Objective To investigate the present status of the emergency nursing training to form the curricula system for emergency nursing training of nurses (including course projects,class hour,teaching form,training aim).Methods Based on the actual investigation,literature research,using Delphi method,the training course system of emergency nursing was established.Results Cronbach's α coefficient was 0.943 and the expert authority coefficient was 0.868.Emergency training should be included in the nursing training program,and the four modules courses were built.With reference to emergency management requirements of home and abroad and the training model of foreign troops as well as combining the reality of our country to set up the training objectives,to improve class hour,enrich teaching form,and adjust the training content to set up the emergency training evaluation model.Conclusions The results of this study supply basic guarantee for nurses to increase coping ability of emergency affairs as well as training basis and reference with clear structure and content,reasonable design and reliable results.

We searched the papers about laboratory education in China Scientific Journal Database(CSJD)and China Journal Full-text Database(CJFD),and carried out the bibliometric analysis on these papers in order to understand the current status and trend of laboratory education in basic medicine in China,improve the teaching quality and provide reference to the reform and construction of laboratory education in basic medicine.

In modern biology and biotechnology research, recombinant gene expression has been the most popular method to obtain the target protein. In recent years, many foreign genes have been efficiently expressed in Escherichia coli. However, proteins encoded by animal, plant or mesophilic microbial genes often lose activities or become denatured within a few hours at regular growth temperatures for E. coli; some other target proteins are toxic to host cells and therefore difficult to be over-expressed. The new T-vector, pEXC-T, was constructed by combining TA cloning and cold-shock induction to obtain high expression levels with low costs. This paper reports the construction of pEXC-T and optimization of induction techniques for gene expression. Two instable proteins were tested and successfully expressed in soluble form by using pEXC vector. The development of pEXC-T offers a convenient technique for the preparations of recombinant proteins to be used in structure/function studies, or as diagnostic markers and medicinal proteins.
Biotechnology ; Cold Temperature ; Escherichia coli ; genetics ; Gene Expression ; Genetic Vectors ; Plasmids ; genetics ; Recombinant Proteins

Objective To study the value of MSCT angiography(MSCTA)in diagnosing lower extremities arterial disease (LEAD) of diabetic foot ulcers and analyze the possible influential factors on the onset of diabetic foot ulcers.Methods 80 diabetic patients for MSCTA examination were divided into two groups by whether combined with foot ulcers.The tibial artery calcification score (TACS) and peripheral arterial occlusion index (PAOI) were calculated and the possible risk factors of diabetic foot ulcer were analyzed.Results There were 30 cases suffered with foot ulcer and 18 cases occurred lower extremity arterial occlusion (LEAO), the average PAOI was 4.40(3.60, 5.75).Non-foot ulcer cases were 50, and there were 8 cases suffered with LEAO, the average PAOI was 2.05(1.43, 3.10).Compared to patients without foot ulcer, patients with foot ulcer were older, had a lower BMI, and were more likely to have a history of tobacco use.They usually had higher TACS and severer peripheral arterial occlusive disease (PAOD).Stepwise regression model showed that foot ulcers had significant correlation with TACS and PAOI.Partial correlation analysis showed TACS was independent from PAOI in impacting diabetic foot ulcer.Conclusion MSCTA has important clinical value in diagnosing and valuing diabetic foot ulcer LEAD.Age, smoking history,BMI,TACS and PAOI affect the incidence of diabetic foot ulcers, and TACS and PAOI are the independent risk factors for diabetic foot ulcers.

Objective To explore CTA characteristics of diabetic lower extremities arterial disease (LEAD) with different Fontaine stage.Methods Data of 100 patients clinically diagnosed as diabetic LEAD and underwent lower limbs arterial CTA were analyzed retrospectively.The patients were classified into grade Ⅰ-Ⅳ according to Fontaine classifications.Lower extremities arteries were graded according to CTA.Stenosis degree of lower extremity arteries in different Fontaine stages were analyzed.Results The grades of lower extremity arteries stenosis in different Fontaine stages had statistically significant difference (x2 =186.24,P＜0.001).There had statistically significant difference of stenosis degree in different lower extremity arterial levels among different Fontaine stages (superior genicular artery:x2 =69.24,P＜0.001;inferior genicular artery:x2 =111.59,P＜0.001;dorsalis pedis and arteriae plantaris:x2 =94.15,P＜0.001).Grades of stenosis between superior genicular arteries and inferior genicular arteries,superior genicular arteries and dorsalis pedis and arteriae plantaris had statistically significant differences (Z=12.59,P＜0.001;Z=10.47,P＜0.001).There was statistically significant difference of stenosis grades between inferior genicular artery and dorsalis pedis and arteriae plantaris (Z=12.66,P＜0.001).Occluded inferior genicular arteries usually associated with collateral vessels.Conclusion CTA can reflect the clinical stages of LEAD,which is the ideal method in diagnosing of diabetic LEAD.

BACKGROUND: Present therapeutic tool cannot supplement infarct myocardium. Studies have shown that stem cell transplantation can promote regeneration of myocardium and vessels and improve heart function and prognosis.OBJECTIVE: To observe changes in morphology and hemodynamics in myocardium following embryonic stem cell transplantation in and surrounding the acute myocardial infarct site.DESIGN, TIME AND SETTING: The randomized, controlled, animal study was performed at the Laboratory of Neurobiology,Department of Human Anatomy and Neurobiology, Xiangya Medical College, Central South University from March 2007 to October 2008.MATERIALS: A total of 40 SPF grade Wistar rats were equally randomized into 4 groups, normal control, infarct model,central transplantation and peripheral transplantation groups. Embryonic stem cells-D3 (ES-D3) and Buffalo rat hepatocytas were supplied by Shanghai Cell Institute, Chinese Academy of Sciences.METHODS: Following resuscitation, ES-D3 cells at (2.0-5.0)×107/L were incubated in a flask, and induced to in vitro differentiate in conditioned medium containing Buffalo rat hepatocytes. Except normal control group, rat models of acute myocardial infarction were established by ligating left anterior descending coronary artery in the infarct model, central transplantation and peripheral transplantation groups. At 1 week following model induction, ES-D3 cells were labeled by BrdU for 1 day, and implanted at 1×109/L. Three sites were selected in the infarct site in the central transplantation group. 10 μ L cell suspension (104 cells) was implanted in the ventricular wall through each site. In the peripheral transplantation group, an equal volume of cell suspension was separately implanted in three peripheral infarct sites by the same method.MAIN OUTCOME MEASURES: Results of immunohistochemistry and hemodynamics were measured.RESULTS: ES-D3 cells in buffalo rat hepatocyte conditioned medium presented regular colony-shaped. At 8 days following differentiation, some embryo proper had spontaneous rhythmic contraction, showed positive reaction of cardiac troponin T after immunostaining. Under the electron microscope, myotube and muscle fiber appeared, which verified the differentiation of cardiomyocytes. Cells were positive for BrdU in the peripheral transplantation group, but negative in the central transplantation group. Cells were also positive for cardiac troponin T. 4 weeks following transplantation, left ventricular systolic pressure,minimum/maximum rate of ventricular pressure (±dp/dtmax) were significantly reduced (P ＜ 0.01), but left ventricular end diastolic pressure was significantly increased (P ＜ 0.01), left ventricular mass and left ventricular mass index were significantly increased (P ＜ 0.01 ) in the infarct model group compared with the normal control group. Compared with the infarct model group, no significant changes in hemodynamics indices were found in the central transplantation group (P ＞ 0.05); left ventricular systolic pressure, ±dp/dtmax were significantly increased (P ＜ 0.01), left ventricular end diastolic pressure was significantly decreased (P ＜ 0.01 ), left ventricular mass, left ventricular mass index and infarct area were significantly reduced(P ＜ 0.01) in the peripheral transplantation group.

OBJECTIVETo investigate the relationships between erythrocyte membrane n-6:n-3 PUFAs ratio and blood lipids and high sensitivity C-reactive protein (hs-CRP).

METHODSThe observational study consisted of a population-based cross-sectional study of 456 Chinese and a subsequent 1-year follow-up study of 171 subjects with the fasting plasma total cholesterol of 5.13-8.00 mmol/L.

RESULTSIn the cross-sectional analysis, plasma low-density lipoprotein cholesterol (LDL-c) had a significant and negative association with the erythrocyte membrane n-6:n-3 PUFAs ratio (P for trend=0.019) after adjusting for sex, age and total PUFA percentage. In the follow-up study, 171 subjects were categorized into quartiles by the changes of n-6:n-3 ratio in erythrocyte membrane (Δ=month 12-month 0). In the top quartile whose ratios of n-6:n-3 increased by an average of 1.25 during the follow-up, the LDL-c-lowering extent was 3.3 times of that in the lowest quartile whose ratios of n-6:n-3 decreased by an average of 1.13 (-1.07 mmol/L v.s. -0.32 mmol/L). The hsCRP decreased by 0.11 mg/dL in the lowest quartile while increasing by 0.10 mg/dL in the top quartile (P for difference=0.052).

CONCLUSIONOur results suggested that the balance between n-6 and n-3 fatty acids may optimize the cardiovascular benefits from dietary PUFAs.

C-Reactive Protein ; metabolism ; Cholesterol, HDL ; blood ; Cholesterol, LDL ; blood ; Cross-Sectional Studies ; Erythrocyte Membrane ; metabolism ; Fatty Acids, Omega-3 ; blood ; Fatty Acids, Omega-6 ; blood ; Female ; Humans ; Lipids ; blood ; Male ; Middle Aged ; Triglycerides ; blood

Objective To determine the incidence and prevalence of transient ischemic attack (TIA) and to evaluate its epidemiological situation in Hunan province.Methods Seven monitoring points were randomly selected from the province,a total of 8 311 subjects aged≥50 years were then chosen by stratified sampling.The cases counted in prevalence was defined as patients diagnosed before 24:00 o'clock August 31st,2013,and the new diagnosis for incident counting was defined as those diagnosed between 00:00 September 1st,2012 and 24:00 August 31st,2013.Results Among all 8 311 screened subjects,the number of TIA patients was 24 (288.8 per 100 000 people),the incidence of TIA was 7 (85.2 per 100 000 people).Standardized prevalence and incidence were 283.2 and 82.4 per 100 000 respectively using 2010 China census population.Among them,the standardized incidence rate of female was higher than that of male (114.8 per 100 000 person-years vs.48.8 per 100 000 person-years),and the prevalence rate of males was higher than that of female (288.2 per 100 000 people vs.273.2 per 100 000 people).Hypertension is the most important risk factor for TIA (55.2％).Conclusion The incidence and prevalence of TIA in Hunan province are higher than the national average.Hypertension is the main risk factor.

Objective:To compare the anesthesia methods for patients undergoing orthopaedic surgery between the epidemic period of COVID-19 in 2020 and the same period in 2019.Methods:A retrospective study was conducted of the patients who had undergone orthopedic surgery at The Trauma Emergency Center, The Third Hospital of Hebei Medical University in the epidemic period of COVID-19 from 20 January through 1 March in 2020 and from 4 February through 14 March in 2019 (the same lunar period). Their anesthesia methods were analyzed.The patients in the 2 periods were divided into a group of ≥65 years old and a group of <65 years old.The anesthesia methods and anesthetic operation time were compared between the total cohorts and 2 age groups in the 2 periods.Results:A total of 285 orthopedic operations were completed in the epidemic period in 2020, a decrease by 63.7% than the 784 operations in the same period in 2019; the proportion of elderly fracture patients ≥65 years old in 2020 [29.5%(84/285)] was significantly higher than that [18.1%(142/784)] in 2019. The proportion of non-airway management anesthesia in the epidemic period in 2020 [56.5% (161/285)] was significantly higher than that in the same period in 2019 [38.3%(300/784)]; there was a significant difference in the proportion of non-airway management anesthesia for elderly patients ≥65 years old between the 2 periods [41.6%(59/142) versus 71.4%(60/84)] ( P<0.05). The proportions of intraspinal anesthesia[36.5% (104/285)] and intravenous/+peripheral nerve block anesthesia[4.9%(14/285)] in 2020 were significantly higher than those in 2019 [25.5%(200/784) and 0.3%(2/784)] ( P<0.05); the proportion of laryngeal mask/+peripheral nerve block anesthesia in 2020 [27.7%(79/285)] was significantly lower than that in 2019 [48.9% (383/784)] ( P<0.05). In the group of ≥65 years old, the proportions of intraspinal anesthesia [48.8% (41/84)] and intravenous/+peripheral nerve block anesthesia [10.7%(9/84)]in 2020 were significantly higher than those in 2019 [29.6%(42/142) and 0] ( P<0.05), but the proportion of laryngeal mask/+peripheral nerve block anesthesia in 2020 [21.4% (18/84)] was significantly lower than that in 2019 [47.9%(68/142)] ( P<0.05). Compared with the operation time for intraspinal anesthesia (6.2 min ± 0.4 min) and for intubation/+block anesthesia (7.4 min ± 0.4 min) in 2019, the operation time in 2020 (12.6 min ± 0.4 min and 13.2 min ± 0.3 min, respectively) was significantly increased ( P< 0.05). Conclusions:The anesthesia methods for patients undergoing orthopaedic surgery in the epidemic period in 2020 were featured by non-airway management like peripheral nerve block anesthesia, intraspinal anesthesia, and laryngeal mask/+peripheral nerve block anesthesia because they might have helped to reduce the postoperative complications in respiratory system.The anesthetic operation time in the epidemic period in 2020 was increased than in the same period in 2019.

Objective Vulnerable plaque of carotid artery is one of the risk factors of atherosclerotic cerebral infarction.Detection and treatment of vulnerable atherosclerotic plaque of carotid artery before symptoms of cerebral infarction is an effective way to prevent atherosclerotic cerebral infarction.Tumor necrosis factor superfamily member 4 (TNFSF4) plays a key role in the process of atherosclerosis,a common risk factor for both myocardial and cerebral infarctions.Studies have indicated that the single nucleotide polymorphism (SNP) rs3850641 in TNFSF4 is associated with higher risk of myocardial infarction and SNP rs3861950 in TNFSF4 is associated with higher risk of atherosclerosis cerebral infarction (ACI),but little is known about the association between TNFSF4 variations and vulnerable plaque of carotid artery.Methods A case-control study involving 510 patients with asymptomatic vulnerable plaque of carotid artery and 485 age and sex matched healthy subjects without vulnerable plaque of carotid artery was conducted in Hunan province.Asymptomatic vulnerable plaque of carotid artery means vulnerable plaque of carotid artery without cerebral infarction.Two SNPs of TNFSF4,rs3850641 and rs3861950,were genotyped by the TaqMan SNP genotyping method,and verified partly by Genomic DNA Sequencing.Results The results revealed a significant allelic association between rs3861950 and asymptomatic vulnerable plaque of carotid artery in case group (x2=9.13,P=0.003;OR=1.41,95％ CI:1.12-1.76).Compared with control subjects,the difference in genotype was significant in case group (x2=25.28,P＜ 0.000 1).However,there was no significant association between rs3850641 and asymptomatic vulnerable plaque of carotid artery(OR=1.16,95％CI:0.92-1.46;x2＝ 1.47,P=0.225).Conclusion TNFSF4 gene polymorphism rs3861950 was associated with the risk of vulnerable plaques of carotid artery in a Chinese population,which might be middle phenotype indicating higher risk of cerebral infarction.