Objective:To investigate the application of The Problem based learning (PBL) method on teaching and researching of cardiovascular disease.Methods: Based on the characteristic of high mortality and arteriosclerosis morbidity of cardiovascular disease and typical cases reported by media repeatedly, the problems were proposed by the students, and further promote the students to think over independently and further investigate. Then the students developed a hypothesis, demonstrated it and got a conclusion.Results: PBL teaching mode can promote the learning motivation of students; improve the ability to solve problems and creativity of the students.Conclusion: In the process of The PBL teaching and training for students, it can improve the innovation ability, solving problem ability, and independent thinking ability of the students. It can lay a solid foundation for the clinical research work of students in the future.

Objective:To observe the additional effects of Xin Qing-ning Tablets,a representative herb with the effect of activating blood circulation and detoxication(ABCD) consisting of rhubarb extractives,on the serum in ammatory markers and blood lipids in stable coronary heart disease(CHD) patients receiving standardized statins treatment.Methods:Thirty stable CHD patients were randomized to three groups(10 in each group):the control group treated with standardized statins;the ABC and ABCD group,treated with Dan Qi Tablets or Xin Qing-ning Tablets respectively in addition to standardized statins treatment.After one month treatment,the concentrations of high-sensitivity C reaction protein(hs-CRP),Tumor necrosis factor-?(TNF-?) in serum,blood lipid and blood-stasis syndrome score(BSSS) of CHD patients before and after treatment were determined.Results:The ABCD group showed superior e ects in reducing the concentration of hs-CRP in serum[a di erence of(6.83?4.99)mg/L]as compared with the control group(1.90?2.15)mg/L and the ABC group(1.49?1.48)mg/L(P

Objective To study the cooperative method of goat's cruciate ligament reconstruction by bone-tendon autograft with interference fixation. Methods A customized reamer was used to make the bottleneck-like femoral tunnel, and the patellar tendon-tibial tuberosity autograft was harvested. Make sufficient preparation for this operation. Results The operation was successful, the laboratory animals all survived without any postoperative infection. Conclusion Scientific and careful operative-cooperation can guarantee the successful operation.

Background Clinical work found that triamcinolone acetonide (TA)bleeding during vitrectomy in proliferative diabetic retinopathy (PDR),but its mechanism is not clear.Objective This study was to explore the anastalsis of TA in vitrectomy for PDR.Methods A prospective study was performed.Twelve eyes of 12 patients who received vitrectomy combined with the intraocular use of TA for PDR were in cluded in Tianjin Medical University General Hospital from 2011 to 2014 and served as TA group.Thirty-two eyes of 32 patients who underwent vitrectomy for epimacular membrane or macular hole were enrolled as control group.The vitreous specimens of 0.6 ～0.8 ml was collected during the surgery.The concentrations of urokinase plasminogen activator (u-PA),tissue plasminogen activator (t-PA) and plasminogen activator inhibitors 1 (PAI-1) in vatreous were measured by ELISA.Results The mean contents u-PA,t-PA and PAI-1 in the vatreous were 25.45,127.44 and 0.42 ng/ml respectively in the TA group,and those the mean contents in the control group were 22.94,142.37 and 0.27 ng/ml respectively,shouwing a significant difference between the TA group and the control group (Z=-2.268,P＜0.05).NO significant difference was found in vitreous t-PA and PAI-1 between TA and control groups (Z =-0.092,-1.847,both at P＞0.05).Conclusions Vitreous u-PA content is increased in PDR eyes,which is more likely to lead bleeding.Anastalsis of TA during vitrectomy for PDR may be relatived to decreasing vitreous t-PA and u-PA contents as well as increasing PAI-1 contents.

Linalool is an important monoterpene, and widely used in food, pharmaceutical and cosmetic industry. The low concentration in plants and the difficulties in extraction restrict its large scale production. Saccharomyces cerevisiae can provide the monoterpene precursor, geranyl diphosphate (GPP) through its endogenous isoprenoid pathway. Therefore, it could be used as the host for monoterpene production. However, the weak metabolic flux through the isoprenoid pathway leads to the insufficient supply of GPP, and results in low monoterpene productivity. In order to increase the metabolic flux, we constructed the integrated expression plasmid pRS305-tHMG1 and free expression plasmid pYLIS-IDI1 to enhance the expression levels of isopentenyl diphosphate isomerase (IDI1) and a truncated 3-hydroxyl-3-methylglutaryl-CoA reductase gene (tHMG1). The two plasmids were separately transformed into S. cerevisiae CEN.PK2-1C, resulting in strains LS01 and LS02. The plasmid pYLIS-IDI1 was further transformed into strain LS01, resulting in strain LS03. GC-MS analysis showed that the linalool concentration was increased by 1.3 times and reached (127.71 +/- 7.68) microg/L. In conclusion, enhancement of the supply of GPP precursors through the regulation of isoprenoid pathway could increase the linalool production in S. cerevisiae.
Biosynthetic Pathways ; genetics ; Butadienes ; metabolism ; Hemiterpenes ; metabolism ; Monoterpenes ; metabolism ; Pentanes ; metabolism ; Saccharomyces cerevisiae ; genetics ; metabolism

Objective:To develop nursing quality evaluation indicator system for perioperative patients with Da Vinci robotic under enhanced recovery after surgery(ERAS), in order to provide references for clinical evaluation of nursing quality for lobectomy patients.Methods:Based on the theory of structure-process-outcome quality model and ERAS, literature review, semi-structured interviews were adopted to determine nursing quality indicator system for perioperative patients. Delphi method was used in two rounds of consultation among 21 experts.Results:The positive coefficient was 100%, authority coefficient was 0.839,0.901, and the coefficients of concordance were 0.317,0.335. The final indicator system consisted of 3 first-level indicators, 14 second-level indicators, and 52 third-level indicators.Conclusion:The nursing quality evaluation indicator system for lobectomy patients with Da Vinci robotic was scientific and reliable, which can provide scientific references for evaluating nursing quality for perioperative patients with Da Vinci robotic under ERAS.

Objective:To construct nursing-sensitive indicators system of perioperative pulmonary rehabilitation for patients in thoracicsurgery, so as to provide scientific monitoring standards for nursing quality of pulmonary rehabilitation.Methods:Based on the theory of enhanced recovery after surgery (ERAS) , evidence synthesis was conducted based on Johns Hopkins evidence-based nursing method for laying the foundation for nursing-sensitive quality indicators system of perioperative pulmonary rehabilitation.Based on the analysis results of the quality of nursing in the past two years, and though group discussion, appropriate indicators feasible to application were determined, and nursing-sensitive quality indicators, calculation formulas were preliminarily decided. Through two rounds of experts consultation, the nursing-sensitive quality indicators system of pulmonary rehabilitation was improved and established.Results:After two rounds of expert consultations, the constructed nursing-sensitive quality indicators system of pulmonary rehabilitation included 3 first-class indicators, 6 second-class indicators, and 31 third-class indicators. Positive coefficients of two rounds of expert consultation were both 100%, authority coefficients were 0.827 and 0.861, respectively, and the coordination coefficients were 0.309 and 0.372.Conclusion:The nursing-sensitive quality indicators system was scientific and practical and it was beneficial to regulate the behavior of nurses and improve the nursing quality of pulmonary rehabilitation.

OBJECTIVETransesophageal echocardiography was performed during closed-chest cardiopulmonary resuscitation (CPR) in in-hospital cardiac arrest to further explore the hemodynamic mechanism of CPR.

METHODSCPR attempts were performed according to advanced cardiovascular life support guidelines in 6 cases of in-hospital cardiac arrest. Multi-plane transesophageal echocardiography was carried out within 15 min of initiation of CPR. Throughout CPR, the motion of the mitral, tricuspid and aortic valves, the changes in the left ventricular cavity size and the thoracic aortic diameter were observed. Trans-mitral and trans-aortic Doppler files of blood flow were also documented.

RESULTSA closure of the mitral and tricuspid valves with simultaneous opening of the aortic valve occurred exclusively during chest compression, resulting in forward blood flow in the pulmonary and systemic circulation. Peak forward aortic flow at a velocity of 58.8 +/- 11.6 cm/s was recorded during the compression phase. Whereas, a closure of the aortic valve and rapid opening of the atrioventricular valves associated with ventricular filling during relaxation of chest compression was noted in all 6 patients. Peak forward mitral flow at a velocity of 60.6 +/- 20.0 cm/s was recorded during the release phase. Mitral regurgitation during the chest compression period was detected in 5 patients, reflecting a positive ventricular-to-atrial pressure gradient. A reduction in the left ventricular chamber and an increase in the thoracic aortic diameter during the compression phase was found in all patients, indicating that direct cardiac compression contributed to forward blood flow.

CONCLUSIONThese observations favor the cardiac pump theory as the predominant hemodynamic mechanism of forward blood flow during CPR in human beings.

Aged ; Aged, 80 and over ; Cardiopulmonary Resuscitation ; Echocardiography, Transesophageal ; Female ; Heart Arrest ; diagnostic imaging ; physiopathology ; therapy ; Hemodynamics ; Humans ; Male ; Middle Aged

Autophagy is an important mechanism to maintain cellular function and metabolism,whereas ab-normal autophagy can cause the advent and worsening of various diseases.N6-Methyladenosine(m6A)RNA methylation is a reversible RNA modification,which is regulated by m6A methyltransferase,m6A demethylase and m6A-binding protein.Studies have shown that autophagy-related genes promote or attenuate autophagy level dependent on the regulation of m6A,and then participate in the process of diseases.This paper reviews the progress of m6A modification regulatory enzymes and their binding proteins in regulating cell autophagy to provide reference for future researches.

Objective:To predict the possible targets and signaling pathways of Jiangtang Xiaoke Granules in the treatment of diabetes mellitus (DM) using computer network pharmacology and molecular docking technology.Methods:The active components and targets of Jiangtang Xiaoke Granules were collected by ETCM; the targets of DM were searched from the databases of DisGeNET and GeneCards, and the intersections of the two were taken to draw a Venny diagram; String database was used for gene transformation and network interaction analysis; the network diagram was constructed with Cytoscape3.6.0; the predicted results were supported by molecular docking technology; GO and KEGG analysis was performed through Metascape database.Results:A total of 128 active components of Jiangtang Xiaoke Granules were screened, with 607 corresponding targets, 1 240 DM related targets, and 53 core targets. Molecular docking showed that the active components had good binding energy with the core targets. GO analysis yielded 46 functional items and KEGG analysis yielded 15 pathways.Conclusion:Jiangtang Xiaoke Granules regulate glucose homeostasis by participating in a variety of biological processes through multiple components, and multiple targets, including affecting lipids and atherosclerosis, Alzheimer disease, AMPK signaling pathway, Apelin signaling pathway, and glucagon signaling pathway.