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Hepatic alveolar echinococcosis (HAE) is a parasitic disease caused by Echinococcus multilocularis infection and has wide distribution and great harm in China. At present, ultrasound, CT, and MRI are the main radiological examination methods for HAE, with certain limitations in preoperative diagnosis and evaluation. This article introduces the guiding effect of three-dimensional visualization technique and its derivative technologies in the accurate diagnosis and preoperative evaluation of HAE, so as to provide help for the clinical diagnosis and treatment of HAE in the future.
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Hepatocellular carcinoma is a common malignant disease in clinical practice, and portal vein tumor thrombosis (PVTT) is one of the important factors affecting the prognosis of hepatocellular carcinoma. PVTT has strong oncologic characteristics and is highly susceptible to extrahepatic metastasis, complicating portal hypertension, leading to gastrointestinal bleeding or liver failure and causing death. In this paper, we review the formation mechanism of hepatocellular carcinoma combined with PVTT in terms of local anatomy, hemodynamics, molecular biology and tumor microenvironment to provide effective reference for clinical treatment.
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Hepatocellular carcinoma is one of the common malignant tumors in China, which seriously threatens the life and health of the nation. Hepatic vein tumor thrombosis (HVTT) is one of the common clinical manifestations. The prognosis of hepatocellular carcinoma combined with HVTT is extremely poor, and there is no unanimous opinion on its treatment in China and abroad. Currently, Asian guidelines recommend multidisciplinary treatment for patients with vascular invasion. This article reviewed the current progress in the treatment of hepatocellular carcinoma combined with HVTT.
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Objective:To investigate the application status of the practice evidence of falls prevention in elderly inpatients in Chinese comprehensive tertiary hospitals.Methods:Using a self-designed questionnaire based on the practice evidence of falls prevention in elderly inpatients to investigate the application status of that in 81 Chinese comprehensive tertiary hospitals.Results:93.83% (76/81) of the investigated hospitals had a falls screen in the admission assessment of elderly inpatients, and 49.38% (40/81) of the surveyed hospitals used Morse Falls Scale to screen. At the same time, 62.96%(51/81) of the hospitals had falls assessment of elderly inpatients, while only 25.93%-40.74% of the hospitals included the fear of falls, urinary incontinence, footwear, as well as foot problems in the falls screen or assessment. In addition, the implementation rate of falls prevention was 12.35%-79.01% in the hospitals surveyed, and only 60.49% (49/81) of the hospitals had individualized falls prevention intervention. Furthermore, the falls prevention participation rate of primary nurses and doctors, as well as patients′ care was higher than 80.00%, but that of pharmacists, rehabilitation therapists and physiotherapists was only between 12.35% to 24.69%.Conclusions:Hospitals should take the characteristics of environment and elderly inpatients in the hospital into consideration to choose the risk factors which should be included in the falls screen/assessment, as well as select the appropriate screen/assessment tools. Meanwhile, hospitals should culture and encourage the right workers′ participation to build a multidisciplinary team for falls assessment and intervention to achieve the goal of falls and falls injuries prevention with the evidence.
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Objective:To explore the main problems and difficulties encountered by nursing managers in the management of elderly patients with accidental falls.Methods:A semi-structured in-depth interview was conducted with ten nursing managers in charge of adverse events, and data was analyzed by Colaizzi analysis.Results:Seven themes were extracted from the data, including lack of active awareness of falls prevention, inadequate ability of safety support, lack of precise implementation of interventions, uncoordinated multi-sectoral control, inadequate concepts of ageing and accessibility, lack of related technology products and lack of policy and financial support.Conclusions:Fall courses and training programs should be added to improve the level of knowledge and skills of medical staff, and increase the risk awareness and companionship for older and caregivers. And a multidisciplinary team should be formed to conduct a multi-factor intervention on falls. Meanwhile, the concept of barrier-free and ageing to improve the hospital environment will be advocated under the supports of the government to formulate medical policies and increase capital investment.
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Objective:To observe the clinical effect of children's massage combined with traditional Chinese medicine hot compress in the treatment of children with night crying heart and spleen fever syndrome.Methods:From April 2017 to January 2019, 90 children with nocturnal crying heart and spleen fever syndrome in the Department of Pediatrics, Shijiazhuang Traditional Chinese Medicine Hospital, who met the selection criteria were divided into 2 groups according to random numbers, with 45 cases in each group. The control group was given oral calcium and vitamin D, and the observation group was given children's massage combined with traditional Chinese medicine hot compress treatment. Both groups were treated for 7 days. The scores of TCM syndromes were performed before and after treatment, and the improved SPIEGEL sleep scale was used to evaluate the sleep quality of the children, and to evaluate the efficacy of crying and TCM syndromes.Results:After treatment, the scores of the primary and secondary symptoms in the observation group were significantly lower than those in the control group ( t values were 44.449, 46.204, 56.476, respectively, all Ps<0.001); SPIEGEL sleep scale score (4.7 ± 0.9 vs. 8.3 ± 1.4, t=14.715) was significantly lower than that of the control group ( P<0.01). While the tongue coating and fingerprint abnormalities did not change significantly after treatment in both groups ( χ2 values were 0.403, 0.401, respectively, all Ps>0.05). The total effective rate of crying in the observation group was 91.1% (41/45) and that in the control group was 62.2% (28/45). The difference between the two groups was statistically significant ( χ2=10.497, P<0.01). The total effective rate of TCM syndromes in the observation group was 97.8% (44/45) and the control group was 48.9% (22/45). The difference between the two groups was statistically significant ( χ2=27.500, P<0.01). Conclusions:Pediatric massage therapy combined with traditional Chinese medicine hot pack can improve the TCM syndromes and symptoms of children with night crying heart and spleen fever syndrome, relieve sleep dysfunction, and improve clinical efficacy.
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Objective@#To explore the main problems and difficulties encountered by nursing managers in the management of elderly patients with accidental falls.@*Methods@#A semi-structured in-depth interview was conducted with ten nursing managers in charge of adverse events, and data was analyzed by Colaizzi analysis.@*Results@#Seven themes were extracted from the data, including lack of active awareness of falls prevention, inadequate ability of safety support, lack of precise implementation of interventions, uncoordinated multi-sectoral control, inadequate concepts of ageing and accessibility, lack of related technology products and lack of policy and financial support.@*Conclusions@#Fall courses and training programs should be added to improve the level of knowledge and skills of medical staff, and increase the risk awareness and companionship for older and caregivers. And a multidisciplinary team should be formed to conduct a multi-factor intervention on falls. Meanwhile, the concept of barrier-free and ageing to improve the hospital environment will be advocated under the supports of the government to formulate medical policies and increase capital investment.
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OBJECTIVE@#To evaluate the effectiveness of the Frog appliance in three dimensions by using cone-beam computed tomography (CBCT) images.@*METHODS@#Forty patients (21 boys and 19 girls), averaged 11.7 years old, with an Angle Class II division 1 malocclusion were included in our study. They had either late mixed dentition or early permanent dentition, and the maxillary second molars had not yet erupted. All patients underwent CBCT before and after the treatment for measuring changes in the maxillary first molars, second premolars, central incisors, and profile. Paired-samples t-test was used to compare the mean difference in each variable before treatment and after the first phase of treatment.@*RESULTS@#The maxillary first molars were effectively distalized by 4.25 mm (p < 0.001) and 3.53 mm (p < 0.05) in the dental crown and root apex, respectively. The tipping increased by 2.25°, but the difference was not significant. Moreover the teeth moved buccally by 0.84 mm (p < 0.05) and 2.87 mm (p < 0.01) in the mesiobuccal and distobuccal cusps, respectively, whereas no significant changes occurred in the root apex. Regarding the anchorage parts, the angle of the maxillary central incisor's long axis to the sella-nasion plane increased by 2.76° (p < 0.05) and the distance from the upper lip to the esthetic plane decreased by 0.52 mm (p = 0.01).@*CONCLUSIONS@#The Frog appliance effectively distalized the maxillary molars with an acceptable degree of tipping, distobuccal rotation, and buccal crown torque, with only slight anchorage loss. Furthermore, CBCT image demonstrated that it is a simple and reliable method for three-dimensional analysis.
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Objective:To compare the osteogenesis ability between human umbilical cord Wharton's Jelly-derived mesenchymal stem cells(hUCWJMSCs) and human periodontal ligament mesenchymal stem cells (hPDLSCs) in vitro.Methods:hUCWJMSCs and hPDLSCs were in vitro cultured.The cell proliferation capacity was examined by MTT assay.After osteogenesis induction culture,ALP activity of the cells was determined,minerialization was observed by alizarin red staining,OPN and Runx2 mRNA expression was analyzed by Real-time PCR.Results:hUCWJMSCs grew faster than hPDLSCs.After osteogenic differentiation induction,hPDLSCs group showed higher ALP level,more mineralized nodule formation and higher Runx2 expression compared with hUCWJMSCs group (P ＜ 0.05);while the OPN expressed higher in hUCWJMSCs than in hPDLSCs (P ＜ 0.05).Conclusion:hUCWJMSCs and hPDLSCs have osteogenesis differentiation potential,hPDLSCs are more osteogenetic.
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Objective To investigate the effect and mechanism of chitosan on vascular smooth muscle cell proliferation of uremia patients with arteriovenous fistula.Methods Primarily culturing the VSMCs of uremia patients with arteriovenous fistula and patients without uremia by explants adherent method,and taking the second generation.VSMCs from patients without uremia cultured with 20％ FBS medium were non-uremia group,VSMCs of uremia patients cultured with 20％ FBS medium were uremia group,VSMCs of uremia patients with 100 pg/ml chitosan were uremia+ chitosan group.The expression of α-SMA was detected by immunohistochemistry.The changes of migration and invasion of VSMCs were detected by scratches and transwell migration assays.The mRNA expressions of TLR4 and PCNA were measured by real-time PCR.VSMCs of uremia patients with arteriovenous fistula were intervened with different doses of chitosan (0,100 and 500 μg/ml),and the protein expressions of TLR4,MyD88 and NF-κB were detected by Western blotting.Results Compared with those in non-uremia group,in uremia group and uremia+chitosan group α-SMA was upregulated,migration and invasion of VSMCs were enhanced,and mRNA expressions of TLR4 and PCNA were increased (all P ＜ 0.05).Compared with those in uremia group,the level of α-SMA was significantly decreased,the ability of migration and invasion of VSMCs were decreased,and the mRNA expressions of TLR4 and PCNA were decreased (all P ＜ 0.05).TLR4,MyD88 and NF-κB protein expressions were reduced in concentration-dependent manner by 100 and 500 μg/ml chitosan.Conclusions (1) In vitro,chitosan decreases the ability of migration and invasion of VSMCs of uremia patients with arteriovenous fistula.(2) Chitosan inhibits the proliferation of VSMCs,which may be relevant in the decreased expressions of TLR4,MyD88 and NF-κB.
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Objective To investigate the effete of chitosan on rabbit carotid artery internal jugular vein fistula intimal hyperplasia and its regulation on TLR4/NF-κB signaling.Methods A total of 28 New Zealand white rabbits were randomly divided into the control group(n=4),the model group(n=12) and the chitosan group(n=12).Model group and chitosan group rabbits were established respectively carotid artery internal jugular vein fistula models.After AVF surgery,chitosan was smeared on venous blood vessels and anastomosis.After 4,6 and 8 weeks,the rabbits were separately sacrificed and the AVF venous vascular tissues were taken.The pathological changes of AVF venous vascular tissue in each group were observed.The changes of α-SMA were detected by immunohistochemistry method.The mRNA expressions of PCNA and TLR4 in the tissues were measured by Real-time PCR.At the same time,the protein expressions of PCNA,TLR4,MyD88 and NF-κB were detected by Western blotting.The experimental data were processed by two-factor analysis of variance in statistics.Results (1) After 4 weeks,vascular intimal was thicked in mdel group.In intimal hyperplasia,α-SMA was staining,and then proliferation of vascular smooth muscle cell was significant.As time increasing,more intimal hyperplasia shown obviously,the expression of α-SMA significantly increased.Compared with model group,chitosan group significantly reduced the degree of intimal hyperplasia,the level of α-SMA was significantly decreased,vascular smooth muscle cell proliferation was also extraordinarily decreased.(2) Compared with control group,the expression levels of PCNA,TLR4,MyD88 and NF-κB increased with time.The indices of Chitosan group were markedly higher than control group,but significantly lower than model groups.Conclusion Chitosan can inhibit the proliferation of rabbit VSMCs.The mechanism may be concerned in down regulating TLR4-mediated signaling pathway,reducing the possibility of intimal hyperplasia of rabbit AVF venous blood vessels.
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Objective To explore the effect of chitosan on vascular smooth muscle cells inhibited proliferation from rabbit arteriovenous fistula and its mechanisms.Methods Established rabbit fistula model on carotid arteryinternal jugular vein.After 1 month cultured VSMCs with primary culture by tissue-pieces inoculation.Cultured VSMCs were divided into three groups:①normal control group.②FBS-treated group:cell were treated with 5％,10％,20％ for 48 h,respectively; established the model of rabbit VSMCs proliferation.③chitosan-treated group:VSMCs cultured with 20％ FBS were exposed to different doses of chitosan(10,100,500,1000,2000μg/ml) for 48 h.And VSMCs were treated for different time (0,12,24,48 h) with Chitosan 1000 μg/ml.Expression levels of PCNA and TLR4/ NF-κB were detected by Western blotting.RT-PCR were applied to measure the mRNA expression of PCNA and TLR4.The protein levels of TLR4 and NF-κB were detected by immunofluorescence.Results Compared with low concentration serum group,FBS-treated VSMCs exhibited a increase in mRNA and protein expression of PCNA and TLR4.FBS-induced protein expression of PCNA and TLR4/NF-κB were reduced by chitosan.Also mRNA expression of PCNA and TLR4 were reduced.They were dependent on concentration and time.In rabbit VSMCs TLR4 was mainly expressed in the cytoplasm and NF-κB expressed mainly in the nucleus.Compared with normal control group,TLR4 and NF-κB protein expression were significantly decreased by chitosan.Conclusion High concentration serum induced VSMCs proliferation.Chitosan can inhibit the proliferation of rabbit VSMCs.It is speculated that the mechanism may be related to the expression of TLR4 receptor activation,reducing expression of downstream factor MyD88 and NF-κB.It is suggest that chitosan can become potential new drugs of arteriovenous fistula prevention of intimal hyperplasia.
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BACKGROUND:Studies have found that combination of two of chitosan (CS), nano-hydroxyapatite (nHA) and poly(lactide-co-glycolide) (PLGA) can improve the mechanical properties and biocompatibility of the composite stent in certain extent as wel as improve osteogenic differentiation of the cels, but there is a certain distance from the ideal bone tissue engineering scaffolds. OBJECTIVE:To study biocompatibility and osteoinductive activity of nHA/CS/PLGA scaffolds with different proportions in vitro. METHODS: nHA/CS/PLGA scaffolds were prepared at mass ratio of 10:10:80, 10:20:70, 20:10:70 respectively by particle leaching method. And human bone marrow stem cels (hBMSCs) were co-cultured with these scaffolds in vitro. Adhesion, proliferation, and osteoinductive activity of these scaffolds were examined qualitatively and quantitatively by growth curve of hBMSCs on scaffolds. Gene expression of alkaline phosphatase activity and osteocalcin was detected by RT-PCR. RESULTS AND CONCLUSION: hBMSCs could be attached, proliferated, and osteoinduced better on the nHA/CS/PLGA scaffold with the mass ratio of 20:10:70, compared to the other two groups of scaffolds. The differences were significant statisticaly (P< 0.05). Alkaline phosphatase and osteocalcin expressions were respectively higher in the scaffold with the mass ratio of 20:10:70 after 9-27 days of co-culture and 15-27 days of co-culture, in comparison with the other two groups of scaffolds. These findings indicate that the nHA/CS/PLGA scaffolds with the mass ratio of 20:10:70 demonstrated preferable biocompatibility and osteogenic inductivity, which is expected to be a promising scaffold material for bone tissue engineering.
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BACKGROUND:How to get a lot of stable and dynamic human umbilical cord mesenchymal stem cels is stil a difficulty. OBJECTIVE:To investigate the best culture way of human umbilical cord mesenchymal stem cels by comparing tissue explant, enzyme digestion, enzymolysis methods. METHODS:Ten fresh umbilical cords were isolated to human umbilical cord mesenchymal stem cels by using tissue explant, enzyme digestion, and enzymolysis methods, respectively. Hereafter, we compared cels harvested using three culture methods in terms of the time for the primary cels to creep, successful rates of cel-culturing, and curves of cellgrowth. Surface markers of cels were detected by flow cytometry and multiple differentiations of cels were detected. RESULTS AND CONCLUSION: The time for the primary cels to creep out in the enzymolysis and enzyme digestion groups had no significant difference, but both of them were significantly shorter than that in the tissue explant group (P < 0.01). The successful rate of primary cellculture in the enzymolysis group was significantly higher than that in the other two groups. The cellproliferations of three groups had no significant difference. The cellsurface markers and differentiation ability of the third generation of human umbilical cord mesenchymal stem cels cultured by enzymolysis method met the characteristics of mesenchymal stem cels. In conclusion, the enzymolysis method can shorten the time for primary human umbilical cord mesenchymal stem cels to creep out and increase the successful rates of primary human umbilical cord mesenchymal stem cels.
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Objective To investigate the expressions of DKK1,SFRP4 and Wnt1 in cervical squamous cell carcino-ma(SCC), and the clinical significance thereof. Methods There were 76 samples of cervical squamous cell carcinoma were included in SCC group and 36 benign uterine resection specimens were control group (NC). The immunohistochemical meth-od was applied to detect the expressions of DKK1,SFRP4 and Wnt1 in two groups. Results The expression of DKK1 was significantly lower in SCC group than that in NC group (P＜0.05). The expression levels of SFRP4 and Wnt1 were significant-ly higher in SCC group than those of NC group (P＜0.05). There were significant differences in the expressions of DKK1, SFRP4 and Wnt1 between samples of different clinical staging, differentiation, sizes of tumor and lymph node metastasis (P＜0.05). The expression of DKK1 was negatively correlated with SFRP4 and Wnt1 in SCC group (P＜0.05). The expression of SFRP4 was positively correlated with Wnt1 in SCC group (P＜0.05). Conclusion The roles of SFRP4 and Wnt1 are syn-ergistic interactions in the development of SCC. DKK1 is an inhibiting factor of SCC.