Objective 1.To explore the role of environmental factors in the development and maintenance of hypertension . 2. To establish a hypertensive model without surgical or phar macologic intervention. 　Methods One hundreds male, 2-3-month-old Wistar rats were rand omly divided i nto 4 groups: 1. Cold-treated group(C, n=28): animals were exposed to cold (4±2)℃ for 4 hours per day for 8 weeks; 2. High salt-treated group (S, n=28): animals were given 8% NaCl di ets for 8 weeks. 3. Cold combined high salt-treated group (CS, n=28). Animals were given 8% N aCl diets for 8 weeks besides cold exposure. 4. Control group (N, n=16). Systolic blood pressur e(SBP, Tail-cuff technique) and heart rate were measured weekly in 4 groups throughout the experi ment. The thoracic aortas were extracted for morphologic studies. 　Results On the end of the first week, the average SBP and heart r ate of C, S, and CS group were sighificantly increased (P<0.01) than that of the N group. Blood pressure reached a maximal level by 3 weeks in C, S, and CS group (127.0±6.0, 125.9±5.5, 131±6.0)mmHg, respect ively, SBP remained significantly elevated for the remaining of the experiment. 　Conclusion Cold circumstance and high-salt intake play an impo rtant role in the development of hypertension. This model appears to be a successful model for the induction of hypertension in rats without surgical intervention or excessive doses of hormones.

Objective To investigate the stroke caused by a combination of genetic and environmental factors Though epidemiological studies have provided evidence of genetic influence on the occurrence of human stroke,however,the role of environmental risk factors to the development of stroke is still not well known. Methods Using cold stimuli plus high salt intake as environmental risk factors, we established a hypertension model in rats, for producing a complicated stroke, then, applied a new technique, suppression subtractive hybridization(SSH),to identify the differential genes which were specifically expressed in total rat cerebrum tissues in between two populations, namely the control and the stroke groups. Results Using this SSH approach, totally 288 clones were generated in our study from a subtractive libraries, among them,226 clones were usable and analyzed The average length of this group is (286 6?120 3) bp Among those clones, 126 clones represented sequences with significant identity to the known genes, 78 were matched to existing ESTs in dbEST but not to any known gene sequences, and the remaining 22 were novel transcripts exhibiting no similarity to any known sequences Mitochondrial transcripts were observed at a high rate of 26 5% Mitochondrial genes may play important roles in causes and effects of stroke. Conclusions Our investigation suggests that environmental risk factors may induce an increased sensitivity to stroke through genetic influence Also we will identify the genes responsible for stroke in this rat model

Objective To evaluate the clinical effectiveness of video electroencephalogram (VEEG) in neonatal seizure. Methods Seizures attacks of 64 newborns with gestational ages 28-44 weeks were monitored by VEEG. Results Incidence of abnormal VEEG was 32. 8%. Among 64 cases found in the VEEG, 13 cases had epileptic discharge in the ictal VEEGs. Three cases showed epileptic discharge in the interictal VEEGs with normal background rhythm. Two cases presented epileptic discharge in the interictal VEEGs with abnormal background rhythm. Three cases had abnormal background rhythm only. Discharge frequency during sleeping was more quick than that during awake-ness, mostly in the quiet sleep phase. Most frequently ictal epileptic discharges were a focal onset (16/ 18) , and 13 cases happened in the temple lobe. No epileptic discharge in the ictal and interictal VEEGs were tested in 46 cases attacked with seizures, which were diagnosed as non-epileptic seizures. Conclusions VEEG plays an important role in the diagnosis and differential diagnosis in epilepsy and non-epileptic seizure in newborns, and is valuable to perform early to improve prognosis.

Objective To study the clinical application of dynamic monitoring of mainstream endtidal carbon dioxide in neonatal respiratory distress syndrome.Methods All of 23 premature neonates diagnosed with NRDS and placed on mechanical ventilation were admitted in this study.Their PetCO_2 was continuously monitored and paired with PaCO_2 at 112 different time points.The correlation between PetCO_2and PaCO_2 was compared.Results This study showed that the average PaCO_2 measured for 112 times was(38.2±5.6)mm Hg(1 mm Hg=0.133kPa)and the corresponding PetCO_2 was,(32.4±4.9)mm Hg;it also showed that PetCO_2 was positively correlated with PaCO_2 and PetCO_2 was even more closely correlated with PaCO_2 in infants with second degree of NRDS than in patients with third and fourth degree of NRDS.Conclusions Dynamically monitoring mainstream PetCO_2 is applicable in mechanically ventilated premature infants with NRDS,it can accurately reflect the level of PaCO_2;Thereby reducing the blood gas analysis,thus reducing the suffering of nursing workload and children.But it has limited significance in cases of severe NRDS.

Objective To investigate the effect of group psychological counseling and peer education on depressive and anxiety symptoms of pregnant females with selective multiple pregnancy reduction in second trimester. Methods Sixty-two pregnant females with selective multiple pregnancy reduction in second trimester were randomly divided into intervention group(n=30)and control group (n=32), two groups of pregnant women all received routine nursing. The pregnant women of intervention group received group psychological counseling and peer education for one month before multiple pregnancy reduction. Results Before the intervention, the anxiety levels of the two groups of pregnant women were not significantly different. After the intervention, the intervention group had less anxiety symptoms than before the intervention[ before(54.2 ± 3.2)points,after(43.4 ± 3.1)points,t=13.250,P=0.000].After the intervention, the intervention group had less anxiety symptoms than the control group[the intervention group(43.4±3.1)points, the control group(50.0±4.4)points,t=6.712,P=0.000].Before the intervention, the depression levels of the two groups of pregnant women were not significantly different. After the intervention, the depression levels of the control group was not significantly different than those before the intervention. After the intervention, there was significantly lower depression score of the intervention group than that of the control group(P < 0.05) [before(56.9 ± 3.5)points, after(45.3 ± 2.5)points, t=14.773,P=0.000].After the intervention, the intervention group had lower depression score than the control group[the intervention group (45.3 ± 2.5) points, the control group (54.6 ± 3.0) points, t=12.802,P=0.000]. Conclusions Group psychological counseling and peer education can effectively improve depressive and anxiety symptoms of pregnant females with selective multiple pregnancy reduction in second trimester.

Objective To investigate the relationships between the levels of plasma soluble CD40 ligand (sCD40L),fetuin-A and pregnancy-associated plasma protein A (PAPP-A) and carotid plaque in patients with acute ischemic stroke.Methods The patients with acute ischemic stroke were enrolled in the study.Carotid arteries were assessed by using carotid artery ultrasound.The patients were divided into either a carotid artery plaque group or a non-carotid artery plaque group according to the assessment results.The former were further divided into a stable plaque sub-group and an unstable plaque sub-group according the nature of plaque.Enzyme-linked immunosorbent assay was used to detect the levels of plasma sCD40L,fetuin-A and PAPP-A.The demography,previous history,complications,laboratory tests and plasma inflammatory biomarkers between the carotid artery plaque group and the non-carotid artery plaque group and between the stable plaque subgroup and the unstable plaque subgroup were compared.Multivariate logistic regression analysis was used to investigate the relationship between plasma inflammatory biomarkers and carotid plaques.Results A total of 200 patients with acute ischemic stroke were included.Among them,78 were females and 122 were males (aged 33 to 87 years,mean 60.1 ± 10.3 years); 139 patients were in the carotid artery plaque group and 61 were in the non-plaque group; 43 were in the stable plaque subgroup and 96 were in the unstable plaque subgoup.The mean age of the carotid artery plaque subgroup was significantly greater than that in the non-plaque subgroup (63.2 ± 8.7 years vs.50.3 ± 9.5 years; t ＝ 10.179,P =0.000),the constituent ratios of men (68.3％ vs.44.3％;x2＝ 10.336,P＝ 0.001),hypertension (71.2 vs.54.1％;x2=5.540,P=0.019),diabetes (46.8％ vs.29.5％ ;x2 =5.199,P =0.023),and hyperlipidemia (78.4％ vs.37.7％ ;x2 =31.31,P =0.000)in patients of carotid plaque group were significantly higher than those of the non-carotid plaque group.The levels of total cholesterol (5.7 ± 1.1 mmol/L vs.5.3 ± 1.0 mmol/L; t =2.433,P =0.016),low-density lipoprotein cholesterol (4.5 ± 1.0 mmol/L vs.4.1 ±0.9 mmol/L; t =2.683,P =0.008),fasting glucose (7.5 ±2.5 mmol/Lvs.6.4±2.1 mmol/L; t=3.002,P＝0.003),sCD40L (151.4 ± 55.8 pg/mlvs.102.8 ±65.9 pg/ml; t =5.360,P=0.000),fctuin-A (390.1 ± 80.6 μg/ml v.s.352.9 ± 98.6 μg/ml; t =2.591,P =0.011),and PAPP-A (11.49 ±4.67 mIU/L vs.8.46 ± 3.99 mIU/L; t =4.409,P =0.000) were significantly higher than those of the non-carotid plaque group.Multivariate logistic regression analysis showed that hyperlipidemia (odds ratio [OR] 6.582,95％ confidence interval [CI] 2.321-18.662; P =0.000),sCD40L (OR6.372,95％ CI 2.174-18.670;P=0.010),and fetuin-A (OR 4.101,95％ CI 1.012-16.619; P=0.048) were the independent predictors for carotid artery plaques in patients with acute ischemic stroke.The mean age of the stable plaque subgroup was significantly lower than that of the unstable plaque subgroup (59.6 ± 9.3 years vs.64.1 ± 7.2 years; t =3.231,P =0.002).The constituent ratio in patients with hypertension was significantly lower than that of the unstable plaque subgroup (55.8％ vs.78.1％ ; x2 =7.213,P =0.007).The levels of total cholesterol (5.4 ±0.9 mmol/L vs.6.0 ± 1.1 mmol/L; t =3.136,P =0.002),low-density lipoprotein cholesterol (4.0 ± 1.2 mmol/L vs.5.7 ± 1.0 mmol/L; t =8.696,P =0.000),fasting glucose (7.1 ± 2.3 mmol/L vs,7.9 ± 1.9 mmol/L; t =2.147,P =0.034),sCD40L (135.3 ±74.3 pg/ml vs.176.5 ±64.5 pg/ml; t =3.319,P ＝0.001),and PAPP-A (10.96 ± 5.02 mIU/L vs.13.98 ±4.63 mIU/L; t =3.463,P =0.001) were significantly lower than those of the unstable plaque subgroup,while the level of high-density lipoprotein cholesterol was significantly higher than that of the unstable plaque subgroup (1.2 ± 0.2 mmol/L vs.1.1 ± 0.3 mmol/L; t =2.314,P=0.022).Multivariate logistic regression analysis showed that HDL-C (OR 0.234,95％ CI0.060-0.906; P =0.022) was an independent protective factor for unstable plaques,while sCD40L (OR 5.290,95％ CI 1.613-17.351; P =0.029) and PAPP-A (OR4.125,95％ CI 1.281-13.283; P =0.021) were the independent predictors for unstable plaques.Conclusions The levels of sCD40L,PAPP-A,and fetuin-A were associated with the existence and stability of carotid artery plaque.The increased plasma sCD40L and fetuin-A were the independent predictors for carotid artery plaques in patients with acute ischemic stroke,and the increased levels of plasma sCD40L and PAPP-A were the independent predictors for carotid artery plaque instability in patients with acute ischemic stroke.

Objective To investigate the change of plasma visfatin in patients with coronary heart disease and its clinical significance.Methods A total of 310 patients with coronary heart disease (ACS group:n =217; SAP group:n =93) and of 90 healthy subjects with a matched age and gender were included in this study.The plasma concentration of visfatin of each subject was measured using ELISA assay,and each patient underwent selective coronary angiography examination.A total of 85 cases of patients in CHD group underwent 64-slice CT coronary imaging to evaluate the main plaque within the coronary.Results The visfatin,LDL,BMI,blood glucose levels was significantly higher in CHD group[ ( 128.18 ± 13.86)ng/ml,(3.63 ± 1.48) mmol/L,( 26.18 ± 1.82) kg/m2,(7.25 ± 2.03 ) mmol/L] than in control group [ (75.96 ± 10.27 )ng/ml,(2.64 ± 0.53 ) mmol/L,( 23.51 ± 0.89 ) kg/m2,(5.11 ± 1.53 ) mmol/L,P ＜ 0.05 ],respectively.The visfatin level in the ACS group [ ( 145.57 ± 19.95 ) ng/ml ] was significantly higher than the SAP group [ (110.79 ±7.78)ng/ml,P ＜0.05].The visfatin concentration gradually increased with the aggravation of the complexity of coronary lesion types and severity of coronary lesions( P ＜ 0.05).The plasma visfatin concentrations in Soft plaque group and the fibrous plaque group were significantly higher than calcified plaque (P ＜ 0.05).HDL-C and Gensini score of coronary lesions were negatively correlated ( r =- 0.055,P ＜0.05) ; LDL-C,Glu,and visfatin was positively correlated with coronary lesions Gensini score ( r =0.464,0.279,0.531,P ＜ 0.05 ),respectively.Conclusions The plasma visfatin level in patients with Coronary heart disease increased and affected its lipid metabolism.It may be an important inflammatory factors promoting arterial atherosclerosis occurs and development,which has a certain value to the judgment of coronary lesions and plaque stability combined with 64-slice spiral CT examination.

Objective:To develop a rating scale on the knowledge, attitude and practice of stroke-dysphagia for nurses, and to test the reliability and validity.Methods:Based on theoretical framework of the Knowledge, Attitude, Practice (KAP), the scale items were determined through literature review, expert consultation, pre-investigation, and qualitative interviews. 633 nurses in the department of stroke that from 18 hospitals in Hubei Province were selected for the survey, to further screen the items and test reliability and validity of the scale.Results:The positive coefficient of the two-round expert consultation were both 100%; the expert authority coefficient was 0.930; the level of coordination of experts ′ opinions was good. Exploratory factor analysis extracted 4 factors, the accumulative variance contribution rate was 44.278%, Content validity index S-CVI was 0.984, I-CVI was 0.857-1.000; the Cronbach α coefficient of scale was 0.855, test-retest reliability was 0.909. Eventually, the scale was consisted of 3 dimensions, 32 items. Conclusion:The scale has good reliability and validity, and can be used as a survey tool to test the current knowledge, attitude, practice of clinical nurses about patient with stroke-dysphagia.

Objective To explore the association between plasma resistin levels and acute coronary syndrome. Methods Four hundred patients were divided into coronary heart disease (CHD) group（310）and control group（90）according to the coronary Angiography (CAG). And CHD group was divided into ACS subgroup（n＝217）and SAP subgroup（n＝93）according to the clinical information. 85 cases in CHD group were underwent 64-slice spiral computed tomography coronary artery imaging. The severity and extent of coronary lesions were analyzed by CAG and graded by means of Gensini coronary score system. Resistin level in plasma of all patients was determined by enzyme linked immunosorbent assay. Results Resistin levels in CHD group［(889.1±248.2)pg/ml］ were significant higher compared with the control group［(261.6±111.9)pg/ml］ (P＜0.05), and resistin levels in ACS subgroup［(1260.0±368.0)pg/ml］ were much higher than that in SAP subgroup［(518.3±128.4)pg/ml］ (P＜0.05). Conclusions The resistin levels of patients with acute coronary syndrome increased significantly and might be associated with the vulnerable plaque. Resistin levels and 64 slice spiral computed tomography coronary artery imaging can be used to detect the vulnerable plaque in CHD patients.

Objective:To determine the relationship between serum resistin levels and carotid intima media(IMT)thickness in patients with essential hypertension. Methods:This study consisted of 272 patients with essential hypertension. The patients were divided into three groups according to their serum resistin levels. Group 1,n=91,serum resistin level 1.233-3.701 ng/ml;Group 2,n=91,serum resistin level 3.728-8.777 ng/ml;and Group 3,n=90,serum resistin level 8.809-28.658 ng/ml. Results:The carotid IMT and maximum carotid IMT of Group 3 were the highest in three groups.(P＜0.05).As shown in multivariate analysis for factors affecting carotid IMT,serum resistin level(β=0.220,t=5.793,P=0.000)was independently associated with the carotid IMT after controlling the age,blood glucose,uric acid,low-density lipoprotein cholesterol,systolic blood pressure and diastolic blood pressure. Serum resistin level(β=0.189,t=4.733,P=0.000)was independently associated with the maximum carotid IMT after controlling the age,blood glucose,body mass index,diastolic blood pressure,diabetes mellitus,high sensitivity C reactive protein,total cholesterol and triglyceride. Conclusion:Serum resistin was independently associated with the increased carotid IMT in essential hypertension patients.