Objective To explore the intervention effect of cathepsin B inhibitor (CBI) and its signaling pathways after flurothyl inducing brain injury in rats with recurrent seizures. Methods 6-day-old (P6) SD rats were randomly divided into: recurrent neonatal seizure group ( RS group, n = 30), CBI-treated seizure group ( CBI group, n=30) and the control group( CONT group). Rats in RS group were subjected to 5 seizures with flurothyl during the first 14 days of life. In CBI group,CBI was injected each day before seizures were induced. Then examined development indexes such as the physical growth, neural reflex, neural behavior and cognitive emotional competence. Western blot was employed to determine Cathepsin B expression at different time points ( 1.5h,3h,6h,24h and P35) after the last convulsion. Results The weights of rats in RS group( (27.28 ± 1.6) kg) were lighter than CONT group( ( 33.45 ± 1.57 ) kg). They had significant difference (P＜ 0.01 ) at the age of p14. The time of cliff avoidance in RS group( (2. 10 ± 1.45 ) s) was longer than CBI group( ( 1.05 ± 0. 32) s). It showed a statistically significant (P ＜ 0.05 ) in p12. In the open-field behavior test: the activities of RS group (20.00 ± 13.08 )were markedly reduced than CONT group ( 57.83 ± 33.22 ) in the horizontal movements, the RS group ( 2.50 ±2.43 ) were significantly decreased than the CONT group and CB1 group( ( 22.17 ± 10.74), (9.33 ± 5.39 ) ) in the vertical motions (P ＜ 0. 05 ). Cathepsin-B expression in RS group( 1.5h, 3h,6h and 24h )was significantly higher than that at the same time in CONT group(P＜ 0. 05 ). Cathepsin-B expression of CBI group was significantly decreased compared with that in RS group (P＜ 0. 05 ) at the time point (1.5h ,3h,6h and 24h). There were no significant differences among three groups at P35(P＞0.05 ). Conclusions CBI can improve brain injury and regulate the expression of abnormal molecules.

Objective To explore the dynamic expressions of autophagia and apoptosis associated protein Beclin-1, Cathepsin B and Bcl-2 in hippocampus and the intervention efficacy of cathepsin-B inhibitor (CBI) after recurrent neonatal seizure. Method Ninty 6-day-old SD rats were randomly (random number) divided into the recurrent neonatal seizure group (RS group, n = 30), CBI-treated seizure group (CBI group, n = 30) and the control group (n = 30). Rats in RS group were subjected to 55 attacks of seizure induced by using flurothyl during the consecutive 9 days beginning on the 6 th postnatal day (P6). In CBI group, CBI (2 μL, 0.5 μg/μL) was administered every day before seizures induced. Western blot was employed to determine the protein level at different intervals (1.5 h,3 h,6 h,24 h) after the last convulsion.Results There were higher expressions of Beclin-1 and Cathepsin B, and lower expressions of Bcl-2 expression in RS group(1. 5 h,3 h,6 h and 24 h) than those at the same time in control group (P ＜ 0.05). Beclin1 and Cathepsin B expressions were lower while Bcl-2 expressions were higher in CBI group at the intervals of 1.5 h,3 h,6 h and 24 h compared with those in RS group (P ＜ 0. 05). Conciusions Autophagic and apoptotic pathways were activated immediately after recurrent neonatal seizures as indicated by expression changes of Beclin-1, Cathepsin B and Bcl-2 in hippocampus, which suggests a synergistic effect of the two pathways in the pathophysiology of the long-term brain damage of neonateε resulted from the adverse effects of recurrent neonatal seizures.

BACKGROUND:General assessment of viability of umbilical cord mesenchymal stem cel s during transport is not considered at home and abroad.
OBJECTIVE:To explore the effects of different transportation conditions such as albumin and transport time on survival rate of umbilical cord mesenchymal stem cel s.
METHODS:Umbilical cord mesenchymal stem cel s cultured in vitro were divided into experimental and control groups. Each of group contained 3.15×109/L cel s in 3 mL normal saline. The experimental group contained 1%albumin in dark environment. The control group included two subgroups:dark preservation group with the absence of albumin and light preservation group with the presence of albumin. Cel counting, trypan blue staining and cel survival rate were compared at 0, 2, 4, 8, and 24 hours.
RESULTS AND CONCLUSION:Compared with the control group, no cel loss was observed in experimental group (with the presence of albumin in the dark) and a 90%viability ratio was achieved at 8 hours. In the control group without albumin, loss rate reached 38.5%and survival rate reached 86%at 8 hours. Results revealed that 1%albumin predominantly improved cel survival rate in long-distance transport of umbilical cord mesenchymal stem cel s. When transport time was more than 8 hours, cel loss rate increased and cel survival rate downregulated. Our experimental data demonstrated that umbilical cord mesenchymal stem cel s preserved in normal saline consisting of 1%albumin placing in dark environment at 16 ℃ apply to clinical application criterion in 8 hours.

ObjectiveTo evaluate bacteria contamination during collection,processing and storage of cord blood to gain insight into contamination mechanism and direct prevention.MethodsFresh cord blood was separated by hydroxyethyl starch (HES) to harvest nucleated cells.The bacteria contamination was tested by culturing 10 ml plasma-red cells with BacT/ALERT 3D-480 automatic blood culture system.Total 87 positive samples were further identified for bacteria species.Ninety six cord blood nucleated cells concentrate with bacteria positive stored in liquid nitrogen(LN2) for 6-7 years were thawed at 37 C and re-cultured for bacteria analysis.ResultsWe collected 19 062 umbilical cord blood.Among them,336 was bacteria positive ( contamination rate 1.8 ％ ).Eighty-seven positive samples were further investigated with facultative bacteria 58 (66.7 ％ ),aerobic 38(43.7％ ) and anaerobic 17( 19.5％ ),Gram- negative accounted for 68％ while positive 32％.The most frequent bacteria were Escherichia coli ( 25.3％ ),Streptacoccus intermediate ( 14.9％ ) and Chromobacteria violaceum(9.2％ ).Ninety-six nucleated cells concentrate with bacteria positive were cryopreserved at liquid nitrogen for researching.Of them,83 samples( 86％ ) showed positive of bacteria culture after deep-low temperature storage for 6-7 years.ConclusionsBacteria contamination rate of the cord blood collection,processing and storage in 2000 ～ 2007 was 1.8％.Stored in liquid nitrogen for 6-7 years,the viability of bacteria was 86％.The aseptic procedures of cord blood collection in delivery room should be intensified.The bacteria re-culture following thawing of cord blood cells is necessary before clinical transfusion.

Objective To investigate the characteristics of the bone marrow mesenchymal stem cell(MSC)in children with aplastic anemia(AA)in vitro,and the expressions of tumor necrosis factor -α-induced protein -8 -like 2(TIPE2)in the bone marrow,and the correlation between the level of TIPE2 mRNA with γ-interferon(IFN -γ)and IL -6 in AA patients.Methods Bone marrow samples were collected from 1 8 children with AA(AA group)and 8 children with bone injury (control group)who were hospitalized in Jinan Children′s Hospital from January 201 2 to June 201 5.MSC were isolated and cultured.The morphology of MSC was observed and immune phenotype was detected.The TIPE2 mRNA was detected by using real -time fluorescence quantitative PCR,and the levels of IFN -γand IL -6 were detected by using enzyme linked immunosorbent assay.Results Different sizes had been presented in the primi-tive MSC of AA patients,but the third passage MSC until 80% confluence had manifested the uniform convergence with long spindle and swirl distribution.In the sixth passage,cells showed degenerative change.The primitive and first pa-ssage MSC in patients with AA was longer than that in the controls.CD73 ,CD1 05 ,CD44 and CD90 were expressed in MSC,while CD34 ,CD45 ,CD271 expressed rarely.The level of TIPE2 mRNA in AA patients (5.29 ±1 .56)was obviously lower than that of the control group(8.68 ±2.00),and the difference was significant(t =-4.48,P <0.01 ).The con-centration of IFN -γ[(5.48 ±1 .97)ng/L]and IL -6[(5.43 ±1 .92)ng/L]in AA patients were higher than those of the control group[(3.40 ±1 .24)ng/L,(3.79 ±0.92)ng/L],and the differences were significant (t =2.70, 2.26,all P <0.05).The level of TIPE2 mRNA in AA patients was negatively related with IFN -γand IL -6(r =-0.838,-0.658,all P <0.05),but there was no significant correlation between them in the control group (all P >0.05).Conclusions The proliferation of MSC is significantly reduced in patients with AA.TIPE2,as an important role to stabilize the immune system,plays an important role in the occurrence of AA by its low expression and up -regula-ting the expression of inflammatory factors.

Objective: To investigate the effect of leading health education path on the clinical nursing of patients with atlantoaxial fracture. Methods: A retrospective case control study was conducted to analyze 38 patients with atlantoaxial fractures admitted to our hospital from January 2017 to February 2018. There were 31 males and 7 females, aged 21-65 years [(49.6±12.5)years]. In the control group, there were 15 males and four females, aged 25-63 years [(48.6±15.3)years]. All patients underwent posterior atlantoaxial pedicle screw fixation. Among the patients in control group, there were eight with atlas fracture, four with axial fracture, and seven with atlantoaxial fracture, of which there were five patients of grade C and 14 of grade D according to the American Spinal Injury Association (ASIA) score. There were 16 males and three females, aged 21-62 years [(51.2±12.3)years] in the study group which adopted the leading health education path to provide patients step by step with knowledge of atlantoaxial fracture. In the study group, there were seven patients with atlas fracture, six with axial fracture, and six with atlantoaxial fracture, of which there were seven patients of grade C and 12 patients of grade D based on ASIA. The visual analogue score (VAS) at 1 week and 1 month after operation, Japanese Orthopedic Association (JOA) score at 1 and 6 months after operation, related knowledge mastery, nursing satisfaction, complication incidence, and ASIA grading improvement were compared between the two groups. Results: The VAS was (2.1±1.3)points at one week after operation and (1.1±0.6)points at one month after operation in the study group, lower than those of control group [(3.4±2.4)points and (2.1±1.2)points] (P<0.05). The JOA score of the study group was (15.9±1.5)points, higher than that of the control group [(14.7±1.3)points] (P<0.05). The scores of knowledge mastery including basic knowledge, appropriate medication, complications prevention and functional exercise were (23.2±2.4)points, (24.1±1.7)points, (21.5±3.1)points and (22.8±1.6)points respectively in the study group, all of which were higher than those of control group [(14.4±3.1)points, (12.9±2.1)points, (15.4±4.3)points and (13.4±3.5)points] (P<0.05). The satisfaction with nursing in the study group was also higher than that of the control group (P<0.05). In the study group, one patient (5%) had pulmonary infection, and in the control group nine patients (47%) had complications including two with lower extremity vein embolism, four with urinary tract infection, two with pulmonary infection, and one with pressure injury (P<0.05). In the study group, there was one patient of grade C, five of grade D and 13 of Grade E according to ASIA; in the control group, there were two of grade C, six of grade D and 11 of Grade E (P>0.05). Conclusion The leading health education path for patients with atlantoaxial fracture to adopt staged treatment guidance is conducive to relieving pain and improving cervical function, reducing the incidence of complications, and deepening the mastery of relevant knowledge.

Hip fracture is considered as the most severe osteoporotic fracture characterized by high disability and mortality in the elderly. Improved surgical techniques and multidisciplinary team play an active role in alleviating prognosis, which places higher demands on perioperative nursing. Dysfunction, complications, and secondary impact of anaesthesia and surgery add more difficulties to clinical nursing. Besides, there still lack clinical practices in perioperative nursing for elderly patients with hip fracture in China. In this context, led by the Orthopedic Nursing Committee of Chinese Nursing Association, the Expert consensus on clinical practice in perioperative nursing for elderly patients with hip fracture ( version 2023) is developed based on the evidence-based medicine. This consensus provides 11 recommendations on elderly patients with hip fracture from aspects of perioperative health education, condition monitoring and inspection, complication risk assessment and prevention, and rehabilitation, in order to provide guiding advices for clinical practice, improve the quality of nursing and ameliorate the prognosis of elderly patients with hip fracture.

Hip fractures are among the most common fractures in the elderly, presenting to be a leading cause of disability and mortality. Surgical treatment is currently the main treatment method for hip fractures. The incidence of perioperative malnutrition is increased after hip fractures in the elderly due to the comorbidities, decreased basal metabolic rate, accelerated protein breakdown, weakened anabolism and surgical stress. However, malnutrition not only increases the incidence of postoperative complications, but also leads to increased mortality, indicating an important role of perioperative nursing management of nutrition for the elderly patients with hip fractures. At present, there still lacks scientific guidance and application standards on perioperative nursing management of nutrition for the elderly patients with hip fractures. Therefore, the Orthopedic Nursing Committee of Chinese Nursing Association and the Editorial Board of Chinese Journal of Trauma organized relevant experts to formulate the Expert consensus on perioperative nursing management of nutrition for elderly patients with hip fractures ( version 2023) according to evidence-based medical evidences and their clinical experiences. Fourteen recommendations were made from aspects of nutrition screening, nutrition assessment, nutrition diagnosis, nutrition intervention and nutrition monitoring to provide guidance for perioperative nursing management of nutrition in elderly patients with hip fractures.