Barriers to implement early mobilization by nursing in adult ICUs:A systematic review and summary analysis / 中国实用护理杂志

Objective:To systematically review the barriers encountered by nursing staff in the implementation of early activities in adult ICU units.Methods:A systematic search was conducted on CNKI, Wanfang Database, VIP Database, China Biomedical Database, PumMed, Web of Science, Cochrane Library and EMBASE for the research on the obstacles of early activity nursing implementation in adult ICU from the establishment of the database to July 2020, and the final integrated analysis of the included literature was carried out.Results:A total of 26 articles were included, and 59 obstacles in 5 categories were integrated, including 6 kinds of technical level, 13 kinds of organizational culture level, 7 kinds of personnel level, 4 kinds of structural level, and 29 kinds of 6 sub categories of patients level. The most frequent obstacles were unstable condition of patients, sedation or continuous deep sedation, low staffing level, disturbance of consciousness of patients, insufficient equipment related to early activities, and low willingness or compliance of patients to participate.Conclusion:The nursing staff are facing with many obstacles in guiding and assisting ICU adult patients to carry out early activities. It is necessary to formulate modified policies aiming at changeable factors in order to promote the application of early activities in adult ICU units.

Diagnosis and differential diagnosis for solitary fibrous tumor in the abdomen and pelvis by CT / 中南大学学报(医学版)

Objective:To study the CT features for solitary fibrous tumor (SFT) in the abdomen and pelvis and to improve the diagnostic accuracy.Methods:Fourteen patients with SFT were collected in our hospital from January,2011 to December,2015.Characteristic of images were analyzed and compared for 10 SFT,which located outside the abdominal organs with extragastrointestinal stromal tumors (EGIST),leiomyosarcoma,and schwannoma.Results:Necrosis and cystic formation were frequently present in SFT in the abdomen and pelvis.CE-CT showed serpentine vessels along the periphery,while pattern of enhancement was maplike inhomogeneous progressive.Comparing with the EGIST or schwannoma,the difference of CT value in non-contrast and the arterial phase were statistically significant (P＜0.05).The numbers of peritumoral circuity vessel were significantly different between SFT and EGIST (~=18.27,P＜0.008) or between SFT and schwannoma (x2=19.25,P＜0.008).Comparing with the leiomyosarcoma or schwannoma,SFT located outside the abdominal organs.We found that tumor necrosis rate was significantly different between SFT and leiomyoscarcoma (x2=8.00,P＜0.008).Conclusion:SFT in the abdomen and pelvis show certain CT characteristics.The CT value in noncontrast and at the arterial phase,tumor necrosis rate,and serpentine vessels along the periphery were pivotal in differentiating SFT from leiomyosarcoma,EGIST and schwannoma.

Diagnostic value of liver imaging reporting and data system MRI on primary hepatocellular carcinoma / 中南大学学报(医学版)

OBJECTIVE@#To evaluate the diagnostic value of liver imaging reporting and classification criteria of data system (LI-RADS) MRI on primary hepatic carcinoma (HCC).
@*METHODS@#The MRI images of 100 patients (72 patients with HCC, 4 with regenerative nodules, 13 with hemangioma, 4 with liver cyst, 3 with Liver abscess, 2 with inflammatory pseudotumor, 1 with hepatic arteriovenous fistula, 1 with Limitations of steatosis) with liver disease were collected in Xiangya Hospital from January, 2014 to January, 2015. All patients were at the risk of HCC. The images were reviewed according to the LI-RADS categorization by American College of Radiology (ACR) under a condition of blindness to the pathological data. The sensitivity, specificity and the area under the ROC curve in the diagnosis of HCC with the LI-RADS categorization were calculated by three associate professors from the Department of Radiology, Xiangya Hospital.
@*RESULTS@#The area under the ROC curve was 0.925 in the 100 patients with HCC. Of the 100 pathologically confirmed patients, 20 cases were LR1 and LR2. However, the post-operation pathological examination showed benign tumor (negative predictive value was 100%). There were 25 HCC in 31 cases of LR3, 27 HCC in 29 cases of LR4 (positive predictive value was 93.1%). All of 20 cases of LR5 were HCC (positive predictive value was 100%). If LR1 and LR2 were considered negative, and LR3, 4, 5 were positive, then the sensitivity, the specificity and the area under the ROC curve was 100%, 71.4% and 0.925, respectively. If LR1, 2 and 3 were considered negative and LR4 and LR5 were positive, the sensitivity, the specificity and the area under the ROC curve was 100%, 90.9% and 0.974, respectively.
@*CONCLUSION@#The MRI LI-RADS categorization is highly sensitive and specific in the diagnosis of HCC, which can improve the diagnostic accuracy.

A randomized controlled trial of improvement of endoscopic visibility in the upper gastrointestinal tract with N-acetylcysteine / 中华消化内镜杂志

Objective To determine the effects and dosage of N?acetylcysteine( NAC) in the im?provement of the visibility in esophagogastroduodenoscopy( EGD) . Methods A prospective randomized con?trolled study was performed on 193 patients scheduled for EGD from November 2014 to July 2015 were ran?domized into five groups using digital table. In group A, 100 mg dimethicone and 2 g NaHCO3 were given. In group B,100 mg dimethicone, 2 g NaHCO3 and 20 000 U pronase were given. Group C received 100 mg dimethicone, 2 g NaHCO3 and 200 mg NAC. Group D received 100 mg dimethicone, 2 g NaHCO3 and 400 mg NAC and group E 100 mg dimethicone, 2 g NaHCO3 and 600 mg NAC.The agents were dissolved in 100 ml water for each patient.Endoscopy was completed by one endoscopist and the score of image visibility assessment was completed by 2 other endoscopists. The 3 endoscopists were unaware of grouping. The total scores, the time of washing, the time of examination and complications were compared and analysed. The total image scores of group A, B, C,D and E were 30?83±3?78, 35?69±2?88, 33?16±3?90, 34?95±3?46 and 36?76±2?91, respectively. Group A was the lowest(P0?05).Images that were scored 3 were the most in group E.The washing times of each group were 38?00±19?10, 17?03±11?44, 15?92±10?81, 15?78 ±10?24 and 15?55±9?69, and the examination times of each group were 13?49±2?49, 9?41±1?86, 9?08± 1?80, 8?73±1?91 and 8?78±1?79 minutes.Group A was the longest in these two indices(P0?05) . Conclusion The preoperative NAC can improve the visibility in EGD. The best dose is 600 mg, whose effects and safety were similar to those of 20 000 U, but yield to less washing time and the examination time in EGD.

Simultaneous inhibition of XIAP and survivin expression on EMT and invasion of human pancreatic cancer cells / 中南大学学报(医学版)

OBJECTIVE@#To investigate the simultaneous inhibition of X-linked inhibitor of apoptosis protein (XIAP) and survivin expression on epithelial-mesenchymal transition (EMT) and invasiion of pancreatic cancer cells Panc-1, and its mechanism.@*METHODS@#On the established human pancreatic cancer cells Panc-1-XS, the expression of XIAP and survivin was inhibited simultaneously. Cell invasion and migration were detected by Transwell chamber experiments and scratch test, and the expression of epithelial marker E-cadherin, mesenchymal markers Slug, phosphatase and tensin homolog deleted on chromosome ten (PTEN) and P-Akt protein was determined by Western blot.@*RESULTS@#Cell invasion and migration of Panc-1-XS cells decreased significantly, accompanied by significantly upregulated protein expression of E-cadherin, and significantly declined protein expression of the Slug, indicating increased mesenchymal-epithelial conversion (MET); and increased protein expression of PTEN, and declined protein expression of P-Akt.@*CONCLUSION@#Simultaneously inhibiting the expression of XIAP and survivin can partially reverse EMT phenotype of pancreatic cancer Panc-1 cells, which then significantly reduces the cell invasion and migration of Panc-1 cell lines. This process may be regulated by PTEN/PI3K/Akt signaling pathway.

Transient gene expression of soluble VEGFR2: I-IV / 生物工程学报

The extracelluar domain I-IV of target gene VEGFR2 (Vascular endothelial growth factor receptor 2) was cloned from villus of trimester abortion by RT-PCR, and linked to the expression vectors. Then, the transfection conditions were optimized in serum-free suspension culture HEK293 using GFP (Green fluorescence protein) as the report gene. The results showed that the optimal transfection efficiency and cell number were obtained when the ratio of foreign DNA: PEI = 1:2 (W/W), DNA = 1.5 g /10(6) cells and shaking speed (120 r/min) in serum free medium in the beginning 4 hours of transfection. After optimizing the transfection conditions, the expression vector was successfully constructed for transient gene expression in HEK293, COS-7, and CHO-K1. The result shows that the target protein was only detected in CHO-K1 supernatant. Because of the C-terminal 8-His tag of target protein, target protein was subsequently purified using Ni2+-IDA and 5 mg purified protein was obtained in 1.5 L supernatant of CHOK1.

A clinical analysis of unsuspected gallbladder carcinoma:a report of 37 cases / 中国普通外科杂志

0.05).However,the percentage of patients with cholecystolithiassis was 86.5% in IGC group,and 50.6% in GC group(P=0.000).Besides the percentage of IA stage in IGC group(29.7%) was relatively higher than that(9.0%)in GC group(P=0.03);the surgical resection rate of tumor in IGC group was 56.8% and 32.6% in GC group(P=0.01).Nevertheless,the percentage of advance stage in IGC group(43.2%) was relatively lower than that in GC group(74.2%)(P=0.001).The overall 1,3,and 5-year survival rate of IGC group was 70.0%,31.2% and 26.8% repectively,and the mean survival time was17 months(51?13);which were significantly higher than those in GC group,in which the 1,3,5-year survival rate was 27.0%,17.7% and 15.1% repectively and the mean survival time was(25?8),5 months(all P=0.006).Single factor analysis showed that the survival time in IGC patients was influenced by the TNM stage(P=0.000),pT-category(P=0.000),operation-category(P=0.008);however,postoperative pathological grade(P=0.080),age(P=0.188) and sex(P=0.234) had no influence on survival rate.According to multivariate analysis,pT-category(P=0.000)was an independent factor for the survival time of IGC.Conclusions Comparing with GC group,IGC has a higher percentage of cholecystolithiassis,IA tumor stage and surgical resection rate,and thus,it has relatively better progonosis.pT-category is the vital independent prognostic factor in IGC.If a patient in ICG has been misdiagnosed during the primary operation,the patient should be re-operated for radical excision as soon as possible,except when the tumor is in stage Tis or T1a.

Lentiviral vector-mediad RNA interference targeted against survivin inhibits survivin expression and induces cell apoptosis of human pancreatic cancer in vitro / 中国普通外科杂志

Objective To investigate the possibility of survivin inhibition by lentiviral vector-mediated RNA interference and the influence on cell apoptosis in pancreatic cancer cell line.Methods The lentiviral vector of SiRNA targeted against survivin(LV-shRNA-survivin-1,LV-shRNA-survivin-2,LV-shRNA-survivin-3) was constructed and transfected into the packaging cells 293T,and then the supernatant with virus was collected to transfect SW1990 cells.Quantitative real-time fluorescent PCR and Western-blot were used to detect the expression of survivin.DAPI staining and detection of enzymatic activity of caspase 3/7 were employed to examine cell apoptosis.Results Three lentiviral vector-survivin-shRNA were constructed successfully.In the LV-shRNA-survivin-1 group,the survivin mRNA and protein expression inhibitory rate was 73.50% and 87.64% respectively;when compared to control group,the activity of caspase-3/7 increased significantly,which showed a 14.5-fold increase,and apoptosis increased 11.95%.Conclusions Lentiviral vector-mediad RNA interference targeted against survivin can effectively inhibit survivin expression and increase cell apoptosis significantly.