Objective:To establish animal model on the basis of the autoimmune etiology for a subset of cases of Tourette syndrome.Methods:Blood samples were drawn from patients with TS(by DSM-IV)and were sent for further enzyme-linked immunosorbent assays(ELISA)to a laboratory.Eight serum samples with the highest concentration of anti-neural antibody were selected for TS model group,and 8 serum sampled with the lowest concentration of anti-neural antibody were selected for the control group.Osmotic mini pump filled with undiluted TS or control serum were microinfused into the rat striatum at a rate of 0.5 μl /h for 72 h.Stereotypic movements were recorded at 1 d,7 d,14 d and 21 d after microinfusion.Several categories of stereotypy including bites(teeth touching the cage,wood chips,vacuous chewing or other objects except the body),taffy pulling(raises of the forepaw to the mouth and face),self-gnawing,licking not associated with grooming,grooming,head shaking,paw shaking,rearing and episodic utterances(EU)were recorded.Results:The anti-neural antibody serum concentration used for TS model was(0.29±0.06) U/L,and that used in control group was (0.10±0.04) U/L.After infusion of TS sera,stereotypic behaviors in rats was increased significantly[(37.2±7.1) vs.(106.3±11.7),P=0.000].Significant difference were observed in stereotypies scores of TS rats compared to control rats after microinfusion[(106.3±11.7) vs.(31.2±6.2),P=0.000].Conclusion:Stereotypic behaviors are increased in rats after intrastriatal microinfusion of Tourette Syndrome sera under noninflammatory conditions.

Objective To explore perinatal risk factors associated with the neurobehavioral development of small for gestational age (SGA) full-term neonates.Methods This prospective cross-sectional study included 111 full-term newborn infants from Apr 2008 to Apr 2010 born in Yan-tai Yuhuangding Hospital.Detailed clinical data in perinatal period of all subjects were recorded.Infants aged 3 ～ 7 days were assessed with neonatal behavioral neurological assessment (NBNA) for neurobehavioral development.Logistic regression analysis was used to explore risk factors associated with the score of NBNA.Results Significant differences (P ＜ 0.05) were found between full-term SGA (10.72 ± 1.41,7.13 ± 0.96,7.32 ± 0.74,37.16 ±1.32) and normal neonates (11.27 ± 1.04,7.89 ± 0.72,7.62 ± 0.64,39.12 ± 0.76) in terms of capacity,active and passive muscle tension and NBNA score.Full-term SGA neonates had lower score than control.Univariate logistic regression showed that delivery,placenta abnormalities,umbilical cord abnormalities,infection in perinatal period,gestational hypertension,twin pregnancy,hyperbilirubinemia affected neurobehavioral development of full-term SGA infants.Multivariate logistic regression showed that mothers' infection in perinatal period (OR =2.175,95 ％ CI 1.981 ～ 2.408,P ＜ 0.05),twin pregnancy (OR =1.936,95％ CI 1.517 ～2.368,P ＜ 0.05) and hyperbilirubinemia (OR =1.518,95％ CI 1.072-2.149,P ＜ 0.05) were risk factors for neurobehavioral delay of full-term SGA infants.Conclusion Full-term SGA neonates showed poorer quality in neurobehavior.Risk factors associated with neurobehavior of full-term SGA infants included mothers' infection in perinatal period,twin pregnancy and hyperbilirubinemia.

ObjectiveTo investigate the effect of mescenchymal stem cell (MSC) transplantation on Tourette syndrome(TS)model rats.MethodsStereotypies can be successfully induced in rats by intrastriatal microinfusion of TS sera.MSC suspension was bilaterally injected into the striatum.Survival and differentiation of transplanted MSC were tested through immunohistochemical analyses.ResultsFlow cytometry results demonstrated that the cells strongly expressed CD29(95.2％ ),CD105(97.2％ ),CD44(96.3％ ) and CD106 (94.1％).TS rats with MSC grafts exhibited significantly decreased stereotypic behaviors at 10 and 14 days(95.5 ±6.6,73.1 ± 6.5 vs.114.1 ± 6.0,108.0 ± 6.4).Immunohistochemistry analyses revealed survival of transplanted MSC and differentiation into neurons and astrocytes in the rat brain.ConclusionIntrastriatal transplantation of human MSC can provide therapeutic potential for TS.

Eighty one infants with severe asthma attacks were randomly divided into three groups:budesonide group (budesonide suspension + ventolin inhalation),methylprednisolone group (Ventolin inhalation + intravenous methylprednisoloue) and ventolin group (ventolin inhalation alone).Compared with the pre-treatment,the respiratory rate,heart rate,wheeze score,self-feeling score of three groups were gradually reduced (q=2.96-163.37,P＜0.05 or 0.01).The respiratory rate,heart rate of ventolin group was significantly higher than those of budesonide group (q=3.08,4.10,P＜0.05) and methylprednisolone group (q=3.24,3.34,P＜0.05) 4 h after treatment,wheeze score,self-feeling score of ventolin group was significantly higher than budesonide group (q=5.63-23.63,P＜0.01) and methylprednisolone group (q=6.76-23.72,P＜0.01) 4 and 12 h after treatment.Results indicate that budesonide suspension can achieve the same effect as intravenous methylprednisolone and bronchodilators alone may not effectively control the severe asthma attack in infants.

ObjectiveTo investigate the effect of mesenchymal stem cell transplantation on stereotypic behavior and level of dopamine of Tourette syndrome(TS) rats.MethodsWistar rats were randomly divided into three groups namely sham group (microinfused with normal sera),TS group (microinfused with TS sera)group and TS plus MSC transplantation group.Auto-immune TS rat model were established and MSC suspension labeled with BrdU was injected into the striatum of TS rats.DA were measured by high performance liquid chromatography and electrochemical detection.ResultsTS rats with MSC grafts exhibited significantly decreased stereotypic behaviors (7d:117.3 ±8.4,14d:94.8 ±7.9,28 d:78.8 ±7.4)and level of DA in striatum(7 d:(898.2 ± 143.2) ng/g,14d:(812.4 ±92.2)ng/g,28 d:(757.9 ± 82.4)ng/g) at 7,14 and 28 days after transplantation compared to model group( ( 129.3 ± 9.8,116.5 ± 8.5,106.8 ± 6.4 ; ( 1209.3 ± 182.3 ) ng/g,( 1033.5 ± 114.7 ) ng/g,(994.8 ±112.6) ng/g,P＜0.01).DA in plasma of TS rats with MSC grafts also decreased at 7 and 14 days(7 d:(530.2 ±86.2)ng/g vs (690.3±72.7) ng/g;14d:(562.4 ±64.2) ng/g vs (689.4±83.9) ng/g,P＜0.01).ConclusionsTransplantation of MSC could reduce stereotypic behaviors in TS rats and regulate the metabolism of DA.

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.