Objective:To explore influence of critical care unit (CCU)clinical nursing pathway (CCU-CNP)in de-partment of cardiology on quality of life in patients undergoing coronary artery bypass grafting (CABG).Methods:A total of 128 patients undergoing CABG,who hospitalized in our CCU from Jun 2012 to Jun 2014,were selected. According to random number table,patients were equally divided into CCU-CNP group and routine nursing group. Changes of quality of life and disease knowledge level were compared and analyzed between two groups before and after intervention.Results:Compared with routine nursing group,after intervention,there were significant rise in scores of anginal stability [(60.12±4.36)scores vs.(77.36±5.46)scores],physical limitation [(68.02±3.98) scores vs.(86.98±4.58)scores],anginal frequency [(60.28±5.12)scores vs.(78.47±3.45)scores],disease per-ception [(61.89±4.36)scores vs.(82.58±5.89)scores]and treatment satisfaction [(63.38±5.23)scores vs. (83.92±6.21)scores],P <0.05 or <0.01;and significant reductions in CCU time [(6.98±1.32)d vs.(3.32± 1.22)d],mean hospitalization time [(12.87±2.66)d vs.(6.36±2.45)d]and incidence rate of adverse cardiac events (14.06% vs.3.13%)in CCU-CNP group,P <0.05 or <0.01. Conclusion:CCU clinical nursing pathway can effectively raise disease knowledge and quality of life,reduce the incidence of adverse cardiac events,shorten CCU time and improve patient′s prognosis in CABG patients.

Objective To investigate the mutation characteristics and genotype of hepatitis B virus resistance gene in Nantong area,and provide scientific basis for clinical rational drug.Methods A total of 158 cases of chronic hepatitis B (CHB)pa-tients who were received with nucleos (T)ide analogues therapy for at least 2 years as the research object,and 30 cases of CHB patients who were not received nucleos (T)ide analogues for the treatment as the control group.PCR-sequencing method was used to detect the HBV P resistant gene and genotype,meanwhile,observe the relationship between three main mutation model and the levels of ALT and HBV DNA was also investigated.Results B genotype was detected in 42 (26.58%)out of 158 CHB patients,and 116 cases (73.42%)were C genotype.A total of 131 patients with different site mutations in P region,the mutation rate were 82.91%.There were totally 11 HBV mutation sites,including the main muta-tion site:M204I,L180M,M204V,A181V and A181T,the frequency of drug resistance were 41.14%,37.34%,22.15%, 11.39% and 10.13%,respectively.Moreover,11 mutation sites had 21 mutation patterns.In lamivudine (LAM)resistance associated mutations,the L180M and M204V sites were mainly co-occurrence,followed by M204I alone.In adefovir dipivoxil (ADV)resistance associated mutations,A181V was the main mutation site.Whereas,the drug resistance rate of entecavir (ETV)was low.Conclusion The main genotypes of HBV were type B and C in Nantong area,and C type was the dominant genotype.The resistance mutations mainly concentrated in LAM and ADV resistance associated mutations,while the resist-ance rate of ETV was low.Multi-locus drug-resistant mutation detection may help to detect viral resistance and guide clinical treatment better.

OBJECTIVE:To investigate the protective effects of diphenyl ethylene glycoside(TSG)on hippocampal neuron cells ischemic injury model rats.METHODS:Hippocampal nerve cells ischemic injury rats’model was established with sodium dithionite,antagonism of TSG on ischemic cerebral injury was determined by methyl thiazolyl tetrazolium(MTT)microcol-orimetry and lactate dehydrogenase(LDH)efflux assay.RESULTS:Pseudo-ischemic cerebral injury could cause significant injury to neurons with elevated cell death rate,significantly decreased MTT value and increased LDH efflux rate.The appli-cation of TSG could lead in significantly decreased LDH efflux rate,elevated MTT value and reduced cell death rate.CON-CLUSION:TSG has a significant protective effect on nerve cells ischemic injury model rats.

Objective To observe the efficacy and safety of Shuxuetong injection combined with Edaravone in the treatment of acute cerebral infarction. Methods Seventy patients with acute cerebral infarction were randomly divided into two groups, the treatment group was given Shuxuetong injection and Edaravone, and the control group was treated by Shuxuening injection. Two groups were treated with routine therapy. ESS and ADL content changes in two groups were assessed at different point before treatment and two weeks after treatment. Results The score of ESS of two groups increased after treatment (P ＜ 0.05) ,but that in the Shuxuetong group was dramatically increased ,showing significantly different from that in the control group(P ＜0.05). ADL of the two groups improved after treatment(P ＜0.01) ,but the increase in the Shuxuetong group was significantly compared to the control group(P ＜0.05). Conclusion Shuxuetong injection combined with edaravone is an effective and safe medicine in treatment of acute cerebral infarction.

Objective To investigate the insulin and glucagon levels in the patients with different islet cell antibody (ICA) subtypes and to explore the pathogenesis of latent autoimmune diabetes of adult (LADA). Methods Subjects were classified by immunohistology and 29 ICA-peripheral-positive DM patients, 28 ICA-diffused-positive DM patients and 17 controls (ICA-negative) were included. Serum glucose, insulin and plasma glucagon were measured at 0, 30, 60, 120 min after standard meal. Results (1) As compared with controls, glucagon in ICA positive groups were higher (both P

0.05)and the differences of AUC 0～t ,T max and C max were not significant as verified by two-one sided t test.CONCLUSION:The relative bioequivalence of polyferose capsules is101.02%which indicates that polyferose capsule is a bioequivalent product of Niferex capsule.

Objective To investigate the effect of propofol on transforming growth factor (TGF)-β1/Smad2 signaling pathway in lung tissues in rats with lipopolysaccharide (LPS)-induced acute lung injury (ALI).Methods Fifty-six male Wistar rats,aged 7-8 weeks,weighing 260-300 g,were randomly divided into 5 groups:control group (group A,n =8) ; LPS group (group B,n =12); 3 propofol groups (groups C,D,E,n =12).ALI was induced by intravenous LPS 8 mg/kg in groups B,C,D and E.In groups C,D,E,propofol 5 mg/kg was injectedintravenously before LPS administration and at 0 and 1 h after LPS administration,respectively,followed by infusion of propofol at 10 mg· kg-1 · h-1 until 5 h after LPS administration.Group A received the equal volume of normal saline.Arterial blood samples were collected immediately before LPS administration and 1,3 and 5 h after LPS administration for determination of pH value and PaO2.Then the animals were sacrificed and the lungs were immediately removed for calculation of the wet/dry lung weight ratio and for determination of the expression of TGF-β1-mRNA and Smad2 in lung tissues.Results Compared with group A,pH value and PaO2 were significantly decreased,wet/dry lung weight ratio was increased and the expression of TGF-β1 mRNA and Smad2 was up-regulated in groups B and E (P ＜ 0.05).Compared with group B,pH value and PaO2 were significantly increased,wet/dry lung weight ratio was decreased and the expression of TGF-β1 mRNA and Smad2 was down-regulated in groups Cand D,and PaO2 was significantly increased in group E (P ＜ 0.05).Conclusion The mechanism by which propofol alleviates ALI induced by LPS is related to inhibition of TGF-β1/Smad2 signaling pathway.

Objective To evaluate the ethical management status quo of Capital Medical Research Fund in 2007.Methods Cross-sectional study was applied to analyze the ethics management and ethics self-evaluation in applications.Results There were 652 applications,covering with 14 districts and 2 counties in Beijing,from 128 Hospitals.Applicants have some knowledge of the ethical issues in clinical research accounted for 88.7％ ; informed consent of subjects considered in 72.5％ ;the potential risk and protection involved in application accounted for 62.0％; personal privacy protection of subject accounted for 49.4％.Unfortunately,the benefit vs risk assessment was only involved in 28.7％ applications.Applicants from general hospitals had more ethical issue knowledge (90.2％) than those from community hospitals (84.6％).Applicants from university hospitals had more ethical issue knowledge (93.9％) than those from military hospitals (80.2％).Applicants aged 55 0r over had less ethical issue knowledge (70.0％) than other applicants (89.2％).The applicants to study on descriptive research and etiological research had less ethical issue knowledge than others.578 applications filled out the approval from ethics committee or research management department.62.6％ of the written were acceptable.Conclusion The applicants for clinical research had preliminary understanding for ethical issues in Beijing in 2007.Hospital ethics committees or research management departments had conducted clinical research ethical review applications for funds management.It has taken place the external conditions to carry out the ethical management in clinical research fund management.

Objective To observe the changes in neurotrophic factors and their receptors in the lumbar spinal cord of aging rats (1, 3, 6, 12, 18 and 24 months) , and to investigate their correlation with gowth. Methods The expression of neurotrophic factors and their receptors in the lumbar spinal cord of rats were measured by immunohistochemis-try and western blot. Nissl staining was used for quantitative detection of survival neurons. Results The expression of nerve growth factor (NGF) and its receptor TrkA, brain derived neurotrophic factor (BDNF) and its receptor TrkB and gliocyte derived neurotrophic factor (GDNF) in lumbar spinal cord of rats showed changes in relation to the aging process. Their expression was lower at the age of 1 month, reached the peak at 6-month, and decreased significantly at 24 months, in which the decline of GDNF was more obvious. The number of survival neurons in lumbar spinal cord kept at a high level from 1 to 6-month, then decreased gradually, and reached the lowest level at the age of 24 months. Conclusion The expression of neurotrophic factors and their receptors change with aging process, decreases in aged rats especially,which may be one of the mechanisms involved in spinal cord aging.

ObjectiveTo investigate baicalin effect against ultraviolet A (UVA) induced senescence in cultured human skin fibroblasts(HSF) and influence on telomere pathway. MethodsHSF were isolated from the prepuce of neonates and cultured. Subconfluent fibroblasts were classified into blank control group (without treatment), baicalin group (treated with baicalin of 50 μg/ml), UVA group (irradiated with UVA of 10 J/cm2) and UVA + baicalin group(irradiated with UVA of 10 J/cm2 and treated with baicalin of 50 μg/ml before and after the irradiation). After additional culture of various durations, flow cytometry was performed to detect cell cycle, telomere repeat amplification protocol-enzyme linked immunosorbent assay (TRAP-ELISA) to measure telomerase activity, real-time quantitative PCR to determine telomere length, mRNA levels of p53, p16 and c-myc, Western blot to examine the protein expressions of p16 and c-myc. ResultsUVA irradiation induced cell cycle arrest in G1 phase, and the percentage of HSF at G1 phase increased from 59.94％ in the blankcontrol group to 81.04％ in the UVA group, but was decreased to 65.55％ in the UVA + baicalin group. The length of telomere in HSF in UVA group was shortened to 31.2％ of that in the blank control group, but was restored to 63.9％ in HSF treated with baicalin before and after the irradiation. Compared with the blank control group, the expression level of p53 and p16 mRNA was increased to 2.93 ± 0.21 and 2.14 ± 0.09, respectively, while that of c-myc mRNA decreased to 0.53 ± 0.03 in the UVA group; baicalin could inhibit these changes. Similarly, Western blot showed that after UVA irradiation the protein expression level of p16 increased to 5.84 ± 0.16, while that of c-myc decreased to 0.35 ± 0.04 in HSF compared with that in the blank control group; baicalin treatment before and after the irradiation induced no significant changes in the protein expres sion of c-myc, but a decline in that of p16 (4.09 ± 0.13, P ＜ 0.05). Telomerase activity was undetected in any of these groups. ConclusionsBaicalin can delay the photoaging process of HSF, which may be attributed to the regulation of expression of senescence-related genes such as p53, but not to telomerase activity.