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 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 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 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 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.

Objective To investigate the effects of dexmedetomidine on inflammatory responses in brain tissues of the patients undergoing carotid endarterectomy.Methods A total of 40 ASA physical status Ⅱ or Ⅲ patients,aged 65-80 yr,scheduled for elective unilateral carotid endarterectomy under general anesthesia,were randomly divided into 2 groups (n =20 each) using a random number table:dexmedetomidine group (group Dex) and control group (group C).In group Dex,dexmedetomidine 0.03 μg · kg-1 · min-1 was infused over 10 min before induction of anesthesia,and after tracheal intubation dexmedetomidine was then infused at a rate of 0.3 μg · kg-1 · min-1 until 30 min before the end of operation.The equal volume of normal saline was given in group C.At 20 min before induction of anesthesia (T0),10 min after induction of anesthesia (T1),15 min after carotid artery clamping (T2),15 min after carotid artery unclamping (T3),and at 6 and 24 h after operation (T4,5),blood samples were drawn from the ispilateral jugular bulb for determination of serum concentrations of malondialdehyde (MDA) (by TBA) and S100B,tumor necrosis factor α (TNF-α) and interleukin-6 (IL-6) (by ELISA).Results Compared with group C,the serum S100B concentrations were significantly decreased at T3-5,the serum TNF-α and IL-6 concentrations were decreased at T2.5,and the serum MDA concentration was decreased at T3 in group Dex.Conclusion Dexmedetomidine can reduce the brain damage through mitigating inflammatory responses in brain tissues of the patients undergoing carotid endarterectomy.

Objective To investigate whether human breast milk may bind to hepatitis B surface antigen (HBsAg) and its characteristics.Methods Breast milk samples from five women with negative HBsAg and hepatitis B surface antibody (anti-HBs) at one to two months post delivery were fractioned into cream and skimmed milk by centrifugation.The human breast milk and each fraction as well as cow and goat milk samples,served as controls,were separately incubated with highly purified yeast recombinant HBsAg,followed by determination of their binding capability to HBsAg by enzyme linked immunosorbent assay (ELISA) and the inhibition rate for binding of HBsAg to anti-HBs by quantitative chemiluminescence microparticle immunoassay.After boiled for 1 min or pasteurized in 65 ℃ for 30 min,the thermal stability of the active components of milk was detected.One-way ANOVA and SNK tests were performed for statistical analysis.Results The operative concentration of HBsAg was 0.1 μg/ml.Breast milk from all five women showed significantly better binding capability to HBsAg than cow or goat milk (1.306±0.300 vs 2.157±0.150 and 2.232±0.093,F=34.303,P＜0.01).The quantitative experiments showed that the inhibition rate of human breast milk was higher than that of the control group [(74.26± 17.26)％ vs (0.00±5.50)％,F=57.806,P＜0.01].The binding ability to HBsAg of skimmed milk was comparable with that of whole milk,indicating milk protein(s) played critical roles in binding to HBsAg (0.877 ± 0.486 vs 0.513 ± 0.069 and 0.376 ± 0.146,F=44.475,P＜0.01).After boiled for 1 min or Pasteurization,the binding ability to HBsAg of whole breast milk remained,but that of skimmed milk went down (F=16.598,P＜0.01).Both whole breast milk and skimmed milk could inhibit the binding of HBsAg to anti-HBs (F=278.341 and 269.408,both P＜0.01).Conclusions The inhibition of binding to HBsAg by human breast milk indicates that human milk may interact with HBsAg.The active components mainly exist in milk proteins and are thermal stable.

Objective To investigate the effects of Fu-Yuan-Zai-Zao capsule , a novel compound drug of traditional Chinese medicine , on learning and memory ability and its mechanism related to oxidative stress induced by global brain ischemia .Methods The mouse model of global brain ischemia was established by bilateral common carotid arteries occlusion and reperfusion .The learning and memory ability was measured by Morris water maze and step down tests.Nissl staining was used to detect the pathological changes in the hippocampal neurons .The activity of superoxide dismutase (SOD) and the content of malondialdehyde (MDA) were evaluated by xanthinoxidase assay and thiobarbituric acid method , respectively .Results The global brain ischemia and reperfusion induced an impairment of learning and memory function, a decrease in the number of neurons in the hippocampal CA 1 region, a decline in SOD activity and an increase in MDA content in the cerebral cortex of mice .Intragastrical administration of Fu-Yuan-Zai-Zao capsule for 14 d after brain ischemic surgery significantly improved the learning and memory impairment , increased the number of neurons in the hippocampal CA1 region, elevated SOD activity and reduced MDA content in the cerebral cortex .Conclusions Fu-Yuan-Zai-Zao capsule ameliorates the learning and memory impairment through inhibiting oxidative stress induced by global brain ischemia in mice .The results suggest that Fu-Yuan-Zai-Zao capsule may have future application in the treatment of ischemic cerebrovascular diseases .