Objective To evaluate clinical application effects of evidence-based practice for proper limb positioning management in stroke patients with hemiplegia.Methods An evidence-based practice was conducted following the"evidence-based continuous quality improvement model"research framework,which included four stages:evidence acquisition,current situation review,evidence intro-duction,and effect evaluation.Convenience sampling was used to select 39 nurses and 86 stroke pa-tients with hemiplegia from the First Affiliated Hospital of Xi'an Jiaotong University as research sub-jects.Among them,43 patients from July to August 2023 did not undergo evidence-based practice,and 43 patients from December 2023 to January 2024 received evidence-based practice.The imple-mentation rates of review indicators,nurses'knowledge,attitude,and practice(KAP)scores for prop-er limb positioning management,and patients'activities of daily living index,motor function,and proper limb positioning qualification rates were compared before and after evidence-based practice.Results A total of 24 pieces of best evidence were finally included in this study,and 28 quality re-view indicators were formulated.After evidence-based practice,nurses'KAP scores for proper limb positioning management increased from(119.95±17.61)to(148.87±8.46).The patients Barthel index score significantly improved from(71.51±9.36)before evidence-based practice to(81.28±7.87)after evidence-based practice(P＜0.05).The patients'motor function scores were(77.21±7.79)before evidence-based practice and(84.14±6.11)after evidence-based practice,with a statistically significant difference(P＜0.05).The proper limb positioning qualification rate was 95.35％(41/43)after evidence-based practice,which was higher than 81.39％(35/43)before evidence-based practice,with a statistically significant difference(P＜0.05).Conclusion Evi-dence-based practice for proper limb positioning management in stroke patients with hemiplegia based on evidence-based evidence can effectively improve nurses'implementation rates of review in-dicators,enhance their KAP levels for proper limb positioning management,and improve patients'clinical outcomes.

Objective:To analyze the reasons for the low results obtained by the determination of isosorbide dini-trate tablets content using the methods in the Chinese Pharmacopoeia and to improve the content determination method.Methods:The content of isosorbide dinitrate in 10 tablets was determined by high-performance liquid chromatography(HPLC)using a Phenomenex Luna C18 column(4.6 mm ×250 mm,5 μm)for separation,with a mobile phase of methanol-water(54∶46),a flow rate of 1.0 mL·min-1,and a UV detector set at a wavelength of 230 nm.The average content of 10 tablets was taken as the result of the content determination.Results:Isosor-bide dinitrate showed good linearity in the range of 49.22 to 1 230.5 μg·mL-1(r=0.999 96);the relative stand-ard deviation was 0.11％,the recovery rate was 96.0％,and the RSD was 1.5％(n=9).Conclusion:This method simplifies the experimental operations and steps,can eliminate the interference factors introduced by the original method,and improves the accuracy of the detection results.

Objective:To analyze the reasons for the low results obtained by the determination of isosorbide dini-trate tablets content using the methods in the Chinese Pharmacopoeia and to improve the content determination method.Methods:The content of isosorbide dinitrate in 10 tablets was determined by high-performance liquid chromatography(HPLC)using a Phenomenex Luna C18 column(4.6 mm ×250 mm,5 μm)for separation,with a mobile phase of methanol-water(54∶46),a flow rate of 1.0 mL·min-1,and a UV detector set at a wavelength of 230 nm.The average content of 10 tablets was taken as the result of the content determination.Results:Isosor-bide dinitrate showed good linearity in the range of 49.22 to 1 230.5 μg·mL-1(r=0.999 96);the relative stand-ard deviation was 0.11％,the recovery rate was 96.0％,and the RSD was 1.5％(n=9).Conclusion:This method simplifies the experimental operations and steps,can eliminate the interference factors introduced by the original method,and improves the accuracy of the detection results.

BACKGROUND:Bone mineral density is the clinical gold standard for determining bone strength,but bone mineral density is less sensitive to changes in bone mass,with large changes in bone mineral density only occurring when bone mass is significantly reduced,so bone mineral density has limited ability to predict changes in bone strength and fracture risk. OBJECTIVE:A model of the normal and osteoporotic hip joint was developed to analyze the stresses and deformation in the hip of normal and osteoporotic patients under single-leg standing conditions. METHODS:A healthy adult female volunteer at the age of 36 years was selected as the study subject.The CT data of the hip joint of this volunteer were obtained and saved in DICOM format.The hip joint model was reconstructed in three dimensions,and the material properties were assigned by the gray value assignment method to obtain the normal and osteoporotic hip joint models according to the empirical formula.The same boundary conditions and loads were set to simulate the stresses and deformation in the normal and osteoporotic hip joints in the single-leg standing position. RESULTS AND CONCLUSION:(1)In the finite element model of the normal and osteoporotic hip,the stress distribution was more concentrated in the medial region of the femoral neck.(2)In the hip bone,the stress distribution was mainly concentrated in the upper part of the acetabulum.(3)The stress peaks in the medial femoral neck and upper acetabulum were larger in the normal hip model than in the osteoporotic hip model,probably due to the reduced bone strength of the osteoporotic bone.(4)The peak Von Mises of both normal and osteoporotic hip models were concentrated on the medial femoral neck,and the peak Von Mises of the hip bone was smaller,indicating that the overall effect of osteoporosis on hip bone stresses was relatively small.(5)In terms of deformation in the single-leg standing position,the maximum deformation in the normal hip model was located at the acetabulum and femoral head,and the maximum deformation was located at the upper part of the greater trochanter of the femur.(6)It is suggested that the finite element analysis method to model the values of parameters related to bone tissue in osteoporosis may improve clinical prediction of bone strength changes and fracture risk.It is explained from the biomechanical view that the intertrochanteric femur and femoral neck are good sites for osteoporotic hip fractures.

Objective:To investigate the effect of 3D-printed customized flanged cup in hip revision with severe acetabular bone defects.Methods:Since February 2017, 10 cases of 3D-printed customized flanged cups were used in hip revision with severe acetabular bone defects, including 2 cases of Paprosky type IIIA and 8 cases of Paprosky type IIIB. There were 5 males and 5 females, mean age 73.6±8.1 yrs (range, 62-87 yrs), 5 left and 5 right cases. The preoperative thin-layer CT scan was preformed to reverse reconstruct digital pelvis. Five cases of one-piece flanged cups and 5 cases of decomposed flanged cups, including 3 cases of composite one-piece cups were designed by computer. The surgery was performed strictly according to the plan.Postoperative follow-up was performed to evaluate the Harris score. Operation time,intraoperative bleeding and other complications such as vascular and nerve injury, postoperative infection, and dislocation were counted. Pelvic X-ray was used to assess the height and horizontal position of the center of rotation and the stability of the prosthesis.Results:The surgical procedure was successful, with an average operative time of 147.9±48.3 min (range, 96-212 min) and an average intraoperative bleeding of 730.4±262.6 ml (range, 500-1 300 ml). The mean time of final follow-up was 40.8±18.7 months (range, 16-70 months) after surgery. At the last follow-up, the average Harris score was 83.80±6.73, with 4 cases excellent, 5 cases good, and 1 case fair. The excellent and good rate was 90%. The last Harris score was significantly higher than that before operation 28.60±8.40 ( t=16.84, P<0.001). The height of affected hip joint rotation center decreased from 46.24±7.74 mm before operation to 15.54±2.54 mm after operation with significant difference ( t=14.61, P<0.001). It was slightly higher than the opposite side (13.81±1.48 mm), which had no significant difference ( t=1.83, P=0.100). The horizontal distance of affected hip joint rotation center increased from 33.79±5.27 mm before operation to 40.53±4.50 mm after operation with significant difference ( t=3.62, P=0.006). It had no significant difference ( t=1.28, P=0.232) compared with the opposite side (38.54±3.46 mm). All incisions were healed in one stage without infection, vascular or nerve injury. During the following-up, all prostheses were in satisfied position without loosening, dislocation or screw breaks. Conclusion:Digitally assisted 3D-printed flanged cups can be used in hip revision with severe acetabular bone defect. It can not only improve hip joint function, but also restore the acetabular rotation center and the prosthesis stability, which can achieve good early and mid-term effect.

Objective To investigate the clinical effect of donor kidneys in rhabdomyolysis(RM) combined with acute kidney injury(AKI).Methods A retrospective analysis was made on the clinical data of 10 donors with RM and 14 cases of renal transplantation from March 2017 to May 2018.Results AKI was caused by RM in 10 donors.Before harvesting the donor kidneys,blood creatine kinase (CK) level was (14 005.19 ± 11 894.27) U/L in 10 donors,plasma myoglobin level was ＞3 000 μg/L in 7 cases,and that was (2 288 ± 680) μg/L in 3 cases.LDH level was 883 ± 453 IU/L and serum creatinine (Cr) value was (216.55 ± 125) μmol/L.6 donors received continuous renal replacement therapy.Six patients with delayed renal function recovery (DGF) were treated with CRRT.The duration of GDF was 3-20 days,with an average of 10 ± 6.6 days.All the patients were followed up for 3-15 months.The glomerular filtration rate was (40.19 ± 19.55) ml·min· 1.73 m-2 and (55.01 ± 15.94) ml · min· 1.73 m-2 at 1st and 3rd month after operation,respectively.Conclusion The incidence of DGF in donor kidneys with RM and AKI is high,and the short-term effect is satisfactory.The long-term effect needs to be further observed.

Objective To investigate the relationship between metabolites of sodium arsenite and sodium dihydrogen arsenate with related metabolic enzymes in kidney of male rats.Methods According to body mass,thirty-five male Wistar rats(body mass 150-190 g) were divided into 7 groups by random number table.Control group drank deionized water; the contents of iAsⅢ in low,medium and high arsenite groups and the contents of iAsv in low,medium and high of sodium dihydrogen arsenate groups were 2.2,6.7 and 20.0 mg/kg,respectively.After 3 months,kidneys were collected and stored at-80 C; high performance liquid chromatography and hydride genesis atomic fluorescence spectroscopy (HPLC-HGAFS) was used to determine the level of arsenic metabolites in kidney,and enzyme-linked immunosorbent assay was used to detect and analyze the content or the activity of metabolic enzymes,meanwhile correlation studies between the level of metabolites and the activity of metabolic enzymes were carried out.Results The differences of total arsenic (TAs),dimethyl arsenic acid (DMA),monomethyl arsenic acid (MMA) and methyl transferase enzyme activity in kidneys of rats between groups were statistically significant (F =1874.672,H =33.513,31.002,F =79.607,all P ＜ 0.01).The TAs[(526.52 ± 25.56),(1 654.00 ± 101.55),(1 904.24 ± 104.76)μg,/kg] and DMA[(323.20 + 16.13),(1 444.40 ± 113.81),(1 765.40 ± 104.39)μg/kg] of sodium arsenite in low,medium and high dose groups were higher than those of the corresponding sodium dihydrogen arsenate groups [(235.70 ± 6.23),(471.05 ± 18.32),(1 677.40 ± 83.29)μg/kg,and(0.00 ± 0.00),(1.75 ± 0.16),(410.50 ± 19.76)μg/kg,P ＜ 0.0024 or ＜ 0.05] ; the MMA[(4.02 + 0.86),(4.20 ± 0.65),(4.04 ± 0.80)μg/kg] of sodium arsenite in low,medium and high dose groups were lower than those of the corresponding sodium dihydrogen arsenate groups[(98.90 ± 9.59),(376.50 ± 15.41),(1 131.90 ± 74.26) μg/kg,all P＜ 0.05]; the methyl transferase enzyme activities[(7.80 ± 0.93),(5.55 ± 0.49),(3.56 ± 0.26)U/g] of sodium arsenite in low,medium and high dose groups were lower than those of the corresponding sodium dihydrogen arsenate group[(11.59 ± 0.93),(8.93 ± 0.88),(6.52 ± 1.04)U/g,all P ＜ 0.0024].The DMA of sodium arsenite in low,medium and high dose groups,the MMA of sodium dihydrogen arsenate in medium and high dose groups were positively correlated with those of TAs in each group(r =0.970,0.984,0.997,0.947,0.961,all P ＜ 0.05).Conclusions Effects of sodium arsenite and sodium dihydrogen arsenate on arsenic metobdites and related metabolic enzymes in kidney of rats are different.The function of sodium dihydrogen arsenate in promoting methyl transferase activity is stronger than that of sodium arsenite,which affects the amount and distribution of arsenic methylation metabolites in kidney.

In order to study the functions of the HSPs (Heat shock proteins) of Eimeria tenella, we cloned a novel gene (which designated EtHSP) coding HSP of Eimeria tenella by RT-PCR and RACE (Rapid-amplification of cDNA ends). The full-length cDNA sequence of EtHSP was 1802 bp, containing a 1455 bp ORF (Open reading frame) (GenBank Accession No. FJ911605) encoding a deduced protein of 484 amino acids. Real-time PCR revealed that the mRNA level of EtHSP was much higher in sporozoites of E. tenella than other developmental stages (unsporulated oocysts, sporulated oocysts and merozoites). We constructed the recombinant plasmids pET28a(+)-EtHSP, then transformed it into E. coli BL21(DE3) for expression. SDS-PAGE indicated that the fusion protein was expressed in included bodies, with peak expression 6 h after induction by IPTG Western blotting revealed that the protein was specifically recognized by polyclonal antibodies against E. tenella, showing that the fusion protein was native antigen.
Animals ; Chickens ; Eimeria tenella ; genetics ; metabolism ; Escherichia coli ; genetics ; metabolism ; Heat-Shock Proteins ; genetics ; immunology ; metabolism ; Inclusion Bodies ; metabolism ; Male ; Molecular Sequence Data ; Open Reading Frames ; genetics ; Rabbits ; Recombinant Fusion Proteins ; genetics ; immunology ; metabolism ; Sequence Analysis, Protein