Objective:To investigate the clinical features of cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) manifested as epileptic seizures.Methods:Clinical data of a family with CADASIL manifested as epileptic seizures admitted to Department of Neurology, Tengzhou Central People's Hospital in December 2018 were collected. Literature on CADASIL manifested as epileptic seizures was collected from databases of CNKI, Wanfang, VIP and PubMed published from database establishment to July 31, 2024. Clinical, imaging and genetic test results of these 48 patients were analyzed.Results:The proband presented with recurrent generalized tonic-clonic seizure, and had history of cerebral infarction and cognitive impairment. His mother had a similar history. Multiple lacunar infarction and extensive white matter lesion (involving the temporal pole, external capsule and superior frontal gyrus) and intracranial artery stenosis (ICAS) was noted at the proband. His son had no clinical symptom, but had multiple white matter lesion, without temporal pole involvement or ICAS. The proband and his son had the same pathogenic heterozygous missense mutation site C.505 C>T(P. Arg169Cys) at NOTCH3 gene. Among these 48 patients, 25 (52.1%) had stroke and 33 (68.8%) had cognitive impairment. All patients showed white matter lesion on imaging, including 19 (39.6%) with temporal pole involvement, 21 (43.8%) with external capsule involvement, 38 (79.2%) with multiple lacunar infarction, and 2 (4.2%) with ICAS. Conclusion:ICAS is rare in patients with CADASIL manifested as epileptic seizures; cognitive impairment and stroke are often accompanied; extensive white matter lesion is the clue for diagnosis.

Objective:To investigate the clinical features of cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) manifested as epileptic seizures.Methods:Clinical data of a family with CADASIL manifested as epileptic seizures admitted to Department of Neurology, Tengzhou Central People's Hospital in December 2018 were collected. Literature on CADASIL manifested as epileptic seizures was collected from databases of CNKI, Wanfang, VIP and PubMed published from database establishment to July 31, 2024. Clinical, imaging and genetic test results of these 48 patients were analyzed.Results:The proband presented with recurrent generalized tonic-clonic seizure, and had history of cerebral infarction and cognitive impairment. His mother had a similar history. Multiple lacunar infarction and extensive white matter lesion (involving the temporal pole, external capsule and superior frontal gyrus) and intracranial artery stenosis (ICAS) was noted at the proband. His son had no clinical symptom, but had multiple white matter lesion, without temporal pole involvement or ICAS. The proband and his son had the same pathogenic heterozygous missense mutation site C.505 C>T(P. Arg169Cys) at NOTCH3 gene. Among these 48 patients, 25 (52.1%) had stroke and 33 (68.8%) had cognitive impairment. All patients showed white matter lesion on imaging, including 19 (39.6%) with temporal pole involvement, 21 (43.8%) with external capsule involvement, 38 (79.2%) with multiple lacunar infarction, and 2 (4.2%) with ICAS. Conclusion:ICAS is rare in patients with CADASIL manifested as epileptic seizures; cognitive impairment and stroke are often accompanied; extensive white matter lesion is the clue for diagnosis.

Objective To investigate the effects of the structural psychological nursing on the sense of uncertainty and adverse cardiovascular events (ACE) in patients with PCI.Methods Totals of 98 PCI patients who admitted to the Cardiology Department of Affiliated Hospital of Binzhou Medical College from June 2015 to May 2016 were selected into the study. The participants were divided into the control group (n=49) and the intervention group (n=49) according to a random number table. Based on the routine nursing care, the intervention group received an additional structural psychological care. To compare the state of pre operative mood and postoperative mood, the sense of uncertainty one day before and after PCI, and the incidence of ACE three months after PCI between the two groups.Results Patients in the intervention group had a better state of mood after the intervention compared with the control group. The sense of uncertainty was similar before the operation (P>0.05) but was significantly different between the two groups after the operation (t=4.635, 3.265, 4.012;P<0.01). In the intervention group, the scores of undefined diagnosis, complexity, and sense of uncertainty to the disease was (35.63±5.96), (21.26±3.01) and (56.89±5.84). After three months, the vasovagal reflectivity and incidence of hematoma on the puncture site had significant differences between the two groups (P<0.05), but had limited difference in the incidence of myocardial infarction or angina recurrence rate (P>0.05).Conclusions The structural psychological nursing can effectively prevent the sense of uncertainty and adverse cardiovascular events in patients with PCI.

Objective To investigate the recognition of nurses and patients on chosing daily caregivers and analyze the influencing factors. Method Totally 1,119 nurses and 1,134 patients from five first-class and two second-class hospitals in Zhuhai participated in the survey using self-designed questionnaires from April to June in 2014. Results There were significant differences between nurses and patients in all life nursing projects (P<0.001) except making beds for patients. The top three factors influencing the nurses′recognition were shortage of nursing staff and time, less presence of professional values and feeling no respects. The top three factors influencing the patients′recognition included tending to be nursed by family members, worries about medical expenses, and nurses′being too busy on treatment. Conclusion The different recognitions of nurses and patients on daily caregivers are influenced by multiple factors. Therefore , nursing managers should take some effective strategies to change the concepts of nurses and patients so as to improve quality of nursing service.

Objective To investigate the effect of genistein on the expression of Bax and Bcl-2 protein in PC12 cells transfected with mutant APP695 Type.Methods PC12 cells were transfected with pIRES2-EGFP plasmid or pIRES2-EGFP/APP695MT expression plasmid,and then divided into normal control group,Unladen group,APP695 transfected group,GST treatment group(5 μmol/L,15 μmol/L).The Bax and Bcl-2 protein expression in PC12 cells was measured by Immunocytochemistry SABC and Western-blot.Results Immunocyto-chemistry SABC showed that:compared with the normal control group,the expression of bax protein in APP695 transfected group was strongly increased((78.02 ± 1.26) ％,P＜0.01)) and the expression of bcl-2 protein was very weak oppositely ((15.40 ± 0.72) ％,P＜0.01)).Compared with APP695 transfected group,the expression of bax protein in cells of 15umol/L GST treatment group was significantly decreased((22.35 ± 0.49) ％,P＜0.01))and the expression of bcl-2 protein in these cells was strongly increased ((68.11 ± 0.24) ％,P ＜0.01)).Western-Blot showed that:compared with the normal control group,the expression of bax protein in APP695 transfected group was markedly increased and the expression of Bcl-2 protein was significantly decreased.Compared with the APP695 transfected group,the expression of Bax protein was markedly decreased and the expression of Bcl-2 protein was significantly increased in the cells of the GST treatment groups.Conclusion GST can reduce the expression of bax protein and the increased expression of Bcl-2 protein has protective effect on PC12 cells transfected with APP696MT.

Objective To explore the effects of the integrated teaching," teaching,studying and doing",which designed according to the nurse's core competency. Methods The integrated teaching of "teaching,studying and doing" was applied to the experimental class. The basal portions of the integrated teaching were as follows:searching for the Internet information,Sharing information between groups,per-forming cleaning care for the elders living in welfare agency according to nursing process,writing Nursing History or reflections. Results Comparison of mean scores between the experimental class and the con-trol one predicted significant differcences on theoretical and practical test,and the former was better than the Last. Conclusions The integrated teaching designed according to the nurse's core competency was more effective than the traditional teaching method,since the students from the experimental class valued the knowledge and skills immanently,and were involved in applying,reviewing them in time.

OBJECTIVE To study the characteristic of pathogenic bacteria isolated from patients in the emergency department and to investigate the relativity of experience and targeted antibiotic treatment.METHODS The pathogenic bacteria and drug sensitivity results of all samples in 2005 were analyzed and the relativity of experience and targeted antibiotic treatment was summarized.RESULTS Totally 1061 specimens were acquired from 463 patients including sputum,venous blood,middle urine,purulent fluid on wound surface and 312 strains pathogenic bacteria were isolated.52.09% of them were Gram-positive bacteria,28.29% were Gram-negative bacteria and 19.16% were fungi.Of all pathogenic bacteria,there were 44 strains of drug-resistant bacteria.The relativity of experience and targeted antibiotic treatment was 89.67%.CONCLUSIONS The patients admitted to the emergency department are in severe and complicated conditions,with multiple system diseases.The pathogenic bacteria of emergency department are different from the bacteria of other units.Antibiotic treatment by experience should combined with bacteria monitoring and drug sensitivity.Infection caused by fungi should be paid great attention.

Objective To construct lentiviral expression vector of rat IP3R1 gene,and identify its silencing effect by using PC12 cell lines. Methods Oligo DNA sequences of 4 pairs of miRNA,named as miRNA1,miRNA2,miRNA3 and miRNA4,were designed according to IP3R1 gene sequence (GenBank:NM_001007235). The single strand of oligo DNA was annealed to form double strand DNA,and then connected with the empty plasmid pcDNA TM 6.2-GW/EmGFP-miR. By using gateway technology,the expression vector pcDNA TM 6.2-GW/EmGFP-miR-IP3R1 was linked into lentiviral destination vector pLenti6/V5-DEST to form the lentiviral expression vector pLenti6/V5-DEST-IP3R1,then it was transformed into infectious lentiviral particles and to infect PC12 cell lines. Silencing effect of gene IP3R1 was detected by Real-time PCR and Western blot. Results The sequence of expression vector pcDNA TM 6.2-GW/EmGFP-miR-IP3R1 was proved correct using sequencing method. After the transfection of letivirus vector pLenti6/V5-DEST-IP3R1 into PC12 cell lines,the IP3R1 mRNA and protein level were down-regulated 48h later,of which miRNA2 and miRNA3 sequence showed the best silencing effect,and the expression of IP3R1 in the blank control and negative control showed no significant changes. Conclusions Lentiviral expression vector pLenti6/V5-DEST-IP3R1 was constructed successfully. pLenti6/V5-DEST-IP3R1 may render the IP3R1 expression in PC12 cell lines down-regulated,and it provides a foundation for studying the function of calcium release channel IP3R1.