During percutaneous coronary intervention,thrombotic storm which is mediated by hypercoagulable state,mechanical distension induced-plaque rupture,platelet activation and adhesion is still the main cause of cardiovascular adverse events.The mortality rate is extremely high if not treated properly.Thrombotic storm can be diagnosed quickly through coronary artery angiography and myocardial blush grades.Once coronary thrombosis occurs,medicine including platelet Ⅱ b/Ⅲ a receptor antagonist tirofiban or vasodilators can rapidly improve coronary flow and effectively treat it.

Objective The effect of lead exposure on children is consistently associated with intellectual and other neurologic deficits.However the exact mechanism by which Pb~(2+) exerts toxic effects on developmental central nervous system remains unknown.Our group has found by gene-chip test that the expression of metabotropic glutamate receptor subtype 5 (mGluR5) mRNA was changed by lead exposure.The present study aimed to examine the effects of different level of lead exposure on the expression of mCluR5 in gestation and lactation.Methods Sprague-Dawley rats were exposed to lead acetate during gestation and lactation.Three concentrations of 0.05%,0.2%,and 0.5% lead acetate were applied and considered as low,middle and high exposure group respectively.The Pb levels of blood and hippocampus of pups were analyzed at weaning to evaluate the actual lead content at the end of the exposure.The impact of lead exposure on the expression of mGluR5 mRNA and protein in hippocampal tissue of pups was investigated by quantitative real-time polymerase chain reaction (PCR) and Western blot.The potential role of the expression of mGluR5 mRNA and protein in lead neurotoxicity were discussed.Results The levels of lead in blood and hippocampus from lead-exposed rats were significantly higher than those in the controls and positively related to the degree of lead exposure.The results of real-time PCR and Western blot showed that exposure to lead acetate decreased the expression of mCluR5 mRNA and protein with a dose-dependent manner.Conclusions Hippocampal mGluR5 might be involved in lead-induced neurotoxicity.

Objective To study prognosis and grading of somatosensory evoked potential(SEP)in long-term unconscious patients after severe traumatic brain injury(TBI).Methods Five prognostic factors including age,sex,injury mechanism,history of temporal craniotomy and SEP grading were selected and analyzed in 47 patients after severe TBI with a duration of unconsciousness longer than two weeks.The prognosis was judged by Glasgow Outcome Scale.Results Prognosis was closely associated with SEP grading(P=0.024).The accuracy of SEP in assessing the prognosis was 91.5%.About 95%-100% of patients with SEP at grade Ⅲ-Ⅲ ended up with severe disability,persistent vegetative state or death.However,43.75% of patients with SEP at grade Ⅰ had good prognoses.Conclusions The SEP grading can objectively and accurately evaluate patients' prognosis and demonstrate the brain function.

Objective:To compare the difference and correlation of HPLC and enzyme-multiplied immunoassay test( EMIT) for the determination of CsA in human whole blood. Methods:A total of 119 clinical samples at different concentrations of CsA were collected and respectively determined by HPLC and EMIT. The difference and correlation of the two determination methods were investigated. Results:There was significant difference in the blood concentrations of CsA determined by HPLC and EMIT(P<0. 05). CsA concen-tration determined by EMIT was 26. 2 ng·ml-1 higher than that determined by HPLC, and 95% CI was (14. 6-37. 7) ng·ml-1 . A satisfactory correlation was achieved between the two methods(r=0. 997 4). Conclusion:There is statistically significant difference in the CsA concentration in whole blood respectively determined by EMIT and HPLC. Attention should be paid to CsA monitoring by E-MIT and HPLC, and relevant adjustment should be carried out.

Objective To sum up effective measures to prevent complications of peripherally inserted central catheter (PICC) by applying evidence-based nursing in patients after PICC insertion.Methods From January 2011 to January 2013,1490 patients inserted with PICC in Hunan Provincial Tumor Hospital were selected by convenience sampling,whom were divided into control group (n =758) and observation group (n =732) with random number table.The control group received routine care,while the observation group received evidence-based nursing.Nursing program for the observation group was formed based on literature regarding the causes of and solutions for phlebitis,malposition of PICC,infection of insertion sites,and hemorrhage of insertion sites.Results The incidences of postoperative phlebitis,malposition of PICC,infection of insertion sites,and hemorrhage at insertion sites in the observation group were significantly lower than those in the control group (3.14％ vs.8.97％,P=0.023;4.23％ vs.11.74％,P=0.021;3.96％ vs.8.44％,P=0.001;4.92％vs.12.66％,P =0.011).Conclusions The application of evidence-based nursing in patients with PICC insertion could effectively reduce the complication,and improve the quality of clinical nursing care.

Objective To observe the protective effect of Vdvet-feeling on phlebitis in rabbit ears induced by Fluorouracil.Methods The models of Fluorouracil induced phlebitis in rabbit ears were established.24 rabbits were randomized into three groups:group A used Velvet-feeling for wet dressing,group B was the blank control group C was coated with Hirudoid.The vein was assessed before and after the intervention,and the changes in appearance of vein and the occurrence of phlebitis were observed.The samples of local vein and surrounding tissues were cut off 24 hours after intravenous injection of Fluorouracil and were made pathological sections,HE staining.The pathological damage degree of the vein and surrounding tissues were evaluated by light microscopy.Results The degree of phlebitis in group A and C were lower than group B,there was significant difference.There was significant difference between group A and C at the degree of phlebitis,especially in infiltration of inflammatory cells of vessel wall and perivascular edema.Conclusions Early application of the Velvet-feeling or Hirudoid coating were better in prevention of Fluorouracil induced phlebitis,and wet dressing of Velvet-feeling was better than Hirudoid coating.

BACKGROUND:In recent years, animal models of lumbar disc degeneration have been popularized to explore the effect of tissue engineering, cel engineering and genetic engineering technologies on intervertebral disc degeneration.
OBJECTIVE: To investigate the influence of biological patches on rabbit anulus fibrosus repair.
METHODS:L3-4, L4-5, L5-6 segments from rabbits were randomly divided into normal control group (the intervertebral disc was exposed correspondingly), control group (the annulus fibrosus was only cut with a surgical scalpel) and experimental group (the annulus fibrosus was cut and sutured with the surgical biomaterial). Six rabbits were selected randomly to take the lumbar X-ray and MRI preoperatively and 1, 2, 4, 8, 12 weeks postoperatively; one rabbit was chosen preoperatively and three rabbits selected respectively at 1, 2, 4, 8, 12 weeks postoperatively to execute hematoxylin-eosin and type II colagen immunohistochemistry.
RESULTS AND CONCLUSION:At postoperative 1, 2 and 4 weeks, the disc height index decreased significantly in the control and experimental groups. MRI and histopathological examination showed that the T2WI signal intensity and hematoxylin-eosin grading were both increased significantly in the control and experimental groups at 2 weeks after surgery (P < 0.05). With time, the number of nucleus pulposus cels gradualy reduced in the control and experimental groups. Annulus fibrosus defects were filed with granulation and fibrous tissues, and the biofilm was tightly fused with the annulus fibrosus. Findings from the type II colagen immunohistochemical staining showed that the histological staining of the nucleus pulposus was gradualy changed from positive to negative in the experimental and control groups. Therefore, cutting the annulus fibrosus can lead to severe disc degeneration at early period, and surgical biomaterials can be integrated with the annulus fibrosus wel to seal annulus fibrosus defects and further prevent nucleus pulposus protrusion. However, this approach cannot restrain the continuous process of disc degeneration.

Objective To understand the available preventive strategies of unplanned endotracheal extubation (UEX) among adult patients.Methods Twelve nurses were in-depth interviewed and data were processed and analyzed using categorization analysis method.Results Major themes were identified as follows:the incidence rate of UEX,tube fixation,efficacious physical restraint,appropriate sedation and training for younger nurses.Conclusions Nursing leaders should further standardize nursing process related to prevention of UEX,strengthen training for nurses,choose appropriate fixation method for patients and promote physical restraint and sedation care to prevent UEX and improve patient clinical outcomes.

OBJECTIVE:To study the effects of arsenic trioxide(As 2 O 3 )on the encoding protein expressions of nm23and P53in gastric cancer cells and to study the anti-canecer mechanism of which in the tumor.METHODS:A control group and a test group were set up.The expressions of gene coding proteinum nm23and P53of the gastric cancer cells cultured in vitro by the action of As 2 O 3 were determined by immunohistochemistry method.RESULTS:The expression levels of nm23and P53in gastric cancer cells have been lowered compared with the control group.CONCLUSION:As 2 O 3 can exert its anti-tumor effect by decreasing the expression of gene coding proteinum of nm23and P53.

Objective To evaluate the effects of pulsed radiofrequency (PRF) application to dorsal root ganglia on the expression of interferon regulatory factor 8 (IRF8) in the spinal cord and brain-derived neurotrophic factor (BDNF) protein in the nucleus accumbens of rats with neuropathic pain (NP).Methods Forty healthy pathogen-free male Wistar rats,weighing 180-200 g,aged 2 months,were divided into 4 groups (n=10 each) using a random number table:sham operation group (group Sham),group NP,sham PRF group (group SPRF) and PRF group.NP was induced by chronic constriction injury (CCI) to the left sciatic nerve of anesthetized rats.The mechanical paw withdrawal threshold (MWT) was measured before CCI and at 3,7,10,14,21,28,35 and 42 days after CCI.Sucrose preference test and forced-swim test were performed at 42 days after CCI for determination of the expression of IRF8 in the spinal cord and BDNF in the nucleus accumbens by Western blot.Results Compared with group Sham,the MWT at each time point after CCI and rate of preference for sucrose were significantly decreased,the duration of immobility in forced-swim test was prolonged,and the expression of IRF8 and BDNF was up-regulated in NP,SPRF and PRF groups (P＜0.05).Compared with group NP,the MWT at 10-42 days after CCI and rate of preference for sucrose were significantly increased,the duration of immobility in forced-swim test was shortened,and the expression of IRF8 and BDNF was down-regulated in group PRF (P＜0.05),and no significant changes were found in the parameters mentioned above in group SPRF (P＞O.05).Conclusion The mechanism by which PRF application to dorsal root ganglia alleviates NP and depressive-like behaviors is probably related to down-regulation of the expression of IRF8 in the spinal cord and BDNF in the nucleus accumbens of rats.