Object: To explore the best modern appeearance of the nurse. Methods: Investigate the nursing students and clients and analysis the results. Result: The difference between the nursing clients and the nursing students is sure existence. Discuss: (1) Nursing teaching still should pay attention to the effect of biomedicine model. (2)To develop nursing speciality to make the nursing clients have a right understand to nursing

Objective: To adjust the distance between SD sequence and ATG in the same expressive plasmid pLX1 to enhance expression of heterologous bFGF gene in E. coli. Methods: Adjusting the different distance between SD sequence and ATG by Klenow and Mung Bean Nuclease. SDS PAGE and Western blot showed the expressed protein bFGF in E.coli. bFGF proteins were purified by HPHIC, HPGFC and HAC. Biological activity was examined by MTT. Results: Recombinant plasmids pLX2, pLX3 were obtained and the expressive levels were 8.03%, 9.9% respectively. Also the purified bFGF was obtained by HPHIC, HPGFC, HAC and its ED 50 was 2.29 ng/ml. Conclusion: Increasing the bFGF gene dosage by adjusting the distance between SD sequence and ATG could increase the expression level of a desired protein.

Objective To study whether amputation of the tail extremity could induce change of Fos protein expression in mice ACC neurons , and explore the role of NK?1 receptor in the change. Methods Immunohistochemistry technique was adopted to study Fos protein expression change in mice ACC neurons at 0.25 h,0.5 h,1 h,2 h after amputation of the tail extremity 2.5 cm,and also the effect of NK?1 receptor antagonist GR82334(iv)or GR82334(ith)in the change. Results Fos protein expression in mice ACC neurons was significantly increased at 0.25 h,0.5 h after the amputation,and reached its peak at 1 h after the amputation,then started to decrease at 2 h after the amputation. GR82334(iv)com?pletely antagonized the significant augment in Fos protein expression in mice ACC neurons after the amputation ,but the antagonism of GR82334 (ith)was incomplete. Conclusion Amputation of the tail extremity could significantly increase the Fos protein expression of mice ACC neurons in a time?dependent manner. Both peripheral and central NK?1 receptors were involved in the process. However ,there are also central conduction pathways of other receptors and neurotransmitters involved in the significant augment in Fos protein expression in mice ACC neurons after amputa?tion.

Objective:To explore the professional care need of the disabled aged post stroke in 5 general hospitals in Shanghai so as to provide a basis for developing the home care service, formulating and implementing the scientific and practicable policy of home care service in Shanghai.Methods:From May 2019 to October 2019, this study selected 301 disabled elderly patients post stroke planning to level hospital and return home in Neurology Department from 5 general hospitals in Shanghai as subjects by convenience sampling. All of patients were investigated with the General Information Scale and the Professional Care Demand Tool for Stroke Survivors Lived in Community. The t-test, one-way ANOVA and multiple linear regression were used to analyze the influencing factors of care needs. Results:The total average score of the professional care need for the disabled aged post stroke was (3.46±0.83) . The top 5 items of care need included the disease recurrence prevention knowledge, getting the care and help from family members, blood pressure monitoring, use methods, attention and adverse reactions of common drugs, explaining disease related knowledge. There were statistical differences in the scores of professional care need among the professional care need of the disabled aged post stroke with different genders, family caregivers, disease types, duration of stroke, other chronic disease and degree of disability ( P<0.05) . The demand of patients who were female, took nursing workers or nannies as caregivers, were with cerebral hemorrhage, stroke duration>1 to 6 months, combined with diabetes and severe disability for professional care need was urgent. Multiple linear regression analysis showed that the influencing factors of professional care need of the disabled aged post stroke were genders (β'=0.117, t=2.327, P=0.021) and degrees of disability (β'=0.496, t=9.706, P<0.001) . Conclusions:The disabled aged post stroke in Shanghai has the high level of the professional care need. Related departments should accelerate the perfection and implementation of home care policy, and provide targeted nursing service based on the most urgent needs.

Objective To evaluate the effect of ulinastatin on postoperative cognitive dysfunction in preoperative sleep deprived aged rats.Methods Sixty clean healthy male Sprague-Dawley rats,aged 18 months,weighing 350-500 g,were divided into 3 groups (n=20 each) using a random number table:control group (group C),sleep deprivation group (group D) and ulinastatin group (group U).Sleep deprivation was induced by using modified multiple platform method in D and U groups,and then splenectomy was performed in three groups.Ulinastatin 100 U/g was intraperitoneally injected before sleep deprivation and immediately after operation in group U.Ten rats were randomly selected at 3 days after operation and sacrificed,and hippocampi were removed for determination of the contents of interleukin-1β (IL-1β),IL-6 and tumor necrosis factor-α (TNF-α) by enzyme-linked immunosorbent assay.Morris water maze test was performed at 3-7 days after operation in the rest ten rats in each group,and the escape latency and time of staying at the original platform were recorded.Results Compared with group C,the escape latency was significantly prolonged at 4-6 days after operation,the time of staying at the original platform was shortened,and the contents of IL-1β,IL-6 and TNF-α were increased at 3 days after operation in D and U groups (P＜0.05).Compared with group D,the escape latency was significantly shortened at 4-6 days after operation,the time spent in the original platform was prolonged,and the contents of IL-1β,IL-6 and TNF-α were decreased at 3 days after operation in group U (P＜0.05).Conclusion Ulinastatin can mitigate postoperative cognitive dysfunction in preoperative sleep deprived aged rats,which is related to inhibiting inflammatory responses.

Primary light-chain (AL) amyloidosis is a rare and fatal plasma cell disease. In recent years, the treatment of AL amyloidosis has changed from the era of bortezomib to the era of daratumumab immunotherapy. However, for the treatment choice of advanced-staged patients, how to achieve organ responses at the early stage and how to monitor the disease are questions that need to be further explored. The 64th American Society of Hematology Annual Meeting in 2022 has reported advances in the diagnosis and treatment of AL amyloidosis, which are briefly reviewed in this article.

Objective: Cardiac magnetic resonance (CMR) is a diagnostic tool that provides precise and reproducible information about cardiac structure, function, and tissue characterization, aiding in the monitoring of chemotherapy response in patients with lightchain cardiac amyloidosis (AL-CA). This study aimed to evaluate the feasibility of CMR in monitoring responses to chemotherapy in patients with AL-CA. Materials and Methods: In this prospective study, we enrolled 111 patients with AL-CA (50.5% male; median age, 54 [interquartile range, 49–63] years). Patients underwent longitudinal monitoring using biomarkers and CMR imaging. At followup after chemotherapy, patients were categorized into superior and inferior response groups based on their hematological and cardiac laboratory responses to chemotherapy. Changes in CMR findings across therapies and differences between response groups were analyzed. Results: Following chemotherapy (before vs. after), there were significant increases in myocardial T2 (43.6 ± 3.5 ms vs. 44.6 ± 4.1 ms; P = 0.008), recovery in right ventricular (RV) longitudinal strain (median of -9.6% vs. -11.7%; P = 0.031), and decrease in RV extracellular volume fraction (ECV) (median of 53.9% vs. 51.6%; P = 0.048). These changes were more pronounced in the superior-response group. Patients with superior cardiac laboratory response showed significantly greater reductions in RV ECV (-2.9% [interquartile range, -8.7%–1.1%] vs. 1.7% [-5.5%–7.1%]; P = 0.017) and left ventricular ECV (-2.0% [-6.0%–1.3%] vs. 2.0% [-3.0%–5.0%]; P = 0.01) compared with those with inferior response. Conclusion Cardiac amyloid deposition can regress following chemotherapy in patients with AL-CA, particularly showing more prominent regression, possibly earlier, in the RV. CMR emerges as an effective tool for monitoring associated tissue characteristics and ventricular functional recovery in patients with AL-CA undergoing chemotherapy, thereby supporting its utility in treatment response assessment.

Background::The potential impact of β cell function and insulin sensitivity on adverse pregnancy outcomes in women with gestational diabetes mellitus (GDM) remains uncertain. We aimed to investigate the association between β cell dysfunction, insulin resistance, and the composite adverse pregnancy outcomes.Methods::This observational study included 482 women diagnosed with GDM during pregnancy. Quantitative metrics on β cell function and insulin sensitivity during pregnancy were calculated using traditional equations. The association of β cell dysfunction and insulin resistance with the risk of the composite adverse pregnancy outcomes was investigated using multivariable-adjusted logistic regression models.Results::Multivariable-adjusted odds ratios (ORs) of adverse pregnancy outcomes across quartiles of homeostatic model assessment for insulin resistance (HOMA-IR) were 1.00, 0.95, 1.34, and 2.25, respectively ( P for trend = 0.011). When HOMA-IR was considered as a continuous variable, the multivariable-adjusted OR of adverse pregnancy outcomes was 1.34 (95% confidence interval 1.16-1.56) for each 1-unit increase in HOMA-IR. Multivariable-adjusted ORs of adverse pregnancy outcomes across quartiles of homeostatic model assessment for β cell function (HOMA-β) were 1.00, 0.51, 0.60, and 0.53, respectively ( P for trend = 0.068). When HOMA-β was considered as a continuous variable, the multivariable-adjusted OR of adverse pregnancy outcomes was 0.57 (95% CI 0.24-0.90) for each 1-unit increase in HOMA-β. However, other quantitative metrics were not associated with the composite adverse pregnancy outcomes. Conclusions::We demonstrated a significant association of β cell function and insulin sensitivity with the risk of adverse pregnancy outcomes. We have provided additional evidence on the early identification of adverse pregnancy outcomes besides the glycemic values.

【Objective】 To investigate the relationship between rapid eye movement sleep (REM) and the incidence of angina pectoris (AP) in different genders. 【Methods】 We recruited 2710 participants from the Sleep Heart Health Study with an average age of (61.7±10.9)y, of whom 1 103 (40.7%) were male and 1 607(59.3%) were female. The participants were divided into grade 1 (<20%), grade 2 (20%-25%), and grade 3 (>25%) according to the percentage of REM sleep time (REM%). Complete polysomnography data and medical records were collected for all the participants. Multivariate logistic regression analysis was used to characterize the independent association between REM% and the occurrence of AP. 【Results】 REM% in the three groups varied significantly in age, body mass index (BMI), smoking, AHI, diabetes, and hypertension (P<0.05). In addition, the incidence of AP in patients with grade 3 of REM% was significantly higher than those with grade 1 and 2 in both men and women. After adjusting for covariates such as age, ethnicity, AHI, marital status, education level, BMI, diabetes, hypertension, and smoking status, multiple logistic regression analysis showed that REM% >25% in women was closely related to AP (OR=1.523; 95% CI:1.132-2.051, P=0.006). 【Conclusion】 Participants with REM sleep time >25% have a significantly increased prevalence of AP in women, but not in men.

Humans ; Consensus ; Immunoglobulin Light-chain Amyloidosis/therapy* ; Heart ; Immunoglobulin Light Chains ; China