Objective To explore the mechanism by which soybean isoflavone(SI)reduces calcium overload induced by cerebral ischemia-reperfusion(I/R).Methods Forty-eight SD rats were randomized into 4 groups to receive sham operation,cerebral middle artery occlusion for 2 h followed by 24 h of reperfusion(I/R model group),or injection of adeno-associated virus carrying Frizzled-2 siRNA or empty viral vector into the lateral cerebral ventricle after modeling.Western blotting was used to examine Frizzled-2 knockdown efficiency and changes in protein expressions in the Wnt/Ca2+signaling pathway.Calcium levels and pathological changes in the ischemic penumbra(IP)were measured using calcium chromogenic assay and HE staining,respectively.Another 72 SD randomly allocated for sham operation,I/R modeling,or soy isoflavones pretreatment before modeling were examined for regional cerebral blood flow using a Doppler flowmeter,and the cerebral infarct volume was assessed using TTC staining.Pathologies in the IP area were evaluated using HE and Nissl staining,and ROS level,Ca2+level,cell apoptosis,and intracellular calcium concentration were analyzed using immunofluorescence assay or flow cytometry;the protein expressions of Wnt5a,Frizzled-2,and P-CaMK II in the IP were detected with Western blotting and immunohistochemistry.Results In rats with cerebral I/R,Frizzled-2 knockdown significantly lowered calcium concentration(P<0.001)and the expression levels of Wnt5a,Frizzled-2,and P-CaMK II in the IP area.In soy isoflavones-pretreated rats,calcium concentration,ROS and MDA levels,cell apoptosis rate,cerebral infarct volume,and expression levels of Wnt/Ca2+signaling pathway-related proteins were all significantly lower while SOD level was higher than those in rats in I/R model group.Conclusion Soy isoflavones can mitigate calcium overload in rats with cerebral I/R by inhibiting the Wnt/Ca2+signaling pathway.

Objective To explore the mechanism by which soybean isoflavone(SI)reduces calcium overload induced by cerebral ischemia-reperfusion(I/R).Methods Forty-eight SD rats were randomized into 4 groups to receive sham operation,cerebral middle artery occlusion for 2 h followed by 24 h of reperfusion(I/R model group),or injection of adeno-associated virus carrying Frizzled-2 siRNA or empty viral vector into the lateral cerebral ventricle after modeling.Western blotting was used to examine Frizzled-2 knockdown efficiency and changes in protein expressions in the Wnt/Ca2+signaling pathway.Calcium levels and pathological changes in the ischemic penumbra(IP)were measured using calcium chromogenic assay and HE staining,respectively.Another 72 SD randomly allocated for sham operation,I/R modeling,or soy isoflavones pretreatment before modeling were examined for regional cerebral blood flow using a Doppler flowmeter,and the cerebral infarct volume was assessed using TTC staining.Pathologies in the IP area were evaluated using HE and Nissl staining,and ROS level,Ca2+level,cell apoptosis,and intracellular calcium concentration were analyzed using immunofluorescence assay or flow cytometry;the protein expressions of Wnt5a,Frizzled-2,and P-CaMK II in the IP were detected with Western blotting and immunohistochemistry.Results In rats with cerebral I/R,Frizzled-2 knockdown significantly lowered calcium concentration(P<0.001)and the expression levels of Wnt5a,Frizzled-2,and P-CaMK II in the IP area.In soy isoflavones-pretreated rats,calcium concentration,ROS and MDA levels,cell apoptosis rate,cerebral infarct volume,and expression levels of Wnt/Ca2+signaling pathway-related proteins were all significantly lower while SOD level was higher than those in rats in I/R model group.Conclusion Soy isoflavones can mitigate calcium overload in rats with cerebral I/R by inhibiting the Wnt/Ca2+signaling pathway.

OBJECTIVE To evaluate the effects of gene polymorphism on the efficacy and safety of citalopram/escitalopram， and to provide evidence-based reference for precision medication. METHODS Retrieved from PubMed， Embase， the Cochrane Library， CNKI， Wanfang data and SinoMed， clinical studies about the association of gene polymorphism with efficacy and safety of citalopram/escitalopram were collected. Meta-analysis was performed with RevMan 5.3 software after literature screening， data extraction and quality evaluation based on Newcastle-Ottawa scale. RESULTS Totally 35 pieces of literature were included， all of which were cohort studies， with a total of 9 836 patients. Meta-analysis showed that the SLC6A4 gene 5-serotonin transporter linked polymorphic region （HTTLPR） LL genotype was associated with high response rate of citalopram/escitalopram [LS/SS vs. LL： OR＝0.47， 95%CI （0.22， 0.98）， P＝0.05]； results of subgroup analysis suggested a higher correlation in white people with LL genotype and escitalopram； there was no significant correlation of HTTLPR genotype with remission rate [LS/SS vs. LL： OR＝ 0.92，95%CI（0.77， 1.10）， P＞0.05； SS vs. LL/LS：OR＝0.73， 95%CI（0.45， 1.19）， P＞0.05] or overall incidence of ADR in patients with gene SLC6A4； but high expression of rs25531 LA was significantly associated with reduced incidence of ADR（P＜ 0.05）. CYP2C19*2/*3 allele was significantly associated with slowed metabolism， higher response rate and increased incidence of ADR. CONCLUSIONS HTTLPR LL genotype is associated with the increased response rate of citalopram/escitalopram， but no significant correlation with safety is found， while CYP2C19*2/*3 allele is significantly associated with higher response rate and reduced tolerability.

Objective:To evaluate ward nurses′ understanding of nuclear medicine and assess whether they can prepare for scintigraphy procedures and answer patient′s questions about nuclear medicine examinations.Methods:An online questionnaire was provided to nurses in 11 wards of Wuxi Second Hospital Affiliated to Nanjing Medical University where nuclear medicine examinations were frequently undergone. The questionnaire contained 3 parts: general data, self-assessment, objective testing of knowledge about nuclear medicine. Professional titles, educations, working years, self-assessment and objective testing for knowledge of nuclear medicine for patients′ preparation and question of involvers were collected. Results of objective knowledge test among different professional titles, educations and the results of self-assessment were analyzed using one-way analysis of variance and independent-sample t test. Pearson correlation analysis was used to evaluate the correlation between objective testing results and working years. Results:The effective receiving rate of questionnaire was 96.4%(267/277). There were 96.3%(257/267) involvers did not receive any specific training in nuclear medicine, and only 4.9%(13/267) considered they knew nuclear medicine well. There were 50.2%(134/267) involvers thought that their knowledge of nuclear medicine was enough to prepare nuclear medicine examination for patients and 49.8%(133/267) involvers thought that they were able to explain nuclear medicine examination for patients. In objective knowledge test, (14.6±2.8) questions answered correctly for each person, with a correct rate of (54.9±10.5)%. There were (14.1±2.8), (15.5±2.3) and (16.8±3.9) questions answered correctly in involvers with primary title, mid-level title and senior title respectively ( F=9.789, P<0.001), and (15.8±2.5), (14.2±2.8) in involvers with bachelor degree or above and college degree ( t=3.477, P<0.001). There was only subtle correlation between objective testing results and working years ( r=0.257, P<0.01). The main way that involvers obtained nuclear information was through experience-based teaching methods such as introductions from colleagues(57.7%, 154/267) and department education(18.0%, 48/267). Conclusions:Lacking of formal nuclear medicine orientation is common in ward nurses, and their understanding of nuclear medicine examinations is insufficient. Working characteristics and learning patterns of ward nurses should be considered when providing information on nuclear medicine treatments for them.

Objective:To investigate the mechanism by which Melittin-K1 reverses multidrug resistance of BEL-7402/5-FU cells.Methods:CCK-8 assay was used to evaluate the effect of Melittin-K1 on the growth of BEL-7402/5-FU cells and to explore whether Melittin-K1 could reverse the drug resistance of BEL-7402/5-FU cells. The expression of MDR1 mRNA level was detected by real-time fluorescence quantitative PCR assay. The flow cytometry was used to measure the expression of P-glycoprotein (P-gp) on the cell membrane surface and the accumulation of rhodamine-123 in cells.Results:Melittin-K1 significantly inhibited the growth of BEL-7402/5-FU cells in vitro in a time and dose-dependent manner. Melittin-K1 suppressed the level of MDR1 mRNA and inhibited the surface expression and function of P-gp in BEL-7402/5-FU cells. Conclusions:Melittin-K1, a novel peptide, exhibited the activity of reversing multidrug resistance of liver cancer cells.

Objective:To investigate the relevance between spatial learning and memory impairment and the changes of inducible nitric oxide synthase (iNOS) activity,superoxide dismutase (SOD) activity and malondiadehyde (MDA) content in hippocampus from Type 1 diabetic mice.Methods:Sixty male mice were randomly assigned into a control group (NC group,20 mice) and a Type 1 diabetic group (DM group,40 mice).Type 1 diabetic mouse models were established by a large dose intraperitoneal injection of streptozotocin (100 mg/kg).The spatial learning and memory abilities of mice were assessed by Morris water maze (MWM) test.After MWM test,we chose 20 mice (diabetic encephalopathy mice) with the worst spatial learning and memory abilities from diabetic model group,and detected the iNOS activity,SOD activity and MDA content in hippocampus in both groups.Results:Compared with the NC group,the escape latency was significantly extended and platform crossings were significantly declined in diabetic mice (P＜0.01).Furthermore,the activity of iNOS and the content of MDA were markedly increased,and the activity of SOD was significantly decreased in hippocampus of diabetic encephalopathy mice (P＜0.01).Conclusion:The established Type 1 diabetic mice show symptoms of cognitive dysfunction,which might be related to the increase of oxidative stress in hippocampus.

Objective To evaluate the application effect of the situation-background-assessment-recommendation(SBAR) communication mode in the intensive care unit in the department of neurosurgery (NSICU).Methods From January 2015, the SBAR communication mode was carried out in the shifting of duty for the nurses in the intensive care unit in the department of neurosurgery. The SBAR communication standard of patients' condition was initiated in the communication between nurses and doctors. The implementation effect of the mode was evaluated by the comparisons of the time of the nurses' shifting of duty, the incidence of adverse events, the average hospital stay of patients, the satisfaction of patients between before the implementation (the year of 2014) and after the implementation(the year of 2015).Results After implementing the SBAR communication mode, the incidence of pressure sores decreased from 2.64% to 0.39% significantly (χ2=4.252, P<0.05). The incidence of extubation decreased from 1.76% to 0% significantly (χ2=4.531,P<0.05). The satisfaction of patients increased from 91.4% to 97.7% significantly (χ2=4.714,P<0.05). The handover time of the nurses was shortened from (8.7±2.1)min every time to(6.1±1.9)min every time significantly (t=2.045, P<0.05). The average hospital stay in the NSICU was shortened from (13.2±2.5)day to(10.5±2.1)day significantly (t=2.057,P<0.05).Conclusions The implementation of the SBAR communication mode is helpful to standardize the shifting of duty and the communication process of doctors and nurses, ensure the safety of patients and improve the satisfaction, which is worth promotion and reference.

Vitrectomy with inert gas or silicone oil tamponade is an effective surgical treatment of complicated retinal detachment.Maintaining the passive position after the surgery related to the success of the operation.If there is no suitable head-resting table,patients will have a lot of symptoms due to long time sitting with head bowed.In this paper,we developed a special head-resting table for patients of sitting position with head bowed after vitrectomy.It can adjust the head position more accurately,increase patient comfort,ensure the maintenance of the correct body position for a long time,and effectively reduce the various symptoms of the prone position,improve the success rate of surgery.

Objective To explore the application of evidence-based nursing in patients with coronary atherosclerosis heart disease (CHD)who received percutaneous coronary intervention (PCI)in selected days.Methods A total of 85 CHD patients undergoing PCI in selected days were randomly divided into observation group (43 cases)and control group (42 cases).Control group was treated with routine nursing while observation group with evidence-based nursing.Re-sults The compliance rates of observation group was 95.35%,evidently higher than the 78.57%in control group (P <0.05).Self-rating anxiety scale (SAS)and self-rating depression scale (SDS)scores decreased markedly in both groups after interventions than intervention before, which were apparently lower in observation group than in control group,and there was significant difference (P <0.05).One month after operation,observation group was obviously higher in seat-tle angina questionnaire (SAQ)than control group (P <0.01).Conclusion Evidence-based nursing can increase the therapeutic compliance,promote the negative emotions and improve the postoperative quality of life of CHD patients with PCI.