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Objective:To investigate the clinical efficacy of laparoscopic eversion fixation of cyst wall in the treatment of simple hepatic cyst.Methods:The clinical data of 27 patients with simple hepatic cyst who underwent laparoscopic cyst eversion fixation in Department of Hepatobiliary Surgery, the First Affiliated Hospital of Henan University of Science and Technology from January 2017 to December 2020 were retrospectively analyzed. There were 8 males and 19 females, aged (60.6±9.0) years. Methods of operation, operation time, pathological results, incisional pain, peritonitis, bleeding or infection in the sac were analyzed. Recurrence was followed up by outpatient or telephone review.Results:Laparoscopic eversion fixation of cyst wall was successfully performed in all patients. Twelve cases (44.4%) were fixed in the falciform ligament, and 15 cases (55.6%) were fixed on the liver surface. The operative time was (119.3±44.3) min. The histopathologic results of the capsular wall were all fibrous connective tissue coated with endothelial cells, and no tumor cells were found. After the operation, 25 cases (92.6%) of light clear cyst fluid were not cultured for bacteriology, and 2 cases (7.4%) of turbid cyst fluid bacteriology culture was negative. There were 11 cases (40.7%) with right upper abdominal incision pain on the first day after surgery, and the pain disappeared after proper treatment without bile leakage, peritonitis, bleeding or infection. All patients were followed up for 18 to 36 months, with a median follow-up time of 24 months, and no cyst recurrence was reported.Conclusion:Laparoscopic eversion fixation of cyst wall is a good method for the treatment of simple hepatic cyst.
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Background@#Inactivated vaccines are limited in preventing foot-and-mouth disease (FMD) due to safety problems. Recombinant virus-like particles (VLPs) are an excellent candidate for a novel vaccine for preventing FMD, given that VLPs have similar immunogenicity as natural viruses and are replication- and infection-incompetent. @*Objectives@#The 3C protease and P1 polyprotein of type O FMD virus (FDMV) was expressed in yeast Hansenula polymorpha to generate self-resembling VLPs, and the potential of recombinant VLPs as an FMD vaccine was evaluated. @*Methods@#BALB/c mice were immunized with recombinant purified VLPs using CpG oligodeoxynucleotide and aluminum hydroxide gel as an adjuvant. Cytokines and lymphocytes from serum and spleen were analyzed by enzyme-linked immunosorbent assay, enzyme-linked immunospot assay, and flow cytometry. @*Results@#The VLPs of FMD were purified successfully from yeast protein with a diameter of approximately 25 nm. The immunization of mice showed that animals produced high levels of FMDV antibodies and a higher level of antibodies for a longer time. In addition, higher levels of interferon-γ and CD4 + T cells were observed in mice immunized with VLPs. @*Conclusions@#The expression of VLPs of FMD in H. polymorpha provides a novel strategy for the generation of the FMDV vaccine.
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Objective@#To explore the epidemic characteristics of injury related deaths in children and adolescents aged 1-24 years old in China from 2010 to 2020, so as to provide a basis for the formulation of policies and measures related to the control of injuries and deaths among children and adolescents.@*Methods@#The data were sourced from the China Death Cause Monitoring Dataset from 2010 to 2020. Annual percentage change (APC) and average annual percentage change (AAPC) of injury deaths in China in this age group during the period 2010 to 2020 were analyzed by Join point regression.@*Results@#From 2010 to 2020, the standardized death rate of injury showed a decreasing trend (AAPC=-6.90%, t =4.58, P <0.01). The standardized death rates of male and rural injuries showed an overall downward trend, with AAPC rates of -8.37% and -7.79%( t =11.87, 10.34, P <0.01). An increasing trend was observed in the 20-24 year-old age group during 2010-2018 (APC=18.11%, t =6.50, P <0.01). The death rate from injuries was higher in males than females, and higher in rural areas compared with urban areas ( χ 2=16 483.64, 3 268.65 , P <0.01). A downward trend was observed in accidental falls and suicide, the overall standardized mortality rate of traffic accidents, accidental poisoning, fire, drowning, homicide and other injuries (AAPC=-10.22%, -6.21%, -7.50%, -7.94%, -9.01% , -10.97%, t =16.23, 7.29, 2.53, 9.32, 7.88, 4.58, P <0.05). @*Conclusion@#From 2010 to 2020, the overall injury standardized mortality rate in the 1-24 year-old age group shows a decreasing trend, but it remains at a relatively high level. Prevention efforts should be continuously strengthened, especially for urban areas, and should focus on women and those aged 20-24 years old, as well as accidental falls and suicide prevention.
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Alzheimer's disease (AD) is an irreversible neurodegenerative disorder that damages patients' memory and cognitive abilities. Therefore, the diagnosis of AD holds significant importance. The interactions between regions of interest (ROIs) in the brain often involve multiple areas collaborating in a nonlinear manner. Leveraging these nonlinear higher-order interaction features to their fullest potential contributes to enhancing the accuracy of AD diagnosis. To address this, a framework combining nonlinear higher-order feature extraction and three-dimensional (3D) hypergraph neural networks is proposed for computer-assisted diagnosis of AD. First, a support vector machine regression model based on the radial basis function kernel was trained on ROI data to obtain a base estimator. Then, a recursive feature elimination algorithm based on the base estimator was applied to extract nonlinear higher-order features from functional magnetic resonance imaging (fMRI) data. These features were subsequently constructed into a hypergraph, leveraging the complex interactions captured in the data. Finally, a four-dimensional (4D) spatiotemporal hypergraph convolutional neural network model was constructed based on the fMRI data for classification. Experimental results on the Alzheimer's Disease Neuroimaging Initiative (ADNI) database demonstrated that the proposed framework outperformed the Hyper Graph Convolutional Network (HyperGCN) framework by 8% and traditional two-dimensional (2D) linear feature extraction methods by 12% in the AD/normal control (NC) classification task. In conclusion, this framework demonstrates an improvement in AD classification compared to mainstream deep learning methods, providing valuable evidence for computer-assisted diagnosis of AD.
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Humans , Alzheimer Disease/diagnostic imaging , Neural Networks, Computer , Magnetic Resonance Imaging/methods , Neuroimaging/methods , Diagnosis, Computer-Assisted , Brain , Cognitive DysfunctionABSTRACT
Osteoporotic vertebral compression fracture (OVCF) can lead to lower back pain and may be even accompanied by scoliosis, neurological dysfunction and other complications, which will affect the daily activities and life quality of patients. Vertebral augmentation is an effective treatment method for OVCF, but it cannot correct unbalance of bone metabolism or improve the osteoporotic status, causing complications like lower back pain, limited spinal activities and vertebral refracture. The post-operative systematic and standardized rehabilitation treatments can improve curative effect and therapeutic efficacy of anti-osteoporosis, reduce risk of vertebral refracture, increase patient compliance and improve quality of life. Since there still lack relevant clinical treatment guidelines for postoperative rehabilitation treatments following vertebral augmentation for OVCF, the current treatments are varied with uneven therapeutic effect. In order to standardize the postoperative rehabilitation treatment, the Spine Trauma Group of the Orthopedic Branch of Chinese Medical Doctor Association organized relevant experts to refer to relevant literature and develop the "Guideline for postoperative rehabilitation treatment following vertebral augmentation for osteoporotic vertebral compression fracture (2022 version)" based on the clinical guidelines published by the American Academy of Orthopedic Surgeons (AAOS) as well as on the principles of scientificity, practicality and advancement. The guideline provided evidence-based recommendations on 10 important issues related to postoperative rehabilitation treatments of OVCF.
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Objective:To summarize the experience on accurate prevention and control of children′s emergency department during the epidemic of novel coronavirus Omicron variant.Methods:We retrospectively analyzed the strategies and management experience of emergency prevention and control of novel coronavirus infection in emergency department at Children′s Hospital of Fudan University from March to May 2022.Results:As a designated hospital for treating pediatric patients who contracted novel coronavirus in Shanghai, the emergency department in our hospital was confronted with the dual pressure of critical patients treatment and pandemic prevention and control.We carefully studied a series of laws and regulations, as well as the newest edition of Chinese clinical guidance for novel coronavirus pneumonia diagnosis and treatment, and combined with the characteristics of novel coronavirus infection in children, then formulated the independent emergency department, fever clinics and novel coronavirus clinics; Updated the emergency department pre-examination triage process, the precautions pratice of clinical stuffs and disfection strategy, and established the second emergency department.From the beginning of March to the end of May 2022, a total of about 12 000 patients were admitted to the emergency department in our hospital, including 704 patients in the resuscitation room, 652 patients in the observation room, and 164 patients in the emergency ward.There were six patients with novel coronavirus infection in the emergency department.Neither nosocomial infection nor occupational exposure occurred.Conclusion:After 3 months of practice, the results showed that it can fully guarantee the timely treatment of critically ill children and achieved zero cross-infection in the hospital, which has important reference significance for the treatment of children, epidemic prevention, control during the novel coronavirus epidemic.
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Asthma is a common chronic airway inflammatory disease, which is characterized by airway stenosis, airway wall thickening and increased mucus secretion followed by reversible airflow restriction.At present, asthma is considered to be a complex and heterogeneous disease, and its pathogenesis remains elusive.There are diverse immune cells involved in the formation of asthma, including T lymphocytes, eosinophils, neutrophils, etc.Due to the continuous renewal of classification and function of T lymphocytes subsets, their role in asthma has attracted more attention.Here, this review aims to summarize the immunological characteristics and roles of different T cell subsets in asthma, and highlight the new findings of T cell subsets in the pathogenesis of severe asthma, leading to provide inspiration and help for the study of the immunology pathogenesis, clinical diagnosis, treatment and prognosis in asthma.
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Osteosarcoma is a kind of primary malignant tumor of bone originated from mesenchymal tissue, which mainly occurs in children and adolescents, and presents the characteristics of high malignancy, rapid growth, early metastasis and poor prognosis. Currently, most of the studies at home and abroad mainly focused on therapeutic procedures. However, reliable predictors are essential for monitoring disease changes, guiding treatment and evaluating prognosis. In recent years, the research on prognosis related genes of osteosarcoma has become a new hotspot. Its abnormal expression affects the progress, invasion and metastasis of osteosarcoma cells, and plays an important role in drug resistance and chemotherapy of osteosarcoma. This paper briefly summarizes the abnormal expression of genes related to the prognosis of osteosarcoma: miRNAs, Incrna, CircRNA, ErbB gene family and the imbalance of oncogenes and immune related genes, and fully understands their characteristics, in order to provide a new direction and possible new drug treatment target for the early diagnosis and treatment of osteosarcoma patients, so as to improve the prognosis of osteosarcoma patients.
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Spinal cord injury has a high rate of disability in clinical practice, which can be divided into complete SCI and incomplete SCI according to different injury segments and severity.The main purpose of treatment is to protect the nerves.At present, acute spinal cord injury is mainly treated with surgical decompression, neurotrophic treatment, hormone therapy, hypothermia therapy, rehabilitation intervention and other clinical comprehensive treatment.In recent years, breakthroughs have been made in the field of endogenous and exogenous neural stem cell research, and important progress has been made in the basic research of stem cell transplantation.In the long run, nerve regeneration and nerve modulation may be the most promising therapy for the repair of spinal cord injury.
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Background and Objectives@#To investigate the effect and the underlying mechanism of exosomes secreted by human umbilical cord mesenchymal stem cells (hUCMSCs) on diffuse alveolar hemorrhage (DAH) in murine lupus. @*Methods@#and Results: Exosomes were extracted from cultured hUCMSCs by ultracentrifugation. The expressions of exosome markers (Alix, CD63 and TSG101) were measured for identification of hUCMSC-derived exosomes (hUCMSC-exosomes). The alveolar hemorrhage of DAH mice was revealed by H&E staining. The primary alveolar macrophages were isolated from bronchoalveolar lavage fluid (BALF) of DAH mice. The expressions of M1 macrophage markers (iNOS, IL-6, TNF-α and IL-1β ) and M2 macrophage markers (Arg1, IL-10, TGF-β and chi3l3) were detected. Flow cytometry measured the ratio of M1/M2 macrophages. ELISA measured the secretion of pro-inflammatory cytokines (IL-6 and TNF-α) and anti-inflammatory cytokines (IL-10 and TGF-β ). DAH mice had hemorrhage and small-vessel vasculitis in the lung, with neutrophil and monocyte infiltration observed around the capillary and small artery. Furthermore, increases of IL-6 and TNF-α, and decreases of IL-10 and TGF-β were detected in the BALF of DAH mice. M1 makers were overexpressed in alveolar macrophages of DAH mice while M2 makers were lowly expressed. DAH mice had a higher proportion of M1 macrophages than M2 macrophages. After hUCMSC-exosome or methylprednisolone treatment in DAH mice, the alveolar injuries and inflammatory responses were attenuated, and the proportion of M2 macrophages was increased. @*Conclusions@#hUCMSC-exosomes attenuate DAH-induced inflammatory responses and alveolar hemorrhage by regulating macrophage polarization.
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Background and Objectives@#To investigate the effect and the underlying mechanism of exosomes secreted by human umbilical cord mesenchymal stem cells (hUCMSCs) on diffuse alveolar hemorrhage (DAH) in murine lupus. @*Methods@#and Results: Exosomes were extracted from cultured hUCMSCs by ultracentrifugation. The expressions of exosome markers (Alix, CD63 and TSG101) were measured for identification of hUCMSC-derived exosomes (hUCMSC-exosomes). The alveolar hemorrhage of DAH mice was revealed by H&E staining. The primary alveolar macrophages were isolated from bronchoalveolar lavage fluid (BALF) of DAH mice. The expressions of M1 macrophage markers (iNOS, IL-6, TNF-α and IL-1β ) and M2 macrophage markers (Arg1, IL-10, TGF-β and chi3l3) were detected. Flow cytometry measured the ratio of M1/M2 macrophages. ELISA measured the secretion of pro-inflammatory cytokines (IL-6 and TNF-α) and anti-inflammatory cytokines (IL-10 and TGF-β ). DAH mice had hemorrhage and small-vessel vasculitis in the lung, with neutrophil and monocyte infiltration observed around the capillary and small artery. Furthermore, increases of IL-6 and TNF-α, and decreases of IL-10 and TGF-β were detected in the BALF of DAH mice. M1 makers were overexpressed in alveolar macrophages of DAH mice while M2 makers were lowly expressed. DAH mice had a higher proportion of M1 macrophages than M2 macrophages. After hUCMSC-exosome or methylprednisolone treatment in DAH mice, the alveolar injuries and inflammatory responses were attenuated, and the proportion of M2 macrophages was increased. @*Conclusions@#hUCMSC-exosomes attenuate DAH-induced inflammatory responses and alveolar hemorrhage by regulating macrophage polarization.
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Based on ASP.NET framework, The Intelligent Estimated System for Rational Deployment of Medical Equipment (MERDIS) is designed and developed with SQL Server 2012 database and C# language. The system is used to realize the rational deployment suggestions and evaluation of medical equipment in hospitals. The system input the data of hospital medical equipment and clinical pathway into the database, and then feedback the deployment information to users which are calculated by big data information, so as to achieve the purpose of giving rational deployment of hospital medical equipment.
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Databases, Factual , Equipment Design , HospitalsABSTRACT
Bronchopulmonary dysplasia(BPD)is one of the most common respiratory diseases in premature infants, and many factors affect the development of premature lung.Recent studies have shown that pulmonary macrophages play an important role in the occurrence of BPD.The number of macrophages in the lung increases in the process of BPD, and classically activated M1 cells dominate, which causes excessive production of pro-inflammatory cytokines such as interleukin-1 and oxidation substances such as reactive oxygen species, promotes the apoptosis of lung cells, and affects the development of alveolar structure and pulmonary microvasculature.Besides, the decrease of autophagy activity of neonatal alveolar macrophages contributes to the occurrence of BPD, but the mechanism is still unclear.This article reviews research progress on the role of pulmonary macrophages in bronchopulmonary dysplasia, in order to further explore the significance of them in diagnosis and treatment of BPD and improve the quality of life of children with BPD.
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Many hospitals in China have realized the information management of breast milk bank, but the systematic management of breast milk feeding is one of the weak links in the work of neonatal ward. Relying on information technology, Children′s Hospital of Fudan University implanting the functions of precise calculation, record, reminder and warning of clinical decision support into the breast-milk management system, realized the whole flow of breast milk closed-loop management monitoring and recording, standardized the breast-feeding and execution process, realized the process management and fine management of breast-feeding, and provided reference for the information management of breast-feeding.
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BACKGROUND: The characteristics of laminin that can promote the proliferation of stem cells have been widely concerned. OBJECTIVE: To review the interactions between laminin and many different stem cells, and provide reliable theoretical basis for chondrogenic research and application of stem cells. METHODS: Wanfang, CNKI, PubMed and Web of Science databases were searched for articles related to mechanism of laminin, changes in stem cell behaviors, and cartilage regeneration published from January 2010 to October 2019. The retrieval terms were “laminin” and “steam cells” in Chinese and English. Duplicated and poorly related articles were excluded, and finally 57 articles were included for review. RESULTS AND CONCLUSION: (1) The structural characteristics of laminin were summarized. The spatiotemporal changes of laminin during cartilage development and degradation were analyzed. At the same time, the distribution of laminin expression in natural cartilage tissue and tissue engineered cartilage tissue was compared. (2) The effects of laminin on the proliferation of various stem cells, including embryonic stem cells, induced pluripotent stem cells and adult stem cells, were described. (3) The possible hotspots on the combination of laminin and stem cells for cartilage regeneration were proposed, with the attempt of providing theoretical basis for cartilage repair and regeneration in the future.
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Objective:To develop a nursing information system effectiveness evaluation scale based on the new D&M model and verify its reliability and validity.Methods:Six dimensions of the scale were constructed based on the framework of the new D&M model,through the methods including literature reading,expert discussion to determine the specific indicators of the questionnaire, and then forming the initial questionnaire. The dimensions and items of the test scale were modified by discriminant analysis method, correlation coefficient analysis method and Cronbach's αcoefficient method. The construct validity of the scale was analyzed by exploratory factor analysis method, and the dimensions and items of the test scale were optimized. Internal consistency and retest reliability were used to analyze the reliability of the scale.Results:Five common factors were extracted by exploratory factor analysis to explain the total variation of 57.462%. The final version of the scale consists of 5 dimensions and 23 items. The total Cronbachα coefficient of the scale was 0.768, and the total correlation coefficient was 0.849.Conclusions:The 5 dimensions retained by the scale have good construction validity, which can effectively explain the psychological characteristics of the subjects, and the results measured by the scale have good stability and consistency. This scale can be used to evaluate the effectiveness of nursing information system.
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The outbreak of novel coronavirus pneumonia (NCP) has become the most severe public health issue at the moment, threatening people′s lives.Pediatricians in Shanghai have recently launched a discussion on the focused questions of NCP, including the incidence situation, epidemiological features, essentials of early screening, treatment and nosocomial infection prevention of children′s novel coronavirus infection (2019-nCoV), and further put forward the experts proposal upon the patterns of disease occurrence, development, diagnosis and control, for the reference of frontline pediatricians.
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The outbreak of novel coronavirus pneumonia (NCP) has become the most severe public health issue at the moment, threatening people′s lives. Pediatricians in Shanghai have recently launched a discussion on the focused questions of NCP, including the incidence situation, epidemiological features, essentials of early screening, treatment and nosocomial infection prevention of children′s novel coronavirus infection (2019-nCoV), and further put forward the experts proposal upon the patterns of disease occurrence, development, diagnosis and control, for the reference of frontline pediatricians.
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Objective To investigate the safety and efficacy of wide local excision surgery combined with 5-aminolaevulinic acid(ALA)-photodynamic therapy(PDT)in treating Paget's disease of the scrotum in elderly people.Methods Patients with an average age of 68.4 ± 4.7 years undergoing wide local excision surgery combined with ALA-PDT for Paget's disease of the scrotum from June 2014 to February 2018 were followed up.All patients underwent wide local excision surgical treatment first and were then enrolled in ALA-PDT study after the diagnosis of Paget's disease of the scrotum was confirmed.Four cases were eliminated as a result of two patients refusing photodynamictherapy for various reasons and two patients lost during follow-up after ALA-PDT.A total of 16 patients were included in the study,of whom 6 cases were in Ray stage A1,7 cases in stage A2 and 3 cases in stage B.Patients underwent 3 courses of ALA-PDT after operation.Then the efficacy,shortand medium-term complications were followed up.Results The duration of disease among the 16 patients ranged from 4 to 76 months before diagnosis,with an average of 35.7 months.Surgery was performed immediately after diagnosis.Ten patients underwent resection and suture and 6 patients were treated with skin flap transfers.Of the patients treated with surgery,3 patients received suspicious lymph node dissection and 1 patient underwent reoperation due to skin flap necrosis.Patients were followed up for 3 months to 3 years and 6 months after ALA-PDT.Recurrence and distant metastasis occurred in 2 cases,with 1 case of brain metastasis and 1 case of systemic metastasis,and the overall recurrence rate was 12.5％.During the follow-up,there were no other serious complications except for 1 case(6.3 ％)with lower limb movement disorders.Conclusions Wide local excision surgery combined ALA-PDT has good clinical outcomes,low recurrence rates and few complications for the treatment of Paget's disease of the scrotum in elderly people.
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Autosomal dominant polycystic kidney disease (ADPKD) is a common hereditary disease, mainly caused by polycystic kidney disease 1/2 (PKD1/2) gene mutation. The main manifestation is the formation of multiple progressive enlarged cysts in both kidneys, which can be accompanied by decreased glomerular filtration rate, hypertension, liver cyst and cerebral aneurysm. About 45% of patients will progress to end-stage renal failure before the age of 60. ADPKD gene sequencing can be chosen for suspicious patients with atypical clinical features, no positive family history, and inconspicuous imaging findings. In the ADPKD positive families, imaging examination is the main means of diagnosing ADPKD. Height-adjusted total kidney volume (htTKV) and kidney growth rate are commonly used to monitor ADPKD disease progression and prognosis. There is no effective treatment for ADPKD to stop its progress. Drugs such as tolvaptan and bosutinib can delay the renal disfunction and they have been applied to clinical therapy in Europe and America.