The effects of carbamates and soman on the metabolism of nicotinic acetylcholine receptors (N-AChR) in cultured skeletal muscle cells were studied by 125I-a-bungarotoxin (125I-a-BTX), a specific marker. It was indicated that N~AChR degradation process was inhibited and the incorperation rate of IshAChR and the number of N~AChR in the surface of the cell membrane were increased 4h after prertreatment of high concentrations of carbamates. The number of N-AChR was also increased after pre-treatment of low concentrations of soman, whose effects on N-AChR metabolism were similar to those of high concentrations of carbamates. The incorperation rate of N-AChR was observed by inhibiting the protein synthesis with puromysin, suggesting that soman may increase the number of N-AChR by increasing the incorperation of N-AChR instead of increasing the synthesis of N-AChR.

Objective To investigate the clinical effect of Edaravone on transient ischemic attack and serum superoxide dismutase and malondialdehyde levels in the elderly.Methods Ninety eight cases with transient ischemic attack treated in our hospital were chosen as the objects, which were randomly divided into observation group and control group (n=49 for each).Patients in observation group were treated with Edaravone combined with conventional therapy, and patients in control group were treated with conventional therapy.The clinical effect and levels of SOD and MDA were analyzed and compared between the two groups.Results The effective rate and total efficiency were higher in observation group than in control group (79.6％ vs.55.1％, 95.9％ vs.83.7％, x2 =6.914 and 4.354, P=0.008 and 0.032).The SOD level was higher and the MDA level was lower in observation group than in control group (both P＜0.001) after treatment.Conclusions Edaravone could improve the symptoms of transient ischemic attack in the elderly, and increase the activity of SOD and reduce MDA level, which is helpful to reduce lipid peroxides, alleviate free radical toxicity, and improve the anti-oxidation ability.

Objective To investigate the auditory sensory gating P50 in schizophrenia patients with homicide during three months of follow up. Methods Twenty-five patients with schizophrenia patients with homicide and 27 healthy adults matched with age and education level were recruited in the present study. P50 was recorded in twenty-seven normal controls and twenty-five schizophrenia patients at the baseline. P50 was repeatedly recorded in eleven patients who completed the follow-up at three months following antipsychotics treatment. The psychotic symptoms of patients were assessed with Positive and Negative Syndrome Scale (PANSS) at the same time. Results ①In comparison with normal controls, schizophrenia patients with homicide showed increased S2-P50 amplitude (P<0.01), increased S2/S1 ratio (P<0.01), decreased S1-S2(P<0.05), and 100(1-S2/S1) (P<0.01) at the baseline and after three months treatment. The differences in P50 amplitude, latency, and P50 suppression index between the baseline and after three-month treatment in schizophrenia patients with homicide were not significant (P>0.05). ② Schizophrenia patients with homicide after three-month treatment showed decreased PANSS total scale, positive scale, general psychopathology scale, and six symptoms scales such as lack of response, thought disorder, activation, paranoid, depression, and aggression (P<0.05). ③ No significant correlations were found between the S2/S1 ratio, S2-S1, and 100(1-S2/S1) with disease duration, PANSS scores, and six symptoms scales at either baseline or after three-month treatment (P>0.05). Conclusions Schizophrenia with homicide has sensory gating deficits and P50 suppression index might be a stable trait maker for schizophrenia with homicide.

Objective To evaluate the accuracy of non?invasive blood pressure monitoring in bilat?eral upper and lower extremities in lateral position in patients undergoing surgical procedures. Methods Forty patients of both sexes, aged 24-64 yr, BMI 20-27 kg∕m2 , of American Society of Anesthesiologists physical statusⅠ or Ⅱ, scheduled for elective neurosurgical procedures, were included in this study. Blood pressure of bilateral upper and lower extremities was monitored and recorded using appropriate cuffs. At 5 min after induction of anesthesia ( T0 ) , 10 min after the patients were turned to lateral position ( T1 ) , 30, 60 and 90 min after start of surgery ( T2-4 ) , and 10 min after the patients were turned to supine posi?tion ( T5 ) , non?invasive blood pressure was measured, and invasive blood pressure was recorded. Results Compared with the value measured on the healthy side, systolic blood pressure ( SBP ) and diastolic blood pressure (DBP) of upper extremities on the affected side were significantly decreased at T1-4, and SBP of lower extremities on the healthy side was significantly increased at T0-5 (P<0.05). SBP of upper extremities on the healthy side was increased by (23±9) mmHg when compared with that of upper extremi?ties on the affected side, and DBP increased by (23±8) mmHg. SBP of upper extremities was increased by (34±12) mmHg when compared with that of lower extremities on the healthy side in lateral position. Com?pared with SBP and DBP of lower extremities measured on the healthy side, no significant change was found in SBP and DBP of lower extremities on the affected side at T0-5 ( P>0.05) . There was no significant differ?ence between non?invasive SBP and invasive SBP of lower extremities on the healthy side, and between non?invasive DBP and invasive DBP of lower extremities on the healthy side (P>0.05). Conclusion For the patients undergoing surgical procedures, the blood pressure of upper extremities is higher on the healthy side than on the affected side when the patients are in lateral position, and there is no significant difference in the blood pressure between bilateral lower extremities; and there is no significant difference between non?invasive blood pressure and invasive blood pressure of lower extremities on the healthy side.

Objective To evaluate the correlation of visual acuity measured using two different types of eye chart in children with amblyopia.Methods 119 cases (213 eyes) amblyopia patients were selected,including 40 cases (80 eyes) of refractive amblyopia,41 cases (58 eyes) of anisometropia amblyopia,and 38 cases (75 eyes) of strabismus amblyopia were selected.Best corrected visual acuity (BCVA) were determined using standard visual chart and visual noise dual chart and the correlation between the two visual acuity result were explored using Spearman's correlation analysis.Results The visual acuity in refractive amblyopia,anisometropia amblyopia and strabismus amblyopia determined by standard visual chart was statistically correlated with that determined by visual noise dual visual acuity chart.Conclusions The visual acuity measured by standard vision chart showed satisfactory linear relationship with that measured by visual acuity chart double among three types of amblyopia,however,the strength of correlation coefficient between different types of amblyopia were different:correlation coefficient in anisometropic amblyopia was the highest,and the coefficient in refractive amblyopia was the lowest.

Objective To explore the effect of team resource management mode in reducing the door-to-needle time (DNT) of acute ischemic stroke. Methods A total of 272 acute ischemic stroke patients admitted to our hospital from January to December 2014 were set as the observation group. The observation group adopted the team resource management mode which was composed of emergency triage nurses, thrombolysis group nurses, emergency CT nurses, emergency intensive care nurses, interventional radiology nurses, cerebrovascular medicine nurses and rehabilitation medicine nurses. Another 264 acute ischemic stroke patients admitted to our hospital from January to December 2013 were named as the control group who was given traditional emergency treatment mode. The DNT, the activities of daily living and the nursing service satisfaction of patients were compared between the observation group and the control group. Results The DNT, Barthel index and the nursing service satisfaction of patients in the observation group were (44.93 ±11.47) min, 65.26 ±21.36, 93.39% (240/257), which were better than those of the control group, (111.99±11.10) min, 39.53±20.56, 80.41%(197/245), the differences were significant (t=115.516, 14.559, χ2=18.740, P < 0.01). Conclusions The team resource management mode is an effective tool to shorten the DNT, promote the recovery of patients and improve the quality of patients′life.

[ABSTRACT]OBJETIVETo analyze the reliability and safety of our simplified microsurgical techniques in head and neck reconstruction.METHODSA total of 3045 consecutive cases of free flap transferred in the head and neck region from May 1999 to May 2015 were reviewed. Data concerning the operation included the date of surgery, defect description and site, stage and histology of tumor, type of free flap, recipient vessel and complications.RESULTSOf the 3045 cases, 1856 were males, and 1189 were females. The age ranged from 5 to 86 years, with the average of 47.8 years. Among the 3045 cases, 2868 were tumor-related defects reconstructions, and 2653 were one stage reconstructions. The overall success rate of free flap was 98.5%. The vessel thrombosis rate was 2.9%, and the flap salvage rate was 48.9%.CONCLUSIONOur microsurgery technique greatly simplified traditional microsurgical technique. Head and neck reconstruction using this technique is very safe and reliable, and needs further clinical applications.

Specialization development of nursing has increasing demand for nursing staff. Competency model is a professional way for the person-post matching, which may replace the job analysis as a new research direction in nursing human resource management. In this paper, the validation and application of nursing competency model were reviewed from the perspectives of competency model, to discuss the thought and method of verifying competency model, so as to lay the foundation for the clinical application of nursing competency model, and promote the rapid development of nursing.

Objective To study the efficacy of tourniquet to block the distal of radial styloid on success rate of radial artery catheterization.Methods One hundred and forty ASA Ⅰ-Ⅲ patients, aged 22-88 years,undergoing general anesthesia and requiring radial artery catheterization were in-cluded in this study and were randomly allocated into touch positioning group (group A)or tourni-quet-assisted group (group B).Radial artery catheterization was conducted after induction of general anesthesia in two groups.The invasive systolic blood pressure (ISBP ), invasive diastolic blood pressure(IDBP)and HR of patients were recorded in group B at 1 min before ischemia (T1 ),using pressure pulse blocking after 1 min (T2 ),2 min (T3 ),5 min (T4 )and the complete release of tour-niquet after 1 min (T5 ),5 min (T6 )and 10 min (T7 ).The first and total success rate of radial artery puncture,puncture times,puncture duration and complications were recorded.Results The radial ar-tery diameter was not statistically significant in group B between before and after blocking radial artery .ISBP at T2-T4 in group B was significantly higher than that at T1 (P <0.05).The first time puncture success rate and overall success rate in group B was significantly higher than that of group A,The number of puncture in group B was significantly less than that of group A,and puncture time was significantly shorter in group A (P <0.05).Conclusion Tourniquet-assisted radial artery cathe-terization could improve success rate,decrease puncture times and shorten puncture duration.

To investigate the vasodilator effect and the endothelium-dependent mechanism of oroxylin A in thoracic aorta isolated from rats.