Effects of Different Degrees of Carotid Artery Stenosis on the Expression of XIAP and Smac in the Ischemic Penumbra of Rats with Cerebral Ischemia-Reperfusion.

OBJECTIVE: To investigate the effects of different degrees of carotid artery stenosis (CAS) on the expression of XIAP and Smac in ischemic penumbra of rats with cerebral ischemia-reperfusion (I/R). MATERIALS AND METHODS: Samples were collected at 12 h and 24 h after reperfusion, and then the treated groups were divided into the NC-12 group, NC-24 group, MIS-12 group, MIS-24 group, MOS-12 group, MOS-24 group, SES-12 group and SES-24 group. HE staining was used to observe the pathological changes of the brain tissue. TUNEL assay was used to detect the apoptosis in the ischemic penumbra. IHC and RT-qPCR were used to detect the expression of XIAP and Smac in the brain tissue. RESULTS: By observing the pathological sections of brain tissue, the rats in MIS, MOS and SES groups showed loose brain tissue on the infarcted side and neuronal pyknosis in the ischemic penumbra. And with the aggravation and prolongation of the degree of stenosis, the degree of brain injury deepened. It was further found that the TUNEL positive rate was significantly increased in the ischemic penumbra in the SES and MOS groups compared with that in the normal control (NC) group. The results of IHC and RT-qPCR showed that the mRNA expression of XIAP and Smac in the ischemic penumbra was significantly up-regulated in the MIS, MOS and SES groups compared with that in the NC group. CONCLUSIONS: CAS may activate XIAP/Smac signaling pathway to induce neuronal apoptosis and promote the injury in the ischemic penumbra caused by cerebral I/R.

[Percutaneous Edge-to-Edge Mitral Valve Repair: New Transcatheter Approach and Nursing Experience in Patients With Severe Mitral Regurgitation and Prohibitive Surgical Risk].

Open-heart surgery and conservative medical treatments have been the traditional, mainstay treatments for patients with severe mitral regurgitation (MR). Transcatheter edge-to-edge mitral repair is a novel technique. Using the transcatheter approach allows delivery of the clip into the left ventricle and the clipping of the orifice of the MR. The heart failure symptoms and outcomes of patients improve after this procedure. Compared to open-heart surgery, the mitral clip achieves similar MR reduction results with a significantly lower rate of complications. Since 2016, MitraClip has been available for clinical use in Taiwan. The aim of this report is to introduce this new treatment with a focus on nursing care in order to provide a reference for clinical care.

Evaluating nurses' knowledge of chemotherapy.

BACKGROUND: The characteristics of the drugs that are used in chemotherapy have given rise to many issues, one of which is whether nurses are competent when working with chemotherapy. METHODS: Nurses' knowledge of chemotherapy was evaluated with a questionnaire that included 20 true-or-false questions. The questionnaire was developed from literature and expert input and validated by subject experts (content validity). A pilot study (contrasted-groups approach) was also conducted. RESULTS: A total of 203 nurses participated in the study and achieved an average overall correct answer rate of 60.9%. Most of the respondents, 63.5% (129 of 203), had a score of less than 70, and 77.3% (157 of 203) hoped to undergo more training on chemotherapy. Their knowledge of chemotherapy came mainly from consultation with colleagues (4.0 ± 0.8) and in-hospital continuing education (3.9 ± 0.8). CONCLUSION: The evidence-based results suggested that nurses have insufficient knowledge about chemotherapy. More fundamentally, however, nurses need more education about chemotherapy in nursing school and through in-hospital continuing education.