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【Objective】 To explore the roles of 1,4,5-trisphosphate receptor (IP3Rs) and ryanodine receptors (RyRs), the two main Ca2+ release channels in sarcoplasmic reticulum (SR), in the regulation of intracellular Ca2+ oscillations in neonatal rat cardiomyocytes (NRCMs). 【Methods】 We isolated and cultured NRCMs for different days, then loaded them with Ca2+ indicator fura-2 and performed real-time fluorescent imaging. To distinguish the effects of IP3Rs and RyRs, NRCMs were pre-treated with phenylephrine (PE, IP3Rs agonist), caffeine (RyRs agonist), 2-APB (IP3Rs antagonist), and tetracaine (RyRs antagonists), respectively. 【Results】 The cultured monolayer NRCMs showed spontaneous synchronized Ca2+ oscillations. PE activation or 2-APB blockade of IP3Rs increased or reduced the frequency of Ca2+ oscillations in NRCMs, accordingly, with no significant effect on the amplitude of Ca2+ oscillations. Activation of RyRs with caffeine increased the frequency of Ca2+ oscillations, but unsynchronized the intercellular rhythm of calcium release and beating pace, while blocking RyRs with tetracaine completely abolished the Ca2+ oscillations and beats in NRCMs. In addition, the effect of PE stimulation on Ca2+ oscillation frequency gradually decreased along with cultured days. 【Conclusion】 IP3Rs regulate the rhythm of calcium oscillations, whereas RyRs are the main channel for bulky store Ca2+ release.
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Objective:To investigate the nursing care of acute leukemia granulocyte deficiency patients with scrotal and perianal infection.Methods:Individualized care plans were developed for acute leukemia granulocyte deficiency patients with scrotal and perianal infection. Nursing measures were conducted from wound care, high fever care, pain care, and psychological care.Results:The infected area of scrotum was reduced from 5 cm×5 cm to 3 cm×3 cm. The new granulation tissue was at the same height of skin. The skin around anus was fully-recovery.Conclusions:Evaluating this patient′s condition and observing the state of the illness, then applied corresponding nursing managements at different period of scrotum infection could reduce the occurrence and development of acute leukemia granulocyte deficiency-related infection and assure the successful chemotherapy.
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Objective To investigate the short-term outcomes and surgical timing in patients who were treated by open reduction and internal fixation (ORIF) for acetabular fractures complicated with injury to lower urinary tract.Methods A retrospective analysis was conducted of the 14 patients with acetabular fracture complicated with lower urinary tract injury who had been treated at Department of Orthopaedics,The First Affiliated Hospital to Nanjing Medical University from January 2011 to September 2017.They were 12 males and 2 females,with an average age of 40.3 years (from 30 to 56 years).According to Letournel-Judet classification,there were one anterior column,2 transverse,3 anterior column plus posterior hemi-transverse,one T-shaped,5 associated both-column and 2 transverse plus posterior wall fractures.The time from injury to surgery ranged from 6.0 to 30.5 days,with an average of 13.4 days.Of the 8 patients with bladder injury undergoing internal fixation of the acetabulum,a modified ilioinguinal approach combined with a Kocher-Langenbeck approach was used in 4,a single modified ilioinguinal approach in 3,and a Stoppa approach combined with an iliac fossa approach in one;of the 6 patients with urethral rupture undergoing internal fixation of the acetabulum,a modified ilioinguinal approach combined with a Kocher-Langenbeck approach was used in 3,a single modified ilioinguinal approach in one,a Kocher-Langenbeck approach in one and a Stoppa approach in one.The fracture union time,outcomes and complications were recorded.Results The mean follow-up time for the 14 patients was 27.2 months (from 12 to 60 months).The fracture union time ranged from 3.0 to 4.5 months,averaging 3.5 months.According to the Majeed's scoring,the pelvic function at the final follow-up was excellent in 7 patients,good in 4,fair in 2 and poor in one;their scores ranged from 30 to 92 points,averging 80 points.No infection or implant failure occurred during follow-ups.Heterotopic ossification at the acetabulum was observed in one patient whose Brooker grading was Ⅳ at the final follow-up.Conclusion The patients with acetabular fracture complicated with lower urethral or bladder injury should be treated with ORIF as soon as possible so that fine clinical outcomes can be achieved.
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Objective To summarize the nursing care measures about patients with Epstein-Barr virus related post-transplantation lymphoproliferative disorder (EBV-PTLD) after allogeneic hematopoietic stem cell transplantation. Methods The nursing care measures about five patients with EBV-PTLD after allogeneic hematopoietic stem cell transplantation from October 2014 to May 2015 were summarized and analyzed. Results After carefully treating and nursing care, three patients were discharged. One patient with exacerbations, respiratory, epilepsy, liver failure, and disseminated intravascular coagulation was automatically discharged and then died. And the other patient died of other diseases. Conclusions Epstein-Barr virus infection is a complication after allogeneic hematopoietic stem cell transplantation. The key points to prevention and treatment of EBV infection included monitoring regularly, diagnosing and early intervention, which was proved to be effective, timely and active.
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Objective To assess the application of Xpert MTB/RIF assay in rapid diagnosis of tuberculous lymphadenitis.Methods Lymph node samples were collected from 1 02 clinically diagnosed patients with lymph node tuberculosis and 65 patients with other lymph node diseases from Zhejiang Provincial Hospital of Traditional Chinese and Western Medicine during January 201 4 and February 201 5. Xpert MTB/RIF,pathological examination and mycobacterium tuberculosis culture were conducted in all specimens of two groups.Taking clinical comprehensive diagnosis as the gold standard,the diagnostic sensitivity,specificity,positive predictive value,negative predictive value and diagnosis efficacy of three detection methods were assessed.The sensitivity of Xpert MTB/RIF in determining rifampicin resistance was analyzed using drug susceptibility testing as gold standard.Results The mean detection time of Xpert MTB/RIF was (2.2 ±0.2)h.Among 1 02 patients,Xpert MTB/RIF achieved higher sensitivity (96.1 %, 98 /1 02 ) than pathological examination (76.5%,78 /1 02 ) and mycobacterium tuberculosis culture (33.3%,34 /1 02)(χ2 =1 6.558 and 87.91 9,both P <0.01 ).Among 65 patients with other lymph node diseases,the specificity of all three detection methods was 1 00%.The receiver-operating-characteristic curve analysis demonstrated that diagnostic performance of Xpert MTB/RIF was better than that of other two methods.In 8 patients resistant to rifampicin confirmed by drug susceptibility testing,Xpert MTB/RIF detected 6 resistant-resistant patients.Conclusion Xpert MTB/RIF shows higher sensitivity and specificity in diagnosis of lymph node tuberculosis with the advantages of easy and rapid performance.