Objective: To introduce a new method which can avoid the interference of ABCD1 pseudogenes in the molecular diagnosis of X-linked adrenoleukodystrophy. Methods: The coding regions of ABCD1 gene of 3 unrelated Chinese patients with X-linked adrenoleukodystrophy were amplified from the total RNA of peripheral blood by long distance RT-PCR; the product was further amplified in 4 segments in a second round PCR; and the PCR products were purified and directly sequenced. To confirm the mutations, the genomic DNA from peripheral blood cells of the patients was analyzed by direct sequencing after amplification of the ABCD1 genes by nested PCR, in which the product of the first round PCR covered the fragment starting from exon 6 and ending at 3′UTR of the ABCD1 gene. Results: The 3 Chinese patients with X-linked adrenoleukodystrophy had 3 different base substitutions(2235C>T,2065C>T and 2190A>T)in the ABCD1 genes of the 3 probands and their mothers, which resulted in 2 missense mutations (R617C and P560L) and one nonsense mutation (K602X). Conclusion: Nested PCR can rapidly and efficiently avoid the interference of ABCD1 pseudogenes in the molecular diagnosis of X-ALD.

Objective To investigate the relationship between insulin resistance and erythrocyte in- sulin receptors in patients with gout associated with macroalbruminuria(MAU).Methods FBG,PBG,FINS, P2hINS,CH,TG,HDL,LDL-c,UA and erythrocyte insulin receptors were determined in 44 patients with MAU,62 patients with normal MAU(NMAU).Results In MAU,the levels of FINS,TG,LDL-c and HOMA-IR were(16?4)mU/L,(2.5?0.6)retool/L,(3.2?0.5)mmol/L and 3.6~1.2 respectively.While they were(13?3) mU/L,(2.3?0.8)mmol/L,(3.0?0.5)mmol/L and 3.0~0.4 in NMAU group.The levels of FINS,TG,LDL-c and HOMA-IR were significantly higher in the MAU patients than those in NMAU patients(P

Objective To investigate the application of two-factor theory of nursing students to improve the quality of teaching.Methods for nursing students of 2009,through the application of two-factor theory,to take effective measures to meet the health factors,and use incentives to improve nursing students to learn initiative and enthusiasm,for the nursing students of 2008,using the traditional clinical teaching methods.Results The 2008 nursing students theory test scores for (83.94 ±8.21 )points,operation test scores for (81.28 ±6.54)points,zongping scores for (82.47 ± 6.89 )points; The 2009 nursing students theory test scores for (87.17 ± 5.13 )points,operation test scores for (85.24 ± 4.61 )points,zongping scores for (86.27 ± 7.14)points,two groups of comparisons were statistically significant differences(t =-3.72,-4.14,-3.97;P ＜0.05).Conclusions Thetwo-factor theory can improve nursing students to learn initiative and enthusiasms to improve the quality of teaching.

OBJECTIVETo study the protective effect of Naomaitong on inflammatory cascade response after focal cerebral ischemia reperfusion in aged rats.

METHODWe duplicated focal cerebral ischemia model with MCAO, with ischemia 3 h and I/R 1, 3, 6, 12 d points. The effect of Naomaitong on the nervous dysfunction score, the water content of cerebral constitution and the expression of TNF-alpha, VCAM-1, ICAM-1 and its mRNA were observed, and the group with nimodipine was as control.

RESULTThe nervous dysfunction score (I/R1, 3, 6 d), the water content of cerebral constitution (all the time points), the expression of TNF-alpha, VCAM-1 (I 3 h, I/R 1, 3, 6 d), ICAM-1 (I 3 h,I/R 1, 3, 6 d) and its Mrna (all the time points) in model group were higher than those of the sham-operated group; The nervous dysfunction score, the water content of cerebral constitution (I/R 3, 6, 12 d), the expression of TNF-alpha, VCAM-1 (I 3 h, I/R 1, 3 d), ICAM-1 and its mRNA (I 3 h, I/R 1, 3 d) in model group were decreased compared with that of model group. The nervous dysfunction score (I/R 6, 12 d), the expression of TNF-alpha, ICAM-1 (I/R 1d) and its mRNA (I/R 1, 3 d) in Naomaitong group were higher than that of Nimodipine group.

CONCLUSIONNaomaitong could protect brain cell from damage after focal cerebral ischemia reperfusion injury by inhibiting the expression of TNF-alpha, adhesion molecule.

Animals ; Brain ; metabolism ; pathology ; Brain Ischemia ; etiology ; metabolism ; pathology ; Drugs, Chinese Herbal ; isolation & purification ; pharmacology ; Infarction, Middle Cerebral Artery ; chemically induced ; Intercellular Adhesion Molecule-1 ; biosynthesis ; genetics ; Male ; Neuroprotective Agents ; isolation & purification ; pharmacology ; Plants, Medicinal ; chemistry ; RNA, Messenger ; biosynthesis ; genetics ; Rats ; Rats, Sprague-Dawley ; Reperfusion Injury ; etiology ; metabolism ; pathology ; Tumor Necrosis Factor-alpha ; metabolism ; Vascular Cell Adhesion Molecule-1 ; metabolism

Objectives To investigate changes in serum levels of adiponectin,leptin and erythrocyte membrane insulin receptor among patients with gestational diabetes (GDM),and to study their relation to insulin resistance.Methods Fasting plasma glucose (FPG),fasting serum insulin (FINS), serum levels of adiponeetin and leptin,indices of lipid metabolism,2 h plasma glucose during oral glucose tolerance test (2 h PG),2 h serum insulin during oral glucose tolerance test (2 h INS),as well as number of erythrocyte membrane insulin receptors with high and low appetency and its constants,were determined in 40 patients with GDM and 34 controls with normal glucose tolerance.Insulin resistance index (IRI) was calculated.Results ① Serum levels of leptin and adiponectin were (11.7?2.8) ?g/L and (7.8?1.6) ?g/L,respectively,and number of high appeteney erythrocyte membrane insulin receptor (R_1) and low appetency erythrocytemembrane insulin receptor (R_2) was (43?9) / red cell and (2297?525) / red cell,respectively.Serum level of leptin was significantly higher in those with GDM than those of normal controls (P

Objective To investigate the current conditions of water iodine,childrens'iodine nutrition and residents'edible circumstance of iodized salt in the villages with high iodine in drinking water and the adjacent three villages in Xiamen city of Fujian province.Methods Four natural villages of Qianbian,Donglian,Dazhong and Dongshan of Xiangan county were chosen as survey spots in 2008.In each village,one running water sample and all well water samples were collected to obtain the benchmark for each location.All children aged 7-13 year in the four villages underwent thyroid palpation and were selected to measure the urine iodine and the salt iodine.The water iodine and urine iodine were determined by As3+-Ce4+ catalytic spectrophotometry digestion,salt iodine was determined by direct titration.Results In four investigated villages,iodine of four running water samples were all 1.5μg/L.The range of 237 well water iodine samples was from 0.1 μg/L to 506.0 μg/L.There were 18.6% (44/237)specimens in which the well water iodine less than 10 μg/L,73.4%(174/237)between 10 μg/L and 150 μg/L and 8%(19/237)more than 150μg/L.The median of urinary iodine was 153.3 μg/L in 79 urine samples,which was 114%(9/79)more than 200μg/L and less than 300μg/L,12.7%(10/79)equal or more than 300 μg/L and less than 500μg/L,7.6%(6/79)equal or more than 500μg/L and less than 800 μg/L in all samples.Seventy-nine students were examined by palpation and the total goiter rate of children measured was 11.4% (9/79).Seventy-one samples of iodine salt were detected and the coverage rate of iodized salt was 77.5%(55/71).Conclusions The well water iodine contents have a wide distribution in the investigated villages.We should enhance the community awareness by educating them on the damage of iodine excess and iodine deficiency.

Background::Whether anesthetic depth affects postoperative outcomes remains controversial. This meta-analysis aimed to evaluate the effects of deep vs. light anesthesia on postoperative pain, cognitive function, recovery from anesthesia, complications, and mortality. Methods::PubMed, EMBASE, and Cochrane CENTRAL databases were searched until January 2022 for randomized controlled trials comparing deep and light anesthesia in adult surgical patients. The co-primary outcomes were postoperative pain and delirium (assessed using the confusion assessment method). We conducted a meta-analysis using a random-effects model. We assessed publication bias using the Begg’s rank correlation test and Egger’s linear regression. We evaluated the evidence using the trial sequential analysis and Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. We conducted subgroup analyses for pain scores at different postoperative time points and delirium according to cardiac or non-cardiac surgery.Results::A total of 26 trials with 10,743 patients were included. Deep anesthesia compared with light anesthesia (a mean difference in bispectral index of -12 to -11) was associated with lower pain scores at rest at 0 to 1 h postoperatively (weighted mean difference = -0.72, 95% confidence interval [CI] = -1.25 to -0.18, P= 0.009; moderate-quality evidence) and an increased incidence of postoperative delirium (24.95% vs. 15.92%; risk ratio = 1.57, 95% CI = 1.28-1.91, P < 0.0001; high-quality evidence). No publication bias was detected. For the exploratory secondary outcomes, deep anesthesia was associated with prolonged postoperative recovery, without affecting neurocognitive outcomes, major complications, or mortality. In the subgroup analyses, the deep anesthesia group had lower pain scores at rest and on movement during 24 h postoperatively, without statistically significant subgroup differences, and deep anesthesia was associated with an increased incidence of delirium after non-cardiac and cardiac surgeries, without statistically significant subgroup differences. Conclusions::Deep anesthesia reduced early postoperative pain but increased postoperative delirium. The current evidence does not support the use of deep anesthesia in clinical practice.

Objective To observe the effects of N-acetylcysteine(NAC)on aging in neonatal SD rat cardiomyocytes and explore related mechanisms.Methods Cultured eardiomyoeytes were randomized assigned to 6 groups:1-day,5-day,10一day,1-day+NAC(1 mmol/L),5-day+NAC(1 mmol/L)and 10-day+NAC(1 mmol/L).Flow eytometry was used to examine cell cycle.Real-time quantitative PCR and Western blot were used to determine mRNA and protein expression of p16INK4a,p21WAF1 and Rb gene.β-galactosidase staining kit was used to investigate β-galaetosidase activity.Results Numbers of cardiomyocytes resided in G0/G1 phase were significantly higher in the group of 5-day+NAC and 10-day+NAC compared with 5-day,10-day,respectively(P＜0.05).The mRNA and protein expression of p16INK4a and p21WAF1 were also significantly higher in the group of 5-day+NAC and 10-day+NAC compared with 5-day,10-day,respectively(P＜0.05 or P＜0.01).The mRNA and protein expression of Rb was significantly lower in the group of 5-day+NAC and 10-day+NAC compared with 5-day,10-day, respectively(P＜0.01).β-galactosidase activity was not affected by NAC in the 1-day+NAC group but was significantly higher in 5-day+NAC and 10-day+NAC groups compared with the 5-day,10-day groups(all P＜0.05).Conclusion NAC could promote aging through upregulating the expression of p16INK4a and p21 WAF1 and inhibiting Rb phosphorylation in neonatal SD rat cardiomyoeytes.

Objective: To assess the clinical application of percutaneous balloon aortic valvuloplasty (PBAV) in patients with calcified severe aortic stenosis (AS) combining heart failure (HF). Methods: A total of 15 relevant patients treated by PBAV in our hospital from 2014-12 to 2017-05 were studied. The baseline information, echocardiography parameters, peri-operative situation and follow-up condition were summarized. Results: All 15 AS patients were combined with severe HF including 3 with NYHA III and 12 with NYHA IV; 2 cases had cardiac shock. 6/15 patients received palliative PBAV for symptom relieving and 9 for bridging step (1 case pre-operative step for non-cardiogenic surgery). PBAV was successful in all patients; the average operative dilation was (2.60±1.3) times; 2 patients suffered from complete left bundle block at immediate post-operation, 1 had ventricular tachycardia during the operation and 1 had ischemic stroke 3 days after operation, no other complications occurred. Catheter measured immediate post-operative peak trans-valvular pressure gradient was decreased from (75.0±24.0) mmHg to (39.8±14.2) mmHg, P<0.01. Echocardiography showed that before discharge, the max flow velocity was reduced from (4.98±0.76) m/s to (4.20±0.75) m/s, P<0.01, max-PG reduced from(101.3±30.4) mmHg to (72.9.0±23.3) mmHg, P<0.01, mean-PG reduced from (62.4±19.0) mmHg to (44.9±15.1) mmHg, P<0.01;while left ventricular diastolic dimension and LVEF were similar at per- and post-operation, P>0.05. NT-proBNP was decreased from (13 889±12 303) pg/ml to (5 412±4 923) pg/ml, P<0.01. The average post-operative follow-up time was (3-27) months and the median NYHA grade improved from IV to II. Conclusion: Palliative and bridging PBAV was reliable and safe in severe AS-HF patients for short time, it had less complication and could be used as an optional treatment.

Objective To evaluate the preliminary experience and mid-term outcome of transcatheter aortic valve replacement(TAVR)in patients with calcifi ed severe aortic stenosis.Methods From December 2014 to February 2016, 10 TAVR cases were admitted in the Cardiovascular Hospital, Xiamen University. The baseline characteristics, echocardiography parameters and clinical follow-up data were analyzed. Results All cases were complicated with impaired heart function(NYHAⅢ in 4 cases, NYHA Ⅳ in 6 cases). The mean age was (75.1±6.2) years and 4(4/10) of them were men. The mean logistic EuroSCORE was (27.2±23.6) % and the mean society of thoracic surgery (STS) mortality score was (9.1±4.8) %. Five cases had bicuspid aortic valve. TAVR was successfully performed in all 10 patients, and valve-in-valve implantation was done in 1 (10%) case. Immediately after procedure, the peak trans-aortic valve pressure gradient decreases from (85.9±22.7) mmHg to (23.2±5.4) mmHg. One case had marginal moderate periprosthetic leak and one case received stent implantation for femoral artery complication during the procedure. During hospitalization, 1 case had blood transfusion for gastrointestinal bleeding and permanent pacemakers were implanted in 2 (2/10) cases. The survival rate was 10/10 at 30 days after TAVR. One case with end-stage renal disease died for gastrointestinal bleeding 36 days after TAVR. For the other 9 patients, 12 months echocardiography data showed that the peak and mean trans-aortic valve gradient was (20.0±5.2) mmHg and (10.6±3.1) mmHg respectively. The lef t ventricular diastolic diameter(LVDD)decreased[(56.5±9.4)mm vs.(51.8±7.6)mm,P=0.035] and left ventricular ejection fraction(LVEF)increased significantly[(46.9±22.2)% vs.(63.7±9.4)%, P=0.029].To date,median follow-up period was(22.0±4.8)month.Clinical symptoms improved in all the 9 cases. The patient with periprosthetic leak had record of hospitalization for several times due to heart failure. Conclusions From the initial TAVR experience of our hospital, TAVR can be done safely and smoothly after strictly TAVR candidate cases selection.