Objective To explore the effects of aging on ventricular remodeling and cardiac rupture after acute myocardial infarction in mice. Methods　Male C57BL/6 mice of 3 months and 12 months old were randomly divided into sham operation group and myocardial infarction(MI)group.Following acute myocardial infarction(AMI)modeling induced by open-chest surgery,the events of cardiac rupture were monitored and the echocardiography and hemodynamics were performed on the 7th day after surgery.Zymography,immunohistochemical method and pathological staining were used to measure the activity of matrix metalloproteinases(MMPs),the content of collagen and the degree of inflammatory cell infiltration on the 3rd and 7th days after surgery,respectively. Results　The incidence of cardiac rupture was higher in elderly group than that in young group(38.0% vs.16.0%,X2=6.139,P＜0.05).Compared with young group,significant infarct expansion,left ventricular (LV)remodeling and hemodynamic deterioration were showed in elderly group on the 7th day after surgery(t=5.754,P＜0.05).The degree of inflammatory cell infiltration and the expression of MMP-9 were significantly increased in elderly group on the 3rd day following AMI modeling(P＜0.05),and the collagen content and the expression of type Ⅲ collagen were significantly increased (P＜0.05)compared with young group. Conclusions　Aging is a risk factor for post-infarct cardiac rupture in the mice model.The mechanisms which are responsible for this age-related difference of cardiac rupture are related to increasing degree of inflammatory cell infiltration, overexpression of MMP-9 and type Ⅲ collagen and aggravated early LV remodeling.

AIM: To explore the changes in extracellular regulated protein kinase (ERK1/2) in the hypertrophic myocardium induced by pressure overload at the different time courses and to determine the molecular mechanism in the myocardium from hypertrophy to heart failure. METHODS: C57/BL mice, aged 12 week old, were subjected to sham-operation (SH) or transversing aortic constriction (TAC) to establish left ventricular hypertrophy. Echocardiographic assessments, hemodynamic determination, organ weight measurement, morphological and histological examination were performed at 1, 4, 8, 12 and 16 weeks after surgery. Meanwhile mRNA levels of atrial natriuretic peptide (ANP), α-myosin heavy chain (α-MHC), bcl-2 and bax were measured by RT-PCR, and ERK1/2 levels were detected by Western blotting. The animals in SH group were performed the same tests then sacrificed at 16 weeks. RESULTS: (1) Compared to SH group, LVESd, LVEDd, Awsth, Awdth, Pwsth and Pwdth progressively increased after TAC. Meanwhile, ejection fraction (EF%) significantly decreased at 16th week (P<0.05). LVSP, dp/dt_(max) and dp/dt_(min) in TAC group were progressively increased after 4 weeks. From 8-12 weeks these parameters maintained stable and then sharply decreased at 16th week (all P<0.05). However, LVEDP was statistically increased at 8th week. These echocardiographic and hemodynamic changes indicated a development of LVH and eventually progressing towards to heart failure. (2) Histologically, cardiac collagen measured by percentage of Sirius red positive stained area and apoptosis index showed progressive increases from 4 to 16 weeks. (3) Compared to SH group, mRNA levels of ANP was time-dependently increased while α-MHC and Bcl-2 were time-dependently decreased. The ratio of Bcl-2 /Bax was decreased. Phosphorylation of ERK1/2 was increased at 4th week, then decreased with age of TAC (all P<0.05). CONCLUSION: Pressure-overload induced by TAC results in a development of LVH from early concentric hypertrophy to late eccentric hypertrophy, and eventually toward cardiac dysfunction or heart failure. Those changes are associated with increase in cell size and cardiac fibrosis. ERK1/2 signaling pathway may involve in the regulation of myocardial cell apoptosis in hypertrophic and failure heart.

Aim.Comparison of the trascranial Doppler (TCD)characteristics of cerebral circulation in persistent vegetative status (PVS),locked-in syndrome and brain death patients.Methods.Using TCD ultrasound to detect the flow velocity and waveform patterns of middle cerebral artery (MCA)and basilar artery (BA)in patients with PVS, locked-in syndrome and brain death.Results．The mean velocities of middle cerebral artery （Vmca）and basilar artery （Vba）were 30．0cm/s and 24．3cm/s in PVS patients respectively，which decreased 45．0％ and 14．4％ in comparing with normal value．For patients with locked-in syndrome，Vmca and Vba were 49．7cm/s and 9．8cm/s，which decreased 5．0％ and 61．7％ than the normal value respectively．These results showed that the decrease of anterior circulation was predominant in PVS，and the decrease of posterior circulation was predominant in locked-in syndrome．A unique diastolic reverse flow，short peak systolic wave or undetectable flow signal in middle cerebral artery were predominant in brain death patients，which was completely different from that of either PVS or locked-in syndrome．Conclusion．TCD was a valuable tool in distinguishing PVS，locked-in syndrome and brain death patients according to the differences in velocities and patterns of anterior and posterior cerebral arteries．

Objective:To explore the influencing factors of working alienation among in-service nurses in Beijing, and provide a management basis for clinical nursing managers.Methods:According to the data from the National Bureau of Statistics in 2018, the convenience sampling method was adopted to select two Class Ⅲ hospitals, three ClassⅡ hospitals, and three ClassⅠ hospitals in Beijing from November 2019 to February 2020. Then through stratified sampling, each hospital nursing unit was randomly selected according to a sampling ratio of 20%. Finally, according to the cluster sampling, all the nurses included in the selected nursing unit were finally selected, including 531 ClassⅢ hospital nurses, 394 ClassⅡ hospital nurses, and 60 ClassⅠ hospital nurses, for a total of 985. The survey was conducted with the General Information Questionnaire, Work Alienation Scale, Person-Organization Fit Perceptions Scale and Organizational Support Perceptions Scale. Single factor analysis was used to carry out the influence analysis of general data, including t-test of independent samples, one-way analysis of variance and the non-parametric test of independent samples. Pearson correlation analysis was used to test the correlation among variables, and hierarchical linear regression analysis was used to explore the influencing factors of nurses' sense of work alienation. Finally, 953 valid questionnaires were obtained, with an effective recovery rate of 96.75%. Results:Among 953 nurses, the highest score of work alienation was 88, and the lowest score was 20, the total average score was (45.52±14.96) , which is in the middle level. The highest score of nurse personal-organization fit was 55, the lowest score was 18, and the total average score was (37.37±8.00) ; and the highest score of nurses' organization support perception was 80, the lowest score was 23, and the total average score was (52.79±12.12) , and the nurses' personal-organization fit and organizational support perception were both at the middle to high level. The univariate analysis showed that there were statistical differences in the scores of work alienation among 953 nurses with different ages, nursing ages, departments, technical titles, personnel relationships, and hospital levels ( P<0.05) . The results of Pearson correlation analysis showed that the total score and the scores of four dimensions of work alienation were negatively correlated with the scores of personal-organization fit and organizational support perception with a statistical difference ( P<0.01) . Personal-organization fit and organizational support were positively correlated ( P<0.01) , the difference was also statistical. In hierarchical linear regression analysis, personal-organization fit and organizational support were the main factors affecting nurses' sense of work alienation with a statistical difference ( P<0.05) . Conclusions:The sense of work alienation among nurses in Beijing is at a moderate level. Increasing organizational care can satisfy nurses' personal needs and make them willing to link their career planning with organizational vision to achieve common goals, thereby enhancing their emotional commitment to the organization and willingness to stay, and reducing their sense of work alienation.

Objective:To explore the correlation between nurses' professional identity and perceived head nurses' humanistic care.Methods:This study was a cross-sectional study. From March to April 2021, convenience sampling was used to select 1 600 nurses from five ClassⅢ general hospitals in Beijing. The nurses were surveyed by the Sociodemographic Information Questionnaire, Head Nurse's Humanistic Care Behavior Scale for Nurses, and Professional Identity Scale for Nurses.Results:A total of 1 526 effective questionnaires were recovered, with an effective recovery rate of 95.4%. The total scores of nurses' professional identity and perceived head nurses' humanistic care were (122.36±25.13) and (114.67±21.22) , respectively. Pearson correlation analysis showed that the perceived head nurses' humanistic care was positively correlated with the professional identity of nurses, and the difference was statistically significant ( r=0.66, P<0.01) . Multiple linear regression analysis showed that the higher the perceived head nurse's humanistic care, the higher the nurse's professional identity, and the difference was statistically significant (β=0.77, P<0.01) . Conclusions:Perceived head nurses' humanistic care has a positive impact on nurses' professional identity. Nurses' professional identity can be increased by improving the humanistic care behavior of head nurses.

Objective To investigate the prevalence and associated risk factors of type 2 diabetes mellitus in populations of Uigurs and Kazaks in Xinjiang.Methods Four-stage selected random samples aged 35 years and over were used to analyze the prevalence and associated risk factors of type 2 diabetes mellitus in populations of Uigurs and Kazaks from 6 localities(Urumqi,Kelamayi,Fukang,the Turfan Basin locality,Hetian locality,Yili Hazakh autonomous prefecture)in Xinjiang according to different nationality,age,and sex.The data were collected according to questionnaire,and physical examination and laboratory test were performed.Results A total of 8 539 Uigurs and Kazaks adults were surveyed.The prevalences of type 2 diabetes mellitus were 5.01%and 3.16%in Uigurs and Kazaks.The prevalence in male was higher than that in female(5.22%vs3.89%,P<0.01).The prevalences of type 2 diabetes mellitus were2.45%,4.92%,5.94%,7.49%,and 5.64%in 35-44,45-54,55-64,65-74,>75 yeats of age groups,respectively.Age,gender,nationality,systolic blood pressure,body weight,triglyceride,and total cholesterol were the risk factors for type2 diabetes mellitus,with the ORs being0.742,1.025,0.673,1.050,1.005,1.517,1.126,respectively.Conclusion It is important to culture healthy life style,enhance the control of hypertension and hyperlipidemia in Uigurs and Kazaks patients for preventing type 2 diabetes mellitus in Xinjiang.

Lenvatinib mesylate (LF), a multi-target tyrosinase inhibitor mainly used in the treatment of a variety of cancers, has low oral bioavailability mainly due to its gelation during the dissolution process. In the current study, in order to enhance dissolution and eliminate gelation of LF, a supramolecular coamorphous system of LF-baicalein (BAI) (molar ratio, 1∶1) was prepared by rotary evaporation and characterized by PLM, PXRD, DSC and FTIR. Results indicated the formation of coamorphous system with a single Tg of 118 °C. Different from original LF crystal, no gelation phenomenon was observed during the dissolution of coamorphous LF-BAI. In addition, the dissolution rate of LF was increased by 2.2-fold after coamorphization. Meanwhile, the dissolution rate of the co-former BAI was also enhanced by more than 25.4-fold. Stability test showed that the prepared coamorphous system had a good physical stability for at least 90 days under 25 °C/ 60%RH and 40 °C /75%RH conditions.

OBJECTIVE: To investigate the association of myocardial blood flow (MBF) quantified by dynamic computed tomography (CT) myocardial perfusion imaging (MPI) with troponin level and left ventricle (LV) function in patients with ST-segment elevated myocardial infarction (STEMI). MATERIALS AND METHODS: Thirty-five STEMI patients who successfully had undergone reperfusion treatment within 1 week of their infarction were consecutively enrolled. All patients were referred for dynamic CT-MPI. Serial high-sensitivity troponin T (hs-TnT) levels and left ventricular ejection fraction (LVEF) measured by echocardiography were recorded. Twenty-six patients with 427 segments were included for analysis. Various quantitative parameters derived from dynamic CT-MPI were analyzed to determine if there was a correlation between hs-TnT levels and LVEF on admission and again at the 6-month mark. RESULTS: The mean radiation dose for dynamic CT-MPI was 3.2 ± 1.1 mSv. Infarcted territories had significantly lower MBF (30.5 ± 7.4 mL/min/100 mL versus 73.4 ± 8.1 mL/min/100 mL, p < 0.001) and myocardial blood volume (MBV) (2.8 ± 0.9 mL/100 mL versus 4.2 ± 1.1 mL/100 mL, p = 0.044) compared with those of reference territories. MBF showed the best correlation with the level of peak hs-TnT (r = −0.682, p < 0.001), and MBV showed a moderate correlation with the level of peak hs-TnT (r = −0.437, p = 0.026); however, the other parameters did not show any significant correlation with hs-TnT levels. As for the association with LV function, only MBF was significantly correlated with LVEF at the time of admission (r = 0.469, p = 0.016) and at 6 months (r = 0.585, p = 0.001). CONCLUSION: MBF quantified by dynamic CT-MPI is significantly inversely correlated with the level of peak hs-TnT. In addition, patients with lower MBF tended to have impaired LV function at the time of their admission and at 6 months.
Blood Volume ; Echocardiography ; Heart Ventricles ; Humans ; Infarction ; Myocardial Infarction ; Myocardial Perfusion Imaging ; Reperfusion ; Stroke Volume ; Troponin T ; Troponin

Hypereosinophilia (HE) is a kind of hematology disorder affecting multiple organs. Multiple studies demonstrated that HE was correlated with ischemic stroke, and it could be a rare and reversible cause for ischemic stroke. Therefore, more and more concerns have been concentrated by neurologists in recent years. Based on the research data, the definition, typical characteristics, possible mechanism, diagnosis and treatment principles of HE related ischemic stroke were summarized systematically, in order to provide possible personalized treatment strategies for this disease.

Secondary traumatic stress refers to the natural, consequent emotions and behaviors that arise from knowledge of traumatic events experienced by others. It is the stress of helping or wanting to help a traumatized person and is considered one of the occupational injuries for nurses. Because of the unpredictable working environment, nurses in Emergency Department often experience patient death, suicide, traumatic events, and participate in emergency first aid and nursing of a large number of trauma patients, and they are at increased risk of secondary traumatic stress. This article mainly reviews the concept, symptoms, current situation, measurement tools and influencing factors of secondary traumatic stress of nurses in Emergency Department, so as to provide a basis for further identification and intervention in clinical practice.