Objective To study the protective role against cisplatin-induced ototoxicity by using radix astra-gali in rats. Methods Forty rats were randomly divided into four groups. Group A received saline as controls. Group B received radix astragali. Group C received injection of cisplatin(4 mg/kg) as experiments for 6 days. Group D received both radix astragali (5 g/kg) and cisplatin (4 mg/kg). Distortion product acoustic emission (DPOAE) was applied to each rat before and 7 days after cisplatin injection. All the animals were sacrificed on the 7th day. Half of the cochleas were observed by frozen section and the apoptosis of hair cells was detected by TUNEL meth-od. Scanning electron microscopy was utilized to evaluate the cochlear morphology of the other rats. Results The DPOAE amplitudes of Group C decreased significantly compared to the group A and group B(P<0.01). The dam-age and apoptosis of hair cells were noted in the group C and group D, while the hair cells of group A and group B showed no sign of apoptosis or damage. Compare to experimental group , the DPOAE amplitudes of group D were higher, and the damage and apoptosis of hair cells were significantly lower(P<0.05). Conclusion This study sug-gests that radix astragali can effectively reduce cisp[atin ototoxicity.

Objective To investigate the biofilm formation,the alginate biosynthetic gene ex- pression and analyze the mucA gene sequence of mucoid Pseudomonas aeruginosa PA17 and nonmu- cold Pseudomonas aeruginosa PA01.Methods The modified plate culture method was used to estab lish the biofilm model in vitro.Semi-quantitative RT-PCR was used to determine the expression level of algD in planktonic condition and during the formation of biofilm.The mucA gene of PA17 and PA01 was amplified and the products were sequenced.Results PA17 biofilm was mature at 6th day, and PA01 biofilm was mature at 3rd day.The structures of the biofilms were both like pellicle.In planktonic condition,the algD expression of PAl7 was higher than PA01;in biofilm formation,the algD expression was maximal when the biofilm was mature.There was a 166～333 deletion mutation and 342A→G in mueA gene of PA17,the mucA gene of PA01 was the same with the sequence of Genbank.Conclusions The mucA gene mutation of PA17 was a new type,which maybe the reason for the little expression difference of algD between PA17 and PA01 during the biofilm formation than it in planctonic condition and the same structure of PA17 and PA01 biofilm.

Objective To construct an immortalized rat astrocyte strain expressing enkephalin which can be regulated by doxycycline.Methods pRevTet-On and recombinant plasmid pRevTRE/hPPE were transfected into packaging cell PT67 respectively by standard lipofectamine methods.The supernatant containing RevTet-On virus was used to infect immortalized rat astrocyte strain(IAST)and RevTRE/hPPE virus was used to infect the IAST/Tet-On cell.Immortalized rat astrocyte strain that stably expressed Tet-regulated enkephalin was established. hPPE gene expression level of IAST/Tet-On/hPPE cell strain was detected by real time-PCR,immuno- cytochemistry and radio-immunoassay.Results Real time-PCR,immuno-cytochemistry and radio-immunoassay confirmed the level of enkephalin expression was regulated by doxycycline in a dose-dependent manner.Conclusion An immortalized rat astrocyte strain which secrets enkephalin as controlled by doxycycline has been constructed successfully.

Objective To evaluate the effectiveness of discharge planning and home care for patients with peritoneal dialysis (PD).Methods A total of 60 PD patients were randomly divided into the intervention group and control group,30 cases in each group.Discharge planning and home care were carried out in the intervention group, while routine nursing and telephone follow -up service after discharge were implemented in the control group.The patientsˊscores of Zung Self -Rating Anxiety Scale(SAS),Self -Rating Depression Scale(SDS),Self management ability of patients undergoing peritoneal dialysis,complication rate and readmission rate were compared between the two groups at the next day admission,discharge,lth month and 3th after discharge.Results The scores of SAS and SDS in the intervention group were significantly lower than that in the control group at 3th month after discharge,the difference was statistically significant(tSDS =5.263,tSAS =3.812,P <0.05).The Self management ability of patients undergoing peritoneal dialysis was significantly higher than that of the control group at lth and 3th month after discharge,the difference was statistically significant (t =6.845,t =7.231,P <0.05).No significant difference in the re -admission rate (16.67%,6.67%)was found between the two groups (χ2 =0.387,P >0.05).The complication rate in the intervention group was significantly lower than in the control group at 3th month after discharge(χ2 =5.124,P <0.05).Conclusion Discharge planning and home care can effectively relieve depression and anxiety in patients with peritoneal dialysis and improve the abilities of daily life.It is worth promoting and applying in clinic.

Aim To discuss whether specific mitochon-drial ATP-sensitive potassium channel opener diazoxide ( DZ ) postconditioning activates RISK signaling path-way to protect isolated rat hearts against ischemica reperfusion injury ( IRI ) . Methods Langendorff de-vice was used to establish rat in vitro model of myocar-dial ischemia reperfusion. SD rats were randomly di-vided into normal group ( NOR ) , control group ( CON ) , diazoxide after treatment group ( DZ ) , and LY294002 antagonistic nitrogen Triazine group ( DZ +LY) , with 8 cases in each. The following was com-pared:①whether heart function of each group changed at the end of equilibration and reperfusion; ② at the end of myocardial perfusion and separation, protein was extracted, and protein kinase B ( PKB / Akt ) , P70S6 kinase (P70S6K), endothelial nitric oxide syn-thase ( eNOS) phosphorylation level of expression were analysed by Western blot. Results ① Indicators of changes in heart function: for DZ group at the end of reperfusion , HR , CF , LVDP , LVEDP , +d p/d tmax and -dp/dtmax were significantly better than those in CON group and DZ + LY group ( P <0.01 ) , but worse than those in NOR group ( P <0.01 ); there was no statistical difference in cardioac function at the end of equilibration. ② For DZ group at the end of reperfu-sion Akt, P70S6K, eNOS phosphorylation level of ex-pression were significantly higher than those in NOR group, CON group, and DZ + LY group (P<0.01). There was no difference in expression level of ERK1/2 phosphorylation ( P >0.05 ) . Conclusion Diazoxide postconditioning through the activation of RISK signa-ling pathway can protect isolated rat hearts against is-chemia reperfusion injury.

Objective Face-down positioning after vitrectomy and gas tamponade is still the standard position for patients with rhegmatogenous retinal detachment.The study was to compare the nursing effects of face-down position and flexible position after vitrecto-my for the repair of rhegmatogenous retinal detachment. Methods We investigated 120 cases of patients with rhegmatogenous retinal detachment in this study.All patients received vitrectomy with long-acting gas for tamponade, 60 patients in face-down position and 60 in the flexible position.Patients were followed up for 6 months.Observation was made on the rates of anatomical retinal reattachment and postoperative complications between the groups. Results The rates of anatomical retinal reattachment after surgery were 88.33%in the face-down position group and 100% in the flexible position group respectively.As to the satisfaction of position, the flexible position group was 100%, which was much higher than 41.67%in face-down position group(P<0.01). Conclusion Flexible position nurs-ing after vitrectomy and gas tamponade for rhegmatogenous retinal detachment repair is safe and effective.Flexible position can replace face-down position for the comfort of patients with rhegmatogenous retinal detachment after vitrectomy with gas tamponade.

Objective To evaluate the role of phosphoinositide 3 kinase/protein kinase B/glycogen synthase kinase 3β (PI3K/Akt/GSK-3β) signaling pathway in mitigation of ischemia-reperfusion (I/R) injury by diazoxide postconditioning in isolated rat hearts.Methods Pathogen-free Sprague-Dawley rats were used in the study.Thirty hearts were excised and passively perfused in a Langendorff apparatus with oxygenated K-H solution at 37 ℃.The hearts were randomly divided into 5 groups (n =6 each) using a random number table:control group (group C),I/R group,diazoxide postconditioning group (group DZ),PI3K inhibitor LY294002 group (group LY),and diazoxide postconditioning + LY294002 group (group DZ + LY).In group C,the hearts were continuously perfused with K-H solution for 70 min.In group I/R,the hearts were perfused with cardioplegic solution 4 ℃ ST-Thomas 10 ml/kg,the perfusion pump was then stopped to induce global ischemia,and 40 min later the hearts were perfused with K-H solution for 30 min.In DZ group,5 min of retrograde perfusion with diazoxide 50μmol/L was performed through the aorta starting from the onset of reperfusion.In LY group,5 min of retrograde perfusion with LY294002 15 μnol/L was performed through the aorta starting from the onset of reperfusion.In LY + DZ group,5 min of retrograde perfusion with LY294002 15 μmol/L was performed through the aorta starting from the onset of reperfusion,followed by 5 min of retrograde perfusion with diazoxide 50 μmol/L.At 20 min of stabilization (T1) and 30 min of reperfusion (T2),heart rate (HR),coronary flow (CF),left ventricular developed pressure (LVDP),left ventricular developed pressure (LVEDP) and ± dp/dtmax were measured.The expression of total Akt (t-Akt) and total GSK-3β (t-GSK-3β) and phosphorylation of Akt and GSK-3β in myocardial tissues were determined by Western blot.Results Compared with C group,HR,LVDP and ± dp/dtmax were significantly decreased,and LVEDP was increased at T2 in the other four groups,CF was decreased in I/R,LY and DZ + LY groups,and the phosphorylation of Akt and GSK-3β in myocardial tissues was increased in DZ group.Compared with I/R group,HR,CF,LVDP and ± dp/dtmax were significantly increased,and LVEDP was decreased at T2,and the phosphorylation of Akt and GSK-3β in myocardial tissues was increased in DZ group,and no significant changes were found in the phosphorylation of Akt and GSK-3 β in LY and DZ + LY groups.Compared with DZ group,HR,CF,LVDP and ± dp/dtmax were significantly decreased,LVEDP was increased,and the phosphorylation of Akt and GSK-3β in myocardial tissues was decreased in LY and DZ + LY groups.Conclusion PI3K/Akt/GSK-3β signaling pathway is involved in the mechanism by which diazoxide postconditioning mitigates I/R injury in isolated rat hearts.

Objective Toinvestigatetherelationshipbetweendifferenttypesofinternalwatershed infarctionandtandemstenosesofinternalcarotidartery(ICA).Methods Atotalof55patientswith internal watershed infarction confirmed by head MRI and diffusion-weighted imaging (DWI )examination were enrolled. They all underwent the extracranial internal carotid artery (ICA ) ultrasonography and intracranial cerebral artery MR angiography (MRA)examinations. According to the findings of imaging,the 55 patients with internal watershed infarction were divided into a simple internal watershed infarction (IWSI)group and an internal watershed infarction accompanied with ipsilateral cortical watershed infarction (C-IWSI)group. The relationship between the two types of internal watershed infarction and tandem stenoses of ICA was analyzed. Results (1 ) Of the 55 patients with internal watershed infarction,24 cases (43. 6%)were in the internal watershed infarction group and 31 cases (56. 4%)were in the C-IWSI group. The ipsilateral vascular stenosis were ICA 20 cases (36. 4%,including extracranial segment 11 cases and intracranial segment 17 cases),middle cerebral artery (MCA)44 cases (80. 0%), and tandem stenoses of ICA 15 cases (27. 3%). (2)Ipsilateral tandem stenoses of ICA:2 cases were in the IWSI group (intracranial ICA+MCA 2 cases);13 cases were in the C-IWSI group (extracranial ICA+intracranial ICA +MCA 4 cases,extracranial ICA + intracranial ICA 1 case,extracranial ICA + MCA 2 cases,and intracranial ICA+MCA 6 cases). (3)Compared with the IWSI group,the incidences of ipsilateral ICA stenosis and tandem stenoses of ICA in patients of the C-IWSI group were higher (54. 8%[n=17]vs. 12. 5%[n=3],41. 9%[n=13]vs. 8. 3%[n =2]),and there were significant differences(P =0. 001, 0.006]). The incidences of extracranial and intercranial ICA stenosis were higher than those of the IWSI group (35. 5%[n=11]vs. 0,45. 2%[n=14]vs. 12. 5%[n=3]),and there were significant differences (P=0.003,0.009).Conclusion Inthedifferenttypesofinternalwatershedinfarction,theincidenceof tandem stenoses of ICA is different. The IWSI patients with ipsilateral cortical watershed infarction often accompany by tandem stenoses of ICA.

Objective To study the feasibility and curative effect of transumbilical single-incision (TSIL) vs multiple-incision (MIL) laparoscopic splenectomy.Methods Ten cases (2 cases of idiopathic thrombocytopenia purpura,1 case of hereditary spherocytosis,3 cases of splenic hemangioma and 4 cases of cirrhotic splenomegaly) underwent TSIL from Jan 2010 to Ju12011,and 12 cases (3 cases of ITP,2 cases of hereditary spherocytosis,3 cases of splenic hemangioma and 4 cases of splenomegaly) underwent MIL.Clinical data were compared with each other.Results No severe complications occurred in either group.The mean operation time of single-incision group and multiple-incision group was ( 182 ± 23 ) min and ( 169 ± 19) min,and blood loss was( 160 ± 13 ) ml and ( 155 ± 16) ml ( P ＞ 0.05 ).The post-operative pain score in TSIL and in MIL group was respectively [ ( 1.60 ± 0.20) vs (3.60 ± 0.90) on day 1,P ＜ 0.05 ; (0.50 ±0.10) vs (2.00 ±0.45) on day 2,P ＜0.05].There was no significant difference between the two groups in the recovery of the gastrointestinal function,the length of hospital stay and the cost of hospitalization, all P ＞ 0.05.The umbilical incision in TSIL cases is more cosmetic.Conclusions Transumbilical single-incision laparoscopic splenectomy is feasible and safe in experienced hands.

Objective To improve the therapeutic response and survival of locally advanced pancreatic cancer treated with radiochemotherapy. Methods Fifty nine patients with stage Ⅱ Ⅲ pancreatic cancer were divided into two groups: 33 patients were treated with three dimensional conformal radiotherapy (3DCRT) plus regional intra arterial infusion chemotherapy (CT)and 26 patients received 3DCRT alone.Results The response (pain alleviating) rates were 78.8% in 3DCRT+CT group and 80.8% in 3DCRT group,while the overall response (CR+PR) rates were 78.8% and 42.3% (P