 and 3.98-4.88, and coefficients of variation were 0.03-0.27 and 0.05-0.25 in 2 rounds of enquiry. The importance of level-Ⅰor level-Ⅱ indicators and operability coordination coefficients were 0.10-0.36, the significance test showed P<0.05. Conclusions The design of each dimension of the index system gives full consideration to 3 dimensions of performance: task-adaptive-relationship. Representative of key indicators is strong. The Delphi method used in building is scientific and the results are reliable. The maneuverability of calculate Method is strong, easy to quantify. The feedback mechanism has a strong incentive by combining the assessment results closely with the individual interests. The establishment of the index system can provide scientific and objective basis for the full implementation of the general nursing goals management.

Objective To treat the patients suffering from intractable epilepsy after brain injury with low-dosage linac accelerator stereotactic radiosurgery through positron emission tomography (PET) localization. Methods PET examination based on 18 F-2-fluorine-2-deglucose (FDG) was carried out in 32 patients in order to localize epileptogenic foci followed by radiosurgery with peripheral radiation dose of 9-13 Gy. The follow-up was conducted over one year. The seizure frequency of epilepsy was recorded to evaluate the therapeutic effect. Results The PET imaging showed that the cortical area around the cerebromalacia caused by primary injury presented low metabolic change. The metabolic changes in different injury areas mainly concentrated in the epileptic foci. In some cases,the low metabolic areas not only was localized at the part of impact lesion but also at the part of contrecoup lesion. The seizure frequency gradually decreased after radiosurgical treatment in most patients,with obvious statistical significance compared with pretreatment. According to Wieser's classification of operative effect,the cases at the grades Ⅰ-Ⅱ accounted for 44% (14/32),grades Ⅲ-Ⅳ for 41% (13/32) and grades Ⅴ-Ⅵ for 16%(5/32). No fresh complications were found in all the cases. Conclusions Low-dosage stereotactic radiosurgery with the PET localization is a safe,effective and minimally invasive surgical approach to intractable posttraumatic epilepsy.