Objective To investigate the effect of hydromorphone postconditioning on ischemiareperfusion (I/R) injury in isolated rat hearts and the role of mitochondial permeability transition pore (mPTP).Methods Male Sprague-Dawley rats, aged 2-3 months, weighing 250-320 g, were used in the study.The rats were heparinized and anesthetized with intraperitoneal 10％ chloral hydrate 350 mg/kg.The hearts were excised, and perfused in a Langendorff apparatus with K-H solution saturated with 95％ O2-5％ CO2 at 36.5-37.5 ℃.Forty isolated rat hearts were randomly divided into 4 groups (n=10 each)using a random number table: control group (group C), group I/R, hydromorphone postconditioning group (group H), and hydromorphone postconditioning + mPTP opener lonidamine group (group HL).Group C was continuously perfused with K-H solution for 120 min.Group I/R was perfused with K-H solution for 30 min, the perfusion was then suspended for 30 min, and group I/R was perfused with K-H solution for another 30 min.Group H was perfused with K-H solution for 30 min, the perfusion was then suspended for 30 min, and group H was perfused with K-H solution containing 0.3 μmol/L hydromorphone for 10 min, and then with K-H solution for 50 min.Group HL was perfused with K-H solution for 30 min, the perfusion was then suspended for 30 min, and group HL was perfused with K-H solution containing 0.3 μmol/L hydromorphone and 30 μmol/L lonidamine for 10 min, and then with K-H solution for 50 min.At 30 min of equilibration (T0), and 30 and 60 min of reperfusion (T2,3), left ventricular systolic pressure (LVSP), left ventricular end-diastolic pressure (LVEDP), left ventricular developed pressure (LVDP) , ±dp/dtmax, heart rate (HR), and coronary flow (CF) were measured.The concentrations of lactic dehydrogenase (LDH), creatine kinase-MB (CK-MB) , and troponin-T (Tn-T) in the coronary effluent were determined at T0 and T3.The coronary effluent was collected at T0 and 15 min of reperfusion (T1),nicotinamide-adenine dinucleotide (NAD+) concentrations were measured using enzyme-linked immunosorbent assay to reflect the degree of mPTP opening.The myocardial infarct size was determined at T3 by TTC staining.Results Compared with group C, LVDP, HR, ±dp/dtmax and CF were significantly decreased, and LVEDP was increased at T2,3, and the concentrations of LDH, CK-MB and Tn-T in the coronary effluent, myocardial infarct size at T3, and NAD+ concentrations in the coronary effluent at T1 were increased in group I/R (P＜0.05).Compared with I/R and HL groups, LVDP, ±dp/dt CF and HR were significantly increased, and LVEDP was decreased at T2,3, and the concentrations of LDH, CK-MB and Tn-T in the coronary effluent, myocardial infarct size at T3, and NAD+ concentrations in the coronary effluent at T1 were decreased in group H (P＜0.05).Conclusion Hydromorphone postconditioning can reduce myocardial I/R injury in isolated rat hearts, and the mechanism is related to inhibition of mPTP opening.

Objective This paper studies on feasibility of low dose CT scanning in lung cancer patients simulated localisation.Methods 62 patients cases of lung cancer are selected.Scan parameter:scan twice by 20/100 mA,the other parameter remain unchanged as voltage of 120 kV,thickness of 5 mm,pitch of 1:1 and scan time of 1 s.After scan,picture quality was evaluated according to excellent,good,bad under different condition.Volume of target was determined by treatment planning system.Data such as dose index value of single helical scan,z-axis scan range,dose length product value and etc.are recorded in order to evaluate radiation dose of patients.Picture quality and the difference of radiation dose were statistically analyzed using Fisher's and pair t-test.Results Picture quality of low dose scanning was a little bit lower than that of normal dose,however,picture quality difference of difference dose scanning was statistically meaningless (number of patients according to excellent,good,bad were 46,13,3 and 50,11,1,P =0.541).There is no obvious difference of target volume under different dose scanning in the same (36.78 cm3,40.35 cm3,t =2.57,P =0.189).Radiation dose of low dose scanning group is far less than that of high dose scanning group and the difference is obvious (133.05 mGy,941.25 mGy,t =-41.24,P =0.000).Conclusions Low dose scanning of 20 mA current during CT simulated localisation tremendously reduces harm that may happen to patients during CT scan,while tumor target delineation and scanned picture quality is guaranteed.

Objective:To investigate the impact of humanistic spirit cultivation on nursing students' ethics cog-nition. Method:Total 364 internship nursing students in 2010 were taken as the control group with the routine clini-cal teaching method, 381 in 2014 as the experimental group, not only a routine clinical teaching method but also to increase of their humanistic spirit culture. Results:Humanity spirit cultivation before and after practice nursing students in medical security system cognition difference is not significant, but in medical optimization, the patients right of informed consent, the life value differences of cognitive and ethical cognitive dimension score was statisti-cally significant ( P<0 . 05 ) . Conclusions:Humanistic spirit culture promote the practice of nursing students to raise the level of moral cognition foundation for humanity quality education and nursing ethics education, should further strengthen the diversification of internship training nursing students humanistic spirit.

Objective To investigate the recent curative effect and adverse reactions of radiotherapy combined with temozolomide in non-small cell lung cancer (NSCLC) patients with brain metastases.MethodsThe clinical date of 51 NSCLC patients with brain metastases were retrospective analyzed in Department of Radiation Oncology of Affiliated Hospital of Hebei University.Patients were divided into experimental group (n=26) and control group (n=25) according to the different treatment methods.The experimental group underwent whole brain and local tumor radiotherapy plus temozolomide.The control group only received whole brain and local tumor radiotherapy.The recent curative effect and adverse reactions of the two groups were analyzed.Results The Karnofsky performance status score of patients in the experimental group was obviously improved than that in the control group (76.2±6.4 vs.72.8±5.3), with a significant difference (t=2.06, P=0.04).The total effective rate in the experimental group was higher than that in the control group (80.8% vs.64.0%), but there was no statistically significant difference (χ2=1.80, P=0.18).Compared with the control group, the incidences of nausea and vomiting (80.8% vs.28.0%) and bone marrow suppression (84.6% vs.24.0%) in the experimental group were significantly higher, with significant differences (χ2=14.33, P=0.00;χ2=18.91, P=0.00).There were similar incidences of headache (69.2% vs.60.1%), liver and kidney damage (73.1% vs.64.0%) in the two groups, with no significant differences (χ2=0.47, P=0.49;χ2=0.47, P=0.49).Conclusion Radiotherapy combined with temozolomide can improve the quality of life in NSCLC patients with brain metastases, which has controllable and tolerable adverse reactions.

Objective To explore the effect of temozolomide on apoptosis and molecular mechanism in small cell lung cancer (SCLC) cell H446. Methods The effect of temozolomide on the viability of H446 cell was measured by MTT assay.The effect of temozolomide on cell cycle was detected by flow cytometry.The activation of phosphatidyl inositol 3-kinase (PI3K)/AKT signaling pathway and expression level of downstream target genes (Cyclin B1), cell division cycle 2 (Cdc2), Bax, Bcl-2 and Survivin were detected by western blot.Results Temozolomide (50, 100, 200 μmol/L) could inhibit H446 cell viability, and the inhibitory rate was highest at 48 h.Moreover, temozolomide made H446 cell cycle arrested in G2 phase.Western blott showed the expression of PI3K, Cyclin B1, Cdc2, Bcl-2, Survivin and the phosphorylation of AKT were reduced, but the expression of Bax were increased by temozolomide.Conclusion Temozolomide could induce SCLC cell H446 apoptosis via blocking PI3K/AKT signal pathway.

Objective To explore the effects of silencing H2AX gene on esophageal cancer ECA109 cell xenograft growth and sensitivity to radiotherapy in nude mice.Methods BALB/c nude mice models were established by subcutaneously inoculating differently treated ECA109 cells into nude mice.By random number table method 60 nude mice were divided into six groups,including blank group,irradiation group,negative group,negative with irradiation group,silence group and silence with irradiation group.The nude mice were irradiated with 15 Gy of 6 MV X-rays 21 d after inoculation.After irradiation 48 h,half of each mice group was terminated.The tumor specimens were processed by Western blot,RT-PCR and flow cytometry were used to detect the change in protein levels,RNA levels,and cell cycle.Results The tumor volume was (42.76 ±4.40) mm3 in silence group,significantly smaller than that of the blank group (73.18±8.80) mm3 and the negative group(71.27 ±8.40) mm3(F=67.8,P＜0.01).H2AX protein expression level in the silence group was also significantly lower (0.12 ±0.03 vs.1.12 ±0.11,1.16 ± 0.08,F =34.27,P ＜ 0.01).Relative H2AX mRNA expression level in the silence group was (0.85 ± 0.31),significantly lower than that of the blank group (1.86 ± 0.26) and the negative group (1.82 ±0.24,F =39.45,P ＜ 0.01).Co-immunoprecipitation assay showed that γ-H2AX and MDC1,53BP1 obvious interaction after irradiation,which would be weakened through silencing H2AX.The tumor volumes at different groups had significant difference after irradiation (F =13.56,P ＜ 0.01).The apoptosis rate in the silence group was significantly higher than that of the blank group and the negative group [(24.15±2.25) ％ vs.(13.26±1.54) ％,(12.78±1.47) ％ (F=54.33,P＜0.01)].G2/M phase arrested in the silence with irradiation group lower than that of the radiation group (F =10.21,P ＜ 0.01).Conclusions Silencing H2AX gene expression could inhibit the growth of esophageal cancer ECA109 cell xenograft and increase the radiosensitivity of tumor.

Objective We aimed to investigate the nurses' ethics cognition status and its influencing factors after carrying out the High quality nursing service demonstration project in Guangxi Zhuang Autonomous Region.Methods From May to June 2014,379 clinical nurses from 59 hospitals of different grades in Guangxi Zhuang Autonomous Region were investigated with the self-designed questionnaire.Results After carrying out the High quality nursing service demonstration project,the total score of the nurses' ethics cognition were (51.29±3.46),which was higher than those in 2010.There was no statistical difference in cognition of medical confidentiality between 2014 and 2010,but it showed significant statistical differences in dimensions of medical optimization,informed consent,the value of life,t value was 11.389,7.448 and 2.126,P ＜0.05.The multiple linear regression analysis showed that nurse-job seniority and hospital hierarchy of clinical nurses were influencing factors of nurses' ethics cognition; educational levels,professional title and nurse-job seniority of clinical nurses were influencing factors of medical optimization; nurses' professional title was influencing factor of informed consent; nurse-job seniority,department and hospital hierarchy of clinical nurses were influencing factors of medical confidentiality; nurses' educational level was influencing factor of life value.Conclusions The High quality nursing service demonstration project contributes to improve the level of nurses' ethics cognition.We should strengthen the nursing ethics continuing education system,in order to improve the nurses' comprehensive ethics cognition.

Objective To find a model of long-term postoperative cognitive dysfunction by hav-ing a splenectomy operation or cardiopulmonary bypass.Methods Sixty Sprague-Dawley rats,aged 18 months,were randomly divided into 3 groups (n =20):splenectomy group (group A),cardiopul-monary bypass group (group B)and control group (group C).From 31 st to 35 th days after the opera-tion,the learning and memory capability of rats were observed through the Morris water maze,the Shuttle box text and Open field test.Results Compared with group C,the frequency of crossing the original platform [(5.2±2.2)times vs.(8.6±3.2)times],the times of initiative avoiding were sig-nificantly reduced [(12.3±2.7)times vs.(1 5.2±1.8)times],the latency of the initiative avoiding was significantly prolonged [(9.50±2.31 )s vs.(5.14 ± 1.43 )s],the number of standing on the back legs [(6.8±1.5)times vs.(10.2±1.7)times]and rearing were significantly reduced [(13.8± 2.6)times vs.(1 9.5±2.2)times],and the time that animals spent in the central square [(7.78 ± 1.5 1)s vs.(5.34±0.72)s]and escape latency were significantly prolonged in group B (P <0.05). Compared with group A,the time that animals spent in the central square in group B was significantly prolonged [(7.78±1.5 1)s vs.(6.06 ±1.67)s,P <0.05].Conclusion The model by having car-diopulmonary bypass operation is an ideal model of postoperative cognitive dysfunction after cardio-vascular anesthesia,for the learning and memory capability is remarkably changed.

Objective To compare the efficiency of National Early Warning Score (NEWS),Chronic Respiratory Early Warning Score(CREWS) and BAP-65(elevated Blood urea nitrogen,Altered mental status,Pulse＞109bpm,age＞65 years)among patients with AECOPD (acute exacerbations of chronic obstructive pulmonary disease).Methods Totally 181 patients with AECOPD were investigated by these three scales,and the efficiency of NEWS,CREWS and BAP-65 was compared.Results The scores of NEWS,CREWS and BAP-65 in the death group were higher than those in the survival group and the general ward group(P＜0.01).Regarding the predicted results of hospital death,the area under the ROC curve of NEWS,CREWS and BAP-65 was 0.878,0.836 and 0.774,respectively,and the differences were not statistically significant(P＞0.05);for predicted results of ICU admission,the area under the ROC curve of NEWS,CREWS and BAP-65 was 0.826,0.813 and 0.716,respectively,and the differences were not statistically significant (P＞0.05).Conclusion NEWS,CREWS and BAP-65 have satisfied predictive efficiency for prognosis,and NEWS and CREWS are much easier and faster to use.

Objective To assess the sensitivity and specificity of vaginitis pathogen detection reagent kit (Nucleic acid hybridization). Methods Four hundreds cases of vaginal secretion samples were detected with Amsel, vaginalis culture, fungal culture and Affirm VPIII detection method, respectively. Using the methods of Amsel, vaginalis culture and fungal culture as the gold standard, the clinical application value of Affirm VPIII detection method was evaluated. Results Compared with Amsel, the sensitivity and specificity of Affirm VPIII detection was 92.2%and 70.5%, respectively. Compared with fungal culture, the sensitivity and specificity was 88.3% and 92.9%, respectively. Compared with vaginalis culture, the sensitivity and specificity was 92.6% and 93.8%, respectively. There was a good consistency between the gold stardard and the Affirm VPIII detection. Conclusion Compared with the traditional detection methods,the Affirm VPIII detection has the advantages of fast detection speed,simple operation, and high sensitivity and specificity. In addition, it can identify three kinds of vaginitis pathogenic microorganisms at the same time,with a certain clinical value.