Objective:To explore the prognostic factors for long-term upper limb motor function recovery after stroke.Method:Patients(n=61)with upper limb motor dysfunction after stroke were included.General demographic and clinical data were collected.Upper limb motor function was evaluated with the Fugl-Meyer assessment-up-per extremity(FMA-UE).Intracranial lesion locations were identified based on head MRI or CT.The recovery of upper limb motor function was monitored longitudinally at admission and at 1,3 and 6 months post-stroke.Patients were divided into a good prognosis group or a poor prognosis group according to the FMA-UE score at 6 months poststroke.Clinical and radiological data between the two groups were compared using the χ2 test and Kaplan-Meier survival analysis.Result:The prognosis of upper limb motor function in stroke patients is determined by the recovery of active hand movement and the location of the lesion,but not with age,sex,stroke type or affected side.The average recovery time to achieve good prognosis for those who experience active hand movement within 1 month and 3 months poststroke is 2.100 months and 3.313 months.Patients with earlier active hand movement had better prog-noses.Poor long-term prognosis is associated with lesions affecting core regions such as the precentral gyrus,posterior horn of the lateral ventricular and posterior limb of the inner capsule.In contrast,patients with lesions not involving these core regions achieved good prognosis after an average of approximately 2.792 months.Conclusion:The long-term prognosis for hemiplegic upper limbs recovery after stroke is significantly influ-enced by the timing of active hand movement and the location of intracranial lesions.

Objective:To explore the prognostic factors for long-term upper limb motor function recovery after stroke.Method:Patients(n=61)with upper limb motor dysfunction after stroke were included.General demographic and clinical data were collected.Upper limb motor function was evaluated with the Fugl-Meyer assessment-up-per extremity(FMA-UE).Intracranial lesion locations were identified based on head MRI or CT.The recovery of upper limb motor function was monitored longitudinally at admission and at 1,3 and 6 months post-stroke.Patients were divided into a good prognosis group or a poor prognosis group according to the FMA-UE score at 6 months poststroke.Clinical and radiological data between the two groups were compared using the χ2 test and Kaplan-Meier survival analysis.Result:The prognosis of upper limb motor function in stroke patients is determined by the recovery of active hand movement and the location of the lesion,but not with age,sex,stroke type or affected side.The average recovery time to achieve good prognosis for those who experience active hand movement within 1 month and 3 months poststroke is 2.100 months and 3.313 months.Patients with earlier active hand movement had better prog-noses.Poor long-term prognosis is associated with lesions affecting core regions such as the precentral gyrus,posterior horn of the lateral ventricular and posterior limb of the inner capsule.In contrast,patients with lesions not involving these core regions achieved good prognosis after an average of approximately 2.792 months.Conclusion:The long-term prognosis for hemiplegic upper limbs recovery after stroke is significantly influ-enced by the timing of active hand movement and the location of intracranial lesions.

Objective:To analyze the clinical characteristics of patients with acute glyphosate herbicide poisoning and the differences in the severity of poisoning.Methods:A retrospective analysis was performed on patients with acute glyphosate herbicide poisoning admitted to the First Affiliated Hospital of Zhengzhou University from January 2014 to December 2020. The general information, exposure time, poisoning dose, poisoning cause, poisoning route, clinical manifestations, laboratory examination results during hospitalization, treatment measures, hospital stays and prognosis of the patients were collected. The patients were graded according to the poisoning severity scoring standard of Chinese Expert Consensus on Diagnosis and Treatment of Acute Poisoning in 2016. The highest severity score during hospitalization was used as the final grade. According to the final grade, asymptomatic and mild patients were included in the mild group, and moderate, severe and death patients were included in the severe group. The independent sample T test or Mann-Whitney U test was used for measurement data, and χ2 test or Fisher's exact test was used for counting data. The differences of general data and clinical data between the two groups were compared. Results:According to the inclusion and exclusion criteria, 83 patients with acute glyphosate herbicide poisoning were selected as the study subjects. All patients survived, mainly mild poisoning (56.6%), with a male to female ratio of 33∶50, and an average age of 39 years. The number of poisoning cases increased yearly (the highest in 2019), and most cases occurred in spring and summer. The main cause of poisoning was suicide (71.1%), direct oral administration (83.1%) was the primary route of poisoning, and the dominating clinical manifestations were digestive symptoms (71.1%). Laboratory tests showed increased white blood cell count (WBC), neutrophil percentage (NEUT %) and D-dimer, and decreased hemoglobin and potassium. Compared with the mild group, patients in the severe group were older [(51±17) years vs. (35±19) years], had a higher proportion of suicide and direct oral administration, a longer hospital stay [8.0 (4.8, 12.0) d vs. 3.0 (2.0, 5.5) d], a higher dose of poisoning [200.0 (50.0, 200.0) mL vs. 30.0 (11.3, 57.5) mL], and higher NEUT % within 24 h of admission [(83.4±10.4) vs. (73.2±12.8)]. The increase of WBC, NEUT %, aspartate aminotransferase, prothrombin time, D-dimer and the decrease of serum potassium were more common in the severe group than the mild group, with statistical significance (all P<0.05). Conclusions:The number of patients with acute glyphosate herbicide poisoning is increasing yearly. Generally, the condition is mild and the prognosis is satisfying. The severity is more serious in the middle-aged and elderly patients andthose with direct oral administration, high toxic dose, and high NEUT % within 24 h of admission. Severe poisoning is more likely to cause changes in laboratory indicators.

Objective:To study the application of flipped classroom teaching mode in nursing teaching of Gastroenterology Department and its influence on the mastery of nursing theory and professional skills of nursing students.Methods:Using the convenient sampling method, a total of 136 nursing students who took internship Gastroenterology Department of Shanxi Provincial People's Hospital from July 2018 to January 2020 were selected. From July 2019 to January 2020, 69 nursing students were selected as the experimental group, and they were given flipped classroom teaching mode. From July 2018 to January 2019, 67 nursing students were set as the control group, and they were given the traditional teaching mode. The nursing theory, professional skills and comprehensive ability of nursing students and their evaluation of the teaching quality and satisfaction were observed and compared between the two groups.Results:The scores of after-department nursing theory and professional skills of nursing students in the experimental group were respectively (88.45±7.12) and (92.78±3.03) , which were higher than (80.32±8.56) and (88.15±3.62) of the control group, and the differences were statistically significant ( t=5.921, 7.952; P<0.05) . Scores of nursing consultation, physical examination, diagnosis, measures, health education, humanistic care, organizational efficiency and overall evaluation of the experimental group were respectively (6.21±1.25) , (6.45±1.03) , (6.53±1.21) , (6.59±1.28) , (6.98±1.12) , (6.59±1.21) , (6.30±1.18) and (7.01±1.16) , higher than (5.37±1.59) , (5.58±1.32) , (5.29±1.64) , (5.62±1.71) , (6.03±1.57) , (5.70±1.42) , (5.21±1.72) and (6.08±1.65) of the control group ( t=3.370, 4.216, 4.940, 3.686, 4.001, 3.867 , 4.246, 3.746; P<0.05) . The scores of teaching effect, teaching content and teaching method in experimental group were respectively (21.65±1.19) , (20.27±1.80) and (21.43±1.25) , which were higher than (19.13±1.28) , (18.81±2.79) and (19.47±1.21) in control group, and the differences were statistically significant ( t=11.676, 3.575, 9.112; P<0.05) . The satisfaction of the nursing students in the experimental group on theoretical knowledge, learning interest, practical skills, self-study ability and actual problem-solving ability were respectively 94.03%, 97.01%, 95.52%, 91.04% and 92.54%, which were higher than 81.25%, 85.94%, 84.38%, 78.13%, 79.69% in the control group, and the differences were statistically significant (χ 2=4.986, 5.222, 4.550, 4.224, 4.560; P<0.05) . Conclusions:The application of the flipped classroom teaching mode in the nursing teaching of Gastroenterology Department helps nursing students to master nursing theory and professional skills and improve the quality of teaching.

Objective:To explore the curative effect of network platform transitional nursing in the rehabilitation of schizophrenic patients.Methods:Using convenient sampling method, a total of 87 patients with schizophrenia who were admitted to Departmentof Psychiatry in the Affiliated Kangning Hospital of Wenzhou Medical Universityfrom February 2018 to January 2019 were selected as the research objects. According to the random number table method, they were divided into the control group (44 cases) and the observation group (43 cases) .The control group was given routine nursing intervention while the observation group was given network platform transitional nursing based on the control group. Before and after the intervention, the psychiatric symptoms of patients in the two groups were evaluated by Brief Psychiatric Rating Scale, medication compliance was evaluated by Medication Adherence Scaleand personal and social function and family function were evaluated by Personal and Social Performance Scale and Family Function Assessment Scale.Results:After 6 months of intervention, the scores of Brief Psychiatric Rating Scale and Medication Adherence Scale in the observation group were lower than those in the control group, and the differences were statistically significant ( P<0.05) .The scores of Personal and Social Performance Scale and Family Function Assessment Scale in the observation group were higher than those in the control group, and the differences were statistically significant ( P<0.05) . Conclusions:In the rehabilitation treatment of schizophrenia, the implementation of network platform of transitional nursing can improve medication compliance of patients, improve their clinical mental symptoms, and finally improve their personal and social functions and family functions.

BACKGROUND:Brahma-related gene 1 (Brg1), a catalytic subunit of an important chromatin remodeling complex, has been considered as a key nuclear transcriptional factor, and tends to be decreased in diabetic cardiomyopathy.
OBJECTIVE:To construct an adenovirus vector carrying Brg1, and observe its protective role in oxidative stress induced-cardiomyocyte apoptosis.
METHODS:The recombinant adenovirus plasmid was linearized and transfected into HEK293 cel s using Fugene HD for packaging and amplification. The adenovirus particles were further purified, quantified, and sequential y transfected to cardiomyocytes of neonatal Sprague-Dawley rats. The Adeno-EGFP transfected and non-transfected cardiomyocytes were used as control group. 24 hours later, the transfection efficiency was observed by fluorescent microscope, and expressions of Brg1 mRNA and protein were detected by quantified PCR and western blotting. After treatment with 100 μmol/L H2O2 for 12 hours, the expressions of Brg1 protein and cleaved-Caspase 3 were measured by western blotting, and cel apoptosis was analyzed by flow cytometry.
RESULTS AND CONCLUSION:(1) The recombinant adenovirus vector of Brg1 had been successful y transfected into cardiomyocytes with higher expressions of Brg1 mRNA and protein, and the transfection efficiency reached more than 90%. (2) After H2O2 treatment, the Brg1 was significantly down-regulated in contrast to the up-regulation of cleaved-Caspase 3;the flow cytometry data showed that the apoptotic cel s were increased. But in Adeno-Brg1 transfected cardiomyocytes, the H2O2 induced cel apoptosis was significantly decreased compared with non-transfected cel s and empty vector transfected cel s. (3) These results suggest that oxidative stress can directly inhibit the Brg1 expression, and overexpression of Brg1 can protect the cardiomyocytes from cel apoptosis induced by oxidative stress.

Objective To establish a chemiluminecentdetection method ( CLIA ) of HCV IgG antibody for the detection of HCV infection and therefore lay a foundation for the research and development of testing kit.Methods Based upon the indirect ELISA method, the microwell plate was coated with HCV-NS3 and HCV-Core antigen expressed through gene engineering, and the anti-human IgG antibody was labeled with horse radish peroxidase.In this way, the chemiluminesent detection method of HCV IgG antibody was established.Meanwhile, the serum specimen of randomly selected 198 patients infected with HCV from No.302 Hospital of PLA and 222 blood donors, and the results were compared.Results The HCV-IgG antibody, a positive consistent rate of 99.0%( 196/198 ) , a negative consistent rate of 98.2%(218/222), and a total consistent rate of 98.6%(414/420) were found through testing 420 serum specimen with self-made agent and contrast agent.One HCV positive serum was repetitively tested with the self-made agent for 10 times, and a coefficient of variation ( CV) of less than 10% was found.Conclusion The chemiluminescent detection method of HCV IgG antibody is initially established, and the method, with an outstanding specificity and sensitivity, is applicable for screening blood donors, clinically detecting HCV infection as well as epidemiological survey.

Objective To investigate the clinical efficacy and safety of cryoablation combined with zoledronic acid sequential therapy for bone metastases pain. Methods Twenty-four patients from our depart-ment suffering from malignant tumors with moderate to severe pain due to bone metastases were enrolled in this study. Those patients with 28 metastatic bone tumors were successfully treated with cryoablation operations under CT-guided. Three days after cryoablation they were offered zoledronic acid(4 mg added in 100 ml normal saline,dripping for more than 15 min),once 4 weeks. Pain level and life quality were respectively evaluated by NRS(Numerical rating scale)and KPS(Karnofsky performance status),before cryoablation,3 days after cryoablation,2 weeks and 12 weeks after zoledronic acid sequential therapy. Results Without serious compli-cations,all of 24 patients were successfully punctured to tumor lesions. Patients’pain scores were 7. 70 ± 0. 86 (before cryoablation),3. 29 ± 0. 95(3 d after cryoablation),2. 54 ± 0. 83(2 weeks after zoledronic acid sequential therapy)and 2. 17 ± 0. 76(12 weeks after zoledronic acid sequential therapy),with a significant sta-tistical difference between pretherapy and post-treatment(F = 530. 64,P < 0. 001);during observation period after treatment,the effective rate in pain was 91. 67% . KPS scores were 45. 83 ± 6. 54(before cryoablation), 49. 58 ± 6. 24(3 d after cryoablation),61. 67 ± 7. 01(2 weeks after zoledronic acid sequential therapy)and 78. 33 ± 8. 68(12 weeks after zoledronic acid sequential therapy),with a significant statistical difference between pretherapy and post-treatment(F = 418. 99,P < 0. 001);during observation period after treatment, the effective rate in KPS was 75. 00% . Six months after the treatment,there were 10 cases of CR,11 cases of PR,and the effective rate was 87. 50% . Conclusion Cryoablation combined with zoledronic acid may be an effective therapeutic method with good safety in the treatment of patients with bone metastases pain.

This study is to evaluate the effects of the metformin (Met) on β cell function of diabetic KKAy mice. Female diabetic KKAy mice selected by insulin tolerance test (ITT) were divided randomly into two groups. Con group was orally administered by gavage with water, Met group with metformin hydrochloride at a dose of 0.2 g x kg(-1) for about 12 weeks. ITT and glucose tolerance tests (OGTT) were determined. Beta cell function was assessed by hyperglycemic clamp. Pancreatic biochemical indicators were tested. The changes of gene and protein expression in the pancreas and islets were also analyzed by Real-Time-PCR and immunostaining. Met significantly improved glucose intolerance and insulin resistance in KKAy mice. Fasting plasma glucose and insulin levels were also decreased. In addition, Met markedly increased glucose infusion rate (GIR) and elevated the Ist phase and maximum insulin secretion during clamp. It showed that Met decreased TG content and iNOS activities and increased Ca(2+) -Mg(2+)-ATPase activity in pancreas. Islets periphery was improved, and down-regulation of glucagon and up-regulated insulin protein expressions were found after Met treatment. Pancreatic mRNA expressions of inflammation factors including TLR4, NF-κB, JNK, IL-6 and TNF-α were down-regulated, p-NF-κB p65 protein levels also down-regulated by Met. And mRNA expressions of ion homeostasis involved in insulin secretion including SERCA2 and Kir6.2 were up-regulated by Met. Met increased SIRT5 expression level in pancreas of KKAy mice under the hyperglycemic clamp. These results indicated that chronic administration of Met regulated pancreatic inflammation generation, ion and hormone homeostasis and improved β cell function of diabetic KKAy mice.